Worksite Metaphor

IMG_2562This past week I spent time cleaning my office at work, recycling (shredding) the detritus of an academic life: tenure and promotion materials,  teaching evaluations, student papers, and my own papers. I do this periodically to ensure there is never too much of me—of my identity—at work, not from a pathological paranoia, but rather from a desire to maintain healthy boundaries. Or at least that is what I tell myself.

But during the cleaning and sorting I found a hand-written draft of a prose poem that I wrote many years ago during a workshop I taught on narrative medicine. It was in response to a close read and discussion of Jane Kenyon’s poem “The Sick Wife” and her husband Donald Hall’s poem “The Ship Pounding.” As Carol Levine writes in “Two Poets: One Illness,” the poems “…offer a rare view of the same illness from the perspective of the patient (Jane Kenyon) and her husband and caregiver (Donald Hall), both distinguished poets.” (Journal of General Internal Medicine, March 2010, 25(3): 275-275.)

In Hall’s poem he uses the metaphor of a ship to describe his experience in the hospital when his wife was sick. He concludes with describing the hospital as “the huge vessel that heaves water month after month, without leaving port, without moving a knot, without arrival or destination, its great engines pounding.” I used as an accompanying writing prompt for workshop participants to write a description of their own metaphor for their particular work site. What is your metaphor for your own work site? Here is what I wrote (and found while cleaning my office—and have now shredded):

Dusty, moldering storage closet

door with stuff behind

forgotten cast-offs

old files labeled for people and departments and programs that died long ago

textbooks for subjects that are no longer taught

a ceramic statue of Florence Nightingale holding her lamp

beside a bowl of nectaries

people who have retired but won’t leave

people who should retire 

computer parts, old landline phones, stenographic paper

which is what exactly?

My office—bare–no books

A few seashells

I can leave, clear out in a moment

Not closed inside a storage closet.

 

 

 

Dear Flo: What Nurses Week Means to Me

IMG_4737Happy National Nurses Week to all you dedicated, compassionate, hard-working nurses out there! While you’re enjoying your free cinnamon bun and coffee, I hope you will pause to reflect on your work and on what truly fuels your continued passion for nursing (or where the heck that passion has gotten to if you have lost it).

And if you have time to read more than patients’ chart notes or community outreach notes, I hope you will pick up and read a “real” book written by nurse authors. We may be a small group compared with the vast number of physician authors, but we are growing in strength. I am proud to be a nurse and I am proud to be a nurse author in the company of some amazing, inspiring people.

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As far as living nurses go, there are many who inspire, innovate, and influence me. One of these is Ruth Watson Lubic, the nurse-midwife, MacArthur “genius” award winner, and founder of the Family Health and Birth Center, located in one of the poorest neighborhoods in Washington, DC. She walks the talk of what nursing can and should do well, to “treat everyone like a human being,” to create a community-based health center where “everyone who walks in that door feels love.” Plus, she has combined direct nursing service with upstream policy work as succinctly depicted in this brief video. (And she is a way cool elder who has her own Hip Hop Saves Lives song and video!)

The American Nurses Association Ethics and Human Rights Statement of 2017 states that “Nursing is committed to both the welfare of the sick, injured, and vulnerable in society and to social justice.” It goes on to proclaim that “Nurses must always stress human rights protections with particular attention to preserving the human rights of vulnerable groups, such as the poor, the homeless, the elderly, the mentally ill, prisoners, refugees, women, children, and socially stigmatized groups.”

I am a proud nurse educator and (most days) count among my blessings, the opportunity to work with the amazing, smart, creative, and compassionate future nurses. Like the students yesterday at the Nurses Week event at Shoreline Community College. And like these University of Washington School of Nursing students at our Doorway Project pop-up community cafe who spent a sunny Sunday afternoon washing the feet of homeless young people. Dear Florence Nightingale, happy birthday and happy Nurses Week! As Florence Nightingale nurse scholar Tony Paterniti, PhD, RN states, Nightingale wasn’t only the lady with the lamp, she was also a “woman with a mission.” (Check out Dr. Paterniti’s fascinating digital archive collection on Florence Nightingale through Texas Woman’s University.)

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Life in the Swamp: Float, Don’t Flail

P1020499Community-engaged scholarship is mucky business. It takes a high tolerance for—and even delight in—ambiguity, lack of clear paths, no solid ground, simultaneous decay and incubation, annoyingly loud squawking ducks, tail-thwacking beavers stirring the mud, and skunk cabbage. Oh yes, the putrid smell of skunk cabbage. Skunk cabbage reminds me of the people who seriously pluck my nerves, who irritate me, yet somehow must serve a useful purpose (for instance, as food for bears coming out of hibernation in the case of skunk cabbage).

Community-engaged scholarship is not for the faint of heart or the fastidious or the unprepared. I’ve learned and re-learned these lessons many times over my thirty-plus years of such work. There always comes a point of crisis, with the inevitable interpersonal and inter-agency power plays coming to a head. In these times, (which I am in the midst of currently with the particularly complicated Doorway Project) when my default mode is to fight back against the stealthy, submerged weeds of the swampland territory of this work.

But then I remember my Red Cross swimming safety instruction as a teenager. When swimming in swampy rivers and the underwater fingers of submerged plants begin to grasp your limbs, threatening to pull you under—instead of fighting them (thus tightening their hold), you are instructed to relax and float. The threatening underwater plants will then release you to the surface where you can gently scull your way back to the safety of shore. Float, don’t flail.

It is useful to have wetlands and swampy areas near at hand to visit and remember these sorts of lessons for life and for community work. (Not to mention, of course, the myriad positive environmental aspects of wetlands.)  I’m fortunate to have Yesler Creek in my (literal) backyard and Yesler Swamp (where the creek empties into Lake Washington) only a mile from my home. Yesler Swamp has undergone a restoration process (ongoing) spearheaded by a campus-community group (Friends of Yesler Swamp and University of Washington Botanic Gardens) and is now a refuge for wildlife—and for humans who need a respite from the bustle and hassle and skunk smells of academic and city life.

Swamps are terrific metaphors for community-engaged scholarship, especially scholarship that deals with wicked problems such as homelessness. I return time and time again to the wise words of Donald Schon, author of The Reflective Practitioner: How Professionals Think in Action (Basic Books, 1984) among many other important works:

….The research university is an institution built around a particular view of knowledge, as the following dilemma helps to make clear:

The dilemma of rigor or relevance.  In the varied topography of professional practice, there is a high, hard ground overlooking a swamp. On the high ground, manageable problems lend themselves to solution through the use of research-based theory and technique. In the swampy lowlands, problems are messy and confusing and incapable of technical solution.  The irony of this situation is that the problems of the high ground tend to be relatively unimportant to individuals or society at large, however great their technical interest may be, while in the swamp lie the problems of greatest human concern.  The practitioner is confronted with a choice. Shall he remain on the high ground where he can solve relatively unimportant problems according to his standards of rigor, or shall he descend to the swamp of important problems where he cannot be rigorous in any way he knows how to describe.

Nearly all professional practitioners experience a version of the dilemma of rigor or relevance, and they respond to it in one of several ways. Some of them choose the swampy lowland, deliberately immersing themselves in confusing but critically important situations. When they are asked to describe their methods of inquiry, they speak of experience, trial and error, intuition, or muddling through. When teachers, social workers, or planners operate in this vein, they tend to be afflicted with a nagging sense of inferiority in relation to those who present themselves as models of technical rigor.  When physicists or engineers do so, they tend to be troubled by the discrepancy between the technical rigor of the “hard” zones of their practice and the apparent sloppiness of the “soft” ones.

People tend to feel the dilemma  of rigor or relevance with particular intensity when they reach the age of about 45. At this point, they ask themselves, “Am I going to continue to do the thing I was trained for, on which I base my claims to technical rigor and academic respectability? Or am I going to work on the problems — ill formed, vague, and messy — that I have discovered to be real around here?”  And depending on how people make this choice, their lives unfold differently. (Donald Schon, “Knowing-in-action: The new scholarship requires a new epistemology,” 1995, Change, November/December, 27-34.)

Here is to all of the swamplands and swamp workers of the world. Let’s keep mucking around together and remember: when things get particularly tough—float, don’t flail.

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Poetry: The Art of Observation

IMG_4390Recently, I had the opportunity to take a Saturday environmental writing workshop at the University of Washington’s wonderful Burke Museum. I signed up for it when I found out that our Washington State Poet Laureate Claudia Castro Luna was teaching a session.  Two out of three of the sessions—including Luna’s—were centered around the practice of close observation. We were instructed to go outside the UW Observatory (coolest old building!), stand or sit in one place, observe and write down as many sensory details as possible for ten minutes. It was raining softly so I stood in the shelter of a doorway to conduct my observation. I was reminded of the truism that the art of paying attention comes through the practice of attention and close observation. These are essential skills for many aspects of life, and most definitely for the provision of good human-centered health care.

And yes, included in my observation and note-taking of details, was this sweet, tenacious dandelion stuck between a rock and a hard brick wall, yet managing to thrive and bloom. An apt metaphor for oh so many things. But dandelions were on my mind since I had just run across a historical document on Seattle pioneer Catherine Maynard. Catherine was second wife to our famous Doc Maynard and she was Seattle’s first official nurse. She is credited with introducing dandelions to the Seattle area. Dandelions were (and still are in certain circles) an important medicinal plant used to treat scurvy and other ailments.

After observing this dandelion, I wrote this poem. Happy Earth Day.

An Ode to Dandelions

labeled a weed

noxious, non-native species

scorned, uprooted, exterminated, poisoned

labeled a tonic

food, medicine

harvested leaves, flowers, roots

eaten raw, cooked

steeped in hot water for tea

fermented for wine

elixer of dandiness

—dandilicious

 

What is a weed?

What is a tonic? A label?

Laughing yellow button

turned to whisp of fluff

blow away

fly away

spread your tonic weed seed!

 

Poetry Heals

IMG_4301 “come celebrate/with me that everyday/something has tried to kill me/and has failed.” Lucille Clifton, “won’t you celebrate with me” from Book of Light (Copper Canyon Press, 1993).

Poetry heals. Is it any surprise that at times of crisis, illness, grief—or joy and celebration—we turn to poetry to help express what straight word prose cannot?

I have been reminded of this over the past week while simultaneously holding the joy of a family milestone birthday with the sudden serious illness of a dear friend. I have been thrown into the arms of poetry.

Poetry heals. Our first responders are poets, as are artists of all kinds. Cherish our poets and artists. Their work is essential for our existence, for our survival. Listen up you curmudgeonly naysayers who proclaim that poet laureates of our cities, states, and nations are a waste of taxpayer dollars—that the money would be better spent on sweeping away our human waste, on filling the potholes in our roads. You too—but perhaps too late—will be thrown into the arms of poetry.

“There are times when people have experiences that don’t fit neatly into a storyline, a narrative of what happened. Especially within the context of trauma, suffering, and oppression, our ability to arrange bits together into a coherent narrative is overwhelmed. Yet these experiences, beyond the reach of narrative, can be formulated, conveyed, and communicated through metaphor, poetry, art, photography, and gesture.” (From my essay, “Witness: On Telling” in Intima: A Journal of Narrative Medicine, Fall 2017.)

I end this, as I began, with the words of Lucille Clifton. Here is a powerful video recording of her talking about and then reading her poem, “The Killing of the Trees.” In her opening statement, she says, “There seems to be very little reverence for life. I think there is a thing which bothers me about people not having reverence for life that doesn’t look like themselves. And I think that is a great mistake.” As a gifted poet, Clifton can “see it all with that one good eye.”

Poetry Saves

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“Pause there while the sea lights a candle” Josephine Ensign/2018

“…when people say that poetry is a luxury, or an option, or for the educated middle classes, or that it shouldn’t be read in school because it is irrelevant, or any of the strange and stupid things that are said about poetry and its place in our lives, I suspect that the people doing the saying have had things pretty easy. A tough life needs a tough language—and that is what poetry is. That is what literature offers—a language powerful enough to say how it is. It isn’t a hiding place. It is a finding place.” p.40

This is one of my favorite quotes from one of my favorite authors, Jeanette Winterson, from her memoir (with one of the best titles ever) Why Be Happy When You Could Be Normal? (New York: Grove Press, 2011). The book’s title comes from an admonishment her abusive, Fundamentalist Christian adoptive mother frequently gave her growing up. Jeanette was frequently locked in a coal cellar and then locked out of her house by her mother (for being “sinful and gay”) before she ran away from home permanently at age 16. In short, she had a tough life as a child. Poetry and literature saved her.

Towards the end of her memoir, Winterson writes eloquently of the complex relationship between madness and creativity. She admits that she often hears voices and realizes “…that drops me in the crazy category” but doesn’t much care. “If you believe, as I do, that the mind wants to heal itself, and that the psych seeks coherence not disintegration, then it isn’t hard to conclude that the mind will manifest whatever is necessary to work on the job.” Then she writes of the part of herself that acted out from her childhood trauma—the acting out in rage, self-harm (including suicidal ideation), social isolation, and “…sexual recklessness—not liberation.” She questions whether this madness could be the creative spirit. But she answers emphatically: “No. Creativity is on the side of health—it isn’t the thing that drives us mad; it is the capacity in us that tries to save us from madness.” pp. 170- 171.

April is National Poetry Month. Also, it is National Child Abuse Prevention Month as well as Sexual Assault Awareness Month—with this year’s theme (appropriately enough with the #MeToo movement) of Embrace Your Voice.

 

Hell Hath No Fury

IMG_6292Hell hath no fury like a host of women “getting woke” and speaking truth to misogynistic power—including that of our current U.S. President who, of course, is on record scorning and belittling women and treating them as sexual objects and then attempting to place gag orders on them.

Hell hath no fury like a host of women (and enlightened men) “getting woke” to the true meaning of being a feminist. Being a feminist goes beyond the wearing of pink pussy hats and marching (although I have done both of those things and they are an important start). Being a feminist goes beyond supporting the #MeToo movement and the brave women who are feeling empowered to speak up about sexual violence.

I am heartened by the increasing number of ethical and solid investigative news reports which bring to light and lead to due justice, not only the mind-bogglingly large cases such as the serial pedophile passing as sports physician Larry Nassar, but also the smaller yet life-altering stories of the many women (or women like them) who live next door—or who may be your daughter, sister, aunt, grandmother, or mother—or yourself. One recent, and local (to me) example of such a news story appeared in the Seattle Times this past week: “‘Shouting it from the rooftops’: Women confront abuse—even decades later” by Susan Kelleher (March 23, 2018). While this news report focuses on women’s stories of sexual harassment and abuse in the workplace, and therefore excludes such abuse in women’s homes and personal lives (where the vast majority of gender-based violence occurs), it is an illuminating and compassionate series of stories. As a woman and a nurse, I especially resonate with the story of retired nurse, Virginia Dawson. Dawson recounts the sexual harassment she endured early in her career at the pawing hands of a hospital physician. He even attempted to kidnap and sexually assault her in the morgue elevator. Female nurses continue to be targets of sexual harassment and abuse in the workplace by patients, family members, and co-workers.

There are, and will continue to be, nasty backlash and negative repercussions for women who speak their truth. I applaud the many good people across our country who are donating their legal, mental health counseling, and other support services to the many thousands of women who do not have the resources of the high-profile likes of Stormy Daniels (Stephanie Clifford in real life).

Hell hath no fury like a host of women “getting woke,” speaking up, joining and supporting the #MeToo movement, learning the true meaning of being a feminist, registering and voting their consciences in the next elections—or who even run for political offices themselves. #MeToo becomes #PowerToThePolls.  Don’t just get angry. Do something constructive with the power of that anger: Vote. And help other people around you to vote for candidates who have the guts to stand up for safer gun regulations, reproductive rights for women, effective anti-violence programs, healthcare programs that work—and who have proven track records of deep respect for all living beings, including women.