Last Year’s Mistakes Wiped Clean

redsquare
 
 
That old September feeling, left over from school days, of summer passing… Another fall, another turned page: there was something of jubilee in that annual autumnal beginning, as if last year’s mistakes had been wiped clean by summer.
~Wallace Stegner from Angle of Repose
 
 
 
fallleaves91518
 
 
mapleWWU
 
 
 

Sixteen thousand students have appeared magically overnight on the campus where I’ve worked for three decades.  Unfortunately a record was set for the number who ended up in the emergency room last night due to their celebrating the start of the school year a bit too aggressively.

How is it the start of a new school year can be wistful, jubilant and potentially hazardous all at the same time?  There are always plenty of mistakes to be made and plenty to learn from, though sometimes at tremendous cost.  This is a risky way to start an education.

More than New Year’s Day, the beginning of autumn represents so many turned-over new “leafs”.  We are reminded of this whenever we look at the trees all over our beautiful campus and how their leaves are turning and letting go, seemingly joyful as they make way for the next stage of growth, the slate wiped clean and ready to be scribbled on once again.

Every autumn each emerging adult comes to the university with a similar clean slate, hoping to start fresh, leaving behind what has not worked well for them in the past.  These are our future patients who we hope are open to change because they are dedicating themselves to self-transformation through knowledge and discipline.

It is a true privilege, as a college health doc, to participate in our students’ transition to become autonomous critical thinkers striving to better the world as compassionate global citizens.  Their rich colors deepen when they let go to fly wherever the wind may next take them.

We who remain rooted in place celebrate each new beginning, knowing we nurture the hoped-for transformation…

…as long as we can keep them out of the emergency room.

 

irresistiblewwu

 

wwu11147

 

 

A Flower Unplucked

rainyroseA flower unplucked is but left to the falling,
And nothing is gained by not gathering roses.
~Robert Frost from “Asking for Roses”

 

Robin Williams spent his lifetime coaxing us to laugh till we cried,
making us cringe and too often wanting to hide from his manic intensity.

He left no flower unplucked and now he has left us weeping again
too soon,
petals shattered and strewn,
a lingering scent of roses rising.

rainyrose2

rainyrose3

Hiding Nothing

changedpriorities
You can hide nothing from God.
The mask you wear before men will do you no good before Him.
He wants to see you as you are,
He wants to be gracious to you.
You do not have to go on lying to yourself and your brothers,
as if you were without sin;
you can dare to be a sinner.

~Dietrich Bonhoeffer from Life Together

One of my Monday morning jobs in our college health clinic is to meet with any student who got so intoxicated they had to spend part of the weekend in the emergency room.  Alcohol poisonings are distressingly common on all college campuses, and ours is no exception.   What I do during our morning-after visit is review the records with the student so they have some idea what took place before they woke up hours later on a gurney in a noisy smelly emergency room– alcohol is an effective amnesia-producing anesthetic when it doesn’t manage to outright kill its consumer.   It is a humbling experience to read about what one said and did while one was under the influence of intoxicants and yet have no memory of any of it.   That is why my time is well spent with the recovering and remorseful.   Not only does their stomach lining still burn from all the vomiting, but their head hurts from acknowledging the risks they took in the name of having a good time.  It is rare that I ever need to meet again with the same student about similar behavior.

This, in reality,  is a very effective kind of hurting, one that is crucial to future decision-making: dangerous behavior is far less appealing when one still carries the scars.  Priorities change for the better.

Today I won’t be able to work in several hundred now-sober students into this morning’s clinic schedule after the unfortunate and widely publicized events that happened just a couple blocks off our college campus a little over 24 hours ago.  I suspect most of the students involved remember more than they wish to about their participation in a big-block-party-gone-terribly-wrong.  They were part of an aggressive mob mentality threatening law enforcement personnel trying to disperse an increasingly rowdy and obnoxious crowd.  Some are finding themselves in video and Instagram/Facebook documentation of their profane words and gestures, throwing potentially lethal objects, vandalizing private and city property as well as causing thousands of dollars of city resources to confront out of control drunk rioters.   These students can try to lay low but there is no place to hide from their inner knowledge of what they have done, the part they played and the irreparable damage they caused to individuals, relationships, property and as well as the reputations of the city and the university.  There is no comforting alcohol amnesia to hide within this time.

The only possible healing from an event like this is to come clean about what one has done, admit the mistakes made and work to make it right no matter the cost — to dare to acknowledge the sins committed and accept the consequences of one’s actions.

Hiding is cheap — guilt and shame remain behind the mask.
Grace and forgiveness is costly but there is no longer need to hide and be eaten away by a continually hurting soul.

My prescription for this day and in the days to come:  changed priorities ahead.  College is about obtaining a valuable and precious education, not about finding the biggest and best party of intoxicants.

Take with food and a large dose of humility.

The Last Hour

photo by Josh Scholten

Resolved, never to do anything which I would be afraid to do if it were the last hour of my life.
~Jonathan Edwards

The first few weekends of any university’s fall semester is fraught with risk.  It is a time when freshmen, in particular, participate in age-old college rituals that take some to the emergency room and result in a few lying in the morgue.  There is sometimes an attitude of tossing care and good judgement to the wind.  Leaving home and being on one’s own means the freedom to do what one wants, when one wants, until the moment when payment comes due.

The national headlines in autumn over the last few years have shouted in large font about toxic reactions at parties serving Four Loko, about students gone missing, about fatal falls off overloaded balconies, and this week about the devastating effects of alcohol enemas.  There never seems to be an end to ways students can experiment with stretching and possibly breaking the slender thread between life and death, in the name of fun and games.

A helpful rule of thumb has always been what our grandmothers said:  “Don’t ever do anything you’d be embarrassed to see on the front page of the newspaper.”

In this day and age of social media, as newspapers become less relevant, the new rule of thumb should be: “Resolved, never to do anything which I would be afraid to see on FaceBook, YouTube or going viral in a matter of hours.”  Unfortunately, in the twisted way modern society works for some, that is all the more incentive.

Jonathan Edwards, writing almost 300 years ago, had it right.  We need to live each hour as if it were our last, considering what that hour might mean for eternity.

A Speech About Compost

(I gave this speech at the annual medical staff dinner last night when asked to “say a few words” (well, it ended up being more than a *few* words) after being selected as one of two “Physicians of Excellence” for 2010 at St. Joseph Hospital, Bellingham)

It was quite unexpected to get a call from Jim Hopper two months ago asking me if I was planning to attend tonight’s dinner.   The usual answer to that question would be  “uh, no…that’s my barn cleaning time…” , but he told me it would be a good idea for me to show up.   So, I’m quite humbled that the medical staff leadership would acknowledge a doctor who tries hard to fly under the radar by attending as few dinner meetings as possible due to farm and family obligations…

Dan and I arrived in Whatcom County  25 years ago; at that time I was a pregnant family doc having trained at Group Health Cooperative, and left behind one of the most diverse and wonderful practices in the Rainier Valley in Seattle.  We had decided we didn’t want to raise our family in the city, so we moved to a farm north of Bellingham, only a few miles from his parents and back to a part of the state where my grandparents had grown up.  I began practice by filling in as a locums for whoever would have me, and it was no time at all that I had more jobs than I knew what to do with.  I filled in at Intalco doing worker physicals, was a supervisor of the nurse practitioners at Planned Parenthood for several years, was the first doctor at the Interfaith Clinic, and soon was managing detox for Whatcom County at Olympic Treatment Center.  I also started seeing children who needed an evaluation for sexual abuse, ending up seeing over 1000 children over 10 years, and testifying in over 100 trials in a 5 county region.

The chemical dependency work moved to the Recovery Center at St. Joseph Hospital in 1988, and I’ve continued to do medical detox as well as my work at the Student Health Center at WWU for over 20 years.

I am not as skilled a diagnostician as many of you.  I’m not as good at surgical procedures, nor am I a wiz at administration.  What I am good at is making compost, which is really what I’ve done when I’ve taken care of thousands of chemical dependency inpatients over the last twenty years.

As a farmer, I spend over an hour a day cleaning my barn, and wheel heavy loads of organic material to a large pile in our barnyard which composts year round.  Piling up all that messy stuff that is no longer needed is crucial to the process: it heats up quickly to the point of steaming, and within months, it becomes rich fertilizer, ready to help the fields to grow grass, or the garden to produce vegetables, or the fragrant blooms in the flower beds.  It becomes something far greater and more productive than what it was to begin with.  That’s what intensively managed detox and treatment of addictions is like.

As clinicians, we help our patients “clean up” the parts of their lives they really don’t need, that they can’t manage any longer, that are causing problems with their health, their families and jobs, and most of all, their relationship with their Creator.  There isn’t a soul walking this earth who doesn’t struggle in some way with things that take over our lives, whether it is work,  computer use, food, gambling, you name it.  For the chemically dependent, it comes in the form of smoke, a powder, a bottle, a syringe or a pill.  There is nothing that has proven more effective than “piling up together” learning what it takes to walk the road to health and healing, “heating up”, so to speak, in an organic process of transformation that is, for lack of any better description, primarily a spiritual treatment process.  When a support group becomes a crucible for the “refiner’s fire”,  it does its best work melting people down to get rid of the impurities before they can be built back up again, stronger than ever.  They become compost, productive, ready to grow others.

This work with a spectrum of individuals of all races, professional and blue collar, rich and homeless,  coming from all over the state for help,  has been transforming for me.  I have worked with incredibly gifted nursing and counseling staff, some recovering themselves, who have dedicated their careers to this work. Over twenty years, I’ve been on call for detox 24/7 for  90% of those days, nights, holidays and weekends, and I thank Dr. Bob Watson and Dr. Tim Buckley for covering for me every once in awhile so I can turn off my pager.  I thank my husband, Dan Gibson, and our three children for letting me commit to this work.

As Jesus says in Matthew 25: 40–‘I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me.’

We must not turn away from those who are our most vulnerable, who clearly need our help the most.   I certainly could not over the past twenty years.

Thank you for acknowledging that.

A Knock on the Door

knockFour years ago, a young woman I’d been seeing for several weeks in my clinic called unexpectedly Friday afternoon and canceled an upcoming appointment for the following Monday and did not reschedule. The receptionist sent me a message as is our policy for patients who “cancel and do not reschedule”. It gave me a bad feeling that she was turning her back on her treatment plan and I was uneasy about the upcoming weekend without knowing what was going on with her.

I could have just put on my coat and headed home at the end of that long Friday but decided to call my patient. She didn’t answer her phone. I mulled over my options, looked up her apartment address and drove there. As I approached her door, I could hear someone moving around in her apartment, but she didn’t respond to my knocks or my voice.

I decided to stay right there, talking to her through the door for about 15 minutes, letting her know I wasn’t leaving until she opened up the door. I finally told her she could decide to open the door or I would call 911 and ask the police to come to make sure she was okay. She then opened the door, tears streaming down her face. She had been drinking heavily, with liquor bottles strewn around on the floor. She admitted an intent to overdose on aspirin and vodka. The vodka was already consumed but the unopened aspirin bottle was in her hand. I was the last person she expected to see at her door.

I called the mental health unit at the local hospital and they had an open bed. I told my patient that we could save time and hassle by heading over right then and there, and avoid the emergency room mess, and the possibility of an involuntary detainment.

She agreed to come with me and be admitted voluntarily for stabilization. I went the following day to visit her and she greeted me with a hug and thanked me for not giving up on her when she had given up on herself. In sobriety, her eyes were brighter and she was more hopeful. She never expected anyone to care enough to come looking for her, and to stand firm when she was rejecting all approaches. She was astounded and grateful, and frankly, so was I.

Four years later, a small card arrived this week in my clinic mailbox on a most challenging work day, from an unfamiliar address two thousand miles away. The name looked vaguely familiar to me but when I opened and read the contents, this time it was my turn to let tears flow:

“Dear Doctor,

I am not sure if you will remember me considering you see a number of patients daily; however, I am a patient whose life you changed in the most positive way. I never truly THANKED YOU for listening to me and hearing my silent words of grief and hearing my cries for help. If it had not been for you, had you not knocked on my door, I would not be writing this letter to you today. I don’t know exactly what to say to the person who saved me from hurting myself fatally. You were a stranger in my life, but a dear friend in my time of need. THANK YOU, for everything that you did for me. You have a permanent place in my heart, you have given my spirit hope, you have reminded me that a life is worth living. Thank you, thank you, thank you! Sincerely, L_____”

I’m grateful 4 years ago I had the sense to go knock on her door, the stubbornness to stay put until she responded, and most of all, I’m appreciative for her gracious note letting me know it made a difference. Now, on a most difficult day this week, she made a difference for me.

She has knocked on my door and I have opened it, awash in my own tears.