Thursday Thoughts From the Throne #5

Mission door in San Antonio

I have been pondering this from the toilet for a long time now:

You know what I hate? Items that have what they are emblazoned upon them. Like a pillow that has “pillow” in huge letters written across it. Or a towel that says, “towel”. Granted, before I have enough coffee to clear my sleep deprived brain, towelling off with my pillow after a hot shower is not entirely implausible…. but still. Seems like if I *did* do something like that I would kind of deserve the subsequent damp bedding, you know?

So every morning I blow dry my hair while standing bent over in front of a cream colored canvas “hamper” hamper. I am compelled to roll my eyes at it every morning, although the “hamper” hamper certainly never seems to appear to have its feelings hurt. The effect of eye rolling is dulled somewhat when done upside down. 

I surely do hate the thing and yet principle dictates that I cannot just toss it out until it wears out. I needed something collapsible and lightweight for lugging large amounts of laundry downstairs (I only do laundry once a week because….laundry) and it was the only option at the time at the local Target store. Mind you, the purchase was made before an Amazon Prime membership opened up a whole new fabulous world of shopping variety delivered to my front doorstep at the touch of a screen. Wicker is cute but it is expensive, heavier, and it dang sure does not last long with repeated trips up and down stairs but you know what? Cream colored canvas “hamper” hampers apparently DO last.

For years. 

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Feel free to join in with your own Thoughts From the Throne. Steve Still Standing did, of sorts. Check it out

And since apparently Thursdays are door days all over the blogosphere, I decided to throw in a door for your viewing enjoyment.

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Missing Out

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“Why can’t I go?” I held the paper clutched to my chest. I’d earned a trip to a church summer camp for free. My ticket out of my own little hell for two weeks. I needed this. Never had I been allowed to go to camp. Up to that point I had been led to believe it was a money issue.

Please let her say yes, God. Please, please make her say yes. I promise to go to South America to do mission work when I grow up if you will just let me have this one thing!

My mother stood silently, her face turned away. 

“Mom! Why won’t you answer me?”

Her body stiffened. 

Finally, her back still turned to me, she answered:

“Because I never got to do something like that.” 

And then it dawned on me. My mother, my own mother, was jealous of me. Jealous of this opportunity. Was there more to it? Probably. But there was an undercurrent of envy and that was what I latched onto.

I judged her harshly.

How can you be jealous of your own daughter? What kind of person does that make you?

It struck me yesterday, listening to my son and daughter practicing on the piano, that I am envious of them. I am jealous that they get the opportunity to have piano lessons from a real teacher. I am jealous of my son’s spelling and math ability, how easily music comes to him. I am jealous of my daughter’s artistic creativity, her ability to easily make friends, and her extensive glitter pen collection. What I could have done with even a couple of those glitter pens back in the day… 

Even now I don’t understand all of the reason behind my mother’s refusal but I did learn an important lesson. I learned I could survive without church camp. I also learned, and a great big wave of relief washes over me even now when I think about it, that God did not *want* me to serve as a missionary in South America. 

Whew.

So where am I going with all of this?

Envy was a surprising emotion to recognize in myself and I find it embarrassing to admit. It snuck up on me. Since I am not a particularly unique person and I am living on this planet with billions of other not so unique people, I expect this means that other parents also experience jealousy when it comes to their kids. I wonder how many?

We all want to believe that we are somehow better than our parents, though, don’t we? 

And yet we aren’t.

I expect that maybe even more than my kids’ glitter pens and the piano lessons that I am most jealous of their youth…. those unexplored futures, the potential looming ahead of them. I wonder if this is simply because I am an older parent, or if younger parents feel this acutely, too.

Ultimately, I don’t intend for jealousy to motivate my saying “no” to things in the future… except maybe if my daughter wants to go out for cheerleading.

Thursday Thoughts From The Throne #3

Black and white Gerber daisies

The nice thing about your loved one continuing to ignore your advice about going to the ER for their severe right lower quadrant abdominal pain until their appendix eventually ruptures is that in a few weeks when it is clear they will live and the post op pain subsides (you have to be nice to them until then) you will have ammunition to use for the rest of their life… if you are the kind of person who does that sort of thing.

*wink*

Cirrhosis 

Laundry room, Ellis Island hospital

He sat silently weeping in the corner. His hand shook terribly as he reached up to wipe his eyes. Misery was etched across his face.

“You didn’t stay at the treatment center.” He had not even lasted a day. “What happened?”

“My wife cried so hard when she left me there. I couldn’t stand it.”

“What about an outpatient center? A day program?”

“Maybe,” he said, noncommittal.

Each visit, fewer family members came until finally it was just him. 

Alone.

And each visit there was less of him. His body was swollen and bloated, faded. A once strong man, now made a shadow. It was hard to stand by and watch. Not as hard as living it, though, I was sure. How he could continue to do this to himself was a testament to the power of addiction.

“You’re going to die.”

“I know.” Then he smiled. “This is the one way I can kill myself and the family still gets the life insurance payout…”

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

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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.