Alice and Dorothy

I have a very strange obsession with two classic fantasy novels.  As you can tell from the title, they are "Alice in Wonderland" and "The Wizard of Oz".  I have to admit, I have not yet read the original "Alice in Wonderland".  I own, two copies actually.  One in print with pictures, the other on my kindle.  I will read it.  I have to.  It's not really something I can avoid.  These two series intrigue me.  I am officially obsessed.  I have watched as many possible iterations of each that I can.  From the classic Disney version of Alice and the first color movie of Oz to the knock-offs.  The recreations.  I love them.  Over and over again, I will watch them.  I can't figure out what it is that so attracts me to these stories.

Perhaps I have a deep-set need for disappearing into a fantastical world.  A world that is like and unlike ours.  Where you can pick out similarities between the characters and people you know.  Or maybe it's the fact that the worlds can be written and rewritten however you want them to be.  They can be this day and age or 50 or 100 years ago.  They can have actual animals, or people dressed like those animals might seem as people (the lion as a general, albeit, one that's never been to war or even considered it; the white rabbit a nervous little man persistently certain he's late for something, anything).

I'm fascinated by each newly envisioned world for Alice and Dorothy.  Each different persons view on how it should be.  I want to fall into each world like Alice fell into the rabbit hole or Dorothy's house fell on the Wicked Witch of the East.  I want friends like the Mad Hatter or Scarecrow.  I want to have that chance to, just for a moment, disappear from the real world.  I want to enter a world that's topsy-turvy.  Something entirely different from the reality I'm used to.  I want that escape from reality.  But only for a short time.  Long enough to realize, just like Alice and Dorothy, that there's no place like home.

Blue Ridge Mountain Man

You twist the sheets in your hands,

Smiling at me;

Your voice is garbled.

Your daughter says

Dementia,

Congestive heart failure,

The diseases slowly taking you.

Then she tells me your life.

A strong man;

You helped create the Blue Ridge Parkway,

The serpentine road carved

Into the Appalachian Mountains.

The mountains,

Larger versions of the creases in your sheets

Where you are trying to rebuild that road.

And I wonder if the view you saw,

Many years ago,

On a crude road of gravel,

Is the same as I see today

When I drive the smooth paved road.

Was the sun more brilliant

Bouncing off the mountain faces?

Were the mountains more blue

In the fading light

At the end of a long day?

Can you show me

What you see now

From those many years ago

As you rebuild the path

Through the wilderness

In the sheets surrounding you?

Bold

The Experiment was a bold one.  She had been planning it for ages.  Endlessly dreaming about each minute piece of the whole project.  Intricately working everything together in her mind.  The process was arduous.  The wait intolerable.  Each day, a new piece of equipment would arrive at her door, and each day she imagined it's place in the set-up.  Bunsen burners, Erlenmeyer flasks, beakers.  Today it was the retort.  Yesterday was a small case of test tubes.  The chemicals each arrived item by item as well.  Her checklist was almost complete.  She would be able to begin on Friday, work through the weekend, hopefully something brilliant by Monday.

Finally the week was dwindling; her time to create approaching.  Thursday night she spent setting up each of the delicate glass vessels.  Round bottom flask held upright by a ceramic donut on the bunsen burner.  Erlenmeyer flasks and beakers lined up with various burettes  and separatory funnels hovering in the air above, poised to release minuscule drops of liquid into the containers below for precise mixing.  At the end, the retort with the resulting distillate designed to drip into a rack of test tubes.  The end result.  All was ready.  All would start tomorrow.

She couldn't sleep for the anticipation.

Friday morning.  She painstakingly rechecked the glassware set-up.  No cracks, no imperfections, all was set-up as it should be.  She began.  One chemical and then another was placed into the round bottom flask, dissolved in water and heated.  The colors swirled and mixed.  Once dissolved, she began to pour the liquid into various containers.  New chemicals added at each stage.  New colors emerged. Reds and oranges like flames licking the inside of the flasks containing it.  The last stage before entering the retort, a violaceous liquid, like melted bubblegum, filled the beaker.  She held her breath, knowing that one wrong move would upend her entire life's work onto the table where it had been created.  The mixture, safely transferred to the new container, swirled and rolled, exploring its new entrapment.  She relaxed only slightly.  The last step of its journey and hers.  The effervescent concoction warmed by the bunsen burner turned a deep, afternoon sky, blue in the dim light of the laboratory.  A green mist of vapor quietly ascended into the top of the retort containing it and condensed as a radiant teal liquid into the softly curving neck above.  Slowly the distilled liquid dripped into a tiny test tube, turning the new, final mixture an iridescent purple.  Glowing with life unknown.  The scientist smiled with content.  Her experiment worked.

Narrative Medicine

I am rounding out the end of fourth year of medical school in a class called "narrative medicine".  For most medical students, we are never truly taught how to process the emotional situations that we encounter daily in a way that allows us to continue growing.  Narrative medicine provides the base on which to be able to process the emotions we feel on a daily basis, giving us the chance to provide better care to our patients.

It boils down to returning to our humanity.  To begin to again deeply experience and enjoy the world around us through readings, movies, art and music.  As we are exposed to the arts, we are provided the chance to reflect and determine how each piece can fit into our idea of self and our interactions with others.

It is the most enjoyable class I've had since my creative writing classes in undergrad.  It is the release and decompression I needed before starting intern year.  My hope is to continue this writing through residency as best I can.  I will need to continue reflecting in order to maintain my compassion and ability to empathize.  I have a fear of becoming hardened and apathetic during residency thanks to sleep deprivation and the grueling schedule.

I do have fears about residency, perhaps not ready to be posted here.  I can do it.  I have a great support group with me.  I am competent and empathic.  I have the tools to reflect on all that I learn and see in the next year.  Now just to hope that time allows it!

I will try to continue posting similar posts to the one below from reflections I do during narrative medicine.

The Movement

Tin Win became Mi Mi’s legs because she couldn’t walk, and Mi Mi became Tin Win’s eyes because he couldn’t see. Together, Tin Win and Mi Mi were one. Tin Win had discovered that “parellel to the world of shapes and colors, [was] an entire world of voices and sounds, of noise and tones”. What he could hear, the sound of an unborn chick’s heartbeat, the rustling of butterfly wings, the voices of leaves, Mi Mi would seek out and describe. Together, each allowed a new world to appear for the other. Mi Mi discovered the world of sound, the voices of the Earth. Tin Win was able to discover what he was hearing through Mi Mi’s descriptions. He was able to see the world his eyes failed to show him as Mi Mi guided him through it. 

The beauty of the story of Tin Win and Mi Mi is not just in their discoveries of life together. Not just the wonder in the time they spent together. Their first meeting, Tin Win’s discovery of Mi Mi’s presence is the most beautifully heart-stopping moments I have ever read in a book. They unite at the beginning and reunite at the end of their lives in a way that highlights the true wonder of discovering another person who truly knows you. Tin Win found Mi Mi through the chaos at the beginning and end of their life together, and their spirits were inseparable, even when they were not in each other’s presence.

“And through all that crackling, through the creaking, whispering, and cooing, the dripping, trickling and cheeping came that unmistakable soft knocking. Slow, calm and even… There it was. Her heartbeat.”

Across the monastery, through a world full of many distracting noises, Tin Win heard Mi Mi’s heartbeat and following it to her. And when they were separated by continents as adults, each with their own lives, families, jobs, it was as if Tin Win could still hear her heart beating. It grounded him. And it eventually brought him back to her when the time had arrived for them to die.

“He laid his head on her breast. He had not been mistaken. Her heart sounded weak and weary. It was ready to stop.

He had come in time. Just.” 

I have never been so moved by a love story. The pureness of Tin Win and Mi Mi’s delight in their deep connection even when apart. The way Mi Mi wanted so badly to hear the world Tin Win heard; how delighted each was in discovering the source of Tin Win’s noises. It truly felt like one of those moments where I was honored to be allowed in presence of someone else’s most intimate moment.

This story taught me two things that I will carry with me. The first is the pure joy of connection. The delight of someone else wanting to enjoy your world with you and share theirs in return. It’s about taking the time to understand that our perceptions of our surroundings differ, allowing us to be in the same place, look at the same thing and interpret the environment in vastly different ways. IN stopping the hear what another is sensing, allows that connection to form and a new approach to life to be learned. In a clinical sense, I need to remember the raw emotion that can affect a patient and their families understanding and comprehension of a situation. I will need to be able to interpret the situation as they would, and provide the guidance that they need during such a difficult and vulnerable time for them.

The second lesson is how vision clouds our senses, providing cacophony that shrouds other truths from us. By not seeing, Tin Win learned to hear his world. At first, all the sounds, noises, symphonies were overwhelming, making it difficult for him to determine his surroundings. Then, Mi Mi’s heartbeat broke through. It provided a steadiness that allowed him the opportunity to explore his world and make sense of it. When we keep our eyes open, it mutes our other senses and denies us the steadfastness needed to explore our world through other routes. In closing them, we remove that additional chaos and allow ourselves to experience the true beauty of the world around us. Until I read “The Art of Hearing Heartbeats”, I had wondered why closing your eyes made listening with a stethoscope easier. By removing the distraction of sight, we allow our ears to hear the subtleties hidden previously. We distrust our ears otherwise.

This was one of those books that when I finished, I felt I’d lost a beloved friend. I felt so connected and part of Tin Win and Mi Mi’s beautiful world, that when it was gone, I felt lost and immobile. Even now, I find I have trouble completely explaining how unbelievably alive I felt in this book. I wanted to reread it just to hear those beautiful sounds again, to experience a world I felt I had no other way of being part of. I remember sitting on the back porch of my parent’s beach house and closing my eyes in dispair of finishing exploring such a wonderful world. Sitting with my eyes closed, the sensation slowly overtook me. The soft swish of the gliders on the sofa swing with a gentle squeak at the end of each arc. The purr of my sweet Maine Coon asleep next to me. The beating of the tiny birds’ wings and the crack of the millet as they gobbled down the soft center. The creak of a branch as a squirrel jumped from tree to tree. The rustling of the voices of the leaves talking to the wind. The cracking of a twig under a deer’s hoof as it approached the bird bath for a drink of sweet water. I couldn’t help but smile as the realization that the world of “The Art of Hearing Heartbeats” would always be with me if I just closed my eyes and let my ears take over.

Patience

If there is something I have learned in the past 24 hours, it is the power of patience and faith.

One week ago, I decided that Chewy needed a new buddy. Namely, a 19 lb., 5 year old Maine Coon named Boris. Yesterday, we picked Boris up and brought him home. Bringing him home turned out to be more stressful for me than I thought it would be. First, the humane society basically said that Boris would die if he so much as touched dry food because of his weight. (As a reminder, most Maine Coons weigh somewhere between 15-25 lbs. depending on the purity of their blood line). And sure, Boris is a little more round, but it's more of an "I used to live in a happy, healthy, safe home" rather than "I'm royalty from the 15th century where weight denotes status in society". So, of course, I'm freaking out because Chewy is 1. underweight and 2. used to free feeding on dry food that I can't remove from where he can reach it. My image of Boris prior to actually getting home was that he would clean out every bowl in the house like a dog that's sure it will never see food again. I started doubting my decision when my sole purpose in adopting Boris was to have two very happy kitties that would keep each other company when my intern year leaves me with more hours in the hospital.

So yes, I was afraid, doubting myself, losing faith that I wasn't purely acting out of selfishness in bringing Boris into Chewy's and my house and lives. When Boris was released from his crate, the first place he went was the food bowl. My heart rate went up, until I realized that he only ate a couple bites before exploring the rest of the guest room that is doubling as his safe place for the moment. I calmed considerably, being reminded, once again, that cats are smart and don't generally overeat the way dogs will. As the next 24 hours continued, I realized that for his size, he eats like a bird.

The next challenge was getting him and Chewy to interact. I spent most of the first night stressed that he and Chewy wouldn't get along. They would just be angry at each other the entire time, and it would cause undue stress for both of them. Day one, Boris did spend most of his time growling at Chewy whenever he was in sight. Chewy, on the other hand, surprised me; he stayed very, very calm the entire time. I was in awe of Chewy's grace and how well he took Boris's arrival in stride. Now that we've made it through the first night, both cats seem so much calmer. Boris has only made one small meow at Chewy. Chewy has continued his usual routine. I am very proud and happy for my boys. I think the longer the three of us are together, the more love we will have for each other. I now can say, I can't wait to see what each day will bring in my relationship with each cat as well as the relationship they have with each other.

Patience: The act of bearing or enduring pain, difficulty, provocation or annoyance with calmness. Both Chewy and I have learned the importance of patience with bringing Boris into our life. I just need to stay strong in my faith for the decisions I make.

My Words

I've decided that I need words to focus on during meditation in order to expand my experience and hopefully gain better insight into myself and ways to personally improve.  I've chosen patience, strength and forgiveness.  I will hopefully have the chance to expand on these words as I continue through the process I've set for myself, but here are the simple reasons for the chosen words.

Patience: for both myself and others.  I find that there are times when I am tired or stressed that I do not give others the time of day that they need.  Therefore, I want to focus on patience in order to remain grounded and open to others.  I also need to be patient with myself, to allow the time for growth that will be necessary, especially once residency starts and I'm beginning to face the real world and learn the way I will continue to practice throughout my career.  I need to be willing to give myself the personal time necessary in order to complete the first goal of more patience with others.

Strength: Intern year and residency are going to be long, stressful and sometimes tiring.  I will need the strength to learn as much as I can when I can.  I will need the strength to provide the level of care necessary to my patients when I'm sleep-deprived and stressed.  I will need the strength to not take my stresses out on those I love and care about most, especially because they have been supporting me my entire life and don't deserve to be treated horribly because I'm stressed, confused or on occasion, floundering.  I need the strength to hear when I need to improve, take praise when provided, and teach when the opportunity arises. It will be difficult, but I know I have the tools, training and support team to conquer even the trials that residency will pose.

Forgiveness: Again, for both myself and others.  I need to be more forgiving of those around me.  We are not perfect creatures.  We make mistakes.  We are always learning and maturing, but it's a lifelong process.  I cannot blame someone for how they are regardless of how I feel.  I need to be more tolerant of people's differences, even when it causes me personal distress.  I also need to be more forgiving of myself.  I am not perfect.  I will never be perfect.  It isn't necessary.  So I need to forgive myself when I do something I feel was unacceptable.  I will have bad days; it's a given.  Therefore, I need to learn from those and continue on instead of focusing on all the negatives.  I need to not get myself bogged down in negative thoughts and feelings.  Therefore, forgiveness when they happen.  Forgiveness for bad days.  Forgiveness for harsh words that should not be said.

At any rate, I will continue to meditate on these words and post as I go through this somewhat new territory for me.

My Place

I started using mindfulness meditation as a way to deal with my ADHD before I even knew what to call the practice. Nights in middle school, I would count my breaths until I fell asleep. When I was trying to do work and was losing focus, I would look out the window, focus on a tree or cloud or something outside, and breathe.

As life got more stressful in college, I used the same technique to let the stress pass me by. Focus on the breathing. Again, meditation before it had a name. Then in medical school, the name was provided. And all that changed was the discovery of my place.

What's interesting to me is how my place changes as I need it to. During family medicine, when my stress reached its peak, all my pain was in my head. My brain was playing tricks on me. Anxiety overran my existence. Thus, my place was the eye of the storm. It was a yellow tree in the middle of the forest, brain-like in its shape. 

It protected me as I lay in the fallen leaves, sinking into their mattress.

Then, I did yoga for stress management for a while. During that time, my place began to elongate as I did. I sit beside a waterfall, surrounded by nature. My stress, anxiety, negative thoughts are leaves that I place in the water to watch flow away.

It cleanses me as I hear the water moving beside me. It is so peaceful.

Today, as I was walking, my place morphed again. This time, it was powerful. Crushing the anxiety, fear, anger out of me as the waves pummel the rocks below.

I needed the power to break the parts of me I no longer wanted. The pent up rage over petty, insubstantial events. Each little thing that had eaten away at me over the weeks was crushed beyond recognition in the power of the surge below me. 

And when the hatefulness, the anger had subsided, when the calm returned, I too could go back to a different place. The places are fluid. One can become the other as needed. When the anxiety needs to float away like red balloons, then the tree is my haven. When soul cleansing is needed, it's the waterfall that moves the stress from my body. When anger fills me, then only the ocean can save me. In each situation, a different place is needed for protection. 

Yet, the one constant is my breathing. Always the same. "Re" when I breathe in, "lax" when I breathe out. A simple mantra that transcends all situations and has become part of my life. Slow and steady breaths from one day to the next. When I get to tripping over myself, I return to my breaths, slow down, and enter the present moment, fully aware.

Autumn

The crisp autumn air filters through the window, quietly adding a chill to the room. Cat sits on the windowsill, trying to catch the scent of a mouse in a distant field; imagining what it would feel like to hunt and kill. I pull the covers closer to my chin while still managing enough room to keep my hands free for reading. I am cold by nature, yet it is impossible for me to sleep in anything but an ice chest. I love October mornings when I wake up to a freezing cold room after a night of opened windows. It makes the bed a haven of warmth, curled up in my little spot, Cat as close to me as possible. Sometimes it's so cold, Cat forgets his Norwegian Mountain Cat roots and crawls under the covers with me, looking for the forgotten "dog" pile. I sometimes imagine him sensing I'm the best he's going to get in terms of a pack.

These mornings are my favorite. Especially when there is no rush to get out of bed. The warmth under the covers contrasts the cold, numbness of my face from a night of cool breezes slipping between the slats of the blinds. I throw the covers over my head, and let the heat from my own body, insulated and protected through the night, warm my face slowly. It's what I imagine an icicle feeling like as it melts away, minus the panic of knowing that as the sun rises, you will soon no longer exist. Cat is curled into the smallest ball of fur imaginable for something his size. He uses his velvety front paw to cover his nose, keeping it protected from the harsh cold. His tail wraps around his entire body, the only distinguishing features his eyes, and his incessant purring a constant reminder to his current status of being alive. I pull him closer to me, using him as the cat version of a space heater. There we lie, curled human around ferocious beast, using each other for warmth and company on the beginnings of a fall day in October.

The leaves on the maple tree outside rustle in the wind, whispering of the beautiful day that has begun, beckoning me to join it. Soft, white sunshine peeks through the window, paled from the earth shying away as winter approaches. Soon, I will leave the haven of my bed, run across the cold carpet and even more frigid bathroom tile to start a scalding hot shower. The steam will pour out like smoke, and encompass me. I'll stand in the shower until the water runs cold, and I'm left with wet hair and an ever shrinking towel to shield the cold air from pricking the water droplets on me. I enjoy knowing that I can slip into a sweater, letting it's embrace remind me of the warm bed that I started the day in. Hot apple cider, a mimic of the rolling steam from the earlier shower. The sun, warm and cold at the same time. Leaves excited at the prospect of me joining their autumn world.

The Monster Inside

My tachycardic heart beats out of my chest, drumming the steps of a foe far greater than myself. Its muscular body smashes into my rib cage, beckoning my enemy closer, alerting her to my vulnerable position. I cannot stop her. Her slow steps toward me elicit a great sense of fear. Fear of what, you ask? Of nothing and everything at once. She encompasses me, and like the dark waters of a hurricane infested sea, she slowly drags me further from the shore, from my stronghold. I'm swept away in the undercurrent until solid footing is no longer an option. I fight for every breath as if it were my last. Fast shallow breaths that barely fill my lungs. My lifesource is taken away from me. Vertigo combines with the lightheadedness of hypoxia to confuse my senses even more. I am surrounded by a deep, impenetrable darkness. No air increases my already rampant heart beat. The chest pains increase the sensation of foreboding. I'm done for. My head wants to explode, like a bullet passing through an apple. Brains spattering on the tumultuous waters like seafoam. Where is the surface? Where is my drive for self-preservation? When will I break free? My body smashes into the rocks that once provided sure footing. I lie crumpled like paper, broken like a piece of coral. Useless limbs shiver at my sides. Heavy as lead, they aren't my own. My mind breaks free like a thousand stallions in the open fields of midwest. Running together but each its own being. Thoughts. Millions of them. All at once. The tsunami hits and it's all I can do to keep from going back out into the waters that want me to succumb to their forces. Tears bathe my numb face. Make it stop! Silent shout. No one to hear. My own ears are silenced under the rampage of billions of hooves. Each trying to draw me to it. All at once. One and all. I disappear into a corner of my mind. Protection. A hovel feigning cover from the water horses.

Silence

When I finally awaken, I'm surrounded by nothing but utter destruction. Tears of anger, of self-loathing. Why cannot I not stop the storms? Why am I so weak as to not be able to control even myself? How can I carry on, not knowing when the next squall will hit? Do I run the risk of letting someone into my secret? Into the darkness with me? Will we both sink, or will it be my saving grace? Can the storms be silenced by the will of another? Will I still thrive without these intermittent monsoons stampeding through the safety of my world? I am too exhausted from the current blitz to be able to consider the ramifications of letting someone truly know my world. I can only let sleep in for now. Pretend I'm safe in my own bed.