It’s with these chronic states of dis-ease that prescriptions of traditional medicine fall short. Don’t get me wrong—heaven forbid, if I’m hit by a car or contract bacterial meningitis, 911 me to the nearest ER for the best that traditional medicine has got. (And, yes, vaccinations are good.) But once traditional medicine has delivered me from that acute phase of illness, I know that if I want to stay well, the root and core of that health come only from complementary means. It was acupuncture that alleviated my seasonal allergies, thereby permitting me to stop an exhausting regimen of allergy shots, nasal sprays, eye drops, and two different antihistamine pills. It is yoga, cardio, and Pilates that keep my body limber and strong. Maintaining a healthy diet—well, that does everything. My meditation practice has made it possible for me to live in a way that is nourishing while the rest falls away. For the chronic conditions of daily life, it is these other modalities that will stave off depression, anxiety, hypertension, high cholesterol, diabetes, obesity, heart disease, stroke, and cancers so that we can find a better quality of life than we can by adding yet another bottle of pills.

Ms. Hernandez, Mr. Wade, and patients like them inspire me. I, too, knew instinctively to stop fighting for my life and begin allowing it. In this way, I had to let my attachment to Colin float away in order to permit both of us to be our best selves. He needed time and space to decide whether he would be a warrior in this life. My decision had been made: I was a warrior already. Whether it took Colin the seventy years it had taken my father or simply the next twenty, he deserved to go at his own pace, as I deserved to continue at mine. With that realization, I had walked away from Colin softly, quietly, and decidedly. Somehow, with only the effort it takes to let go, receive, and believe, what my heart called for would come in. My dis-ease would dissolve. This time now was the invitation to be okay, even happy, without filling in the details of how my love would come to me, how my family would look, or what the final destination of my professional journey would be. While I figured out the next bold career move, I would continue to serve. This was the time to live my love now. No better time.

ELEVEN

    Jenny and Mary: What Falls Away

My first day back, and I can’t stop thinking about the goo I discovered between the pages of the in-flight magazine.

Come to think of it, I’m probably one of the few people in the world who actually reads the in-flight magazine tucked in the seat pocket in front of us when we fly. Maybe it’s an extension of my type-A personality, but part of me believes there could be some critical morsel of information in it. Or it could be that I’m still gullible enough to think that if the airline put it there, it must contain a safety update necessary for my survival or, at the very least, a surprise deal on the afternoon snack. Or maybe I’ll be tipped off about the perfect place for Sunday night jazz in Nashville, should I ever go there. For all these reasons, one of the first things I do whenever I board a plane is check out the magazine. And after years of my being vigilant, my last trip delivered.

In the midst of everything—the job switches, the blockage of my complementary medicine center, the breakup with Colin, the what-the-hell-am-I-doing-with-my-life internal conversations—I had forgotten that I had volunteered to attend the VA conference on women’s health. While it turned out to be, arguably and quite sadly, one of the poorest-quality conferences I had ever attended in my medical career in terms of providing the attendees with comprehensive, up-to-date medical information, there were a couple of highlights: The patient models who coached us in optimizing our physical exam skills were masterful, and a female veteran gave a heartfelt talk about how she had survived her time in the military. While I was used to providing female veterans with general medical care and treating their military wounds related to sexual assault and harassment, there were other aggressions on military women I hadn’t yet considered before hearing this vet share her experience: for example, the various chronic pain syndromes that developed from their being forced to use gear that had been specifically designed for male bodies. While women were allowed in the military, in most cases they weren’t permitted to exist on an equal footing with men.

There were three nonclinical elements that made the conference worthwhile as well. My fellow conference participants were delightful. Of course, we swapped the all-too-familiar stories of the creative workaround strategies we used to compensate for the lack of resources at our respective sites, from the Carolinas to Colorado. The fact that this was often done over quesadillas and drinks by the pool only added to the camaraderie. Hearing about the dedication of my colleagues in other parts of the country was a nice reminder that there are still doctors and nurses out there who aren’t willing to give up on the art of medicine or on the people who rely upon it.

Then there was the hotel fitness center’s steam room, the discovery of which inspired an unreasonable amount of joy in me. I can always find refuge in a steam room. Whenever I use one, any toxic thoughts expire on the vapor, leaving space for positive inspiration. Assuming a sense of ease as I breathe in the sweltering steam is the only way the extreme heat becomes tolerable. This requires the engagement of every component of yoga—the body, the breath, and the mind. In this way, within seconds of my entering its quarters, the steam room challenges me to achieve alignment. My reward? An ultimate fast track to the infinite.

As if primed by the steam, I was now ready for the pièce de résistance of the trip. On my flight back to Philadelphia, after I collapsed into my window seat, I picked up the in-flight magazine. After skimming the ads for watches and suitcases, followed by hot new restaurant listings across the globe, I happened upon an article about the life cycle of butterflies. As I learned in my youth from The Very Hungry Caterpillar, a butterfly begins in the caterpillar stage, in which it eats and eats and eats, and finally ends up majestically bewinged. But I didn’t know that after this growing caterpillar enters its cocoon for the pupal stage, it literally turns into goo. Apparently, scientists don’t understand why or how the caterpillar form breaks down during this period of transformation in order to emerge as a butterfly.

As I placed the magazine back into the seat pocket, a thought struck me: That’s truly how it is, isn’t it? As long as we’re willing to move forward, to nourish our body and spirit and allow for the disintegration of any attachment to patterns that do not serve us, without our understanding exactly how the next bits will fall into place, beautiful outcomes do unfold.

Back at work, I continued to ponder this process of transformation. Breaking my butterfly daydreams, an announcement blared over the speaker system: Campus response parking lot level C. Campus response parking lot level C. Within minutes, the campus response team, the group of men and women designated to respond to potential medical emergencies throughout the hospital, were rolling in a stretcher bearing a small, limp patient: a child. A distressed young man followed quickly behind them. The team assembled in Room 4, encircling the child. I stood at the foot of the bed and supervised Jaya, the medicine resident on her ER rotation, as she assisted in care for the patient.

“What’s going on?” Jaya asked the team leader.

“Twenty-two-month-old with febrile seizure. She was here today with her dad, visiting one of the patients. She has no past medical history. Dad said she’s had a cold for the past couple days and fever this morning. She started to have jerking movements in the parking lot, and a bystander called for help. She has appeared post-ictal the whole time with us. Dad said the seizure lasted for less than a minute, and she’s been like this since. No seizure activity with us.”

The child was small and beautiful in her golden yellow dress decorated with unicorns. Soft brown curls swayed from side to side as she stirred languidly on the bed. Her thick black eyelashes fluttered as we positioned her on our stretcher. Her eyelids stayed closed, then tensed for a moment as if she were warding off a nightmare, before relaxing back to whatever dream state she was in. The nurses rapidly scrambled for pediatric supplies to get a set of vitals. When we hooked her up to the monitor, we found her heart rate was in the 120s, saturating 97 percent on room air. Her temperature was 100.5, and her blood sugar was a reassuring 89.

“Jaya, please go talk to Dad and get any additional history and come back with the scoop,” I instructed. “We’ll continue the case together at that time.”

I turned to the tech. “Liza, please help completely undress baby Jenny. We need full exposure.”

To the nurse assigned to Room 4, I said, “Ted, we’ll need basic labs, chest X-ray, and urine. Let’s also give a bolus of normal saline at ten cc/kg.”

Jaya returned, and we examined this little doll together. She moved her extremities spontaneously in reaction to our gentle touch. She flinched, and her lips curled in a slow-motion cry, when the IV was inserted, and then two tears formed in her right eye before she slipped back into her stupor. While she wasn’t yet alert, at least she was intermittently responsive. Her skin was flawless from the crown of her head to the bottom of her itty-bitty toes. Her diaper was normal and wet with clear, light yellow urine. Jaya lifted the child’s eyelids to reveal large green eyes with pupils that reacted to light. Tympanic membranes and oropharynx normal. Lungs clear and heart sounds normal. The abdomen was soft and appeared to be non-tender.

“Jaya, you want me to enter those orders for you?” I asked.