July 10th, and on our way west from Iowa, Wyoming’s Big Horns are the first of the big mountains to scratch the horizon, the highest, Cloud Peak among them, syruped with snow.
And the next day, along the Beartooth Highway bridging Montana and Wyoming, at, what, 10,000 feet, snow banked at the road’s edge to 10 or 12 feet, names carved, graffiti-like, in the walls, those walls of snow, the names of wife Karen and daughter Siobhán now among those many names, and likely there for weeks, if not months, a year, memoriam.
By the time we had rear-viewed Yellowstone, snow was, however, passé: we had seen it, walked it, even, in July, formed and thrown snowballs.
And then came Montana’s Paradise Valley, snow still drizzled across ranges east and west, every last river and stream all but riotous with run-off.
And me outside a cabin, this cabin, in that valley, there in the sunlight, watching snow melt.
Someone, the old line goes, has to do it, so why not me?
And, given, I’m told, that the snow on one nearby ridge has not melted in three years, this could well be a full-time job, one, even if I’m not yet qualified for, I might grow into.
Doing little more this.
Little more than watching.
Watching what has year after year unfolded, decade by decade, century after century.
Winter at last relaxing, unpacking kit and case, drop becoming dribble, dribble a trickle, trickle a rivulet, rivulet to run to creek to river. And, by August in Montana, kids from bridges leaping, those rivers at last tamed by summer, summer already languid, languid with the imminence of fall.
But back to watching snow melt.
Think of that now, this moment, whatever else you might this minute be doing.
Because there is, even now, snow melting, not all of it seen, let alone under anyone’s careful scrutiny. If not in the Rockies, then the Pyrenees, the Andes, the Alps, the Urals.
And someone—you, even—should be watching, watching snow melt, watching life happen, watching time, time itself, those seconds become droplets and on to rivers, to bays, to the ocean of life itself.
And your hand, your one hand, the rest of you maybe now, maybe making love, that one hand, though, liquid in the sunshine, catching what cannot, not now, not ever, be entirely caught…
© 2011 by Dónal Kevin Gordon
Saturday, July 23, 2011
Thursday, July 21, 2011
Home
…is, I know, where the heart is.
And my heart, for all that Iowa has done for me and for my family over this last decade, has never entirely been here, never entirely been at home.
Always, I have hankered after the Vermont I knew, always wishing I might have again what I had once known.
And, if not Vermont, then Montana, maybe Michigan, maybe Wisconsin.
This, my wayward heart…
This heart wanting more than any one life might willingly give me.
This heart, this past week, out west, and finding itself…at home
And how to explain?
Those mountains speaking to some deeper sense of myself. A certain wildness, certainly absent in Iowa. A rough edge here in Montana, a reminder of a place not yet entirely tamed. And, yeah, the heat, this heat, usually intolerable to me, but tempered, tempered just enough, by low humidity.
And something more…
That thing intangible, all but indescribable. That sense, that if I were strung now, strung here, here in Pray, strung between two trees in a hammock, I’d be at peace.
© 2011 by Dónal Kevin Gordon
And my heart, for all that Iowa has done for me and for my family over this last decade, has never entirely been here, never entirely been at home.
Always, I have hankered after the Vermont I knew, always wishing I might have again what I had once known.
And, if not Vermont, then Montana, maybe Michigan, maybe Wisconsin.
This, my wayward heart…
This heart wanting more than any one life might willingly give me.
This heart, this past week, out west, and finding itself…at home
And how to explain?
Those mountains speaking to some deeper sense of myself. A certain wildness, certainly absent in Iowa. A rough edge here in Montana, a reminder of a place not yet entirely tamed. And, yeah, the heat, this heat, usually intolerable to me, but tempered, tempered just enough, by low humidity.
And something more…
That thing intangible, all but indescribable. That sense, that if I were strung now, strung here, here in Pray, strung between two trees in a hammock, I’d be at peace.
© 2011 by Dónal Kevin Gordon
A farewell to paradise…
Behind me some 2,000 miles, Iowa to Poulsbo, Washington.
And since then another day’s drive, this one east, another 700 miles.
East now as far as Livingston, in Montana, to the gates, to the gap, to Paradise Valley. The three of us—Karen, daughter Siobhan, me—holed up in the Murray, as Peckinpah once did, albeit without bullet holes in the walls to commemorate our stay.
And out there in Paradise…
This morning, this last morning, I’m alone in Paradise Valley, Karen and Siobhan in the car, me scuffing dirt car-side, the sun chinning up over the Absorakas.
Not far away the Yellowstone rippling, loudly rippling, river meeting rock. The smell of hay from nearer fields, hay as redolent as July itself, the bales themselves rounded, tumbled into some semblance of a stack. Cows from across the road lowing, reminding me, if reminding were necessary, of life.
And rimming the horizon, the Absorakas themselves, the highest still skirted with snow, those skirts tattered by sunlight. Clouds this morning skirling peaks. The air crisp, but waiting to warm again to 90°, the heat’s saving grace its low humidity.
A last look, this last look, and eastward to home…
© 2011 by Dónal Kevin Gordon
And since then another day’s drive, this one east, another 700 miles.
East now as far as Livingston, in Montana, to the gates, to the gap, to Paradise Valley. The three of us—Karen, daughter Siobhan, me—holed up in the Murray, as Peckinpah once did, albeit without bullet holes in the walls to commemorate our stay.
And out there in Paradise…
This morning, this last morning, I’m alone in Paradise Valley, Karen and Siobhan in the car, me scuffing dirt car-side, the sun chinning up over the Absorakas.
Not far away the Yellowstone rippling, loudly rippling, river meeting rock. The smell of hay from nearer fields, hay as redolent as July itself, the bales themselves rounded, tumbled into some semblance of a stack. Cows from across the road lowing, reminding me, if reminding were necessary, of life.
And rimming the horizon, the Absorakas themselves, the highest still skirted with snow, those skirts tattered by sunlight. Clouds this morning skirling peaks. The air crisp, but waiting to warm again to 90°, the heat’s saving grace its low humidity.
A last look, this last look, and eastward to home…
© 2011 by Dónal Kevin Gordon
Wednesday, July 13, 2011
Along Mill Creek Road…
Today, along Mill Creek Road, Montana’s Mill Creek itself did what it has done for millennia, times like these, times when winter’s snowpack has meant an extended spring, creeks like Mill Creek, roiling as it has so often roiled before, meeting the Yellowstone River, the river itself belly-high, spreading itself hip to hip, water, so much water, rippling between.
Out here in Montana’s Paradise Valley, life literally flows on.
The valley itself at the whim, the wile, of that Yellowstone.
The river, yet again, declaring ownership of its banks, reminding those living nearby that those banks are fluid, that life itself is ever subject to change.
This one river announcing itself one year, surprising another. Those mountains now and forever rimming the horizon.
All that is different is that I am this year witness.
Witness to this life.
To this creek, this river.
To life itself.
Life rippling rock to rock. Bank to bank.
Those banks widening, this year to accommodate life’s flow, as it has always before accommodated life’s flow. And, another year, barely breaching rock.
And me, looking, listening to that water meeting that rock. The creek itself today exultant.
Me, at the same time, so small.
This speck, my life, against this landscape, against all of time.
And me today sixty…
Out here in Montana’s Paradise Valley, life literally flows on.
The valley itself at the whim, the wile, of that Yellowstone.
The river, yet again, declaring ownership of its banks, reminding those living nearby that those banks are fluid, that life itself is ever subject to change.
This one river announcing itself one year, surprising another. Those mountains now and forever rimming the horizon.
All that is different is that I am this year witness.
Witness to this life.
To this creek, this river.
To life itself.
Life rippling rock to rock. Bank to bank.
Those banks widening, this year to accommodate life’s flow, as it has always before accommodated life’s flow. And, another year, barely breaching rock.
And me, looking, listening to that water meeting that rock. The creek itself today exultant.
Me, at the same time, so small.
This speck, my life, against this landscape, against all of time.
And me today sixty…
Saturday, July 2, 2011
All we have is what we bring into the room
Practice medicine, and getting a CBC, checking a potassium level, ordering a TSH is as easy as asking. Want a chest x-ray? Need a head CT? What about that ultrasound to rule out that DVT?
Write it. Sign it. Done.
Less easily ordered, less easily done, is that CT of the soul. The ultrasound that tells those of us in Palliative Medicine that there’s a herniated depression, a pocket of anxiety, some fulminant pain. The x-ray that reveals that this patient never got along with her daughter, but loves her, loves her to no end, would never hurt her, even if it means not making her power-of-attorney, not having her make those, those terrible decisions. That another patient’s son, faced with saying goodbye to his father, had yet to learn to say hello.
All we have is what we bring into the room.
Any experience. Whatever medical knowledge. Some amount of insight, of intuition. None of it measured in milligrams, colonies, rads.
Oh, to see what cannot be seen…
To enter that patient’s room and to know, not just a creatinine level, not only a sodium value, but to already have depression’s number, to have seen the spirituality films, to understand, by some algorithm of the EMR, that this patient’s pain is not in her back, has nothing to do with her diagnosis, will never respond to narcotics.
To see what can’t be seen…
Like the fifty-two-year-old woman I saw yesterday, only recently diagnosed with rapidly advancing pancreatic cancer.
How to measure the fact that her husband loved the light in her once, loves that light still, will love it forever, even when that light is out.
That, as he said to me, pleasantly, with no anger toward the world shuttering his world, and me believing him from his first word, “You can’t tell me anything worse than what I have already heard.”
That their youngest child, a daughter, will be married in September.
That her mother once never questioned seeing her younger daughter’s wedding day.
And that patient herself?
Beautiful.
Head without a hair. Earrings defiantly in place. Cheeks summered, red. And now and then a smile. A smile transcending any and all pain. Her face itself transcendent. A face all at once reflecting all she is, all she loves, all she is so likely to so soon lose.
My hand reaches for hers, and hers, tellingly, reaches for mine.
“My father had pancreatic cancer,” I say to her, almost whispering, lest her husband, talking to the nurse, hear me acknowledge the obvious. “I understand.”
But, of course, I don’t.
Sure, I lost my father to pancreatic cancer.
But this woman is losing her one loved life to the same thing.
And her husband, his tears dammed by his smile, his laughter, is himself losing the girl he married. The girl, who at 18, bore their first child. The woman who has shared his life since, and who for more than 30 years returned a love that appears more than love.
How can I understand?
Maybe one day with that CT of the soul. That ultrasound of anxiety. That x-ray of family dynamics.
But today all I know is what I somehow know.
Labs more or less normal.
Imaging unremarkable, except, of course, for that mass.
Nothing, really, by the numbers physicians so often care about.
But my own father dead of pancreatic cancer.
This woman, her husband, losing the life they loved, the one they, like all of us, took for granted on too many a day.
And she herself beautiful.
Her face, her eyes, those cheeks, transcendent.
© 2011 by Dónal Kevin Gordon
Write it. Sign it. Done.
Less easily ordered, less easily done, is that CT of the soul. The ultrasound that tells those of us in Palliative Medicine that there’s a herniated depression, a pocket of anxiety, some fulminant pain. The x-ray that reveals that this patient never got along with her daughter, but loves her, loves her to no end, would never hurt her, even if it means not making her power-of-attorney, not having her make those, those terrible decisions. That another patient’s son, faced with saying goodbye to his father, had yet to learn to say hello.
All we have is what we bring into the room.
Any experience. Whatever medical knowledge. Some amount of insight, of intuition. None of it measured in milligrams, colonies, rads.
Oh, to see what cannot be seen…
To enter that patient’s room and to know, not just a creatinine level, not only a sodium value, but to already have depression’s number, to have seen the spirituality films, to understand, by some algorithm of the EMR, that this patient’s pain is not in her back, has nothing to do with her diagnosis, will never respond to narcotics.
To see what can’t be seen…
Like the fifty-two-year-old woman I saw yesterday, only recently diagnosed with rapidly advancing pancreatic cancer.
How to measure the fact that her husband loved the light in her once, loves that light still, will love it forever, even when that light is out.
That, as he said to me, pleasantly, with no anger toward the world shuttering his world, and me believing him from his first word, “You can’t tell me anything worse than what I have already heard.”
That their youngest child, a daughter, will be married in September.
That her mother once never questioned seeing her younger daughter’s wedding day.
And that patient herself?
Beautiful.
Head without a hair. Earrings defiantly in place. Cheeks summered, red. And now and then a smile. A smile transcending any and all pain. Her face itself transcendent. A face all at once reflecting all she is, all she loves, all she is so likely to so soon lose.
My hand reaches for hers, and hers, tellingly, reaches for mine.
“My father had pancreatic cancer,” I say to her, almost whispering, lest her husband, talking to the nurse, hear me acknowledge the obvious. “I understand.”
But, of course, I don’t.
Sure, I lost my father to pancreatic cancer.
But this woman is losing her one loved life to the same thing.
And her husband, his tears dammed by his smile, his laughter, is himself losing the girl he married. The girl, who at 18, bore their first child. The woman who has shared his life since, and who for more than 30 years returned a love that appears more than love.
How can I understand?
Maybe one day with that CT of the soul. That ultrasound of anxiety. That x-ray of family dynamics.
But today all I know is what I somehow know.
Labs more or less normal.
Imaging unremarkable, except, of course, for that mass.
Nothing, really, by the numbers physicians so often care about.
But my own father dead of pancreatic cancer.
This woman, her husband, losing the life they loved, the one they, like all of us, took for granted on too many a day.
And she herself beautiful.
Her face, her eyes, those cheeks, transcendent.
© 2011 by Dónal Kevin Gordon
Sunday, June 12, 2011
And at light's end...
He’s only 25 years old. My daughter’s age.
But he’s dying, and there’s nothing I, just one of his doctors, can do to stop the dying.
We’re talking a good kid, a kid until March just living his life.
A kid not unlike most 25-year-olds.
Not unlike my daughter, my own 25-year-old daughter.
Hanging with friends. Living. Loving Iowa’s Hawkeyes. Never thinking the inevitable. Until three months ago, when a foot drop signaled, not just a problem, but the inevitable.
His tumor, his glioblastoma, is right now doing what glios do.
Making his brain its brain.
Short-circuiting everything that makes any 25-year-old a 25-year-old, let alone anyone, anyone.
But his smile.
His smile makes you think that tomorrow could truly still be tomorrow.
With all the promise of another day.
Another day to go to classes.
To text friends. To catch a round of ultimate Frisbee. Complain about cafeteria food. Wonder who that girl is. Whether she might be his.
But the boy, this boy, is dying.
And this morning, this boy—and, Lord knows, he’s still but a boy—curled to half his height in the bed, so soundly asleep after radiation that I cannot wake him, his shaved head the only glimmer in the darkness of this, his room, too likely his last room.
“I don’t get to make the rules of the world,” I tell him, one hand on his, the other on his shoulder. “If I did, you wouldn’t be here…you’d be doing what my own kids are doing. You’d be just twenty-five…doing what 25-year-olds do…”
Again, that smile.
That smile, in that darkened room, even if then just half a smile, a night-light from the door to his bed.
And, at light’s end, this boy, curled in that dark around this, his unwelcome death…
© 2011 Dónal Kevin Gordon
But he’s dying, and there’s nothing I, just one of his doctors, can do to stop the dying.
We’re talking a good kid, a kid until March just living his life.
A kid not unlike most 25-year-olds.
Not unlike my daughter, my own 25-year-old daughter.
Hanging with friends. Living. Loving Iowa’s Hawkeyes. Never thinking the inevitable. Until three months ago, when a foot drop signaled, not just a problem, but the inevitable.
His tumor, his glioblastoma, is right now doing what glios do.
Making his brain its brain.
Short-circuiting everything that makes any 25-year-old a 25-year-old, let alone anyone, anyone.
But his smile.
His smile makes you think that tomorrow could truly still be tomorrow.
With all the promise of another day.
Another day to go to classes.
To text friends. To catch a round of ultimate Frisbee. Complain about cafeteria food. Wonder who that girl is. Whether she might be his.
But the boy, this boy, is dying.
And this morning, this boy—and, Lord knows, he’s still but a boy—curled to half his height in the bed, so soundly asleep after radiation that I cannot wake him, his shaved head the only glimmer in the darkness of this, his room, too likely his last room.
“I don’t get to make the rules of the world,” I tell him, one hand on his, the other on his shoulder. “If I did, you wouldn’t be here…you’d be doing what my own kids are doing. You’d be just twenty-five…doing what 25-year-olds do…”
Again, that smile.
That smile, in that darkened room, even if then just half a smile, a night-light from the door to his bed.
And, at light’s end, this boy, curled in that dark around this, his unwelcome death…
© 2011 Dónal Kevin Gordon
Saturday, June 4, 2011
I Don’t Want to Die…
Who does.
Not you. Not me.
At least not yet.
Most patients I see in the course of most weeks, even if dying, only want to go home. Whether to some home you and I might think of as home; whether to a care facility; whether to the care of some caring son, daughter, sister, or, even more poignantly still, a mother, a father.
One and all, those patients all want to go home.
And you, who, wouldn’t?
Your home. Your room. Your bed. Your death. Your way.
For those of us in the business of shepherding the dying, ours is too often about the shepherding.
The dying itself is, after all, for the dying themselves.
Far be it from us to intrude.
And yet we do.
Want this?
We’ll crush your chest; we’ll crack your ribs. Not like TV, I tell patients.
Want that?
That tube down your throat. That tube to a machine. And you no longer you afterwards, even if you are, somewhere, still somehow you.
I don’t want that, most say.
“I’m 87,” one tells me, just the other day. “I’ve lived a long life. I’m done.”
And who am I, the palliative care doc, to say otherwise?
I’m not 87.
I’m not willing to say that my life, at almost sixty, is a long life. I don’t yet know when done is done.
Her choice, then, is not my choice.
“And if you die now. If you stop breathing now. If your heart all at once falls silent…”
Then, by your choice, I, standing nearby, stand nearby.
Watching death do what death does…
Me, cradling the rope to your small boat…
The pond beyond. That larger pond. And my hand opening…
The rope slipping from hand, my hand, slipping from my hand for good…
For good.
Surely, for good…
© 2011 Dónal Kevin Gordon
Not you. Not me.
At least not yet.
Most patients I see in the course of most weeks, even if dying, only want to go home. Whether to some home you and I might think of as home; whether to a care facility; whether to the care of some caring son, daughter, sister, or, even more poignantly still, a mother, a father.
One and all, those patients all want to go home.
And you, who, wouldn’t?
Your home. Your room. Your bed. Your death. Your way.
For those of us in the business of shepherding the dying, ours is too often about the shepherding.
The dying itself is, after all, for the dying themselves.
Far be it from us to intrude.
And yet we do.
Want this?
We’ll crush your chest; we’ll crack your ribs. Not like TV, I tell patients.
Want that?
That tube down your throat. That tube to a machine. And you no longer you afterwards, even if you are, somewhere, still somehow you.
I don’t want that, most say.
“I’m 87,” one tells me, just the other day. “I’ve lived a long life. I’m done.”
And who am I, the palliative care doc, to say otherwise?
I’m not 87.
I’m not willing to say that my life, at almost sixty, is a long life. I don’t yet know when done is done.
Her choice, then, is not my choice.
“And if you die now. If you stop breathing now. If your heart all at once falls silent…”
Then, by your choice, I, standing nearby, stand nearby.
Watching death do what death does…
Me, cradling the rope to your small boat…
The pond beyond. That larger pond. And my hand opening…
The rope slipping from hand, my hand, slipping from my hand for good…
For good.
Surely, for good…
© 2011 Dónal Kevin Gordon
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