Snail

Just because I need you to co-sign my physician notes

Doesn’t mean I’m codependent on you

You fire shots at my ego

Arrows fly through the air

You can’t hit a target that’s not there

Anxiety crushes me all day every day

I get back up every time, keep moving forward

Though the pummels are fierce and I’d rather rest

I give life my best

Though I could do better

I show up without fail

I am patient, like the snail

Flame

Your rage strikes my heart like a lightning bolt

Cracking it open and setting it afire
I am at a loss for what to do, so I warm my hands over the embers and wait
To transform, part of me must die
I cannot rush, only trust
How many times can one heart break?
As many times as it takes
To learn the sacred lessons
To consciously unite with the divine
Time and time again
Pain is pain, sensation is sensation
No matter the form or formal education
Lucid dreaming just before waking
I see a sea of broken hearts glowing in the dark
Each a floating lantern offered up
Burning with the same flame

Workaholic

I went into medicine partly due to heartbreak

The exhaustive training of medical school and residency was a welcome albeit ineffective distraction from my sorrow and loneliness
24-hour shifts are a convenient justification for not keeping in touch with loved ones
Even though the real excuse is my social anxiety and sense of inadequacy
Living within hospital walls, I suspect that I am not the only physician who became a medical doctor to try to forget unrequited love, to escape the world of human relationships
My older colleagues work far more than they need to to make ends meet, far more than any reasonable person would work in a week
Who needs friends or feelings when you have patients and science?
Our skin grows pale under fluorescent lights
Our vision becomes shortsighted as the screens stare unblinkingly
Our hearts forget how to feel carefree
Our muscles atrophy as our brains hypertrophy
Our minds become boxed in with facts, our mental filing cabinets overflow
I am a recovering workaholic working alongside workaholics who do not appear to be in recovery
Perhaps they suspect the same of me
Heads down in the trenches, none of us can know another’s heart
We can only know our own heart, if we listen
We carefully administer medications, surgeries and therapies
We measure progress in numerical metrics of lab values, calculated scores and vital signs
We arrive early and stay late
We work day and night without a break
We always have too much on our plates
We deprive ourselves of sleep, fresh air and food
We know why we have irritable moods
Practicing medicine is an unhealthy, imbalanced lifestyle and we know it
We can only ever heal ourselves
I’m ready to show it
I am finally healing my broken heart
I found that I had to begin at the start
Childhood wounds tangle and bloom
Trauma begets trauma until we change our thoughts, words and actions
Breaking old patterns even as we hold traction
I am love itself, I am the source of what I sought
My cup overflows, it was not all for naught

Sex, Money, Dishes

Tell me you’ve never fought with your partner about sex, money, or dishes.
Sex
I used to fight endlessly about sex, mainly because I didn’t want to have it but my partners did, so we’d fight and fuck, then I’d cry and be blinded by images of destroying my body or their body just to stop the rape and the torture of not feeling safe in my skin. Amazingly, we all survived and now I have a loving partner with whom I have gold-medal sex; you have to experience it to believe it, it’s like I’m cashing in on some sex fund which I invested in long ago. Happily I don’t fight about sex anymore- I’ve got a man I’m attracted to inside and out, and he loves me the way I want to be loved.
Money
I used to exchange sex for money. It seemed like there was always too much sex and not enough money in those transactions, or transgressions. Even those back-alley deals were more straight forward than my relationships in which sex was exchanged for the illusion of not being alone, for food, housing or ‘safety’, though I learned that the cost to my physical, mental and spiritual wellbeing which false relationships exacted was not worth the dinners, drinks, gifts of lingerie, attention or the roof over my head. You might get raped if you travel alone, but if you travel with a man you are guaranteed to get raped. Live within your means because fine dining won’t taste good if you are eating with a strange man, believe me I know. If you have to learn on your own I understand, however if my years of pain can help prevent a moment of your suffering, it will have been worth it.
Dishes
Rare is the man who finishes the dishes. Common are the men who stack the dishes artfully in the sink until there is barely room to turn on the faucet. I have noticed this pattern during my co-habitations with men. I’ve done too many dishes. It especially irks me when men drown sponges in the rinsed yet still not washed dish pile, unperturbed as the sponge decomposes into a musty mess. Men seem deaf to the silent cries of the forgotten dish sponge. Day after day, I rescue the sponge, wringing it out and restoring it to its rightful place safe on dry land, in sight. My man shows his love for me not only through our award-winning sex, but also through money (ie, responsibility for personal  finances to contribute to our future together) and dishes: ladies and gentlemen, my man did the dishes tonight, thus allowing me time to write the words you read. If a man loves you he will want to learn your love language, which you must teach him with patience, positive reinforcement, and more patience.
I grew up doing the dishes, in poverty, and sexually molested by family and friends. My sister would beat me when she got in trouble for not doing the dishes with me after we were told to do them, but the alternative would have been getting beaten by my parents for not doing the dishes, so I was going to get beat no matter what I did. I wished that someone would do the fucking dishes with me. A girl can get lonely amidst the dissolving suds.

Corona

I wear my crown of martyrdom

On the front lines, yet still at the back of the testing line- haven’t been tested

I think of you, virus, though you do not think of me

Coronavirus, on the news
Coronavirus, in my body
Is the aching in my muscles and bones your calling card?
You desire to enter my cells, virus, as much as I long to keep you out
Together, yet separately, we hunger
You want to pick my lock, use my typewriter to transcribe your RNA, then mail your enveloped self-promoting propaganda air mail special to Hadestown.
Don’t bring me down on the way, I pray
Not like this, not today
My heart breaks to think of those who have lost their lives to you, and those who needlessly will still
My head is intoxicated with fear
You always seem too near
Perhaps we Americans deserve the repercussions of our recklessness
Though it is the innocent who pay, as usual
Another day deep
I march on with trembling hands and heavy feet
Tracking invisible mud out of the wards and onto the street
Ashamed to stay in the job I was fixing to quit anyway,
Ashamed to leave now and abandon my post
The war is on, dwarfing the existential crisis of living the life I want versus fulfilling my societal obligation
I am among the minority who have a medical education
Only in following my heart can I grow up at last, no longer a slave to the judgements of others who do not bear my burden
My mind’s liberation opens up like a blue sky
Back to here and now, overcast again
In clinic and in the hospital
I struggle to bring my heart into the mundane and mission-impossible tasks which overflow from one day to the next
Virus, I gaze at your storm clouds accumulating on the horizon, and feel small
I see your silver lining, as I am well practiced in finding positivity amidst disaster
You are rich in potential
Look at the way you are uniting humanity, virus
People are taking care of themselves and each other like never before
Practicing presence in hospital hallways and supermarket aisles, smiling shyly at each other from behind our suffocating masks
We are finally being mindful of our precious resources, thinking globally and acting locally for sustainable solutions
We are cultivating more community and camaraderie than we could ever quantify
Teamwork and solidarity are weaving our spirits more closely together even as the physical distance between our bodies grows
I take a step back to take in the beauty of the tapestry you wove, virus
You bring opportunity for innovation and flexibility, you demand it
Many of us no longer take life for granted
We are cleaning our hands as often as we always should have
People are being prioritized over profits as we focus on what is essential
We settle in, acknowledging at last that we are in the same boat
Living in unspoken gratitude for each day of health
Please don’t rock my boat too much, virus
Though you are armed with cunning skills
And you may bring about more positive change still
I plan to ride out this storm, though land is not in sight
Virus, perhaps you could rest tonight?
Virus, my type II pneumocytes are mine, my lungs are a celebration of life and you are not invited
I wind-down after another day on the front lines,
I give thanks to those who are doing their part in time
To those in the comfort of your own homes,
Please stay where you are, be satisfied
Coronavirus, we will destroy you with patience and ingenuity, with solidarity and community, with soap and water, and with love for one another

Emergency Room

Emerging from the emergency room, gasping to find my breath, I weep.

I finished my last shift in that hell-hole, and I thought I would cry tears of joy, but instead I am crying tears of raw emotional release.
My patients called me an angel, but many of them were also angels to me- holding my spirit buoyantly with their sparkling eyes, a much-needed balance to my co-workers who seemed mostly dead inside.
Crushed inside the machine
Their eyes see only the screen
Their skin knows no fresh air or sunlight
As they toil day and night
In a crowded, chaotic space filled with alarms
Long ago, they replaced their charms
With rigid motions, mechanical minds
Without windows, they don’t notice the passage of time
When did they become so cold and bitter?
It must have been little by little
The fire in their hearts was starved of oxygen, their spirits wore away
I hope I keep my heartspirit intact, at the end of the day
Flashback to a line of gurneys in the ambulance bay
My attending grilling me, I didn’t know what to say
Broken bones and chronic pain
STAT CT to look for a bleed in the brain
Patients sustained on turkey sandwiches and diet ginger-ale
We wait on them, they wait for us, but we are all stuck in this jail
Trapped in a health care system which is systematically inhumane
No wonder so many of us don’t feel quite sane
My vision is blurred by tears
I’ve finished one more day in the middle of many hard years
Of sacrificing my life, enduring unfathomable strife
Just to help others survive another night
I want to get off this roller coaster, but I’m strapped in
Though I am sick to my stomach and deafened by the din
I return to my breath, breathe in new air
I have the rest of my life to move on towards
Tomorrow night, I’ll be back in the wards
With renewed gratitude, I leave this emergency beast
I walk past patients waiting to suckle the mechanical teat
Finally allowing room for my own emergency
My meltdown of tears isn’t enough to drown out the blaze
Which burnt me out long before today
I struggle to justify
Why I put myself in situations that make me cry

Pain

Pain and addiction.

I walk the line between giving too much and giving too little.

Rarely do I get it right.

Rarely do I feel right with myself when I prescribe opioids.

Knowing what lies on the other side of pain relief, knowing the train wreck waiting at the end of the line, knowing the lifelong prison sentence that opioid dependence brings- held hostage in our own skin, til death do us part.

Too many loved ones have died too young from overdosing.

How can I justify prescribing a substance that could suddenly and unapologetically kill someone I’ve never met, somebody’s beloved son or daughter, a curious teen who wanted to feel comfortable in their changing body, experimenting at a party, sampling the medicine cabinet

I want to feel comfortable too.

You complain of pain that you’ve had for years and expect me to fix in an instant.

You say there is a national opioid epidemic, but that you are not a part of the problem.

You say that tylenol and ibuprofen don’t work on you. You say that you need at least Percocet.

You say that other people have been prescribed more for lesser reasons.

You become bitterly enraged if I hesitate, and sickly saccharine if I yield to your request.

You shout that I wasted your time if you don’t get what you want. It kills my spirit to prescribe you opioids, because opioids are, in my humble opinion, the worst medicine- the most risk for the least benefit. With opioids, there is no healing, only the creation of an unnecessary problem without a solution.

It makes me want to leave medicine when I prescribe the medicine you beg for. I’m not practicing medicine for my health, so if I’m not ultimately benefitting your health, then what the hell am I here for.

Can’t you feel my pain? I’m so damn uncomfortable in this drug-dealer role.

If we reserved opioid use for more select scenarios, like only metastatic cancer or the immediate post-operative period, perhaps opioid dependence would be prevented for many who have yet to be born.

However, there are more drug profits to make and more blood to spill before change will come.

The whole scene makes me ill.

If I wanted to deal drugs, I wouldn’t have put myself through the brutality of medical school and residency. I could’ve just dropped out of high school and saved myself a lot of hassle. That might sound cold, but my pain ignites my fire. You didn’t ask about my pain.

I don’t want to be part of this system because I feel like I’m doing more harm than good.

I’m trying to do right in a world of wrong.

I swallow my words until they explode in a song.

Nobody hears my melody because I work all day long.

Sing sweet nightingale.

Pockets of Bliss

Pockets of Bliss

Hard-scrabble
Uphill battle
Stoically strong
All my life long

That was my marching song

Yet if I let myself unwind a bit
I find myself basking in pockets of bliss
Soaking in satisfaction, abundance, gratitude
It feels like the ultimate kiss
As I both receive and radiate
The generous glow of the sun

My mind usually tells myself that I don’t have time
For such indulgent, frivolous nonsense
That I’ve got to push push push
And forever rush rush rush

I fooled myself into believing
That I didn’t deserve the luxury of deep breathing
That rest and relaxation were only for the privileged rich
Such was my justification for prioritizing everything else                                                       Before my own needs

For too long I wrongly bought into the ideology
That my life was not to be enjoyed
That I should run hungry all my days
As if pursued by a ravenous wolf in all kinds of ways

But today I re-realized that I am the wolf
And also the prey
Only I have the power to say,
‘Enough of being tough.
I am ready for ease!’

If only in pockets to start
Because old habits are hard to break,
Just ask my heart

So it is with patience and persistence,
Guided by gentle wisdom
That I fill my pockets to overflowing
With bliss bliss bliss