Saturday, May 12, 2018

Brave Moms

Memory: my eldest, back when she was about 3, running along behind us in Monterey as we walked and talked along a walled-in pathway overlooking the Pacific. My husband and I turn around to check on her and see that she has decided running on top of the stone wall between path and cliff is a good idea. She has her tongue sticking out against her upper lip as she does when concentrating. Hair flying behind her. We, her frozen-in-terror parents, had the presence of mind not to shout at her, not to interrupt her focus, not to startle her into a temporary bird who would then be broken on the wave-carved rocks below.

I read this article today about being a brave mom. About how we are told to raise courageous children, but generally tend to do so while hyperventilating into a paper bag due to our own anxiety. The article refers to letting children do dangerous things, like climbing, biking, diving from high places. Personally, I do not need extreme sport to make me feel anxiety about the safety of my children. I think it is universal among parents, and probably especially among mothers.

My own Mom, may she not be hyperventilating into a paper bag somewhere in Mom heaven, could not even attend my childhood cross country meets for the nervous wreck she would be if my race did not go as planned. She could not care less if I ran fast, but she could not bear my own intense teenaged self-loathing.

I was watching Steph Curry play the other day, back from missing 16 games or so due to another injury, and realized watching him play is like parenting. That is, I found myself just waiting for the next shoe to drop, in the form of a twisted ankle or mangled knee. That feeling, of wanting so badly for things to go well, but bracing yourself for something bad to happen.

It is sweet to remember my Mom getting anxious about little things like cross country meets and piano recitals. Though to be honest I think her fear was about my type A driven personality and the deep abyss of depression I would teeter right over, like a 3 year old running on the top of a stone wall over a cliff. So maybe sweet is not quite the right word. I might not have offered the same grittiness as fodder for fears as has, for instance, a certain son of mine. He had me picturing the absolute worst. Which, thus far, has not yet occurred. The second absolute worst, yes. When your fears come true as a Mom, you rise up. And fall down. Then rise up again and then fall again. And somehow finally stop falling long enough to live life each day with some semblance of hope and gratitude.

My son wrote a letter from prison to my 10 year old nephew recently. Nephew brought it to show me and son's Dad. It said how he wished he had tried in school. How important it is for nephew to do this, to not end up making choices like son did. Nephew held the letter close to his heart, probably a little bit awed by having a family member in prison, but also clearly wanting son to be free. Free so they can open a mechanics shop together some day. It will be on the top floor of our house, where only the right people will know how to find it. A secret mechanic's shop with a slide off the roof into the hot tub. Son to nephew: "no secret mechanic shops will happen if you ignore education and get addicted to drugs." Only he said it in a way a 10 year old boy could absorb.

God knows we tried such words on son, among a million other pisses in the wind trying to help him and assuage our own anxiety. Even in the less potent arena of regular old day to day parenting, knowing what to say to guide your child without pushing them, knowing how to comfort them without making their eyes roll so far back in their heads they can see the root of their optic nerves, knowing how to let them fall down so they can learn how to get up because some day they will need that skill is the holy grail. If I knew, my son would not be in prison. If I knew, my children would be happy every second of the day as they aced their exams and won the prize for "best kid to talk about in the doctor's lounge to impress everyone there" award.

I have no clue how to be a brave Mom. I think I will write a poem instead.

I Can Only Speak for Myself, as a Mother

The little hands
Six in all
Clasped mine
Expecting magic from the wands
Of my own fingers

Two that write
As predicted
By Fifth grade teacher
Tapping into third sight
Zen Master all grown

Two that draw
On bodies of imprisoned men
Ink found
Somewhere alongside awe
You never could sit still but now you can

Two that strive
Dragon claws
Clapping with delight
Not held by me until after five
I never want to let go

Expecting magic from the wands
My own fingers
Like holding sand
Warm and slipping away.

-Jennifer Heidmann 5/12/18

Tuesday, April 24, 2018

Diving for Pearls

I love anatomy. Don't get creeped out. If you have a medical doctor who does not (to some degree) love anatomy, there is something wrong with them. I also love physiology. The science of how we function. The deep dive into the chemicals and salts and biological brilliance that helps us do everything from breathing to running to playing a Bach fugue. Having recently re-read A Wrinkle in Time, I must consider that the anatomical sinews and physiological perfections of the body well-studied may not be all there is to it. Maybe we have always existed and maybe we are existing in countless places at once. Maybe my perceptions blind me to the possibilities of wonder.

All that being said, I have this nagging injury that would go away if I stopped running for awhile but I am on a streak and it means something to me I cannot explain, so I just keep running. I try to compromise by taking slow days often. I vary terrain, shoes, pace, elevation. Today the weirdest thing happened, which I think even Charles Wallace Murry would have trouble understanding. I set off for an afternoon run after seeing patients. My legs were very sore (see above re injury). I decided to do a "rest run", which involves a very slow pace. Usually "rest runs" are emotionally challenging for me. But today, from the very first step, I was blissed out with a complete, full-on runner's high. I just felt like nothing was wrong in the world. That nothing else needed to be happening at that moment. This was weird, because simultaneously my hamstrings were so tightly wound that there was a real possibility I was going to get flung across town by them, slingshot style. My right sciatic nerve was screaming bloody murder. But my brain just floated up there and was like, wow this feels good, the flowers smell like ambrosia, the spring air is soft and gentle, that SUV who just cut me off is super nice, that escaped chihuahua running circles right in front of me on the trail is pretty cute.

I do not really like chihuahuas. Or being cut off by SUVs. So, what the heck?

Physiologically, it is serotonin and norepinephrine and such percolating around my brain cells and communicating with the system that is me. Spiritually, it is inexplicable. Psychologically, it made my day. Kinesiologically, I was a slug. Egotistically, this generally puts me in a foul mood. But today, my sluggish, athletically barren self was as happy as could be.

Maybe we can exist in two planes at once, one of suffering and one of bliss. Maybe the key to a well-lived, well-loved life is riding the curl of these extremes. Go too high and the wave of life tips you over, go to low and it crushes you while shoving salt water up your nose. When I surfed, I tended to go too high on the wave, and subsequently dive for pearls.

There was this fragrant shrub I ran past at the start and end of my run today that made me swoon. I think for once in my life, I was in the curl today. Getting all misty over chihuahuas and scrumptious blooms while my very real anatomically-based hamstring misery was something I just acknowledged.

A couple of patients I care for deeply will die this week. I find myself coming at this fact sideways, with my gaze softened and trained at some point just above the strong shoulders of the universe. Wiping the brow of someone in transition without losing oneself to sadness is tricky. Usually the act of dying is not transcendent for anyone involved (though I cannot speak for those that have died and what might happen then), but showing up is probably enough. Transcendence might be overrated. When I have saved up enough in my good vibes account to visit Transcendence, I will be sure to leave a review on Trip Advisor so everyone can know what I think about it.

I love anatomy and physiology, the way it all fits together. How we can run and dance and heal and sing and cry and surf and snuggle. How our chemistry sparks our electricity and our ability to love. How we will never have a shortage of mitochondrial power as long as we live. How after we die our bodies become part of the universe, one way or another. How we might all be connected and powerful and nothing at all, all at once and never before and sometime in the future.

It is possible my endorphins are still in excess. Because none of this makes sense. I should not have had a runner's high today. And beloved people should not get sick and die. It is possible my tendency to accidentally dive for pearls is just one more piece of my DNA, a wrinkle in some part of my mind. Written in my chemistry, just waiting there for the next grand experiment. I think it lives next to that part of my brain that still believes I could go sub 3 in the marathon.

Magical, obtuse, and just this side of possible.

Saturday, April 7, 2018

Pushups in the Rain

I found a new use for coban. Rainy, busy day. Determined to get my run in around noon. Realized I had neglected to bring my running bra. After a moment of cursing under my breath, my wilderness medicine skills kicked in. Coban: truly versatile. I am thinking of starting a new line of running bras for emergencies, called "CoBras".

As I ran in the rain with my CoBra comfortable enough I forgot it was even there, I pondered the last few weeks. They have been defined by sore legs and a tight ass, compassion fatigue and a whole lot of injuries for Warrior's players.

My engine is all revved up in some ways, but the daily running for almost 200 days now does leave me with a bit of that exhaustion peculiar to marathon training. It goes into your bones, and drags you to the couch more often than usual. There are three spots, one on each leg plus a butt cheek, that are so tight that when I first start running I am fairly certain I look exactly like my father did when he moaned and groaned getting up from the sofa after a nap, walking like Frankenstein. Like with marathon training, I am acutely aware of injury risk, so I have been trying to tone down the pace and mileage a bit. Probably should stop for a few days but I am not yet ready to take orders from my butt. Rx: massage.

An occupational therapist I work with (incidentally, it is occupational therapy month, so go thank one) suggested a foam roller on steroids. Which is to say it has a rechargeable battery that allows it to vibrate, at three different speeds. It is magnificent. Though my IT band is still hiding under the bed.

Compassion fatigue is the buzz word of the early 21st century for those in the business of caring for others. When I run, I try to stop thinking about the suffering, except my own (see above, re tight ass). Still, my brain is like a spin cycle, all the tough stains of concern agitating around from lobe to lobe. Doctors like to fix stuff, but it turns out there is not a lot we can actually completely fix. Oh, we can comfort till the cows come home, and that is my best power, but comforting takes a lot more out of a person than, say, prescribing an ACE inhibitor or cutting out a stony gallbladder.

Last night I dreamed I accidentally left my hospital shift to go to a fundraiser at the mall, then got lost trying to find my way back, and was really stressed about getting my rounds done, then went for a run in the forest and found myself lost again on a snowy crag with mountains rising, and the thing that really got me was I did not have my Garmin on to record my run. I asked for directions back home, not remembering so many snow capped mountains in my redwood forest in the past. No one could help. A fair amount of brain energy was spent deciding how to describe this run on Strava, as it would not have the usual hard data. About how far did I go? What pace? I got a good picture of the mountains though, so there was that.

As I ran in the rain with my coban bra, I thought about kindness. When I have "compassion fatigue", I am less kind. Kindness is a superpower. It requires putting the ego under wraps, finding the beauty and humor in each interaction, absorbing anger that was never meant for you, then melting it with your strong, unflappable heart, beating warm and solid and bradycardic.

The Warriors have disappointed me in that respect in recent weeks. Their coach, Steve Kerr, is someone I deeply respect. For instance, he speaks honestly and openly about gun violence, and has some personal experience with this as his father was gunned down. He and his team usually model sportsmanship and joy in the game of basketball. Lately I have noticed more anger right on the surface. Anger about calls, technical fouls stacking up. Granted, it is not their responsibility to be nice. But I have a theory, and that is that kindness helps people win.

Handing the ball to your competitor would be stupid (hey, Warriors, enough with the turn overs!), letting someone elbow you out of your lane on the track foolish. But solidity of purpose, on a foundation of benevolence, with compassion to self and others, with unrelenting hard work, using actions to show prowess, not words of hate or boasting, and the ability to do joyful pushups when you fall in the rain steps before finishing a disappointing marathon? Superpowers.

As I ran in the rain, breasts cobaned, I wondered if I would ever see sub 7's again.

I don't really want to race again until I do.

Self kindness: a work in progress.

Meb always signs his autograph with the words "Run to win".
The kindness to self and others part? Super powerful. I don't really want to race again until I can do pushups in the rain.

Saturday, March 31, 2018

Ode to Scales and Trails

The piano is built for fingers. The way the black keys sit above the white at just the right
angle. It is a fact of nature that the thumb goes into the curl of fingers like surfer in wave
when ring finger sits on ebony. There is no fight involved.

Two against three, three against four, by separation of thirds, all to keep scales fresh. Fingers alert
even though it is familiar ground. Exert now, collect later when runs on the page drill via retina to synapse to fingers. So solid a pathway that the mind can drift.

"Do not be thinking of what is for dinner tonight when on stage" my piano teacher once said.
The terror of looking down at flying fingers you forgot were there, wondering how they got air

Presence always scares the wise, easier to reprise that argument from earlier today or consider your next play. Wandering away from present truth. What comes next is prescience. What just happened is lost, like a miracle sent back unopened.

The problem with retinas is they are always looking. Shutter the eyes and the fingers still find their way, the legs still spin on the path. Sudden focus gained, the deranged mind chatter stops. Blindness is safer on piano than trail running where roots grab toes, with bloody aftermath.

Softening the gaze, lowering the hunched shoulders, marveling in the harmony of hamstrings and quadriceps, smelling the salt air, hearing the crunch of crab shell underfoot, slipping on the rain slicked redwood fronds, imbibing dopamine and other endorphinic hormones. Heart and hamstrings burning bright.

The scratched piano wood is from nails slicing through air. All those hours etched in plain sight.

Wednesday, February 28, 2018


To be of the opinion, to have a way of thinking, a sentiment.
This is where the word "sentence" comes from. 
"In my opinion your son deserves 13 years", said the judge, unsentimentally.
No tender feelings of emotion, just a motion, sealed by a gavel.
That is 4,745 days, during which no pizza is delivered, no joints smoked (well, as far as we know). No studying for exams, no kissing girls, no tossing a baseball with your old man.

I often wonder if people in prison have a plan.
For getting through each day, I mean. I have heard some thrive because in all their prior years
there was no structure, so the structure is a relief of sorts.
I can relate to this, being a lover of structure who is oxymoronically also the least organized creature in the universe. By loving structure, I mean anatomy and histology were like water to a fish or air to a balloon or milk to a hungry baby for me. When I studied these things, I saw nerve bundles in tree branches, liver cells in sidewalk splotches. I walked around my medical school campus in Madison and named your forearm muscles when you waved or flipped me off. By structure I mean I like to know where I will be sleeping, when I might wake up and whether I have enough clean running bras to last through my next day's run. I like to know my hospital orders are being carried out and making someone better instead of worse. I like my family to leave a note if they won't be home when I expect them to, and to text back instantly so I know some ditch somewhere has not claimed them as its own.

My disorder lies in the state of my desk on any given day, by the moat of books that tends to form around my bed, by the piano music lying open in competition for my attention. I am entropically gifted.

I am nearly halfway through a year of running every day. What happens on day 366?
Running has become something of a fix.
Fixing my broken parts. I have always wished to be a quilter. Someone who can make a lovely whole from smaller bits of oddity and beauty. I once did house calls on a quilt artist who saw the end approaching and quilted like a cyclone in those final months, harnessing and sewing pieces that were swept into her eddying energy, fueled by chemotherapeutic fumes.

On day 160 of running I realized something, in-between sneaking peaks (hoping not to burn my retinas to a crisp) at the setting sun drowning in the Pacific Ocean.
I am making a quilt.
Metaphorically lame, yet the thought stopped me for a moment.
Quite literally I have a picture of each day of running thus far. I pick one that most captures my senses. I notice things. Those pictures form a sort of story. Seasons, state of dog grooming, flora, fauna, urban austerity, travels, darkness, all captured.
But what made me stop in my tracks on run 160 was my brokenness that feels like it heals just a little bit more each day I run, like pieces coming together, even in the physical strain and fatigue, the admonitions of too much running and the potential harms, even in the days I fall and draw blood. It reminds me of how Wendy sewed that shadow back on Peter Pan. Ouch, but he needed that thing.

Running is hard, I suppose. Tonight it was cold, rainy, and my work day had been stressful. A couple of weeks ago my femur was screaming in pain. Have you heard the screams of a bruised bone? Angry skeletons are scary as shit. On days when I work a 12 hour hospital shift, the run will be in the dark on one end or the other, and usually the morning end because 12 hours is a nice thought but usually that will become 14 or more. I am not a morning person, really. There are two professions to avoid if you are not a morning person:
1) parent
2) physician

I am a mourning person, as are we all or as we all shall be if we are lucky enough to ever love.
The dopamine surge of exercise is a nice temporary ticket to planet Happy, but that is not why I run. Running is not my cocktail of choice. I do sometimes wonder how I got into running every single day. Once a colleague pulled me aside, and bored his almost black eyes straight into my soul while whispering with Slavic accented mystery "I see you running so much. What are you running from?"

Dude, sometimes running is just, well, running.

I am not sure 365 days is the right goal. Because my structure-craving side needs a goal, that seemed like a reasonable one. But the thing that has me most broken these days, that makes me mourn, is the 4,745 days my son has been dealt. Just desserts? I don't know. He's a kid who screwed up. And I am a Mom who cannot fix it.

So, although my running is by no means a prison sentence for me, and in fact is about as freeing as anything I can imagine in life, it is something I can show up for every day in some solidarity with my child. Maybe I will run for 4,475 days. And hope some of the beauty and hope I feel when doing so will transmit to him through that unruly bond we share called family.

If we get early parole or the proverbial bus takes me out before then?
Well, then, hopefully someone will finish my quilt for me.

Sunday, February 11, 2018

Flames, Failure and Falling: Advice to My Children

If you were to substitute I in falling, you get failing. I prefer to keep the El in falling though, because without it I would feel like a failure, and would know I had lost my connection to my superpowers. The superpowers that let me get up every single day.

Falling, like failing, is hard to define. Unintentional travel from a higher place to a lower place might sum both up. With falling, everything can fall apart in an instant. Failing might occur more slowly, sneaking up and standing next to you for awhile before you give it the side eye and realize with a start, oh man, that is Failure next to me!

When you fall, get up. If you can't get up, punch your lifeline. If failure is at your side, wrap your arm around its shoulder. If that scares you, it should. I try not to be afraid of anything and am afraid of everything. I try to look tough despite my bleeding heart. I can wear pants like these and still be on top of the world.

The other day, I fell in the literal sense on a trail marked "use at your own risk". 

It is not like I have not fallen before. You can expect this with trail running. But this one left me wondering if a had fractured my femur. I figured not, as I could bear weight after the first couple of nauseating minutes laying on the ground. So.....I finished my run, albeit at an extremely slow pace, such that the banana slugs were passing me left and right. When the next morning found me barely able to walk, I decided to use some modern technology instead of my super Xray vision, and got an Xray of the biggest bone in my body (besides my head). No fracture! So.....I went running, because I am on a streak, people. Day 144 today. It is going to be slow going for awhile though.

Doctorly Disclaimer: never run on an injury. Unless, like me and El, you have superpowers and checkered pants to prove it.

Figure skaters should not fall. They train their whole lives for this 3 minutes of olympic glory, and if they fall, nay even wobble, they fail. I have to watch their leaps and landings through a little slit in my fingers, with hands ready to hide the horror, sort of how I watched the movie It. 

It all brings me to think that we are too quick to judge the value of everything. It is fear of failure, fear of falling and fear of the unknown. It is standing right next to us.

Say, for instance, a skater is on a frozen pond, of the type we used to have in winter in my hometown in Wisconsin. It is dusk. There is no one else around. Skater nails a quadruple axel. If a skater nails a quadruple axel at dusk at a pond where no one is watching, does it count? Does it count less than nailing it in that one 3 minute time slot allotted to the olympic contender?

I have been traveling more in recent years, and finding myself more overwhelmed by how many people there are in the world. People living their lives, just like me, and each and every one of them the center of their own universe. People who will do great and terrible and mundane things on any given day. Some people will die of hunger, some will die of gluttony. Some will have sons who get olympic gold medals, some will have sons in the hole in prison for their own safety after standing up to a gang. Some people *cough Emma Coburn cough*will be leading a race till the last two laps then get spanked by that one woman with the wicked kick, plus a few others that had more left in the tank.

Some doctors will be famous. Some quietly do their care, one patient at a time. Some pianists will play Carnegie Hall. Some will never be able to afford a piano and thus never even unlock the talent inside their brain and fingers. Some writers will be published and some will sit in solitude writing the most beautiful things no-one ever read.

Some need to never fail, never fall. Or at least appear that way to the world. I, for one, grab the hand of my friend failure and take my chances. This is what I want my kids to do too:
Fail miserably, fall often, and live life. Forget about not going gently when death reaches out a hand. Instead, devote yourself to not go gently in all the days leading up to that last. Look up from the hole and see the light, burning from within. Lean in and whisper all that matters. Its your superpower.

This poem failed to win a contest. But maybe it is better just curled up right here in my preachy blog.


Antiseptic flared my nostrils,
white light burned my eyes.
One hand was balled into a fist,
the other tucked inside my mother's as she led me to say goodbye to my father.
I did not raise my hand to my face to protect myself from breathing fire.
It filtered through me and curled up inside:
an ember, a bomb, a pyre.

A white coat and dozens of notebooks crammed
with a new language.
Greek and Latin pouring light into dark corners of human anatomy.
Anyone could be blinded by my new armor
under the glaring fluorescents.
The man with AIDS laughed with me
as I made my rounds.
I wanted to make a good impression
on my attending. I wrote a beautiful note.
Later when my team was summoned,
we marched where he led: the morgue.
My laughing man was splayed open
on the silver table. Dead.
I did not raise my hand to my eyes
burning with formaldehyde.
The image burned my retinas,
curled upside down and righted again.

Housed by hippocampus, a hotel with many rooms,
Little tombs.
For the black man, first night intern year
who died and died and died again.
I pushed on his chest and felt bones crunch, my own bile rising.
"Good," my senior resident said,
"That's good CPR."
For the young husband, who was losing his wife.
Obviously terminal, she suffered
while he raged.
My words with no power to tame, I learned
Some must go down in flames.
For the veteran who outlived war
only to drop on a nursing home floor.
I ran the code and he lived again, with displeasure.
He's there, curled up with all the others,
tucked in my hand—
but sifting through, falling away,
grains of sand,
dry and warm like the parched lips
I lean into, my own hair graying,
white coat brushing the forearm of
the hand grasping mine.
Whispering all that matters:
an ember, a bomb, a balm.

Jennifer Heidmann, MD

Monday, January 29, 2018

Pantoum on Multifactorial Burnout with a Side of Absurd

They tasted 27 flavors of Gu and ranked them all.
Cucumber Mint fared poorly, as did Tastefully Nude.
I can't say I'm surprised. It also turns out
siding with the underdog in prison is ill-advised.

Cucumber Mint fared poorly, as did Tastefully Nude,
but I am still deciding when to refuel.
"Siding with the underdog in prison is ill-advised"
could flow from my pen to him, but then who am I?

But I am still deciding when to refuel.
Thoughts churning, stomach yearning, calves burning, patience
could flow from my pen to him but then who am I
To be so strong when none of it makes sense.

Thoughts churning, stomach yearning, calves burning, patients
Needing endless attention and someone else
To be so strong when none of it makes sense.
My treehouse home and freedom from want is some recompense.

Needing endless attention, and someone else
To laugh with me about everything, stupid and wise.
My treehouse home and freedom from want is some recompense,
my retreat from disenchantment in its thin disguise.

To laugh with me, about everything! Stupid and wise.
I can't say I'm surprised it also turns out
my retreat from disenchantment, in its thin disguise,
is also my fuel: Love, in 27 million flavors of pain and doubt.

JH 1/29/18