Atticus

Mon, 03 Aug 2009 02:05:58 GMT

i have moved to: www.atticus-part2.blogspot.com

Mon, 03 Aug 2009 01:52:48 GMT

I have moved on to a different site: www.atticus-part2.blogspot.com

Wed, 08 Apr 2009 02:47:51 GMT

crossing the line

Last night I presented a talk about the body affecting the mind and vice-versa to about 40 residence hall students on our college campus. I mostly talked about sleep and exercise and how they affect our brain power, describing some of the work of Dr. John Medina, a developmental molecular biologist from the University of Washington School of Medicine, who wrote Brain Rules. And I threw in a couple of off- beat studies from Malcolm Gladwell’s book, Blink. All this with an occasional toss of a beach ball out into the audience because Dr. Medina says any audience will stop listening after 10 minutes. The bouncing ball worked, I think. There was intense listening, especially when I affirmed their stressful college days. Mentioned the word journey more than once, rather spontaneously, it seemed fitting since so many of us, no matter how old we are, seem to be struggling with direction.

Then, the director of our counseling and advisement center led an activity called Crossing the Line. A line of tape was put across the room and we all stood on one side while she read statements. If they applied to us, we stepped across the line and stood facing the other side, then stepped back across afterwards. The statements got more intense as she read. First, it was about glasses and where you lived and what languages you spoke. Then, did we have friends who were gay, are we comfortable with our own sexual orientation, are we spiritual, are we accepted by others in the residence hall, have we ever been sexually abused, do we feel lonely and isolated, have we ever thought about suicide. This was an incredibly moving experience watching as the masses walked across the line, perhaps claiming for the first time who they are or what they feel. Some would hesitate a little, then go across when others crossed. We talked a bit afterwards and there were some tears, mostly relief at not feeling so alone.

We know that the clinic and the counseling center will be busier than usual over the next few weeks as the semester comes to a close. If you know someone in college you might like to know that the rates of depression went up 58% from 2000-2005, and when college kids across the US were asked if they ever got so depressed they couldn’t function, 31% said yes. (ACHA survey, Fall 2008) This is a tough time, not as fun as the images that come to our heads thinking about freedom and beer kegs. It is a time of foundations being shaken, identities being discovered and connections lost or found. And very little sleep. By the way, did you know that a 26 minute nap could increase your productivity by 34% ?(a NASA study) So if you know a college kid, tell them to take a walk, or a nap and to find someone to talk to about things that matter. Tell them that counseling is available to them on campus. Be sure and tell them about these statistics. Tell them they are not alone.

Mon, 09 Mar 2009 12:13:04 GMT

9 more minutes

These words still echo in my mind from my dream last night. My husband and I were walking a twisting trail over giant tree roots and gaping earthen holes. I was exhausted and he was ahead of me, and there were other people pressing me from behind. I paused on the trail, looked down at the tree root and thought, I just can’t go on. My husband said, “come on, it’s just 9 more minutes.”

So I googled number 9 in dreams, and lo and behold it means God, or eternity. But wait, it can also mean there’s trouble up ahead. Well, gee, which one is it? I’m thinking it’s about God again. Because in the dream, before we hiked the trail, we were in an open space where people were choosing spots to sit down, spreading picnic blankets and stuff. When we came to the first place, all the space was taken, so we kept going. Finally, there was some free ground and we began to look for an open area and then we realized this was a church’s reserved area. My brain quickly figured that these church people wouldn’t mind a bit if we joined them. So we did.

Or perhaps it’s the 9^th commandment: Thou shalt not bear false witness to thy neighbor. I was thinking about the concept of lying yesterday. How some people get caught in a big lie and seem to feel terrible; or the same person gets caught in a little lie and they don’t even see it. I guess lying is a big deal to me. The little ones make you think there are bigger ones to come. Who we work with, how many lies they tell, big or little, is on my mind. Tree roots, strong. Walking difficult trails with a partner rooting me on. Landing right smack in the midst of a church when we weren’t even looking. And 9 more minutes.

God is just around the corner.

Or maybe I’m just dreamin’.

Tue, 17 Feb 2009 03:37:01 GMT

helpless

I put away the gloves and the sweater and the coat. I dived right into the domestic duties of home, just after playing with Sophie for a few minutes in the almost rain. The suitcase was emptied and I laid the museum pamphlets in a pile to be looked at later. I looked at all my photos again, ready to show them to F and E, as soon as they get home. When a trip is over, it’s really not over. It sticks to me like the scent of something I brushed against and lingers for days... I hope. Knowing where she lives and where she walks and with whom she eats should help in this apartness from my first-born. After all, we’ve been apart for so long. But we were physically so close these past few days, sharing space and time and food. I entered her world in an intimate way, capturing her thoughts and some of her memories, things I never knew, things that are hers.

Parenting has always been a tough journey for me. I remember the nights before A was born, I wondered how in the world I could take care of someone else, a being totally dependent on me and her dad to survive. Then I just poured myself into her life. My pictures capture the closeness, the way a mother holds her baby, watching her every move, keeping her close. And I have journals that chronicle her growing up. I observed her every day without her knowing I was doing so, at the advice of a Montessori teacher. I thought that would help. I relished watching both my girls. But I couldn’t peg them after doing so. They were changing all the time and, besides, I was too wrapped up in their wonderful “being.”

How could I ever really know her? I mean, we talked, but I figured the important stuff she probably didn’t tell me. After all, that’s what growing up and away from parents is all about; normal developmental growth. I knew some of her fears, but apparently I had missed some things along the way. At least she told me now. Then there were things I knew but chose to forget, like a parent who’s afraid to see everything.

And that’s what’s tough. With all the care and watching and loving, she’s still her own person. She can love me and keep me informed but she is her own being; separate and different from me. Oh sure, she got some of the traits, the ones that glare at me and make me want to constantly apologize. But somewhere between me and F, she got a little mix of things that she balances well. I cannot project my own fears onto her. I cannot tell her much of what is best for her, if I don’t know her. At first I felt shame when I realized how little I know my daughters, but now I am okay with it. I’ve heard mothers talk about their children as though they know them so well and as much as I envy that, I am not sure I trust it.

I don’t know what I want to say, just that watching your flesh and blood grow up, struggle, make decisions, step out, step back, hurt, well, it’s a hard thing. I feel helpless, and I wonder if I knew her better, if I could help more. And I don’t understand how I could not know someone like the inside of my heart who is so dear to me, literally a part of me. But what I do know is that we do not have to understand everything and I know that she and I can stand together in the fear and helplessness. That’s what parents do.

Thu, 12 Feb 2009 04:57:34 GMT

good power

that’s what I called it when I spoke to the group of about 40 counselors and foster parents last month. I spoke about sexual exploitation by professionals which led nicely into a discussion about professional boundaries, sexual and otherwise. Three hours of ethics. It’s always hard for me to prepare for a talk to strangers, but this time was especially difficult because I decided to tell my story. It was something I felt I had to do; be honest, that is, with it being an ethics talk and all. It was a nice audience, probably more women than men, but all were good listeners with great eye contact and challenging questions, not necessarily to me personally but to the world and to a system that doesn’t always work.

I started with history, with lots of interesting examples, like Eli’s sons and Jung. I kept it in order, chronologically, leading right into Clinton which then led to the definition of sex. Then came anatomy, a little sex physiology, ie, “what’s the most important sex organ for the female?” (answer: the brain)

After all the intros and definitions, I reviewed the law in Texas, and the ethical guidelines of each of the major professions, looking mostly at where they stand with having sexual relations with former patients/clients. I got into the dynamics of this form of abuse: adults abused by professionals who are in a position of power. I had lots of examples: others’ and my own. One of the participants was a nun and when I got to the slide about predators using the spiritual bond with their clients to sexualize the relationship, I got a little tripped up when she asked me what sex had to do with God (paraphrased, but that’s how I heard it.) Well, duh, I thought, but then I saw her pure, white head covering and realized she may have never had sex. Well, duh. I guess I was nervous, but I completely forgot my favorite all-time quote: GK Chesterton said, “A man knocking on the door of a brothel is a man knocking on the door of God.” I think I started to say things, like sex is the most spiritual, intimate relationship we can have with another….that felt too personal. I don’t think she got it, but she said she did. Like I said, nice audience. Anyway, she and 2 other women came up to me afterwards and thanked me, saying the talk helped them a lot.

I closed the last 30 minutes of this eternally long talk with words about recognizing and setting professional boundaries with our clients. I talked about that good power that we have in helping our patients change unhealthy lifestyles. (ie, studies show that people stop smoking when their health care provider tells them to) And if we are too uncomfortable with that power, we might unconsciously try to equalize the power, by being “equals” with our patients. I think I may have done this subtly immediately after my abuse, thinking perhaps that all power is bad. I also got into the small community phenomenon where boundaries are crossed inadvertently with social and professional lines being blurred quite easily.

I would love to do this for the professional schools on campus, like nursing, counseling, PA, pharmacy, gearing each talk to their specific laws. I am working on a letter right now to the dean to see if he can help with this. And next year, when I have a little more time, my husband and I may submit a presentation for the PA’s at one of the state meetings. I’ll let him do the legal aspect since he is on the licensing board. Ok, so I will use his clout. He will use my power point.

So that’s where I was, but before that, my mom was staying with us for 2 months as she recuperated from knee surgery. Then my brother stayed a few days, after my daughter from DC came for Christmas. Having my mom here was different. Nice, but different. A little strained. I saw myself in a different light. Through my mother’s actions and thoughts, I saw pieces of myself and I understood more about my negative thinking.

I am trying to pace myself at work. I am pacing my heart, too. “Stay calm,” I tell myself off and on throughout the week. Accreditation is coming soon. Stay calm. I think I might do some clinical hours with a psychiatrist to polish my prescribing skills. I think that might be a win-win solution to some staff shortage problems. We might not be in such a hurry to re-locate to be close to my mom, due to the economic woes, but I worry about her every day. She is lonely because her friends are dying. This is what she told me and it’s the truth, not drama. Her cat is alive and well, though, and for now, I pray for a little more joy to slip into her life.

I asked my friend yesterday about her spiritual life. The question sounded so absurd when it slipped out of my mouth: Do you think about God these days? I think I asked because I think about Him a lot. In all the not going to church and not reading the Bible and carelessly offering up words like prayers, I am missing something I once had. Well, happy birthday to me, Valentine baby, and while I am visiting my daughter this weekend, I will send a prayer up in the DC skies for a little understanding, a little hope, a lot more joy and some of that good, good power.

i hear it might snow.....

Wed, 17 Dec 2008 03:04:01 GMT

Here's the link to SNAP 2008 Stories for Living, a contest for writers for their stories of healing and living after abuse. SNAP stands for Survivors of those Abused by Priests and Pastors. It is a wonderful source of support and networking if you know of someone needing help.

The stories are a wonderful testament to the human spirit, not only the strength in those abused, but also the amazing connection we have to others in our journey. And on that note, my story is #16 if you care to vote. I thought about not mentioning it, but oh well. And the friend i wrote about in One Good Thing wrote a winning story last year and you can click into 2007 stories to read her #1 story, Turning the Corner.

http://www.snapnetwork.org/stories_contest/stories.html

Sat, 06 Dec 2008 20:29:41 GMT

blink

To honor my latest good read, Blink, I must write this as spontaneously as possible. That is, without much thinking and no editing. The subtitle on this book is “the power of thinking without thinking.” Well, ever since reading The Tipping Point, by Malcolm Gladwell, I wanted to read this one, and I was not disappointed. I finished it in 3 days while waiting and caring for my mom who was post op left knee replacement. I usually read 2 or 3 books at once, interchanging them depending on my mood and time frame. So, I also finished Robert Johnson’s, The Fisher King and The Handless Maiden, more on the male and female subconscious. And now I am reading Exuberance by Kay Redfield Jamison. They all seem to be related which is exciting to me. Like even my subconscious picks my books.

Blink gives all kinds of stories of interesting people who do very interesting work, such as facial muscle readings or improv theatre directing or war planning. The author gives insight into decision- making from several different perspectives but the main point is that sometimes the instinctual feel, the decision made in the blink of an eye is often the best one. Even though we may not be conscious of why we say or do something when we are under pressure, our subconscious is playing a huge part in our decision –making. Of course, we are left wondering, great, how do we know when we should weigh it all out, pros and cons, lists and all and when we should let our gut reaction take over. The author himself tackles this with no definitive answer, thankfully, after all, we are talking subconscious, and we cannot know all these things. But I like this quote from Sigmund Freud, “When making a decision of minor importance, I have always found it advantageous to consider all the pros and cons. In vital matters, however, such as the choice of a mate or a profession, the decision should come from the unconscious, from somewhere within ourselves. In the important decisions of personal life, we should be governed, I think, by the deep inner needs of our nature.” (Joseph Campbell said this, too, in a different way.)

Another favorite piece of information I really grasped well and hung onto was Gladwell’s comment about how little we seem to truly know ourselves, and others. We tend to misjudge others quickly. Also, studies have shown that people make decisions and often do not know why. Or they might say, I like this and this and this, then when they decide on something (such as a mate) they completely change their list of priorities in that choice. In other words, they chose more out of some deep instinct, instead of what they thought they liked. This affirmed me in so many ways. Every time I hear someone say, “I am like this, or I do things this way,” I wonder how they can be so sure of themselves. I mean, I think a lot about things, I meditate, I write them down, and I can say very little about who I am, generally speaking. And lately, when people have said they are a certain way, I have noticed that they are just the opposite in their actions, so now I wonder if their words are meant to impress, not to be mean or dishonest, but it’s what they wish they were like.

After I read this book, and the Fisher King book, I hoped I would dream so I could do some more analyzing, and last night I had a dream filled with interesting images and possible inner workings. I was in a house with a man and 2 women. The 2 women were bitter and hostile and talking about me so that I could hear. There was jealousy and mocking and overall cruelty. I was with the man. He handed me a fork and told me to find the place where it belongs, but I couldn’t find the right place. I thought he would give me more clues, so I went to find him, and that is when the 2 tormenting women cornered me in a confrontation. I stood up to one of them, shouting and sticking my finger into her chest, very pointedly. She said that she would now beat me to a pulp, into the ground, and I was fearful for a few seconds, but when she shouted to the man I had been with to cover the doorway, I wondered why. I looked up in the doorway and there was another man, in a black cape, who looked amazingly like the Dark Shadows Dracula-like man ( I never watched that show, but recall the commercials and ads from it) I gathered up all my courage and voice and shouted at man #1 to clear the doorway, to stop blocking it, and as he jumped away from the door facing, the Dracula man leaped onto the woman and I was saved. Then I woke up. Since all I could think of to describe this savior was “dark shadows” character, this must be my shadow side, the one leaping out of the doorway, but I am calling it into being, and I am the one that is saving myself, by allowing it to come forward.

Now here’s the really interesting part. Before the attack scene, this man #1 had no name, but at the time I was about to be attacked by the woman, I shouted his name: “Jeremy” to have him clear the doorway. Jeremy? I don’t even know anyone named Jeremy. But I do know Jeremiah, the prophet from the old testament. I wrote about him once and taught this about him in a Sunday school class: From Eugene Peterson’s intro to Jeremiah in The Message: Jeremiah’s life and Jeremiah’s book are a single piece. He wrote what he lived, he lived what he wrote. There is no dissonance between his life and his book. Some people write better than they live; others live better than they write. Jeremiah, writing or living, was the same Jeremiah.”

Now, how’s that for blending the conscious and the subconscious world? For becoming the person we were intended to be we may have to fight off things inside and outside of our worlds. We may need to call on help from a higher source or from deep within ourselves, the seemingly unreachable places. Or maybe not, if we wait and listen. Or dream. Or even blink.

Fri, 28 Nov 2008 04:13:55 GMT

firstfruit

Pulling out of the driveway fast one morning this week, up at 5:30 am, baking pumpkin cookies for work, loading up the casserole and cookies after fetching a fruit platter for e’s day at her school. Mom is here, for the upcoming knee surgery, here with her cat, which is good, but all things taken together, I am feeling a pull, like a stretch and I take a deep breath as I see the oranges on the tree and they are oranger than yesterday. So I stop the car without a thought to my 8:00 patient, probably waiting now. I pick the orangest one and it snaps off the stem so easily, I smile, cause I know that means it’s ready. I put it to my hair dryer-warmed face and it feels oh so cool and damp, and I place it on the passenger seat, where I can smell the sweet aroma all the way to work.

The first fruit is special, biblically, the best. It is what we’ve waited for all season, watching the fruit grow and change from green to orange, oh so subtle. And the thrill of tasting it, sampling the season’s firstfruit. Even the bible doesn’t put a space between the words, it’s a word in itself. The drama, the tension mounts as we await the verdict, as we slice, we taste, we pronounce the sweetness. But most of all, this firstfruit is a symbol of what is to come. A symbol of loyal waiting. Holy waiting and holy fruit.

And so as I finish up dinner last night, e rolls into the driveway, and she casually places a strange looking orange—not from our tree—on the cabinet next to me. It rolls a little and plants itself into my view. Thin-skinned. I reach for it, smell it, nice. And she says so nonchalantly, that R gave it to her—the first one off his tree from his backyard.

Tis the season of firstfruits here in South Texas.

“So here I am. I’ve brought the firstfruits of what I’ve grown on this ground you gave me, O God. Then place it in the Presence of God, your God. Prostrate yourselves in the Presence of God, your God. And rejoice! Celebrate all the good things that God, your God, has given you and your family.” (Deuteronomy 26: 11-12, The Message)

And as I read these words about holy fruit, I celebrate all the things I’ve waited for, the sweetest things in my life:

My mother who is still with me, and ever so witty and fun and thoughtful. She is staying with us these holidays during her knee surgery and recovery; I am teaching her how to be taken care of and it’s a tough lesson to teach for someone who cares so naturally for everyone but herself.

My husband who loves me and is still trying to make things better as we age and could grow old and tired of each other; “closer and closer apart” is my biggest fear and I always feel that we are one foot away from that potential, until he says or does something amazingly different and refreshing, and I get new eyes and it all starts again, the dance of togetherness, the struggle of union of two very different, two too much alike souls.

My two daughters, together now in DC, one cooking for the other, the other gleaming knowledge from the one who is oldest. Maybe missing us and home, maybe not, due to the forging of new homelands. Just so grateful that they are mine and they are together and they are in a good place, where they know themselves better than I knew myself at their age, 18 or 23, and they see the world through old souls’ eyes. I do not know why this is so, but they do.

My friend who is there in spirit even when we cannot talk to each other face to face.

My job, with earnings of salary and confidence,

And lastly, I celebrate all the changes in my life, yes, all the crazy things inside and out that send my life into a whirlwind of yearning one day and surrender the next. Somehow, I still believe it’s possible that I can be transformed; that I can live a life that is more aligned with God’s likeness, one that has pure insight into what needs changing, and that I can nurture mine and others’ dreams instead of hindering them. And through all the changes in my life I sense a strong pull back into some safe place where God, my God, knows me.

Perhaps He is my firstfruit.

Tue, 11 Nov 2008 04:42:29 GMT

little things

Writing is such hard work. Yet, so liberating, getting the thoughts out. Away from me and just out there to you or whomever. Somebody, anybody. Is anybody listening? It matters more these days, therefore, I write less. But I ponder more on what I hear, and I respond carefully. I want the words to have meaning and to be heard. Pondered back. Talking to a therapist may or may not bring more meaning to my life, my relationships. I’ll keep saying it does, it should. But we are tricky beings, having to connect to someone else; disclosing such deep things to a stranger is intense, but she has to be a stranger to do any good. So how crazy is that? Talking to someone you barely know about the things you can’t even say to those you thought you knew so well. Right now, it’s not good for me, because all I can remember is her hand writing down what I said and me wanting to grab her notebook and run out of the room, fast. And never go back. Don’t write it down; just take it, but not too seriously, because next week, I will think in a whole different way, and I will not want to tell you this stuff if you keep writing it down. But of course I can’t tell her any of this. I say the subdued things, the things that are workable. How can anybody handle my unspoken, hardly-felt grief, when it comes and goes so elusively, not like a butterfly, but like a hot flash. Gone before you know it. No trace of harm. Wash over me, river of life.

So, listening to Tracy Chapman has helped. It’s an old CD, as I await her new one coming out tomorrow. She is just what I need these days. She repeats herself in a bluesy sort of way and I fill in the words in my head, and I feel soulful and beautiful and understood. Hearing the blues while you’re blue is a good thing. It feels right.

Maybe I’m blue from listening to others’ blues. I’ve been thinking a lot about what I hear, and how my words may help. Just a brief line or two to help someone get a new perspective, focus on the positive aspect of their character, not the negative, which seems to be the focus of those who are depressed or anxious. They seem to define themselves too simply, too black and white. In The Tipping Point, the author, Malcolm Gladwell tells us about the FAE, the Fundamental Attribution Error, “which is a fancy way of saying that when it comes to interpreting other people’s behavior, human beings invariably make the mistake of overestimating the importance of fundamental character traits and underestimating the importance of situation and context.” Oh, this is so true. Look at an interview of the neighbor of someone who has just been taken away for some terrible deed. He is such a fine man; there’s no way he could have done such a thing. Unbelievable, they say. And lawyers, well, it’s what most of them do for a living. “Isn’t it true, Mrs. Jones, that since you lied to your husband on these two occasions, that this would make you a pathological liar?” Somehow, in all her honesty and good character, Mrs. Jones doesn’t want to lie now and says, why, I suppose so, through a broken voice and shame-filled tears. And there you have it. No context. Only character: Liar. Never mind that she lied to protect herself or her children or because in her state of mind, she thought she was doing the right thing at the time.

Mr. Gladwell says that “ there is something in all of us that makes us instinctively want to explain the world around us in terms of people’s essential attributes: he’s a better basketball player, that person is smarter than I am.” The FAE “makes the world a much simpler and more understandable place.” But, he goes on to explain, “Character is more like a bundle of habits and tendencies and interests, loosely bound together and dependent, at certain times, on circumstance and context. The reason that most of us seem to have a consistent character is that most of us are really good at controlling our environment.”

I wonder if certain religious folks might take offense to this, preferring to ignore our environments that change us, and needing to see things a bit more black and white, following the good book, doing what Jesus would do. Shaping our own character, in His image. But things are pretty complicated in this world, with children being abused, adults re-living the cycle of abuse, surviving by thinking certain ways, mostly wrong ways, or hurting themselves to feel again, or running from painful places. And some of us survive by talking it out or writing it down or listening to the blues. Works for me. I’m a lucky one. Understanding comes in waves. Just before the crash, I see a little light, a different perspective. And I’m lucky to have someone who can listen, take it in. I’ll give it back in ways he’ll feel lucky.

Mr. Gladwell also talks about how it’s the little things, structured in just the right way that can make a big impact in our lives. There is that moment that an idea or a trend catches on, reaches that tipping point, and suddenly, it takes on a bigger shape. Then, change happens.

Oh, there’s a tipping point in every day things, too, isn’t there? That point we can’t take it anymore, we’ll either fix it or throw our hands up in despair. And it’s all the little things around us that move us into action, cause us to think a little differently: the consistency of a favorite blogger, the tears in that Chicago crowd last Tuesday, the therapist who draws the boundaries so tight that I feel so far away, but it works, the little things she said or did all begin to add up and something clicks.

They gather themselves silently around us, shaping us, holding us.

We don’t even see them most of the time.

These little things.

Tue, 21 Oct 2008 04:37:07 GMT

two new words

        I learned 2 new Spanish words this past Saturday at Penitas clinic. Toronja, for grapefruit. And aceituna for olive. I did quite a bit of nutritional counseling. I am slowing down, taking my time. I will not quit what I love so much. No sirree, but I will empower folks to take care of their own health, in case I decide to retire from indigent care.
         I might also have some fun while I do some empowerering. One man had a history of kidney stones, among a list of other chronic illnesses that required medicines too expensive to continue. High blood pressure, high cholesterol, you know- the usual. Only the doc who treated him before billed his Medicare and prescribed expensive drugs, not the ones on the Walmart $4 list. Now he has no Medicare, and has been out of meds for a year. Really empowering the people, right? So anyway, he’s had 2 spells of nephrolithiasis, the stone thing, and I tell him (in Spanish, of course), you know kidney stone pain is the equivalent of child birth, how was that? And his wife is sitting next to him (sometimes I let the spouse come in; especially when it comes to a lot of cooking and eating talk) and she says, well, if that’s the case, he needs one more, since I’ve had 3 kids! And we all laughed so hard, even him!
          A 12 year old boy was my translator for these 2 words I didn’t know. And as he left (after I diagnosed him with chiggers, NOT chicken pox, and cleared him for school) I told him he needs to go to medical or PA school and come back here and help us out; this ‘ole gringa cannot do this forever, we will need him. His mom said he was in the gifted & talented program, and he did look proud, and I did tell him about the great pre-med programs down here, and to please consider it. I think he will. Just starting the recruitment a bit earlier, before the greed of medicine sets in.
          It seems like I utilize my history-taking skills more out here. I mean, no one expects to go to the specialist or to have an MRI.   If I decide to order tests or refer, it’s a long process to obtain (possible) funding. And no one wants to go to the ER. So, they rely on what I tell them about their bodies.   And they listen. I explain anatomy and physiology, and how the meds work and they listen and learn. And they are empowered to understand their own bodies a little bit more, and to watch and treat, with cheap, available meds, so when I am not around, they won’t feel so helpless about their health.
         One thing I noticed the last few times I have worked at the clinic, is how important it is to weigh the patients at each visit. No one has a scale at home. Some have never weighed themselves. And they have no clue what they weigh. Most are working on losing some weight, so it is important to them. I love how they lean in to take a look at today’s weight, asking me how it was the last time, to compare. It’s a big deal. It kind of breaks my heart. It also breaks my heart that they respect me so much. It’s like they have the utmost trust in my words, but at the same time, they feel comfortable enough to crack jokes with me and to laugh.
             Pues, no tomen las toronjas con su medicina para la cholesterol, y si cocina el pollo en aceite, usen el aceite de aceituna.
            They even put up with my Spanish here in penitas.

Mon, 29 Sep 2008 02:36:54 GMT

too many dogs

I talked about mission and purpose at our work retreat last month. This, from someone who is searching for a little purpose herself these days, and so my reading materials included Billy Graham’s The Journey, All I Need to Know I Learned in Kindergarten, Kadison’s College of the Overwhelmed, Dave Eggers’ A Heartbreaking Work of Staggering Genius and Nemo. Yes, Nemo. I kept it simple.

First, I had them gather in 2’s and share one thing about each other that the rest of us might not know, something that makes them unique. Then we shared with each other. I was pleased people opened up. Then I did my Sunday school thing with excerpts from Simon Birch (now there’s a child who knew his purpose, in spite of others’ doubts along the way) and Tortilla Soup (tying in the family and needing others theme as well as doing what we were meant to do giving us back our “taste.”) And like Sunday school kids, they hollered when I turned off the film. Focus, people, focus.

Yet, I feel like a failure at this purposeful work thing. I try too hard to make each day count as some momentous moment of my life, each encounter, each word, wait, this is the HSP thing, isn’t it, with a lack of estrogen thrown in. focus, focus. On the big picture. Some people are gifted at that. Letting the little things go, seeing the forest, not all the trees.

But let’s not be so negative about HSP’s. Speaking of forests, I saw Prince Caspian last month at the dollar movie and I loved it so much, I cried. The good tears. The LIFE DOES HAVE MEANING kind of tears. The trees and all their individual significance that only an HSP would notice. C.S. Lewis’ imagination captured the human plight of battles with enemies surrounding us, surely defeating us, the camaraderie of our allies, the fighting between us and our allies, our temptations, our weaknesses, our fronts. The roots of trees capturing evil, then the huge running trees “and they will cry out, even the stones will cry out” and “the trees will clap their hands,” are the verses that roared in my head. Aslan the Lion, makes me cry. I see God behind the fur in the way he tumbles playfully with Lucy. And in the way they missed him, only, I’m the one that’s been gone.

Purpose for me now is in the trying, the wanting, the struggling to not struggle so much with it all. Just being is so hard for me. But life does have a funny twist sometimes and as I was finishing up a visit with a former therapist’s housekeeper whom she had brought out to Penitas’ clinic last month, I turned to this healer and mentioned how I missed her remarkable way of summing up life’s patterns or people’s ways. And right there, on the spot, she said one of those amazing phrases, and I felt affirmed. I then affirmed her gift of paraphrasing and bringing closure to challenging life events in this quest for sanity and sense.

Now, I am reading a book on Osler, the great bedside physician. I am thinking I may type up his 9 points for living a full life and put them in my examining rooms.

Manage time well. Find a calling. Find mentors. Be a part of community. Be positive.

Learn and teach. Care carefully. Communicate. Seek balance.

I guess work has been difficult, but in a way that I don’t see. I move from one patient to the next and if there is any time between, I do risk management assessments or QI studies. It’s all got somewhat of a negative trend to it, looking for things that might go wrong in a clinic. Even though I am looking to make things better. Some things do turn out well, like our charts on positive chlamydias, we did good, treatment and prevention –wise. Hard to quantitate “doing good,” isn’t it? I try hard when it’s possible. But it is absolutely impossible to see the “doing good” in medicine on a day to day basis. For an HSP, this is hard to take, knowing we don’t always help someone. Just trying here.

Well, I have one last point to make here. I never liked the phrase, “nervous breakdown.” First of all, there’s no such medical diagnosis. People use the phrase to try and objectify a melt down, those times when they’ve been trying to do too much, didn’t say no enough, perhaps didn’t take care of themselves, perhaps didn’t see it coming, just too busy. Too busy. But it sounds good, doesn’t it? “I had a nervous breakdown.” As though something happened to me outside of my control. That is such bull shit. Well, I had one last Saturday at Penitas. After seeing 4 patients, each with about 6 medical problems, 3 of them chronic and worse, and after racking my brain for the best treatment, then listening some more and talking some more, I put my head on the counter, and cried. Everything just seems too big for me. Too many medical problems and too many mental problems. Too much poverty and too little control over their lives. Too many patients still waiting in the waiting room. Not enough me. I calmly stepped out and called Shirley in. She grounded me for a few minutes. I could have left if I wanted to. But I stayed and things calmed down immediately. One or two problems each, some improvements, some just refills.

There is a breaking point sometimes. Like tonight at the dog park, there were too many new dogs, and there were 2 German Shepherds and 2 Collies and 3 or 4 yelping puppies. Just too many dogs. And sometimes the breaking point is not in the numbers or our own pain, but in the pain we feel for others. But who am I kidding? The pain I felt for my daughter yesterday was perhaps all mine. She can take care of herself, I think. I seem to be the one falling apart rather easily. Let’s review these one more time. This is my mantra for the week.

Manage time well. Find a calling. Find mentors. Be a part of community. Be positive. Learn and teach. Care carefully. Communicate. Seek balance.

Wed, 17 Sep 2008 04:57:47 GMT

seasons, weeds, liberty and listening

It’s cooler outside and I don’t feel as old. In fact, my step is lighter and my knees don’t hurt. It feels like 50 degrees, but the thermometer says 82. This is grand. The feeling younger part especially. Nothing like a little shake up in the seasons to put a new lease on life.

And I visited with my mother in the Hill Country. I defied her orders to stay home and away from the flow of Houston evacuees. And I made the right decision considering there was no rain or traffic as predicted. And that was good, because we laid the new grass-appearing arrangement on my dad’s grave (“your father always wanted to be different from everyone else.”) Now, see, I didn’t know that. I did know she wanted me to care about what goes on the grave and I never have cared much. So I brought them this time; the weed arrangement that looks so real, like a field untended and natural. He would like these.

And we saw a movie together, The Women. A good one for a mom and daughter. She needs company and a little help at this time, and we can’t move just yet. We are almost at that place. It’s not the job-changing or moving so much as the daughter in her last year of high school. And my mom is so intent on NOT being any kind of burden that she is ready to pack up tomorrow and go into assisted living. But let’s try the knee surgery, and staying with us for rehab first. Recruit my sister to visit once a month and me once a month and take it one step at a time, with the neighbors watching closely, and check with the Florida sister just in case I am missing something between the lines here. This is tough. My daughter must have read it in my face this morning when I got off the phone with my aunt; she walked right over and gave me a hug. Not really like her. It was so good, I asked for another.

Presentation on sexual exploitation accepted for a local (Corpus Christi) conference sponsored by CPS, CASA and other child abuse prevention organizations. I submitted one on STI’s and child abuse, but they chose the one on sexual exploitation by health care and human service professionals, and asked for 3 hours for ethics. Yo can do. A few video clips perhaps, a few case examples, maybe even my own. Empowered enough to submit the same thing, with a college twist to the ACHA. Getting the word out.

I wrote to Tibor Machan today; he’s a columnist who wrote something interesting about universal health care and how it shouldn’t be. I don’t agree with what he says—something about how we can’t make professionals (doctors, etc) provide health care for free. I tried to show him another side to that. That it is not necessarily a burden to professionals, but something we can offer to better our world. He had no ear for my words, only a mind to clarify his own, evidently Libertarian, point of view. I got it. And it was interesting. Just not a two-way thing. I thought that was the point of writing for the public, to not only be heard but to hear other views. I guess not. To some, it is perhaps only to be heard.

He’s right, though. We should not force people to do anything against their will. God forbid. And health care is not a universal right, because, well, we would have to make someone else give them health care for free, and that is taking away from those professionals’ God-given rights. I tried to tell him that there are a few professionals around willing to serve in this way (although lately I cannot find very many of them to help me out in Penitas!) and if we could model this kind of serving the poor, instead of promoting some sort of justification based on individuals’ freedom to choose, instead of standing by while people suffer from ear aches because their co-pay is too high to afford to go to a clinic. Yeah, that’s right some people even have insurance, they do work, and yet they have no access to health care. And medicine is not rocket science. Geez, sometimes it’s just writing a prescription for the diabetes medicine to prevent complications that will eventually cost the public much more in expensive hospital stays. Common sense, not liberty.

And here I thought people were just too busy to help out at free clinics. Nope, they believe in freedom for all. And no forced labor. Now that is more noble. Nothing like justifying not helping the poor among us. Nothing like creating a reason to be comfortable with the state of things as they are.

There, I feel better saying my peace. Thanks for listening, Tibor. (not)

Glad I’m a democrat, by the way.