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.

Every day

I haven’t written in a long time.

This is how writing always starts for me, with an apology for not having written sooner. I don’t know what that’s about, the deferral and the delay, the email that is left in the inbox a few days (or weeks) too long, the stories and ideas that sit in the on-deck circle of my mind as the earth spins around itself and then around the sun, unwritten, undone. It’s on a long list of things that I’d like to change about myself, that I try to change about myself, that I may never quite manage to change about myself. Things always happen for me in ebbs and flows. There are long periods of constant accomplishment followed by a day when it takes me three hours to get dressed in the morning, periods of thrift followed by a lethal trip to IKEA, a sense of all being right in the world alternating with the sense that the quest stands on the edge of a knife. In the midst of it all, there’s almost nothing, other than eating, peeing, and thinking of my family with love, that I consistently do every single day, or on a schedule at all. Because my job is what it is, I can’t even put sleeping on that list, because sleeping is not something I necessarily do in every 24 hour period. Each of my days feels like it is invented from scratch.

I went to an Integrative Medicine conference two weeks ago which was dreamy, in the sense that I was surrounded by people who are interested not only in making people better, but also making their lives better, and also making our own lives better. The issue of physician wellness came up a lot. On the one hand, we are an infinitely privileged group of people and what can people possibly complain about who are eating organic steel cut oats and fresh strawberries on a resort veranda in the cool desert morning?  On the other hand, so many people spoke of burnout, of struggling to provide good care in a system more concerned with efficiency and documentation, of seeing numbness and dis-ease in their colleagues and trainees, of finding the weight of the world’s unsolvable problems too heavy to bear, of bearing the heaviness of the world with grace but wondering, deep down, about what good medicine might truly look like. It was good to remember what I had dreamed of, when I started on this path. And to know that other people still dream of it.

As part of the conference, several people gave mini-TED talks, two of which centered on the concept of daily practices — in one case a daily gratitude practice, in the other a daily practice of writing morning pages, a practice suggested by Julia Cameron in her book “The Artist’s Way.” Each of the speakers had been doing their daily practice for over a year. And each of them spoke about the profundity of practice, of doing the thing every day no matter what.

I belong to a number of different cohorts that espouse daily practice. I’m Jewish, to begin with, and if you practice Judaism to the letter of the law, your day is one long daily practice of prayers and blessings and prescribed acts. Then there’s meditation and more broadly mindfulness, which I’ve been dancing with for more than a decade. I’m mindful every day, but I don’t meditate every day and that is without question the recommendation. Then there’s writing. Most people who are serious about writing — or any art practice — do it every day or most days.  (People who talk about their daily practices don’t often make fully clear whether it’s truly EVERY DAY or just most days, and even though the stickler in me kinda wants to ask, maybe it doesn’t fully matter, because either one would be progress.) So I’ve become adept at feeling guilty about my daily non-doing in multiple of life’s domains.

I had a wellness session with a few of the interns this week. We watched a TED talk together about the power of positive psychology. We talked a bit about the research presented in the talk that shows that by doing something positive for two minutes everyday for 21 days, you can retrain the way your brain thinks. I’m kind of allergic to the whole notion of the “21 day fix” because it implies that there is something that needs fixing (I’m doing the best I can and it’s pretty damn good, thank you very much!) and that anything that needs fixing could really be changed in 21 days. As a concept, it seems (very) reductive and simplistic. But on the other hand, I’VE NEVER BEEN ABLE TO DO IT. So who am I to say it isn’t true? Maybe it really is that simple.

We broke into small groups and talked about what we might try to do every day for the next 21 days. I promised to write every day. Then I didn’t write that day, Friday, or the next day, Saturday. Now it’s Sunday, and I’m writing. So I’m not sure whether to classify this as a failure or a success. I’m not sure if it’s day 3 or day 1. But regardless it feels so good, like an awesome first date that is also tea with an old friend. Because it’s been so long, but sentences are still a sweet road to understanding.

So I guess I’m going to try to write every day. 21 days. Just 21 days! It feels insurmountable. Right now, for example, my daughter’s nap has gone on longer than it should have. There are some work emails I haven’t answered that will have to wait a little longer because I was writing this instead. Two minutes isn’t really a feasible time frame for writing, so what I’m committing to is more significant than that. But if I can do it, I’m pretty sure I’ll be glad I did. And if I don’t make it every day, maybe I’ll make it most days, and that would still be a lot.

Anyone want to join me? Write the thing you are going to do every day for 21 days in the comments and we can check in on each other and see how it’s going and then in the end, we can see how it went, and maybe we’ll even keep going.


Can it really be six months since I last wrote? There is this perpetual sense of the days and weeks and months tumbling out of my hands like so many marbles covered in margarine. They cannot be grasped. I keep trying to send down an anchor, to carve out a quiet homestead for myself in the wilds of all the things that must or could or should be done. If I just get the house organized, I am always thinking to myself, then it’ll all fall into place. Meanwhile things both large and small are happening: Residency ended and I started a new job. We bought a house and moved into it. C has a stable job situation for this year and we’re the most relaxed we’ve been since before I started medical school. We’ve been eating lots of salad and going for walks together and instead of me collapsing into an insensate, dreamless sleep at 8pm and C working until midnight every night to make up for the long days of solo parenting, we go to bed together and it’s the sweetest. Last Friday, I got home at 8pm after a wonderful, tiring second week of being an attending and E and I had a rocking dance party courtesy of YouTube. It was the first time in a long while that I completely forgot myself in the moment. I was just a body and a smile and a beating heart. We spun and spun and spun around each other. C was watching — the perpetual sole audience member for our crazy dances — and I did a little (extremely tame) strip tease for her which mainly consisted of removing my stethoscope and hospital badge. The song “Uptown Funk” came on, which we used to time compressions during CPR simulations in the ED, and there it all was: love and sex and death and all the extreme things I have witnessed and the crazy privilege of being there for others at the borderlines of life and the feeling of having no escape from the intensity of that. And, since I’m a parent and a pediatrician, running through it all, the awesome sense of responsibility for the gift of a child, and the pleasure in it.

It’s been a puzzling time. Things have unequivocally improved: I’m working so many fewer hours. I’m getting paid more. I have more time with my family. I enjoy my job. But I’m still waking up in the morning with a sore jaw and a sore neck from the worries that don’t sleep. There’s this new anxiety that stems from not being in survival mode all the time. During residency, I was just trying to make it through. I didn’t expect much of the months: Just to do a good job at my job and to take some delight in my family. If money ran out before the next paycheck, there was a credit card and a nod to some future pay-off. Now, there are so many things I want to do, so many ways I want to be better, so many thirsty parts of myself that haven’t been watered in so long. After three years of chronic pain, my body is in desperate need of concerted attention. I want to be more involved in all the communities I belong to. I want to write more and build out a professional niche for myself that feels authentic. I want to feel like I have some control over my finances. I want to finally get better at keeping up with email and be much more organized. I feel accountable to myself in a new way and so, oddly, though everything is better, I’m feeling more pressured and anxious and distracted than before. I’m expecting more of myself than is reasonable. It’s harder to put down my smart phone. It’s harder to just be at the table with my family. It’s harder to just sit on the couch with E and play Dinosaur Family. I’m finding it harder to just be. I’m having to relearn how to live in long arcs and it’s not going smoothly quite yet.

Today is Rosh Hashanah, the Jewish New Year, which this year has coincided with the beginning of fall, though the calendar won’t catch up for a few weeks. It was legitimately cool this morning. For the first time in a while I had to run back into the house to grab a long-sleeved shirt for E. The house has fallen quiet in the absence of all the fans and air conditioning that have kept us going and the air coming in through the windows has a point to make: the circle is about to turn again. There is something so comforting about the changing of the seasons, about another Rosh Hashanah, about another chance to be made new again. When I was young, the promise of Rosh Hashanah was the opportunity to reinvent myself. Now that I’m older, it’s more about the opportunity to reinvest. We spent the evening last night with friends from our neighborhood — our gaggle of five kids were running around shrieking with delight — and I could feel the roots we have been working to put down wending their way into the soil. Amidst the swirl of my usual worries about how to fulfill on my potential in this life, I had the sense that the answers are close at hand.

For someone who does not quite believe in God — at least not as traditionally defined — I have quite a potent response to attending synagogue. It’s all I can do while I’m there to keep from weeping. There are lots of reasons — the comfort of the familiar, the opportunity to reflect — but I think the main thing is that when I’m there, I feel like part of something, both in now time and in historical time. Lots of people have sung these songs, are singing these songs, will sing these songs. I hold hands with E as much as she’ll let me in synagogue and I can feel all the love that went into my creation flowing through me and into her. It helps that I attend about the warmest, funkiest, most progressive, most diverse synagogue imaginable where you can wear your sneakers if you want and it’s ok if your kid whispers “Is it lunchtime yet?” during the silent prayer.

At today’s services, there were five aliyot — five readings from the Torah scroll. Before each reading, a different group of people was invited to come up to offer a blessing and receive a blessing. First, there were the families who had welcomed babies in the previous year. They scraggled to the front, their little ones in carriers, in arms, in someone else’s arms. How could I not weep for them, for all the joy and the challenge of it, and for the hope for the future that is contained in the decision to bring new life into the world? Then there was an aliyah for people experiencing an ending, and one for people experiencing a beginning. How, I wondered, can one category not contain the other? But you could tell that the people who chose to mark an ending — mostly people mourning loved ones — were different from those who were marking a beginning — mostly newlyweds. You could feel the warmth of the congregation embracing them both. Then the fourth Aliyah was for people in need of healing, or praying for healing for others, or for those who work in healing professions, and given that all three categories apply to me, I decided to rise, and my mother also rose, for her own reasons, and E came with me because that’s how we roll. We gathered under a prayer shawl, surrounded by many others, and spoke the familiar blessing. I knew some of the other people up there from work — and I felt proud of them, proud of us, for all that we give of ourselves to heal others. After the Torah reading, the whole congregation sang a meditative prayer for healing — ana el na rafa na la  — the brief, poignant prayer that Moses spoke on behalf of his sister Miriam. Please God, please God, heal her. People called out the names of people who were in need of healing. I wanted to speak the names of all my little patients, who have had to start life by fighting for it, but of course I couldn’t because: HIPPA. So I just thought about them, their little fingers curled up around their breathing tubes.

In this world where people are killed because they are black and refugees are washing up on unwelcoming shores and millions of children die each year from diseases that vaccines could prevent and medicines could cure, it is a bit narcissistic to claim a spot amongst those who are in need of healing, but that’s how I’m feeling these days: not quite whole. So for me, this year is going to be about healing: healing myself, helping others heal, trying to heal the wounds of the world in the small ways that are available to me. May it be a good year. And it spite of all that is difficult, may it also be sweet. To quote a T-shirt that my mother wears: Lord, give me coffee to change the things I can and wine to accept the things I cannot change. And maybe some honey along the way.

Into the mystic

It’s been so, so, so long since I wrote. Part of writing for me is figuring out what the hell is going on in my life, so if you ask me what’s been going on in my life these past months, I’ll quite honestly tell you: I have no idea. It’s like the tupperware drawer, all containers and tops that don’t fit on the containers, some stray tops from containers that never made it home from daycare, a misplaced frog magnet, beads with no strings to connect them, a day then a day then a day.

Which is not to say that these have been empty months. Quite the contrary. I’ve been surfing wave after wave of check boxes. Every to-do list is a redo of the one before and a preview of the one to come. As residency winds down, and the-easier-life-that-has-been-promised rises over the horizon, there has been so much bureaucracy to take care of: medical licensing, credentialing, job application, disability insurance, life insurance. We are are thigh-deep in a house purchase that seems likely to actually happen (super exciting! And so much work!). I continue to try to accomplish more than is possible per unit time. The endless cycle of toys going into and being dumped out of bins continues (If you want to do an interpretive dance about parenting, all you have to do is put on yesterday’s pajamas and repeatedly stoop, pretend to pickup ten small objects with your two hands, stand and pretend to put them into bins.) All of these things are good things and necessary things but also seem far from the soul somehow. What was it again that was burning in my inner hearth those many years ago? Something about transcendence and understanding what it means to be alive and being fiercely present to suffering and always feeling the beauty of the world against my skin like a hot sun?

I got an email from my insurance broker yesterday congratulating me on my successful application for life insurance. “This is great news,” it began, and I couldn’t help but snort with laughter. “This is great news!” saith the prophet in the marketplace. “She hath died, yet her ashes are now transmuted into 1.5 million dollars.” I have been trying, really trying to change my relationship with money recently. I have read, without irony, with full hope for a life transformed, such books as “Your Money or Your Life” and “Think and Grow Rich,” the latter of which is truly a masterpiece of capitalist sociopathy. I have made spreadsheets of all my expenses. I have read several books on how to get organized and have made a few lists of things I should be doing (“Organize desk area” for example, which has appeared on every one of my to-do lists since 1996). I have manged to reduce my monthly electric bill from $197 to $165 after a borderline obsessive — ok, actually obsessive — household campaign during which I overheard my three year old say to her stuffed dinosaur “It’s ok. If your hands are cold, you can just put them in your pockets.” And yet I still cannot shake the feeling that none of this matters one little bit. I want to believe that once I have purchased a home, am fully insured (health, car, disability, life), have an emergency fund totaling three months of living expenses, and have paid off my credit card debt, nirvana will open its hungry mouth and swallow me whole, but I feel farther than ever from a sense of spiritual purpose. There is only so much room in my head and when part of that empty space is occupied with questions like “I wonder if volatility in the bond market will result in higher mortgage rates tomorrow?” and “Is the light in the basement off?”, there’s just not much room left for Mary Oliver’s worn-but-still-new question, “What are you going to do with your one wild and precious life?” I feel like more of a grown-up than ever these days, but I think I might have been closest to the truth at the age of 23, when I lived for long conversations with friends over tea and I was spending 1-2 hours a day sitting on a cushion, staring at a candle and trying to empty my mind.

E and I were in the kitchen one recent evening after dinner. As I mentioned above, I’ve been trying to keep more on top of things around the house, so I try to clean up after dinner these days instead of piling all the dishes in the sink and turning out the light (n.b. this can feel almost as satisfying as cleaning). E is not such a fan — she would rather I stare into her eyes or color with her or play “I’m Elsa. You’re Anna.” So it can be a tense time, me doing dishes, which I hate, while E literally hangs off my back pockets, shrieking for my attention. I opened the freezer to assess the dinner possibilities for tomorrow and E grabbed a row of Pedialyte Pops leftover from a past illness. “Let’s have a popsicle party!” she exclaimed. I decided to be done with kitchen cleaning. E broke off a cherry pop and I broke off one of the green ones that tastes like nothing nature ever made. We sat on the couch and E stretched her legs out onto my lap and we were just sitting there for a while, sucking on our frozen rehydration solution and listening to the Paul Simon Pandora station. Van Morrison’s “Into the Mystic” came on and I suddenly felt like my younger self, glowing with uncertainty and desire, waiting for something to happen. “We were born before the wind/also younger than the sun.” “What are you thinking about?” I asked E. “Dragons,” she said, without any hesitation. “Dragons and sheep.” She closed her eyes and licked her popsicle. It’s an odd experience, being so intimately bonded with a person whose cognitive world is almost totally inscrutable. Her feet starting bobbing to the music and I felt the wildness of chance that made her, the life energy that has flowed from me to her into forever. I thought about what lessons I would want my life to teach her by example: “Get good insurance”? Perhaps. But not only. Also, and much more so, “Love fiercely” and “Feel everything.” I guess it’s a matter of figuring out how to weave them together, the life of sober preparation and the life that carries you away toward an unknown destination.



An extra cup at the Thanksgiving table

As a pediatrician-mama, I find that Thanksgiving is — to use a timely cliche — easy as pie. I don’t have to search my mind for even the shortest moment to access my gratitude place: My child is alive and healthy (*gods, do not be tempted by this statement*). The ocean of gratitude I feel for this has no bottom. I am aware of it dozens of times in the course of my day taking care of sick children: How lucky my partner and I are. How tenuous and temporary and fragile our luck is. How we can claim no credit for this fortune. There are many, many other things I am grateful for, but even if all those other things evaporated, this one thing, this everything, would still fill me up on Thanksgiving day and every day.

Yesterday, as a pre-Thanksgiving treat, my partner came and picked me up from work so we could pick our daughter up together from school. It was a gray, cold day and little specks of icy rain were making it hard to keep my eyes open as I waited just outside the entrance of the hospital. I’m on Jeopardy call all weekend but if I’m not called in, I get to have four days with my family in front of our slightly creepy ventless gas fireplace. (Where does all that CO and CO2 go? Whatever — pass the pumpkin pie!) So I closed my eyes and sent a surge of warmth towards each of my co-residents, wishing for their well-being and the well-being of their families. Sure, it started from a place of self interest and humor, but then it felt good and right to be sending them little non-denominational blessings in honor of the holiday. There is a special place in my heart forever for the people I am training with — a certain affection and protective instinct and a huge folder of moments in which these people have awed and inspired me, sometimes unexpectedly.

Then my mind turned to all the families I have cared for who are without a child this Thanksgiving. The babies who never made it into the world, the babies who stayed for only a few hours or days, the babies who left this world after a long struggle in the NICU, the babies who arrived to our ED in the early hours of the morning already cold and pulseless, the children whose otherwise healthy lives were shortened by cancer or trauma, the children with chronic illness who were in and out of the hospital for months or years before a cold or stomach bug proved to be more than they or we could fight. Then I thought of all the children whose lives have been shortened by war or preventable disease or treatable disease or famine or — this week especially — by racism or homophobia or genocide or hate-motivated injustice of any kind. I thought of their parents and the huge, gaping unfairness of what they were given by luck, or the universe, or God, or just random chance, depending on what you believe. I wondered how they go on with things like Thanksgiving. Would I be able to? In Judaism, when someone dies, the thing you say to the people who love them is: zachur li’vracha. May their memory be a blessing. And so, my eyes closed against the rain, I sent this out to all the parents who have lost children: May the memory of your children be a blessing and may there still be things to be grateful for.

On the Jewish holiday of Passover, we leave a cup of wine out on the table for the prophet Elijah. The teaching is that Elijah will one day come as an unknown guest and you want to be ready to welcome him. This year at my Thanksgiving table, I’m going to leave out a cup for all the parents who have lost children, that they may know they and their children are not forgotten. That they should feel welcome back into the rhythm of ritual and community, whenever they are ready. Also, that we may never take our good fortune for granted. And that we may fight in whatever way we can to prevent parents from losing children needlessly.