When Flesh and Heart Shall Fail

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(Ten years ago this week, this healthy young college student came to our clinic stricken with seasonal influenza complicated by pneumonia.  His family gave permission for his story to be told.)

 

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Nothing was helping.  Everything had been tried for a week of the most intensive critical care possible.  A twenty year old man, completely healthy only two weeks previously, was dying and nothing could stop it.

The battle against a sudden MRSA pneumonia precipitated by a routine seasonal influenza had been lost.   Despite aggressive hemodynamic, antibiotic, antiviral and ventilator management, he was becoming more hypoxic and his renal function was deteriorating.  He had been unresponsive for most of the week.

The intensivist looked weary and defeated. The nurses were staring at their laps, unable to look up, their eyes tearing. The hospital chaplain reached out to hold this young man’s mother’s shaking hands.

After a week of heroic effort and treatment, there was now clarity about the next step.

Two hours later, a group gathered in the waiting room outside the ICU doors. The average age was about 21; they assisted each other in tying on the gowns over their clothing, distributed gloves and masks. Together, holding each other up, they waited for the signal to gather in his room after the ventilator had been removed and he was breathing without assistance. They entered and gathered around his bed.

He was ravaged by this sudden illness, his strong body beaten and giving up. His breathing was now ragged and irregular, sedation preventing response but not necessarily preventing awareness. He was surrounded by silence as each individual who had known and loved him struggled with the knowledge that this was the final goodbye.

His father approached the head of the bed and put his hands on his boy’s forehead and cheek.  He held this young man’s face tenderly, bowing in silent prayer and then murmuring words of comfort:

It is okay to let go. It is okay to leave us now.
We will see you again. We’ll meet again.
We’ll know where you will be.

His mother stood alongside, rubbing her son’s arms, gazing into his face as he slowly slowly slipped away. His father began humming, indistinguishable notes initially, just low sounds coming from a deep well of anguish and loss.

As the son’s breaths spaced farther apart, his dad’s hummed song became recognizable as the hymn of praise by John Newton, Amazing Grace.  The words started to form around the notes. At first his dad was singing alone, giving this gift to his son as he passed, and then his mom joined in as well. His sisters wept. His friends didn’t know all the words but tried to sing through their tears. The chaplain helped when we stumbled, not knowing if we were getting it right, not ever having done anything like this before.

Amazing Grace, how sweet the sound,
That saved a wretch like me.
I once was lost but now am found,
Was blind, but now I see.

Through many dangers, toils and snares
I have already come;
‘Tis Grace that brought me safe thus far
and Grace will lead me home.

Yea, when this flesh and heart shall fail,
And mortal life shall cease,
I shall possess within the veil,
A life of joy and peace.

When we’ve been here ten thousand years
Bright shining as the sun.
We’ve no less days to sing God’s praise
Than when we’ve first begun.

And he left us.

His mom hugged each sobbing person there–the young friends, the nurses, the doctors humbled by powerful pathogens. She thanked each one for being present for his death, for their vigil kept through the week in the hospital.

This young man, now lost to this life, had profoundly touched people in a way he could not have ever predicted or expected. His parents’ grief, so gracious and giving to the young people who had never confronted death before, remains unforgettable.

This was their sacred gift to their son so Grace will lead us home.

 

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Partly Cloudy with Sun Breaks

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When it snows, he stands
at the back door or wanders
around the house to each
window in turn and
watches the weather
like a lover. O farm boy,
I waited years
for you to look at me
that way. Now we’re old
enough to stop waiting
for random looks or touches
or words, so I find myself
watching you watching
the weather, and we wait
together to discover
whatever the sky might bring.
~Patricia Traxler “Weather Man”
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My farm boy does still look at me that way,
wondering if today will bring
frost,
a wind storm,
maybe fog or mist,
a scorcher,
or a deluge.
I reassure him as best I can,
because he knows me so well
in our many years together:
today, like most other days
will be partly cloudy with showers
and occasional sun breaks.
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The Jeweled Prize

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But we are older,
I to love
                 and you to be loved,
                                        we have,
no matter how,
                 by our wills survived
                                        to keep
the jewelled prize
                   always at our finger tips.
We will it so
                  and so it is
                                       past all accident.
~William Carlos Williams, excerpts from “The Ivy Crown”
written at age 72, published in Journey to Love

 

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How can we, at our late middle age,
who have treated love as no accident,
look into a well
of such depth and richness~
how can we tell the young
to will their love to survive –
to strive through thorns and briars,
though tears wept and flesh torn,
to cherish the prize
of rose and ivy crown.

It is all that matters,
this crown of love
we have willed and worn together
through the years:

I love you or I do not live at all.
I to love and you to be loved.

 

 

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A Simple Welcome

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He saw clearly how plain and simple – how narrow, even – it all was;
but clearly, too, how much it all meant to him,
and the special value of some such anchorage in one’s existence.
He did not at all want to abandon the new life and its splendid space
s, 
to turn his back on sun and air and all they offered him 
and creep home and stay there; 
the upper world was all too strong, 
it called to him still, even down there, 
and he knew he must return to the larger stage. 
But it was good to think he had this to come back to, 
this place which was all his own, 
these things which were so glad to see him again 
and could always be counted upon for the same simple welcome.
~Kenneth Grahame, from Wind in the Willows (about the Mole and his home at Mole End)

 

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If your everyday life seems poor to you, do not accuse it; accuse yourself, tell yourself you are not poet enough to summon up its riches; since for the creator there is no poverty and no poor or unimportant place.
― Rainer Maria Rilke

 

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As a child, I would sometimes spend long rainy afternoons languishing on the couch at home, complaining to my mother how boring my life was.  Her typical response was to remind me my boredom said more about me than about life – I became the accused, rather than the accuser,  failing to summon up life’s riches.  Thus convicted, my sentence followed:  she would promptly give me chores to do.   I learned not to voice my complaints about life because it always meant work.

Some things haven’t changed, even fifty five years later.  Whenever I am tempted to feel pitiful or bored, accusing my life of being poor or unfair, I need to remember what that says about me.  There is a whole world out there to explore, plenty of work needing doing and always a welcome home when I return.

If I’m not poet enough to celebrate the gilded edge of the plain and simple, if I’m not poet enough to articulate beauty even in the sharp thorns of life, if I’m not poet enough to recognize the Creator’s brilliance in every molecule, then it is my poverty I’m accusing, not his.

Back to work then.  There is a life to be lived, a world to experience and words to be written.

And it is good to think we have all this to come back to, this place which is all our own.

 

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photo by Nate Gibson

 

 

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A World of Wet and Weeping

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My own heart let me more have pity on; let
Me live to my sad self hereafter kind,
Charitable; not live this tormented mind
With this tormented mind tormenting yet.
I cast for comfort I can no more get
By groping round my comfortless, than blind
Eyes in their dark can day or thirst can find
Thirst’s all-in-all in all a world of wet.
~Gerard Manley Hopkins

 

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January 1979
Surfacing to the street from a thirty two hour hospital shift usually means my eyes blink mole-like, adjusting to searing daylight after being too long in darkened windowless halls.  This particular January day is different.   As the doors open, I am immersed in a subdued gray Seattle afternoon, with horizontal rain soaking my scrubs.

Finally remembering where I had parked my car in pre-dawn dark the day before, I start the ignition, putting the windshield wipers on full speed.  I merge onto the freeway, pinching myself to stay awake long enough to reach my apartment and my pillow.

The freeway is a flowing river current of head and tail lights.  Semitrucks toss up tsunami waves cleared briefly by my wipers frantically whacking back and forth.

Just ahead in the lane to my right, a car catches my eye — it looks just like my Dad’s new Buick.  I blink to clear my eyes and my mind, switching lanes to get behind.  The license plate confirms it is indeed my Dad, oddly 100 miles from home in the middle of the week.  I smiled, realizing he and Mom have probably planned to surprise me by taking me out for dinner.

I decide to surprise them first, switching lanes to their left and accelerating up alongside.  As our cars travel side by side in the downpour,  I glance over to my right to see if I can catch my Dad’s eye through streaming side windows.  He is looking away to the right at that moment, obviously in conversation.  It is then I realize something is amiss.  When my Dad looks back at the road, he is smiling in a way I have never seen before.  There are arms wrapped around his neck and shoulder, and a woman’s auburn head is snuggled into his chest.

My mother’s hair is gray.

My initial confusion turns instantly to fury.  Despite the rivers of rain obscuring their view, I desperately want them to see me.  I think about honking,  I think about pulling in front of them so my father would know I have seen and I know.  I think about ramming them with my car so that we’d perish, unrecognizable, in an explosive storm-soaked mangle.

At that moment, my father glances over at me and our eyes meet across the lanes.  His face is a mask of betrayal, bewilderment and then shock. As he tenses, she straightens up and looks at me quizzically.

I can’t bear to look any longer.

I leave them behind, speeding beyond, splashing them with my wake.  Every breath burns my lungs and pierces my heart.  I can not distinguish whether the rivers obscuring my view are from my eyes or my windshield.

Somehow I made it home to my apartment, my heart still pounding in my ears.  The phone is ringing and ringing, and won’t be answered.

I throw myself on my bed, bury my wet face in my pillow and pray for a sleep without dreams.

 

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Forsaking All Others

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The forsaking of all others is a keeping of faith, not just with the chosen one, but with the ones forsaken…  One is married to marriage as well as to one’s spouse. But one is married also to something vital of one’s own that does not exist before the marriage: one’s given word. It now seems to me that the modern misunderstanding of marriage involves a gross misunderstanding and underestimation of the seriousness of giving one’s word, and of the dangers of breaking it once it is given. Adultery and divorce now must be looked upon as instances of that disease of word-breaking, which our age justifies as “realistic” or “practical” or “necessary,” but which is tattering the invariably single fabric of speech and trust.
~Wendell Berry from “The Body and the Earth” in The Art of the Commonplace: The Agrarian Essays

 

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Covenant between two married people, between parent and child, between coworkers, between countries, between God and His people — is too often broken, irrevocably shattered when convenient and deemed necessary.

I see the sequelae of these broken vows, broken words, broken covenants every day in my work.   Divorcing parents destroy the integrity of a family built on trust and commitment.  Relationships wax and wane with the ebb and flow of one’s mood and need for something/someone new.

This disease of chronic deficiency of trustworthiness, this lack of keeping faith with one another, is a brittle bitter breaking of word and promise.  The only cure is clinging to the One who we forsake again and again, who keeps His promise fully and wholly as He renews His everlasting covenant with us until His last breath.  He deems us worthy.

 

Ye are Blood of my Blood, and Bone of my Bone,
I give ye my Body, that we Two might be One.
I give ye my Spirit, ’til our Life shall be Done
~Diana Gabaldon – a Scottish wedding vow from Outlander

 

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An Amalgam of Black and White

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Let me say finally, that in the midst of the hollering and in the midst of the discourtesy tonight, we got to come to see that however much we dislike it, the destinies of white and black America are tied together. Now the races don’t understand this apparently. But our destinies are tied together. And somehow, we must all learn to live together as brothers in this country or we’re all going to perish together as fools.

…Whether we like it or not culturally and otherwise, every white person is a little bit negro and every negro is a little bit white. Our language, our music, our material prosperity and even our food are an amalgam of black and white, so there can be no separate black path to power and fulfillment that does not intersect white routes and there can ultimately be no separate white path to power and fulfillment short of social disaster without recognizing the necessity of sharing that power with black aspirations for freedom and human dignity.
~Martin Luther King, Jr.
in one of his last speeches, given at Grosse Point, Michigan high school (near Detroit) to a mostly white and often heckling audience, March 14, 1968

 

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I grew up during the 1960’s in Olympia, Washington, a fair-sized state capitol of 20,000+ people at the time and our city had only one black family.

One.

There were a few Japanese and Korean families, a few Hispanics, but other than the Native American folks from the nearby Nisqually Reservation, our community seemed comprised of homogenized milk. Pretty much plain Anglo Saxon white.

In 1970, a white Olympia High School graduation student speaker caused a controversy  when she called our town a “white racist ghetto” in her speech. Numerous parents walked out of the ceremony in protest of her protest, and didn’t watch their children graduate.

It was the first time I’d heard someone other than Martin Luther King, Jr. actually crack a previously unspoken barrier using only words. What she said caused much local consternation and anger, but the ensuing debate in the newspaper Letters to the Editor, around lunch counters at the five and dime, and in the churches and real estate offices made a difference. Olympia, after being called out for bigotry in its hiring practices and housing preferences, began to open its social and political doors to people who weren’t white.

Attending college in California helped broaden my limited point of view, but in the early 70′s there were still few diversity admissions initiatives, so Stanford was still a mostly white campus. While living in Africa to study wild chimpanzees in Africa in 1975, I experienced being one of two whites living and traveling among hundreds of very dark skinned Ugandans, Rwandans, Tanzanians and Kenyans. I became the one gawked at, viewed as an oddity, pointed at by small children who were frightened, amused and perplexed by my appearance.

I constantly felt out of place. I did not belong. Yet I was treated graciously, with hospitality, although always a curiosity:  the homogenized white milk in the mix.

There was minimal diversity in my medical school class where women constituted less than 25% of my class graduating in 1980.  It wasn’t until I was in family practice residency at Seattle’s Capitol Hill Group Health Cooperative Hospital that I began to experience the world in full technicolor. I joined a group of doctors in training that included an African American activist from the east coast, a Kiowa Indian, several of Jewish background, a son of Mexican immigrants, a daughter of Chinese immigrants, a Japanese American, someone of Spanish descent, and a Yupik Eskimo.  I was challenged to appreciate my inner city patients’ cultural, racial, religious, ethnic and sexual minority identities, and saw how much more effectively my colleagues and teachers of diverse backgrounds worked with patients who looked or grew up like them.

My training was such a foundational experience that I was drawn to a medical practice in a Group Health Rainier Valley neighborhood clinic. There I saw patients who lived in the projects that lined Martin Luther King Way, struggling to overcome poverty and social fragmentation, clustered together in knots of extended family within a few square miles. There were many ethnic groups: African Americans, Vietnamese, Cambodian and Laotian refugees, Ashkenazi Jews, Middle East Muslims, Russian immigrants and some Catholic Italian families who spoke broken English. I delivered babies who would grow up learning languages and traditions from every corner of the globe. It was a wide world of diversity walking into my exam rooms, richly filling in the white corners of my life in ways I had never imagined.

I found that white milk, nurturing as it was, was not a reflection of everything the world had to offer.

When I married and Dan and I started our own family, we made the decision to move north near his parents and home community of Lynden, a town of Dutch dairy farming immigrants. We planned to own our own farm to raise our children in a rural setting just as both of us had been raised. There was significant adjustment necessary once again adapting to a primarily Caucasian community. I am not Dutch even though I am as white and tall as the Frieslanders (some of my ancestry is from Schleswig-Holstein in Germany, right across the Holland border).  Even though I looked like my neighbors, I still didn’t belong.

I didn’t share the same cultural or church background to fit in easily in my new home. The color of my skin no longer set me apart, but the difference in rituals, language quirks and traditions became very apparent. In other words, the milk looked just as white, (maybe skim versus whole or 2%), but varied significantly in taste (were the cows just let out on grass??)

Over the past thirty plus years since we moved here, our rural community is transforming slowly.  We have two growing Native American sovereign nations within a few miles of our farm, the Nooksack and Lummi tribes, along with increasing numbers of migrant Hispanic families who work the seasonal berry and orchard harvest, many of whom have settled in year round. My supervisors at the University where I work are African American. Our close proximity to the lower mainland of British Columbia has brought Taiwanese, Japanese and Hong Kong immigrants to our area, and many East Indians immigrate to our county in large extended families, attracted by affordable farmland. A rural corner grocery close to our farm is owned by Sikhs with shelves stocked with the most amazing array of Indian spices and Mexican chili sauce, with Dutch peppermints and licorice thrown in for good measure.

Our children grew up rural but, as adults, have become part of communities even more varied. Nate teaches multiracial students from a dozen different countries in an international high school in Tokyo, has married a Japanese woman and our beloved granddaughter is biracial. Ben finished two years as a Teach for America high school math teacher on the Pine Ridge Lakota Sioux Reservation in South Dakota, and married to Hilary, have lived as a racial minority in a mostly black neighborhood in New Haven, Connecticut before moving to the melting pot of the Bay Area in California.   Lea is teaching fourth graders of multiple ethnicities in a Title 1 school in a military town just a few hours away.

Our children are privileged to work within the kaleidoscope of humanity and our family is blessed to no longer be just plain white milk.

Homogenized means more than just uniformity. It is a unity of substance, a breaking down of barriers so there is no longer obvious separation.  Martin Luther King, Jr. called it amalgam — a mixture that yields something stronger than the original parts.

I am still all white on the outside — that I would never want to change —  but I can strive to break down barriers that separate me from the diverse people who live, work and worship around me.  Thanks to that amalgam, my life is enriched and the flavor of my days remarkably enhanced.

 

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