Monday, June 29, 2015

Painting at midnight, pancakes at dawn

See last post: what I am doing?

By streetlight at 11pm I am painting the first side of a door purchased this afternoon at a second-hand store, so that in the morning I may measure, saw it in half, then paint the remainder of the bottom and hang it upstairs for a top-open door to Felix's room. By the early rays of sunrise I am peeling and shredding a butternut squash to mix with eight eggs and perhaps 4/3 cup coconut flakes for pancakes. At noon LL and I are pulling dandelions in the slab of concrete in our yard, to fill the cracks in with drought-hardy perennials, and also, along the edges, raised beds of kale, strawberries, and a few valiant shoots of broccoli. This all while trying to chase after Felix and Sam, read a (worthwhile) book called "No-Drama Discipline" and apply it as much as possible, stay up to date on CME, and slowly increase our clinic encounter numbers. In other words: staying busy, yes, and anything I may be doing pales beside LL, who is doing all of this while actually directly providing the bulk of Sam's calories.

And yet. Mentally, I am infusing this busy-ness with an urgency it does not always merit. In so doing I am often doing more at a time than is necessary, doing something that may not be the most needed action at the time, and/or not giving myself adequate pauses, breaths, such that the few times I do get a "break", I quickly rush to fill that void with activity that is not always restorative.

Keeping such a schedule becomes a form of what Naomi Klein calls "looking away." She is referring, in her intro to "This Changes Everything", of looking away from the full and terrifying impacts of climate change and, inseparably, the full and terrifying impacts of unfettered capitalism. And this looking away has the ultimate effect of curtailing the creativity that is so needed right now to fix our world. By pouring my every attention into each painted corner, each perfectly grilled pancake, each word of praise or redirection for the boys, and yes, each doctor-patient encounter, I am denying myself the time and space needed to imagine a truly better world.

And in case you noticed: yes, I'm also taking all this WAY too seriously! Part of the delicious paradox of the entire situation is that I need to lighten up, sleep more, care less--at least about details--and enjoy life. Only as such can I or any of us be the change we wish to see. Hey! At least I'm a day early on this post! There's still another whole day of June! Yay! To bed! :)

Sunday, May 31, 2015

The foolish consistency of my little mind

"A foolish consistency is the hobgoblin of little minds, adored by little statesmen and philosophers and divines." -Ralph Waldo Emerson

Five and a half years ago I started writing this blog. I soon settled into a pattern of writing monthly, usually in the last few hours of the last day of the month. With each new entry I clung--and to this day still cling--to the hope that something changes. To wit, that the writing would propel me to achieve my original aim of reaching out to others, of connection. But connection, to paraphrase Georgia O'Keefe, "takes time, like to really see a flower takes time", and clearly I was and still am spending my time elsewhere. I live a fairly consistent life. What then are the foolish consistencies which not only occupy, but continually create, my mind?

In other words, what on earth am I doing? And not just with my physical energy, but with my mental energy, since both literally create who I am?

I shall return to this question next month. As usual it is late and I am tired. Who was it that said, the definition of crazy is doing the same thing over and over and expecting different results? For now it is enough that I am and have spent the vast majority of my time and energy being a father, a husband, a doctor.

Tuesday, April 28, 2015

upset

In the children’s picture book Captain Small by Lois Lenski, a storm comes up as our ubiquitous hero (see also, Cowboy Small, The Little Farm, The Little Train, etc.) navigates his sailboat home. “Water washes over the bow. The boat heels and nearly upsets. But brave Captain Small brings it about and safely sails into the harbor.”

Upset. To turn upside down, to, as defined by my 1966 Reader’s Digest Great Encyclopedic Dictionary, “overturn, throw into confusion or disorder…” Even as an adjective: “1. Tipped or turned over. 2. Mentally or physically disturbed or ill. 3. Confused; disordered; messy.” Though it’s been diluted over time to mean mostly “unhappy” or “to make unhappy”, it was helpful for me to be reminded of the original and more full intention. A sailboat in rough seas, overturned.

I am not faring as well as Captain Small right now. Nor is the small town of Omak, which I left behind only two weeks ago, and for which, upon departure, I had words that may have left some people leaving unhappy. I would rather that they were upset.

Explanations, shorter sentences, plain English for God’s sake lad! Let me try:

A year ago, LL and hadn’t planned to leave Omak this year. We have a just-turned-3-year-old and (as of a couple days ago) a 10-month-old. Moving away from a familiar home, friends, work, the walk up Ross Canyon, the scooter ride to the market, is upsetting. Our boat has turned over. We are extremely lucky to have excellent flotation devices in the form of loved ones and some time. But we’re definitely swimming. We moved into a rental with a clothes washer that doesn’t drain, a dishwasher that doesn’t exist, and a ceiling we keep bonking our heads on. Disrupted sleep routines for our boys has translated into minimal sleep for us. Felix has announced that he’s moving back to Omak. My car battery’s dead, the back door handle fell off, and the dog ran away…oh wait, we don’t have a dog. It’s hard to keep track sometimes. I can’t say we would recommend a similar move to anyone with young ones.

At the same time, as our feet begin to find solid ground, we are reminded of all the things we’re grateful for. We’re an hour away from Nana and Papa. We’re two from my sister and her family. Previously both were five. We have an Asian (and yes, it is Asian, which really means more American than were it Thai, or Japanese, or Korean, but still!) bistro, within takeout range. Curbside recycling. For that matter, we have curbsides, and sidewalks, and even a bus line that takes us right downtown to the Asian bistro.

Most importantly, we have work that we are excited to begin. Though we loved the people we worked with, we ultimately felt unsafe in our hospital. A lack of vision, leadership, and collaboration added up to accidents waiting to happen—or already happening. In a remote and rural community, people can’t afford to not work together. Upon leaving Omak, LL and I submitted a letter to the editor of the local paper, who ran it as a guest column:
http://www.omakchronicle.com/news/2015/apr/15/do-you-think-your-hospital-safe/
(sorry you have to cut and paste!)

Our new jobs are also in a rural area. We think they will be an outstanding fit in terms of our colleagues, opportunities for personal development, the mission of the clinic, and so on. The first and fundamental requirement is that it feels safe here. A huge part of that feeling of safety is that there really seems to be, both in the healthcare community and at large, a spirit of working together for the common good.

To expound on this: America has some of the worst health outcomes on the planet, especially in light of our healthcare expenditures. This fact is not surprising when one also considers that we are one of the world’s most unequal countries in terms of wealth. Not just poverty, but inequality itself, is strongly linked to poor health. Our tax structure often serves to exacerbate these inequalities, especially in rural areas. For example, schools being funded by local property taxes creates better educational opportunities in areas that are already rich. Omak is not only poor, it is also rural, so there is not the buffer of nearby pockets of wealth that cities tend to have. As is the case for education, funding for public healthcare facilities is similarly bereft. In such a setting, what one long-time resident of the area called “the stark fist of poverty”, it is essential that people work together. This is what was lacking, and correcting it is, I believe, where opportunity lies. When things are getting by—when there are small errors in safety or quality of care but no big events—when there is perhaps imperfection but not crisis—such a situation can carry on. Now there is crisis. There is upset, and sometimes upset is what it takes to change.

That is why I hope anyone who reads our article in The Omak Chronicle, and might be unhappy, is also upset. At least a little bit. Maybe upset enough to ask questions. As we stated, our intention is not to make anyone feel bad. It’s to rock and perhaps help tip over a sinking ship, so that a better one can begin to be constructed.

Monday, March 30, 2015

Gratitude

things I am grateful for:
my 9-month-old
my almost-3-year-old
the love of my whole life, LL
my friend Randall for putting up with me while teaching me guitar
all the people I've worked with here in the Okanogan
rivers especially the Salmon which is the longest un-dammed river in the lower 48 states
coconut shells which can be made into fun things
my friend LDawg who travelled all the way out here from Michigan
orcas, which are not whales but rather members of the dolphin family
coconut oil
fresh coconut water
fresh coconut meat
the joy that my almost-3-year-old takes in opening a coconut with me, and the satisfying "pop" it makes when we first break the seal
the joy that my 9-month-old takes in almost everything
hair, of which, when I was younger and would cut it myself sometimes with patchy results to say the least, I would tell my mother, "It's ok, it will always grow back" (now I know better)
watercolors
color vision
the color blue, especially the color of the sky between Cornucopia and Red Mountains when viewed from Pine Lakes
sunlight, snow, rain
Catalpa trees, mangrove trees, giant sequoias
my parents, my siblings
igloos, which are one of the many things my older brother is amazing at
having a partner who's the smartest physician I know
my hands which still have 5 fingers apiece despite the abuse I've put them through, and their ability to do things as varied as type these words, play a guitar sort of, and make forts which are almost as much fun for my boys as for me
red-tailed hawks
salmon
mangoes, raspberries, avocados, chocolate, kale, butternut squash, kabocha squash, not necessarily in that order
food in general
the amazing abundance of food that arrives daily even to far-off corners of the world like the Okanogan
the knowledge that all of this is transient, that in under a billion years the increasingly toasty sun will make the Earth completely inhospitable for life as we know it, that in fact we may do the the same to the Earth in the very near future, yet that we have hands and minds and imaginations that can still try to make things as beautiful and as sustainable as possible
the songs "Valedictorian", "I will do the breathing", and "Little Hands" by Matt the Electrician
the existence of dance
my dance teacher Chery from my first year at Wesleyan
more people than I can possibly name in a poem
waterfalls especially the one in South Africa that Paul, Richard and Miriam hiked around with me
my family in South Africa
sailing ships
the past existence of pterodactyls
sleep, time for that

Friday, March 27, 2015

I want that hour back

I realize that the hour lost to Daylight Savings can't serve as as excuse for not posting in February. That change occurred on March 8th. This brief posting isn't meant to replace the one I didn't do then, nor to serve as this month's.

Instead I'll use it to share a few links--there are a ton out there--about why DST should be done away with. Fascinating that, for instance, the main reason DST was extended to the 1st of November was to profit convenience stores, who sell more candy when trick-or-treaters have an extra hour of light in the evening. From my perspective as a family physician, one thing that is clear is that children would do better to have that extra hour of light in the morning (e.g., there are numerous studies citing better school performance with a later morning start time). It looks like a good book on the subject, as these are all just short blogs, would be Michael Downing's "Spring Forward: The Annual Madness of Daylight Saving Time." If anyone's read it I'd be curious to know what you thought. Cheers!









Hmmm…links not appearing to show…here they are for copying and pasting:

http://now.tufts.edu/articles/cost-daylight-saving-time

http://www.businessinsider.com/economic-and-health-effects-of-daylight-saving-time-2014-3

http://www.latinospost.com/articles/54344/20150301/daylight-savings-time-2015-when-is-it-and-why-are-lawmakers-trying-to-lose-it.htm

http://www.amazon.com/Spring-Forward-Annual-Madness-Daylight/dp/1582434956





Saturday, January 31, 2015

The Deep End

It is Saturday night and I’ve just finished up at a meeting of family physicians. It takes a while to wrap up some final paperwork and goodbyes, then I wend my way through the snarl of traffic I used to call Seattle and pick up my friend Neville for dinner. Neville says that when we lived here the traffic was the 18th worst in the country. “Now it’s the 3rd,” he says.

After dinner I drive by the Central Cinema. I love the Central Cinema! Dinner, drinks and dessert—a fabulous crème Brule, if I recall—while you watch a movie. It’s here that LL and I first saw “Best Worst Movie”, a charming documentary about what truly is the best worst movie ever made, “Troll II,” and then stayed up for the namesake midnight movie. Right now they’re showing “Groundhog Day” and I’m tempted enough that I park the car to check show times. Right in the middle. Too bad. I get back in the car and drive back up 23rd, then take Boyer to cut back west again. I drive past the church where I crashed a wedding in order to meet the band that LL and I ended up asking to play at our own reception.

Everything feels eerily normal.

Everything has felt too normal, ever since reading the introductory chapter to Naomi Klein’s latest work.

In language brilliant for its clarity, Klein lays out a thesis captured by her title. “This Changes Everything: Capitalism vs The Climate”. I haven’t yet read beyond the 30-page introduction. Now at LL’s parent’s house, I can see the book out of the corner of my eye. It crouches on the desk, a fire-breathing dragon cloaked under a sky-blue cover. An ocean-blue cover. A tropical ocean blue, swallowing islands, cities, and the sky.

“The International Energy Agency warns that if we do not get our emissions under control by a rather terrifying 2017,” Klein writes, “our fossil fuel economy will ‘lock-in’ extremely dangerous warming. “ ‘The energy-related infracture then in place will generate all the CO2 emissions allowed’ in our carbon budget for limiting warming to 2 degrees Celsius…As Fatih Birol, the IEA’s chief economist, bluntly put it: ‘The door to reach two degrees is about to close. In 2017 it will be closed forever.’ “

2017 is 23 months away. Suddenly lower gas prices don’t seem so great. Seattle’s traffic mess, even as it buries a few billion dollars in a car-only tunnel that’s already way over-budget and way under current sea level, is one piece of a rapidly sinking planet. We are headed for deep water. And that’s if we were to stop, for all intents and purposes, now.

If we instead achieve the more-likely (without drastic action) prediction of 4+ degrees Celsius by centuries end, “even the best-case scenario is likely to be calamitous. …This would drown some island nations such as the Maldives and Tuvalu, and inundate many coastal areas from Ecuador and Brazil to the Netherlands to much of California and the northeastern United States, as well as huge swaths of South and Southeast Asia. Major cities likely in jeopardy include Boston, New York, greater Los Angeles, Vancouver, London, Mumbai, Hong Kong, and Shanghai.”

A chime. I look up. A text. My phone is pulling me back to the surface, back to the present, the normal, to a beautiful family 5 hours’ drive away on the other side of the Cascades, two beautiful boys who are asleep and a beautiful wife wanting to check in before sleep. I must go. “This Changes Everything” will have to wait. But not for long. Not for very long at all.

Wednesday, December 31, 2014

what I want

I’ve watched Keanu stop bullets with kung fu
too many times to not want to be famous.
Too often I’ve watched the out-takes
at the end of a Jackie Chan movie
that shit is for real y’all
to not know that amazing things
are, indeed, possible.
With enough practice.
Most recently I’ve related
to Mark Ruffalo in The Avengers, right before
he turns green and huge and tears apart bad guys,
he says (when asked how he can become angry so quickly)
“I’m always angry. It’s keeping it down that’s the hard part.”
Some days I wish I could skip the Jackie Chan discipline,
dedication, dislocated joints,
and just let my anger turn me huge and green
and tear things apart.
Tear apart things like the Grand Coulee Dam
and in the process restore the salmon run,
the Colville confederated tribes whose culture was that salmon run,
the broken lives that show up in our ER because it’s gone.
Tear apart things like Monsanto
and in the process bring back farming that isn’t actively destroying the planet
things like Coca Cola
and bring back clean water as public property and a human right
things like Walmart, Shell, the empires of the Koch brothers and Kemper Freeman,
and restore representative democracy and community and some last vestige of hope
for our planet.
I wonder if this poem will get the attention of the FBI.
Some days I want to be famous for channeling my anger to destroy bad things.
I want people to look past the mild-mannered family doctor
and see a simmering pot of rage just waiting to tear things apart.
But today
today I am angry over trivial things
little things
petty and avoidable things like wasting time online trying to decide
which superhero movie to watch in the precious time that LL’s parents watch the boys.
And so I walk down 45th and instead of reading the movie marquee
I walk into Open Books
and buy, for LL the love of my life,
a book of poetry by Mary Oliver.
Next year Mary Oliver will turn 80.
I open the book and read a poem called “What We Want.”
Then I don’t want so much to be famous.
I don’t want to stop bullets with kung fu.
I don’t want to be angry.
I just want to listen.
To observe nature, such as it is, such as is left of it, such as we are a part of it.
I just want to be a good husband and a good father
and as much as possible
to inspire my two little boys to make the world a better place
by doing so myself.
And if Monsanto and Coke and all the dams and prisons and jetski manufacturers
go by the wayside
in the process
well, that will be okay too.