Such a Simple Song

On Friday I had a really heartbreaking situation involving a young patient and her mom. Both homeless, and the little girl was ill, really ill. The shelter they were staying at wasn't allowing the mother to makes soup or other foods for the young girl. Many shelters do not allow food because it can lead to infestation of bugs and rodents and other unsightly situations (sad, but true). Shelter residents eat meals in a common area and no food is allowed in rooms, if the resident is fortunate enough to have a room. 

So, this was a tricky situation. A common cold could quickly evolve into something worse if not treated with supportive measures such as fluids, good food, and rest. This is where I get to play not only medical provider but also social worker - which, of course, is the perfect role for me.

There was a call to the shelter. There was a reached upon agreement for this young family that an exception could be made for the time being. Feeling good about this, but still feeling unsettled about their situation overall, I wanted to do something else. I wanted to give the little girl something. All she had was a small backpack with her, and she had been such a good patient. Probably, in fact, my best patient all day. We have these books donated to our facility through Reach out and Read (great program) and I grabbed a book suitable for a 4 year old, which was her age. I read the title as I sat down and gave it to her, "You Are My Sunshine."

When I said that the little girl looked up at me and we glanced at each other as I turned the page, "My only sunshine." As I turned the page again her and I started to sing together softly because the next page said "...you make me happy, when skies are gray." It was only then that I realized the book was a simple picture book with the words to, "You are my sunshine," a song from many of our childhoods.

When we finished the short book my heart was pounding not only because the little girl was beaming and wanted to sing it again (which we did: me, the little girl, her mom and the interpreter!) but because this is a song my own mother has sung to me from as far back as I can remember. So, thank you, to my own mother, for the effort and energy and love she has put into raising me the last 39 years. I adore the moments when I get to pay that love forward. Also, wow, the power of a book!! 

Truth

I told him

on the first visit he made to his doctor

in years, I told him,

“You don’t have youth on your side

anymore." He stared, nodded

back 

to the memory

of his grandfather and

a generation of stoic

hard work, black coffee and

calluses, knowing the 

truth, his failing

body, but still spinning

his lie. I told him,

“If you don’t slow down,

something, I swear something," I told him, 

"something will stop you, 

cold.”

In my inbox on a rainy Monday:

68 yo male, admitted to the ER on a Thursday,

diffuse abdominal pain, weight loss,

suspect pancreatic cancer

with mets to the liver.

I never wanted to be right.

The Moment

Oh, of all the things I so enjoy about life one of the most amazing, fascinating and humbling opportunities I am blessed with is to witness human beings having a "moment"--maybe "the moment"--when they realize they can overcome something they never imagined they could, or discover something they have been searching for only to realize it has been in front of them all along.

Or, when I ask an aging Somali woman with chronic "all over body pain" if somedays she feels like she just wants to raise her fists to the sky and yell, and she begins to weep silent, subtle, sweet tears and looks up at me in wonder and says through a Somali interpreter, 'How could you possibly know? How could you possibly know how I am feeling. You must be a magician."

Those moments. Sometimes I am part of the awakening, sometimes I only show people what they allow me to see. It is magic, and I get to watch it unfold every day.

Depression's Cure: Training for a 50K trail race

Training for a 50K is grueling: Forcing me out for a 2-hour run in the dark after an 8 hour work day and now sucking up the majority of my Saturdays as I've taken the time to find and complete a visually inspiring 15 mile + run (next Saturday, 18 miles!) Not to mention how tired I feel most of the time; my muscles thankful, but achey.

To many of you, the above sounds dreamy. In a world where we are increasingly "running out of time" - who has time, you may ask, to go and run for 3 hours!

Well, right now, I do. But that doesn't mean it doesn't suck.

Yesterday I decided to start dedicating each of my long training runs to a cause, a person or a situation I care about. Inspired by the following video of a runner in the Grand Canyon and recently posted on Outside Online, I decided that yesterday's run was for depression. Irrefutably, medication and therapy are beneficial in treating depression, but evidence has shown that strong social relationships and EXERCISE are paramount to keeping the mind healthy.

Lacing up the shoes now. Today, I run with awareness for the blue, perfect, sun-filled Seattle skies.

http://vimeo.com/105194950

The Thing Is

What I absolutely adore about poetry, is that no matter badly I am feeling (or feelings of joy, despair, elation, awe...), there is someone out there who has felt the exact same way. I know this because I have read their words, somewhere along the way, on a page or spoken from the podium of a packed auditorium. Poems. Poems are what get me through. Time and time again, since as far back as I can remember. This is a new favorite. 

The Thing Is
by Ellen Bass

to love life, to love it even
when you have no stomach for it
and everything you've held dear
crumbles like burnt paper in your hands,
your throat filled with the silt of it.
When grief sits with you, its tropical heat
thickening the air, heavy as water
more fit for gills than lungs;
when grief weights you like your own flesh
only more of it, an obesity of grief,
you think, How can a body withstand this?
Then you hold life like a face
between your palms, a plain face,
no charming smile, no violet eyes,
and you say, yes, I will take you
I will love you, again.

Creativity and "Madness"

I've often thought that suffering and art (of some form) often go hand in hand. Expression--and therapeutic processing--of those more difficult or less palatable topics has often found a place of meaning in the context of words, paintings, photographs and music. Dr. Kay Redfield Jamison has written countless articles and essays on creativity and mental illness. Nice to see her experience and insight in the news this week:

"It must be emphasized that most creative people do not have a mental illness and most people who have mental illnesses, such as bipolar disorder, are not unusually creative. It is rather that there is a disproportionate rate of mood disorders, especially bipolar disorder, in creative individuals." ~ KRJ

http://www.cnn.com/2014/08/14/opinion/jamison-depression-creativity/index.html

Time to Ponder

Well. This week was a rough one. I experienced my first patient death--a man I "inherited" from another doc when I began practicing medicine 8 months ago. A stubborn, charming, charismatic, and quick witted man, who appeared to appreciate the same in me as he "kept me", when he had previously "fired" a lot of other providers. We were very kindred, in many odd and unexpected ways. His death stunned us all, and has been difficult and enlightening to process. Then, Robin Williams. I mean, WOW. If someone who brings such joy to the world can feel so down and hopeless, well...

I pondered a few of these things today with a patient. During the course of our 45 minute "appointment", he told me I had one of the greatest gifts in my own two hands and didn't even realize it. The gift of time, and the "luxury" to explore not only my own life but all of the intricacies of those around me and the disparities, and joys, the world over.

What a luxury, this time to ponder. What a gift. Every thing around us. What gifts. And, time, I am not going to waste you.

On Addiction

I have worked in the field of addiction as a detox supervisor and acute addiction counselor for roughly 2 years and continue to help my current patients maneuver through addiction as a primary care provider of predominately low income patients.

One of the reasons I've been drawn to the field of addiction is because, as stated by Dr. Gabor Maté, we all have one (or several) addictions. The chemical process that causes someone to exercise too much, collect classical music without reprieve, or "need" to hike every Colorado 14er (14,000 foot mountain, of which there are 54) isn't much different than the wiring that causes one to become addicted to alcohol or heroin. Rather, the hiker, music lover and exerciser have just picked "addictions" that are more socially accepted by society. The brain physiology is the exactly the same. The craving, is the same.

I tell you this because very recently, it was mentioned to me, after a somewhat heated debate, by a rather educated and appropriate figure, that I - yes me- have an addiction... to romanticism. That I tend to seek out the beauty in everything, and ponder to perpetuity. If I didn't do so, it was therapized, then life would be too drab for me to go on, and on....

I believe this. Yet, don't know what to do with it. I will definitely seek out the exquisite romantics of the statement and surely write a poem about it. At the very least. After telling a few friends of mine this one stated that, "We are all born romantics. But, society is the cure for romanticism." He went on to say that he also finds romance or beauty in everything. Since everything that matters to him is romantic, everything, to him, matters. I like that.  

If an "addiction" is a normal adaptation or response to an "abnormal" situation, then we all have one. Or many. Each of us. 

Can you identify yours? And, perhaps, more importantly, do you know where your addiction will take you today? 

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Spare Change

Recent published piece. About hope. Thanks to the brave women (as mentioned in the piece) who helped me write it. This is also the first piece I've published as an actual medical provider. Although always a student of life, I graduated from the University of Washington in 2013. 

http://journals.lww.com/jaapa/Fulltext/2014/05000/Spare_change.17.aspx