Time

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Lazy Saturday evening on Burntside lake

Afternoon light fell sharply across the boy’s face as I walked past his house. He was three maybe four years old and sitting in the grass by the front steps. As we made eye contact he raised his hand solemnly and waved to me. I waved back and kept walking down the street. Spring light hangs long in the sky this far north, a good light for walking.

 

Walking gives me time to think about the day, the week, the year. Walking gives me time to think about the taser pointed at my chest. It was just a second or two, enough time to see the fear in the cop’s eyes. He was so scared. Then it was gone again, pointed back at the man who was trying to hurt himself. The dressing I’d hastily bargained for and wrapped was back on the ground. He started to bleed again. Towering over the cop he screamed Get out of my house.

 

I didn’t leave the hospital until close to 11 pm, but I have the time. I have the time to squat down next to his bed and listen. To push aside the hunting knife and bucket of blood. I have the time to talk, to step between the patient and the cop, to wait and wait and wait and wait until he was ready to let me work. There was blood all over the ER bay, blood on my clothes. I’m worried about the day when I don’t take the time. I was proud of the 15 stitches which took very little time.

 

My time in this town is winding down. Two more weeks and then I’m back in the city. I just had two weeks of study troll time at home in Minneapolis in order to study for USMLE Step 2. It’s unnerving how quickly it takes for my time in Ely to feel completely alien. I woke up at 3:30 Friday morning so I could make it to the clinic by 8:00 am. Once the Ely water tower came into view and I rolled down the windows and leaned my head outside to smell the woods. The clinic day passed in a fog and I made it out to my housesitting paradise on Burntside Lake just in time to take a nap.

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View from the bedroom

My eyes opened with wind blowing in the cedars and the lake rippling in the soft breeze. Ollie (the lab and my charge) and I strolled down to the shore and surveyed the array of canoes, kayaks, paddle boards, and speed boat. He chose the boat. I forgot what a rush it is to lean into the throttle and feel the rise toward 45 degrees before crashing forward and skimming across the sunset drenched water. After we both dove into the black water Ollie moped on the dock as I taught myself how to paddle board. Taught might be an overstatement as paddle boarding is one of those rare activities that’s just as easy as it looks. I paddled south for 15 minutes or so and just as I swung back around I saw an eagle drop from the sky, screaming down towards me. She passed no more than ten feet above my head, touched the water behind me, and soared back up into the sky. I watched her do this three more times before flapping off toward another bay. She was hunting.

After a late night sauna, I slept like the dead and woke up to a roaring thunderstorm. The rain cleared as I finished Swing Time over a pot of hot coffee. After the coffee ran out, both Ollie and I were ready to use our bodies. I was trailing him through the woods at Hidden Valley when the greens started to swirl in front of me. My watch only read 18 minutes, so I realized that the problem was that I was a shit runner compared to my partner. By the time I got into a relative groove, I was undone by my sweat. It only takes one horsefly to send me crashing back to earth with the reminder that I’m far from a true woodsman.

Sitting in this beautiful kitchen, drinking fresh coffee,  and listening to the wind slip through the trees, time feels decadent.

Doesn’t even mind the Chacos

 

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Winter/Spring

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Wintery spring

On Wednesday night I was stopped in the gym by a patient who wanted to tell me that his bowel movements had improved. After telling me about his poop he said that at first he didn’t recognize me because I didn’t have a beard the day before in clinic. I didn’t think anything of it until my friend Jill came up to me and asked me if I was a Chia pet. No streaking at all, the patient said as I leaned up against his treadmill trying to catch my breath. Good good, I replied inching back towards the door before he pulled out his phone to show me pictures. I’d seen the pictures yesterday in clinic, and I figured that I didn’t need to see them again. I was escaping back onto the rowing machine because I’m spoiled and I was tired of running outside in the cold. Spring lowered my defenses for the past couple of weeks, and then camping, birds, green grass, and warm breezes all gave way to 10 days of rain, sleet and snow. On Wednesday there was enough snow to plow the roads.

 

If my mind is slow to adjust to the changing winds, my body and beard evidently change just fine. The night before the real snow hit, my phone informed me that bad things were to come. I went to a fundraiser dinner with my friend and I immediately started packing in calories in case everything went to shit. I continued that course late into the night, finishing off a box of Samoas, two quesadillas, and some Moose Tracks ice cream with Sandies crumbled on top. I don’t care how many people make fun of me for eating Sandies. They’re delicious and they put me right back in Agnes’s kitchen where Drayton and I would sit after school and tell her about our day. I woke up on Wednesday morning to snow on the ground and ice cream on the corners of my mouth. Life’s real tough up here in the north country.

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Winter

That’s the hard thing though, because in so many ways I live a perfect life. I love my work, I have great friends, great health, and a family that I value more than anything in this world. My joy however doesn’t negate the fact that injustice is rampant and there are plenty of people who need change to achieve a basic human standard of living. Unlike me, most people don’t have the luxury to wait around for change to come. I just finished reading Sister Outsider by Audre Lourde, and there was a lot that I liked, some that I loved, and occasionally things that I couldn’t stand. Mostly however, she reminded me how insane this racist and sexist society that we live in is. Her writing doesn’t need my validation, but I appreciated how she created moments in which the curtain was pulled back and I was left staring dumbly at the page and wondering how the fuck we got here.

 

I am by no means woke and I sleepwalk through most of my interactions comfortably cushioned by my own privilege. However, once smarter people than me start to blow away the smokescreen of normative racism and sexism, it becomes hard to stay blind. Questioning my reality however can be disconcerting. I walk to work and see the American flag fly over the veterans memorial, go to bowling league most Friday nights, and drink too much beer and then sing karaoke at the steakhouse. This life is good and easy. The real world though is more interesting, troubling, and unjust. Given America’s history of violent colonial intervention abroad and it’s foundation on slavery and the genocide of Native Americans, it’s impossible to maintain the illusion of American moral superiority. Values matter much more than borders. Reactionary good-ol-boys in Kazakhstan, Mexico, or Ely have much more in common with each other (regardless of politics) than they do with people in each country who advocate for social justice.

 

There’s simply too much information available today to stay asleep to the insanity of racial and sexual injustice in America. As I continue to work towards being a part of the solution, I know that I’ll fuck up often. For a while I was concerned that there were too many liberals engaging in “woke-offs” (I stole that from a friend) with each other, because it’s easier to pick apart someone who agrees with you than address the very real and scary problems that exist with people whose world view you find abominable. I still think it’s stupid to argue with people in order to out politically correct them for the sake of my own ego. Now however, I think that’s only part of the story. White liberals like myself can’t possibly know what it’s like to fear for our lives and the lives of our children at the hands of those sworn to protect us due to the color of our skin. I have no idea what it means to live in a world where the story of my life is twisted and corrupted into various narratives in which I am a lesser human. With that in mind, I’m going to try as hard as I can to stay open to critiques of my own behaviors and viewpoints. I want to do this because although cliche, I know that my freedom is bound in the freedom of those around me and that it is impossible to fight for justice in the world if I can’t do it in my own heart.

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Family Medicine

 

I’m  lucky to be up here. The doctors I work with are all exceptional, each one teaching me something different about how to be a physician. The nursing staff however have become my family. Their teaching spans from the dangers of leaving my cell phone unattended to the various reasons why I should stay humble. My nicknames vary daily, oscillating between “Mr. Target Customer Service,” when I wore my red sweater and khaki pants to “Romeo,” which I recently saw stored as my contact info in Mel’s phone. Beyond the medicine I’m learning, the warmth and kindness I’ve received this past year has been overwhelming. I am constantly in awe of the privilege with which I get to move in the world, be it doing facial biopsies, giving bilateral knee injections, or the hours of visits trying to make diagnoses while having intimate conversations with total strangers.

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Results of leaving my phone at the nurses station

Last week I had the opportunity to drive to a lakeside converted barn for a home visit with a patient with aggressive metastatic cancer. Sitting in his living room with his family, I felt like I was really seeing someone. I was surrounded by their art, their love, and their beautiful messiness. Just watching him lean back in his own chair in his own home helped me contextualize this man in a a way that I never would have been able to in a clinic visit. This struck me as especially poignant while visiting someone for whom cancer has robbed of so much his humanity. The tenderness of that interaction and the vast information gleaned from sitting in someone’s house, further convinced me that Family Medicine is a uniquely privileged profession. Although it’s not romantic or flashy, it is by far the most challenging and fascinating specialty I could go into. I take that back, it is romantic in a messy sort of way. During this past year I have learned a little more about love every day. I see parents bringing children in, spouses bringing spouses, and children bringing parents. I get a daily dose of “old love,” the love between people who have lived a lifetime together. That love is never perfect, but it’s easy to pick out the couples who started with magic, because that’s what keeps their rheumatic eyes flashing even as their bodies fail them.

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New Love

Sometimes near the end of a long clinic day my face feels frozen in a greasy smile. Adhesive facial myositis isn’t a thing, but after twenty or so patient encounters I feel like there is something not right with my face. Last Friday was one of those long days where I kept glancing outside to see sun brightly illuminating everything with the glitter of spring. When I have to work inside, those perfect days are harder for me than today’s grey clouds and cold sleet. I left the clinic at the end of the day, headed straight home, and quickly threw some camping equipment in my old green backpack. I stuffed in a peanut butter sandwich, 2 polish sausages, 1 green pepper, ground coffee, a percolator, rolled tobacco, and a flask of Wild Turkey. My app showed clouds rolling in around 7 pm, but that the rain would hold off until midnight or so.

Secret blackstone is perfect for this kind of night because the trailhead is about a half hour from Ely and the campsites are only an 8-10 min hike from the parking lot. The light was still holding as I set up camp. This allowed me to forage around for plenty of downed firewood. I had to spend an extra 5 minutes looking for cedar bows to put under my sleeping bag because when I was putting up the tent I realized that I’d forgotten my sleeping pad. It must have fallen out of the pack in my rush to leave the apartment. The campsite fire pit faced east toward the coming night. It was protected from the wind by the roots of an uprooted tree. A strong wind was coming off the lake, but as I leaned back against the logs that were scattered around the fire it only functioned to blow the smoke past my right shoulder. Dinner was simple, two sausages skewered on a sharpened branch, one similarly roasted green pepper, and whiskey to wash it down. After dinner I laid back against the logs watching the stars appear one by one in the sky as the clouds rolled away. I rolled a cigarette and watched the flames dance in front of me as my mind drifted between the past, present, and future.

 

The next morning I waited until the rain stopped to pull myself out of my tent and into the foggy morning air. There were only a few cedar bows left directly under my bag, as the rest of them had been squeezed out to the sides of the tent during the night. I quickly shook as much water from the rain fly as I could and packed up the tent wet because I knew I’d have to dry it later at my apartment. I then fired up the percolator over my little camp stove and waited for the coffee to boil as I ate my peanut butter sandwich. There are few things more satisfying than savoring good coffee while looking out over a glass lake and hearing absolutely nothing but the wind in the trees. After I finished the coffee I hiked back out to the car, changed into running clothes, and ran through the wet trails. I mostly concentrated on the smells and sites in the woods, but I also reflected on how lucky I am to have the family that I do.

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Blackstone Lake

My brother had left back to the cities the day before, taking with him his newly adopted dog Frankie. Frankie is a 7 month old yellow lab who is impossible not to fall in love with. Even so, the best part of the trip was being able to spend time with Drayton. It’s hard not to relish hanging out with your brother when he has grown up into such an impressive person. He engages being a high school english teacher with all of the drive and intelligence that it deserves. I cannot think of a more challenging and important profession, and he is diving into it with both his heart and eyes open. It’s always humbling to be in the company of someone who is genuinely good through and through, as well as who has a razor sharp wit and intelligence. We hiked every day he was up here and watched his little lab become a creature of the woods, daring and explosive if lacking in coordination and judgement. Taking her through town however, we witnessed the full display of her powers as she charmed even the most grizzled of Ely residents. I’ve always hated how people get weird about dogs, so I’ll leave it at that.

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There’s never been a happier couple

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She made it hard to play it cool

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Northern spring

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Patterns in the spring ice

There’s a day every spring when you become a runner again. The muscles that atrophied/hypertrophied from a winter of skiing suddenly find their balance. On Saturday I spent too much time watching my footwork over the icy trail around Bass Lake to know what kind of shape I was in. It felt great to be back in the woods, but it was hard to get going when I was spending most of the time trying not to slide off the trail over a cliff or into a sharply cut tree limb. My speed was tempered by the thought of a false step followed by a sharp branch sinking into my side. Sunday however, I ran an old logging road deep into the woods and kept stretching out my stride as the trees flowed past me. I think that all runners share the same yearning for the pounding peace that we get when we’re alone with our thoughts. On Sunday I knew I was a runner again.

I recognized the patient and her husband immediately when I walked in the room but I couldn’t remember where from. I think they were both in their sixties but they looked like they’d lived a rough seventy-plus years. She presented for a COPD exacerbation likely brought on by a viral URI. I spent over half of the visit trying to figure out what and how much medication she was taking. Between the coughing and two of them griping at each other I was having a hard time concentrating on creating a differential beyond the obvious, when suddenly I realized that I’d seen her in October for a similar complaint. At the time, her husband was wearing a “Make America Great” biker t-shirt with a picture of Trump and Clinton on the front and a back that read “If you’re reading this, the bitch fell off.” Swallowing the wave of judgement that washed over me, I finished up the visit and left the room.

My preceptor agreed that the patient was likely suffering from a COPD exacerbation probably brought on by the combination of a viral URI and medication non-adherence. We stepped back into the room to create an action plan and get the patient on a tapered dose of oral prednisone. As I sat on the step of the exam table, my eyelids got heavy and my eyes began to glaze over as the doctor went over patient education. Hey Collin, you need to get more sleep honey. I jerked my head up and looked right into the patient’s eyes. There was something uniquely kind in her voice, and it was evident that she’d paid close attention to my name when I introduced myself. I have to constantly resist the urge to narrate my life as a personal “This American Life” episode. I don’t want to minimize real experiences as teachable moments that lead to understanding between individuals who are good but flawed in different ways. However, I couldn’t help but feel that this moment was another reminder of how most people have a goodness in them and how important it is for me to take the time to find it.

I eased myself back down on the seat of the rowing machine feeling weak and vaguely nauseated. It was my last of 3 sets of 500 meters rowing, 10 pull-ups, and 30 dips. I hadn’t been on a rowing machine for over a year, but I felt obligated to change things up for Jill my workout partner and ER nurse. Five hundred meters is nothing, it takes about a minute and a half if you’re pushing it and no more than a minute and forty five seconds if you’re dogging. At one minute I felt like I was going to barf and twenty seconds later my vision started to tunnel. At 500 meters I dropped the handle and toppled sideways off the erg. Pushing myself to my feet I stumbled towards the mats but had to take a knee in front of the squat rack. Nothing in my body seemed to be working. A couple seconds later I struggled up and over to the mats. I used my last bit of energy to catch myself before hitting my face and twisting over to my back. I didn’t move for 20 minutes or so as Jill castigated me for being a terrible patient with a worried look on her face. All I could think about was my stomach rising and falling with my breath and my heart buzzing in my chest.

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A red pine grove reminiscent of truffula trees

There are some clinic visits that I wish I could film. In the same way that watching Louis CK talk about shitty emotions in his brilliant “of course but maybe” sketch, there’s something cathartic about hearing the truths of others. I’m fortunate enough to receive daily doses of unfiltered honesty, and I can’t imagine a better way to learn about life. It’s exhausting and means that usually when I come home all I want to do is cook, eat, and be alone. I wouldn’t trade it for anything. One of my favorite parts of this job is when patients uproot the narrative I’ve created for them. There’s been a lot of talk lately about blue collar workers and mining, and I’ve developed more than a few of my own prejudices. This past week I met two people who work the Iron Range mines and who blew these prejudices to shit. The first was a 72 year old man with 48 years in the mine. Our conversation was meandering per the usual retired old man visit until he started tearing into Donald Trump’s five draft deferments. You’re probably a Republican he grinned while looking at me, but I’m a Democrat because they work for the common man. They’re not perfect either, he continued as I wondered why he thought I looked like a Republican, but at least the Democrats try to make this world a better place for common people. I couldn’t have said it better myself.

I met my next miner last Wednesday afternoon. Her exhaustion was palpable when I walked into the room. She was a woman in her late 60s who was presenting for a complete physical. When screening for constitutional symptoms, she noted that she had gained a lot of weight over the past year. After a hint of further questioning, she looked up at me from blue eyes heavy with bags and her story came pouring out. She’s worked her entire life driving truck in the mines. Her shifts were recently increased from 8 to 12 hours. She has only one 45 minute break per day and the mine provides a dank mouse infested shack to spend it in. She’s looking forward to summer so she can eat her lunch outside instead of inside her truck. She hates spending time in the shack where the sexism can get overwhelming. Here she paused, I’m sorry I shouldn’t have said that. At first I didn’t understand what she was apologizing for, and then I took her hand and inarticulately muttered that she had nothing to be sorry for. She kept talking.

This is the fourth mine she’s worked for and it’s taken her four mines to realize that they don’t give a shit about the people who work for them. She’s had to take pay cut after pay cut in order to do her part to keep the mine afloat. She knows that her loss of salary is of no real consequence to the inevitable outcome of the mine shutting down. Her face looked drawn and tired. I used to hate the tree huggers who came up from the cities and now I sign every anti-mining petition that I see. I’ve struggled to put food on the table as a single mom working the mines and the first three mines I worked for took every dollar that I put towards retirement. They’re all liars and they don’t care at all about the community or the people who work for them.

Sometimes I meet patients who leave me at a loss for words. They’ve simply lived so much more life than I have, that any advice or consolation I could give seems ridiculous. Maybe someday I’ll have the right words, but last week all I could do was listen.

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Northern sunset

That being said, I won’t shut up if given the right opportunity. A little over a month ago I got a call from a professor at Vermillion Community College asking if I’d give a lecture on STIs to her human sexuality class. As we were hammering out the details, she said that she’d also appreciate if I included a little information about consent while I was at it. She mentioned a few times during our phone conversation that her class had 35 students and was “fun but wild, so I jumped at the offer. What better opportunity to put my money where my mouth was regarding gender and health? I have never worked harder putting together a lecture in my life. I have also never been less satisfied with the lecture that I’d prepared. Knowing what a problem sexual violence and health is, I felt pressure to get it right. The class was multi-racial, mixed gender, and had varying perspectives. They were more engaged than I could have hoped for and they peppered me with difficult but legitimate questions.

It was quickly evident that there’s a huge need for young people to have facilitated conversations about sex where they get facts and aren’t being judged or moralized to. They seemed starved for the conversation, and it was great to hear 18 and 19 year old guys from the south talking openly about consent and asking questions about when things can get murky. The STI talk got a little derailed with a conversation about rabies (one student asked whether viruses kill hosts), but the conversation about consent was open and forthright and it made me realize how ready people are to having that conversation. It was difficult to strike the balance between being humorous, honest, and serious. There was a running joke about about how the goal of my talk was for them to have better sex, but they easily grasped the concept that communication not only leads to a better experience for both parties but decreases the risk of someone experiencing trauma. They then impressively pivoted to talking about trauma when we briefly talked about the letter that Emily Doe read to Brock Turner. I left with frustration and hope. If a group of socially/racially/economically diverse men and women at a local college were this open and receptive to such a hard conversation, we need to be stepping up our engagement in schools across the country.

You guys are working out like girls today, I’m impressed you’re keeping up! I grunted out my thanks to the 60-some year old Amazonian doing burpees to my right. Greg and I had finally made it to Jill’s workout class and we were struggling. Seeing Jill’s no excuses attitude in the gym, I’d spent the past two months avoiding the workout class she teaches. However, when Greg’s wife finished class one night and commented that it was probably too hard for us, we were put on notice. He’s a nurse at the hospital and firefighter with two kids and five years on me, so there was nothing fair about our beer challenge for who could get through the workout easiest. Okay, now down into super-woman! Jill screamed at us. Or super man, said one of the other other women in the class. Today we’re super-women, Greg choked out next to me. Agreed, I groaned the goal is to be super-women today. The older ladies laughed and kept on kicking our asses. It took a few beers and a lot of sauna to begin to feel normal again. Drinking more beer and cooling off on the dock, we were both able to put our aerobic class humiliation behind us.

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The “Next Jesse Diggins” Award

 

A warm end to this northwoods winter just gave way to a brutally cold first week of spring. I’m writing from a hotel in Virginia Minnesota, my right leg propped up on an ottoman because my old man tendons are having a hard time transitioning from skiing to running. A few weeks ago our MYSL season ended with fireworks, state champion skiers, and speeches. I couldn’t make out much of the closing ceremony through the gorilla suit I was wearing. However, the rest of the day was magical as six of the state champion Ely girls ski team joined my group of sixth graders (eight girls and one boy) on our final ski. When we got out on the trail I went for a Herb Brooks-eque speech about what an amazing opportunity my skiers had to learn from champions, but I think they all just wanted me to shut up and get on with skiing. So I paired them up with the champs and we hit the trails.

I ended up co-coaching a group of three novice skiers with Laura, a high schooler that had coached with us for most of the other sessions. The kids were skiing between me and Laura while working on transitioning around a corner. We’d each give them a few words for technique then watch them ski away from us and disappear around the corner heading toward the other coach. While I was leaning on my poles and waiting for the skiers to come back my way, I could hear Laura clearly through the winter air. She was kind, smart, and encouraging, and I felt a lump in my throat listening to her coach and cajole. There was something beautiful about listening to a teenager teach someone younger with that kind of wisdom and skill, and it was humbling to hear the ease with which she skillfully found the right words. When we were done, I stifled the urge to tell her that she should think about going into teaching. Instead I ended up congratulating her on her season and thanking her for her help. Maybe that wasn’t the right move, but she was a state champion and I didn’t want to say anything to diminish that ferocity.

At the end of the day, my skiers huddled around me in the chalet and I passed out their certification cards along with little awards that I wrote out for each of them. It was ridiculously fun to watch their eyes light up when I read their awards and explanations for why they earned them. My only regret is that I only gave out one “The Next Jesse Diggins Award.” There was no MVP award or bullshit “best hustle” award, but “The Next Jesse Diggins Award” was close to the top honor. What I didn’t anticipate however was that I would get to  look them in the eyes and  realistically say that I thought they were all on track to become state champions. Watching those sixth graders look up to the high schoolers reminded me how important it is for people to have role models to look up to, identify with, and then topple.

My own ski season ended much more inauspiciously than the Ely Nordic Wolves. I drove down to the Pepsi Challenge 50K at Giants Ridge with the stated goal of winning it. It was a hot day with temps reaching almost 40 degrees Fahrenheit by the afternoon. I shot off the line and took off ahead of the pack for the first 5 kilometers. Once the elation wore off I started to feel a little funny before my lower back locked up as I was cresting one of the hills on the Silver Trail. Unfortunately for my ego, it wasn’t due to any nefarious cause, I was just pushing harder than I should have been and my body failed. The main pack caught and passed me after a few minutes and I spent the next six kilometers struggling to work out my spasming back. Eventually the second pack caught me and it was all I could do to hang on for the next twenty kilometers or so. Soon enough however we began to pick off skiers falling off the first pack, inching our way into the top 10.

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Overconfident at the start

I didn’t have the race I wanted but I could care less. I had nothing left in the tank at 45 kilometers and blew my body out in order to comfortably beat my packmates. When you’re a grown person racing in spandex, you can’t take yourself too seriously. I race now because it’s my church, my meditation, and my education. I can live with the fact that for lack of training and probably talent, I didn’t finish as high as I wanted at the Pepsi or Vasaloppet. Exploding towards the finish with nothing left to give is still good enough to remind me that I’m alive.

When I was little, I was under the impression that it growing up was a linear process with a clear beginning and end. I figured that I wouldn’t have to keep glancing over the edge to remind myself where I was standing and who I was, and in some ways that’s true. Somewhere between the ages of twenty four and twenty six, I emerged from an amorphous fog of multiple personas as a complete human being. What I didn’t anticipate was the need for continued maintenance and reflection on that being, or how difficult it is to change once the epoxy has hardened into something more substantial. I’ve been thinking about this specifically lately in terms of how it relates to feminism. I’m not delusioned enough to believe that one day I’ll go to bed knowing that I lived the perfect day, thought the perfect thoughts, and acted in the perfect manner. Racism, classism, homophobia, chauvinism, and all of the other isms live inside me in one way or another. However, many of my isms have been tempered by experience and education.

I don’t think that children are born with specific fears and discriminations, but that they do seek conformity, ease, and acceptance. Kids have love and tolerance in them, but it has to be taught to overcome fear, ignorance, and comfort. It’s embarrassing to think about, but I remember how difficult it was for me during the first few hours of volunteering overnight with my family at Camp Courage. At the time, spending the night caring for intellectually handicapped adults made me uncomfortable. That changed through spending time with those men and women, but it took experience through visceral empathy and understanding before it became natural. Through exposure and experience I have grown out of many of these intolerances even as the remnants of prejudices remain as unconscious biases.

I remember sitting in a sociology of work class during my sophomore year of college and feeling a nativism inside me that made me feel ashamed. It was later on in that same class that I felt that nativism melt away. It took readings, essays, and conversations to understand in my gut that as I did nothing special to be born into opportunity in a country as wealthy as mine. I know that race, class, religious beliefs, appearance, sexuality, gender, weight, education, and differing abilities all affect the way that I interact with those around me. However, I see growing up as a continued striving toward seeing those around us for their individual humanity. This isn’t easy for me and in our current culture of blatant and unconscious bigotry, I’ve begun to realize how important it is to continually reassess these biases.

For me, feminism specifically is easy to say and hard to achieve. I recently had a long conversation with two women much smarter than me who talked about the subtle chauvinism of the men in their lives. These are men they love and respect, but who nevertheless patronize them through words and behavior. And I know I do it too. I have trouble seeing gender as a truly constructed phenomenon no more essential than race or class. Sure there are significant differences in biology between males and females, but even that gets complicated medically with variations like XXY, androgen insensitivity disorder, and different adrenolopathies. On a warm summer night this year, I was sitting on the patio outside the new VFW on Lyndale closing down the bar with my friend and his wife. I don’t know who brought up what, but at some point the question was raised regarding what aspect of our culture that our children would think is insane. What will our grandchildren think about and unanimously agree that we were Neanderthals? The three of us decided that our best guess was gender.

I’m not sure where to go at this point beyond staying vigilant to my own biases and striving through words and actions to let those around me know that they can be whoever they want, be it conventional or not. This idea has been especially pertinent this year as I spent two hours every Sunday coaching young women. Chauvinism shouldn’t be a cloak I take on and off. If I can do it while coaching, then I can bring that mindset into other aspects of my life. Seeing through gender to whatever human lies underneath is a challenging but important goal for me if I want to truly see people as themselves and gender as merely another aspect of their personality. Thinking about the way I look at gender is humbling because I see how easily it is to casually live in my comfort zone because my biology just happened to line up with our culture today. If I’m blind to my own chauvinism then I can spare a little more empathy to those who are blind to their own privileges in terms of race, religion, and sexuality. Not for a second do I mean to condone the hatred and stupidity that is propelling this nation towards moral ruin, but that I hope to approach changing this country with a more nuanced appreciation for our common humanity.

That appreciation for common humanity is what I believe that liberals have to offer. You can’t rip something away from someone without giving them something to replace it, so I think we should offer up love. We live in a beautiful and terrible world in which we will all die without knowing what comes after. I understand why we “cling to our guns and religion.” People need something to hold onto, be it power, nostalgia, faith, or tradition. It’s scary to live in a world with so much unknown, so it makes sense that people would want to hold onto stability values. There’s been a lot of talk lately in progressive circles about how racism, sexism, and Islamophobia shouldn’t need to be explained to white men. I agree, but even though something shouldn’t “need” to be explained, it doesn’t mean that taking the time for explanation isn’t a more effective way to create change. At the end of the day, if we want to live in a world that’s changing beyond our own bubbles, we have to go out there and change it ourselves.

I can’t help but return to the values that I was taught by my parents and then which I eventually taught while in the Peace Corps and as a kindergarten aid. We teach children that humanity is precious, that difference is to be celebrated, and then we should strive to be loving and accepting of those around us. I was always uneasy regarding the hypocrisy of teaching these values without perfecting them myself. Even so, I think they’re a powerful and solid foundation to hold onto. In exchange for faith, tradition and power, my replacement might seem paltry. However, it’s it’s what gets me out of bed in the morning and if it’s enough of an existential anchor for children, then it should be enough for me.

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Maybe I’m predisposed because I share genes with a man who obviously gets his kicks from simple pleasures.

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It’s time for a frame-shift

There has been a lot of talk lately about the fact that we seem to be in a post-fact society. I think we also could look at through the lens that we’re in a post-critical thought society. Facts are only facts to the extent that they hold up to critical thought, and this kind of thought appears to be completely absent from the current GOP ideology. I’ll just use the latest decision by the Trump administration supported by the majority of the GOP (politicians and voters) to illustrate this point.

Trump just lifted a federal mandate allowing transgender students to use the bathrooms best suited to their gender. Their argument is that allowing transgender women to access to the bathroom of their choice endangers cis-gender women and girls. This is not backed up by facts. Not one study. Nothing. Not to mention that it makes little intuitive sense, as trans people are far more often the victims than the perpetrators of sexual violence. This mandate and its support is  based simply on the fact that the GOP is now solidifying itself as the party of intolerance. They want to marginalize trans children and promote a culture that is homogeneously white, heterosexual, patriarchal, and Christian. I believe that it’s important to call it out for what it is, trans people make them uncomfortable and they don’t see a place for them in their world. If the GOP truly wanted to reduce sexual violence against women, there are plenty of evidence based steps they could take. They could start by changing their language regarding reproductive rights, investing in sexual education programs in schools and universities, and supporting the many organizations that fight against this abomination. If they really gave a shit, they would end NCAA sports until each university put as much money towards fighting sexual violence as they do propping up their good-ol-boy bullshit glorification of gladiators, or cancel the Super Bowl until it stopped being a Mecca for sex-trafficking.

I’ve been working over these ideas of what it means to be a civically engaged American while trying to live in the moment up here in Ely. It might seem ridiculous, but being recognized as the local med student by the guy who stamps my card at the dump was affirmation enough to get through an entire day of CNN updates. My mom has these moments where she throws her arms up in the air and screams “I’m having a moment!” My moments are usually a little more reserved, but I experienced something close last weekend. The black and freezing cold water rolled off me as I pulled myself out of a hole in the ice. I quickly stood up on the wooden dock and felt the warm winter air as it brushed my skin. I was alone on the dock and the sky had cleared above me revealing a patchwork of stars. There was no moon, so the stars glittered down like diamonds on velvet. I stood alone as steam slowly faded from my skin, and the only sound I could hear was my heart beating in my chest. My whole body buzzed with each beat as my eyes traced the stars. I felt solid and at peace in space and time.

I didn’t think that I’d have to run so much while dog sledding. A couple weeks ago I suited up to go mushing in my Kazakh parka, cross country ski pants, and beat-up Timberlands. My friend picked me up in her little red car with a dogsled strapped on top and we drove out into the woods. It was a cold night with light snow falling and obscuring the full moon. I sat in the sled for the outbound trip. The snow crunched underneath the runners and the dogs plowed through the thick snow that was falling faster by the minute. After six miles of hard running, we swung the sleds around and pointed them back toward where we’d come from. We were in the middle of a massive lake. The real musher then gave me the reins of the smaller sled and a second later I was jerked to attention by a team of dogs ready to head home. Hovering over the wooden handles of the sled, I had to squint my eyes to try to make out the team in front of me. The lake shore was beginning to fade as the snow fell faster and faster. I spent most of the trip running next to the sled as the dogs struggled through the thick snow. Once we hit a plowed section of the road though, I sat back on the runners and felt the tips rise underneath the sled as the dogs flew across the snow in front of me.

Most days I cannot believe how lucky I am to be up here working in the clinic and hospital. I wake up every morning and get to spend the rest of my day thinking about what it means to be human, talking intimately with strangers about their lives, and using my whole brain in complex problem solving. Almost all of the patients I see struggle with one or more of the following: weight, back pain, diabetes, hypertension, hyperlipidemia, and dysthymia. These are challenging illnesses that are caused by a variety of intrinsic and extrinsic factors. We have medications to treat each of these illnesses, and usually in clinic visits we mention that it’s important to make lifestyle changes to diet and exercise as well. However, since I have a little more flexibility with my time, I’ve been spending more and more time discussing the importance of exercise. Evidence based medicine has demonstrated through study after study that exercise is a magic bullet that improves every one of these health conditions as well has a separate beneficial effect on all-cause mortality. That being said, I completely understand why it would be difficult for doctors to keep prescribing and advocating for behavior change that they rarely see patients make. I also see the problematic nature of a young, healthy, privileged medical student telling people how they should live their lives.

I am far from perfecting this conversation, or even from being effective at it. However, I’ve also spent the past 4 months trying to learn how to have these conversations with people who humble me daily with their frankness. I try as hard as I can to listen to what patients tell me while affirming that their struggles and success are normal and human. I don’t mean this in the bullshit way that it’s important to affirm someone. I mean that it’s logical to remind people that the struggles they have daily (exercise, diet, smoking, stress) are universal. At some point it’s more helpful and logical as a society to look at the structural problems setting people up for failure instead of solely ascribing agency to their behavior. Every good conversation has give and take so I’ve found that in certain contexts it can be helpful to admit to my own failures as a human. I love nicotine, I’m insanely lazy when I get home from work, and I eat like a stoned pregnant woman.

  • I got up at 7:10 Thursday morning and was out the door by 7:45. However, in the 35 minutes that I had between rolling and of bed and walking out my door, I actually made time to bake and eat 6 chocolate chip cookies from dough that I’d made the night before.

I get why people have a hard time dieting. Normalizing destructive behavior while accompanying it with spare facts and a prescription for how to move forward is a tricky dance. We all do things that we wish we didn’t, but for some of us, the stories of these decisions are written on our bodies and in our laboratory reports.

It was almost 50 degrees out last weekend in Ely…. in February. Because I have no shame I went skiing shirtless and in spandex bottoms I won at a race this year in Duluth. I decided to embrace the hot sun because no matter how foreboding the weather felt, there was nothing that I could do that day to change it. The sun beat hot on my skin and water dripped down from branches thick with old snow. I slipped through the woods on wet snow that was just barely able to stay formed and icy. I try to use these long Saturday skis as a time to reflect on different problems or ideas that bounce around my head during the week. Usually this is the perfect time to do so as my body stays in cruise control and my mind floats along on its own. It didn’t work on Saturday. I was cruising down a shaded and icy hill that opened up to the hot sun baking a sticky bog. When I hit the bog, my body shot forward off the trail as my skis stayed firmly rooted in the wet snow. It was painful lesson in living in the present moment that tore me from the question I was working on.

The question in question was how to bridge the gap between small town values and small town politics. I work and hang out with good people, actually some of the best people I’ve ever met. Part of the charm of living in a small town is that it is harder for people to retreat into their own private lives due to the fact that you’re forced to interact with the same limited number of people for all of your mundane daily interactions. This closeness builds a sense of responsibility and brotherhood different than what we have in metro areas. For example, when I asked my friend, a full-time dad and RN at the clinic, why he goes out on every single odd-hour EMT call that brings in a minimum wage salary, the answer was simple: “This is my town.” There are problems here, some startling in their viciousness, but there are problems everywhere that people gather and live. However, the average interaction that I personally have in the street is much warmer than I’m used to while living in the city. People constantly open themselves up to me, invite me into their homes, and go out of their way to make sure that I feel welcome. That’s why I’m still having trouble understanding why the good and decent people I know here are so quick to malign our culture of political correctness.

The conversation eventually veered towards politics at our Valentine’s Day taco party the other week. After hearing yet another complaint about our “current state of censorship,” I shared my thoughts through a mouthful of guacamole and ground beef. To me it’s simple, I see political correctness as an extension of common decency. If I have to limit my vocabulary in order to make sure that those around me feel safe, accepted, welcomed and non-threatened, then that’s an easy way to make the world a little bit better. It’s no skin off my nose to be a little more careful in how I speak in order to create an accepting and loving space around me. When people here talk about small town values, they talk about helping your neighbors, investing in your community, and caring for your children. That’s why it’s so confusing to hear political comments that are so contrary to these values. I think I’m beginning to understand it a little though. Change is hard and no one likes being told what to think or how to behave. Besides the underlying current of white fear that has been fomenting in our country for generations, people have a legitimate desire not to be told how to be.

To this point however, I want to propose a mental frame shift, similar to the way in which I mansplained my concept of feminism to my friend’s girlfriend who asked me about my bumper stickers. She told me she didn’t see herself as a feminist because she enjoyed conventional gender norms, and I responded that I saw feminism as her right to choose to live however she wants, be it conventional or not. I see feminism, trans-acceptance, religious tolerance, and racial equity as deeply American ideals consistent with small town values. America is a community that has come together around the idea that people should be free to live their own lives in the way they see fit. That oppositional dynamic of a community built on individualism is precisely what makes this country so unique. This is a complicated foundation for a democracy and requires that its citizens strive continuously to maintain these values while fending off attempts by fear mongers and bullies who wish to warp America into their own neo-fascist autocracy. The very nature of America demands that its citizens use moral fiber and critical thought to defend it. The Trump administration and those who support it actively and passively should be afraid. They should be afraid because they have given the citizens of this country a worthy cause to fight for.

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To feel important

What’s happening right now in America is unconscionable. Muslim ban, border wall, avowed white nationalist on the US security council, DAPL, Keystone, and assault on reproductive rights all in the the first week. This isn’t just going to be another political rant, there are enough out there already. That being said, as staying silent is tacit approval, I would consider myself remiss if I didn’t say off the bat that I will continue to stand with those who are marginalized in our current (and past) culture of racist sexist xenophobic fascism. Just today I connected with two men who I consider brothers, men from predominantly Muslim countries who are not only two of the kindest people I know, but who have graduate degrees in engineering and economics. These brilliant, kind, and fully americanized professionals are no longer sure that they feel like they can make this country their home. I’m far from perfect and am constantly face to face with my own humanity and shortcomings. However, I am also sick and tired of hearing well-intentioned liberals discuss the need to further explore the flaws of the leftist ideology and hear out rural America to better understand this conservative/reactionary/impotent white male perspective. I don’t buy it. We’ve been living that perspective for the past two thousand years and it’s time we stood up and fought to broaden our fucking horizons.

 

Selfishly living in Ely allows me to escape our current political horror show whenever I want to and think about smaller problems. First on my list is that I have yet to see a wolf. I’ve wanted to see wolves since I moved up here, but the closest I’ve come is a ragged coyote that looked like it had mange. For the first few months I was here, almost every time I closed my eyes  wolves would come to me in my dreams. They were always powerful and wild, looking me in the eyes at a distance just too far to smell them. There hasn’t been a fatal wolf attack in the wilds of the lower forty eight since 1893, and I tried to keep that in mind when I was putting on my skis the other week. The sun had long since gone down and I was alone in the pitch black parking area in front of the Hidden Valley ski trails. My long day working with Schwinghamer, the on-call doctor, had given me a lot to think about. Dr. Schwinghamer is built more like an offensive lineman than an academic. He thunders in and out of clinic rooms too quickly for me to catch him but that’s a small price to pay for what I’m learning. In addition to the doctoring, he’s showed me power of putting your hands on patients, of being unafraid to say you don’t know, and letting down your guard to show your patients that you care for them. 

 

As I kicked off into the trails, I thought about the second patient of the day. He was a guy in his early 20s with a left below the knee amputation from a job site accident. I looked down to hide my emotion in the clinic when he started talking about his service dog as his “little lover.”He had no bitterness, no callousness, and no anger. He was just trying to do the best he could with the cards he’d been dealt and wasn’t ashamed to tell us that it was hard. It was all I could do to keep myself from giving him a hug when we finished talking. The next patient was a woman in her early 30s who had an infection s/p mastectomy for breast cancer. She had three young children, one of whom is completely dependent. When she told me about her children, I remembered that I’d met her husband a few months earlier when he brought in their daughter due to an episode of her recurrent aspiration pneumonia. I will never forget that ER visit. The love and care emanating from that man towards his daughter was palpable. We were worried that we couldn’t give her appropriate care in Ely, but he told us that if we would just let him care for his daughter at the hospital instead of sending her down to Duluth, he would take care of everything on his own. I was telling this story to his wife and before I knew it I had another lump in my throat and she needed my box of tissues. Medicine so often seems to rob people of all that is good, but almost daily it can reveal these brilliant moments of pure love.  

 

So I had a lot to think about as I stepped out of my car into the dark night the other week. My skis were sticking to the wet snow, and the air was warm and murky with patches of fog that were so dense you could only see three or four feet in front of you. My headlamp did little more than create a dim outline of the trail in front of me. I streaked down hills virtually blind, more than a few times veering off the trail into the pines. For the first time since coming to Ely, the woods unnerved me. Something about the fog and the dark made it feel like every glint I saw in the trees were eyes staring back at me. I finished up my workout and was going to take the outer loop for a cool down lap mostly because my instincts told me not to take the trail going into the heart of the forest. Fighting my craven gut I plunged back into the trees. Then I was going to take the meandering loop back to the chalet in order to avoid “The Screamer” in the now total darkness . The next thing I knew I had pushed off into the darkness. A moment later I felt my skis leave the ground for a few glorious and terrifying seconds before reconnecting with and skidding across the icy hill. I’ve night-skied since and have yet to feel again that same sense of uneasiness that I did the other week. It might have just been the fog, but I’d like to think that as I skied through the woods I was flanked by silent canines running beside me.

 

Last weekend I joined the Ely Women’s March before heading out to explore the North Arm ski trails by Camp DuNord. There were only about 40-50 of us out there, maybe 4-5 depending on White House estimates, but it felt good to be involved in something as our maniac in chief took office. Plus I scored a dinner invite from an incredible couple in their 80s. Reflecting on the past few weeks though I realized that Trump and his cronies might hold office today, but there’s so much that they’ll never have. Fame doesn’t matter, if humans survive another 10,000 years no one will remember our names no matter how famous we are. Wealth doesn’t matter because past a certain point (~70,000/year) it does nothing to improve our life. Power doesn’t matter for the same reasons that fame and wealth don’t matter. At the end of the day, all that matters are the individual moments where we are good to people. Being kind, loving someone, working for justice and equality, etc are infinitely priceless moments because unlike fame and power, goodness stands on its own. Thousands of years after the dust from our bones settles on the ocean floor of what was once the coast of Florida, those moments of kindness and love will still have happened. Those moments will be all that mattered.

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Ely Women’s March

I was thinking about this in light of our current president and the lengths for which he is willing to go in order to feel important. Unfortunately I think that his mind is too twisted to ever understand that none of the wealth, fame, or power he has matters. He is a little man and he will live the rest of his miserable life a little man no matter how powerful he becomes. What I do hope however is that the republican politicians in this country can wake up and realize that power isn’t worth the almost unpayable moral debt they have incurred. As many others have mentioned, one of the only silver linings in this abomination has been watching so many people in our country turn out for one another, showing us that maybe we do still have the potential to be the greatest country on earth. I’m proud watching my countrywomen and men march on cities and airports. I’m proud to be a part of a family where my mom was just hired to be the executive director of Mediation Services for Anoka County and my brother was just hired to be a 10th grade English teacher at Cottageview High School. They turn out every single day and I look up to both of them as examples of how to live and work with purpose.

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