Rose window example, San Antonio

“Can you tell me anything about your father’s medical history?”

“No. I don’t know him.” He shrugged as if it was no big deal but his voice said otherwise. 

Next patient…. 

“What about your father’s medical history?”

She scrunched up her face. “I think he’s still alive? I don’t know for sure. I never knew him.”

Next patient…

“So your mother is alive and has diabetes. Do you know anything about your father?”

“I’m not in contact with him.” The disdain came across loud and clear in her voice. “I hope he’s dead.”

If fathers ever think they don’t matter, they should sit in my seat and listen to the pain they can generate even when they are not there.

A Virtual Reality Devotional

Stained glass window

The body lies prostrate

On the confessional floor

A weakened avatar

Your closed door

Heartbeat slowed

From afar

Fading finally

Into empty code

Mere tokens


Meaningless and broken

Nothing of value

Can be taken

Only the memories of love

Gained and lost

And gained again

Virtual virtue

Virtually gone

And truth now clear


Turned into fear


A final frontier

Hold your breath

It is not so painless 

As they wanted us

To believe

Pecking Order

Flamingos fighting

Just take a nip 
Here and there
So I can be pretty
Fix my hair
Pull and tuck
Gouge at my eyes
Make me look pretty
Slim my thighs
Whiter teeth
A larger bust
I’m still not pretty
Another adjust
Raise those cheeks
Now my nose
Got to look pretty
Paint my toes
Some fuller lips
Sharper jaw
She is so pretty
Fills me with awe
Chisel me down
Tighter skin
I could be pretty
If I were thin
Sew me up
Dress me up
Give me more pain
So I can feel alive
So I can feel loved 
Still not happy
Just a pinch more
Want to be pretty
Want to be adored
Soon I’ll be there 
You wait and see
Soon I’ll be pretty
Soon I won’t be me

Hanging Out

Old Ferris wheel in black and white

I find that I am more and more conscious of my own nose hair. What is interesting about this is that I never, ever notice the nose hair of other people and if I did happen to see some bits poking out of a nostril it would not gross me out. So WHY on Earth do I care about my own nostril hair? 

Is this because my nose hair is getting longer? 

Perhaps I am growing more and more sensitive about the change of appearance that comes with aging and I am finding myself more interested in controlling the things that I can have some influence over? 

And then I wonder if there are people who do care about other people’s nose hair and if so, why do they care? What else do they do in their free time?

These are the thoughts I have on a Sunday morning after yet again having one of those pesky hairs ripped from my poor tender nostril by the stupid nose hair trimmer that is supposed to CUT the stupid things. I swear, next time I may as well just tweeze them out….


Lichen close up

Reminiscing is a form of masochism

Reliving, savoring, using the pain 

Rubbed over and over and over again

Until the memory is sufficiently buried

Under a thickened, leathery patch

Numbed, no longer holding power 

Peaceful… for a time at least… then

The need to feel alive arises once more

Seeking out the next memory to scratch

* Note, the photo is a picture of lichen, a fungus living symbiotically with an algae as a composite organism. Lichenification is a dermatology term for thickened skin due to repeated scratching, like with eczema. 

Dark Days

pond before a rainstorm

So how was it? The first day of the new EHR?

If you really want to know… It was a cluster F**K with a capital “F”.

I don’t want to bore you with all of the gory details but suffice it to say some clinics had staff so frustrated they were just walking out, quitting on the spot. 

My staff is all coming back tomorrow. I think. I’d like to believe that pizza and slushies and chocolate helped but I am not sure there was anything that really could have made it better short of an electrical fire. A devastating electrical fire….


There’s always tomorrow.

Pushing Buttons

“This is none of your business!”

“Ma’am, I am trying to explain your benefits to you so you understand why you have the balance of $32…”

“Shut the F* up! I’m not paying anything. And you, little man, what the hell is your problem?” She turned from the front desk woman she had been yelling at to the office manager who had come to address the commotion.

Admittedly, he is a bit on the short side but who belittles someone to their face because of their height?

He identified himself. “You sounded upset and I thought I would see if I could help.”

“F* off!” She grew redder in the face and threw a clipboard at the check in window. “I am going to report you, you bitch!” Her voice rose, full of venom. “I am going to report the whole lot of you!”

Everyone stared, silent. Shocked. Finally, she turned and stormed out.

Later that day, she called the complaint line and raised holy hell. My staff and office manager were left to defend themselves to the higher ups, as if they were the ones on trial.

We have had a rash of verbally abusive patients over the past couple of months. I am not there to witness the interactions, but I do get to hear about them later in great detail. It is over silly stuff, like having to have a copy of the driver’s license of the person picking up a controlled substance prescription. 

Bullying. Almost daily. From new patients but also from people we have been seeing for years.

I realize that I talk about this sort of thing a lot. Healthcare is a tough field. You’ve got to have a thick skin or it will destroy you. Here’s the thing, though: I am used to these sorts of things happening from time to time, people are scared after all and there is nothing more frustrating than navigating the healthcare system, but I have never, in over twelve years of practicing medicine, ever witnessed the amount of abuse laid down over the past couple of months. I wonder why my staff even comes back every morning for another day of it. I am not sure we can ever pay them enough. The attacks are incredibly mean and ugly, more over the top than I am used to witnessing in past years. People are becoming more abusive, more hateful with each interaction and I don’t know where it is coming from.

If you work in healthcare, you are expected to maintain a perky and yet calm and meek facade at all times. We are to be patient, kind, respectful and never let our emotions show even in the midst of a brutal onslaught. If we crack, even just a little bit, suddenly the whole event becomes our fault. Let me tell you, that it is extremely difficult to maintain calm when you are getting beaten down every single day. I feel for my staff who absorb the brunt of it.

Why is this behavior even necessary? 

Is it a symptom of the political climate right now?

The Calling

Chicago skyline from Sears Tower in black and white.

She hesitated, staring at the caller ID.

There was only one person who would call her personal phone from that number, from that office, and in actuality she was not sure she wanted to speak to him. She stopped referring patients to him or anyone in his group long ago, specifically to maintain the distance they both needed.

Distance that had persisted until the apparition began to show up, unbidden and unwelcome. Haunting, attacking, cursing, taunting…. trying to drive her over the edge.

Why don’t you just jump? You worthless, crazy whore. Slut. Slut. Evil, insane, unworthy whore.

The phone rang again, vibrating in her hand.

Then again….

You don’t even know me.

She groaned, exasperated with herself because she knew she would answer. Of course she would answer.

She always answered. Curiosity was her nemesis.


There was a pause. She closed her eyes, bracing herself, not sure what would come next.

“I’m sorry,” he said. “I let things get out of hand.” She had not heard his voice in… she couldn’t remember when. “I wanted her to hurt you…. because….” He trailed off into his customary silence. 

He had always wielded his silence like a sword, slicing his way through her. It was one of the things about him that drove her away.

“I know,” she said finally, even though she didn’t know. She didn’t really understand anything. 

Some secrets are best left shrouded in silence.

“It won’t continue,” he said. She could hear that he meant those words.

He might have said more but she wasn’t listening. The truth was she did not need anything more. She didn’t even need the apology. All she needed was for him to be the man she thought he was so she could go on remembering him as she always had…



And very far away.


I am going to do “Fiction Fridays” so expect to see these vignettes and short stories on Fridays in the future! I had to use this one today as I have several posts I am working on but nothing actually finished and publishable to my satisfaction. The start of the school year yesterday plus catching up at work after vacation is kicking my butt!!!