I've only been sporadically able to write specifically towards my initial goal in  a writing course I'm enrolled in right now, but that's actually ok...I'm working on the things that block me.

Today, I got rid of the weeds and overgrown wanted plants growing over my steps and pathway out the front door. Because it's New Mexico, with iron hard dry dirt, it took a sharp pointed grub hoe and softening up with the hose. I found hidden cacti with spines while clearing, and had to stop for a bit to pull spines out of my gloves and hands.

I planted pansies and chrysanthemums in my outdoor pots, and then washed clear the kitchen window, the glass plant shelf and the crystal that throws morning rainbows.

Tomorrow I will finish rebuilding the gate in my fence. It was poorly built by a contractor, and has been pulling off its hinges, and dragging on the ground. The new gate will be true and trim, and is already painted a lovely turquoise blue.

This is a way to clear both the approach to my heart and egress to the world.

Crystal flash rainbows
illuminating the dust
covering my life

More later about how I think this new concept of using haibun can help me write what I want to. .

One of the very,very cool things about having worked in health care for so long, and in critical care especially for more than 30 years, is just how far we have come.

I was assisting a procedure a couple days ago with a colleague of my own vintage, and we were sharing some specifics:

I remember when chest tubes and chest tube drainage setups were 3 glass bottles..a suction chamber, a water seal chamber and a collection chamber. break one glass jar, and the whole set up was a recipe for disaster. Now we have these really nifty devices with all three chambers in one, which come complete with a prefilled syringe of sterile water to fill the water seal compartment, everything pre-marked for monitoring drainage, multiple sized connectors.

I remember a time when nurses actually mixed their own chemo infusions in the med room. All of our IV solutions came in glass bottles, too.

I remember actually carrying a tiny set of screwdrivers to adjust gain on the old HP cardiac monitors...and when a set of calipers was mandatory equipment to measure intervals on ECG printouts.

Monitoring internal heart functioning was a huge deal...Swan Ganz pulmonary artery catheters were kept in a locked cabinet in the pulmonary lab at Mary Hitchcock (now Dartmouth Hitchcock hospital), and inserting one was for a time a rare event. Then it was ubiquitous..every patient admitted to a critical care unit bought an arterial line and a "Swan". Now we use them for cardiac surgical patients, but with discretion.

Imaging: I actually remember when CT scanning was new, and remarkable,,,and then we had  MRI available. I literally cried when I saw my first MRI scan of a patient with a brain tumor...it was so incredibly clear and beautiful in all its detail.

Now we have MRI angios and catheter images that give us dynamnic, moving images of hearts; functional MRI's that show brains reacting in real time to stimuli; ultrasounds that give us not just black and white images but color images of blood flow, and 3d pictures of infants in utero.

Now we have 3d printers that can give surgeons actual forms of defects to hold in their hands and pracdtice with  before they operate. It is within the immediate future that we can see 3d printers provide scaffolding for building actual replacement valves and organs. Now, when I give report to the nurse coming on next shift I can pull up those images, and if it is a new, less experienced nurse that I am orienting, I can explain exactly what is going on with our common patient, why that baby is manifesting the particular physical symptoms we can verify and correlate by hands on.

We should not take these things for granted!

I started reading at a very early age...well before 4, and I was very blessed by parents who read omnivorously, so I was exposed to science fiction very early. And as it turns out lots of  the "hard science fiction" writers were then and still are, actual scientists ,who write speculative fiction because they are trying out ideas...ideas about possible things in their fields which have since become reality. The physicists and early immunologists and biomedical engineers and pharmacologists  and chemists and computer programmers who have created the equipment I work with every day now very probably were also inspired by
30 years ago, the idea of stem cell engineering was absolute science fiction, Now it is reality, and one which will save lives.

Our healthcare system may well have deficits...and it does,huge deficits,  in terms of dealing with long term chronic disease, with funding, with equity, with dealing with the whole question of what is enough and the inevitability of death and how to be compassionate and ethical in extraordinary circumstances. And those are subjects for further writing, for sure.
But one of the reasons I am still hooked into, love what I do, is the recognition that a) what we did then was crude and elementary and is now better...and b) what we do is crude and elementary and we will do better. Very soon.

http://circ.ahajournals.org/content/117/18/2388.full
http://biomedical.materialise.com/cases/3d-printed-congenital-heart-defect-models-pre-surgical-planning