Grace, Race, & Love.

There are a lot of people we are supposed to be loving. 

And if I'm honest, sometimes it is overwhelming. 

We are supposed to love our neighbor, our enemy. We are supposed to love our kids. And our jobs. We are to love widows and orphans and the least of these. We are expected to 
love our spouses, our God, our houses, our food. 

We love chocolate and the Bachelor and Kylie lip gloss and an Uber driver who makes us smile. We love our new suitcase and our electric toothbrush and our coffee thermos. We love Starbucks and Amazon Prime and Joanna Gaines and our favorite jeans. 

And sometimes, we love well. But sometimes, we slap "love" on the wrong things. 

For as much as I want to love well and love wholly, I know I don't have the capacity to love it all. Perhaps it's because our language doesn't give us the privilege of having more than one word for love. Greek gives us four. Though it's obvious that I love my toothbrush and my husband quite differently, the outward perception is one I can't control when I attach love to both of them. 

Because though we are quite good at spouting off all the things and places and people and souls that we love, we often fall short in being as vocal about the things we do not. Primarily, maybe, because we've been taught that the opposite of love is hate. And when people take a platform of opposites—whether good or bad, morally or personally, it welcomes retribution and retaliation from both the boy next door and the hands at the helm of the Internet. 

I can try my best to give loving soul food to the things, the places, the people, the platforms that I care about. I can try to advocate and appreciate and support and sustain all the causes that ring true and sit well in my soul. 

But I'm isolated. And privileged. And if I'm honest with the critics, I'm also naive. 

My priority platforms might not look the same as yours. Sometimes the things that sit the most comfortably are not the ones we should be sitting on.

I lived in rural West Virginia for almost four years during medical school. My cadaver lab study group contained white, black, brown, and yellow skin. One of us was restricted from rotating in certain towns because of safety issues. I should have to tell you which one of us it was, but given the recent headlines I don't think you have to gamble on your guess. 

And now, seven years outside of my time in training, I live in a small dusty town in the Pacific Northwest. We have no black friends--not because we don't want them, but because an overwhelming majority of our community is white. Our blonde haired, blue eyed son will enter kindergarten this year with most of his class looking just like him. My 3-year-old daughter picks the dolls and princesses and Barbies that look most like what she sees in the mirror. Maybe it's because she prefers pink sparkle dresses to yellow or because, even as children, we naturally reject that which is foreign. 

Or maybe it is both. 

As the headlines rolled in this month, I was left feeling both dejected and discouraged. Yes, we are better than that. Yes, we--as a nation, a people, a humble collection of ever sinful-souls can LOVE better than that. And yes, I thought we had moved past this too. 

But we haven't. And history tells us that until we approach LOVING differently, we probably never will. 

A surprisingly wide body of research tells us that unless we teach and talk and intertwine race with intention for children, our future will continue to look the same. We, as a people, will continue to love what is most like us. We will skirt around important issues because they sit uncomfortably. And we will look in a mirror as a not-guilty party thinking naively that we are not part of the problem because we are inactive in seeking solution. And until we realize the cadence of our conversations is rooted in contempt, our hearts won’t recognize the need for change. Because that better than mentality is the very thing that ruins relationships, drives couples to divorce, and singes seams of friendship.

We will continue to buy blonde haired baby dolls over those with black curls because it is comfortable. We will cook the cuisine we grew up with because it is familiar. We will watch the movies that make us laugh instead of ones that push us to the edges of our seats and the valley’s of our Hearts because we don’t like feeling uneasy. We will judge the elderly at the crosswalk, the Food Stamp user at the grocery checkout, the teenage pregnancy at the food bank, the troubled kid in Juvi again—because although we might spout mercy or donate money or be humbled to give a sweet morsel of grace, we cannot love them well until we accept that we are ill-informed of their struggle.

I don’t have time to fold our laundry most weeks. The baseboards are dusty, walls are smudged with fingerprints, and a stack of books sits unread on my nightstand. Most nights after the kids are finally asleep, my love-tank has been drained of every sunshiny drop. I cannot find the time in my week to sync my phone, muchless become a Big Sister to a Little in need or push the waves of racial change in my corner of community. On a good day, I close my eyes feeling like I loved my own kids through their tantrums and fits and ingratitude well. And on a bad one, I find myself ignoring the responsibility I have to love people well—whether or not liking them makes me uncomfortable. I do not have access to a diverse audience. I am not exposed to the Big City lights or days in the Inner City life. My children have never voluntarily skipped a meal. I have not needed Food Stamps or spent time in detention. The only time I’ve been called to court was to testify on behalf of a patient. We do not own a black baby doll. And aside from doctoring and motherhood, I don’t have a platform I feel lead to preach from. I am privileged. And I recognize that I cannot know the struggle of those that are hurting or hating or hunted not because I don’t possess the capacity to love them well, but possibly because I don’t know the way to love them right.

If my uninformed contempt can kill my marriage, imagine what its effects are when multiplicity is applied. And if my admitted naivety takes me to the first step of realization, imagine the power wielded in simply looking in the mirror of our souls. By responding with blanket statements about all lives having value, we are speaking truth but foolishly ignoring the motive behind the rally-cry.

Our son starts Kindergarten soon. His school supplies are stocked, backpack is ready, and heart is inevitably going to change, molded by a moral-filled battle of nature versus nuture.  I will set aside my laundry, my task list, my baseboards and bend low to listen to his little struggles not only for comfort, but so that he knows my presence when the big ones come. I will reach down deep in my empty love-tank to reach and teach and treasure when he needs just a bit more direction or discipline. The dinner table will hopefully not only be filled with conversations of good deeds and reflections on positive learning, but directed dialogue on differences. If I—if we—can find the boldness to approach our culture and differences with the tenderness our children deserve we might look in the mirror to find that we all deserve the same. And that person staring back at us might just be the one who is finally able to get love right.

Dreamer.

You counted your birthday chain today: 37 days until you turn five. Half a decade. Five trips around the sun. One thousand eight hundred and twenty-five sunrises (I swear you have been awake for at least half of them). Countless minutes to grow and learn; countless opportunities to make it right, make it better, make it count.

You are still learning. And my biggest hope for you is that you become a student of your life.

Yesterday, while you recited the Pledge of Allegiance and built your fifth Lego dragon of the week, our Country got a new President. His name is Donald. And while you pranced around munching on white cheddar cheese and salami, he raised his right hand and vowed to protect and supervise the place we call home for the next four years. I would have turned on the television to show you, but we made the choice long ago to forego channels and commercials for the sake of our sanity and our budget. I think you would have like the music, though.

You must realize that this new President-thing is going to happen a lot in your life. And while you don’t care today, someday you might. Someday I hope you do. Someday I hope you care enough to sign your name on a ballot and commit to using your Citizenship for bettering.

Today, while you built a Lego Igloo and turned your nose up at the yogurt fruit dip I made, women joined hands and walked on city streets and country roads to tell the World that they believe in something. And while you sat in time-out for body-slamming your sister and giggled with glee at the puppies up for adoption at the Pet Store, Americans spent their morning in the rain and snow and cold holding high signs and babies and hearts, reminding the World that they have a voice to be heard.

You must realize that passionate people have a place just as much as passive people do. But the former group will initiate change, expand perspectives, and fight for justice in ways that are more bold and more foreign and sometimes more uncomfortable. This doesn’t mean they are wrong. I hope someday you feel passionate. I hope someday you feel strongly enough, convicted enough, to see through the signs and marching. I hope your vision is clear enough to see the message.

You see, leadership does not mean the best kid on the playground wins. It does not equal the captain of the football team or the kid that is always mimicked in high school. Leadership is a privilege that must be earned. And while many people are questioning the mind and message and motivation of our new President, in our household we will still recognize him as the Leader of our Country.

But I want to set the record straight about a few things.

Our political opinion doesn’t matter. It certainly doesn’t matter to you at age almost-five. And the truth is that where we stand on the donkey-elephant spectrum today probably won’t matter in a decade. We change as the World changes. As a human race, we are supposed to evolve. We are supposed to advance. We are supposed to look back with applause and appall. And we are supposed to stand on the corner of commendation, moving forward in our human journey with greater perspective.

Do not take this to mean that opinions don’t matter. Or that they don’t have a place to be voiced or displayed or dispersed. More than the way in which they are shared is the heart behind their creation. As the World Turns, sweet boy, life will continue to move. People will move forward. Technology will advance. The impossible will become reality. Dreams will materialize. And just as much as these great and beautiful and bold things will happen, the opposite will also be true. Communities will look backward. They will forget to hold close the lessons and lesions and losses of road-pavers and justice-makers. Hearts will harden. Tragedy will transpire in unthinkable and indescribable ways. Dreams will dissipate.

You are not your opinion. You are not the opinion of someone else. You are not the subject of accuracy in the tabloids or on the lips of your peers at school. You belong to something better. And our biggest prayer for you is that your soul finds home in Someone Greater.

Opinions matter, kid. But hearts matter more. I don’t know our new President. I don’t know what he eats for breakfast. Or what laundry detergent he uses. I do know he poops, though—which might make your almost-five-year-old mind fall into a fit of giggles. He is human. A sinful, selfish, soul-bearing mortal who happens to be in a position of leadership. He is like us.

Each morning, as God pulls up the sun, equal grace is poured on us all. On me. On you. On him. Although our opinions may be polarized, our voices may take up residence in different octaves; although our wrinkles may show years of wearing different emotions, GRACE has to win.

The difference, my boy, between you and the world is receptivity.

I know the day is coming when you decide that you don’t like me. The day is coming where you will roll your eyes at the way I fold underwear or organize groceries. The day is coming where you will dislike more than just yogurt fruit dip. You will grow. You will continue to journey around the sun with billions of other gleeful souls. You will continue to form wrinkles that paint stories of your emotions, continue to form opinions that shape your convictions, and continue to stand for things you love—be it Lego dragons or equality. We hope that regardless of the marching or mayhem or misfortune, you continue. We hope you continue on in grace, realizing that you do not have to be shaped by your leaders but can become one yourself. We hope you continue on in love, recognizing how worth it the heartbreak of commitment can be. We hope you continue on—to make it better, to make it right, to make it count.

Our trips around the sun are numbered, but your dreams don’t have to be. 

Dear President Obama

Dear President Obama,

I am 32 years old and don't think I've ever penned a letter to a political figure. Santa Claus, sure, but the President? Mayor? State senator? Never. 

To be honest, it is not that I haven't cared. It's just that I haven't felt enough passion in contrasting boldness to what the actions or rumors of my politicians have shown. And maybe I never believed my letter would make a difference. I learned in Mrs Castleberry's eighth grade debate class that words are a powerful thing. And that convincing a mind change in someone you consider to be an opposite thinker is even greater a task. 

And as such, you probably won't read this anyway. 

But I'm writing it. Because I want my kids to know how I feel about you--the man who lead our country through the most formative of my young adult years. And I want to prove to myself that I was wrong. 

You see, Mr President. I didn't vote for you. If I'm honest with the world, I think I forgot to vote in that last 2012 election. I was elbow-deep in delivering babies & working 70+ hours per week suturing & studying & not-sleeping. The year you won the last election was the year that my Hospitals' management changed. It was the year that made me a mother. The year my marriage was sprayed by the unexpected poison of depression. The year my husband said goodbye to half a decade of service in the Army & hung up his maroon beret forever. Two-thousand-twelve was the year he had knee surgery, I had my first cavity filled, & the year America welcomed you back for another 4 years. 

I must say, Mr President, that I wasn't sure about the country's choice. You seemed to have proven yourself despite the media feeding us doubt, apprehension, & disbelieving statements about where you came from, who you were, &all the things you would (or wouldn't) manage to do in office. The crop of bumper stickers about "keeping the change" from 2008 that had been stuck on metal and glass and minds were faded and peeling. The country was finally rebounding from the market crash where we, as a young 20-something couple, lost almost half of our meager investments. You and the First Lady had appeared on SNL, Facebook, & even the occasional talk show. You had handled the protestors, the rally's, & the beginning bloom of racial throttle with what appeared to be well-intentioned action. Mrs Obama's toned arms continued to be the subject of focus in the tabloids & popular news magazines. And although I'm not sure on the timeline, I do remember that you had successfully quit smoking. Things--life In the United States of America--finally felt stable again. 

Stable, that is, for me. 

I've asked hundreds of patients who our President is in the process of testing mental acuity & orientation. And I've gotten a variety of colorful (& hilarious) answers. Jesus. Nixon. Reagan. Princess Diana. Bart Simpson. And you, Sir, "Obama". But I must admit that me talking about my patients & my work week & my marriage all point to who I am, where I know I stand in the complex web of race & gender & privilege in not only this Country, but also in this World. 

I am a Doctorate-educated white, married, middle class woman living in a semi-rural town in one of the most privileged countries in the world. I have not skipped dinner involuntarily this month. I have never been without health insurance, $100 in my bank account, mostly white teeth, or shoes on my feet. And I am well aware that even the fact that I can use words like "investments" or "work" or "cavity" makes me one of the wealthiest people in the World's greater populace & assumes that I have the pennies to stow away, the employment to help support my family, & preventative healthcare. I am immensely lucky. 

Months ago I told myself I was not going to talk about the most recent election. I am not writing about repealing the vote, recounting the absentee ballots, or rescinding the position of the upcoming President of the United States. I am not writing to disagree with policy or nitpick your vacation time or comment on the great debates that are fired up all over the country in streets & homes & hearts. 

I am writing, Mr President, to thank you. 

My skepticism of your leadership was wrong. My judgement of your character biased, influenced by the easy media sources around me, by my inaccurate funneling of politics through my religious beliefs, and by my preconceived notions of what I thought our country needed. 

And I was wrong about you.

I come from a personal conviction that demands that my heart be free of guilt. So for my ungrounded judgement, bias with lack of full knowledge, & even for my own pride, I am asking for forgiveness.

I'm not even sure I could pinpoint all my inaccuracies. Nor would I expect the same from you. In my daily job, when I make mistakes, lives are on the line--the breath & body & being of people are what I handle. And this, we have in common. The magnitude of your decision, the weight of your work, however, is incomprehensibly larger, more public, more dissected than I ever hope mine to be. 

And you've handled the job with suave, grace, & poise. 

You haven't micromanaged my life--which if I'm honest with you, my young 24 year old brain expected of a new president in 2008. Finally outside the roof of my parents & the guise of college as "real life", I had convinced myself that your role was altruistic, telling me who I could love, pinpointing both child rearing theories & the content of school lunches. From what laundry detergent to buy to how much to spend on my next car, I made your role bigger than it was meant to be. And possibly like many others across the country, falsely believed that your power forcibly extended beyond policy about housing & healthcare and somehow had the uncanny ability to make unwelcome changes in my home & in my heart  . "News" is a big category & a quick swim in the great Internet Ocean left me weighted by all sorts of opinions about you, your opinions, & your then-to-do list. 

And that "Change" you promised? Some of it has come alive--my own citizen mind completely unaware of the hours & days & piles of paperwork it took to instate things like the ACA, the healthcare exchange, or the closure of Afghani occupation. I have an opinion about most of the changes that have happened--both initiated from your desk & from the hand that time has dealt. We still don't agree on a lot of things, Mr President. And some of my reasons for not voting for you originally still stand--big debate topics for which this is not the time nor the platform. The beauty of this country is that I can still hold my opinion, and that despite your leadership & title & privilege, we have the right to disagree. 

For all the things, Sir, that we don't agree on, I must tell you--THANK YOU--reminding myself & my fellow citizens that there are some things that should know no political party nor be ignored in any role of leadership. Some things are worth banding together for. Things like love, equality, children, balance, health, access to vaccinations & bandaids & preventative examinations. Things like peace, justice, food, the right to Worship, & attention to the underprivileged. Though the details of your fight and my fight have been & will continue to look different for each of these cornerstones, the contrast in our beliefs makes me grateful that you've stood for them at all. 

Two weeks ago on the Eve of Halloween, I saw photos of the White House Halloween Party. I stayed up late browsing Facebook, munching on candy I stole from the loot of Thor & a Butterfly Princess that were, by then, sound asleep upstairs. And I was grateful for you & for your family. 

And this past Tuesday, when it seems the hearts & hopes of half the country broke or shattered, I am still grateful for you & for your family. 

From one gender to another, from a white to a black, from a mother to father, a small town girl to a big city man, thank you. Thank you for reaching out to your citizens, for bridging the gap in Elitist leadership, for inviting the world changers & policy makers & trick-or-treaters & unfortunate grievers on to the lawn of the White House. Thank you for hugging. And for hosting. And for proving me wrong in character & in compassion. 

You will be missed Mr President. 

And if you ever find yourself in Central Washington, know that there will be a lawn who welcomes you & your family. And there will be two adults & three Dinosaur-loving kids eager to welcome you inside--without regard for religious differences or political party or personal beliefs. Not only because you served as our President, Sir, but because you are human. For as much as our human nature resists a change from the comfortable, change is exactly what you've brought. And sometimes we all need a bit of the unexpected. 

The Table.

The world has felt extra heavy this week. Stories have poured into my screen, my ears, my heart about infidelity, brokenness, miscarriage, cancer, addiction, death, & raging hearts. I can’t quite get a hold of it, much less myself. Maybe it is that I’m thinking of the jealousy that stirs up emotion--the jealousy of stable relationships, picture-perfect families, easy fertility, healthy cells; the jealousy of living life together & experiencing the mist & rain & sunshine when others hide from joy or die early or never get the chance at all.

Life is so confusingly fragile.

But at the crux of a brain break, a heart break, a soul Earthquake, i have to make a choice; we have to make a choice: choose God or choose the World. Choose the God who made that mist & rain & sunshine, choose the God who crafted those cells & telomeres & heartbeats, choose the God who knows my days & the hairs on my head & the seeds in my heart. ChOOSE GOD. Or choose the World. Choose the World full of broken people, mortal souls, sinful pride, & hearts with holes. Choose the World with smoggy blue skies & rain on wedding days & rejection & failure & disappointment without cause.

I can come to the Table. I can take the bread & drink the Wine. I can come whole & polished & perfect. I can lay down my color-coded planner & my lifelong plans, I can kneel on starched pants & clean floors. I can recognize a Jesus & know him, but my heart can keep its distance.

Or I can approach the Table. I can feel that broken bread, a body broken--cells lysed, telomeres shortened, breath stolen. And i can feel that maybe the cancer & the miscarriage & the impending emptiness was felt by the one who Emptied Himself; maybe it comes from the one who Fills. I can take in that scarlet wine & cut open the wounds & the sack-fulls of hurt & heartache, letting them spill & sweep & succumb to the Hope hidden in the brokenness. And I can stay at the table, basking in the candlelight, relishing in the dirt that I bring, sinking into the World’s grime, waiting for Hope to wash the scarlet clean. (Psalm 51:2)

And maybe that is what it is about anyways: Brokenness. Messiness. Dirt & grime & ugly-tears. And choices: choosing a side, choosing a Hope, choosing a God. Resting in that Blessed Assurance that Jesus is the One who came. For me, the miscarriage, the mismanaged, the messed up. Looking henceforth with HOPE that the heaviness I feel has a destination in the One who will bear all burdens alongside me, heal all hopelessness within me, & meet me at the Table.

May God bless you with a restless discomfort

about easy answers, half-truths and superficial relationships,

so that you may seek truth boldly and love deep within your heart.

May God bless you with holy anger at injustice, oppression,

and exploitation of people, so that you may tirelessly work for

justice, freedom, and peace among all people.

May God bless you with the gift of tears to shed with those who suffer

from pain, rejection, starvation, or the loss of all that they cherish, so that you may

reach out your hand to comfort them and transform their pain into joy.

May God bless you with enough foolishness to believe that

you really CAN make a difference in this world, so that you are able,

with God's grace, to do what others claim cannot be done.

And the blessing of God the Supreme Majesty and our Creator,

Jesus Christ the Incarnate Word who is our brother and Saviour,

and the Holy Spirit, our Advocate and Guide, be with you

and remain with you, this day and forevermore.

AMEN.

a four-fold benedictine blessing - sr. ruth marlene fox, osb - 1985

Goals 2016: FOOD

I’ve been pro-Real Food for a few years now. Not strict. Not biblical about it. I still eat grain. I still engage in the occasional pop tart. But our eating habits have changed drastically since 2011—when I was overly pregnant and reading the book, Real Food.

In her book, Nina Planck beautifully outlines a life that is full of foods sourced locally, prepared lovingly, and eaten slowly. It’s a non-extremist perspective of the art of slow food.

Dr. Alessio Fassano has done ground-breaking research in the world of celiac disease and made monumental discoveries about things like gap cell junctions, IGF-1, and gut microbiota. Without too many boring (but beautiful) scientific details, his discoveries point to the fact that maybe the amount of gluten we are eating isn’t good for us. And maybe our food has a direct bearing on our disease.

Our Small Group before we moved was lovely. We called it a Small Group. But really, it was a large group of dynamic people who were, in all senses, our tribe; spunky, life-filled people who loved the Lord and loved us well. And thankfully, it was also full of people who cared about their health. Best not bring oatmeal cookies to group because they would go untouched. A bowl of kale chips, though? ALL OVER IT.

My CME in December of last year pointed to the fact that for a real perspective on food, we need to look at the Metabolic Disease-free history of our world. The Blue Zone Project followed the eating habits of the places on Earth with the highest concentration of centenarians. Combine their findings with the hearty work of Dr. Ornish and Dr. Hazen, and we are left with a startlingly-clear but gosh dangit hard picture of what we should be eating.

First, our relationship with food needs to be one that looks at food as a positive experience—one of nourishment and sustenance. Aside from true eating disorders, most of us (myself included some of the time) probably have disordered eating. We grab the chocolate instead of the carrots, the French fries instead of the fritter itself. Our coffee is drowning in syrups and whip and although our hips may not feel the difference, our hearts know it. Our genes are smarter than we are & they sense the changes, the unhealthy habits, the molecular balance before we’ve even swallowed.

Second, we need to choose vegetables over every. other. (Gosh dangit.) food that exists. Over meat. Over grain. Over bread. Over fruit. Every Blue Zone had a diet that consisted of at least 60% vegetables.

And third, we need to limit meat. Our ancestors ate it a few times per month—usually in the form of fish. They did not have Type II Diabetes. They rarely died of acquired heart disease. They did not have triple bypasses or suffer lifestyle-induced high blood pressure (on the regular, exceptions are always a guarantee). Obesity was almost non-existent. There were genetic cases of these diseases, no doubt, but genetics instead of nutrition played a much stronger hand in their development. Instead, they chose beans. EVERY DAY THEY CHOSE BEANS.

Gosh dangit. Again. And again. And again.

We have a quarter cow in our freezer as I’m typing this. And to be honest, I was really looking forward to a hamburger.

But as I’ve been reminded time and again by the research, food has incredible power. It is the most powerful medicine or the slowest form of poison. Making good choices for my family means choosing foods that are not as awesome to eat as a Wendy’s frosty with French fries.

“The only way to keep your health is 

to eat what you don’t want, 

drink what you don’t like, 

and do what you’d rather not.” 

(Mark Twain)

But this year, I’m counting on it being different. I’m counting on food being part of our lives—in a positive and rewarding way. Thankfully, the changes we’ve made mean we don’t have far to go. The evidence is irrefutable. But like all things in life, I’m committing to taking baby steps. Lots of them. I’ll probably walk backwards half the time. But I’ve got my eye on a goal now.

·      Eat 80% plants on 8 out of 10 days.

·      Eat more beans, less meat.

·      Eat slowly, intentionally.

·      Linger at the table longer.

·      Make better, more consistent food choices.

·      Serve better foods and teach our children to find more balance.

·      Source foods locally when possible, organically when not.

·      Be more intentional about planning regular, simple meals.

·      And be more purposeful in trying new ones a few times per month. 

Rid the expectation that meals need to be complex, complicated, perfect. I don’t expect the perfect soufflé or stock. We’ll have a lot of fails. I’ll end up giving my kids rice and apples for dinner. But in the midst of all those could have been better’s, I’m hoping for a few home runs. 

dropped.

the words just fell out, dropped from my mouth onto the floor.

the floor.

where they bounced & broke.

where they bounced & broke…and remained.

remained.

until i swooped them up & tried to mend the pieces. and then hide those words, cracked but glued back together in my pocket—as if they’d never come to life.

life.

the one i was living. the ME. right here, right now. the me that sprang those words to life. now plagued with regret.

regret.

of my audacious openness with a stranger. so i hung my shoulders and walked out of the room, embarrased that i’d broken the rules.

the rules.

the ones that tell me i’m not supposed to share. that i’m supposed to listen. that i’m supposed to be transparent & empathetic, but never personal.

personal.

no. this is what it has to be.

be.

i never liked rules anyways.

back-and-forth.

he waxes & wanes between the words, hopping over syllables, darting between the letters. an old Irishman one minute, an English gentleman the next. but his flannel shirt & black leather loafers point to who he really is: a small town American.

but the jumping, the hopping, the stumbling & stopping…an unintentional habit of seraching. his “th” sound rings as an “f”. The “r” translates a “w”. and the “c” hangs in the air, repeated as an echoing stutter until the words flow smooth again.

the journey had run long, & his searching for self continued. in words. in letters. in syllables.

but isn’t that what we all do? we set out on a great search for self. trying. testing. experimenting. we mix. we scramble. we spin the compass. and then, ultimately, return to comfort.

we change ourselves. our looks. our clothes. our voice. the title of our vocation, even, to sound more impressive to those who air a “higher status”. longer words flow, more syllables. nervous laughter. head temporarily taut in a burst of faux-confidence. the falsity matching the illusory mink fur shawl wrapped around our necks. and dripping in sparkles, the painted smiles cascade down to bounce from our cubic zirconium & finally meet the new-age girdles we don to hide our flaws.

it all seems to be an unintentional habit of searching. trying. testing. experimenting. our accent lived out in real time, true color.

that is, until our lives are mixed up; pocketbooks a scramble of red & black. we spin the compass, pack up boxes & lives, & move to new places, new faces, new opportunities. starting fresh. never airing our own flannel shirt & black leather loafers for fear we’ll be discovered.

and then, ultimately, we return again to comfort. holed up in plastered walls. illusory mink fur shawls hung & sparkling zirconium removed, we finally let out real laughter. maybe for the funny man, the light box. maybe for the friendly spider.

we wax & wane. between the lines, the expectations, the built-up illusion that we have to meet the Jones’. we dart between realities barely missing the freight train of truth only to find raw, cold exposure in the wind it leaves behind.

but someday. someday we’ll be discovered.

who are you going to be?

me & them.

i look at them sometimes and wonder. wonder how they perceive life. do they know they are alive? can they see? hear like i do? can they taste food, enjoy chocolate, drink the sweet nectar that drips off the summers ripened tree? do they notice the wind in their hair, kisses of sunshine on their skin, drips of heaven on their face? is the smile real joy? the crying real emotion? the moaning real pain?

neurologists may say no.

preachers may say yes.

but what do i say?

i say love them. most of the time.

but sometimes the “love them” can’t find an anchor. it drifts into that raging sea of judgment. the sea, angry & gray, where my thoughts are tossed about in swells. the sea that convinces me that science rules: the smiles are random neurological firing, the moaning a sequence of reflexes. the sea, white capped & turbulent, convinces me that they are shells—defunct brains, malformed limbs, hopeless cases of life. i stay submerged in that sea. gasping. drowning. thrashing. until a Hand reach in & scoops me out of the abyss.

me.

the Hand rescues me.

the Hand carries me, pulls me, guides me, pushes me, & wheels me. me—a spiritual shell of a defunct heart & malformed grace. a hopeless case of life. and in that angry sea, the Hand becomes my life boat—pulling me back to the safety of the shoreline.

to finish the race.

victoriously.

that Hand hoped in me & knew that i was more than a sinister case of genetic misfortune.

their malady, physical.

mine, a sinful spirit.

neither fixed by medicine, only the Hand of HOPE.

and it is then that i realize, wet & cold, shamed with the salty drops still clinging to my skin, that me & them?

we’re not so different after all.

Dear Angry Mother, From Regret…

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Dear Angry Mother:

when I plotted your sons BMI on his growth chart today & the dot barely made the margin of the page, I knew we had something to talk about. and i also knew that it wasn’t going to be easy.

so i walked into your room to do a well-child exam & found your 161-pound 10-year-old son quite pleasant. nice kid, you have.

but what i didn’t know, Angry Mother, was that my mentioning your 161-pound son’s weight was going to offend you so. i didn’t know that my preceptor would be 30 minutes behind schedule because of the extra time she had to spend explaining to you why we needed to talk about your son.

i didn’t know, Angry Mother, that my recommendation to eat more fruits & vegetables, my telling you that the acanthosis nigricans rapidly spreading on your son’s neck was linked to childhood diabetes, or that my explaining that he should try his best to be more active was going to send you stomping out of the exam room to tell the nurses just how offensive i was.

and i know, i know i’m just a student. i’m still learning. and when i walked in your exam room today, i tried my best to use gentle words & approach this confrontation with empathy.

i heard later from my preceptor, who was gracefully able to diffuse your anger over my audacity, that your son cried because he apparently wasn’t aware he was overweight prior to our chat today.

really? really Angry Mother?

i guess he thought it was normal to have oozing hydadenitis suppurativa in his skin folds, normal to look down only to find his chin was in the way of full neck flexion, and normal to have a stomach covered in white striae from skin stretched too far by the bounty of adipose underneath.

i’m no exception from flaws, failures, and need-for-improvements, Angry Mother. but this is YOUR time—this is YOUR time to guide him, teach him, challenge him to eat right, better, purer foods. this is YOUR time, Angry Mother, to pass on good, healthy habits that he will carry with him to old age. and this is YOUR time to be a positive role-model for him with regular exercise & healthy eating. even still, our physical flaws, mine included, are no reason for condemnation.

i guess i was out-of-line today. and rude.

and i guess i’m sorry.

but Angry Mother, i want to tell you now…that less than 25% of childhood obesity is because of genetic predisposition. i want to tell you that just because your kid doesn’t eat protein, mac+cheese isn’t a healthy substitute. and i want to tell you that today when i tried to encourage you, you spit the forewarnings i had about the long-term complications of childhood obesity right back in my face.

so thanks for that, Angry Mother. and thanks, too, for the now-permanent hesitation i have with ever being honest with a patient again. you’ve changed my perspective—& i’m sorry to say that it isn’t for the better.

best of luck with your 10-year-old.

sincerely,

regret.

clarification.

It isn’t often that I publicly change my opinion. And really? Most often, it is because I deliberately think through my words, my thoughts, my actions before making them public. But I’m finding that more days than not, my opinion of life, of people, of faith, of stuff is just changing. The changes are largely out of my control... fed by my experiences, resurrected by my stories.

And tonight? You deserve to hear more of the story. Instead of changing my opinion, however, I’m going to make an addendum.

To this post.

You see, when I wrote this story about this giggling girl’s mommy, I was writing mostly out of frustration. Because it IS frustrating to see patients that don’t have emergent (or even urgent!) problems, that are not sick, not in pain, not needing immediate medical attention in what is supposed to be the emergency room. In my ideal world, we’d see emergencies in the ER. And if you talk to “old-time” physicians, you might find that Emergency medicine has mercilessly changed. In most community (read: smaller hospitals without advanced trauma units) medical centers, the ER is filled with a myriad of patients on any given night. And what used to be a population of patients with what, in my opinion, were true emergencies or urgencies have now become patients with minor medical problems that very-well could have waited for tomorrow…or 2 days from now…or next week when they could have gotten an appointment with their primary care doctor.

I fully (FULLY!) realize that other issues are present in many of these cases. Patients may not have insurance. They may truly be worried…& in many cases, the patient truly does know best & their concerns are fully warranted. They may have an underlying condition or problem that would not have been discovered had they not come into the ER. But for the most part, the patients I was referring to in my post were those who did need medical attention…eventually.

Such was the case with giggling girl & her mommy. It wasn’t the fact that the little girl had a reddened throat that bothered me so. In fact, literature (& Grey’s Anatomy, for the record) cites cases where red throats turned into something much, much more serious. But such cases are, largely, outside the norm. And giggling girl had nothing more than a red throat. No fever. No cough. No signs of infection. But her impatient mother decided to forego waiting for her pediatric appointment just a few days following & rush her to the ER because it might be something serious. That "common sense" doesn't seem to be common anymore...

The patients I was speaking of were those who coming in for toenail trims. Or for hangnail removal. Or who want to “be fixed” in less than an hour after 19 years of pain.

And, more likely than not, the patients I was speaking of…ARE NOT YOU.

So PLEASE….go to the Emergency Room if there is an ioda of concern, of anxiety about your situation that arises in the midst of whatever medical chaos you might be experiencing. Use your best judgement. Think through the situation. Ask yourself if it really is EMERGENT…or even URGENT. I certainly can’t go through each diagnosis here (we’d all be dead by the time I was halfway done)…& that is not my intent. I write to vent, to share my now-feelings with my 40-year-old-self in a couple of decades, & to remind myself that there is PURPOSE, greater purpose, behind the sometimes frustrating-monotony of my days with patients.

I cannot be the judge of your medical decisions. And I cannot be the decisive voice in your care. That responsibility belongs to you. What I can do, however, is share: my opinions, my experiences, my HOPE.

Common sense.

mirror.

So our choices add up.
Habits into hours.
Decisions into days.
Lists into a life.
--Ann Voskamp, A Holy Experience

*******

He shook his head, adamately denying the accusation.

Shirt wet, salty water leaking from pores. Heavy breaths, body struggling against the extra weight.

Ridiculous, I thought.

He was a large, proud man; just a sliver of apprehension between the lines of his bold verbal paragraphs.

“I don’t eat junk,” exasperated.

I sensed his offense at my questioning.

“Mr. Hepp, your blood pressure is still elevated. Your three meds are at their maximum doses. And its been five months.”

I probably should have been more sympathetic.

“Yeah?...and I’m still trying.”

Doubt overwhelmed me.

Really Mr. Hepp? Really? You are still trying?

Judgement shot from my viewpoint.

“Well, let’s talk about what you are trying. We’d really like to see more progress—we are concerned about your health! Both now & long-term. We’ve talked about the consequences of your condition...”

Saccade eye movements disappeared. I’d lost his attention at “let’s talk about it.”

“I really have been trying, you know…”

I bet you have!...

“I cut out the bacon with my biscuits & gravy each morning at Carl’s Jr. And I don’t order fries anymore with my McDonald’s hamburger at lunch. And at least once a week the wife makes me eat a salad, usually at Applebee’s where we eat dinner every night.”

Ridiculous, I thought.

It would have been easier to ignore him…the excess he had. The thousands of extra calories he was consuming each day, the money he’d spent on having his meals prepared, served, & cleaned up for him.

‘Talking about it’ felt like a waste of breath.

******

To satisfy the world's sanitation and food requirements would cost only US$13 billion- what the people of the United States and the European Union spend on perfume each year.

--Thinkquest.org

******

I could picture them, boney limbs & burgeoning bellies filled with parasites. Forever etched in my mind were their eyes, their dirty faces, their fallen homes. The empty bowls. The matchstick arms.

Ridiculous, I thought.

It would have been easier to ignore them…the poverty they lived in, the dirty & smelly & lonely they felt. The deficit of calories that caused autodestruction of their internal organs. The dried-up wells & trips to the contaminated river each day for water. The hopelessness & lack of opportunity that promised the same life to their great-grandchildren.

******

“One out of four children in developing countries is underweight, & some 350 to 400 million children are hungry. Worse, it is estimated that a child dies every five seconds from hunger-related causes.” –Richard Stearns, The Hole in Our Gospel

******

I stepped out of the shower & brushed the steam from my face. It was just what I wanted after a long day on my feet. I’d stepped into the steamy stream of water…& emerged 15 minutes later, the days stressors washed down the drain.

******

“As many as five million people die every year of water-related illness. This creates a no-win situation for millions of parents in our world today—they can watch helplessly as their children die for lack of water, or they can watch them die from diarrhea, because the only water they have is tainted.” –Richard Stearns, The Hole in Our Gospel

******

It would have been easier to ignore that I’d just wasted 21 gallons of water—more than twice the number a person in Africa uses per day. It would have been easier to brush off the contaminants like I’d brushed off the steam. I wanted my steamy solitude.

I can ignore him.

I can ignore them.

But I can’t ignore myself.

When I wiped a small circle from the mirror, I saw her.
I saw him.
I saw them.

I saw the wastefulness.
I saw the excess.
I saw the need.

And I was faced with a decision.



****Change starts in the mirror.****

******

Defend the cause of the weak & fatherless;
Maintain the rights of the poor & oppressed.
Rescue the weak & needy;
Deliver them from the hand of the wicked.
-Psalm 82:3-4

******

“We can be a generation that no longer accepts that an accident of latitude determines whether a child lives or dies—but will we be that generation? Will we in the West realize our potential or will we sleep in the comfort of our affluence with apathy & indifference murmuring softly in our ears? Fifteen thousand people dying needlessly every day from AIDS, TB, & malaria. Mothers, fathers, teachers, farmers, nurses, mechanics, children. This is Africa’s criss. That it’s not on the night news, that we do not treat this as an emergency—that’s our crisis.
Future generations flipping through these pages will know whether we answered the key question. The evidence will be the world around them. History will be our judge, but what’s written is up to us. We can’t say our generation didn’t know how to do it. We can’t say our generation couldn’t afford it. And we can’t say our generation didn’t have reason to do it. It’s up to us.” --Bono