wishful thinking 2023

 

Why, of course. Help yourself.

Tomorrow is New Year's Day. I'm fairly confident the sun will rise in the East as usual, and it will set in the West, as expected. My house is quiet. The woods out back are still. Except for the year on the calendar, I don't expect much to change overnight.

"Bad news: a lot can change in a year.

Good news: a lot can change in a year."

~various attributions~

So, why do we gather with family and friends to raise our glasses at the stroke of midnight on New Year's Eve?

Simply put, it is a celebration of wishful thinking. It is proof that we believe...or hope...that the new year holds limitless possibility for us...the possibility that good will come to us, that our burdens will be lifted, that help is available. It enables us to envision a world at peace, to imagine an end to poverty and hunger, to hope for an elusive cure, to pray for an end to suffering. 

Wishful thinking is an act of the imagination, the acknowledgement of fantasy, of faith, of hope. It is a meditation on possibility, the defeat of despair, the embodiment of optimism. It is childlike, playful, and enduring. It is the gateway to creativity, to our vision, to the soul.

"Imagination is more important

than knowledge."

~Albert Einstein~

So, instead of making New Year's resolutions this year, why not try wishful thinking? It has a more optimistic ring to it than making resolutions that require self-discipline and grim determination. For example, I could promise to journal first thing every morning this year...but what if I have to wander outside because the sunrise is too heart-achingly beautiful to miss? What then? I could resolve to write one thousand words every day...but what if it snows? If I don't get out there, who will build a snowman in my yard?

Resolutions are often doomed to fail. Optimism, on the other hand, is an empowering force, and hope is a saving grace. There is no limit to what you can wish for. There is no end to what you can do. There is no limit to who you can be.

This is my New Year's wish for you:

May you be happy.

May you be healthy.

May you be safe.

May you dwell in peace and loving kindness.

~loving kindness (metta) meditation~

What are you thinking wishfully about for 2023?

jan

the truth about winter

"The snow fell as softly as a poet's tears."

~Kevin Ansbro~

It's hard to believe that Christmas is behind us already. All the decorating and baking are finished. All the wrapping that kept us busy for weeks has been cast off, all so we could celebrate with friends and family on Christmas day. So we could welcome the kids home for the holiday. So we could enjoy the  company of people we love but seldom see. 

"I wonder if the snow loves

the trees and fields, 

that it kisses them so gently."

~Lewis Carroll~

Except that some of them didn't make it home this year. Some took ill, or because they cared for someone who was sick, or injured, or unable to travel, they stayed with them. Or perhaps they refused to come...out of anger or bitterness or resentment. Or they missed Christmas because most of us were hunkered down against an historic cold spell, and in some places, blizzard conditions that closed airports and made travel dangerous, if not impossible.  

All that preparation. All that anticipation. For naught.

"I pray this winter

will be gentle and kind--

a season of rest 

from the wheel of the mind."

~John Geddes~

If you are a writer, you know what this feels like. You understand what it takes to get ready for the big day--when you finally query an agent about your narrative. Your word count is spot on. The chapters are numbered and titled. Everything has been checked and rechecked. Revised again and again. You are ready...

...but nothing happens. Disappointment reigns. All that preparation. All that anticipation. For naught.

As cold and dark as it feels right now, I'm optimistic that winter will run its course. With a little luck, we could even have an early spring. I'm confident that the shovels and the Quik-melt will find their way back into storage for another year. That the people we missed at Christmas will find their way back to us...or we will make our way to them.

Likewise, with a little luck--or a lot of it--your writing will find a publisher...and all that work, all that preparation will eventually pay off. 

Are you prepared for winter? Are you ready for spring? Are you eager for success?

"Always be prepared
for something amazing to happen."
~Melanie Perkins~

jan

 

remember to look up

On Christmas Eve~

                                                            

Hope springs eternal.

jan

what gift will i give

 

Are you ready for Christmas? I think I am, as ready as I can be given the fact that this isn't the easiest celebration to pull off every year. A snowstorm can sweep in and ruin everything. A simple cold can lay a person low. People we love may be missing this year.

This is always a bipolar time of year for me. I can be full of eager anticipation one day...empty, the next. With the approach of Christmas, we enter a time of irreconcilable contradictions and undeniable reminders of the dualities that coexist in our lives--joy and sorrow, poverty and wealth, war and peace, anticipation and dread, indulgence and denial. Good health and bad. Which, when you stop to think about it, feels so unfair.

The problem is that I have friends who are sick...so sick, in fact, that this could be the last Christmas they see. I have friends who are grieving. I know people who are lonely. Angry. Depressed.

And most likely, you do, too.

The holidays have a way of putting life's inevitable struggles into perspective. The bright lights and merry carols that the rest of us enjoy can dampen the spirits, deepen the grief, and aggravate the loneliness that so many feel at this time of the year. 

 

www.personal.psu.edu



I wish everyone could be happy and healthy at Christmastime. That everyone was at peace. That everyone had hope. It's hard to know what to do for those who don't. What good are presents when pain is the problem?

Which leads me to reflect on what I think would be helpful to me if the tables were turned:

If I were sick, if I were the one receiving chemo, or struggling against pain, I would want a friend at my side. Don't bother bringing me fuzzy pink slippers or bubble bath or a bouquet...unless, of course, it makes you happy...in which case, bring it on! Even though it's your presence I really need.

If I were grieving the loss of a loved one--my spouse, or one of my children, or my best friend--I would want you to sit at the kitchen table with me and share stories--the sweet, funny, important moments that we enjoyed with them. I'll make the tea. You bring the cookies.

 

If my house turned to rubble in a storm, or I lost my job, or my marriage went south, I would need you to hold me up, to cheer me on, to shelter me if it came to that. Don't say, "Call me if you need anything." I would need everything, and I wouldn't have the strength to pick up the phone. Just come. Sit. Stay.

 

www.weheartit.com

 

One of the best presents we can give is exactly that--our presence. Our halting, not-sure-what-to-do-or-what-to-say presence. Our I'll-be-here-for-you-no-matter-what friendship. Our I-wish-I-could-do-more-for-you selves even though some of us may have been planning and preparing for weeks, now. Shopping. Baking. Wrapping. Tending. Caring. Hoping to make everyone happy...

...not that we have much control over it.

Still, if Christmas with your family is happy, loving, and peaceful, I wish you a merry one.

If not, I wish you hope. Courage. Friendship. Beauty. Time. Snow if you like it…sunshine if you don’t.

~What Gift Will I Give~

You have no idea how hard 

I've looked for a gift to bring you.

Nothing seemed right.

What's the point of bringing

gold to the gold mine, 

or water to the ocean.

Everything I came up with

was like taking spices to the Orient.

It's no good giving you my heart

and my soul because you already have these.

So I've brought you a mirror.

Look at yourself and remember me.

~Rumi~

jan

how to avert a disaster

~one of my favorite winter images~
attribution unknown

True story:

A friend of mine posted a request on social media last week asking for prayers for her daughter, although she didn't offer any details. So, even though prayer doesn't seem to work very well for me, I called to find out what the problem was. It turns out her daughter was experiencing severe lower abdominal pain. Coincidentally, she developed a sore throat, leading to a positive Covid test...meaning she was on her own when it came to evaluating the abdominal pain.

Because of the Covid issue, no one laid a hand on the young woman's abdomen, instead opting for a CT scan of the abdomen...and then, deciding instead to get a CT with contrast...meaning a prep that would intimidate the bravest among us. 

My friend got the results of the scan over the phone...not from the doctor or the nurse, but from a receptionist who had no idea what the report meant except that it showed "a massive tumor that had to come out." And...oh, by the way...a urinary tract infection.

Wait. What? What kind of a tumor? Where? How massive is massive? The patient was sent home to wait for the doctor to call. He never did. A prescription for a ten-day course of antibiotics was called in, except that it only provided seven doses, and the pharmacist wasn't able to honor the opioid script for pain from the ER doctor. The PCP had to write it out. Calls to his office went unanswered. No referrals were made. No explanations were offered. No treatment was initiated.

"America's health care system

is neither healthy, caring, nor a system."

~Walter Cronkite~

Altogether, four days passed. During the entire ordeal no one laid a hand on the young woman's abdomen. No one took her history. If they had, they would have known that she was autistic. Confused. Terrified. She just wanted to get home to her mother. But her mother was at high risk for severe Covid infection, so she couldn't be there to advocate for her daughter. Not to mention the fact that she nearly lost her son to Covid last year. 

The plot thickens.

In desperation, the patient's mother put in a call to someone she knew well...someone she trusted: the pulmonologist who saved her son's life last year when he was in ICU with Covid, on cardiopulmonary bypass. She begged him for help. And he did. 

"To know even one life has breathed easier

because you were kind.

This is to have succeeded."

~Ralph Waldo Emerson~

He arranged a consult with a surgeon that afternoon. He read the CT scan himself and discussed the report with her in detail. The tumor was a teratoma so large they couldn't tell which ovary was involved. It was described as "larger than a baby's head." The UTI resulted from pressure on the bladder. Antibiotics and pain meds were secured. Surgery was scheduled. A potential disaster was averted.

This scenario highlights some of the reasons I retired from medical practice early. Not only is this level of care...or neglect...unacceptable, it is dangerous and cruel for a number of reasons:

• No one took the patient's full history.
• No one examined the patient.
• No one communicated with the patient or her family.
• Mistakes were made in prescribing.
• The patient was discharged without treatment or follow-up.
• The lack of attention and concern caused unnecessary mental and physical anguish for the patient and her family.

We are all probably guilty of similar oversights and errors at some point in our careers. We're only human. And, God knows, our offices, clinics, and emergency rooms are overwhelmed with the recent surge in hospitalizations for patients with Covid, flu, and RSV. I get it. You get it. There is just so much time in the day. Everyone is working against the clock. Doing their best...

...or not. 

This is what frustrates me. In today's health care system, taking shortcuts is seen as acceptable, even necessary, given the mandate to see more patients faster, in order to generate revenue for our corporate taskmasters. As physicians, we devote four years to medical school and three or more years to residency to become little more than remote triage officers. Technology outpaces touch. The patient's narrative is  driven underground. A diagnosis is missed. A patient suffers. A connection is lost. We have betrayed our sacred duty. According to Stephen Cope, Scholar Emeritus at Kripalu Center for Yoga and Health:

"Sacred duty is the thing

that if you do not do it,

you will feel a profound sense of self-betrayal."

~Stephen Cope~

The problem is not so much the inevitable shortcuts and slip-ups that we have come to expect, but the fact that they are excused, denied, or accepted as part of practice nowadays. That these practices have become the norm, and no one cares to make them right.

"We touch heaven

when we lay our hand on

on a human body."

~Novalis~

jan

a huge, heartbreaking problem

I spent a good chunk of my weekend completing the mandatory child abuse recognition and reporting course I am required to submit in order to renew my (retired) medical license every couple of years. If you are reading this blog, and you are a healthcare provider or a therapist in any field licensed by the state, you know what I'm talking about. You have to complete a couple of hours of required child abuse CME before you can renew your license. This is because you are, by definition, a mandated reporter.  You are obligated by law to report any incidence of child abuse or neglect whether you witness it yourself, it is shared with you, or it is something you otherwise remotely suspect...even if it occurs outside the scope of your practice, in the grocery store or on the playground, for instance. 

"The true character of a society

is revealed in how it treats its children."

~Nelson Mandela~

  

The reason we do this over and over again is that the process changes over time. The laws change and our awareness of the problem may dwindle. And...because child abuse and neglect are so damaging to our culture. To our future. We aren't required to update our understanding of heart disease, the newest treatments for cancer, or our grasp on mental illness to maintain our professional license. We are required to understand the nature, magnitude, and recognition of child abuse.

This is a huge, heartbreaking problem. It is estimated that a report of suspected child abuse is made every ten seconds in the United States. Over four million referrals are made every year. On average, five deaths occur every day due to child abuse/neglect. Even so, this may represent a gross underestimate given the problem of under reporting.

This is the thing: you may be reading this blog even though you're not a healthcare worker, therapist, or other mandated reporter. (This includes childcare workers, teachers, coaches, even librarians, among others). Perhaps you're a friend of mine, an on-line acquaintance, or even a previous patient of mine. So what does this have to do with you?

Whether you realize it or not, you are identified as a permissive reporter, meaning you are encouraged to report suspected child abuse even though you aren't required by law to report your concerns. While mandated reporters can file their reports through an on-line process, permissive reporters must contact Childline directly to register their concerns:

CHILDLINE

1-800-932-0313

AVAILABLE 24 HOURS/DAY

7 DAYS/WEEK

This is what you need to know. Your call will be kept confidential. Your call can be made anonymously. You do not have to prove that abuse did, indeed, take place. That's for the experts to determine. Your suspicion of possible abuse justifies your call. You will never face legal retribution for placing it. 

"Child abuse casts a shadow

the length of a lifetime."

~Herbert Ward~

I have written about Adverse Childhood Experiences (ACEs) before. (See "take this test," November 23, 2021). These are potentially traumatic events that occur in childhood (ages 0-17) and they include violence, abuse, and neglect, parental substance abuse, mental health issues, and household instability. ACEs are linked to long term, chronic health problems that manifest in adulthood, including heart disease, immune disorders, and mental health problems. These long term effects should compel all of us to take the problem of childhood trauma seriously. Personally. We should do all we can to identify it. To prevent it. To mitigate it. For more information on this important topic, this is a good reference:

https://www.cdc.gov/violenceprevention/aces/fastfact.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fviolenceprevention%2Facestudy%2Ffastfact.html

Remember this:

"You can spend a lifetime

trying to forget a few minutes

of your childhood."

~www.HealthyPlace.com~

If you're interested in learning more about how to recognize and report possible child abuse, this is an excellent course:

https://www.reportabusepa.pitt.edu/

*

"Give me your past,

all your pain,

all your anger,

all your guilt.

Release it to me and

I will be a safe harbor for the life

you need to leave behind."

~Jewel E Ann~

jan

https://www.reportabusepa.pitt.edu/