To The Rock Star…

Radio City Music Hall in New York City

“Don’t tell Dad I broke the plate, OK?”

“But it was an accident, sweetheart.”

“I know he won’t be mad but I still don’t want him to know.”

He cares what you think about him.

“Mom, I miss dad.”

“He’ll be back before you know it.”

“Can we set a place for him at the table even though he isn’t here?”

“Sure!”

Your presence is missed when you are away.

“Mom, I let her have the rest of my Gatorade even though I really wanted it.”

“Because she wanted it, too?”

“Yeah. It was the right thing to do.”

He is paying attention to the example you set.

So… thank you. Thank you for being such a great dad!

A touch of tenderness

This is a wonderful post about the importance of touch in life and death. Please pop over and read it if you have not done so already.

Sue Vincent's Daily Echo

The Cathedral by Rodin.

My son gleefully squeezed harder at the knotted muscle in my shoulder, with a ‘Now I’ve got you’ as I groaned in agony. We have established and agreed that he has a slightly sadistic tendency where I am concerned. It may have something to do with my knack of getting just the right spot on the painful muscles as we got his body working again. Day after painful day, for months on end. So now it is payback… and he appears to enjoy it. He still manages to lay the blame squarely on my aching shoulders, muttering something that sounds vaguely like ‘hereditary’.

He is a little more squeamish than I. His face screws up in horror as my wrist bones crunch back into place when he applies traction. It is, however, nice to regain freedom of movement occasionally. So I make him do it…

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The Cost of Protection

Carved flowers on a Victorian tombstone.
There have been several times over my career that I have had to step in to protect a patient from their family. Each and every time it gets nasty. It takes a certain kind of person to abuse their child or to molest a mentally challenged adult or neglect an elderly person to the point they have maggots in their wounds. Those kinds of people fight and they fight dirty.

I marvel at how some attorneys can look at the facts of a situation and defend it by attacking and terrorizing the physician who had to make the call. It is exhausting and terrifying and can leave you questioning yourself and your judgement throughout the process:

Surprise subpoenas summoning you to appear in court in 60 minutes, requiring you to cancel all of your afternoon clinic appointments at the last minute.

Threats of lawsuits.

Antagonist depositions. 

Lies and accusations made publically.  

Nothing in medical school prepares you for this sort of thing. Physicians have malpractice insurance but this is not malpractice. There is no one to walk you through it unless you hire your own expensive attorney.

Eventually you are vindicated but not before your life is made a holy living hell. It takes a toll on your family and friends as well, as you cannot discuss it with anyone else. The process can drag on for months or even years.

You are isolated and alone.

Fortunately, all of my experiences have been before social media. I have seen, of late, some unbelievably ugly online attacks made on physicians who are only doing their duty and trying to protect the vulnerable. It appalls me how quick the rest of the world is to jump onto the hate the doctor bandwagon when they do not know the whole story. Physicians are not allowed to defend themselves due to privacy laws. The rest of the world will never know the whole story.

What some people seem to forget is that our role as physicians is to assess the situation and make a recommendation. We are required by law to report suspected abuse. We are not omniscient super humans and maybe we don’t always get it right. All we can do is our best. In the end is up to the courts to decide guilt or innocence. 

The price we pay to do so is often very, very high….

The Deviled Inside

img_2933

What food do you love the most at Thanksgiving or Christmas, or any other holiday for that matter? What do you look forward to being on the table? 

I don’t really care for turkey or dressing. Or congealed cranberry “sauce” from a can. Green bean casserole? Ick. My personal favorite holiday food is deviled eggs. In fact, I ran an extra four miles this morning just so I could eat 4-5 eggs and not feel guilty about it. Oh, who am I kidding? I will probably try to eat six or more…. Of course, I have to sneak them. Most people judge you for openly putting that many deviled eggs on your plate.

For my international readers who may not know what deviled eggs are exactly, they are hard boiled eggs that are shelled and cut into halves. The yolks are popped out and mashed with mustard and mayonnaise, some salt and pepper, and then piped back into the egg halves. They are then topped with a dash of paprika and a slice of pimento stuffed green olive.

Mmmmmmm…..

There are countless variations out there. Some with bacon. Capers. Dijon. Schiracha. I haven’t met a single one I didn’t like. 

I first discovered deviled eggs when I was a kid. Thanksgiving at my grandmother’s house, to be more precise. She would boil up about three dozen eggs and assemble several platters of deviled eggs, one for the elder adult table, one for the lesser adult table, and one for each of the kids tables. Fortunately, the kids at my kids table hated deviled eggs. More for me….

Here’s the thing, though. The eggs are hard work. I would much rather make a key lime pie with a homemade graham cracker crust and fresh squeezed lime juice from dozens of those teeny, tiny limes without the help of a juicer or garlic press, my finders bloodied from trying to get a tablespoon of zest off of the awkward rinds, than make deviled eggs.* 

Why do I love something so much and yet hate to make it? Dunno, but there it is. Probably a good thing because honestly, I cannot control myself. Twice a year, if I am lucky, I can get my fill.

So, what are YOU eating today?

*I made a key lime pie once and I promise you it will not happen again!

In Hiding 

screens at Versailles

I have a habit of checking the State Medical Board discipline postings whenever they come out to see if anyone I know is on there. 

Typically there is no one. In fact, I can’t remember the last time I found someone that I knew.

This time, however, I found two.

Two.

The first I recognized as an old classmate of mine from medical school. He lost his license due to substance abuse… alcohol specifically. Several DUIs. A failed treatment program. I wondered when that issue started. In medical school he never seemed to be a partier. There were those but he did not run with that group. He was quiet. Studious. Funny. I liked him back then. What happened between then and now? All of those years of training and sacrifice. What is left of his life? His family?

The other was a man I had worked with as a partner for a number of years. He pled guilty to Medicare fraud. It startled me because he was heavily involved in his church all those years that I knew him. Not to say that religion makes you perfect. Hardly. Still, it shocked me. You think you know someone and WHAM! You find you don’t know or understand anything. Was it greed? Desperation? His wife was so nice. His kids. What is happening to them? 

Sobering. 

We want to judge harshly….

I always remind myself that I am only one bad decision away from being on that or some other list myself. We all are. We like to believe that we are above that sort of thing, that there is something about us that is more perfect. We couldn’t possibly have a character flaw, a weakness that makes us vulnerable. And yet each of these people thought the same thing about themselves at some point. 

That doesn’t make what they did right and it doesn’t mean they shouldn’t be punished.

It just helps to remember that we are all human.

Their Last Supper (Part One)

interior of Opera Garnier in Paris

He was so far away. She stared at him across the vast canyon of cream colored linen that stretched for miles and miles between them. It seemed to grow wider with each passing minute.

She tried to make lighthearted conversation to mask the uneasiness she felt. It did not help so she stopped pretending and grew silent, folding her hands over the matching cream colored linen napkin resting in her lap.

Nature abhors a vacuum.

He filled the quiet by recounting his day, glossing over the children who had died on the hospital service. At least it is no longer drowning season, she thought.

He had seen so much of death. As had she. They all knew each other intimately by now. It drew them together and yet kept them apart.

A ménage a trois of sorts, sans the kink.

There were wrinkles around his eyes. She wanted to reach out and smooth them away, to bring his soul back to her. His face had aged ten years in the past two. She wished she could be some comfort to him again but it had been so long since he had wanted that from her.

Not since they had lost their own child.

There was no printed menu. She tried to focus her mind on what the waiter was saying but her thoughts raced off anyway as she watched those wrinkles deepen further.

He was lonely. 

They lived their life with each other in brief snippets of time. They could count the nights they had spent together over the years on their combined hands. So few. Too few. Loneliness lived in the empty spaces and made them seem even longer. But those nights. You could fill up a lifetime with those nights.

She had something else to live for now.

He had only the hospital. Over the months and years he sensed he was losing himself to it and his urgency and pleading had intensified.

She glanced furtively around the restaurant to see if anyone recognized them but they were all engrossed in their own personal dramas.

He poured a dozen packets of sugar into his iced tea and swirled it around quickly with a table knife. His manners made her cringe. 

She loved him anyway. She had always loved him.

“I wish you wouldn’t do that,” she whispered, smiling.

He looked up at her, holding her eye in defiance as he licked the syrupy tea from his knife then signaled the waiter. Anger flashed there momentarily.

He wanted her to know that she could not control him.

She wished he understood that she didn’t want to. Not really.

The waiter was there almost instantly, waiting expectantly. 

“Could I get some more sugar?” he asked. But his tone…. it wasn’t a question. It was a command. He was used to giving orders now, and expected them to be followed.

She had known him before…. Before his confidence. Training had changed him. Death had changed him. It had changed her.

The waiter opened his mouth in surprise, seeing the pile of empty packets that littered the table cloth, but then caught himself, simply nodding instead. He swept up the bits of white paper silently, efficiently, then left.

You think he’s crazy, don’t you? Everyone does when they first meet him. Brilliant people are hard to understand.

She stared at his face again. 

They were two unbending, unrelenting forces that danced around each other, sometimes coming together for a brief moment before shooting off like the opposing ends of a magnet. Drawn together by unseen forces that both compelled and yet repelled. 

What he wanted from her was something she could not give… her only child, the only child she would ever have, sacrificed on the altar to love. 

An offering. As he had once been.

How could she explain in words that it was impossible? That what was done to him as a child was not fair and not right? 

That it should not be repeated.

He could not understand, no matter what she said, blind to his own hurt. So she stopped explaining. 

She let his anger wash over her again. 

“Coffee with dessert?” the waiter asked.

She nodded yes silently, hoping to make this last supper last as long as possible. She sat watching closely this strange man who now sat across from her as he ate, trying to memorize every detail of his features. She wished he would smile again so she could save that memory, but he did not.

They both stepped out into the cold December after sipping their French press. The cold air took her breath away for a second. He took her by the hand protectively and led her to her car, illuminated dimly by the lone streetlight on the corner a block away. 

She felt safer in the darkness than she had in the light.

“We loved each other once,” she said quietly.

“We still do, don’t we?” he responded. “I will be here when you figure things out. But don’t wait too long. I won’t be here forever.”

He leaned over and placed a chaste kiss on her forehead, lingering there. She closed her eyes, savoring the moment.

Peace would never belong to them. Not ever.

He squeezed her hand, then was gone. She watched his shadow walk away shoulders squared, head held high. He faded into the night, a gray ghost that would forever haunt her.

Remember me.

She resisted the powerful urge to run after him, instead screaming silently into herself, into the pain he left behind, the empty that would never be filled…. the empty he could not see, the empty that would bring her to her knees even years later.

It echoed there. 

Remember when.

He would find someone else. She knew this. Her presence had kept him from it for so long. He would have something more to live for soon enough. The tables would turn. She would be the lonely one. She would be the one begging and pleading to someone who would not listen.

Remembering.

Her life as her own had long ago ended. 

Fishing for Something More

shadow of fisherman in the water with float visible on the water surface

“If you are going to fish you need to learn how to cut a worm in half with your fingernail.” He grabbed my hand and placed a long squirmy pink one into the palm. We had dug it and half a dozen of its siblings up from my grandmother’s flower beds that morning.

Sometimes you have to get your hands dirty.

I squinted up at him in disbelief. “I can’t do that, Grandpa! It’s a worm.” I was five years old, old enough to have a sense of what was really gross and what wasn’t. 

There was no way…

“You can always do things you think you can’t.” He said it in such a way that it left no room for argument. 

He stood waiting.

I sighed as I tore the slimy thing into two wriggling halves. Brown and yellow colored worm guts were all over my fingers and under my thumbnails. 

He was right. 

Listen to your elders.

It was not as hard as I had imagined… and I was surprised to find that my hands washed off clean in the river. Clean enough to eat a bag of Cheetos with, at least. 

I hadn’t really wanted to go fishing. Fishing was for boys. But I really, really didn’t want to stay at home with my grandmother to help with the canning. That was too hot and messy and boring. Plus, grandpa had Cheetos.

Girls can do boy things.

Mmmmm. Cheetos. Finger lickin’ good…

He showed me how to thread my bit of worm onto the hook properly and how to cast without injuring anyone. We stood there for hours. Casting. Reeling back in. Casting. Reeling back in. I watched the bobber dunk below the surface countless times, felt the hard tugging on the line, only to pull up a bare hook again and again. Bastards. I never caught a thing. 

The fish were taunting me.

Sometimes you don’t get what you want, even when you work hard for it.

I was terribly disappointed but strangely addicted. I knew I could get those buggers next time…

My grandpa stopped to clean the fish he had caught so my grandmother could cook them up for dinner that night. He made me help, even though I begged him to let me play in the water instead. Worm guts were bad enough. Now fish guts?

Unpleasant things are often necessary and as much as you might want them to signal the end of the world, the world will not end. Not for you. 

As we were packing up my grandfather took my hook to pull off the last bits of remaining worm. I was not paying attention and ended up pulling the hook through his index finger.

Somehow, he didn’t cuss at me. He was a good man.

Always say you’re sorry. AND carry wire cutters in your tackle box in case of emergencies.

“Can we go again tomorrow, Grandpa?”

He grinned his lopsided grin as he slung the poles over his shoulder and led the way back to his beat up green Chevy truck. “You bet.”

I was secretly hoping for more of those Cheetos…

Corsage 

 black and white tiny flowers 

The cluster of tiny white flowers were now brittle and desiccated. The clear plastic box it originally came in served as a protective shrine of sorts. Picking it up out of my cedar chest I could see the cream colored ribbon, two faux pearl tipped straight pins, and the tiny rhinestone heart were still intact.

I had no date.

Each day that crept by I had waited and waited, ticking off each eligible male until it was clear no one would ask me.

Finally I had resigned and purchased the ticket to my senior prom with babysitting money. The dress I picked up for $35 at the Dilliard’s clearance store downtown while my shoes were $25 satin pumps from PayLess. I could not afford to get my hair or make-up or nails done or the shoes dyed to match my dress. In fact, I was not allowed to wear make-up or nail polish, anyway.

Nor was I allowed to drive, for that matter. I was eighteen and still did not even have a learner’s permit. So my parents dropped me off at the venue, a worn out old country club, and picked me up again promptly at 8:30PM because all of my friends had dates and limo rides and there was no way I was going to ask if I could tag along. 

I thought prom was an important rite of passage, that I would regret missing it if I did not attend. In truth, it was a miserable experience.

The corsage was a surprise. 

My brothers pooled their meager resources and purchased it. Remarkably, it matched my dress. Granted, it had been intended for someone else, an unknown relationship that had crumbled right before prom, so the florist sold it for cheap, but still they thought of me and that by itself was remarkable. It helped keep my head held high as I circled the room, looking for someone, anyone to talk to. 

I still rate a corsage, you bastards.

Unexpected kindness is often the best sort. That is why I still keep the reminder of that awful night hidden away deep in my cedar chest. My brothers and I really don’t talk to each other. We keep our distance now as adults, it is more peaceful that way. We are different people with different lives and vastly different values. But once…. once we cared, once we loved each other.

The kindness you show now will be kindness remembered later and may someday form the foundation for a bridge back to each other.

The Scent of Flowers

pink tulips

“Doc, I just want him to send me flowers. But if I have to say it, it cheapens the whole thing. So when he comes in for his physical exam this afternoon do you think you could work that suggestion into the conversation somehow?” 

“Um, sure…”

Family practice is truly awesome. 🙂

Timeless

Golden, ornate museum clock.

It was noon on Christmas Eve. 

He had asked me to call him as soon as I had the results.

Still.

It was Merry frickin’ Christmas Eve.

I didn’t want to do this. Not to him. Not to his family. Not to anyone. Not on Christmas Eve.

But it was cancer. No doubt about it. The five centimeter tumor in his bladder had caused him to pee blood. 

I picked up the phone, hesitated, then put it back down. 

No. 

Not today.

I packed the laptop into my bright red leather bag and turned off the lights in the office as I walked out, the last one left in the clinic. My footsteps echoed down the hallway to the alarm code panel. I could feel the cold sneaking in around the glass door and I shivered involuntarily.

I stopped.

Sometimes you have to trust that there is a higher power at work, something beyond you. There was a reason he was supposed to learn about this diagnosis before the holiday. Maybe to help him reconcile with someone? Maybe so he could make this the best Christmas of his life, in case it was his last one?

I don’t get to decide. It is not my place.

He wanted to know.

I walked back to my office, picked up the phone again, and this time I actually dialed his number. 

He answered. 

I told him the news.

“Thank you, Doc.”

“Merry Christmas,” I said.