we all deserve a little "down" time

We all deserve a little "down" time now and then, don't you think? Time away from work. Time away from the news. Time to daydream. Even Mother Nature can't be at the top of her game every day of every week of every season. Which is why we're headed into October, and this week, the weather is beach worthy, hot and humid. At this rate, the pumpkins we put out will rot before Halloween. Perhaps Mother Nature just needs a little time to muster the energy it takes to move into Fall.

"I prefer winter and fall,

when you feel the bone structure

of the landscape.

Something waits beneath it.

The whole story doesn't show."

~Andrew Wyeth~

Although, to her credit, Mother Nature did share a moment of inspiration with us last week when she let loose with a few days of glorious cool, crisp autumn-like weather. Now it's back to the same old thing--the heat and humidity--just when things were looking up. It makes you wonder. Will Fall ever come to stay? Will winter ever get here? Does Mother Nature just need a little "down time"?

 

This comes to mind because that's how my writing has been going lately. I've been slogging back and forth through the last three chapters of my WIP for weeks, not making much progress. Except for a rare moment of inspiration, I have been stuck. I sometimes wonder if I'll ever move ahead. If I'll ever get to the end of it. 

 

Like Mother Nature, I think we all occasionally need a little "down time" in our writing, because, in Brenda Ueland's words:

 

"Inspiration comes very slowly and quietly...

The imagination needs moodling--long, inefficient,

happy idling, dawdling and puttering."

~Brenda Ueland~

 

Patience. Optimism. Nurturing. You can no more rush a thought into being than you can hurry the seasons along.

 

Eventually, autumn will get here. Sooner or later the story will finish itself.

 

Do you ever experience "down" time? Do you let it discourage or energize you? Are you open to what will follow?

"...it is the way you are to feel when you are writing--

happy, truthful, and free,

with that wonderful, contented absorption

of a child stringing beads.

With complete self-trust."

~Brenda Ueland~

jan



 

off topic, but worthy of reflection

"Alpabzug" or Alpine Descent in Switzerland

I met up with a friend at our favorite restaurant the other night. It's something of a joke between us because I can order her meal from memory. Steak. And she can predict what I will have. Seafood. It's as predictable as the tide. It never changes. There's a story behind it, though.

Perhaps you have already noticed this. There are certain books that leave a lasting impression on you. Others, you can't even remember having read. I picked up a copy of "The Mind Illuminated" by John Yates, PhD this week. It has been collecting dust on my bookshelf for a while now. It's a guide to meditation based on Buddhist wisdom and modern neuroscience. It sounded interesting. Imagine my surprise when I opened it up and discovered I had already read it, complete with underlining, notations, and dog ears. Obviously, though, I'd forgotten about it.

On the other hand, I read "The Jungle" by Upton Sinclair when I was in high school. The book is an expose of the greed, cruelty, and indifference Sinclair uncovered in the meat packing industry. It changed me, but I didn't respond to the horrors and cruelty he exposed right away. After all, I was still expected to eat what my mother put in front of me...meat and potatoes. Still, the images of cruel and abusive breeding and butchering of animals stuck with me until I made the transition to vegetarianism, actually pescatarianism (veggies and occasionally seafood) in my later years. Almost fifty years later.

"All animals just want to be loved."

~Anthony Douglas Williams~

I won't bore you with arguments for or against vegetarianism except to suggest you give it some thought. Or read "The Jungle" yourself, or read something by Jane Goodall, or check in with Joar Berge online at https://moustache-farmer.de/en 

'Nuff said. Pictures speak louder than words:

~Joar Berge
 @moustache_farmer~

~@thegentlebarn~

~Arik Vasquez~

~estherthewonderpig.com~

~Tatyana_tomsickova~

Consider this:

"The greatness of a nation

and its moral progress can be judged

by the way its animals are treated."

~Mahatma Gandhi~

...and not just its pets, I would add. Also, according to Darwin:

"The love for all living creatures is

the most noble attribute of man."

~Charles Darwin~

No offense intended, but if you love animals, you could consider not eating them. If you can't resist a good steak or chop once in a while, you should offer deepest reverence and gratitude to the being that offered it up for you. Or, in deference to hunters:

"Don't eat anything

you aren't willing to kill yourself."

~Lorene Lavora~

jan

 

questions we should be asking ourselves

 

If you have dedicated your life to work in the field of health care, chances are it was more than the prospect of a secure income that motivated you to spend so many additional years studying and preparing when your friends were already out in the world. Earning money. Cultivating a social life. Even starting a family. Perhaps you come from a long line of nurses or doctors and felt the pressure of expectation to continue the tradition. Maybe you were attracted by the prospect of authority and prestige. Perhaps you pursued medicine or nursing out of a heartfelt desire to do good in the world. To help people heal. Or because you felt called to this line of work.

"The two most important days in your life

are the day you are born

and the day you find out why."

~Mark Twain~

If medicine is your calling in life and you know it, good for you! But if your purpose in life is not yet clear to you, if you're not sure what you were put on Earth to do, or who to be, or why it makes any difference, you might want to start thinking about it. Otherwise, you may find yourself wandering through life without a clear path forward. Chasing after someone else's expectations for you. Investing time and effort in something that offends your sense of right and wrong. Surrendering to something that is meaningless to you or harmful to others. 

If you have been contemplating your calling in life but still feel lost, or you've been avoiding the issue because you don't know where to start, I highly recommend Stephen Cope's book, "The Dharma in Difficult Times".

In it, he illustrates the teachings of the great Hindu text, the Bhagavad Gita, through the lives of dedicated visionaries including Gandhi, Thoreau, Sojourner Truth, and Marion Anderson, among others, all of them committed to non-violent resistance/activism. How did they discern their sacred calling? What were they willing to sacrifice to achieve their goal? How did they apply the principles of non-violence to their efforts? What was the outcome?

These are questions we should all be asking ourselves at this time of political divisiveness and retribution.

Why is it important? Because we all have a sacred calling, a duty to ourselves, to others, and to the planet, whether we care to embrace it or not. Sooner or later each of us will be confronted with a dilemma that will require us to discern right from wrong, truth from untruth, whether to follow the crowd or to stand up for what we believe and value. Each of us needs to decide if this is a challenge we are willing to accept. A goal worth pursuing. A battle worth fighting. 

"Tell me,

what is it you plan to do

with your one wild and precious life."

~Mary Oliver~

I believed medicine was my sacred calling in life. I ignored the naysayers who insisted women weren't meant for it. That I would regret my decision. That I would fail at it. Instead, I made the sacrifices that were necessary to do the work I chose. Diligently and without fanfare. For over thirty years.

What about you? Where are you on your journey? To what cause do you feel a sacred duty? Cope states: 

"Sacred duty is the thing that

 if you do not do it,

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

~Stephen Cope~

 

Is it health care? Climate change? Racism? World hunger? Cruelty to animals?

All of the above?

How will you make a difference?

"Be the change you wish to see

in the world."

~Mahatma Gandhi~

jan

your untold story

 

Those of us who support the narrative medicine/narrative healing movement would like you to believe that the simple (or not so simple) act of telling your story and knowing it has been heard can bring about healing. How does that happen?

"I will soothe you and heal you.

I will bring you roses.

I, too, have been covered with thorns."

~Rumi~

Perhaps something like this has happened to you:

You wake up and it's a beautiful day. The sun is shining. Your bills are paid. The laundry is done. You pick up a good book and head out to the porch to read. But you can't concentrate. You sense a heaviness in your chest, and you can't stop sighing. You're tired, even though you haven't done much all day. You feel a certain sadness, but you don't have anything to be sad about. Your neighbor sees you and comes over to say hello. She immediately senses something is wrong. You shrug her off, and then it hits you. This is where you were sitting when you heard the screeching tires that you knew meant trouble. This is the same kind of beautiful September day you lost your dog on the street in front of your house. Seventeen years ago. 

"If you never heal from what hurt you,

you'll bleed on people who did not cut you."

~Karen Salmonsohn~

Or you go out for the mail and in it is an invitation to your friend's baby shower. You burst into tears. Because you never got to have a baby shower. You lost the baby before anyone knew you were pregnant, so you never told anyone. Or maybe you were never able to get pregnant in the first place. And your arms feel so empty.

Or maybe your story plays out like this. You didn't mean to put a dent in the fender the first time you took the car out alone when you were sixteen. Your father told you to be careful when he handed you the keys, and you promised you would. Then, a ball rolled out into the street and to avoid it, you swerved and grazed a tree in somebody's yard. You knew you'd be in trouble when you got home, but you didn't expect a beating for it. I mean, you were being careful, and it wasn't your fault. But your dad had been drinking that day, and when he saw what had happened, he hauled off and bloodied your nose and gave you a swollen black eye. In school the next day, you told the teacher you'd slipped and fallen down the basement stairs. And that was the end of it, but not really. Now your heart races and your head throbs and you break out in a sweat every time your own son takes the car out. And you don't know why.

"The scars you can't see

are the hardest to heal."

~Unknown~

If you sometimes react to situations in ways that don't make sense, or you can't explain why you feel sad, or tired, or anxious, or people often ask you what's wrong, your untold story may be hiding in the shadows, playing tricks on you. Because until you call it by name you may not know it's lurking there.

When you give your story a title, and describe how it unfolded, you may begin to understand why it still disturbs your peace after all these years. If someone you trust is listening, you may come away with an entirely fresh perspective on it. You may be able to forgive yourself, or the person who hurt you. You may be able to cast aside some of the things you've always imagined were wrong with you but never were. Your energy may improve, your headaches may lessen, your heart may open. 

If your story has been under lock and key for years, or you've forgotten where you left it, or you can't imagine finding the words to express it, you should consider getting back to work on it. Somebody else may need to hear it.

"Just because no one can heal you 

or do your inner work for you

doesn't mean you can, or should, or need to

do it alone."

~Lisa Olivera~

jan

l

  

 

Janet Cincotta, MD

2254 Old Hollow Road

Mechanicsburg, PA 17055

drmomjfc@gmail.com

(717) 574-7357

 

Governor Gavin Newsom

1021 O Street, Suite 9000

Sacramento, CA 95814

 

Dear Governor Newsom,

 

I am writing to express my relief and gratitude for the leadership you have shown on behalf of your fellow Californians as well as Democrats across the country for the past several weeks. The current political climate is driven by greed, injustice, deceit, and fear. You have demonstrated great courage, integrity, and clarity in your efforts to counteract this blight on our democracy. I hope you have your sights set on a presidential campaign in 2028.

 

To be brief, however, I would like to suggest that you consider tempering the humor you have employed to mock and even mimic our current president’s rhetoric and buffoonery. While your satire and mockery are clever and engaging (please don’t stop), the issues at stake are grave. As such, I believe they deserve to be presented with utmost dignity and sincerity. You do not have to stoop to the inferior standards of conduct employed by your Republican colleagues to make this point. A little parody goes a long way. This is serious stuff.

 

As an aside, speaking as a physician, if you have not already done so, I would suggest you have your vocal cords checked. You sound a bit hoarse which could be caused by a polyp, which is an easy fix. I’m concerned because America needs to hear what you have to say in a clear, loud voice.

 

Thank you for your attention. Again, you have my deepest respect and hopeful anticipation for our country’s future as a democracy.

 

Yours truly,

 

 

Janet Cincotta, MD

 

how does life go on

This past week was a tough one for me. Not for me personally, but for people I know and love, for people I don't know but whose stories I've heard, and for millions of others around the world who, we all know, suffer every day.

It reminds me that my week passed quite peacefully. The sun came out, but it stayed relatively cool thanks to an arctic front that pushed through, a perfect week to get yardwork done and to get some walking in. I went to the grocery store and picked up whatever I wanted to fill my cupboards. I slept in a safe, soft bed. I got a little writing in. It was a quiet and pleasant week for me, but unfortunately, much of the rest of humanity didn't fare so well, and that disturbed me.

It started with images of skeletal children dying of starvation in Gaza, their mothers watching in horror. It continued with pictures of people shuffling through the debris in war-torn Ukraine. It reminded me of people fleeing their homes ahead of the wildfires out West and in Canada, and of those who were reinforcing sand dunes along the East coast head of a monster hurricane. I heard about an otherwise healthy teenager who presented to the Emergency Room with shortness of breath and fever suggestive of pneumonia whose chest x-ray and subsequent CT scan revealed a 15 cm. (that's almost seven inches across) mediastinal mass with lymph node involvement...and I learned about a father who found his daughter hanging close to death in her bedroom when he got home from work. 

How will life go on for them? This is their reality, now. How will the rest of us process it?

"Be kind,

for everyone you meet is fighting

a battle you know nothing about."

~Wendy Mass~

Part of the problem is the sheer magnitude of suffering in the world. Part of it is the utter sense of futility that greets us in our efforts to reach out to others. We do what we can, but it amounts to little more than a dewdrop in the ocean. With a couple of clicks on my keyboard, I donate regularly to a couple of organizations that provide food and assistance to victims of war, poverty, injustice, and natural disasters although I have no clear idea what happens to my donations. I don't know if they help anyone at all. You may do the same, or you may volunteer to pitch in when disaster strikes, or you may simply rely on the power of prayer to relieve the world's suffering, but pain and sorrow still hang heavy around us...

...as does guilt. The gratitude we feel for all we have...food, shelter, good health, and community...can amplify the heartache we harbor for those who are not so lucky. We feel guilty even though we have done nothing to deserve it. We feel guilty because we are so helpless.

"Guilt is not a weakness.

It's a reminder of our capacity to care."

~DESIQuotes.com~

Do you share my sense of futility? Of frustration? Of discouragement?

Where do you turn for solace? For Peace? For joy? How do you sustain a sound spirit of equanimity? Is it even possible?

"EQUANIMITY:

(n.) mental calmness, composure, and

evenness of temper, especially 

in a difficult situation."

~various attributions~

If this week is difficult for you, try this: Take a deep breath in and let it out slowly. Feel the pulse beating in your own wrist. Ask yourself how the universe we know to be cold, dark, and dangerous drapes itself around us in baby blue. 

Wendell Berry may have said it best:

"It may be that when 

we no longer know what to do,

we have come to our real work,

and when we no longer know which way to go,

we have begun our real journey."

~Wendell Berry~  

jan

the consequence of fear and ignorance

 

I was going to try to avoid writing about anything political this week, but I couldn't help myself. This blog is about the role storytelling plays in the practice of medicine, including the stories that describe our patients' experiences and the stories we recount as health care providers. I'm afraid the narrative is about to change, though, as we witness efforts to discontinue public health programs and dismantle medical research initiatives. Meaning that people...children...will die.

"The two public health interventions

that have had the greatest impact

on the world's health are 

clean water and vaccines."

~World Health Organization~

I've been around long enough to have celebrated the triumph of vaccination against polio, make that "paralytic polio", a disease you do not want to see, treat, or God forbid, suffer. We are already witnessing an uptick in cases globally, not because the vaccine is unavailable (yet...), but because RFK is spearheading efforts to withdraw funding from Gavi (the Vaccine Alliance, or Global Alliance for Vaccines and Immunization) whose purpose it is to fund immunization programs in underserved populations around the world. Trouble is brewing.

Closer to home, disinformation has bred skepticism and fear. Parents are hesitant to provide their children with even routine vaccines that have been proven safe and effective for many years. We have already seen an upsurge of measles cases among the unvaccinated that have claimed the lives of three otherwise healthy children.

Count yourself fortunate if you have never watched a young polio victim struggle to use crutches, much less fight to breathe in an iron lung. We thought those days were behind us. Now, we can't be sure.

The stories we have enjoyed for years may be changing. We may be going backwards.

"Universal vaccination may well be

the greatest success story

 in medical history."

~Michael Specter~

I can tell you the story of an otherwise healthy child who came home from school one day with a headache and a slight fever...and died the next day of meningococcal meningitis. That fast. Back in the days before we had a vaccine that would have prevented it.

I can tell you what it was like to treat a child with measles encephalitis and watch them die of a totally preventable disease or suffer its consequences for the rest of their lives.

I can tell you how hard it is to intubate an infant who is struggling to breathe with whooping cough or a toddler with epiglottitis, diseases we never see in vaccinated children anymore. 

Without a doubt, the stories we tell and those our patients tell will change given the present leadership of the Department of HHS. From triumph to heartbreak. From hope to despair. From success to defeat.

Trust me: you do not want your child, or grandchild...or ANY CHILD...to suffer or die from a preventable disease. You don't want ANYONE to die of a preventable disease because of skepticism, fear, or ignorance. If you agree with me, please make your thoughts known at:

Contact Us | HHS.gov

The US Department of Health and Human Services

Hubert H. Humphrey Building

200 Independence Ave., SW

Washington, DC 20201

1-877-696-6775

"To fear what you do not understand

is to mistake ignorance for safety."

~Ginn Hale~

jan