This Doctor is Open For Business

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Astonishing material and revelation appear in our lives all the time.
Let it be.
Unto us, so much is given.
We just have to be open for business.

~Anne Lamott from Help Thanks Wow: Three Essential Prayers

 

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I have the privilege to work in a profession where astonishment and revelation awaits me behind each exam room door.

In a typical clinic day, I open that door up to thirty plus times, close it behind me and settle in for the ten or fifteen minutes I’m allocated per patient.  I need to peel through the layers of each person quickly to find the core of truth about who they are and why they’ve come to clinic that day.

Sometimes what I’m looking for is right on the surface: in their tears, in their pain, in their fears.  Most of the time, it is buried deep, often beneath a scar I must search to find. I need to wade through the rashes and sore throats and coughs and headaches and discouragement to find it.

Once in awhile, I actually do something tangible to help right then and there — sew up a cut, lance a boil, splint a fracture, restore hearing by removing a plug of wax from an ear canal.

Often I find myself giving permission to a patient to be sick — to take time to renew, rest and trust their bodies to know what is best for a time.

Sometimes, I am the coach pushing them to stop living sick — to stop hiding from life’s challenges, to stretch even when it hurts, to get out of bed even when not rested, to quit giving in to symptoms that are to be overcome rather than become overwhelming.

Always I’m looking for an opening to say something a patient might think about after they leave my clinic — how they can make different choices, how they can be bolder and braver in their self care, how they can intervene within their own finite timeline to prevent illness, how every day is just one thread in the larger tapestry of their lifespan.

Each morning I rise early to get work done at home before I actually arrive at my desk at work, trying to avoid feeling unprepared and inadequate to the volume of tasks heaped upon each day.   I know I will be stretched beyond my capacity, challenged by the unfamiliar, the unexpected and will be stressed by obstacles thrown in my way.  I know I will be held responsible for things I have little to do with, simply because I’m the one who often acts as decision-maker.

It is always tempting to go back to bed and hide.

Instead of hiding,  I go to work as the exam room doors need to be opened and the layers peeled away.  I understand the worry, the fear and the pain because I have lived it too.   I know the limitations of a body that wants to consume more than it needs, to sleep rather than go for a walk, to sit rather than stand.

Even now in my seventh decade of life,  I am continually learning how to let it be, even if it is scary.  It is a gift perhaps I can share.

No matter what waits behind the exam room door,  it will be astonishing to me.

I’m grateful to be open for business.  The Doctor is In.

 

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A May 19th Memory

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photo by Larry Goldman

 

Reflecting on, and with respect for, the courage shown by Tanzanian park rangers and my kidnapped research colleagues on this unforgettable day 43 years ago  —  I’m reposting this again as part of my Gombe saga from when I worked as a student research assistant for Jane Goodall in western Tanzania in 1975.

At first glance,  Gombe National Park in Tanzania felt like paradise—a serene piece of the earth filled with exotic and fascinating wildlife, an abundance of fish and fruit to eat, and the rich unfamiliar sounds and smells of the tropical jungle.  It was a façade.  It was surrounded by the turmoil and upheaval of political rebellion and insurgencies in its neighboring countries, inflamed even more by the fall of Saigon in Vietnam a month previously due to the earlier pull out of the Americans from that long and tragic war.

Only a few miles north of our research station in Gombe National Park in western Tanzania, there had been years of civil war in the small land locked country of Burundi.  When the wind was just right, we could hear gunfire and explosions echoing over the valleys that separated us.  Escaping refugees would sometimes stop for food on their way to villages in Tanzania to the south, seeking safe haven in one of the poorest countries in the world, only a decade into its own experiment with socialism, Ujamaa.

There was also word of ongoing military rebellion against the dictatorship of President Mobutu in the mountainous country of Zaire twelve miles west across Lake Tanganyika.

Morning comes early for field studies of wildlife, as the research day must start before the chimpanzee and baboon subjects wake up and begin to stir. Before midnight, while we slept soundly in our metal huts scattered up the mountainside, a group of armed soldiers arrived by boats to the shore of Gombe National Park.

Storming the beach huts housing two unarmed Gombe park rangers and their families, the soldiers seized one and demanded to be told where the researchers were. The ranger refused to provide information and was severely beaten about the head and face by the butts of the rifles carried by the invaders.  The armed soldiers then divided into smaller groups and headed up the trails leading to the huts, coming upon four sleeping student researchers, tying them up, taking them hostage, forcing them into boats and taking them across the lake back to Zaire.

Asleep farther up the mountain, we were wakened by other researchers who were fleeing, hearing the commotion.  No one really understood what was happening down lower on the mountain. There were shouts and screams, and gun shots had been heard.  Had someone been injured or killed?   There was no choice but to run and hide deep in the bush at a predetermined gathering spot until an “all clear” signal was given by the rangers.

We hurried along barely familiar  trails in the black of the jungle night, using no flashlights, our hearts beating hard, knowing we had no defense available to us other than the cover of darkness.

That was the longest wait for morning of my life, sitting alongside Jane holding her son Grub.  A hand full of other students had also made their way to the hiding spot, none of us knowing what to think, say or do.  We could only barely see each other’s faces in the darkness and were too frightened to make any sounds.  We carried no weapons, and there was no way to communicate with the outside world.   We had no idea how many of us may be missing, or possibly dead.

Jane held Grub in her arms, endeavoring in vain to keep him quiet, but his eight year old imagination was ignited by the events that had just unfolded.

“Will they kidnap me, Jane?  Will they come for me?  Where will they take us?  Will they shoot us dead?”

Jane, her face hidden by her blonde hair loose about her shoulders,  sat rocking him, cradling him. “Shhh, shhh, we don’t want them to find us.  We’re safe staying right here.  Everything will be fine in the morning.  No one will take you from me.”

Grub began to sob silently into her shoulder.

When the morning of May 20 dawned, the park rangers located us, and pieced together the events as best they could–the soldiers were Zairean rebels living in remote mountains, fighting  an insurgency against the Zaire government. Seeking funds for their cause, they saw a kidnapping of Americans and Europeans as a way to raise quick funds and world publicity and sympathy.  Four of our friends/coworkers were missing, the camp was ransacked and the rangers beaten but with no life threatening injuries.   There was no way to remain safe at the Park, and our colleagues needed whatever help we could offer for their rescue.

We were able to send a messenger to a nearby fishing village, and a radio call was sent out to the small town of Kigoma, then relayed to Dar Es Salaam and Nairobi.  Help arrived within a few hours, when a United Nations boat monitoring the civil war activities in Burundi pulled off shore near our camp.  We were told we needed to evacuate Gombe that day, and would be taken to Kigoma, and then flown by bush pilot to Nairobi, Kenya to cooperate in the investigation of the kidnapping.

In Nairobi, at the US Embassy, I met CIA agents who viewed our wild primate studies with suspicion.  Each of us were grilled individually as to our political beliefs, our activities at the camp and whether we may be somehow involved in subversive actions against the Zaire or Tanzanian governments.  We were dumbfounded that our own countrymen would be so skeptical about our motives for being in Africa.  It became clear our own government would be no help in resolving the kidnapping and bringing our friends home to safety.  The agents did not shed any light on whether they knew our friends were alive or dead.

We were then hustled into a press conference where we were interviewed for television and print media by the worldwide news agencies, and my parents saw me on the CBS evening news before they actually heard my voice over the phone.  I flew back to Stanford the next day, spending 24 hours on a plane that made six stops up the coast of West Africa on its way back west, to tell what I knew to Stanford President Lyman and other administration officials as they prepared a plan to locate and free the students.   I then returned home to Washington state to await any news that came too slowly from a place so far away that I remain astonished to this day that I was ever there at all.

It took over three months, private negotiations and ransom money to free all four of our friends back to safety. They remain close to each other and the remarkable man who helped free them, Dr. David Hamburg. We have had several reunions together over the years to remember those days of living in a place that at one time seemed like paradise.

several of my colleagues have written books about their experience at Gombe:
Following Fifi by Dr. John Crocker

The Ghosts of Gombe by Dale Peterson

Jane Goodall by Dale Peterson

The Jane Effect by Dale Peterson

and of course, Jane’s wonderful books that led me to Gombe in the first place:

In the Shadow of Man

Through a Window: My Thirty Years with the Wild Chimpanzees of Gombe

Reason for Hope

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photo from a press conference at Stanford a few days later

 

 

Alumni during the HumBio 40th Reunion.
Gombe Alumni and faculty in 2011 at Stanford (I’m in the very back 5th from the left)

Those Who Love Each Other

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And this, then,
is the vision of that Heaven of which
we have heard, where those who love
each other have forgiven each other,

where, for that, the leaves are green,
the light a music in the air,
and all is unentangled,
and all is undismayed.
~Wendell Berry “To My Mother”

 

 

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To think of a mother’s love strengthened
by the knowledge of a life and light within her
and gratitude for forgiveness that knows no bounds:

~this is heaven where all is grace~

the tangles we have made of our lives
are unraveled, straightened and smoothed,
no longer worry or dismay over mistakes we’ve made

I can only hope I have loved
as I’ve been loved
and forever will be.

 

 

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When Faith Appears Like Dew

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Faith steals upon you like dew:
some days you wake and it is there.
And like dew, it gets burned off 
in the rising sun of anxieties,
ambitions, distractions.
~Christian Wiman from My Bright Abyss

 

 

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My faith,
refreshed in the light of morning,
can evaporate in the dry stress of the day.
May I turn my face up
each night, asking to be washed
in the mist of God’s dew,
my anxiety settled like dust.

 

 

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A Bleeding Heart

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Love your neighbor as yourself is part of the great commandment.

The other way to say it is, ‘Love yourself as your neighbor.’ Love yourself not in some egocentric, self-serving sense but love yourself the way you would love your friend in the sense of taking care of yourself, nourishing yourself, trying to understand, comfort, strengthen yourself.

Ministers in particular, people in the caring professions in general, are famous for neglecting their selves with the result that they are apt to become in their own way as helpless and crippled as the people they are trying to care for and thus no longer selves who can be of much use to anybody. 

It means pay mind to your own life, your own health and wholeness, both for your own sake and ultimately for the sake of those you love too. Take care of yourself so you can take care of them.

A bleeding heart is of no help to anybody if it bleeds to death.
~Frederick Buechner from Telling Secrets

 

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We are reminded every time we hear safety instructions on an airplane before a flight takes off: “in the event of a sudden pressure change in the cabin, oxygen masks will appear – remember to put your own on before helping others with their masks.”   

If we aren’t able to breathe ourselves, we won’t last long enough to be of assistance to anyone around us.  Too often,  sacrificing self-care threatens others’ well-being.

A headline appeared in my email from the American Psychiatric Association this morning: “Physicians Experience the Highest Suicide Rate of Any Profession” – there is rampant depression and burn-out among those who should know best how to recognize and respond to the danger signs — for women physicians, nearly 1 out of 5 are afflicted.   Yet the work load only seems to increase, not diminish, the legal and moral responsibility weighs more heavily, and the hours available for sleep and respite shrink.  In forty years of practicing medicine (my father liked to remind me “when are you going to stop ‘practicing’ and actually ‘do’ it?”),  the work has never gotten easier, only harder and heavier.

I see suicidal patients all day and am immensely grateful I’ve never been suicidal, thank God, but anxiety is embedded deep in my DNA from my non-physician fretful farmer ancestors.  Anxiety becomes the fuel and driver of the relentless physician journey on long lonely roads, spurring us to stay awake too many hours and travel too far when we should be closing our eyes and taking a break to breathe, just breathe.

However, we are trained to respond to anxiety from the first day in anatomy class:
“and while you, Miss Polis, are trying to think of the name of that blood vessel, your patient is exsanguinating in front of you– drip, drip, drip….”

Terror-stricken at the thought I was inadequate to the task of saving a life, it took years for me to realize the name of the vessel didn’t bloody matter as long as I knew instinctively to clamp it, compress it, or by the love of the Living God, transfuse my own blood from my bleeding heart into my patient’s.

I learned well those many years ago:

To save a life, I must preserve my own.

 

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Lifting a Veil of Gauze

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Veil after veil of thin dusky gauze is lifted, 
and by degrees 
the forms and colours of things are restored to them, 
and we watch the dawn 
remaking the world in its antique pattern.
~Oscar Wilde from The Picture of Dorian Gray

 

 

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Dawn is the time when nothing breathes, the hour of silence. 
Everything is transfixed, only the light moves.
~Leonora Carrington from The Hearing Trumpet

 

 

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Poetry lifts the veil from the hidden beauty of the world,
and makes familiar objects be as if they were not familiar.

~Percy Bysshe Shelley

 

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Too much of my life is lived behind a gauzy veil, hiding my face and feelings so my flaws and foibles are not so obvious to the world.

Yet God lifts my veil as a groom does his bride’s;  He reminds me I’m made in His image and He wants to see me wholly to make me holy.

Just as the dawn restores with light what has dwelled in darkness, God removes our shroud of hiddenness to tell us: “You, my child, are beautiful because I made you.”

 

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Leaving a Footprint

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…And both that morning equally lay
In leaves no step had trodden black.
Oh, I kept the first for another day!
Yet knowing how way leads on to way,
I doubted if I should ever come back.
I shall be telling this with a sigh
Somewhere ages and ages hence:
Two roads diverged in a wood, and I—
I took the one less traveled by,
And that has made all the difference.
~Robert Frost from “The Road Not Taken”

 

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photo by Per Wolfisberg this morning from north-central Montana

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Two lonely cross-roads that themselves cross each other I have walked several times this winter without meeting or overtaking so much as a single person on foot or on runners. The practically unbroken condition of both for several days after a snow or a blow proves that neither is much travelled.

Judge then how surprised I was the other evening as I came down one to see a man, who to my own unfamiliar eyes and in the dusk looked for all the world like myself, coming down the other, his approach to the point where our paths must intersect being so timed that unless one of us pulled up we must inevitably collide. I felt as if I was going to meet my own image in a slanting mirror. Or say I felt as we slowly converged on the same point with the same noiseless yet laborious stride as if we were two images about to float together with the uncrossing of someone’s eyes. I verily expected to take up or absorb this other self and feel the stronger by the addition for the three-mile journey home.

But I didn’t go forward to the touch. I stood still in wonderment and let him pass by; and that, too, with the fatal omission of not trying to find out by a comparison of lives and immediate and remote interests what could have brought us by crossing paths to the same point in a wilderness at the same moment of nightfall. Some purpose I doubt not, if we could but have made out.

I like a coincidence almost as well as an incongruity.
~Robert Frost from “Selected Letters”

 

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When a man thinks happily, he finds no foot-track in the field he traverses.
~Ralph Waldo Emerson from “Quotation and Originality”

 

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Robert Frost enjoyed how readers misinterpreted his ironic “The Road Not Taken” poem.  His point was not “the road less traveled”  “made all the difference” but that the roads were in fact the same.  As humans living our daily lives, we have to make decisions that take us one way or the other, not knowing and very uncertain where our choices may lead us.

Our assurance lies in understanding the Hand that guides us, should we allow Him.  We may choose a path that leads us astray; God continually puts up signposts that will guide us home.  Our journey may be arduous, we may get terribly lost, we may walk alone for long stretches, we may end up crushed and bleeding in the ditch.

He follows the footprints we have left behind, and we are found, rescued and brought home, no matter what, and that — not the road we chose at the beginning — is what makes all the difference.

 

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