Dear Lord,

I hear your message today – do not fear. And yet so much of my life is about fear. So much of my life is about fearing what you are calling me to, fearing stepping off that boat, fearing that I will sink in the black murky water, and there will be no hand to pull me out.

Lord, I don’t see you even when I know you are there. I get so caught up in the hurry, bustle, stress, crisis, that I don’t see you. I don’t know you are enough, I don’t know that you are working all around me continually. I look for glimpses of you, of you “doing something cool,” when the truth is you are interwoven in every moment, and that your hand is always there as we sink into darkness.

Lord, I fear every day. I fear getting up every morning. I fear being overworked. I fear the empty spaces when the crises have passed and there is now unoccupied brain space. I fear what is left of me in those times. I fear there is nothing. I fear for the future, that I will be alone, becoming more and more drawn into myself, more attached to my routine, more tired, until I cannot focus out at all.

I fear disorganization. I arrogantly fear when I realize that I cannot keep up with everyone, I cannot be on top of all the problems of those around me. Every day I orchestrate a complex dance, with the illusion I am in control, the illusion that I can stay on top of everything…But deep down inside knowing that one unexpected event could shatter the whole thing to pieces. I fear losing that control. I fear the day when the house of cards comes falling down. What then, Lord? What is left of me when the external success has passed?

I fear the next steps of my career. I fear being on my own, not knowing what to do. I fear the possibility of going to Africa. I fear not listening closely enough to your call for me.

Lord, I lay these fears at your feet. Lord, you tell us not to fear, but only believe. You tell us perfect love drives out fear. You tell us you will guide and lead us. You tell us not to fear because you are our God. Lord, I want to knit this into my soul. I want to trust in you. Lord, I want to look for you to fill my empty spaces. Lord, I want to step into the blank slate, the unknown of the every day, stepping onto that unseen bridge, knowing that there will be solid ground under my feet. Lord, I do not want to look at unfolding events with a lens of hopelessness and overwhelmed, but with the peace that you will supply all that I need, that you are there, with a hand to pull me out of the water.

The Unit

I am back on the ICU, a month I have dreaded for a while. A little scary to be the senior resident on a month where you have to lead codes, where daily you make decisions affecting people’s mortality, etc. That said, it has been ok. I have been working with the right people, and I have had what I needed to handle any given situation at any point. Thank God. It is a tenuous balance. I led my first code without incident, put in more lines than I can count. Dealt with strokes, heart attacks, brain herniations, death, sepsis. Have gotten commended in the morning on some decisions, on others got yelled at and called an idiot. Business as usual in the ICU.

More than ever, I am acutely aware of my own mortality. Every day people show up at the ICU dancing on the line between death and life. For some of them, it is an expected outcome of a longstanding disease, for some of them, it was the result of a sudden, unexpected, life stopping event. Some of them make it out, some of them don’t. I have watched families cry at the bedside, I have watched patients breathe alone on the ventilator, and wondered where there families are. I have watched peace in some people’s eyes as they depart from this world, knowing there is something better beyond. And fear in others, as they realize they are losing control.

And in this life, with air thick and fogged with emotion and death, I feel like I am treading through. Wanting to grab onto my own family, want to make my life meaningful. I get addicted to being in that transitional space, while at the same time wanting to run away and sleep for days.

7 more days.

I need you every day

Dear God,

Lord, I am empty.
My body is tired,
my emotions unstable,
my perspective smashed;
any hope and glimpse of you I quickly brush aside as it drowns in my worries and daily cares.
I am in need of you every day.
There is no day I can get through without you.
My worth as a child, meaning, drown in the messages of the world.
And Lord, I cry out to hear you.
I cry out every day.
And as a drowning victim claws onto driftwood rushing by,
I claw onto the glimpses given of you.
Keeping me afloat for a moment

Lord, teach me to swim.

I need you every day.
Not just when I am at the end of my rope.
Not just as a last resort.
I need you to keep me afloat.
To be my raft and keep me stable in the wind and waves.

I cannot control the every day.
I try to see and to learn
But ultimately, the outcome is up to you.
Help me to trust things into your hands.
And not into my illusion of control.

Lord, help me to see you in the darkest of moments
Help me to hear your voice above others
Help me to be a voice of hope and encouragement when none exists.
Help me to love and not be quick to anger.

Lord, I need you every day.
Teach me to swim.

Eva...My last patient essay, now 2 months old

Midnight, the melancholic mood of the evening sets in. And I get called to her room, a wild little thing, thrashing like an animal. Hair unruly and tangled, face full of bruises and dirt. Feet and legs scratched and burned, a baby cub that ventured out of the lair too soon and whose bravado let a creature bigger than her take over.

But despite the fight and scrappiness of this little girl, she is a scared little puppy, and I know she didn’t try to take anything bigger than her on. I feel fatalistic, that this situation she has been raised in has turned her into a little animal, and wonder if she can ever really recover. Maybe in the future she can regain a semblance of normalcy, and perhaps even appear normal to the outside world, until some part of that inner animal, that was taught to fight at early age kicks in…I wonder how much of that you can undo.

The next morning, I go to her room. Her covered crib, it strikes me how much those cribs look like enclosed cages, kennels, when you have a child you are trying to control. I approach slowly, just like I would a scared animal. I speak to her softly from outside her cage, offer a hand through the bars and pat her head a little to show her that I am not going to hurt her. And as she acclimates to my presence in the room, I open her little cage. Before I can even get the bars all the way down, she outstretches her arms and tumbles onto me, her spindly arms and legs wrapping around me and holding tight. Wanting to be protected, wanting to be safe in someone’s arms, burying her little face with it’s wild hair into my shoulder. She even throws her wounded, infected, burned foot around me, without carefulness to avoid touching the tender parts. And I realize that despite the animal instinct in this child, she is still love, she is still wanting that basic need met. And like an animal fighting for survival despite a deadly injury, her instinct ignores the pain so that she can keep going to reach survival. Where she can be taken care of and someone else can take over. I walk around with her a little bit to give her a break from her crib. To my surprise she can talk, and can point things out to me. She takes my stethoscope off and puts it in her ears, putting then the bell to her own heart to listen.

Because I am not allowed to ignore the fact that I still have work to do, I sit her in my lap while I am making calls and writing notes. And within minutes of sitting, she is thrashing, screaming, and I don’t understand…Until I have to put her back in the crib, and she is hard to console. Today it was the same pattern.

And hours later, it strikes me. She latches her body around me, hoping I am going to be her vehicle, transport out…To survival…And like a little refugee, she is fighting, screaming, everything in her is trying to get that last seat on the convoy going out. Like it is her last chance.

This breaks my heart and brings tears to my eyes as I realize what she is trying to do. That at 19 months her instinct for survival is so strong, and she is so smart and intuitive, so resourceful, trying to use everything she can to escape this mess. And again I feel fatalistic, because I know that chances are that she is not going to have a happy ending. The goal of the foster system is to reunite children with their families and unless something drastic happens, she will likely be back in her mother’s house.

Despite my deep sadness about what this girl’s life is and what it will bring, and what she has already overcome, I see some beauty in her spirit. In who she is, and who this has already made her. And I wonder, how can I see so much beauty in the “human spirit” of another, when I am so apt to allow my own spirit to give up?

Crank-ster

I am cranky today.

It is my day off, after 28 days of intense senior-ing on the wards. A full census of patients always, 11-12 hour days, 31 hour calls...Delving into the depths of darkness of people's lives...Having to be "on" all the time, only receiving criticism no matter how hard I work, pointing out the one thing I missed.

I am cranky today as I think about what needs to be done (cleaning, etc), feeling lonely, feeling like I need to exercise but can't get up the motivation to do it...and feeling like I have to make today count because tomorrow starts another week of insanity: 10am-8pm for 7 days straight, running the VA ER.

I can't feel thankful for my day off today.

I spent some time praying with God. And needed to acknowledge that it is ok for me to feel exhausted. And maybe all I need today is not to meet my own expectations or anyone elses but just to chill out and "be." And I think all this crankiness today has to do with feeling a month's worth of my own un-met needs, as well as falling behind on the needs of others that I have committed myself to...

All that spewing aside, I am going to lay on the couch, and watch TV and ignore everything else that I "have" to do, and maybe that will be the best thing for me...

New Hope in the Arabs v. Jews

So I woke up today feeling a little discouraged and down...Nothing more, really, than working in the ER until 4am, then sleeping until 2pm to catch up...Waking up in the middle of the day always leaves me feeling a little off the normal cycle of life, more disconnected with the world. I decided to try to pick myself up with some coffee and pumpkin bread and the newspaper, and I found some news, from a hopeless-seeming part of the world that left me really encouraged.

In the recent Israeli attack in Gaza, as usual, people are taking their sides, pointing blame, staunchly refusing to see the other side. Which I find discouraging always. But Prince Saud of Saudi Arabia made the following comment which I find encouraging: "This terrible massacre would not have happened if the Palestinian people were united behind one leadership, speaking in one voice...we are telling our Palestinian brothers that your Arab nation cannot extend a real helping hand if you don't extend your hands to each other in love."

Now, I find that encouraging...No secret or suprise, being an Arab, I have some strong feelings on the conflict in Israel. Although I absolutely do not think that either side is blameless, it makes me a little nuts that the US government and largely the church blindly support Israel, at the expense of the Palestinians. I hate that the government ignores the suffering of the palestinian people, that they ignore that they are living in refugee camps, constantly surrounded in violence, having their homeland yanked from under them, without hope for a future. I hate that the church blindly supports "God's chosen people," without realizing that the Palestinians are also God's children (and many of them Christians!), and that they are also suffering under the hand of injustice...

All that said, it is discouraging to me that people on both sides of the conflict refuse to even consider thinking about the other side's viewpoint. People are so embittered in years of conflict and loyalties that there is no compromise, no understanding. Why I love Prince Saud's remark is this: he is an Arab, he clearly sides with the Arabs, but he doesn't jump to blaming Israel for the recent massacre, he is somewhat retrospective about his own side of the conflict. I know many people would disagree with me on this, but I find this to be a small piece of hope in a world filled with conflict and misunderstanding. He talks about Palestinians loving each other first...And I find a great parallel to our own lives: when we don't love ourselves, we don't love others well...I know I am probably being a little too rainbows and unicorns about this remark, and extrapolating way too much, but i do find it to be a bright spot in a somewhat hopeless world.