Monday, February 27, 2012

Why Do Anything?

I was listening to an interview with Walter Mosley today and he said this thing that struck me. It was in regard to President Obama and how he felt about his track record thus far. Essentially he said people have a short memory of the incredible mess this President walked into, and sure it hasn't been perfect, but he is just one (admittedly powerful) guy in the White House. Really, it is up to us to carry the momentum of real change in this country. I believe that is the first time I have really heard someone put it into just those words:
"I agree, he has a lot of power. But he doesn't have enough power without us."

Later in the day today, I encountered a friend and colleague who somehow started talking about Betty Chinn, about serving the food alongside Betty Chinn. I think we were talking about sometimes feeling lost in the bureaucracy of a very greedy and broken healthcare system, and how that lost feeling wears you down. Betty Chinn, just thinking about her, gets you out of feeling lost. I suppose she has done more to heal our community than most of the doctors combined.

Even later in the day, I came home to refresh prior to tonight's night shift. I had two choices: nap or run. It was seriously chilly out and I, still being an impressive insomniac, am dog tired. I wavered for a bit, but then got on what turned out to be too many clothes and ran for 90 minutes.

I have been reading a lot, which is my usual thing when my brain is abuzz and I cannot sleep. My reading has been mainly set in the jungle for some reason. Africa, South America (twice, two different novels), Florida, and finally Vietnam. After a string of women authors I reached for Matterhorn.  This book initially was jarring. No offense to feminists, of which I suppose I am one, but this was most definitely written by a man. I can only say that it is a beautiful, horrible book. I am glad I read it sort of how I am glad I read Night by Elie Wiesel. I cannot get it out of my mind. Matterhorn leaves you asking why about every other page.

I am full of WHY these days. Like a two year old who reads too many intense novels.

Why should we hold ourselves responsible for the work our government?
Why should Betty Chinn feed so many, and ask for nothing in return?
Why does that make me feel better able to concentrate on the day to day healing I attempt to do in my broken profession?
Why did I read that book and why did those guys have to suffer so much and why can't I sleep??
Why does my teenaged son NEVER take his hoodie off?
Why run when a perfectly cozy bed is beckoning you to nap a bit before a night shift?

Hippocrates is who I always go to for answers:

"Eunuchs do not take the gout, nor become bald."


"Life is short, Art is long; the crisis fleeting, experience perilous and decision difficult."


"Declare the past, diagnose the present, foretell the future."

Or, my personal favorite:

"Walking  Running is man's best medicine."

Now I just wish he had some advice on teenagers who lurk under hoodies.

Tuesday, February 14, 2012


Look, and it can't be seen.
Listen, and it can't be heard.
Reach, and it can't be grasped.

Above, it isn't bright.
Below, it isn't dark.
Seamless, unnamable,
it returns to the realm of nothing.
Form that includes all forms,
image without an image,
subtle, beyond conception.

Approach it and there is no beginning;
follow it and there is no end.
You can't know it, but you can be it,
at ease in your own life.
Just realize where you come from:
this is the essence of wisdom.

-Tao te Ching (Stephen Mitchell)

At 16, I was insanely jealous of Whitney Houston. She was gorgeous, talented, and seemingly full of self-confidence. At 16, I was a geeky, unsure college student, not long out of braces, with a bad haircut and poor self esteem. I could play piano quite well, but this is hardly something you brag about at age 16. Whitney, as far as I knew, had it all. So when I heard she died on Saturday, the first memory I had was being in a dorm room with some guy friends, listening to Whitney, and singing along at the top of my voice. One of the boys suddenly switched off the CD, knowing I would be exposed as the geeky terrible singer I am  was, and then they laughed hysterically at me. I don't think I ever intentionally listened to Whitney after that, and God knows I did not sing aloud in the company of others. Though, to be clear, I do that now regularly, without shame, often horrifying my children in the process.

Anyway. After reliving that moment, my next feeling for Ms Houston was deep sadness. She died not much older than I, and younger than my beloved spouse. I have no idea exactly what troubled her. But addiction played a part. Which begs the million dollar question: How can someone who has it all throw it all away?

Not a day goes by when I work clinically that I do not encounter the stink of addiction. So common it is, that as we head toward computerized physician order entry, we developed a pre-made order set for alcohol withdrawal. This I know: the brain really does NOT like to go cold turkey from booze. It tortures my patients with voices and crawling, nonexistent bugs and the oddest hallucinatory specters. People find themselves tied down, literally, figuratively, medically, until their nervous system settles and they find their way to the surface.

Lately, it is heroin taking the biggest toll. I finally had to ask why this renaissance of a drug I most associate with my days at San Francisco General or with my historical reading of the 1960's and '70's? They tell me: "That's simple. Heroin is cheap. And we can't get pills any more." So, we pull people out of their endocarditis or their empyema or their terrible skin infections. We plead for sobriety. We hope for the best.  

I cannot in good conscience compare my attachment to running to the self-destructive monster of addiction. But I have to say, it has felt really good to get back to it after about 9 days off (illness, work). It does provide endorphins, the original feel-good drug, and one for which I shall not apologize. But beyond that, it grounds me. It makes me feel at ease in my own life. Add in some Beethoven, three children tucked safely into bed, and a husband whom I adore (shouting-out to St Valentine), and I am medicated on life. Now, the Tao, the Buddha, and even Jesus would say: only by letting go of it all can you be truly free.

At the moment, I am content with being attached to the earthly. Earth, with a heavy dose of love.

Monday, February 6, 2012


The thing about being a runner is you don't feel like a runner when you miss a day. Even worse two days. So the fact that I have missed seven days is something of a catastrophe. I am endorphin-starved. I am grumpy. And I am not even sure I ever was a runner or if I actually know how to put one foot in front of the other at a pace beyond walking the halls of the hospital.

Walking the halls, climbing the stairs, this was my exercise for the week. Also blowing my nose and keeping my head from flopping over onto the desk where I was charting. This keeping your head up business is quite taxing.

It seems ridiculous to complain about my bad cold and sleep deprivation and 14 hour days when the people I was attempting to heal all week were so much worse off than I.

There is an ongoing debate in my profession about "work-life balance". The generations ahead of me think this concept is complete nonsense and that the younger generations of doctors are wimps. My generation and those youth coming up behind me (at an alarming rate) look at the elders and think "no way am I living my life like that." Still, we do. Because when you are in it, in the caring for sick humans, you are consumed. Consumed with desire to fix, to heal, to bluster at death, to palliate or diagnose or push someone to quit [insert bad habit here]. Consumed with something very similar to a runner who decides to be a marathoner or worse, an ultra marathoner. It might have a name already (type A? narcissistic megalomania? stupidity?). But I am going to call it filling the void.

I read all of the Harry Potter books multiple times. First, in one quick private delicious reading when they first came out, then aloud to my kids, then on long road trips on tape via the dulcet tones of Jim Dale. I bring this up because of the "Mirror of Erised". Erised backwards is the void. Dumbledore had to pry Harry P. away from this mirror, which showed you what you most desire (for Harry it was seeing his dead parents, as if they were alive, standing beside him). The happiest person would see themselves exactly as they are: without desire. Not looking to fill a void. Men have died in front of that mirror though, forgetting to eat and drink and move, just staring at what they think they most desired.

I consider myself happy (in a chronic sort of way, not like I go around leaping for joy or anything). I consider my self lucky. I do not consider myself happy-go-lucky. I consider myself rich in many ways. But the void? That I cannot seem to avoid. Running, doctoring: love them. They are what I gaze at in the mirror. Even Dumbledore was full of it when he claimed himself to only see a pair of woolen socks in his hands in the Mirror of Erised (one can never have enough socks, he said, with which I must agree).

Excuse me now while I go run into the void.