Tag Archives: photography

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Old man 

Old man
yes, we hear you
every niggling detail
it used to be about X
but now it's about Y
yells
about X 
and he doesn't like
the internet
where it has gone
at
the moment
in his car
it used to be
food, shelter
and a broadband connection
but now that doesn't 
seem to satisfy
as the tortured veins
repurposed as arteries
moved from the leg
to the heart
slowly close back down

the internet
is not the place
of glory and kindness and free exchange
of ideas
old man asks
hates to ask
for money
and in spite of evil internet
has a wishlist on Amazon
where he directs those
who do not care to donate
through apple pay
he is no longer allowed on
Go Fund Me

soon there will just be

cloud

________________________

For the Ragtag Daily Prompt: magnitude. 

The magnitude of trivia on the internet.

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Liar, liar

Liar, liar, pants on fire, nose is as long as a telephone wire.

Trigger warning: sexism, child abuse, dating, US culture. Kinda not tame.

The last guy I date, only we don’t date, is a liar.

It is a bit into Covid. He knows I’ve had three pneumonias and he texts. “Are you worried about this?”

“Heck, yeah. Of course.” Then I ask if we can talk on the phone.

We start doing distanced beach walks and talking. Talk, talk, talk. At first he has to lure me out.

“Want to go for a beach walk?”

“I dunno.”

“I made lunch.”

“Oh, then yes!”

He points out that I have food insecurity. He is annoyingly correct. By the end of any meal, I am checking to see if there is food for the next meal. It is automatic and dates to when I was a toddler.

We compared abusive childhoods. Really. Back to toddlers. He finally says, “You win.”

“What?” I am not trying to win.

“Your childhood was more abusive than mine.”

I think various unprintable words.

I start noticing lies. They are stupid lies, as far as I am concerned. They shut me up over time because there really is no reply except, “Uh, why are you lying? I am not believing any of that.”

He says he is really really smart. Ok, fine. He says he can read my mind. I do some attempt at a girlie modest shy face which probably more resembles a grimace. But he is deep in his dream lies and honestly, notices me less and less. When he says he can read my mind, I know he can’t, because he’d be horrified by the swearing and laughter.

He is the smartest one in the room, though, he says modestly, often people don’t realize it. I nod and keep looking for calcedony nodules, aka agates. He’s better at finding them than me. I am automatically competitive, but that’s on an upper level of my mind. At the deeper level I could care less.

I also do not care if he’s trying to impress me with his smarts. My feminist level laughs hysterically and thinks nasty nasty nasty thoughts. But I have a deeper level that can love most people. I keep that stuff hidden and I know he can’t read it. Though I can read him: not his mind, but my inner psychiatrist gets involved and wants to know, why does he lie? And he’s lying to himself, not me. I don’t believe a word, but I am interested. What is the goal, here? Why lie?

He had a perfect marriage. I can’t control my expression on THAT one. Uh, doesn’t exist, hon. Why THAT lie? It starts to sort out. Well, in a way it was perfect. Perfect for him. Not perfect for his wife. She was super super depressed. Guess none of that was his fault. Our absolutely sexist culture. And now I know why he is hanging out with me. I am depressed. But it is situational and temporary. I need to close my clinic and I still have a year on the lease. And I will go work temp doctoring, but it is risky. I may get pneumonia a fourth time and it could kill or disable me. So I cannot take the risk of closing early and paying off the lease as a temp. I have to work the year out and I am really down. He is looking for a depressed woman and I seem to fit the bill. And I am a doctor. Who better for a really smart male to control than a woman who is smart enough to become a doctor (but not as smart as him).

Well, it all blows up after a year. I close my clinic, go work as a temp, and keep walking in to rooms where patients have their masks off. It only takes me five week to get bad Covid, even though I am masked and even though I ask the clinic manager, the nurses, the medical assistants to have people keep their masks on. I am down and this time I need oxygen.

Pneumonia for me comes with tachycardia and the opposite of brain fog. The tachycardia makes me drop ten pounds in the first week and wires my brain like a rocket. I wake up in the morning anxious like that cartoon of the cat attached to the ceiling with all four paws and fur all on end.

He says, “Pneumonia makes your brain go faster.”

I say, “Nope.”

“No? What do you mean?”

I say, “My brain is the same speed as it always is. But when I have this, I can’t hide it.”

“I don’t like that idea at all.” Yeah, that is the moment when our relationship is done. By him, not me. For one thing, I am no longer depressed. For another, he is the smartest person in the room. But. My brain might be faster. He says, “I can follow what you say, but you don’t even take a breath when you switch from one topic to another and I can barely keep up.” Yeah, well, sorry. That’s why I bloody well hide it most of the time. Because our culture dislikes smart women A LOT. It’s okay, barely, for a woman to be a physician, but men don’t want to date them. They wouldn’t mind screwing them. My maternal uncle told my mother that he was looking for a wife, “But I don’t want a woman who is smarter than I am.” My mother snarled about my uncle for weeks. Go, mom.

So this guy was a liar. But maybe I was a liar too. I shut up once he started lying and I shut the gates and doors of the vast garden and jungle that is my mind. No entry to people lying to themselves. There is a public garden in my mind that they can visit, but the rest is closed, hidden, contains the entire ocean and the deep trench, and maybe the universe.

And I haven’t dated since. Because I can’t stand that the virginal disney princess girl mythos in our culture feeds the sexist child abusive Epstein and all the men with him. And bloody well don’t say, “But there are some men that aren’t like Epstein.” Yeah? Well then why aren’t they fighting the Epstein crowd to the death with guns and knives. Until all the men are protecting all the children, all the girls and all the boys, and the gay folk and lesbians and trans and different races and yeah, I expect you to model Kwan Yin and protect EVERYONE from being abused. Meanwhile, men can stay the heck away from me. And yes, you can substitute a lot of swears for the word heck.

For the Ragtag Daily Prompt: tame. I think this is not a tame subject.

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Show me 

I have been flying under the radar
for a long time
I want to be visible
on screen
maybe
I want to teach
Residents
Medical students


I want them to love rural medicine
as I love it
I am a pterodactyl
wanting to rise
among the AI satellites
and say
Use the telephone to reach other doctors
Listen to your patient
Listen to what they don't say
Listen to the pieces that don't fit
Let the patient teach you
Why are they really here?
It's not always a pill
Sometimes it is just
So that someone will listen
to the feelings
that our culture
denigrates
ignores
vilifies
hates
Listen
You might turn in to a pterodactyl too
Or a cross
between a modern AI manipulator
and a pterodactyl
It is good to have more tools
than a hammer
Let me show you mine
And you
show me yours

________________________

The Ragtag Daily Prompt is timid.

Argh, the formating is wrong. And WordPress has updated enough that I don’t know how to single space the parts I want single spaced! Feedback welcome!

Hmmm, used the poetry block as per Sgeoil — do I put it all in one block?

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Eating sunlight

Beloved
I don’t think I can bear this
It’s a good plan
To work five more years
And retire in better financial shape
House paid off
But it hurts so

My tattered bruised and battered heart
Already patched so many times
And to see so many people each day
Hurting

Why, Beloved?
Why don’t we mature?

Maybe I’ll be a tree again
Living wood
That bends and moves with the wind
That eats the sunlight
Drinks the rain
Endures the snow and drinks it as it melts
Until spring comes
And I stir and start to bud
Deciding when it’s time
To uncurl leaves in warm sun

_______________________

For the Ragtag Daily Prompt illusion. Or should it be delusion? Or survival? Or beyond that to peace?

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Scree dream

In September, I hike with the three friends in the Ragtag Daily Prompt photograph. I have not really backpacked into back country in years. The last time I carried the pack was in Italy with my daughter, a few years ago. She wanted to plan the trip as we went and stay in hostels. We did.

We hike in the first day, up switchbacks from the parking lot at about 3200 feet, to a pass at 5400 feet, over and down to a campsite. The sites for cooking are separate from the sleeping sites and there are serious big metal bear boxes. We are to put everything in them, including the deet and toothpaste and anything that could possibly interest a bear.

We pack day packs the second day and climb back up to the pass. We peel off there to the trail to Sahalie Glacier. After being on oxygen at sea level for a year and a half, I am beyond delighted that I can actually do this. We go up and up and the trail gets worse and worse, until it is rather nasty scree. Two other people coming down say it is even worse, slippery, unstable, if we go on.

So, like sensible people, we stop for lunch. The slope is very steep and we each find a place to perch. Lunch tastes good. Then the other three want to go on. I don’t. I want a nap. They go on, I find a slab and the view from it is the photograph: down, down, down to the lake far below.

They will get me on the way back down.

And I do go to sleep. It’s all that night time call I’ve taken over years and years. I can sleep practically anywhere, including in a noisy casino in the past. I tuck up against the rock and the sun is almost warm.

I wake up. Two other people have come by. My inner clock thinks my people should have come by. Do I wait? Do I stay? There are more ominous clouds building up and this will be much more slick and dangerous if it starts raining. And we are exposed, for lightening.

Then I see a hat, on a curve of trail below me, moving. I swear it’s one of my party. But how did they go by without seeing me or waking me. THEY ARE DITCHING ME ON THE MOUNTAIN. No, that is ridiculous. Hmm. She is not with either of the guys. I debate for a minute, shout and then grab my things and head down.

I catch her. Once they left me, there really was not a clear trail. There were multiple sort of trails. And it was tricky. They separated a bit. She lost track of the other two and then picked the least difficult way down, which seemed to be a trail. It was NOT the trail that went by me, but she didn’t know that.

We found one of the guys below us, waiting. The last came down a bit later. None of them had come on the “right” trail by me. We headed down and stopped to put on rain gear. It rained lots! We were also above the tree line, but also I would say that we were above the marmot line. We saw eight hoary marmots marmoting around on our way down. They did not seem deterred by rain at all.

So that is how I was left in the scree to dream. I would have returned by the time it started raining anyhow, and the trail was good once we got past the scree. Not all the way to the lake in the photograph, the trail ran along a ridge that is not in the picture and wound down near the lake.

For the Ragtag Daily Prompt: scree.

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Balancing act

I am working at a site in the greater Seattle area, but I am not going to say where. Why? Two reasons. One is that the patient diversity is huge: the organization is organized to take care of low income, uninsured and immigrant patients. The second is that I am still trying to decide if the balance of the organization is working. It may be working but it might not be working for me.

I am at a large clinic, with primary care, dental, behavioral health, a nutritionist, a pharmacy and three in person translators. In any one day I will probably use translators for at least six languages. English, Spanish, Dari, Hindi, Punjabi, Arabic, French, Somali and sometimes languages that I have to look up the country because I don’t know where that language is spoken. The work is fast and furious.

The overall no show rate is 20%. This makes the day very unpredictable. It can be very very fast and busy with everyone showing up and then later there are three no shows in a row. I think that the no show rate has been less than 20% but on Tuesday it was more. However, everyone showed up in the morning and there was a hospital follow up that should have had 40 minutes and only had 20 and of course then we ran later. My lunch theoretically starts at 12 but I went to lunch at 12:50 and came back 6 minutes late, at 1:06. Then people no showed while I worked to finish off everything from the morning. It did feel a bit nuts.

We are using the electronic medical record EPIC. I find EPIC epically frustrating. It is “feature rich” which means it has too many ways to do things. If I ask someone how to record a phone call to a patient, it takes eight steps. A week later I have to do it again, I ask again, and the next person shows me a DIFFERENT set of eight steps. And there have to be at least eight ways to do anything, so it is very confusing. Also, the “home” page can be personalized to the extent that people look at my version (I have not personalized it much) and say, “Mine looks different. I don’t know how to do that on yours.”

Whew. So, how to cope with the fast furious unpredictable schedule? I am “precharting”. For this Tuesday, I spent 70 minutes going through the patient charts on Saturday. Then I may know why they are coming in, if they had a heart attack two weeks ago and are following up, if it is a well child check and the last one was two years ago, if there are outstanding issues like a elevated liver tests or they have not been in for their out of control diabetes for a year. Then, of course, some of them do not show up. It is so busy that all I feel when someone no shows is some relief, like a ray of sunlight in a dark forest. Ok, the person who was horribly sick and in the hospital for a week and had surgery, they really do need to follow up. But I cannot make them, no one can.

We have live translators, outside translators who come with the patient, family sometimes translates and two phone translation systems. Our live translators cover the following. One Spanish only, one Dari, Arabic and ?maybe Russian. A third language. The third does Hindi, Punjabi and something else. I can’t tell by language who is a recent immigrant or refugee or who is a citizen of the United States for thirty years.

The clinic system has high standards for care of an often vulnerable population. However, I have not decided if it falls into a statement by my grandfather: “The higher the ideals of an organization, the worse its’ human relations.” My job in Alamosa had very high ideals, but I was fifth senior doctor out of 15 in a mere two years. A burnout job. This one has three new doctors coming in soon. My training and assistance to learn EPIC has been sparse and not up to my standards. If the new doctors are treated the same way then this is a burnout job as well. This is a place that I could work in intermittently alternating with other places in the country, but only if it is balanced for both the patients and the physicians. The jury is still out, but there are many red flags. It is a six month job and I am two months in, so we shall see.

Hugs to everyone.

_____________________________

For the Ragtag Daily Prompt: nuts.

The photograph is from Larrabee State Park this weekend. My daughter came out and saw many of her friends, stayed with me, and we camped for one night at Larrabee.

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Perspective: beneath the clouds

Beloved why?
I am glad for your love
and warmth
and connection
and my cat’s
and my adult children
friends
family
patients
work
and why? Beloved

A high Adverse Childhood Experience Score
Two alcoholic parents
One sick with tuberculosis through pregnancy
Letters from the hospital to her mother
After birth
Never mention me
As if I do not exist

She told a story that she dreamed
she gave birth to kittens
played with them
and gave them away

Not a dream of joyously welcoming her new baby
Me.
Yet I didn’t hate her or my father
My damaged parents
My damaged sister
Who followed their path, not mine
There was nothing I could do
Only three years old when she was born
Try to shield and mother her
As best I could

Why Beloved
I have tried so hard to grow
to love
to forgive
and yet I have no human lover

My cat jumps on my notebook
And interrupts this writing
She is happier to welcome me home
Than any man I’ve ever dated

My daughter’s boyfriend picks her up
at the airport and has made her dinner

If I am a failure at love with a partner
Or too smart or damaged or difficult
To love
For humans
At least my children have both found love
And if I were to choose me or them
Yes, I’d choose them

Is that why, Beloved?
Sacrifice to heal the next generation?
It is worth it.

And yet, that small child part of me
That even as a toddler thought the adults were unpredictable, dangerous, mean when drunk as they laughed.
She is angry at them, Beloved
She is angry at you, Beloved
Or at people
Or at the universe
She still believes in every cell, in her bone marrow, in the vast universe in her mind

that she too could be, should be

loved.

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Dissolution

I am sorting, Beloved.

I dream that my sister has drowned
in the ocean. A sailboat went down.
There were others on board.
Two friends ready me to dive and find her.
I don’t want to scuba dive, I am not trained.
I don’t know how to use the equipment.
I am afraid I will drown too.
I see her daughter, who is four.
Her daughter knows from my face that her mother is lost.
My friends say, “You will be able to find her.
You can find your sister.”
“But she is dead,” I say.
“I don’t want to find her.”
I know that they are right, I could find her.
But I might be separated and lost, in the depths.
I don’t want to die too.

I wake up.
The dream sticks.
My friends wanting me to wear a borrowed wetsuit
and scuba gear and go down untrained.
My sister floating in the depths, dead eyes open.
But she has been dead for years, I think.
And this is the sea of dreams
my unconscious
the greater unconscious
everything.
So why isn’t my sister’s body dissolving?
Changing to a skeleton.
A skeleton coming apart over the years.

I don’t need a wetsuit
or scuba gear
to dive in the sea of dreams
I can breathe in the unconscious
I have been to the bottom of the sea
many times before.

My niece is four in the dream.
She was thirteen when her mother died.
I think she was lost to me long before that.
The dream knows.
Her mother was lost to me
when my niece was four.
Drowned.

When the dream returns
I will say yes to the dive
I love the sea and the ocean and going deep
I don’t need a wetsuit
I don’t need scuba gear
I don’t need to find my sister’s body
She is gone
Dissolved
I let my past go.

I have not dreamed of the ocean

since.

__________________________________

I really don’t know where my sister is, because of the family schism after she died. Are her ashes somewhere?

This poem wanted to be born. For the Ragtag Daily Prompt: Who knew?

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Hungry

Each time I’ve gotten pneumonia, I drop ten pounds in a week. The weight stays off, each time for longer. Then I gain it back and go past my “normal” weight. It takes work to get that extra weight off.

I have been trying to lose that extra weight since the start of the year. At first I just tried to increase my vegetable intake. The green, yellow and orange vegetables have the lowest calories and carbohydrates. The grains and rice and potatoes and bread are all more dense and have more calories and carbohydrates. I tried to go easier on them.

I did not make much progress. The climbing gym has been building muscle and clothes fitting better, but the scale did not move much.

I started having conversations with my stomach. I would eat. My stomach would demand more. “HUNGRY! WANT MORE!” This is not real hunger, as the people in occupied territories are having. This is my stomach or hindbrain fussing. It was easiest to control at lunch. I would fill half my container with spinach or mixed greens and then add more vegetables or tuna salad or egg salad or humus and vegetables. I would take a piece of fruit. Once that was done, we were done. “HUNGRY!” my stomach would complain. “That’s ok,” I would tell myself, “It’s ok to be a little bit hungry. We’ve had enough food. Stop fussing.”

My stomach fussed a lot at first. Now it is more of a query: “Hungry?” “No,” I reply, “we’ve had enough.” It seems to quiet down much more quickly. I think I am losing weight but I have no scale here and haven’t remembered to weigh myself in the last 3 weeks at work. Never mind. I have more muscle, at any rate, which is denser than flab. Muscle burns 9 kcal/gram and fat burns 4 kcal/gram. I climbed yesterday at the gym and might again this afternoon. It did take weeks or a couple months for my stomach to quiet down. Changing habits is not easy.

The tuna salad and spinach and green chili dish was my breakfast this am. I don’t think my stomach complained at all after it. It was distracted by packing and clearing out the refrigerator and cleaning. Sol Duc knows I am packing but is pretty sure she is going with me. I have been putting her toys in the carrier and she’s gone in and out to suss out the situation.

I hope all the people who are suffering from hunger get fed, today and tomorrow and the next day.

For the Ragtag Daily Prompt: hungry.

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Done and undone

I am done with my third Grand Junction travel doctor assignment and packing to go home. I don’t think much of my temp company at the moment. I had to nag them for two weeks regarding the travel plans. I had to call both airlines (one hour 18 minutes and one hour 38 minutes) to be sure that taking Sol Duc on board the plane is arranged (it wasn’t). I called the hotel for the day between planes and they do not take pets. I called the company that takes me from the airport the last two hours home and they DID know about the cat. One out of four. They finally switched the hotel on Friday, the last day of work.

Then at 5:18 pm I am sent an email saying I have to vacate on the 19th. The first plane is on the 21st. It was sent by the rep who is covering me and knew the travel arrangements are for the 21st. I am glad that I pay way more attention to detail as a physician than they do to my travel and housing. They frankly suck. And I am not vacating until Monday. They may charge me at which point I will say they need to pay me for spending more than 5 hours fixing their travel screw ups.

I did say to the rep on Friday, “Well, if it’s not arranged today, I will just call the emergency travel line at 5:01 pm. They will help me.” The emergency travel folks cost them more money. That apparently caused them to do the last arrangements. I am doing the travel in two days because otherwise my cat would be in the carrier for 12 or more hours. That is not reasonable.

I am done except for travel home. Today I finish packing and cleaning.

The photograph is Sol Duc in front of our rental house yesterday. I think she will miss the heat here. She seems to quite enjoy 90+ degrees.

________________________

For the Ragtag Daily Prompt: done.