Flooded with wonder

It’s 3 hours and 18 minutes into Sunday. The house is quieter than it is during the day, and the world is quieter than it has been in my lifetime, coronavirus being what it is, etc. etc. It’s de riguer but also totally authentic to notice — as often as every second of the day and night — how different things are now. Within the urban landscape that I choose to call home, the rhythm of life is more aligned now with that of the sun. On a typical Saturday night in my neighborhood, until midnight or beyond, the sounds of human activity follow you from room to room. The crescendo and decrescendo of footfalls and subwoofers approaching, passing by, and moving along. Snippets of conversation that you can overhear even through ear plugs — betrayals, reminders, “can you believe he said that?” The urgent possibility of hell over the church loud speaker. Every so often a cry or a scream — and you can’t tell if its laughter, stretching, cumming, or murder. But these days, no matter what day it is, as the sun sets, a curtain of quiet comes down and it’s hard to tell whether you are 500 feet from 50 people, 5 people, or no one at all.

Today (well, yesterday) was such a good day. My little family took a long walk in the woods. My kid had a violin lesson in which it was clear to her, to me, and to her teacher, how far she has come into herself through the labor of learning to play. We then swept and tidied our back porch and filled our planters full of flowers that had been selected and assembled in a wagon for contact-free pickup at the nursery by a benevolent, faceless stranger. Somehow, it was so much sweeter than having chosen the flowers ourselves. What delight is this? I wondered to myself as I pulled a verbena plant from among the tangle of foliage and read the cryptic instructions for its care through a film of dirt on the accompanying label. We ate so well all day, thanks to my partner’s kitchen genius. Without going into every detail suffice it to say: homemade pita. We had dinner with friends via zoom and it actually felt like we were able to connect, despite an unstable internet connection. In short, it was one of those days when you feel that perhaps it is better to be alive after all — the answer to a question you didn’t even realize you were asking yourself from behind your mask.

Now I’m laying in bed next to the person who came through me into this world. I’ve stared at her in her sleep for what feels like so many hours over the last 8-and-a-half-years but I still can’t get enough of her features. I’m sure all parents feel this way about their children, but I find her to be just so perfectly made. My gaze travels from her jaunty cowlick, to the familiar geography of her ear, to her long eyelashes, to the dimple in her chin that is both younger and older than she is. I reach out to stroke the soft rise of her cheek with just one small plane of my index finger, not wanting to wake her. She stirs and takes a deep breath and I make my body completely still and then her breaths return to their somnolent regularity and I begin again to drink her every feature in. The birds are beginning to sing their morning songs now out in the hushed world and the moment zig zags, expands, and accordions out of itself and I feel aware suddenly, to whatever extent is actually possible, of everything. I am flooded with wonder at the fact of her.

If I had to put a name to the thing about me which motherhood has wrought, it is this: I am constantly flooded with wonder. Certainly this capacity was already latent in me, and I’m not saying it’s true for all mothers or has to be true, but for me, bringing E into the world and raising her has made manifest the light in everything. And this throughline of wonder is connected to the physical fact of her body having been made in mine, of her having come into being from nothingness through the portal of me. I am unsettled by the gendered nature of the term “motherhood” and by the way that essentialist ideas of gender are projected onto parenthood to differentiate “fathers” from “mothers” and by the way that biological parenthood is reified above other avenues to parenthood. No gender or body has exclusive claim on any of the vast experiences of parenthood. And yet, within the context of my own life, my sense of myself as a parent is linked to my sense of myself as a mother, which is connected to my sense of myself as a woman, which is in turn mapped forever onto the experience of giving birth to E. When I was giving birth to her, I had a realization as I was struggling to let go and accept the incredible sensations that would accompany her birth. I realized that for her to live, I would have to accept the possibility of death. And in that moment, I did. For her to live, I was willing to die.  It sounds terrible, but it was just the opposite. I realized that my understanding of myself could expand to include another person and by extension everyone. This realization happened in my body, my mind, and my heart, all at once, the proverbial ZAP! Like the trickle of water high on a mountain that feeds the river below, that moment continues to animate my capacity for empathy, my understanding of love, my shock at the ongoing fact of war and other forms of brutality, my hunger for the world to be better, and the abiding sense of wonder that never leaves me, no matter what is happening in the inner or outer world. Each of us came through someone to enter this world! I mean, how effing incredible is that? And how precious we are, each of us. As sacred as the whole world.

Laying here thinking of wonder, I pick up my phone and log in to check on one of my patients, whose death was expected to be imminent. I had checked in just a few hours ago when I woke up and it was hard to tell from the notes what was happening, but now when I log in, I see that he has died. It’s tempting to think that perhaps that is why I woke up at 2:21am, for no apparent reason. Perhaps he was passing out of this world. He wasn’t my child, my loved one, mine to mourn, and yet still I weep. I can feel a shift in the world with him no longer in it. I hadn’t gotten to know him before his long illness left him sedated on a ventilator — I only had one interaction with him as he played a video game and tried to tune out the reality of the hospital around him — but I had gotten to know his mother well as she faced what would be his last weeks. As I weep, I feel that my tears are not for him, but for her. I imagine her, sitting by his bedside, stroking his face, memorizing his features, knowing that soon the wonder of his physical body would no longer be hers to hold and touch and admire. I am sorry I never asked her to share with me the story of his birth. I wish I could know what it felt like to touch him for the first time, and then for the last. I want to know — both as a kind of inoculation against the possibility of this kind of grief in my own life, and as a way of helping her carry the burden of it — what it feels like to have your body be the only physical evidence on earth of your child’s having lived.

The sun is rising now and soon my household will stir awake and it will be Mother’s Day. E has all kinds of plan for me — a pedicure on the porch, a surprise gift, a special meal. Telling me about her plans before bed, her eyes sparkled with mischief and excitement and delight. In honor of all the other mothers I have known who can no longer touch their children with their own hands, I will savor every minute of it.



What it’s like to try to fall asleep when you are a health care worker during the COVID-19 pandemic

Dedicated to everyone whose job is putting them at risk in these frightening times

It’s 12:08am and I can’t sleep. I only really sleep every few nights now. The rest of the time I scroll and worry. Hopefully what I’m about to say is common knowledge at this point, but it it still worth stating: It is a scary and disorienting time to be a health care worker.

I will lay all my cards on the table. I’m a pediatric hospitliast. I take care of kids who are admitted to the hospital. My COVID-19 risk is less than that of health care workers in adult medicine, especially those in high risk areas like the emergency department and intensive care units, though kids are more likely to be silent carriers so there is an X-factor there: many of the COVID-19 patients I end up caring for may not be billed as such. I may not know which children are exposure risks. I live with my 8 year old and with my immunocompromised spouse and I’m terrified of what COVID-19 would mean for him — as it is he has lung infections frequently and recovers from them slowly. To a lesser extent — these virus seems to be kinder to children — I’m worried about my child getting it. And to an even lesser extent, but with more mental load attached, I’m worried about what illness for me, my spouse, or both of us would mean for the functioning of our household. Through a fluke of scheduling, COVID-19 hit at the beginning of a rare stretch in which I was not scheduled to take care of patients for three weeks — one of those weeks was to have been a vacation — so I have been working from home. During this time I have been attending meetings remotely and trying to be productive but I am also homeschooling a very active 8 year old, trying to keep the entropy at bay in my household, standing in line at stores, trying to stay current on the medical and lay news, and trying to stay connected with colleagues, friends, and family members. I feel like I’ve never been more exhausted, but I know so many people are so much more exhausted by infinite multipliers. So those are my credentials, my own personal cocktail of risks and life circumstances. Everyone in the health care field has their own coronavirus cocktail these days.

So I lay in bed at night and worry and the worry has become a predictable but inescapable loop. The first stop on the loop is: What if going to work will result in the death of my immunocompromised spouse? How do I balance my promise to take care of sick people against my promise to prioritize and protect my spouse? Maybe I should move out of my house for awhile? But what if this goes on for months? Do I want to be separated from my child for months? Is that even good for her? Maybe I’m being selfish, imaging that my absence would be somehow harmful to her, imagining that matters in the grand scheme of things. I think of men going off to fight in World War II. I should be willing to sacrifice everything. I remember that my spouse’s job is at risk because of coronavirus, so I need to keep working so that we can continue to pay our bills. Well, unless I die. But then I remember that I have pretty good life insurance. Is death by pandemic covered in my life insurance policy? I should check on that. This particular thread, the “What if I kill my spouse” thread, and it’s closely related cousin ” Other negative familial consequences that could befall us if I contract coronavirus” never feel fully resolved, but my ultimate decision is to continue working, the equation of which goes something like this: this is what I promised I would do when I became a doctor x don’t want to let my patients and colleagues down x strategies to mitigate risk x panic about finances.

Then on to the next loop: What if I die? A sizable percentage of COVID-19 cases and deaths in China and Italy have been health care workers. If the numbers have become hazy in my mind — was it 5000? 20%? — this is the part of the loop where I look up the statistics again, because what harm could come to me of spending 20 minutes reading about health care worker deaths again at 12:20am? I should write a will, I think. Add that to the mental list — maybe I’ll do that tomorrow, the day before I go back to work. Actually, that’s already today.

The idea of not seeing my kid grow up and her growing up without her mommy is just the worst. That’s the darkest place in the loop. I try to be kind to myself by not dwelling there so much but every loop passes through it.  Should I not go to work so my kid can continue to have a mommy? I land back in the “yes, I will go to work” folder. (see above re: this is what I promised I would do when I became a doctor x don’t want to let my patients and colleagues down x strategies to mitigate risk x panic about finances). But then I wonder, how bad would this have to be for me to opt out? Cue guilt and imposter syndrome. Am I a bad person or a bad doctor for even contemplating this option? And then I wonder why have I not been saving more money so that we have more of a cushion if I decide to opt out? Then I reflect on how much luckier I am than most other people in this moment. I remember all the workers — grocery store workers, postal workers, public transit workers, so many others — who are absorbing these same risks for much less financial reward, and all the people who have lost their jobs. Cue self-flagellation about how often my anxieties are reflective of blindness to my own privilege. I should just be grateful for my job.

Then I remember that my parents are actually at much higher risk than any of my immediate household members and I worry about them and the idea that I would not be able to see either of them again in this life if they died of coronavirus several states away. But they are staying inside and being really rigorous about it. I allow myself to fantasize that they will be ok and this feels like a break from the loop.

All of this feels a bit abstract, until at some point, I remember that I will be going back to work on Monday, in two days which is actually now only one day. I wonder how many COVID cases there are at my hospital now. I spend some number of minutes planning, like a champion skier about to jump, how I will decontaminate myself after working on Monday so that I can protect my spouse. And yet, no matter how many layers I add into the hypothetical routine, there is a moment in the chain of actions where it is impossible to be fully sterile. Where should I keep my shoes? In my car? At the hospital? In the basement near the washing machine? Tomorrow I should sew a few head coverings for myself, I think, that could be washed with my scrubs each night. Add that to the mental list as well. Sew head coverings. I read and re-read my hospital’s protocol on universal masking. How will I eat and drink while I’m at work? My shifts can last 11 or 12 hours. If I only have one mask, how can I safely remove it to eat and then replace it? I imagine getting an energy shake and slipping the straw carefully up under the mask and into my mouth. Surely, that fails every rational approach to infection control, I think. I’ll just eat a really big breakfast. I scour Facebook for recommendations from other health care providers — it turns out health care provider groups on social media are the most reliable source of information these days. I am so proud to be a member of the global community of health care workers — I bear witness everyday on these forums to more ingenuity and bravery and sheer force of will to serve others than I can possible describe here.

I think of all these incredible healers and innovators and I quickly enter the part of the loop that I am most ashamed to describe, the part where I feel like I haven’t done anything or nearly enough to help in this crisis. You would think that the death of my loved ones or my death would be the most prominent part of the loop, but the “I’m ineffective and powerless and somehow some piece of this mass suffering is my fault” is where I spend most of the long, sleepless nights these days. Doctors across the country and the world are injecting patients with convalescent sera, writing ethical guidelines about allocation of resources, opening drive-thru testing clinics, and just plain seeing patients, I have been…. attending meetings and trying to move long-range projects forward but feeling very unfocused, reviewing vocabulary words with my second grader, doing the dishes, and reading COVID-19 articles. I have started a daily zoom meditation which is attended by 15-30 people each day and perhaps there is some positive impact there. I have been helpful to my institution’s response to the crisis in some small instances. I have been trying to be as present as I can to the communities I belong to in remote ways. But I feel like I haven’t done enough, by a mile, by a long-shot, by any means. I haven’t 3-D printed any masks, convinced a biotech company to start making cheaper ventilators, created online courses for first responders on protective equipment, or volunteered to test people at homeless shelters. How are people doing these things, I wonder?! Do they have high energy children at home with them?! And because I haven’t been on service with patients in so long, I haven’t even done my usual amount of service to others in the form of good old regular medical care. Cue the brutal self-judgmental thoughts. If there is a championship in self-judgment, I assure you that I would be the winner. “That’s about the only thing you’d ever win,” says the voice. See? It’s really, really good at its job. I remind myself that I’ve been trying to stay at home at all costs to spare my spouse from whatever risk I can. I remind myself that we’ve been splitting childcare. I remind myself that this is a stressful time. “Pitiful,” the voice says. “No one cares about your shitty little excuses. Stop whining.”

Now its 12:46am. I should really try to go to sleep, if for no other reason than to bolster my immune system. Even insomnia feels like a transgression against some larger humanitarian purpose these days.

But wait, I think. All this was preventable! The virus was not preventable, but the shortage of personal protective equipment for health care workers most certainly could have been averted with some foresight and effective planning. Not enough ventilators? Preventable! People gathering for parties in parks despite clear guidance not to? Totally preventable! The guy who blew out his cigarette smoke at me as I flattened myself face first against a building to avoid him while walking my dog. There’s a special circle of hell waiting for you, buddy, and news flash — there aren’t enough ventilators there either! I hear from friends about administrators forbidding health care workers to wear masks, even those they brought in themselves, because it might be perceived as scary by patients. I read about doctors being fired for speaking out about the shortages in personal protective equipment at their institutions. I read tweets from the president about how critical medical equipment supply for the states is a quid pro quo situation and I think to myself: Hell. F-ing. No. Here I am lying in bed for 2-3 hours per night worried about exposing my loved ones to risk by going to work and society is showing me and my colleagues in small and big ways that they just don’t care about us at all. I appreciate all the people clapping on their balconies, but the government could have been funding pandemic preparedness and it didn’t. Test kits could have been made widely available in time to given containment a chance. Our leaders could be invoking mechanisms to force private industry to manufacture needed equipment and they aren’t. Government at the state and federal level could have imposed shelter-in-place orders sooner given what was already known about the spread of disease in China and they didn’t. It feels like the lives of health care workers are invisible and disposable, their bodies instrumentalized to compensate for a system that has been overstressed for years under the false guise of resource scarcity and is shockingly underprepared to meet this challenge. Is a patient’s sense of fear really more important than a nurse’s life? I read my social media feed from friends debating whether to allow their kids to play with other kids and I know everyone is doing their best but I think: I’m about to maybe expose my loved ones to a disease that could kill them. The least you can do is not host playdates! This is the anger part of the loop, and it feels much better than the other parts of the loop — it can really generate some warmth on a cold night — but it’s just as toxic, because now it’s 1:32am and the best case scenario for me at this point, if my kid sleeps as late as she ever does, is 6 hours of sleep, and that’s not enough for the night before the night before I put on the N95 respirator my father mailed me — one of the last in a box he has in his woodshop from before COVID — and suit up for work.

I was an anxious child and an anxious young adult and it took a decade of meditation and therapy and another decade of medical training to turn me into someone who, until very recently, was basically no longer afraid of anything. I’ve held a patient’s intestines inside his surgical incisions with my own hands so his loved ones wouldn’t have to see them popping out while he received CPR. I’ve sat in rooms with parents and their dying children for hours as they gasped and drew their last breaths. I’ve seen severed body parts and absent eyes and drowned children and gunshot wounds and suicide victims. And I have never been as afraid or unsettled as I am now.

Because of my history of anxiety, I have always been hypervigilant about any signs of anxiety in my kid (hypervigilance — another competition I could win!). From the time she was old enough to walk, I have encouraged her to climb and explore and touch things and look at life with her eyes open. When she expresses fear about trying something, I sit quietly with her and talk about her worries and then we go together and do the thing. “You have to face your fears.” I tell her. “That’s how you get strong.” Now that she’s older, I overhear her saying it to her friends sometimes, when they don’t want to try the monkey bars or climb to the top of the dome. She’s even said it to me a few times — the instance that comes to mind was in San Francisco, when I was seized with fear at the prospect of driving down one of its dizzying inclined roads. Now, as I imagine leaving my house for work on Monday morning, I hear her little voice saying it: “You have to face your fears, Mommy.” And just maybe, it will feel like a good enough reason to do it.

My not-so-silent retreat

I had the honor of reading this piece at the book release for How to Break Up With Your Phone, the new book by my dear friend and always thoughtful observer of culture, Catherine Price. Writing this piece gave me a chance to take stock of all the ways my phone has become central to the way I experience life, for better and for worse, and has inspired me to try to push my phone a little farther to the periphery. I hope you’ll join me in reading her book and participating in The National Day of Unplugging on March 9-10. Maybe we can sit an have an uninterrupted conversation over a cup of tea that day!

Last month, during the cold dawn of 2018, I went on a silent meditation retreat. Or at least, it was supposed to be silent. But more on that soon.

I’ve been trying to get better at life since I can remember. My two favorite genres of writing are self-help and memoir and even better if it’s both. I have trialed every diet you can imagine – vegetarian, vegan, gluten-free, sugar-free, whole 30, the zone, paleo – each with its delightful and ultimately unsustainable qualities. I have meditated for what is probably a total of months at this point. I have exercised, yoga’ed, slept more, slept less, bullet journaled, pomodoroed, prayed, and decluttered (n.b. there are important things in life that do not in fact spark joy. Two words: menstrual pads). I have kept meticulous track of every calorie, every minute, and every dollar and I have learned something from every one of these exercises but the most salient lesson of all has been that on some basic level, I cannot be improved. I am who I am. Gluten-free or not, I am an inconsistent, somewhat anxious ball of desire and wonder and love. I have difficulty with routines. I am perpetually about to cry because of the sorrow and beauty of it all. I am bad at email.

And yet, I still hold out hope. And so, I created an impossible space in my impossible schedule to attend the five-day silent retreat. The retreat was supposed to start at 6pm on a Wednesday and as is usually the case, I overscheduled my day so that at 5:55pm, I was frantically driving through the dark and winding roads of suburban Philadelphia trying to find the retreat center, my Google maps app frantically trying to correct my course, “Turn left, then turn left. Turn left. Turn left. Make a U-turn then turn left.” I parked, huffed and puffed my way into the building and tried to compose myself to enter the meditation hall where everyone else was sitting serenely on their cushions.

The retreat leader started to talk about what the retreat would be like. It would be hard, he said. Lots of negative emotions would come up. It’s hard to be still. It’s hard to maintain silence. Did I mention it would be hard? he said again. I must admit I kind of scoffed on the inside. I take care of dying children for a living, so I am hard-pressed to define almost anything I experience as “hard” while on the other hand, my life feels hard all the time so there’s almost nothing that could happen to me on a cushion that wouldn’t feel a bit like vacation.

“And of course,” he said, “no cell phones.” Heads nodded. Solemn faces. “If you must have one, don’t look at it, don’t bring it out, interact with is as little possible.” Hmmmm, I thought to myself. I don’t know about that one. You see, snow was predicted. Inches or even feet of snow. Apocalyptic, school-cancelling snow. I was already feeling guilty for leaving my spouse with the threat of snow hanging in the air, with the possibility of four long days of solo childcare stretching ahead of her. I had to keep my finger on the pulse. Which brings me to the first thing I learned about myself from the cell phone embargo: I suffer from the delusion that I can prevent or at least fix anything, and my phone is the instrument of that delusion. Tina Fey said it best, “It’s a burden being able to control situations with my hypervigilance, but it’s my lot in life.” I furtively checked my phone throughout the evening, refreshing the weather channel page again and again to see if there was any change in the predicted timing or severity of the snowfall. “I’ll drive back if it’s too bad,” I texted my spouse, without any prompting from her, apropos of nothing.

No sane person would have utilized any other means of communication as often as I was checking my phone. You would never turn the TV on and off or open and close the newspaper 12 times in 20 minutes, or call someone several times in an hour to say one sentence and then hang up. Had I attended the retreat in the era before cell phones, I would have had to make peace with the fact that I would not be there for snowpocalypse, that my spouse would have to find her own way. But the presence of my cell phone gave me the illusion that I could somehow be both here and there. Which brings me to the second delusion my cell phone supports: The delusion that I can live in parallel streams of reality at the same time. But what we know to be true is that multitasking is a myth. Your brain can do only one thing at a time. And what I had committed to do during this time was meditate. And was I was doing was trying to prevent snow from falling by looking at my phone.

I proceeded to put my cell phone in a little orange bejeweled bag and carry it with me everywhere I went, like an oxygen tank, like the scarlet letter, like a child’s security blanket. I had brought only comfortable clothes with me — yoga pants and stretch pants – which had no pockets. In order to keep my phone near me at all times for the purpose of controlling the weather and paying my self-imposed marital guilt tax, I put it into the bag that usually holds my meditation bells. I put my room key in the bag with my cell phone and I tried to project to others the silent message “This bag is for my keys, you see, MY KEYS!” But my cell phone didn’t fully fit in the bag and so it was peeking out. “MY KEYS!” I yelled silently, as I carried it from the meditation hall to the dining hall, back to meditation hall, and upstairs to my austere yet cozy shared room.

We had been randomly assigned roommates and I was bunking with a refugee who had been a Buddhist nun before fleeing religious persecution in her home country. We smiled at each other a lot and changed in our respective closets. We turned out the light and there was a velvety silence made more evident by the sound of snow falling outside, a sound that is really a vacuum of sound.

Less than 20 seconds later, my cell phone vibrated. It was the inevitable automated phone call from my daughter’s school announcing the cancellation for the next day. “Fuck,” I thought to myself, but the silence was so complete that I had the momentary fear that my roommate had heard it. I scrunched down in my sleeping bag as far as I could go without suffocating and spent the next thirty minutes in a marathon texting session with my spouse, our carpool mates, and my various babysitters, architecting a childcare solution. In my stress, I didn’t disable the vibrate function and so a few minutes into the texting storm, I realized with horror that my phone had been buzzing every few seconds. I stopped texting and tuned into the regular sound of my roommates’ breaths. Was she asleep? Or was she so enlightened that she was pretending to sleep to lessen my shame?

The following day, the world outside our cloister sparkled white in the clarion, frigid air. The childcare having been arranged the previous night, I managed to keep my phone in its bag for the duration of the morning. We sat. We walked. We sat. We did yoga. We sat. We were silent. We ate lunch, which tasted amazing in the way that food can taste when you are really paying attention to it. After lunch, I layered on every article of clothing I had brought with me and ventured out into the 2 degrees. As I trudged through the snow, the trail offered up a series of visual surprises, each more beautiful than the last: a series of icicles under a stone overhang, the shocking red flash of a bird against a snow-laced branch, and most spectacularly, a grove of thick bamboo arching overhead to form a living tunnel.

The bamboo was a rich green under the snow. It’s visual texture was echoed in its sounds as it swayed in the wind – the hollow wooden knocking of the thick stems juxtaposed against the rustling of its infinite delicate leaves. I wanted to remember it, to remember it forever. I debated the merits of taking off my ski gloves and pulling out my phone to take pictures, but I feared for my fingers. I felt a pang of loss, which brought me to another realization: Since the advent of my phone, I don’t feel like I am experiencing something fully unless I can document it. I can often be found in front of something beautiful or interesting staring down at my phone and flipping through the pictures I have just taken of it. I stood under the bamboo for a long time, trying to absorb its every color and angle.

Each day of the retreat, my phone checking became less frequent, but it continued to demand my attention — an unavoidable conference call, an email that had to be answered, FaceTime with my daughter. I became aware of how often my distractions during meditation were related to the tug of my phone and its many sources of news, trivia, and triviality. One afternoon, as I sat on the cushion, a phrase came into my mind from a GQ article on Brad Pitt that had been shared around on Facebook some years ago, “At my age, you learn to never trust a fart, never waste a boner, and…” What was the third thing?! I invited this thought to pass, but it was an itch that had to be scratched. At the next opportunity I furtively pulled my phone out and googled it and in case you are curious, the third thing is “never pass up a bathroom” and it was not a quote from Brad Pitt, but from an an alligator wrangler he had encountered in the desert. What did it mean, that this detail had been retained in my mind, that I had broken the cell phone embargo for it, that I had been unable to resist the temptation to revisit this article which I never would have seen in the first place in any world in which I had to seek out information based on my native interests. Which brought me to another insight: My phone has filled my head with trivial knowledge and the desire for more trivial knowledge. I know more than perhaps I would know without it, but more of what I know is of little importance.

I don’t mean to suggest that the retreat was a wash. I learned a kind of yoga – yin yoga – that I am practicing to this day. I was reminded of how much there is to notice and be grateful for in this life, and that stays with me, a deep bass note that I can still hear when I get quiet. I rested and practiced being tender with myself and everyone else. But I don’t think I can say that it was a silent retreat, though I didn’t talk to my fellow participants. I was still part of the noisy, busy, 2×7-inch world of my phone.

Like sugar and anxiety, I don’t think I’ll ever be fully free of my phone. It’s how I learn and connect and remember and navigate and plan and even if I could let go of all that, it’s woven into the fabric of how I take care of patients. If I tried to get rid of my phone, the hospital would buy me a new one. But it’s also how I worry and obsess and waste time and distract myself when I should be paying more attention. It gives me a lot, but at a cost. I am never truly in silence. I am never truly still. Next time I go on retreat, maybe I’ll leave it at home and find out what is possible. Maybe.

Milonga Sentimental

It has been almost eight months since my last post. Almost an entire YEAR. I can’t process this information. It’s like I finished the last post, got up from the table to wash out my tea cup, put the laundry in the dryer, spent a couple more (thousand) hours answering email, and now it’s now. I’ve written a couple of partial posts in my head — about running during the time a few months ago when I was running, about the law of 10,000 hours and the tyranny of the electronic medical record, about watching my child learn to read — and I’ve held on to them for so long, for weeks and months, as living possibilities. Then there have been all the many moments that I have felt and observed deeply, deep in my body where language is born, somewhere between the slip of a skipped heartbeat and a quickening between the navel and the knees. These moments could and should have made their way back up through my body and out through my fingers and into the world. But they didn’t.

Annie Dillard said it best:

How we spend our days is, of course, how we spend our lives. What we do with this hour, and that one, is what we are doing… There is no shortage of good days. It is good lives that are hard to come by. A life of good days lived in the senses is not enough. The life of sensation is the life of greed; it requires more and more. The life of the spirit requires less and less; time is ample and its passage sweet. Who would call a day spent reading a good day? But a life spent reading — that is a good life.

How do I spend my days? How am I spending my life? I care for people and I really love it. It’s my job to take care of sick people, but it’s more than that. I try to care for everyone I meet, as if such a thing were even possible. I try to hold each person I encounter in my hands — softly! — like you would a newly born thing, to keep the bones intact, to keep the predators at bay. “And each body, a lion of courage, and something precious to the earth.” Not that I am successful at that by any means, but it is my intention, my practice. That’s one way to answer the question of how I am spending my life.

But there are other ways. Everything flows out of me all of the time. Money, especially. It’s not like I’m buying lots of clothes or flying all around the world. Actually I barely have enough business-appropriate clothing to dress appropriately for work every day and I carry my lunch to work in E’s old Elsa and Anna lunchbox which is way, way too femme for her these days. It’s that one extra minute with E in the morning that turns the Lyftline into a Lyft, riding the wave of one of C’s warm smiles all the way to the Indian buffet for dinner, forgetting to turn in my receipts in time to get reimbursed. I’ve read all the books and I know I’m supposed to be figuring out which gas station has the cheapest gas and maximizing my Roth IRA but I feel like I’m at odds with it on a cellular level, which is no defense. “As for my life, I am always / like Venice: What is just streets in others / in me is a dark streaming love.” Which makes it sound like a good thing but I assure you it’s not. Time works this way too. I fill every 2 units of time with 3 units of activity, and maybe even a fourth thing that has to hide behind the shed in the back to get done in the dark when everyone else is asleep, like a crime. So that’s how I’m spending my days: guiltily. If I could just hold on to anything.

But none of this gets at what I’m trying to express, which is that I am doing so many worthwhile and satisfying things with my days but I’m worried that I am missing my life. The life of words and stillness and sustained attention and the unexpected and the unexplained. The life that can’t be rationalized and certainly not monetized. Is it the life of the mind or the life of the spirit or the life of the body that I’m missing? And if the life I’m in now is not any of these three lives than what is it? The life of the engine? The life of doing. The life of activity. I want to live my life of doing but I also want to live in a small house on the edge of an island and write. And write. And write. And write. And punctuate the long, quiet solitude of writing with a furtive trip to a milonga every once in awhile, to dally. Because in this version of my life, I can dance tango. I can follow. I can be caught off guard. I can take risks.

Does everyone live this double life? The life of doing and the life of desire. The life that is and the life that isn’t.

I traveled to a conference recently which was really a joy for me professionally, the first conference I’ve ever been to that spoke directly to what I am passionate about. As such, while there was a bit of performance involved — I wore a skirt suit for example, and used words like “leverage” and “stakeholders” with conviction — I was by and large being myself there. As is the case with working parenthood, the trip had to be everything: a networking opportunity, a meditation retreat, a return to my youth, a chance to sleep, finally, to sleep. So I stayed at the Zen Center I had visited almost fifteen years ago when I was a more consistent Zen practitioner, when I was way more anxious and way more porous. This time, as last time, I woke at 5am with the wooden clapper and sat in the dark among the monks with their dark robes and smooth heads and singing bowls. I bowed to everyone in the halls. I walked softly. I ate a new kind of high tech synthetic ice cream you can only get in Silicon Valley. I put my toes in the Pacific Ocean. The first night, after the conference, I saw a friend from long ago. Then the next night I went by myself to a tango concert.

For unclear reasons, I have become a accidental fan of a musical genre I understand almost nothing about — tango electronico. Like this. And to a lesser extent this. The first of these links is by a band named Otros Aires and I’m not ashamed to admit this — I am just a huge fan of theirs. Like I listen to their albums over and over again in the secret space between my ear buds. Like I know all the words. I am not even a big fan of tango the dance. The gender dynamics do nothing for me and the dance seems over complicated and then there’s those gender dynamics again. But then maybe I’m a little more smitten with tango than I want to be. In any case, Otros Aires was playing in San Francisco that second night of the conference — all the way from Argentina! What are the odds of that?

I left the conference with my laptop backback and my sensible shoes and my conference nametag on its lanyard and make the long trek to the venue. The website said “Doors 7pm” so there I was at 7pm which turned out to be roughly 2.5 hours from the start of the Otros Aires set. Every other person there was there with a friend. Every other woman there else was dressed in some form of femininia by which I mean either a one-piece halter garment (are these really called rompers?) or really, really high heels or both. Every other person there was drinking a cocktail, but alcohol gives me migraine headaches these days so I was bruisingly sober and alert as recorded tango music started playing and the tango dancing started, equal parts awkward and seductive and, after 2.5 hours, really, really boring. And then Otros Aires started their set.

There was a clear social expectation that only tango dancing would be happening on the dance floor but my body would not, for once, obey the social expectation. I picked a spot in the corner of the dance floor — surely I cannot be begrudged this tiny little square? — and I started to dance as I used to dance, with total abandon. I caught the eye of some of the tango dancers every once in a while and I couldn’t decide if they were thinking: “You go, early middle-aged woman!” or “Disgusting” but whatever it was, I was not to be stopped. I danced through the entire set, though by the middle of the set I found myself up at the front, near the stage, singing along to all the words, interacting with the band members like I’ve heard tell of but never experienced myself, giving them back everything they were giving to us, to me. At one point, the lead singer took out his phone to film the audience and I caught his camera pointed at me out of the corner of my eye and I turned toward the camera and smiled and closed my eyes and danced and danced and danced. I thought to myself, “Who is this woman, this woman who is somebody’s mother, this pediatrician (I challenge you to say the word “pediatrician” and simultaneously call up an image of anything remotely seductive), this women with her uterus poised to at any moment fall onto the floor from all the gyrating?” Absurd. Intoxicating.

At the end of the concert, a gaggle of women of all ages lingered near the door by the stage awaiting the band and I kind of wanted to be among them but also not, because, well, see above re: mother and pediatrician not to mention married and gay. I leaned up against one of the columns at the edge of the club thinking, “Maybe I can just tell them, ‘You guys are my favorite’ or something.” Then they emerged and the lead singer made his way around the room and when he saw me he came up and gave me a hug and said, “Muchas gracias, mi amor, muchas gracias.” And we smiled at each other for slightly longer than a second and then he turned away to talk to someone else and I picked up my laptop bag and called a Lyft to take me back to the Zen temple and my room with the small statue of Buddha on a shelf where I lay in bed and wished for the trip to end right then, to be able to be at that very moment back in my own bed with C and E, the familiar arms, the familiar legs, the sweet familiar smells.

It’s hard to know where to locate this part of a life, this part at the margins but also at the center, somewhere between the slip of a skipped heartbeat and a quickening between the navel and the knees. The adventure. It’s hard to figure out whether it matters or not, once so much else matters so much and so much more. So the life of doing continues and hopefully, I’ll be able to write again sometime sooner than a year from now, from whichever seam of time can be made to yield.

The Piano

For my mother and her mother

A week after Donald Trump was elected, our new piano was delivered. My mother found a baby grand for sale that had been sitting silent for thirty years in a wealthy family’s living room. The owner was less interested in recouping the piano’s cost and more interested in its going to a good home, so my mother bought it for the proverbial song and now it lives in our living room. This is one thing about my mother — she is always bringing beauty into my life, even when I have altogether forgotten about the possibility of beauty, even when I am questioning the validity and purpose of the entire construct of beauty.

I don’t know that I will ever be equal to the gift of this piano. I am in awe of it. I am humbled by it, but humbled is not even enough of a word. I am devastated by its beauty. It sits under our living room window, its lacquered surface reflecting the many-colored trees in the park across the street and the broken stained glass panes that have been watching over our house since it was built in 1922. Both the house and the piano will outlive me and I imagine them whispering voiceless wisdoms about the arc of history to each other in the early morning.

Aside from a few sporadic hours stolen from family holidays at my parents’ house, I hadn’t played the piano in over fifteen years. Sitting down at the new piano for the first time, my fingers found their way through the Fifth Prelude from Bach’s Well-Tempered Klavier, stumbling at all the usual spots — a G suddenly sharped, a big leap of the left hand landing one note short. As a child, I was never much for practicing — or any pursuit requiring discipline or daily routine — so several attempts to make progress with a formal piano teacher fizzled out and my engagement with the piano occurred  on my own terms in a process that can only be described as repetitive meandering. I would sit down at the piano on a weekend day and open one after another of my mother’s books of music — Mozart Piano Sonatas, Mendelssohn’s Songs Without Words, Bach, Bach, and more Bach — and sightread as many pieces as I could at whatever tempo I could manage. For obvious reasons, I came to specialize in the slow movements, and mastered several pieces through sheer repetition. I passed hours and hours and days this way, pulled from one juicy cadence to the other, vibrating with the tension of dissonance leading to release, missing lots of notes, dreaming in some vague way of fulfilling on the expectation — mine? my parents’? — that I would follow in their footsteps and become a musician but also knowing that it would be otherwise.

Music was the only way my parents could ever have come into contact, let alone gotten married and stayed married for 40 years and counting. My mother was born in a refugee camp in Cyprus, having being carried across Europe in her mother’s womb. My grandparents met when my grandfather, a partisan fighter, liberated my grandmother from a train carrying her from one concentration camp to another. They named my mother Aliza after my grandfather’s first first-born child, Freidl, who had been killed by the Nazis, the word for happiness translated from Yiddish to Hebrew in the spirit of the new possibility of life that awaited them in a land that should never have been promised. They had almost nothing in their eventual home in Israel but my grandmother found a way to buy a piano and lessons.

Across the earth in Iowa, my father’s mother, a devout member of the Reorganized Church of Latter Saints did an unusual thing, a thing her church friends were not doing. She paid for mail order classical music records. Later, she started driving her children all over the state for music lessons. Three of her four children became classical musicians.  There was no precedent for it.

Their love was a mirlo blanco, a white blackbird, an impossible dream, the impossible dream of their mothers come to fruition in ways their mothers would never have predicted or chosen. They met when they were both studying music in London. In pictures from the time, my mother’s tight curls are huge and free, her lips full and red, her shirts tight across her chest. My father’s eyes are hidden deep beneath thick glasses, his hair long, his face almost always serious. I wonder what their courtship was like — it still feels sometimes like they lack a shared language, but then I remember Bach. After the year in London, my father returned to American and my mother came with him. They were wed in a courthouse in Buffalo right before my  mother’s visa was to expire, using a ring borrowed from the judge. When I was born, their parents eventually came around.

My very first memories are of my parents playing music together, the elegant carriage of my mother’s arms and head silhouetted against the light from my clandestine vantage point in the darkness at the top of the stairs, her body swaying away from and toward the piano, crescendo and decrescendo. I loved when their eyes met and they moved their bodies together to synchronize the end of a phrase. I loved to hear the sounds of their breathing, the catch of an inhale before an entrance, an exhale before a big chord. Nothing is as comforting to a child as the evidence of her parents’ love, the glue holding the universe together.

Classical music is odd glue for a Jew — at its heart, an expression of German and Austrian culture — and I often wonder if this crossed my grandmother’s mind at the time, as she kept my mother at the piano for hours each day practicing the notes that Bach wrote for the glory of his Lutheran God in a city where several hundred years later, in 1945, only 15 Jews remained. And yet, for many reasons of culture and history and economics, Jews have been over-represented among the ranks of classical musicians since the 19th century and the music of Bach, Mozart, and Beethoven was held dear among the community of Jewish survivors that came to Israel from Europe. And I suppose that is the fate of persecuted minorities and refugees everywhere — to share a culture with your oppressor. Every treasured thing recalls, in some way, a feared thing. What is yours is also not yours.

It has been a time of deja vu. As I have returned to my natal deities — Bach, Mozart, and Beethoven — Germans and Austrians all — the swastika has also returned. It does not feel accidental. I was lulled into a sense of American-ness, living as I do in a multi-everything urban community, alive with the promise of interactions that transcend category. Now, since the election, I feel more Jewish than ever, more white than ever, more gay then ever, more female than ever, more vulnerable than ever. History persists. Home isn’t. The only threads that connect me to this world are some melodies that were carried, tattered, across Europe, the embrace of beloved bodies whose fate I cannot control, hope for the abiding love that has been promised by every form of human wisdom, yet to be fulfilled.


(Temporary) solo parent chronicles

It’s been a million years since I wrote and so why not start again now? It’s 11:13pm and I just finished folding my fourth load of laundry of the day while standing at the dining room table and sipping un petit peu de Manischewitz out of the mug my residency program gave me as a graduation gift. If you aren’t *just* a little bit jealous right now, my advice to you is this: do not have children. 

C is out of town for two weeks and so I am getting a brief glimpse into what it might be like to be a single parent. I am realizing the parenting chops I thought I had are kind of like twinkle-twinkle-little-star compared to the Beerhoven sonata of doing it all alone. To all the single parents out there: hats fucking off to you. How do you do it? No really — how do you do it? This is not a rhetorical question.

My temporary role as a solo parent is made harder by the following shameful secrets about me:

1) I. Hate. Cooking. I used to like it, I think, but C has been doing 99% of the cooking for the last ten years and I have lost my mojo. The small repertoire of things I used to cook easily — stir fry, kale and white bean soup, rice and beans — are all toddler kryptonite. Last time I made E put a cooked green in her mouth, she half-spit, half-gagged chewed up greenery into a paper towel for longer than you would think would be possible then demanded that I brush her tongue with a toothbrush. Let’s just say: One of us has eaten Trader Joe’s tortellini and string cheese for more than one meal this week. And by one of us, I mean both of us. Au revoir, gluten-free, dairy-free, sugar-free diet!

2) I like my mornings to be minimally interactive. Because the field of medicine is dominated by competitive masochists, I am usually required to wake up at about the time attractive young people are staggering into strangers’ apartments to make the beast with two backs. My beautiful loved ones are usually still snoozing away as I tiptoe out of bed to shower and dress by iPhone flashlight. I make my smoothie. I pack my lunch. I leave. I do not speak. I am not spoken to. This is in sharp contrast to my solo parent mornings. My first thought upon waking is ecstatic: I will be able to see her perfect, gorgeous little face this morning! *inner squeal* 90 minutes later I am already 15 minutes late for work and she will only eat her eggs if I feed them to her while making the sound of a light saber. *inner scream*! She and I have never had to solidify a weekday morning routine together so when I’m there with her in the morning, she reverts to weekend mode. She wants cuddling. She wants french toast. She wants to put every article of her clothing on at the exact same moment as I put on the corresponding article of my clothing. “Can’t you put your bra on after?” she says, pouting because this one step breaks the symmetry. No, no I cannot.

3) I am not a good multitasker. I am at my best as a parent during focused one-on-one activities. I am not as good at making chicken nuggets while trying to sharpen a crayon using a pencil sharpener. Because of my nutty work life, I’ve learned to parent in the manner of a desert wanderer at the oasis. I don’t talk and drink, or think and drink. I just drink. When I’m with E, I’m usually just with E. 

As a result, I have tripped our house alarm twice this week. We usually don’t turn it on at night but I feel a little exposed without my Appalachian culture-of-honor afraid-of-no-one life partner by my side. This morning I was feeling *pretty good* about myself — lunches packed, rain boots AND sneakers in the backpack — but then we had to turn back to home because I forgot the fire engine sweater. “Mommy, why is there a policeman at our door?” My heart started racing and then I remembered: the alarm. “False alarm,” the policeman yelled to his colleague in the *second* cruiser that has responded to my damsel-in-no-distress call. #privilege

All of the above notwithstanding, though, I’m enjoying our uninterrupted intimacy. We hit our roadblocks and then recover, because there’s no one else to suggest a friendly game of Yahtzee. There has been a lot of laughter. We’ve been sleeping together evey other night (one night for the fun of it, the other night for my internal organs to recover from the contusions) and E’s breaths and sighs make for a sweet, sweet night. It reminds me of being pregnant with her — just her and me, registering each other’s moods and perturbations, breathing a single air. 

Two nights ago, we were looking into the mirror as we always do after E’s bath, the towel and my arms wrapped around her tight. I looked tired and a few new wiry gray hairs caught the bright bathroom lights. E looked as she always does: joyful and rosy and well-made. She reached her hand up to my forehead where a series of lines no longer fully recede when I relax. 

“I know what these lines are for, Mommy,” she said. “They are my maze.” She traced them with her finger as if they had a beginning and an end. Even my face is hers, it seems, which it is. “How do I get lines on my face?” she asked me. Just keep smiling, little one, and worrying (hopefully not as much as me), and being surprised by this life.

Dancing in the waves

We’re on vacation. This time, it’s an actual vacation, where you go away and spend time in another place. We haven’t done this in a long time. Since before residency. Since before E was born. We’ve been to my parents’ house. I’ve been to conferences for one or two nights. C has gone to artist retreats and film shoots. We have spent a night or two with family members. But a whole week away, with no work purpose, with no arms-length to-do list of overdue life tasks (dentist, taxes, roof leak) — this we haven’t done since 2010.

It’s day one and I woke up at 6:38am. I felt rested but restive. I reached for my cell phone, the phone I had promised to keep off, and searched for the YMCA in the beach town where we are staying. Maybe, I thought, I can get in a swim before everyone gets up. Because this is how my life usually works — everything is stolen from something else. I am a thief of time. I discovered that the YMCA is farther than I thought — 22 minutes away — and I thought to myself: If I go I will not be here when E wakes up. Because that’s how my life usually works — the days are counted in how many times E sees me when she wakes up and when she goes to sleep. Somewhere in my heart there’s an old man with an abacus and every time I miss bedtime or a morning cuddle, he peeks at me over the top of his ancient reading glasses and slides a blue bead over to the left.

So, not going swimming. My next thought was: “The vacation is almost over and I haven’t done anything meaningful with this time.” Which is when I realized how much I need this vacation.

C stirred next to me and it occurred to me how much of the time I have been stealing has been from her, from us. I have been in resolute denial about this — trying to justify in my mind all the ways in which her career ALSO demands of us and ALSO impinges on us (there’s the old guy with the abacus again), but the reality is that my schedule means she spends many nights alone. I settled back into my pillow and tried to inhabit time.

It was the rare day when E slept later than us by a significant amount. We were afraid to move, to step a foot onto the wood floor for fear of its creaking and breaking this new magic spell. We held each other and whispered about this and that. My stomach started growling and at a certain point we couldn’t stay in bed anymore. It’s amazing how much sound a few simple actions can make in a sleeping house. The cabinet creaked as I opened it, the bowls clinked against one another like a car backfiring, the silverware drawer opening sounded like a herd of ponies braying. Slowly everyone in the house — E, her cousins, her aunt and uncle — emerged from their beds and we made ready to head for the beach.

It was only E’s second time at the beach and she was in a state of ecstasy. Every time the surf lapped up over her ankles, she shrieked with delight. At moments, the delight was so great that she seemed unable to contain it. She would throw herself to the ground and roll in the sand until every inch of her skin was covered in sand, like a fresh donut rolled in sugar crystals. At one point, she suddenly broke into a run along the edge of the shoreline out of the pure sensation of being alive, until she was so far from me that I had to call her back.

The waves today were steep and hard and the undercurrent was strong enough to unfoot me several times. There was scarcely any territory on the shoreline where it was safe for a four-year-old to wade — only a foot or two separated the edge of the surf from the violent crash of the waves. Little E was like a sandpiper, running toward the receding surf and then scampering back up the beach as the next wave approached. And I was right there beside her, ready to hoist her up when a wave proved faster or taller than she anticipated. Each wave promised the sweet reward of her giggles and also the possibility of her being tumbled into the brine and carried away, a possibility which felt so close — too close — like a layer of weight added to each of my breaths. The Lord giveth and the Lord taketh away, I kept thinking. The ultimate wave.

Do all parents feel this way? I wondered to myself. Is this normal? I surveyed the other families around me for signs that they too were greeting each incoming wave with a combined sense of delight and the understanding that life is incredibly fragile. Younger children were certainly being supervised but everyone seemed to be having a good time, though what you can tell about a person’s internal life from the outside is nothing.

It’s hard to talk about this aspect of my job, but I have watched the waves carry many beloved children away and I don’t think I have really acknowledged the way this has changed me. In part because in comparison with their families, what right do I have to claim any piece of grief? When a patient dies, it isn’t really a life event for the doctor, even if it is. Even if they inhabit your dreams for months. Even if you think of them as you are watching your child leap into the surf on your first vacation in years.

I am realizing that for me, there is no vacation from that part of my life experience. At the sweetest core of parenting — and what, in this life, is sweeter than your child’s delighted laughter? — it vibrates. I cannot unknow what I know about nature’s indifference. Which is not to say that there’s can’t be a full range of positive experiences and emotions. Which is not to say that anxiety needs to limit me or my child. Which is not to say that I scooped her up out of the waves and ran. Today was one of those best days ever, one of the days that would be slowed down and put to feel-good music in the movie of my life. And it did not feel wrong or contradictory to acknowledge, in a wordless way, all that has been lost, and therefore all that must be held sacred and never taken for granted.

This year since the end of residency has felt tumultuous for me. I think I was expecting for things to “go back to the way they used to be,” whatever that means. I think I thought “it would get easier” as was so oft promised. Many stresses — namely time and money pressures — have been reduced somewhat, but caring for very ill children is just as hard and it should be. If it’s not hard, I don’t think you’re doing it right. (But if you don’t acknowledge how hard it is you can’t do it well for long.) Without being aware of it, I think I have been waiting for my innocence to return — for life to feel light again. But I am beginning to understand that certain things can’t and shouldn’t be peeled away. Certain things can’t be “left at work” because they become part of your emotional and spiritual and ethical being. Though I am sometimes envious of people who can contemplate pregnancy without running through a litany of possible complications or feed their children vegetables without calling to mind mental imagines of actual choking survivors, in reality I would not want my innocence back, in part because I want so much to be of service on a deep level to the families I care for and also because the suffering and loss I have witnessed inform the way I love, the way I care for my patients, the way I participate in community, and my desire to contribute to the repair of this broken world.

Tomorrow we’ll be back on the beach as early as we can get all seven of us up and fed. The waves will crash in and recede and I’m looking forward to dancing in them with E, in spite of but also because of all that might be lost.

Here is a picture of E, meeting the unending sea.


The Year of the Wandering Snail

E found a snail in our side-yard a few weeks ago after a good rain. “Our” side-yard actually belongs to our neighbor, who bought it a few months ago after a long battle with the city and has proceeded to do nothing with it as of yet. A house once stood on this lot, one half of a duplex that burned down some number of decades ago, leaving the adjoined house intact, the black scars of the fire still visible on its broad stucco sidewall. The side-yard is the reason our house has light on three sides, a clearing in the otherwise closely-spaced Victorian twins that line the streets of our neighborhood, clothed in their surprising splashes of yellow and purple and blue.

The side-yard has an ecology of its own. It was once tended by a neighborhood gardener, so you can discern amidst the ungoverned growth of weeds the echo of human intention — a patch of day lillies, a stand of sturdy hostas, a deep tangle of morning glory vines that have nowhere to climb and so have elected instead to spread along the ground. The foundation of the absent house is still visible at the surface of the earth in between the verdant volunteers — a submerged ruin of stone and brick and wire mesh that has left the ground pock-marked and uneven. Things appear in the lot sometimes — a pile of thin wooden beams, the inevitable stream of Doritos bags and sex, drugs, and rock’n’roll paraphernalia that blows in from the park across the street, discarded paperwork that has escaped from our neighbors’ recycling bins, and, most notably, a large wooden structure that looks like a spool of thread that has been blown up to giant-size, Alice-in-Wonderland-style. The unexplained appearance of these objects is a source of some consternation for C, and I can understand why, but I secretly welcome their comings and goings. It feels like the city is breathing in and out around us. Every few months, the motion sensor light that was installed facing the side-yard by the previous owners of our house mysteriously turns on at night. The harsh fluorescent light illuminates a wedge-shaped area of the side-yard for several minutes when this happens and I peer out of the windows trying to identify the human or animal that triggered it, but nothing is ever visible. The thing to do with this side yard would be to buy it, fence it, fill it with earth, level it, landscape it, and put a swing set on it, but I kind of like it as it is — wild, nationless, filled like the Elvish forests in the Lord of the Rings with a magic whose intentions are beyond human understanding.

So it is fitting that E found the snail in this side-yard. It happened when I was at work. E wanted to keep it and so it was brought inside, with the plan to observe it for a time, feed it some lettuce, and release it the next day. When I came home, E led me upstairs excitedly and we peered in at it. There was nothing of its meat visible, just a shell adhered to the side of the tupperware, its seal easily broken to reveal a crust of dried mucus at the shell’s opening. Nothing about it suggested the presence of life. Why, I silently pleaded, must all pet experiences end in lessons about death? But we didn’t speak of that possibility and instead, we covered the tupperware with foil, leaving a few holes for air, and went to bed.

In the morning, the snail was nowhere to be found. The tupperware was exactly where we had left it and the foil seemed undisturbed but there was no snail. We searched every surface of the playroom, the edges of the furniture, the walls, the baseboards, the many books and boxes and toys — no snail. The effect was one of uncanny silence. It’s not like the snail had been making noise when we knew where it was, but the snail’s absence seemed to leave a vacuum of sound borne of the knowledge that we would simply have no way of knowing where or if the snail was. You can call to a snail, but you will get no response. And what pattern governs the movement of snails? Not even Google could guide us. We learned that they are nocturnal, that they require calcium to maintain the health of their shells, that they can live up to 25 years, that they have around 14,000 teeth parts in their mouths, but we still didn’t know where it was.

It made me uncomfortable, knowing that the snail was at large in our house. I found myself opening doors slowly, anticipating the startle of finding it in some unlikely place. I didn’t know whether to fear it from below — I didn’t want to find it by stepping on it — or to fear it from above — would it fall on me from the ceiling? But then the morning picked up speed and I mentally gave the snail back into the care of the universe, acknowledging the likelihood that we would probably never know what had happened to it.

A week passed and we all forgot about the snail. Then one night when I went in to feed the frogs, there it was, adhered to the side of the frog tank, inert. There is a moment in movies when a character enters a room and is unaware of the presence of another person but you as the viewer can see them reflected in a mirror or hidden behind a door. That’s what it felt like. Nothing about the snail seemed alive in that moment but the fact of its having returned spoke to a week of activity — of whatever constitutes the activities of daily living for a snail. Tell us the story of your week! I wanted to say. But there is nothing you can learn from a snail about its past.

We placed the snail in a small drop of water and watched it slowly unfurl itself from its shell. I’m a little sheepish to admit it, but I haven’t experienced such visual curiosity or taken such pleasure in observing a living thing since they put E’s squirming, slick, blue body on my chest that bright morning four-and-a-half years ago. I was shocked by the miracle of it. At a pace that is just above the perceptible, the translucent body of the snail slowly expanded from the mouth of the shell, its dark “foot” finding its way toward the table, its featureless neck and head extending up, its four antennae emerging last, alert, with what I now know to be its eyes turning in every direction at the tips of the top two longer stalks. Its colors both were and weren’t — somewhere between clear and gray and white. It started to move across the table in one fluid movement and I thought of Michael Jackson moonwalking — that level of perfection and genius. It moonwalked over to the leaf of romaine lettuce that we had prepared for it and started to eat. If nothing in the room moved and you held your breath, you could just hear the sound of its 14,000 teeth parts chomping, the smallest sound that could reasonably be distinguished from silence.

The next day, E found another snail and so now we live with two snails. E named them Dino and Nino or Dinah and Nina, gender being the mystery that it is. They spend the majority of their time in the interior wilderness of our house, unseen, but then they return to the table where the frog tank is and we feed them. My spiritual development is not their job — and if I’m honest with myself, I don’t know how ethical it is to keep them in our home at all — but living with them is reminding me about wildness and I’m so grateful for that reminder.

It is easy to forget about wildness. There are all the schedules and plans and account numbers and passwords and meetings and aspirations and metrics and milestones and accomplishments. There is all the work of creating a life. It’s easy to feel that the substance of your life is that which you cultivate. But there is another story to life, which is a story of wild chance — to have been brought into being from the hundreds of thousands of eggs and the millions of sperm that might have been instead, to have avoided dying of the thousands things that could have killed you, to happen to sit next to a stranger on an airplane who soon is no longer a stranger, to look up one evening just as the sun’s last light sets the entire side of a glass-walled skyscraper on fire. Then there is the life of the animal. Soaked in amniotic fluid we arrive, beset throughout our lives by the scents and sensations of food and love and the body’s functioning, living through the infinite unconscious bodily processes that sustain us and move us through space until for whatever reason they no longer can. It is easy to forget about wildness until it comes into conflict with the life we choose and make, but it’s also possible to live in that wildness all along, an experience parallel to and in communication with the life that is reflected on the Google calendar.

I’m turning 36 today, which is not a huge number, but it’s not a small number either. It is conceivable that the majority of my days in this life have already occurred, perhaps even the vast majority — one never knows. The prospect of dying used to seem just completely impossible to me on an existential level. But whether it is a function of getting older or the fact that my job brings me into such intimate contact with birth and death, I can see now how life comes and goes, possessed of so much drama and emotional meaning, yet also indifferent to it. The awareness of life’s finitude has produced dueling urges: On the one hand, there is the urge to do and create and make a mark on the world. But even more strongly, I feel the urge to live out the full fruit of my wild life — to taste everything and smell the air and have my fingers in the dirt and the sea and to more fully inhabit my body and to sleep deeply and to love and to love and to love and to see what there is to be seen. To be, like the wandering snail, complete unto myself on this adventure of days and nights.

I was searching the other night for a poem to give to a friend who is in a hard spot, and I found this Mary Oliver poem which I haven’t read in a long time. It was not the poem for my friend at this moment — there are times when you just can’t send someone a poem about death no matter how profound it is — but it is the mantra I am going to carry into my 36th year, the year of wildness, the year of the wandering snail.

When Death Comes

When death comes
like the hungry bear in autumn;
when death comes and takes all the bright coins from his purse

to buy me, and snaps the purse shut;
when death comes
like the measle-pox

when death comes
like an iceberg between the shoulder blades,

I want to step through the door full of curiosity, wondering:
what is it going to be like, that cottage of darkness?

And therefore I look upon everything
as a brotherhood and a sisterhood,
and I look upon time as no more than an idea,
and I consider eternity as another possibility,

and I think of each life as a flower, as common
as a field daisy, and as singular,

and each name a comfortable music in the mouth,
tending, as all music does, toward silence,

and each body a lion of courage, and something
precious to the earth.

When it’s over, I want to say all my life
I was a bride married to amazement.
I was the bridegroom, taking the world into my arms.

When it’s over, I don’t want to wonder
if I have made of my life something particular, and real.

I don’t want to find myself sighing and frightened,
or full of argument.

I don’t want to end up simply having visited this world.

It’s a beautiful day, isn’t it?

One of the pleasures of parenting is watching your child develop into language which is to say, develop into relationship. A few days ago, E and I were walking hand in hand down the sidewalk and she looked up at me and said “It’s a beautiful day, isn’t it?” She said it with a borrowed intonation, trying on a phrase that she had heard grown-ups say. She wanted to make conversation, which is a grown-up kind of impulse. Toddlers speak to express their needs, their wants, their questions, their frustrations, their observations, their fears, and — so charmingly — their nascent humor, but they don’t really talk in order to talk, in order to maintain a social interaction. It’s takes a certain amount of social awareness to say to someone “It’s a beautiful day, isn’t it?”

The thing is, it wasn’t really a beautiful day. It was sunless and the sky was flat and gray. A fine, cold rain was falling intermittently — the kind of rain that can soak your clothes without you really being aware of it. At the very moment that she said: “It’s a beautiful day, isn’t it?” I had just registered the sensation of tension caused by having left the house in one too few layers. I smiled to myself. It’s a gentle responsibility, to bear witness to a person experimenting their way into a self. If another adult in that moment had said “It’s a beautiful day, isn’t it?”, I might have answered. “I don’t know, it’s colder than I expected.” But instead, I asked E, “What do you think is beautiful about the day?” “The sun is shining,” she said. “It’s fresh.” She was so glad, you could see it, to be her very own self in that moment, moving through the ritual of an adult conversation. “Please,” I thought to myself. “Please, world, let her be spared all of life’s little humiliations.” By a certain definition, I thought to myself, the sun WAS shining, somewhere above the dense clouds, the absence of night.

She said it again today, as we were walking up the ramp to the CVS, on our way to get some children’s Tylenol. I was post-call — tired, a little more grumpy than usual, a little more anxious than necessary. Last night, while I was on call, E had fallen out of bed onto the hardwood floor for the first time in a year. She had a nosebleed. At 5am my phone rang. I looked down and saw C’s number and was immediately sure that someone beloved had died. “Oh god, oh god,” I actually said as I hit “Accept.” But no one had died. There was just a nosebleed and a hysterical four year old, sobbing, inarticulate, totally freaked out. I haven’t breastfeed E in over three years, but hearing her sobs on the other end of the line, I felt like my body might make milk again. I burned to be comforting her. My skin literally felt warm with the desire to be there instead of where I was. I wanted to smell her hair and kiss her soft nose and wipe her tears and cuddle her. But instead I told her it was going to be ok and instructed C in all sorts of vicarious physical exam maneuvers. I had the sense that she was ok but then a part of my brain started up with the insidious differential: nasal septal hematoma, orbital fracture, CSF leak. And mostly I ached to be there.

I got home and spent a few hours staring at E’s swollen nose and wondering if she should be seen by a doctor other than me, a doctor with some shred of objectivity in relation to her swollen nose. I touched her nose again and again. Then, when it was clear that she was fine, and bored, I took her to school. But I worried. And so there we were in the CVS parking lot, going to get Tylenol, and my mind was still on the carousel of irrational worry and guilt.

“It’s a beautiful day, isn’t it?” she said. “Look at the sun on that building.” And I looked up to see the afternoon sun reflecting off the glass and chrome windows of a building across the street, ringing it in golden flame. It was so, so beautiful. I squeezed E’s hand. “Thanks so much for showing me, E.” It’s one of the pleasures of parenting, being jolted out of yourself, back into beauty.

The call room

I’m on a 24-hr call. I’m sitting in the small, windowless room that serves as our sleeping space on call, in which can be found a computer (of course a computer, always a computer), a bottle of Purrell foam, a red-topped canister of Sani-Cloths Plus germicidal wipes which features on its front a picture of both an adult and a baby with a red line through them as if to say: not for use by either diapered or continent humans, a programmable safe like the ones you find in hotels (as if anything of value really exists in this life beyond your own breath), a desk lamp that doesn’t work, a bulletin board with no tacks, a breast pump, and a bed made in all white with one thin fitted sheet, one thin flat sheet, one thin blanket, and one thin pillow in a thin pillowcase, as if to say: so too will your sleep here be thin. The walls are blank. The overhead light is bright and garish, but someone, in a touch of gentleness for which I am always grateful, decided to install a wall sconce with a soft, low light. So the inevitable calls do not wrench you from quiet darkness all the way into hospital fluorescence. Instead you flip on the mood sconce which affords just enough light to log in to the computer. Always the computer.

I’ve been taking 24 hour call for several years now — in total I’ve probably done it somewhere between 100-150 times, but every time I’m awake for almost an entire turn of the Earth, it’s newly shocking. The most challenging part of call is the way your physical being can be stretched, like a round of dough that you roll thinner and thinner until a hole opens up in it, but the hole almost never opens up, because you are trained to cohere. When I am on call, it is evident to me that the mind is a part of the physical realm, as susceptible to fatigue as the gastrocnemius or the bicep. The spaces between your thoughts get longer and longer. The two ends of the circle of a thought suddenly, for a split second, don’t meet. And then you force them to meet again and continue on.

The interesting thing about working in the ICU for 24 hours is that it is when you are in the best position to understand the lived experience of your patients’ families. They are at the bedside at all hours of the day and night, sleeping on cold, vinyl recliners under the same thin sheets and blankets. They may or may not be in fresh clothes in the morning. They might have had a granola bar for dinner and then again for breakfast. No one can ever truly understand the way it feels to keep vigil over a beloved, sick child until such a thing happens, and may it happen to as few people as possible. But in my 20th hour of being awake, my hair flying out in every direction in rebellion from my ponytail, my scrubs crumpled and stained, when I come to a bedside for the umpteenth time and there again is the mother, in an oversize man’s T-shirt and no make-up, knitting a pink hat as her tiny baby’s rib cage is expanded and contracted forty times a minute by a ventilator, I feel that we have at least shared a small leg of the journey. When I’m on for 24 hours, we can write the narrative of that day together, whether it’s the first or the last or just one of a number that we all hope will be uncountable. This is one of the reasons I count call among my secret sacred rituals: because why should you always get to go home when they do not.

It’s 12:57am now, and every word written is a second of lost sleep. Outside the call room, workmen are painting some kind of chemical on the floors. I am reminded that all kinds of people work at night, for all kinds of reasons — there is really nothing all that special about it. The chemical is irritating my mildly asthmatic lungs and in the light fog of call I am perseverating on the possibility that I will be poisoned in my sleep. I open the door to inquire about the chemical and find that they have strung masking tape across the door jam at eye level and again at hip level, such that I am unable to exit. My most visceral association is with police caution tape and for a moment I entertain the question of whether, in this imaginary universe, I am the criminal or the corpse.  “But I have to respond to codes!” I say, which is really just my cover for the claustrophobia that the tape evokes. “Sorry,” the man says. “Those are the regulations. So you don’t fall.” I am flummoxed. Are people getting taped into their call rooms all over the hospital, I wonder? Is there a job aid that stipulates how many pieces of masking tape are required to barricade the average medical provider? But he has his imperatives and I have come to learn when a thing is just not going to change. I close the door again and it’s back to the temporary universe of my call room, the room that is everyone’s and no one’s, to await the next inevitable thing.