Angela is in love. But HE doesn’t know it. At least Angela is pretty sure. She sees him once a week when she goes for the therapy…having a bad knee has become fun.
Angela sits at the edge of the table, watching him. His hands touch her kneecap, the back of her calf. His hands are warm, his eyes….she waits. They sometimes talk.
She knows she is waiting for the knee to get better, but also waiting for him to see if anything lies between them, in the silences. They talk of exercises, how to go up and down stairs…body mechanics. He says words to her like femur, soft tissue.
In the car driving home, she listens to the radio, has it loud, vigorous in her ears. But also his words, “Let’s see how you do this week. You’ll be okay.”
But in some ways she is not okay. She thinks of him, plans what they will talk about, considers that maybe her knee isn’t getting better, because her mind doesn’t want it to.
She turns down other opportunities, using her knee as an excuse. At some level she knows that’s crazy. It’s all crazy. He is married and she…what chance does she have…soon her knee will heal; then she reminds herself to make a new appointment.
In four weeks, he is ready to dismiss her. Feeling foolish, she smiles at him, goes through the motions, flexes her knee, lets her leg rock back and forth…the knee working, her calf hitting the deep edge of the table. He stops writing, reaching out to grab her leg, stop these unnecessary movements.
They don’t speak, though they are looking at each other. Soon his hand drops away. Her therapy is done, it’s over. He’s given her the help she needed and what she came for.
As she slides off the table, he taps her knee one last time, because now she is pain-free…right?
She tries to say something like Thank You…forgets herself, has to smile, has to walk away.
Dr. Jennifer Obel is a retired oncologist who writes about the intersection of medicine, ethics and public policy. This piece appeared in THE CHICAGO TRIBUNE.
In between patients at my oncology clinic, I couldn’t catch my breath. I asked my nurse to check my oxygen level and pulse. My chest felt heavy, as if something were pressing on it.
I sat in the same examination chair my patients use, watching the monitor and running through possible diagnoses. But I knew what this was.
A panic attack. My mother had just called. While she felt fine, her routine CT scan showed fluid around her lung. I didn’t need anyone to explain what it meant. I’m an oncologist. Pleural effusion, in this context, is definitive: It meant her cancer had spread.
She didn’t know yet. I did. Over the next two years, as she lived with Stage IV lung cancer, I moved between my roles as daughter and doctor, managing my own patients and quietly absorbing her suffering. The message from my oncology division was clear: Keep working. There was no space to feel.
That expectation is not incidental. It is structural. The system holds because the people inside it are asked to absorb more than they should.
That’s why a scene in the HBO medical drama “The Pitt” stopped me.
She didn’t know yet. I did. Over the next two years, as she lived with Stage IV lung cancer, I moved between my roles as daughter and doctor, managing my own patients and quietly absorbing her suffering. The message from my oncology division was clear: Keep working. There was no space to feel.
That expectation is not incidental. It is structural. The system holds because the people inside it are asked to absorb more than they should. That’s why a scene in the HBO medical drama “The Pitt” stopped me.
D.Rr. Samira Mohan is dealing with a chaotic emergency department while fielding calls from her mother. The pace is relentless. Her body gives way to chest pain, sweating and a sense of impending doom. She is triaged as a patient. But it isn’t a heart attack.
When she returns to her duties, Dr. Robby, the attending physician, dismisses it as “mommy issues.” It was one of the first times I felt seen, and it came from a TV show.
“The Pitt” reflects the failures of our health care system — overcrowded emergency rooms, too few doctors and too many patients. It shows an uninsured patient who is suffering from diabetic ketoacidosis, a condition in which blood sugar spirals out of control, but who leaves before his treatment is complete because he cannot afford to stay. It shows a son who drives for more than an hour so his critically ill father can get dialysis after they discover their local hospital has closed.
But what the show captures with unusual insight is something more fundamental. “The Pitt” reveals not just what the system lacks, but the self-sacrifice required of the medical team in order for health care to stay afloat. Medicine does not just demand our competence as professionals. It demands that we ignore ourselves and our needs, even when the personal cost is high.
In a recent episode of “The Pitt,” a student doctor who leaves promptly at the end of her shift instead of working over tells a senior resident that 60% of emergency physicians report burnout. Hers is a quiet act of refusal. Because in medicine, the expectation is that we should stay through exhaustion, personal crisis and the slow erosion of self we are trained to ignore.
Every part of medicine functions this way. The emergency department is just where the strain is most visible. In the operating room, care depends on layers of people — nurses, anesthesiologists, surgical technicians, assistants — contributing a different piece of the whole. Oncology clinics run on the same coordination, as do inpatient teams.
It is less like a hierarchy than an orchestra, each person entering at the right moment. There is little margin for error. When one note is missed, whether from fatigue, overload or distraction, the entire performance begins to unravel.
“The Pitt” is filmed the same way, the camera moving continuously from one person to the next, as if there is no pause in the system. Burnout is not simply an individual condition. It is the predictable result of a system that operates without a buffer.
Health care redistributes strain. When one physician is exhausted, others compensate. When a nurse is stretched too thin, someone else absorbs the delay. To patients, the system appears relatively intact because the people in it bend to keep it that way. But when enough people are depleted at the same time, what appears to be an isolated error is often the predictable result of a system pushed past its capacity.
“The Pitt” lays bare these pressures. In the first season, a charge nurse takes a break outside from a relentless shift. A disgruntled patient follows her and punches her in the face, knocking her to the ground. She returns to work.
In the second season, a patient under the influence wraps his arm around a young nurse’s neck and chokes her until the charge nurse intervenes. Though shaken, the novice nurse insists on finishing her shift. There is no pause long enough to process what happened and no space for recovery.
I have done this myself. Years ago, I had a nonviable pregnancy and chose a surgical termination — not because it was an emergency but because it fit around my clinic schedule. I saw nine patients that morning before driving to my gynecologist’s office for the procedure. I returned to work the next day without time to mourn. It was practical. I did not feel I could risk miscarrying at work because of the pain, the bleeding and the disruption it would cause me and my patients.
This is what medicine teaches: Endure hardship and organize your life around the expectation that patient care is paramount. While we call resilience a strength, it is often a requirement that does damage over time. The system depends on people carrying on without time to recover or reflect.
At the Art Institute of Chicago, there is a painting I often return to: pointillist Georges Seurat’s “A Sunday Afternoon on the Island of La Grande Jatte.” It depicts a calm afternoon along the Seine River in Paris. But step toward it, and the image dissolves into tens of thousands of points, which you can see only up close.
“The Pitt” is that way, too. From a distance, the system seems coherent. Up close, it becomes clear that the system depends on individuals taking on more than they should, persisting when they should be allowed to stop and breathe.
Art preserves a moment by showing a historical portrayal of how people lived. It does not have to define the future.
I have a novel that I want to publish. And please do not laugh. Because everyone reading this might say: “SO, big deal. We all have a novel we have either written or its all there in our heads!”
Yes. I get that. Mine is a kidnapping story, that over the years has changed…and changed again. And yes, I have blogged about my writing heroes like Donald Maass, who read portions of my work, praised my creativity. Was I thrilled? Yes. But the novel is still unpublished.
At a writing conference, here in Chicago, I met an agent who eventually also rejected my query…thus, I went on and queried another 20 agents. All of them either sent back a standard NO…or basically ignored my query. IT IS TOUGH OUT THERE.
One agent said she was looking for a rich, intense, female-centric domestic suspense, with marginalized characters in the starring roles. Perfect description of WHEN THE COTTONWOODS BLEW. Thus my log line in my query:
When Ella Singleton’s only child is abducted, memories of her dead mother Cecile, take on new power, propelling Ella into a search that will not only redeem four-year-old Sarah, but also extricate Ella from a debt Cecile and society owe the kidnapper.
So, I will never give up on this novel, or the two others I have written. (I shortened one, wrote about it being available on Amazon KDP. TITLE: AFTER PAPA LEFT.
I’m also preparing to release a nonfiction work: 10055 Wood Street, the Story of a Family. I wrote it to remember my childhood, to honor the four people who learned how to support one another, help one another after my father died, leaving my mother with a six, three and three-month old. It’s a story of LOVE, FAMILY, of the woman who raised an English professor-published writer; a well known and loved music writer-promotion artist….and me.
But…am I starting in the right place?
“Mama, I can’t do this shit. Make it stop, make it stop!”
Sixteen-year old LaToya Jackson, primigravida, no prenatal classes, now in labor, Ella Singleton’s first patient on her 3-11 shift.
“I need you to push, LaToya, like we just talked about…you can do this…so when you feel a pain starting, take a deep breath, bear down and push, like you mean it.”
LaToya’s mother with her, silent, sitting in a chair, watching the television, occasionally leaning forward, as if by some miracle the birth might already be over, her new grandchild waving as he or she appeared in the world.
“I can’t do this shit, Mama. Make it stop. Tell the lady, make it stop.”
Ella tried again. “LaToya, you are having a baby, everything’s okay, but you have to push. It’s what all woman do to have a baby. Your mother had to, I had to…” Ella struggling to keep her voice firm but quiet, her patient just a girl, a sixteen-year-old girl having a baby. And though Ella had helped many like her at Chicago Community Hospital, LaToya was more frightened, fragile…her chart failing to indicate that maybe some boy she hardly knew…or a man who took advantage of her innocence was the father, LaToya’s face one of pain, fear…Ella having to urge the girl again, eager for her to finally get it, stop thrashing, focus and push this baby out, each push now revealing more dark hair that advanced, then receded, LaToya writhing in the grip and the release of her contractions..
“Now remember, when the pain starts, hold your breath and push.”
Ella had experience with patients of all ages, different backgrounds, she able to remember her position, focus and not get caught up in her patient’s pain, though being a mother, Ella still remembered the burning of perineal tissues, every pain receptor lashing out at the weight, the force of that head.
“Mama, please.
“You can do this Toy.” The mother’s voice like warm pudding, smooth, soothing, she glancing at the girl, then at the television, face flaccid, the distance in her demeanor palpable in this chaos of beeping monitors, thrumming IV pumps, the click of the blood pressure machine beginning its fifteen-minute check…and then LaToya screaming….“Shit—cut me, make it fucking stop.”
Familiar words, Ella checking the infant’s progress on the fetal monitor, the fetus’s heart tones dipping during a contraction from pressure on the umbilical cord. Time to have LaToya change position, get the baby off the cord, heart tones quickly recovering, 130’s, 140’s—strong, quick beats, Ella moving to the head of the bed, wiping the girl’s forehead with a cold cloth.
“You’re doing great, almost time to move to the delivery room, you can do this, LaToya, I’ll help you have this baby.”
“Mama?” Tears now mingling with sweat on the girl’s face, then the crumpling of smooth skin, LaToya grunting, “Get this outa me!”
Now Ella moved quickly, no need to again check her patient with sterile, gloved fingers…when LaToya bore down, a large circle of dark curly hair, approximately four centimeters.
When one green shoot suddenly appeared in my garden, I took a photo of it, posted it on social media.
I didn’t get a huge response, but readers did immediately respond. SPRING is a meaningful time for many of us, the air is warmer, rains are welcome, and we find ourselves being called OUTSIDE. Surely, many of you live in climates where SRING means little. And that is lovely. When we were in California recently, we played croquet, took walks and flew kites. AWESOME.
But now we are home in Illinois, and the arrival of SPRING is always very welcome. The sun is soft, the air is warm, and we are once again called outside. The feeling of lightness, of eagerness to watch green shoots pierce the ground is part of living in temperate climates.
It’s a call to nature, a call to breathing in the scents and sounds of SPRING. Children suddenly appear, shout out to one another. Adults are eager to walk the dog, extend that walking time….share a smile when approaching anyone out for the spring stroll. And yes, the arrival of spring and warm weather is more meaningful to people who live in temperate climates. Spring is a gift of change, of adventure and the longing to be outside. But it is also a reminder of work that needs to be done: wow my windows need to be washed, my garden planted, my bedding changed…time to put away those heavy quilts. A busy time, but also a welcome time….because humans thrive on change, on awakening to time in the garden.
Elizabeth Kelsey, who moved from Florida to New Hampshire, wrote in her piece in TIME: I can trust that longer, lighter days will inevitably return. I can navigate change.” Which is always good thing for all of us to learn.
My Aunt Margaret was a true gardener. A writer and editor for a publishing company, I believe she was never happier when she could “work in the garden.” Spring meant clearing away winter debris, waiting to see what perennials had made it through another Chicago winter. Then she would make several trips to the Singler Florist. I imagine that some days she walked there, the shop being a block away. I also imagine there were cheerful conversations with Bob or his mother…they not only being avid gardeners but also Margaret’s cousins. They admired her garden, were eager to show her a new rose or a perennial shrub that might fill an empty space near the western end of the garden.
And when I, as a child, found a small plot of soil along our driveway and mentioned it to Margaret, she was eager to help me choose some annuals that might encourage me to also become a gardener. I never earned the gravitas that Margaret did. But in a few weeks, when I am out in the garden…weeding, raking and getting ready to plant, I will think of her, how happy she alway was, down on her knees, planting…which I have come to realize is something very simple and basic: in our family, we all just LOVE digging in the dirt.
In my past, I spent hours in the shoe store, not because it’s my absolute thing to do, but because when going on long walks, I wear bulky orthotics in my shoes, and have to make sure all will fit properly. It takes time and makes me jealous of ladies who can wear tiny ballet slippers that give one’s foot absolutely no support…or torturous heels that attempt to reshape the foot during the hours one wears them. I guess there were years when I squandered my chances to be like those ladies.
In the seventh grade, the cusp of life when girls want to shed bulky clothing, shy ways and morph into the first stage of womanhood, I was having foot problems. The lost-in-the-old-ways doc that my mother took me to, not only removed a growth on the bottom of my foot using a very painful process, he also ordered my mother to put me in oxfords. For the younger crowd, these are shoes like men might wear, or women who care nothing about fashion. They are leather with stiff soles and ties, and are usually black or brown. I must have still been under the influence of the painkillers my mother gave me after the doc shot the bottom of my foot with some form of acid, because I agreed to a pair of cherry red oxfords. And I subsequently wore these shoes to school, in the seventh grade!
That’s why Jack D. came up to me at our years later reunion, and told me that he’d had a crush on me in junior high, but he just could not get beyond those red shoes. Damn! Even he remembered them. I don’t know what shoes I was wearing that night, but I can assure you they weren’t oxfords. I moved from those red shoes to saddle shoes, and then quietly relied on my mother’s busy life to blot out the doctor’s warning that I had weak arches or something!! I can still remember the elegantly thin loafers I wore in high school with my white crew socks folded way down to reveal my ankles.
Ah yes, I had years of wonderful carefree shoes—woven flats in various colors, dyed poisdeseau for every prom dress or dance ensemble, also sandals that revealed lots of skin, and heels that were chunky or spindly depending on the style of the season.
But most of all, years and years of walking around barefoot. I always cleaned my house in my bare feet, even in winter. I don’t really know why—I guess I thought I moved faster.
But those years caught up with me. Chronic foot pain led to the discovery of a stretched tendon. Surgery was mentioned, but the orthotics I had to wear protected that tendon. And foot surgery is always an ify choice.
Now I often wear gym shoes. But I still cheat and wear little shoes for holidays and evenings out with friends…though trips to the shoe store will never be the same.
Bottom line, I can still throw on a pair of athletic shoes and walk for miles. No complaints. I just wonder if I would have stuck with more-supportive shoes my entire life—maybe if those oxfords hadn’t been RED! How beautiful a thought.
THIS POST, part of a longer work, honors my brother Bill, who died on January 6th. We were a family of 4, my mother and her three children, our father dying at 45 when Bill was only three months old.
But we were blessed with an amazing mother, (SHE in the text) and thus, we thrived.
John, Beth and Bill. Three years between each of us. But when a salesman or an older woman selling potholders comes to our door, She won’t by, has an excuse, tells them she is “just a widow with three kids.”
But every night at the dinner table, as the years stretch on, there is laughter or we argue about who will wash the dishes, or we watch Bill try to tell a joke, then fall on the floor laughing and rolling around. Then much later, we will sink into bed, sleep coming quickly, because we are safe, have no fears. At least the three of us feel that way. We don’t think to ask how it is for Her.
But if the nature of a complete family is the presence of that taller male figure with the deep voice, Bill, for a long time, has no framework for such a concept, and instead he has fears.
Bill is afraid of the egg man, the milkman. He hangs on his mother’s skirts when they come to the back door. He also needs the security of his baby bottle for so long, that he is able to open the refrigerator door and take one out. But don’t chastise Her for this. Such decisions are called survival, they being nature’s way, as time passes and Bill grows. Then She buys him a trike with a rubber cowboy saddle over the seat. I like his saddle, I don’t have one. Bill is beginning to see the wider world, make friends in the neighborhood. He is also beginning to ask questions: “Would my daddy fix my bike? Would he come home every night?” She never ignores these questions…answers them truthfully.
At the age of three, then four, Bill is thin, pale so that some neighbors make comments: poor Jinni, she must be struggling, not feeding him enough. Oh, She feeds him! We never lack for anything! Genetically, Bill is thin—but loved, so loved by all of us.
Bill and I are buddies, but being 3 years older, sometimes I take over. I tease him or John and I gang up on him. Bill is thin, and so blonde and fair that he’s like a shaft of sunlight. And for a while, he has a spate of bloody noses, his nasal membranes sensitive to dry air. This problems is discussed at the dinner table, anyone’s health being common knowledge in our family. But then a mean rhyme appears, one that slips off the tongue—alliterates well: boney, bloody, blue-nosed, bow-legged, bats-in-the-belfry, Boston baked bean Billy. And yes, Bill cries when we chant it. So, we keep it up. We have kid-power over this beautiful child who we all love. But when She walks into the room, tell us to “Cut it out” we do.
As I grow, so does Bill, and “boys” come into the yard, Bill’s friends, some older boys. They play baseball till there’s no grass near our apple tree. But I am on my swing, so I ignore them, swinging and singing, watching the sky as I float back and forth, back and forth, my head held straight along my body, an arrow hurtling upwards.
But one day when I look down, the Darche boys are fighting in the yard. They roll in the dirt, hitting with fists, hitting on backs and stomachs..Bill runs into the house. Then one of the Darche boys starts to cry; another says, “I’ll beat the shit out of you.” But I stay on my swing, reaching higher and higher, away from them, until finally they leave, and I sing a last song, until my feet can touch the ground. Yes, I am forced to solid earth, where clouds are harder to see, where winds don’t move as quickly through my hair.
Then one day, when standing in the gravel driveway, I look up at Bill’s bedroom window. It has a little roof right below it, like a terrace that is really the top of the dining room bay. The two of us talk about walking out on it, like having a fancy balcony. But She warns us that it won’t hold our weight, we’d fall, get hurt or worse. And it’s now Bill’s room, that back bedroom at the very end of the hallway, the one that was the nursery, that we used to share, the room that holds the sound of my voice, my crying, my growing up.
But Bill and I will always be buddies, though being older, I sometimes I let that role take over. I tease him or our brother John and I gang up on him, bait him. Bill is thin, blonde and fair, he’s like a shaft of light. And for a while, he has a spate of bloody noses, his nasal membranes sensitive to dry air. And because family problems are discussed, a rhyme is created, something that slips off the tongue—alliterates so well: boney, bloody, blue-nosed, bow-legged, bats-in-the-belfry, Boston baked bean Billy. And yes, he cries when we chant it. So, we keep it up. We have kid-power over this beautiful child who we all love. But then She walks into the room, tells us to “Cut it out.” And we do.
From childhood on, Bill will keep his smile, his ability to accept our teasing. Because Bill knows how to love, to forgive, to believe in his talents and where they will take him. The friendships he forms will often help make his way in the world. His openness, his smile and laughter, his love of people are truly Bill….someone that people want to know, hang out with, to love.
