Not pets, right? PETS here stands for President Elect Training Seminar. We are gathered to meet each other, exchange ideas and prepare for a year as president of our local club. Yesterday the president elect for Rotary International spoke to us, amazing. We also had a flag ceremony with the flags you see, from nearly 200 countries. How amazing!
I get to start again
I have always seen the monsters under the bed
I have to
you don’t tell people about their monsters
I learn that early
they get angry hit punish send away
and anyhow they leave you even if they love you
when I am alone
the monsters and I
they are so happy to be seen
they cry often
why doesn’t he love me?
why won’t she hold me?
why does he throw me out?
I hold them
dry their tears
wrap them warmly
they cheer up
they never forget
their person is near
they rush back
sometimes one rejected
returns with seven friends
hoping to storm the person
that doesn’t work
the monsters never lose hope
sometimes I see
a person see their monster
let it be conscious
the person is grown enough
I am so used to the monsters
I work with them in clinic
visit after visit
the monsters weeping on my lap
while the person refuses refuses refuses
and sometimes a crack opens
like a portal light blinding
and the monster
that’s why I am here
what makes it worth staying
now I think
I am new again
it’s hard to date
when the monsters are yanking at my skirt
crying howling distracting
and I am hopeful
but it is not my role
it’s not ok
to ask about the monsters
I am new again
I won’t date anyone with monsters
that I can see
they must love them first
For the Ragtag Daily Prompt #69: community.
The photograph is from 2010, when the mad as hell doctors toured California to talk about single payer health care, medicare for all.
Small communities rolled out the welcome:
In this community, every table was sponsored by local health groups: clinic, the health department, mental health, addiction treatment. In small communities everyone knows someone who has lost their health, their health insurance and/or their job and home.
Here we are setting up for another program:
People asked questions:
And they listened and responded:
The health care industry has money. The insurance companies are for profit and make enormous profits. But in the end you and I have VOTES. When we stand up as a nation and say that we want medicare for all, Congress will listen. Stand up.
The mandate for health care already is a law: no one can be turned away from an emergency room. But as things stand, we do not take care that the person in the emergency room has care after the emergency room. The hospital may take the person’s house. We already have the government doing no profit care for over 50% of the care in the US: Medicare, Medicaid, active duty military and the Veterans Association. It is time to shut down the for profit insurance companies that refuse medicines, refuse care, refuse to answer their phones, tell me on the phone “we don’t have a fax”, the parent company tells me a medicine is covered and then the part D drug coverage still refuses: it is BEYOND TIME TO SHUT THEM DOWN.
Is the goal of health care profit? Or is it care for our citizens, support for families, works like the police and the fire station: we all support each other. Stand up, shout and VOTE.
More women in office. Stand up, speak out, march, run, vote!
For the Daily Prompt: strategy.
Are there toxic people?
No, I do not believe so….
I think there are toxic interactions.
Toxic behavior. And it takes two to tango, really.
Do I have to stay away from someone who behaves badly? Do they set me off? Well, that’s about me, isn’t it? I need to go look in the mirror and see what is bothering me. What does this remind me of? Are they getting under my skin? So what part of my skin needs better boundaries?
I realized that my father drank too much when I was in college. I read about it and went home, ready to intervene. My mother and my sister refused, much to my surprise. And slowly I realized that my mother was enabling the drinking.
I set boundaries with my father. I said that he could not come to my house drunk and he could not drink at my house. I refused to sleep in my parents’ house because he was falling asleep and there were cigarette burns in the floor and an 8 inch diameter one between the couch cushions. I told my mother I was having nightmares about fires. She joked that she would be mad if he burned a hole in the waterbed. I told my father I was afraid to sleep upstairs and moved to my grandmother’s, two doors away. I was lucky that I had that option.
My father stopped drinking a decade later. I took my young son to visit, and found that my father had started again. I asked my mother, “Why didn’t you tell me?” She replied, “I told you I would leave if he drank, but I am not going to leave.” I said, “We are not staying with you.” and we moved to my mother-in-law’s house.
As a family doctor, I try to help each person. My clinic and I do have boundaries. If they no show for three visits within one year, we ask them to change to another doctor. People call for referrals often. I can’t do a referral without documenting a diagnosis and doing an examination, so they need a visit. “But you’ve seen me for hip pain!” “Yes, and that was a year ago. Time to reevaluate, right?” And all doctors here are swamped: they want to save their over busy time for people who truly need them. The orthopedist does not want to see that hip unless I agree that they need to: if physical therapy and discussion can fix it, one less person that they don’t get to operate on.
I recently had calls for an emergency referral. I left a message with both the patient and the specialist. I had not seen the person for five months. I have no idea what is happening. If it’s an emergency, they need to contact the insurance, not me, because I have not seen the person: no diagnosis. And insurance should cover if it is an emergency. If it is not an emergency, well…
There is behavior that I prefer not to be around. There is behavior I will tolerate in clinic but not my personal life, since I get paid in clinic. There is behavior I won’t tolerate in clinic. But think of the great ones that are still spoken of: the Buddha, the Bodhisattvas, Jesus. They had boundaries to where any person was allowed to approach them and was received and was sometimes changed by that reception. When I say “I can’t be around him or her,” how do I need to change? Ok, not the crazy person shooting into crowds, no tolerance. But day to day, the things that get under our skin, it’s our skin that is fallible.
I do not want to label anyone toxic. I hope to make a small difference in the world through my clinic. And add to the joy in the world.
For the Daily Prompt: saintly. I am not there.
Sweet Honey in the Rock: Would you harbor me?
I don’t have any of THEM as patients. The unwashed masses. All of my patients are smart.
There aren’t any unwashed masses.
I have a gentleman who is overweight, obese, diabetes. He is not stupid. He is not unwashed. He is not exercising or controlling his blood sugar right now because the temperature is below freezing. He has a hole in his trailer floor and no heat. So he huddles under the electric blanket.
I have a gentlewoman, also diabetic. She too is not stupid. She is not unwashed. She lost her husband to cancer and then everything else and then was homeless for a period. She has a small house but she has no heat. She stays in bed to stay warm. Her contractor quit before he put in the furnace and he’s gone bankrupt. She is cold.
I have veterans. They are not stupid. They are not unwashed. One was homeless for a long period and pooled his resources with another to rent a section 8 house. I am so proud of them. They are having trouble living together, each would rather live alone. Only sometimes they would rather not be alone. It is hard.
I have a massage therapist. She started to train as a counselor. To be a counselor, she needs a certain number of supervised hours and was getting this through the county mental health. “I didn’t know.” she says. “It is taking twice as long as I thought because half the time they don’t show up. They don’t show up because they don’t have gas, they don’t have food, they have been evicted, their son is in jail, they are in jail. I had no idea. My massage clientele is so different, they pay. I thought poverty was in third world countries, but it is here, in my county. I didn’t know.”
I know the people who live in the woods. A schizophrenic who comes once a month for his shot. He was losing weight. “Why are you losing weight?” I demand. “I am only eating once a day.” he says. I nag him to go to the community meals. He is shy, he is afraid of people and he is hungry. He is not stupid. He is not unwashed.
I have opiate addicts. Six years ago one expressed concern. He is 6 foot 5 and big. “I am afraid of some of the other people. You shouldn’t be doing this! It’s too scary and dangerous!” My opiate addicts are not stupid. My opiate addicts are not unwashed. Sometimes they relapse. Sometimes they die, in their 50s, 40s, 30s, 20s.
One in six people in the US is below the poverty level. They are not stupid. They are not unwashed.
And when someone talks about the masses, the people, the stupid people, most people are stupid, the sheep….
….I am beyond angry….
….my heart hurts….
Poverty in the US: http://www.census.gov/newsroom/press-releases/2016/cb16-tps153.html.
The examples are taken from 25 years of practice, details changed for hipaa, but I can list dozens at any one time. The photograph is during the sunset after clinic, when I walked down town, the view across the sound.