The Alleviation of Dawn

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For what human ill does not dawn seem to be an alleviation?
~Thornton Wilder

 

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Early fall mornings often begin obscured – the low fog clings to the moist ground,  creating a muted reality of muffled sound and distorted distance.

My head feels just like this when I first wake.  I struggle to shake loose of cloudiness and clear my vision so I can take on the day.

Clarity doesn’t come from within.

The dawn burns off the fog, renders and refines landscape colors, separates light from shadow.  I too must become part of the solution instead of clouded with precipitate.

 

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So Absolutely Clear

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Don’t surrender your loneliness
So quickly.
Let it cut more deep.

Let it ferment and season you
As few human
Or even divine ingredients can.

Something missing in my heart tonight
Has made my eyes so soft,
My voice
So tender,

My need of God
Absolutely
Clear.
~Hafez, 14th century Persian poet

 

foggyfield
photo by Nate Gibson

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When my heart clenches with sadness,
when my thinking is muddled with stress and doubting,
when I can’t focus on what is right before me because tears cloud my vision,
I remember one thing remains absolutely clear in the mist and midst of the fog:

I have need for God and I too am softened in my neediness.

 

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photo by Nate Gibson

 

 

 

 

 

 

God Leaps Out

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… And now in vast, cold, empty space, alone.
Yet hidden deep within the grown-up heart,
A longing for the first world, the ancient one …
Then, from His place of ambush, God leapt out.
~ Rainer Maria Rilke

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That’s the mystery of us.
But then there’s the mystery of God,
lying in ambush,
watching, waiting,
waiting for the fulfillment of time,
the nexus of his grace and our vulnerability.
Maybe today.
~Kathleen Mulhern “Hangs My Helpless Soul on Thee”

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Sometimes, during a long night of fitful sleep,
when nothing makes sense and worry takes over,
I ponder the mystery of how our brains were made to wonder at all.

I long for a simpler time,
for clarity of purpose,
for laughter through tears,
for gratitude even in hard times.

Yet as I toss and turn,
I know my God lies in wait for me,
as He watches for the moment
when being ambushed is exactly what I need.

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A Terrible Clarity

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Romantic love is blind to everything
except what is lovable and lovely,

but Christ’s love sees us
with terrible clarity and sees us whole.

Christ’s love so wishes our joy
that it is ruthless against everything in us
that diminishes our joy.

The worst sentence Love can pass
is that we behold the suffering
which Love has endured for our sake,

and that is also our acquittal.
The justice and mercy of the judge
are ultimately one.

~Frederick Buechner

 

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photo by Jim Randall from burmachronicles.com

 

As we prepare for the season of Lent to begin this week:

We see with terrible clarity
the Love we are shown,
the Love given freely to the undeserving,
the Love paying our ransom in full,
the Love enduring all for us~

this Judge convicts,
metes out justice upon His own head,
serves the whole sentence Himself,
thus sets us free
to see and share
the Love we are shown.

 

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Prepare for Joy: A Terrible Clarity

10974197_10152586644562046_2617999342651512955_o
photo by Jim Randall burmachronicle.com

 

Romantic love is blind to everything
except what is lovable and lovely,

but Christ’s love sees us
with terrible clarity and sees us whole.

Christ’s love so wishes our joy
that it is ruthless against everything in us
that diminishes our joy.

The worst sentence Love can pass
is that we behold the suffering
which Love has endured for our sake,

and that is also our acquittal.
The justice and mercy of the judge
are ultimately one.

~Frederick Buechner

 

To see with terrible clarity
the Love we are shown,
the Love given freely to the undeserving,
the Love paying our ransom in full,
the Love enduring all for us~

this Judge convicts,
metes out justice upon His own head,
serves the whole sentence Himself,
sets us free
to see and share
the Love we are shown.

sunrisepond22115

Absolutely Clear

 

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Don’t surrender your loneliness
So quickly.
Let it cut more deep.

Let it ferment and season you
As few human
Or even divine ingredients can.

Something missing in my heart tonight
Has made my eyes so soft,
My voice
So tender,

My need of God
Absolutely
Clear.
~Hafez, Persian poet

When my heart clenches with sadness, when my thinking is muddled with stress and doubting, when I can’t focus on what is right before me because tears cloud my vision, I remember one thing remains clear in the mist and midst of the fog.

I have need for God and I am softened in my neediness.

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Obscurity in Medicine

photo by Josh Scholten

Be obscure clearly.
~E. B. White

As a family doctor, I work at clarifying obscurity about the human condition daily, dependent on my patients to communicate the information I need to make a sound diagnosis and treatment recommendation.  To begin with, there is much that is still unknown and difficult to understand about psychology, physiology and anatomy.  Then throw in a disease process or two or three to complicate what appears to be “normal”, and further consider the side effects and complications of various treatments — even evidence-based decision making isn’t equipped to reflect perfectly the best and only solution to a problem.  Sometimes the solution is very muddy, not at all pristine and clear.
Let’s face the lack of facts.  A physician’s clinical work is obscure even on the best of days when everything goes well.  We hope our patients can communicate their concerns as clearly as possible, reflecting accurately what is happening with their health.  In a typical clinic day we see things we’ve never seen before, must expect the unexpected, learn things we never thought we’d need to know, attempt to make the better choice between competing treatment alternatives, unlearn things we thought were gospel truth but have just been disproved by the latest double blind controlled study which may later be reversed by a newer study.   Our footing is quicksand much of the time even though our patients trust we are giving them rock-solid advice based on a foundation of truth learned over years of education and training.   Add in medical decision-making that is driven by cultural, political or financial outcomes rather than what works best for the individual, and our clinical clarity becomes even further obscured.

Over thirty years of doctoring in the midst of the mystery of medicine — learning, unlearning, listening, discerning, explaining, guessing, hoping,  along with a little silent praying — has taught me the humility that any good clinician must have when making decisions with and about patients.  What works well for one patient may not be at all appropriate for another despite what the evidence says or what an insurance company or the government is willing to pay for.  Each person we work with deserves the clarity of a fresh look and perspective, to be “known” and understood for their unique circumstances rather than treated by cook-book algorithm.  The complex reality of health care reform may dictate something quite different.

The future of medicine is dependent on finding clarifying solutions to help unmuddy the health care decisions our patients face. We have entered a time of information technology that is unparalleled in bringing improved communication between clinicians and patients because of more easily shared electronic records.  The pitfall of not knowing what work up was previously done will be a thing of the past.  The risk and cost of redundant procedures can be avoided.  The patient shares responsibility for maintenance of their medical records and assists the diagnostic process by providing online symptom and outcomes documentation.   The benefit of this shared record is not that all the muddiness in medicine is eliminated, but that an enhanced transparent partnership between clinician and patient develops,  reflecting a relationship able to transcend the unknowns.

So we can be obscure clearly.   Lives depend on it.