Snow is a force that gives us meaning

As a kid growing up in eastern Oregon I loved snow. No matter how much it snowed, it was never enough for all the skiing, sledding, snowforts, snowball fignts and snowjumping (jumping off of the roof into a big snowpile) which could be dreampt up by my siblings and I. In fifth grade the snow reached over my head, the closest it ever came to my imagined quota. Now, 25 years later, I again find myself in snow country. And once again I want more.

This morning it snowed a couple inches while I stayed inside and fiddled with the new projector that LL and I have decided to treat ourselves to. Now that that is done--as with all projects remotely electronic and/or mechanical, it always take way longer than expected--I am temporarily at a loss for what to do. Not that I don't have any number of things I could/should be doing. But none are as fun as...

Of course! Snow. Outside I go, shovel in hand, to tackle the driveway.

As I push snow my mind relaxes. The task is simple and at hand. The reward is tangible, measurable, satisfying. Even as I clear a path, I wish for more: as long as it snows, I will have something which must be done, just as after finishing the driveway, I have to take LL's rig in for studded tires.

I wonder--not yet having read Chris Hedges's War is a Force...--if our urges toward violence might not be taken out more benignly on snow. We (and by we I mean of course I) have within us (me) the occasional urge, borne of the daily stresses accumulated by living an imperfect life, to destroy something. Snow is beautifully unique in its range of accommodation. Like water it can be hit and pushed without harm to do-er or do-ee, but in a way that water can't it can also be used for creation. In skiing and sledding, the desire for speed, even reckless speed, can be satisfied with yet a soft landing for crashes. In moving snow, there is unfettered access to the physical labor that is so often lacking in our lives. Maybe we all could use a little more snow.

Maybe, too, part of my love affair stems from the sense of something fragile and vanishing. We are in a La Niña year so it's supposed to be colder and wetter. But the numbers implied by global warming do not bode well for snow in the years to come. Snow, at ever-higher latitudes and elevations, may be an endangered species.

In which case, maybe snow could become the icon that finally galvanizes the floundering (or dead, as per the title of Hedges's latest, Death of the Liberal Class) progressive movement into action.

Ok, so that's a stretch. But such recent events as the failure to pass I-1098, which the 98$ of people who DON'T make more than $200k/yr would have benefited from, against a backdrop of huge cuts to essential services in healthcare and education, have me grasping at straws. At fragile and ephemeral things. At snow.

I'll write again when it's over my head. Until then let it snow!

Pumpkin soup

1 large pumpkin
A few ripe tomatoes
Hot peppers--3 or more, depending on BTU level
1 freshly picked coconut, or, if you don't live where coconuts are freshly picked, 1 package of processed coconut product
3-7 cloves of garlic
fresh ginger root, grated
2-4 orange and/or red bell peppers, depending on size
some ground nuts (e.g., hazelnuts, cashews, almonds--probably 1 cup)
1 beer of your choosing. Moose Drool is nice. If the beer is too tasty, more of it will end up in your belly than in the soup...
salt and pepper to taste
cilantro to garnish

What would you do, if you knew you could not fail?

Facing the end of another week in which the in-box is not empty I think of this quote. I don't know the author. The words are printed on a wooden placard in LL's parents' house in PT.

It is Friday morning and I am making some pumpkin soup before heading in to work. In point of fact it will be a turban squash soup. And also, I will be finishing it when I get home after work. This will probably be the time at which I'll take the baked squash and blend it with the roasted red peppers and roasted tomatoes, and throw them into the pot where the garlic, ginger and hot peppers will be sauteing. Also I still have to buy the hot peppers. I'm hoping for habañeros.

Also, in looking for an enye (ñ) to copy and paste, I learned that habanero is actually spelled just like that, and that ñ is incorrect--and on the screen just below that, I learned that "octopi is ignorant in three languages simultaneously", as it is derived from Greek instead of Latin and thus would be octopodes (while in modern English octopuses is considered "correct"). Thanks Wikipedia!

But I digress. What would I do if I knew I could not fail?

Hopefully, I would still be doing exactly what I am doing now, which is to say, I'm about to turn off the oven and go into the hospital where one of my patients was just admitted and then go to clinic and finish some charts and make some phone calls and look up some information on how better to treat chronic pain and how better to diagnose chronic suffering and how better to encourage a healthy diet and regular exercise and nurturing relationships, which are the things that keep all of us out of the hospital, and all the while I hope to be learning, learning, learning, which of necessity requires some letting go of previously learned information and letting go of some long-held habits and prejudices and beliefs, not all once of course because that would be too easy, but perhaps bit by bit.

And maybe if I can keep working at this I can not fail. Maybe if I can slowly change, bit by bit, my self-expectations, I will not let myself down. Perhaps if I keep reaching out to others, asking for help where appropriate, which is really almost always, we will succeed.

Perhaps the question should be re-framed, to What would we do, knowing that we can not fail?

We have to go for it. As Andrea Gibson says, we have to create. Whether a jack-o-lantern or pumpkin soup, a patient care plan or meaningful relationships, this is what we are here for.

And then of course I look back at what I've written and realize it's too pithy. Too canned, too hokey, too much of this, not enough of that. I have failed. I think that now that my blog frequency has dropped off to near-zero, I am trying to squeeze too much metaphor into too little space, and the result is--well, to forge on anyway, it's a soup.

And at the same time, why not go for it? Most of us, as LL likes to say, are going to die. Most of us will start out looking like the pumpkin at the top, and slowly wither to become the pumpkin below. Why not make a soup of it? Why not do it anyway?

Perhaps the question is, If we know we are might fail anyway, what will we strive for?

The answer, I hope, is Yes.

Processing speed

It has been 4 months since my last post. When last I wrote, spring was in the air, blah blah blah ("they" say 3-element lists have a nice ring to them), and I was sitting at LL's computer in our little duplex in Seattle. Now it is October in Omak. It is cold outside. Blah blah blah.

I honestly don't want to be writing right now. Even inside it is cold, blah blah blah (normally I can fill in these blanks--today my own internal processing speed seems to match that of my decrepit computer), and I'm frustrated by spending two hours online with India only to have my internet security unresolved.

But clearly a part of me wants to be writing right now, or I wouldn't be doing it, right? Perhaps I write from the desire to process the flash that was the last 4 months, and in so doing, dampen the speed with which those memories must inevitably fade. Perhaps someone has snuck into the dark spaces, the interatomic recesses, the quark-quark interface, of the cesium NIST-F1 clock in Boulder, Colorado, and monkeyed with its current accuracy of +/- 1 second in 60 million years--perhaps sped it up by a second or two.

Perhaps I am getting old.

But what is age but the accumulation of experiences? In the last 4 months, we:

...moved out of our little duplex and put all of our belongings into a storage facility located somewhere on the Columbia River

...moved into the basement of LL's parents, for the rare times we weren't traveling

...deposited a check on the one place available for rent in Omak, sight mostly unseen

...ran the lower Salmon River from Hammer Creek to Heller Bar for 5 glorious days and 3 glorious nights and 1 Hells Canyon thunderstorm night, including
--an unforgettable trip though the left-hand side of Snowhole Rapids by my brother Hans and my friend Tyler's brother James,
--a gourmet menu of mole enchiladas by my mom, quinoa salad by LL, and home-made cinnamon rolls (overnight sleeping bag rise action) by Tyler and Loren,
--37.5 gallons of water pumped from side streams using our REI filters

...flew into the world'd 3rd-largest city before traveling further to the 400-person village of Cabo Pulmo and snorkeling the only coral reef on the west coast of North America

...flew back into the world'd 3rd-largest city before traveling, in a truck whose engine exploded (required not only a mechanical fix but also a bribe to the local police to look the other way), on to the loud, dirty, blah blah blah city of Cuernavaca for 2 weeks of outstanding language classes and horrendous host family stay (think hot dogs, chicken nuggets and cold showers)

...finally traveled a 3rd time back to Mexico City where we visited the Frida Kahlo Museum (incredible) and managed to not be mugged

...flew back to the US, had a couple days in Seattle, drove out to Omak where our belongings magically materialized, unpacked with the help of LL's parents, drove back to Seattle

...woke up at 4AM to catch a flight to Minnesota, where we rented a car, bought the audio-CD version of "Three Cups of Tea" by Greg Mortensen, and listened to his incredible story as we drove up to the Gunflint Trail near Canada

...joined my dad for the first couple days of a canoe trip, during which we had our food broken into by bearaccoomooses, ran out of cooking fuel, and generally had a great time

...drove down to the Twin Cities to stay with LL's aunt and uncle, who spoiled us silly with food, wine, and entertainment, before going to one of LL's friend's wedding, and then, to celebrate our own 1-year anniversary, stayed at a downtown hotel and saw the musical "Wicked"

...returned to the Emerald City for one last week with LL's parents and a wonderful send-off party before packing up our almost-final belongings and driving out to Omak to start work.

And now here we are. Somehow I feel better, and I haven't even gone into these first 3 weeks of work, which have included our first hospital calls, my first deliveries in this new hospital, a trip with our beautiful little 14-foot sailing boat out to Omak Lake, the discovery of a local Slow Food group and a co-op and new friends.

In fact, as I reflect on this time, process this speed, I realize how incredibly grateful I am to be here, alive, healthy,
able to be doing the work I want to be doing,
sharing this experience with the love of my life,
here, alive, healthy,
here, alive, healthy,
here, alive, healthy, repeat.

Patch Adams

Started on June 6, 2010

Until this morning I had shyed away from news of the Gulf Oil Spill. It seemed a tragedy too enormous to comprehend, much less do anything about. And my fears were not unreasonable. If anything, after reading an article my sister-in-law wrote and following that up with some Democracy Now! coverage, it is worse than I imagined—worse, probably, than most of us could imagine, in no small part because we really have no idea how bad it is. Even BP officicials quietly acknowledge that the amount of oil could be 10 times what we think it is. Already it is turning the entire Gulf of Mexico into one giant dead zone. By next summer, the Gulf Stream could carry that up the Atlantic coastline.

In the face of such overwhelming news, it might seem an odd or even inappropriate time to dedicate one of only two posting in two months to Patch Adams.

And yet I think to Patch Adams I owe in some small way the fact that I am writing at all. In the midst of everything happening in the outside world, LL and I have begun to prepare for our move this fall to remote Omak. As part of that preparation I've been sorting through old paperwork with the not-always-successful goal of throwing most of it away. In such manner I came across a paper I'd long given up for gone: my introductory words welcoming Patch to speak at Johns Hopkins.

Below are two excerpts from the beginning and the end of that introduction; the beginning was mostly logistics and a discussion of how it was that I'd met some resistance to bringing Patch to campus. Apparently he'd come a few years earlier and there was a small but vocal minority who didn't want him to return. So Patch called me up and offered to come for free, and the funds that we raised to thank him were matched by a sympathetic undergraduate dean to give to a local women's shelter.
...

When Patch came to speak at Wesleyan in my junior year there, it was as if someone put into words all the things that I already knew were important in life. I've had a similar reaction when reading the work of Daniel Quinn, and one of the things that struck me was that neither Adams nor Quinn encourages anyone to emulate them blindly. They share a strong belief—based on observation of trends in population, the environment, culture, and politics—that the world society we've created is unsustainable. They also feel that change would, rather than the conventional wisdom of "having to give things up," make us immeasurably richer. But we must find this for ourselves. Patch also said, "If you need a friend, write to me, and I will write back." So I wrote, and he not only responded to that first letter, he remembered who I was and always built on our friendship in correspondence over the years to come.

...

In pondering [my own experience], I couldn't honestly fathom [that some people had responded unfavorably to Patch] until I asked myself: what might I myself find dangerous about this doctor, this clown, this person who had written to me as a friend?

I believe Patch Adams is dangerous to those parts of myself that say, "That's just the way it is."

I believe Patch Adams is dangerous to those parts of myself that say, "Just get through today, and tomorrow you can be revolutionary." Those parts that say, "I'm too busy with school and stressed out to have fun, much less help anyone." Those parts that say, "These four years of college and four years of medical school and 3 or 4 or 14 years of residency and 50 years of paying off debts will be really tough, but then, (if I'm still alive) I'll take a break." And you might laugh, but there are times when it feels like this is the mentality I need just to survive medical school!

Patch Adams is dangerous because he's saying, "Make revolutionary work itself the break." I think Patch is dangerous not because hes's crying out against injustice and the direction our planet is taking—there are numerous folks out there telling us how bad things are—but because he's actually trying to make an alternative work, and he's having the time of his life doing it. If Patch Adams were advocating an alternative program, I don't think he would get such a strong reaction. If he were saying, I want you to recycle more of your Coke cans, and take public transit instead of your car, and water your houseplants on Wednesdays, we could write him off. Because all of these things—while they're good programs—aren't really going to transform our society. Patch is dangerous because he has a different vision. Patch is saying that we can make helping our planet and its people the most fun thing ever imaginable. And that we have within ourselves the power to make that change—that I do, and that you do.

Thus I challenge you tonight to ask yourself not just what you can do to help, but how you can do it so that nothing else could be more fun. In conjunction with Physicians for Social Responsibility and several student groups, we will be arranging a follow-up forum of the ideas of Dr. Adams in the context of medicine and social justice, and I invite any of you who are interested to join us. Regardless, I ask you tonight to listen to the words of Patch Adams, and to think about what they mean for you and your community.

I was going to close my introduction with a quote oft attributed to Nelson Mandela but actually from Marianne Williamson which talks about how our greatest fear is not being inadequate but rather being powerful beyond measure, because I think this quote applies to Dr. Adams. He is letting his own light shine, and giving all of us permission to do the same. But rather than recite that quote, I think it would be an injustice for me to not share with you what is for me Patch's most important message. Once this spring when Patch left a message for me, I called him back and said, "My room-mate told me there was a message on our answering machine, but I thought it was just my friend!" Patch said, "I want you to erase that word 'just' from your vocabulary. If anything, I'm a 'just.' To have a friend is gold; that is the gold of life!" And so forgive me for taking this opportunity to say,

"Thank you, my friends, for all your incredible work in making tonight possible. I would like you to meet Patch Adams."

Thousand-dollar diarrhea

56 hours ago I awoke with terrible stomach pains and over the remaining hours of the night vomited three times. In-between vomiting I was kept from sleep by cramps which progressed to diarrhea with accompanying exhaustion, and with each passing minute I saw my hopes of going to work fade. When day broke I finally slept. For the next 24 hours I would be intermittently awoken by the dire urge to go to the bathroom, after which I would sip on gatorade before drifting back to an uneasy slumber.

During this time I missed my most productive workday of the week, wherein, because I start at 7:30AM and often work until midnight plus or minus a few hours more for a delivery, I might earn up to $1000.

Which leads me, 56 hours later and with stomach cramps slowly subsiding, to reflect on where I stand in the global scale of wealth.

Let's say that I worked 100 of these 24-hour clinic+call shifts for $100,000 a year. According to Global Rich List, such an income puts me in the top 0.66% of earners worldwide. If I earned a tenth of that—$10,000 a year—I would still be in the top 13%, with 87% of the world's population earning less. Even at $1000 a year—the amount I missed in a day's work because of a GI bug—I would be in the top 44%, meaning that greater than half of the world survives on less, which is less than $3 a day.

One limitation of this website is that it doesn't delineate the breakdown of salaries greater than $200,000. This might not seem to matter, except that in this tiny fraction of people most of the wealth is concentrated, and the further to the right of the wealth-vs.-number-of-people graph one goes, the steeper the curve.

A site which gives a better idea of this graph, which looks like a reverse letter "L", is called just that: The L-Curve. The L-curve site focuses on America alone. Since America has a median income of $40,000, it's like taking the final three person icons on the Global Richlist site (the top 3% of all earners) and expanding them in detail. The results are shocking.

If income is stacks of $100 bills, America's median of $40,000 is a stack 1.6 inches high. For an income of $100,000, the stack is 4 inches high; for $1 million it is 40 inches high. $1M is reached at "one foot from the goal line"; population is plotted along a football field with the median income at the 50-yard line. One has to zoom out to appreciate the full scale. At $1 billion worth of income, the stack is 1km high. Using what it says was an estimate of Bill Gates's greatest increase in net worth in 1 year of $50 billion, the final stack of bills is 50 kilometers high.

I went to Forbes.com to confirm this. While wealth is not equal to income, the spread is the same. As of 2010:

-There are 1,011 billionaires

-The richest 51 billionaires control over $1 trillion dollars

-The world's 3 richest men control assets greater than the combined GDP of the world's 71 poorest countries (using CIA - The World Factbook, 2009)

-If one of these men lost money because of diarrhea in commensurate fashion to my 2-day loss, that bathroom break would cost him...one billion dollars.

Unsettling, to say the least.

So. Clearly we non-billionaires don't at this time have the power that money commands. On the other hand, there are 1000 of them, and more than 6 billion of us. I cannot help but think of the Jimi Hendrix quote, “When the power of love overcomes the love of power, the world will know peace.”

Such are the reflections of an unquiet stomach, which as I write is quieter already.

Optimism II

It is Sunday night. There is a long list of things that I could have, should have, would have (if only the [blank] hadn't gotten in the way) completed, things that are probably more important to be working on right now than this.

In my fourth year of medical school I participated in an amazing--truly, amazing--elective called HEART. Loosely, this spells "Humanistic Elective in Alternative Medicine, Activism, and Reflective Transformation." (A week ago was my five-year reunion, and the first reunion I've missed in these five years.) This elective marked my first formal exposure to the idea of nonviolent communication, or NVC.

Among other things, NVC encourages taking responsibility for one's own feelings and actions. To restate my first paragraph, I chose to do other things instead of the items on the "long list." I don't regret any of the things I chose, just as I don't regret doing the things I chose to do the previous weekend instead of going to the HEART reunion. At the same time, I did really want to go to that reunion. And I did really want to get to the things on my ever-evolving list.

The truth is that right now I am struggling.

I am struggling to try to keep up with things I want to do, things I said I would do, things I have hoped to do, things I've chosen not to do yet because I've chosen to do other things.

Years before the HEART elective, I had another amazing opportunity, namely to serve in the Peace Corps in South Africa. After several months working with township grade schools my job description was pretty clear in my mind. It was to get the teachers to stop hitting the students. This seemed fundamental. Yet the application of it was so complex, nuanced, daunting. How does one maintain order in a 30-minute class crammed with 60 students and armed only with a textbook in Afrikaans from 1952? How does one contend with parents' expectations that a classroom should be run as they experienced it, with a sjambok? How does one reverse the mental effects of Apartheid? How quickly can they be reversed?

One afternoon, after a particularly disheartening schoolday, I returned home only to find my normally pacific host mother stormy and my 8-year-old host brother crying. I can't recall the offense. Only the punishment. After briefly comforting 8-year-old Zama I recognized in myself the need for air, breath, wide open space, something, anything to escape the choking anger and hurt that threatened to cut off my airway.

I walked. Out of the township and back up the hill towards the railroad and the open veldt. Crying. Overwhelmed.

Halfway up I heard a familiar voice. I turned to find my best friend, 17-year-old Jeffrey Nkosi, running after me. His bright voice was tinged with concern. "Hey, my man! Why are you crying, my man?" In sobs and starts my responses, my story, my frustration and sense of helplessness at taking on this enormous task, found their way out. As they did, ever so slowly, the edge to the day softened. By the time we crested the hill and turned to walk along the coal-strewn railroad tracks, my tears were gone, and Jeffrey was inviting me home to share a loaf of bread with tea. "A half a loaf is better than none, you know?"

The answer is that one doesn't reverse 50 years of Apartheid, hundreds of years of poverty and oppresion. That task, as do most things worth pursuing, takes at least two. Just as there are few things more overwhelming than taking on a struggle alone, there are few things more empowering than finding comrades with which to share the struggle.

Remembering that I am not alone, I feel better. The list will still be there in the morning. Jeffrey, wherever you are, thank you.

Stillness

April 9th, 2009, Halfway, OR:
Stillness is usually the first thing I notice about coming home to my dad's house in Halfway. This time that was not the case, because yesterday was my dad's 70th birthday, and we threw him a surprise party. All the plans were in place: the false premise of a party a couple days later, the Higginses with a birthday cake comprising the initial sortie, the congregation at the bottom of the hill and the subsequent walk up. It was perfect. And in inimitable Hammar fashion, Dad took off in the car with our dog Hugo to go for a walk just half an hour before the Higginses were supposed to show up. I arrived after the eight-hour drive from Seattle to find my older brother circling on his bicycle at the end of our lane, hoping to divert all cars until Dad returned. A few minutes and several cars later we made the impromptu decision for everyone to go up the hill. I ran up and down the hill several times in the next hour as we awaited Dad's return—eventually he arrived home, was completely surprised, and the party was enjoyed by all—and did not really feel like I caught my breath until I went do bed that night. So my usual awareness of the stillness was postponed until today.

I wake up, for the first time in weeks, not to an alarm clock but to the rising of the sun. I get up and feed Hugo. We humans feed variously on granola (not Dad) and ham and eggs (Dad). Hugo and I go for a walk.

The sun is bright. The air is crisp and still quite cold and several large patches of snow blanket the ground. We climb to the upper bench, walk through a stand of pine trees that when I was growing up were Christmas-tree size and now reach 30 feet or more. Where the ground is bare it is still flattened, whether grass, leaves, or pine needles, only recently having shed an enormous weight. We walk through the North Gate. A ditch runs along the top of the ridge, eroded in places by cattle, and I have to find a place that is both shallow enough to jump and free enough of hawthorn bushes to permit passage.

An old dirt road leads from the ridge down into a marsh and up and over another hill. Here selective logging has thinned the pines enough to allow the sun to shine through in several places, the ground is dry and almost sandy; it would make an ideal home for the rabbits of Watership Down. Over the other side of the hill is another marshy flat with slowly flowing water that occasionally coalesces into a little brook.

In the center of the marshy flat nature is quickly reclaiming a cabin and a shed long abandoned by their builders. Three ancient relics of cars are more slowly decomposing. What looks to be an International Harvester pickup truck is but a rusting shell, while the tailfins of a '59 Cadillac still burst with their original, albeit-faded, lemon yellow color. A few stubborn pieces of glass remain in one rear side window. The third car, a convertible by design or destruction, is now undergoing its final metamorphosis into a truly open-air design.

As I cross over a barbed-wire fence and head back up into the woods that will eventually lead me home, it strikes me how indelibly we've altered the landscape even here in the tiny, remote Eastern Oregon town of Halfway. True, some of its former habitations are now dissolving into the ground whence they sprang up. In places fences sag or are gone completely. Trees once cleared for pasture are re-growing where permitted. But some changes may take longer to reverse. The beggars lice weed synonymous with livestock is now ubiquitous. Natural predators—grizzlies, mountain lions, wolves—are scarce or absent.

And yet in places like Halfway there is still stillness. There is still ample space and time for reflection, about the pace and nature of change, about presence of weeds and lack of wolves, about anything. This is less true in the city. At least for myself, I feel an unavoidable pull into motion when I am in Seattle, a raft pulled along by a current into what at times seems an unending rapid. Part of this has to do with density of humans, and perhaps part of it might have to do with most of those other humans seeming as though they are also struggling to keep their heads above the waters of a fast-paced river. Unless one makes a conscious effort to the contrary, this pace can lead to human interactions being shorter and more superficial. Needing to have more packed into any given time frame. Containing less stillness.

In the 70 years since my dad was born, the physical landscape of the earth has been altered more by human activity than in the 10,000 preceding years combined. We are now living in a landscape that is more different from that of 70, or certainly 170 years ago, than the landscape of those times differed from that of 10,000 years ago. And now since the time I was born an entirely new landscape is being created. This virtual landscape, that of the world online, is farther removed even than our cities from the natural world of fields and forests—the world from which all that we eat derives, the world in which once we ourselves were occasionally eaten, the world that, through an incredibly complex and varied symbiosis of millions of living organisms and natural cycles, gives us the air, water, and food essential to life. This new landscape is more prone to more and more packed and superficial interactions. By its very nature, of always being in creation, always being revised, improved upon, changed, it is anything but still.

I would be the last to say that we should not embrace this landscape, for it also contains an incredible potential to inform, to share ideas, to instantly access information that can help us make better decisions and to make them faster. At the same time I think it will be vital for us as a species to spend time in the stillness that can only be found outside, offline and unplugged. We are and always will be dependent of that landscape. And probably too on that stillness.