REIJAGAINSTHEMACHINE

For Grandma, On The Occasion Of Her Final Trip Home, And For So Many Other Women Who Aren't Home Yet

2012-02-18T21:01:00.009-05:00

"Every Mormon girl has a story to tell."

That's the catch line on the back cover of the book I was reading last night before I fell asleep. What an apt phrase for this little snippet of lifeline-- a time in which I find myself, again, transported eastward across a hundred years of history and the three thousand miles of the sands of Pacific, the wild red deserts of Southern Utah, the long long flat plains of Nebraska, the miles of wheel and foot trodden grasses, acres of mud and mosquitoes, farmlands and graves.

I am back in upstate New York, in the very place where a young man was desperately seeking for God, but finding Him distant even among his many resources, went into a grove of trees alone to pray. Women that I love, I am back here in your stories. He was not the only one seeking then, and you are not the only ones seeking now.

My grandmother tells the story of her own journey eastward from her home in Arizona to upstate New York circa 1960. She was a little miffed at Grandpa the morning of their visit to the Sacred Grove, but as she walked along with her infant son in her arms and a toddler son (my father) at her side, she said her own little prayer in the wood. And there, on that same ground, she experienced what she described as the strongest overwhelming spiritual confirmation that the Father and Son really did appear in that place to Joseph Smith. She described it as it being the most powerful witness that she had ever had.

She would weep nearly every time she told this story.

This morning when I awake the book is askance on the floor where it has slipped from my fingers and the air is still like it is when the snows have fallen, veiling everything in whiteness over night. In the perfect stillness of that empty room a quiet voice whispers, "Open your computer and check your email." Around midnight I had prayed, no more loudly than the voice, that God would take Grandma back to Him. I didn't specify a timeline but here in the silence of this room, wrapped in my white down comforter, I find out that my prayer has been answered.

I drive to Palmyra and do an Endowment session in the temple. What else is there to do to mark a death but serve the dead? The work has not stopped. After the session is over I don't linger in the Celestial Room. I drive over to the Sacred Grove, put on my coat and winter boots, and go for a walk. No one else is there but a herd of deer that don't find me a stranger. The snow has fallen, white on brown, but it is melting making everything gloriously muddy.

I think about Grandma coming here in the summer, everything green and growing and alive. I think of her with her two children and a picture emerges of a young mother, alive with opportunity, at the cusp of her spiritual journey. There is a sense of beginning here, that sense of openness and newness and revelation we see in the pictures of Joseph Smith, bathed in the greenness of the grove and the whiteness of God. I am forced to rethink the picture. The child she carries is her not her first, but her seventh. The toddler at her side is her sixth. Her oldest child has already left home. She is a little miffed. She is probably tired. She has, in her life, already crossed plains, forged rivers, made the desert to blossom as a rose. As I trudge through the mud in my boots, I imagine Grandma walking with me.

But you, women that I love, you are here too, yes? I imagine you walking here with me also. It may be my feet standing on the ground Joseph Smith walked on, but it is your hearts kneeling. Your lips are here moving silently, waiting for something to happen.

We are all trying to walk in the Sacred Grove together. You and me and Grandma and all the Mormon women in between. We are all waiting, like Joseph Smith, for the morning to break. We are hoping to find truth. We are waiting to see God.

What I feel walking in the Sacred Grove today, as I think of all of you is this: We will all find truth. We will all find truth. We come to it at different times, in different ways, and in different places. We don't have to be perfect to receive it. We don't have to be alone when we receive answers. We carry our hearts into closets, buses, subway stations, icecream parlors, living rooms, church bathrooms, gardens and they become our groves. Some of us are given our answers as children, some as teenagers, sometimes if you and I are lucky, now and again and again. Sometimes, like my Grandma, we have to pull our carts a long long way before to get to the Grove, and then we get to pull our carts again for another 50 years.

We will all see God. We will all see God! We will all see God. This morning my Grandma, after 89 years, saw God. She, this faithful, diligent, persistent, loving, dancing, mothering, toast-buttering, Dominos-playing woman that I love, she now knows and sees God.

Standing again in the Sacred Grove carrying the hearts of the women I love and wearing my own naked heart under my red plastic coat, I find that extremely comforting. And I am willing, again, to pick up my cart and head West.

I love you Grandma. Because of you, I will never stop pulling.

December 7, 2011: San Francisco General Hospital

2012-02-09T01:53:00.005-05:00

"We're going to have to tap your belly tomorrow if you're still feeling nauseous and in pain."

Mr. Willy Wilson nods at me from his pillow. "Is that where they stick a big needle in me?"

"Yes. You had it done before in the ICU but you were asleep then."

"Do I have to be awake this time? Will it hurt?"

"Yes you will be awake but it shouldn't hurt. We'll give you some numbing medication beforehand."

"Who is going to do it?"

I have been seeing Mr. Willy Wilson every day for two weeks now since he left the ICU and came to the regular medical floor. "I'm going to do it."

"Oh good. I know you'll do a good job."

"I have to let you know that I've never done this before. You would be my first time."

"It's ok. I trust you."

"You really have to know this is my first time. I might not do it right. We can have someone else do it if you're uncomfortable with that."

"I trust you."

"Ok. Tomorrow then. You, me, and a big needle. It will be a party."

"Ha!" he laughs. He has an incredible smile, this man. His smile is why I lent him my copy of A Christmas Carol. That, and when I saw him in the emergency room the night before Thanksgiving, he was reading Wide Sargasso Sea as he lost the ability to breathe.

*************************

My hands are shaking slightly and the small injection needle for the lidocaine-- not the big one for the tap-- slides in awkwardly and not at the right angle.

"Take it out and try again."

I've never met this doctor before but he's the one coaching me through this tapping process. I'm wearing a big face shield but through it I can still see Willy's big eyes looking at me.

"Ok." I try again.

"Now push the lidocaine in while you slowly pull the needle out."

"Ok." But I push the plunger too slowly and pull the needle too quickly and when the needle slips out of his skin only 2.5 of the 10 mL of lidocaine has left the syringe.

"Do you want me to go back in and push in more?"

"No. Put it down. Pick up the thoracentesis needle."

The thoracentesis needle is long and unwieldy. Willy is a tough old bird and the needle with its fat blunt end doesn't go easily in. "Twist! Twist!" the doctor cries.

I twist with both hands. The needle still doesn't go in.

"Twist! Twist!" His skin is like a tanned horse's hide. My wrists are weak yet I'm afraid if I go too fast I will puncture his bowels.

"Twist! TWIST!"

"STOP!"

"STOP!"

"STOP!"

That isn't the doctor. It is Willy. "It hurts it hurts it hurts. Oh God I can't go on I can't stand the pain, Stop!"

I look up from the needle. His face is contorted in pain. His grimace is as awful as his smile is sublime.

"Oh God Oh God Oh God Please Stop."

I turn and look at the doctor's face and then I stop. I put the big needle down.

I take my face shield off. We clean up the litter on his bedside-- the sterile field, the syringes, the iodine packages, the empty bottles which will remain empty. The doctor exits the room, leaving me to care for the patient. I fold some gauze into a square, tape it over his injection site. Willy relaxes and opens his eyes to find mine.

"I trusted you."

"I know. I'm sorry."

*************************

The next morning I go in to round on Mr. Wilson, my tapping victim. A huge piece of gauze is taped to his abdomen and covered with film. Under the film yellow fluid has soaked through the gauze and is collecting in a bubble.

He is smiling his silly toothless smile at me.

"How are you feeling this morning Willy?"

"Great! Never been better!"

He points at the bandage on his stomach. "Look! I'm tapping myself! Something must have worked there because I'm leaking like a faucet and feeling like a champ! I've soaked through ten of these!" He laughs gleefully.

"I'm sorry about yesterday Mr. Wilson."

He is still laughing. "Oh the tap?"

"Yes. I didn't mean to hurt you."

"Don't worry about that, honey. If someone had to cause me pain, I'm glad it was you."

I don't know what to say, so I say back, "Then I'm glad it was you, too."

Just Another Post About Kiva

2012-02-09T01:09:00.004-05:00

My first year as a graduate student I heard about this little online group called Kiva.org which did this cool thing called microfinance. Little loans to the little people of the world. And you could choose who to lend to yourself! For only $25 a loan! So exciting. I put my first $25 into the system and became a part of a loan to a woman named Prudence in Ghana.

She paid it back. I became hooked. I found another woman in Samoa who made donuts and lent another $25 to her. For donuts!

Eventually my $50 in the system became $100. Not a large amount of money, but not unsubstantial either. It allowed me to have four loans out at a time, at $25 per loan. And what fun to choose who to loan to! I would scour the lists of loans for women who I thought, given my luck in life, would have been at Stanford like me. Young women in their 20s. Some with children. All hard workers, entrepreneurs. When my brother was in Ghana, I loaned to women in Ghana close to where he worked and served and felt that in some way I was doing my part. Oh I know Kiva doesn't give my exact $25 to the exact person I choose. But no matter. Allow me the joy of believing in the process.

Today, remembering Kiva after a long while of neglect, I logged in and was surprised to find over time from my little $100 I had actually given $500 in loans and all 19 of my loans had been repaid in full! Overjoyed, I picked out three new women in Peru-- Argentina didn't have any loans up today-- and lent them $25 from my same little pot started back in 2004. Oh little loaf, oh little fish! Multiply and multiply again!

Kiva.org. I'm still a believer. (And you can be too.)

On Talking the Talk

2011-11-03T22:30:00.004-04:00

by Elder M., one-month into his mission in Argentina:

Although I still lack very many vocab words and phrases to understand what people are saying, with what I do know I can usually get the gist of it and almost keep up in understanding. The real big problem now is conversing. That's a real big problem, especially because here conversation must be rapid-fire. You have to get in at precisely the right moment, or people will keep talking and talking and talking. But for me, conversation has always been a slower thing - despacioso, it's called. Slow words, finished thoughts, with space between them. Space to think, time to think, time to gather your words and say just what you mean. But here it's like conversation is a freeway, full of cars but not choked up. There are no onramps, though - you have to turn on and accelerate from zero. But here I sit by the freeway in my little clunker of a Fiat or something, and all the spaces between the cars are too small for my bucket of bolts. When a space large enough comes up, I slam in the clutch, move the gearshift, let off clutch and brake, and stamp the gas, but still move too slowly and miss the space. So I keep sitting by the side of the freeway, and in the rare times when I do get on I can't stay in the same lane but have difficulty switching lanes, so I get run off the road pretty quickly. There's much temptation to just watch the traffic go by, if you see what I mean. That's a real problem.

This same brother flew at zero-G just one and a half months before his mission. Check him out in his super cool space pose (He's the short red-headed one. I have a lot of those in my life right now):

A Bed For The Night

2011-09-12T22:45:00.002-04:00

by Bertolt Brecht

I hear that in New York
At the corner of 26th Street and Broadway
A man stands every evening during the winter months
And gets beds for the homeless there
By appealing to passers-by.

It won't change the world.
It won't improve relations among men.
It will not shorten the age of exploitation.
But a few men have a bed for the night,
For a night the wind if kept from them,
The snow meant for them falls on the roadway.

Don't put down the book on reading this, man.

A few people have a bed for the night.
For a night the wind is kept from them,
The snow mean for them falls on the roadway.
But it won't change the world.
It won't improve relations among men.
It will not shorten the age of exploitation.

August 17th

2011-09-06T22:52:00.004-04:00

In the morning I woke up to my new life. Gone was the trusty truck, the big arm chair with the oatmeal fabric, and the geranium pot my friend S. bought me when she burned an old one. Gone also, inexplicably, was my summer craving for McDonald's icecream cones and my never-ending thirst for juice. Here my hair was curling spontaneously, a rejoicing mass of ringlets.

I was new again waking up in this old place.

The first day was a day of errands-- a trip to the DMV in a $10 red dress and my wedding earrings and a smile from ear to ear. I sat down to fill out the forms and heard my name called and turned to see a face I knew, but for ten seconds could not place it as here or there-- California or New York? A friend new or a friend old? Coming to my senses, I sat by my old friend and we chatted about long-distance marriage, my recent end to it and her plans to begin and I shuddered. Having spent so much trying to end this, how could I understand her desire to start? In the evening there was Navajo tacos and chocolate strawberry shortcakes and more old friends, LRH and DRH on the eve of their departure day-- but best of all, how best of all!-- there was my Robber. Coming home on his bicycle. Home to me.

In the morning of the second day I woke up next to my Robber and puttered outside to wave him goodbye in the driveway as he left for work, a small-framed man in a dinosaur T-shirt and a bicycle helmet with a ginormous pack attached to his back. A small voice in my ear was heard to say, "This moment won't be too much different twenty years from now," and I was glad.

On the third day I put on my scrubs and went into the hospital where I found the simulation room in the medical school and pretended to save mannequins from various ills-- alcohol intoxication, seizures, sepsis, heart attack, abdominal pain. And although I had been to this campus a million times before, there was a new familiarity, a new belonging, the ease of feeling like a colleague more than as the star of a masquerade show.

For here, in my new life, I am a doctor. Not because I hoped it would be a good idea, not because I didn't know what else to do. Not because my other classmates were trying to be doctors or because I was getting a grade. Because I had chosen this deliberately, because I had worked to receive this, because this is what I, myself, have decided to become.

And here, coming home after my day of work in the emergency department, I am no longer a long-distance lover, a text message in the afternoon, a voice on the telephone line at night, a flat presence on the computer screen, a girl longing for a man living in another world. In this new world, yes my new world, after fourteen months of marriage-- I am finally a wife.

Happy R Day, Robber!

PICU

2011-07-29T02:22:00.005-04:00

There is a grace to be had in loving the odd-shaped things of this world. A bird born without a wing. A tree that bends into the face of the wind. A clover that grows not three leaves, but four. Our God has given His Earth creatures in all their variety, and we as His children are not exempt from this part of His divinity.

I am not sure if this truth causes Him grief, but it is part of His grace.

We speak of grace as if it is given freely, but there is a price to be paid for His wisdom. The PICU is a halfway home for the ill and the dying, a platform placed between two opposite-bound trains. There came to us tonight a young girl, born without that crucial structure that connects the two halves of the brain. She was five and had just learned to smile. When the moment came the critical care fellow whispered, "She is dead," and laid her hand on the shoulder of that tall, sturdy inconsolable father. He picked up the body of his daughter and laid it on the lap of his wife as they held each other and wept.

I am waiting to see the angels I know to be here.

For The Robber On My Last Lonely Little Night In This Apartment

2011-07-27T20:29:00.002-04:00

Come unto me," Jesus says;

"I am coming, Lord!" I answer,

But I do not expect to hear

The echoes of my shout

Reverberating off those gates

Built of celestial pearl.

Heaven is too far away,

And I can no more shape

Stairs out of the ether

And begin the long climb past Jupiter

Than I can flap my arms or click

My heels and find myself transported

Between the two oceans

Miraculously into your arms.

It is, in truth, harder to love

Someone whom you cannot touch,

See, or feel. I am not

The child Christ is embracing

In the pictures. Neither am I

The woman who washes

His feet with her hair.

I am the one who is sent

To love you-- although I cannot

Hold you, I have already learned

To run the second mile,

Bake the leavened bread,

And pay our taxes using fish.

I am still working on that last

Part about the fish.

I am working still on being

Worthy to receive

Of your relentless love; the silly

Cartoons you send me in the mail

That on the back say, "I love you,"

The letters you write that are

Stories of other times and places,

And your bleary eyes each morning

When you wake up at three a.m.

Your time, just to have me call

You and say hello

Before I leave for the day.

You are always reaching out

Your hands, across time and

Space, to help me remember

That your love is not

Dependent

On touching, seeing, feeling.

Yours is constant.

Never yielding.

Never ending.

Always present.

Love.

I wonder if some day,

When the long absence is over,

When I am finally allowed

To move in with you, and we

Are finally once-and-for-all

Together, will I find that Christ

Is living with us too?

I Wrote This About You When You Were Sixteen

2011-07-26T16:19:00.002-04:00

My brother Iggy is slow of speech
Like Moses before him, he was
Plucked out of the salty weeds
(or so we have it from legend)
That grew up from the sea on the day
His nation celebrated its freedom
From oppression, but while we
Still wandered in the wilderness.

He was too young when we reached
The Promised Land to remember
Egypt, now called the city of Angels:
Rows and rows of cement bricks
Towers built with sweat, asphalt rivers
That ran with blood while smoke poured
And fires of race riots burned and where
Ephram, the oldest, always had rashes.

But having grown up in the shadow
Of mountains, his voice has its thunder
When his words are carved on paper,
With an assured confidence that his
Shy glances and guttural diction deny.
Was he too born to deliver? I ask
As he puts on his coat and wordlessly
Shovels out a dry path through the snow.

Haikus on Love

2011-07-22T19:39:00.004-04:00

Flipping through my ACE syllabus, I find the only page I consider worth keeping.

Or blogging and then tossing.

I present to you:

Haikus On Love

2/12/09,

written for the

BYU Salt-Lake Center Faculty Valentine's Day Haiku Contest

during a lecture titled

Atherosclerosis: pathophysiology, diagnosis, and prognosis.

I didn't win the contest. And I don't remember anything from the lecture.

But it did pass the time.

Haiku #1

I have four daughter.

I said, "Love" but they just heard

"Algebra," and cried.

Haiku #2

I knew I loved you

When in freshmen math you hissed,

"Let's take Swahili."

Haikus #3 - 4

I loved you so much

I majored in chem with you

Hoping to make sparks.

After you left me

I switched to physics, finding

comfort in constants.

Haikus # 5 - 6

My first chem lab was

An experiment in love.

You dug my goggles.

With wedding photo

attached, our write-up reports

Hundred percent yield.

Haiku #7

Integrate love from

Zero to infinity.

Find eternity.

Haiku #8

Galileo, too

Got it wrong. My universe

Revolves around you.

Haiku #9

My students think I am

Absent-minded, but I'm just

Thinking about you.

Haiku #10 - 11

He said, "Professor,

Don't fail me. My wedding is

During your final."

I said, "Bring your wife.

Let this be the first trial

You pass together."

Haiku # 12

Marrying you is like

Enrolling in one life long

Master course on love.

Longing

2011-07-21T15:05:00.005-04:00

Oh hello Robber! You are making your Frozen Pizza Face.

Why such a sad sad Frozen Pizza Face?

Don't you want the delicious sausage, the juicy pineapple, the spicy sauce?

Oh I do! I do!

But I want my Sunshine more.

I only eat frozen pizzas when you are gone.

Atlantis-- A Lost Sonnet

2011-07-17T10:46:00.001-04:00

by Eavan Boland

How on earth did it happen, I used to wonder
that a whole city—arches, pillars, colonnades,
not to mention vehicles and animals—had all
one fine day gone under?

I mean, I said to myself, the world was small then.
Surely a great city must have been missed?
I miss our old city—

white pepper, white pudding, you and I meeting
under fanlights and low skies to go home in it. Maybe
what really happened is

this: the old fable-makers searched hard for a word
to convey that what is gone is gone forever and
never found it. And so, in the best traditions of

where we come from, they gave their sorrow a name
and drowned it.

I Could Give All To Time

2011-07-06T19:41:00.001-04:00

by Robert Frost

To Time it never seems that he is brave

To set himself against the peaks of snow

To lay them level with the running wave,

Nor is he overjoyed when they lie low,

But only grave, contemplative and grave.

What now is inland shall be ocean isle,

Then eddies playing round a sunken reef

Like the curl at the corner of a smile;

And I could share Time's lack of joy or grief

At such a planetary change of style.

I could give all to Time except - except

What I myself have held. But why declare

The things forbidden that while the Customs slept

I have crossed to Safety with? For I am There

And what I would not part with I have kept.

My Father's Daughter

2011-06-19T19:57:00.003-04:00

This is my eighteen year old Dad with his first pickup truck, a yellow mustard Datsun that he drove around with never more than a quarter's worth of gas. Dad and Mom tooled all over the Valley of the Sun in this truck, including to ASU where they both went to college and majored in chemistry (until Dad got back from his mission and switched to physics.) Dad has never been happy unless he's been driving a small truck since. It was he who-- wisely--advised me to get a truck instead of a motorcycle when I first moved to California and as you well know that was one of the best things to happen to me! I loved my truck, and it did so much good for me and for others. When I bought that truck Dad was sure jealous until he went out and bought himself a little green Nissan, which just passed the 200,000 mile mark! Who is jealous now? (Me. Actually, my baby truck was at 204,000 and would have gone on longer, had it not met its sad end. Would that my new Chuck truck would be so lucky.)

Happy Father's Day to you Dad and to your little truck! May it roll its way without mishap to 300,000 and if not, maybe I'll be rich and famous (errr done paying off my student loans) and I'll buy you a new little old truck to replace the replacement truck some day.

Love,

Your Truck-Driving Daughter

This Is A Story About A Fish Named Stanley

2011-06-15T20:11:00.004-04:00

Stanley was a bright red beta fish with purple-tinged fins that my roommate R. brought home proudly a few months into our sophomore year of college.

"Look what I bought at Walmart!" she announced with an excited grin as she ceremoniously pulled from a little water-filled sack from her smiley-faced plastic Walmart bag.

"Oooooooooh," we all squealed and came over to admire our new friend. We were young sophomores, all of us 18 and trying to stay that way forever. L. and I were in tank tops and shorts studying chemistry and K. ran down from her bedroom to join in the fun.

R. plunked the fish-bag down on the kitchen table, pulled out an empty glass bowl, and managed to dump the little bag of water and the fish into the bowl. We each took a chair around the table and began to stare at the fish, oohing and aahing at his every move as he shook he fins out and feebly began to swim around the bowl. "Look, he's staring back at me!" L. cried. "What a handsome fish!" K. purred.

"I'm naming him Stanley!" R. announced, her excitement growing with our attention. "Stanley the fish!" we cried out in unison. "What a perfect name! Stanley he is!"

And that was it. Stanley became the celebrity of our home. R. and L. would sneak up to the chemistry labs late at night and steal de-ionized water for Stanley's bowl. For Christmas our home teachers R. and J.-- who to this day get the best home teachers award-- bought Stanley a nice big rock with a little miniature tree to decorate his bowl. Whenever we were bored all we had to do was gather around Stanley's bowl and sit, mesmerized, while he swam around and around. And we protected him, fiercely. When J-Dog, our apartment's nemesis, tried to bring a mirror over and make Stanley fight himself, we forthwith threw him out and gave him the silent treatment for a week. Even R., who was known to betray the apartment and actually go on dates with J-Dog, joined in the fray. Nothing came between us and our fish.

Except that Stanley needed protection more from us than anything. Soon after we got Stanley R. and L. were changing his water one evening in the sink and accidentally dumped him in while the sink disposal was running. With a shriek and a scream they shut the disposer off and miraculously little Stanley survived, but not without a big gash to the head. Who knew beta fishes could survive gashes to the head? Well Stanley did. He didn't swim much for days, but eventually resumed his normal circling.

His next mishap was when another roommate M. was transporting him to her parents' house for Christmas where she could take care of him. She left him in the bowl and covered it with plastic wrap and put it on the floor of the back seat of her car, but by the time she reached Logan from Provo the bowl had tipped over and Stanley was found flopped over, panting heavily, on the floor of the car. Who knows how long he had been apart from his watery home? And yet he survived, somehow, again.

And then, as much as we loved our home teachers, one day the rock-tree they bought for Stanley somehow tipped over and managed to pin Stanley to the wall of the fish bowl while we were all away at school. R. came home and found the poor trapped fish piteously flapping his poor fins. She freed him but poor Stanley swam as far away from that rock as he could for a long, long time.

Stanley was a rock of a fish. Nothing could kill him. He was indestructible, durable, strong with a long thin white scar across his fishy head to prove it.

We were in awe of Stanley, our fish.

Then came one day when a friend in our apartment complex who was student teaching in a third grade classroom asked if she could borrow Stanley for a show-and-tell lesson she was planning. "Just for one afternoon," she pleaded. "I would be so wonderful and I don't have time to buy a fish myself!"

It was finals week and everyone was busy. R. didn't want to let her take Stanley, but someone must have convinced her as she eventually folded and the following day the girl disappeared with our fish with promises to return him later that evening. When I got home from finals that day I glanced over to the fish bowl to see a happily swimming red beta fish with purple-tinged fins and headed to the kitchen to make a grilled cheese sandwich.

I was eating said sandwich on the living room couch when R. walked in, took one look at the fish bowl and proclaimed, "That fish is NOT my fish! You fish are NOT Stanley!"

We all once again came running. "What!!! Noooooooooo, noooooooo," we wailed. A look of fury was growing on R.'s face. "This is NOT my fish! Stanley had a scar! This fish has no scar! Stanley wouldn't swim near the rock to save his life! Look at this fish swimming around all la-di-da close to the rock! What has happened to my fish?"

"This fish is shiny!" K. cried. "And he swims so fast! Stanley was old and beat up and swam slowly!"

As more and more of us cried out, we became convinced in our heads that this truly was not Stanley the fish. We began to grow livid. "But if this is not Stanley, then what fish is it," I asked.

"It is an imposter fish!" L. announced. "How dare the fish masquerade as Stanley, think it can replace Stanley, swim in Stanley's bowl!"

"I will not call this fish Stanley," R. said, seething in the poor fish's direction. "Imposter fish!"

"I will call this imposter fish Chuck the fish," L. said derisively and we all joined in hissing with her, "Chuck the fish."

No one ever confronted our neighbor about what happened to Stanley, but we were considerably less pleasant to her overall, sad to say. To this day everyone believes she-- or her students-- had somehow killed poor Stanley and she had gone out and tried to cover her dastardly crime with buying a look alike fish. And she would have gotten away with it too-- had Stanley been a normal fish. But he was not a normal fish. No fish could ever be like Stanley.

We kept Chuck the fish, but always spoke his name with a little contempt. He was the same bright red-purple beta fish that Stanley had been, and to the casual observer coming through our apartment nothing in the fish bowl had changed. But the whole apartment attitude towards the fish went from hot to cold. No one stopped to watch Chuck the fish swim around the tank. No one got him deionized water from the science lab. No one bought him a new rock. I don't know what happened to Chuck the fish in the end. I think he went home for the summer with M. but never came back and the following year when we were juniors the fish bowl was no more.

*******

Let me present to you:

Chuck the Truck

(Ummmmm..... you didn't really think I was going to name my new truck Chuck, did you? Hahaha. It's too much. Probably I will just call it "Truck" like the last one, but not the affectionate "baby truck" as I would call my old one. Maybe I will call it "El Trucko" or "The Black Castle." Here's to the providence of God-- who-- finding me in need of a new truck, granted a truck almost identical to the one before it, just eight years younger and 90,000 less miles of road.)

Letting Go

2011-06-08T20:02:00.003-04:00

My patient-- let's call him Tex-- comes to the ED and is admitted to the hospital for the seventh time in seven months. He is diagnosed with a new heart attack, acute exacerbation of his congestive heart failure, and severely low levels of sodium in his bloodstream. We give him diuretics and a concentrated solution of sodium intravenously along with oxygen and a list of about ten other medications but we all know this is only a temporary solution and not a fix.

Two mornings ago I'm in with Tex and we're having a nice little chat before I examine him. Despite the odds he has much improved and he smiles at me and says, "You're the one who comes in and always brightens my day." Fully 120 seconds after that charming moment his son-- let's call him Frank, he is also his father's health care proxy-- marches in and unceremoniously announces that Tex's brother and last remaining sibling has died overnight. As Tex digests this information, Frank turns to me and says, "Who are you? The medical student? What the **** are you going to do to help?"

Usually I would just brush this aside, but like Frank, I'm also less than 24 hours from losing something I really cared about. My truck was hit-and-run by a drunk driver fleeing the scene of a shooting at the end of my block early early Sunday morning. I didn't cry when I called the cops or when the tow man came for my truck, but I'm emotionally weakened and this man's gratuitously spiteful comment rankles me. I manage to shrug, smile, and quickly examine Tex before making my hapless exit.

Later that day I'm back in Tex's room with my senior resident-- let's call him Dr. Amit. When we walk in Tex is dozing comfortably in the hospital chair. Frank points at Dr. Amit and crows, "You're the one who told me my father wouldn't live! Look at him now! Look, here he is!" Dr. Amit sits down and tries to reason with Frank. "I didn't say your father wouldn't live. I did my professional duty and told you my medical assessment of your father and what his long term chances are." Frank simpers, "And you were wrong. You made me feel so guilty for nothing." Multiple other physicians-- the cardiologists and the kidney doctors who have been consulted on Tex's care-- have told Frank the same thing. That even if his father lives through this time, he isn't expected to live much longer overall, six months is a generous estimate. That he is receiving maximum treatment. That one more little heart attack might be enough to end his life. Dr. Amit tries to tell him this patiently again, but Frank will have nothing of it. I stand silently at the bedside while Dr. Amit does the talking. When we leave the room, Frank indulgently says to me, "And thanks again for all of your help."

"How do you think that conversation went?" Dr. Amit asks me when we're safely down the hallway. "Well.... I wouldn't give it ten out of ten stars," I reply. "He wasn't helping you out much because he's in denial. He's in denial about his father's true state of health and he's scared about the conversations that need to take place to be prepared. He probably sees a lot of his future self in his father but also doesn't want to make the changes in his own life to preserve his health. So he's accusatory because being so allows him to shift responsibility off of his shoulders." "Yes, I agree," Dr. Amit is nodding, "He would not only help his father, but he would also help himself if he came to terms with reality."

*****

The truck has overall been trucking along as it has for the last nineteen years, but in truth it has been a rough winter. The four wheel drive never transitions smoothly making me hesitant to use it, but hesitant not to use it in light of the constant onslaught of ice and snow that was this last winter. The right and the left turn signals have both gone out and been fixed, the passenger door no longer opens from the outside, the tailgate has malfunctioned again, and last October as I was driving over some train tracks the tailpipe rusted off with a crash, taking the muffler system with it. One month later with a new muffler on board it crossed the 200,000 mile mark, a landmark of aging for any vehicle.

The acute problems started about a month ago, when I began having grinding noises turning or going forward. I took the truck into the shop and out of the shop two times and still no answers for the truck's problems. The truck would go into the shop making noises and come out, without real intervention, silent only to have the worrisome crunching noises recur again in two or three days. I was already planning on bringing the truck back into the shop-- for the third time in three weeks-- on Monday, when early Sunday morning it met a brown-purple Audi going fast in the front and a brown Oldsmobile parked behind it in the back. So the truck ended up back at the mechanic a day early via tow.

This morning I called my mechanic Bruce on the phone from the hospital. We're on a first name basis now, Bruce and me. "Tough luck," Bruce is sympathetic, "It was a good little truck. What are you thinking?" I've already decided in my head I'm going to tell it to him straight. "Bruce, you know what I need out of this truck. I need to drive it across America one more time. Plus, I love my truck. So if you can fix it for me, I want to know. But, if it's time to call it quits on the truck, I need you to just tell me that honestly. I don't want to hear that, but if I need to bite the bullet and just buy a new vehicle then I want to know."

Bruce hems on the other end of the line. He's for me and for my truck, I can tell, but I can also tell he might think this is the end of the road for el trucko given the whole string of recent events. "Well, I'll take it over to my friend Johnny and see if he can fix up the lights and the bumpers. Then we can ..... take this off, and move this, and rummage up this discontinued part, and drain this, and do that.... and maybe... we can get your truck across the country. Call me back in a few days and I'll look your truck over after what Johnny can do and tell you what I think." "Thanks Bruce," I say, sigh, and go back upstairs to round with Dr. Amit on our patients, including Tex, who is still here.

I'm glad Bruce gave me a couple of days at least. Even after all this time, I don't think I'm ready to hear the truth of the bad news quite yet.

Getting To Know My Neighbors

2011-06-05T18:01:00.003-04:00

While spending all day since this morning standing out on the curb waiting for things, I met more of the people that live on my street than I have in the last year of living here.

Death Comes To The Welsh-man

2011-06-04T10:44:00.005-04:00

One of our patients died last night. He was chipper when we met him in the ED one week ago and optimistic-- I guess he had reason to be since, pushing 90, he had already survived three different types of cancer and was now cheerfully battling his fourth. It wasn't his cancer, however, that brought him to the hospital but the very common, insidiously morbid, COPD.

Chronic obstructive pulmonary disease. People live with it so long they forget that it can kill. "I have a bad feeling about him," my resident said the first day he saw him. "What are the chances he will get worse?" I asked. "He's not going to get better," Dr. N. replied.

In his waning days, he sat in the chair in his hospital room with two types of breathing devices on and his finger hooked up to the pulse oximeter, a device that measures the saturation of hemoglobin with oxygen in his blood. He would sit all day watching the number as he breathed. In and out. In and out. In and out. Fast fast fast. He was a chatty man, but talking to us alone would make the number drop and cause him to be anxious. In his final hours, the residents and nurses tried to take the oximeter away from him, just so he wouldn't have to watch his own death.

He wished me good luck the day before he died, told me he wished he would get better. "I have places still to see you know," he said. His accent was delightful, untypeable.

I've been thinking I need to create a moment for death, a ritual perhaps? A platform upon which to place the role of death in my life, a symbol to capture the weight of passing. Death is an inevitable part of life for everyone, but as a physician I will experience not only the deaths of loved ones, co-workers, neighbors, friends-- but also of strangers. Those I know for two days, two weeks, five minutes. Yet even though our associations in life may be short, I still want a small moment to honor their experience in life. A way to both place the emotions that could come with death in a box outside the door, accessible but not omnipresent. Not dulled to the point of invisibility, just noticed and then stored in a safe place.

What would you do, to mark the point of another's passing? Would you do something somber, or joyful? Would you note only the person's death, or would you include a moment of celebration in your own life? Would you eat an icecream cone every time a patient died? Cover yourself in ashes? Rend your clothes? Purchase a flower? Take yourself for Chinese? Write your own psalm and recite each evening after a death?

I've been thinking also that I might want this moment to be translatable to my children, assuming that death is still a part of things for me after they are born. Something small and inobtrusive to our daily family life, but something that lets them in a little into my world and into the path I have chosen of caring for others. Something that teaches them kindness in life and peace in death.

Should everyone get an icecream cone because the Welsh-man has died? And if so, should it be vanilla or dark chocolate? Rainbow sherbet, perhaps?

Burning The Old Year-- for Mom and her paper shredder

2011-06-03T21:40:00.001-04:00

by Naomi Shihab Nye

Letters swallow themselves in seconds.

Notes friends tied to the doorknob,

transparent scarlet paper,

sizzle like moth wings,

marry the air.

So much of any year is flammable,

lists of vegetables, partial poems.

Orange swirling flame of days,

so little is a stone.

Where there was something and suddenly isn’t,

an absence shouts, celebrates, leaves a space.

I begin again with the smallest numbers.

Quick dance, shuffle of losses and leaves,

only the things I didn’t do

crackle after the blazing dies.

White Coat

2011-05-29T20:58:00.007-04:00

I think I'm becoming a doctor.

Isn't that the point, you ask? Yes, well-- I guess. Perhaps I started medical school to become a doctor? I wasn't sure at the time. I told my interviewers this thing-- that I wasn't sure I wanted to be a doctor. Only that I wanted to be useful in different ways. That I didn't want to sit inside watching humanity pass by outside. That I wanted to get my hands dirty. That I loved my teaching job more than anything I had loved before, but I felt there was something more to be done, something more to be learned.

I enrolled in medical school without knowing that I wanted to be a doctor. It was all just one leap of faith, and now after three long years of studying and work I guess it shouldn't be so surprising now that the curriculum is working. That I'm becoming the thing medical school works so hard to create.

And yet there's a newness about me these days, an energy and a growth that wasn't quite expected. It's as if suddenly I've woken up in a different skin. I have opinions about the ways my patients should be treated-- medically, personally. I have ideas about steps for the plan, tests to be done, drugs to be given. I want to be the one with my hands on the patient, I want my voice to be the one communicating the plan, I want it to be me the patients think of when they think of "my doctor"-- or, "the person who cared for me when I needed help."

I'm five weeks into my internal medicine rotation and falling in love, suddenly, wonderously, with patient care. As if I've passed out of the realm of survival into the realm of thriving, from being tended to into wanting to be the tender. "Medicine,"I said to my friend M. two months ago when she told me she was thinking about medical school, "Medicine is a series of very hard, deeply personal moments. And if what you want to do is take very hard, deeply personal moments and stand in them, be the negotiator of them, than you should do it. And if that doesn't sound like a good idea to do, you should look for something else."

Sometimes I try to capture on this blog the truth of hospital life, the way every day is a long string of very hard, deeply personal moments. The negotiation and finesse such a day requires. The way doctors try to be helpful and good in the face of the ever-flowing ebb of the ED tide. But try as I might, I can never quite capture the raw vulnerability found in the hospital. I worked all day today, a Sunday. My usual day of rest. I personally spent over a half hour talking to and touching an 88 year old lady with an infected parotid gland, a 95 year old woman with cholangitis, a 61 year old man with multiple strokes, an 86 year old man with chronic lymphocytic leukemia, a 52 year old man with hepatitis, and a 71 year old man with diabetes. Each person so different and so delightful and each of them with a set of questions to ask and problems to be solved. Not a single one of them over whom I could wave a magic wand and cure anything, but every single one with some way in which I could ease their life, at least for a moment. For their very hard, deeply personal in-hospital moment.

I'm feeling useful these days. Useful and dirty all over-- quite literally-- with humanity. I have so much more hope that even with all the vices and failures of medicine, that some day I can be truly useful to the world. I'm finding in medicine what I came to medical school for, and even in its constant sorrows, it is filling my heart with joy.

I think I really like what I'm starting to become.

revolutionary dreams

2011-05-27T20:00:00.004-04:00

by nikki giovanni

i used to dream militant dreams

of taking over america

to show these white folks how it should be done

i used to dream radical dreams

of blowing everyone away

with my perceptive powers of correct analysis

i even used to think

i'd be the one to stop the riot and negotiate the peace

then i awoke and dug

that if i dreamed natural dreams

of being a natural woman

doing what a woman does

when she's natural

i would have a revolution

One Year Later

2011-05-22T21:58:00.005-04:00

We are still so excited.

Woman In Love

2011-05-15T18:13:00.006-04:00

by Rainer Maria Rilke

-- for K. and M. but most of all for S., on the occasion of her engagement

That is my window. Just now

I have so softly wakened

I thought that I would float.

Where has my life its limit,

And where begins the night?

I could fancy all things around me

Were nothing but I as yet;

Transparent like a crystal's

Depths, darkened, mute.

I could keep even the stars

Within me; so immense

My heart seems to me; so lightly

Would it let go of him, whom

For all I know I have started

To love, it may be to hold.

Like something strange, undreamt-of,

My fate now gazes at me.

Here, then, am I stretched out

Beneath this infinitude,

Fragrant like a meadow

Swayed this way and that,

Calling out, yet fearing

Someone will hear the call.

I am destined to disappear

Inside some other life.

Crazy

2011-05-13T19:05:00.004-04:00

Yesterday was-- for lack of a better word-- CRAZY.

I've been thinking a lot lately about how I'm supposed to begin to communicate to the Robber the truths of the medicine experience. How every day I encounter manything(s) that, if you told the story in isolation, would sound horrific or tragic or at minimum downright depressing but how those same manythings become routine and often mundane in the hospital. How the sensation of the blindingly dramatic blurs into the background of beeping, coughing, choking, buzzing that is the everyday hospital life.

Take yesterday for example. I wanted to tell the Robber about what was happening, so I sent him a little mid-day email where I said, "Everything is madness. The first patient we wanted to send home refused to go. The second patient we wanted to send home decided to be crazy. (We think he is crazy.) The third patient we wanted to send home is KNOWN to be crazy, and we want to send her home anyway because she is ALWAYS CRAZY, but our attending thought she was not back to baseline crazy. So all of them stayed. The only patient who left has been CRAZY SINCE BIRTH. And he's the one we released back into the Rochester streets. Just saying."

In a little while, the Robber wrote back to me and said, "I confess that after a while I don't really know how to respond when you say that a patient is crazy, because apparently they are all crazy. Maybe there is a rating system?"

What I meant to say to him was this:

The first patient we saw, who until yesterday was sweet, decided to refuse the bed offer he has for nursing home placement. He has multiple serious medical conditions, and most of the nursing homes in the area aren't equipped to provide for him. The offer came from a home with a very good reputation. But despite the fact that everyone wanted him to go, (and he has been in the hospital for three months now), he refused to go because he has been to that home before and thought he didn't get very good care. So even though we know and he knows that the next offer he gets, if he gets one, won't be to as good of a place, he still refused to go. Crazy strike one.

The second patient we saw is not medically crazy, but he's no peachy pie either. This is a man who had a bowel obstruction and had to have part of his bowel removed. After surgery, you can't eat while your bowel heals and this man kept trading in his life for, quite literally, a bowl of pottage. He left the hospital three times "AMA"-- against medical advice-- went out and ate a cheeseburger, and came back in with worsening abdominal pain. Each time we took him back. As you can imagine, things got worse. He ended up with a vacuum device attached to his abdominal incision. He has been trying to leave the whole time, and would still-- but he has this vacuum attached to him and every single nursing service in the county is refusing to treat him at home because he has been mean to them in the past. And the surgery team is refusing to take the vacuum device out. It will take weeks for his stomach to heal. Crazy strike two.

The third patient we saw is a young foreign college guy who ingested some cocktail of Russian remedies and came in catatonic. Now he wants to leave too, but he fluctuates between states of paranoia, racing thoughts, wild inappropriateness, and more subdued attempts at reasoning. The leading diagnosis is first paranoid schizophrenic break. We sat with him for 45 minutes trying to persuade him to stay in the hospital, and while he didn't leave, we didn't convince him to accept any more testing for his condition. Crazy strike three.

The fourth patient we saw-- who is well into her eighties and has paranoid dementia at baseline and came in after she beat up five other people at her living facility-- we thought was ready to go back home again, but then on rounds she punched the resident and tried to scratch her face with her 1 inch nails. Crazy strike four.

Only the fifth patient we saw-- who has some mental condition from birth that has made it impossible for him to ever fully take care of himself and who came in rocking a grizzled beard worthy of Gandalf-- only he smiled when he saw us and was compliant with our plan. He was the only one that actually left the hospital from our team that day.

That is what I really meant to tell the Robber when I said, "Everything is crazy." And that was without mentioning our patient who has episodes of talking herself for ten minutes at a time that she calls hallucinations, two other patients who are missing legs, a patient who probably has lung cancer, a patient who is dying, and.... oh yes. My last patient who had a left hemi-craniotomy who now either sleeps all the time or hits people. And that is also without mentioning that I had the second full blown migraine aura of my life yesterday and lost the ability to see for an hour. And that by the end of rounds two of my residents were crying.

I don't mean to sound trite about all of these things. It was really just another day at the hospital, and I don't know how to talk about any of this without sounding crazy myself.

Do you?

Medicine Patient #1

2011-04-26T16:39:00.004-04:00

"There are days we live as if death were nowhere in the background," says the poet Li-Young Lee. As a medical student, such times are luxuries. Death is a perpetually lurking presence, still more a stranger than a well-known acquaintance who draws ever closer, no farther than a floor, a corridor, a room away. Some months ago I was talking to a young man who had attempted suicide when the girl across the wall drew her final breath and ended her battle with cancer. The nurse came out with "her head hung low" and the work of other lives continued as before.

Yesterday I met my first patient of my medicine clerkship, a frail woman pushing towards 90, her left lung a fresh victim of pneumonia. Our meeting in the ED was brief and she didn't remember me early this morning when I went in to pre-round on her in the morning. Her cough was worse and when I listened to her right chest, now I heard the harsh sounds of infection in that lung too.

Out of all the people this woman had met in her life-- millions, perhaps-- here I am, at the end. I could have been the one who helped with her bags at the airport, the queen at her high school prom, the person who introduced her to curry. Instead I am the one who, when she was found unresponsive before noon, administered "noxious stimuli" and called out her name, not expecting her to come back. My eyes were the ones she saw when she did wake up and smiled. Why did she smile? I was pressing firmly on her sternum, a maneuver chosen to cause pain.

Yes, and my eyes were the ones her daughter saw when she asked, "How will I ever be comfortable with this decision? Are you comfortable with this decision?" I am the one who said, "Yes, this is a good decision." And we stopped giving antibiotics, fluids, the long list of maintenance medications from before, and turned on the morphine.

And I am the one who brought in the bright pink MOLST form, the one who signed the "first witness" line under the do-not-resuscitate, do-not-intubate, do-not-re-hospitalize, do-not-give antibiotics check boxes, the one who said to her daughter as she signed, "It takes a lot of courage to make a decision like this." As if I knew something about courage.

I wonder when we meet in heaven, will my patient thank me for this? For holding her hand gently for a few minutes as she lay in bed, dying? For comforting her daughter, sitting alone in her hospital room? Or will she come to me angry, demanding to know how I thought I could be the one to stand in that moment, making decisions about her life and death? Telling me she wanted to live, despite her handicaps, her loneliness, her crumbling mind? Reprimanding me for my rash judgment, my willingness to let go of her life?

In truth, I don't fancy that we actually will meet in heaven. It is somewhat vain to think that despite my involvement in this moment, she will actually care a hoot about me after this is over. I am but a passing moment, a dream into which she will fade over this long night and tomorrow until she takes her last breath. On this side and on the other, she has friends and family a million times beyond me. She will be with her husband, whom she has not seen in over thirty years. In some time she will be with her daughter, who took care of her for the last decade of her life. By the time I make it there, she will be with grandchildren and parents, old school chums, new friends from heaven. She will be with Christ.

And if we were to meet on the Elysian fields, say-- run into each other on the Frisbee course during a game of heavenly ultimate-- I wouldn't recognize her anyway. Her blue eyes full of vitality. Her wavy brunette hair. Her looking young and lovely. The way that I know her now is not the way she is meant to be forever.

Death will come to be, for her, nowhere in the background.

Faces For Easter

2011-04-24T09:57:00.000-04:00

For all the faces I have forgotten over the last year and will forget, I am grateful I have reserved the mental space to not forget hers. Her unconventional beauty made possible by relentless cheerfulness. Her bright orange hair tightly curled around her ears. Her skin still with the blush of pink from that day on the lake. And her wide blue blue eyes that stared straight into mine as we were introduced. "Hi T.," I said, and when no hand was extended I reached out and touched her shoulder instead. "Nice to meet you."

It was the Fourth of July and T. had family over at her house on the edge of the lake. They were out boating in the middle of the lake when her heart stopped. Her brother gave a valiant effort at CPR, but it was thirty minutes before they could reach emergency help. When T. woke up, she was blind.

Over time she regained the ability to see colors, and could see me-- I think-- when I came into the room to accompany her to therapy. It wasn't fair exactly, me following her around-- she was doing such a hard, hard thing, and there was already not enough privacy at the rehab facility where she was staying. Sometimes in therapy she cried, but mostly I remember her smile when she figured out how to do something old a new way and her hard work trying, over and over again, to learn how to live anew. How to pour her coffee without spilling it or burning her fingers.

**********

Now I am in OBS-- short for "Observation Unit," which is where the E.D. sends people when they cannot decide whether to send them home or admit them to the hospital. Once I meet him, I know I cannot forget his face either. He has the saddest face in the hospital that day, I am sure of it. A totality of grief etched upon a bushy brown mustache, sunken brown eyes, and the beginnings of the deep wrinkles of age, most of which is buried within the palms of his hands.

R. had experienced seizures earlier in life but for several years they had been controlled by his medications, which he took religiously. One morning as he was driving on the freeway on his way to work, he experienced a breakthrough seizure and, made helpless by his runaway brain, drove into the side wall of a nursing home. On the other side of the wall, an elderly gentleman drank his morning coffee while seated next to the hot water heater. While I am in OBS with the driver, my classmate J. is on the burn surgery service, seeing the elderly gentleman. Only one of them will walk out of the hospital alive.

The other one will have to spend the rest of his life with the consequences, none of which he intended or desired, of that day. Never knowing when another breakthrough seizure might occur, another accident that could take someone else's life.

**********

His face is already starting to blur, but I remember clearly the parts of his person that are no longer with him. His surgery wasn't being done by my surgical team, but I got permission to leave my team for the morning and watch his procedure. Partially because I was a little bored by the idea of my umpteenth gastric bypass, and partially in support of my classmate R., who was assigned to P.'s surgery. She had been present during his first one, had fainted, and an embarrassing MERT response had been called for her in the OR. I volunteered to go in with her on the second surgery, hoping that the moral support of having two of us present would keep both of us from fainting this time.

P. had significant peripheral vascular disease, a product of many years of smoking and uncontrolled diabetes. "Watch out," R. told me, "he's a flirt." And indeed, when I first met him lying in bed behind the curtain in Pre-An (that's the place where people wait for surgery), he made all sorts of comments in that direction until the anesthesiologist came along and thankfully put him to sleep.

Standing beside the table in the OR, I decided the best way to avoid getting sick was just to face things. I touched R.'s hand and then I stared straight on as the resident took out a large --something-- and. let's just skip the details and say it.-- took all the man's toes off until only the stub of his foot was left. They saved the toes in little jars of formaldehyde. "What are you calling this?" the scrub nurse asked as she plunked the specimen in its container. The nurses have to ask. "Big toe," said the surgeon. Some moments in the OR are grotesquely humorous. I guess you would have had to have been there.

**********

I'm not quite sure what her face looked like because I never saw her--alive. To be fair, I didn't wait around for her death but went home to nap. We had done a tracheotomy on a blizzarding Thursday in January right at her bedside in the ICU. She was too sick to take the OR, but the tracheotomy needed to be done if she was going to remain with us much longer. The surgery was short and uneventful and by the time it was over I had forgotten the thrill of seeing a bedside surgery in the non-thrill of my perpetually aching feet. We hooked her tracheotomy tube up to the ventilator and went on our way.

That Saturday morning we are rounding in the ICU on a new admission when we get emergently called to her bedside. She has suddenly begun to hemorrhage out her ostomy, and my resident reaches in the ostomy bag and pulls out fistfuls of bright red clot which she dumps into a pink vomit bucket. This woman had come to the ED in July and has never gone home. She has survived the care of five chief residents, almost died nine times, and now she is out of lives and we cannot save her. We call her husband and daughter. They had hoped to bring her home. After all, it was just a regular ED visit back in July, right?

This is the closest I have ever been to death, but she doesn't look like something that is capable of dying. She is like a waxy doll with hair that has survived scissors and mud and the washing machine. Her eyes are open but no one pretends they can see.

I have been carrying a little packet of red Gushers in my white coat pocket all of that week. I don't know why, in this moment, I get the sudden urge to eat them. It is April and the rest of the box of Gushers remains untouched at home.

**********

Isaiah 53:4-5, "Surely he hath borne our griefs, and carried our sorrows; yet we did esteem him stricken, smitten of God, and afflicted. But he was wounded for our transgressions, he was bruised for our iniquities: the chastisement of our peace was upon him; and with his stripes, we are healed."

Alma 7:12, "And he will take upon him death, that he may loose the bands of death which bind his people; and he will take upon him their infirmities, that his bowels may be filled with mercy, according to the flesh, that he may know according to the flesh how to succor his people according to their infirmities."

Matthew 15:29-31, "And Jesus departed from thence, and came nigh unto the sea of Galilee; and went up into a mountain, and sat down there. And great multitudes came unto him, having with them lame, blind, dumb, maimed, and many others, and cast them down at Jesus’ feet; and he healed them: Insomuch that the multitude wondered, when the say the dumb to speak, the maimed to be whole, the lame to walk, and the blind to see: and they glorified the God of Israel."

**********

Jesus Christ lives. I don't know how or understand why, but I am grateful this Easter season that through Him it has been, and can be, and is being, and will be done.

The Word From His Song

2011-04-23T18:17:00.002-04:00

by Li-Young Lee

The sparrow on my rooftop shouts,

"All roads be blessed." His voice a ring

for the finger of the beloved.

And he wouldn't work harder at his song

if all the world prized it,

nor temper what sounds like ardor

if a public thought him wrong.

He says singing redeems the body's loneliness.

All praise is homage to an older praising,

a drastic sum and ruling mean,

earth's urging the grapes to a clearer fate,

sun's pressing them to a more potent praise.

Flying fixes the heart to the sky's wheel, he says.

Salt cures the script.

Light is a fractal script.

Imagination is branched, flowering,

and each fans the buds himself.

He says every atom burns.

Hunger rends the kingdom by mending,

marrying voices and wings.

Singing builds a throne

for hearing, sets up a swing

between our one night and our day.

It's all song, all singing, the body's seat

and number, the mind's pleats, time's hem.

The voice is a sighted brink.

Its mission is to sort the world.

The tongue is a mortal flower.

The dew at last. The guests arrive.

The child learns his name,

a virgin bell. And even that

iron note is God awake in two worlds.

God seeks a destiny in all things fired

in the kiln of the sun or the mind.

That's the word from his song.

Lately

2011-04-21T20:18:00.004-04:00

The Robber and I have been so much in love. This is always the case but it seems crazy how much more I just fall in love with him all of the time. A few days ago the Robber said to me, "It doesn't hurt as much anymore, but I just WANT it more and more all the time. Every time I see you my wanting grows." It #1 being the distance. And It #2 being us living together like a real married couple. Even though tomorrow will mark our 11 month anniversary, I ask the Robber to marry me at least once a week. "Silly Sunshine," he says, "Remember how I have already married you for eternity?" "Oh Robber," I say, "it's not that I want another wedding day, I still just want to be married to you so badly." Turns out I am a greedy lover not sated with promises of eternity. I want him in the here and now, in the messy everydayness of mortality. Marriage has deepened our relationship beyond engagement, but I am afraid I will feel perpetually para-bridal until the time we are under the same roof.

I have left my obsession with packing my apartment to the fateful march of timed applications and moved on to being consumed with breakfast foods. Every recipe I see these days, I want to try and so I add it to my growing pile hoarded away in a Gmail draft. On the top of my list right now are pear pie, risotto with peas, citrusy black beans, and chocolate orange scones. I am, simultaneously, trying to learn to eat like an adult. This is just another reason why I need to move in with the Robber. Because then I can cook up any old storm I want, try out a few bites, and then have someone to gobble all those delicious calories for me. Last time the Robber was here he purposefully ate everything that he knew I wouldn't eat so it wouldn't go to waste. You see how he really does love me. "It's just what husbands do," he says.

The right-hand turn signal on my truck isn't working and the passenger side door has-- yet again-- decided to stop opening. The transmission feels a little more tired than it has in the past, and last October I lost my tailpipe. I'm starting to think that if I'm going to drive my baby truck-- not so baby anymore-- back across the country it should be sooner than later. Maybe before next winter, when the salt-covered roads bathe the truck's delicate wirings with their corrosive spray. Maybe this summer would be a fine time. Maybe tomorrow, I have no plans. Oh I would love that, my feet up on the dashboard and the Robber in the driver's seat and both of us singing along to Bob Dylan as we hurtle on through the Ohio.

On Monday I start my medicine rotation for two months and the great thing about medicine, everyone says, is that they feed you lunch every day. "Everyone puts on weight, the food is so good!" they say. You can see how this is quickly becoming the perfect storm. Me trying to eat wisely, cook perfectly, and tamp down my insane desire to flee the hospital, get into my truck, and drive west just when I will be back in the hospital 12+ hours a day, eating these lunches, and being tied down in Rochester even on the weekends.

Oh but I am not complaining. Because by the time it is over, the Robber and I will have been married 13 months, be even crazier in love, and be two months closer to living together. Bring it on.

To Grandma, A Belated Note For Your 89th BIrthday

2011-04-08T00:34:00.005-04:00

I knew then-- but know now-- why breakfast at Grandma's was always an extravagant affair. Why she would offer us fresh-squeezed orange juice, cereal, bagels, grapefruit from her backyard trees-- with sugar on top, eggs, jam, milk, and thick slices of raisin-bread toast. Why she poured our juice and insisted on buttering the toast-- generously-- herself. Why she continued to do this even after the chances of her spilling became equal or greater than our own.

She was trying to fit years worth of loving us into one weekend, and as you can imagine, sometimes it would bulge a little at the seams.

I can hear my father clearly saying, his tone on the brink of exasperation, "Mom, please sit down. Please stop fussing over us. We can get down the milk and bread ourselves. Look, we are happy getting the milk and bread down for ourselves!" This was a cue for us to jump up and make a dash for the cupboard with big smiles on our faces. Look! Reaching for bread! What fun!

But his pleas and our antics fell on deaf ears and blind eyes. Nothing short of God himself, or the vertigo, could stop Grandma from rising up to serve us. I suspect that is still the case now, although I haven't been to her house for well over five years. Now with a tiring mind, she came to the family dinner the night before my wedding and kept trying to pass her dish to the rest of us. "I don't know whose this is," she gestured, "but it is delicious and you should have some!"

We didn't want to eat her dinner, but how could we say no to Grandma?

"Here, have another slice of banana pie," and I look at the Robber with pleading eyes. "I swear you are trying to fatten me up, Sunshine, " he says but he takes another piece anyway. "No. No. No. It's just. I love you, Robber."

"I love you," is what I say to everything these days. When I first see him and last talk to him for the night and every ten seconds in between. When I am reeling with attraction to his green-blue eyes. When there is a silence in the conversation. When I don't know what else to say. Not to cheapen the expression, but because I want him to know that it is true, in every situation. "I'm so tired I just fell asleep while you were praying"-- and I love you. "I am so overwhelmed with happiness to be with you for all of today!"-- and I love you. "When I look at you over the g-chat camera in this moment I am filled with such painful longing for you I can barely speak"-- and so I say, again, I love you.

"I love you too," the Robber says, and he eats his fifth slice of pie in so many hours. He has just flown in this morning and already I have showered him with a left-over banana, a coconut cream flavored energy bar, an incredibly fancy and time-consuming deep-dish pizza, spinach salad with strawberries, blood orange soda, and now this pie.

For his birthday visit to Rochester the Robber asked me to not do anything, just to relax and purposefully not prepare a thing, clean the bathroom, or even wash the sheets. I know that what he wants is just to be with me, but I can no more hold back my pies than Grandma can hold back her toast.

I'm trying to fit an eternity's worth of loving into just one weekend.

On The Origins Of Things

2011-04-05T18:51:00.001-04:00

by Troy Jollimore

Everyone knows that the moon started out
as a renegade fragment of the sun, a solar
flare that fled that hellish furnace
and congealed into a flat frozen pond suspended
between the planets. But did you know
that anger began as music, played
too often and too loudly by drunken performers
at weddings and garden parties? Or that turtles
evolved from knuckles, ice from tears, and darkness
from misunderstanding? As for the dominant
thesis regarding the origin of love, I
abstain from comment, nor will I allow
myself to address the idea that dance
began as a kiss, that happiness was
an accidental import from Spain, that the ancient
game of jump-the-fire gave rise
to politics. But I will confess
that I began as an astronomer—a liking
for bright flashes, vast distances, unreachable things,
a hand stretched always toward the furthest limit—
and that my longing for you has not taken me
very far from that original desire
to inscribe a comet's orbit around the walls
of our city, to gently stroke the surface of the stars.

In My Father's House

2011-04-04T15:11:00.006-04:00

My parents are moving to the Provo/Orem faultline this summer. Close to the city divide, their new house practically straddles the two cities and their institutions at eight minutes from UVU, twelve minutes from BYU and a two minute walk to both church and a park. There is blue carpet in the basement, hardwood floors upstairs, a huge bay window and six bedrooms. Not to mention a charming children's room with a dollhouse and built-in crawl spaces and shelves. The current writing on the wall reads, "NO GIRLS ALLOWED!"

There is room to grow in this house. I think my parents are hoping there will be growing to be had. They are uprooting the kitchen door from their current house, the one with the pencil marks, and bringing it with them. Fortunately for them, their one grandchild H. is also moving to Provo/Orem sometime this next year and so there will be some one to provide new marks on the door.

It has been a long time coming.

My parents first lived in Provo/Orem for six years while my dad got his Ph.D. in physics & astronomy at BYU. The first winter was a long and hard one for my parents, who spent their younger years and first years of marriage-- in at least three different residences-- in sunny Arizona. Once in Utah they lived on the first floor of a red brick house on the banks of the Provo River. It is this house that I first remember as a home. My earliest memories are in this place, chasing the ducks that would settle in our backyard, chasing our Siamese cat Timothy, chasing my sister R. down the long hallway to the couch. This was the only house we lived in with no side fences to stop our chasing in circles and circles. Mom planted bulbs along the front-yard fence, tulips, crocuses, irises and bleeding hearts. When he came home, Dad would play the piano or read books with us-- Little House on the Prarie, Mark Twain-- and then put us to bed, me on the top bunk in the last room on the right hand side of the hall. On weekend evenings or for Family Home Evening we would go on bike-rides in trailers my parents used to pull us four girls around town or out to Wilderness Park where we would chase the fat white geese to send them squawking or pick blackberries. Sometimes Mom would put R. and I in a trailer and pull us to campus for lunch with Dad in the arboretum and I remember those stairs, the endless stairs up the hill and over to the Eyring Science Center. Those worn grooves in the green marble stairs are worn also into my memory.

We left BYU after Dad graduated and moved to St. Anthony, Idaho and into another house, yellow-white and tiny but with a generous backyard with a swing set and raspberry brambles and the river replaced by an alleyway that ran between our strip of houses and the next. Across the street, the Presbyterian Church offered us chimes in the early Sunday morning hours and bats that would swoop across our yard in the summer evenings. R. and I shared a tiny bedroom that barely fit our two twin beds and a laundry hamper. Our neighbors next door had a black-and-white dog named Jigs and for years after we moved away the woman, Ida, would send me hand-painted birthday cards and trilobites in the mail. They were dear friends to my parents, that lovely old couple next door, Vern and Ida. The first winter we were there was a long also. My dad would ride his bike twelve miles in the cold to Rexburg for work. I still cannot fathom that. I would walk with S. and T. to their elementary school, and then catch the D-3 bus to my school. The D-3 bus was always the last one, and it was always late. It was the only winter we spent in Idaho.

In May we moved to another brick house, this one yellow and in Tucson, AZ. It was very much like our house in Provo, only flipped horizontally and with cockroaches, barrel cactuses, and a grapefruit tree in the backyard. We could catch lizards or soft-bellied horned toads when they ran along the brick walls and tried to catch the rabbits that dug holes along the fence. Mom planted yellow and purple pansies in the front yard next to the prickly pear cacti. The house was close to a park where we would play with the other street children, a boy and a girl. His name was R. and I forget her name., but I have always loved the name Aurora because of that park we played at, Arroyo Park. My sister R. and I shared a bigger room-- a room that would house also our little brother E. when he was born. One day in school we watched Labyrinth and to this day, it is the scariest movie I have ever watched. I was scared the cooing sounds of the doves outside would give cover the creeping advances of a gremlin, come to steal my brother. Fortunately they never did and now he is tramping around all day in Ghana, battling bigger bugs and eating goat-stew. I remember also our neighbors in Tucson had a hammock on their back porch and I also, to this day, want a big hammock in which to take a long afternoon nap, like a fat and happy Arizona lizard.

We moved on and traded cockroaches for ants. Our next house was a two-story white stucco structure with a brown roof in Cerritos, California. It was located on a cul-de-sac, which we used to play baseball and to ride our bikes endlessly in circles to the end of the street and back. The back yard again had brick walls, on which we would pretend to walk tight rope, and a swing hanging from the ficus tree. I would spend hours raking the shells that dropped from that ficus tree, and Dad would spend hours wrestling with the purple bougainvillea that draped itself over the walkway to our front door. It was beautiful-- to be sure-- but thorny and he was stung by bees multiple times trying to prune that bush. We kept my first rabbit Janus, the turtle Manasseh, the dog Hessu and the guinea pigs in the backyard-- that is until the pigs got eaten one night by an opossum. Provo had raccoons and Tucson had rabbits, but Cerritos had opossums and we once had a mother and her nine baby opossums in our backyard for a morning. The roof of the house leaked and when it rained-- endlessly in January-- we had to put out pots and big white plastic buckets to catch the rain so it wouldn't spoil the carpet. In the summer the mosquitoes would bite poor E. until he was covered all over in heat rash and bites. I. was born shortly after we moved in and one morning, when I was mowing the lawn, the neighbor next door asked if we had a new baby. I said we had and he brought over a present a few days later although he didn't like much me mowing the lawn on Saturday mornings.

Times were hard there. We had very little. We prayed for years to be able to leave. When we finally did, it was to the house where my parents live now. A house they bought without really even seeing it in a crazy leap of faith. A house that has served us and them well now for fifteen years. I never supposed it would be that long. I only lived in that house for five years, so to think of them being there fifteen still is a little crazy to me. It is tucked away again on a cul-de-sac and the backyard shares fences with seven other houses in a crazy-shaped piece of land that makes no real rhyme or reason. The turtle has made that yard his own, to the extent that my parents built a deck with a turtle-ramp so that it could climb up and scratch at the big glass sliding door with its claws. But the yard became less important over the years as my life became both further from home and more confined to my own room, a converted family room with blue carpet and no heating and where the turtle is kept in the winter-time when he is hibernating. In high school I would wake up around 4:40 in order to get up, do my hair, eat breakfast and get to early morning seminary by 6:00. I don't do my hair anymore, especially in the winter. We girls occupied the downstairs floor with an open area we call The Commons which has housed at times quilt frames, a ping-pong table, a weight bench, multiple computers, a Wii play area, and stacks of Encyclopedias and AP study guides. The plastic glow-in-the-dark stars I taped to the walls the first week we moved are all mostly still there, and glowed faintly on the ceiling as I cuddled with Bob in that room in the dark this last Christmas. I made my brother I. take down my old prom pictures before Bob came. Just... because. But I think the pet-net is still there. And the pink bedside table I salvaged from the garage the day we moved in, 15 years ago.

I moved out at age eighteen and in the ten years since that time have not lived anywhere longer than two years. I lived in a little three bedroom, six person apartment at the end of the street one year in Provo, and an identical apartment in the middle of the same street the next. After that I lived briefly on the ninth floor of a building looking directly over Union Square in Manhattan, and then in a tiny house one street over with a big backyard I never once set foot in, except when I first looked at the house to rent it.

When I left Utah I lived two years in an apartment near the lake at Stanford with a bright orange door and a small room dwarfed by my queen size bed, for which I had to move the standard-issue graduate student twin bed into the living room. At first it was a space burden, but having two beds came in handy later when I was sick, and would wake up at nights drenched with night-sweat and would move from one bed over to the clean cool sheets of the next. I moved from there to an even tinier bedroom with a gigantic mirror in a wonderful place we called Melville, with its windows and garden and pink-flowering magnolia tree. Of Melville, I have already spoken.

Then New York and a room in another house, the Simplex, where once again, I lived with R. I was living in that house when I met the Robber, and coming back to that house, worked through a long year of engagement through a computer screen and a built-in camera. I walked from that house across to the street and back again in flip-flops, defying snow and ice and rain and below freezing temperatures. No one ever lost a toe in two minutes!, I would tell the nay-sayers without letting on how often I would huddle under my blankets in bed waiting to warm up.

Now, in my ninth month of living alone in this tiny studio with its yellow kitchen walls, I am aching, with every bit of my being, to move on again. To leave behind the fourteenth roof that has covered my head in twenty-eight years. I am itching to pack, to feel the satisfaction of pulling brown tape across a neatly packed box, knowing not a square inch of space was wasted, to stack that box on top of another until everything has been boxed into place. It reminds me of when I was little and while grocery shopping with Mom would constantly re-arrange the items in the cart until they fit my particular space requirements. Now I am also madly crocheting bits of old yarn into mittens for the poor so that I will not have to pack them, ripping old clothes into quilt squares, finding papers in my collection to toss into recycling, imagining which objects I own can be given away, sold, or packed for storage, and which ones are essential still for living. I am working myself into a delirium wishing I could sweep the floors of this apartment one last time, turn over the key, and drive back again across our long and glorious nation, back to California and a one-room Cubby in a converted garage carpeted in forest green.

My parents, in all their moving, have always had each other. And so, in all the houses they have lived in since their marriage, they have always had a home.

I would like to move home, too.

Spiritual Creepsters

2011-03-23T17:27:00.002-04:00

In honor of Jimmer Mania I have decided to tell you all about the time that I met the second-most (okay third-most? fourth most? fifth most? The list in my head just keeps getting longer) famous Mormon basketball player. It was a night to remember. A night I will never forget. I might even remember it longer than that time I built a bed with Steve Young-- but that is another story.

But before I tell you the story about meeting said nth-most famous Mormon basketball man, I'd like to tell you about how the Robber and I have been having discussions about spiritual creepsters recently. Probably because we have been leading up to teaching a lesson on polygamy in seminary. For an example of spiritual creepsters, think about those creepy priests of King Noah. They just go creep creeping around the in the forest, watching girls dance around, and then they creep creep kidnap them! Does it get creepier than that? I told Bob that I bet all those creepy priests wore fez hats. Nothing is creepier than a creepy priest in a creepy forest wearing a creepy fez hat kidnapping multiple wives. Creepy Creepy CREEPY!

So back the story.

One night I was home alone-- or so I thought-- late at night at my house Melville. I lived in this little teensy, tiny bedroom (think Anne of Green Gables miniature-style with a gigantic mirror to help the room look larger) and the only way into and out of my bedroom was through this other bedroom and down the creaky stairs, or to break the glass on my window and jump out to my death. Well I am just lying in bed, all dressed up in my PJs and whatnot, trying to fall asleep when I hear the CREEPIEST laughter I have EVER heard in my WHOLE life.

In my house.

The CREEPIEST MAN laughter I have ever heard.

In my whole life.

I am alone in my house.

The CREEPY MAN laughter continues. Maybe it is not a man, I wonder. Maybe it is a werewolf! (This was back in the Twilight days. I have never read Twilight.)

Maybe it is not a werewolf, but a murderous lunatic???

Maybe it is just one of my friends???

NO. Not one of my friends. I had friends with laughs, true, but none of them are that CREEPY. I am frozen under my bed sheets.

What does a frozen girl do? I grab my cellphone.

I call my roommate K. Are you at home? I ask. Are you on your way home? I am alone. I am scared. I think there is a creepy man in our house. I am scared. Be careful. Don't come home too soon. I am ten minutes away, says K., and coming. Ok, I say. Be careful. Be safe.

I call my roommate M. Are you at home? I ask. Are you on your way home? I am alone. I am scared. I think there is a creepy man in our house. I am scared. Be careful. Don't come home too soon. I am ten minutes away, says M, and coming. Ok, I say. Be careful. Be safe.

I call my roommate S. Are you at home? I ask. Are you on your way home? I am alone. I am scared. I think there is a creepy man in our house. I am scared.

I am at home, says S. I am in the living room. I am here with ****, the famous single Mormon basketball player.

Has he been laughing? I ask.

He has been laughing, she answers.

He is the CREEPIEST MAN ALIVE, I say.

Come downstairs and see for yourself, she says.

I go downstairs, in my PJs. I tell ****, the famous single Mormon basketball player, that he has the CREEPIEST laughter of any CREEPSTER I have ever heard. He doesn't laugh, but chuckles nervously. His legs are enormous. He is sitting on my couch, my couch I paid $300 for on Craigslist, the one with the Victorian couch-legs. He has been sitting on my couch, laughing.

He has asked all of my roommates on a date before. All of them except me. One time he sat by my roommate S. during Sacrament Meeting and she noticed that his scriptures were blank. No markings.

I tell him he has the CREEPIEST laughter I have ever heard. And then I march back upstairs, turn out my light, and try-- try-- try-- to go back to sleep.

The End.

Epilogue: The next day I told my 16 year old sophomore students that I had an NBA player in my house the night before and they thought I was the coolest teacher in the school for the rest of the year.

The Answer

2011-03-23T16:07:00.001-04:00

by Jack Gilbert

Is the clarity, the simplicity, an arriving
or an emptying out? If the heart persists
in waiting, does it begin to lessen?
If we are always good does God lose track
of us? When I wake at night, there is
something important there. Like the humming
of giant turbines in the high-ceilinged stations
in the slums. There is a silence in me,
absolute and inconvenient. I am haunted
by the day I walked through the Greek village
where everyone was asleep and somebody began
playing Chopin, slowly, faintly, inside
the upper floor of a plain white stone house.

Things The Surgeons Said To Me

2011-02-20T21:15:00.002-05:00

S: Where are you from?

Me: The West. My parents are in Utah, my husband is in California.

S: You are from Utah but you are not a Mormon!

Me: I am a Mormon.

S: Impossible! You are a woman and you are in medicine. You cannot also be a Mormon.

Me: I am.

S: You must be some kind of strange Mormon then.

Me: No, just a regular Mormon who happens to also want to be a doctor.

S: Impossible! When will you learn in Mormonism it is not about what you want?

Me: I am a Mormon, and it is about what I want.

*************

S (within two minutes of meeting me, in an OR filled entirely with men, besides me and the patient who is asleep): Can you explain to me why human men are so obsessed with female breasts?

Me: I can't help you with that, sir.

S: The first question I ask you, and you can't help me. Some medical student you are. There went your honors grade.

*************

S: Why do you think we teach with love and with intimidation?

Me: (fishing) motivation blah blah, remembering things blah blah, to help us be tough, blah blah.

S: WRONG. Listen to me now. Do you think this job is loving? NO. THIS JOB IS NOT LOVING. IT IS INTIMIDATING. And you need to learn how to work under intimidation!!!!

Me (inwardly): You see me? I'm intimidated now. Your evil plan is working!

**************

S: What does your father do?

Me: He's a physics professor.

S: What kind of physics?

Me: His degree is in plasma physics, but he did a lot of research with Jupiter and Io and stuff.

S: So he does astrophysics.

Me: Sure.

S (any time I got any question wrong the rest of the day): What do you think this is, R? Astrophysics? Get your head out of the clouds!

*************

S: Who is Rock Hudson? Your other medical school counterpart didn't know and I want to know which one of you is smarter.

Me: I can't claim to be smarter, sir, but Rock Hudson was a leading man in Hollywood in the 1950s, perhaps best known for his movies with Doris Day such as Pillow Talk. He is also known as a gay icon, being one of the first celebrities to die of HIV/AIDS.

S: Ha! Trick question! You are a strange Mormon! No real Mormon would be up on their gay icons.

Me: Once again, I'm just a regular Mormon, sir.

*************

S (asks me a math question. I get it wrong): Tell me, were you good in math in grade school?

Me (lying through my teeth): Not particularly, sir.

S: Finally you are right. You were not good at math then, and you are not good at math now.

*************

S: What kind of doctor do you want to be?

Me: Some kind of primary care. Family medicine, or pediatrics.

S: You will not be able to pay off your debt.

Me: I will. I'm not worried about it.

S: You will never be rich.

Me: I've never been rich but I am already richer than 99% of the world that has ever lived has ever been. I will be rich enough.

S: Good heavens. With an attitude like that, primary care is the only thing you deserve. Have fun being poor and crazy.

Me: Thank you, sir.

*************

S: You look quite young, but you must be really quite old. You act more mature than a lot of your peers. Did you take time off before coming to medical school?

Me: Yes, sir. Thank you, sir.

S: I didn't necessarily mean it as a compliment.

Me: I will take it as one, nonetheless.

*************

S (gesturing towards the patient): See what I do? All day long, I work hard to fix patients. And then they go home, drink Coca Cola, watch TV, smoke their cigarettes and then they end up back here again wanting to be fixed after all the effort I go through for them! It is like the Greek man who pushes the rock up the hill every single day only to have it fall back down again! Can you think of anything more miserable than him?

Me: Not if he enjoys pushing the rock up the hill.

S: Not if he enjoys pushing the rock up the hill! Who do you think you are? Not if they enjoy pushing the rock up the hill! (Mutters to himself the rest of the surgery: who do these medical students think they are these days, mutter mutter.)

*************

Me: What advice would you give for choosing a residency?

S: To go to the best program you can find. Don't let your boyfriend/husband/other determine where you go because they hate the weather or something. Just find the best program you can get into and go to that program. You're going to be a doctor the rest of your life, invest in your training.

Me: I'm married already to a man in school in a particular location.

S: Go to the best program and find yourself a new man in that location. If you're willing to do that, that's how you know you are cut out for surgery.

*************

S: Tell me what is the difference between how a woman threads a needle and a man threads a needle.

Me: It depends on if you want it defined as in Huckleberry Finn by Mark Twain, who describes the differences between men and women when a woman is trying to trick Huck who is dressed as a girl at the time. In today's world, there is probably no functional difference between a man in the operating room threading a needle and a woman.

S: You didn't answer the question.

Me: I move the needle over the end of the thread. Men move the thread into the needle.

S: That is correct. Next time, please get it right on the first try.

*************

Only one more week left to go,

and then I am out of the OR forever.

I'm allergic to the face masks and my skin is cracked from all the scrubbing.

But I have to admit, and who would have guessed?

I had a really good time-- and--

I think I'm actually

going to miss it.

This Poem Didn't Come To Me At All

2011-02-08T17:20:00.005-05:00

Broken toe,
broken toe,
to the ED
with thee I go.

Not my own
relief to seek,
But at a girl's
belly peek.

Her face is red.
My toe is blue.
Pain and swelling?
Oh, me too.

What to do?
What to do?
Surgery's
the thing for you!

Limp limp
to the OR
ED to OR
Oh, so far!

Appendix's out.
My toe is not.
Throb throb toe
stop throbbing stop!

Have some rest,
here's some ice!
Oh dear girl,
does that feel nice?

I give the girl
Tylenol--
What do I take?
Naught at all!

Broken toe,
broken toe.
To the ED
with I thee go.

This Poem Came To Me Last Night As I Was Falling Asleep

2011-02-06T18:33:00.007-05:00

I call it:

"On Prayer"

Every evening, as the sun sinks low
over the Pacific coastline,
a lone man in a single-room apartment
plays three songs on his guitar and sings,
to sleep, his wife on the Eastern seaboard.

It is already dark there and she,
having completed the affairs of the day,
has turned off her lights in preparation for sleep.

“What song would you like tonight?” he asks
and she tells him, “A love song”--
or, more often,
“a lullaby, that lullaby song you wrote for me.”

“You go to sleep now,” he responds
as he starts softly strumming the strings
of his guitar, closing his eyes also.

There is no one in his room,
and his curtains are pulled shut.

He sees only one small screen light telling him
they are connected still, by some invisible thread
eras of Earthly time in the making.

Finishing the first song, and expecting
no response in return, he pauses briefly
to re-tune the guitar and presses forward.
Sometimes he hears her murmur
“I love you” --but better yet
there is silence.

Her eyes closed, she does not see him.
On her way to sleep, perhaps she does not
even hear him, or remember that he is singing.

He plays a second song, and then a third--
his voice filling his apartment still, he being
a confident singer, and an able plucker
of the guitar strings.

Some late nights, after listening carefully,
and being assured of her slumber,
he breaks out an old Bob Dylan tune,
a honky-tonk song he learned from long ago.

Satisfied that his task has been accomplished,
he whispers, “Good night dearest, I love you,”
puts down the guitar, and places it
in the guitar-case, knowing full well that
tomorrow he will open the case and play,
perhaps, the same three songs over again.

Some Things Don't Change Much In 25 Years

2011-02-04T10:08:00.005-05:00

I'm still doing this at every possible moment that I can.

(Like yesterday. 11 a.m. Miner library. In my white coat. With my stethoscope in the pocket.)

Not Yet As Job

2011-01-24T19:10:00.002-05:00

There is this scene from Ayn Rand's novel "We The Living" that keeps playing through my head these days.

Two lovers are living in Russia during the Leninist Revolution circa 1920. They are both arrested and sentenced to life in separate concentration/labor camps in Siberia. It is dark when they are boarded on two separate trains placed on parallel tracks. As the trains take off, both at the same time, they can see each other still through the lights within the trains. The trains gain speed, going faster and faster, their faces become a blur. And then the tracks diverge, and for as long as she can, Irina stares at the disappearing, smearing light that represents her lover until it grows dim and she is left on a hurtling train, plunging in to blackness.

I know it is a little dramatic, but I can't help thinking about the scene when, at 5 a.m., I drive my lover to the airport. We hold hands through the passenger line until at the last minute I duck under the ropes and watch as he moves through security until finally I can no longer see him among the crowd. And then, trying my best to hold back tears, I walk back out into the icy winds and below zero darkness of a Rochester winter.

I've been doing this now for one year and five months and I still haven't learned not to cry.

Untitled 1 and 2

2011-01-20T19:58:00.002-05:00

by Anonymous

. . . and who is the she-warrior
without her fair verse?

How shall she know to fight
and make war with all evil
save she learn from victors past?

and wherewith shall she draw
the strength
to press the battle,
when the blood is fierce?

How will she not faint
and call retreat
if she not drink in
the strength of others

Nay, she shall have her fair verse
and conquer

she walks as one without a cause
with head slung low and arms tucked in
while missing life and living loss
but how to live a life again?

from shards of a failure strikes anew
while slowly finding strength of heart
oh, wars are fought and some we'll lose
campaigning is a dirty art

but who will come when blood is shed?
and who will press the fight when fierce?
not those who found an easy bed
but one who walks low, scarred and pierced

she rises up to strive again
and find her well-fought victory
oh, wars are fought and some we'll win
campaigning yields utility

"Yet Already I Have Given A Great Many Things Away...

2011-01-16T16:06:00.003-05:00

We had been lost driving for two hours earlier that day. And by we, I should really say the driver-- I would not have blundered in the way that he did, said I in my head. Hours later and none the better for it, except for perhaps some skipped rocks and a gigantic ice cream cone with sprinkles, we were winding our way back home along the lake shores of northwestern New York. I was resigned to having lost my day and was also mostly out of conversational energy and so had lapsed to watching the landscape and noticing the large houses scattered along the edges of the lake with grand yards and perhaps most importantly, wrap-around porches.

I have always dreamed of living in a house with a wrap-around porch, with a veranda. One can dream of houses in many ways that change over time but mine have always had a veranda and screen doors, not that screen doors are romantic in the way that a veranda might be but that they speak of summer evenings and the open air and leaving the door open all day and all night and wearing flip flops and sipping lemonade and having a porch swing.

We were passing a house with a spectacular example of a veranda when I heard quite distinctly in my mind a voice saying, "Would you be willing to give up ever having a house with a veranda if it meant being sent where you could serve more people and be of better use in building the Kingdom?"

Now, said I to that voice in my head, I will have to think about that one. And I thought. I really liked the idea of a veranda and a house with a lawn and whatnot. Was this one of these "you ARE GOING to have a veranda, and WILL you give it up?" or just a hypothetical? I would be very happy in my house I thought. Why do these questions come anyway? As if you couldn't serve, and have the veranda both?

"Of course I would," I replied back to my head. "Of course, if it meant that in the end I would be a more useful person, if I could do more good." And then the dream of the veranda house and the lightning bugs on the porch and the rocking chair and the warm summer night air all began to fade. One by one an element of the picture faded out of a future that probably was never even real, a dream that had been not a passing fancy, but not ever a purposeful goal either. Finally all that was left was the house itself and then I let go of that, too.

"Ah yes, so you would," said the head voice and that was it. We drove past so many other houses that day with long wrapped porches but it wasn't the same. I couldn't project them into my future any more. The sun sank slowly in the sky but the car only grew hotter and by the time I was finally dropped off home I was terribly tired and slept well into the evening, as I am rather an accomplished napper under any conditions, but especially under such ones.

Perhaps it was less than two months later that I was in another car, this time with a handsome redheaded man in a tux. We had been to the opera, and-- as desired-- slain by my vintage red taffeta dress-- the young man was pouring out newly forming dreams of his own future. "We could run away to Oregon and live in a little beach house," he was saying, "with a big open front room window and we'd leave the lights on in the evening and dance in the living room and the local kids passing by would look in and see that we are still so much in love." He had said "I love you" for the first time only two nights before.

I began to build the little beach house in my head and try as I might there wasn't room for a veranda. The house was already too tiny and with low ceilings and perpetually crowded by a mash of objects united only by their curiosity. There was a low fence and some cacti and a little flower garden and pebbles and something that looked remarkably like a chicken that to this day, I have yet to resolve. But no veranda. I couldn't fit in the veranda.

And I found I was just all right with that.

Happy Birthday today, handsome redheaded man. Here's to you, our beach house, and trying to own a couch and live in the same state before either one of us turns 30.

Shoveling Snow With Buddha

2010-12-15T16:44:00.001-05:00

by Billy Collins

In the usual iconography of the temple or the local Wok
you would never see him doing such a thing,
tossing the dry snow over a mountain
of his bare, round shoulder,
his hair tied in a knot,
a model of concentration.

Sitting is more his speed, if that is the word
for what he does, or does not do.

Even the season is wrong for him.
In all his manifestations, is it not warm or slightly humid?
Is this not implied by his serene expression,
that smile so wide it wraps itself around the waist of the universe?

But here we are, working our way down the driveway,
one shovelful at a time.
We toss the light powder into the clear air.
We feel the cold mist on our faces.
And with every heave we disappear
and become lost to each other
in these sudden clouds of our own making,
these fountain-bursts of snow.

This is so much better than a sermon in church,
I say out loud, but Buddha keeps on shoveling.
This is the true religion, the religion of snow,
and sunlight and winter geese barking in the sky,
I say, but he is too busy to hear me.

He has thrown himself into shoveling snow
as if it were the purpose of existence,
as if the sign of a perfect life were a clear driveway
you could back the car down easily
and drive off into the vanities of the world
with a broken heater fan and a song on the radio.

All morning long we work side by side,
me with my commentary
and he inside his generous pocket of silence,
until the hour is nearly noon
and the snow is piled high all around us;
then, I hear him speak.

After this, he asks,
can we go inside and play cards?

Certainly, I reply, and I will heat some milk
and bring cups of hot chocolate to the table
while you shuffle the deck.
and our boots stand dripping by the door.

Aaah, says the Buddha, lifting his eyes
and leaning for a moment on his shovel
before he drives the thin blade again
deep into the glittering white snow.

The Secret Computer Lab

2010-12-14T15:05:00.002-05:00

R. and I are in the secret computer lab.

We are here because we are Mormons. Only* the Mormons use the secret computer lab. This is because Mormons are masters of secrecy.

"I think my heart has a murmur," I say to R.

(I am paranoid about my heart because it has an arrhythmia. And I get these palpitations like I'm falling down an elevator shaft or like my heart is trying to leap out of my rib cage.)

I pull out my stethoscope and hand it to R. Why I am carrying my stethoscope during a week of lectures I don't know.

She listens to my heart carefully. No one else is in the room. Just us two Mormons, one of them listening to a heart.

"I don't think you have a murmur," she says.

I put the stethoscope on and am still not convinced that I am not about to die.

"Listen again!" I demand.

"No murmur. Your heart sounds pretty normal to me."

I am disappointed. I am starting surgery in January and need something new & exciting to get me through that black hole. Like a heart murmur. Or Ebola. Anything, really.

30 Cents, Two Transfers, Love

2010-09-30T19:42:00.003-04:00

by Richard Brautigan

Thinking hard about you
I got on the bus
and paid 30 cents car fare
and asked the driver for two transfers
before discovering
that I was
alone.

The day began when I got to the Simplex and discovered my parking spot was taken over by a car from Massachusetts. I had to drive to the depths of the ghetto to find a space and then rush in to the hospital where I was late to pediatrics morning report. It was raining.

All this was quickly swept away by the morning, where I examined a baby we called "The Moose" who was born to a hopelessly obese woman, and another baby, more adorable, who was born to a hopelessly unprepared woman. She had named the baby "C" but after the father, who naturally is not with the mother called in saying "C" was an ugly name, she had to redo the birth certificate to read the new name, "D".

That was the least of our worries in the newborn nursery. Not that all is worry. There are three beautiful triplets, all boys, all named "L" names and how that mother will keep them straight is so beyond us all. But they are heaven to hold! These days I think I could run newborn nursery all day and never be tired.

Lunch time lecture was about debt repayment. Internal and external groans.

And then, the NICU (neonatal intensive care unit) where I have been moonlighting in the afternoons this week. I say moonlighting because it always feels like night-time in the NICU no matter what the time of day. It is always 9 p.m. in the NICU. Over the weekend I have become a NICU "doctor" and-- Facebook tells me as I run to change into my scrubs-- one of my high school friends has become a NICU "mother."

For one hour we NICU people talk about a baby who has meningitis. He is alive, but to the doctors he is dead. In the hospital "dead" really means "incurable and imminently going to die" or "prognosis indicates a quality of life doctors don't think is worth living." His parents are teenagers. This is not exactly Juno.

Then there is a pager beeping and off I run, run with a resident down to the birthing center, where a lovely mother has produced a gigantic baby with petechiae all over its face. We decide this is not a NICU-bound baby and the resident hands the baby to the mother, for the first time, and her face crinkles up and she begins to cry. Our work being done, we leave.

There is a lump in my throat.

We run up to the PICU (pediatric intensive care unit.) There is a baby there who used to be in the NICU, and has been transferred to PICU because she is going home soon. She is a Mennonite baby and her mother is lovely in her perfectly ironed long black dress and white bonnet. Her face has more wrinkles than her dress, but is angelic in its simple beauty. I have never been to the NICU and not seen another Mennonite woman sitting outside while she is inside with the baby. The mother is never alone. On Tuesday, a whole crowd of Mennonite women descended, bearing long bouquets of fresh cut flowers.

It is still raining.

Our work being done, I wander around with another medical student and cuddle some babies that are big enough to be taken out of their cribs. One little baby is so tiny his eyes are still shut. He looks like E.T. I have never seen anything so perfect.

It is the last day of September and the first leaves of autumn have fallen bright gold on the sidewalk. It has not yet frozen overnight and the grass is still as bright as the leaves. My leopard print shoes are soaked as I make my way back through the ghetto to my truck.

On the way, I am lost in thought thinking about my dear husband, the Robber. I turn left on Stanford Avenue and head down that way for half a block, before realizing what I am doing. My truck is parked on Edgemont, still a quarter mile away. I shake my head and think to myself, "I am only trying to make it home."

What Could Have Been

2010-09-23T20:03:00.036-04:00

The other day I got a little sneak peak at my friend K.T.'s dress for the big day (in ONE WEEK!) via the internet and I was reminded of my own wedding dress experience.

It wasn't very traditional. I was a second year medical student with no time and no budget-- and, for the first two months-- no wedding date. I never once, in my entire time as a bride, set foot in a wedding store. My "shopping" trips were google searches in between classes or late at night or on Sundays when I couldn't study anyway. I even shopped worldwide!-- I found a pair of shoes I thought I was bound to love, and -- much to his credit-- my friend CKP allowed me to ship them to his home in London and then he carried them across time and space at Christmastime, where I met up with him and shoes in Utah.

I didn't wear the shoes. They were much too yellow-- how shocking! I eventually bought my wedding shoes-- while being led by the Spirit-- at the Nordstrom Rack in East Palo Alto in March. Let it be known to you, CKP, that I wear those yellow shoes all the time in clinic. And they are beloved by everyone who sees them: faculty, patients, residents alike. And I never wear my wedding shoes. They hurt my feet.

I digress.

In my perusing online, I would find pictures of dresses with an idea or motif that was similar to what I had in mind, and then I would stow all the pictures away in a folder. Most, of course, were too expensive, or too immodest, or whatnot, but taken together, they represent a little peek into my early bride mind.

For the purpose of posterity, I unveil them now. Enjoy.

Don't you just love those peach ruffles peeking out under the white of the dress in the picture on the top? You can see already how much I am just into ruffles-- not ruffles exactly, tiers? These brides above just look like so chic and fun. I find these tiers so cute and feminine and a little bit funky. A bit flapper-ish. I think part of me has always just wanted to be a flapper. Even on my wedding day.

There's nothing particularly flapperish about this dress, but you can't tell me that it is not gorgeous:

And how could you possibly resist the simplicity this gown's bodice with the elegance of its lace tiers? Lovely.

Of course, not all tiers are equal. Some tiers have "Vogue" written all over them, while others look a little more... shall we say... Wagner...

And, if I had a million dollars, I would definitely, for sure have worn the next dress, which isn't exactly tiers, persay-- but it is just too funky/strange/beautiful to have passed up. If I had a million dollars, and a million wedding days:

For some non-insignificant amount of time I went through a phase where I really, REALLY, wanted to wear a non-white dress. It all started when I found this pink dress. I don't know what is so fabulous about it now, but at the time it was everything I wanted. Short. Simple. Fun. AND... pale pink! A whole horizon of possibilities opened up.

The next two dresses are really, quite unforgivable, but after I had found the first pink dress I had a lot of hope, a lot, that could find another suitable one:

Eventually I moved on--- to gold. Or white and gold. So much closer to being the right direction, don't you think?

And then there is this next dress which I would die to own, wedding or no wedding, but be assured if I had owned this dress I would have worn it some part of my wedding day. I love the shade of brown. It reminds me of the part of Anne of Green Gables where Matthew goes to the store to try and buy material for a dress for Anne and ends up buying a rake and some brown sugar instead! And then finally he asked Mrs. Lynde for help and she makes Anne a dress out of brown material and Anne feels like a queen. I've always wanted a dress like that.

Eventually it dawned on me that maybe I could have my cake and eat it too. I could have tiers AND color both....

Not all the dresses I looked at were as interesting as all that though. In my wade to find dresses that were white (ish, maybe, ok not really....) and modest and affordable I came across a nice array of really boring dresses. And I mean REALLY BORING. You can skip through them if you want to. I've made them small so you won't have to suffer as much if you don't skip.

But there and again, I came across some dresses that were anything BUT boring....

What I really wanted, though, in my heart of hearts was not so much any of the dresses above, but just a nice simple white tea dress. Unfortunately, finding one that was in good repair and in my size and in my budget proved to be difficult. But to give you a flavor of what in my head I was actually shooting for, take a look at the dresses below. I would want to wear ALL of them, or even one particular one, but the overall gestalt is what I felt like I wanted most.

After all, if Audrey chooses to wear it, it can't be anything but the epitome of class, right?

Even better than Audrey, though, is this girl who is lovely and buoyant and looks so, so, so happy in her dress. I wanted to be everything about her. Except her mousy brown hair. But look how radiant she is!

Allow me to show you just one more dream dress:

I mean, if I was a completely different person almost, right? But so so wonderful. I am still in love with that gown in the picture above.

Two months into my ten-month engagement, I ordered my dress from a lady in Nebraska named Ellene, who made me a custom dress from off of an old vintage slip and a pattern she created without ever meeting me in person.

And as you can see, despite it being really nothing like any of the dresses that you see above, it was absolutely 100% perfect for me.... during the next eight months of medical school and engagement...

and beyond....

The She Warrior

2010-09-20T23:43:00.002-04:00

When I moved from the Simplex into my new little studio I packed all my books tightly into STAPLES folded office boxes and left them there. Multiple childhood and subsequent adult moves have made me an efficient packer. I magically arrange my books such that every nook and cranny of every box is filled to perfection. There is a certain prideful satisfaction in closing each box with brown paper tape knowing that not an inch of space has been wasted.

Knowing (hoping?) that I am going to move back across America in two years, I chose not to unpack my books. How dare I disturb such a work of art? Besides, I barely had room in my studio for my two tall bookshelves, and one of them I needed for a pantry. Where once there was Dostoyevsky, Rand, Austen, Potok, Talmage, and Stegner now there is flour, Club crackers, linguine, and peanut butter. And a barely opened jar of Nutella. Despite my elite education, I still don't know what to do with Nutella.

Yet now that I have lived here two months I find there to be a certain emptiness that I can't quite identify. I ghost around my two little rooms and hallway, unsure of what to do or where I should go. I stare at the computer screen, thousands of pages and eons of information at my finger tips. And I simply feel numb.

I find that I need pages. And poetry.

I want to lick my fingers and thumb through a book, hoping for the pages will fall open to an answer, a solace, a story into which I can disappear, a metaphor that transcends this little New York space and opens time or emotion.

Once, when I woke up on a Sunday morning under a gloomy soul that defied the bright sun of California winter, I found a package on the hood of my truck on to which was attached a poem. In pink letters, the anonymous gifter had written for me,

and who is the she warrior without her fair verse?

Inside was a volume of war poems. I ran my fingers over those poems in the subsequent months, worked through my incomprehensible, startling anger by running my tongue over the phrases, thumbed from the first page to the last in the nights when I couldn't sleep and recited to myself over and over again that short phrase: "the she warrior." I was fighting only against myself.

Better times came. The war poems found their way to the bookshelf, but were joined by other anthologies over time. When I was searching for life direction after leaving my Ph.D., another friend gifted me "Thirst" by Mary Oliver and I would intone, like a mantra, as I drove into work,"Another morning and I wake with thirst for the goodness that I do not have." I came across the Li-Young Lee book containing a poem I had long ago heard and could not forget, "[God] asks, 'Do you love me?' and [God] answers, 'I love you' and the world keeps beginning"... and "Sister, do you remember when we died in childhood together?... then where should I look for you but in everything I see,"... and a new poem that provided a new mantra for that taffy-stretched year when I was engaged long distance and lived neither in California nor wholly in New York: "I know she lies dispersed."

Today when it came night-time and I could not sleep, could not go to bed, missing so terribly the arms of my husband who left me at 5:30 a.m. this morning at the security checkpoint at the Rochester airport, I broke down, opened the boxes, and went in search of an answer, a solace, an image.

After a few minutes of rummaging I took out my copy of "Paradise Lost."

Suddenly, I Find This Scripture Very Sad

2010-09-16T01:23:00.002-04:00

There were no robbers,
nor murderers, neither were there Lamanites, nor any manner of -ites;
but they were in one,
the children of Christ, and heirs to the kingdom of God.

-- Mormon, the prophet
Book of Mormon: Fourth Book of Nephi, 1:17

"Delilah"

2010-09-11T17:43:00.004-04:00

For my psychiatry rotation, we had to do a type of doctoring called "narrative therapy." The idea is that after the patient tells you their story, you write it up and give it back to them. Seeing their story written down on paper is supposed to help them comprehend aspects of their illness that they hadn't quite grasped before. I imagine it helps some people more than others. I wrote about a young lady in her mid-teens, who I became friends with on the adolescent psych ward where I worked for the last four weeks. Here is her story:

she only wanted, like everyone else, to be loved for who she really was and not for what was written-- or what was said-- about her. the thing was-- people were writing and saying things about her before she really was. so they looked to the words first and loved her last.

she grew up in the shadow of their words, not the other way around. and because shadows cast darkness over everything, those words painted her with broad strokes of “angry”, and “hostile,” and stained her with “oppositional.”

the words became stuck to her as if they were her skin. she wrapped herself up in them. lived them, became them. after all, her skin was the only permanent thing she carried around.

she was found stealing food from a grocery store to feed her brother at age three because there was no food at home. her mother was taken away and for many years on she would live as a virtual orphan, never being claimed for too long by anybody. she tried to claim her siblings for herself, and would always be proud of her efforts to keep the family together. but eventually even her brother was taken away and her baby sister was taken away and it was just her and an ever changing parade of providers. “care-givers,” was the word she read on the paper next to their names.

the losses didn’t start-- or stop-- with her siblings. too early, she lost any sense of safety she may have carried into this world from heaven. she was witness to the abuse of her mother, who in turn failed to protect her from falling victim to that same abuse. her innocence was stolen, bargained for, and preyed upon by older men at her mother’s request. she stole innocence from her brother, who in turn stole it from her baby sister. no one stopped to explain that in the best of worlds, those things were reserved as the ultimate expression of love.

in all the moving and leaving and losing, no one stopped to define anything about love for her. she was born with a need but not told how to mold it. she didn’t understand that love was like a puzzle. it wasn’t simply that you could give love in any form or frame that you chose, but that the love you gave had to fit the shape of the love the loved one could take in. perhaps it was a desperate love then that sent her-- when her foster mother threatened to separate her from her brother one night-- running around the house with a knife.

or sent her running at school, towards and not away from, those who provoked her. she would rather have been their friends, but didn’t know how. she would rather have been skinny, popular, admired-- loved. but the dots didn’t connect somehow and she only met with failure. taunts and rumors were her reward for yearning.

the year she was adopted by dixie mae was the best year of her life. it was february 27th and after the paperwork had been signed and sealed they all went out to ihop for pancakes. later that year she had slumber party with her adopted cousins. the theme was her favorite disney character, tinkerbell-- the pixie girl who faded away when people stopped believing in her.

things were better after the adoption, for a while. she started at the arts school, stopped getting in fights, and started seeing a regular psychiatrist. all went well until dixie mae went into the hospital for knee surgery and came out cranky and helpless. she felt helpless too. what if she lost dixie mae? later she would regret not taking care of dixie mae better, genuinely regret that hurled object striking dixie mae’s injured knee and the cleaning solvents that ended up in dixie mae’s drinks. was she trying to control the abandonment she worried was inevitable and push dixie mae away rather than have her be the one left behind? in the end she was the one who left dixie mae when the cops came and took her away with flashing lights and sirens.

once in the hospital it was exhausting trying to change when the only words recorded were the non-erasable bad ones, copied dutifully from one chart to the next. she didn’t know that the tablets of history carry in carved stone stories of wars, and not of kitchens, hearths, homes. perhaps that is always why men have fought, and ultimately, why she fought. because it was easier to keep raised the hammer and chisel, the sword-- or the kitchen knife-- or her fists-- than to watch days of goodness go by unnoticed.

if only the records would write out in glorious description the way she looked at her cousin’s wedding on a warm summer evening, light falling all over her as if it had traveled all the billions of miles from the sun just to adorn her in that moment. her hair was ironed flat and she had on a short gold tulle dress with four inch heels. everyone who saw here there knew that she shone.

if only dixie mae would speak-- ever-- of her with words of praise instead of harshness. how she tried hard to please, how she could be at times so affectionate, full of the childish attention that softens the hearts of old women who, long ago, had also been abandoned by their mothers. if only dixie mae would call her beautiful, she might believe it, or even become it. the dimples were there, and the smile, and the curls in her hair which-- although she fought them daily-- had the potential to be a crowning feature.

if only it could be noted how hard she worked for her goals and her dreams. how when she truly wanted something, she would try and try and try and not give up until she had reached for that thing. how she would never give up, never give up, never give up once she was out of the hospital, until she was married and living in nebraska, working as a forensic scientist and raising her own two children. a boy and a girl. she would never give up on them.

if only they would give her credit for bending her knees and speaking to God.

if only everyone would just stop talking, writing, making words and stop to listen to her fingers touch the bow of her viola. at the first note they would hush, voices dampened by the eagerness of their ears for the sound. their eyes would be entranced by the movement up and down, up and down of the bow against the strings. perhaps after some time their eyes would close and they would no longer see or think of her at all, but only be conscious of the beautiful sound everywhere around them. after some time they could re-open their eyes and find the sound coming from her. the sound which soothed, calmed, pleased. could they see her as that sound, too?

if only she could take the book of words, paddle to the middle of a lake, dive to the bottom, leave the book there in a chest in the mud, and re-emerge with water dripping down from her hair on to her now-clean face.

“i hear there’s a lake at princeton,” she says. “and a river a harvard.”

“yes,” i answer. “and an ocean at yale.”

Distracted On Another Saturday Afternoon

2010-09-11T17:20:00.003-04:00

I live alone in Upstate New York. On the "sketchier side of Park Ave"-- as my neurology resident once put it. It is certainly the sketchiest neighborhood I have ever lived in, if you discount the drug dealers who lived next door to our house in Provo. At any rate, this is a life circumstance I didn't see coming.

It is not all terrible living alone. There are many advantages. For example, the whole, gloriously wide, refrigerator is mine and mine alone. I open it up and all that food in there is mine. My milk fits and there is space and more space in the crisper drawer, the meat drawer, the freezer...

And I never have to close the bathroom door when I shower. Or not shower.

But sometimes the loneliness of-- living alone-- is so thickly palpable I feel like I am suffocating. There is no escape. I find loneliness lurking in the bedroom, the kitchen, the bathroom. I fling open windows and doors and it does not leave. I can't shoo it away with a broom or the frying pan. It has come into my home to stay.

I was trying to study for my neurology and psychiatry shelf exams this upcoming Monday but loneliness kept making snorting sounds in the corner and wouldn't shut up. I kept getting up to shove it away and even tried to rope it with a bandanna but nothing was working. So I put on my blue cardigan and fled the half-mile down the street and over the freeway to Granny's Icecream Parlor.

Loneliness doesn't like Grandmas who have ice cream.

There I met Granny herself, who was also wearing a cardigan. Hers was green. She served orange sherbet on top of white chocolate ice cream on a cone and wished me luck on my exams and for those brief moments today, I was not alone.

Come visit me soon, Robber Man. I miss you.

Distracted On A Saturday Afternoon

2010-08-14T14:44:00.002-04:00

Just looking at these. Huge props to J.D., our fabulous photographer.

Je Suis Malade

2010-08-12T15:43:00.003-04:00

It is two days shy of the end of my first rotation and I am home, sick. I've been rocking a cough since Sunday and when passed the threshold of fever yesterday at work, they let me go home half a day early. My fever ran upwards, other symptoms appeared, and I landed in the doctor's office-- not the traumatic brain injury rehab office-- the student health services office. I was sent home with with an empirical treatment for pneumonia and a doctor's note excusing me from work for the rest of the week.

I was scared. Not of the pneumonia, but of failing my rotation. Technically we can only be sick two days out of every rotation before we have to remediate the rotation and here I was at two and a half. Fortunately there is mercy in this world and after sending out emails, I will not fail for having had the pneumonia. Thank you, Dr. J.

Now this sickness has given me the chance to reflect on my time in neurology and I have decided it is time to pass on a few observations/advice I've accumulated in my four whole weeks bopping around the hospital and rehab. Here goes:

1) If for any reason you or someone you love is going to the ED, take an extra five to ten minutes before you go to pack a lunch. You may think you are dying quickly, but the ED most likely won't. You are most likely to be there at least 10 hours, during which time no one will feed you unless you ask, and you will want your own food more anyway. And even if the sick person doesn't get hungry, the family member will. There are a few cases where five to ten minutes make a big difference-- but twenty seconds to grab a banana or box of cereal won't. Do yourself a favor and bring some food and water.

2) Try to avoid having a traumatic brain injury at all costs.

3) Try to avoid having a stroke at all costs. This may be difficult for you. Try moving to a farm if you have to, which at least will prevent you from having a stroke until you are very old and in the process of riding your tractor.

4) Recovery from stroke, or any other brain injury, can take a long time. Having responsible family around both in the hospital and rehab can do wonders for the patient and for the doctors. Nothing is really as helpful as having an accurate family historian who knows the patient well and who can both cheer the patient on and answer the doctor's questions accurately.

5) Nothing makes doctors more agitated than having a brain dead patient whose family won't pull the plug. I don't know when it happens, but somewhere in training the majority of doctors will choose to fall on the side of pulling the plug once brain death is established. They get very irritated when families prolong the decision one way or the other by arguing. Have these conversations early among yourselves. It's a hard topic to talk about, but it will help everyone be more prepared to choose one path or the other if the circumstance arrives.

6) Doctors consider a patient dead much sooner than other people do. "Won't ever progress" is virtually equivalent to "dead."

7) If you are ever riding in an ambulance driving on the freeway, don't jump out.

8) Old people who have their language intact can hide a multitude of deficits by being funny or by turning questions and phrases. Just because someone can make a joke does not mean that they can balance a checkbook, understand a schedule, or take their medications correctly.

9) A skilled physical and occupational therapist can work miracles.

10) There are a lot of sad, sad stories out there in the world. I knew that already, but in the hospital that is mostly what you are dealing with every day. Sad, sad stories. Like the man who had a seizure driving and hit a nursing home. That was as sad, sad man. You have to learn to find joy in the small steps of recovery amongst the sadness. One day a woman wiggles her fingers. After two days of therapy a man can swallow thick liquids. A child's strong arm gets put in a cast so he will be forced to use his weak one. A man learns how to use a sheet to transfer himself out of bed. Men are, that they might have joy.

I am going to go find that joy and hopefully some recovery in a nice long nap, and maybe afterward, a little Arrested Development.

Blobfish

2010-08-09T20:14:00.002-04:00

How I felt at brain rehab today at 3 p.m.

To The Generous Giver(s) Of Our Shower Curtains, A Heartfelt Public Thank You!

2010-08-06T09:43:00.004-04:00

It seems every wedding involves a few -- unusual -- gifts. When my sister T. got married, some lovely person gave her a foot-high white ceramic pig with a kitchen hat and a little chalkboard held between its hooves that said, "What's cooking?" Immediately we dubbed it "the heinous pig" but my sister dutifully packed it in the moving van that carried her and her new husband out to St. Louis and into a little tiny house in Dogtown. Somehow that heinous pig found a niche in the new place and after three years in St. Louis survived another move out to North Carolina. When her three year old son had an irreparable run in with the heinous pig this last year, my sister truly mourned its loss. The initial ridicule in her heart had been replaced fondness.

By and large our wedding was free of such funny objects. The Robber and I were the recipients of such generosity and practicality from many people. We were touched by the kindness many showed to us.

Still, there remains a gift(s) that we-- although we delight in, and which in fairness is actually quite practical-- we cannot explain. Nor can we write a proper thank you for, because the gift(s) have come anonymously.

The first package arrived shortly before our marriage in mid-spring, shipped to the Robber at his Stanford address. It might have been the first "wedding" present we received, so early it came that we weren't 100% sure that was its intent. Bob opened up the box and surprise! inside was a wonderful shower curtain, embellished with red poppies. We had not registered for this particular shower curtain, but cried, "How appropriate! Whoever sent this must know us well!*"

"Who is on the return address?" I asked the Robber. He looked and again to our surprise, it had been sent from a person with an address on Long Island, New York. We do know a family on Long Island, but this was not the name attached with the address. We were not familiar with the name. We scanned the invitation list. The name was absent. "Perhaps this was a mistake?" Robber asked. But there was no receipt with shower curtain, and in the end, we decided to accept the shower curtain and delight that, by some unknown means, we had obtained a shower curtain somehow specific to our story.

Two months later another box arrived on the doorstep of our new home in Menlo Park.

The box contained a lobster shower curtain. There was no return address, no name attached to the receipt, no phantom woman in Long Island. We had not registered for the lobster shower curtain either. We brought out both shower curtains and looked at them together. Red poppies. Lobsters. Would two separate people buy us couple-specific shower curtains? Or just one person, with their own personal, personally delightful practical wedding present joke? Was this coincidence? A strange happenstance of string theory?

The romantic in me wants it to be just one giver, possibly a little old lady on Long Island herself, sitting alone trolling the internet for secret shower curtains, wrapping them with brown paper and string, chuckling and humming to herself at her own subterfuge.

Oh phantom shower curtain giver(s)! How we long to know ye. How we long to thank ye! In person, if you would reveal yourselves, over blogpost, if you will not. A large and very merry thank you for giving us not only shower curtains to bless our daily bathing, but also intrigue to that begets curiosity.

Please note that we will be expecting a raccoon shower curtain to appear shortly before Christmas.

One Year Later

2010-08-03T18:17:00.002-04:00

One year later I'm sitting the traumatic brain injury rehab unit at a hospital in New York watching a young boy who has lost half his brain try to catch a ball. He has a helmet on that looks twice the size of his head. On the top of the helmet someone has plastered New York Yankees emblems, the bravery of these logos shield you from the shock of jagged scars running across the length of his skull. He can't move one side of his body and he only speaks in monosyllables. But his eyes are wide and green and when he smiles everyone stops to cheer.

Carole King comes on the radio. "So far away," she croons, "doesn't anybody stay in one place any more. . ." and I think of how in two and a half weeks I'll finally see your face at the door of my new little studio, the place with the yellow kitchen walls. I knew by the yellow kitchen walls that it was the place for me this year. When you get here though I imagine it will take some time for us to get to the kitchen to see the yellow walls.

I didn't want there to be a place for me here. Remember how we prayed that this would not happen? Part of getting engaged so quickly last year was that we thought, hoped, that getting engaged earlier would make it easier for me to transfer medical schools and come back to the West Coast this year. I have never wanted anything so much in my whole life as I wanted you, wanted that transfer. We prayed and prayed and prayed and the miracle didn't come. One by one each medical school removed its transfer program until there were none remaining. At least it wasn't personal.

On the morning of the day we got engaged one year ago I woke up early and went to hike the Dish alone. I wanted to take one final inventory of my life, make sure I was ready to commit to always loving you. What a beautiful morning it was. The air was clear all the way up to San Francisco and across the Bay. I felt nothing but readiness, the same way I felt the morning of our wedding when we hiked the Dish together before our elopement breakfast. You ran long circles around me and I walked. We kissed every time you passed by. I marveled at you.

Then during that first run together on our honeymoon, there were times when you would run around the trail bends and I couldn't see you for some time. Always you turned around and ran back to me and I wished you wouldn't run so far ahead, already I missed you like crazy. I figured this is just the way marriage to you will be like for a while, maybe the first two years. You'll run ahead or behind and sometimes we'll get to cross paths and kiss for a brief moment in time. Then you'll run again your way and I'll run mine, each of us moving forward-- together-- but just at different tempos and times.

Carole King stops singing and the helmet boy has finished his therapy for the day. I get up from my stool and put my stethoscope back around my neck and button up the front of my short white coat. I am going to visit another patient. A redheaded woman who had sudden cardiac death, but didn't die. Now she is blind and today, she is going to relearn how to tell time.

Was Leo Tolstoy Ever Married Long Distance?

2010-07-22T13:54:00.004-04:00

I got married.

Almost two months later on the plane flying back to Rochester I hunched up dreading what would come next. All the questions. The smiles, everyone wanting to know what it was like to be married. All the well wishes. The happy faces of my friends. The thought of confronting the people who loved me.

I worried because I didn't have words for them. I had only tears.

Two months ago I left on the brink of marriage and I feared being the returning bride back for the first time since, not triumphant (although there was triumph, and plenty of it) but so fragile it was everything I could do not to weep. So I went only for the Sacrament to church and then slipped out the back before I could be approached by anyone.

How do you talk about something that is both the easiest and hardest thing you've ever done? The most joyous and the most wrenching? How to do be emotionally generous to the people you with whom you talk while conveying with honesty or justice your experience? Marrying the Robber was easy-- so easy and wonderful and natural and perfect-- and leaving him to come back to Rochester has only begun the accordion-like parade of hurt. It will hurt for as long as we are apart. Probably for somewhat after.

Perhaps this is why we have great literature-- because somewhere, someone has learned to articulate those feelings in the context of another story and another time, remote enough and yet familiar enough to relieve the comfort of deeply personal pain.

But this is my life-novel, and I currently have writer's block in creating dialogue of my own. Perhaps I will start carrying around copies of "Anna Karenina" or "War and Peace"-- it doesn't matter if the storyline is relevant-- only that it contains words that are somehow more eloquent than mine and will provide a distraction while I slip out the back and try hard not to cry.

p.s. This makes it sound like I'm a train-wreck. Let me assure you that I am not dead and for much of the day doing just fine. I finally got power in my apartment, if not food or internet, and yesterday I was tired enough after working 14 hours at the hospital that I actually slept. In the daytime when I'm seeing patients in much worse situations than I am in I lose myself in hearing, reading, repeating, and writing their stories and I forget my own and feel excited about learning and useful to others. Perhaps I will not carry novels around after all, but rather tell hospital stories. Like the story of the man who cut off all four of his fingers on one hand while making cookies and brought them all into the ED in a bag full of cinnamon sugar. That's a good conversation breaker, don't you think?

I Miss My Husband.

2010-07-22T13:51:00.001-04:00

Thirteenth Day of Marriage

2010-06-04T23:36:00.003-04:00

This is what marriage is like. . .

When you are married to the Region 6 Corn-on-the-Cob eating champion from a Special Ed event.*

*-- He did not compete against Special Ed students. He competed against athletes. Really big athletes.

Eighth Day of Marriage

2010-06-04T23:35:00.001-04:00

All of Bob's dreams come true.

What I Learned Studying For Boards Today

2010-06-03T20:44:00.003-04:00

Or: Things I Will Remember Instead Of What I Should Remember

Believing you are the reincarnation of Fred Astaire is a symptom of schizophrenia.

Imprinting is an important conditioning system for ducks, geese, and chickens.

You should be careful about prescribing TCAs to little old ladies because the side effect of orthostatic hypotension may cause one of them to fall and break a hip-- and it would be all your fault.

If you give a little old lady a benzodiazepine for insomnia and she falls due to drowsiness and impaired balance, it will again be all your fault!!!

If a little old lady falls in the shower, all of her bruises will be on the same side of her body.

Narcissistic personality disorder is often a consequence of being more intelligent than most people (common in surgeons!)

Formication is the sensations of ants crawling on one’s skin.

Gender identity is decided by age three, but left or right handedness is decided by 18 months.

Children can kick a ball at age two, but can't hop on one foot until age four. (How do you kick a ball without hopping on one foot again?)

1 out of every 100 of us is bipolar.

And my favorite:

Studies have shown that being in medical school decreases dating frequency. (p<0.05).

BUT if you are a single physician, you can ethically have a "social relationship" with someone two years after you terminate the physician-patient relationship.

Good thing I just got married!!!

Third Day Of Marriage

2010-05-25T22:37:00.002-04:00

Wedding Day

2010-05-25T22:32:00.002-04:00

G-Scat With A Valedictorian

2010-05-18T10:50:00.002-04:00

This is about the most intelligible he ever gets over g-chat.

11:00 PM me: boogle de boogle de boo

11:01 PM de boogle de boogle de bop

bop de wadda boogle de bop de wadda

wadda wadda bugle de bop

Iggy: ejpri homglom

me: now that is just not jazzy at all

shwoop wadda boogle boogle shwoop bop

11:02 PM Iggy: ba bep bop hoddy hoddy hom bom boomi

11:03 PM me: now you've got it

swing it iggy!

11:04 PM Iggy: hem hem bobbadi boom

bobbidi tappiti tom tom ta koom!

7 minutes

11:11 PM me: koom wadda wadda tom bop tom bop bop shwoop de bop shwoop be dop

11:12 PM Iggy: be ba badda badda hadda hadda haddock! Bee Bo Bad he hadda hadda haddock!

11:13 PM me: bobbadi boddadi hadda wop wop

de doop doop badda badda kiggidy shwoop shwoop ahhhh

11:17 PM Iggy: aaaaaaaaaahhhhhhhhh tippi toppi shooba shoo shoo hhhhhhaaaaaaaaaaa

me: now your jazz is getting unwieldy

11:18 PM zaah boompa boompa gabbity gabbity shoodye shoodye zaah kra kra kra zeeeeeeeee

11:21 PM Iggy: me oh my oh mip mip mipmap bitmap marbly marbly doo doo de dah lah doo dit de dah lah

5 minutes

11:26 PM me: zing zing zing zi zi zin ziz zazzly dah le zao zao zoop zoop zoop zeeble ze zeeble zoowah dop

11:29 PM Iggy: twangety twangety wah wah wah twanga twonga booma whacka twang twong wong wong tweer

11:31 PM me: let's do a duet!

11:32 PM we'll both type at the same time!

starting now

zeep zeep zah

Iggy: ba ba ba '

me: boogleydy

Iggy: ba ba ba tootoo too doo doo doo

me: zop

Iggy: dwee bobba dwee bobba

me: zop zebbey zeeby zeeby

booba

bobba

Iggy: bom bom bom bom boodle fobba boddle fobba

me: dooba

fobba

fobba zeep zeep

bliggle

Iggy: bort bort court

bort bort court

me: bliggle cort coo coo cout zeep

figgle

Iggy: bort bort bobba nort bobba lort fwam fwam fwam

me: figgy

11:33 PM Iggy: fwammi wammi wammin on the haddock hose!

me: zip zip zip de de doo doo dah wammin wammin hose dahhhhhhhh!!!!!!

Iggy: haddock hose, heat the haddock, eat the haddock, haddo bobba doo ba de dit dah dit dah doo

11:34 PM me: bleat bleat sheep sheep bleat dit dah haddock dah doo wammpo

Iggy: sheep, haddock, shippy shippy sharlo

sheep, haddock, shoppy for the wool

me: shoopy shoopy bleat bleat haddock haddock rock bock wocko wocko wakka dakka shoop wool

11:37 PM Iggy: wocka doop

wocka wee

wocka hocka smocka wee

11:38 PM smock smock smock smock smock

I do not want a smock

but Hobbes wants a smock

give Hobbes a smock

11:40 PM me: Cal calv ca hobbo hob smockum wakka dooby dooby smockum no give

11:41 PM cal ca ka ka kee keep de smock smock foh hisself

doo wop

shwoop

shwoop de ba bum

11:43 PM Iggy: bonty bonty bonty ba

hobbesy hobbesy hobbesy ha

hava hoovy hoovy hava hoyo

hava hooby hooby haba hoi!

hava hooby hoovy hava hoyo

hava hooby hooba ha

shuoo!

11:46 PM me: reb bek bek ka rakkka want to know rak rak what do doo doop dop whatta whatta doo be doo dop you dop dop me mean eee eeeem

Iggy: ooby dooby pom pom hoi

11:47 PM ooby dooby mompim dlom

dlomitoingi

hojpoin troi

troi troi trotro twelfy pope

Trotro! Chuffa chuffa Choo choo! Grumba grumba Trotro!

All In The Family

2010-05-18T00:10:00.005-04:00

See those two lovely people in the middle? They started it, back in the day in Duncan and St. David, Arizona where they graduated valedictorian of their high school classes.

Next up came the lady in blue you see with them. She rocked the WJ world in 1998 with her perfect ACT score and her valediction.

Now this week in 2010 we get to leave high school on a strong note with the second valedictorian of our generation and the fourth overall, the snowman sculptor himself:

And to cap it all off, we'll add a third in the mix on Saturday. Just to keep the gene pool strong.

Faith Of My Mother-- Reprise

2010-05-10T19:06:00.007-04:00

Remember the hats?

It is finished. The work is done. My mother has completed her miracle.

Here are her hats in all their splendor. There are even 2 extra hats made from extra yarn! They have all been donated to the poor. Somewhere out in the world, 52 once cold heads are wearing my mother's miracle hats.

And they are miraculous. Aren't they beautiful?

I think my favorite hat is still the shredded coconut hat.

This is proof that if you have faith like my mother, bargain with God, and then you keep your end of the deal, God will keep His.

Happy Mother's Day and thank you Mom!

I hope you like your new son-in-law, because I sure do.

Making Progress?

2010-05-08T02:31:00.005-04:00

This Thursday was my second to last week at my preceptor's office. Every Thursday afternoon since September I have worked in the clinic with Dr. A., the rabbi. In a typical afternoon I'll go see 2-5 patients by myself, do the history and physical, and then come back in to see the patient with Dr. A. who makes all the real clinical decisions. She's the real doctor, it's her job.

My first patient on Thursday was an elderly lady. I glanced over her chart as I stood outside the exam room door, white coat on and stethoscope over my shoulders. Pen in the pocket. I'm ready to go. Two chart folders only, and no "thinned" sticker-- for a woman her age that's not bad. I thumb through the chart, make a mini mental plan, give a little tap and walk in the door.

"Hi, I'm R. the med student working with Dr. A. How are you today?"

The white haired lady before me puts her open magazine down on the table in front of me, and nodding her head to the title of the magazine article says, "My dog and me. I have a dog. He's thirteen years old. . . "

And then she starts telling me about her dog.

And telling me about her dog.

And telling me more about her dog.

In a study of patient-physician encounters in primary care offices across America, physicians interrupted their patients after an average of only 23.1 seconds into the description of their concerns. At Rochester, they teach us to not interrupt our patients during the first five full minutes of the encounter. I don't think this is practical in real life, but maybe they hope by teaching us five as students, we will get to one as practicing physicians.

I get to 23.1 seconds and my patient is still talking the dog and only the dog.

At one minute I start to wonder if the story about the dog is really a projection of her experience with illness. It may sound funny, but we're taught that if an elderly patient comes into clinic and talks about an ailing dog and asks about meds to put the dog down, the next question you're supposed to ask is not about the dog. You're supposed to start screening the patient for suicide risk.

At two minutes I decide she really is just talking about the dog.

At three minutes I decide she is never going to talk about anything but the dog.

And then something clicks. Knowing I was in this dog story for the long haul, I start asking myself questions that I can answer without asking the patient.

Is this patient experiencing elderly abuse? Are there bruises I can see? Is there anger, sadness, or fear in her story?-- I give her a look over. I note her fingernails are long, but shaped. Her hair is freshly curled. Someone is taking good care of this lady. Elderly abuse unlikely.

How is her breathing? Am I worried about pulmonary edema associated with congestive heart failure?-- I look discreetly at her chest. Regular respirations. Not struggling to breath. No pauses in her story to gasp for air.

Are her ankles swollen? Does she have edema in her extremities?-- I glance at her hands and ankles. Hard to tell but they didn't look puffy. Probably ok.

Any arthritis in her hands?-- Mild swelling in the MCP but no overt deformity.

She recently had an accident. Is she holding her body in a way that would indicated continued pain? I look at how she sits and which joints she is moving. I make a few mental notes for my physical examination.

What's her bone density like? Am I worried about osteoporosis? Especially with this recent accident? Uh oh. Definitely some kyphosis in the vertebral spine. Better check when she had her last DEXA.

Are there signs of early onset dementia? Is this story making sense? Can she remember dates, places, names? I return to listening to the story. Still making sense but tangential. But why is she talking about the dog anyway? I asked about her, not the dog. But she is making sense. Everything follows like a normal story.

What am I learning about her speech? Any signs from her history of stroke? I listen again. No slurring, dropped sentences, fragments, stuttering, dysphonia. This woman can talk all right.

What else can I learn about her functional status from what she is telling me? A lot, it turns out, and we're still only talking about the dog.

All this while I'm asking questions and answering them in my head I'm also nodding appropriately and saying things like "uh huh" and "oh no" and "I see" and of course maintaining some eye contact. But now instead of just listening to the story about the dog, as I might have done in September, I've got a plan, made decisions about her health care, altered what I planned to do for the physical exam, and screened mentally for commons problems in the elderly including congestive heart failure, suicide, abuse, and dementia.

Sweet.

So when, after seven minutes of non-stop talking, she closes the magazine and says, "I'm sorry. We're not here to talk about the dog. But do you have time look at a picture?" I just look at her, smile, and say:

Yes. But of course, yes.

-- My next patient also talked about his dog and his friend, who died after rapid onset dementia around his same age. The patient said, "We put dogs down when they get old and start to suffer. Why can't we do the same thing for human beings? It's more humane." I glanced at his chart. Being medicated for depression. I screened him for suicide.

Languages of Love Reprise

2010-05-06T21:14:00.003-04:00

Some people sing songs.

Some people write poetry.

In the old days, people used to go on quests.

Or fight dragons.

Now most people just send text messages across the room.

All this to try and say:

I love you.

Now little me

I can't sing songs

Or write poems

Or slay dragons.

So when I want to say

I love you

I just do it my own way.

I take a big round Mylar balloon

and some noise-makers and I

spray paint them red

and make

a

giant

collapsible

paper-mache lobster.

Which I wrap up in tissue paper

and stuff into a gift bag

and sneak

past

security at

the Salt Lake City airport

and later assemble when the Robber isn't looking

and leave on his toilet.

Hoping that when he sees it

What he will hear is

I LOVE YOU

Loud and clear.

(wouldn't you?)

--but that was before we got engaged--

And now

when my love is bigger

and

BIGGER

and

BIGGER

and

BIGGER

and

we are getting sealed together for ever

it becomes clear to me

that one lobster is

not enough

love

and what we really need

in this relationship

is another lobster

to solidify things. You know, show the world,

that we really care (or that I really care)--

what we need is

a permanent lobster

a giant

red

felt and fabric

lobster

with legs and a fish tail that come on and off

with buttons.

Now that is really love, I said.

It's a good thing Bob agrees.

(What oh what

am I going to do

when we have been married fifty years? At five hundred

I will make a whole planet just full of lobsters

pink ones

green ones

bright blue ones like the ones on our planet under the sea

ones that sing songs

and write poems

I will wrap that planet up in milky way tissue paper

that will be easy.

It's our fiftieth anniversary

that I'm worried about.)

Is it Still Eloping if You Announce Beforehand on Your Blog?

2010-04-26T21:51:00.002-04:00

Bob started talking elopement before he was talking engagement. This was on opera night, just two days after he told me he loved me. We were driving home from seeing Turandot in Walnut Creek, happy and drunk on the wonderful evening we were spending together. At some point someone-- I think it was me-- said, "You know we could just take the next exit and head up north to Oregon and never come back. "

Bob didn't miss a beat. "We could elope," he replied, "and live in a little house by the beach. Just the two of us. And just stay in it and grow old together."

I remember us both looking ahead down the long highway lit by his headlights as we drove in the dark. That was the beginning of our shared vision together and it began with eloping.

Four days before we got engaged I was sat in the Jiffy Lube off of El Camino and wrote Bob an elopement poem. I'll spare you most of the cheese, but I will say that at one point I rhymed "mobster" with "lobster." Oh and coast, toast, roast, post, and most in that order. Truly it was genius. It's a wonder he didn't carry me off then and there, when I read the poem to him later that night.

The day after we got engaged we drove from Palo Alto, California to West Jordan, Utah and along the way passed three temples. I'm sure that at least two of them Bob threatened to pull over. I didn't do anything to stop him. We are madly in love.

Time passed and we were engaged two months without a wedding date and without having eloped. Bob came out to visit me in New York and we went to the Palmyra temple together for an endowment session. We prayed about when we should get married. Bob felt like we should elope then and there or November or December or January or the soonest I would possibly do it. I liked the idea of eloping, I told Bob, but I felt like we should wait until June. We set our wedding date for June.

November came and we planned a trip to the Manhattan temple the day after Thanksgiving. Bob reminded me that if I just got a recommend we could elope in New York City. "What would be more romantic than that?" We went to Manhattan, did a session in the temple, strolled through Central Park, at cheesecake from the Roxie delicatessen and and kissed right in the center of Times Square. It was all very romantic, but we didn't get married. I hadn't brought a recommend.

Finally Bob confronted me. "I don't think you actually want to elope," he said.

"I do, I do," I insisted. "It's just that I want other things too. I want our families to feel loved. I want to finish my year of medical school. I want to live with you. I want to marry you the right way. But I do think eloping sounds marvelous."

"Your heart isn't in it."

"Fine. You're right. But I'll tell you what. If you double double dare me, I'll elope with you. That way the power is in your hands. I want to marry you and I'll marry you any old time you say the word. If you really want me to elope with you all you have to say is I double double dare you to elope with me and whammo! I'll say, 'is tonight soon enough?' and I'll be there. Deal?"

"Deal. But your heart still isn't in it."

Well the months went by and Bob never said those magic words. From time to time I'd tease him about it and maybe he double dared me, but that's the magic of the double double dare. You really have to mean it to get out those words. I double DOUBLE dare you. Yeah. Take that, wimpy single double dare.

Two weeks ago it came up again. In a text message. I had been texting Bob bits of my Jiffy Lube poem I had just rediscovered in my journal, a rare moment of chronicled history (of all moments to record for posterity, being in the Jiffy Lube). I was playing with fire, it's true, but I'd come close before and not been burned. All was fine and dandy the whole day, until late that night. From 10:49 to 10:51 p.m. on April 12, he sent me these texts:

I'm going to call your bluff lest anyone accuse me of not pursuing elopement enough. So here goes...

I double...

Double...

And just for good measure DOUBLE dare you to elope with me in may.

Little did he know that while my heart was in a scheduled marriage more than in elopement, I was not bluffing. Because my heart was really in marrying him more than anything. I'm not sure exactly what I texted back, but it must have been convincing enough because the first text I got the next day said:

Good morning. I just called the temple and rescheduled for may twentieth at three pm.

And that was that. He called my bluff and I called it back. We were eloping*.

So quite naturally, three days later, when the remnants of our Stanford transferring dreams came crashing over our heads and we realized that the heavens were not opening up this specific miracle for us, it seemed only natural that we could pull this little bit of manna out of the wilderness of my tears.

"Wanna elope for reals?" Bob asked.

"You don't even have to double double dare me," I gulped. "Let's just do it."

Turns out sometimes dreams do come true and visions, if you believe in them long enough, sometimes materialize when you least expect them. Bob is getting his dream of eloping and let me tell you, my heart is in it this time, especially since I'm getting my dream of marrying my perfect match who I am madly in love with in the temple. We're now getting married on Saturday, May 22** and driving off into the sunset to live happily ever after-- until Monday morning, when Bob has to go to microscopy class and I have to start studying for boards full-time. That little beach house in Oregon? We'll get there, and some day soon. It's still only a few hundred miles of dark roads and headlights up to the north.

*--Whether or not Bob actually rescheduled with the temple is still unclear to me. Bets are on not. His heart may be in eloping, but it's more in making me happy. That's why he's such a fantastic fiance.

**--Reception still June 25th, and don't worry, it's still in Foothills Park and you're still invited.

***-- Our letters are on hold. We have to move faster in real life. But that's the beauty of writing fake letters. You can go back and post date them. :)

Mark 10:27

2010-04-17T00:15:00.008-04:00

--"And Jesus looking upon them saith, With men it is impossible, but not with God: for with God all things are possible."

In August 2009, Stanford School of Medicine had an existing transfer policy online.

Today in April 2010, they do not.

It's official. The Robber and I will not be living together the first year of our marriage.

How do I create a wedding registry for frequent flier miles?

(Let us pray for strength.)

(I have turned in a transfer application to Keck School of Medicine at USC. If they have a spot available, the acceptance rate is 5-10%. Let us pray for submission.)

(Two weeks ago I was assigned my number one choice of schedule for third year if I have to stay here in Rochester. And this week I got accepted to the Medical Education Pathway at the University of Rochester, a program I'm really excited about doing if I end up here. Let us pray for gratitude.)

Why I Love Rochester

2010-04-15T20:55:00.003-04:00

It's less than two months before the Boards and guess what the first word in our current course title is?

STRESS

Just like that. In big bold letters. It's the first word I see every day on my Stress, Adaptation, and Transition course syllabus, that lovely syllabus with the term paper requirements inside, the homework and problem set schedule, and reminders for our upcoming Family Med shelf exam and continuing clinical responsibilities.

It's like the time they made us saw off the skull of our cadavers on Halloween.

Or disembowel the cadavers on the day before Thanksgiving.

Or when we had to endure an oral exam about cardiology on Valentine's Day.

I guess they're just trying to reinforce the point.

Thirst

2010-04-13T00:34:00.003-04:00

by Mary Oliver

Another morning and I wake with thirst
for the goodness I do not have. I walk
out to the pond and all the way God has
given us such beautiful lessons. Oh Lord,
I was never a quick scholar but sulked
and hunched over my books past the hour
and the bell; grant me, in your mercy,
a little more time. Love for the earth
and love for you are having such a long
conversation in my heart. Who knows what
will finally happen or where I will be sent,
yet already I have given a great many things
away, expecting to be told to pack nothing,
except the prayers which, with this thirst,
I am slowly learning.

(--I met this poem when my dear MH left it, bookmarked among pages, on my pillow. When I was trying to decide whether to go to medical school, continue the teaching job which I loved, or return to the Ph.D. I would recite this poem and say the words slowly as I drove over the Dumbarton Bridge at 6:45 in the morning watching the sun rise over the Bay. "Another morning," chug chug went my truck, "and I wake with thirst," spring was early and glorious that year and daffodils grew on the hills, "for the goodness that I do not have." The truck exited the freeway, but I was lost in the words "who knows what will happen," and by itself turned left on to Mission Boulevard, "or where I will be sent," and pulled into the parking lot, "yet already I have given a great many things away," I was thinking of my students' faces which, even one whole semester into the year, sometimes continued to baffle me.

I think I will start reciting it to myself again.--)

Decisions

2010-04-12T08:44:00.004-04:00

The Robber and I are dealing with a lot of questions right now with only a very few clear answers.

Here's an example of a question with an answer:
Q: When are you guys getting married?
A: June 25th, 1 pm, AND NO LATER.

Or another one:
Q: How much do you love your fiance?
A: More than 1,000,000,000,000,000,000,000 x 17 blue whales worth.

But there are lots more questions that people ask me all the time for which I have no real reply. Like:

Where are you guys going to live after you are married?

Where will you be in medical school next year?

Will you stay in the branch if you're stuck in Rochester or go to a family ward?

How will you survive if you have to be married long distance?

These days when people ask me these questions I just shrug my shoulders and say, "I'd like to know the answer to that question too. Let's both pray." I know that God is mindful of us, and I have felt the powers of heaven throughout this year. But they remain silent as to specifics of the questions above.

One thing we do know is that both the Robber and I will have to leave our current places of residence in the next two-three months and move elsewhere. This means we are both on the housing market, but neither of us knowing how many people will be living there or where that living place should be. Talk about craigslisting by faith. It's a tricky business we're in.

On Friday we were nearing the end of our housing discussion when the Robber changed the subject and asked, "When do you want the story in our letters to end?"

(If you haven't noted from previous posts, the Robber and I write weekly letters to each other that are kind of like a serial novella. Our characters live in the early 1700s and are engaged, but I'm back in our home country of Ireland working a shady job and running around with a skunk and he's off to America in search of his fortune.)

I balked. It's hard even to plan your virtual life when your real one is so up in the air.

"I don't know," I said. "On one hand, if we're going to be together, we should put our characters back together and finish it off before I come out in May. But if we're going to live apart, I think we should keep writing."

"True," he said, "But don't you think our characters should get married when we get married in real life?"

"That's kind of fast, don't you think, for the story to end?" I asked. "I mean, you still have to get through the Raccoon Forest, the Dangerous Desert, the Mysterious Mountains, and over the Icy Lake before you conquer the City and then come all the way back, rescue me, and carry me happily off into the sunset! And I've still got to, you know, clear up this whole shady leprechaun grave digging stuff. We've still got lots of story left to go. And we've only got five more weeks of for sure letter writing."

"I know. But our characters should reunite and get married anyway. There are faster ways to end this story. And if we end up living apart in real life after our wedding, we can start a new story or write a sequel. I just want us to be together."

"Me too. That's all I want too."

"So we'll keep writing until our wedding date, and that will give us another six weeks to wrap the story lines up and get our characters reunited in time to get married."

"Ok. That's a good plan. Deal."

"Done."

At least we've got that much of our real and our virtual lives decided.

We're getting married. June 25th. 1 p.m. AND NO LATER.

The Telephone Game

2010-03-26T13:44:00.005-04:00

I'm sitting in the medical school library computer room working on a lovely take home assignment when my classmate A. comes in, pulls a chair up next to me, and says:

"You're gutsy."

I looked at him, surprised. I'm not a very gutsy person. And this is really random.

A. continues. "I hear you denied birth control to an adolescent. That's gutsy."

Oh my. I don't even know what he's talking about and already I know this is going to be a pain.

"Where did you hear that?" I ask.

"A.C. and M. talking about it in the hall and pulled me in to their conversation. They were really going off about it and how you sometimes say you want to be a pediatrician and they're worried that you..."

A. looks at me. "I thought it was gutsy to come out and stick to your moral guns."

Now I remember and identify the situation that is probably going on (but for the purposes of this blog can't state it) and sigh. Big sigh. I had mentioned a patient encounter to my classmate A.C., and apparently she had totally misinterpreted my comments. I had objected to prescribing birth control to an adolescent. It's true. But not on moral grounds, on authoritative grounds. I had recommended she get a prescription for birth control, just not from me because I didn't think I was the proper medical professional in her life.

But I'm Mormon and everyone knows it. And A.C. is not Mormon, let's just say. I guess I should have learned by now to be careful when explaining myself when mentioning these issues. So I told A. the careful truth. "Do I personally believe unmarried teens should be having sex? No. Do I as a medical professional think this girl, having decided to have sex, should take birth control? Yes. But my objection was not moral, it was authoritative. Turns out I'm not gutsy at all."

"And I'm not even that much of a religious radical. I'm for birth control. Sorry to disappoint."

A. laughs. "Sorry," he says, "but you should stick up for yourself when you can anyway." After another ten minutes of venting over medical school affairs, he leaves me staring back at my take home assignment.

Now I'm worried it will get back to my Advisory Dean that I won't prescribe birth control to adolescents-- or worse. Who knows what the story will be by that time. And then I'll get called into the office, and my Dean who probably already thinks I'm way too conservative (I think she's way too liberal), will give me more of the evil eye and tell me to repent.

Double sigh. It's the last Friday in March, 26 degrees outside, and I still have another take home assignment left to do and my third year schedule requests to fill out.

I need a nap.

Hug Me Gently, I'm A Delicate Masterpiece

2010-03-22T22:01:00.007-04:00

Turns out the Robber and I are living works of art. One of our engagement photos was recently hung in an art gallery in downtown Rochester! The curator of the show said of the photograph, "This is the most romantic, most beautiful shot to ever come out of Corbett's Glen." Go Team Rawle! Here we are in February checking ourselves out.

Scott K., our excellent photographer was showing along with other local photographers from the area. You can see more of his excellent work HERE.

Rochester might not be the big time yet, but this is only the beginning of our trophy-couple-as-art career. Just wait a few years and we'll be on the cover of Vogue. Then we'll sell the pictures of our child Ruggles to People for $5 million, pay off my medical school debt, and retire to a small beach town in Oregon, where we will set up a studio for visiting artists yearning to paint a masterpiece of our red hair against the setting sun over the Pacific Ocean.

Want to see our famous picture? You can see it now on at the top of our wedding website HERE. Only three months and three days! We'll be sending out wedding announcements soon. If you get one and plan on attending our reception, please follow the directions and RSVP!

Future Trophy Husbands...

2010-03-01T11:10:00.003-05:00

always wear tweed when they go out to eat.

(Especially if they are official Stanford Ph.D. candidates.)

Susan, Jane, My Patient*, and Me

2010-02-19T00:15:00.003-05:00

She was eleven the day Congress passed the 19th Amendment of the Constitution of the United States of America. “My mother sang all day in the kitchen,” she reminisced, “and she took me and my sister down to the polls the day she cast her first vote. I’ll never remember how happy she was.”

As she is speaking I remember-- but don’t recall out loud-- how I had my fiance kiss me over the grave of Susan B. Anthony on his first trip out to Rochester. “Wouldn’t that be a bit disrespectful?” Bob asked. “Are you kidding me?” I rejoined, “She would dig it! I’m a modern woman and I have everything Susan B. Anthony spent her life fighting for!” Thus convinced, Bob took advantage of a beautifully chilly day last October to help me pay our own special homage to Susan B.

Like Susan Anthony, she never married. “In the days when women were told they could be nurses or teachers and nothing else,” she tells me, “my parents taught me I could do anything in the world.” She joined the Red Cross, toured the world, and testified in the Nuremburg trials. She moved to Rochester and founded the Genessee Settlement House which served underprivileged children and families. She remains a board member of several charitable organizations and attends meetings, although she can’t drive herself. At home she sits wrapped in an afghan in a big easy chair, a living Jane Addams, like out of the picture books my mother checked out from the library for me when I was little. Two whole walls of the room are covered with commendations and awards, including a letter from the Obamas on her 100th birthday. She asks me what I think about Michelle Obama and I tell her I’m a fan. She is too. She isn’t close to one pound of body weight per year of life, but her voice still has authority. “Don’t call me by my first name!” she commands, “Old people don’t like being called by their first names by young whippersnappers like you!” When she asks me to fill her teapot with ice, I ask for how many cubes. I want to get it right.

As I go to the kitchen in search of ice I remember an email I received last fall following my engagement from a well-intentioned relative advising me to drop out of medical school and return to California where my fiance lives. Her email said, “[Our] society. . . tells women not that women's roles are as important as men's roles, but that a woman can do anything a man can do and so be as valuable as a man. I believe that this idea has led to the shortages experienced in teaching, nursing and mothering. We have been brought up in a society that says a female doctor is as good as a male doctor and not that good and experienced nurses are as vital to our care as good and experienced doctors.” I open the freezer and pull out the ice tray, put five cubes of ice into the pot, fill the tray again and return.

We sit in her room and I hold her hand as she tells me about the first car she bought and I tell her about my 1992 Ford Ranger which I drove all the way to Rochester from San Francisco. She asks me if I have children. “I’m not married yet,” I answer and she responds, “I’m so glad you mentioned that married part!” “But I’m engaged,” I tell her, “to a man with a good heart and a handsome face.” I bring a picture for her the next week to show her. She agrees. He is handsome. “Will he always love you first?” she asks. “God first, then me,” I answer without a doubt. “Good then, you’ll do just fine.” I ask her why she has never married. “No one ever loved me enough.”

I ask her what she wants people to remember about her. Her answer is simple. “That I was kind to children.” She asks me what kind of doctor I want to be. My answer isn’t as sure. “Maybe a pediatrician. Actually I think adolescent medicine would be cool.”

We aren’t nurses or teachers, she and me. We aren’t Susan B. Anthony or Jane Addams. But we both had parents who loved each other first, who taught us that in this world we could do anything, and she turned that into an amazing life of tireless service and charity. I’ve got the things that made her strong-- good parents, faith in Christ, a healthy constitution-- and a man who loves me enough. No reason I can’t try and follow her life example. I might as well live to be 100 too.

*-- I wrote the following as the "creative" part of an assignment for our primary care clerkship. We were assigned to visit a patient who is nearing life's end and possibly home bound three times at their residence, interview them, and write a summary of their health status based on our visits and interviews. I met my patient previously in the waiting room of the clinic, when she accosted me at the door and asked me to carry in a huge box of Christmas cookies for the office staff. A few minutes later, I met with her in the an examination room where we had a lovely visit. Later I jumped at the opportunity to see her again when my preceptor suggested her as a possibility for the home visit assignment. How I have come to love this woman.

Sometimes Medical School Is Just Sad

2010-02-09T22:52:00.003-05:00

Today the theme in clinic was children whose fathers had been murdered.

Sometimes Medical School is Just Weird

2010-02-05T00:15:00.003-05:00

On Thursday afternoons I work in the outpatient clinic with Dr. A, the Jewish rabbi. Sometimes the patients are a group of disconnected people, each with a different problem, but more often than not there seems to be a little mini-theme of the week. Meaning that there will be more than one patient that presents with the same problem, or a cluster of patients that are alike in some way.

One week I swear I saw three 64 year old women in a row who all complained of knee pain. I guess that's not totally remarkable. What 64 year old woman out there doesn't have knee pain?

But then there was the week I saw two men in a row complaining of a two month history of ringing in their ears and progressive hearing loss. One was a professional bassist and felt like his music sounded distorted and warped. Sad man. I hope his ringing went away. I don't remember the other guy's story but I hope his ringing resolved too.

Another week was crazy person week, where every patient I saw was crazy! I mean, not really. But sometimes before I go into a room Dr. A. will say "Good luck in there, (s)he is a crazy one!" and then I know the interview will be long and I'll have to dig dig dig. I did a lot of digging that day. I'm getting better at digging faster, but I tell you with some people, it's really hard.

Last year, with Dr. W., there was a week when the only patients I saw all afternoon were nuns.

Well this week there was definitely a theme to trump all previous themes. Ready for it? This week, half the patients I saw were

MEN WITH MISSING FINGERS!

No joke. Every single man I saw today was missing a finger. And I saw more than one man.

I don't know what this world is coming to, with all these missing fingers. Fingers are important, universe! Why are there so many men out there without fingers and why did they all come into my clinic today?

And why, after examining his whole shoulder, elbow, lungs, and chest, did I not notice it on the first man until after the exam was over and I was back in the room reporting with the doctor?

We spend a lot of time trying to learn to recognize the subtle in medical school. Not just the things five-year-olds would notice. Maybe this is a good reminder for me that I'm supposed to be noticing everything.

Let's hope next week isn't the week of men with no heads.

Just Let Obama Do His Thing

2010-02-02T23:08:00.002-05:00

I've been going to the gym. This as a winter coping strategy. In a month when the average temperature is well below zero, exercising offers a third place where I can feel truly warm: the shower, my bed, the gym.

One consequence of my new found gym attendance is that I've been watching a lot of college basketball. I park myself on the closest empty treadmill to the ESPN TV, and then I time my workout by watching the clock on whatever game is going on. "I can't look down at my exercise clock until seven minutes have gone by on the game clock!" I tell myself. Exercising is a lot mental for me. My head gets bored and tries to duck out early. So I have to play games like this.

What is surprising in my sports watching this year is that I never root for the underdog. I always want the highest-ranked team going in to win. Today I watched the first half #5 Michigan State vs. #16 Wisconsin and despite having a sister who spent eight years at Madison, despite them having a redheaded ballplayer who looked a bit like my man, despite having been personally hugged by Bucky the Badger in 2004-- I still rooted for Michigan State. They're up! They're living the #5 dream! Let them win!

This is dangerous territory, I know, because it has led to me rooting for Duke in both of the games I have watched them play in this season. I've rooted for Villanova, for Syracuse, and for Kentucky. I have yet to watch two unranked teams play (this is ESPN), but I've already decided if that happens I'll wait until I see their records and then root for the ones with the most wins.

This is my strategy for the Super Bowl too, come Sunday. The Colts are 14-2, the Saints 13-3. I'm going with 70% of NYTimes pollees and choosing the Colts. They've won the Super Bowl before. Let them do it again.

I'm even this way about my rooting for teams on The Biggest Loser, which I have only seen twice now, but which I have read the Season 9 Wikipedia entry about twice also. Turns out the red team is rocking it this year, so guess who I'm rooting for? The red team. And even though Miggy is trying hard to come back after abdominal surgery, stating, "If walking is the only thing I can do, I'll walk to Puerto Rico and back if I have to," I just want her to go. Her team is already behind.

These are the thoughts that I have while I puff it out on the treadmill, turning the brightest shade of pink and starting to sweat through my shirt. Never mind that my beautiful classmate, who manages to look as serene here after twenty minutes on the elliptical as she does perpetually in class, is not breaking a sweat at all. Never mind that another classmate, a former wrestler for Notre Dame, walks in and starts lifting weights twice the size of my head. I smile at him. Hi. Maybe we're friends. Never mind also that the first-year girl on the treadmill next to me is going 1.33 times my speed and it's messing up my rhythm.

Since when was it all about winning anyway?

Child in Red

2010-01-29T23:26:00.003-05:00

by Rainer Maria Rilke

Sometimes she walks through the village in her
little red dress
all absorbed in restraining herself,
and yet, despite herself, she seems to move
according to the rhythm of her life to come.

She runs a bit, hesitates, stops,
half-turns around...
and, all while dreaming, shakes her head
for or against.

Then she dances a few steps
that she invents and forgets,
no doubt finding out that life
moves on too fast.

It's not so much that she steps out
of the small body enclosing her,
but that all she carries in herself
frolics and ferments.

It's this dress that she'll remember
later in a sweet surrender;
when her whole life is full of risks
the little red dress will always seem right.

*-- post partially inspired by the illustrious J.S.N.

Half Way

2010-01-24T21:03:00.005-05:00

Yesterday our friends J. and M. got married in the Newport Beach LDS Temple in California. Granted-- J. and M. had been dating well over a year at the time of their engagement-- but they got engaged just before Thanksgiving and are now man and wife.

The average Mormon engagement is roughly three months long. Bob and I have been engaged five months and twenty one days. In that time, five couples we know have gotten engaged after us and married before us. Five more couples that have been engaged after us have planned wedding dates yet to come before us. Tomorrow, we will have five more months let to go. There's still time! You could beat us to the altar too! (I'm not-so-secretly hoping for at least one particular couple to trump the Robber and me and do it.)

I'll admit it. I'm jealous of these couples. They get to hold each other every day they are engaged. In weaker moments, they can say reaffirming words while looking directly at each others' eyes. They can make difficult decisions holding hands. They know they will live together after they are married-- and then they get married and wake up next to each other each day and the day after and the day after. Their belongings intertwine, wedding presents strewn or stored about a house they both inhabit. They begin to live their shared dream.

Robber and I are having such a long engagement not because we just love love love being engaged so much, but because the logistics of our circumstances make this arrangement the one feel best about. We don't know that even after our marriage we will be living in the same state. Nonetheless, I want to be married too. I want to be sealed to Bob for time and eternity. His commitment I already have-- it's the powers of heaven I thirst after now. I want our bond to be unbreakable. I want him for my husband and I want to be his wife.

I want to marry him infinitely more than I did in August when he proposed and I want to live with him afterward. And we are only half way to marriage and some way to the end of our separation.

Today in Sacrament Meeting one of the speakers quoted the words of the Savior as recorded in Matthew 7, "Or what man is there, whom if his son ask bread, will give him a stone? Or if he ask a fish, will he give him a serpent? If ye then, being evil, know how to give good gifts unto your children, how much more shall your Father which is in heaven give good things to them that ask him?

I've been trying to think of this year as bread, and not as a stone. Early in the year-- when everything was new and my heart was more volatile over the matter-- I prayed that this year of engagement and separation could be one of joy. I prayed that I would be able to make something beautiful of it, despite the way my emotional stability seemed to rise and fall inexplicably and without pattern. I prayed for the ability to see and to taste bread.

And, as the Israelites gathering manna from heaven, I have received. It turns out-- it does somehow turn out-- that there are blessings to be found in doing a long distance, long timeline engagement.

One of them is that the Robber and I never get tired of being with each other. We don't imagine other engaged couples do either-- but we really really don't. Every moment that we do have together, because they are so far apart and so few, is cherished.

There was one funny moment over Christmas time that the Robber and I still laugh about. One week into our two week break we were eating dinner with my family at my parents' home. My sister started saying, "So, do you two want a break some time?" The Robber and I were baffled. "What do you mean, break? We're on break right now." My dad picked up the thread, "You know. A day where you stay at home just with your family, and Bob goes home and has a day just with his family, and you don't see each other?"

Robber and I just looked at each other with wide eyes. Instantly we said emphatically, "NO." Then we laughed at the sheer ludicrousness of what they were suggesting. "No, no, no, no no," we repeated. "Why would we want that?" We were totally flummoxed. What part of being in love and living 3000 miles apart did my family not understand? The Robber and I still laugh about that to this day. Silly family, we say. Such a silly idea.

Another big benefit is that I have overcome my aversion to the web camera. I used to think that the web camera was the most annoying invention known to man. I was a big phone talker-- but I never just talked on the phone. I talked and walked around the neighborhood, went down to a garden park bench, smelled the roses. I talked and cleaned my room, did the dishes, ate dinner, folded my laundry, colored with crayons. I never just sat around and talked-- something the webcam required. I hated the awkwardness of never quite obtaining eye to eye contact. I hated the angle of the camera. I hated everything about it.

Then, it became the only way for me to see the man I loved. Even now, I hate that his is 2-D when I want so much for him to seem more real, a 3-D living person I can reach out and touch. But it is better to see his handsome face in 2-D than not at all. And so I have learned to love modern technology. The web cam. Also text messages.

Also letters. I have always loved letters, the old fashioned ones, a whole whole lot. I have nothing against this almost bygone means of communication. But I love them so much more now, every time a love letter comes in the mail to me from California. Although it is a dying medium, to be sure, someday I will have a big stack of aged, yellowing letters to pull out of a drawer and show my grandchildren, and they will read of love and faith. Hopefully they will also laugh. Our letters are not about real life. They are a story. They involve characters including a talking skunk named Scooby, a marauder with the measles, an alchemist with a shady past, and a librarian named Lawrence turned from the law. Some people talk about writing a novel, but we are writing one in weekly installments, without knowing the end from the beginning. In the end, our letters will certainly be enough to fill a book.

Another blessing is that I have had a long time to mentally and emotionally prepare for marriage. This is not to say that I had not prepared before, but engagement is different. There is an actualness about the person whom you will marry once you know who they are. I worried in the past that I would not be able to make such a mental jump from independence to co-dependence in such a short time. Now I have so long to study the doctrines of marriage, to organize my life, to become emotionally ready to let a man navigate with me the closest parts of my life. The more I prepare, the more confident I become that the Robber and I can have a strong marriage and the less afraid of the marriage process I become. All this contemplation time, does, yes, allow me to recognize the reason so many of my American pairs choose not to marry. But seeing the difficulties and the fears strengthens my conviction that, with a Christ-centered marriage, these fears can be overcome and I will enter marriage with such a stronger testimony of its rightfulness than I would have if engagement had been a whirlwind of planning instead of a slow wade through patience, prayer, and pondering.

Because I have had to wait and to work, I know Bob much better now and that knowing-- of both his strengths and his weaknesses-- has engendered a deep love in my heart for him that continues to grow. I loved him when I agreed to marry him, but I love him so much more now. They say that you love those that you serve. I can't serve Bob in the usual engaged ways. I can't kiss him or hold him. I can't cook him dinner, do his dishes. I can't go with him to shop for our wedding, help him to sort through his belongings, go with him to look for apartments, and he can't do those things with me either. And so we have to find more creative ways to serve each other from afar. It is hard work. Everyone assumes that because we aren't around each other it's "easy" and we can "just focus on our studies." Maybe that is true-- but it is hard work loving and building from afar and it is time consuming working and loving all the same. But out of the sacrifice grows strength and self-discipline engenders a pattern of making time for the other person, even if they aren't currently present.

Working hard to love from afar brings an emotional, mental, and spiritual closeness that can be masked when the feelings of physical closeness are overwhelming. As we seek to be close, we must be open with our hearts and lay bare the most inner feelings of our souls. Our communication must be tender and thoughtful and sincere as there is no embrace of forgiveness. Only words. And facial expressions in 2-D. Our capacities for emotional generosity are stretched as we choose to pray for the Spirit to bind our hearts together.

Most beautifully of all, the Lord has strengthened my faith and the faith of the Robber. Neither one of us knows what will happen. But we feel continually reminded of the mindfulness of God and of His mercy. He tells us again and again that He is the Lord of the earth and Father of our souls. He speaks peace to our hearts when we cry to Him. We know that he is mindful of us and will not leave us Comfortless. The power of His Atonement has fell upon our path towards marriage and in His temple, our conviction that our covenants with Him will help us overcome all tribulation in this life grows stronger. We feel to sing the song of redeeming love, to rejoice in the salvation offered us through Christ, to move forward with faith as countless other Saints have done before us. We know that God can work miracles and trust in His hand.

Christ has given us bread. He has given me bread on days where I was starving. He has multiplied my offering and given me strength. There are still five long months of hard work, hard decisions, prayer, mighty fasting, hoping and praying for miracles ahead. I do not know how these months will pass.

But I do know, when the day comes that I am sealed to the Robber for eternity, that I will be grateful for this time of preparation and work, grateful to be able to say yes with a powerful and determined love, grateful to have confidence that the Lord is with our marriage, and grateful-- so very grateful-- to have one Robber Man sealed mine as my husband forever.

Cheer us on to the finish line.

Making The House Ready For The Lord

2010-01-21T23:15:00.002-05:00

by Mary Oliver

Dear Lord, I have swept and I have washed but
still nothing is as shining as it should be
for you. Under the sink, for example, is an
uproar of mice-- it is the season of their
many children. What shall I do? And under the eaves
and through the walls the squirrels
have gnawed their ragged entrances-- but it is the season
when they need shelter, so what shall I do? And
the raccoon limps into the kitchen and opens the cupboard
while the dog snores, the cat hugs the pillow;
what shall I do? Beautiful is the new snow falling
in the yard and the fox who is staring boldly
up the path, to the door. And still I believe you will
come, Lord: you will, when I speak to the fox,
the sparrow, the lost dog, the shivering sea-goose, know
that really I am speaking to you whenever I say,
as I do all morning and afternoon: Come in, Come in.

Goal-Setting Part 2

2010-01-20T14:53:00.001-05:00

http://www.xtranormal.com/watch/5952841

This might be my new favorite website. Thanks, SLO.

The Night In Between

2009-12-19T00:18:00.006-05:00

Last night I didn't shower and I studied until my eyes were blurry and I literally felt about to throw up with facts (oh, why not go fancy and say factoemesis, that is what doctors would call throwing up facts, they have fancy words for everything-- can you get serum concentration of facts on a lab slip?) and my eyes got puffy and then I wore my pseudo-PJs to class for my exam on the kidney.

But.

Tonight is a new night. Tonight I have no tests to study for--

and--

Tomorrow I am seeing the Robber.

So. I am painting my toenails and I have curled my hair.

The Robber won't care a fig about this. Not a fig or an acorn or a whale or even a T-Rex. He will not care a T-Rex that my hair is curled.

(This summer for the first time in my life I wore mascara and eyeshadow every day-- to her credit, my friend A. has said since high school, "R., if you would just wear mascara and pop out those baby blues you would have a boyfriend"-- but Bob swears he never noticed a thing. Nor does he notice when it's gone. He says not to wear it since it makes my eyes sting and I rub it all off by 4 p.m. anyway. So I stopped.)

Certainly my curls will be gone by 4 p.m. when my last flight gets in tomorrow afternoon. And he won't see my toes because I'll be wearing my new Christmas socks from my classmate S., which I put on while I sat by her during my exam.

But tonight is a new night. And tomorrow is a new day. And I am a new girl, and I am in love.

And girls in love curl their hair.

p.s. Book list for the airport (all new reads): Northanger Abbey by Jane Austen, Silas Marner by George Eliot, Paradise Lost by Milton, and A Whole New Mind by Eckhart Tolle. Prediction: I read the Eliot and the Austen, the first chapter of Tolle, and wish I had read the Milton.

p.p.s. I loved the Robber yesterday when I was taking my test too. Sometimes girls in love study for their lovers instead of curling their hair.

The Gingerplex

2009-12-13T19:39:00.005-05:00

Out of Control

2009-12-12T23:43:00.004-05:00

It's 11:45 p.m. and my roommates are building a gingerbread replica of our house-- The Simplex.

We call our house The Simplex because we are trying to follow the prophet. When we first moved in almost a year and a half ago we spent a few weeks trying to name our new house. During one conversation we decided we would call it The Complex-- because all we roommates just happen to be quite-- in our own estimation-- complex women.

Shortly thereafter came Fall General Conference 2008. Elder L. Tom Perry gave this talk about simplifying our lives. Food. Clothing. Shelter. Fuel. Faith. We looked around and examined our lives. What could we do to simplify? This was easy. We changed the name of our house.

Now the dining room table is covered with large slabs of flat gingerbread, packages of twisted hard candy, peppermint swirls, decorating bags, frosting. Our friends H. and A. are over and the result is squeals and peals of high-pitched laughter rising up from the kitchen. I'm upstairs, hiding from the fray, but I saw the prequel earlier during a lull where R. made her third trip to the grocery store today for more flour, sugar, and molasses. Thankfully it is not this moment snowing.

This late hour activity is part of a decorating war, rashly entered into against the house of Diddy-G and his partner in crime. How can Diddy-G possibly win? Apparently he has a whole hallway full of snowflakes. But our house already has four Christmas trees. One big one in the front window where the medical community passing by can see our Christmas cheer, a small red and gold one on the piano, a blue and white one in the dining room, and R.'s tree in her room which is covered with owl ornaments. You can see her tree, too, from the street, in the little attic window in the peak of our V roof. Of course trees are not everything. Yards of tinsel hang from the ceiling of our living room, a whole Santa village is on the mantel, a gold runner graces the dining room table, and we have a wreath and a special Christmas shoe mat.

It's possible that we also have Chinese lantern/fiesta lights, lights with glowing monkey heads, and a pink candy-cane door ornament on the entrance to the basement. Also three nutcrackers on the TV table. I've thought about adding my nutcracker to the mix, but I like him standing on my dresser upstairs by my two piggy banks (neither of which are pigs), holding his grapes and bottle of wine as a Christmas offering in case I survive my finals. I still haven't named him, but sometimes I call him Millet in my head. He arrived in a big box in the mail one day in November from Bob.

The squeals from downstairs have wonderously morphed into carols. It seems that Christmas, if not simplicity, has come to The Simplex and is here to stay.