Mind Fullness

I started this morning in a beautiful way.  I woke up lying in the perfect position on my left side to feel my heart beating.  I know that statement seems strange, but it was a very fascinating and wonderful feeling.  It was more than just the PMI (point of maximal impulse), but a feeling deeper than that.  I could feel the sensation of the muscle inside my chest.  I could feel the left ventricle, the larger portion of the muscular part that pumps blood around the entire body.  I could feel it pumping stronger than the right ventricle that only pumps blood to the lungs and is right up against the breast bone.  I could feel it almost rocking in my chest as it contracted regularly, providing the life-source of my being.  It really was a most remarkable sensation.  I jut laid there for a few minutes just feeling my heart dangling just enough to move with each pulsation.  It was magical and wonderful and calming just being in the moment sensing the greater workings of my own self.  It's still miraculous to me, despite years in training in the medical field, that the body works so beautifully together with minimal input from me.

Inspiration

I believe in the intrinsic goodness of all people and the beauty and resilience of the human spirit

I wrote this line January 7, 2010.  I was halfway through my first year of medical school, and I woke up from sleep repeating the line over and over in my mind.

My wealth spring for continuing to seek the underlying good stems from my Grammy Lou.  She taught me this time and again before her death, and now occasionally, comes back in my dreams when I need the gentle reminder again.  I remember the last time I needed her.  It was before starting residency.  I was afraid I wouldn't be able to be the kind of doctor my patients would need in the coming years.  I was sleeping fitfully and thus remember the dream vividly.  I was at a beautiful old stone church with ivy climbing over the stoic Gothic facade.  I was getting married.  I stood beside my daddy at the grand wooden doors of the church, in a courtyard filled with sunlight, an eerily beautiful graveyard behind me with a large, graceful Oak tree in the center.  I was afraid, and in my fear, I ran into the graveyard to sit on a bench, silently wondering if this was the right thing for me to be doing at this time.  Grammy Lou was standing beside me, and I poured my insecurities, my reservations out to her.  She stood silently listening, smiling gently, and then hugged me.  Afterward, cradling my cheeks and looking straight into my soul with her bright blue eyes, she said, "You are ready for this day and have been for a long time.  You are not alone in this journey for even when those standing beside you in life are not there, I am always right behind you cheering you on and supporting you."  It was all I needed to hear to walk back to the courtyard, to link my arm through my daddy's, and to make the walk down the aisle with all my friends and family watching.  When I arrived at the alter and handed to my husband-to-be, I turned, and there was Grammy Lou enveloped in the streaming glow of the sun pouring in through the open wooden doors.  I knew in that moment that everything I did from then on was with her ever vigilant guidance.

As I've continued through residency, there have been so many times that I've had to listen and care for the sickest of the sick and the dyings' families.  I know that every conversation I have where I break bad news and every discussion about withdrawing care is the part of Grammy Lou in me shining through.  In talking with my daddy, I am embodying one of her greatest strengths, and I wear it humbly.  She sits on the collar of my white coat as my guardian angel, ever present to me and my patients, even when they are not aware. 

Fear

What are you afraid of?
That you will fall
and I won't be there to help you up?
That I won't walk beside you
to keep you from falling again?

What are you afraid of?
That you will make a mistake
and I won't forgive you?
That I will turn you away
and never want to see you again?

What are you afraid of?
That you love me too much
and I won't return the sentiment?
That I won't listen to your heart's desires
and care about them time and again?

What are you afraid of?
That you will wake up alone
and I won't be there to hold you?
That I won't cradle your head in my hands
and kiss the apple of you cheek ever again?

What are you afraid of?
That you will give me all of you
and I won't understand your vulnerability?
That I won't give you all of me
and you will be left broken again?

What are you afraid of?
Tell me.
Please.
For all I want to do
is tell you what I'm afraid of, too.

Desensitization

When is it that we become so numb to life that the specter of death glides passed like an old friend, taking another life without us so much as batting an eyelash?  Is this an expected part of the path to becoming a doctor?  We go through the boot camp of medical school wide-eyed and bushy-tailed, high and mighty ideas of saving each person who calls us doctor.  We think that we have been armed with the tools to make a difference.  We are charged with false hopes of making a difference, of changing the world one person at a time.  And then residency puts us in the trenches.  The first person that dies on our watch is painful.  We think about everything we did, and what we didn't do, and which things could have changed the ultimate outcome.  We swear to ourselves we'll be more vigilant the next time.  And the process begins again.  The insidiousness makes it almost imperceptible until we reach a point where we're actively discussing who's going to die next.  Even worse, we determine who should die instead of receive all active measures of treatment to sustain life.  We see a set of disorders and symptoms instead of a person.  When do we become the decision makers on who gets the "full court press" and who gets a toe-tag on admission.  Are we so calloused that we forget the person has a family and friends?

I feel like I'm suffocating.

Pain is such an overwhelming state of being.  I don't say "emotion" because it is so much more than that.  It is all encompassing.  It cause physical pain and exhaustion.  It clouds our sight and judgement.  I feel like having spent the last few weeks in the MICU has made me more acutely aware of pain.  Not only have I watched the people around me close in on themselves from the ever mounting power of the darkness that can seep out from our insides when put under stress, but I too, have sunk into the molten pit.  Like a rat in a cage with a charged floor, we lash out at those that love us most because we can't fathom suffering alone.  It's slowly taking its toll.

These Words Are Not My Own

The girl sat in a clearing quietly, the trees standing around her like prison guards.  Each time she tried to step into the woods, to move toward a greater clearing, to see what was beyond her little cell, she was thwarted by snarling thorn bushes and whipped back by the tall weeds that could only grow in the soil that would bear no other living creature.  She knew there was something far greater beyond her protected little Hell, but she had little knowledge of how to outsmart her captors, little skill on becoming invisible.  She longed for the warmth of the sun that was so filtered out by the time it reached her that the warmth had been sucked out and left only as a cold tendril, a ghost of what was far away and shrouded by the foreboding limbs of the trees above.  Even the birds were afraid to speak to her, to call her name for fear of demise at the hands of the wicked.  She was so very much alone, longing only for the caress of another, the small safety of a hug, the shallow peace of companionship.  How had she found herself abandoned by the world beyond?  What had she done to deserve the hatred that locked her in and sealed her off from humanity?

Sometimes, she thought she could hear the distant noise of life.  She imagined the hum of a cart pulled by a mule, full of the delicious fruits and vegetables a farmer had poured his life into growing, protecting, cherishing for the day he could share them with others.  She thought the song of laughter faintly reached her ears, of children's gaiety as they finished a day of exploration into the great unknown.  She was touched by the cooing of new parents over a squealing infant, excited and mesmerized by the tantalizing newness that this small plot offered.  How far away these all seemed, cut-off and muted by the great darkness that locked her away from their beauty.  She faintly remembered the days where she fought off the pain of the whippings, the tearing at her skin to try to reach these longings.  Now, she was resigned.  She no longer fought the barriers, but gave into the protection she feigned to enjoy.  She, too, began to fade away, much like another life she had before her captivation by darkness.