Wednesday, October 14, 2020

Mask up!



I wear a mask

Some might label me a sheep

Yes, proudly I am

In fact, it is something called herd immunity*

Proudly part of the herd

Baah’ baah’

 

I wear a mask.

Even as a doc, I can’t cite you the risk level as another person passes

But I wear the mask to show respect for their life, their health, and their family at home

And yes, for myself and my family at home as well

 

I wear a mask

Not any more as a political statement than

getting a flu shot

flushing the toilet

or picking up my dog’s poop

I wear it because it is the right thing to do as a member of a larger community that relies on me to make the right decision

I wear it because I don’t want to see communities of color suffer any further in this pandemic

I don’t want anyone to suffer

 

I wear a mask

Believing in science

And a crazy principle called “disease transmission through air particles”

Not because of how I vote or my religious beliefs or my political party (feminist)

 


I wear a mask and ask that you do the same

Why?

Because you are too important not to be here because of COVID

Ditto for those in your family

Ditto for those you might infect

 

I wear a mask and ask that you do the same

Because it is a statement of love for your community

Because together we can bring reason, humanity, and caring for each other back into this polarized, angry shouting match we find ourselves in

Because we are together in this herd called humanity

Baah’ baah’



* As a professor in population health, I need to clarify that herd immunity is not quite the same as wearing a mask. Herd immunity is the idea that if enough people are immunized, the herd as a whole is protected. But in this case, I couldn't resist the poetic connection between sheep...herd...herd immunity. This blog is an escape from my academic life, after all :)


Wednesday, October 7, 2020

Bass and Treble

 

Way back when, humans listened to music without Spotify, Air Pods, smart phones, and blue teeth/tooths.

In those B.S.P. (Before Smart Phones) days, people would actually get off their tooshies (medical term for gluteal area) and walk over to a thing called a stereo to adjust the sound using something called an equalizer. Crazy huh? Millennials reading this are already distractedly Googling all of this to verify I am not spinning tall tales.



Let’s use the equalizer analogy as we consider what music we play for ourselves today. 

Treble represents the positive in life – the beautiful moments of each day, the practice of gratitude and the people and experiences that make us grateful. All that sustains us will be treble.

Bass, meanwhile, represents the negative – things that stress us, things that cause us to worry, fear, and which bring on anxiety.

Yes, life does give us a starting material for the music we hear, but it is our decision of how we adjust the equalizer that makes the difference between symphony and cacophony.

“Woe is me” is not a reflection of the orchestra, but is a reflection of that person’s inability to lower the bass so that treble can ring.

And if treble weren’t easy to tune up, the majority of media even exist. Regurgitating the same bad news, knowing humans will consume it over and over and over. In those rare cases of treble amongst so much bass, you would never hear a “feel good” story repeated one day to the next on the 10pm news.

“Now to follow up on that incredible tale of the boy who raised $10,000 for his classmate with cancer from yesterday. We thought we would take another look at this tale since we felt it was so important for our city.”

Nope. But crime, natural disasters, political squabbling attract attention day after day. I think our own internal “news feed” plays out similarly. Much easier to regurgitate and perseverate on the bass in our lives.

My friends, play with the equalizer today. Play with that innate ability to attune to treble and let the positive dictate your thoughts and actions. Bass will still be there, but it will exist in balance with, and in the context of the treble sound. You might even appreciate new and more constructive angles on the bass sounds by not focusing on them.

Today, life will not give us treble or bass. No, today we get to choose how to manipulate the equalizer and make music out of the sounds that life presents.



A simple exercise for those interested in tuning their equalizer:

Write down 3 things that have most bothered/worried you in the last week. These are your bass.

Now, take those 3 things and come up with the opposite statement. Ex: “I am worried about my grandmother’s health becomes “I am grateful to have my grandmother in my life.”

Today, as you go about the day, when you find yourself beginning to think in “bass”, simply adjust the equalizer and turn that worry into its “treble” opposite.

Repeat as needed.

Friday, October 2, 2020

Gháájí’: New Year, New You

Renewal

As full moon lights the sky, 

Gháájí’, the Navajo New Year is celebrated. 

A chance for all of us five-fingered people to breathe deep
                                                                         give thanks
                                                                         renew vows to self
                                                                                                  life
                                                                                                  each other
Leaves brighten to hues not seen since 2019
Melons, squash, apples reaching maturity after months of growing pains
Mornings crisp with scents of green chile wafting olfactory goodness our way.
Cinnamon, pumpkin and other flavors soon to come.

What do you want the new year to look like?
What do you want the new you to look like?
What do you need to leave behind in the year that was?
What must be cultivated in the year to come?
Beyond the seeds themselves, 
How will you water and fertilize and nurture those seeds you plant?
Where do you want to start?

Take some time this weekend to breathe it all in, get out the Crayolas, canvas, journal, etc. and begin to draw yourself into a new year, into a new you.




 


Friday, September 25, 2020

The Ever-Present Presence of the Present




The ever-present

Presence

              of the

Present

              a

Present

              Gifted to those seeking its warm embrace

              Remedy for dis-ease

              Cure for living in worlds

              “Has been”

              “What was”

              “Yet-to-come”

 

The ever-present

Presence

              of the

Present

              Is our natural state

              Known well to little ones and wise elders

              Sought by those in between (if they even care to seek)

             Like all things valuable, it can't be captured by smartphone, thumb drive, DVR


The ever-present

Presence

              of the

Present

              a

Present

              That offers itself to us at this precious moment

              And next hour

              And all of tomorrow

              Fear not as you reach to greet its embrace


Note: This piece brought me back to the second piece in this Writing to Heal blog, a prose piece about the Superpower of Being Present. Feel free to revisit that piece!

Friday, September 18, 2020

Signs of Change

Can things really change?

Can our country find a way to admit systemic racism and then do the hard work to undue it?

Can we begin to live with our Earth, ending our suicidal quest to dominate it?

Will we begin to honor the Indigenous Peoples of this land, reversing their second-class status in a land that is their own?

Well, I can’t honestly answer all of these questions with a positive answer. At least not with confidence.

But I can see some signs that make me hopeful. I want to share two of those with you.

Example 1: U.S. Forest Service

My family thought about places to get away and enjoy a hike. The outdoors seem to be one place where the pandemic loses its grasp over us. Aside from a piece of fabric covering the face’s mid-section, you almost can forget about words like “6 feet apart” and “Zoom”.

With fatherly skill, I quickly steered the conversation toward Wheeler Peak, my selfish choice for our hike. Our tallest mountain in NM at 13,147 feet, I had wanted to climb this for many years. We looked up the hike and found that, at that moment, the trails in that area were closed. Reading further, they were closed due to traditional ceremonies of the Taos Pueblo.


Carson Forest Supervisor, James Duran stated

“It’s important that the Carson National Forest works to support local traditional communities to continue a traditional way of life that makes the culture of Northern New Mexico so rich and truly unique”. We appreciate the public’s patience and willingness to support our local tribal communities in maintaining long standing connections to these mountains during this unique period.” (link here)

YESSSSS!!!!!!!!

Many of us, myself included, may never have associated public lands and the National Park System as anything beyond an attempt to conserve and preserve the natural beauty of our country. But Indigenous communities have a very different history with the creation of such lands.

Just as land was stolen from these people since the arrival of Europeans, conservation efforts simply provided another avenue to trample over these same communities. As Marcus Colchester writes, “National parks, pioneered in the United States, denied indigenous peoples’ rights, evicted them from their homelands, and provoked long-term social conflict. This model of conservation became central to conservation policy worldwide.”

Making the position of the Carson Forest even more important is the context of Taos Pueblo and the U.S. Forest Service. Just a few miles away from Wheeler Peak is Blue Lake, known to the Taos Pueblo as Ba Whyea, a sacred site to that Tribe used for many traditional ceremonies.

In the name of conservation, the U.S. government appropriated Blue Lake and the surrounding area and placed it under the control of the Forest Service. The Equivalent of The Vatican being taken away from Catholics, Mecca confiscated from Muslims. These thefts usually came without consultation with Indigenous communities. The struggle by Taos Pueblo to regain control of Blue Lake similar to Standing Rock in 2016, represented Indigenous struggles for religious freedom and the protection of sacred sites. (After 64 years of protest, appeal, and lobbying by Taos leaders and their supporters, Blue Lake was restored to the Pueblo in 1970.)


So, to see the Forest Service now working as a protector, not a threat to Taos Pueblo is a victory for all of us. To see words acknowledging that traditional ways are what make our land unique is incredible in a land that has largely ignored and “othered” Indigenous ways at best, often working explicitly to eradicate them completely. (“Kill the Indian, Save the Man” policy of the U.S. Boarding Schools, for example).

Example 2: Princeton University



No, I was not about to take my family on a trip to New Jersey. “Kids, jump in the car. We are heading to audit a weekend course at an Ivy League institution.” Not quite.

But September 2nd letter by Princeton’s president Christopher Eisgruber to acknowledge systemic racism caught my eye.

“Racism and the damage it does to people of color nevertheless persist at Princeton as in our society, sometimes by conscious intention but more often through unexamined assumptions and stereotypes, ignorance or insensitivity, and the systemic legacy of past decisions and policies.  Race-based inequities in America’s health care, policing, education, and employment systems affect profoundly the lives of our staff, students, and faculty of color.

Racist assumptions from the past also remain embedded in structures of the University itself.  For example, Princeton inherits from earlier generations at least nine departments and programs organized around European languages and culture, but only a single, relatively small program in African studies.”

YESSSSS!!!!!!!!

Coming from an institution that represents power and privilege, this divergence from the default - finding ways to justify unjust systems that serve to benefit that person/group speaking - is refreshing. It is healing. It is needed.

So, back to those initial questions, I can say that I have some hope that I can be a part of making real change happen. That is the only place any of us can start – acknowledging our own responsibility to pave a different road for our own lives, our own words, our own actions. We can be transformed just like the Forest Service and Princeton University to stand for undoing racism and a new way of treating each of Creator’s beautiful creations, land/air/animals included.

Healing awaits us, my brothers and sisters.


Wednesday, September 9, 2020

Connection

 

We had turned to leave, the ICU machines and monitors beeping their goodbyes.

Working at the University of New Mexico’s Hospital as a family physician, I had come to visit this patient with a colleague who is a physician assistant upon the request of the ICU team.

Our patient, Ms. Armijo, an elderly woman who'd been hospitalized in critical condition after emergency abdominal surgery for abdominal pain called out after us: “You know, the thing I am really worried about is being all alone.”

As we turned around, and I saw Ms. Armijo’s fright amidst her frail, failing body.

I had thought that our lengthy, pathology-driven questioning had covered all of the bases pretty thoroughly. Where do you hurt? How do you hurt? Are the pain meds working for you?

Now, frozen in mid-stride by her question, I realized that we had neglected the most important thing: Connectedness.

COVID had forced our hospital to adopt a no-visitors policy. On every floor, the hand-holding and bedside banter that partners, siblings, neighbors and coworkers normally lavish on hospital patients was replaced by a sickening silence. Even I, a family physician, couldn't visit my own patients who'd been hospitalized or sent to skilled nursing facilities due to COVID.

Imagine yourself in that ICU bed. Scared for your life, feeling so weak that you cannot even lift a spoon to your mouth--and suffering all of this alone, without the comfort of your loved ones at your side.

This was the situation Ms. Armijo was facing. Not only that, she didn't even have her connection to her family and the outside world with her cell phone missing. No wonder she was distraught!

Our team went back to her bedside. This time we did the listening, not the talking.

“I have no idea what happened to my cell phone in all of this,” she started.

“Have you been able to talk with your sister and family?” I asked.

“No, and that’s what I am really worried about. My sister who takes care of me and she must be going crazy not knowing how I am doing. Sitting here, I don’t think they even know if I made it out of surgery alive! If it weren’t for the pandemic, they would be sitting right here by my side.”

I was being taught, the physician as the student, my patient Ms. Armijo as my teacher.

“Thank you for sharing”, was all I could muster.

“This is not a ‘no news is good news’ scenario for them,” she added.

Listening to her speak, both what was spoken and lay in the pauses and expressions, I was not ashamed but more eager to be her student. To me, it felt like a direct, visceral reminder [or some such] that asking Ms. Armijo about her sense of connectedness, or otherwise, was as important as probing into her abdominal pain and lab results. We were being taught that you cannot have full health or healing if you're disconnected from those you love.

I've started to realize that connectedness can actually be considered as yet another vital sign--as important, in its way, as any heart rhythm or puff of breath.

And in these extraordinarily difficult times, loneliness can almost be considered a new medical condition, one affecting close to 100% of our hospitalized patients, one requiring its own treatment plan. This was true, I realized, not only for Ms. Armijo but for all of our hospitalized and nursing facility patients.

The phone was found by her family, discarded in the chaos that led to her ambulance ride to the hospital. Over the next few hours, with painstaking effort, it was delivered to the hospital - passed like a hot potato to the security guard at curbside, then to a nurse courier, past the badge-access checkpoints and, finally, safely into the hands of Ms. Armijo.

Her body still had a long way to go in terms of healing. But she was now connected back into her world, her support system.

Heading to the next patient on our list, we all knew which question we would ask first. It would not be about pain level, appetite, or bowel movements. Those would wait for later. First question would be simply, “How can we help connect you to those you love?”




* This piece was first published July 28th, 2020 by Pulses: Voices from the Heart of Medicine.


Friday, September 4, 2020

Sacred Play and Imaginary Escapes - Thriving in our New Normal

 

“Hope things go back to normal soon.”

That was the text I received from a friend yesterday. It struck me in reading those words that I have stopped thinking or worrying about the end of the pandemic. In those first months, absolutely. Daily thoughts of getting back to normal life.

Now, out of self-preservation and a renewed sense of life’s sacredness, I have turned to making the most of each day, not wasting a moment of living spending time trying to beg normal to reappear.

My response was simply, “Yep! But let’s make the most of each day until then.”

And in that spirit, I want to share two stories that remind us to find joy, creativity, sacred play, even imaginary escape as tools for thriving in our new normal. Enjoy.

The Teacher Has Arrived

Our house is a weird place these days. We don’t own a TV, our children don’t have phones, and we are as close to screen-free as a modern day family could be. But now? Now, we are 5 people zoomed in to our classes and work, zoned out from each other and the world beyond our 48 square inches of screen space. We have a 7th, 4th and 1st grader and all of them have adapted well to this online life.

Our 2 year-old Sihasin has taken in this sudden change, and it is interesting to see her interpretation of this virtual world. “Dad, do you have another meeting?” she will ask the second I open my computer. “Dad, are you going to your office?” anytime she senses that I am about to start a work session. “Office”, as she has figured out, is a very loose term and could apply to garage, porch, kitchen, living room, etc. “Office dress”, as she and her siblings have observed, ranges from tank tops to running shirts to sleepwear to an occasional collared shirt.

Well, Sihasin voiced that she wanted to go to school just like everyone else. She was feeling left out, not having a screen of her own to stare into. So Nizhoni, our oldest devised a plan. On times when she was not in school, she would sneak upstairs, put on a disguise, and become the teacher for Sihasin. Let me explain that “disguise” in this context means simply changing 1-2 things about appearance. I asked Nizhoni if she uses a different voice as teacher, and she gave me a look. “Dad, that really isn’t necessary. I use my normal voice and I still don’t think she knows it is me.”

Action shot of little one at "school" with Ms. B

So, Teacher Nizhoni broadcasts from upstairs to Student Sihasin who we get onto a tablet downstairs. Teacher Nizhoni goes by "Miss B" and gives her choices – “Do you want to do music or dance today?”. Usually, the class is quite short as Student Sihasin loses interest and simply walks away from the screen. No “good bye” or “I have to go now” but just a departure to signal that this class session has ended. Teacher Nizhoni is quite understanding.

Pics of, in order of appearance, Teacher Nizhoni and (Regular) Nizhoni


 

A Breathe of Fresh Air is All We Need

We were a tired group of physicians, immersed in sickness, loneliness, COVIDness as we cared for patients at UNM Hospital. The week had worn us down, taking out our zip and pep and replaced it with “argghhh”. I think someone mentioned something about fresh air in a figurative sense, but I suddenly realized that real fresh air was exactly the antidote. With inertia of hospital work and an indoor existence the entire week working against us, I was able to coax everyone to come outside with me. I had tried multiple times previously in the week to get us outside, failing each time. Intertia and a huge work load will do that. This time, I think the combination of me using my best attempt at an authoritative voice plus the presence of “argghhh” made the group start to warm up to the idea of a few minutes outside.

We found a nice place of shade on a beautiful late May afternoon and suddenly we were transformed. The grass felt so good, so real. The hospital walls now dissolved, we were free in mind and spirit. Free from work. Free from the burden of so much hardship that was our patients’ reality. Free from ourselves. Spontaneously, the crew starting talking about how incredible it felt to be outside. How it surprised them how quickly they felt rejuvenated by shade, breeze, birds, grass and all that now embraced our senses.

The power of fresh air and simple escapes. From “argghhh” to this pic below in a matter of minutes.

 


May you find joy, creativity, sacred play, even imaginary escape as tools for thriving in our new normal. Practice daily. Titrate dose upward if needed. Enjoy the silly moments along the way.