Wednesday, November 19, 2014

"The long and winding road"

coming to the end of the road...

Long and winding; just like that song--- and it feels like a footpath for deer, now-- not easy to see how to get gracefully past the twisting switchbacks.  I am praying many more times in the day, opening the day with a sitting meditation, hands in lap, "head over shoulders" and thinking that the back should try to stay straight, and opening up into "heavenly Father, creator of the universe", and seeing that swirling cosmos across the Milky Way...  how inconsequential these political machinations seem, then; and how unimportant these issues of how to assuage my anxiety in the face of the loss of the "persona" I was trying to be, all this time.
Rachel, my friend and mentor,  has said to me that I should get out of the way, and let God do His work.  It is amazing to think I have been blocking His work, rather than trying to assist it.  But someone once said that religion is one of the best places to hide from God, from vulnerability and helplessness, and not knowing.  And it was Rachel that said "we are not the tube God shouts down through."  Sometimes we have substituted expertise for depth of commitment and integrity.
I was entranced, reading the book by Wallace Stegner, called "All the Little Live Things", how insightful he is, into the pompous mind of someone in our 60s, trying to put up with stuff we have seen before, think we understand, and perhaps unfairly wish to dismiss.  I cannot stand listening to the radio in my work place--- it sounds heinous to have whiny voices or rap singing, especially if someone has a complex problem we are trying to address.  I much prefer Bach, or quiet  "music for people without teeth" as my husband calls the MUZAK that they pipe into office buildings.  Still, a kinder,gentler universe is what we would really like to occupy.  And what I love best, still, is Palestrina.  I think now of T.S. Eliot's "Love song of J. Alfred Prufrock" --- "there will be time to murder and create;  time for the taking of toast and tea;  time for a vision and revision which a moment will reverse."  And all of that is true;  and still, one should not be silly with remembering the punctiliousness of our youth.  And yet, we must be conscious and grateful for the miraculous gift of time which we have been given, whether or not we deserved it, or can still use it well.
Now it is November, and Sebastian is almost turning 23.  I remember his birth, so awful, disastrously hard,  a mid forceps delivery and lateral vaginal wall tear all the way to the cervix, and he was in the ICU for 5 days.  I was raw, feverish, anemic, and bleeding.  Dad and Mom were in the hall, pale as ashes.  What an idiot I was to put my body through it;  but it was arrogance, pride, belief that somehow I could get through it;  and of course I made my patients do it, so it was a "holding of standards" which I was trying to do-- as if we all fit the protocols.  Now I rail against the protocols, and some days I am wiser than others, in giving up on that ephemeral vaginal delivery dream and instinct.  Greg said, "it looks like the Civil War"-- and I still remember how appalled he was!
People talk of leaving a legacy, but the whole thing of birth is tricky, humbling and humiliating,  and it is something you just have to do one at a time, and there are too many variables.  It is never the same.  And it is something which requires skill, but now it is being left to the midwives, and the whole thing of skills and seasoned judgement in obstetrics is being a bit lost, as the cesarean rates climb, and there are more and more things to worry about in the protocols, which are built so that employed hospital doctors and nurses will not take medico-legal risks--- which always is what natural childbirth IS.  We are hoisted on our petards.   I read an article this week that said it really is not possible to achieve the standard of being able to do a CSection in 30 minutes, if one is assiduously attending to the number of minutes, and all the protocols that need to be done for surgery.  Still, that poor baby---  Sebastian--- in the NICU with dents in his forehead, and his heart beating fast, after such a tough labor and forceps delivery;   I am glad he grew up to be hard-headed, and strong, and good with his hands.  It is also nice that his birthday is so close to Thanksgiving, and I do give thanks, over and over, that as old as I was-- 41, I was able to have him.  I had 5 miscarriages, and it was hard, wanting them so much, to lose them, knowing there was no solution to being old.   I am so grateful that Sebastian made it.  I think of him in that little bumble bee outfit, and the little red jeep, when he was 3 or 4.  It was such a gift to have such a happy child.  How blessed, how lucky I have been!  Whatever else, I am still so grateful for the two big gifts of my sons.
And if there is still time, I will try to write some more poems, and get that book about the Camino done.  I just haven't been able to pull myself together to get it done-- the clinical work is taking all my energy.   Although the latest Vienna reunion in Southern California was so wonderful;  and I got the time boogie-boarding, and the walking on the beach, which always has helped revive me.
This week I read a blog about physician suicide, and a man wanted to know if it was possible to find a doctor who is HAPPY?  I think maybe only the doctors who are in smaller towns, where they are still known, and have a stable life, and haven't had their wives divorce them, or their husbands, if they are women,  and whose kids are not strung out on drugs are really happy.  Some of the docs I know are glad to have carved a life which is bearable in a big corporate structure, and they get paid enough to go on nice vacations.  They are learning how to work in teams, and have enough back-up so that they aren't completely missing from family life, and somehow the corporations are paying enough.  So I guess you could say they are happy.  But happiness is ephemeral,  and maybe they are having a beast of a time, in some other facet of their lives.  I know for me, that the hell of the computer system has broken my spirit.  The thing freezes, it is awkward, and I cannot type quickly, and there is too much to do to fix each chart.  And I do not want to do it in front of the patient, or have to interact with it instead of with the patient.  So I sit there long after everyone has gone home, trying to get the charts right.   And the big corporate practice near here has a better, more expensive system,  which fills in the blanks in a way which makes it easier to bill the insurance-- which they can afford, but small practices like ours cannot afford.  And the insurance companies and the pharmaceutical companies are running away with the store--- so that doctors and patients are all at their mercy, and they do not want to let me give my patients estrogen even if they need it, and the husbands are able to get Viagra. So we still are dealing with the ongoing structural inequality between men and women, and all that that entails.  But I know, and the patients know, that we are trying to keep them as healthy as we can, and meet as many of their needs as we can, given all these uncertainties and inequities.  And the patients understand that it matters, that the doctor actually KNOWS them.  And CARES.  So here I am, at almost-the-end of the long and winding road, in what has begun to look like a deer-path;  saying my prayers, hoping for the best, putting it into God's hands.