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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Prescribing Good Medicine

 

A good night sleep, or a ten minute bawl, or a pint of chocolate ice cream, or all three together, is good medicine.
~Ray Bradbury

 

 

 

If there is anything I’ve learned in over 40 years of practicing medicine, it’s that I still must “practice” my art every day.  As much as we physicians emphasize the science of what we do, utilizing “evidence based” decisions, there are still days when a fair amount of educated guessing and a gut feeling is based on past experience, along with my best hunch.  Many patients don’t arrive with classic cook book symptoms that fit the standardized diagnostic and treatment algorithms so the nuances of their stories require interpretation, discernment and flexibility.    I appreciate a surprise once in awhile that makes me look at a patient in a new or unexpected way and teaches me something I didn’t know before.   It keeps me coming back for more, to figure out the mystery and dig a little deeper.

I’ve also learned that not all medicine comes in pills or injections.  This isn’t really news to anyone, but our modern society is determined to seek better living through chemistry, the more expensive and newer the better, whether prescribed or not.  Chemicals have their place, but they also can cause havoc.  It is startling to see medication lists topping a dozen different daily pills.  Some are life-saving.  Many are just plain unnecessary.

How many people sleep without the aid of pill or weed or alcohol?  Fewer and fewer.  Poor sleep is one of the sad consequences of our modern age of too much artificial light, too much entertainment and screen time keeping us up late, and not enough physical work to exhaust our bodies enough to match our frazzled and fatigued brains.

How many of us allow ourselves a good cry when we feel it welling up?  It could be a sentimental moment–a song that brings back bittersweet memories, a commercial that touches just the right chord of feeling and connection.  It may be a moment of frustration and anger when nothing seems to go right.  It could be the pain of physical illness or injury or the stress of emotional turmoil.  Or just maybe there is weeping when everything is absolutely perfect and there cannot be another moment just like it, so it is tough to let it go unchristened by tears of joy.

And without a doubt, the healing qualities of chocolate are unquestioned by this doctor, however it may be consumed.  It can fix most everything that ails a person,  at least for an hour or two.

No, it doesn’t take an M.D. degree to know the best medicine.

Just remember: sleep, weep, reap (chocolate!)

 

Preparing Through Parable: Keep Watch

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35 “Therefore keep watch because you do not know when the owner of the house will come back—whether in the evening, or at midnight, or when the rooster crows, or at dawn.
36 If he comes suddenly, do not let him find you sleeping.
37 What I say to you, I say to everyone: ‘Watch!’
Mark 13:35-37

 

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Between midnight and dawn, when the past is all deception,
The future futureless, before the morning watch
When time stops and time is never ending;
And the ground swell, that is and was from the beginning,
Clangs
The bell.
~T.S. Eliot from “The Dry Salvages”

 

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I wait for the Lord, my soul waits,
    and in his word I put my hope.
 My soul waits for the Lord
    more than watchmen wait for the morning,
    more than watchmen wait for the morning.
Psalm 130: 5-6 from a Song of Ascents

 

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We can tend to suffer from Attention Deficit when it comes to waiting and watching for the Lord.  Our focus wanders as we want what we want when we want it.  Sitting in worshipful watching is hard work for us when all we can think about is recess or a nap.

He must not catch us sleeping.  We must keep our eyes wide open to not miss His coming.

May my eyes see, my ears hear, my heart understand.  He prepares me with parable.

 

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Barn Light

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The light by the barn that shines all night
pales at dawn when a little breeze comes.

A little breeze comes breathing the fields
from their sleep and waking the slow windmill.

The slow windmill sings the long day
about anguish and loss to the chickens at work.

The little breeze follows the slow windmill
and the chickens at work till the sun goes down—

Then the light by the barn again.

~William Stafford, from The Way It Is

 

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For years I was convinced that vapor lights turning on at dusk had no place on our farm.
Light pollution and all that.
Then I got older and awkward enough to stumble in the dark on uneven ground while walking to the barn — I needed a light to help me avoid a face plant.

We now have motion detection lights that turn on when I approach.  They provide illumination just long enough to get me where I need to go and once I’m safely inside, they fade out and allow the sleeping barnyard the cover of darkness it needs.

The sun itself is a kind of motion detector in reverse – a motion activator/deactivator.  When it is time, it turns on to get us moving and we are spurred to the work of the day.  When it is time to rest, it shuts off and we become still as chickens in a roost.

It is the rhythm of work and sleep that we need in our lives – a cycle of activity and rest.

And today is Sabbath – the Light is On us.
Even so, we are to stop and listen, cease work and rest.

 

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Tree Secrets

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Of winter’s lifeless world each tree
Now seems a perfect part;
Yet each one holds summer’s secret
Deep down within its heart.
~ Charles G. Stater

 

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Enduring the dark and quiet winter months, the trees appear to doze deep while standing stark naked against the sky, roused only by the whipping of the winds and when breaking under a heavy coat of ice.

It is uneasy sleep.

When I look close now, I can tell:
they conceal summer secrets under their skin, the sap flows thick and sluggish, there is a barely palpable pulse in those branches.

A heart pumps within, readying.

 

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In the Dark, Reconciled

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I am the rest between two notes,
which are somehow always in discord
because Death’s note wants to climb over—
but in the dark interval, reconciled,
they stay there trembling.
And the song goes on, beautiful.
~Rainer Maria Rilke from “My Life is Not This Steeply Sloping Hour”

 

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On Sunday evenings I often feel I’m the spot in the middle between discordant notes. There is on one side of me the pressure of catch-up from what was left undone through a too-brief weekend and on the other side is the anticipated demand of the coming week. As I prepare to sleep at the end of a Sabbath day, I feel uneasily in dead center, immobilized by the unknown ahead and the known behind.

This moment of rest in the present, between the trembling past and uncertain future, is my moment of reconciliation: my Sabbath extended.

This evening, I will allow myself a steeply sloping hour of silence and reflection before I surge ahead into the week, knowing that on my journey I’ll inevitably hit wrong notes, yet beautiful nevertheless.

Even the least harmonious notes resolve within the next chord. I will move from the rest of my Sabbath back into the rhythm of my life.

Trembling, still trembling, always trembling at what is to come.

 

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photo by Josh Scholten

 

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photo by Lea Gibson

 

 

 

 

The Rain Drop Ploughs

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They sing their dearest songs —
    He, she, all of them — yea,
    Treble and tenor and bass,
        And one to play;
    With the candles mooning each face….
        Ah, no; the years O!
How the sick leaves reel down in throngs!

 

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They clear the creeping moss —
    Elders and juniors — aye,
    Making the pathways neat
        And the garden gay;
    And they build a shady seat….
        Ah, no; the years, the years;
See, the white storm-birds wing across!

 

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    They are blithely breakfasting all —
    Men and maidens — yea,
    Under the summer tree,
        With a glimpse of the bay,
    While pet fowl come to the knee….
        Ah, no; the years O!
And the rotten rose is ript from the wall.

 

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    They change to a high new house,
    He, she, all of them — aye,
    Clocks and carpets and chairs
        On the lawn all day,
    And brightest things that are theirs….
        Ah, no; the years, the years;
Down their carved names the rain-drop ploughs.
~Thomas Hardy “During Wind and Rain”

 

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A waning November moon reluctantly rose,
dimming from the full globe of the night before.
I drive a darkening country road, white lines sweeping past,
aware of advancing frost in the evening haze,
anxious to return home to familiar warmth and light.

Nearing a county road corner, slowing to a stop,
I glanced aside where
a lonely rural cemetery sits expectant.

Through open iron gates and tenebrous headstones,
there in the middle path, incongruous,
car’s headlights beamed bright.

I puzzled, thinking:
lovers or vandals would seek inky cover of night.

Instead, these lights focused on one soul alone,
kneeling graveside,
a hand resting heavily on a stone, head bowed in prayer.

This stark moment of solitary sorrow,
a visible grieving of a heart

illuminated by twin beams.

This benediction of mourning
as light pierced the blackness;

gentle fingertips traced
the engraved letters of a beloved name.

Feeling touched
as uneasy witness, I pull away 

to drive deeper into the night,
struggling to see despite
my eyes’ thickening mist.

~Emily Gibson – “Grief Illuminated”

 

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a stone pinecone, environmental art by Andy Goldsworthy, rural Scotland