Possibilities

My Medicare card came in the mail the other day, and Social Security is set to begin in September. Life as I have known it will cease, the job; career really, and all the attendant responsibilities that have been a part of me for so many years will end and i will officially be retired.  I will leave the clinic with more than a bit of anxiety and many mixed emotions.  My days in medicine are over, since I have chosen to not renew my license. There's no turning back.  It is time to reinvent myself, as a newly ( and happily)  retired colleague counseled. His exuberance is encouraging, I am less frightened by the changes that are fast approaching. The fear is of the unknown, leaving the safe and familiar; even though it has become energy draining and stressful. The fear is of losing a large part of my identity, that of a damn good practitioner, and really loving the work I have done. There is anxiety in admitting that I am getting OLD! Medicare, grey hair, reading glasses, a little arthritis, post-menopausal weight gain...who is this person!
Thus, the need to reinvent me, this new me.....with freedom from a job, to go when and where I please,  and to be more responsible now for my own life and decisions than for the lives of strangers. I have interests that I have not had time or energy to pursue, I have cleaning and laundry and yard work that have always been such a chore because all of my energy was spent on the job. And, not less than these, a family that has waved goodbye in the morning and not seen me again for two days! And when I came home, all I wanted to do was sleep! We sacrificed much for my career.
So, the possibilities in front of me now are endless.  Time.  Energy.  Freedom.
It's the leap that scares me.

Goodbye, Dr. Welby

Another doctor sent out his retirement letter today. I read it, thinking that we are seeing the end of an era. The days of your family doctor actually being your doctor "til death do you part" is over, gone the way of house calls and the traditional black bag he carried. We have replaced them with computers and sub-specialists. This is the day of a team of specialists, none of whom really know who you are, and rarely communicate with each other....or you!
Don't get me wrong, Medicine is better than ever! Knowledge has increased dramatically, new drugs and procedures save lives, everything that science has brought us has improved both longevity and quality of life.  This is the science part of the "Art and Science" that is Medicine.  Art, however, has diminished in popularity and importance.
 There seems to be an inverse correlation between the two, which is tragic as far as I'm concerned. The smarter we get, the less we care about the people we see every day.
We care about symptoms, test results, standards of care, even wait times.....but don't know the person it all revolves around.
The old way of black bag medicine and house calls told us so much more about our patients. We could assess mental status, depression, financial well being, diet, and safety concerns in just minutes in a house call. That throw rug could be removed before the fall that fractures a hip. Is there enough firewood or heating oil for the winter? Who else lives here?
I don't think "health care reform" will do much good. We need more time with patients, more hands on, low tech medical care....not the fancy machines and tests and computers that substitute for real caring.
Medicine IS an art and a science; unfortunately Art is being overshadowed by Science and a growing corporate mentality. Money has replaced ministry. Computers take the place of compassion; and the entire process is rushed and depersonalised.
Hippocrates is rolling over in his grave!

Legacy.

Some things are only learned through experience. As vividly as imagination attempts to create images and emotions, it is unable to reach the width and depth of reality. There is no way to prepare for the death of your child.
Every mother has feared first a miscarriage, then SIDS, illness, cancer, car crashes, drug overdoses, war, and on and on as her child grows. There is a never-ending stream of terrors that threaten our children, we are always alert and subtly fearful.
We tell ourselves that it is unlikely, improbable, our fears are unrealistic and could never be realized, that we are somehow immune or special or blessed. Children should outlive their parents, it is the natural order.
The truth is that there are mothers with empty arms and broken hearts, mothers with an emptiness inside that can never be filled.
There are mothers who grieve every day for the rest of their lives for the child that is gone.
Pain, grief, loss, and emptiness become the window through which the world is viewed from then on. Life, any life, all life, is seen in a new light that reveals not only how precious it is, but how fragile as well. We are forever changed,
In time, we rise from the ashes of a shattered life. The nightmare of the loss becomes a part of our consciousness, and we are able to embrace the pain, since it is all that keeps us connected to our beloved child.
The path is narrow and rocky, difficult and lonely, but will ultimately lead us to a place of gentle strength, quiet faith, and a depth of character, born of the darkest dispair, that would never have emerged otherwise.
We must follow the path. We are obliged to smile in spite of the pain, to continue living, working, cleaning, cooking; in spite of feeling immobile. We must continue to decorate the Christmas tree, bake birthday cakes, and have baby showers for smiling friends who have no idea that there is a desperate howl inside of us that would never stop if it were allowed to begin.
But we know... and we know each other. This is a sorority we never asked to join, but we are bound to each other by our losses. We are there for each other, and for those that find themselves in our midst through the death of a child. We are all different, and our experiences have been different, but we share the same emotions and pain. We are sisters.
We carry a torch that is a living memorial to our children. They live on in us as we walk in the strength, and faith, and the depth of our character that continues to grow as we follow the path that leads from darkness to light. They live on as we reach out to each other to simply say "I know".

This is our Legacy.

The Spirit of Christmas has struck. The tree is up and decorated, many of my gifts purchased and almost wrapped. The list is shorter and actually do-able!!  I even thought about mailing cards. The kids are always the motivator for me to get Seasonal, and usually I fake it, and barely make it! This year as been a little different..... I am retrospective, introspective, alternating between tears of joy and tears of sorrow as memories play in HD .  I have gone through some old photos, trying to organize them, and have felt such awe and gratitude for the life I have been given..... the good and bad, happy and sad.....

The Night The Boys From Nashville Came to Town

In a dusty little town in Idaho

The seasons roll by and by real slow

A place where all the days all seem the same,

But the folks are always friendly and they call you by your name.

There’s an old saloon that sits across the tracks
A quiet spot where you can go eat or relax.
It comes alive on Friday night with drinking and dancing,
There’s some lying and fighting, and even  romancing.

Local friends and neighbors gather there
To wash down the road dust and to let down their hair.
They all dress up and drive to town
On Friday night when the sun goes down.
Put a quarter in the jukebox....circle 'round.

The buckaroos all line up at the bar
Drinkin ’theirdraft beer from an old canning jar.
Town folks come to sip and sit at tables together
And talk about the kids and cars, and wonder 'bout the weather.

A big old truck showed up one afternoon
And stopped and parked in front of that old saloon
It didn’t take long ‘til word got around to get washed up and come on down,
Some Nashville boys had come into our town.

The people came in from near and far
And filled up every seat  in that little bar.
The neon moon was shining bright when Nashville music filled the night
Faces glowed and whiskey flowed. and everything felt right.

They sang, we danced and sang along
The flat tops rang the whole night long.
Sociable glasses  raised up high to thank those boys when they said good-bye.
Please come back soon,..... they said they'd try.

Chorus:

It was the night the boys from Nashville came to town
Singing songs and telling stories as folks all gathered ‘round
Hands were clapping, toes were tapping , they played ‘em all so sweet.
Country music filled the barroom and spilled into the street.
We will always remember dressin’ up and getting’ down,

The night the boys from Nashville came to town.

JT©5/10

Thank God I'm a Country Girl

Living a rural lifestyle provides a simplicity and a grounding that would be impossible to achieve in the city. Even though I am immersed in technology;with my computer and iPhone, Twitter and Facebook at home, and fight with computerized medical records and digital radiology at work; living on our little "patch of green" up here in the hills can take me away from all the wifi voodoo that we have all become too dependent upon. Life here is a constant reminder that there are things that cannot be controlled by modern day electronic gizmos.

We are feeding horses and cows, waiting for calves to drop, cleaning up branches and pine cones from a windstorm, starting seeds in the greenhouse, and busy with other Spring chores. The chores never end, but they cycle with the seasons and the weather. The seasons and the weather control much of our activities here, especially in their extremes; like five feet of snow, or fifty mile per hour winds, or one hundred degree heat and a well going dry.

There's no app for that, or any of the activities and events that we wake up to every day. I am just fine with that, too. It reminds me every day that I have very little control over anything in life. It reminds me that I am but a speck in this big universe, but that other living things depend on me being responsible. I am brought closer to God when I am surrounded by the beauty of His creation. I am able to appreciate the life around me that is new and different every day. Geese overhead in the morning, as I sip my coffee while filling the stock water tanks. Quail and turkey that hatch and grow through the summer months. Moose, mamas and babies, that wander out of the woods , and an occasional big bull that has been known to jump the pasture fence and cause panic with the horses. There is a herd of elk that migrate through every few weeks, now with some new babies running along side. Coyote songs at night, with a wolf howl now and then, as well. Listening to them on a clear night while pointing out the constellations to the kids is a gift. iTunes can't hold a candle their music.

We have beautiful sunrises and sunsets that we actually see. We feel the wind or rain or cold, because we have to go out into it. We get dirty working in the soil in the garden, the dirt in the fields, or the manure in the barn. We sit by a fire in the fire pit with friends and family, warmed by the flames and the companionship, roasting marshmallows after a barbecue.

I go into the real world to work and shop, the world ruled by technology and gadgets and plastic cards. I hurry home. I do marvel at it all, and I think I'm pretty savvy with downloads and blogs and tweets and photoshopping, but if it all disappeared tomorrow, I'd do just fine. I'd have a pitchfork and a shovel, my horse and my saddle, the stars and coyote serenade.

This is a wonderful life.

Healthcare Reform Makes Me Sick!

I am tired of the debates and the rhetoric and the talk shows and the political posturing that has taken place around Health care reform. I am frustrated and angry. I watched another political program this morning with various elected officials arguing back and forth with their own ideas of what will work, and why the other guy's idea won't. They are all so far from reality!! I don't believe that any of the people we have elected to guide and guard our future have a clue about the REAL state of health care. They are blindly leading us down a road to destruction.
Dr. Starner -Jones was eloquent in his recently published letter to the White House stating that we have a "culture crisis" rather than a health care crisis. He is so right. Most of us who are actually working in health care would agree with his assessment. The is an attitude of entitlement, that the medical card awarded by the state, to provide a safety net to families that qualify, is a porch pass for freebies that Doctors and clinics can provide.
Dr Starner-Jones noted a patient with state funded medical insurance with an expensive car, tattoos, cell phone, and tobacco habit. His observations are not at all unusual. We see this, and worse, multiple times daily. Then, it is common for this patient to ask for prescriptions for over the counter medications like ibuprofen, because they don't have cash. It's hard to do when there is a five dollar pack of smokes and an iPhone hanging out of a seventy-five dollar purse. I believe that anything "free", is not respected as much as it could be. The system is abused and disrespected. Because a family has a medical card, a child is brought in the the Emergency Department with a "cough" that started today..... no fever, no vomiting, just cough. Then, three siblings are also registered into the ED, just "to be checked out". All the children are fine, one has a cold. No antibiotics needed. but Mom wants prescriptions for Tylenol and Motrin, and codeine cough medicine,as well as a note for her caseworker to document her (needless) trip to the ED as an excuse for not attending the job training or anger management or parenting class that she missed. Grand total: about $500.00 of "free" medical care. Not to mention the amount of time the encounter took in an already overcrowded ED. If there had been a co-pay of even $1.00, would we have seen these four kids? I doubt it.
I wish the government officials who are making the decisions that impact the system would involve those of us who actually have first hand knowledge of the problems and suggestions for fixes that may actually benefit all of us.
I feel strongly that there needs to be reform; lets identify the real problems and implement sensible solutions.

Home for Christmas

He was a handsome young man and he came through the airport terminal late last night with self assurance and with confidence beyond his years. He must have been the last person off of our plane, which was so late in arriving that the terminal was all but shut down for the night. Perhaps he waited for the pineapple-toting vacationers, some college kids, and the rest of us to disembark and clear out of the public area, or he took a minute to compose thoughts and feelings, to wash up and look at his reflection in a mirror on the Men's' Room wall.

Wearing civilian clothes, he could be mistaken for a student, a musician, or a junior partner in some law firm . He is none of those; he is a soldier coming home for the Holidays.

I was privileged to watch.

Family members that included an anxious Mom, a preteen girl holding a hand drawn WELCOME HOME poster, and a few other adults and children had been waiting a long time. They were restless. A gentleman in a suit and tie waited with them. He wore medals of combat on his chest and a VFW hat on his head. An honor guard, of sorts. They were positioned where they could see the passengers descend on the escalator , head for baggage claim, and then to the cars idling at the curb.

I stood back, unnoticed, to wait with them.

The kids saw him first, and the excitement escalated. He rode the escalator down and saw them waiting. Hugs, tears, and camera flashes from the family; then a quiet handshake from the older veteran said what words could not. The young man then turned to his mother she fell into his open arms. This was the moment she had waited and prayed for, the hope that kept her strong. He lifted her off the ground and hugged her for a long time. He had waited and prayed and hoped, too. Their laughter and tears collided. Mine did, too.

As they all began to walk away, I touched his arm and when he turned to me I thanked him for his service, welcomed him home, and wished him a Merry Christmas. I'm sure he will not remember me, but I will never forget him.

Summer's Over

The cooler, wetter weather has settled in......so soon, so soon. The summer flew past me this year and I miss it, already. We are getting the place ready for whatever snow falls this year. (Please, God, not another one like the last two!!) One last trip for the bulls next week, as Jim and I head for the PBR Finals in Las Vegas. Then we just hunker down until Spring.
Now, I have time to read, write, create some crafty doodads and gifts, and get some indoor projects finished. When the sun is warm and bright, and long in the summer sky, I have a hard time being inside the house....so the chores have piled up.
Fall changes are everywhere, the trees are beautiful in such bright colors. The moose are around more, even had a big bull running around in the horse pasture a week ago. The elk herds are here in the hills, they know that snow is coming and have left the summer graze in the higher elevations. Wild turkeys that we watched grow from little poults are all full sized and noisy. There were about thirty in the middle of the road as I pulled out of the driveway yesterday.
Every season has it's own beauty. There is a rhythm and a routine that I look forward to as the changes unfold.
The sun is shining as I write, and even though it is cold, it is drawing me out. Horses and cows to feed, water tanks to top off, and I have the gift of another day to experience the beauty that surrounds us here on the ol' Brand X.

Change in Seasons

Cooler weather has arrived. The days are shorter, the air is brisk, I enjoy a little wind and a little rain.... after a summer of sunny sameness. Fall is my favorite time of year. We are working around the ranch, getting ready for winter; hard to believe it is right around the corner. All the summer toys are put away, flower beds mulched, fields cleaned up, and fences tightened.

So, I returned to my blog. I realized today that I am a foul weather blogger. It's not that there is a lack of things to write about in the summer, it is just that the outdoors holds me captive and it's difficult to sit inside and write when there is outdoor fun to be having.