Tag Archives: sky

by

Longing 

When I am little
I long to be old

I adore my grandmother
she is wise

when I come to her 
at four months

I am angry 
and turn my head from the spoon

my mother tells the story
I do not remember

my grandmother studies me
and says, "Yes,

you may feed yourself."
My mother laughs and tells

"You lived on cheerios
and chunks of banana

and would not let anyone
put anything in your mouth."

There might be a darkness there
that I don't want to think about.

And the finger thumb skill
does not appear

until nine months.
Before that it is a sweep of the hand

to pick things up.
Difficult with cheerios.

I held the bottle too. 
I am returned to my parents

at nine months
the grandmother gone

1000 miles away.
I do not like my mother

or my father
nor do I trust them

at first. But one must live
and I do

At two I play falldown
tackling my father

like the people on the television
and he falls down

and I laugh
It is only later that I realize

that only men play falldown.
I think to myself

nothing will stop me
if I want to do something

being a girl
will not stop me

if I want to play falldown
or anything anything else.

My grandmother gives me 
the gift of anger

the gift of independence
permission to refuse 

the spoon. Permission
to feed myself

and feel my feelings.
And I never ever stop.

I learn to hide some feelings
from my parents

because they cannot allow them.
Sorrow, fear and humiliation

three monsters that I must hide
or refuse to feel.

On a boat my father says
to my young daughter

"Don't be scared
or go below."

I say, "No.
What are you scared of?"

"I am scared that we are stuck
aground

we can't get to shore."
I say, "Look.

We are very close to shore. 
I can swim there.

We could wait for the tide
to come back in 

and float us free.
But we have two strong mothers

who are trying to winch
us off to float free."

My daughter is satisfied.
Soon another sailor sends a rowboat

taking the four children 
to play on shore

while my friend and I 
continue to use all our muscle

to winch the boat off 
the stubborn earth.

I think it is the tide
coming in 

that finally frees us
and we are too tired to sail

by then 
and return to the slip.

We have entertained 
every live aboard

and they tease us
mercilessly

and we do not care.
But my father's words

"Don't be scared
or go below."

resonate. I chose
to go below 

as a child
to hold my feelings sacred

and refuse to entirely 
stuff them.

As an adult
a friend says

"You feel things too strongly."
I clam up

immediately.
I feel things too strongly

for HER
but not for me.

My feelings are 
MINE and sacred.

My feelings are
prayers to the Beloved.

Your feelings are 
prayers to the Beloved.

My best work 
as a physician

is when I open the door
to someone's feelings

and they let them out
terrifying 

to them.
But not to me.

And when they are done
I say

"It seems to me
your feelings

are perfectly reasonable.
I would feel that way too."

Sometimes I ask
would they still want

the antidepressant?
A counselor?

A follow up visit?
They look surprised.

A weight lifted
for now.

"No.
I will see how I am doing.

I will call if I need 
to come in."

"That's fine."
I say.

Somehow I don't
think the AI

can really do this
as I do.

I may be wrong.

When I am very small
I want to be old

and wise 
as my grandmother

who saves my heart
and lets me feel.

Now I am middle aged.
I don't want to be old

and wise
for a while yet

but it isn't my choice now,
is it?

Bring it on
Beloved.

Bring it on.

For the Ragtag Daily Prompt: partner.

I think the Beloved is my partner in joy, in sorrow, in wicked humor. Thank you, Beloved.

by

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.

by

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.

by

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.

by

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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Choose the best

If you are going to have a knee replacement , you would try to choose the best surgeon, wouldn’t you? Yes. I am thinking of this because there is an illness where people often refuse the best. Not once but over and over.

I receive a card in clinic, a few days after a rather difficult day. Initially I don’t want to open it because it could be a yelling at me or threatening card. Hand delivered to our front desk. I open it and the card says what great care I give.

Wonderful, right? Except that there is a letter too, asking for a refill.

Most refills come through the pharmacy. Why a card and a letter? Have you guessed yet?

I call my patient. The patient was referred to the best addiction specialist in the area. The patient is not going to go to the specialist. The patient is not going to go to the group therapy, inpatient or outpatient. They can do this alone.

I let them know that I am not the local expert. I fail to change their mind. Yes, I will do a refill, but if they won’t see the expert, they have to come see me. Regularly.

This is typical for addiction. Denial and charm. A sweet card but trying to obscure that the patient is not going with the best treatment. I think of it as the drug or alcohol stil in control and whispering to the person: you are not really addicted, you don’t need anyone else, you can do it by yourself, we got this.

Chance of relapse? Well. I pretty much expect it. I would see this person monthly at least.

In what other illness do we refuse the expert, refuse help, refuse the best and say, I can do it alone?

For the Ragtag Daily Prompt: best: https://ragtagcommunity.wordpress.com/2025/06/29/rdp-sunday-best/.

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Alcohol myths

I am back working in Colorado and a recurring theme this month is alcohol and alcohol myths.

Myth: If I only drink on my days off, I am not an alcoholic. Nope. People can binge one day a week and still be an alcoholic. A standard “dose” of alcohol is 12 ounces of 5% beer, 5 ounces of standard wine or 1.5 ounces of liquor. But what if someone drinks 8% beer, 12 ounces? Well, that’s 1.6 standard drinks. An 8% 16 ounce beer? That is 1.6 times 1.3, so 2.08 drinks. Perhaps we should have an app that calculates this. And locks the car ignition when we are over the limit.

How much alcohol means that we are an alcoholic? The guidelines right now in the US say 7 drinks per week maximum for women, 14 for men, no more than one in 24 hours for women, no more than 2 in 24 hours for men and no saving it up for the weekend. Here: https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/basics-defining-how-much-alcohol-too-much#pub-toc3. However, alcohol is bad for the liver, bad for the heart, bad for the brain, and increases cancer risk. There is not a “safe” amount.

What is binging or heavy drinking? For womenβ€”4 or more drinks on any day or 8 or more per week, For menβ€”5 or more drinks on any day or 15 or more per week. The rate at which people drink is also part of this.

MYTH: If I don’t throw up, I’m not an alcoholic. Now that’s an interesting one. When we drink, alcohol is absorbed into the blood and goes through the liver. The liver has enzymes which break alcohol down into aldehyde. Aldehyde is a carcinogen, causes cancer. Aldehyde is broken down by other enzymes into acetate and then to carbon dioxide and water. Some people break down the aldehyde quickly, fast metabolizers. They can drink a lot and not throw up because they break the aldehyde down fast. However, the process inflames and kills liver cells. If they keep drinking, the liver slowly dies, and this is cirrhosis. Eventually they will not be able to break down alcohol fast because the liver makes the enzymes. Then they will start throwing up.

Other people make enzymes that are slower or make less, and they get sick and have alcohol poisoning more quickly. The fast metabolizers are at higher risk for cirrhosis and the slow ones for liver cancer, but they can get either.

MYTH: “My blood pressure is fine.” I spoke to a person who stated that their blood pressure was ok during pregnancy so they did not have high blood pressure. The chart shows very high blood pressure for the last three years and I didn’t look back further. I ask, “Did you stop drinking alcohol while pregnant?” “Of course.” When NOT pregnant, this person admits to 4-5 drinks a day. Also, the history in the chart states that they had blood pressure complications in pregnancy. I did not have time to go through the chart and look at that, but this person is in denial. I think of denial as the addiction taking over and the addiction lies. It lies to me but it also lies to the person. They want to believe what they say. They want everyone else to believe what they say even if it is patently a lie and ridiculous. A woman who says a friend gave her something, she didn’t know what it was, for a headache. “How did you take it?” I asked, looking at the urine dip results. “I snorted it.” “So what things do you snort for a headache?” She was positive for cocaine and pleading ignorance was ludicrous. Another person has a positive urine drug screen for multiple things. “Can I try again?” Pause. “Sure.” I say. The first one is a false sample and I am very curious to see what the real sample will have. It has nothing. He is then surprised that I won’t fill his prescription and offer inpatient drug rehabilitation. Come now, sir, you got a urine sample from a dealer when you sold the medicine I gave you for something else. Your dealer must have been annoyed or gave you the wrong sample. When someone is really out of control, they do not have convincing lies and the only person they can convince is themselves. It is interesting to watch someone be all outraged that I do not buy the story, accusing me of discrimination or hating them or hating their race or whatever. They attempt to accuse and distract. It is harder for families because they desperately want to believe their loved one, even when the evidence shouts the opposite.

What does blood pressure have to do with alcohol? Alcohol drives blood pressure up and pulse, especially when it is wearing off. Severe alcohol withdrawal is delerium tremens and people can have such high blood pressure that they have a stroke or a heart attack or encephalopathy — a poisoned brain. They can hallucinate or have seizures and it is very dangerous. “Very dangerous” means they could die or have permanent disability. Tobacco, cocaine, methamphetamines, all raise blood pressure. The number one cause of death in the United States is the heart, but it’s not just from hypertension and weight and cholesterol and inactivity. Addictive drugs have a huge contribution.

There is nothing cheap about the cost of addiction in our country.

For the Ragtag Daily Prompt: cheap.

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If eggs aren’t available, why can we still buy chicken?

I note this article this week: https://apnews.com/article/usda-firings-doge-bird-flu-trump-fdd6495cbe44c96d471ae8c6cf4dd0a8. That version says that the Trump Administration is trying to rehire bird flu experts that got fired. Most of the news outlets frame it differently: https://www.nbcnews.com/politics/doge/usda-accidentally-fired-officials-bird-flu-rehire-rcna192716. Suddenly it is the USDA at fault not the Trump administration’s chainsaw fool.

Should we worry about bird flu? Oh, yes, I think so. I have been wondering why we still have chicken to eat and chicken in the stores, if millions of chickens are being wiped out to try to prevent H5N1 bird influenza from moving into humans. This article explains in unreassuring detail how factory farms, packing chickens together, and killing them at 6 weeks old for meat, puts pressure on the virus to become more deadly and kill the host. In wild birds the influenza virus wants to spread, so it’s better not to kill the host fast. That is not true on our national and international big factory farms.

The Unnatural History of Bird Flu

Firing the people working the track the H5N1 bird influenza and trying to stop it if it starts going human to human, well. Is that injustice or arrogance or stupidity? Or all three? And who wants to work for the government now? It is being treated as a corporation, but it isn’t a corporation. Public service often pays less. Good luck hiring the best and brightest who want to serve our country and humanity.

This is the worst year in the US for influenza since 2017-2018 so far. That is without the H5N1 bird influenza really getting in to people. Here is the graph for the week ending February 15th from the CDC. I keep an eye on it all through influenza season.

The article on H5N1 bird influenza is the best argument I’ve ever read for choosing not to eat meat. I like meat, but the factory farming is going to more countries. It may produce more eggs and more chickens, but if it is also the perfect breeding ground for lethal influenza, that changes my viewpoint. We cannot go on. We will have another pandemic.

Why are humans such fools?

For the Ragtag Daily Prompt: injustice.

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Batter batter

Right now the nuisance in clinic is not a bat or a batter but a battery. I have a hospital issued laptop from last April. I had a day of orientation and one day that they walked me through the electronic medical record. I absorbed about ten percent of what they said. One day is silly, it should be broken up over the orientation, over three days or more, but places do not do that. Anyhow, Friday afternoon I was done and supposed to see patients on Monday, with support.

I wandered back from the IT office to the HR office. “Um, I’m supposed to have a laptop. Is it already at the clinic?” HR didn’t know. They called the clinic. Nope, IT was supposed to issue me one. We went to IT together. IT was in the middle of a massive update. No one had remembered that I needed a laptop. They “found” one and set up my program. This all took another hour.

Months later we were on the phone with IT and I had to say the name of the laptop. “Oh,” said the IT person. “THAT’S where my laptop went.” I was issued an IT one, not a provider one. I don’t care, do I?

Except, the battery is old. I guess the laptop is “old” too, but it works. So far. However, the battery won’t last even through a morning now. I put in a ticket to IT about a month ago and a battery is on order “because that’s an old one, we don’t have those in stock”. I plug it in to the desk top in the office, but we run two or three exam rooms and it’s awkward and a nuisance to plug in and unplug in each room. I leave the cord in one room and cross my fingers.

Yesterday someone from IT shows up right before my last patient and takes the back off my laptop. Except the battery he’s brought doesn’t fit. He has to put it all back together. I laugh, because it’s kind of ridiculous. He does leave me a second charging cord, so now I have ones for two rooms. The risk is that I will forget and walk away with it plugged in and drop it. Of course, then I might be issued a “new” laptop.

That is the present silly mildly annoying nuisance at work.

For the Ragtag Daily Prompt: nuisance.

The picture is from the Saturday parade, a tree on a distant roof.