McDoc

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Poems for December 2012

Posted by mcdoc on December 7, 2012

Ronald Wallace
(1945 – )

The Truth

for Amy

Her breast cancer, she said,
had metastasized to her liver;
she was going to die, and
soon. She said it made her
sad. I didn’t know her well.
We were co-workers and
I liked her, but
what do you say when someone
actually answers the question
how are you?
with the unvarnished truth:
Not well, she said. I haven’t
long to live. And should I
have said Oh you will! Should I
have smoothed it over
with the syrup of nervousness,
or done what I did
which was to
talk about terror and anger,
the unfairness and the lie,
to take the truth at face value?
No, she was just sad, she said.
She had her faith, she said,
and started to cry. And only then
did I see what she needed from me
was miracle, a simple belief
in miracle, and if that was varnish,
well, it would bring the grain
of the truth out, would save it
from wear and weather.
It would make the truth
almost shine.

“The Truth” by Ronald Wallace, from Long for this World. © University of Pittsburgh Press, 2003. Reprinted with permission.

David Wagoner
(1926 – )

The Escaped Gorilla

When he walked out in the park that early evening
just before closing time, he didn’t take
the nearest blonde in one arm and climb a tree
to wait for the camera crews. He didn’t savage
anyone in uniform, upend cars
or beat his chest or scream, and nobody screamed
when they found him hiding behind the holly hedge
by the zoo office where he waited for someone

to take him by the hand and walk with him
around two corners and along a pathway
through the one door that wasn’t supposed to be open
and back to the oblong place with the hard sky
where all of his unbreakable toys were waiting
to be broken, with the wall he could see through,
but not as far as the place he almost remembered,
which was too far away to be anywhere.

“The Escaped Gorilla” by David Wagoner, from A Map of the Night. © University of Illinois Press, 2008.

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Poems for June 2012

Posted by mcdoc on June 1, 2012

Raymond Carver
(1938-1988)

What the Doctor Said

He said it doesn’t look good
he said it looks bad in fact real bad
he said I counted thirty-two of them on one lung before
I quit counting them
I said I’m glad I wouldn’t want to know
about any more being there than that
he said are you a religious man do you kneel down
in forest groves and let yourself ask for help
when you come to a waterfall
mist blowing against your face and arms
do you stop and ask for understanding at those moments
I said not yet but I intend to start today
he said I’m real sorry he said
I wish I had some other kind of news to give you
I said Amen and he said something else
I didn’t catch and not knowing what else to do
and not wanting him to have to repeat it
and me to have to fully digest it
I just looked at him
for a minute and he looked back it was then
I jumped up and shook hands with this man who’d just given me
something no one else on earth had ever given me
I may have even thanked him habit being so strong

“What the Doctor Said” by Raymond Carver from A New Path to the Waterfall. © Atlantic Monthly Press, 1989.

Dana Gioia
(1950 – )

Finding a Box of Family Letters

The dead say little in their letters
they haven’t said before.
We find no secrets, and yet
how different every sentence sounds
heard across the years.

My father breaks my heart
simply by being so young and handsome.
He’s half my age, with jet-black hair.
Look at him in his navy uniform
grinning beside his dive-bomber.

Come back, Dad! I want to shout.
He says he misses all of us
(though I haven’t yet been born).
He writes from places I never knew he saw,
and everyone he mentions now is dead.

There is a large, long photograph
curled like a diploma—a banquet sixty years ago.
My parents sit uncomfortably
among tables of dark-suited strangers.
The mildewed paper reeks of regret.

I wonder what song the band was playing,
just out of frame, as the photographer
arranged your smiles. A waltz? A foxtrot?
Get out there on the floor and dance!
You don’t have forever.

What does it cost to send a postcard
to the underworld? I’ll buy
a penny stamp from World War II
and mail it downtown at the old post office
just as the courthouse clock strikes twelve.

Surely the ghost of some postal worker
still makes his nightly rounds, his routine
too tedious for him to notice when it ended.
He works so slowly he moves back in time
carrying our dead letters to their lost addresses.

It’s silly to get sentimental.
The dead have moved on. So should we.
But isn’t it equally simpleminded to miss
the special expertise of the departed
in clarifying our long-term plans?

They never let us forget that the line
between them and us is only temporary.
Get out there and dance! the letters shout
adding, Love always. Can’t wait to get home!
And soon we will be. See you there.

“Finding a Box of Family Letters” by Dana Gioia, from Pity the Beautiful. © Graywolf Press, 2012. Reprinted with permission. (buy now)

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Poems for April 2012

Posted by mcdoc on April 13, 2012

Wesley McNair
(1941 – )

Old Guys

Driving beyond a turn in the mist
of a certain morning, you’ll find them
beside a men-at-work sign,
standing around with their caps on
like penguins, all bellies and bills.
They’ll be watching what the yellow truck
is doing and how. Old guys know trucks,
having spent days on their backs under them
or cars. You’ve seen the gray face
of the garage mechanic lying on his pallet, old
before his time, and the gray, as he turns
his wrench looking up through the smoke
of his cigarette, around the pupil
of his eye. This comes from concentrating
on things the rest of us refuse
to be bothered with, like the thickening
line of dirt in front of the janitor’s
push broom as he goes down the hall, or the same
ten eyelets inspector number four checks
on the shoe, or the box after box
the newspaper man brings to a stop
in the morning dark outside the window
of his car. Becoming expert in such details
is what has made the retired old guy
behind the shopping cart at the discount store
appear so lost. Beside him his large wife,
who’s come through poverty and starvation
of feeling, hungry for promises of more
for less, knows just where she is,
and where and who she is sitting by his side
a year or so later in the hospital
as he lies stunned by the failure of his heart
or lung. “Your father” is what she calls him,
wearing her permanent expression
of sadness, and the daughter, obese
and starved herself, calls him “Daddy,”
a child’s word, crying for a tenderness
the two of them never knew. Nearby, her husband,
who resembles his father-in-law in spite
of his Elvis sideburns, doesn’t say
even to himself what’s going on inside him,
only grunts and stares as if the conversation
they were having concerned a missing bolt
or some extra job the higher-ups just gave him
because this is what you do when you’re bound,
after an interminable, short life to be an old guy.

David Whyte
(1971 – )

Sometimes

Sometimes
if you move carefully
through the forest

breathing
like the ones
in the old stories

who could cross
a shimmering bed of dry leaves
without a sound,

you come
to a place
whose only task

is to trouble you
with tiny
but frightening requests

conceived out of nowhere
but in this place
beginning to lead everywhere.

Requests to stop what
you are doing right now,
and

to stop what you
are becoming
while you do it,

questions
that can make
or unmake
a life,

questions
that have patiently
waited for you,

questions
that have no right
to go away.

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Poems for February 2012

Posted by mcdoc on February 9, 2012

Ann Campanella

Mid February

The day is warm and dank as early summer.
Crows scream and pitch in the woods
like the ruckus of old women fighting
for the shreds of their lives.

A sudden silence — then the hum
of a black-winged cloud oozing
through the naked sky —
the ruckus begins again.

Under the layers of winter grey,
the farm is pale and muted, the barn doors
shut tight. The only animals in sight
an earth-brown squirrel and these harbinger birds.

I am waiting for the sun to shine again,
to learn how to unfurl my heart in its warmth.
These days, neither long nor short, bright nor dark,
wet nor dry, fill me with a sadness I cannot name.

Yesterday was Valentine’s Day, a day of love
and chocolate. My father, born eighty-one years ago,
always bought red cardboard hearts full of truffles
for my mother, my sister and me. Now he is gone.

This morning, the doctor taps his pencil
against the screen. A six-week ultrasound.
There, that’s the heartbeat.
A tiny flutter outlined by grey.

Joseph Mills

The Husband

He comes every day to eat lunch and sit
with her in the sun room. Sometimes he reads
letters out loud from their children or friends;
sometimes he reads the paper as she sleeps.
One day the staff makes her favorite cake
to celebrate their anniversary,
and he tells how, to buy her ring, he worked
months of overtime at the factory,
so she thought he was seeing someone else.
“As if I would look at other women
when I have Pearl,” he says, shaking his head.
She begins to cry and tells him, “You’re sweet,
but I miss my husband.” He pats her hand.
“I know,” he says, “It’s all right. Try some cake.”

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Engage With Grace 2011: Occupy With Grace

Posted by mcdoc on November 24, 2011

The term “Blog Rally” was coined in 2008 with the phenomenon of concerted blogging in support of the movement called, “Engage with Grace: The One Slide Project.” Engage With Grace was organized to encourage family members to discuss what is important to them with respect to end-of-life care issues. The timing coincides with the annual American Thanksgiving holiday weekend. The idea being to capitalize on the fact that many families gather together in particular over Thanksgiving.

This is a movement you can easily get behind in person if you are an advocate for good patient centered health care, which you likely are if you are reading this blog. So donate your blog, Facebook update, Twitter account (#EWG) to Engage With Grace this holiday weekend. And then put your money where your mouth is and bring it up yourself while your family is together.

Here is the this year’s post from the Alexandra Drane and the Engage With Grace Team:

Occupy With Grace
Once again, this Thanksgiving we are grateful to all the people who keep this mission alive day after day: to ensure that each and every one of us understands, communicates, and has honored their end of life wishes.

Seems almost more fitting than usual this year, the year of making change happen. 2011 gave us the Arab Spring, people on the ground using social media to organize a real political revolution. And now, love it or hate it – it’s the Occupy Wall Street movement that’s got people talking.

Smart people (like our good friend Susannah Fox) have made the point that unlike those political and economic movements, our mission isn’t an issue we need to raise our fists about – it’s an issue we have the luxury of being able to hold hands about.

It’s a mission that’s driven by all the personal stories we’ve heard of people who’ve seen their loved ones suffer unnecessarily at the end of their lives.

It’s driven by that ripping-off-the-band-aid feeling of relief you get when you’ve finally broached the subject of end of life wishes with your family, free from the burden of just not knowing what they’d want for themselves, and knowing you could advocate for these wishes if your loved one weren’t able to speak up for themselves.

And it’s driven by knowing that this is a conversation that needs to happen early, and often. One of the greatest gifts you can give the ones you love is making sure you’re all on the same page. In the words of the amazing Atul Gawande, “you only die once!” Die the way you want. Make sure your loved ones get that same gift. And there is a way to engage in this topic with grace!

Here are the five questions, read them, consider them, answer them (you can securely save your answers at the Engage with Grace site), share your answers with your loved ones. It doesn’t matter what your answers are, it just matters that you know them for yourself, and for your loved ones. And they for you.

We all know the power of a group that decides to assemble. In fact, we recently spent an amazing couple days with the members of the Coalition to Transform Advanced Care, or C-TAC, working together to channel so much of the extraordinary work that organizations are already doing to improve the quality of care for our country’s sickest and most vulnerable.

Noted journalist Eleanor Clift gave an amazing talk, finding a way to weave humor and joy into her telling of the story she shared in this Health Affairs article. She elegantly sums up (as only she can) the reason that we have this blog rally every year:

For too many physicians, that conversation is hard to have, and families, too, are reluctant to initiate a discussion about what Mom or Dad might want until they’re in a crisis, which isn’t the best time to make these kinds of decisions. Ideally, that conversation should begin at the kitchen table with family members, rather than in a doctor’s office.

It’s a conversation you need to have wherever and whenever you can, and the more people you can rope into it, the better! Make this conversation a part of your Thanksgiving weekend, there will be a right moment, you just might not realize how right it was until you begin the conversation.

This is a time to be inspired, informed – to tackle our challenges in real, substantive, and scalable ways. Participating in this blog rally is just one small, yet huge, way that we can each keep that fire burning in our bellies, long after the turkey dinner is gone.

Wishing you and yours a happy and healthy holiday season. Let’s Engage with Grace together.

To learn more please go to www.engagewithgrace.org.

This post was developed by Alexandra Drane and the Engage With Grace team.

Posted in Blog Rally, End-of-Life, Engage With Grace, medical humanities | Tagged: , , , , | 1 Comment »

Poems for November 2011

Posted by mcdoc on November 4, 2011

Linda Hogan
(1947 – )

The Way In

Sometimes the way to milk and honey is through the body.
Sometimes the way in is a song.
But there are three ways in the world: dangerous, wounding,
and beauty.
To enter stone, be water.
To rise through hard earth, be plant
desiring sunlight, believing in water.
To enter fire, be dry.
To enter life, be food.

Ronald Wallace
(1945 – )

Obituary

Just once, you say,
you’d like to see
an obituary in which
the deceased didn’t succumb
after “a heroic struggle” with cancer,
or heart disease, or Alzheimer’s, or
whatever it was
that finally took him down.
Just once, you say,
couldn’t the obit read:
He got sick and quit.
He gave up the ghost.
He put up no fight at all.
Rolled over. Bailed out.
Got out while the getting was good.
Excused himself from life’s feast.
You’re making a joke and
I laugh, though you can’t know
I’m considering exactly that:
no radical prostatectomy for me,
no matter what General Practitioner
and Major Oncologist may say.
I think, let that walnut-sized
pipsqueak have its way with me,
that pebble in cancer’s slingshot
that brings dim Goliath down.
So, old friend, before I go
and take all the wide world with me,
I want you to know
I picked up the tip.
I skipped the main course,
I’m here in the punch line.
Old friend, the joke’s on me.

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Engage With Grace

Posted by mcdoc on November 25, 2010

Things we are grateful for this year

For three years running now, many of us bloggers have participated in what we’ve called a “blog rally” to promote Engage With Grace – a movement aimed at making sure all of us understand, communicate, and have honored our end-of-life wishes.

The rally is timed to coincide with a weekend when most of us are with the very people with whom we should be having these unbelievably important conversations – our closest friends and family.

At the heart of Engage With Grace are five questions designed to get the conversation about end-of-life started. We’ve included them at the end of this post. They’re not easy questions, but they are important – and believe it or not, most people find they actually enjoy discussing their answers with loved ones. The key is having the conversation before it’s too late.

Engage With Grace, theoneslide


This past year has done so much to support our mission to get more and more people talking about their end-of-life wishes. We’ve heard stories with happy endings ~ and stories with endings that could’ve (and should’ve) been better. We’ve stared down political opposition. We’ve supported each other’s efforts. And we’ve helped make this a topic of national importance.

So in the spirit of the upcoming Thanksgiving weekend, we’d like to highlight some things for which we’re grateful.
Thank you to Atul Gawande for writing such a fiercely intelligent and compelling piece, Letting Go: What Should Medicine Do When It Can’t Save Your Life – it is a work of art, and a must read.

Thank you to whomever perpetuated the myth of “death panels” for putting a fine point on all the things we don’t stand for, and in the process, shining a light on the right we all have to live our lives with intent – right through to the end.

Thank you to TEDMED for letting us share our story and our vision.

And of course, thank you to everyone who has taken this topic so seriously, and to all who have done so much to spread the word, including sharing The One Slide.

(To learn more please go to www.engagewithgrace.org. This post was written by Alexandra Drane and the Engage With Grace team. )

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Poems for September 2010

Posted by mcdoc on September 4, 2010

Sharon Olds (1942 – )

Diagnosis

By the time I was six months old, she knew something
was wrong with me. I got looks on my face
she had not seen on any child
in the family, or the extended family,
or the neighborhood. My mother took me in
to the pediatrician with the kind hands,
a doctor with a name like a suit size for a wheel:
Hub Long. My mom did not tell him
what she thought in truth, that I was Possessed.
It was just these strange looks on my face—
he held me, and conversed with me,
chatting as one does with a baby, and my mother
said, She’s doing it now! Look!
She’s doing it now! and the doctor said,
What your daughter has
is called a sense
of humor. Ohhh, she said, and took me
back to the house where that sense would be tested
and found to be incurable.

W.S. Merwin (1927 – )

September Plowing

For seasons the walled meadow
south of the house built of its stone
grows up in shepherd’s purse and thistles
the weeds share April as a secret
finches disguised as summer earth
click the drying seeds
mice run over rags of parchment in August
the hare keeps looking up remembering
a hidden joy fills the songs of the cicadas
two days’ rain wakes the green in the pastures
crows agree and hawks shriek with naked voices
on all sides the dark oak woods leap up and shine
the long stony meadow is plowed at last and lies
all day bare
I consider life after life as treasures
oh it is the autumn light
that brings everything back in one hand
the light again of beginnings
the amber appearing as amber

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Poems for August 2010

Posted by mcdoc on August 13, 2010

Wow, I had my August poems all queued up in mid-July, and then life happened. My 22-year-old son came for a very nice visit, and then to celebrate my 49th birthday, my wife and I are on vacation in Québec. Alors, voilà les Poems for August posted from our little appartement in the beautiful arrondissement du Plateau Mont-Royal de la Ville de Montréal:

Sue Ellen Thompson (1948 – )

Hospital Days

The tests, the bloodwork—they
were good days, with magazines
to absorb the time spent waiting.
The nurses’ banter spread a sheen
of normalcy over everything,
and the doctors left a little space
in their advice where spirit
might lodge. The three of us
went everywhere together, and at last
I knew the pleasure that the only child
takes in the company of her makers.

Then the doctor came to us one day
and said the chemo hadn’t made
the kind of progress he was looking for,
that we could take my mother home
and stay. We sat there, stunned by what
our weeks of rushing to appointments
had not left us to contemplate,
then drove home without speaking. This day,
unlike the others, would not end
with smiles and good-byes, my father’s
and my arms tucked beneath my mother’s
and hope’s modest, steady flame
still unextinguished in us at the thought
of eating supper at the kitchen table
before we called the cats in from the dark.

Eleanor Lerman (1952 – )

The City, Berobed in Blue

What do you think has come over me?
I did not feel like this yesterday
but today, all I find myself thinking is,
This could be my last apartment,
my last lover; this could be the last dog
I ever own—as if I were going to die
at any moment. Which of course
is possible (myocardial infarction,
genetic defect, lighting bolt)

The anxiety may pass, but not
the age. Yikes, every moment says
And then, Look out!

Well, what can be done but put
a good face on it? A big one,
round as a moon and glittering
to the last. Or maybe slide into
an om state, where nothing is
something and everything is
more or less of something else

Better yet, maybe it’s time to think
about the city, berobed in blue,
which now appears to me in memory
as a good place for a young girl,
who only I can recognize

See how lightly she steps off into
another, and then another morning
And as if she has never done it before,
begins to breathe

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Poems for July 2010

Posted by mcdoc on July 7, 2010

Wendell Berry (1934 – )

The Wish to Be Generous

All that I serve will die, all my delights,
the flesh kindled from my flesh, garden and field,
the silent lilies standing in the woods,
the woods, the hill, the whole earth, all
will burn in man’s evil, or dwindle
in its own age. Let the world bring on me
the sleep of darkness without stars, so I may know
my little light taken from me into the seed
of the beginning and the end, so I may bow
to mystery, and take my stand on the earth
like a tree in a field, passing without haste
or regret toward what will be, my life
a patient willing descent into the grass.

Lisa Furmanski (1969 – )

The History of Mothers of Sons

All sons sleep next to mothers, then alone, then with others
Eventually, all our sons bare molars, incisors
Meanwhile, mothers are wingless things in a room of stairs
A gymnasium of bars and ropes, small arms hauling self over self

Mothers hum nonsense, driving here
and there (Here! There!) in hollow steeds, mothers reflecting
how faint reflections shiver over the road
All the deafening musts along the way

Mothers favor the moon—hook-hung and mirroring the sun—
there, in a berry bramble, calm as a stone

This is enough to wrench our hand out of his
and simply devour him, though he exceeds even the tallest grass

Every mother recalls a lullaby, and the elegy blowing through it

Audio file of the poet reading her poem.

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