Ghost in This House

Ghost in This House

I’m just a ghost in this house
I’m just a shadow upon these walls
As quietly as a mouse I haunt these halls
I’m just a whisper of smoke
I’m all that’s left of two hearts on fire
That once burned out of control
You took my body and soul
I’m just a ghost in this house

–Alison Krauss

 

May You Find God’s Grace in Every Day!

Nostalgia

–When the unknown and difficult decisions become crystal clear
–To know that I would want to have the choice to honestly and completely walk away when it is not Me who completes you
–To have my hand fit effortlessly into yours and feel so natural
–To sense your rhythm and synchronize instantly without thought
–To fall into your arms any time and all the time as natural as the breeze
–To love you so deeply that I would give my life for yours
–It is all clear when considered in this reality

Veridical Doc

May you find God’s Grace in every day!

Unforgiveness

Unforgiveness is a sin, my sin.

Everyday I ask for Forgiveness of my sins and Grace from God especially for my free spirit and my mouth…

But tonight (or last night since I am still up )is different…I almost died last night.

If you know me, really know me, then you know I am not afraid to die. But that does not mean I am ready to die.

In the moment my entire life flashed before my eyes:

Who is going to tell my 8-yr-old son? He is less than 2 miles down the road having a great time celebrating a birthday with his bestie?

Who is going to tell my 11-year old daughter that mommy is dead because we had a slight delay, and I had to drive her separately? Will she blame herself?

Who is going to tell my husband that his wife is dead, and he has 2 children to raise alone?

Who is going to tell my 84-year-old father that he has to bury his only child?

Who is going to tell my bestie’s son, that his mother is dead?

How could this happen?

In an instant….

Just driving down the road with one of my besties…listening to an update on the status of another friend declining on Hospice Care…Bluetooth.

I saw him slowing down….no turn signal…it was dark…lights on…driving the speed limit…watching…

Then I saw it…he was going to turn right in front of me….I remember hearing my bestie gasp…I don’t think she even had time to scream….

I hit my brakes and felt the ABS kick in…I felt every safety feature on my car engage….

“Please no God….if I hit him, I will kill us all”…

I could not have missed him by more than 1/2 inch….

He was turning into his driveway…shaking I backed up and pulled in behind him…

Thinking surely something is wrong….

I found him sitting in his car in his driveway…reading…it was too dark to see if it was phone or paper….

In that instant I knew….he was reading and driving…I stood there staring at him for what seemed like minutes….

I said are you ok…He looked at me as if I were an idiot…

Then I knew…I said do you realize that you turned in front of me and almost killed both of us….

He said I never saw you…

And then my MOUTH…”well I guess not…it is challenging to read and drive at the same time in rush hour traffic and in then dark…”

He came flying out of his car….and thought it was proper to get in my face…and start yelling profanities….

I said “go ahead put your hand s on me”….my Mouth again, “because when you do, it is game, set and match!”

So for all you guys….if you don’t know, then, my daddy can explain it to you…do not get in a ladies face, do not yell profanities at her…and NEVER, EVER under-estimate what might happen, if that lady is an Army brat with years of service to our country as a Navy Doctor…and way too many years in the SCHOOL of Hard Knocks….

And if you live in Winterville, watch Cory Road…. there is a guy who thinks it is okay to read and drive simultaneously…and it appears he is not skilled at either…

My sin of unforgiveness tonight….”God please help me find my way to forgiveness…that man did not care!”

May you find God’s Grace in everyday!

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Civility and Racism in Life and in Medicine

And I’m back…

My children started school today. Like any parent, I have mixed emotions. Some of you may have noted that I do not post pictures of my children or really speak of them in my writing. Yes it is deliberate….

An aside…I believe that my children have a right to privacy, and they have been taught from birth that they will make their own way through life (not judging anyone). Yesterday I discovered that I am free-spirited…humm…did not see that coming… Someone described me as being ” like a genie in a bottle”. With that in mind, I am allowing my children to put themselves out there when they are ready. Not when I am ready…

So what does my view on talking about my children and contemplating my personality have to do with civility, racism, life, and medicine? Maybe a lot…

I have watched this spring and summer as we have killed and maimed each other for reasons that have escaped me. So when I need to feel centered in my thoughts and feelings, I turn to my Bible…

29 Jesus replied, “The most important commandment is this: ‘Listen, O Israel! The Lord our God is the one and only Lord. 30 And you must love the Lord your God with all your heart, all your soul, all your mind, and all your strength.’[a] 31 The second is equally important: ‘Love your neighbor as yourself.’[b] No other commandment is greater than these.” Mark 12:29-31

So, how does this apply to life today? Medicine? And what is missing in our society? One word: Civility. (I am borrowing this term from my children, their incredible teacher, and their amazing school. And yes, they are really talking about civility)…

The Merriam-Webster dictionary defines civility as “polite, reasonable, and respectful behavior”. So, if we are going to be “civil” to each other, that would preclude engaging in any form of racism. As a society, it seems that we are not able to accomplish civility in many settings.

So, how does this manifest in medicine? Many, many ways…Just a few real examples…

  1. A nurse pages the doctor on call because a patient is not doing well. The doctor takes 30 minutes to call back, yells at the nurse for disrupting his evening, and refuses to come in and take care of the patient. (Impolite, unreasonable and disrespectful)
  2. A patient with Bipolar Disorder goes to the emergency department with severe back pain. Her symptoms are attributed to her mental illness and she is discharged without having her complaints addressed. (Unreasonable, disrespectful)
  3. Two men come to the hospital with chest pain. One of the men is white…the other is African-American. The African-American man receives a toxicology screen for cocaine. The white man does not…. (Disrespectful)
  4. And my personal favorite: a doctor faxes end of life prescriptions to a pharmacy for a patient with Hospice Care who is actively dying at home. It just happens to be Thanksgiving Day. The pharmacist declines to fill the prescriptions. When the doctor calls to find out the problem, the pharmacist states that he believed the prescriptions to be forged since “doctors don’t work on holidays”. (Impolite, unreasonable, disrespectful) 

The fourth example actually happened to me….did I handle the situation with civility?…Not a chance…I was disrespected, but that was not really my concern…my dying patient was not receiving reasonable medical care…and that was both impolite and disrespectful….

So, how can we change behavior?…I am not pretending to have the answers…

But, for me it starts with awareness of my own behavior, and a core belief that if I expect to receive Grace, then I must be willing to extend Grace to others…and my “free spirit” needs a lot of Grace everyday…

Do the right thing…At the right time…For the right reason…No matter how much it may inconvenience you or make you uncomfortable…

–Veridical Doc 

May you find God’s Grace in everyday….

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Do We Allow our Lives to Be Limited by Our Comfort Zones?

It’s been a long time…I have been thinking…

Contemplating the idea of our “comfort zones”. My comfort zone…A patient’s comfort zone…And what role a physician should play in discussing “a life well-lived”.

“Your life is like the morning fog—it’s here a little while, then it’s gone.” James 4:14 NLT

One of my patient’s came to me, recently having been discharged from the hospital, wife in tow…I really enjoyed talking with them both, but today was different.

He was distressed. His vast array of medical problems had gotten much worse and were unlikely to improve significantly.  But he had these tickets for a once in a lifetime trip…a cruise around the Greek Isles…

Before I had a chance to talk with him, I could hear staff discussing the fact that he would never be able to take that cruise…he was just too sick. Apparently, he had a similar response from the team who took care of him in the hospital…

I sat down to talk with him and his wife joined the conversation…I learned about his hospital experience, his declining health, and finally the trip…he hung his head after telling me about the trip he had planned.

It was one of those moments where you silently pray for God to put the right words in your mouth…I called him by name and he looked up at me with tears in his eyes…I said simply “you and your wife are going to make that trip”.

In that instant it became apparent to both of us that it would be their last. And it was…but they made wonderful memories on that trip…

Cheers GS to “a life well-lived”…should I have the occasion tonight I will drink “The Parting Glass” in honor of you and how you chose to live…

A little known secret that physicians rarely reveal is that we learn more from our patients than they ever learn from us…

That brings me back to my months of pondering…my comfort zone became very small St. Patrick’s Day 2015. That day could have been just an ordinary day…but it crushed me like a soda can. 

“But something touched me deep inside. The day the music died”. American Pie, Don McLean

It was the day I was publicly humiliated both personally and professionally….a day that will forever remain in my memory and in those of my family including my 9-yr-old and 6-yr-old.

The event shrunk my comfort zone initially to the four walls of my bedroom…

My foray last Fall into Ethiopia was as much for myself as it was for the Ethiopian people. It was in fact my version of the book “WILD” by Cheryl Strayed (minus the drugs)…The trip had a unique descriptor: 2 women, 2 weeks, hiking 200 miles to make a difference in the lives of a people…

On St. Patrick’s Day, I thought my life was over…

After traveling to Ethiopia, I realized it was just beginning…

I am not convinced that my time will end in “a life well-lived”, but I have been true to myself…

I decided long ago, never to walk in anyone’s shadows, If I fail, if I succeed, At least I’ll live as I believe, No matter what they take from me, They can’t take away my dignity…..Learning to love yourself, It is the greatest love of all”….Greatest Love of All, Whitney Houston

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“May you find God’s grace in every day.”

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I DREAMED OF SIERRA LEONE…and somehow DISCOVERED ETHIOPIA

Sometimes it is simply difficult to know where to begin. But I know that everything begins and ends with GOD.

“For I know the plans I have for you,” says the LORD. “They are plans for good and not for disaster, to give you a future and a hope.”

 Jeremiah 29:11 NLT

For those of you who know me, you are aware that this has been the worst year of my life…But it has also been the best year!

For many years, God has been tugging at my heart. As a new medical student, I dreamed of traveling to Sierra Leone. I was fascinated by this new virus, HIV, that causes AIDS. And I have to get right in the middle of things, scrubs on and hands dirty. Trying to save the world. But somehow the birth of my two beautiful children, changed my pace and priorities.

God continued to tug…but I was too “busy” with life to answer and obey. Obey, which I am not very good at, is a tricky word when it comes to God. So it took a major personal and professional disaster to get me moving in his direction.

Back in 2010, I sponsored a mamma with my friend Teff in an organization called “Because Every Mother Matters” (BEMM). The idea is to empower women in Ethiopia to create small businesses so that they are able to feed their children. Many of their husbands have died of AIDS or simply left the family. Many children have been left orphaned and “mammas” have poor self-esteem. How can you believe in yourself when you cannot even feed your children?

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Needless to say, the program has been very successful. Most of this is due to the vision of the President and founder of BEMM, Stephanie Cooper. She created a grass-roots organization, and 90% of all contributions go to the “mammas”.

While I have been on hiatus, I had the opportunity to learn more about Stephanie, BEMM, and the mammas. I learned that much of our budget was going to health care costs and even with assistance, “mammas” and children were dying of preventable problems. Health concerns were an even bigger problem in the southern regions such as Arba Minch where there are 42 villages.

This time, God did not tug at my heart. He gave me a directive….Go to Ethiopia and I will show you what to do…

So two women, two weeks, hiking 200 miles began the adventure of a lifetime. Much of the trip had to be done on foot because of poor access to the southern villages by road. We lived among the natives and shared available food. I did without almost everything that I would have at home, but somehow I didn’t seem to notice. We hiked steep mountains with a few personal belongings and all the medical equipment I could put together.

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I walked and listened to God, and he carried me up the mountains. Over 4 days, my diet consisted of 1 boiled egg (thank you village #1), a piece of bread, and a banana. But I was never hungry.

On the most challenging day of the trip, physically and emotionally, we hiked for 20 miles, climbing rocks and navigating steep inclines. Then I saw more than 100 patients with the help of our guides and Stephanie. They all had the same problem: infected wounds mostly on the lower legs and feet.

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This sweet little guy could not bear weight on his right foot. Everywhere I touched, pus flowed like a river. There is only so much I could do in the village. He needed a surgeon and an operating room. The idea that had our team arrived 1-2 weeks earlier, I may have been able to treat him on site permeated my thoughts. What if??

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This smiling father brought his daughter because she is small and not gaining weight. She is a beautiful little girl whose mother left her many months before she was ready to stop nursing. Biologically, she is 1-year-old. Physiologically, she was the size of a 6-month old baby. Formula is not available in the villages, and the villagers had never been introduced to the concept of a “wet-nurse”. She will likely die from complications of malnutrition. Again, completely preventable. I cried.

The most memorable experience was one of holding a new-born baby girl. I missed the birth by 15 hours. Fortunately, it went smoothly. She was wrapped in swaddling clothing similar to the baby Jesus…I felt the presence of God all around me. And a perfect peace.

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I returned home, a changed person. The difference between needs and wants was quite clear. God no longer has to call me. Ethiopia calls…

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“May you find God’s grace in every day.”

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The Enigma Of Death – a Physician’s Perspective

For those of you who are following, if you can really call it that with one post, you have noticed that it has been more than a month.

I promised myself when I started that I would write when the spirit moved me and not feel guilty when it didn’t. I have kept to my word, mostly.

Lately, it seems as though there are a large number of people in my life who are facing death…head-on. Some are staring it down, and others are anxious and fearful.

Physicians are frequently asked about death : how long do I have (I never answer this one because I prefer not to look like a complete idiot.), will I experience pain, what happens next, will you be there, and how do physician’s experience the death of a patient. Do they mourn? Do they cry? Do they miss their patient?

I have decided to answer two of the questions…

“Will you be there?”…Yes, I have always been in for the duration. When occasionally questioned on how long I might be staying,  I respond that I will depart with Jesus and my patient.

I believe it is equally important to help a dying patient as it is to help one survive a serious illness. (My comment is in no way referring to or commenting on physician assisted suicide.)

How do Physician’s experience the death of a patient? I can only answer for myself…

Two years spent as a Hospice Medical Director, one who attended deaths on request, and 7 years spent on my own personal walk with Jesus have left me with what I think are some unusual perspectives on death.

To start with, I am not afraid to die. And I do not view death as a bad event. It is expected. The only real questions are when will it happen, and how can I contribute to making it a positive experience for the patient, family, and friends.

There is a prerequisite to the “meaningful, dignified” experience. And it is simply acceptance. Acceptance of what is to come…

I do mourn the loss of every patient I have had the privilege of caring for over the years. As I gaze around my office wiping back tears there are so, so many reminders: an old ornate perfume bottle, 2 beautiful shells, a military insignia, a pair of handmade earrings, blown glass from one last trip to Europe, a well-worn afghan knit at the bedside, many pictures, a small anchor, and the poem “The Parting Glass”.

I look around and remember and smile in celebration of the people I have had the privilege of knowing and all that they taught me along the way.

At the end of the day, there is one simple truth: it is God’s will, God’s way. He has merely gifted me with the experience of being an observer.

May you find God’s Grace in every day!

Cheers Tom “the jazz man”…

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Launch Day

September 1st and Official launch day!

The excitement is tempered by the seriousness of the topic on my mind: suicide.

September is National Suicide Prevention Month.

How many people reading this blog have seriously contemplated suicide? I venture to guess that the answer is too many. Have you ever wondered what is going through the minds of those who consider, plan, or even carry out suicide? It was impossible for me not to wonder. After all, doctors in general have a high “need to know”. So I asked…

MJ was an elderly gentleman when I first met him. I say gentleman because he was polite beyond words. Not something that I was accustomed to encountering. He stood up when I entered the room. MJ had lived a long life, and his past seemed to stretch endlessly. Like most men of his generation, he had worked hard, physically. He had injured his back numerous times and broken too many bones to count. He served in the Marines in Vietnam. He raised a family mostly as a single father… I have just given you a snap-shot of what the world sees.

Here is what I saw…

MJ is a beautiful yet tormented soul. He was abused as a young child. This left him with PTSD (Post Traumatic Stress Disorder) before he ever arrived in Vietnam. Hard work left his body wrought with pain. Just standing up took a painful effort. And he was alone. And so very lonely. He had access to health care…but no amount of medication could ease his pain. He was anxious and depressed every day of his life. He woke up every morning hopeful that he had died in his sleep. No day was particularly worse than another. It was the daily grind of painful joints, depression, anxiety, and pervasive nightmares. He was suicidal because it was simply too hard to keep on living…

How do you ask someone to persevere under those seemingly impossible circumstances? Simply put, it is the “one person rule”. It takes one person to make a difference. So we have a deal…if he wakes up and decides to do it, he calls me. I walk in faith with Christ that when that day comes, he will put the right words in my mouth. And I will make a difference…

May you find God’s Grace in every day!

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