am

Early morning is the prize for those who labor all night

And its slanted golden light and stillness

And all the memories of summers gone 

(and the smell of breakfast cooking)

And things that might yet be just dreams

And all that promises to be

My tired eyes face unblinking

 

Fall Into Stars

I don't remember what anything means and the night is too dazzling to fall into dreams the words that are failing me fill up the void but no one but me seems to feel it.

Hard to forget that my work is to know and to do what it takes and to put on a show that will make you feel better at least til you go and alone you yourself have to heal it.

And all by ourselves we still gather and hover and tell all the stories and laugh with the others like all of the ways that I've sat and imagined I know what it's like to be in it.

So tonight go outside let the laughter be second to sounds from the stars as they recount the record the tales from the ancestors poets and priests and all of the fishes and all of the trees

Cause I want to remember the silence of meaningless want to sink blissfully into irrelevance want just to be and to know that I'm worthless and infinite just like the stars

And as much as I'd like to be given a reason I'll settle for just being part of the seasons and doing as much as I can and believing that living is more than just knowing and seeing

Pain, first of many

Miracles You Don't See

Let's be clear about a few things.  If you are found outside the hospital in a car not breathing and we have to code you or call an ambulance because you took too much of your oxycodone, I'm not going to give you any more. Period. NO. You clearly are dangerous with that stuff.  Also, a minute ago you were driving.  And I have little kids.  And they were also maybe on the road.  I mean with their father, of course, driving.  So, to summarize, no.

And it was thus that I had the following discussion at least twice this week, with different people:

You:  So I need a refill of my oxycodone.
Me:  Oh, really? Hmm.  Well, I've been meaning to talk to you about this.  Actually maybe we should talk about that medication again.
You:  Well, it's the only thing that's helped.  I've tried everything.  Believe me.
Me:  Oh, like physical therapy?  And acupuncture? And OMT? And exercise? And weight loss? And an anti-inflammatory diet? And tricyclic antidepressants?  Or NSAIDS?  Or meditation? 
You:  I'm pretty sure I tried all of that.  I don't know what it all is, but I'm sure I tried all of it.  Because I've tried everything.
Me: (avoid eye contact, look at chart) Uh...
You: Once I saw a traditional Kazakh hypnotist who introduced me to my spiritual analogue, which is a unicorn.  Another time a Honduran pool boy recommended I snort some penicillin, which I tried.  None of that stuff works.  Oxycodone works.
Me:  Ok.  So I hear you saying that nothing else works but the oxycodone.
You:  Yep.
Me:  Ok.  But the thing is, you took too much recently and passed out in your car.
You:  Well, no one told me I shouldn't also take a Valium that a friend gave me.  So that was a mistake that now I will never do again.
Me:  Ok.  So I hear you saying you will never do this again.
You:  Yes.  Sure.  I'll take any drug test, doc. Every week. I need this. It's the only thing that works.
Me:  Ok.  But, wait, this is ridiculous.  I can't give you this medication anymore.
You:  What????
Me:  No. I can't give you this medication...I have a personal policy to not...I mean, you passed out in your car.  Like a week ago.  I'll lose my license.
You:  But it was a mistake!  Come on, you can't do this to me.  It's the only way I can function.  I'll go into withdrawals!  You just don't understand what it's like!
Me:  So I can't do it.
You:  I can't live without it!
Me:  So I don't know what to do then.
You:  So I don't know what I'm going to do!
Me:  There are some things, you know, like you could go to physical therapy again, or... like,
You:  Dude.  I tried all that.
Me: (Thinking to self: well, maybe actually this is the only thing that works.  Maybe I'm just not being empathetic.  Maybe you did learn your lesson.)
You:  Really, it won't happen again.
Me:  But.  I have kids.  You could have been out there on the road and crashed into my kids.  So, no.  Not going to prescribe this medication.  Anyway, studies show that this medication is no good for chronic pain anyway and I can work with you to find other modalities that...
You:  Fine.  I'll just find another doctor.

There is a lot of pain in the world these days.  And I'm extremely lucky to be not truly able to understand where folks are coming from when they talk to me like this.  I want to understand.  But probably I can't ever.  There's physical pain, chronic, gut-wrenching, raw, tear-your-eyes-out pain.  And there's what the Falcon calls "existential pain."  And it seems like narcotics help a little with both.  But only to a point.  They numb.  But, try doing anything with a limb, or lip, or mind that's numb.  Life can suck, and some folks get the brunt of it.  I honestly don't know how to help these people.  At least, not if all I have to work with is oxycodone.

These are the worst of clinic encounters.  No one is satisfied.  Nothing gets fixed.  We go around and around until someone leaves the room.  It makes me sick, it makes me sad.  They cry, I fight back the tears. 

Three years ago, a kinder, gentler, intern version of myself wrote this poem to describe this relationship.

To the unbeliever: miracles

do happen but tonight

your tired eyes cannot see

the pain that wraps me

like a child around myself

and collapses the universe

to a tiny point

your outstretched hand

offers me. I accept

your skeptic gift

and feel the miracle

of life wash over me.

maybe

tomorrow this agony will

be over, maybe tomorrow

never comes, but

please oh please

don’t stop

please don’t

stop

believing.

 

Names

There’s a bird

that’s between mourning

dove and whippoorwill, that lives in

those dusty streets I ran.  And

those streets are the other side of Earth

from here.

But here’s the thing:

I don’t know names. To name it

fails to capture what is.  Running down streets bare

feet with fields, firewood burning dust and ashes

falling sunlight filtered red and rosy cheeked.

The haunting calls.

Despite it all I named love.  I named it

to know it and to call it

capture forgets who chose the ring

around

my heart

to keep

the pieces as one

But then what is your name? 

And I don’t want to call it.  Words dance

in a circle of games and eyes and

never speaking the pockets full of

things we know.  Looks to filter

light and laughter and other ways

we are.  If.

And I left that haunt of the bird and I

left the sun and ashes in the dust

and I know it was so long ago but

when we parted the dust

never settled. 

I heard it again today,

here.  The call.

That bird.