Sunday, July 31, 2005

Thinking About Writing

There are many reasons why I'm glad I'm not a professional writer (although I have thought about it over the years), and this morning I find myself giving thanks for my decision. One of DD's frequent commenters, Christian Marcus Lyons, is himself a writer, perhaps he can relate to my sentiments. (Whaddayasay, Christian?)

Take this morning, for instance. I know I want to blog, but I truly could not think of anything to write, despite my best intentions. Instead, I switched the laundry, cleaned the bathrooms, vacuumed, and walked the dogs. Granted, these are chores I planned to do anyway in the course of the early part of the day, but my mind kept saying, "Write!", and my brain answered back, "About what?"

Putting on a CD by The Crash Test Dummies, I was moved to laughter by Brad Roberts' lines:

An Old Scab
Written by Brad Roberts
Published by Songs of Polygram International/Tannerfield (Socan/BMI), copyright 1996

I sit each morning, look at my empty notebook
The room is quiet, the air conditioning sounds like rain falling
Manic-depressive composer Robert Schumann,
When he could not write, he'd get down on his knees and he would pray for help

It's not as bad as eating your own liver;
But still, I'd like to think that there are better methods

I try to tackle the page that lay before me
But then I drift off and think about the concept of Ben-Wah balls
I rouse myself and I finish washing dishes
Make lists of errands, make all my phone calls
And then I pray for help

But each time I try to make a fresh stab
I end up just picking at an old scab

I'm leaving my scabs alone today and I notice that, actually, the rain falling sounds like the air conditioner......

Saturday, July 30, 2005

Thursday

On Thursday, August 4th, we will be attending a hearing at the United States 2nd Circuit Court of Appeals in New York City. I have mentioned our dear friend Woody many times, including quite recently. As some of you know, he was shot and killed (read "murdered") by the Brattleboro, Vermont police in 2001 and his case has been whitewashed, covered up, and otherwise thwarted since that terrible day. His parents' suit against the Town of Brattleboro was thrown out of federal district court in 2004 and we have been waiting to see if an appeal would occur. Well, on August 4th, the lawyers for both sides will have 12 minutes each to present their case---for or against a civil trial taking place---before a panel of judges from the 2nd Circuit. (For those of you who are not familiar with the justice system, the Circuit Court of Appeals is the last stop in the federal system before the Supreme Court.)

Much hinges on the outcome of those 24 minutes of legal argument, and based upon our experience since December 2nd, 2001, we are rather pessimistic that the 2nd Circuit will allow a civil trial by jury, but we will reserve our judgement and hope for the best. Thoughts of this trip to New York City are clouding my mind this morning and I will attempt wholeheartedly to embrace this beautiful weekend and lay worries about Thursday to rest.

Now, that said, there are blue skies outside, dogs to walk, and a home to attend to, not to mention a bicycle begging to be ridden. I will remind you all later this week to think about us on Thursday morning at 10am.

Enjoy whatever is on your plate today, and tell your friends and family that you love them. I'm so glad my last interaction with Woody was a loving one, and the loss of his physical presence on this Earth reminds me to express my love and appreciation readily whenever I am moved to do so. After all, our lives are indeed transient notions in the universal continuum.

Friday, July 29, 2005

The Small Things

I have a patient with schizophrenia who I take out to lunch about once a month. Seeing as it was his birthday recently and he verbalized a desire for Chinese food, I took him somewhere different for a special treat.

Sitting for the first time with him in a real restaurant---not just a pizza place or delicatessen---I was struck by the normalcy of what we were doing. Here we were, two people talking about our families, making comments about the weather, the food, the Red Sox, passing the soy sauce, pouring tea. Given his somewhat different way of relating to the world (schizophrenia being essentially a personality and thought disorder), this gentleman's conversational skills can be somewhat lacking in the strict sense of social decorum and "normalcy", and his personal brand of logic can sometimes be challenging to follow. That said, our time together was lovely, relatively comfortable, and very satisfying for us both on several different levels.

During the course of the meal, he looked me squarely in the eye and said, "Y'know, I appreciate this more than you could ever imagine. I look forward to our outings (his word) so much, and it's such a breath of fresh air to go out and do this." He added later, "I wish there was a way I could repay you." I responded that he could repay me by taking the best care of himself that he possibly could. We shook hands heartily and he got out of the car.

This interaction reaffirmed for me the therapeutic value of this monthly tradition, as unconventional as it seems. I don't do this with any other patients, although I have been out for coffee with a few here and there. There's a technique in psychological treatment called "therapeutic use of self" which refers to the professional individual disclosing personal information in a nonmanipulative way in order to normalize the patient's experience, perhaps helping the client to see that the clinician can empathize based upon actual personal experience. I've practiced this technique by disclosing the fact that I take antidepressants, for instance, or that, yes, my cholesterol is also high and my reflux is out of control when I forget to take my medication. When convincing a patient to use a weekly pill-box, I'll often comment that I could never remember my meds without using one (a very true statement, indeed).

While I can't afford to pay out of pocket to take all of my patients to lunch every month, the value of my decision to do this regularly with this particular individual is worth much more than the actual cash value of said expense. It has become something that I simply plan on, and today exemplified for me the fact that the benefit is both therapeutically measurable and personally meaningful. The interpersonal connection and trust that's been created in this "clinical" relationship is something that I can see is a valuable tool in the therapeutic kit which I employ with this gentleman.

Today I acknowledge that it is often the small things that pay the largest, most meaningful dividends.

Thursday, July 28, 2005

Just Hit Refresh

The restfulness of sleep performed its job so nicely. My inner state is mirrored by the outer: a cool breeze, blue skies, temps in the upper 60's this morning, expected to peak at a lovely 78. This summer, I've embraced the heat, even when visiting my patients' steaming apartments, but this cool morning is a welcome change. The air this morning reminds me of days in Amsterdam, biking along the canals, the markets teeming with tulips, bicycles darting along, often with children balanced fore and aft, no helmets capping their fragile heads.

Another work day ahead---it's just another day. Chinese herbs with black tea and milk and honey, banana-mango smoothie, Happy Pill, lunch packed, morning ablutions complete. Dogs patiently await their morning constitutional. I'm captivated by the light on the trees and the sounds of the birds waking up to the day. Boy, that hammock looks inviting. What a day to spend reading and writing on the porch!

Alas, duty calls. There are people to see, tasks to complete, care to administer, details to attend to. Tonight I'll reward myself with time to simply be.

Off to the races.....

Wednesday, July 27, 2005

Human Do-ing

With Mary in New York for the next five days, I observed myself going about my usual evening routines without the benefit of the presence of my "other whole" (I hate the term "other half"!). I realized how much time I can spend just puttering away at myriad activities, the hours sailing by until the time for sleep descends. Between phone calls, preparing, eating, and cleaning up from dinner, feeding and walking the dogs, reading and answering emails, checking voicemail, and taking out the trash and recycling, how much time is really left for other endeavors on your average evening? Precious little, I say!

I assume that this pattern of behavior---human "do-ing"---is repeated and replicated all over my neighborhood, the region, the state, the continent, dare I say the world? Part of our human being-ness, it seems, is filling our lives with things to do, hence our doing-ness. While this is a natural and easy thing to do---and we all partake to differing levels---some of us are better than others in making more time for simply being.

Our dearly departed friend Woody was very good at manifesting himself in our midst and cajoling us out of our workaday torpor, getting us outside, taking the dogs running, engaging a then-young Rene in map-making or some other creative endeavor, and reminding us that there was so much to be found in the moment, away from the headiness of adulthood and the doing that it involved. I miss having his input and enthusiam in my life, and now I just say to myself, "What would Woody recommend in this moment? How would he change this state of mind I'm currently caught in?" There is only so much time we can spend paying bills, checking email, and organizing our ever-expending kingdom of stuff. Sometimes we need to eschew those well-worn paths of thought and action, embracing another way of seeing and interacting with the world. But it's so easy to forget that there is another way.

Sometimes it seems that there's no one else in the world I'd rather talk to than Woody, and I must comfort myself with the notion that I'm certain he's still here with me on a level which I just can't directly sense. I can talk to him, yes, and I can imagine what his response would be, but the void which remains is one which is still quite palpable, even more than three years after his untimely and violent death. I had no idea I was going to write about him tonight, but he naturally came up when I began to think about my mental state and how I spend my time and brain power.

That said, the power remains within me to change the way I make use of my time, how my thoughts control my feeling state, how I choose to be in the world at any given moment. Several minutes ago, I decided to simply write from my gut and follow the trail, which led me to this point, where I realize that the computer must go to sleep now, as should I, and the still summer air outside my window will hold this house in its damp embrace. Time for the recharging restfulness of sleep. May Orpheus treat you all well this night.

Monday, July 25, 2005

Corporeal Realities

I often find myself wondering about how other people feel inside of their own bodies. I also wonder whether others experience the same sensual input that I do in sort of the same way. For instance, when listening to the same piece of music, each person's cochlea and nerve endings receive the same basic impulses, although each person's brain will interpret the music through various filters of personality, knowledge, culture, prior experience, and so on. That said, what is it exactly that causes those two individuals to have a separate experience of said music? What is actually happening in their brains at the cellular level (and on the spiritual and psycho-emotional level) that can engender a totally disparate experience of the same sensory input?

And take bodies, for instance. I know what it's like to inhabit my own body. I know it's skin, it's idiosyncrasies, the "feel" of living in this particular bag of bones. Why do I feel the way I do? What's so different about how I feel inside of my body as opposed to how Mary feels inside of hers? What do my dogs feel within their skin and psyches? I've always wanted to have the experience of "switching" bodies with someone and seeing through their eyes and experiencing the world through their senses, sort of like "Being John Malkovich" but without the weird office building and strange connection to the New Jersey Turnpike (if this is nonsensical to you, rent the video).

As a healthcare professional, I think my desire to understand others' experience is an expression of a desire to feel empathy on a deeper level. I know several doctors who've taken AIDS medications simply in order to know what the side effects are like, enabling them to more fully understand and empathize with their patients' symptoms. Some of you may remember Isaac Asimov's science fiction story, "The Fantastic Voyage", also made into a 1966 movie of dubious quality (now there's a great idea for a remake, you screenwriters out there!). That said, being a microscopic hitchhiker inside of someone's body is not exactly what I have in mind. Rather, I wish for the experience of being a psycho-emotional hitchhiker, actually living another's life as that person, so to speak, but also having the wherewithal and self-awareness to compare that experience with my own unique life.

Now that's impossible, you say! Why waste time even thinking about it, let alone writing about it and wasting our time with reading such drivel? Well, that's a good question, dear Reader, and I don't have a ready answer, other than that I'm certain others may have had similar thoughts, and this is simply a self-exploratory process by which I will, in the end, learn more about myself through my connection to others.

Reading this, you, too may have a change of perspective, however brief. Perhaps, the next time you're at a traffic light waiting for the light to change, a man will be squatting in the island between the lanes, holding a sign saying, "Disabled Vet, Will Work for Food or Money", and you'll pause longer than you might have otherwise, and wonder what it's like to be that person, to live his life and feel his pain. Maybe you'll be moved to give him a dollar that you may not have given otherwise. Maybe you'll give thanks for your own priviledge of not having to stand on that traffic island begging for money. Perhaps you'll simply see that man and know in your heart that he is simply an extension of you, another manifestation of spirit on earth, if you will, made of the same clay from which you were born and to which your body will return. If you have such an experience, please write to me about it, or share it with a friend. It's all just grist for the mill as we live on this wonderful and horrific physical plane of ours.

Sunday, July 24, 2005

Traffic Report

I just learned from Stat Counter that Digital Doorway has received 2,654 pageloads over the life of the site. Now, that doesn't mean that 2600 different people have visited, but it means that my site has been visited on 2600 unique occasions! (Editor's note: my home computer is blocked from this data so that my visits---and Mary's--- do not artificially inflate the numbers.) I'm excited by this news and also humbled that my writing has reached an audience wider than I ever hoped. While the statistics also state that many of those visitors have not lingered very long---some for only seconds (was it something I said?)---, it seems my peregrinations and wanderings have attracted some repeat visitors over the months. I can also see that the majority of my visitors are from the US, but there are many from Canada, Europe, and beyond.

To all of you bloggers out there, I highly recommend Stat Counter as a way to track your website's traffic.

Off to enjoy a lovely Sunday. Blessings to all, and as always, thanks for visiting.

Saturday, July 23, 2005

Artificial Self-Recognition?

For some reason I find it very disturbing when I encounter an automated voice on the phone and the very unreal voice states, "Please wait while I connect you" or something of that nature. What irks me is the fact that this disembodied and artificial voice is actually referring to itself as "I". Having grown up with Isaac Asimov stories like "I, Robot", the super-computer HAL from "2001: A Space Odyssey", and Robby the Robot from the insipid Lost in Space TV series, not to mention the ubiquitous robots with feelings from Star Wars, I still cringe when I hear non-sentient "beings" refer to themselves in the first person.

As much as I rely on computers and their powers on a daily basis, there is a part of me that still retains the view that a machine---as much as it is programmed to use the term "I"--- is incapable of perceiving its own existence. While I will readily anthropomorphise (spelling?) my dogs, and attribute great powers of self-awareness and abstract thinking to their small brains, I find it difficult to make the stretch to feeling similarly about a machine. I'm fascinated by the thought of artificially intelligent machines with powers of self-awareness, but I also still wonder if a non-sentient machine can ever truly have self-awareness as we know it, and how would we ever measure that anyway?

So, dear Reader, the next time you call Information for a phone number and the voice says, "Please wait while I search for that number", consider how much you are willing to suspend your disbelief that that disembodied voice created by a digital voice synthesizer actually cares whether you get the right number or not. I'm always relieved when the real operator comes on the line and I can make a human connection with him or her.

Just a random thought from my sleepy brain.......

Friday, July 22, 2005

Where Does the Time Go?

Seems like it was only yesterday that I posted on Tuesday night. My, how the week does fly. Working only three days, seems like I did the same amount of work I would normally do in five. Maybe I did.

Rose, mentioned in previous missives, is now in the hospital, deemed legally incompetent, and awaiting what comes next.

Another patient called me begging for prednisone for her worsening asthma. I declined and sent her to the ER. She's admitted now and I knew in my gut that prednisone wouldn't cut it. Looks like pneumonia. Sometimes I think about my nursing license when I make such decisions. Must think clearly and not just try to save the patient the inconvenience of an ambulance ride.

Another patient was in the ER today---brittle diabetic, alcoholic, eschewing his insulin and other self-care, sticking to his bottle instead. I don't foresee a happy ending there.

A medical student followed me on my rounds today and we were able to visit three very diverse and interesting patients in their homes: an alcoholic with Hepatitis C and bad pulmonary disease, just out of the hospital; a lovely older man with cancer who takes such good care of himself that I offered to pay him as a consultant to teach my other patients his secrets of success; and finally, a transgendered man (of whom I am exceedingly fond) with more life-threatening diagnoses than you can shake a stethoscope at, and he is still filled with joie de vivre and a strong will to live. Sometimes work can be inspiring, especially when someone takes such responsibility for their life and personal self-care.

That said, work fatigue is definitely weighing on my eyelids this evening, while my old nemesis "compassion fatigue" is nowhere in sight. The weekend is for the recharging of the batteries, and I'm so very pleased that my batteries aren't disposable.

Tuesday, July 19, 2005

Meanwhile, back in reality...

...our Hero realizes that his four-day weekend retreat from the workaday world is quickly drawing to an abrupt and painful end, necessitating a return to the "real world" oh-so-early tomorrow morning. Folding laundry, ironing a shirt and trousers, gathering together beeper, Palm Pilot, cell-phone, pen, stethoscope, and myriad accoutrements of his daily working life, not to mention packing a bag for an extra-early trip to the gym, our Hero prepares for the three-day onslaught of responsibility and task-driven hours, counting the days until that welcome two-day reprieve (the beloved Weekend--brought to you by the Labor movement) returns to once again embrace our Hero's face with Leisure's soft, languid hand. It will be only eight hours until that cursed alarm clock signals that the long weekend is over and work is nigh. Til then, the forgetful embrace of Sleep will lull our Hero into that timeless space of the dreamtime.

And so, dear Reader, tune in next time when our Hero ponders the meaning of that ages-old dream of arriving to work in one's pajamas.....

Monday, July 18, 2005

Generations

No, this is not a treatise on m-m-my generation. This is not about me in so much as anything I write can actually not be about me. (Blogging is, after all, a self-spectator sport, oui?) Anyway, this is really about the generations coming after us, the members of which are populating the families who move in our orbits.

This weekend, we have been fortunate to host our beloved nephew, Adam, following his three-week "youth liberation camp" at Rowe Camp and Conference Center in Rowe, MA, a place which has earned mention previously here on DD. While Adam was here, we took a road trip to lovely Manchester-by-the-Sea, MA, and paid our respects to my ever-lovely god-daughters, Victoria and Cassandra, who quickly accepted Adam as their older "god-cousin" and family member. The melding of two separate aspects of my life into a more seamless whole was like opening a door of family and kinship. This also got me thinking about the brilliant Sabina, Adam's older sister who is currently at the prestigious New Jersey Governor's School, a four-week creative arts camp for the best and brightest high school students in the state, not to mention my niece Caroline in Atlanta, and Mary's brother's wonderful children, Patrick and Raquel, and last but not least our son, Rene, a child of light himself. Add to this list the many other children connected to us by some common thread and a portrait of the newer generations emerges.

Many naysayers might denigrate the youth of today in terms of their use or alleged addiction to media of all kinds, including television, the Internet, iPods, etcetera. Many say that the younger generations lack the attention span to accomplish great things and move the society forward. Everywhere there are warnings that today's youth are swirling in a media-saturated mire of consumerism and self-satisfaction. (And who, may I ask, is responsible for that mire's creation, dear Readers?)

But I'll tell you, folks, there is a level of savvy, emotional development, and cultural knowledge among the young today that can rival or exceed that of any previous generation. While I will agree that childhood obesity is at epidemic proportions and perhaps fewer children are able to negotiate iambic pentameter as did their predecessors (did I ever really get iambic pentameter, anyway?), the current generation moving its way up the educational ladder has a level of media/cultural sophistication and global awareness unmatched by previous cohorts. This "global village" of ours has never been so connected, information has never been so readily available, and I hypothesize that the brightest minds of this generation will transform the world in far-reaching and profound ways, hopefully undoing some of the devastating damage wrought during the previous century.

When I hear pundits and others denounce the young and hold them responsible for their current state---however that state is perceived---I remind myself that this generation did not grow up in a vacuum. This generation did not create cable television, fast food, the Internet, the iPod, and instant messaging. Each generation simply accepts the tools it is handed and makes their generational bed with what is at its disposal. Previous generations were handed "Father Knows Best", the transistor radio, LP records, internal combustion engines. What was accomplished by those tools falling into those cohorts' hands is a story that fills many of our libraries and bookstores today.

What I see is a globalizing society, for better or worse, with people of myriad cultures interwoven by electronic communication, global travel, and the inexorable breaking down of barriers which previously disallowed the occurence of certain human interpersonal transactions. While no one in their right mind in 1921 could have envisioned, for instance, the simultaneous worldwide broadcast of, let's say, the Live8 concerts around the world and the potential impact of such an event, perhaps the founders of the United Nations on June 6, 1945 had an inkling of what a more united world would look like (and I do not mean Benneton, folks!). That said, the reverberations of each generation's accomplishments reverberate through the milennia for what many native peoples might be seen as seven generations.

I, for one, am so heartened by what I see in those younger than myself. Like any ageing fart, I of course wish to pass on my "invaluable" advice and can sometimes lapse into worry that, in my golden years, all hell will break loose and no one'll be competently minding the ship. That said, there is a heart and spirit existing out there, growing daily, that moves me to write these words tonight. While Karen Berquist of Over the Rhine has sang, "Sometimes I think this world's too fucked up for any first-born son", I also know that those sons and daughters born into this world are the key to its eventual and probable redemption. Tonight I surrender to the fact that as my generation's sun begins to set, there will be many others worthy, willing, and able to assume the helm. Let's leave them something to hang onto, shall we?

Friday, July 15, 2005

Narcotic Nightmare

It seems that more and more of my time at work is taken up by patients in need of narcotic medications. As the "middle-man" between my patients and their providers at the clinic, I negotiate contracts around the use of narcotics and monitor patient's side effects, pain levels, and adherence to our agreements. While many people are sincerely in pain and certainly need narcotics to ease their suffering, there are always some whose motivations seem slightly dubious and cause confusion and difficulty for their providers. A history of substance abuse also complicates the picture and makes treating pain more challenging. It's times like these that I give thanks that I'm not a Nurse Practitioner and have no prescriptive authority. Put into the position of listening to a patient's complaints and assessing their needs, I know that I would be a soft touch, always erring on the side of believing a patient, even if my intuition led me to think otherwise.

Pain is widely under-treated in this country and I'm happy to assist in managing patients' pain, but it is admittedly a confusing and trying ordeal at times. While pain advocates in the medical world are pushing for more recognition of pain as the "fifth vital sign" (after temperature, pulse, respirations, and blood pressure), it is still not always clearly seen by providers and is treated with less than germaine levels of attention.

Many of the docs at the clinic only work part-time, so I often find myself negotiating for narcotic prescriptions when my patients call for refills. Add to that the fact that patient's charts are often MIA at the the clinic, making documentation and double-checking of doses even harder. I think I can say that this is my least favorite aspect of my job, one which causes me endless distress and cognitive dissonance. The fact that I started writing this entry just before midnight on a Friday underscores the notion that it weighs heavily on my mind.

I'd like to write about this some more in future, but send this missive out into the cyber-ethers to allow myself to let it go for my long, four-day weekend. A short vacation is in order and I must clear my mind of static.

Thursday, July 14, 2005

Down Time

So much time spent in the mode of doing. Being seems to take a back seat so often. Work consumes the day beginning with the rise from bed at 7am, the exit to the car at 8:15, and doesn't really end until the work duds are shaken off back at the homestead, usually after 6pm. Summer, however, invites one to partake of the outdoors, stay out late with the sun, drape oneself in a comfortable spot with a book, splash in water, roll away on a bicycle....

Last night we went to a picnic celebrating the first birthday of Class Action, a local organization dedicated to bridging and understanding the class divide. Politics aside, it was a wonderful group of people in a lovely location. The summery foods and good humor of the crowd just spoke of the ease and languor of summer. This weekend, The Green River Festival beckons, and then a quick overnight to the ocean to see friends and dip in the oft-frigid New England surf.

Today, driving through the stiflingly hot city, I spied people crouched in doorways, parked under shady trees, sitting on fire escapes in somewhat vain attempts to beat the urban heat. Every city should have free swimming pools open to the public for ways to cool off and enjoy the heat, rather than suffer its consequences. My son found a free pool in his neighborhood in Brighton, Mass., but the poor people of Springfield have no such luck. Tonight I bask in the air-conditioned comfort of my home, and know that I will sleep well in this cool retreat in the woods, while so many in the cities wallow in the sticky night air.

Priviledge is everywhere, and while I give thanks for that which I have, I wish I could bestow it upon all and sundry. Making sense of that cognitive dissonance is a life's work.

Tuesday, July 12, 2005

In The Trenches

As much as I avoid TV and radio news, I still read the news on the Internet daily and stay abreast of local and global happenings. On that note, this last week has been a roller-coaster of emotions, with bombings in London, children used as shields and killed by the LAPD, increases in aid to African nations with a promise of debt relief, and the continuing "War on Terror" that the public is force-fed 24/7 by the American media-at-large. It's overwhelming, and I think to myself that if I was one of those middle-Americans who watches Fox News every day and soak in all of that sensationalism and jingoistic self-flagellation spiced with blind patriotism, I'd be ready to drown myself in my neighbor's pool, or at least sink into a summertime gin-soaked stupor. Keeping up on the news is like wearing a hair-shirt in the summer heat: you want to know, you care to know, but it hurts like hell and gets under your collar in the worst way.

Staying sane in these times of universal violence, deceit and corruption is a full-time job for the post-modern world citizen. If we are lucky enough to know where our next meal is coming from and are not living purely in survival mode (as so many are forced to do), then we have time and energy to focus our gaze beyond our own individual plight. When one does this, the wide world just appears to teem with suffering and pain.

Making sense of the existence of such pain is a life's work for me, and my attempts at alleviating a very miniscule corner of that painful world is about all I currently feel capable of. I give thanks that there are people out there who live life in a large way, wielding enormous impact in the world by using their skills and expansive personalities to wage war on suffering and effect the lives of thousands, perhaps millions. For every Bono, Mother Teresa, Jimmy Carter and Peace Pilgrim walking the Earth, there are thousands of us "little people" who do our best out here in the trenches of society. I myself am a trench dweller and am personally comfortable with that role. At times it feels so desperate, so ineffectual, but I know that my own small efforts are part of a larger wave of compassion washing through some of those trenches on a daily basis.

A huge thank you to all of you trench-dwellers out there. For those of you who wonder what it's like, feel free to drop in. There are plenty of opportunities for participation. It may not always be pretty, but there are great rewards when one genuinely attempts to alleviate the pain of another. Volunteer for a soup kitchen, be a Big Brother or Sister, drive people with cancer to their medical appointments. There are so many ways to do a small act, the effects of which ripple outward in waves of compassion, including Buddhist practices of simply breathing in the pain of the world and exhaling compassion, all in the comfort of your own home. Take a moment and partake of such a practice, and you contribute more than you may ever know.

As always, may all beings be free from suffering. Regardless of how bad the news may seem, there is always room for healing and redemption. Personally, that thought helps me to get out of bed in the morning. How about you?

Monday, July 11, 2005

"Expert" Witness

Today I testified in court for the first time and it was in the role of the "expert witness". Luckily I was not being taken to court myself. I was simply called as a witness for the defense in a case in which an unnamed state agency was taking an unnamed agency/facility to court for unnamed offenses, and I was there to testify that the medical care of my (unnamed) patient who lives in this facility is up to snuff, which it is.

Several amusing things I noticed as I sat waiting for my turn on the stand:

-The prosecuting attorney's last name was very close in spelling and pronunciation to the word "vendetta". I kid you not, although she was not apparently Italian.

-The state seal of whatever it was which hang above the judge's head can only be described as a Native American standing in the center of a shield-shaped area outlined in blue. The individual is holding a long bow in one hand and an arrow in the other. Above his head there is a disembodied arm with ruffled sleeves, bent at the elbow, holding a sword as if to strike down upon the head of the Native American. Again, I kid you not. What kind of patriarchal judicial hocus-pocus is that? Beneath the Native individual was a scroll-like shape with the following words inscribed: "Ense petit placidum sub libertate quietem", for all you Latin scholars out there. Translations, anyone?

Anyway, my day on court was short-lived, and may I never need to use my own malpractice insurance which covers me for up to $6,000,000 per annum.

'Nuff said.

Saturday, July 09, 2005

The Teacher Redux

I just received a contract in the mail inviting me to teach again next semester. I also received a copy of my evaluation with actual quotes from my students, some of which are almost embarassing, to wit: "Keith is the best instructor ever! He deserves a raise!" "Keith is the best teacher I have ever had in my whole life. He makes learning interesting and fun at the same time!" "Kindness radiates from him, a wonderful nurse, an excellent human, and a terrific teacher" (Oh my!) "Keith is the SHIZNIT!" (I'll have to ask my son to explain that one...)

Wow, that is overwhelming and humbling. After one year of teaching, I did not expect such high marks, and I give thanks for having such a forgiving first audience. Now that all of the prep work and front-loaded new-teacher learning curve is overcome, this next year can involve more thoughtful planning of fun games and more innovative ways of communicating information. Any advice from you, dear Readers, regarding new ways to teach adult learners, I am all ears...well, at least somewhat more ears than usual, anyway.

The teacher is learner is teacher is learner, andI look forward to a renewed opportunity to explore this aspect of myself once more. For now, I'll enjoy the summer and the pleasure of working only 40 hours a week (plus a few per diem evening shifts here and there).

Now off to pick up our son who is rolling into town on the bus from Boston in order to celebrate his 22nd birthday with his good old 'rents.

More soon from birthday land...

Thursday, July 07, 2005

Moving right along....

Yes, moving right along. Another week almost under the belt. My patients tax me but I'm holding up under the pressure (thanks, Prozac!). One of my clinical team-mates is currently on vacation and her eighty-some-odd patients have been adding to the melee. Phew!

For those of you who were following the story of Rose, she has been living with her son with 24-hour supervision, and Protective Services and the visiting nurses are keeping a watchful eye. We're edging closer to starting her on antiretrovirals (AIDS drugs) but I'm still not holding my breath.

A brittle diabetic patient is refusing to continue to use her insulin, and when the visiting nurses come to her house, she acts as if they aren't there. Another diabetic continues to abuse alcohol as I warn him that he's heading down a slippery slope towards ill health, dialysis, amputations, and heart disease.

Many of my other patients are behaving themselves nicely, taking care of business, responding to my prompts, and moving right along their paths of self-care.So many patients, so little time.

At any rate, as violence explodes in London, I also watch the violence on our streets here at home---the violence of poverty and disenfranchisement and institutional neglect. There are fires everywhere, but some are less noticeable than others. I try to maintain my precipitous optimism for humanity as the signs of global devolution become more stridently obvious.

Moving right along is what we can do, as long as our own movement somehow involves the forward movement of others for whom we can serve as guides, mentors, or allies. The G8 is a venue for sharing the wealth of the industrialized world with others, but it remains to be seen if those in positions of power have the cojones to do the right thing......

Let's all take a collective inspiration and exhale compassion for sentient beings everywhere.....

Wednesday, July 06, 2005

Fourth of July Fallout

As I shared in my last post, a conversation which occurred on my friend Anvilcloud's blog was quite interesting. Luckily, some very astute and intelligent individuals chimed in and made the whole thing both entertaining and informative. I learned that some Canadians hold the citizens of the United States in high esteem while simultaneously loathing our government's actions and policies. I also learned first-hand that there really are Americans out there with a "love-it-or-leave-it" attitude which precludes any criticism or discontent from the citizenry. (Since the start of the current war, I have been told to move to France many times by those unhappy with my dissent). I also saw how some Americans like to put aside their criticism on the 4th of July and simply revel in All Things American. While I appreciate all of the above considerations, I also revel in the freedom which I have to voice my dissent at any time of day or night in many different venues, including this one.

I noticed that the ensuing conversation led Anvilcloud to ask some questions about having comments on one's blog, and this has also got me thinking. A fellow blogger warned me early on that having comments can be troublesome, leading one to feel beholden to respond to each and every comment. One must also take into consideration that negative comments may be par for the course, especially if one tends to write about and examine controversial topics.

In my experience, comments left on my blog have always been nothing but a joy. Any comment which is left is immediately and automatically forwarded to my personal email and I am consistently and honestly excited every time I receive notification that a new comment has been left.

Blogging has become a way of life for me, as well as a life-line for my creativity. I've finally found a creative outlet which is immediately gratifying, allowing me a public venue to share my thoughts and experiences, further enjoying the responses which come my way.

For those of you who do indeed comment from time to time, thank you very much for doing so. For those who choose not to comment or have never done so, commenting is welcome but not obligatory. Although you are welcome to comment anonymously, I do prefer signed comments, personally. FYI, a link to my personal email in my profile on the home page of Digital Doorway also allows you, dear Reader, to email me directly rather than comment publicly.

Thus, all forms of contact are welcome, and my experiences of the last six months only reinforce the fact that public comments on my blog are gratefully accepted, as the world wide web was originally conceived to be a public space, and I see Digital Doorway as another space where others can leave their digital mark.

Monday, July 04, 2005

Interdependence Day, Part II

My Canadian blogger friend, Anvil Cloud, posted a lovely and neighborly "Happy 4th of July" aimed at us Americans who scan his blog. In response to his post, I commented on his blog with my own feelings about the Fourth of July as an American inside the belly of the beast. Here is the text of my response:

"Wow, Anvilcloud. After writing a fairly anti-American note on my own blog today, I surf over here to your appreciation of us folks. Food for thought.

"I appreciate your enthusiasm and support for us Americans, but also remind you that there is much more to the story than this.

"Our country is founded on the exploitation and slaughter of millions of Native Americans. We have exploited migrant labor since our inception, migrants who built our roads, bridges, skyscrapers and railroads. Now those individuals grow our food, clean our houses and do all of the menial labor that we are too good for.

"Our country has instigated coups and civil wars, divided peoples of many countries against one another, undermined true democracies, and stuck its nose in many unwanted places, Iraq included. We created the seedbeds for mass slaughter and unrest in many Central American counries, installed CIA-backed dictators, and silently colluded with drug lords in Columbia and Afghanistan. We were best friends with Saddam Hussein for many years, selling him the chemical weapons which he used on his own people with our prior knowledge. We installed the Shah of Iran in order to counterbalance fundamentalism in that country, a move which has had no positive outcome of any kind, especially taking into consideration the recent elections there.

"As a people, I feel that my country is haughty, self-centered, egocentric, nationalistic, and currently bordering on fascist in its ideology and outlook. Based upon our Gross Domestic Product, we actually give pitifully small amounts towards debtor nations and those suffering from famine, war, and natural disasters.

"I highly recommend that you read A People's History of the United States by Howard Zinn for a true accounting of our origins and deeds since the 18th century. Sorry to burst your bubble, but this southern neighbor of yours is not what it seems, and my shame at being American is enormous at this time.

"Thank you for your sentiments and praise, but I also encourage you to look deeper and see the real face of my devolving nation.

"All the best, today and every day to my Canadian friend."

Interdependence Day

On this, the 4th of July here in the US, we tend to celebrate Independence Day and all things American. Some of us are wont to escape to Canada for the weekend rather than be barraged by the nauseating patriotism that seems to sweep the nation like a plague (Albert Camus would agree!). Speaking of which, as a balance to all of the "God Bless America" bumper-stickers that seem so ubiquitious these days, I recently saw one that read, "God Bless The Whole World, No Exceptions!" My sentiments exactly.

Our national egocentrism has taken on vitriolic proportions since September 11th, 2001, and I sometimes seethe with resentment at the tunnel-vision that has swept our nation, a nation to which my emotional attachment has only weakened.

The Sirius Community celebrates what they call "Interdependence Day" on July 4th, underscoring the opposite of nationalism and American egocentrism---the interconnectedness of all things, all peoples, all lands. How I wish we could adopt this more inclusive paradigm into our national self-image. Until that time, I see this day as an opportunity to see how our country has devolved, and continue to visualize what could be, what might be, and what some of us already work to create and nurture daily.

Here's to interdependence!

Sunday, July 03, 2005

Summer's Cauldron

Once again, dear Readers, name the musical reference for this missive's title and earn a gold star. Last gold star went to GXF for naming Peter Gabriel as the muse for "Rhythm of the Heat".

Anyway, take one part sun, one part lush green, two parts water, add beer, watermelon, fruit smoothies, fresh organic vegetables, strawberries, bicycles, wet and panting happy dogs, two hammocks, an occasional gin and tonic, several camping trips, at least one jaunt to the ocean, and the promise of fresh corn and blueberries to come, and you have yourself the makings of my quintessential summer.

Since the reality of work must so rudely interfere with enjoyment of this dearly loved season, it's even more important for the evenings and weekends to be as much like retreats or mini vacations in and of themselves as possible. With only several long weekends and one full week of vacation planned for the summer, one must grab each day by the horns and enjoy it as much as possible. The relative nightmare of car-shopping herewith dispensed with, we now interrupt this bulletin for an important message: make the most of summer, for its fleeting loveliness is something to be savored, like a ripe strawberry begging to be eaten.

Here's to drowning in summer's cauldron. No life-preserver needed.

Saturday, July 02, 2005

Sweet Sixteen


Sixteen years of marriage, replete with joy, changes, ups and downs, death, tragedy, loss and rebirth. I wouldn't trade this partnership for the world....... Posted by Picasa