Saturday, December 15, 2012

Newtown, Connecticut: The Streets of Heaven

The Columbine High School Memorial, located in...

"The streets of heaven are too crowded with angels tonight..." ~ President Josiah Bartlet, The West Wing

Following a tragedy such as took place yesterday in Newtown, Connecticut, one often hears the statement, "Let's not politicize this." But failing to recognize its political implications is as irresponsible as attempting to use them for political gain. Remaining silent on the pretense of respect, renders the needless, senseless deaths of children meaningless. Can there be anything worse?

In the latter days of the war in Iraq, when it had become clear there were no weapons of mass destruction, when the Bush administration determined a "war of liberation" would play better in the media, families of soldiers killed in action relied on those three words to assuage a loss no parent should ever have to face. The alternative was a sacrifice without meaning, and that was unthinkable.

We flirt with meaninglessness, however, when a murderer rips our loved ones from us and from the public stage we hear, "I hope no one uses this as an excuse to talk about gun control." What we've witnessed in Connecticut is neither an excuse, nor is it evidence we need an armed electorate to take the place of those we've empowered to protect us against violence and mayhem. What is is, is evidence of our national refusal to listen to the voices of victims at Columbine High School and a theater in Aurora, Colorado.

If we could tune down the noise of our own convictions, we'd hear a voice shouting from the periphery of those convictions, "For the love of God, please, don't let this happen again." But we do. The gun lobby argues, "guns don't kill people, people kill people," and there's an element of truth in that. I've never seen an M-16 walking down the street, creating havoc. Not without a person at the butt end, pulling the trigger. Then again, what if they couldn't get hold of a semi-automatic weapon with a 30 round magazine in the first place? Would that really impinge on anyone's Second Amendment rights?

We treat gun ownership like pornography. We put up with Hustler because we want to be free to purchase a copy of The New Yorker or Road and Track at the grocery. We also regulate Hustler to keep it from falling into the hands of children. We presume the right to own an assault weapon secures our right to own the 12 gauge we take bird hunting in the fall. Maybe it does, but that doesn't mean anyone who wants one should have one. Mutual responsibility in a free society requires us, at key times, to limit the exercise of our freedoms for the sake of the common good. 

We regulate pornography better than we regulate guns. If we're going to honor the memory of those who've died tragically, we've got to change and we've got to start now.

(The West Wing citation from 20 Hours in America, (2002); GNU free documentation image of the Columbine High School Memorial via Wikipedia)
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Thursday, November 22, 2012

Can You Cuss a Little?

English: New Year's Day postcard. Reads: "...

I must have been around seven, seven or eight, though it could have been nine -- certainly no later -- when I met my paternal grandfather the first time. If he held me as a baby and surely he must have, I'd be hard-pressed to dig the memory out of my distal recesses. The other first time, however, is as vivid as this morning's frost on the grass. 

He lived in Oklahoma, my parents and I in Colorado, and he'd come for a short visit. More like a stopover than a "visit," he was gone the next morning. I sat in a brown or green -- I never knew which -- overstuffed relic from the 1940s with short, fat wooden feet and a flowery pattern that rose off the fabric like continents on a globe. It was big enough to curl up in while he talked with my parents about people and places they knew and I did not. After a while, he turned to me and suddenly young blabbermouth Beggar was at a loss for words. Particularly, the ones he wanted to hear.

"Have you learned how to cuss yet?" 

For the record, I wasn't really at a loss for words -- by then I'd acquired a vocabulary of two bad and two really bad words and combinations thereof, thanks to my father's verbal creativity. I just wasn't supposed to say them. Ever. And now, here's my father's father, asking me to do what would ordinarily result in my catching the word that began with an "h" and ended with me wishing I'd said "heck," instead. I looked from my mother to my father, hoping for permission. They may as well have been playing poker for all the help I got from their expressions. Hell -- I mean, heck -- of a time to enforce the rules.

"Come on, Beg, you must know one or two. Let me hear you cuss," he said with a truly conspiratorial glint and grin. Let's play a good one on your folks, I read. Talk about caught between "the devil" and the deep blue sea. I wanted to, oh, how I wanted to, the blood rising to my neck and then flowing like a flood over my face. 

The clock was ticking, he was waiting, they're silent, and all I can think is, "Damn it, Grandad, you know I'll get in trouble if I do!" If there was ever a time I needed a Get Out of Jail Free card. 

"Well, I can see you'd rather not go against your folks and that's good. We can save the cuss words for later," he said, winking, after my shirt had nearly soaked through with nervous sweat. 

I felt relieved, but also felt I'd let him down. I wanted to do both, be good (and incidentally, avoid a lickin') and be grown up at the same time. It's funny how these things go. Eventually, you do find out how to be both at once and true to yourself in the bargain. Back then, all I knew was, that's the night I began to love my grandfather. 

I sure hope he knows.  

(English: New Year's Day postcard. Reads: "A New Year's Resolution / Jan. 1st / To Gossip, Slang and Cuss words / I'll bid a last "Adieu" / And place a bridle on my tongue / And thoughtless actions, too!" Photo credit: Wikipedia)
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Wednesday, November 21, 2012

The Sighing Thing

"Oh, God!" he sighed, heavily. So heavily I thought he and the ancient, paint-stained,  ladder back chair he was sitting in were going to sink through the scraped and scratched wooden plank floor to the soil beneath. I waited for the thunk! -- it never came. His eyes were closed, but he wasn't sleeping. Nor was he being profane.  

"It's all right, Beggar, he's just praying," my grandmother said, overhearing him. I wondered if she knew how many times I'd heard him before. So many I'd lost count.

I looked at her and smothered a smile. Did she really believe that or was she trying to preserve my youthful innocence, the very thing my grandfather -- her husband -- had done his best to turn into good judgment, something he considered eminently more practical.  

He did the "sighing thing," as I came to think of it, mostly while sitting in the shade near our bunkhouse door. It wasn't really a bunkhouse, but we called it that, just the same. It was a detached single car garage that had never housed a car, at least in my memory. My father converted it into a saddle shop at one point and I've written about cutting firewood for his stove. Summers, it was the bunkhouse where my grandfather stayed. Those months, I've realized since, were a journey in character development.

"If you absolutely have to point a gun at someone to protect yourself or your family," he said once, "it's too late for threats. Indecision at a time like that can be deadly." He spoke from experience. Another summer night, years before, he stared down a neighbor who had the nasty habit of occasionally firing his gun in the general direction of my grandfather. "The man's crazy," he said, refusing to get dragged into something he knew he'd have to finish, "and besides, he can't shoot worth a damn." Only this particular evening, it was different. The man had shot at my father who was about my age and I was thirteen. 

Why not call the police or sheriff, I imagine you're thinking. That would have been the thing to do, if they'd had a phone. Forty miles into barely civilized northwestern Colorado, the ranch was a two or three hour drive by Model A Ford from the nearest town. There were no phones, nor were there corner stores or gas stations. I'm not even sure there was electricity. It wasn't that you took the law into your own hands, there just wasn't anyone else who could take it into theirs.   

So, father and son rode out to address the situation. Watching the scene unfold, my father was fearful, certain he was going to witness my grandfather meet out justice just as his father had fifty years earlier. In my imagination, reliving those long seconds, I see my grandfather with a look in his eye that left no doubt, as his hand strayed to the pistol at his side, that he fully intended to use it. The neighbor must have seen that look, too, because he backed down and that was the end of it.

Grandchildren are a second chance for parents to get it right. Those summers, I was my grandfather's trusty teen sidekick, Cowboy Toby to his Roy Rogers (photo). I listened, learned, and hopefully digested far more than I actually remember. I've never forgotten the "sighing thing," though, nor the day I finally asked him what it meant.

I'd really been hoping he'd tell me himself when he was good and ready. That's how things usually went between us, though I never knew from day to day where his mind would lead. But it was nearing the end of summer and he'd said nothing, so I screwed up the courage one day and asked what was he thinking about when he sighed so deeply. He was surprised I'd noticed. How could I not? 

"You live as long as I have, Beggar, you're going to make a few mistakes. Don't be afraid, everybody makes a few and so will you. Some, maybe most, don't matter, least not as much as we give them credit for. People who know you, forgive like you forgive them. Some mistakes do matter -- maybe more than they should, but that doesn't change the fact. Problem is, you either don't realize it or you're too stubborn to admit it, until it's too late. I think about those."

"So you don't make the same ones again, right?" 

"No, because I made them the first time." 

I was too young to understand regret. Sorry, wish I hadn't said or done this or that, oh yes -- plenty. Regret was something else, something -- I don't know -- bigger, something I hadn't lived long enough to become acquainted with. Something that only comes about with experience, with trying to do what you think is right even though you don't and can't know everything but you have to try anyway because it's all you can do and it's really all anyone can do. Don't worry, we all make mistakes, so will you. It's okay. My grandfather said so.

Happy Thanksgiving.

(Creative Commons image by vintagecobweb,com via Flickr)
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Saturday, October 13, 2012

Advising Mitt

I sort of feel sorry for Mitt Romney. He did what most of us have done, or I have anyway, and wished almost immediately we hadn't. Opened our mouths and watched as the unspeakable came out seemingly of its own accord. Maybe we were angry or afraid or eager to be viewed as acceptable and be embraced by others. At the time, it might have seemed innocent enough -- we thought we were in a protected environment -- and of course, we weren't, as demonstrated by the fallout we're unable to duck no matter how deep we dive into the shelter. Now, we're left, picking up the scattered remnants of our self-esteem, detritus from stepping on one of our own land mines.

Have you ever noticed how easily, on such occasions, a person  says, "But that wasn't me"? Well, if it wasn't, then who was it? It sure looked like me, it sounded like me, people say it was me. I haven't been cloned lately, so far as I know. It sure wasn't Robin Williams doing his best Beggar imitation. I "inhaled" in high school but my sensibilities have long since moved in other directions. I can't blame alcohol -- with my limited tolerance, slurred words are far more likely than misspoken ones. True, at least this way I'll never have to explain how "what made Milwaukee famous, made a loser out of me." (Thanks, Jerry Lee Lewis -- wish I'd written that line.)

So, basically, it was me, or you, or in this case, Mitt. Now, in retrospect, I'm sure he wishes he'd never said anything about the 47%, but it was caught on tape and splattered onto the news, so there's no denying it. The problem is, he's attempting to do what anyone would under similar circumstances, i.e. try to dissociate himself from the image he just created. That's normal -- we don't want people to think of us in terms of what we say or do when we wish we'd said or done something else -- and would if, please God, just this once, is it okay if we turn back the clock?

On the other hand, I sometimes wonder if a better strategy might be to simply own up and admit the truth. Instead of trying to convince us that he really is empathetic, state for the record, "Yes, I'm an elitist. I have a strong preference for associating with wealth, I don't relate well to the working class, I disapprove of welfare and those who depend on it, I'm opposed to government restrictions on business and given the opportunity, I'll lower taxes on people like me and if you want to see my tax returns, watch how fast hell freezes over."

You don't think that's going to get him elected. Well, you're probably right, I suppose it is asking a bit much. But trying to pretend he's someone he's not is even worse. The unconscious has a nasty way of making itself known and frequently does when least expected or welcomed. We all have an inner trickster who absolutely delights in making us appear foolish and the harder we try to keep her/him locked in the closet, the more determined s/he becomes to make us regret it. So, Mitt, if you still aspire to the presidency and you don't mind my unsolicited advice, admit you need to change. Trust me, it won't hurt. Okay, it will, but only your pride and most of us can use a little bit of that now and then.  

(Creative commons image, "Trickster Tales Sketch" by Amanda Schutz via Flickr)

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Sunday, September 23, 2012

Trickle-Down Economics

It used to be referred to as the horse and sparrow theory, i.e. if a horse was given enough oats, sooner or later some "ended up" in fields or along the road where sparrows could feed on them -- doesn't that sound lovely. But that's basically what trickle-down economics comes down to. Provide the wealthy with enough tax breaks or economic benefits and eventually the effect will trickle down to those on the lower rungs of the social ladder. As one who's worked his entire life for a living, as did my father (we were both business owners, by the way), you'll have to pardon me if I find that offensive.

For one thing, it's just too much like saying, if I devote myself to the care and feeding of a narcissistic parent, some day I'll be glad I did. Oh, please. For another, it's insulting to presume a "trickle" is all those who compose the majority of the American populace are deserving of. Who's making the rules here, anyway? Who decided a person born into a blue-collar family was less worthy of a seat at the socio-economic table than someone else born to wealth or privilege? It's not a good idea to forget history, you know.    

It was Paris, the summer of 1789, probably a warm and humid one like we had in Maine this year, when the so-called "benevolent aristocracy" came face to face with destiny.  Taxes were inequitable; merchants, tradesmen, and the poor bore the burden while the wealthy lived a life of the rich and famous. The court of Louis XVI had virtually spent the country into bankruptcy and reform was slow in coming. Food was scare and a revolution had taken place in America. The time was ripe for storming the Bastille.

Now, trust me, I'm not sounding the trumpet for revolution and I'm definitely not a member of the Tea Party. Nor, by the way, am I saying there's something wrong with having money. However, I do think it's time to take a look at the underpinnings of trickle-down aka supply-side economics, especially since one of the major presidential candidates seems to think it's the solution to what ails this country. As I see it, trickle-down economics is an outgrowth of an outmoded and substantially mistaken belief that wealth is a sign of moral, intellectual, and cultural superiority. Put another way, personal worth is what distinguishes saints from sinners. Not only is that theologically bogus, it's factually baseless. Crimes are committed by both rich and poor; Louis XVI lost his head making that clear. 

Of all the things we need in this country and God knows, we need a lot, a repeat performance of trickle-down economics isn't one of them. I don't know if anyone's noticed lately, but there are a great many of us out there who are first-generation college, graduate school, and medical school graduates. Like our parents, we've clawed our way through public education and worked like demons to establish ourselves as persons of social, if not yet economic, value. Not because we think that makes us "better" than anyone else or because we think it qualifies us to stand in judgement of those who've made different choices. We've done so because we believe our efforts create opportunities we and our children might not have had otherwise. Opportunities to be of service, opportunities to improve the lives of those around us, opportunities to establish justice and build a world where no one goes hungry or lives in fear of annihilation. It's not wealth that makes us do this, it's our humanity, and thank God for it.      

 (Creative Commons image by David Shankbone via Wikipedia)
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Sunday, August 19, 2012

His Failing Heart

English: Heart diagram with labels in English....

JVD is an anachronym for jugular venous distention, a phenomenon I observed Friday for the very first time outside a classroom. It's one sign of a failing heart, a heart that has virtually worn itself out pumping against the unrelenting resistance of untreated high blood pressure. Besides the accumulation of fluid in the lungs -- pulmonary edema -- which leads to shortness of breath, with heart failure the jugular vein becomes distended and you can literally see the pulse throbbing away, driving the rhythm of circulation like a drummer's foot on the bass pedal. Boom, boom, boom.

For clarity's sake, we aren't talking oxygenated blood here, the bright purplish juice of life that shoots out the left ventricle into the aorta. Nor is JVD the same thing as an aortic aneurysm. You've heard of those, I'm sure. An expansion of the artery in all directions forming a cul-de-sac typically (though not exclusively) in the gut with two openings, an entrance and an exit, instead of just one. As long as it stays intact, blood can make its way from the heart to the toes and back again. If it begins to leak or worse, if it blows, you get a STAT ticket to the surgical suite.  

The blood carried by the jugular vein is deoxygenated -- it's already given up its cargo of oxygen molecules in the name of everything that constitutes daily life. On its way to the lungs for more, however, it runs into a problem. Heart failure starts out with an overworked left ventricle but as it progresses, the right ventricle slowly turns into an anatomic approximation of a child's balloon that has been inflated a few times too many. Having lost much of its elasticity, the right ventricle can't pump as well and back pressure builds in the veins above it; naturally, they distend with the volume of blood waiting in the queue.

I'd read about JVD, but reading is one thing, seeing it up close, is another. I watched my resident turn our patient's neck to the left in order to tighten the skin on the right, then watched wide-eyed as his neck bulged outward every half-second. I'd been talking with him for fifteen minutes -- how could I have missed seeing it before? As must have been the case with my entering classmates when they were in my shoes, my mind raced through a litany of possible explanations, while I waited for the end of the day when we'd finally have a free moment to recap. I was glad my first best guess was the correct one.

Yesterday, going over material for board exams, I thought about my patient's physiology, why he was short of breath, why he gained excess weight in water only to lose it when he took his diuretic medication, why just sitting there talking with me was an effort. He was a good teacher who taught his lessons well. But I also thought about him, his experience, what it meant for him to retain his driver's license, why he was so determined to hold tight to his independence and live like there was no tomorrow. Why he continued to have heart. Despite his failing heart.

(GNU Free Documentation Image via Wikipedia)

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Tuesday, June 26, 2012

Repeating History

description: Ricky Nelson plays a concert in L...

Those who cannot remember the past are condemned to repeat it. ~ George Santayana

I don't know that remembering has much to do with it. Human nature being what it is, we seem bent on some things whether they've worked at all, worked only a little, or ended up in disaster. Knowing they've been tried before doesn't appear to prevent their being tried again with similar results. Mr. Hughes hid in Dylan's shoes and wearin' his disguise, as the late Rick Nelson put it.

I'm thinking about Germany in the early 20th century, in case you're wondering. High unemployment (30% in 1932), deficit spending, economic depression overlaid with inflation from the printing of large amounts of paper money, unable to meet foreign debt payments, national pride in the gutter. Whenever I watch something about the rise of Adolf Hitler, as did yesterday afternoon, I can't help thinking about the social conditions that made him possible. 

And then I start thinking about Santayana's quote.

I know, I know, Germany didn't have 1776 and the aftermath of two hundred years of democracy. Then again, she didn't have slavery and the subjugation of the western frontier. Let's play fair. I'm not one of those writers who makes a living telling you what's wrong with America, but neither do I want to ignore the obvious for the sake of good feelings. When something stinks, there's usually a reason.

What Hitler accomplished was masterful -- demonic, but masterful. Instead of taking reality on its own terms and leading Germany to do likewise, he fled into a delusional fantasy and created a massive marketing machine to sell it like Volkswagens. There are at least two ways to offer hope to those in need of it. One entails accepting responsibility for yourself, your successes and flat out, falling down failures, and by so doing, show others how to survive doing the same. Another is to imagine there's nothing wrong with you or wouldn't be if it wasn't for someone else. Say it often enough, sooner or later people will start believing. Say it long enough, maybe you'll win, and then you get to rewrite history so no one remembers the way it really was.

For instance, an editorial in an upcoming Southern Baptist theological journal, in complete ignorance of the wider social issues involved, described the fundamentalist takeover -- some have suggested "highjacking" is more apt -- of the Southern Baptist Convention a few years ago in terms of a restoration of biblical Christianity. The subsequent split with social-theological moderates, the virtual purging of non-strictly-doctrinaire seminary faculty, and the smear campaign against those who stood up to be counted, were conveniently overlooked. When the ends are used to justify the means, whether we're talking about theology, the search for weapons of mass destruction, or the virtues and vices of universal health care, a lot of things get overlooked.

Trouble is, this is precisely how we end up repeating history. And isn't that a hell of a thing.

(Creative Commons image of singer Rick Nelson via Wikipedia)
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Monday, May 21, 2012

Graduation: Catching Up at Last

If the road to hell is lined with good intentions, I was well on my way yesterday, having fully intended to write and yet finding my brain utterly exhausted from the events of Saturday. To say graduation was memorable is so far from the truth as to almost be a lie: it was more like a dream and I was living it. Truthfully, though, Sunday morning I was almost certain it had been precisely that. It wasn't until I took the dogs out for their walk and looked in the car for my sunglasses, that I noticed the box my robes had come in. "Well, guys," I said, "I guess I wasn't dreaming, after all."

It sure felt like it and I'm sure it stems from the fact that I've never had any absolute assurance I'd make it this far. Not that I was a doubter, like Hero Boy in The Polar Express, who wanted proof of the existence of Santa Claus before committing himself to believing. I knew in my "heart of hearts," as my mother used to say, the obstacles and difficulties I'd encountered along the way would only make graduation sweeter. But still in all, our demons have a tendency to haunt us in the darkness of night, especially before exams, whispering wickedly, You're a fraud -- you're in over your head -- if you were meant to do this, it would be easier. 

Martin Luther, the 15th century church reformer, said the Devil was exquisitely sensitive to humor and the trick to banishing him lay in laughing in his face. I've wondered if that's a skill we must learn to employ and if so, medical school has given me a lot of practice.I was definitely laughing Saturday, along with my classmates, when my best friend placed my doctoral hood round my neck backwards. It wasn't intentional; he'd been handed it backwards and the rest will go down in Hooding Ceremony history. But what better way to thumb my nose at all those demons?

All the same, there is a tender, albeit bitter sweetness to graduation, that comes from having to hold off being called "doctor" a bit longer. I've gone through the exercises and taken my Osteopathic Medical Oath, but with rotations yet to complete, I won't hold my degree in hand until later this year. Like a teenager who is neither child nor adult, I'm in a liminal space. I'm no longer entirely a student, but then again, I'm not entirely a doctor. Thankfully, however, I'm closer to one than the other and the confidence I've gained from standing shoulder to shoulder with my graduating classmates, pledging my life, loyalty, and sacred honor to the practice of medicine and the care of patients, will see me through.  

To my beloved entering classmates, nearly all of whom preceded my graduation in 2010, I can truly say, look behind you, the footsteps you've been hearing are mine. I'm catching up at last.        

(Photo of the author and graduating classmate and friend Dr. Joseph Scott, copyright 2012, all rights reserved) 

Saturday, May 19, 2012

Off to Graduation!

Since I can scarcely remember when, Brahms Academic Festival Overture has been synonymous for me with the fulfillment of dreams. I first encountered it as the sound track for the film People Will Talk, the movie that got me thinking of becoming a doctor when I must have been about nine or ten. I'm listening to it now, the version by Maron Allsop and the London Symphony -- my favorite -- because today is graduation day. 

I'm not done yet -- I still have boards to take, rotations to complete, but by the grace of my university I'm walking across the stage at 3.00 pm EDT to receive my doctoral hood and a few moments later, will raise my right hand and speak the words of the Osteopathic Oath, choking back tears, and joining friends from my incoming class at long last. 

Actually, I've got to leave in about 30 minutes, so forgive me for making this brief -- more to come tomorrow. In the meantime, please also forgive my absence these past months while preparing for boards. I've wanted to write but whenever I've begun, my conscience has spoken up, telling me to get back to studying or else. Thanks to all who've come by in the meantime, I appreciate it so very, very much.  Now, off to graduation!

Saturday, March 3, 2012

The Liebster Blog Award

Applications for medical school and residency usually contain a space where applicants may list the awards they've received for academic or professional achievement and it's usually at this point my hard-earned self-esteem takes a nose dive. Apart from a couple of work-related "pats on the back" and Scouting's Order of the Arrow, I don't have a lot to report. I'm just guessing, but it's doubtful committees are interested in my horse and I having taken third place in Western and English Equitation at Denver's National Western Stock Show when I was 13.

One never knows, perhaps I ought to list some of those accomplishments for good measure. But, in general, I'm assuming they'd prefer to know whether I managed a summa cum or summa cum laude or was recognized for an outstanding something or other. The truth is, I must have been out, literally standing in a field when they were handed over, because I ain't got any of 'em.

I'm not complaining, though, because the sparsity of awards has made me appreciate those I've been given all that much more -- rather like the one appended below. I'm deeply grateful to everyone who's visited this website over the past three years, validating my desire to write and have what I've written, be read. That in itself really is recognition enough; when someone decides it deserves an award, I'm blown away -- so much so that it takes me a week to get up the nerve to make it public. Pride goeth before a fall, says the writer of Proverbs, and the last thing I want to do is fall flat on my face, tooting my own horn. That said, I'd like to express my sincere thanks to rosewiththorns, author of but I'm beautiful, for her kindness in nominating my blog for The Liebster Award.

I'd also like to thank my mother, my father, my make-up artist, my fellow actors, my dogs and cat, and last, but not least, the Academy of Motion Pictures...oops, sorry, wrong speech. Seriously, please visit rose's blog as well as the others I've listed below as worthy of receiving a Liebster Award. And, as always, thanks for reading.

Trust Me, I'm a...Resident, written by one of my classmates who is currently a resident in Family Medicine in Pennsylvania.

Surviving Medical School and Motherhood, by another of my classmates, sharing her experiences juggling children and husband with one hand and medical school with the other.

Cafe of the Cosmic Dance, by Paul Sunstone. Although Liebster Awards typically go to blogs with less than 20 followers, I'd like to pass on the link anyway in the hope you'll find his writing as enjoyable as I do.

Garnet's Virtual Salon, by a pharmacist and fellow Mainer who lives in the mountains near the Maine-New Hampshire border and drives a Camaro -- wow.

The Student Epicure, written by a Massachusetts med student who has a way with food that I hope translates into medical magic once she's graduated and joined the work force of resident physicians.

The Liebster Blog Award

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Saturday, February 18, 2012

A Proliferation of Porcupines

English: Photograph of two North American porc...Image via Wikipedia
I had just gotten out of the car, backpack and arms loaded down with books and miscellaneous school-related items, when I saw a shadow scoot across the ground in front of me. It was after dark, but the street light was bright enough for me to discern a basketball-size shadow with a little nubbin sticking out of one end and four legs. Then I noticed there were more of these NBA wannabees, maybe a dozen, multiplying so quickly, I couldn't keep up with their numbers. Suddenly, there were what I took for babies, hundreds of them, swarming around my feet like flocks of birds gathering to migrate south for the winter. Next, hundreds of infants swarmed behind the babies, and like Mary's lamb, everywhere I stepped, they were all sure to go.

Porcupines. Big ones, little ones, littler ones still, following me like geese in the film, Fly Away Home (1996). Sounds cute, you say? Well, I suppose it was, but cuteness wasn't going to solve the problem of getting into the house without a proliferation of porcupines clinging to my heels. Fortunately for me, dawn's early light intervened at that moment, accompanied by a full bladder and empty stomach. I didn't tell you? Shame on me. Yes, this was a dream from night before last in the wee, wee (no pun intended) hours of the morning.

Why was I dreaming about porcupines? I'm glad you asked. It all started with Freddy, a sweet little porcupine who lives under my barn, snitches apples from the tree next to the house, and has been growing increasingly comfortable having dogs and a person around. I won't use the word "tame" because he's still a wild animal, though one who's obviously nonplussed whenever the dogs and I go outside while he's gnawing away at lunch in the front yard. I speak to him, naturally, and he seems to respond to "Freddy" by looking my way.

Porcupines are supposed to be nocturnal, but this fellow's more of a day person who likes the warmth of the sun on his back. There have even been a few occasions I've discovered him lying in the flower bed, snuggled up against the house, right below my study window. The first time this happened, he had me worried because he hadn't moved in several hours and I thought, Oh, no, he's been sick, I didn't know, and now he's gone to the Happy Munching Ground in the sky. I got down on one knee, maybe an arm's length away, and gently called his name. He woke up, looked at me sleepily, and of course, said nothing, as is his way.

Now, why my dream has porcupines in such numbers is probably due to there having been another one in the yard lately, a big one, easily twice Freddy's size. He or perhaps, she -- I'm not getting close enough to find out -- lives in the forest behind the house and when the dogs and I go out at night with a flashlight, s/he looks at me as if to say, Do you mind, I'm eating here?! and ambles off into the bushes. I'm guessing Freddy's mentioned something about the quality of the menu and as with any good restaurant, the word gets around. Either that, or he's left his scent on the grass like a sign reading, Porcupines Welcome Here. The point is, now there are two -- well, actually, three. Last evening we had a new customer who took off before I had a chance to ask how they liked the service.

Jung or Dr. Freud would likely say my dream was a portrayal of how my unconscious views the coming months of board preparation, graduation, fourth year rotations, residency interviews, and the Match. I'm not going to argue; they know dreams better than me. But that doesn't change the fact, I'm honestly a bit worried. The last thing I want is to become so popular my best customer (Freddy) takes his patronage elsewhere simply because he doesn't like having to wait for a table. Porcupines are particular about these things, you know.

(GNU Free Documentation image via Wikipedia)

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Tuesday, February 7, 2012

OB/GYN: A Dream of Women

As of last Friday, my obstetrics and gynecology rotation has come to an end, and as you've probably noticed, I've been uncharacteristically reticent to talk about it. Don't worry, nothing bad happened. As a matter of fact, in retrospect, this has been one of my favorite rotations. Scrubbing in on surgical procedures several times a week was an absolute kick and being able to act as first assist because I'd just completed surgery was like the icing on German Chocolate Cake. And, naturally, there were the babies. One, a few weeks premature, had the most beautiful, delicate, perfectly formed little fingers. Another fell asleep in the crook of my arm with her lips sealed against my left shirt pocket. No, darlin', I'm not mommy, but thanks anyway.

The truth is, I really had a wonderful six weeks and when it came time to leave, I felt almost as wistful as on the last day of my psychiatry rotation and that is saying something. What was holding me back from writing, though, took a few days to reveal itself, and unexpectedly, it did so in a dream.
I was a student on the obstetrics unit in an unnamed hospital one evening, sitting on a counter ledge in the nursing station, watching a group of women. A few feet away on my left was a new mother breastfeeding her infant. Directly across from her, on my right, seated on a soft, pillowed couch, were five other women -- nurses -- mostly in their 40s and 50s. They were smiling and singing or chanting, I can't recall which, and clapping their hands in unison, swaying from side to side. I couldn't hear the words clearly, but they were obviously enjoying themselves immensely.

Everything was so totally natural no one, not even the woman breastfeeding, seemed even remotely self-conscious or uncomfortable because a man was present. I got up from my seat and approached one of the older women whom I knew well, just as the group stopped singing and began laughing, with the intent of whispering to her, "This is the first time I've seen breastfeeding have cheerleaders," because that's how it appeared. In the dream, of course, I thought this terribly funny and was sure she'd think it uproarious. It's easy to be Robin Williams in Dreamland.

What strikes me about the scene were the colors. Everything, including my clothes and those worn by the women, was done in shades of white. Not paper white, but more like the pastels used to depict heaven on film, with boundaries fading at the extremes and an absence of sharp lines. It reminded me of heaven as Maxfield Parrish might have painted it, ethereal yet earthly, mythic yet real.

It seemed to me, I was seeing womanhood in a way few have the opportunity. The women themselves knew this to be true and graciously permitted me a glimpse of the way they are privately, when they're amongst themselves. As a man, I wasn't exactly an outsider, but neither was I an initiate. I don't know what I was, a guest, perhaps? All I know with any certainty is, I was witnessing a young woman in the company of older women, all of whom having done as was she, feeding their children from their own breasts, and the feeling I had was of joy and serenity.

Rotations are about a lot of things, I suppose, learning and practicing new skills, adding to a growing body of knowledge, feeling more confident in oneself, but this one was far more. Frankly, I'm still having trouble putting it into words. I'll figure it out eventually; right now, I'm still in awe.

(Creative Commons image "White" by LaWendula via Flickr)
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Thursday, February 2, 2012

Letting the Chips Fall

A pile of gambling chips.
I was getting some work done on my car and enjoying a visit with the mechanic when it happened, but I'll get to that in a minute. I like talking to mechanics and it's unusual for them to allow customers in the auto bays -- liability, you know. But this fellow's doubled as his waiting room, which, by the way, says a lot about the size of his operation. Anyway, since one of the two chairs was occupied by a morbidly obese collection of tools, greasy parts, and half-empty cans of WD-40, I sat down in the other.

I'd actually brought a book along to keep myself from distracting him with questions, but he wanted to talk and so talk we did, mostly about this and that. In which of the neighboring towns did I live, had I been there long enough to know his sister, when is the next snow coming. The kinds of things that make up life outside medical school and are common to small-town Maine. Probably small-town anywhere, for that matter.

Then he asked what I did for a living. If not the first question men ask one another, this is certainly the second or third. Men talk about work, what we do, how long we've done it, have we done it all our lives and where. It's how we size each other up, determine if we're responsible, reliable, if we can be taken seriously. I thought he handled my answer, that I was a medical student, rather well. It only took him about ten seconds to recover from the initial shock -- he did, however, turn around sharply and look at me like I'd just offered him a thousand dollars for a job he'd bill at ten -- before composing himself to ask what I'd done before. A guy my age must have done one or two somethings, maybe a few more, before sticking his neck out.

"I was a psychotherapist," I said in the most benign tone I could conjure. He picked up the theme like it was a favorite wrench he kept near at hand and related tales of family members who'd engaged the county mental health service, saying how he'd love to "get outta this garage" and do something with his life, while there was still time. Before standing on an uninsulated concrete floor in the dead of winter crippled him like it did his father. He reminded me of the bartender in Billy Joel's Piano Man.

He walked away from the window he was repairing in my passenger side door, shattered late one night by small-time crooks too stupid to realize a 2001 Honda was too old to have a navigation system they could pry free and fence for drug money. If they'd taken time to look in the window before throwing a brick through it, they'd have known. He stepped through the maze of tires and boxes, found a radio sitting on an oil drum, and switched from classic to alternative rock to country, listened a moment or two, and returned to my window. Watching him, I ducked my head and smiled; it was the same thing I would have done.

"Have you always been a therapist?"

Here it comes, I thought. No, I said, I'd also been a minister since about 19 aught 3, or so it seemed on weekends when I came home from rotations, dog tired, with two days to catch up on a week's sleep deprivation. Trying to salvage the situation, I added, but medicine had always been simmering on the back burner and just before my dad died, I finally gave myself permission to move it to the front. Too late, his demeanor had shifted as subtly as the tectonic plates and as noticeably as the Richter Scale identifying a tremor. Some things never change.

Up til then, we'd been two relatively ordinary guys talking about life and limb; a stranger would have sworn we'd known each other for years rather than 30 minutes. All that vanished so quickly it felt like it had never been there in the first place. I was a minister now and he was on his best behavior.

I didn't say it then, but I really haven't spent my adulthood with my head buried in the sand, fearful seeing the world as it was would sully my spiritual sensibilities. If I ever had them, and I feel sure I must have, they've been knocked down, brick and stone, by my own fallibility. A religion that's only good for Sunday morning rarely has much value the rest of the week. Some clerics like the interpersonal distance a collar or title provides; I like risking honesty. I like people who are sufficiently real to swear and not give a damn whether I notice.

In any case, I wasn't eager to put on my minister's hat quite yet and my friend couldn't see me wearing anything else. It's going to take some time. I'll go back to get my snow treads installed, and we'll talk again. Maybe eventually we can find a middle ground, one where he's him, I'm me, and we let the chips fall where they may.

(Creative Commons Sharealike image via Wikipedia)

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