The Piano

For my mother and her mother

A week after Donald Trump was elected, our new piano was delivered. My mother found a baby grand for sale that had been sitting silent for thirty years in a wealthy family’s living room. The owner was less interested in recouping the piano’s cost and more interested in its going to a good home, so my mother bought it for the proverbial song and now it lives in our living room. This is one thing about my mother — she is always bringing beauty into my life, even when I have altogether forgotten about the possibility of beauty, even when I am questioning the validity and purpose of the entire construct of beauty.

I don’t know that I will ever be equal to the gift of this piano. I am in awe of it. I am humbled by it, but humbled is not even enough of a word. I am devastated by its beauty. It sits under our living room window, its lacquered surface reflecting the many-colored trees in the park across the street and the broken stained glass panes that have been watching over our house since it was built in 1922. Both the house and the piano will outlive me and I imagine them whispering voiceless wisdoms about the arc of history to each other in the early morning.

Aside from a few sporadic hours stolen from family holidays at my parents’ house, I hadn’t played the piano in over fifteen years. Sitting down at the new piano for the first time, my fingers found their way through the Fifth Prelude from Bach’s Well-Tempered Klavier, stumbling at all the usual spots — a G suddenly sharped, a big leap of the left hand landing one note short. As a child, I was never much for practicing — or any pursuit requiring discipline or daily routine — so several attempts to make progress with a formal piano teacher fizzled out and my engagement with the piano occurred  on my own terms in a process that can only be described as repetitive meandering. I would sit down at the piano on a weekend day and open one after another of my mother’s books of music — Mozart Piano Sonatas, Mendelssohn’s Songs Without Words, Bach, Bach, and more Bach — and sightread as many pieces as I could at whatever tempo I could manage. For obvious reasons, I came to specialize in the slow movements, and mastered several pieces through sheer repetition. I passed hours and hours and days this way, pulled from one juicy cadence to the other, vibrating with the tension of dissonance leading to release, missing lots of notes, dreaming in some vague way of fulfilling on the expectation — mine? my parents’? — that I would follow in their footsteps and become a musician but also knowing that it would be otherwise.

Music was the only way my parents could ever have come into contact, let alone gotten married and stayed married for 40 years and counting. My mother was born in a refugee camp in Cyprus, having being carried across Europe in her mother’s womb. My grandparents met when my grandfather, a partisan fighter, liberated my grandmother from a train carrying her from one concentration camp to another. They named my mother Aliza after my grandfather’s first first-born child, Freidl, who had been killed by the Nazis, the word for happiness translated from Yiddish to Hebrew in the spirit of the new possibility of life that awaited them in a land that should never have been promised. They had almost nothing in their eventual home in Israel but my grandmother found a way to buy a piano and lessons.

Across the earth in Iowa, my father’s mother, a devout member of the Reorganized Church of Latter Saints did an unusual thing, a thing her church friends were not doing. She paid for mail order classical music records. Later, she started driving her children all over the state for music lessons. Three of her four children became classical musicians.  There was no precedent for it.

Their love was a mirlo blanco, a white blackbird, an impossible dream, the impossible dream of their mothers come to fruition in ways their mothers would never have predicted or chosen. They met when they were both studying music in London. In pictures from the time, my mother’s tight curls are huge and free, her lips full and red, her shirts tight across her chest. My father’s eyes are hidden deep beneath thick glasses, his hair long, his face almost always serious. I wonder what their courtship was like — it still feels sometimes like they lack a shared language, but then I remember Bach. After the year in London, my father returned to American and my mother came with him. They were wed in a courthouse in Buffalo right before my  mother’s visa was to expire, using a ring borrowed from the judge. When I was born, their parents eventually came around.

My very first memories are of my parents playing music together, the elegant carriage of my mother’s arms and head silhouetted against the light from my clandestine vantage point in the darkness at the top of the stairs, her body swaying away from and toward the piano, crescendo and decrescendo. I loved when their eyes met and they moved their bodies together to synchronize the end of a phrase. I loved to hear the sounds of their breathing, the catch of an inhale before an entrance, an exhale before a big chord. Nothing is as comforting to a child as the evidence of her parents’ love, the glue holding the universe together.

Classical music is odd glue for a Jew — at its heart, an expression of German and Austrian culture — and I often wonder if this crossed my grandmother’s mind at the time, as she kept my mother at the piano for hours each day practicing the notes that Bach wrote for the glory of his Lutheran God in a city where several hundred years later, in 1945, only 15 Jews remained. And yet, for many reasons of culture and history and economics, Jews have been over-represented among the ranks of classical musicians since the 19th century and the music of Bach, Mozart, and Beethoven was held dear among the community of Jewish survivors that came to Israel from Europe. And I suppose that is the fate of persecuted minorities and refugees everywhere — to share a culture with your oppressor. Every treasured thing recalls, in some way, a feared thing. What is yours is also not yours.

It has been a time of deja vu. As I have returned to my natal deities — Bach, Mozart, and Beethoven — Germans and Austrians all — the swastika has also returned. It does not feel accidental. I was lulled into a sense of American-ness, living as I do in a multi-everything urban community, alive with the promise of interactions that transcend category. Now, since the election, I feel more Jewish than ever, more white than ever, more gay then ever, more female than ever, more vulnerable than ever. History persists. Home isn’t. The only threads that connect me to this world are some melodies that were carried, tattered, across Europe, the embrace of beloved bodies whose fate I cannot control, hope for the abiding love that has been promised by every form of human wisdom, yet to be fulfilled.


(Temporary) solo parent chronicles

It’s been a million years since I wrote and so why not start again now? It’s 11:13pm and I just finished folding my fourth load of laundry of the day while standing at the dining room table and sipping un petit peu de Manischewitz out of the mug my residency program gave me as a graduation gift. If you aren’t *just* a little bit jealous right now, my advice to you is this: do not have children. 

C is out of town for two weeks and so I am getting a brief glimpse into what it might be like to be a single parent. I am realizing the parenting chops I thought I had are kind of like twinkle-twinkle-little-star compared to the Beerhoven sonata of doing it all alone. To all the single parents out there: hats fucking off to you. How do you do it? No really — how do you do it? This is not a rhetorical question.

My temporary role as a solo parent is made harder by the following shameful secrets about me:

1) I. Hate. Cooking. I used to like it, I think, but C has been doing 99% of the cooking for the last ten years and I have lost my mojo. The small repertoire of things I used to cook easily — stir fry, kale and white bean soup, rice and beans — are all toddler kryptonite. Last time I made E put a cooked green in her mouth, she half-spit, half-gagged chewed up greenery into a paper towel for longer than you would think would be possible then demanded that I brush her tongue with a toothbrush. Let’s just say: One of us has eaten Trader Joe’s tortellini and string cheese for more than one meal this week. And by one of us, I mean both of us. Au revoir, gluten-free, dairy-free, sugar-free diet!

2) I like my mornings to be minimally interactive. Because the field of medicine is dominated by competitive masochists, I am usually required to wake up at about the time attractive young people are staggering into strangers’ apartments to make the beast with two backs. My beautiful loved ones are usually still snoozing away as I tiptoe out of bed to shower and dress by iPhone flashlight. I make my smoothie. I pack my lunch. I leave. I do not speak. I am not spoken to. This is in sharp contrast to my solo parent mornings. My first thought upon waking is ecstatic: I will be able to see her perfect, gorgeous little face this morning! *inner squeal* 90 minutes later I am already 15 minutes late for work and she will only eat her eggs if I feed them to her while making the sound of a light saber. *inner scream*! She and I have never had to solidify a weekday morning routine together so when I’m there with her in the morning, she reverts to weekend mode. She wants cuddling. She wants french toast. She wants to put every article of her clothing on at the exact same moment as I put on the corresponding article of my clothing. “Can’t you put your bra on after?” she says, pouting because this one step breaks the symmetry. No, no I cannot.

3) I am not a good multitasker. I am at my best as a parent during focused one-on-one activities. I am not as good at making chicken nuggets while trying to sharpen a crayon using a pencil sharpener. Because of my nutty work life, I’ve learned to parent in the manner of a desert wanderer at the oasis. I don’t talk and drink, or think and drink. I just drink. When I’m with E, I’m usually just with E. 

As a result, I have tripped our house alarm twice this week. We usually don’t turn it on at night but I feel a little exposed without my Appalachian culture-of-honor afraid-of-no-one life partner by my side. This morning I was feeling *pretty good* about myself — lunches packed, rain boots AND sneakers in the backpack — but then we had to turn back to home because I forgot the fire engine sweater. “Mommy, why is there a policeman at our door?” My heart started racing and then I remembered: the alarm. “False alarm,” the policeman yelled to his colleague in the *second* cruiser that has responded to my damsel-in-no-distress call. #privilege

All of the above notwithstanding, though, I’m enjoying our uninterrupted intimacy. We hit our roadblocks and then recover, because there’s no one else to suggest a friendly game of Yahtzee. There has been a lot of laughter. We’ve been sleeping together evey other night (one night for the fun of it, the other night for my internal organs to recover from the contusions) and E’s breaths and sighs make for a sweet, sweet night. It reminds me of being pregnant with her — just her and me, registering each other’s moods and perturbations, breathing a single air. 

Two nights ago, we were looking into the mirror as we always do after E’s bath, the towel and my arms wrapped around her tight. I looked tired and a few new wiry gray hairs caught the bright bathroom lights. E looked as she always does: joyful and rosy and well-made. She reached her hand up to my forehead where a series of lines no longer fully recede when I relax. 

“I know what these lines are for, Mommy,” she said. “They are my maze.” She traced them with her finger as if they had a beginning and an end. Even my face is hers, it seems, which it is. “How do I get lines on my face?” she asked me. Just keep smiling, little one, and worrying (hopefully not as much as me), and being surprised by this life.

Dancing in the waves

We’re on vacation. This time, it’s an actual vacation, where you go away and spend time in another place. We haven’t done this in a long time. Since before residency. Since before E was born. We’ve been to my parents’ house. I’ve been to conferences for one or two nights. C has gone to artist retreats and film shoots. We have spent a night or two with family members. But a whole week away, with no work purpose, with no arms-length to-do list of overdue life tasks (dentist, taxes, roof leak) — this we haven’t done since 2010.

It’s day one and I woke up at 6:38am. I felt rested but restive. I reached for my cell phone, the phone I had promised to keep off, and searched for the YMCA in the beach town where we are staying. Maybe, I thought, I can get in a swim before everyone gets up. Because this is how my life usually works — everything is stolen from something else. I am a thief of time. I discovered that the YMCA is farther than I thought — 22 minutes away — and I thought to myself: If I go I will not be here when E wakes up. Because that’s how my life usually works — the days are counted in how many times E sees me when she wakes up and when she goes to sleep. Somewhere in my heart there’s an old man with an abacus and every time I miss bedtime or a morning cuddle, he peeks at me over the top of his ancient reading glasses and slides a blue bead over to the left.

So, not going swimming. My next thought was: “The vacation is almost over and I haven’t done anything meaningful with this time.” Which is when I realized how much I need this vacation.

C stirred next to me and it occurred to me how much of the time I have been stealing has been from her, from us. I have been in resolute denial about this — trying to justify in my mind all the ways in which her career ALSO demands of us and ALSO impinges on us (there’s the old guy with the abacus again), but the reality is that my schedule means she spends many nights alone. I settled back into my pillow and tried to inhabit time.

It was the rare day when E slept later than us by a significant amount. We were afraid to move, to step a foot onto the wood floor for fear of its creaking and breaking this new magic spell. We held each other and whispered about this and that. My stomach started growling and at a certain point we couldn’t stay in bed anymore. It’s amazing how much sound a few simple actions can make in a sleeping house. The cabinet creaked as I opened it, the bowls clinked against one another like a car backfiring, the silverware drawer opening sounded like a herd of ponies braying. Slowly everyone in the house — E, her cousins, her aunt and uncle — emerged from their beds and we made ready to head for the beach.

It was only E’s second time at the beach and she was in a state of ecstasy. Every time the surf lapped up over her ankles, she shrieked with delight. At moments, the delight was so great that she seemed unable to contain it. She would throw herself to the ground and roll in the sand until every inch of her skin was covered in sand, like a fresh donut rolled in sugar crystals. At one point, she suddenly broke into a run along the edge of the shoreline out of the pure sensation of being alive, until she was so far from me that I had to call her back.

The waves today were steep and hard and the undercurrent was strong enough to unfoot me several times. There was scarcely any territory on the shoreline where it was safe for a four-year-old to wade — only a foot or two separated the edge of the surf from the violent crash of the waves. Little E was like a sandpiper, running toward the receding surf and then scampering back up the beach as the next wave approached. And I was right there beside her, ready to hoist her up when a wave proved faster or taller than she anticipated. Each wave promised the sweet reward of her giggles and also the possibility of her being tumbled into the brine and carried away, a possibility which felt so close — too close — like a layer of weight added to each of my breaths. The Lord giveth and the Lord taketh away, I kept thinking. The ultimate wave.

Do all parents feel this way? I wondered to myself. Is this normal? I surveyed the other families around me for signs that they too were greeting each incoming wave with a combined sense of delight and the understanding that life is incredibly fragile. Younger children were certainly being supervised but everyone seemed to be having a good time, though what you can tell about a person’s internal life from the outside is nothing.

It’s hard to talk about this aspect of my job, but I have watched the waves carry many beloved children away and I don’t think I have really acknowledged the way this has changed me. In part because in comparison with their families, what right do I have to claim any piece of grief? When a patient dies, it isn’t really a life event for the doctor, even if it is. Even if they inhabit your dreams for months. Even if you think of them as you are watching your child leap into the surf on your first vacation in years.

I am realizing that for me, there is no vacation from that part of my life experience. At the sweetest core of parenting — and what, in this life, is sweeter than your child’s delighted laughter? — it vibrates. I cannot unknow what I know about nature’s indifference. Which is not to say that there’s can’t be a full range of positive experiences and emotions. Which is not to say that anxiety needs to limit me or my child. Which is not to say that I scooped her up out of the waves and ran. Today was one of those best days ever, one of the days that would be slowed down and put to feel-good music in the movie of my life. And it did not feel wrong or contradictory to acknowledge, in a wordless way, all that has been lost, and therefore all that must be held sacred and never taken for granted.

This year since the end of residency has felt tumultuous for me. I think I was expecting for things to “go back to the way they used to be,” whatever that means. I think I thought “it would get easier” as was so oft promised. Many stresses — namely time and money pressures — have been reduced somewhat, but caring for very ill children is just as hard and it should be. If it’s not hard, I don’t think you’re doing it right. (But if you don’t acknowledge how hard it is you can’t do it well for long.) Without being aware of it, I think I have been waiting for my innocence to return — for life to feel light again. But I am beginning to understand that certain things can’t and shouldn’t be peeled away. Certain things can’t be “left at work” because they become part of your emotional and spiritual and ethical being. Though I am sometimes envious of people who can contemplate pregnancy without running through a litany of possible complications or feed their children vegetables without calling to mind mental imagines of actual choking survivors, in reality I would not want my innocence back, in part because I want so much to be of service on a deep level to the families I care for and also because the suffering and loss I have witnessed inform the way I love, the way I care for my patients, the way I participate in community, and my desire to contribute to the repair of this broken world.

Tomorrow we’ll be back on the beach as early as we can get all seven of us up and fed. The waves will crash in and recede and I’m looking forward to dancing in them with E, in spite of but also because of all that might be lost.

Here is a picture of E, meeting the unending sea.


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.