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!)

 

Trust All This to be True

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Trust that there is a tiger, muscular
Tasmanian, and sly, which has never been
seen and never will be seen by any human
eye. Trust that thirty thousand sword-
fish will never near a ship, that far
from cameras or cars elephant herds live
long elephant lives. Believe that bees
by the billions find unidentified flowers
on unmapped marshes and mountains. Safe
in caves of contentment, bears sleep.
Through vast canyons, horses run while slowly
snakes stretch beyond their skins in the sun.
I must trust all this to be true, though
the few birds at my feeder watch the window
with small flutters of fear, so like my own.
~Susan Kinsolving “Trust”
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photo by Emily Vander Haak
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When I stand at the window watching the flickers, sparrows, finches, chickadees, and red-winged blackbirds come and go from the feeders, I wonder who is watching who.  They remain wary of me, fluttering away quickly if I approach with lens in hand.  They fear capture, even within a camera.  They have a life to be lived without my witness or participation.  So much happens that I never see or know about.

I understand:  I fear being captured too.

Even if only for a moment as an image preserved forever, I know it doesn’t represent all I am, all I’ve done, all I feel, all my moments put together.  The birds are, and I am, so much more than one moment.

Only God sees us fully in every moment, witness to our freedom and captivity,  our loneliness and grief, our joy and tears, knowing our best and our worst.
And because He knows us so well, in Him we must trust.
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photo by Tomomi Gibson

We Haste Away So Soon

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Fair Daffodils, we weep to see
You haste away so soon;
As yet the early-rising sun
Has not attain’d his noon.
Stay, stay,
Until the hasting day
Has run
But to the even-song;
And, having pray’d together, we
Will go with you along.
 
We have short time to stay, as you,
We have as short a spring;
As quick a growth to meet decay,
As you, or anything.
We die
As your hours do, and dry
Away,
Like to the summer’s rain;
Or as the pearls of morning’s dew,
Ne’er to be found again.
~Robert Herrick “To Daffodils”
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So short a spring:
today some parts of this land are in the throes of winter with blizzards, ice storms and snow drifts keeping them home-bound on the Sabbath.  There is little hope for the brave bulbs that tried to surface from the ground over the last several weeks.
Here in the northwest, we are springing late as well, with chill winds and unending rain. The daffodils have melted on the stem unable to sustain the battering while hordes of slugs luxuriate with unending voracious appetites for their petals.
We ourselves aren’t much different than these tender blooms – though we hope not to be chewed to death, we are, after all,  here today, gone tomorrow.  When bud bursts to blossom, we flame hearty with such exuberant joy, then wither until we are no more.
We are, for our brief days, a reflection of the Sun itself, just as we should be.
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Breathing In and Out

What is there beyond knowing that keeps
calling to me?  I can’t
 
turn in any direction
but it’s there.  I don’t mean
 
the leaves’ grip and shine or even the thrush’s
silk song, but the far-off
 
fires, for example,
of the stars, heaven’s slowly turning
 
theater of light, or the wind
playful with its breath;
 
or time that’s always rushing forward,
or standing still
 
in the same — what shall I say —
moment.
What I know
I could put into a pack
 
as if it were bread and cheese, and carry it
on one shoulder,
 
important and honorable, but so small!
While everything else continues, unexplained
 
and unexplainable.
 
….mostly I just stand in the dark field,
in the middle of the world, breathing in and out…
~Mary Oliver from “What is there beyond knowing”
I’m reminded daily about how little I know and understand.  I work with people who are suffering, whose symptoms may fit prescribed diagnostic criteria but yet defy explanation or reason.  They care about what relief I might offer rather than a label that names the illness.
Like so much in medicine, what I witness daily is unexplained and unexplainable.  What I do know I carry with me, small and honorable and shareable.   I offer it up to each patient, one after another:  here is what I think might help.  here is your next step to take.  here is the hope that goes with taking each breath, the next and the next.
Even when standing in the dark, as we all do at times in our life, we just keep breathing.  In and out.  In and out.  We are filled even when empty.

Divine Discontent and Longing

 

 

 

…the Mole felt a great Awe fall upon him, an awe that turned his muscles to water, bowed his head, and rooted his feet to the ground. It was no panic terror–indeed he felt wonderfully at peace and happy–but it was an awe that smote and held him and, without seeing, he knew it could only mean that some august Presence was very, very near.  All this he saw, for one moment breathless and intense, vivid on the morning sky; and still, as he looked, he lived; and still, as he lived, he wondered. 

…Spring was moving in the air above and in the earth below and around him, penetrating even his dark and lowly little house with its spirit of divine discontent and longing…
~Kenneth Grahame, The Wind in the Willows

 

 

 

 

It is as true for me as it is for Mole in Grahame’s wonderful story:  I must stray from my comfortable little home to look and wonder at the world around and above me.  Spring drives me forth with awe and longing and discontent more than any season: the light is so different and compelling, the clouds dramatic and ever-changing, the greens never more vivid, the smell of the air perfumed and enticing.

What seems so plain, so ordinary at other times of year, becomes magical and beautiful in the spring;

…maybe, just maybe, so do I.

 

 

 

To Turn Suffering Into Beauty

 

 

(Poetry) matters because it’s beautiful. It matters because it tells the truth, the human truth about the complexity of life. . .
It tells the entire truth about what it is to be alive, about the way of the world, about life and death.
Art embodies that complexity and makes it more understandable, less frightening, less bewildering.
It matters because it is consolation in times of trouble.
Even when a poem addresses a painful subject, it still manages to be consoling, somehow, if it’s a good poem.
Poetry has an unearthly ability to turn suffering into beauty.

Be a good steward of your gifts.
Protect your time.
Feed your inner life.
Avoid too much noise.
Read good books,
have good sentences in your ears.
Be by yourself as often as you can.
Walk.
Take the phone off the hook.
Work regular hours.

~Jane Kenyon from A Hundred White Daffodils

 

 

There’s nothing “regular” about the hours I work and I’m my own worst enemy when it comes to obsessive commitment of my time.  My phone is attached to me day and night for good reason.  I don’t read enough, don’t particularly enjoy being alone, don’t spend enough time walking nowhere in particular and am immersed full time in the noise of life.

Yet I recognize beauty when I hear it, see it and read it.  Sometimes I actually write it.

In the meantime,  I cleave to good sentences in my heart and the cadence of good phrases in my ears.  It’s what a good steward and harvester of words must do.

 

 

It Sings in Me

 

 

 

The roofs are shining from the rain,
The sparrows twitter as they fly,
And with a windy April grace
The little clouds go by.

Yet the back yards are bare and brown
With only one unchanging tree–
I could not be so sure of Spring
Save that it sings in me.
–  Sara Teasdale, “April”

 

 

 

 

 

 

 

Frogs plutter and squdge-and frogs beat the air with a recurring thin steel sliver of melody.
Crows go in fives and tens; they march their black feathers past a blue pool; they celebrate an old festival.
A spider is trying his webs, a pink bug sits on my hand washing his forelegs.
I might ask: Who are these people? 
~Carl Sandburg from “Just Before April Came”

 

 

 

And so spring asks:

Who are these people?

Here we are, closing in on mid-April and it has been a week of heavily drifting snowstorms in the Great Lakes and northeast, tornado weather in the south, and blustering wind and rain in the northwest.  I am not so sure of Spring nor is anyone else.

Yet it sings in me.  Yes it sings.

The calendar does not lie, nor does my nose.  The pollen counts are rising despite the rains and as I step outside in early dawn, I can catch the slightest fragrance of just-opening cherry and apple blossoms in the orchard.  Within a week there will be sweet perfume in the air everywhere and the fruit trees become clothed in white puffy clouds of blossom before bursting full into green.

In defiance of the calendar, our oak trees cling stubbornly to their brown bedraggled fall leaves as if ashamed to ever appear naked, even for a week.  In May they will go straight from brown to green without a moment of bare knobby branches.

Even so, it sings in me.  Yes it sings.

A morning bird symphony tunes up ever earlier including the “scree” and chatter from bald eagles high up in the fir trees surrounding our house.  Nesting has begun despite the wet and cold and wind because their nest is the secure home that calls them back, again and again, year after year.

Like them, it sings in me.  Yes it sings.

I rise opening like a bud, I dress my nakedness to cover up my knobbiness, I wander about outside exulting in the free concert, I manage to do chores despite the distractions — this routine of mine which is so unchanging through the calendar days becomes glorious gift and privilege.

Hopefulness sings in me in Spring.  Yes it sings.