Tag Archives: perspective

Intention: Humanity

I’ve heard that at the beginning of a yoga session, people may set an intention to guide that period of time and help it translate into life as a whole.  While I haven’t formally done yoga before, I really like the idea of setting intentions.

In past years, I’ve picked a word or phrase to help guide the year in lieu of writing out a list of January resolutions (which I never seem to look at again anyways).  This year, I set an intention to be curious about life and each new experience it brings.  I was in the tentative first few weeks of a new relationship as 2016 rolled in, and my goal of embracing curiosity helped me to keep my heart open to the day-by-day unfolding of what has now become a beautiful part of my life.

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I’m finding that sometimes life can knock the wind out of you, and other times it can give you wings to fly.  The relationship that started with curiosity has been an incredibly wonderful instance of the latter.

Time has been moving quickly, and now I’m exactly 30 days away from starting my first clinical rotation.  The idea of setting an intention is coming up again, this time because I’ve spent a portion of the past two days thinking about what it means to be a compassionate medical caregiver.  I’ve also been spending a good deal of time pondering how on earth I’m going to manage being a clinical student.  I’m 26 now, and I can see that I’ve grown a lot (especially in the past year), but I’m still trying to figure out who I am.  So perhaps part of this is a cry from my soul to reaffirm who I am, to reconnect with the reasons I am in medicine.

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I’ve decided I want to set an official intention for my clinical years.  I already have one (hopefully) realistic goal for clinics: walk into my rotation on Day 1 with my head up, get along well with my team, learn from the mistakes I make, connect with the patients I’m assigned to follow, and walk out the door at the end of the day with my head still up.

As the lyrics go, chin up buttercup.

I also want to have a broader intention for my full 16 months of clerkships.  I think I’m starting to sort that out as I try to chart the courses of the rivers draining into the cognitive and emotional depths of who I am.  What are the reasons at the core of why I want to be a physician?  Why am I doing this?  What is going to get me out of bed every day for the next several decades?

It reminds me of when I was in the throes of applying to medical school several years ago, asking the same question–why medicine?–as I agonized over my AMCAS application form and the ensuing secondary essay questions. I actually went back to some of those essays today, blowing dust from the computer files.  It was like opening a time capsule and reliving the tense anticipation of applying to medical school: waiting for a secondary application invitation…waiting for an interview…waiting on pins-and-needles for an acceptance.

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Are my reasons still the same as they were when I was a 22-year old student fresh out of undergrad?  I believe they are, at their core, although they’ve evolved and grown with the passage of time.

Sitting down with my journal, I parsed out four reasons why I am in medicine:

  1. When I’m able to bring a moment of compassionate connection into a hospital room or patient interaction, I feel like my soul has been nourished (and hope the feeling is mutual with the person I’ve connected with).
  2. I enjoy being able to share information; it’s gratifying and gives me the sense that I’m contributing something to other’s lives.
  3. Medicine is full of stories if I stop to pay attention and listen to them.  I want to learn people’s stories and give them the space to share them, if they want to.  This ties in to reason #1.
  4. Learning engages my mind and makes me feel incredibly happy and alive.  The medical field is one of lifelong learning.  This leads to reason #2.

Ultimately, I found that everything can be reduced to the following: (1) I find compassionate connection with other humans to be deeply satisfying and meaningful and (2) I enjoy the personal growth and sense of contribution to society that comes from learning new information, thinking critically, and teaching others.

So these are the bare-bones reasons of why I am in medicine.  Medicine is an environment where compassion and information-sharing can be practiced on a daily basis, and it positions me at a time point in peoples’ lives where this is especially needed.  I personally found, when undergoing a minor (but painful) medical procedure recently, the only two things I cared about were whether I trusted my provider (i.e. whether I felt he cared about and respected me as a person) and whether he was competent (i.e. could do everything efficiency and effectively).  I know everyone has unique priorities when interacting with the medical team, but I feel that trust and competency would likely show up as common themes.  And those are words I’d like to be able to be applied to me.

I actually feel a bit vulnerable sharing all this on my blog, because it gets down to why I’m doing what I’m doing.  And of course, there’s always the question, is it enough?  Are my reasons good enough?  And am I?  I have to believe that I am, and that I can do this.  I may not become the absolute best at what I do, but I will try my absolute best.

So my intention for the next year and a half?  To be compassionate, to pay attention to people’s stories, to accept that I’ll make mistakes, and to do what I can to learn from them.

In a word?

Humanity.

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Looking back

 

It’ve been two years since I wrote the poem below.  I remember being in my immunology class during the second quarter of medical school, listening as our instructor talked about anaphylaxis.  The emotions it evoked later found their way into written words.  I’ve shared this poem a few times in different ways–first in my creative writing class, later in our medical student journal–but I haven’t revisited it in at least a year.

A lot has changed in the course of that time, even if I didn’t see it happening.  Perhaps I haven’t paused and looked back often enough, to see how far I’ve come since the beginning of my journey into medicine.  I’m almost done with my third year now, and sometimes I forget just how much I’ve learned since I began.  I think it is that way for many of us, actually.  We live with ourselves 24/7, and it makes it difficult to see ourselves grow because it happens so gradually.  But grow we do.

This poem looks back to a time when I was seven years old, and my brother (who was a toddler at the time) went into anaphylactic shock after tasting peanut butter.

He just turned 19 years old this January, and I turned 26.

To this day, I’m thankful for the medicine that saved him.

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Dim lecture hall and early morning and I am sitting in the seat I always take, watching the words flashing against the wall. Pruritus. Urticaria. Angioedema. 

Immunoglobulins, the E isotype, not the A isotype…so many letters to keep straight. 

I am a child again, tracing out the alphabet, learning to spell like when you were born and I had to remember to write your name with an “a” two letters from the end, not an “e.” A child again learning my ABCs: airway, breathing, cardiac. Treatment includes epinephrine. 

And suddenly, we are children again. 

Flashes of images in my mind, a moment remembered, transected from the whole. 

The stroller with its small wheels, and you in it, and Mom bending over to give you a bite of our sandwich because you are hungry on that sunny walk in the park, and we are carefree. 

So ordinary, the child and the peanut butter and jelly sandwich and the young family paused in time on the sidewalk. 

And then the next image, more sound than sight: your sneeze, and the worry in Mom’s voice. 

And then you buckled in the car seat and Grandpa getting into the car beside you and Mom rushing because you have to go to the emergency room. An impression of puffiness, of you and your elfin ears and fine brown hair and a body suddenly too full of that which should have been life. 

An empty driveway, lonesome gray against the sky. 

Me waiting. 

You came back—you came back to us before your lungs could squeeze out the last thin tendrils of your breath and the surging current of medicine drew your tiny boat back from a shore we could not reach. 

And I am the medical student in the lecture hall caring about the mechanism of epinephrine, and I am the sister caring about nothing other than that you came back.

Just One Step

Attempting a new endeavor sometimes leaves me feeling like I’m standing in my hiking boots at the base of a slope, debating whether there are enough handholds to scramble up without falling and breaking my leg.  Or my neck.  Whether it’s writing papers, doing research, or starting a new phase of medical school, it’s often daunting to summon the internal energy needed to begin.

I’m beginning to realize, however, that my ability to gauge the energy required to take a particular action is not always so accurate.  I enjoy meeting goals, and I have some long-term ones in place as guiding stars for my life journey.  It’s like picking a distant mountain peak and saying, I am going to trek from here to there.  Doing so may keep me from getting completely off-course, but if I think that I need to have enough energy to make the 100-mile hike in a single shot, I’m not likely to ever get out the door.

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In reality, I would only need to have enough energy to make it to my first campsite.  I wouldn’t presume to have enough stamina to make it to the end without pausing, and if I felt beaten at the thought of doing so I wouldn’t blame myself.  But I certainly do that with less tangible journeys.  If need to start something and feel overwhelmed at the thought of carrying it to completion, I can respond to myself in any number of ways and they usually aren’t positive.  It’s something I’m trying to become more aware of, and perhaps this post is, in its own way, a part of sorting this out.

Being more realistic certainly would help.  If I realize that I only need enough internal power to get started–to create the ignition spark–it will help keep me keep the big picture in mind without feeling daunted by its implications.  One strategy I’ve used is committing to a first step that is so small, it would be ridiculous not to do it.  Need to write an email I’ve been putting off because it feels like too much to do?  Just log into my computer and open my inbox, and that is all.  No expectations beyond than that–if I get into my inbox, I’ve accomplished my goal.

By beginning with something small like that, I’m able to overcome the inertia of starting because I narrow my focus to what I need for the step right in front of me.  I’m no longer trying to bully myself into walking for miles; I’m just lifting one foot off the ground. I’m surprised each time I do this by how well it works–usually I end up getting far more accomplished than I had planned.

So far, I’ve applied this strategy mostly for writing-related things like papers or emails.  We all face more in life than emails, however.  I have a few landmark peaks in the distance, and the highest one would be realizing my dream to become a physician-writer.  That’s what I’m aiming for: to be someone who cares for the body without forgetting that it contains the human spirit.  It will be a lifelong journey, one that will hopefully include matching into residency, graduating from medical school, finishing my post-graduate training and finding my place in the world as an attending physician.  Right now, I’m just trying to figure out how I’m going to make it through clinics.  It feels overwhelming to think about right now, but I’m going to try taking the one–step approach to starting my rotations this April.

Review how to take a medical history.  One step.

Find one video to practice the eye movements in the neurological exam.  One step.

Watch the video.  One step.

Sign up to volunteer again at one of Stanford’s free clinics.  One step.

They’re little steps, and they don’t seem like much, but they’ll keep me from postponing everything until I feel ready.  Because, honestly, I’ll never feel completely ready.

And one day near the end of April, I’ll take a deep breath and remember to keep my head up.  And I’ll take one step that will carry my over the threshold into my clinical years.

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All right, right now

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I love the idea of time and space being a fabric with folds and multiple dimensions.  It intrigues me like a song sung in a language I cannot understand: mysterious and perplexing, even, but also deeply beautiful.  If time and space are woven together, I wonder, what if I were able to loop back in time like a backstitch formed by needle and thread?

What if I were actually a time traveller?

My mom told me about a thought experiment she tried recently, where she imagined that she was a few decades older and had been granted a wish to go back in time to the present day.  What would it be like, she wondered, to live this moment–this afternoon in January 2016–with the perspective of her older self?  The poignancy of her description struck a chord deep inside me, and it came to mind again today while I was driving through Palo Alto beneath a brooding sky.

I realize that I spent a lot of time last year wishing for the future.  It’s because my vision of my future self often feels more comfortable than the skin I’m currently in…the future me is confident and experienced, someone who has navigated her clinical rotations, finished residency interviews, graduated from medical school, and survived her intern year.  She is taller (which is completely unrealistic, since the growth plates in my bones fused long ago), wiser, and stronger.  At least, that is what I hope.

While it is important to have goals and a vision for the future, I’m beginning to understand at a deeper level that they should not obliterate my ability to experience and enjoy the present moment.  It does me little good to dream if doing so makes me sleep away the life I have right now.  I want to wake up.  Even if my present life feels overwhelming and intimidating at times, I want to stay open to however it unfolds.  This is something I’ve been focusing on more recently, and I’m gradually seeing that many of the things I’m afraid of are shadows cast by my own mind.

The mind is powerful, capable of either intimidating or inspiring me with a simple flip of perspective.  So as I was driving today, I wondered what would happen if I were actually 70 years old and no longer able to practice medicine because my body couldn’t keep up with my soul any longer.  Perhaps I’d have silver hair cropped close to my head and tendrils of blue veins winding beneath rice-paper skin.  Maybe I’d be sitting in a chair by a window with dust motes catching the light.  Or maybe I’d not even have lived that long.  But if I did live to that age and were granted a wish to return to this week in January, what would I think?  What would I do?

I don’t think I’d be wishing for the days to pass quickly.  I don’t think I’d be as afraid of failing, either, because I’d know that my mistakes had helped me learn and grow into the person I had become.  I would probably be wildly, vividly grateful to be here, in this very moment, a Stanford med student and a daughter and sister and friend.  To be nearly 26 years old and very much alive.

It’s hard to keep this perspective; honestly, it’s easier for me to worry and wish for an imaginary future where things are easier.  But I know that sort of a future is simply a mirage, and that life is always going to be challenging.  It is for everyone.  And I’m starting to be much more okay with that.  I am part of humanity in all its joy and agony, and I may not love everything about that but I do love being human.

This year, I’m going to try to stop more frequently and realize that I am all right, right here, right now. 🙂

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Deliberate Practice

I’ve never really spent much time looking at the bricks inlaid on the path that runs past the Li Ka Shing Center, but yesterday morning I snapped pictures of the following words while on break between lectures.  I was trying to catch an impression that I wanted to write about without exactly knowing what it was, but today I think I know.

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It came together after reading from the Harvard Business Review.

I hadn’t realized how breathtakingly relevant pieces from this journal could be to my training in medicine. As part of my Managing Difficult Conversations class, however, I was reading through an article in the HBR this morning when the following sentences jumped off the page and into my lap like an oversized tabby cat:

“Not all practice makes perfect. You need a particular kind of practice—deliberate practice—to develop expertise. When most people practice, they focus on the things they already know how to do. Deliberate practice is different. It entails considerable, specific, and sustained efforts to do something you can’t do well—or even at all.”

This was particularly relevant because, just yesterday, I was mulling over how I am hesitant to do some parts of the physical exam when working with actual patients. The parts where I’m not yet confident of my skills.

Certain things I’ve practiced enough to feel mostly comfortable with—for example, placing the stethoscope in the four positions on the chest wall to listen to the heart. And some things are straightforward enough that they are no longer intimidating.  I am confident while feeling for the rush of blood through the carotid arteries, listening for bowel sounds, or examining the extremities for edema.

Other things leave me feeling like I’m approaching a forest with mist swirling about my feet. How exactly do I test strength and reflexes in a patient who is unable to leave the hospital bed?  Is that really the thyroid gland I’m feeling…or should I ask them to swallow one more time as I feel for the subtle slide of lobes beneath the skin? What if I forget to test one of the cranial nerves while doing the neurological exam?  What if I don’t feel something that is there, or if I think I feel something there that isn’t?

What if I mess up?

For me, our Practicum sessions this quarter have brought some of these anxieties to the forefront of my consciousness. In Practicum, we spend an afternoon in the hospital every other week, and during this time we each meet with an assigned patient to gather their history and perform parts of the physical exam. After the history and physical, we join our preceptor and present our patient’s case in (what is hopefully) a concise, organized manner. All this comes together to prepare us for when we start our clinical rotations, and it is an invaluable opportunity to gain actual experience in the hospital setting.

As I reflect on my own performance, however, I realize that my times of practice aren’t fully yielding the dividends I seek. This isn’t a fault of the sessions–Practicum gives me all the opportunities I need.  Since a good portion of my time is spent alone with my patient, I am the one who decides which questions to ask and which physical exam maneuvers to perform.  And as a student, I have the rare gift of time to do so.

But I have been drawn towards the things I already know how to do fairly well. I have the human love of discovery, but I also very much have the human love of competence. It’s uncomfortable pushing myself out onto the tight wire that spans the cliffs between what I am and what I can become.

As I read on, one other sentence in the HBR article caught my attention.  It especially stood out since we’ve been receiving coaching on how to improve the cohesiveness, clarity and delivery of our oral presentations in Practicum:

“Bear in mind that even Winston Churchill, one of the most charismatic figures of the twentieth century, practiced his oratory style in front of a mirror.”

It’s awkward to do so, perhaps, but this echoes what I’ve told about improving my presentation delivery by practicing out loud on my own.  More than any other time since starting medical school, I’m sensing that the way forward is through focused, intentional practice above and beyond what I would normally do in my sessions.  I need this deliberate practice–the sort of practice that drives me into the realms where I am not skilled, past all the whispering shadows of fears that would try to keep me out.

By embracing the discomfort of what I can’t do well, I will be in position to move forward in the way I need and want to.  I know who I am and who I have been; I am not one to back down in the face of challenges.  But somehow, my journey as a medical student is revealing vulnerabilities that have laid latent within my soul.

That’s okay, though.  As I talk with some of my classmates about these areas, I find that I’m not alone in how I feel.  We all have our own uncertainties, hopes, visions and vulnerabilities, and although on individual journeys, we’re still in this together.

I’m excited to see how far we’ll all have come a few years from now!  And since I’ve realized how to engage in deliberate practice, I’m not as afraid of falling short of my vision of who I want to be as a third- and fourth-year medical student.  I have a plan moving forward, and I believe I can actually get there.

I really do.

Patient-Physician

Yesterday, I performed my first rectal exam.

We began our Project Prepare sessions this week, which is a training program to teach us how to perform the male and female genitourinary exams in a sensitive and skilled manner. This was a big milestone for me, as I’ve been anticipating this day with some apprehension for about a year now. I remember one of my Practice of Medicine TA’s telling me about Project Prepare when he was a student in it last fall, and although I knew I would have my own turn in the program this year, time flew by faster than I expected.

So here I was on a Wednesday afternoon, about to learn how to perform the male breast, GU and rectal exam.

I had been told that the educators in the program are fantastic teachers, but I hadn’t realized just how amazing they would be until I met my trainer. The Project Prepare educators are people who have dedicated themselves to teaching these exams on their own bodies, and they are truly incredible. Because of them, what could have been a very discomforting experience ended up being one of the most amazing educational moments I’ve had yet. (Here is a San Francisco Chronicle article from 2003 on Project Prepare.)

I entered the simulated exam room with my three classmates, feeling as on-edge as if I was the one about to get a GU exam instead of the one learning to give it. Our instructor quickly set me at ease with his warm and genuine manner, though, as he explained that he would be modeling for us the same sort of communication we would be using with our future patients.

It really was a whole-hearted experience for me.  Here, I was the vulnerable one, uncertain about what was about to happen, while he was the calm one with years of experience. The dynamics were immediately appreciable; his approach to the encounter made all the difference.

That afternoon, I felt that I was the patient seeing a doctor, rather than a medical student seeing a patient. Now that I’ve been in medical school for a year, I’ve begun seeing more distinction between the identities within me—I am both patient and physician-student. At times, I feel a tension between these pieces of myself.   I believe this tension is not a bad thing, for it reveals an effort to maintain multiple perspectives, but it makes me think. In some sense, we all have this tension within us, although it may be defined by different parameters for different people. It is the same tension within the mother who is also an employee, the son who is also a husband, and the sister who is also a student.

This multifaceted dynamic within me is something that I have to accept as part of living within two worlds—or rather, within multiple hemispheres of the sphere of humanity. Even as I write this, I am a bit hesitant to admit this. This isn’t a struggle that I wanted to have, but it is one that I expected. Our Project Prepare session threw it into new light for me, and it has made me think of it again.

As I sat across from the one who was both my patient and teacher, I keenly felt the importance of bringing compassion and warmth into an encounter. If I can be as help my patients relax as well as my teacher helped me to, I will be very satisfied.

Over the course of the following three hours, we learned how to examine the breast tissue and the surrounding lymph nodes (although breast cancer is rare in males, it can still occur and is essential to screen for). Step by step, we practiced the genital examination and learned how to properly word our dialogue to minimize unease or apprehension. We checked for inguinal hernias and learned how to properly set up for the rectal exam.

As we neared the end of the session, it was my turn to do the digital rectal exam. I had already filed the nail on my dominant index finger to a down hairline crescent of white (we were provided with nail clippers and emery boards earlier in the session to get our nails as short and smooth as possible), and so I coated my gloved finger with lubricant up to the main knuckle.

The rectal exam was actually the most amazing part of the experience for me. Using the pad of my fingertip, I defined the contours of the prostate gland as I swept my finger across it, feeling for any abnormal textures or lumps. I had a sense of awe at examining that which I could not see, like trying to read Braille written within our bodies.

Like trying to find shapes in the spaces between the clouds when looking at the sky.

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Afternoon sunlight and fall foliage at LKSC

I found it a bit funny how the day ended for me—I was participating in a poetry reading at the Cantor Center’s new Anderson Collection that evening, so I went almost straight from practicing the genitourinary exam to reading poetry at the event. It was a wonderful time; members of the Pegasus Physician Writers at Stanford shared original pieces of poetry inspired by the art collection, and the St. Lawrence String Quartet gave a stirring performance of Benjamin Britten’s Second String Quartet in Three Movements.

In a way, this odd juxtaposition of prostates and poetry seemed almost fitting to me. In Project Prepare, I looked again at my identity as a medical student within the greater world, which I relate to in part through writing. Creative writing is what helps me process the struggles of life, and I like to think that it will help me to better relate to my patients since it reminds me that everyone’s life is a story. We all have backstories, and we are all read as sentences and paragraphs, sometimes even as chapters.

Oftentimes, there are multiple storylines that run through our lives.

I am a patient.

I am a student-doctor.

I am human.

Healer’s Art

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I wanted to share a picture I drew this week.  It’s based off of a drawing I did as part of my first class in Healer’s Art, an elective founded by Dr. Rachel Naomi Remen at UCSF and now taught at medical schools across the country.

As some background, the purpose of this course is to help medical students clarify and cultivate their calling as physicians and recapture the heart of medicine.  It’s described in our course catalog as follows:

“For pre-clinical and clinical medical students.  Explores core dimensions of meaning, service and healing exemplified by the outstanding physician. Goals are to develop and preserve personal values such as service, harmlessness, compassion, altruism, self care, integrity, equality, justice, respect, and nurturing wholeness; to develop the compassionate listening skill that is foundational for clinical practice and for finding personal meaning and satisfaction; and to clarify a commitment to medicine as one’s life’s work.”

Healer’s Art is taught each fall at Stanford and this quarter came at a perfect time for me, as I am facing some questions of purpose and direction as I move forward into second year.  I know who I want to be, and I at least have an idea of where I want to go within medicine, but the questions are still there.  I suspect nearly everyone faces them and that they never truly disappear.  I’m okay with that, though, because the questions keep me on my toes and push me to explore more deeply why I do what I do.

In our first class, we were each given a little bag of crayons–tangy, waxy, new.  The assignment was simple yet complex: think of something which you value about yourself and don’t want to lose during your journey in medicine, and draw a picture or symbol to represent it.

And so, with my classmates, I drew.  Some of us knelt on the floor while others sat by tables, each of us working to pictorially capture flames too important to extinguish.  I felt like a kid again as I bent over my big sheet of paper with my handful of fresh crayons.  It had been years since I really used crayons.

After several quiet minutes of sketching, we broke into our small groups and scattered throughout the building to settle down and discuss the heart of our work.  Words like “trust” and “resilience” and “love” emerged, along with stories of past journeys, current experiences, and future hopes.

My own picture sprang from a part of me that has faded somewhat over the course of my collage and now medical school years.  As a child, I loved to create stories and imagine fantastic odysseys, and one of my favorite pastimes was writing fiction. I loved to imagine things that could only live in the mind, like horses made of wind that, if touched, felt like streams of cool air blown from a fan.  In the past years, however, my mind hasn’t had as much time to wander such unknown paths.  Rather, it’s travelled the paths of biochemical mechanisms and lines of reasoning, and my writing has been reincarnated as reflective blogging and poetry.  And, while I love these paths, part of me misses the imaginative adventures of childhood.

As I reflected in the quiet moment prior to starting this drawing, a picture came to mind of me as a physician sitting beside a patient’s bed–a child’s bed–telling stories to help chase away the foreign loneliness of the hospital room.  To provide a portal to another world, a wall-less world of color and fantastic creatures.  To heal with imagination.

I shared some of this with my small group, and they shared in turn that the theme running through this picture seemed to be one of hope.  As I thought about it some more, I realized that in a way, it was.

Imagine hope.

For me, imagining hope means being able to see without my eyes–to look beyond time and space and see who the person before me really is.  The child that they were, the journeys that brought them here, the heartbeat beneath the gown.

Maybe I don’t have much time for imagining winged horses anymore, but just perhaps I can imagine the wings of the human soul.

Why

Remind me why I chose this way
Where I am going,
The meaning of knowing

Remind me who I really am
All that defines me,
The pen that outlines me

Remind me what colors fill this life
The red of blood,
The white of light

Remind me why I walk this path
A serpent bound
Upon the staff

– The Stethoscopist

Grounding Moments

Late in the morning, I sat on a stone step near the Clark Center and planted my palm into the freshly-cut grass beside me.  The sunlight danced through the leaves of the slender tree to my right, scattering confetti of light across the vivid green patch of lawn.  I could almost feel the coming autumn in the air.  Since September has begun, some mornings carry a slight crispness that make me think of misty dawns, fire-colored leaves, pumpkins and home-baked joy.

I probably didn’t draw much attention sitting there with my hand in the grass, surrounded by the glass curvature of the Clark’s windowed walls.  On the outside, I was a student breathing in the sunlit air.  On the inside, though, I was struggling against a vague loneliness that had unexpectedly caught me in the middle of my day.  I think it had something to do with not sleeping quite enough this week, if my drowsiness earlier that morning was any indication.  After class, I wandered down the walkway and settled down on the step, feeling the beauty of the golden leaves against the clear blue sky even as I grappled to understand my own emotions.

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And I determinedly pressed my hand to the ground.

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Last week, a wonderful friend from my class shared with me what another classmate and friend had told her about experiencing the moment–about feeling the earth beneath your hand and the sunlight on your face, and realizing in that moment you are there, alive.  So here I was, my eyes closed and my face to the wind as I tried to regroup myself for the afternoon.

That’s why I was sitting there with my hand in the grass.  And I was reminded of the simple yet intricate beauty of a few willowy branches waving in the wind, painting the sky.

I was reminded just how good it is to be alive. 🙂