Notes on life, philosophy, and medicine

Wrapping a 4 day conference here in Washington, DC,  our Nation’s Capitol. It seems fitting to have a reunion of sorts in the birthing place of the US as we know it but of course, something else lurks beneath all this… That parallels something along the lines of what I heard an experienced colleague share, we are practicing “band aid medicine.”  Like the concrete streets that cover up Mother Earth and has taken us far from our roots is the money that goes around spinning us into a tizzy for its own sake and pulling us far from our passions and that which needs our love and care - earth, family, friends - and we ask why is our country in an epidemic of depression/anxiety. We answer it with yet another advertised medication, some need-to-be-consumed self help product, everything other than what we all could use - time to connect without the need to be dictated by a job, constrained by hours and money - but the machine we built up is too big to fail? We need not some curriculum to learn g

Rushing to get  Here ? Through turmoil and heartache  Misunderstood  Because If you would  No such pain ? So I miss the moments  Not fully alive Yet grateful because tonight  I can reflect And tomorrow I can try  Try again  I can hear you rustling now  Big yawn  And a sniffle I feel the warm air settle in the room  I can wish for the open air breeze and the Reflection of the stars And see the glimmer of the ocean I missed So when night falls And all is still  Not all is lost Next to me  Another soul breathes His own wishes and dreams  Not yet told Hopefully not lost  It must end  With joyful heart All is well  Because my fruit springs Not of this world  Where let downs are commonplace  When will I learn  Be still  Through and through  Be still Day and night Rest this weary soul  And find anew  Spirit rises  I will see daybreak  And smile for another chance  To get it right  I will settle quietly  Peacefully  Here

Woke up at midnight to the stirring of our new pack member - I have officially joined dog moms/dads in their incredible love for our four legged domesticated animals - it’s been fun with joyous gratitude the day she gave us a near solid 8 hrs; it is like having a child on speed dial. I’m thankful that her real dog mom and breeder cared for the first 8 weeks- I wonder what that was like… Anyway digressing, I’m listening to Sapiens by Yuval Harari and am now into the 2nd or 3rd hour and realize why it is a NYTimes best seller - such a revolutionary way of thinking and analyzing history of our human species and its “humanity.”  it sets the context for our complex dissatisfaction with the world as it stands today and how humans through micro changes over time have dug us without thoughtful consideration to a brighter future into a great big ditch - and finding our way back into the future is terribly challenging.  As for me and you here and now perhaps we can leave the world a little bette

Bora bora: At the first sight of sun light over mountaintops, what was once dark reveals the most ethereal blue hues and the signs of depth shines just below the surface which is not hidden if one cares to look. Within your body lies another world full of treasures and colors unbeknownst to just the passerby yet it was not meant for that, but rather to be uncovered and even explored. Your body is a reflection of all bodies. If we can listen, preserve then we can learn, cherish.

Over the last several weeks, I've been posting material I wrote in the months preceding, rather than put typed letters directly onto this old blog. So here I am, in all my glory and not, at 4:12am after fussing around, exploring the dark of night in my home and my withering mind.  Withered from hustle of days, lost in unconscious meanderings, un-fully appreciated in the present. The bright glare of the computer screen stares back against the blackness of this small room, hoping for magic. Magic to transform days passing to days living. To give this little life, ALL.  Take me as I am, embrace all my imperfections, because I want to shine.  ... 

Bora bora: At the first sight of sun light over mountaintops, what was once dark reveals the most ethereal blue hues and the signs of depth shines just below the surface which is not hidden if one cares to look. Within your body lies another world full of treasures and colors unbeknownst to just the passerby yet it was not meant for that, but rather to be uncovered and even explored. Your body is a reflection of all bodies. If we can listen, preserve then we can learn, cherish.

The tragedy of life is not that it ends so soon, but that we wait so long to begin it” CS Lewis I found this incredible missing link to the work I do as a physician, a wannabe healer of my patients, and that is the work of understanding trauma, of how trauma can trap someone from the experience of life anew.  Even without trauma, a question of how to mindfully and presently live our lives is still a powerful and challenging one.  Top that off with the mind numbing,  haunted by automations of the brain, that entraps us to relive our worse moments and to be stalled by fright, how does one live presently?  The first part of that answer may be to accept our emotions - to  feel them and to label them - so that we can tell our story, grounding us enough to give us back our wings. 

Yes there are doctors, counselors, psychiatrist, psychologist, nurses, medical assistants, physical therapists et al...it's all good, sort of, but at the end of the day, what you need is your community.  You need your family and friends and neighbors to step in and step up. Since moving all over the world has become possible and our careers have taken us to all corners of the world, our family unit, our community unit is hard to find and with that comes the social isolation, the real illness of our society. If we want real health and healing...whole minds, bodies, souls...we need first to build on people's skills and talents within the community and  for the community .  Healing requires connection and relationship and makes room for creative engaged thoughtful minds that advance society. The REAL work and impact takes place with the people in our lives, our community, our neighbors, our friends. What I mean is that there is a barrier between the professional and the patient or

This one gets a spot on its blog post. "Breathing in I bring calm presence of mind, breathing out I smile this beautiful moment." - Viet philosopher and monk,  Thich Nhat Hanh (10/11/1926-1/22/22)

I spent the last 10 days moving cautiously around the house, mostly in my son’s bedroom to prevent my husband and son from getting Covid-19. The good and bad of it is I know exactly how I got a good dose of the virus - one day before my sister started showing symptoms she was loudly discussing her political view points from the driver’s seat as I cautiously found points I could agree with before mindfully trying to pull her from the edge of what I in part feel like is the cliff that falls into a worm hole of several conspiracies - not all without merit - but regardless of the topic - she was loud and spewed a fair amount of viral particles into an enclosed space and I took it having thrown some caution to the wind or at least made some subconscious choice that this moment or that one my child was having from the back seat several feet away with his beloved cousins was worth it and I didn’t really know because well they don’t believe in masking and how deadly covid could be was not enou

It was 8am, I stopped by the Fred Meyer's store to purchase a few items for my son's lunches this week. As I walked out of the store, I was greeted with a vast empty parking lot. That morning on my way to take my son to school, there was an equally sized empty building up for lease with another generous parking lot. As I drove home, pulling onto the I-5 south corridor was a much smaller space with tents and a large array of trash.  I have always had a fascination for the effective use of space, what I saw was that we had been building our nation not for humanity, but for large cars, and the next big thing that was going to peddled as the ideals of living.  Just like in medicine, towering hospitals, brand new clinic spaces, but long wait times and 5-minute encounters that don't leave you feeling healthier or stronger, or better...rarely anyway. I hear there are really incredible places of healing.  So, is time for a little revolution? How do we take back our health and empow

If only words or even pictures could describe - we thought our first morning in Papeete was serene and pleasant with a well manicured lawns and ample color from tropical flowers than onto a beach front bungalow that seemed like everyday could be as sweet with sun kissed rays along lush green mountain tops and stretches of turquoise beach but no, there is a yet more wonder and majesty as we stepped off the plane onto a narrow stretch of runway that is surrounded by an even clearer blue as the sun was near setting and we boarded our sunset cruise to our overwater bungalow greeted by the sounds of Tahitian drums and lightly draped by the filling warmth of the night sky that lifts all spirits into equanimity, pure blissful tranquility.  Here, I can only imagine is only a minor glimpse of heaven…if this small piece of our world and planet exist…what words, what sight have we to see and feel upon reaching heaven’s gate?  May we stand in awe and anticipation of what awaits. In utmost humility

I don’t yet understand the reference and I didn’t thoroughly enjoy the roundabout way the story unfolded…but when it comes to people and their hidden even subconscious thoughts Liane Moriarty strikes me as a genius over and over again. So I’m hearing the end, in the middle of our little family vacation on the Tahitian island of Moorea and I’m struck by how quickly this book came together in the time of COVID…and how as my son and I walked hand in hand toward our most lovely turquoise ocean beach front bungalow and he said he wouldn’t send me to the sun to test out his sun suit if he ever invented one because it would be too dangerous… that I have no idea when I would have to have to leave him to find his own path in this life, praying it would never be the other way around…father God, I just pray it will be when I’m old and gray and he would have already gotten his wings.  Whenever this little journey takes us, give us strength and courage and peace. Grateful I got to hold his little h

Outside our beach front bungalow behind blackout curtains are the endless sounds of ocean waves and a perfectly lit sky by filled brilliantly with stars- and yet my heart weighs heavy - that love and marriage is not what I had in mind - wordless sighs and a chasm I so desperately want to bridge but our hands and hearts don’t seem to meet and despair hangs silently in the air - I am full of assumptions of what such silence bears - and that is how it will stay until tomorrow - perhaps it was simply fatigued misread. 

STOP.  Inherent value.  Move in your world, in your traffic pattern with that deep rooted knowledge.  The message the world gives you does not define you.  You are you and there is no one better being you than you.  This is step 1 This you that is God pre-knew  There is only one.  Be. 

  https://www.instagram.com/tv/CaSTsXcFQ8C/?utm_medium=copy_link To inspiring one another  To each reaching their fullest To living in the present moment To feeling all the feelings To speaking truth  To sharing your hurts  To leave it on the table  To forgive To cherishing this day To not waiting until it’s the end.

You carried me through  My small newborn body wrapped in your arms You must have smiled knowing  I was flesh of your flesh  Creation  Creator You may not have known always what it meant to be my ba But in your quiet ways  You carried me A home I always had because of you A safe place  Full of anguished love  Because of its depth  You left this earth but never without considering  How you would leave us cared for  You shed tears unseen  You wore the wrinkles of stress on your forehead And always it was for us  Your precious children Your little babies  How grateful am I to have been yours. Father,  Because of you, I could shine. How I wish I could relive those moments when you first held me When you first saw me and knew I was yours  May your days right now be as sweet as my memories  May you carry on that smile and heavy lightness that gave me wings Wishing you well daddy and hope your journey in life after is treating you well. 

How does one keep the best primary care note, we can copy and paste and transfer historical information from one to the next. We can update problem lists with care plans. We can addend the previous care note to reflect upcoming plans to not miss all the possible things we can miss.  My desire is to create a note that reflects the complexity of our patients, the stories that are interwoven and the dynamic changes that move in and out of their health story.  I wish to do that and to do it well. May our patients know that we know them so that our health care is not just limited to one problem.  May we as the stewards of health/family medicine doctors in partnership with our patients create thriving and fulfilling lives that bring together a community. 

Starting to feel the fish bowl effect of isolation. I like it. It's fascinating. I do have a room with a lovely view of calm rippling water moving gently with the wind, glowing lines of reflections undulating, a line of tall evergreens, and shades of gray/blue skies. The sound of water hitting water playing softly from my fishtank. The mild yellow hue of a lamp on my desk. Smiling faces of some of my most valued humans staring back at me from their frames.  If in the end I will settle in one room, I would have more photos. I would want to see it all and remember all the wonderful times. I would wish for all the above. Perhaps not in isolation but one does not know but most certainly in the presence of angels. I had never really put much thought into this, I wonder if that would be such a useful exercise. To manifest and visualize so that you can appoint that day.  Well I would probably get rid of a lot more junk, there is trash strewn about, a few dishes to be put away, and bag ful

I once said that I wanted to experience what my patients experience, that in knowing, I could have a deeper appreciation, deeper understanding of the disease process and therefore 1) I could diagnose it and give people clarity and 2) hopefully have the read enough, learned enough that I could present the cure or treatment plan toward healing.  So, over the last few days, I've been home experiencing some of the symptoms of Covid-19, I suspect the omnicron variant as it spread relatively quickly through the home I was staying in, regardless of the mindset I took in staying and visiting with family I suspected having it, I am here now.  I started with a slight cough but mostly noticed deep aching pain in my back/left thigh, wondered if I could just be feeling run down from the trip. I can't recall if I had headache yet, if anything it was mild and intermittent, similar feeling the next morning but headache was more noticeable, and now I felt certain that the ache was not just from