Illumination

Summer 2016—South Haven, Michigan It was truly the best ten minutes of each and every week for as long as Rachel could remember. Her life was good, happy—though sometimes conflicts and disappointments seemed to cloud over even the best moments. And she was always rushing. Rushing to her pediatric office or home to Bill and the kids. Therefore, the simplicity of taking out her candlesticks, alone, lighting both of them and saying a Hebrew prayer she had been taught as a child was just the break she needed. She did not consider herself a religious person, but Rachel did believe there had to be something greater going on. She remembered a college course she took freshman year at Brown where the professor talked about Abraham Joshua Heschel and his description of the ineffable. It was something about parting company with words...a “tangent to the curve of the human experience.” Yes, she believed strongly in something greater, something one could not explain. But just as Heschel described the ineffable, the arc of her life and her acceptance of faith might be described as two parallel lines never to intersect. Lately, this caused her to feel as if there were a hole inside, at the core of her being. As if the parallel lines ran along each side of her body leaving a gaping space between. Rachel had married outside her faith and chosen to accede to her husband’s strong devotion to the Catholic church. Or was her husband’s faith simply the result of growing up in a small town where Catholicism ran unopposed? In any event, they committed to raising their children in a single religious tradition. Still, those ten minutes every Friday night when she lit the Sabbath lights were almost like Transcendental Meditation in the sixties or the Mindfulness Movement of the current day—just her and her great-grandmother’s candlesticks. Though Rachel had never met the woman, the candlesticks were a palpable link to her past. Rachel was a pediatrician. It usually took several hours after finishing at the office for her mind to settle down and leave the problems of her patients behind. Every day was long and pretty similar to the previous one. She called those Groundhog Days, like the movie. Just occasionally, there was an opportunity to shine and the day her partner called her in to examine a two-year-old child was one of them. The child had a hard, red, swollen cheek and Rachel listened while her partner explained his diagnosis of buccal cellulitis. He was nearly certain but wanted Rachel’s corroboration. If he were correct, the child had a serious bacterial infection requiring admission to the hospital and a septic work-up involving pain, many needle sticks and even a spinal tap. As her partner finished his explanation, Rachel turned her attention from him to the child, and then to the child’s parents who were standing anxiously by the examination table. The importance of establishing facts for herself had been drilled into her during medical school and reinforced in residency training. At the back of her mind, she could hear her mentor, Dr. Phillips, saying to make a correct diagnosis you must start with a “good history followed by a thorough physical examination.” She questioned them, her manner brisk but kind. What had the child been doing in the last twenty-four hours? Where had he played? What had he eaten? It turned out the child didn’t need all that poking and prodding. His parents just needed to avoid giving him popsicles in the future. Who would have thought she would ever see a case of popsicle panniculitis, inflamed inner cheeks from cold exposure, in her career? Usually, pediatrics was less glamorous, full of blocking and tackling to see thirty patients a day with common colds, diarrhea, rashes, and school avoidance. And the phone calls. Parents were anxious; helicoptering was the term in vogue. Who could blame them with social media having so many wrong answers swirling at their fingertips. This hovering over their children, ready to intervene before physical or emotional injury had an opportunity to occur, had become the new normal in parenting, reinforced by pressure from friends and grandparents alike. The practice she chose to join in South Haven was exhausting and not what she had expected after finishing her hospital residency training in Ann Arbor. There, the focus was on sick children—Rachel being taught to order as many tests as necessary to quickly and accurately make a diagnosis and follow clinically proven treatment protocols. But the practice of pediatrics away from a university teaching hospital was quite different. The children she saw were rarely so sick that they needed to be admitted. No, their presenting problems were subtle and rarely solved by a knee-jerk reaction to perform more tests. Though it had taken a couple of years to become proficient, honing her skills of listening and observing, she was now an excellent clinician—seeing herself as part detective, part social worker, and part psychologist. No longer was a physician expected to be paternalistic, calling all the shots at times without a patient’s explicit consent. Best practices called for shared medical decision making where a doctor needed to, first, educate patients about the science behind a diagnosis in order to next, together, make the best treatment choices in an efficient and compassionate manner. Though more time consuming, Rachel liked practicing in this manner. If she were not a doctor herself, it was how she would expect to be treated when someone in her family was ill. Rachel continued to gaze at the candlesticks allowing her mind to wander further. Somehow over the last twenty years, in addition to establishing a thriving pediatric practice, she had caught up socially, married Bill, and pushed out a son and a daughter. Today, the kids were still at soccer practice and Bill was picking them up after his full day teaching biology at a local high school. She wondered how they were doing as parents. After all, on a daily basis she saw all kinds of parenting adventures of both the good and not so good variety. So far, their mistakes did not seem too awful. But could she see herself and Bill honestly? Thinking about the future had interrupted her meditative moment with the candles and the respite she needed. Maybe if she could somehow manage to cook dinner for the kids and get them started on their homework, her mother might come over to the rescue. The kids loved NaNa who wouldn’t mind having a few minutes alone with them, so perhaps she and Bill could still make an eight o’clock movie. As the candles burned, Rachel wondered how different her life must be than the one her great-grandmother had lived. How did emigrants survive the trauma of leaving everything behind? Why had her family chosen to settle in Southwestern Michigan? How did her family go from farming to resorts, to her life as a physician all without leaving a fifteen-mile radius from her current home on North Shore Drive?