We are never broken

Barb (of So The Thing Is... fame) has a new blog, called Listening for a Change, about finding joy in the everyday. I love and highly support this idea.

There's a Jungian concept called synchronicity, wherein two events that seem causally unrelated occur together in some sort of meaningful way, which (this is where it differs from coincidence) belies a larger system at work. I've been thinking about this a lot lately, for a number of reasons, some of them a bit spooky.

This comes up again with Barb's most recent post, Hands. Watching my mom after the stroke, doing three hours of PT and OT every day, struggling to find ways to do the smallest tasks with her right hand that would normally be so mindless... It's remarkable to watch her and her fellow rehab patients. We have ways to adapt the world to them, to a degree (like how yesterday I couldn't find a spoon that didn't have a giant grip adjuster on it). We have ways to help them adapt to the world, to an extent (walkers and wheelchairs and sock pullers and grabbers). But nothing is the same. Even her left arm is a little weaker, which is common after a contralateral brain injury. But it makes you slow down and think about a lot that we take for granted. Like being able to type this blog post - my mom has been an executive secretary for close to 45 years. Her first sign that something was amiss was when she lost her ability to type. Subsequently, she lost her ability to read, to walk, to understand language as well as she had, to do such simple things as dress herself. It's been a humbling experience, certainly for her, but also for those of us around her who are observant and sensitive.

But in the tragedy of all this change, despite its sudden and concerted efforts at derailing her life and irrevocably altering mine, there is a great deal of amazing. It's forced both of us to take a step back, to slow down, to think about the breakdown of things we would normally not even notice. Every moment becomes a triumph. Little successes become magnified. But the thing is, they should've been that important to begin with; they've always been magnificent.

I'm reminded, too, even though I spend every single day wading through the minefields of the psyche, what a remarkable piece of equipment the brain is. The progress my mom has made just within the week is extraordinary. We used to think - easily in my lifetime - that you were born with the same number of neurons you died with, and the brain couldn't repair itself. Which is nonsense. While it seems to be accurate that mature neurons don't divide (at least, the last I heard), we're starting to realize they're far more plastic and resilient that we've ever imagined. When one part of the brain takes a hit, other parts rev up and compensate to minimize the deficits. The chatter works a little like a bad phone line at first, but as the brain makes more and more new neuronal connections, the reception clears up. Knowing the nervous system as I do, having even the vaguest idea what goes on in there - seeing my mother button her shirt becomes like seeing the hand of God in her.

I spent a good deal of time today thinking about the muscles we use to let go of something (there's a great deal of poetry about that, I think). In OT today my mom was trying to put pegs in a board with her right hand. And as her muscles fatigued, she could still get her hand clamped around the peg and push the peg into the board, but she had trouble releasing the peg. And I thought, huh. People totally take that for granted. We all assume letting go is a passive process - you just stop holding on and it's over. But that's not at all true - you have multiple muscles in your arm and hand dedicated just to the extension of your fingers. There are hundreds of tiny movements involved in just picking up a pencil and setting it down again.

Imagine how much energy is involved in letting go of the big things in life. But you can't carry around that peg forever.

Better laid plans...

....still didn't happen.

So, I've been thinking a lot about the life of Dr. King, lately. As I've said every MLK day for a few years now, I respect the work that he did. I admire that he died for the cause. And I think he changed the world, for which I'm grateful.

And I've been pondering over the past couple of days, what to say in today's post. And, once again, I had big plans for today. Mags and I slept in, then got up and got breakfast and went to PetSmart. After that I Furminated her, and by the time Mags decided she'd had enough I had over half a plastic grocery bag full of undercoat (which I saved, and will continue to add to it, and intend to someday spin). I was contemplating meals and groceries (I am determined to get back on my meal plan...you know, eventually...), did a bit of other stuff, showered, and then Faye was like, "Hey, want to get lunch?" So we did, and it was lovely, and then I stopped by my friends' house on the way home. Just to drop in. For, you know, not more than a half an hour. No, seriously, I was going to leave by 3:30 - 4 at the very latest - because I wanted to hit the grocery store and then come home and finish the laundry and clean the kitchen and get the Christmas tree put up and make dinner and...

So, I left around nine.

We had a lovely time. It was a good end to the weekend. We talked and laughed and told stories, messed with the Wii, ate dip. I knit, and actually got quite a lot done on my current project. And I finally was like, no really, I have to get home (because as I type this, it's 11pm, and I start on the Crisis unit in the morning). And so I got home, and made some dinner, and was fussing with the laundry, and I thought, you know, well, this was probably a much better course of action for the day. My house may still be a disaster, but my soul feels better. And that's really the point, right?

And then I was thinking about the blog, and what I was going to write before I went to bed, and then, it suddenly dawned on me that the friends with whom I was hanging out were black.

And I thought....you know...I'm not sure I could think of a better way to honor Dr. King's vision than to spend 6 hours on an impromptu social call, having discussions of various family members' skin tones and assorted cultural mores of both "my people" (the Greeks) and "their people," and generally enjoying the company of good friends, without it ever really occurring to me to question that they were any more different from me than anybody else who was raised in a different cultural subset of Americans.

Thank God Almighty...is this "free at last?"

Oh yeah....

So, once upon a time, this was an anonymous blog. The first post or two I ever wrote, way, way, way long ago, were very frank accounts of what I was thinking. I didn't especially feel the need to censor myself, since I was quite sure no one I knew would be wandering by, and if they did, by chance, they wouldn't actually know it was me. That's why my handle is dk, and not just outright Kate.

When I was getting ready to leave for NC, my friends convinced me that I needed a public blog, so they could follow my adventures (and mundanity) when I was so far away. I could easily have just started a different blog, but there was something about the one I already had to which I felt attached. And to be honest, I'm a really well defended person (note the difference from "defensive"), so even in anonymity, that kind of extreme openness was really difficult. Plus, that was a point in my life when my defenses needed to be particularly strong and well-structured, so it wasn't the time to push that. Thus, I deleted my initial efforts, and started again. In retrospect, it was a reenactment of my real world - I was starting over, trying to be open about things I didn't need to be ashamed of, to be accepting of myself. Less about what others wanted me to be. More about what I think, feel, and know, but in that truth, of course, still guarded - particularly acutely - still measured, but more authentic than the previous few years of my life had been.

As the years have passed, I have a more regular readership; more of my family, more of my co-workers (hopefully none of my patients), more people I really do know, either through actual real life or from the blogosphere. This makes me sanction myself differently, I think, but regardless, I don't mind; it's something I find strangely reassuring about my relationship with the people who are real and important in my life. Yes, it means my thoughts are more filtered - i.e., I don't talk much about the dysfunction of my various families, I lose the ability to complain about my coworkers, and I sometimes have to think pretty hard about what I want people to know who can look me in the face the next morning and have an opinion on it.

It's funny how, despite the exhibitionist, narcissistic, self-important nature inherent in blog writing, so much of what I do here is centered around other people, even before I type a single character. And I'm cool with that. I always have been a fan of irony.

But every now and then, I have these moments where I remember that, in fact, this is my blog. It's a window into who I am, regardless of how tightly I pull the curtains from time to time. I have no particular reason to be ashamed of who I am, or why I am this. And I forget, sometimes, that this is an acceptable forum for being who I am.

Curious, though, that this is the incident which led me to this musing.

I had barely a confrontation this morning with someone I considered a friend. Not necessarily a "good" friend, but someone to whom I felt connected in a couple of different ways. Someone I know to be resistant, but, being who I am, I tend to tolerate resistance fairly well, and to be frank, thought there was progress. And after a little too much ambiguity for a little too long, I finally took the "What exactly is going on, here?" road (in much more subtle language). And...I can't say that didn't work out, because I'm always a fan of knowing over not knowing. And I think drawing a boundary in this case was actually an important communication in itself. But the answer was sort of painful, for a variety of reasons for which this particular friend is and is not responsible.

I responded, on the surface, reasonably, I think. Internally? I felt for a moment like my little boat had been capsized.

Not that this friend has all that much power, but the issues activated were much greater. So I did my best to let those pass, tried not to fight them, to figure out what was at the real heart of the situation.

I gave up on what I'd been doing (because, well, distracted...), and I picked Mags up and we went over to State Hospital. Which may seem like a weird place to walk your dog and think, but trust me, that's just the place. The grounds are beautiful, there's a lot of open space to run (if you're Maggie) and a lot of trees and sunshine and scenery (if you're me). The place has a mojo, you know? Lots of stories of hauntings abound, but whatever, the place has a very old energy. So we went, and we walked a little. Maggie played with some other dogs, I played with some other owners, and both Mags and I made new friends. It was a great choice.

And what I came to, eventually, was that under the anger and defensiveness and fear of what had been stirred, was mostly disappointment. At that, mostly in my friend's lack of insight. There was some sadness and a little bit of sorrow about the things here that I can't fix (because that's what I do, I fix things). And ultimately - really, the part that was and still is painful several hours later - a good deal of recognition of the things I can fix; that is to say, the things that are mine. Unfortunately, none of those will particularly help this individual situation, but they will help my own journey.

Here's another thing I notice: when people are coming from a defensive place, they tend to say the exact opposite of what they really mean. Not always knowingly, and in fact, they probably consciously hold that what they really feel in that moment is what they're saying. But in the light of authenticity, this is rarely what they actually feel.

Today? That I know this, and my friend seems not to, makes me really, really sad.

Some things never change...

Yeah, so, I was planning on being in bed an hour ago... For some reason, I had no problem going to bed at a reasonable time when I was on vacation, and woke up bright and early. And yet, coming home...

My 7am cancelled tomorrow. I was going to get up and go to the gym like a good girl, but, we'll see when I wake up...

I have a lot of things I want to change over the next few months. One of these is, I really want to work harder on my yoga practice. Which means I have to actually start doing yoga more than just sporadically. Plus, I have like a million other things I want to do. Which means I have to extend my day to at least 26 hours...maybe 30...

One thing I am doing - for the next two weeks, I'm going gluten-free. It's something I've been thinking about for years. Look, I clearly have a dietary intolerance to something, which is probably actually an allergy (rather than a strict intolerance, like lactose intolerance; there's no immune response, just a failure to break down lactose. Which, still is hell for uncomfortable), given how I can't quite get my asthma or my allergies under control. It's an experiment; we'll see how it goes.

Okay, okay, I'm going to bed...

Obake

So my folks and I went to dinner at this cute little Italian place tonight, and afterwards wandered over to the Long's Drugs next door, which is apparently something of a Hawaiian institution. I got a bunch of stuff for people back home who did nice things to make this trip possible for me (nothing says, "Thanks for doing extra work so I could go sit on a beach in paradise!" like chocolate covered macadamia nuts). And I picked up a book of Hawaiian ghost stories.

Dude.

I think I shouldn't be reading that shit before bedtime.

The Hawaiians are a very superstitious culture. There are lots of mystic, supernatural kinds of things that are alleged to go on around here. And for some totally non-rational reason, I completely believe this is the case. There is a distinctly preternatural vibe about the islands. I think there are places where mystical energies tend to coalesce; I find this to be true of several places I've been: Savannah, Georgia...Charleston, SC...NOLA...to name a few. I think if you are still and quiet, often you can feel the undercurrents of these places being a little differently charged than, say, Winnetka.

Now, does this mean I believe any ghost story I hear, or buy into every superstition anyone presents? Of course not. But, let's face it - the Greeks are a pretty superstitious people themselves. So it's kind of in my blood. And I think there is so much that happens on this plane of existence and others that we can't even comprehend...I'd quote the line from Hamlet, here, but that seems a little trite. Still, Horatio...

Honestly, even the most conservative organized religions have quite a bit of mysticism and supernaturalism about them. Transubstantiation, the choirs of Angels, stigmata, pretty much anything from the Old Testament, even the belief in a higher power itself is a kind of mythos and superstition. So why do we so easily dismiss that which we can't immediately explain? When my father was born and, let's face it, he's not that old - the suggestion that DNA was the heritable material of life, the code for every single aspect of who we are biologically - that would've been sneered at as preposterous. The entire vocabulary of existence reduced to four letters? Please. And yet, now I can send a Q-tip and $60 off to Utah and get a full profile of Maggie's lineage. We can cure some diseases with gene therapy. Every woman who gets prenatal care is offered testing to determine the likelihood of certain heritable illnesses. Heck, when *I* was born, ultrasound screening in pregnancy was mythical. Now, three decades later, you can get 4-D images of your unborn child at a shopping mall that are almost as good as having a window in one's uterus.

So why is it that we so easily discount some of the oldest lore? It's kind of weird, when you think about it...

Oh! Also weird? Some woman in her 60s was attacked by a shark right down the beach from us yesterday (we're staying in Kihei). Thanks, Jenn, for alerting me to that! Fortunately, the most dangerous thing I've seen around here (aside from the sailors) are the jellyfish I encountered on my beach walk this evening.

More pictures up tomorrow. But right now, it's 11:20pm local, and y'all, ghost stories or not, it's time for bed...

Maui no ka 'oi.

So we're on Maui.

It was one long-ass and arduous day. Somehow the inter-island flight was more hassle than the trans-Pacific one. And, the TSA stole my mustard.

But my day started out very lovely. I got up before dawn (because I do this) and hoofed it down to Waikiki Beach, which is a mere 6 blocks or so from our condo in Honolulu, and yet, I hadn't made it down there through the whole week. So I wandered over there this morning, and spent like two hours taking 700 or so pictures of surfers, and sunrise, and water, and then after while I just started shooting people (in a snap, snap kind of way, otherwise you'd be hearing about this on the news instead of on my blog). I tend mostly to take environmentals; I'm all about depth of field and perspective shots and still life, I think because this is what translates best from my brain to my lens. Which at this point is mostly a matter of skill, which is of course a matter of experience. So I've decided I need to spend more time shooting action and people and life life.

I sat for a while at the beach and then on a street corner and just watched people. I tried to stop thinking technically and start thinking with my grander sense of life, my more ineffable, artistic sense. And I got some pretty darn good shots. And had a very good time feeling more connected to humanity in general.

The rest of the day was a series of fiascoes. Did I mention that the TSA STOLE MY DAMN MUSTARD?

So, I'm giving up and going to bed. Fortunately for me, my parents were very kind and let me have the bedroom with a window, which happens to be the "master" bedroom (there's some feeling that I may have earned the upgrade, but that's another story for another day). So I'm going to go take advantage of that...

Hawaii By Night

(...is actually the name of the strip club across the street from where I'm sitting. But it also seemed like a fitting title...)

I'm sitting outside the Starbucks at Kuhio and Seaside on a lovely, breezy, Honolulu evening. There's a couple of street performers down the way, and the low rhythmic drumming pulses like a heartbeat as the nightlife flows by. This really is a very pleasant city. Beautiful scenery, lovely weather, wonderful people. Hawaii has such a unique and adaptive culture. I'd love to know more about what goes on when the tourists aren't looking.

I get the sense, though, that I wouldn't actually want to live here. I'm not really sure why I think that.

When we were in medical school, one of my colleagues was in the military, and discovered that if you didn't match into any of the military programs, you could go through the general match process and get into a civilian one. He thought, no problem, and just didn't interview at any of the military programs, so that he could match into a civilian program closer to his family. Great idea, right?

Except...

He was one wicked smart guy. In the top ranks of our class, good CV, excellent board scores. He looked so good on paper, in fact, that at least one of the military programs ranked him without even meeting him. And he matched in Hawaii.

I always have felt kind of bad for him in that Hawaii and Iowa are a long way apart. And that was the same year I matched into a program I wasn't expecting (although, I ranked them third, it was kind of my fault. Or, at least I had a hand in it). And I can imagine being stuck on an island in the middle of the Pacific can be daunting for a Midwesterner. And certainly one person's paradise can be another one's hell.

But still.

I have distinct memories of a weekend sometime about January. I was in the middle of a q2 weekend, which meant I hadn't slept all night, and was due for another sleepless night of call the next day. I already hated my life and my program and felt for all the world like the worst resident ever. And I dig my damn car out of where it's been plowed in, and I drive home, and there's four fucking feet of snow in my driveway.

I thought of my friend from medical school at that moment. I thought of the night we'd spent out drinking with a bunch of our other friends during Senior Disorientation Week, and we talked about how we were both trying very hard to accept where we'd been sent, were trying to be optimistic, but when the veil of denial was lifted by a large bucket of something rum-containing and fruity with eight straws and half a bottle of maraschino cherries in it, neither of us was really very happy with the way things turned out.

I felt like FedExing him four feet of snow.

In the end, I lost touch with him, because I lost touch with almost everyone during that year, and he's not on Facebook (which is how I've managed to reconnect with a lot of my classmates). I still think about him once in a while. He was a good guy, and a good friend, and I hope that in the end, his misstep worked out as well as mine ultimately did. I thought about asking if anyone knew if he was still on the island, but his residency should be over, and I expect that he isn't.

Besides, how would I explain that big soggy box he got intern year?

How did the week go so slowly...

...and the weekend so fast?

Hmm.

Today was not as productive as I'd hoped, but wicked enjoyable. I went to the 'Bucks this morning and spent like three hours writing a ridiculously long letter for a patient of mine. I grabbed some lunch, and then I met up with my aunt and uncle for the Local Farm Tour. We only made it to two farms, actually, but they were pretty awesome. The first one had goats and sheep and ducks (ducks that eat fire ants, how cool is that?). I ate some goat cheese, picked up a lovely bar of goat's milk soap, and - of course, the real prize for me - procured four ounces of very pretty white Border Leicester roving. We also bought some yarn from her sheep for my cousin, who's a relatively new knitter. Seriously awesome yarn. One of the farm folks was knitting a thick wool sweater out of it, and wow, was it gorgeous.

On #6 straights. I was like, seriously? Who knits a sweater on straight needles anymore? But I digress.

The second farm we went to was just so beautiful. Unlike the first farm, which was still sort of being restored, the second was like four generations deep. It was so lovely. They had sheep and goats and a pair of llamas. They also had two really gorgeous horses and all these hilarious chickens. And, Guinea....um....are those chickens? Guinea fowl. They were hysterical. And apparently really like to eat ticks. Way to go, Guineas. There's also a lovely patch of gardens which grow things including cotton, which becomes more relevant in a minute.

On that farm, the woman had this whole building where she spins and weaves. The building itself was made from trees that were uprooted during hurricane Fran. It's a gorgeous little studio, and she has this antique wheel that's like taller than me. She also has a Schacht that's much more functional. I bought another half pound of roving from her - four ounces of something brown and soft that I don't remember what kind of sheep it came from (something that started with a T, I think), and four ounces of this unbelievably awesome Cotswold roving. It's pin drafted, so all you really need to do is just fire up the wheel (were that I had one...soon, soon. This lady also gave me some good ideas about where to find used wheels). And it's just totally...I'm so in love. I need to get me some Cotswold sheep some day.

I also really like Cotswold cheddar. Maybe what I need to do is just move to Cotswold. It sounds like a magical land...

We were going to go to a local vineyard as well, but spent way too much time talking to the spinner lady (and, really, North Carolina wines....), so we diverted and just went back to their house and made pizza. And I took my drop spindle over to illustrate what I'd been babbling about on the farm, and gave my uncle a brief lesson in spinning on the drop spindle. He did really well with it, actually (he's an engineer, and gets the physics of all of this). We had a very good time, as we always do.

Today definitely fueled my little pipe dream of being farm people. I come from farm stock, after all (I got very nostalgic today, as the second farm smelled a lot like my great-aunt's). I frequently have this bucolic little fantasy about living out in the country with my alpacas and a few sheep and a couple of goats. Not as any real sort of means of self-sustenance, but I imagine we'd make a little extra money from the alpacas and whatnot. And chickens. I'd also like a little coop of laying hens. And maybe a cow. And a husband who really liked to garden, and we could grow all of our own produce and maybe we could trade stuff with our little farmer neighbors (maybe I'd let them have the cow) and grow berries and have those freakin' hilarious little Guineas running around. And dogs. We'd need a couple of really huge dogs and then a couple of indoor mutts. And definitely some cats in the barn (although, no cats in the house). Ooh, and a horse. A really nice old mare that I could ride around the farm on. I don't think it would have to be that big; maybe 15 or 20 acres would more than suit us just fine.

And then I remember that this little agrarian utopia conflicts with my pipe dream of living on the beach. And also that there aren't a lot of Starbucks near farmland.

Meanwhile, I stayed out way too late on a school night. And, I still smell like farm.

Makes me want to shine up my trowel...

So, as we do every Monday at noon, we had psychotherapy lecture today. And Dr. Jabba says, kind of as an offhand comment, "Psychiatry is like archeology." Which was closely followed by a comment about digging around in people's heads.

I've been amusing myself with this analogy all afternoon.

It's a pretty good analogue, I think.

Consider an archaeological dig. You start out with shovels, right? Sometimes backhoes. It's not delicate work. It's general, it's rougher, you have a basic idea where you're going and what you're looking for, but more or less, you just dive in.

But then you start to find evidence that there's something else there. So you park the backhoe and pull out smaller implements. You take spade-fuls of dirt away. You carefully pull off layers with your trowel. It's not super fine work, but it's more careful. And you take a closer look at what's in the soil you pull off.

And then you find something - a flash of metal, a change of texture, the smell of putrefaction. You expose a little more, gently, but rarely does it just plop out, all intact and pretty. So you pull out more cautious tools for that, delicate, tenuous things that require great care and a little skill. You're still gentle with the surrounding material, but you focus more on the piece at hand.

Sometimes the artifact comes out in pieces that you have to reassemble. Sometimes it comes out intact, and in pretty good condition. Sometimes it really does dislodge itself and plop out at your feet. Sometimes, you sift and sort through all that dirt, you think you've found something really important...and it turns out to be a plastic cup from McDonalds. And not the prehistoric McDonald's, either.

Such is it with therapy. You start with general ideas. People usually have a reason they come to see you. It's rarely what's really at issue, but it gives you a place to start. Together you dig, you sift, you sort, through layers of their past, looking at what turns up in the process. Eventually you find something that seems somewhat more important, so you slow down, you take note. You usually dance around it for a while. You observe, you examine, as it comes to light. Sometimes it comes out in pieces. Sometimes it makes an inglorious entrance. Sometimes, you look at it and say, "aha!" And then it's your job to figure out the significance of it. Often that may not be readily apparent, until you find more artifacts around it - the context of it, what accompanies it, what's related. You catalogue, you examine, you explore, and then you set it aside and keep digging, because there's always more to find, always more to know.

And some days? You work and work and work and still come up empty handed. But when all is said and done, you find what you find, whether or not it was what you were looking for.

Hmm.

Twice the Speed of Life

I'm on vacaaaa-tion. I'm on vacaaaaaa-tion.

Well, okay, not technically until tomorrow. Today I'm really post-call. Yesterday was decent. I saw three consults, two people in the ER, got about 6 hours of sleep. So, not bad at all.

Today has been generally unproductive - there's been some lounging, some napping, some time at the gym, and some planning what I need to do in the next week. And a lot of random driving. During which, I kept hearing this song:



(The lyrics aren't quite right, but you get the idea, and the audio was the best on that clip. I thought the actual best version of the song was this one, except the handheld video will make you seasick and someone passes out in the middle of the performance.)

It's called It Happens, and it's by Sugarland, who is one of my favorite bands. And I just totally love it.

It's sort of funny, actually, because I was walking out today in the rain, and before I actually got outside I was thinking about how gorgeous and sunny it was yesterday and how I was a little confused this morning when I got up and looked out the window and was like, what? Where'd the sun go? But I go out the ER and was walking to my car being all wet and found myself thinking, gosh, I'm so glad it's not raining any harder than this. And my inner critic made some snarky comment about silver linings and I started thinking about how I've been so, like, "Ohmigod, what's coming next?" recently, and I really need to adjust my mindset. Which made me think of one my very favorite lyrics, from a different Sugarland song, which is, I want to find what it means to be the girl who changed her mind and changed the world.

And then I heard this song all day. I'm taking it as an omen (not an idea of reference, so back away from the Zyprexa).

And then I tried to buy the single on iTunes and realized that, somehow, I missed the fact that I already owned this whole album. I was wondering why the previews all sounded really familiar...apparently I last listened to it last July.

Oy.

I mean, what a pleasant surprise.

So maybe I need a little practice at this positive attitude business...

A post about sex, and religion

One of my friends emailed me this article today.

I've always liked the Jesuits.

So, I, myself personally, am not Catholic. Or Lutheran. Or particularly religious, for that matter, although I identify myself as Orthodox Christian. But I tend to find my spirituality much more important than organized worship, and in my own faith have learned from a lot of different traditions. And yet I went to a very religious, conservative Lutheran college, and a very religious, more liberal Jesuit medical school. Maybe it was just that the Jesuits seemed so much more realistic than the crazy fringe Lutherans we went to undergrad with (okay, they weren't all crazy, but some of them were reasonably extreme. I once witnessed an LCMS Lutheran and an ELCA Lutheran get into a fistfight over who performed the baptism sacrament most according to God's plan or something like that. I thought this was especially ridiculous, because from the Orthodox Christian perspective, you're both doing it wrong!), but I really got comfortable in that environment. We had a ministry office in the commons of the medical school, replete with priests and nuns and other ministering types, and I tell you, that was the nicest place to be on a bad day. I sang in the Gospel Choir every year on Martin Luther King Day (it was really the only time we performed, but man, you should hear this crazy white girl belt out "We shall overcome"). We celebrated Ramadan, and the Jewish holidays, and Orthodox Easter. They were such a welcoming, accepting, inclusive bunch, and that really surprised me.

We also had 12 full time chaplains on staff at the hospital, and a bevy of part timers, and they all had pagers and specialties and assigned areas of the hospital. There was a chaplain in-house, on duty, 24 hours a day. They responded to traumas, codes, and plain old requests. The medical students had to do shifts with the chaplains. I cannot tell you the impact this had on patient care, and frankly, the whole mood and mode of the hospital was influenced by the Jesuit ideals. The way we practiced was more holistic, more inclusive of families, more centered on the patient as a person.

It definitely tied our hands sometimes - i.e., one of the most heartbreaking cases I had as a med student was this woman who had a baby with anencephaly - a baby in whom the brain had not, and would not, develop. This kid's head literally stopped at its ears. These babies, obviously, cannot survive long, if at all, when disconnected from their mothers. We were a Catholic hospital, so we couldn't offer her a genetic termination. She was Catholic, so she wouldn't have done it anyway (or so she said...who knows, if we'd been able to provide it, if that would've changed things). It was absolutely heart-wrenching, to watch her go through the pregnancy, feeling her baby move, having strangers come up to her and ask when she was due, if it was a boy or a girl, did she have a name...knowing her child would be born with no chance at life. It struck me as months and months of torture, and I couldn't fathom the idea that God wouldn't understand her decision to terminate.

But that whole respect for life thing was, in general, a really positive influence on my education. I did a rotation in Child Advocacy my 4th year. I talked to my patients, their families. I did a sub-internship in the NICU, and watched the way those little lives were cared for as they walked that line between life and death, how they were respected as full human beings with resplendent potential. How they were held up in those final hours. One night, I stayed several hours after my shift was over because one of the 24 week twins I'd delivered a few days earlier (when I was doing an OB rotation) was dying. Her sister had passed the night before, and her parents were so distraught they couldn't bear to be up there once they'd made the decision to let her go. We took her off the ventilator, swaddled her tiny body in handknit cloth, and the nurses and I took turns holding her until her little heart finally stopped.

I know a lot about end of life care, and am comfortable with the inevitability of death, at least professionally. I can deliver bad news like no one's business. I think I've mentioned on here before how, at the Emerald Palace, I felt like the angel of death on my ICU month, because the team always waited until I was on call to withdraw support from our patients, because I was "so good with the families," and I was "just so much better at it." Likewise, when I was on the labor deck, I always, always took the genetic terminations. Because my cohorts would check in at the beginning of the shift, and then leave them alone until something happened. You know, "so they could have their privacy" (read: "we don't know how to deal with them, so we won't"). I, on the other hand, went in, introduced myself, asked how they were feeling, learned everybody's names in the room, asked if the baby had a name and referred to it as such if it did, and checked in every two hours like I did with my other laboring moms. Plus, delivering a significantly pre-term, dead, and often deformed fetus takes some skill - not so much technical skill, but skill at knowing how and when to do things. They're fragile, their skin is delicate, you can damage them easily. It's important to know how to collect and present the fetus so it looks like a real baby, so they can touch and hold and understand their child. It's important to understand the pain of malpresentation, even for someone so small, and how much it hurts to force an immature uterus to contract. It's important to respect the life ending and the ones being left behind. It was such a horrible, traumatic experience for most of these women anyway, that a cold, impersonal stranger rushing in awkwardly at the last minute to deliver their child was just unacceptable to me.

Interestingly, it was my Jesuit medical school at which I also did my sex therapy training. We only treated married couples in the clinic, and we would talk about God if the patients wanted to, but beyond that there was little to brand the therapy as "Catholic" or "faith-based". But there was something there that went unsaid, this undercurrent of respect and celebration of life, union, and effort that imbued the way we taught, and interacted with, our couples. So many of them came in with taboos, misconceptions, and shame that had been imparted under a guise of "religion"; we were open, accepting, unfazed. We touted sex as a good thing and an important piece of a good Christian marriage. We taught masturbation (yes, yes we did) as a means of exploring, accepting, and learning about one's God-given body. We "preached" love, tolerance, compromise, and connection. It was a nice view.

The article above reminded me of all this. I particularly like how she holds casual sex up not as "sinful" and in a punitive light, not as a "violation of sex", but rather, a disappointment, a failure to expect enough of themselves and their partners, that they are "not asking enough" of sex. That good sex is an expression of incarnation, a celebration of our physical nature, given to us by God. Who can argue with that?

Just an interesting read, and a nice foray into musing philosophical.

(PS - Comment with reckless abandon, but, I don't want to hear about the evils of abortion or how abstinence is the only way. Go blog about that on your own space.)