This Doctor is Open For Business

yinandyang

 

pinksunset52019

 

Astonishing material and revelation appear in our lives all the time.
Let it be.
Unto us, so much is given.
We just have to be open for business.

~Anne Lamott from Help Thanks Wow: Three Essential Prayers

 

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ticklethemoon

 

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I have the privilege to work in a profession where astonishment and revelation awaits me behind each exam room door.

In a typical clinic day, I open that door up to thirty plus times, close it behind me and settle in for the ten or fifteen minutes I’m allocated per patient.  I need to peel through the layers of each person quickly to find the core of truth about who they are and why they’ve come to clinic that day.

Sometimes what I’m looking for is right on the surface: in their tears, in their pain, in their fears.  Most of the time, it is buried deep, often beneath a scar I must search to find. I need to wade through the rashes and sore throats and coughs and headaches and discouragement to find it.

Once in awhile, I actually do something tangible to help right then and there — sew up a cut, lance a boil, splint a fracture, restore hearing by removing a plug of wax from an ear canal.

Often I find myself giving permission to a patient to be sick — to take time to renew, rest and trust their bodies to know what is best for a time.

Sometimes, I am the coach pushing them to stop living sick — to stop hiding from life’s challenges, to stretch even when it hurts, to get out of bed even when not rested, to quit giving in to symptoms that are to be overcome rather than become overwhelming.

Always I’m looking for an opening to say something a patient might think about after they leave my clinic — how they can make different choices, how they can be bolder and braver in their self care, how they can intervene within their own finite timeline to prevent illness, how every day is just one thread in the larger tapestry of their lifespan.

Each morning I rise early to get work done at home before I actually arrive at my desk at work, trying to avoid feeling unprepared and inadequate to the volume of tasks heaped upon each day.   I know I will be stretched beyond my capacity, challenged by the unfamiliar, the unexpected and will be stressed by obstacles thrown in my way.  I know I will be held responsible for things I have little to do with, simply because I’m the one who often acts as decision-maker.

It is always tempting to go back to bed and hide.

Instead of hiding,  I go to work as the exam room doors need to be opened and the layers peeled away.  I understand the worry, the fear and the pain because I have lived it too.   I know the limitations of a body that wants to consume more than it needs, to sleep rather than go for a walk, to sit rather than stand.

Even now in my seventh decade of life,  I am continually learning how to let it be, even if it is scary.  It is a gift perhaps I can share.

No matter what waits behind the exam room door,  it will be astonishing to me.

I’m grateful to be open for business.  The Doctor is In.

 

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To Thank the Light

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Now a red, sleepy sun above the rim 
Of twilight stares along the quiet weald, 
And the kind, simple country shines revealed 
In solitudes of peace, no longer dim.
The old horse lifts his face and thanks the light, 
Then stretches down his head to crop the green. 
All things that he has loved are in his sight; 
The places where his happiness has been 
Are in his eyes, his heart, and they are good.
~Siegfried Sassoon from “Break of Day”

 

 

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I am growing older along with my horses. I think of them out to pasture throughout my workday as I continue to climb in the harness to pull the load as fast and hard as I can muster, returning home in the evening sore and weary.

I think of them with the morning sun on their withers, the green blades under their feet, as they search for the sweetest tender patch to munch.

They remind me to bring the calm of the pasture inside to balance the noise and bustle and troubles found in the clinic.  There still is peace and light to be found; I have only to look for it.

 

“To practice medicine with good spirit does not mean to be in a place where there is no noise, trouble or hard work. It means to bring your calm and loving heart right into the midst of it.” from www.theheartofmedicine.org

 

 

 

wallysunset

 

sunsettony2

 

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A Calling Out

geese113162

geesev6

A psalm of geese
labours overland

cajoling each other
near half…

The din grew immense.
No need to look up.

All you had to do
was sit in the sound

and put it down
as best you could…

It’s not a lonesome sound
but a panic,

a calling out to the others
to see if they’re there;
~Dermot Healy from A Fool’s Errand

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geese113165

We are here to witness the creation and abet it. We are here to notice each thing so each thing gets noticed. Together we notice not only each mountain shadow and each stone on the beach but, especially, we notice the beautiful faces and complex natures of each other. We are here to bring to consciousness the beauty and power that are around us and to praise the people who are here with us. We witness our generation and our times. We watch the weather. Otherwise, creation would be playing to an empty house.
~Annie Dillard from The Meaning of Life
edited by David Friend

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By the time Saturday rolls around, I am overwhelmed by the amount of “noticing” I needed to do in the course of my work that week.  Each patient, and there are so many,  deserves my full attention for the few minutes we are together.  I start my clinical evaluation the minute I walk in the exam room and begin taking in all the complex verbal and non-verbal clues sometimes offered by another human being.

How are they calling out to me?

What someone tells me about what they are feeling may not always match what I notice:  the trembling hands, the pale skin color, the deep sigh, the scars of self injury.  I am their audience and a witness to their struggle; even more, I must understand it in order to best assist them.  My brain must rise to the occasion of taking in another person, offering them the gift of being noticed and being there for them, just them.

This work I do is distinctly a form of praise: the patient is the universe for a few moments and I’m grateful to be watching and listening. When my patient calls out to me, may they never feel they are playing to an empty house.

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geese11516

Enter a Closing Door

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Enter autumn as you would
a closing door.  Quickly,
cautiously.  Look for something inside
that promises color, but be wary
of its cast–a desolate reflection,
an indelible tint.
~Pamela Steed Hill from “September Pitch”

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webs3

The door of summer has closed quickly behind me;
I am back to long days and interrupted evenings,
of worried voices and midnight calls with over-the-phone sobs,
of emergency room referrals and work-them-in schedules.

I want to tell them it’ll be okay, hug away their anguish
despite the encroaching lengthened nights;
that winter coming does not mean
the end of all.
It takes a background of darkness
for the light to shine brightest
Shadows are borne from illumination~
It will be okay, even now, even so.

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The Fierce Humility of Rain

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Praise to the Maker of the torrent
and the hurricane,
praise for the fierce humility of rain:

whose motion will not end, neither come to rest
nor ascend again until, like grace,
it finds the lowest empty place.
~Matthew Baker “Rainfall”

rainyiris2

rainypeony

See, banks and brakes
Now, leavèd how thick! lacèd they are again
With fretty chervil, look, and fresh wind shakes
Them; birds build — but not I build; no, but strain,
Time’s eunuch, and not breed one work that wakes.

Mine, O thou Lord of life, send my roots rain
~Gerard Manley Hopkins from “Thou art indeed just, Lord”

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rainyiris3

As I look out through a tear-streaked window at the beginning of this lightening day,
I fear inadequacy to the task before me:
Parched and struggling patients line my schedule.
Anxious and weary and barren too young,
seeking something, anything
to ease their distress in a hostile world,
preferably an easy pill to swallow.
Nothing that hurts going down.

While others thrive around them,
they wilt and wither,
wishing to cease breathing.

Lord of Life, equip me to find the words to say that might help.
May it be about more than genetics, neurotransmitters and physiology.

In this dry season for young lives,
send your penetrating rain
to fill with grace
the emptiest space.
Reach down and shake their roots
fiercely
and slake their thirst.

storm518163

haflingerrainbow

The Doctor is In

waterfall 3

waterfall2

Astonishing material and revelation appear in our lives all the time.
Let it be.
Unto us, so much is given.
We just have to be open for business.

~Anne Lamott from Help Thanks Wow: Three Essential Prayers

__________________________________

I have the privilege to work in a profession where astonishment and revelation awaits me behind each exam room door.

In a typical clinic day, I open that door up to thirty plus times, close it behind me and settle in for the ten or fifteen minutes I’m allocated per patient.  I need to peel through the layers of each person quickly to find the core of truth about who they are and why they’ve come to me.

Sometimes what I’m looking for is right on the surface: in their tears, in their pain, in their fears.  Most of the time, it is buried deep and I need to wade through the rashes and sore throats and coughs and headaches and discouragement to find it.

Once in awhile, I actually do something tangible to help right then and there — sew up a cut, lance a boil, splint a fracture, restore hearing by removing a plug of wax from an ear canal.

Often I find myself giving permission to a patient to be sick — to take time to renew, rest and trust their bodies to know what is best for a time.

Sometimes, I am the coach pushing them to stop living sick — to stop hiding from life’s challenges, to stretch even when it hurts, to get out of bed even when not rested, to quit giving in to symptoms that can be overcome rather than be overwhelming.

Always I’m looking for an opening to say something a patient might think about after they leave my clinic — how they can make better choices, how they can be bolder and braver in their self care, how they can intervene in their own lives to prevent illness, how every day is just one thread in the larger tapestry of their lifespan.

Each morning I rise early to get work done at home before I actually arrive at my desk at work, trying to avoid feeling unprepared and inadequate to the volume of tasks heaped upon each day.   I know I will be stretched beyond my capacity, challenged by the unfamiliar, the unexpected and will be stressed by obstacles thrown in my way.  I know I will be held responsible for things I have little to do with, simply because I’m the one “in charge” as the decision-maker.

It is always tempting to go back to bed and hide.

Instead of hiding,  I go to work as the exam room doors need to be opened and the layers peeled away.  I understand the worry, the fear and the pain because I have lived it too.  Even now in my seventh decade of life,  I am learning how to let it be, even if it is scary.  It is a gift perhaps I can share.

No matter what waits behind the exam room door,  it will be astonishing to me.

I’m grateful to be open for business.  The Doctor is In.

 

waterfall

Known Before We Know

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hivecells

octleaves2

Before Jeremiah knew God, God knew Jeremiah:
“Before I shaped you in the womb, I knew all about you.”
This turns everything we ever thought about God around.
We think that God is an object about which we have questions.
We are curious about God.
We make inquiries about God.
We read books about God.
We get into late-night bull sessions about God.
We drop into church from time to time to see what is going on with God.
We indulge in an occasional sunset or symphony
to cultivate a feeling of reverence about God.

But that is not the reality of our lives with God.
Long before we ever got around to asking questions about God,
God had been questioning us.
Long before we got interested in the subject of God,
God subjected us to the most intensive and searching knowledge.
Before it ever crossed our minds that God might be important,
God singled us out as important.
Before we were formed in the womb,
God knew us.
We are known before we know.

This realization has a practical result:
no longer do we run here and there,
panicked and anxious,
searching for the answers to life.
Our lives are not puzzles to be figured out.
Rather, we come to God,
who knows us and reveals to us the truth of our lives.
The fundamental mistake
is to begin with ourselves
and not God.
God is the center from which all life develops.

~Eugene Peterson from Run With the Horses

My clinic days are full of people panicked and anxious,
too unsure to know themselves,
too unsure to know those around them,
too unsure of knowing which road to choose,
too unsure of whether to take a next breath.

I want to say:
this isn’t about you.
This isn’t about what you know
and what you don’t know or
whether you are sure of where you are headed
or hopelessly lost.
This is about being known
far before you came to be.

This is all you have to know:
You are known.
And the road to choose
is the one that leads
straight to Him who knows you
and the next breath you take
has come straight from Him.

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