Concord

my heart is broken
love doesn’t conquer all
unselfish love
unreturned
unrequited
opens me to wound after wound
some turn from love no matter what
cling to the lies they tell themselves
cling to the poison they embrace
turn from love into the uncaring bottle
turn from love into the insensate smoke
turn from love even to the grave

I wish my heart would let them go
and heal

__________________

My friend Liz took the photograph, half way through the Rainshadow Chorale concert last Sunday.

Love and grief

I got a letter from a family member, talking about happy memories of my father, mother and sister, who are all dead. How much fun they were and my mother’s influence taking them to museums, art museums and the Smithsonian.

It’s a bit difficult to answer, since my memories are much more complicated and tangled.

I wrote a poem called Butterfly Girl Comes to Visit a long time ago. It is about my sister. My mother could charm a room full of people and enthrall them with stories. Sometimes the stories were about me and my sister and actually making fun of our feelings: fear or grief. However, my mother was so good with an audience that I didn’t break the stories down until after she died. She was 61. That involved exploring a lot of really dark feelings. My sister and I even asked my father what our mother was really like: his reply was “Morose”.

I inherited my mother’s journals. My sister told me not to read them because they were “too depressing”. I don’t agree. They explain some things. My parents often fought, screaming at each other at 2 am while I was in high school. The family story was that my father was an alcoholic. As an adult, I wondered why she would fight with someone who was drunk. Her journal says “I drank too much last night,” over and over. Well, that would explain it, right? It takes two to tango. Or fight.

My sister could also charm a room. That is the sparkle in the Butterfly Girl poem. There was a period where she would tell me that I couldn’t talk about certain things, that she was fragile, that I was hurting her. This is after I gained control my feelings and had actual boundaries: I could refuse to fight with her. Before that, she could set me off like dry tinder. Her first husband called me once, saying, “I can’t not fight with her when she wants to fight. What do I do?” I replied, “I can’t either. I don’t know. I am so sorry!” I think it took until I was in my early 30s to refuse to fight with her and took a lot of conscious work. A fiance that broke up with me right after college told me I was an ogre when I was angry. I took that seriously and worked on it. My parents were not good role models for dealing with anger or grief or fear.

I am not much in contact with my maternal family. One person said that we could be in contact if we only said nice things about my mother, father and sister. I suggested we never mention them at all. We did not reach an agreement. I realize that our society wants to speak well of the dead, but to really be someone’s true friend, I think we have to accept that people may be angry at the dead as well. I gave this handout, Mourner’s Rights, to a patient on Friday. He is in the midst of grief and we talked about it. He thanked me and said, “I am grateful to talk to someone who knows about grief.”

My parents moved to Washington State in 1996. My mother was diagnosed with stage III ovarian cancer in 1997. I moved to be near them when her cancer recurred, arriving on Y2K. My mother died on May 15, 2000, four and a half months after we arrived.

My mother was only in that area of Washington for four years. She made such a charming impression that I had people tell me how wonderful and charming she was for a full decade. I was working though the complex feelings about her and tried very hard to thank people, even though I did not feel thankful.

I have not answered the letter yet. I want to return a gentle replay but I will not play the “only happy memories game”. I don’t mind my dark feelings. The family member would mind my dark feelings, I think. It is nice to be a physician and to be allowed to let patients talk about their dark feelings. Our culture wants to deny them, remove them, be positive. That is a disservice to love and to grief.

People are astoundingly complicated.

For the Ragtag Daily Prompt: astound.

The photograph is of my friend Maline, me, and two of her husband’s family members. Maline was one of my alternate mothers, a friend of my parents. She died within the last few years.

Sad about the cows

The first photograph is Sol Duc. She is lying on my jacket to object to and obstruct me going to work. She has learned the new schedule, but things are a little different. In the three weeks we were gone, the night time temperatures have dropped into the 20s, so it is frozen outside. Yesterday it warmed to a high of 53 but not for long. It is dark in the morning and dark at night when I get home and we have not been walking with the harness and leash as much. Brrr, cold. We had a long walk yesterday at 10 am because it was my administrative day and I was caught up.

Sol Duc can’t find her pet toad any more. I think the toads have dug in for the winter and there are fewer and fewer insects. I think she is a bit bored. I’ve been building cardboard box puzzles for her, with the cat food ball inside. She has to roll the ball around to get the dry food to fall out. Maybe now she misses Elwha a bit, too. My work days are a bit long, leaving at 7:00 am and sometimes not home until 6:00 pm. Right now I have to drive to the other end of the valley.

The second picture is this morning’s sunrise. Gorgeous, yes? But that is the field across the street from us and that changed while we were gone too. They are building roads, all of the wild plants are gone, and it is staked all over and has large machines. And kitty corner, to the southwest, no more cows! The cows are gone! Are they inside for the winter or really gone? I think that they are really gone, because I see cows in other fields. The hay barn is still in use, but the cows have been moved. The city of Grand Junction is building and encroaching on the farms. We are right on the western edge of Grand Junction. No more early morning roosters, either.

I am not sure how to tie this to the Ragtag Daily Prompt, circular. Sol Duc is pretty circular when she curls up. The earth and the sky are circular. Emotions circle, happy to sad to surprised to worried and back. I am a little sad about the loss of the field and the cows, sigh, but happy Saturday to you.

Return again

Return again to friends and home and stumble
My house wraps around me familiar then grief
There is so much grief here: death makes us humble
Mother, marriage, sister, father, time a thief
Has stolen them and more to come, a long lived life
Means loss on loss. Memory wells up, deeps swells
We thought we would be different, wise, no strife
Yet the world burns, children bombed in warring hells
Our children know our failure and our malice
We thought we’d be adults and show the way
Our intentions of a wired on-line palace
Yet anger and greed now rule the day
As a child adults are drunk confusing fools
Now my adult children wonder why we are such rigid tools

For the Ragtag Daily Prompt: rigid.

The isolated working

I ran my own small clinic from 2010 to 2022, working somewhere else, got Covid, was on oxygen for a year and a half, did some healing and then came back to work.

There has been a culture change in medicine that feels very strange to me. I did not notice it because I was in a solo clinic and not “part of the system”.

All the doctors, providers, are more isolated. I got a compliment yesterday when I was doing a “warm hand off” of the most sick or complicated patients, three new diabetics, a person with cancer, a person with a genetic heart problem. The doctor who I was handing off to is in the same clinic but we have barely talked since May. I don’t know her at all. She complimented me on excellent care “and calling specialists”.

I thought, huh. But I think that is a dinosaur doctor thing. I think mostly people communicate through the electronic medical record email, send messages about patients. For the decade that I was solo, I had to call other specialists because I was on a different electronic medical record. The email didn’t connect. The hospital reluctantly gave me a “link” to their system, but it was only a link to look. I could not write or send anything.

About two months ago I got an echocardiogram result. I read it and thought, ok, it’s not normal but what does it mean? Outflow obstruction by the thickened heart wall. Hmm. I called cardiology and spoke to the cardiologist who read it. He sounded surprised and said, “Idiopathic hypertrophic cardiomyopathy, most likely. It’s a classic echo.” “So, what do I do?” “Send him to me.” “Anything that I should change meanwhile?” “Yes,” says the cardiologist. He had me stop one medicine and start another. “No vasodilators and the beta blocker slowing the heart rate should help decrease the outflow obstruction.” “Got it.” I said. He also gave me two more tests to order.

I referred the patient to cardiology but it was a month before he got in. The two tests were done and they ordered more. If the diagnosis is correct, he’ll be sent to a special clinic in Denver. I called my patient while we were waiting for the cardiology visit. The medicine change had not made much difference as far as he could tell.

I was also told when I got here that I would never get a local nephrologist to see a patient, they were two busy. However, I have called two nephrologists about two patients and both took the patient and again, gave me instructions.

Two specialties have been very difficult to contact: orthopedics and gastroenterology. I have no idea why they are so difficult.

I can see that email feels faster. But there is no human contact, asking follow up questions is difficult, I don’t get that bit of further helpful education: this is what you do next. I have learned so much over the years by touching base with specialists. Once I fussed at a patient to go to hematology oncology about their high platelet count. The patient didn’t want to. He came back and said, “Apparently I have this newly found genetic problem. They put me on two medicines, not expensive. And I feel better than I have in 20 years.” I asked the oncologist about it the next time I called. He lit up, excited, and told me about the JAK-2 mutation. It is so exciting to learn about new areas in medicine and my patient says, “I have to thank you for pushing me to see the oncologist. I feel so much better.” Wow and cool.

Clinic feels like I am mostly isolated, a silo, an island, rarely talk to the other physicians unless I go to find them. I think hospital administrations like this, keeping the physicians in line by having their schedule be so packed that they almost never talk to each other. What a good way to keep physicians from interfering in the money making production! Ugh, I think it is quite horrible and unhealthy for the providers and for our countries medical system in the long run. I was seriously less lonely in a solo clinic.

The prognosis for our current medical system is very poor. The patients say to me, “Why do my doctors keep leaving?” They aren’t attached, they are isolated, I don’t think the physicians know what they are missing. Colleagues. Not silos.

For the Ragtag Daily Prompt: prognosis.

The photograph is from the Fruita Fall Festival.

Free agent

The Agency contacted me yesterday.

“Yes?” I say.

“Are you free?” Dispatch always sounds so disinterested.

“Yes, I’m free.” I try not to sound annoyed. I am too good at my job. I’ve given up on dating. This frees me up for the Agency.

“Room two.”

Room two has a woman who looks frozen. I introduce myself, a stranger, her previous person left.

“Are you sleeping?”

“No. Well, I fall asleep but then I wake up. Nightmares and my heart beats so fast. Then I can’t go back to sleep.”

“Did something happen?”

Her face tightens all over. She wants to tell me but not let the emotions out. “A scam!” Now the dam is cracking and falling apart. The story comes out bit by bit. “They opened an account in my name! Took out a loan! I am so scared. And ashamed. We could lose the house.” Not many tears. She won’t let them.

“Ok, I think this is a PTSD reaction. The not sleeping is really common. Can you talk to your husband?”

“I’ve snapped at him! We never fight! Forty two years!”

The monsters are visible now. Clinging to her, but some are coming to cling to me. Fear, shame, grief, anxiety, fatigue. They aren’t really that big, because she has been a careful person, a wise person. But this has cracked her open because she never expected it.

“Have you contacted the authorities?” We talk about what she has done, the practical bits. She has already made wise moves. It’s the feelings that are upsetting her.

We pick something for sleep, a low dose, not one of the newer addictive ones. An antidepressant that will hopefully make her sleepy. Close follow up is even more important, to be sure that she is starting to comfort the monsters. Many of the monsters are crying for her. I think they will be ok.

She is more comfortable before she leaves. She brought the feelings out and I was not horrified and I did not shame her. They weren’t so bad after all, when she brought them out in the light of day. It’s when they are fighting to be felt and heard that they feel so dark and dangerous and frightening.

I leave the room. She will be back in a week, sooner if she needs to. One of her monsters smiles at me tremulously as it clings to her. I smile back and nod. I think they will be ok.

For the Ragtag Daily Prompt: agency.

I write this and then start humming. Yes, this is the right song.


Wild

I keep wondering at the stubborn part of me that will not let go.
 That wants to reconcile with all, no matter what they’ve done.
 I go inside, deep and deeper, in the depths all is slow.
 That part is the holy part that longs for the One.
 I have been told to let go of things, forget, no more longing.
 But the longing is a sacred place, a longing for the Beloved.
 I think that excising it would be a horrid evil wronging.
 Handle gently, with care, with love, and gently gloved.
 I meet someone who says, “You are very in touch with your inner child.”
 I know it’s not a compliment, I smile and pay little mind.
 My Child is my connection to the Beloved, fierce and mild.
 Jealous judging rolls right off, people can be unkind.
 I won’t excise the holy core, the Beloved inner child.
 I feel the Beloved’s laughing play and joy, heart running wild.

_________________

For the Ragtag Daily Prompt: realize.

https://www.playingforchange.com/videos/words-of-wonder-get-up-stand-up-song-around-the-world

Beading memory

Both I and my sister have done some beading.

She gave me this necklace one of the last three times I saw her. She was at home with breast cancer and referred to hospice. I flew down to visit three times in the last three months. I was expecting it before then but she was very very strong and fought it all the way to the end.

We were both born in March, so this has amethysts. She liked silver more than gold and we both liked the irregularly shaped pearls. I am not sure what the dark round beads are. They could be bloodstones, which were the March birthstone before amethyst took over. I like the clasp in the front and that it is not symmetric. My sister died in 2012 and of course I still miss her.

For the Ragtag Daily Prompt: beading.

Long way

I am a long way from my ocean and from home.

I looked for a job close to home and then the temp company mentions a job in another state. “Where?” I said. They told me and I said, “I’m interested!” We started the process. I always forget what the process is like. It is hella annoying. There is miles of paperwork. We had a delay from the state, because I need a license for each state and they weren’t meeting until after the start date and then they said, “We’ll let you know in two days.” and THEN they said, “We’ll let you know in two days to two weeks.” So I had three weeks of being half packed and trying to just flow with it. I finally got word, yes, ready, two weeks ago Monday. By Friday morning the cats and I are in the car and headed out.

Now I have worked for a week here. The US currently has 500 different electronic medical records and I supposedly learned my 8th (or 9th) on Tuesday. About six hours of training on the computer and my brain shut down after four. However, the support on Wednesday was good and I started seeing patients. I was careful to say, “If I look grumpy, it’s at the computer, not you.”

So far mostly good. Except, one cat got out two days after we got to our destination. He is chipped and I am still walking miles and calling. The local lost pet group is trying to help. I miss him quite terribly. The door popped out of the carrier when I put it down. I feel like a cat mom failure, but things happen. Elwha is big and strong and I may yet get him back. Sol Duc was sensible enough not to run, but I had to secure her before going after him.

For the Ragtag Daily Prompt: flow.

Matter

If something doesn’t matter, is it anti-matter?

Lily’s person moved two days ago, much closer. Supposedly to a place where Lily the cat can go, but instead of a private room, there is a roommate. It took me a month to get Lily cat to let me pat her, so the roommate won’t work. We are all very very frustrated. And next week daily treatments for Lily’s person start, thirty minutes away, without enough warning to get volunteer drivers. So it will be me. I am tired. But I suppose it’s anti-matter, right? We were given 24 hours notice by the nursing home and by the physicians about both the move and the treatment and they wanted to start the treatment the same day that she was moving. Whether we can provide all the transport seems to be irrelevant.

The stealthie is from Whidby Island. Right, I’m just an irrelevant shadow as far as the medical dysfunctional machine is concerned.

For the Ragtag Daily Prompt: irrelevant.