Saturday, December 31, 2011

Ringing in the New

This year, my goal is to try one new thing every day, and write about it. While this is not strictly a new idea, I find it exciting and inspiring. Stay tuned my 5 and 1/2 loyal readers, we are going to have some fun this year!

Friday, December 16, 2011

Showing Up

It is 8:45 pm on a Seattle Thursday night, and I have been staring at this blank page for forty-five minutes. I made an appointment with myself to write tonight, and I am both punctual and full of integrity. My father says I am indeed full of it, and I like to call "it" integrity. My very, very dear friend, whom I will call Nell (because that's her name) calls me "tenacious." I know this is her delightful, Southern, classy-lady way of saying I'm just like a dog with a bone. Oh good lord. Did I just compare myself to a dog? Really? Are these the visuals I want to plant in the heads of my readers? Anyhow, I made an appointment with myself, and here I am. I show up.

Oh, sure, I spent half of that time looking up words, including a full twenty minutes spent on the word "braise", which, should, by the way, NOT be confused with saute, which I confess I did until I researched it. In case you were wondering, braise involves searing the food in question (usually meat, mushrooms, or occasionally root vegetables) at a high heat to seal in the juices, and create a carmelized, crusty layer of deliciousness, some of which will stick the pan. We'll get to that in a moment. This process is called the Maillard Process. Just saying that makes me feel prepared to go toe to toe with Julia Child.

After the Maillard Process is complete, you are ready to add your liquid, and eventually reduce that liquid into a sauce by cooking off the water (a sauce reduction). The liquid should have an element of acidity, such as balsamic vinegar, tomatoes, lemons or ideally, wine. The acid works on the carmelized sugars to deglaze the pan. At the end, to finish the sauce and round out the mouth-feel, a bit of butter or cream is added. The acid breaks down the milk solids to make it smooth. It's a complex, delicious dance of organic chemistry that makes it all work, and I feel a better person for being clear on the exact difference between braise, saute, and simmer. I mean, it comes up. I wouldn't want to confuse one with the other, because let's face it, that would just be embarrassing.

If I'd had any sense tonight, I would have taken my laptop down the street to a coffee shop to write, or maybe a restaurant or happy hour. I would have encouraged strangers to tell me their stories, so I could break them down and put them together into something heroic. I would have sipped a Ginger Martini instead of hot ginger tea, tears of laughter would have been dabbed with monogrammed handkerchiefs instead of Puffs Plus, all the men would have looked like Gabriel Byrne and at no point would I have inadvertently written myself into a word corner by comparing myself to a dog.

These are the things I do, at 8:45 pm on a Thursday night in Seattle.

It ain't pretty. But at least I showed up, and stories are written by those who show up.

Tuesday, December 13, 2011

Silent Nights

Tonight, as I crawl into bed for my first night of writing in weeks, I am listening to the traditional music of Advent, O Come Emmanuel (Veni, Veni Emmanuel). The weeks of Advent are about waiting in anticipation of the fulfillment that is to come. It is about clarifying, focusing, and clearing out one's soul in preparation to receive. The words to this hymn were written in the 9th century, the music in the 15th century, and it fits my mood tonight.

For weeks, I have heard little but silence in my soul. I have experienced such a period of intense outward change that my core, writer self has simply been hanging on for dear life, both hands to the pole and screaming into the wind, as the changes, (hereafter referred to as The Great Atlanta To Seattle Move-Tornado of 2011) picked up my little bag o' bones, blew them across this great nation of ours, and deposited them in a completely new life. It was my fourth transcontinental move. That won't sound like much to some of you, and the first three times, it wasn't difficult for me. I was much younger then.

But as I sit here tonight, trying to tie thoughts to paper, I begin to feel less shell-shocked, less brittle, more at home. My Christmas tree is glowing, the warm white lights reflected off of the teal and plum ornaments, colors that make me happy when I look at them. Remnants of my old life, a print of poppies that reminds me of France, a print of a winding path that calls me back to Italy, and sepia photographs of Crete and Florence blend with new modern elements, curiously pewter and silver seem to be my new favorite colors. A cascade of sprout green raw silk, bedroom drapes that shut out the Atlanta night and cocooned me as I wrote, remind me now of springs and growth yet to come here in Seattle.

The night is silent, yet gratefully, after much waiting, my mind begins to come alive. The ticking of the clock, the black and silver Baby Ben that my Grandmother wound every night, ticks beside me, like her comforting heartbeat when she hugged me goodnight. I am in a good place, a place that demands work, offers love, and invites peace. My captive thoughts have at last been ransomed, and I can write again. No more silent nights.

Friday, November 11, 2011

Test Post from New Location

Test post from new location. After several weeks of hiatus, I'm ready to write again.

Monday, October 24, 2011

The Lightness of Letting Go

In a few short days, I will be moving across the country. I am beyond thrilled. Where I am going is a beautiful place, and where I am leaving is the me that I was, not the me that I am now. So it feels right. All week, I have been sorting out my belongings, keeping only the best of the best, a few of my favorite things, because I am moving into one third of the space. This move from gracious, three-story brick Southern townhouse to open, loft-style urban Northwest apartment is not what I expected to be doing at this point in my life. And yet, that too, feels ultimately right. The experiences you don't plan so often turn out to be the best ones.

As I sort through basement and attic, office and garage, I have to laugh at all the ages and stages of my life, and I am grateful that with each passing year, I become simpler, deeper, more satisfied with less. Even things I thought I could never part with, I find myself laughing that I ever kept them in the first place. Boxes and boxes and bookshelves of books, enough to stock a respectable library, must go, for there is no longer room. I must keep only a few favorites, and donate the rest to the Decatur Public Library. Surely they will name a wing in my honor. But, I have read them. With rare exception, I will not read them again. As the water flows over the stones in the river, I will not pass that way again. The classes that I taught, the research that I did, the courses that I took, are over. Those houses, those trips, those hobbies, they are the me that was, and it is well and truly over. I can let it all go now.

The experiences I had, the people I loved, the things I have done, I carry within me as a rosary of experience. In my memory, I can touch the stones and remember. I do not need outward reminders. In my basement, a huge stack awaits donation pick-up, and I shall take the tax write-off. More will follow. Furniture, even furniture that I liked, will go, because it no longer fits my reality. And the curious thing is, the more I give away, the more sure of my choices I am, the easier it becomes, and the freer, lighter and calmer I feel. In life, as in travel, there are those who travel light, and those who wish they did.

Copyright 2011. All Rights Reserved.

Tuesday, October 18, 2011

What We Do For The Least of These

Three times a week, he waits for me, sitting in his broken wheelchair, behind a glass door. He is legally blind, cannot hear, and has lost both legs below the knee. For weeks I have been trying to get him equipment. I have made calls on his behalf, trying to locate the equipment he needs that Medicare will not pay for. He is not the first, nor is he the only, of my patients who needs a new wheelchair. The brakes are now broken, and his wheelchair ramp needs repair. I repair what I can, eye glasses, Hoyer lifts, walkers, canes, tub benches. I realize I need better wheelchair repair skills than I currently have.

Another man, behind another door, who has no use of his left side due to stroke, sits in a borrowed wheelchair that is too small for him and is contributing to scoliosis of the spine. He is barefoot, wears a dirty t-shirt with a hole and pants that do not zip held up by one suspender. Nothing has been washed, he is in the same clothes he was in the last time I came. He has no sliding board to assist in the transfer from wheelchair to bed, no tub transfer bench to assist in washing himself. His son is asleep in another room and cannot be roused. The smell is unbearable. He is proud as he tells me he does his own washing, in a bucket, with bits of soap.

I spend ninety minutes on the phone, making every call I can think of, yelling at people I do not know, trying to make some progress, trying to make some meaningful change. The answer always seems to be the same, no matter who I call. They need something from someone else, before they can do their job. I am banging my head against a concrete wall. My patient is not a theory, he is not a statistic; he is an elderly man who cannot walk who needs a bath, a clean set of clothes and sheets, and a wheelchair that fits. For the love of Christ, it cannot be that difficult.

And yet, it seems to be. At the end of the phone line, sitting somewhere in an air conditioned office and wearing clean clothes, a "representative" tells me that they can do nothing, yet again, for my patient. I am told that my patient needs to make calls, fill out paperwork, and the most they, the representative, can do is "drop off a brochure." I am dangerously close to losing it. "Well," I say to the representative, determined to choose my words carefully. "My patient has no family available to help, has severe mental and physical limitations, cannot walk, is sitting in a borrowed wheelchair that is causing curvature of the spine, pisses in a cup and cannot wash himself adequately after shitting into a plastic bag because that is what he has available, but by all means, DROP OFF A BROCHURE."

After ninety minutes, I am late for my next appointment, and must move on. "You must call, and follow up. You must ask your son for assistance. It can be better. But you have to be a squeaky wheel on your own behalf." We are both frustrated. "At least you tried," he says. You've done more in an hour than anyone else has gotten done in four months." I don't feel like I've gotten anything done. He is sitting in the same wheelchair, and he will be wearing the same pants the next time I come. We have done no actual therapy, because his need for equipment is so great, it has to be first priority. He has plenty of brochures, but nothing has changed. I will be quizzed by a bean-counter about my use of therapeutic minutes.

Around the country tonight, people will watch the evening news, and shake their heads, and get angry, thinking of all the people out there trying to "cheat the system." System? What system? I see old men in wheel chairs with no legs who cannot make phone calls on their own behalf because they cannot hear, and who cannot get anyone to follow-up on completing paperwork or sending a fax. I see elders in America who are so poor they are washing their own torn t-shirts in a bucket, who cannot get assistance unless they pay $400 of their $900 Social Security check to a program to bring them "down to Medicaid-eligible."

I call everyone I know who might have equipment lying around unused. I call the donation houses to get my patients wait-listed for a wheelchair that fits and bathroom equipment so they can take a bath safely. Medicare will not pay for "bathroom equipment." I want a number-cruncher, and the American voters who think all of my patients are out to cheat the system, to come with me on patient rounds. I would like to show them the challenges these people are facing just to get out of bed and take a bath every morning. I would like to show them exactly what we are doing for the least of these, our brothers.

Copyright 2011. All Rights Reserved.

Tuesday, October 11, 2011

My Life as a Perp

The music: Bad Reputation, by Joan Jett and the Blackhearts

Lately, my permanent record has been taking a beating. Yesterday I came home to find, in my mailbox, a "False Alarm Citation and Warning: False Alarm of Automatic Response Alarm Systems" because one week prior, I had inadvertently set off my house alarm while dashing out my basement door on the way to my afternoon patient rounds. It is rather dark in my basement hallway, and while juggling computer, treatment bag, keys, phone, Mi-Fi, calendar, a bottle of raspberry selzter, mail and gently toeing three cats out of my way, I hit a wrong button, and then another, and then another, in a frenzied attempt to turn the damn thing off. When the alarm company called to tell me the police had been dispatched, I asked them to cancel and explained my mistake. I had no idea I was setting off such a furor at city hall.

This black mark landed squarely on my already-much-besmirched reputation, as it followed right on the heels of a moving violation I received two weeks prior when I was involved in what I hope to someday remember fondly as "The Great Left Turn Incident of '11." Right now, I remember it simply as "Getting My Bumper Smashed By A Cheeky Young Turk Going Too Damn Fast Through The Intersection." I admit I am not yet quite at peace with either of these two incidents. I hit a wrong button in the dark, and I turned left. Now, I am, apparently, a perp, and although generally I have always tried to see all sides of any story, I am starting to feel just the tiniest bit oppressed by The Man. If I had a tin cup, I would be running it along the bars of my cell, pausing only to strum and sing a soulful rendition of "Folsom Prison Blues" on my guitar.

I suppose it was really only a matter of time. My parents saw the writing on the wall early, and warned me about it, that night I attempted to tip-toe up the stairs four minutes...no, wait, four hours...past my midnight curfew. Once midnight came and went, I reasoned, as only adolescents can do, that since I was already in trouble I might as well make the most of it. Upon my return, as I crept up the stairs accompanied by the, Lord Have Mercy, Christ Have Mercy, rosy-fingered dawn, carrying my shoes, I found both of my parents standing, arms akimbo at the top of the stairs, sputtering, "Where HAVE you..." and "What in the HELL have you..." and the ever-popular "If you think for ONE MINUTE you're going to...". Now, I have only myself to blame, 'cause Lord knows, Mama tried.

And it's made me wonder, this week, about forgiveness, and how maybe we could all use just a little bit more of it in our lives. I pressed a wrong button, I turned left, I had fun, I laughed so hard I forgot to look at my watch, and I loved somebody. I'd do it all again, and in fact, since I'm still stumbling around like an idiot in a thorn bush at the age of...old enough to know better, but young enough to still enjoy it...I probably will. Not really such a walk of shame, at least not in my book.

Copyright 2011. All Rights Reserved.

Thursday, October 6, 2011

The Time We Took For Granted, In the Life We Gave Away

Music: Life is a Bittersweet Waltz, by Leon Redbone

"With all of its' glories, and all of its' faults, it seems life is a bittersweet waltz."

I sat today with an dying man, and I fed him with an eye-dropper. He has not been eating enough to keep a bird alive, and so we have resorted to tricks used to actually keep birds alive. He is tiny now, shrinking daily, has trouble drinking liquids and prefers to spend his time sleeping. Today, his blood pressure began to fall, and he began shivering. I covered him up quickly with a blanket and held his hands for a moment, and then I took his blood pressure, heart rate, respiration. "Talk to me. Tell me a story." He opened his eyes, and smiled at me, a lop-sided smile. Bell's Palsy has made the other side of his face droop. In the few weeks I've been treating him, I've come to love the little lopsided grin, the bald head, how he lifts his eyebrows when he recognizes me. "Come on now. Be a gentleman. Don't leave me alone on the dance floor." I tease him as I take his blood pressure. "We need to lay him down now, it will help his blood pressure come back up," I call to his granddaughter, who is caring for this elderly man and his wife. Both need care around the clock.

Over the weeks, I've had gentle talks with the granddaughter. She is carrying a heavy load, carrying for a special-needs son as well as her grandparents. Both are confused, and need moment to moment direction in all tasks. I see both for physical therapy, and it is a task. The granddaughter does not get a break, and has been getting little sleep.

I have talked to her gently about options for care, trying to ease her mind while trying to ease her burden. Today, we go further, and discuss discharge from restorative care to palliative care. Although I am more practiced now talking to family members about end of life issues, it is never easy. I am not ashamed to say I cry with them, I can't help it. No one cries alone in my presence. There are times when human touch and a shoulder to cry on are all I can truly give. If they want me to pray with them, I pray with them. If they want to talk and cry, I let them talk and cry it out. People need loving support in these decisions, they need to know it is okay to choose hospice, that they have not failed as family members. Today, the admission that things are not going to get much better, and comfort and joy, in the time that is left, should be the only goal.

We ease the tiny man into bed, his alertness changes moment to moment. I take his vital signs again, and discuss monitoring issues with his caregiver. Rather suddenly, he stops talking. "Is he okay?" She peers anxiously. Without showing alarm, I check his pulse, and stick my stethoscope in my ears for a breathing check and blood pressure.I touch his check and rub his sternum. His breathing is shallow, and suddenly he opens his eyes. He had fallen asleep. His granddaughter and I both started laughing, our cheeks wet from tears moments ago.

She seems at peace with the decision, and as I leave we hug. "Thank you. Thank you for everything," she said. I feel I have done little, except listen and support. "You bet," I replied. "This is why I'm here."

Copyright 2011. All Rights Reserved.

Monday, October 3, 2011

Sanctify Me

Saturday afternoon, I went in search of anchovies. Because Friday night, I had decided that the one thing I truly, positively wanted to eat over the weekend was a fresh Caesar salad, made from scratch, by me. Saturday morning, after an hour-long massage during which I may have actually seen God (or at least called out Their name a few times), I wandered happily through Whole Foods, sniffing, tasting, touching everything in my path. I uncapped and smelled essential oils, I ran my hands over mangoes, I inspected berries, I inhaled cheeses. I said yes to every hummus and organic cracker sample on offer. I don't trust people who say no to pleasure when it is freely given, it smacks of a stingy soul. I come out of any market not just smelling like a rose, but smelling like rosemary and mint, Tunisian olives, sandalwood candles, Bob Marley One Love incense and a little cinnamon-clove oil behind each ear.

Saturday evening, home from a long,hard day of mind-blowing sensory indulgence, I drew the drapes, lit the vanilla candles, poured myself a glass of Cabernet and commenced to cook. As I gathered my ingredients and turned on Cat Stevens Footsteps in the Dark and listened to old favorites "Katmandu" and "The Wind", the words of the Catholic communion rose on my breath. Take this bread, and eat it, I thought, as I prepared the garlic and parmesan-dusted croutons. Take this wine, and drink, I thought, as I poured myself another glass of the Cabernet, finding a ridiculous amount of solitary enjoyment in making a Caesar salad. For this is my body, as I chopped up the lovely little salty anchovies, their bodies, which they had given up for me.

As will often spontaneously happen around dinner time when you are cooking, a friend rang. Was I interested in coming out for drinks and dinner? It was my complete pleasure to reply, no, not tonight, but why don't you come over and let me cook for you? Slow food, enjoyed in, what could be better? And so my enjoyment of my dinner was doubled, as I chopped the Romaine, rubbed the bowl with garlic, whisked the olive oil and anchovies, shredded the chicken, squeezed the lemon, grated the Parmesan, and my friend and I shared the stories of our week as we shared our wine. Never one to rush courses, I like a separate plate for each one, to fully appreciate each item. Sometimes I talked, sometimes my friend, sometimes there was silence as we savored and contemplated. Silence is key in a good conversation, it is the space between the notes that defines the music.

The strawberries, peaches and mangoes were perfectly ripe, fragrant from sitting in my warm car as I dawdled through errands that afternoon. I chopped slowly, carefully, deliberately, as the priest offers up the host in the Mass. As I dribbled the Chocolate Balsamic Vinegar over the sugared fruit, I once again heard the Mass in my inner ear. Do this, I thought, in memory of Me.

Holy communion in an ongoing act of sharing. Of sharing what we have, of sharing who we are. Cooking, if done correctly and well, is a sacred act. An act of communion with yourself, with your mind, your body, your sense of touch, smell, and taste. It is an act of communion with others, preparing something for them, watching them enjoy and experience something they have never experienced before. This is where I find God, in the body. In what the body needs, in the true humanity of the Divine in all its forms, and in the divinity of humanity. Take this bread, and eat it, for this is my body. Take this wine, and drink, for this is my blood, given up for you. Do this, in memory of me.

Copyright 2011. All Rights Reserved.

Friday, September 30, 2011

"Well, she was a plain gal, but she could tell a good story..."

And thus was Mary Flannery O'Connor described by some cheeky bastard whose name I can no longer recall. I have just finished reading Flannery: A Life of Flannery O'Connor by Brad Gooch (2009), and turning the last page, I feel I have lost a friend. Reading a detailed account of her life, and her death from Lupus at the age of 38, and visiting her home, Andalusia, at Milledgeville, Georgia several weeks ago has immersed me in her world. Every night for the past week, I have ended my day with her. Living here in Georgia as I do, the towns and places she speaks and writes of are intimately familiar to me; Atlanta, Savannah, Milledgeville. Through her I have come to know places, and the culture and mores of the American South, at a deeper level. But more than that, she's been good company and a friend in the way that good writers and good books are: in their words you find yourself, a better self, a deeper self. And with them at your side, you feel less alone.

My relationships with books have been some of the most real of my life. If you are a reader you will know what I mean by this. I cannot remember a time in my life when I could not read. I know I was reading and writing in kindergarten, and my teacher angered my mother by telling her she had "ruined" me, because I was supposed to learn these things in school, not already know them when I got there. In spite of this, my kindergarten teacher wanted to fail me and make me repeat the year, because apparently I was so quiet that she thought I was socially awkward and needed another year to adjust to the other children. If she had bothered to ask me, I would have told her that I didn't find I had much in common with the other children because they could not read yet, so I preferred to spend my time painting rather than talking. But she did not ask.

At home, my circle of friends was large, spanning the globe and the centuries. My grandfather and I read the National Geographic together, my grandmother and I read together every afternoon during the month of June, which I always spent with them at their home near what is now the Oregon Dunes National Seashore. The only child in a family of very modest means, I was spoiled in two ways: my parents and grandparents spent time with me teaching me skills and telling me stories, and while I was not allowed to ask for things, I was allowed to choose any book I wanted from a bookstore. This thrilled me to the very marrow, prompting spontaneous pirouettes of glee, and very early I developed lists of books to read, books to purchase, books to borrow, books already read, books I loved, books to give as gifts, books to read again, books that really should be written, and books that I would write. My hall table now holds books borrowed from Nell, books to give to Nell, notes on books as heard on NPR that sound worthwhile, books to finish because I started them, books to tuck away discreetly before the in-laws visit the next time, books I'm flirting with but haven't made up my mind about reading yet and really should make a decision about before next Thursday night, when Nell comes over for a glass of wine, and declares, "Oh GOD! Look at this! We're such book-sluts!"

Long, luxurious afternoons inhaling books and the smell of hot boxwood. Days spent with chicken pox eating caramels and reading all of the Laura Ingalls Wilder books in quick succession. Pneumonia and Margaret Mitchell. David Copperfield in one fevered night. Picking up Paul Reiser and David Sedaris in public places and reading entire books standing up, laughing so hard strangers look at me with a mixture of pity and envy. The month I read War and Peace, and then almost everything else Tolstoy wrote, and fell in so in love with being in the middle of that wonderful book I walked around bereft for a week when I finished it because I didn't know where my bookmark lived. Baths that have started out hot and turned cold without me noticing. Sunny fall afternoons reading Nathaniel Hawthorne on the front steps, with a cup of Red Rose tea, as Hawthorne should always be read. May Sarton's diaries every spring, Plant Dreaming Deep, entering deeply into one writer's life, and by doing so, entering more deeply into my own.

The act of writing is the act of taking your skin off, and the act of reading is the act of temporarily wearing another's skin. To see their world through their eyes, to share in and value their experiences. Thomas Merton's epitaph of O'Connor, on the back of Everything That Rises Must Converge read "I write her name with honor, for all the truth and all the craft with which she shows man's fall and his dishonor." (Gooch, pg. 372). Thank you Flannery, and from one plain gal to another, you did tell a damn good story.

Copyright 2011. All Rights Reserved.

Tuesday, September 27, 2011

Twenty Pieces of Advice to a Young PT

In the spirit of keeping my fingers limber while I toss ideas around in my mind, wait for them to settle, and collect the courage to write about larger, tougher, even less popular issues than I usually write about. This, from 2010:

Twenty Pieces of Advice to a Young PT

1. Give your Clinical Instructor (CI) time to get to know you. You know you can do the job, but they have just met you and need to observe you for awhile before they know they can trust you to do your thing. You have to earn their trust with your behavior and your skill, and that takes time.
2. CI's differ, just like people, because amazingly enough, CI's ARE people. Some will want to micromanage you, some will give you a longer rein right away. Don't make assumptions about someone's likes and dislikes, ask them what they prefer.
3. Keep a running list of things you need to look up or review. It will help the next day and in the long run. Develop your special interests and then don't be timid, offer your knowledge and opinions in a humble yet confident way.
4. You are the student and that's okay. Some people will completely ignore you, some will assume you know absolutely nothing because your tag says student, and some will have as much confidence in you as you have in yourself. In the end you are just passing through. Learn as much as you can, give the best care you know how, and let the rest go.
5. You will not click with everyone, CIs, coworkers or patients, and that's okay. With some CI's and patients you will get along like a house afire and genuinely make friends and "chosen family". With others a strictly business relationship is all that is required. They are your boss, treat them as such, and then go home.
6. Go to different states, different cities, and different hospitals if you can. You will meet people with a wider experience, varied perspectives and get to be a temporary local in great places. Every place is what you make it. If you aren't loving it, maybe you need to put a little more love into it.
7. When your first, second and third choice for clinic falls through, be excited! This only means that the experience you are truly meant to have is coming your way. Three out of four of my original choices were changed to something else, and I ended up loving what I got instead of getting what I thought I wanted.
8. Be assertive and brave and open to all new experiences. The ones you never considered can turn out to be the best ones. Go up on the high wire, the view is great!
9. Laugh at yourself regularly. Here's a little known secret: CI's don't actually expect you to be perfect. They expect you to be competent and get better with practice. That's a big difference. Perfect will make you crazy. Practice will make you better.
10. Never underestimate the value of repetition. Perhaps you, like me, sometimes get bored by repetition. No matter. There is value in it and you will come to respect the ability of the brain and the body to remember a piece of information or a skill with repeated exposure and practice. Soon things will be second nature, and then you can add a little style.
11. "To thine own self be true." Know yourself. Know if you are an introvert or an extravert, know the signs when you need a little rest or silence, and know that it's okay to ask for what you need. If you sometimes need silence to concentrate, learn to express that professionally and with good humor, because you don't want to get to that frazzled point and then snap someone's head off before you know you've done it. If you have a quirky sense of humor, express that appropriately. If you like to use your body in your work you will discover that. People differ in what makes them happy, pay attention to what makes you happy in your practice, where you get bored, where you need "more cowbell."
12. Find your tribe. PT's are a pretty varied group. What part of PT gives you that "all systems GO!" feeling? Warning: it may not be what you expect. This is why it is vitally important that you try everything you possibly can, including working with different age groups, different approaches and different hospital and corporate environments.
13. Be organized. I'm not talking about freakish organization here, I'm talking about keeping a basic calendar and a few labeled manila folders. Print your syllabus, mark your dates, allow for the inevitable SNAFU. Really. Don't make yourself, your CI or your professors crazy over such a simple thing. Get and keep your "poop in a group" with regard to papers.
14. Learn all you can about your organization. Know the mission, the goals, the basic structure of the organization and demonstrate your knowledge early. Ask your CI if you can spend an afternoon in specialty clinics, with other PT's who have specialty knowledge, etc. This will help you broaden your experience.
15. Develop a gentle hand with people, literally and figuratively. Your patients aren't feeling well, they have pain, or they would not be coming to you. Start gently with them, you can always add more pressure, force, energy, intensity. Think of it as coaxing a kitten. Watch their face, watch their eyes, pay attention to what you feel beneath your hands. Ask, ask, ask. Ask them for feedback. More? Less? Here? There? Better? Worse?
16. Know your anatomy. You've heard it everyday for three years. It really is your best friend in the end. PT's are maestros of the body and in order to play well you have to know your instrument, inside and out, upside down and sideways.
17. "People are crazy." And that's okay. A wise friend offered me that bit of advice a long time ago, and now I offer it to you. It explains a lot of situations, and I say it lovingly. We are all crazy in our own way. Your patients, their families, your co-workers and innocent passersby on the street are "whole body preps" - they come with a past, a present and future, they sometimes come with mental challenges of various sorts, mental illness diagnosed or undiagnosed, fears, frustrations, needs, wants, memories, hurts, foibles and ticklish places. Treat them gently, they have placed their trust in you. Treat yourself gently, stay focused, know your boundaries, and do your best work in the midst of the craziness around you.
18. In the end people are responsible for themselves. I would love to tell you all your patients will be grateful, that they will always adhere to their program, they will follow your advice to quite smoking and eat smaller portions, but alas, some will and some will not. You will continue to do your job by considering the whole person and counseling and treating them holistically. However, you cannot "make" them do these things. You can explain in ways they can understand, you can break tasks down so they are less daunting, you can instruct, encourage, demonstrate and modify. People must meet you half way and do their part. Explain that good PT treatment and good outcomes is a partnership.
19. Laugh if you can, cry if you must. You will be with people in some incredibly intimate moments, and the more appropriate humor you can demonstrate the more comfortable everyone will be. Dealing with "Brother Ass" can be incredibly funny, and it's okay to laugh WITH your patient. You will also work with patients and families who are facing a very hard time in their lives, some may even be dying, and relatively soon. Unless you are made of stone you may shed a few tears, too. Remain composed, be discreet, keep your focus on the patient, and have a big boo-hoo later in private if you need to, there is no shame in it.
20. Throw your hands in the air and enjoy the ride. Individual days may be long, but the experience itself will go by fast. Don't forget to enjoy yourself, and be thankful for the opportunity.

Wednesday, September 21, 2011

Tribal Wanderer

"The snowflakes fall, as winter calls, and time just seems to fly...Is it the loneliness in me that makes me want to cry?" - Whispering Pines, by Johnny Horton

Although I've always said that home is wherever I hang my stethoscope, lately I've begun to wonder if that is true. My entire life I have been the one who leaves, and I have liked it that way; jobs, towns, schools, groups, friends, organizations. I pack my little red suitcase like I used to pack my little red wagon, and I ease on down the road. New experiences call to me like the sirens called Odysseus; countries I have not seen, skills I have not mastered, wines I have not tasted. I have always viewed my life as incredibly short, and in my heart I know that one hundred years will not be enough time to experience all that I want to experience. I'm secretly hoping the Hindus are right and I get several lives, because there are so many things I will not get to do in this one. Like the clever north wind in the movie Chocolat and the people it influenced, I disappear from pictures, lives and memory. Yes, ladies and gentlemen, I am a tribal wanderer. And now, much to my own surprise, I am about to wander home.

Is there something deeper in us than we know that defines home? Something that calls us home on a cellular level? Something that is always there, no matter how far away we travel, no matter how long we stay away? What is it that calls me back to this place? They are my earliest sense memories, but is that it? With each passing year, I find myself less willing to spend any time or energy on experiences, places or people that don't feel right. Who among us really knows how much time we have allotted to us? Why spend it in the wrong place? No place else has ever smelled right, although they smell good in their own right. Other places have felt good, and I've enjoyed them. But they have not been home.

For there is something about the pine trees there that looks right to me. The way the top of the Western Hemlock tilts over slightly, branches held at honest Charlie Brown angles. The way the mist hangs in the air and the way the sea smells when I stand beside it. The way dark falls early in the winter, wrapping me in a blanket of night as I read the thoughts of centuried others, and try to write my way into, and out of, my own. The slick of the roads as I drive to the coast, a plaid thermos of hazelnut coffee on the car seat beside me, singing the Johnny Horton songs my grandparents used to sing, and that I now play out into the darkness of heaven in hopes they might hear. The smell of a smokehouse full of fish caught that day, moss on the fallen trees on a wooded path that looks like a dinosaur might wander through. The first strawberries of June, the first snowfall in late Autumn. The first time I felt I might want to stay somewhere, and the first time I admitted it.

Monday, September 19, 2011

Rhythm Method

Music: Siuil a Run, by Clannad; and Rising of the Moon, by Column MacOireachlaigh

"I bear orders from the captain, get you ready quick and soon, for the pikes must be together by the risin' of the moon. By the risin' of the moon, by the risin' of the moon, with your pike upon your shoulder, by the risin' of the moon." - Rising of the Moon, Column MacOireachlaigh

In his classic book, Running and Being, George Sheehan says that if the game is played in your rhythm you will win, and if it is not, you will lose, and the real trick of life, and running, is to make sure it is always played in your rhythm. I have felt this for years in my running, in guitar, more recently in fencing, and flying. There is that moment in all four experiences where you reach perfect rhythm with yourself, let go, and fly. Everything becomes easy. The piece of music is in your perfect key and your voice and your instrument vibrate as one. Your legs seem to lengthen, your breathing becomes deep and ancient, and you never have to stop. Your weapon flies, you score every touch and laugh because it is so easy. Your muscles relax and the plane almost flies itself. These moments are special, and you remember them, not so much for their rarity, but because it is favored country, the place where you live, the place that is cellular home, deeply true in your DNA. You remember it, you seek it, you're a little in love with it, if the truth be told, because you know the difference between it and a game that is played not in your rhythm.

For three years, in my doctoral program, I was a fish out of water. A mid-life career changer, I was surrounded by twenty-something college athletes and cheerleaders. Yes, the kind who build pyramids and win awards in national competitions. As you might imagine, we had a lot to talk about. Over the three years, I came to enjoy and respect them for their many good and unique qualities. If they thought about me at all, I think they relied on me for what I could always be counted on to do: come through. Be older. Carry the conversation. Teach the class. Volunteer. Take big chances and make a fool of myself in front of big crowds. And in the end, win awards for doing just that. My best friends were a few others who were just like me in that we were all unique. A pediatrician from Russia. An orthopaedic surgeon from China. A chemist from Nigeria. An engineer who runs marathons. We stuck out because we were older, more experienced. Introverts in a sea of extroverts. We stuck out because we stuck out, the thing an introvert hates most yet cannot help but do.

Three classes of 40 students each, pressed together in a few classrooms on the top floor of a converted parking garage. No windows, sweltering in summer, freezing in winter, smelling year round of formalin and formaldehyde, cadavers, athletic sneakers and sweat. An only child, I suddenly had 39 younger brothers and sisters with whom I spent every waking moment. We saw each other in the best and worst of circumstances, successes and failures happened together, with everyone watching. When you succeeded or failed it was in front of the crowd. Tears and fears and feelin' proud were shared with the entire class not always by choice but because we were hard workin' sardines in a can. What I had always hated most, being human in front of others, I gradually came to trust, because I trusted them.

We made allowances for each other, and over the course of three years, I gradually found a way to integrate my own rhythm into the larger class. Before every exam I ever took, I could be found on my own, separate from the chattering crowd, with my headphones in my ears listening to Irish drinking songs, in traditional Gaelic, and non-traditional English. They knew not to bother me as I paced the halls, playing the bodhran drums to blow off steam, or busily running my hands over an imaginary skeleton or body, tracing nerves, combining music with kinesthetic learning, visualizing everything in my head for later recall. However odd it may have seemed to others who relieve their anxiety by talking, it was my rhythm and when I played in it, I always won. When the high scores and awards came, and the inevitable surprised looks, I found it was best just to smile, shrug and put my headphones back in.

Find a way to play the game in your own rhythm. If you do, you will win. If you don't, you will always be at odds with yourself, and you will always lose. Find your rhythm, stand in it, and then start running.

Tuesday, September 13, 2011

Looking for Superman

Today my last patient of the day was a bilateral below the knee amputee who could only see me if I was approximately 3 inches from his face, and could only hear me if I literally shouted at the top of my voice into his ear. "He had hearing aids, but destroyed them during one of his spells. Medicaid won't pay for anymore. He's on medication now, and he's really calm," his son informed me. It was the end of my patient treatment day, and my voice, never particularly loud, was fading, as many of my patients are hard of hearing. I do everything I can to preserve the dignity of my patients, and one of those kindnesses I try to extend includes not shouting at them. Today, as I treated the blind, the deaf and the lame, I could not help but think of Helen Keller, and Anne Sullivan.

To say his home was humble would be an understatement, and yet as I settled into my history and physical of the man, I noticed, as I often do, the warmth in his face, and in the face of his son. These are ordinary people, on an ordinary street, on an ordinary day in America. Dogs ran to greet me at the door, smells assaulted me. There was garbage, there was animal feces, and the man had what he referred to politely as, "sometimes I leak a little, ma'am. Sometimes I don't make it in time." "Yes sir. We're going to work on that," I shouted into his left ear, trying not to breathe too deeply, so I could keep going. "We're going to work on your strength, and speed, so you can." In a world that sometimes seems filled with unsolvable problems, this is one I can solve.

Wisdom will happen to you when you least expect it. It does not happen to me in church, or sitting at a cafe reading de Beauvoir, or walking through the woods, although I find peace in these places. Wisdom happens to me in the heat of a needy moment, and makes me want to believe in an attentive God. It taps me on the shoulder and turns my head around, before I make a mistake. Today, that nudge from within, that whisper in my ear: Ask this man to show you what he can do. "Sir, before I offer any suggestions, would you show me how you get from the wheelchair to the commode, and the commode to the bed?"

And in a maneuver with no less than a dozen distinct and precarious steps, he did, describing each move proudly. When he finished, his thick glasses were smudged, steamed with sweat, and sat crookedly on his head. "Hey, Superman," I said as I reached out and straightened them, as I so often do for my patients. He sat panting with effort, looking like a super hero, capable and proud.

His eyes were tiny behind the thick lenses and four crooked teeth beamed at me in an open-mouthed smile. "Well, sir! I'm mighty impressed, and I don't impress easily." He threw his head back and laughed. I reached out to shake his hand, and he clasped it and pulled me down so he could see me clearly. "When are you coming back?" "Next week," I said, and suddenly, I couldn't wait to get there. I know Clark Kent when I meet him, I thought, on an ordinary street, on an ordinary day in America.

Friday, September 9, 2011

Hello, is this thing on?

This is my very first test post from the road. Or, from the airitport lounge on the way to the sky. If this works it will open up new writing possibilities. For the approximately five of you who are interested.

Monday, September 5, 2011

The Skill of Disappointing Others

The incense is sandalwood, the candles are pear, and I am once again contemplating the mind of Camille Paglia as I settle into my evening and try to make sense of my day and the cosmos. Today, frank conversations with families about rehabilitation potential, the sort of conversations no clinician really wants to have. Their lives are changing in big ways, and they want me to tell them it will all be okay, that it will be the same as it was before, and I can't. It won't be the same, but it WILL be okay, and I try to help them see that. I try to guide them as best as I can, with grace and tact, and help them see positive aspects of situations where they can only see the negative. I am an optimistic pragmatist, lighting candles against their darkness, one step ahead of them on the path. They keep their eyes on me and that candle, as I lead them into their dark and tell them not to be afraid. We grasp hands as we hurtle toward heaven.

At the end of the day, a good hard run through the cemetery in the pouring down rain makes me feel alive again. I connect with the earth by running her roads, splashing through her puddles, a run that is a swim and my dolphin-self is delighted because I don't have to choose between water and earth. A hot bath with sandalwood oil and a quote I love from Paglia (1992, in Sex, Art and American Culture, from her work Sexual Personae: Art and Decadence from Nefertiti to Emily Dickinson), worthy in my mind of preserving here, because it rings so true for me:

"Jung says every man has a repressed female self, the anima, and every woman a repressed male self, the animus. In my case, it was the anima that took longer to emerge, for the animus was never repressed. I remember my fifth-grade teacher making me stay after school because of some shoving and wrangling, I was always fighting with boys to be first in line. Furious, she pushed a dictionary toward me and made me look up the word aggressive, which I did, hot tears of shame rolling down my cheeks. Colorful incidents abound, such as when, as a student shopping in Liggett's drugstore at Yale, I broke my umbrella over the head of a rash molester. From childhood to the present day, I have considered it my task to challenge, by word and deed the public standards for female behavior. Marooned in the conformist, domestic Fifties, I felt little connection with the boy-chasing girls of my time. Instead, I was galvanized by late-night movies from the Thirties and Forties which showed quite a different kind of woman, either bold and pioneering, like Katharine Hepburn in Woman of the Year, or elegant, sophisticated and sexual like Marlene Dietrich in Dishonored. Film became my door into a lost world. What I was glimpsing was the first phase of feminism, born from the push for the vote and then peaking in those rugged individualists, the brilliant career women of the prewar era, like Dorothy Parker..." pp. 110-111.

She had me at wrangling and shoving. While I don't agree with everything Paglia writes, I do agree with quite a bit of it, and I certainly relate to her experience of kicking against the barn door of convention. Her stories brought back my own memories of being sent to the principal's office in the fifth grade for leaping on a boy who was teasing me, wrestling him to the ground and sitting on his chest while I punched him mercilessly. Or the third grade, when I slammed my Miss America lunchbox down on the head of another neighborhood boy who would not leave me be at the bus stop. Or the age of three, when I stood up and whacked the neighbor boy over the head with my toy shovel. For some reason I find it comforting to find out that Paglia sports a similarly checkered history, and writes about it so eloquently.

Saturday, September 3, 2011

A Glass of Wine, Camille Paglia, and Thou

The end of summer, and I sit on my deck in the heavy Georgia heat with a glass of Cabernet Sauvignon and a copy of Camille Paglia's essays on "Sex, Art and American Culture." It is Labor Day weekend, and I am celebrating the end of summer. Tomorrow I will be swimming and feasting and toasting with friends by the lake, but tonight I savor the end of a season and dig deep into Paglia's essays.

The trees are the rich, deep green of early September, a few early leaves have begun to fall. My early morning runs are pleasant, and while evening runs are still hot, my core body temperature remains at a manageable level and recovery is swift again. This summer has passed in the blink of an eye, and I have had little time to enjoy the pleasures of summer I usually indulge. Last summer marked the end of my doctoral program, and while it was busy and stressful, it was more flexible than this summer has been. I spent a wonderful eight weeks in Florida, working at a fantastic hospital, being adopted as a temporary local in a great neighborhood, taking salsa classes, running along the waterfront, even joining a wine club. I feasted on tuna steaks and fruit, wrote interesting and worthwhile research papers, took off down A1A whenever the spirit moved me. By day I helped kids walk again, at night I explored new places, music, people. It was heaven, and I knew I was in it.

This summer, the dailiness of a full-time plus caseload has made the summer go by faster than any summer I can remember. As I am sitting on my deck tonight I hear my neighbor moving about on his deck, and smell the pleasant smell of his cigar. I suddenly remember it has been ages since I brought my guitar outside to play and sing, lighting candles and working up new songs and pretending no one hears me. For years now, I have brought my guitar outside to play on hot summer nights, and on most I would hear my neighbor raise his window very slowly, open his french doors, and settle his dog. At first disconcerting, as I do not sing in front of anyone but fireflies, I gradually got used to his presence through the smell of his cigar, and my playing picked up again. It was a sort of gentleman's agreement, I think. I never acknowledged his presence, and he never closed his windows.

The end of summer, and I realize how few of summer's pleasures I have indulged this year. It's time to wipe off my guitar, and bring it outside again. I know the fireflies will appreciate a tune or two, and unless I am completely mistaken, so will my neighbor.

Thursday, September 1, 2011

The Trouble With Art Museums (2002)

THE TROUBLE WITH ART MUSEUMS (short fiction, 2002)

Marie opened the box she had brought with her from home. The corrugated tan box was soft, frayed at the edges, almost paper-like in some spots. She had used this box to move her belongings from desk to desk, office to office, life to life, for over twelve years. She had used the same box on her move from Great Falls to Helena, from Helena to Austin, and now from Austin to Marietta, Georgia. Each time, she had carefully wrapped her picture frames, small crystal vase, silver potpourri bowl and matching desk accessories (a gift from her Aunt Violet, God rest her soul) in newsprint and secured them for the journey to the new city. The box was filled with newspapers from every city in which she had lived.

She carefully unwrapped her personal items and arranged them on the large, empty, putty-colored metal desk. From the bottom of the box, the last item she took out was the first item she had put in when she had packed her box in Austin. The item was a new wall calendar, full of pictures of great works of art, from the Museum of Art in Boston. Boston! Marie had never been to Boston, but it sounded like a wonderful place. Her supervisor at MacroTech in Austin had given her this calendar as a parting gift. Marie sighed, remembering Constance, Connie, a friend as well as a supervisor. Marie remembered the many lunchtime walks she and Connie had taken through the office park, a rather non-descript place that was brightened by Connie's description of the wonderful museums in her home town. Connie had brought the art alive, talking about the artists and their lives, often bringing a book about a particular movement to share with Marie. She would miss Connie, but Marie had promised that she would not stop thinking about art, that she would continue to explore museums and read some books about her favorite artists. Maybe she would even take up painting herself. Why not? There were so many things in life to enjoy, to try.

Marie tacked the calendar to the putty colored wall at the left of her desk, flipping it open to January. The painting for the month was "Starry Night" by Van Gogh. Van Gogh's works made Marie's heart race, she could feel the tension in the swirling, whirling paint, the intense colors. She always though that Van Gogh must have been the most intensely unhappy and intensely happy person who had ever lived. To create such beautiful paintings, so alive, so breathtaking! What a great gift. Marie wondered if she could ever create something that beautiful. It might be enough, she often thought, just to try.

Marie looked about the cavernous room, filled with putty-colored desks, and putty-colored chairs. Putty on the walls, putty on the chairs, putty, putty everywhere, she thought. The room reminded her of a pumpkin patch filled with the Lumina white pumpkins her grandmother used to grow. The clock at the front of the room shone on the desks like a large, storybook moon, lighting them up, casting shadows on the uniform emptiness. Not a scrap of color. How could a room like this exist? Marie's desk, by comparison, was already a riot of color. The calendar drew the eye like a beautiful jewel, the colors of the Van Gogh, though only a small print, looked like a spray of sapphires on the wall.

Seven forty-five. Everyone would be arriving soon. There were so many people to meet on the first day of a new job. Marie smiled as she imagined her new co-workers gathering around her desk, bright-eyed and friendly, perhaps noticing her calendar and, discerning her interest in art, striking up an intense conversation and inviting her to join them for lunch. Perhaps in this office people even went out for happy hour! Marie wriggled in anticipation, feeling the carefully pressed creases of her new red suit. Oh, this was going to be fine! A new city, a new job, and soon, new friends! She touched the calendar, rubbing it excitedly like a talisman.

"Good morning!" She called out a cheery greeting to the man who had just entered the room. The man stood at the coat rack just inside the door. He took off his tan overcoat, exposing a grey suit underneath. He looked around, saw Marie, and lifted his chin in greeting. Once free of the overcoat, he picked up his briefcase and walked down the center aisle, looking neither left nor right. Marie readied herself for conversation. "My name is Marie Beckwith." She beamed a genuine smile in the stranger's direction.

The man stopped at one of the desks and put down his briefcase. He checked his breast pocket for eyeglasses. "Well. I'm Harold Smythe." He reached over and turned on his computer, staring at the blank screen, absently jiggling the mouse. Then, he pulled out his putty chair, sat down and began to point and click. As Marie stood by her desk, lips parted slightly and eyebrows raised in anticipation, she started when Harold looked up from his computer screen. He looked at her (rather, at her red suit) and then at the calendar. Then he looked back at his computer screen.

Marie took the opportunity. "Do you like Van Gogh?" Good! Good opener! Everybody likes Van Gogh. Really, what wasn't to like? Van Gogh was known, safe enough, unlike Salvador Dali whom nobody really understood or a contemporary political artist who might be inflammatory. Everybody had seen this picture, it was a good thing to get started on. She smiled brightly as she leaned casually against the edge of her desk. The metal edge felt uncomfortable on her thigh.

"Who? Oh. I don't have much time for that arty stuff." He directed his gaze back to his computer screen. And that was it for Harold Smythe.

Marie looked out the window. Well, I guess he's just busy, she thought. Most people don't mean to be rude, she reminded herself. Besides, people were starting to stream in the door. A few more men, mostly women, young, old, thin, heavy, carrying all manner of bags, lunches, newspapers. They were boisterous as they stood by the coat rack, hanging their tan, brown, or putty overcoats on misshapen wire hangers. A plump woman sang out "One, two, three, there ya be!" A burst of laughter issued from the knot of women. One of the men chimed in with "Oh you women! Any little thing sets you off!" Hearty laughter all around. Marie noticed that she was nodding her head and smiling in a very determined way, trying to discern what was clever about the conversation. There must be something funny, or they wouldn't be laughing. I'm just new, she thought, they are just repeating punch lines to funny old stories. After I've been here a while, I'll laugh too.

The group turned an about face like a well-trained core of cadets at a military training academy. They proceeded forward as a unit, eyes front. They stopped when they saw the red suit coming toward them. "Good morning! I'm Marie Beckwith, new account representative." Marie extended her hand and smile warmly.

The plump woman in the front spoke for the group. "Well. Marie. I'm Lois. I'm sure you'll like it here at Taylor, Tate and Vaughan." Marie stood there with her hand extended and her eyebrows raised for a few more moments as she waited for the woman, or anyone, to shake her hand. No one did, although they did all smile putty-colored smiles at her. "My goodness," Lois spoke for the group. "What a bright red suit." The group dispersed to their desks, leaving Marie standing alone in the center of the room. Computers clicked on, proceeded through their series of beeps, and the second hand on the moon clock inched forward another notch.

Marie used the time she expected to spend getting acquainted with her coworkers to familiarize herself with the accounts that had been assigned to her. Periodically, she looked up from the pile of manila folders and studied the people in the room. Across the aisle sat a moon-faced girl with small eyes. The name plate on her desk said Betsy Morrisey. Betsy Morrisey. Betsy Morrisey. Marie said the name over and over to herself under her breath. This had been a habit of hers since she was a little girl and had sat alone in the back of the car on long car trips with her parents. The moon-faced girl turned and looked at her.

"Are you saying my name?" she asked dully, as if she were speaking from very far away, from the very surface of the moon. Her lips were flat, spreading out like the Sea of Tranquility in the middle of her face. Marie watched the lips move. She wanted the girl to say something else so she could watch her lips form the words. Marie realized the girl was waiting for an answer.

"Saying your name? Well, I guess I was. Please forgive me. I noticed your name rhymed, and I like to play with words. Words are funny, aren't they?I mean one word just leads right into the next and pretty soon you have poetry. Why, I read somewhere that most poets get started in the poetry business just because they like to play with words. I just love words. I really do. Say, who do you prefer, Robert Frost or Emily Dickinson?" Marie waited expectantly for a reply. None arrived. Betsy looked at Marie as children who have never had to move always look at the new kid on the first day of school, disdainfully, blissfully unaware and uninterested. Marie smiled weakly. Betsy turned back to her computer screen.

I guess I won't be having lunch with Betsy, Marie chuckled to herself. She called her account contacts and made an appointment for get-acquainted visits throughout the week. Noon arrived and a few people brought out lunches from home. Smells of egg salad and tuna wafted around the room, mingling with new carpet smell and an undercurrent of Calvin Klein's Obsession. There's always one woman who wears too much Obsession, Marie thought. She leaned around her cubicle wall and knocked playfully on the file cabinet of the man behind her. "Hi there!" She looked at his name plate. "Ronnie. Is there any place good to go for lunch here? I'm starving. First-day on the job, you know, nervous-hungries."

"Lunch? Never eat it myself." The man patted his stomach and cocked his head in the manner of a former marine who is about to tell you what is wrong with Amurrica today. "But if you go in for that sort of thing, you got your choice around here. Yessir, the Thorson Family Barbecue is about two blocks down Front Street, and the Jones Brothers Southern Style is around the corner on Water Street. Both good places. The man gave Marie a big smile. She noticed he had a thick neck and a moon-face similar to Betsy's.

A moon-faced man behind me, and a moon-faced woman to my right. I have two moons orbiting me. Just like Mars! Marie suddenly felt rather wicked inside her red suit inside her putty-colored cubicle. "I was sort of hoping for someplace with a salad bar. Is there someplace where people usually go?"

"You girls! Always watching your figure! Well I guess if you don't watch it, none of us fellas will either, am I right?" He chuckled. Marie's eyebrows knitted into a quizzical look in spite of her determination to get along with each and every one on this, her very first day. Every time it happened, she was dumbfounded when someone called grown women "girls." Still, he was the only person who had shown any signs of being friendly. She decided to ignore it and move on. "I don't know of any place with a salad bar, ma'am. About half the folks here bring their lunch. I don't rightly know what the others do."

"It's too bad there isn't an art museum nearby. In Austin, my colleagues and I used to bring lunches from home and go to the art museum grounds. Sometimes a band would play. Then we would stroll in the museum for a little while."

The man held up his hands in the "whoa" position. "The trouble with those art museums is that they've got no Christian values. I mean, the nudity is one thing, that's okay I guess if it's tasteful and all. But some of these artists, like that Mapletree fella, they got no common decency. I can't take my kids to see something like that."

Marie gave a non-commital nod. She didn't really care for "that Mapletree fella" either, not her taste. But she was troubled by something else in the man's tone. He, along with Harold Smythe and Betsy Morrisey, seemed determined not to like art. They acted as if purple howling dogs would show up on their front stoop at the stroke of midnight if they gave into creative, or any other, desire. Marie glanced at the clock. Noon. She gathered her thoughts, her things, and left.

That afternoon, her pre-order of office supplies arrived. When Rita, the unit secretary, brought the box back to Marie's desk, she lingered, making small talk and looking enviously at each brightly colored item Marie pulled out of the box. "Gee, I've never seen anyone use folders in those bright colors before. I didn't know folders came in purple and yellow. Ooh! Look! Red, too! What are you going to use the red ones for? Everybody in this office orders green." Rita's whole face was lit up. It was the most curiosity Marie had seen on any face in the office.

"Color adds life. I'll color code my clients, red for restaurants, yellow for wholesale food distributors. You should order some colored folders too, Rita. I think things could use a little more color around here." Marie was feeling expansive, almost giddy. She grinned at Rita, whose bright but blank face reminded her of a bolt of cotton calico, full of the promise of what it might become under the right artistic hand.

"I think I will. Wow, you know, I've looked at the pink folders a dozen times. I've just never had the guts to buy them. They cost extra, you know." Rita was hesitating. Spending extra money on something just because it was beautiful seemed not only frivolous, something her mother had discouraged, but downright unpatriotic and probably un-Christian. She looked pleadingly at Marie.

"Rita, I think that if you are surrounded by beautiful, artistic things you will be more productive. As a matter of fact, I think we should hang some prints or photographs in this office. Good for morale, and good for business. I'd be happy to pick them out."

"Do you think? I have a catalog...at least, I think I still have it, I may have thrown it away. It's full of prints and things for offices." Rita giggled, the promise of adventured seemed to well up in her, gurgling to the surface and splashing over. "Oh my goodness! Oh my GOODNESS!" She walked away from Marie's desk toward her own putty expanse at the front of the office. She continued shaking her head and waving her hand in the air as if she were at that very moment testifying at a church revival.

After 20 minutes of rooting around at the bottom of all six of her desk drawers, Rita pulled out a faded, creased catalog of Fine Art Prints Suitable for Today's Office Environment. On the front of the catalog, a politically-correct crowd gathered in admiration around Monet's Irises. Rita beamed and held the catalog up so Marie could share in her victory. Inspired for perhaps the first time in her work, Rita brought the catalog right back to Marie. She was panting with excitement. "Okay. Pick. I'm ready." Rita licked the tip of her pencil and held her notepad aloft...

(Part 2 to follow in next entry)

Return of "Bad Poetry Never Dies"

Written after watching an episode of Unsolved Mysteries, circa 2001. It was very cold that day.

GARRETT'S COVE IN WINTER

The cold dawn, the cold night
Chilly laughs of nervous fright
Emotionless knowing, glacial stare
The cold-shouldered newcomer, who spoke unaware.
Frigid morning, shaking sleep
Frozen feet stamp off the deep.

Long night full of shivering fits
The second hand sweater, all she could get
Dead ashes of a fire she could not restart
In a brutally cold, judgmental heart
Unaffected usualness, chanted intonations
The cold shoulder he gave to her self-revelation.

Woman-half-girl, too young to see
How love grows cold, or will never be
Long hard stares from an angry man
Neighbors don't help, unsure if they can
Deep down they know, but refuse to see
Cold fears they carry, "That might have been me."

Icy ground, icy air
Accusatory husband with a stony blank stare
Followed by outbursts, shouts without thought
Sinking realization: It was all for naught.
Hard won forgiveness, stingily given
The cold, dingy corner into which she was driven.

Broken-nailed fintertips scrunched into her palm
Callous executioner, performing with calm
A cold report, oh yes, the neighbors heard
They heard too, the car, pull away from the curb
Into the January snows, that wintry day
A lover-turned-killer, who just sped away.

Lonely mist, the sleet begins to fall, when
A midnight phone call! Upsetting us all
Bare feet hit the hard wood of the floor
Her echoing laughter will ring no more.
One wintry day we laid her to rest,
Shame filled our mouth, "How could we have guessed?"

The silvery cold room where the murder took place
Wrinkled worry-fright on a small child's face
Pennies forgotten laid out on the track
He ran out of his childhood, and he's never been back
He looks into steamed windows, feeling always alone
Fifty years later, a little boy grown.

Numb waves of confusion, his eyes focus afar
The breeze stirs his heart, a door left ajar
Tinsel tracks of late autumn dew
A shiver acknowledges all he's been through.
Grey stones, his seat by the sea
Silent, impassive, wondering what this day will be.

The slow gray coldness of a lonely man's hands,
The blue regret he feels as he looks out on his land.
The chilly call of geese as they fly overhead
Reeds in the mist, the season now dead.
Years flew by, how no one knows
"It's just how things are."
"It's just how life goes."

Snowflakes that fall in the lost midnight
Drifts on the ground in the frigid moonlight
The blue black emptiness of each winter's eve,
He shivers and trembles and wants to believe
That God is here, that She is here
Above him, around him, that voice in his ear
That wakes him hello, and soothes him down deep,
That comforts him, lulls him, and loves him to sleep.

Bad Poetry Never Dies

Looking back over files of Very Bad Poetry Written While In A Funk. This, from 2002:

FADE TO HAPPY (2002)

I've often thought lately
That maybe I'm not that bright, less than some.
A dangerous, self-defeating thought?
Perhaps an invitation to be content
An open door to understanding and acceptance.
A whisper to move into
A new thought space
One where I do not judge myself
In the same old ways.
One where I know myself to be valuable
Without an entry fee of IQ points
Without a dossier of Important Accomplishments
But a new party, where the other guests
Are more like myself.
Flawed, but curious, open, changing
Unwilling to be impressed by the old academic games
Or to judge everyone else by the same standard.
No need to shake them down
To make sure they are less
So that we are more.
An open field, where I can spin
Arms open, looking up at a clear blue sky
And all the limiting voices from outside, from inside,
Just fade away.

Monday, August 29, 2011

Meanwhile, Back on Earth

Music: Jupiter's Child, by Steppenwolf

Overhead, planes take off, planes land, and today I am neither flying them nor riding on them. This week, I am earthbound, my neck craned upward, eyes squinting at the sky, heart leaping, feet twitching controlling rudders. As I drive, I remind myself that on earth I am limited to 65 mph, that I will not achieve take off if I push my Volkswagen Jetta up to 90 mph. I feeder hop, argue with my GPS, take back roads, promise myself a trip to Candler Field Museum to see the vintage exhibit.

This week, I clean and bandage, juggle gauze and tape, explaining treatment to concerned loved ones. I explain pain cycles to frustrated patients whose bodies are not reacting the way they expected. I see their eyes grow round, reaching into me for answers. If I see something surprising, I react outwardly with all the calmness and surety I can muster. I project confidence, partially because I feel it, and partially because that is what they need from me. They sigh and relax, knowing someone more knowledgeable is in charge. Then they trust you, and then they tell you more. "And hey, before you go, would you take a look at this..." Facades are dropped along with trousers, and I pull a lamp over and focus a light where the sun don't shine. "Jesus", I think. Did we cover this? I take a deep breath and silently offer my usual inelegant but honest prayer, "Good God almighty and whoever else might be listening, please let me be doing this right." They listen to me intently as I explain Dermatology 101, treat, and give after-care directions as I re-adjust the light, help them pull up their pants and snap off the latex. I wonder if everyone goes through this.

And yet there are moments when I am so in flow with what I am doing it is as if I am watching myself from a distant planet. I hear my voice coming out of me, speaking so confidently, that I swear it is almost as if the gods are speaking through me and I am simply a conduit. This is what Mihaly Csikszentmihalyi speaks of in his work on achieving flow. I am lost in the work, it is no longer work, it is play, it is something beyond play. It is restful because there is no resistance. I find my rest in my work. Not all moments are like this, but some are. It is another way of slipping the bonds of earth, and I am grateful for it when it happens.

Suck it, Gravity. One way or another, I'm taking you down.

Tuesday, August 23, 2011

Let's Get Small

When I rolled out the yoga mat onto her living room floor, she looked skeptical. When I brought out the tennis balls and uttered the words "self massage for gluteals and paraspinals" she started shaking her head. In the past two weeks, I have introduced this lady to relaxation and diaphragmatic breathing ("That could take YEARS to learn!"), cervical retraining, core stability exercises, and one memorable session during which I explained the role of the pelvic floor in lumbar spine support (stopping just short of interpretive dance). Each step of the way, I have taken a pain rating, and rather consistently, following my direction, her pain comes down to a zero out of ten. Last week, we discussed the roll of excess abdominal weight and the biomechanics of the back, neck and shoulders. I put her on a walking program and taught her how to monitor her symptoms. Today, she met me in the driveway, carrying a bag of fast food. Ladies and Gentlemen, Mrs. Chronic Pain America.

I viewed this as an opportunity for education, not a stinging defeat. I see many chronic pain patients during my week, and many if not most of them are morbidly obese and suffering from diseases of excess. Too many cigarettes, too much food, too much stress. Too little exercise, too few fruits and vegetables, too little water. Their bodies are bloated, stuck in states of chronic inflammation, stiff and sore not from fun and natural movement but from years of no movement at all. They carry around bags and boxes of pills, make the rounds from one prescribing physician to the next, stop to get fast food on the way home and wonder why nothing gets better. I have not met a patient yet who has been put on a reasonable reducing diet by a physician, or even referred to a nutritionist, and believe me, I ask. Every. Single. Time.

America is drowning under the weight of it's own gluttony. Inflammatory and autoimmune related diseases are on the rise, and a large percentage of this country is living with some type of chronic pain. That we do not connect this to the poor quality of what we are eating and drinking dumbfounds me. In a nonjudgmental way people I hope my patients can hear, I try to help them connect a dot between what they eat, excess weight, musculoskeletal biomechanics and chronic pain. Things can be better.

Monday, August 22, 2011

Skin Diver

The first time I meet a patient a lot of information comes at me very fast. How they walk, their posture, how they carry each part of their body, scars, skin, facial expressions, evenness of movement, which way they lean (away from their pain}, skeletal alignment, condition of their skin, the emotions they wear on their face, how they smell, the energy they put out or pull from me, areas of weakness, strength, and pain all rush at me as I introduce myself and reach out to shake their hand for the first time.

When I examine them, I work first with my eyes, then my hands, then my ears. My mother always asked me, "Why don't you ever listen?" I don't know, Mom. I do listen. But until I absorb something with my eyes, and then examine it with my hands to know what I think, I cannot really hear what you say. It's like my occipital and parietal lobes have to tell my temporal lobe what is coming. I don't just picture them naked. I picture them without skin. I have to dive beneath the surface, layer by layer, to help them sort out their pain. They know they hurt. It's my job to tell them why, and how to stop it. Every time I am successful at that, I hear a little voice in my head that says, "This is why you are here." I always laugh when people say, "What do you want to be when you grow up?" I tell them, "I am grown up. I am what I want to be." I want everyone in the world to have that great feeling.

It's a luxury to be able to have longer treatment sessions with my patients, and ultimately it's why I picked physical therapy school over medical school. I wanted to spend more time with my patients, I find it more satisfying. Hands on is what I am about, and no one else gives that. One of my beloved professors, a genius at manual therapy and reduction of musculoskeletal chronic pain always said, "If your hands aren't on the patient, why the hell are you there? Shut your mouth, open your eyes, and feel." Often I am surprised at what I find no one has bothered to explain to them before. With the typical contact time for patient visits dwindling by the day and required paperwork increasing exponentially, I have to fight to keep my hands where they should be: on the patient, and I have to fight for enough quality time in a patient encounter to really understand what is happening and why. When my father was diagnosed with Parkinson's disease in his mid-forties, it took the neurologists five years to make the final diagnosis. Five years of 15-minute patient encounters. Kind of makes me wish that one person had taken 45 whole minutes and gotten it right the first time.

Today, as everyday, so many satisfactory moments. When one of my patients, a beautiful, beautiful woman with a diagnosis that makes me weep for the finality of it and want to believe in Angels in America, told me today, "You always shake my hand, today I want a hug. You are the only person I know who actually listens to me." I heard what I always hear at these moments. This is why I am here. See Mom, I do so listen.



Thursday, August 18, 2011

Speaking Ill of the Dead (excerpt, 2003)

from, SPEAKING ILL OF THE DEAD (short fiction, excerpt, 2003)

So Tuesday night, Boozer started much earlier than usual, drinking I mean. Really it was a continuation of the night before, he hadn't really stopped, just passed out stinkin'. Jack was pretty fed up with him and so was Elena. I was too, really, He'd said some pretty mean things to me. I was just the tiniest bit tired of the whole Jennifer Drama. As a matter of fact I was just tired. I had worked late, and we were very short-handed at the restaurant.

When I got home, Jack was in the same damn mood he always seemed to be in lately, the one where he just sits and chain smokes and stares at me, and I say "What? WHAT?" Believe you me, Jack's been getting a little creepy lately. The whole house was just crackling, you know, like a pile of dead leaves waiting for a spark. I cooked up this really great Low Country Boil to cheer us all up, but I was the only one that wanted to eat it. Well that is just alright, I said, I'll eat it by myself. And I did. I had a few glasses of wine, too. By myself. Fine and dandy. Y'all go ahead and weird out, don't bother me one bit. I'll still enjoy mine, you know. I started thinking for the first time about getting my own place. I couldn't really afford that, but maybe a change of roommates. Maybe we're just all getting on each others' nerves.

Boozer started to go downhill fast after he started working at Michael O's. I mean, even I noticed it, out of the corner of my eye sometimes, or over my shoulder. Boozer, well, Marcus really, did I say? Boozer's real name is Marcus. He never liked it. I didn't either, really. It was a family name. He started coming in every night in a worse and worse mood. One night with a black eye, the next with a cut lip. He got morose. I asked him about it but he just ignored me. For days. The hard ignore.

Finally I said, "Alright, Mr. Shithead. Mr. I'm the only one on the planet with a problem. You can ignore me, but you're falling apart, and between you and me, I'm the last friend you got in this damned house, and I'm standing in line for my bus ticket to anywhere else so listen up. I don't want anything from you. Not anymore. You can waste your money, your time and your life on some bouncy fool who will never see you, I don't care. You're an idiot, but if that is what you want, fine. But for God's sake look in the mirror and do something about yourself. Clean up. Eat a green salad. You've just become gross. Your sister is through with you. Jack is ready to verbally drive your head into a wall. You're just fucked up, Boozer. I'm not as young or as dumb as you've always thought I was. This ain't love, hon. This is just fucked up, pure and simple."

He looked at me for a moment, and just for a second, I thought I saw a glimmer of the old Marcus. The one I missed. The one I'd followed around my whole damn life, dragging my blanket. Dragging my doll after, dragging my school bag after, dragging my paintings after. Dragging my raggedy-ass ol' heart after, leaving sad little furrows in the wet Tybee Island sand. The one I would've done anything in the world for, if he slowed down long enough to see me standing there, seen me for who I was instead of who he got in his mind I should be.

I guess it's always that way, isn't it? By the time you recognize the reality of someone, all you can see is their back, disappearing over the horizon, all you are left with is the memory of their fire to keep you warm, blue-orange shadow trails of what they meant to you. Just for one damn second, I was pretty sure he saw me, that we stopped spinning in our solitary pirouettes long enough to just see each other for who we were. I'd been waiting for that my whole little life, I guess. And then the door bell rang, and it was gone. But not the memory of it. No. Even after how it all turned out, I guess I'll always have the memory of that one second. That's more than some people get, I suppose.

When the doorbell rang it was a jumpy shock. I'd just fixed it that morning. It had never worked before, so it was strange. Elena came out from the kitchen, drying her hands on her tee shirt. It even roused Jack from his corner, and he got up slowly as if out of a dream, and kind of sleep walked across the room. You know how when the phone wakes you from a nap, and you are up and across the room and your heart is pounding and you are answering the questions of a stranger before you even know you are awake? Jack opened the door before I could get to it, I was still clutching the threads of the moment, trying to weave something up out of them, but I looked at Boozer and I could tell he was gone again. Gone and never coming back. I felt like I aged about twenty years in that one moment. Probably that's a good thing. I don't know.

Jack opened the door, and there was this guy standing there in a brown leather jacket over a black shirt. Boots. He had this fuzzy red hair and beard. Boozer saw him and started forward, this crazy look in his eye. "You ignorant son of a Dublin whore" he said. His hands came up together. He looked crazed. I mean, I'd seen him mad before, but not like this. This was different. This was hard, stony death anger. The red giant in the doorway just stood there, with a teasing, triumphant look on his face. This little visit to our doorway was his victory lap. He wasn't here to sell anything, he wasn't here to deliver anything except the final blow. Boozer looked like a man with nothing left to lose. God knows why. I'll never understand it. I will never, ever understand it, not until the day I die and St. Peter himself explains it all to me. But I knew what he felt. He'd just realized he'd lost the only person in the world that meant anything to him. I understood that, believe you me. I understood it hard. Because less than a minute before, I had too.

It was the lightest decision I ever made. I know it should, but it doesn't really bother me much, not even now. It might, later, you know, after the lacquer coat of martyr love wears off. Elena couldn't have done it, she'd just stand there and dither. She's sweet but she'd dither you into the next century, gathering opinions. Really. Jack was a non-actor, always was, too cerebral. I'm sure they are comforting each other right now, Jack and Elena. Elena dithering, spinning her little what-if worry circles, Jack just trying to explain it all rationally and failing miserably. Boozer was too angry to think things through, plus he was ham-handed and stumbly, all he could every think to do was lunge. Poor guy, always flinging himself head-long in the wrong directions. That was way too over for me, I'd watched him fling himself off a cliff too many times. I wasn't going to watch him do it again tonight.

And then I saw the pipe...

The Kindness of Strangers

The music: La Mer Opale, by Coralie Clement
The wine: Pinot over ice. It's hot as the 9th circle of hell here.

If I had fifteen minutes off, I would flee to the sea. I would float, ears submerged, listening to the sounds of the ocean. It's been that kind of day. Instead I am listening to the subtle chord changes from major to minor and the sound of the water in a favorite piece of music. This day was a thousand years long, with a thousand lessons in it. I record them here only to remind myself, so I can be less stupid the next time. In future writings, perhaps I can shape them more appropriately, less personally.

I woke up this morning to find that two people very important to me had...well...dumped my ass. One was a family member, the other someone I had cherished for years as a friend. No explanation of course, just...well, you know how dumping goes. No one ever has the balls to tell you to your face. Ironically, both of these people have been telling me for so long..."Oh you are so wonderful" and "Oh you are so beautiful." Well, beware when these words are spoken to you because apparently what it really means is, "I can no longer stand to be around you." And so I write, and comfort myself with the illusion that someone, somewhere, is out there listening. It's okay if you don't, I confess I'm a little bitter tonight. The family member, well, let's just say I'm used to it. I'm basically an orphan, without family. I've gotten used to being disowned and excluded, it's happened too many times. The friend, well, it was always touch and go. Still, I did my best. Sometimes when you are ridiculously happy it really turns people away from you. I just never thought it would be them. I so wanted them to be happy, along with me. Be happy for me, be happy with me, be happy. I would do the same for you. When will I ever learn? All "love" is conditional. There is no other kind, even from family. Especially from "family". The only unconditional love is the love you give yourself.

Still, today, there was the incredible kindness of strangers. My patients with dementia have kind families, and for a moment each day I get to participate in that, and those who have no families appreciate the love and care I try to give them. A wonderful man who changed my tire in a parking lot. The beautiful, incredible photography in my email from a former patient. The son of one of my patients who gave me an unexpected gift. The patient I will forever think of as "Black Santa Claus." "He's so happy when you are around" his wife told me. "He said you make him feel better. I've never been able to get him to do what you can get him to do in 45 minutes." These moments bolster me through a day, get me through temporary sadness. The friend who dumped me used to send me poetry, and I will miss that. The family member, well, it was family. There are only a few people in the world I am actually related to by blood, and it hurts that apparently they cannot manage to be around me. This is the price of happiness, of success. But one goes on, wiser for the experience.

I remember one time I was very upset about something, and I approached two people I considered friends. I was quite upset, actually crying. And I asked them if they would talk with me for a while. They just stared at me. "Please?" I asked. It won't take long, and I would appreciate it." Still they just stared at me silently. Then they resumed talking to each other. This is why writers write.

Wednesday, August 17, 2011

Nocturnal Emissions (from October 2002)

The music: Amy Winehouse, Back to Black. All the songs, because they are all good. And whatever her demons, so was she.

Sifting tonight through old writing, essay and story ideas to see if there is anything valuable that can be worked up. From October 2002, these amused me:

from "Nocturnal Emissions" 2002
"Thinking tonight about all those awful things that get said after midnight, when the truth comes out and you can't get it back in. Then what happens? Do you ignore it, or work with it and shape it? You didn't really want to keep it in in the first place, it rises and surprises you when it comes out, and you feel really good afterward. Have you ever said something so fast and hard and unexpectedly that you couldn't believe it was you who said it? Something that built up over so long a time that you thought you might just explode if you didn't say it? And then you did, and it felt so great that suddenly you smelled colors. You felt so great you could just evaporate into a cloud of joy and relief. For about three minutes. And then you realize that the BOOM BOOM BOOM sound you hear are the jaws of your friends and loved ones hitting the floor all around you. Then there it is: the great sticky wad of TRUTH in the middle of the floor, lonely and pointless. You all look at it, and don't really know what to say. You know it will have to be cleaned up eventually, and it will have to be you that does it, because you are the one that put it there. But right now, you are damn glad you said it, and you feel satisfied and justified and spent. All the dark stuff comes out after midnight in October."

from "St. Christina the Astonishing" 2002
"There was never a moment when I wanted what the angels were handing me, and never a moment when I wanted to give it up. I could never understand or accept that I had to choose, choose one path, and let the others go. It's the dusty path I've always been on, since the beginning, driving my own car, watching as the other women become permanent passengers in their own lives. They always screamed in my ear that their choice was right, that I would somehow be sorry for trying to be too much, but I would notice tightness that played around the corners of their mouths and I would wonder. I felt my own heat follow me around like a demanding shadow and I wasn't content, but I was filled with bits of passing comets and that felt right. In high school the ones who were asked out were the ones that could make their face appear completely serene, blank. Blank and bland and see through souls like cut crystal vases and I would wonder, where did they go? Where did they put themselves?"

Sunday, August 14, 2011

Every Day a Beautiful Page

The wine: Chateau Ste. Michelle Merlot, 2007, because it tastes like home.
The music: Mascagni, Cavelleria Rusticana: Intermezzo; and Giordani, Caro Mio Bien

Tonight I light a stick of incense and put on Mascagni. All day I have been sorting my life and tossing it into boxes. In a trunk I found ten volumes of an old journal series I wrote, years ago, forever ago, Honest Ink Vols. 1-10. Another file holds story outlines, impromptu portraits. I searched for an essay I remembered writing on Jekyll Island, sitting at the edge of the sea, writing under an umbrella while it rained. Short sketches of family members, an entire volume written while I waited for the results of my first cancer biopsy. I was 32, and felt so angry that my life had hardly started before it was threatened. It was then I started using real ink, and fell in love with Parker Pens and black and white composition books. They seemed solid, eternal, timeless. I sat by the edge of a lake, watched the geese fly overhead and wrote as the leaves fell red on the water. It was that fall I decided to start really living, allowing myself any damned pleasure I wanted. I bought a beautiful stereo, listened to classical music in the dark, and wondered why it took living in the shadow of The Big C to break me open in all good ways. Now, years on, I light incense called Heaven, and listen to Mascagni, and am thankful for that fall, because it was then I became invincible. I found a short essay I wrote during that time. It is unedited and overly-sentimental, as am I tonight, and I make no apologies.

"Yesterday I had a revelation, an epiphany while driving. In one burst, I understood that I am not a Reformer, as are the people I am surrounded by at the place I go to earn my daily bread. I am at base a Creator, a very different creature indeed from a Reformer. Whereas Reformers look at the world through the lens of what is wrong, I tend to see the world as a starkly beautiful place, full of images so wondrous it is almost painful to my eye. All around me are compositions of a positive Universe, and my only mission in life is to sustain the creative state of grace long enough to capture them in some form others can perceive. In that, I rarely succeed but while in this pursuit, I enjoy a happiness so complete that tears flow from my eyes in joyous testimony. There is beauty in the world for those who would see it.

I become mute around my left-hemisphere dominated Reformer brethren. While a part of me understands and sympathizes with the quest of the Reformer to redistribute the wealth of nations, lower the world cholesterol count and implement a thousand well-intentioned ideas, try as I might, I simply am not moved to the same actions. Much to their dismay, I am completely and happily engaged in the creative process, absorbing my surroundings, observing, seeing, smelling, touching, tasting. Turning things over and upside down to understand them. Getting it all down, then sitting quietly, blissfully doing "nothing." When I engage in these activities which are most natural for me I am too busy absorbing and creating to pass judgment on things or people. I am far too absorbed in looking at things to form an opinion on them. Everything is simply and inherently interesting. The shape, the form, the color, the texture.

Throughout my life, some have judged me a "simpleton" because of my "right-hemispheredness." This hurts a little. My truth is one that is global, wholistic and provides a deep and through understanding of the nature of things. For example when I observe something for a long time, I learn more about it than does someone who only gives a passing glance before passing judgment. Absorbing things, people, places and events enables me to recreate the scenes later in my head for writing stories, or for using pieces of what I have absorbed in the creation of something very new.

I am thankful for having a small talent, a reason for being in the world. I know in my heart that while I cannot do every thing, nor would I wish to, that life indeed has a great purpose for me. When I listen to music, the words and the tears flow from me in equal measure. I compose entire chapters, essays in my mind. Books issue in one burst and I am filled with the great joy of knowing that at the very least, I can do this one thing.

And yet, when I sit down at the computer or at the pad and pen to write these things down, I sit mute and within minutes have started to berate myself for not having the discipline or raw naked talent that will pull these word symphonies from my head onto the paper. In short order, I become a silent lump and have convinced myself that I am indeed a waste of flesh. The only way I can get the words flowing again is to take my keyboard in my hands and close my eyes. I imagine the music in my head and play the book on my keyboard. It is all there, fully composed, and if I sit quietly and squint, I can see it and write it down.

So today and everyday for all of my life, I lift my eyes and heart as I lift my pen. I have witnessed the beauty in the universe and have vowed to be a humble correspondent. I celebrate all that I see by attempting to preserve the tiniest bit of it with words. Everyday, something new to see. Every day, a beautiful page."

(1997)






Tuesday, August 9, 2011

The Change Diaries, Vol. 1

The wine: Chateau Saint Michelle Merlot 2009
The music: Changes, by David Bowie

Trying something different tonight. I haven't written in a while, my work and other activities have been consuming too much of my time. Tonight, I just want to put pen to paper and see where it goes. Write it out, see what comes. May be nothing, may be something. In any case my fingers will be more limber at the end. Perhaps my mind will be more limber as well. Nothing fancy tonight, I'm afraid. Just good ol' home-cooked, pot roast writing.

My last patient of the day today was a woman who has been experiencing a lot of musculoskeletal and neuromuscular pain from as yet unidentified causes. Test results are pending, and naturally I have my theories. Today was the first treatment session post examination and I decided to do deep tissue massage and manual work first, to try to loosen her up a bit and give the poor lady some pain relief. When I did, I realized how much I miss manual work, and how much I miss having a good treatment table. I don't have this in the home setting. Her muscles were like stone, she has been in a lot of pain for a long time and her shoulders were hiked up to her ears. I let my hands lead me, and it was wonderful to enter the musculoskeletal zone again, my voice dropping, asking leading questions of the patient, listening to their breathing change, feeling the tissue relax. This work makes me feel like I have done something genuine, and although it seems sometimes very simple and intuitive to me, I realized today how little people know about their own bodies, how confused they are about their pain, and how much better they feel after what seem to me like the world's most obvious suggestions.

And then I remember, not everyone knows all the attachment points of the trapezius, and how the greater occipital nerve and artery go through it and up the back of the skull and cause headaches, and how the attachment points of the rectus capitis and obliquus capitis can develop trigger points and cause incredible pain and headaches and how a touch of my fingers and postural retraining can make it all go away, when they thought they probably had a terminal disease and were going to die. It's all a mystery to them, and I can explain it, open their closet of pain and make all the monsters go away. This is why I spent three years dissecting cadavers. This is the field I play in. I need more moments like this. Not everyone has my hands, and today, as I was thankfully able to bring some relief to a patient in pain, and saw the amazed look on her face, I remembered that. I remembered that, and held it, and valued it.

Change is coming. Change is underway. As I walked/ran around my lovely, humid, green Southern neighborhood tonight, I inhaled the hot boxwood, and made memories. I will not be here forever. I never thought I would be, but now the knowing is more immediate, more urgent. In flight, there is that moment at the end of the runway where you throttle forward and commit to take-off. Natural forces take over, and you are in the air, ready or not. It is the best feeling in the world.