Foggy and Fine Days Within Me

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And so you have a life that you are living only now,
now and now and now,
gone before you can speak of it,
and you must be thankful for living day by day,
moment by moment …
a life in the breath and pulse and living light of the present…

~Wendell Berry from Hannah Coulter

 

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~Lustravit lampade terras~
(He has illumined the world with a lamp)
The weather and my mood have little connection.
I have my foggy and my fine days within me;
my prosperity or misfortune has little to do with the matter.
– Blaise Pascal from “Miscellaneous Writings”

 

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photo by Nate Gibson

 

Is my gloom, after all,
Shade of His hand,
outstretched caressingly?

~Francis Thompson from “The Hound of Heaven”

 

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My days are filled with anxious and sad patients, one after another after another.  They sit at the edge of their seat, struggling to hold back the flood from brimming eyes, fingers gripping the arms of the chair.   Each moment, each breath, each heart beat overwhelmed by questions:  will there be another breath?  must there be another breath?   Must life go on like this in fear of what the next moment will bring?

The only thing more frightening than the unknown is the knowledge that the next moment will be just like the last or perhaps worse.  There is no recognition of a moment just passed that can never be retrieved and relived.   There is only fear of the next and the next so that the now and now and now is lost forever.

Worry and sorrow and angst are contagious as the flu.
I mask up and wash my hands of it throughout the day.
I wish we could be vaccinated to protect us all from these unnamed fears.

I want to say to them and myself:
Stop this moment in time. Stop and stop and stop.
Stop expecting someone or some thing must fix this feeling.
Stop wanting to be numb to all discomfort.
Stop resenting the gift of each breath.
Just stop.
Instead, simply be.

I want to say:
this moment, foggy or fine, is yours alone,
this moment of weeping and sharing
and breath and pulse and light.
Shout for joy in it.
Celebrate it.
Be thankful for tears that can flow over grateful lips
and stop holding them back.

Stop me before I write,
out of my own anxiety,
yet another prescription
you don’t really need.

Just be–
and be blessed–
in the now and now and now.

 

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A Deep Fear of Emptiness

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Wheels of baled hay bask in October sun:
Gold circles strewn across the sloping field,
They seem arranged as if each one
Has found its place; together they appeal
To some glimpsed order in my mind
Preceding my chance pausing here —
A randomness that also seems designed.
Gold circles strewn across the sloping field
Evoke a silence deep as my deep fear
Of emptiness; I feel the scene requires
A listener who can respond with words, yet who
Prolongs the silence that I still desire,
Relieved as clacking crows come flashing through,
Whose blackness shows chance radiance of fire.
Yet stillness in the field remains for everyone:
Wheels of baled hay bask in October sun.
~Robert Pack “Baled Hay” from Rounding it Out: A Cycle of Sonnetelles (1999).

 

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Each day I am called to see and listen,
to open fully to all that is around me.
From the simple stillness of the fields
surrounding our farm,
to the weeping of those who sit with me
day after day
in their deep fear of emptiness,
their struggle with whether to try to live
or give up and die.

Their deep fear of emptiness renders me silent;
I struggle to respond with words
that might offer up a healing balm
assuring them even in the darkest time
hope lies waiting, wrapped and baled,
radiant as fire,
ready to spill out fragrant,
to bear us silently to a new morning,
to a stillness borne of grace.

 

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Just Sad

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We didn’t say fireflies
but lightning bugs.
We didn’t say carousel
but merry-go-round.
Not seesaw,
teeter-totter
not lollipop,
sucker.
We didn’t say pasta, but
spaghetti, macaroni, noodles:
the three kinds.
We didn’t get angry:
we got mad.
And we never felt depressed
dismayed, disappointed
disheartened, discouraged
disillusioned or anything,
even unhappy:
just sad.
~Sally Fisher “Where I Come From”  from Good Question.

 

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I felt sadness in that moment because, having been raised in a certain culture, I learned long ago that “sadness” is something that may occur when certain bodily feelings coincide with terrible loss. Using bits and pieces of past experience, such as my knowledge of shootings and my previous sadness about them, my brain rapidly predicted what my body should do to cope with such tragedy. Its predictions caused my thumping heart, my flushed face, and the knots in my stomach. They directed me to cry, an action that would calm my nervous system. And they made the resulting sensations meaningful as an instance of sadness. In this manner, my brain constructed my experience of emotion.

…if you could distinguish finer meanings within “Awesome” (happy, content, thrilled, relaxed, joyful, hopeful, inspired, prideful, adoring, grateful, blissful.. .), and fifty shades of “Crappy” (angry, aggravated, alarmed, spiteful, grumpy, remorseful, gloomy, mortified, uneasy, dread-ridden, resentful, afraid, envious, woeful, melancholy.. .), your brain would have many more options for predicting, categorizing, and perceiving emotion, providing you with the tools for more flexible and functional responses.
~Lisa Feldman Barrett from How Emotions Are Made: The Secret Life of the Brain

 

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Emotions are fleeting. But they are unavoidable and they are the most human of all things. They are not universals; they are arbitrary. But if we feel them deeply and we share them with others, nothing in this life is more real.
~Eric Barker on his blog Barking Up the Wrong Tree

 

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If there is anything I’ve come to understand over the decades I’ve been a physician, it is that human beings have emotions that make them uncomfortable and that makes them more difficult to share with others.  Sometimes those feelings become so locked up that they leak out of our cells as physical symptoms: headaches, muscle tightness, stomach upset, hypertension.  Other times they are so overwhelming we can no longer function in a day to day way – labeled as rage, panic, mood disorder, depression, self-destructive, suicidal.

Somehow we’ve lost the ability to be just sad.  Just sad.  Sad happens and it happens to us all, some longer than others, some worse than others, some deeper than others.  What makes sad more real and more manageable is if we can say it out loud — whatever ‘sad’ means to us on a given day and to describe the feeling in detail can categorize and manage it — and explain it to others who can listen and help.

Strong emotions don’t always need a “fix”, particularly chemical,  but that is why I’m usually consulted.  Alcohol, marijuana and other drugs tend to be the temporary self-medicated anesthesia that people seek to stop feeling anything at all but it only rages stronger later.

Sometimes an overwhelming feeling just needs an outlet so it no longer is locked up, unspoken and silent, threatening to leak out in ways that tear us up and pull us apart.

Just tell me where you come from, who you are and who you are becoming and then, only then, we might be able to understand why you feel what you do today.  Then, armed with that understanding and how you might respond in a different way,  tomorrow may well feel a bit better.

 

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Missing the Knock on the Door

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When a great moment knocks on the door of your life,
it is often no louder than the beating of your heart,
and it is very easy to miss it.
~Boris Pasternak

 

 

 

Years ago, a young woman I’d been treating for depression for several weeks in my clinic called unexpectedly on a 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 after a very stressful work week and even more stressful year. I was discouraged about many aspects of the clinic work load and the after-hours responsibilities only seemed to get heavier.  I was frustrated at how ineffectively I was communicating to administrative supervisors about the need for change.  I was ready to quit and walk away.

Instead I decided to call my patient to find out how she was doing.  She didn’t answer her phone. I mulled over my options, looked up her apartment address and drove the few blocks to get there. As I approached her door, I could hear someone moving around in her apartment, but she ignored my knocks and my voice and when I tried the door, it was locked.

So I stayed 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 unlocked 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.

Miraculously the mental health unit at the local hospital had an open bed. I told my patient that we could save time and hassle by heading over there together 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 visited the hospital the next day 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 knock on her door when she was at her lowest point,  and she struggled to answer, as consumed as she was in her own painfully beating heart.

She was astounded and grateful and frankly, by deciding to do what I knew was necessary and right even though it disregarded every workplace policy, so was I.

Four years later, a small card arrived in my clinic mailbox on another 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 the knock on the door was to get my attention, to focus the beating of my heart on what was most important – not the stresses of my work place — and 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 when all she could hear was the beating of her own painful heart. I had 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. When I needed it the most, she made a difference for me that has kept me on the job all these years later.

She knocked, oh so gently, on my door and I opened it, amazed that someone cared, and found me awash in my own tears.

 

 

A Salt Water Cure

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…when he looked at the ocean,
he caught a glimpse of the One he was praying to.

Maybe what made him weep was
how vast and overwhelming it was

and yet at the same time as near
as the breath of it in his nostrils,
as salty as his own tears.

~Frederick Buechner writing about Paul Tillich in Beyond Words

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The cure for anything is salt water–sweat, tears or the sea.
~Isak Dinesen

 

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photo by Nate Gibson

 

I grew up an easy crier.  Actually growing up hasn’t cured it, nor has middle age.  I’m still an easy crier – a hard thing to admit especially when my tears flow at an inopportune time in a public place.

It might have had something to do with being a middle child, bombarded from both directions by siblings who recognized how little aggravation it took to make me cry, or it may have been my hypersensitive feelings about …. everything.  I felt really alone in my tearful travails until my formidable grandmother, another easy weepy, explained that my strong/tall/tough/nothing-rocks-him former WWII Marine father had been a very weepy little boy.  She despaired that he would ever get past being awash in tears at every turn.  His alcoholic father tormented him about it, wondering if he would ever learn to “man up.”

So this is a congenital condition and that’s my excuse.

A few years ago I read a fascinating article about how different kinds of tears (tears of joy, tears of pain, tears of grief, tears of frustration, tears of irritated eyes, tears of onion cutting) all look different and remarkably apt, when dried and pictured under the microscope.  This is more than mere salt water leaking from our eyes — this is our heart and soul and hormonal barometer streaming down our faces – a visible litmus test of our deepest feelings.

I witness many tears every day in my office, and not tears of joy.  These are tears borne of pain and loss and rejection and failure, of hopelessness and helplessness, loneliness and anguish.  Often my patients will describe having a “break down” by which they mean uncontrollable crying.  It is one of the first-mentioned symptoms they want relief from.

Tears do come less frequently as depression lifts and anxiety lessens but I let my patients know (and remind myself) that tears are a transparent palette for painting the desires and concerns of our heart.  Dry up the tears and one dries up emotions that express who we are and who we strive to be.

When I’m able, I celebrate the salt water squeezing from my eyes, knowing it means I’m so fully human that I leak my humanity everywhere I go.  Even God wept while dwelling among us on earth, and what’s good enough for Him is certainly good enough for me.

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Fully Sufficient

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There are a thousand thousand reasons to live this life, every one of them sufficient.
Marilynne Robinson in Gilead

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There are a thousand thousand people on any given day who cannot think of one sufficient reason to live this life.
There are a few thousand who will decide this is their last day.
There are a few who say goodbye.

It is enough for me to find just one reason to live today.
It is enough for me to help someone else find just one reason today.
One is enough.
Fully sufficient.

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Ephemeral and Sacred

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Beauty, to the Japanese of old, held together the ephemeral with the sacred. Cherry blossoms are most beautiful as they fall, and that experience of appreciation lead the Japanese to consider their mortality. Hakanai bi (ephemeral beauty) denotes sadness, and yet in the awareness of the pathos of life, the Japanese found profound beauty.

For the Japanese, the sense of beauty is deeply tragic, tied to the inevitability of death.

Jesus’ tears were also ephemeral and beautiful. His tears remain with us as an enduring reminder of the Savior who weeps. Rather than to despair, though, Jesus’ tears lead the way to the greatest hope of the resurrection. Rather than suicide, Jesus’ tears lead to abundant life.
~Makoto Fujimura

 

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Everyone feels grief
when cherry blossoms scatter.
Might they then be tears –
those drops of moisture falling
in the gentle rains of spring?
~Otomo no Juronushi (late 9th century)

 

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Thoughts still linger –
but will those who have parted
return once again?

Evening is deep in the hills
where cherry blossoms fall.
~Shinkei (1406-1475)

 

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Again today I will see patients in my clinic who are struggling with depression, who are contemplating whether living another day is worth the pain and effort.  Most describe their feelings completely dry-eyed, unwilling to let their emotions flow from inside and flood their outsides.  Others sit soaking in tears of hopelessness and despair.

Their weeping moves and reassures me — it is a raw and authentic spilling over when the internal dam is breaking.  It is so human, yet we know tears contain the divine.

When I read that Jesus weeps as He witnesses the tears of grief of His dear friends, I am comforted.  He understands and feels what we feel, His tears just as plentiful and salty, His overwhelming feelings of love brimming so full they must be let go and cannot be held back.

Jesus who wept with us became a promise of ultimate joy.

There is beauty in this, His rain of tears, the spilling of the divine onto our mortal soil.

 

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A fallen blossom
Returning to the bough, I thought –
But no, a butterfly.
~Arakida Moritake (1473-1549)

 

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fallen sakura petals in Tokyo (photo by Nate Gibson)