Category: Life Style

Its coming up on three months now that my daughter exchanged wedding vows with her best friend and now husband, Tosh. It was a perfect day. The sun shone brightly in Bend’s beautiful afternoon sky highlighting the majestic Three Sisters mountain in the background. A gentle breeze cooled the delighted audience as they sat in radio silence, watching the elegant wedding party walk down the sunflower flanked aisle making way for the stunning bride’s grand entrance, her dad on one side, and her stepdad on the other.

Embracing a newer trend, Elena and Tosh exchanged vows they wrote themselves. They spoke of each other’s attributes. They spoke of their quirks. They spoke of their love. They recognized that though they could not know their future, they were committed to growing together and encouraging the best in each other whatever the future held for them. And Elena spoke of her prayer of surrender.

Elena did not date much in high school. Though she had a wide circle of friends, there was no special guy, and I saw that as a grace—high school relationships can so often lead to heartache. College brought a bigger pond and a few dates, but still, no one serious.

After college, she moved to Bend, earned her master’s in teaching and started her career as a high school Spanish teacher. Her desire to be married only intensified. I was excited when she was asked to participate in so many of her friends’ or cousins’ weddings. Single men attend weddings. And weddings are as fine of a place to meet a guy as any. I would cling to her every word as she described the details after the wedding, waiting with bated breath for her to finally tell me that she had met someone. But that’s where my fairy tale ended. She remained a bridesmaid, only to rejoice with the happy couple as they married and started their families, not to find one of her own.

As her mom, I tried to approach the boyfriend subject gently over the years, letting her bring it up when she was ready.

One weekend, while we were driving on a mother-daughter outing, she confided that she surrendered. She explained that she was no longer going to pray for a husband, because God knew her heart. He knew she longed to be married and have a family. She acknowledged that marriage may not be God’s plan for her. So, she decided to let go, to hold her dream a little more loosely. She surrendered, trusting that God would do what was best for her.

At first, I thought she was giving up. Though I never said it out loud, I wondered if she was becoming cynical, as if marriage was just not for her. But I was not ready to stop praying. I could not surrender my hope that she would marry or my desire for grandchildren. Elena was approaching thirty at that time and unmarried. Which meant what exactly? That she was too smart, too intimidating, too tall, too pretty, not pretty enough, unlucky, passed over, not ready?

It meant none of those things. It meant she was almost thirty. Why did I feel the need to assign any meaning to that number?

Still, I promised myself I would stop asking about boyfriends, dating apps, or possible setups. Instead, I reassured myself that I would keep praying, whispering silently, for God to give her the desires of her heart.

Since then, I have learned a lot about this kind of mindset. This kind of surrender.

It is not apathy and it is not certainly not giving up. Instead, it is a way of living that emphasizes openness and vulnerability, connection and grace. Holding hopes and dreams loosely. It’s not about believing in the dream so much as believing the Giver of the dream. It’s not disconnecting from hope but rather connecting to the Giver of hope. It is not about waiting for future happiness, it’s about embracing happiness now. And it is acknowledging that I can’t always know what or when is best for me because I can’t know the future.

And this kind of surrender does not leave me helpless or give me an excuse for doing nothing. It is an active waiting place, a posture that takes every day as it comes, one day at a time.

So, what does all this have to do with wellness or weight?

A few of my patients walk through my doors married to a number on the scale as if they could not possibly be happy unless and until they weigh that number. Weight loss is their only treasured outcome, their only measure of success. Every month, as they approach the scale, they take a deep breath and hold it, closing their eyes, and turning their head away, not wanting to peek or see the number because if the scale is not down—by a lot—it means they have failed and nothing is working. They attach meaning to the number and it weighs them down like a ton of bricks. Sometimes they call and cancel because the scale is just too hard to face. The crushing disappointment of weight plateaus sinks their ship so much so that some give up on their dream of weight loss altogether.

At Oregon Weight and Wellness, we do a lot of work on mindset, detaching from dreaming about “weight loss” and attaching to dreaming about “health gain.” We work on letting go of old stories of a certain number on the scale to make us happy, and we write new stories of healthy habits and how good they feel. The appointments have less to do with “weighing in” and more to do with “checking in.” Every appointment, I ask about the small changes people are working on regarding food quality, movement, sleep hygiene, and stress management. And I ask how them to connect the dots and notice their body changing because of those small changes. We sometimes spend so much time talking about the changes they are making that we forget about the scale and weighing altogether.

I love hearing my patients beam with excitement. “I can cross my legs.” “I can tie my shoes easier.” “I did not have to ask for the seat belt extender the last time I was on the plane.” “I hiked all the way up our hill with my grandkids.” “I have more energy when I eat protein for breakfast.” “I am sleeping better on the days I exercise.” “If I take a few deep breaths before starting my next meeting, it goes more smoothly.”

“And how does that make you feel?” I ask. Happy. Well. At peace with the process. Those are the constant comments.

When we attach happiness to the habits that build wellness, we create value around them. We want to stay consistent with these values even when we don’t feel like it. Whether we are on vacation, or at a party, or at the beginning of a new school year, we stay open and vulnerable, aware of circumstances that present new challenges, looking for strategies to stay on track. We stay connected to the support we need to persevere. And we give ourselves grace when we feel the pressure to default to old ways. We don’t give up. We get up, dust ourselves off, and move on. Wellness has become our identity, not a number on a scale.

Change that is not challenged does not usually stick. It’s not easy, and it is not supposed to be.

What is an ideal body weight anyway? Well, it is not necessarily a BMI less than 25 like the books want to tell you. It’s more about body composition than a BMI, muscle mass, body fat percent, and where the body fat is. (We measure all of that at OWW, by the way.)

It’s a weight that can be maintained with a healthy relationship with food, understanding the difference between nourishing foods and fun foods. It’s a weight that supports metabolic markers, like blood pressure and blood sugar and liver functions and cholesterol. It’s a weight that allows freedom of movement. I never tell a person how much they should weigh. We figure that out together.

So let go of that number in your head that you think will bring you happiness. Give up that idea of your ideal weight. Surrender to the much higher calling of wellness. And better yet, surrender to the Giver of wellness who will never give up on us.

June was an ongoing if not exhausting extravaganza of family festivities.

Our Texas family and friends joined us for nearly two weeks of memorable celebration. The events commenced with Gabby’s pinning ceremony, a long-held tradition heavily influenced by Florence Nightengale, the famous nurse who earned the Red Cross of Saint George. Now nursing schools design their own pins representing knowledge, service, and dedication to patient care. During the ceremony, graduates are typically pinned by a faculty member or a person of significance. Gabby was pinned by my mom, her grandmother, who had practiced nursing for over fifty years. We took pictures and basked in the moment. But we could not linger long because we were soon whisked away to the next event of the evening.

And of course, we marked each milestone and each graduate with grand parties.

Then came the final push: last-minute preparations for Elena and Tosh’s rehearsal dinner, welcome party, wedding, and reception.

We made lists upon lists, prepped food for days, collected beverage containers and serving trays, hauled tables and chairs, washed silverware and glasses, ironed napkins and wedding clothes, arranged flowers and bouquets, built archways and tables, ran last minute errands, all the while texting back and forth to an ever-increasing chat group.

Finally, the wedding day was upon us, truly a family affair.

I drove to my sister’s house around 3 o’clock the next afternoon after a long day of clean-up and collapsed on her couch.

“Do you need to spend the night?” she asked, sensing my fatigue.

“No, I’m looking forward to sleeping in my own bed tonight,” I mumbled only partially coherent. Apparently, I needed a nap first.

I slept hard for thirty minutes, drank some left-over iced tea, and set off for the two plus hour road trip to home, sweet home.

Being home never felt better, the sanctuary of my porch swing, the quiet of empty rooms, the dogs happy to see me. I thanked myself for having the foresight and giving myself permission to take the next day off work. I didn’t just need sleep. I needed rest and recovery.

Cleanup continued Monday, but the pace had finally softened. I washed one hundred seventy dishes one at a time, slowly, letting the quiet work make room for gratitude, reflection, and the first hints of renewed strength.

I washed a few dishes, dried a few, and put a few away. In between, I gave myself permission to pause—to sit with iced tea, pet the dog, water a flower, or simply stare at the walls.

The rest of the week followed that much-needed rhythm. I made simple, nutrient-dense meals, took gentle walks instead of pushing through hard workouts, and went to bed early.

Across cultures, people have long recognized the need for recovery by building rhythms of rest into the week, such as the Sabbath.

In his book about the Sabbath, Wayne Muller says: “Because we do not rest, we lose our way. We miss the compass points that would show us where to go, we bypass the nourishment that would give us succor. We miss the quiet that would give us wisdom. We miss the joy and love born of effortless delight.”

“God knows we need rest, and one of the reasons He established the Sabbath was to give us rest,” Billy Graham famously remarked.

Rest has also become central to athletic performance. Sports science now treats recovery as an intentional, measurable process—one that directly supports progress rather than simply following it. Trainers preach a better balance of fitness and fatigue, teaching practices that help the body repair and grow stronger: giving muscles time to rebuild, reducing the risk of injury, supporting immune function, improving sleep, and restoring energy for the next effort. Today, athletes use tools such as cryotherapy, compression gear, mobility work, sleep tracking, and heart-rate variability to understand when the body is ready to go again.

“Rest is not idleness; it is a sacred time to recharge and revitalize our spirits.”

I think the same principle applies to my recent marathon of family celebrations. Four graduations and a wedding. That was a lot! Even when events are happy and deeply meaningful, we cannot stay on the mountaintop indefinitely. Our bodies and spirits still need time to recover, settle, and receive what just happened.

At OWW, we spend a lot of time working on lifestyle to improve health, and teaching about actively resting for recovery will be the next addition.

Nancy was the one who reminded me of our college reunion dates. “Are you going? It would be so great to see you!” she messaged me on Facebook a few months ago. That’s all it took for me to make the arrangements. I hadn’t seen her for fifteen years. We were overdue.

As I walked across Bryn Mawr’s beautiful campus last week, I felt like I had stepped back in time. Had it really been forty years since I graduated from this small women’s college a few miles outside of Philadelphia? Who was I then, and how much had I changed?

Most of my high school classmates stayed close to our small-town Ohio home for college, and they had plenty of excellent options nearby. For reasons I cannot fully explain, I wanted to reach beyond my own backyard. To escape? To prove something? To be somebody?Maybe. I am still processing.

So, my father arranged a trip to visit several prestigious East Coast schools: Princeton, Dartmouth, Brown, Yale, Harvard, Cornell, and the University of Pennsylvania. Since we were already in Philadelphia, he suggested we also stop at Bryn Mawr, one of the Seven Sisters associated with the Ivy League. All the schools impressed me, and many even had ivy climbing their stately old buildings, but Bryn Mawr stood out. Her Gothic stonework, turrets, crenellations, and intricate arches magnified her academic atmosphere, but it was her small class size that drew me in. I could easily imagine walking from the dorms across the sprawling green lawns and up the well-worn stone steps of Taylor or Thomas Great Hall for classes. I applied, matriculated, and moved into Rockefeller, aka Rock, in September 1982.

Barely seventeen, unsure of who I was, and so far away from everything I knew, my self-esteem was on shaky ground. I floundered. Seeking a sense of identity, I threw myself into my studies. I had to bury myself in books to keep up with all the other top-of-their-class girls who seemed much more intelligent, interesting, and attractive than I.

Nancy and I first met on the Blue Bus, the bus that drove students back and forth from Bryn Mawr to Haverford, another liberal arts college a mile down the road with whom Bryn Mawr had strong cooperation. You could live, take classes, declare your major, and of course party on either campus. On this occasion, Nancy and I were headed back from a Haverford mixer. We started talking and discovered we were both living in Rock on the same floor. We became fast friends and were inseparable that first year.

Though we did not share any classes, Nancy being a history major, and I pre-med, we studied together, coaxed each other to attend various mixers, laughed, cried, cheered each other through hell week and finals, took many a needed break, and studied some more.

We also ate together in the various cafeterias about campus. Rhoads, Haffner, and Erdman Halls each had excellent cuisine prepared on campus. And with so much deliciousness, you could pick and choose whatever suited your fancy whenever you wanted. Bryn Mawr took every occasion to have feasts readily available for her students. Donuts in Thomas Great Hall from 9-10 every weekday morning. Strawberries and cream on May Day. And, weather permitting, hamburger BBQs on Taylor Green at least once every other week, complete with mounds of chipwiches, a dessert new to me. Who could resist softened vanilla ice cream sandwiched between chocolate chip cookies and rolled in mini chocolate chips. Sometimes I ate two. Nancy worked at the after-hours student center where you could buy inexpensive brownies or blondies, or both, which I did.

Yes, we endured the crucible of freshman year together, and we gained the proverbial freshman fifteen (or twenty in my case) together.

Nancy and I often commiserated about our growing waistlines, not fitting into our clothes comfortably any longer and not having the financial ability to buy new ones. Every Sunday night after dinner, we would make a list of what we were NOT going to eat that week. And every week I would start off strong, but fatigue and stress would topple my willpower by the week’s end.

Nancy took up running and returned to a healthy weight. I continued to struggle and though a psychologist would not have diagnosed me with an eating disorder, I certainly had disordered eating. Restriction led to over-eating which led to restriction, and so on. A two-way street existed between mild depression and disordered eating, and the sabotage and self-doubt were real. Food was a comfort and a curse.

I had an unhealthy relationship with food without even realizing it. That pattern followed me through medical school, residency, four pregnancies, and years of practicing family medicine while raising a family. Not until 2014, when I reinvented myself as a lifestyle and obesity medicine specialist and immersed myself in nutrition, did I begin to understand what real food really is, how it affects the body, and how the body affects it. It has been a journey, and I am still learning.

What I eat, how I move, sleep, etc is remaking every cell, shaping every biochemical reaction in my body. I find this fascinating if not miraculous. I am not the same person I was a year ago let alone forty years ago. I cannot be.

Foundational to practicing a healthy lifestyle has been cultivating a safe space to challenge my old ways of thinking. This new objectivity and awareness has allowed my deeply rooted beliefs about value and worth to shift. I don’t have to strive for or study more or stew about my worth. I am because of “I am.” Therefore, I have worth. My worth is conditional on nothing other than being created. Period. Not because of my intelligence or anything I have accomplished, and certainly not because I went to Bryn Mawr. Simply by the fact of being.

I am because He is. “I am fearfully and wonderfully made,” sings the psalmist.

To be human is to have needs. Chiefly among them are nutrition, movement, sleep, emotional regulation, and connection. Caring for those needs is an act of respect for the Creator. Self-care is stewardship, not selfishness, because it enables me to serve others well. “Love your neighbor as you love yourself. ” If I am to pour into my neighbor, I must first be filled. I cannot give what I do not have. Self-neglect is no longer virtuous. It has taken years to give myself permission to care for myself.

I had a wonderful time at the reunion, and it was especially good to see Nancy, my dear friend, without whom I may not have made it through that first year. “I get by with a little help from my friends,” we sang unabashedly at Step Sing Friday night. We walked our legs off on both campuses, reminiscing and laughing about our old antics and our old food rules. We were young and naive then. Now here we are—older, wiser, accomplished, healthy, and ever so grateful for that time we shared together.

Even before I truly understood how vital sleep is to health, I cherished it. During my years as a college student, then medical student, resident, and new mother, I was often sleep-deprived. As a family medicine physician, being “on-call” every third night only added to the fatigue, nay exhaustion. I’m still making up for lost sleep—if that’s even possible.

Now, sleep has become a kind of Olympic sport for me. I have no trouble practicing the sleep hygiene I preach to my patients. Every morning, I get up at the same time—5:15 AM. I anchor my body clock by stepping outside before 9 AM for several minutes enjoying the morning sun as the visible spectrum of light passes through my retina and stimulates the suprachiasmatic nucleus ensuring the proper release of melatonin from my pineal gland after the sun goes down. I stick to my caffeine curfew: 9 AM, my food curfew: 6pm, and my screen curfew: 7 pm. I wear blue blockers if I have to be in front of a screen after the sun goes down, as the blue light from screens decreases melatonin release. I make sure to exercise throughout the day to build up “sleep pressure.” My phone charges in another room instead of on my nightstand so I’m not tempted to look at it. I have a consistent bedtime routine: stretching, deep breathing, and prayers of gratitude. I brush my teeth, take magnesium, slip between the cold sheets in my cool darkened bedroom and I’m sleeping like a champ for a glorious eight hours.

Why? Because sleep is good medicine. It’s when and how the body clears out the toxic byproducts of stress and the countless biochemical reactions that occur automatically in the brain and body throughout the day. It’s the time for restoration, repair, and recharging. People who prioritize sleep and sleep well live longer with less chronic diseases. And now there are so many ways to track sleep with apps and wearable devices. Sleep is a vital sign.

So these last several days of poor sleep have been especially troubling for me. And I know exactly why I’m not sleeping well—I injured my neck during a recent quilting marathon. I was determined to finish whipstitching the binding on a quilt for my mother for her birthday, and I thought fine needlework during the drive to Bend would be the perfect use of time. In reality, being hunched over in the back seat for three hours like a body contortionist was a disaster for my neck. I fall asleep fine, but whenever I move and turn my neck, I wake up in excruciating pain.

Experiencing poor sleep firsthand has given me a much deeper understanding and appreciation for my patients who struggle with getting quality rest. It is easy to see how self-care takes a back seat. Waking up feeling groggy can sap motivation and energy, making it difficult to engage in healthy habits such as preparing nutritious meals or finding the drive to exercise.

Lack of sleep also significantly affects decision-making. When I am tired, I notice how easy it is to gravitate toward quick and convenient foods, which are far more tempting than usual. Even my non-negotiables are hard to negotiate. I asked my husband to make me a chocolate milkshake, something I would not typically crave. At least I added chia seeds to it.

It’s probably time for some body work, like massage or physical therapy.

Worse than the pain, though, is waking up and worrying.

Worrying at night isn’t new for me. I often fret about finances, perseverate about projects, obsess about obligations, or dwell on disputes. Typically, I can coach myself off any cliff and get right back to sleeping like a baby.

This time, however, my usual strategies—thought dumping, deep breathing, visualization, prayer, and meditation—aren’t working. My mind keeps spinning, and restful sleep mocks me. Even an insomniac would empathize with my sleepless nights.

This time, I am worrying about my daughter. She was recently engaged to be married.  And of course, I am over the moon happy for her. Interestingly though, being the mother of the bride is altogether different than being the mother of the groom. Sure, I am more involved in the wedding plans. There are so many decisions not to mention complicated relationship dynamics. I chuckle over the vision I had of Elena’s father dancing in front of her like a whirling dervish. I tried to protect her from the clouds of commotion that were brewing, but instead I got caught up in them and caused more commotion myself. Poor Kenny had to anchor me down by tying a rope around my waist while Elena’s fiancé did the same for her.

That is certainly taking up some of the real estate of my night watches. At least I can laugh at myself, which is another strategy that helps me get back to sleep. But that’s not the half of it.

Elena is getting married. And I am wondering if I have I done everything for her that she needs, if I have taught her enough, if I have nurtured her well. Have I been a good role model for her? As her mother, I mean.

While Jacob’s engagement and wedding brought up latent grief that gently requested tender loving care, Elena’s engagement is uncovering even more layers which seem to be screaming for attention. Grief often wants to point the finger of blame. What was that saying when we were kids?” When you point a finger, there are three fingers pointing back at you.”

This is what screeches at me when I wake up in pain. I think about all the ways I have fallen short as her mom and all the things I could still do that might make a difference in her life. But is there still time for me to be her mom. I frantically conjure up the perfect scenario and search for the perfect words and the perfect timing. And I rehearse them over and over.  So I can undo what I did wrong and do now what I didn’t do then. So I can rescue her. So I can save her.

And when I realize that whatever it is I have figured out won’t work, I sit straight up in bed, heart racing, face flushed, in a cold sweat.

Save her from what? She does not need saving. She’s not dying.

I glance at the glowing red numbers on the clock: 3:33am. I lay back down and stare at the ceiling until the alarm goes off.

After a week of this madness, I decide to reach out for help. Yes, I need body work, but more than that, I need heart work. I check in with my accountability partner and ask for prayer. I call my sisters. I schedule a session with my coach. They are so skilled at active listening, reflecting, and asking nonjudgmental questions with curiosity and not criticism.

These safe conversations give space for me to observe the guilt that still clings to me. Those twenty-nine years ago, the story I am telling myself is that I did not do enough when Sammy, Elena’s younger brother, fell ill very suddenly. And he died. If only! If only! That powerful “if only” belief that has been pushing me around and haunting me is now bullying me with Elena. Amy asks what I would say to this younger version of me.

Another picture comes to my mind. I am on the sidelines of Team Elena, running up and down the field. God is the coach and I am chomping at the bit. “Put me in, Coach! Put me in!”

My own coach wisely inquires, “and what is God saying?”

Perhaps Jeremiah 29: I know the plans I have for Elena (and you, beloved Julie). Isaiah 55:8-9 For my thoughts are not your thoughts, and my ways are not your ways. Philippians 1:6 I have begun a good work in both of you and I will be faithful to complete it. John 14:27 My peace I give you. Do not let your hearts be troubled and do not be afraid.

“Beautiful,” the coach affirms and then offers Psalm 84:3 Even the sparrow has found a home, and the swallow a nest for herself, where she may have her young – a place near Your altar.

And now I see God smiling and I hear God reassuring me that He has always been and always will be right here. “I’m right here and I’m letting Elena call the plays. Let’s you and I cheer her on.” And rather than resisting, I stand in wonder that I am not in control and that’s the way it’s supposed to be. I stand in amazement at the beautifully imperfect human being I am allowed to be. I could never be a perfect mom, not for Sammy and not for Elena. And that’s ok.  Actually, wow, that’s such a relief!

We don’t have to be perfect, you and I. Instead, in our humanity, we are lovingly invited to live in the grace of God, the redemption of Jesus, and the comfort of the Holy Spirit.

“The beginning of love is to let those we love be perfectly themselves, and not to twist them to fit our own image. Otherwise, we love only the reflection of ourselves we find in them.” Thomas Merton.

I scheduled a massage for myself and am happy to report that though I still have some neck pain, I am slumbering soundly once again.

Sleep, I am learning is healing for the body. Peace is healing for the soul.

I will lay down and sleep in peace, for You alone, O Lord make me dwell in safety. Psalm 4:8

The following story is based (loosely) on true events. Names have been changed to protect the innocent.

Once upon a time, in a quaint little PNW village that overlooked bountiful blueberry fields and a slough, there lived a doting mother named Jewelee. Her children were grown and gone so Jewelee doted over her dogs, her flowers, and her husband. One day her beloved son announced his engagement to a fair maiden. Delighted, the mother set out on a quest to find a festive frock for their wedding.

Jewelee freely admitted that she spent too much time brooding over a dress, scrolling through websites, visiting shops, buying and returning gowns of various styles and colors and lengths, exasperating salesclerks, friends, and family, especially her poor husband. Finally, a month before the event, she found “the one.” It was elegant but not overstated, it coordinated beautifully with the wedding hues, and it fit well.

“I have made up my mind,” she declared decisively to her husband who simply smiled back at her, wisely saying nothing but secretly wondering if it were really true.

Yes, she had decided… until she was informed of a color change. She deemed her color choice a little too close for comfort and well, she didn’t want to be matchy-matchy with anyone. No problem. She ordered the same dress, in the same size, but in the navy rather than the stormy blue. And she waited.

Every day Jewelee checked for the gown’s arrival and every day it did not come. She checked the front porch, the side porch, and the mailbox. She checked around the corner of the house on the patio where the delivery person hid packages from time to time. Still nothing. Twice a day she checked the Amazon app on her phone and on her computer. “Out for delivery,” the tracking system teased. She willed the little dotted line from the warehouse icon to the delivery truck icon to connect to her house icon within the promised fourteen-day period. Finally, after twenty-five of the longest, most laborious days of waiting, the gown arrived, just one short week before her planned departure.

No matter, she reasoned in her mind as she sighed with satisfaction. The dress was here, and she could hardly wait to finish her workday and try it on. Jewelee was bursting at the seams with anticipation. Little did she know that she was about to burst seams literally.

Panic struck as she gently coaxed the unforgiving chiffon over her ample hips. “ARE YOU KIDDING ME?!!!” She screamed a string of expletives loud enough to wake the neighbors’ napping newborn. The long-awaited dress barely fit. It was so tight she had to walk with her knees pressed together taking short, dainty Geisha girl like steps across the tiled bathroom floor. She stood in front of the mirror and tightened every muscle as if her body was silly putty and she could somehow magically morph her shape.  There was no way she would be able to sit comfortably in it.

Aggravated and acrimonious, she attempted to remove the dress over her head. Beads of sweat formed on her forehead and in the center of her back as she shimmied the dress a little further up her torso to her shoulders trying desperately not to tear it.  She was stuck! Claustrophobia set in and she stumbled around her bedroom, her arms flailing in the air, the dress half on half off, like a mediocre escape artist whose straight jacket malfunctioned. She yelled for help, but the gown was around her head now and muffled her voice. Her husband was nowhere to be found, so her youngest son came to her aid and rescued her from the costume’s clutches. She prayed he wouldn’t be scarred for life.

When her breathing eventually slowed, and oxygen returned to her body and brain, she doubled-checked the confirmation emails and then read the dress label. Had she made a mistake when ordering? Both displayed the same size as the previous dress. But when she laid one dress on top of the other, even her untrained eye could perceive that it was cut smaller, by an entire inch she estimated, maybe more. How could this have happened?

Jewelee envisioned a dark, crowded sweat shop, where a newly hired and therefore inexperienced employee stumbled under the weight of the mountain of material he was charged to carry through narrow aisles, depositing fabric at each workstation and bumping the shoulders of every dressmaker seated at archaic black trundles sewing at fever pitch. The girl working on what would be Jewelee’s dress must not have realized that her hands swerved, and she got off track as she mindlessly guided the material under the sewing machine, unknowingly stitching the seams a little too wide and therefore the dress, Jewelee’s dress, a little too narrow.

Jewellee blinked away the images with feigned forgiveness, embracing the reality of the situation. There was no time to order a new dress. Besides, there was no guarantee another one would be the correct size either.  Her next thought was to have the dress altered. She called the only local seamstress she knew and explained her dire situation. “Happy to help,” the dressmaker exclaimed exuberantly from the other end of the line. “Hang on Honey while I check my calendar.” Her first opening? Not for three whole weeks!

Jewelee tried the dress on the next day, this time with the shapewear she stole away to purchase in the dark of the previous night. She stared into the mirror ruefully. It helped, but not enough.

So, she determined to do what any God-fearing red-blooded American woman would do in her situation.

“I am going on a diet,” she divulged sheepishly to a dear friend, minutes before their weekly podcast espousing the benefits of sustainable lifestyle changes in nutrition, movement, sleep, and stress management to improve health.

“A diet,” the friend repeated the word with a downward inflection to her voice, scrunching her eyebrows in concern and confusion. “Are you sure,” she said very slowly, as if trying to persuade Jewelee from jumping off a cliff.

A diet was the exact antithesis of what Jewelee had been preaching and teaching for ten plus years now. The exact opposite of how she lived. Lifestyle is the better way, the upper road, the journey. DIET was practically a four-letter word in her world.

“I can’t help it,” Jewelee rationalized. “It’s the dress. The dratted dress is making me do it,” she explained in hushed tones as if through a screen to a priest in a confessional.

Oh, the shame of it! The hypocrisy! Still, she had to do something. Shapewear alone wasn’t going to shave that inch and a half off those hips.

Vexed by vanity, Jewelee dug deep into the recesses of her mind rummaging through the myriads of diets that were filed in her mental library. Cabbage soup? WW? South Beach? It was no use. There was a reason she stored them in her brain’s banned books section.  

She eventually concocted a version of intermittent fasting mixed with protein-sparing modified fasting, and a dollop of clean keto, just to stir things up. She measured her food. She measured her ketones. She measured her hips.

Every day she rode the recumbent bike HIIT style and pumped iron every other day. She added Pilates exercises to target crucial areas and even used a near infrared light box on said areas to persuade her mitochondria to their increase energy output.  

With the willpower of an Olympic body builder, she ate white fish and nonfat cottage cheese and cucumbers. She was a woman on a mission, focused on one thing and one thing only: she was going to sit comfortably in her dress at her son’s wedding a week from Saturday.

Jewelee’s plan seemed to be working until Monday when her right foot swelled up for some unknown reason. Probably a stress fracture from all the jumping rope. Yes. She jumped rope, too. There was no way her foot would be able to fit in, let alone dance in, the three-inch heels she planned on wearing. With ice now strapped to her ankle, Jewelee fussed and fumed like one of Cinderella’s ugly stepsisters after forcing her fat foot into an unwilling glass slipper.

The proverbial third strike struck Tuesday morning when she woke up with a painful, blood-shot eyeball! Now what?! Pink eye? Iritis? An allergic reaction to the eye makeup she had to practice wearing?! Even if the dress and shoes somehow miraculously fit, her red eyes would ruin the pictures! Now she’d have to take precious time away from food prep and exercise to go see an indifferent doctor then stand in an interminable line at an out of the way pharmacy for whatever magic potion was going to make her eyes better.

If her ketotic breath was bad, her mood was worse. She cried silent tears of mental anguish like a spoiled toddler whose balloon just burst.

Yet, when the departure day arrived, she faced it with the equanimity of Queen Esther and the voice of Doris Day. “If it fits, if fits. Que sera sera,” she sang in her mind as she boarded the plane to Atlanta with two dresses in tow along with an additional pair of sensible flats, and Visine. To get the red out. Just in case.

The day of the wedding came, and Jewelee found herself running errands and doting on her children rather than thinking about her dress dilemma. She picked up her daughter’s dress from one location and delivered it to another. She carefully ironed the creases out of her son’s pleated wedding shirt. She drove over hill and dale to fetch the wedding rings. But time grew short, and she could put the inevitable off no longer. She had to get dressed.

Standing in the closet staring blankly at both gowns, she wondered what to do when three of the most lovely and talented god-sisters appeared. “Don’t worry, we can fix it!” they humbly proclaimed with great assurance, producing a sewing kit from thin air. They poured over the gown’s construction with keen attention to detail. After a few precise snips to let the seam out here, and expert reinforcing stitches well-placed there, la voila! Jewelee could sit!

The wedding was beautiful, and Jewelee was so enraptured by her son and his bride she didn’t notice herself or her dress at all. The lovely couple were married, and they would live happily ever after.

Jewelee went home to reclaim her healthy habits and reflect on her foolishness. She sighed at her silliness and chortled at her childishness.  Starving for style? Good health is the best fashion. A dress may dazzle for a night, but a healthy lifestyle is your lifelong light.

 A hungry heart won’t fill a dress. Better a nourished soul than a fleeting fit.

….and that’s why it’s called Weigh Different.

I don’t know much about Waco’s past, only that he was rescued and living at a dog shelter called Brightside in Redmond, Oregon. He was part of a pack sent from Oklahoma to be adopted. All the other dogs had been snatched up quickly, so he was there by himself for some time. My sister Amy’s daughter, Gabby, had seen him on Brightside’s website and asked to meet him.

Gabby told me that the first time she met Waco she sat in silence with him on the floor of the “meeting room” for the better part of ten minutes. She said he never looked at her; he just stood there with his nose to the ground. She turned her body away and held out her hand. He sniffed apathetically and again, just stood there. She didn’t push but carefully took his leash and gently guided him to the yard on the premises. She went back to the shelter three times over the next two weeks to try to gain his trust. Apparently, other families were interested in him as well, but the shelter staff observed he would not allow any of them to come near him. The last time Gabby went, he snuggled up to her. She adopted him in January of 2023 at the age of two.

We all steered clear of Waco in the beginning with the understanding he had lots of triggers. But his transformation over these last two years has been remarkable. He has gone from being skittish and nippy around everybody save Gabby, to at least tolerating being in the room with people, and off leash no less.

I noticed this specifically while visiting Amy at her home in Tumalo where Gabby lives with Waco.  Beth, my Texas sister, was there too. It was a sisters’ weekend.

We were all chatting in the family room catching up on all the details of each other’s lives.  Amy sat in a chair across from me. Gabby sat on the floor to my right with Waco who sat on his haunches between Gabby and Amy. Beth chimed in from the kitchen.

Waco, looked like a regular happy dog, tongue hanging out, one black ear standing up straight and the other black ear permanently flopped forward, peacefully enjoying the company of others, and seemingly wanting to show and receive affection.

He let me scratch his chin.  That was a first.

I was so excited at this new spark of acceptance into Waco’s world that I became overly confident and went to scratch behind his ears.

Waco let out a singular jolting bark. Only one. But that one bark was so full of pain and anguish it cut me to the quick. His one bark was so piercing, I saw stars, a flash of light so bright I winced and recoiled.

I had no knowledge of his past but, in that instant, it felt like I saw through a portal right to the exact spot in Waco’s brain where abuse and neglect were recorded and an automatic response was activated.  Even though all he had experienced from his new owner in the last two plus years was love and affection, safety and structure, care and concern, that specific trigger spot along with the automatic response remained intact. I wasn’t fearful. Waco did not snap at me. He wanted love and affection, but he could not NOT respond any differently in that moment to that touch.

That bark seemed to rip the galaxy and I saw into my own psyche and my trigger areas and automatic responses. I saw how my own “bark” had been manifesting in so many reactions toward people who may have been just trying to show me love or were just there and unaware. I felt overwhelmingly remorseful for my reactions and at the same time immensely compassionate toward myself and others.

Paul recognizes this aspect of our shared humanity in Romans 7: 19-25, when he states,

” For if I know the law but still can’t keep it, and if the power of sin within me keeps sabotaging my best intentions, I obviously need help! I realize that I don’t have what it takes. I can will it, but I can’t do it. I decide to do good, but I don’t really do it; I decide not to do bad, but then I do it anyway. My decisions, such as they are, don’t result in actions. Something has gone wrong deep within me and gets the better of me every time.

It happens so regularly that it’s predictable. The moment I decide to do good, sin is there to trip me up. I truly delight in God’s commands, but it’s pretty obvious that not all of me joins in that delight. Parts of me covertly rebel, and just when I least expect it, they take charge. I’ve tried everything and nothing helps. I’m at the end of my rope.”

Sometimes, it seems like I cannot NOT respond any differently than to bark. When I am overly tired or overly committed or have had a hard day, old tapes begin to play, lies bubble up in my brain and melt away the cement that I thought was permanently covering my old painful neuron pathways. I bark. And usually, it is directed at my husband or my kids or the poor customer service person on the other end of the phone just there to do a job.

There were so many layers to that moment that day. I experienced a cinematic telescoping time warp in which in a flash backward I saw all the wrongs done to me and the wrongs I have done to others, my family’s unique generational sin, all the way back to its inception in Noah’s tent in Genesis 9, and incredibly simultaneously, the flash forward of God’s long suffering and compassion, His way of redemption, not stopping at the cross but pushing forward to glory yet to be revealed. It was a nanosecond but so powerful that I could not move.

I sat trembling and weeping, trying to take in the whole experience. I could see the pain of sin all the way back through the ages and the wonder of Jesus as He is described in Hebrews 1:3, “He is the radiance of God’s glory and the exact representation of God’s nature. Jesus upholds all things by the word of His power. When He had made purification of sins, He sat down at the right hand of the Majesty on high.”

I am playing that bark and that other worldly glimpse over and over in my mind and am awestruck by the tender mercies of God.

Simply put, I saw Grace.

Maybe you feel at the end of your rope. You recognize your bark and don’t know what to do. You have tried everything: self-help, therapy, medications, books, distractions, hobbies, alcohol….food. And nothing is working. Maybe you are asking is there no one who can do anything for me?

The answer, thank God, is that Jesus Christ can and did and does. 

I sat on the exam table waiting under the bright lights of the room. I felt overly warm, even though I was only covered by the customary thin gown, the kind that opens in the back leaving the rear on display. My bare legs hung over the edge of the table. My feet dangled.

Menopause had broken my personal rheostat. I felt moisture creeping out of my pores in the usual creases, my armpits, the back of my neck, the backs of my knees, my groin. The frayed gown was now absorbing the perspiration below my breasts like an ratty wornout sponge. I could feel the paper sticking to my skin as I shifted on my hips. The mask made matters worse. I pulled it down under my chin and blew out a hot puff of my stale rebreathed air to mix with the sterile smells of antiseptic lingering in the room.

I was waiting for the doctor to see me for a preop exam, to determine if I was healthy enough for surgery. I stared at my toes. The orange nail polish had chipped on some. I rubbed one foot on top of the other to cover the most unglamourous of them. I examined my legs and discovered a few rogue hairs that apparently ducked and dodged my razor that morning. They glistened in the bright light now. I knew he would not notice. As a physician myself, I never noticed except to attend to patterns of hair growth or skin issues behind the hair. Still, I felt vulnerable. Conspicuously unkempt.

The doctor arrived presently. After minimal small talk, he established the reason for my visit. He quickly reviewed my supplements, allergies and prior surgeries. He started in on a perfunctory examination of neck, heart and lungs while he went on asking questions. “Any night sweats, chills, fevers?” He clicked off the usual list, moving his stethoscope from over my chest to my back.

I could see him checking imaginary boxes and making notes in his head like a quality assurance inspector as he performed the exam robotically. Then he came to immunizations.

The red tab on the electronic medical record flagged me overdue for two. I smiled and nodded agreeably to one, and calmly shook my head no thank you to the other.

This was a record scratch for him. He asked me why, genuinely shocked that I had any other response than complete compliance. I explained that I had reviewed the literature, weighed the evidence, and because I lived a healthy lifestyle and had a healthy immune system, I decided that for me, the risk outweighed the benefit.  

He shook his head in disbelief as if I had checked my brain, medical training, and years of experience at the door. “You’re a doctor and you’re refusing an immunization.” Clearly, we were not having a shared decision-making dialogue like the one I had previously with the surgeon discussing the risks and benefits of surgery and whether it was the next right step for me.

His tone was condescending. “What side effects are you talking about!? You know you are putting yourself and others at risk,” he continued as if the science was settled. There was only one way to interpret the data. In these last short months, the vaccine had proven itself safe and effective for everyone everywhere in every situation no matter what no questions allowed. I could not tell if he was truly concerned about me or if he was annoyed that I was not taking his advice. Maybe he was in the running for most vaccinations and Krispy Kreme coupons handed out that day, and I just broke his streak.

He completed the exam in pin drop silence.

I sat up pulling the gown tighter around myself, like a child clutching a blanket, desperate for a sense of safety that the flimsy fabric failed to provide. I felt his burning disdain creep over me making a mockery of my earlier hot flash.

“Dr. Smith was healthy as a horse, and he died last just last Tuesday.” He paused for effect, his hand now on the doorknob ready to rush off to the next room. “Get. The shot,” he commanded with all the authority the MD embroidered on his starched white coat carried.  When I declined a second time, he scoffed, “Good luck, you’re going to need it,” and closed the door behind him.

I felt my flushed face, retrieved my sense of self, and wondered why I was so surprised. It wasn’t as if other colleagues hadn’t chided me spitting the science in my face and talking about me behind my back. The medical school where I had been an esteemed clinical preceptor for their lifestyle medicine track let me go.  The hospital where I was on associate staff for twenty-five years practically made me sign in blood that I would not darken their doorstep; but interestingly, they were quick to schedule surgery for me as an unprotected patient. It made sense, and it didn’t make sense.

Driving home I wondered if I had ever humiliated a patient in this way. It did not take long for conversations to flash across my memory banks, like lightning bolts across a stormy sky.  I winced as I recalled a few of my least favorite moments as a doctor.

Clap! went the first bolt. I braced for the thunder.

The day after Obamacare passed, I declared with exasperation, “Maybe Obama can help you,” to a patient who had come back a fourth time for the same petty problem which my treatment had not cured.    

Crack!

“Today is the day. Put a stake in the ground. You have diabetes.” I said that to a person who was battling breast cancer and was not registering the reality of this new diagnosis and the impact on her health.

I closed my eyes as if to lessen the unpleasant cloudburst of memories.

To a woman who chose not to vaccinate her baby according to my regimen, I replied, “Your children are well because my children are immunized.”

Yes, I know it is hard to believe. I said those things. To my patients. And those are the ones I remember. And no, I’m not proud of it. I wish I could take those words back. The first part of the Hippocratic oath is “do no harm.” That included do no harm with my words. I still felt the sting of conviction even though I had long ago apologized.

Let me ask you a question. What horrible thing has a doctor said to you?

I have heard some doozies from patients.

“No surgeon would ever touch you with a 10-foot pole at your weight.”

“Did they take you to the back to weigh you on the industrial scale?”

“If you would only try to lose weight, your condition would get better.”

“Your cervix must be the smallest part of your body.”

“And then what did you do”? I asked my patient after she related her story to me.

“I went out to my car and cried.”  Tears rose behind my eyelids for so many reasons, acknowledgement of her pain and resentment, the doctor’s shortcomings, my own failings, our collective humanity.

The providers who say those things don’t understand obesity or their patients who have obesity. They don’t know how hard the person in front of them has tried to move the needle on the scale. They don’t know how to help. And they don’t know that their words are doing harm. Truly, they don’t know what they do.

So, here’s the next question? What are you going to do with it?

Ok, I get it, fire the doctor if you are able. We deserve it. And yes, write us a letter. We need to hear what you have to say. But what is your ultimate power move, even when we don’t apologize?

I am going to ask you to do the very hardest thing: forgive. Not for the doctor’s sake, not because he or she deserves it, but for your sake, because you deserve it. You deserve to be free from the bondage of those words. Forgive because it is a way to reclaim your power. In releasing the grip of negativity and pain the provider caused, their words can no longer dictate your emotional state or sense of well-being. You get to oversee how you act and feel. And you deserve to be at peace. It is not easy. It takes time. That’s ok. Break the curse and forgive.

Knowing what it is like to have a hard day, knowing that that doctor just did not understand me and where I was coming from, and wanting those patients to whom I said those horrible things to forgive me, I forgave that doctor.

Someone somewhere once said “Forgiveness is unlocking the door to set someone free and realizing that you were the prisoner. And like Jesus taught his disciples to pray, “Forgive us our trespasses as we forgive those who trespass against us,” I am endeavoring to adopt his posture of forgiveness, for others as well as myself. I am accepting my inability and the impossibility to do no harm one hundred percent of the time, but maybe I can be part of the remedy for peace.

It wasn’t a day off. It was an “off” day.

I was at my Reach Out Weight and had been there for at least the last week. I didn’t know exactly how long because I stopped weighing myself the previous month since the scale reflected my Refocus Weight. I chose to start this day with curiosity, however, considering the consistency of my rhythms in the last month. What had changed?

I decided to fast. Not as punishment to be sure. But I had not fasted since January. Maybe my system just needed a break from food.

I shrugged my shoulders shaking off the frustration and determined to make it a good day.

For the next eight hours, I carried on as usual, listening to my patients talk about their areas of confidence and motivation. Together we identified specific barriers that come up again and again. I supported them as they shifted their thinking, uncovered new approaches, hung on to hope, and chose not to give up.

In between appointments, I struggled to fight voices in my head crying,  “You Charlatan, who do you think you are?!?!” I could feel the curiosity melting into criticism. Why did the scale still hold so much power? It’s only one data point and an incomplete one at best.

Memories of weight recurrence throbbed in my brain like a debilitating migraine. I had worked hard for several years to gain and lose the same thirty or forty pounds. I tried all sorts of fad diets. WW, Zone, Southbeach. The calorie restriction worked, but only for a while. I could not bear the weight of the unforgiving dietary laws.

I spent 2014 learning a different way: lifestyle change. Lifestyle change brought a freedom from the oppressive focus on calories to the guidance of practices, not only around nutrition, but around sleep, movement and stress management as well. This was effective for me, and I lost the forty pounds one more time, and I thought, for the last time. It was so effective, I was compelled to make a major shift in the way I practiced medicine.

But in the first three months of starting a lifestyle and weight management practice, I regained ten pounds. Ten pounds! I had learned from an esteemed mentor that an increase of five percent from realistic nadir weight seemed to trigger exponential regain.  Adipose cells have memory, and they will fight for the higher set point. Who is going to go to a lifestyle medicine doctor who is gaining weight? That’s like going to a cardiologist who smokes and needs a heart transplant!

Despite implementing every tool I had learned about leveraging weight without dieting, I stayed stuck for two years. I was running circles around the scale and getting nowhere.   

As I recalled the battle, I fretted. Was weight recurrence threatening once again?

My “off” day brought other discouragements as well: news of a beloved one’s cancer, disagreements among family members, and bills. It was always the bills that reminded me that even if I wanted to throw in the towel and give up, I couldn’t.

My husband tried to console me. “You look fine,” he said with real sincerity, “you are beautiful.”

It didn’t help. When I get to this state, there is no encouraging word, no mound of ice cream, no vat of wine that drives out despair. There is only sleep; and I could not get to bed soon enough to put an end to this “off” day.

My dream world took me to a courtroom setting where I played all the roles: relentless prosecuting attorney eager to expose the crime, smug judge eager to enforce the law, biased jury eager to convict the criminal, and indifferent executioner eager to carry out the obvious guilty verdict. I was on trial again, and it was not looking good for me. There I stood in the witness box, swearing an oath to tell the truth, the whole truth, and nothing but the truth, so help me God.

The prosecution directed my attention to Exhibit A. “Describe to the jury, Doctor,” she began, emphasizing the word “doctor” in the most mocking voice, “what you see in this picture?”

He directed the jury’s attention to an image of an empty yellow box ten times its Costco size projected on to a screen. Incriminating crumbs appeared defenseless around the box’s perimeter.

“Wheat thins,” I replied meekly, my head hung in shame as the salty words left my parched lips.

“A little louder please, so the jury can hear you,” the self-righteous judge scolded me.

“Wheat thins,” I said again, pleading with and leaning toward the jury, “but, please, I can explain. You see, it was my anniversary and…” A lone cracker flew out of a fold in my sweater, landed on one of its corners on the white marble floor, and spun like a top until it fell flat on its face. Damning evidence for all to see.

The jurors sucked in gasps deep enough to create a vacuum and strong enough to draw the next breath from my lungs leaving me speechless. They jerked their necks side to side eyeballing their neighbors. Like a tempest wind, indignant whispers rippled, then surged among them. “Everyone knows wheat thins don’t make you thin! Everyone knows wheat thins don’t make you thin!”

“Order in the court!” the judge cried banging his gavel all the while glaring at me as if the ensuing commotion was my fault too.

The prosecutor cut me off, not interested in my explanations. “No more excuses, Doctor! This picture clearly shows a lack of restraint. And isn’t that what got us here in the first place!?” Even my defense attorney had no objections.

My heart sank. This courtroom, this trial, it was all too familiar. I knew the routine well—the self-accusation, the guilt, the endless cycle of blame. I imagined, even in my dream state, my defendant’s assistant bursting into the courtroom, her right arm lifted high, waving new evidence to sway the jury’s verdict: a faulty bathroom scale, a better body composition, there must be some rational explanation.

But then I took a moment. A deep breath. I reminded myself that this was a dream, a manifestation of ancient fears, not my new reality. Life happens. Weight happens.

I looked again around the courtroom and saw the people in the dream soften as they morphed into my family members, my friends, mentors, and even my patients—each one representing a piece of the puzzle that was my life. They weren’t judging me; they were symbols of support and understanding.

As I faced the jury, I began to shift my perspective. Yes, there were moments of weakness, and still would be, but there were more moments of strength, perseverance, growth and reasons for celebration. Even celebrations with food. I remembered the countless times I had overcome obstacles, how I had guided others through their own struggles, and how much I had learned along the way.

The prosecutor’s voice faded, replaced by a sense of clarity. This wasn’t about punishment. It was about acknowledgment. Acknowledging the journey, the ups and downs, and the progress I had made despite the challenges. Acknowledging that data is information, not ammunition. And the scale is never the only measurement of health.

With renewed resolve, I rose from the witness box, no longer the defendant, but the advocate for my own journey.

Yes, weight happens, and it’s going to be ok. Progress, after all, is not always linear. And every step, whether small or large, contributes to a healthier, more integrated life.

P.S. My sincerest gratitude to Donna and Melissa, who spoke words of encouragement over me and chased my fears away:

This is the original text from the book where Desiderata was first published.

Go placidly amid the noise and the haste, and remember what peace there may be in silence. As far as possible, without surrender, be on good terms with all persons.

Speak your truth quietly and clearly; and listen to others, even to the dull and the ignorant; they too have their story.

Avoid loud and aggressive persons; they are vexatious to the spirit. If you compare yourself with others, you may become vain or bitter, for always there will be greater and lesser persons than yourself.

Enjoy your achievements as well as your plans. Keep interested in your own career, however humble; it is a real possession in the changing fortunes of time.

Exercise caution in your business affairs, for the world is full of trickery. But let this not blind you to what virtue there is; many persons strive for high ideals, and everywhere life is full of heroism.

Be yourself. Especially do not feign affection. Neither be cynical about love; for in the face of all aridity and disenchantment, it is as perennial as the grass.

Take kindly the counsel of the years, gracefully surrendering the things of youth.

Nurture strength of spirit to shield you in sudden misfortune. But do not distress yourself with dark imaginings. Many fears are born of fatigue and loneliness.

Beyond a wholesome discipline, be gentle with yourself. You are a child of the universe no less than the trees and the stars; you have a right to be here.

And whether or not it is clear to you, no doubt the universe is unfolding as it should. Therefore be at peace with God, whatever you conceive Him to be. And whatever your labors and aspirations, in the noisy confusion of life, keep peace in your soul. With all its sham, drudgery and broken dreams, it is still a beautiful world. Be cheerful. Strive to be happy.

by Max Ehrmann ©1927

It was a lazy Sunday afternoon. That morning, Kenny and I had enjoyed a beautiful worship service at a church in Portland we recently started attending, and then a leisurely lunch discussing the challenging sermon we just heard, and then, a luxurious nap.

It was now 4:30pm and the sun hung low in the sky patiently awaiting its disappearance below the horizon. Kenny was across the street finishing up a few chores.  I relaxed in our living room in the brown leather chair with a glass of pinot in one hand, a book in the other, my feet up on the hearth in front of a warm fire, endeavoring to practice the ancient rhythm of Sabbath. I found my thoughts shifting from God to my patients and the upcoming work week as I read my book, Practicing the Presence of People, by Mike Mason.

The author explained how he was inspired to write this book after studying Practicing the Presence of God written by the seventeenth century Catholic monk Brother Lawrence. I had been drawn to the book desiring to do a better job at my job. Having recently overcome a few financial hurdles, I was wondering about slowing down a little, to spend more time with people, namely my patients, and to make that time more quality time, staying fully present, really listening and reflecting, rather than thinking about what was coming next. I had even commented to a friend a few weeks earlier that I felt the Holy Spirit was leading me to “practice the presence of people over profit.” I was not sure what that meant or what it looked like exactly, but I was curious to find out.  

The blaring ring of my cell phone jolted me from my thoughts and brought my Sabbath to an abrupt end, even preempting the setting sun. I heard Kenny’s weakened voice on the other end of the line. He was gasping for breath. “Call 911- I drove – the tractor – over the bank – call 911 – you won’t- be able – to get – me out – of here.”

I ran as fast as adrenaline enabled, yelling into the phone, “I’m coming! Where are you!  I’m coming!” I sprinted the half mile across the street, down the hill, and over the gravel road, first spotting the upside down, mangled tractor and then arriving upon my mangled husband.

Old training kicked in. There was no blood. He had an intact airway, was breathing, all be it shallowly, and he had a pulse. He was moving all four extremities as he flailed in pain.  I could feel the fractured clavicle but was unsure of internal injuries.

I spoke calmly to the 911 operator who suggested I put a blanket over Kenny while we awaited EMS. Our friend and neighbor, Terry, appeared, seemingly out of nowhere, and laid his coat over Kenny.

The ambulance arrived presently, and five paramedics went to work. They quickly placed a C-spine collar on him, assessed his vitals, lifted him onto a backboard and then onto a gurney. Each bump over the gravel elicited wails of increasingly excruciating pain from Kenny and jerked anguished  tears from me. Clearly this was more than just a broken collar bone.

I drove behind the ambulance but could not keep up. I made a few phone calls and asked for prayer. “It’s 5:15pm now,” I calculated, “With CT scans and all, we’ll get back home before midnight.” I remained naively hopeful, “I’ll still be able to get enough sleep and see my patients tomorrow.”  

I realized we had experienced a miracle. The injuries were not as bad as they could have been, not by a long shot. He was not dead or maimed. He had no head or neck injury and no major internal hemorrhaging that would require surgery. Even so, the injuries were worse than I expected: fractures of the clavicle, eleven ribs in several places, and three vertebrae, as well as a small pneumothorax, a hemothorax, multiple contusions, and skin lacerations.

He needed to be admitted to the hospital. I needed to cancel my Monday patients. Yet I chose to keep family and friends up to date. That in itself was a full-time job.

Kenny finally made it to a room and fell asleep, exhausted from the trauma and drugged by the pain medications.

I went home to take care of the dogs and sleep in my own bed. I wrestled with myself but still did not reschedule my patients. Instead, I woke up the next morning and after my ritual water and black coffee, planned to race to the hospital to make sure Kenny was ok. I would be able to exercise, rush to the hospital, check in with Kenny’s attending physician, and rush back in time to start seeing patients by 9:30am. I felt almost prescient having reworked my schedule with late start Mondays about three months ago.  I can do this. I can do this. I coached myself.

I walked down the dark hallway into the waiting room of my home office where my treadmill beckoned. Before I could even turn on the light, I was slapped in the face by a horrible stench. One of my dogs aberrantly left a pile right in front of the entry door. No, there was no way I would be able to get rid of that awful smell in time to see patients. I finally gave in.  I guess I am canceling patients for today. Practicing the presence of people over profit apparently started with Kenny.

Rachelle conveniently texted a random question. I informed her what had happened. She wanted to help. I conceded and she cleared my day.  

At Kenny’s bedside, I had lots of time to ponder. I realized it seemed ridiculous that I would even contemplate going about my normal day when my husband lie broken in a hospital bed with multiple fractures and internal injuries. It’s a no brainer that as his wife, this is where I needed to be. Why was this such a difficult decision for me? Just as I observed myself running to Kenny, was I now seeing myself running away?

Instead of judging myself for even considering working, however, I stayed curious. What was I afraid of? What story was I telling myself? I talked with my sister, Amy, and she stayed curious with me.

Practicing the presence of people, as I was to find out, reading further in the book, actually started with me.  I first had to be open and honest with all my thoughts and feelings.

“I do not judge myself,” states Paul in 1 Corinthians 4:3. As I explored my various emotions, “taking every thought captive” took on new meaning.  There was space at the table for all of them: fear, worry, anger, uncertainty, as well as faith, hope, love, and trust.

I recognized that some of my own past traumas were resurfacing, particularly when my son, Sammy, became ill and was hospitalized twenty-seven years ago. This was not that; but it sure smelled like it.

I observed that the memories were not threatening to take me down; they were asking for help. I allowed them to resurface and invited the Holy Spirit to shine His compassionate light, to sort out truth from fiction, and start a deep, healing work.

Practicing the presence of people. If I am not able to truly come to grips with my own thoughts and feelings, positive and negative, especially in the face of curve balls, withholding judgment and leaving space for compassion and curiousity, how would I be able to do this well with others.

Kenny’s injuries are well on their way to recovery. And so are mine.