Of All My Heart

My heart is an impossible zoo,
Transplanted a few centuries ago
From the left side of my chest
To the middle of my head.

Curiosity races through dense grassland
As judgment towers high above,
Bending down to drink from pools of memory
While watching for anger and fear lurking below.

Yet as all things do with time,
The long edges grow fuzzy,
The habitats stretching loosely
Down my neck, my back, my toes.

Swarms of shame flutter in my stomach
And worry hops from wrist to shoulder
To forehead, where anxiety sits,
Waiting to squeeze and paralyze.

Still, at least you can still find love and bliss
Galloping together from my ears to my eyes,
Their rhythmic steps blurring worry’s path
So that it gets lost along the way.

And you might hear gratitude and calm howling
So loudly that all the predators hide away,
Letting joy perch safely in my cheeks
As care swims down to my hands.

Hope is a handed-down drum

Hope is a handed-down drum,
Worn out over decades of use.
I hold it in my hands, over my head
And let the rain pound down upon it
The music drowning out the deluge,
Letting me walk through the storm.

Sometimes, after a fierce hail,
Some wayward drop will pierce
Right through the battered top.
Suddenly I fear any light shower
Might fill it up till the water’s weight
Breaks through and drowns me.

I rush to the nearest friend
And ask for shelter and fabric
And time to piece it together,
Until I can spend the hours I need
To repair my drum properly
Once I am safely at home.

Poetry is a Mad Mirror

I wrote this in response to poet/teacher Taylor Mali's MetaphorMonday on 8/6/18 (and ended up winning!). As you can see, he has made these Metaphor Dice that make the hardest part of poetry - starting - a little easier. This metaphor is particularly rich, and it was much fun to reflect upon.

Consistency

consistency, n: 

1. Solidity, substance, firmness

2. Condition, degree, quality

3. Agreement, harmony, compatibility

Identity x vision is our compass, 

Paving the path we must walk 

To move from who we are 

To who we want to be. 

Must our professional 

And personal identity 

Be one and the same? 

Or might it be sufficient to 

Have two compasses, distinct 

But consistent, to point the way?

Knight of the Round Wing

I kneel before you
Gowned and gloved,

Yet you bless me still

With a gallant kiss

To the hand you hold

With more gentle care

Than it has to give.

Barrier precautions

Preclude contact,

Yet you touch me still,

Lips through latex,

Warmth into skin and veins

Flowing upwards to

Somber, smiling cheeks.

I knelt before you,

Humble and distraught,

No more cures to offer,

No way to raise the sun

On your tomorrow,

Yet you blessed me still,

And still you remain.

Health is not about Medicine

"Water-borne diseases are not caused by lack of antibiotics but by dirty water, 
and by the political, social, and economic forces that fail to make clean 
water available to all; heart disease is caused not by a lack of coronary care 
units but by the lives people lead, which are shaped by the environments 
in which they live; obesity is not caused by moral failure on the part of 
individuals but by the excess availability of high-fat and high-sugar foods."

- WHO’s Commission on Social Determinants of Health, 2008

Medicine may be about health and illness, but health is not about medicine. It is about the lives people lead, and the world in which that happens. Medicine can save lives, sometimes miraculously. It can improve quality of life, sometimes significantly. But we know now, or perhaps have re-learned, that health is determined by all sorts of factors far more than medicine or health care. (Not to mention how all those factors affect access to care.)

This 2012 infographic from the Bipartisan Policy Center's Lots to Lose illustrates the gap between what matters and what we spend on. What it does not show is the extent to which healthy behaviors and environment are themselves dependent on social, economic, and political factors. 

 It is hard to eat healthily when the closest supermarket is over a mile away and you have no car. It is hard to get an education when your family needs you at home to work or take care of younger children. It is hard to enjoy activity and sleep when you might be arrested for loitering and being homeless. It is hard to find a home when your prior incarceration prevents you from finding a job.

Is it any surprise, then, that the United States performs so poorly compared to other high-income countries? We are among the most unequal nations in the world, and our social institutions (including health care systems) are far from equitable. Our best hospitals can work magic to save patients from heart attacks and strokes, but our impact on chronic disease is tepid at best. Our impact on what causes chronic disease is not tepid, but instead profoundly detrimental. Public health matters, so public policy matters. As is often said in the quality improvement world, "every system is perfectly designed to get the results it gets."

Further reading:

1. "Tools for Putting Social Determinants of Health into Action." CDC, 2018.
2. "It's an Unequal World. It Doesn't Have to Be." New York Times, 2017.
3. "Poor Health: When Poverty Becomes Disease." UCSF News Center, 2016.
4. "Criminal Justice, Homelessness, and Health." NHCHC, 2012.

Fireflies, Part 4: Playing Around with Poetry

Whenever I'm asked or inspired to write poetry about a particular topic, there are a few short forms that I often play with to get my synapses firing. They each have their own constraints, and it is a fun puzzle to write within them. So, here are examples of all three from the last week of fireflies. :)

Haiku
A traditionally Japanese form, haiku has 3 lines with 5-7-5 syllables. They usually involve a juxtaposition of two subjects with focus on nature or seasons.

Dancing in darkness

A lightbulb flickers off

The firefly unseen

Limerick
A 5-line poem with an AABBA rhyme scheme, where the 3rd and 4th lines are usually shorter. The meter is mostly anapestic (duh-duh-DAH). Often humorous, sometimes bawdy, it arose in 18th century England.

Our love letters used to be mail 

Sent at speeds seeming slow as a snail. 

Now as fast as we think, 

Like a firefly’s blink, 

We can send light-speed text and email! 

Acrostic
A literary form where the first letter/word of each line spells out another word or message. This is one of my favorites because when not highlighted, it can be a kind of code.

Falling fairies shower their dust 

In tall grass under taller trees 

Radiant in their summer green 

Ecstasy for the warmest season 

For a longer day and shorter night 

Loving the twilight in between. 

You ever see a firefly in sunlight? 

More Firefly Posts:
Fireflies, Part 1
Fireflies, Part 2
Fireflies, Part 3