To Russia (with love)

One of my dreams has been to travel to Russia...and I did it! I'm in Moscow visiting my cousins!

We almost didn't make it here. First, bureaucracy: the Russian consulate sent our applications BACK to us saying we hadn't calculated the fee appropriately (grrrr...we followed the instructions on their website to the LETTER), then they took their sweet time to process the "corrected" application, and our passports arrived at our house THE DAY OUR FLIGHT WAS SCHEDULED to take off! So we packed in a frenzy, only to find that because of the volcano in Iceland our flight had been CANCELLED. More frenzy as we re-booked ourselves on a flight out of New York the following day and got a rental car to drive to the airport there. Whew. (I just learned that the equivalent flight the next day ended up being cancelled too, so we really just made it to Russia! Hope we can get back without too much trouble...)

Our flight took a longer flight path than usual, cutting aross Northern Italy. We made up a little time getting blown across the Adriatic by a mighty tail wind, but it was pretty long all the same. I was SO relieved when we finally touched down. The passport control guy was a dead ringer for Val Kilmer (but cuter!). I've been having fun practicing my cyrillic reading.

We had a very relaxed, delicious lunch at my cousins' place before heading out to evening Mass (the closest experience we're probably going to get to a clandestine Mass - the Catholic Church's position here in Russia's somewhat unclear to us but seems little tenuous). The priest's apartment was in a building with a very Soviet feel (and aroma!) to it; it even had the diminished-visibility screens on the windows. Mass was intimate and lovely, bilingual in French and English (so my husband was invited to do the second reading in French), with the priest singing the prayers in a deep plainchant that transported us back a few hundred years.

Afterward we took my cousin's son shopping for suit pants at Gum, which has to be the most gorgeous shopping mall, inside and out, that I've ever seen. Red Square is right outside Gum, so I peeked into the soul-stirring interior of little Kazan Cathedral and was thrilled to walk across the vast expanse of Red Square, toward colorful and iconic St. Basil's. Then home again to a home-cooked dinner, showers, staying up till midnight talking, and a deep, restful sleep. A really great first day in Russia!

When Your Life ALMOST Flashes Before Your Eyes

One day, recently, there was a disturbing hissing sound in the O.R. from one of the gas tanks. A huddle of O.R. personnel got on it right away and tried to trouble-shoot for several minutes.

All of a sudden there was a loud popping sound, like a pistol going off, and the hissing crescendoed so that we could barely hear each other above it.

The surgeons and I exchanged looks, eyes wide. They stopped what they were doing. We all turned to the culprit tank and tried to see, tried to understand, what was happening. Meanwhile, the people on the team whose task was to make sure the equipment was functioning properly were still hard at work doing their job. The rest of us were ready to offer our teammates help but were also limited by our obligation to stay physically close to our areas of responsibility - for me, the patient's airway, and for the surgeons, the patient's surgical site. A technician was called from outside to assist.

I started to feel nauseated. I put an oxygen mask on myself as a precaution - the last person who needed to feel queasy was the person in the O.R. directly responsible for the patient's safety - and set about making sure my patient was still okay under the drapes. Breathing tube: check. Monitors: check. Eye covers: check. IV access: running. Warming blanket: on. Vital signs: stable.

My thoughts went whizzing around in my head like ricocheting bullets. What's going on? What can I do to fix it? What if we have an explosion - do I throw myself over the patient or on the ground? Boy, it would really be a bummer if we all went up in flames in here...I have so many things I wanted to enjoy with my husband and kids...

Thankfully whatever valve needed turning or tweaking got tweaked, and the deafening hiss stopped. As it turned out there wasn't any major or prolonged danger. But the incident reminded me that all those things we are trained to be vigilant for in addition to patients needing resuscitation - fires in the O.R., falling objects or projectiles, unexpected chemical hazards, aggressive patients, falls, and the like - are real possibilities, and that we really can't take our training or teamwork for granted.

Reflections During the High Holy Days, Part Two: Belief and Ritual

[Photo: Dazu Wheel of Reincarnation by Calton.]

Last night the obstetric doctor on-call and I stayed up late in the call room waiting for the dreaded beepers to go off and playing with the Belief-O-matic quiz on Beliefnet.com, according to which I am only 65% Roman Catholic. Deep down, it diagnoses, I am 100% mainline-to-liberal Christian Protestant, and my colleague is either a Unitarian Universalist or a neopagan.

As I've written before, my beliefs are a jumble and at times inconsistent. Sometimes I suspect there may be a personal God at work in the world and other times I suspect there may not be one at all. Yet I pray/talk to the dead, and sometimes even think I perceive some very concrete help from them in the "happy coincidences" that arise in my life every so often.

Inspired by the Belief-O-matic game, my friend and I started to talk about belief and realized most religions give their members a framework in which to fit in some answers to the following:

• Do you believe in God? What kind of God?
• Do you believe in the existence of the soul / consciousness without form / an energy that lives on after death?
• What is the basis of your moral convictions (i.e. what makes something right or wrong)?
• Where do we come from?
• Where are we going?
• Why are we here?
• Does free will exist?
• Does evil exist?
• Does fate or destiny exist?
• Why do we suffer?
• What are your views on gender identity, gender roles, sexual relationships, abortion, euthanasia?

My answers to many questions like this are along the lines of "possibly" / "yes and no" / "I have no idea." The only thing I know for sure is that the basis for my faith - whether it includes belief in God or not - is the idea that every human being is precious (a conviction with, admittedly, deep roots in my study of the teachings of Jesus in the New Testament). I may be unable to articulate a concept of God, but I keep searching - and if theological musings don't make you fall asleep right in your chair, you're welcome to a glimpse (below) of what goes on faith-wise in my head - and why, despite my doubts and struggles, I still try to participate in the rituals and practices of my home religion.

***

[Photo source here.]

There are two moments in Catholic liturgical life that I await and savor each year.

The first is the singing of the Exultet at the beginning of Easter Vigil, when the darkened church gradually fills with the light of hundreds of candles and the story of the Church as a people from its ancient (even prehistoric) origins to the Resurrection unfolds ritually through the songs, readings, and prayers of the most special Mass of the year.

The second is also during the Triduum, at the very beginning of the Good Friday liturgy. The priest and deacon enter the church in silence, then lie prostrate before the bare altar for several minutes. It's shocking and arresting, and somehow deeply moving too. Incarnate in their bodies is grief, profound humility, and the striking image of the person who has been struck down, by death or suffering or personal failing or all the above. The presiders of the liturgy express for the assembled people what no words can express. They look like they're weeping silently, motionlessly.

All my life I have struggled with the death of Jesus. I struggle with its cruelty, which shows so starkly our darkest side, what we human beings are capable of inflicting on one another, as much today as back then. I struggle with the meanings others have read into it. For so many people it was more than just a political inevitability; it holds mystical meaning.

I cannot say that I can easily accept concepts of atonement so readily when I believe that Jesus life was about our worthiness, not our unworthiness. I believe his gospel, his "good news," was that far from being a fallen, intrinsically unworthy people, we are instead so love-able and so gifted with love that we are precious beyond estimation, and if we could embrace that truth about ourselves, we'd have no need for the paltry comforts that come from arrogance, prestige, material success, praise, etc. Our true nature makes our betrayals of each other all the more tragic.

By reading his ministry and life this way, I find it impossible to read Scripture apart from this over-arching theme of intrinsic worth. Because I read his ministry and life this way, I see many more consistencies than inconsistencies in his teachings - love one another, don't ostracize the lepers and outcasts, respect women and children, take care of the sick and the poor, see the divine presence in each person.

I've been reading lately the letters and journals of women who chose to live out this very gospel every day (and, by the way, also ended up getting killed for those choices). From them I've learned that we are called to ever-deeper commitments to compassion that we may not be able to reach. Concern for others is manageable for most people; empathy that impels action is also relatively within-reach; but solidarity, true solidarity with those who need help - that, I think, is tough and rare. In the end if there's any mystical meaning in the death of Jesus that I can grasp, it's that ultimate commitment - that solidarity that he entered into with the suffering, broken, sinful world. I actually think the existence of a just God would almost make such solidarity a moral imperative for a God who calls all people to it. But what do I know...

Which brings me back to that shocking moment when the priest prostrates himself before the cross. If I'm right about Jesus' "take" on his own life, he threw himself right into our experience to the bitter end because he was willing to make the leap of ultimate compassion, and that's what that prostration expresses. I find the real saving grace lies not some magic blood ransom to right wrongs we can never undo or make up for, but rather in the possibility or truth of a God whose compassion is so infinite that it carries him into a life of solidarity with us.

Reflections During the High Holy Days, Part One: Why I'm Still Here

I can truly understand the criticisms of those who feel religions do more harm than good. I don't agree, because I think there often exist in such criticisms a willful neglect of the good inspired by so many faiths, but I can definitely see the harm people can do in the name of their interpretations of their own religions and why the bitter opinions arise.

I'll be the first to admit that of all the times I've ever felt like rolling my eyes at, taking by the shoulders and shaking, or feeling totally embarrassed for the Catholic Church, this current period ranks right up there with any number of historic moments people have pointed to ad nauseum as evidence for why the institutional Church sucks.

And I can understand why Christians in general, not just the Catholic ones, can be a real turn-off. Who wouldn't be frustrated by a group that seems, despite a Messiah who taught, "Do not judge," to be comprised of some of the most judgmental people on the planet?

Then there's Islam. The religion of peace if one looks at all my wonderful Muslim friends and colleagues, but just the opposite if you're choosing to look only at Islamists: the misguided militant, the suicide bombers in Russia and the Middle East. If it's hard to be a Christian in today's world, it's probably even harder to be a true and faithful Muslim.

I have tried to learn about many of the world's religions in an effort to develop my own beliefs, moral convictions, and practices. I embrace the interconnectedness taught in many faiths of the near and far east, but I cannot relate to spirituality that seeks to cultivate indifference or imperviousness to physical realities, relationships, and sufferings, or to distance individuals from the world they inhabit. Archbishop Oscar Romero once said, "The Christian faith does not cut us off from the world but immerses us in it." I related more to that kind of statement of faith than any other. Faith, for me, is a way of seeing the world and living in it, not a set of beliefs. I want my faith to put me in the trenches.

Why, by this time, have I not left this troubled Church, with its frustrating history and frustrating issues and frustrating people?

Part of the answer can be understand by simply substituting the word "family" for "Church." It's home. I may need a break sometimes, but in the end I've accepted an identity that is rooted in the stories, symbols, pains, and hopes of this ancient People.

Another part of the answer is the person of Jesus. I won't go into my understanding of him here - that's a reflection for another day, and perhaps even another blog. But as I've tried to examine how the leaders or founders of religions have lived - not their successors, necessarily, who may have distorted their messages or used power to hurt rather than heal - I've asked myself questions like, Have they valued children and other powerless members of society? Treated women with respect (or disrespect)? Waged war? Regarded human beings as full of worth and wonder? I've concluded that Jesus is still the teacher from whom I want to learn the most important lessons.

So here I am. Still in the fold. Reluctantly at times, and in fact sometimes kicking and screaming and tearing my hair out, but definitely present and participating and trying to make my way. I may not believe some of what other Catholics believe, or express my beliefs in the same way, or even conceptualize Christ or the key ideas of Christian thought the way as many Catholics do, but I have an approach to scripture and an interpretation of Jesus' life that has enriched my own life and work, so for me faith, despite the struggles, has been a positive force.

I've been feeling contemplative lately, more so now that the Triduum is upon us, so stay tuned for "Part Two" wherein I may try to grapple with some questions that are probably thousands of years old.

Oscar Romero

Romero.

August 15, 1917 - March 24, 1980.

Prophet of the people,

voice for social justice, human rights and dignity,

freedom, and non-violence,

killed by an assassin's bullet while celebrating Mass.

Remember him today.

If, like Patricia Hardy of the Texas school board,

you have no idea who he is and what he has done for the world,

learn about him today.

Thirty years later, his light still shines.

May we grow to be worthy of it.

[Icon by Robert Lentz, available at www.trinitystores.com]

For further reading, click here and here.

Too Good Not to Share

For those of you who have cringed when I've mentioned awake intubation, here's a video that might make you feel better...or worse...In any case, I think the Massachusetts General Hospital residents are incredibly fortunate to have such a committed and courageous teacher!

(Click here to watch it on Youtube.)

***

Hubby's Birthday Cake

This is the best cake I've ever made, so I want to share all the sinful delight here for posterity (adapted from a ricotta pound cake recipe by Gina DePalma in her book Dolce Italiano):

Preheat oven to 350.

Generously grease and flour a rectangular (13 x 9) cake pan.

In a medium bowl sift together

-2 c+ 3 Tb all-purpose flour

-5 Tb cornstarch

-4 tsp baking powder

In a large bowl cream together

-2 1/2 sticks unsalted butter

-2 1/2 c part-skim ricotta cheese

-2 1/2 c sugar

Add

-4 tsp vanilla (can replace some of this with scrapings from a vanilla bean - haven't tried that yet)

-1 tsp almond extract

-5 eggs, one a time, beating well after each addition

Gradually add dry ingredients + 1 1/2 tsp coarse salt, stirring well after each addition.

Pour batter into prepared baking pan and bake at 350 till inserted knife or toothpick comes out clean (45-55 min).

Top with lemon glaze or buttercream frosting of choice. This cake should be allowed to rest overnight and be served the day after baking because for whatever reason it always tastes better the second day!

Thinking About the First Time

A life in medicine is filled with milestones large and small.

The first time you touch a dead body.

Or hold a human heart in your hands.

The first time you pierce another's skin with a needle.

Or cut it with a scalpel.

The first time you witness a birth.

Or a death.

Your first code.

Your first infant intubation or spinal tap.

Your first solo anesthetic.

Your first job.

Not to mention licensure boards, three different sets.

On top of those, separate written specialty boards.

And of course, oral boards, everybody's favorite.

Recent events have caused me to reflect on the first time I and my classmates performed pelvic exams. As I recall, most of us anticipated this particular lesson with a little dread - at best, some mild anxiety. Physicians and nurses have to do such invasive things - stab people, gaze at parts of them even their spouses or parents have never seen, listen to their secrets, probe the most private areas of body and life. As a woman who has never particularly enjoyed visits to the doctor for a complete physical or to the gynecologist for a check-up, I was particularly un-enthused at having to inflict on even a comfortable volunteer such an invasion of her privacy.

The special instructors hired by my medical school to guide us through the process of examining their pelvic areas were highly trained educators who unselfishly allowed us novices to practice an examination on them that would require, for our patients' sake, our very best in terms of skill, gentleness, and respect. I know I couldn't do what they did - allow myself to be examined and give constructive, moment-to-moment feedback during the exam. I've volunteered my veins for students to practice I.V. insertion - that's about as far as I go.

We were divided into small groups of four, I think. I remember the sound of the speculum rattling as one of the students ahead of me trembled nervously while inserting it. I remember how we giggled nervously when another in the group asked the instructor, "Uh, could you uh, drop your top" and was gently given the feedback, "Perhaps you could rephrase that with, 'could you lower your gown,' or something like that?" I remember thinking how much more comfortable the instructors were with the whole process than I felt, and how embarrassed I was when I let out a surprised "Whoa!" when the woman I was examining did a mega-strong Kegel move while I was doing her pelvic exam.

As with everything in medicine, after a while even the most invasive and intimate action can go from being completely foreign and frightening to being completely familiar and comfortable. Whether I'm the patient lying on the table or the clinician doing the exam or procedure, I have individuals like those pelvic exam instructors during med school to thank for what I or my physician is doing with confidence and competence. I thanked them when they came to school to teach us, but I want to thank them again, many years later. They made a difference they'll never be able to know or see.