I'm Suffused

I’ve been thinking a lot lately about the Higgs Boson, which is great, because then I don’t waste my time thinking about less important things. Like electronic medical records. And how everyone is angry at work because of the implementation thereof. Or how I’m an hour late going home because I’m on the committee for said medical record.  And there is lightning and I’m on my bike.

According to Time magazine, which may or may not be an authority on quantum physics, the universe is a field of energy suffused with Higgs bosons, which allow the greater energy particles to turn into the mass form of energy.

I don’t know what “suffused” means, but it reminds me of when they sell olive oil that has a certain flavor to it.

Also I thought particles by definition already had mass, but I could be confusing them with Doritos.

So all we are is energy, bundled up and stored, with lots of empty space between. Somehow that energy stays in a constant form, a constancy of being, of life. But life is ever changing. Cells constantly remodeling, dying, dividing. Pieces used up by another process. Waste recycled. Air and water exchanged. Where do I end and the world begin? Or you?

My legs connect to the bicycle which grounds to the street. I’m here and moving and the trees are whirring and it could be all in my mind or I could be everything.

As I ride my bike up the last hill home I have that euphoric sensation that I’m peeking through a tiny window into the mind of the universe. My own mind is splitting open and I could almost, maybe, barely grasp the meaning. And know, by virtue of being that energy itself, hurtling down the last corner on a bike, pure kinetic and potential and mass times the speed of light squared. Barely held together at any moment by bosons.

And then I passed a mailbox. And I thought, that mailbox, too, is pure energy.

Huh.

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

Eve of

War Christmas

She was born this morning around five.  I walked in to meet her and examine her.  It was as if nerve gas had gone off in the room.  Three people, completely unconscious, barely arousable to a shouted “HOLA SOY DOCTORA BISON POR FAVOR PUEDO EXAMINAR A SU BEBE?”

She has curly black hair and looks like what angels might when they’re born.  Or when they spring fully formed from their father’s foreheads.  Or however angels regenerate.

She has a stork bite mark on her forehead.

She barely rouses when I uncover her to check her belly and hips.  Together we wrap her again and she goes back to sleep.

Oh, yeah, my dad is with me today.

He came to follow me on call.  We round together and discuss the cases.  I push aside the nagging worry of appearing incompetent in front of my father, and it’s really fun.  It’s also lovely to talk through the cases with someone else again.

On the way home for lunch we talk about illegal immigration.  We’re of the same mind on this one, I think.  Like, seriously, America, can’t we move on?  These are people.  Most of whom contribute to society.  Most of whom live in what used to be Mexico.  All of whom just want a better life for their children.  Just like me.  Just like you.

Mom’s not convinced.  We talk about their difficulties of the last four months. 

At home we make enchiladas.  My 22-year-old brother wants us to help him decide whether he’s a republican or a democrat.

Dad:  “How do you feel about gun control?”

Buddy:  “There should be less.”

Dad:  “Okay, then you’re a republican.”

Dad:  “How do you feel about women’s right to choose?”

Buddy: “Women shouldn’t have any rights. (ha ha snicker snicker.)”

Dad:  “Then you’re republican.”

Mom (staunch republican): “That’s not a republican value!”

Me:  “Right. He’s an Iranian.”

Later, doing dishes, Mom tells me how upset she got with my father a few months ago, how she almost thought of leaving, for good.

Really?  Mom?  I thought I was the only one who had those thoughts. Months ago now, but still. 

Is there hope for any of us?

I wrap gifts for my kids and can’t help thinking about all the overflowing heaps in dumpsters and landfills and fragments of plastic and worse that all these toys will be in just a few years.  And how so many other mothers’ children lie awake tonight, hungry, without a roof over their heads.  While my children fight over their mountains of belongings. 

But these plastic playthings will outlive any of us.  And since we’ll all die soon, does any of it matter?  The toys, the trash, the hunger? 

God, these are not very Christmassy thoughts.

My heart feels like a noiseless patient spider, sending forth filament after filament until the ductile anchor hold.  No, wait.   That’s Walt Whitman.  Actually maybe it’s just a vagrant, tired, unsettled.  Ideas and yearnings burgeoning, just about to be born, if they could only be organized.  Searching still, nightly, looking for a home.  Or maybe just a hotel room.

The family, all of them, bundle up to walk to the downtown festival of lights.  I put on my coat but drive to another home of sorts, the place where life so often begins and ends. 

Three ambulances stand between me and the back door.

Baby Guadalupe was not in a hurry.  We sat together for more than an hour before she decided to meet us.  But she was beautiful, quiet when she came, eyes wide open.  A family of 20 descended immediately upon her and her mother as I departed.  “Feliz Navidad, y que Dios le bendiga.”

So what can we offer this new innocent wonder?  What do we have to give this life?  Just fragments and plastic, war abroad and domestic disputes?  Parents too tired, from mundane struggles, to make this world a better place?  Minds full and spinning and with television and coffee and bills and weekday and weekend.  Feuding, fighting, acquiescing, quietly stewing.  Rotting, decomposing, dying.

No.  It has to be better than this.  We have to make it so. 

The cold is bitter, dark as it greets me.  My car and I speed through the night.  As I pull into the driveway I see a dawning glow. 

GB made me my own set of lights.  The luminaria glow alongside the path to our door.  I feel the heaviness lifting.

Peace. On. Earth.

The Hokey, or Evidence-Based Medicine

Evidence-Based Medicine

Once, during surgery at 2am, the Dragon asked me what religion I was.  I had an unexpectedly visceral reaction to the question, not the blood and uterus in my left hand, and said "That's a pretty personal question."  "Is it?" he apologized.  "I didn't think so."  Then I backpedaled and said "That's okay," and jumbled together some approximation of words suggesting, that, what with all the medicine I'd been immersed in for the past 7 years, I hadn't had time to reflect on the world in that way.  You know, and come to conclusions in an empiric fashion.  Maybe using a spreadsheet.  "Well, for some people medicine is their religion, and that's okay," he offered.  "Yeah,"  I said vaguely.

But here's the thing.  And it's a Sting song, so be prepared.  You could say I've lost my faith in science and progress.  Medicine is most definitely not my religion.  I think I believe in what we do about as much as I believe in anything, which is, not to put a definite number on it, approximately 97.5%.  So there's 2.5% of me that says you know what?  Maybe planetary alignment is what it's all about.  Or perhaps meridians.  Need to look more into meridians.  Maybe Western medicine is just a teeny tiny part of the whole of health.  (I actually am pretty sure that statement is true).  And how about that homeopathy?  Vs. rock crystal energy?

Yesterday at work a new colleague expressed her excitement about us newbies arriving.  Maybe now that we're here we can lend a more academic atmosphere than she's experienced previously.  I smiled and nodded.  Because, sure I can digest and regurgitate research with the best of them.  I can look up my statistics and decide whether a paper is accurately reporting the data or fudging a bit.  And, oh, hellfire and brimstone if they're faking it.  I can teach.  I can work with what I "know."  Every day, in fact, I assume that what I've been taught is true, even though I know a fair amount of it isn't.

Because every medical student finds out in the first few weeks of school that "about 50% of what you're learning here will be found to be untrue in the next 5 years."  And how in the hell are we supposed to work with those kind of numbers?  When a patient comes to see me, we enter into what my dad describes as a "sacred trust."  I'm agreeing to be their healer, to use the best of my knowledge to bring them to health.  Do they know that only 50% of the best of my knowledge is actually true?  And which half?  Of what the board believes is necessary to practice family medicine, I know a fair amount.  I score above average on most tests.  Still, I don't get all the questions right.  My dear, trusted patient, let me get out a pie chart and see how you feel.

And don't even get me started on the pure capitalistic fraud that flies routinely under the radar disguised as "research."  Designed to stuff our heads with "knowledge" that was never known to be true in the first place.  That is another issue entirely.

Even if all the research in the world was done by well-intentioned, non-profits and if every single study was randomized, controlled, double-blinded, do you know what?  There'd still be the unknown.  We'll accept something as fact even if there's a 5% chance the results could have happened by chance alone.  Are you okay with that?

Let's take a math break!  What I know = 85%ish boards material x 50% of that is true x 95% probability that results aren't explained by chance alone = 40.3% under ideal circumstances.  Not great.  60% chance I'm missing something here, something maybe astrology could explain.  Or energy vortexes.

And patients don't follow the rules.  Here's what I think.  People are fantastic, infinitely complex.  And that's personality, physiology, psychology, pathology, all of it.  Inherently unknowable in their entirety.  Just like God.

So there you have it.  I'm an agnostic, medical or otherwise.

I used to see this bumper sticker sometimes on the way to work that said "What if the Hokey Pokey IS what it's all about???"  That, my friends, is the true absurdist extreme of what I believe about the world.  What keeps me up at night.  When the kids and the pager aren't.

But that doesn't mean I can't be a doctor.  I believe in a lot of things.  I just believe I might, just maybe, be wrong.  I believe there's a road in front of me.  There might not be, but I'm going to walk anyway.

And here's the other thing.  I love it.  Every day.  I love experiencing what I cannot ever truly know.  And that includes God, and people, and nature.  And actually maybe those are all the same thing?  I guess I'll never know for sure.