Saturday, January 31, 2009


As much as I have complained about this harsh winter, there is something about it that I find deeply satisfying: at least the landscape is achieving the emptiness that is eluding me. Yes, I have been fretful. "I love to complain!" I announced at work after a small rant. When I am not fretting, I am plodding through the day, wanting it to be over, over, over so I can scuttle off into some hibernating solitude. At work I whipsaw between this naysaying, involuting irritation and the stance of listening, empathy and openness that seeing patients requires. I find myself using more and more hand sanitizer at the exam room doorway, for the small moratorium it affords as I rub the foam into my skin. Then I grit my teeth, knock, enter, introduce myself and Bartleby scuttles off to sulk and glare at me from somewhere under the corpus callosum. It's dizzying.

So finally, last Saturday morning, I bundled up and went to the river. I have not spent enough time outdoors lately, and it felt good to be out in the cold with my camera. The act of looking supplants everything. The bitching Bartleby and the listening-by-the-skin-of-her-ears doctor both take some naptime (heaven forbid they should negotiate a truce) and the world floods in -- the abstract, minimalist, winter world of branches crazing through a cold sky, and of the frigid intimacy of black water touching white ice.

I've left a string of lights up in the front window. "Isn't it time to take the Christmas lights down ?" asks DK, whose Jewish/secular sensibilities have been sorely tried by my church-related activities.

"I know Christmas is over. They're just lights. Think of them as hippie lights," I reply.

"They make me nervous," he mutters.

Tiny, human lights in the vast winter darkness: yes, maybe tentative and improbable and imperiled as God born as a infant in a manger, but also tentative and improbable and imperiled as our own existence.

"Receive the light of Christ," says the priest, handing a candle to the newly baptized.

The light of Christ.

As I drove home the other night there was a thin, crescent moon caught like a boat low in the trees -- a boat bearing a round, heavy, dun darkness, flinty, dusty. Around it flowed a sea of luminous black.

It's not either/or, it's both/and. Light, dark; Martha, Mary; together, alone; sound, silence; profane, sacred. We shuttle between polarities. It's all raw material, stuff stored in the atelier of our days. What will we make of it ?

Before I joined the church, I pictured to myself what belonging would be like. I placed a little effigy of me in a mock-up of a church and moved it around like a doll in a doll house. There was a certain satisfaction in that, like being a character in a story or a movie. Not unlike reading a biography of someone else.

And now, from time to time, I think "so this is what it is." Like today: sweeping flakes of crumbling stucco off the deep, sloping sills in the narthex under the Martha and Mary windows. Like ironing linen, putting numbers on a hymn board, buying groceries for the food pantry, filling the cruets with water and wine, picking up the altar flowers from the florist. I think of all the people who have moved through this big, shadowy, stone church. I think of centuries of church: altar guilds, sacristans, women and men caring for the linens and vessels used in the liturgy, that sacred dance wherein we participate in the Mysteries of God, God Incarnate, and Spirit.

So there is church, there is the river, and there is work: like a child's finger game -- this is the church, this is the river, this is work, watch the doctor shiver.

That is the koan, isn't it. To bring the same attention and affection to work as I do to the other two spheres of activity. In the exam room, oddly enough, it's not that difficult. Listening, like looking, clears the mind, facilitates itself. But what about that moment when 6 patients are queued up, all the exam rooms are full, three patients have just retiurned from xray, and the only available nurse is doing two other things, or when you've called for the third time for the stat xray readings and the patients are threatening to walk out, or when you see the name of an all-too familiar personage a few patients down on your list, presenting with yet another bout of "excruciating" dental pain or "excruciating" low back pain and the oral surgery or orthopedic appointment has been postponed for the nth time, and they need some more of that medicine, the only one that ever helps, doc, perco-,perco-, or when the EMR freezes in the middle of a complicated note, or the pharmacist calls to say the patient's HMO won't pony up for the drug you've just prescribed, or when the final patient finally leaves an hour after closing time and there are still 20 progress notes to write, or when some functionary from some department deep in the hospital calls to say that the CAT scan you've just done does need a pre-authorization after all, even though the insurance company functionary you called an hour ago told you it didn't and you want to scream "well, screw it then, just stuff the fucking xrays back into the scanner," or when the new outpatient practice configuration just HAS to happen NOW ! NOW ! NOW ! rather than in 6 months when the registration software will be ready, despite the labor-and-time intensive double registration the interim will entail, and they reassure you it will be OK because patients will be preregistered two days in advance, causing you to ask "And so have you retained a clairvoyant to pre-register the walk-in patients ?"

Attention and affection, but even more importantly equanimity. That's what eludes me. By mid day I am crouched at the heart of a massive whirlwind of fire-breathing gadflies, eyes squeezed shut, swatting wildly. Or so it seems.

It's like the story in Mark 4, isn't it, about the apostles in the boat in the storm. Wild-eyed, they bail, panic, shout snarky rejoinders at one another, as Jesus sleeps peacefully in the prow.

35 On that day, when evening had come, he said to them, “Let us go across to the other side.” 36 And leaving the crowd behind, they took him with them in the boat, just as he was. Other boats were with him. 37 A great windstorm arose, and the waves beat into the boat, so that the boat was already being swamped. 38 But he was in the stern, asleep on the cushion; and they woke him up and said to him, “Teacher, do you not care that we are perishing?” 39 He woke up and rebuked the wind, and said to the sea, “Peace! Be still!” Then the wind ceased, and there was a dead calm. 40 He said to them, “Why are you afraid? Have you still no faith?” 41 And they were filled with great awe and said to one another, “Who then is this, that even the wind and the sea obey him?”

Peace. Be still.

The answer to the koan work ?

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