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!)

 

Visitors to the Farm

 

 

 

Fingers of twilight shadow
begin to reach over the hill
crawling down through the field
up unto the bank of blackberries
covering fences along the alder grove.

The horses chew their last
leaves of clover before
coming to the barn for night, eyelids heavy,
relaxed and full, drowsy with spring evening
peace at hand and hoof.

A sudden change in the air forces
their heads up and ears forward;
they form a line, staring at the hilltop
above them, riveted to the spot, alert
to an coming intruder, unfamiliar and foreign.

The roar is intermittent, like a warm wind
rattling a barn roof, but inconstant;
then peaking over the crest of the hill
a rounded top of technicolor glory:
The hot air balloon rises.

The horses silenced, baffled, fascinated;
no alpine instinct prepares their response
to this wizard’s act from Oz in their own backyard.
The basket riders wave and laugh at the equine audience below
in formation with golden noses in the air and white manes blowing in the breeze.

The balloon summits the hill, dipping low, almost touchable
before moving back up to race the sunset,
and search out other pastures, other valleys and hills.
The horses released from the spell
leap in response, snowy tails high, noses flared-

To race up the hill to catch impending darkness,
night mares cavort, float suspended
until their air is let out, gently, in softening snorts,
to settle down in a shavings bed in the barn
where night, blissful, becomes ordinary again.

 

 

 

 

 

 

 

 

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

 

 

 

 

A Blanket of Peace and Forgetting

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Well I know now the feel of dirt under the nails,
I know now the rhythm of furrowed ground under foot,
I have learned the sounds to listen for in the dusk,
the dawning and the noon.

I have held cornfields in the palm of my hand,
I have let the swaying wheat and rye run through my fingers,
I have learned when to be glad for sunlight and for sudden
thaw and for rain.

I know now what weariness is when the mind stops
and night is a dark blanket of peace and forgetting
and the morning breaks to the same ritual and the same
demands and the silence.
~Jane Clement from No One Can Stem the Tide

 

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I did not sleep last night — my mind would not stop, my blankets twisted in turmoil, my muscles too tight.  The worries of the day needed serious wrestling in the dark rather than settling forgotten under my pillow.

Yet morning dawns anew and I’m comforted by the rhythm of hours starting fresh.

Today I’ll get my hands dirty digging a hole deep enough to hold the worries, and tomorrow forget where exactly I buried them.

 

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Another Day’s Chalking

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“Life is grace. Sleep is forgiveness. The night absolves. Darkness wipes the slate clean, not spotless to be sure, but clean enough for another day’s chalking.”
~Frederich Buechner

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And tomorrow
move forward
to leave a mark on a new day
after night’s erasing rest.

No matter what took place the day before,
no matter the misgivings,
no matter what should have been left unsaid,
no matter how hard the heart,
there is another day to make it right.

Forgiveness finds a foothold in the dark,
when eyelids close,
thoughts quietly open,
voices hush in prayers
of praise, petition and gratitude.

And so now
sleep on it
knowing his grace
abounds in blameless dreams.

Morning will come
awash in new light,
another chance
freely given.

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A Time to Sleep

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Season of ripening fruit and seeds, depart;
There is no harvest ripening in the heart.

Bring the frost that strikes the dahlias down
In one cruel night. The blackened buds, the brown
And wilted heads, the crippled stems, we crave –
All beauty withered, crumbling to the grave.
Wind, strip off the leaves, and harden, ground,
Till in your frozen crust no break is found.

Then only, when man’s inner world is one
With barren earth and branches bared to bone,
Then only can the heart begin to know
The seeds of hope asleep beneath the snow;
Then only can the chastened spirit tap
The hidden faith still pulsing in the sap.
~Anne Morrow Lindbergh

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Our farm has been changing dramatically over the past several weeks, each day moving a little closer to the reality of winter around the corner. Most of the fruit which is not residing in our freezer has fallen from the trees, and the walnut husks are hanging lonesome and bulbous as a windstorm pulled many leaves to the ground creating a multi-colored carpet everywhere I walk.
Readying for winter’s sleep is quite a glamorous affair for some trees on our farm–they are clothed in rich crimson and gold like the most alluring and ostentatious negligee. However the majority of tree leaves turn drab yellow or brown, as if donning a practical flannel nightgown or an oversized t-shirt without any pretense of grandeur. Even our Haflinger horses laze about, comfortable in their soft winter woolie coats and feathered slippers, happy with their gift of hay. I’m understand their contentment as I prefer fluffy flannel myself.This has not been a leisurely autumn for me, instead full of turbulence and fretfulness, too much work to do in too few hours,  rushing full force toward the hoped-for calm and quiet of winter. Like so many others, I’m ill at ease with this transition, as unready as a small child who resists the approach of bedtime, even when exhausted to the point of meltdown. It takes someone to quietly sit down with me to read a good bedtime story and to sing a soft hymn of lullaby. I keep leaping up, eyes propped open, pushing on, aware there are still too many “miles to go before I sleep”.

The time to sleep will come, sooner than I think. Just as a storm brings the leaves to the ground, so shall I be laid to rest, to be restored when the time is right.

Maybe I should think about wearing that bright red nightie.
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