I have been reading the book by Ann Voskamp, called "One Thousand Gifts." It is a great book, with some slightly difficult phrases, but also some very sharply pungent metaphors, which aim at deepening her own spirituality and consciousness, as she reflects on her life as a busy farmer's wife, a mother of 6 children, and a person of faith, who is trying to go deeper. She uses the tool of writing down gifts. Her lists-- the few things on it which she actually tells us, and her thoughts are intense and poetic, and well-educated and well-informed. She is the kind of person one wants to be. She is able to slow herself down, in times of intense emotions and busyness, by going into deep and true gratitude for gifts given-- the slant of light on the walls and floors of her farmhouse, the way the soap bubbles look iridescent on her hands as she does dishes. The book centers on several thoughts which are the ballast of Christian theology, the idea of Eucharisteo-- taking bread, giving thanks, being present to the great presence of God as the beloved who fills our longing with plentiful grace and perfect joy. But she has such clarity about the ways we forget to be open to that love, open to that way of seeing.
I started my own list, which this week, (early February) contains chiefly the gift of rain. We are in the 3rd year of drought in California, and we need buckets and buckets of rain; enough rain to replenish the aquifers, to help the salmon have enough water to get downstream to the sea, and back again; enough water to help the crops. The redwood trees seem to be standing taller, more gracefully green, more openly embracing the drizzle which is letting them breathe and unfurl their beauty. We have the Soquel cherry trees blooming on Old San Jose Rd, right on schedule. Their frilly pink blooms always seem to come too early, but then I realize it is February, and they know better than I when it is time for them to go onstage! I am also watching the bridal plum tree open its dazzling white blossoms, now covered with diamond-bright raindrops. And this week, in my family, our German exchange student/son came to visit, cementing now 19 years of friendship with us. He has always been like an older brother to my boys; and he loves Point Lobos like I do, so we were able to rejoice that we got to make it down there--- and even though the day was blustery, the beauty of it has not been lost on us. We stopped at the beach at Marina, which was not being rained on, although we could see storm clouds over both ends of the bay, and Jan was so glad to get to dip his toes in the Pacific ocean, and walk a bit on the strand. To appreciate the seasons, the way the rain has come finally, the way we have had to tuck ourselves into winter again, to be waiting for the harbingers of spring, and to start working on this gratitude list, trying to pay attention with more grace, more patience, more humility, and yes, more love, is my hope.
Sunday, February 9, 2014
Monday, October 28, 2013
Justice, Charity, Healthcare and the U.S. Constitution
Justice, Charity Healthcare and the U.S. Constitution
I promised my friend Danielle, that I would try to write something which I think is not being very clearly stated in the public dialogue around the politics of the Affordable Care Act (which should perhaps have been called National Health Care). The Constitution of the United States is a very supple document; a blue-print, establishing the way our government is supposed to run. It has this nice balance between the Houses of Congress, and the Judiciary and the Administrative branches. I am pretty rueful that most high schools no longer offer civics classes, or American government. In my school years, it was mandatory that students begin to learn and try to understand their role in our government. This became even more urgent to me, when we were going through the Watergate scandal and the impeachment of President Nixon, while I was in the Peace Corps. It was inconceivable to the Paraguayans, and the strongest possible argument that we actually ARE a democracy, when we told them that none of us had voted for him, and almost all of us were opposed to our role in Viet Nam. They could hardly believe it would be possible to get a job for a government when you voted for the other party.
The United States Constitution starts out "We the people, in order to form a more perfect union" and goes on to list other vital parts of the functions of government, including "provide for the general welfare".
When conservatives say they uphold the Constitution, I think they are actually LYING-- in so far as they do not want to "provide for the general welfare" through the establishment of national health care. The idea of forming a "more perfect union" is that the society over time should be improved. We the people want to have a seamless interaction as much as possible, in getting the most out of the social interactions as citizens. We understand that some of what we want may take time, and needs to be worked toward. When the Emancipation proclamation happened, President Lincoln knew that it was the most important legal thing that had happened to the country since the beginning of the nation, and that it had to be ratified to keep the country together, and for the nation to function. They had to pound it out, in the blood, sweat and tears of the Civil War.
Lately we have had the evidence that the taxpayers had to bail out the banks, in the 2008 crash, to the tune of something like 80 billion dollars, because that is how the whole banking world worked, and no one wanted to watch the financial ruin of the country and possibly the whole world. We also have seen that companies like Walmart are paying their workers sub-standard wages, which force the workers to need food stamps and Medicaid--- effectively putting them into needing to be SUBSIDIZED by the taxpayers for the basic necessities of life.
The other thing that we know is that Social Security has been a great boon to the elders in our country. Prior to Social Security, a few people had enough income saved up for their retirement years, but most people either died soon after retiring, or became dependent on their children-- needing them to earn the means of continuing to provide for the elders as they aged. Many were living in penury. The Bible speaks often of the duty of providing for the widows and the orphans. The widows are the elder women, who were dependent for food, housing, healthcare-- and often were so self-effacing that they would die of anemia due to eating only tea and toast. No sweet granny would want to take the food from the mouths of her grandchildren, and food scarcity persists in being one of the very difficult things for people in poverty. As Americans have stayed healthy into their 70's and 80's, their needs for adequate food, medical care and housing have also expanded past the time of natural retirement.
When the ACA was proposed, the conservatives refused to let the idea of a Single Payer medical system even come to a vote. The kind of system that Medicare is, which had an overhead of 2% administrative costs, is the most efficient and cost-effective--- FOR the taxpayers, who are THE PEOPLE, who are trying to form a more perfect union. The insurance mega-business forced the Congress to keep them in the loop, instead of cutting them out. Many insurance companies take 40, 50 or 60% profits from the dollars paid for the healthcare policies people buy. The problem also was made worse because some of the cost was offset by businesses, on behalf of employees, for SOME of the employees, in SOME of the companies.
Health care costs rose for many reasons-- the aging of the population, the increase in effective and sophisticated medications which could save lives, more expensive healthcare in hospitals and nursing homes; and ALSO, the increased administrative overhead-- which profits led many people to have good returns on investments in the healthcare sector of the stock market.
There were doctors and many people from many walks of life benefitting in each part of this system, and so it was difficult to tease out what the truth is, for the WHOLE society to see.
Still, many doctors believed and fought for the ACCESS to care--- because poor patients would not even come to see a doctor if they couldn't pay for the visit, or the medications. Different states had different rules and variable strength of their Medicaid programs. Also, about 40 years ago, in order to lower costs, the mental healthcare needs were SEPARATED from the total healthcare needs of patients, so most mentally ill people had NO care, as most of them were poor, due to their diseases; and many doctors who would otherwise have treated these patients, could not afford to take care of them, in their dire poverty.
So to me, the answer had to come from that first sentence in the Constitution, that WE THE PEOPLE, in order to FORM A MORE PERFECT UNION, would endeavor to provide more reasonable healthcare to the WHOLE population. As the ACA gained momentum, the insurance giants wanted to keep their power and money, so they gave a little, in order to gain a lot--- the law would force everyone to purchase insurance. The doctors in every medical society and in every specialty tried to see how to help themselves stay solvent, and still be able to see the patients they needed to see, with rules which are medically sound. In states where there are more progressive doctors, like California, and where systems like Kaiser Permanente had already built a program with "economies-of-scale" to help keep costs down, it was reasonable to use their data as the benchmarks for the new rules of engagement. At least for the beginning, it would allow a predictable assessment of costs, and a way to tell people how to compare "apples-to-apples" in what they were being promised in the healthcare exchanges. Finally there would be transparency, and at least some real competition between the big insurers.
Now as we go forward, the smaller frictions are going to have to be ironed out, also depending for vitality on that urge to "form a more perfect union" and to "provide for the general welfare". For the last 4 years, we have been waiting with baited breath for January 2014, hoping people will not die while waiting for the exchanges to open up, and hoping that families will not go into bankruptcy as someone becomes significantly ill.
Those of us in gynecology and obstetrics were adamant that women's health be covered--- pregnancy and miscarriages, and pediatric care of premature babies can be super-expensive. Family planning is expensive, as the pharmaceutical industry got HUGE concessions, which allow them to charge top dollar for things which should have been under "economies-of-scale" bargaining.
As we go forward, the new science of "Health Care Delivery"--- as defined by Paul Farmer MD and Jim Kim MD at Partners in Health and for the World Bank will help change the economics to make sense of the concepts of economies of scale. I believe this will bring in a whole new era of cost-reduction, and that PUBLIC HEALTH will again be the queen of the sciences. Our attempts during the past 20 years to get to this moment, looking at the future of healthcare FOR ALL, will seem like bumbling around in the wilderness, like the journey in the desert in the Book of Exodus.
I rejoice, that of all the unfairness of the last 100 years, the failure to address the needs of patients for mental healthcare are finally about to be addressed: to become part of their total healthcare. We are not going to act like people are jigsaw puzzles, and only certain parts are worthy of our medical attention.
Physicians are also scrambling to avoid bankruptcy, as many of the older ways of practicing medicine are dying. We are fearful and anxious. But the doctor-patient relationships will come back, stronger than ever, when we actually ARE COVERING the WHOLE patient! As a woman in medicine, I am glad to have lived long enough to see some of the changes which will help doctors to also be healthier and more sane, and to have healthier families.
I do believe we will have to hold onto our hopes and dreams, as the new system is tried, and as new problems, which will not have been anticipated, need to be ironed out. The whole thing is do-able, as long as WE THE PEOPLE, intend to FORM "a more perfect union". The intentionality is paramount. We cannot assume that people who are fighting for their own piece of the jigsaw puzzle actually SEE the whole picture. So I believe it is a good idea to keep that sentence in mind. It is a good idea to remind ourselves and each other, that NO other government in history has accomplished so much for its citizens, in such a short time. We MUST continue to cooperate, in order to live up to the promise our founding fathers could barely begin to see.
The United States' Constitution gives us a mandate, and a framework. We have work to do; and the work we do will help us be a light to the nations.
I promised my friend Danielle, that I would try to write something which I think is not being very clearly stated in the public dialogue around the politics of the Affordable Care Act (which should perhaps have been called National Health Care). The Constitution of the United States is a very supple document; a blue-print, establishing the way our government is supposed to run. It has this nice balance between the Houses of Congress, and the Judiciary and the Administrative branches. I am pretty rueful that most high schools no longer offer civics classes, or American government. In my school years, it was mandatory that students begin to learn and try to understand their role in our government. This became even more urgent to me, when we were going through the Watergate scandal and the impeachment of President Nixon, while I was in the Peace Corps. It was inconceivable to the Paraguayans, and the strongest possible argument that we actually ARE a democracy, when we told them that none of us had voted for him, and almost all of us were opposed to our role in Viet Nam. They could hardly believe it would be possible to get a job for a government when you voted for the other party.
The United States Constitution starts out "We the people, in order to form a more perfect union" and goes on to list other vital parts of the functions of government, including "provide for the general welfare".
When conservatives say they uphold the Constitution, I think they are actually LYING-- in so far as they do not want to "provide for the general welfare" through the establishment of national health care. The idea of forming a "more perfect union" is that the society over time should be improved. We the people want to have a seamless interaction as much as possible, in getting the most out of the social interactions as citizens. We understand that some of what we want may take time, and needs to be worked toward. When the Emancipation proclamation happened, President Lincoln knew that it was the most important legal thing that had happened to the country since the beginning of the nation, and that it had to be ratified to keep the country together, and for the nation to function. They had to pound it out, in the blood, sweat and tears of the Civil War.
Lately we have had the evidence that the taxpayers had to bail out the banks, in the 2008 crash, to the tune of something like 80 billion dollars, because that is how the whole banking world worked, and no one wanted to watch the financial ruin of the country and possibly the whole world. We also have seen that companies like Walmart are paying their workers sub-standard wages, which force the workers to need food stamps and Medicaid--- effectively putting them into needing to be SUBSIDIZED by the taxpayers for the basic necessities of life.
The other thing that we know is that Social Security has been a great boon to the elders in our country. Prior to Social Security, a few people had enough income saved up for their retirement years, but most people either died soon after retiring, or became dependent on their children-- needing them to earn the means of continuing to provide for the elders as they aged. Many were living in penury. The Bible speaks often of the duty of providing for the widows and the orphans. The widows are the elder women, who were dependent for food, housing, healthcare-- and often were so self-effacing that they would die of anemia due to eating only tea and toast. No sweet granny would want to take the food from the mouths of her grandchildren, and food scarcity persists in being one of the very difficult things for people in poverty. As Americans have stayed healthy into their 70's and 80's, their needs for adequate food, medical care and housing have also expanded past the time of natural retirement.
When the ACA was proposed, the conservatives refused to let the idea of a Single Payer medical system even come to a vote. The kind of system that Medicare is, which had an overhead of 2% administrative costs, is the most efficient and cost-effective--- FOR the taxpayers, who are THE PEOPLE, who are trying to form a more perfect union. The insurance mega-business forced the Congress to keep them in the loop, instead of cutting them out. Many insurance companies take 40, 50 or 60% profits from the dollars paid for the healthcare policies people buy. The problem also was made worse because some of the cost was offset by businesses, on behalf of employees, for SOME of the employees, in SOME of the companies.
Health care costs rose for many reasons-- the aging of the population, the increase in effective and sophisticated medications which could save lives, more expensive healthcare in hospitals and nursing homes; and ALSO, the increased administrative overhead-- which profits led many people to have good returns on investments in the healthcare sector of the stock market.
There were doctors and many people from many walks of life benefitting in each part of this system, and so it was difficult to tease out what the truth is, for the WHOLE society to see.
Still, many doctors believed and fought for the ACCESS to care--- because poor patients would not even come to see a doctor if they couldn't pay for the visit, or the medications. Different states had different rules and variable strength of their Medicaid programs. Also, about 40 years ago, in order to lower costs, the mental healthcare needs were SEPARATED from the total healthcare needs of patients, so most mentally ill people had NO care, as most of them were poor, due to their diseases; and many doctors who would otherwise have treated these patients, could not afford to take care of them, in their dire poverty.
So to me, the answer had to come from that first sentence in the Constitution, that WE THE PEOPLE, in order to FORM A MORE PERFECT UNION, would endeavor to provide more reasonable healthcare to the WHOLE population. As the ACA gained momentum, the insurance giants wanted to keep their power and money, so they gave a little, in order to gain a lot--- the law would force everyone to purchase insurance. The doctors in every medical society and in every specialty tried to see how to help themselves stay solvent, and still be able to see the patients they needed to see, with rules which are medically sound. In states where there are more progressive doctors, like California, and where systems like Kaiser Permanente had already built a program with "economies-of-scale" to help keep costs down, it was reasonable to use their data as the benchmarks for the new rules of engagement. At least for the beginning, it would allow a predictable assessment of costs, and a way to tell people how to compare "apples-to-apples" in what they were being promised in the healthcare exchanges. Finally there would be transparency, and at least some real competition between the big insurers.
Now as we go forward, the smaller frictions are going to have to be ironed out, also depending for vitality on that urge to "form a more perfect union" and to "provide for the general welfare". For the last 4 years, we have been waiting with baited breath for January 2014, hoping people will not die while waiting for the exchanges to open up, and hoping that families will not go into bankruptcy as someone becomes significantly ill.
Those of us in gynecology and obstetrics were adamant that women's health be covered--- pregnancy and miscarriages, and pediatric care of premature babies can be super-expensive. Family planning is expensive, as the pharmaceutical industry got HUGE concessions, which allow them to charge top dollar for things which should have been under "economies-of-scale" bargaining.
As we go forward, the new science of "Health Care Delivery"--- as defined by Paul Farmer MD and Jim Kim MD at Partners in Health and for the World Bank will help change the economics to make sense of the concepts of economies of scale. I believe this will bring in a whole new era of cost-reduction, and that PUBLIC HEALTH will again be the queen of the sciences. Our attempts during the past 20 years to get to this moment, looking at the future of healthcare FOR ALL, will seem like bumbling around in the wilderness, like the journey in the desert in the Book of Exodus.
I rejoice, that of all the unfairness of the last 100 years, the failure to address the needs of patients for mental healthcare are finally about to be addressed: to become part of their total healthcare. We are not going to act like people are jigsaw puzzles, and only certain parts are worthy of our medical attention.
Physicians are also scrambling to avoid bankruptcy, as many of the older ways of practicing medicine are dying. We are fearful and anxious. But the doctor-patient relationships will come back, stronger than ever, when we actually ARE COVERING the WHOLE patient! As a woman in medicine, I am glad to have lived long enough to see some of the changes which will help doctors to also be healthier and more sane, and to have healthier families.
I do believe we will have to hold onto our hopes and dreams, as the new system is tried, and as new problems, which will not have been anticipated, need to be ironed out. The whole thing is do-able, as long as WE THE PEOPLE, intend to FORM "a more perfect union". The intentionality is paramount. We cannot assume that people who are fighting for their own piece of the jigsaw puzzle actually SEE the whole picture. So I believe it is a good idea to keep that sentence in mind. It is a good idea to remind ourselves and each other, that NO other government in history has accomplished so much for its citizens, in such a short time. We MUST continue to cooperate, in order to live up to the promise our founding fathers could barely begin to see.
The United States' Constitution gives us a mandate, and a framework. We have work to do; and the work we do will help us be a light to the nations.
Tuesday, June 25, 2013
Thinking about the book "A Constellation of Vital Phenomena" by Anthony Marra
One of the great things about a brand-new fresh book from a young author is that no one has said much about it yet. One can consider what it means, without overlays of other people's interpretations already coloring the landscape. This book is extremely rich, luminous, full-bodied. It is a once-in-a-great while achievement. I am still compelled to think about it, all the parts of it, as well as the whole. It has not faded, but is like the glowing embers of a fire, which was a bonfire of sumptuous proportions.
I must say that I love to read. I have re-read Anna Karenina 4 times, and War and Peace twice. I have read Checkhov's stories at least 3 times, Doestoevsky (the Brothers K) twice. So the potential connections to Russian literature, which were what drove Anthony Marra to visit St. Petersburg in school, and possibly to writing in the first place, are not completely lost on me. And I will also say that I love children's books, and am a big fan of the Harry Potter books by J.K. Rowling. What I love about the best books is how they help hone one's consciousness about what it is to be a human being. Tolstoy is the greatest writer, still, because of his ability to show so many textures and colors to any scene that it comes "alive"-- his cinematography shows us when a smile is enigmatic, when it is delighted, when it is ironic. And he is able to follow the thoughts of so many persons, of so many psychological bents, so amazingly well! But the depth charge is always to ring the bell of the conscience, to hone recognition of the soul, the needs of the soul, the peculiar growth of the soul.
The big theme in this book, for me, is the story of Abraham and Isaac. It is all the more interesting because the culture he writes about in Chechnya is Islamic. The people are Abrahamic. He is writing about the way humans behave in a time of war, in a fringe area of a terrible devastation, with a huge sense of defeat, and invasion, and bullying. There is no victory, there are no victors, there is no "rightness' to the geopolitical landscape in which the story is set. One could call it a wilderness, with brambles. It is very post-modern; the landmines, the urban orphans scavenging, the hopeless question of whether it is federal troops or guerrilla warfare-revolutionaries doing the bullying, and how in so many ways, it doesn't matter. It is also very post-modern in that the main character for "stability" is a woman surgeon, trying to keep a hospital going, and who has calluses on her hands, from using the bone saw to amputate all the victims whose legs have been blown to smithereens.
The two stories of the child-parent bond, are Dokka and his daughter Havaa; and Khassan and his son Ramzan. They amplify and resonate and clash with each other. The amazing amazing thing, is that the ultimate question is whether to help a child live, or to destroy the child. It is this fundamental question, which I think is the underpinning of the JK Rowling books also. And the question is the soul's question. And I think for all of time, I will see that small piece of paper which Akhmed has left for Khassan, with the word "mercy".
We are absorbed, many of us, with the problems of PTSD, of torture and its sequelae. We are also absorbed with prostitution, drug-addiction and the hellish power of the procurers of whatever can be sold; guns, drugs and people. Against the backdrop of a time-immemorial landscape of the hills one heads for when there's political trouble (the Caucasus); where there are forests, snow, no electricity, minimal roads, and minimal access to modern conveniences, there are only the ballast of story-telling, hearsay, rumor, memories, and the ways we treat each other. The landscape helps throw the human behavior into stark relief.
There are severe mercies, in this book. There are immense beauties. The writing is like a summer field full of fireflies. The memory Khassan writes, of Dokka peeling plums is shimmeringly lovely. It is then even harder to bear the crippling of his hands. I love the description of Havaa's birth, and of how Natasha comes back to life as she helps mothers with birthing, with new babies. I love the way Akhmed gives his wife a bath. The soul lessons are about the simplicity of kindness, the costliness of compassion, and the gift of freedom from bullying, from becoming the thing you hate. And even at the landfill, dancing for joy, as we know that the child has been saved. There are things about friendship, and love, and the things we hold dear, even through immense suffering. And I think one of the great gifts of this book is to recognize that the ones who are tortured can still refuse to become the torturers. We can understand the reasons, and still say no. It is in this that Marra's book resembles the way Tolstoy wrote, to me. There is the old-fashioned kind of honor in it, which is durable, time-immemorial. When I went to the bookstore reading here in Santa Cruz, a lady said "I resent you for making me understand and care about the bully." I thought that was a great compliment. We cannot drop down into black-and-white thinking, and we need to pray for mercy, for humility, for help to reach for the better way to be.
I must say that I love to read. I have re-read Anna Karenina 4 times, and War and Peace twice. I have read Checkhov's stories at least 3 times, Doestoevsky (the Brothers K) twice. So the potential connections to Russian literature, which were what drove Anthony Marra to visit St. Petersburg in school, and possibly to writing in the first place, are not completely lost on me. And I will also say that I love children's books, and am a big fan of the Harry Potter books by J.K. Rowling. What I love about the best books is how they help hone one's consciousness about what it is to be a human being. Tolstoy is the greatest writer, still, because of his ability to show so many textures and colors to any scene that it comes "alive"-- his cinematography shows us when a smile is enigmatic, when it is delighted, when it is ironic. And he is able to follow the thoughts of so many persons, of so many psychological bents, so amazingly well! But the depth charge is always to ring the bell of the conscience, to hone recognition of the soul, the needs of the soul, the peculiar growth of the soul.
The big theme in this book, for me, is the story of Abraham and Isaac. It is all the more interesting because the culture he writes about in Chechnya is Islamic. The people are Abrahamic. He is writing about the way humans behave in a time of war, in a fringe area of a terrible devastation, with a huge sense of defeat, and invasion, and bullying. There is no victory, there are no victors, there is no "rightness' to the geopolitical landscape in which the story is set. One could call it a wilderness, with brambles. It is very post-modern; the landmines, the urban orphans scavenging, the hopeless question of whether it is federal troops or guerrilla warfare-revolutionaries doing the bullying, and how in so many ways, it doesn't matter. It is also very post-modern in that the main character for "stability" is a woman surgeon, trying to keep a hospital going, and who has calluses on her hands, from using the bone saw to amputate all the victims whose legs have been blown to smithereens.
The two stories of the child-parent bond, are Dokka and his daughter Havaa; and Khassan and his son Ramzan. They amplify and resonate and clash with each other. The amazing amazing thing, is that the ultimate question is whether to help a child live, or to destroy the child. It is this fundamental question, which I think is the underpinning of the JK Rowling books also. And the question is the soul's question. And I think for all of time, I will see that small piece of paper which Akhmed has left for Khassan, with the word "mercy".
We are absorbed, many of us, with the problems of PTSD, of torture and its sequelae. We are also absorbed with prostitution, drug-addiction and the hellish power of the procurers of whatever can be sold; guns, drugs and people. Against the backdrop of a time-immemorial landscape of the hills one heads for when there's political trouble (the Caucasus); where there are forests, snow, no electricity, minimal roads, and minimal access to modern conveniences, there are only the ballast of story-telling, hearsay, rumor, memories, and the ways we treat each other. The landscape helps throw the human behavior into stark relief.
There are severe mercies, in this book. There are immense beauties. The writing is like a summer field full of fireflies. The memory Khassan writes, of Dokka peeling plums is shimmeringly lovely. It is then even harder to bear the crippling of his hands. I love the description of Havaa's birth, and of how Natasha comes back to life as she helps mothers with birthing, with new babies. I love the way Akhmed gives his wife a bath. The soul lessons are about the simplicity of kindness, the costliness of compassion, and the gift of freedom from bullying, from becoming the thing you hate. And even at the landfill, dancing for joy, as we know that the child has been saved. There are things about friendship, and love, and the things we hold dear, even through immense suffering. And I think one of the great gifts of this book is to recognize that the ones who are tortured can still refuse to become the torturers. We can understand the reasons, and still say no. It is in this that Marra's book resembles the way Tolstoy wrote, to me. There is the old-fashioned kind of honor in it, which is durable, time-immemorial. When I went to the bookstore reading here in Santa Cruz, a lady said "I resent you for making me understand and care about the bully." I thought that was a great compliment. We cannot drop down into black-and-white thinking, and we need to pray for mercy, for humility, for help to reach for the better way to be.
Saturday, June 15, 2013
Obstetrics, Gardening, and the ribbon of Time
I have been thinking about time. I started thinking about it when I was in college, and read a book by Henri Bergson, trying to talk about how time is one of the most important construction elements in our minds, our experience, our sense of ourselves in the world. Time is what makes history a progression, a sequence, not just an endless morass. I realize now, as a middle-aged obstetrician, that most of the day I am thinking about the future--- about 9 months from the beginning of the pregnancy of the woman in front of me--- I am aiming my thoughts at that date. Right now, people are coming in who are due in 2014, in the spring. I have one dear young woman who is due in January, so I was just saying to her that she could be Mary in the Christmas play this year. I start thinking about Christmas, and the fullness of time, of delivering the baby.
I have decided to publish my book of poems "the Rose Windows in the Cathedral of Mary". This set of poems was written in 1994, just before the death of my father. He was able to hear them, listening deeply to me read them. He loved them, and loved that I was finally able to reclaim the metaphorical side of myself, to make this collection of poems. I read the last one, "the Assumption of Mary", at his funeral. I was thinking about the life of Mary, who is a paradigm of women, women having babies, women trying to be good mothers, and to discern what their children need. This year was the year of graduation from high school of my nieces, Katherine and Margaret. It is the end of the era of raising children, in my generation. Now they are all adults, and ready to embark on careers, marriages, ongoing educational goals. Time marches on.
My husband is reading about John Montgomery-- and the beginning of the era of flying machines. Montgomery was a great inventor, and invented the propeller, and the curved wing, for airplanes. One of the buildings at our university (Santa Clara) was named for him. They tore it down, several years after we left, to make room for the theatre. One hundred years has changed California so much! I am thinking often about my grandmother, and her songs, and the era in which she was raised. It is that same time, when Montgomery was building flying machines. My grandmother was born in 1892. History is unique, and themes repeat themselves over time.
What I meant to say was that obstetrics is like gardening, which is always aimed at the seasons, the potential for growth, and when things may flower or bear fruit. We need to put things in the right place, to get water and light, and sufficient nutrients, and then keep an eye on them as they grow. I have a little dwarf Meyer lemon tree, which we bring inside when it is cold, so it won't freeze. I was ecstatic that this year, as we carried it back outside, it has two little yellow lemons on it. I have been reluctant to pick them-- watching to see when they are truly ripe. Obstetrics is like this too--- waiting for labor, waiting until the cervix is ripe, and the womb begins to open, to be ready to deliver the baby. This is different from other fields in medicine, in which it is the NOW which matters-- the problem is acute, and needs to be addressed urgently. I am looking at the bridal plum tree, outside my window. It is mid June, and the plums are green. It usually is late July when they are so ripe, and so loaded on the tree, that I go into anxiety about making jam, and can not rest easy until I have tried to deal with the fruit. I cannot just let it fall and rot. Maybe when I am older, I will be sitting here, and be willing to let them fall and rot-- but most likely I will be begging someone to come and make jam from them. No one else near me seems to feel this urgency about the fruit on the trees. For this reason, I believe it is from my maternal lineage, from the Native Americans or Mexicans, from the mitochondria in my cells, that I have this insistent alarm clock about the time for ripeness. I wake in the night, knowing it is time for a baby to come. The nurses ask "how do you know?"-- maybe it is from attending many, many labors, but I know people in my field who don't seem to have this acute sense of the time of labor. Right now is the time of petunias blooming full-bore. I love to be on the deck looking at them. My dad was a person who loved wild colors in the garden, and who tried to make the garden look like a painting. When I saw Monet's garden in Giverny, it was like saying hello to my dad. There is a kiss in it-- for the eyes, for the heart, of one who loves color, light, texture, blossoms, amazing color schemes and overlapping shadows. I will post a photo, of the blooming petunias, and of last years' ripe plums. Sometimes, the time stretches out, like Isis on the deck, and labors sometimes take a long time getting into high-gear. Time is not always with the same amount of weight, of gravity, moment by moment. And there are times when it is just like "A Hundred Years of Solitude" by Gabriel Garcia Marquez, when it is all confluent, and the same thing over and over, in comforting familiarity, but with just minor differences, like trying new spices on a favorite dish. One does not have to be bludgeoned by future shock, strangeness and newness.
I have been reading off and on, a book called "Poets and the Psalms". This is an interesting book, with different poets talking about how the psalms have affected them, run through their lives, with little ribbons of repetition; of comfort, of challenge, and occasionally, the perfect words for the particular agony we are experiencing. Perhaps, because of this, I have come to love my cd of the music of Palestrina --- "Gloria Dei Cantores" the most of all the music I listen to. It is overlapping, shimmering rainbows of sound, which is actually a mass being sung, but there is a feeling of timelessness. It is like ripe fruit, holding everything-- a hologram, a sacrament, a quintessence, and it opens that wide eternal NOW, breathing room for the soul.
I have decided to publish my book of poems "the Rose Windows in the Cathedral of Mary". This set of poems was written in 1994, just before the death of my father. He was able to hear them, listening deeply to me read them. He loved them, and loved that I was finally able to reclaim the metaphorical side of myself, to make this collection of poems. I read the last one, "the Assumption of Mary", at his funeral. I was thinking about the life of Mary, who is a paradigm of women, women having babies, women trying to be good mothers, and to discern what their children need. This year was the year of graduation from high school of my nieces, Katherine and Margaret. It is the end of the era of raising children, in my generation. Now they are all adults, and ready to embark on careers, marriages, ongoing educational goals. Time marches on.
My husband is reading about John Montgomery-- and the beginning of the era of flying machines. Montgomery was a great inventor, and invented the propeller, and the curved wing, for airplanes. One of the buildings at our university (Santa Clara) was named for him. They tore it down, several years after we left, to make room for the theatre. One hundred years has changed California so much! I am thinking often about my grandmother, and her songs, and the era in which she was raised. It is that same time, when Montgomery was building flying machines. My grandmother was born in 1892. History is unique, and themes repeat themselves over time.
What I meant to say was that obstetrics is like gardening, which is always aimed at the seasons, the potential for growth, and when things may flower or bear fruit. We need to put things in the right place, to get water and light, and sufficient nutrients, and then keep an eye on them as they grow. I have a little dwarf Meyer lemon tree, which we bring inside when it is cold, so it won't freeze. I was ecstatic that this year, as we carried it back outside, it has two little yellow lemons on it. I have been reluctant to pick them-- watching to see when they are truly ripe. Obstetrics is like this too--- waiting for labor, waiting until the cervix is ripe, and the womb begins to open, to be ready to deliver the baby. This is different from other fields in medicine, in which it is the NOW which matters-- the problem is acute, and needs to be addressed urgently. I am looking at the bridal plum tree, outside my window. It is mid June, and the plums are green. It usually is late July when they are so ripe, and so loaded on the tree, that I go into anxiety about making jam, and can not rest easy until I have tried to deal with the fruit. I cannot just let it fall and rot. Maybe when I am older, I will be sitting here, and be willing to let them fall and rot-- but most likely I will be begging someone to come and make jam from them. No one else near me seems to feel this urgency about the fruit on the trees. For this reason, I believe it is from my maternal lineage, from the Native Americans or Mexicans, from the mitochondria in my cells, that I have this insistent alarm clock about the time for ripeness. I wake in the night, knowing it is time for a baby to come. The nurses ask "how do you know?"-- maybe it is from attending many, many labors, but I know people in my field who don't seem to have this acute sense of the time of labor. Right now is the time of petunias blooming full-bore. I love to be on the deck looking at them. My dad was a person who loved wild colors in the garden, and who tried to make the garden look like a painting. When I saw Monet's garden in Giverny, it was like saying hello to my dad. There is a kiss in it-- for the eyes, for the heart, of one who loves color, light, texture, blossoms, amazing color schemes and overlapping shadows. I will post a photo, of the blooming petunias, and of last years' ripe plums. Sometimes, the time stretches out, like Isis on the deck, and labors sometimes take a long time getting into high-gear. Time is not always with the same amount of weight, of gravity, moment by moment. And there are times when it is just like "A Hundred Years of Solitude" by Gabriel Garcia Marquez, when it is all confluent, and the same thing over and over, in comforting familiarity, but with just minor differences, like trying new spices on a favorite dish. One does not have to be bludgeoned by future shock, strangeness and newness.
I have been reading off and on, a book called "Poets and the Psalms". This is an interesting book, with different poets talking about how the psalms have affected them, run through their lives, with little ribbons of repetition; of comfort, of challenge, and occasionally, the perfect words for the particular agony we are experiencing. Perhaps, because of this, I have come to love my cd of the music of Palestrina --- "Gloria Dei Cantores" the most of all the music I listen to. It is overlapping, shimmering rainbows of sound, which is actually a mass being sung, but there is a feeling of timelessness. It is like ripe fruit, holding everything-- a hologram, a sacrament, a quintessence, and it opens that wide eternal NOW, breathing room for the soul.
Monday, May 27, 2013
Diane Lindsay is visiting. We have been talking about that deep prayerful connection to the God who is beyond all telling, who is the upwelling of the creative and healthy and joy-filled Spirit. It is a miracle to have a friend come to visit, to have such a conversation, to sit on the balcony, to listen to birdsong, to watch the hawks over the redwood trees, to be able to walk on the beach with Isis, and to eat grapefruit which is ripe and juicy! Yesterday Diane played Nana's piano for me-- it is a Chickering, and about 100 years old. The insides got rebuilt about 15 years ago, by a lovely piano-builder here, named Beth. It sounds so great! Diane played my grandmother's songs. They are also 100 years old, and they belong with this piano. It is a waking dream, a miracle, that I am here, listening to this music, which I so dearly love. I am remembering, and I am remembering all the soldiers who have given their lives for our country. God bless them! I hope for them a true heaven, a place of infinite fun. Not just peace, because for some, peace sounds boring. But for the kind of peace which is fun, and truly heavenly! Today I am feeling that grace, which is the joy and peace and miraculous fullness. I so wish it for everyone, especially for those who have given their lives in service.
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