Social Distancing and Beth March

“There are many Beths in the world, shy and quiet, sitting in corners till needed, and living for others so cheerfully that no one sees the sacrifices till the little cricket on the hearth stops chirping, and the sweet, sunshiny presence vanishes, leaving silence and shadow behind.”

Anyone who knows and loves the book Little Women knows the story of Beth. Beth is the third sister, quiet and shy, not quick to pour herself into social occasions like her younger sister, Amy. And though Beth is timid around a lot of people, she is quick to notice those who need help. Above all, Beth is kind.

The story begins at Christmas time. Beloved Marmee has gone to visit a poor neighbor family, huddled in one room with sick children. Later on in the story, when Marmee has to leave to go be with her wounded husband she charges her daughters to not forget this family. The only one of the sisters who remembers and is willing to go see them and care for them is Beth.

Beth ends up with scarlet fever, a disease that she caught directly from the family she had been assisting. It was an illness that we know now is untreated strep infection and includes a sore throat, high fever, and a bright, red rash that covers the body. For her kindness, she ends up teetering between life and death. The family desperate to see her well again, and she does recover from this initial illness. But scarlet fever can carry with it some residual damage, and she later dies from complications of the disease.

Does Beth’s kindness kill her?

History is full of people who die helping others. The “Chernobyl Three” who stepped into a radioactive area to drain a pool, and in doing so averted another explosion; Annalena Tonneli, who fought TB in the Horn of Africa and ended up killed by terrorists; Corrie Ten Boom whose family helped Jews escape by hiding them in their home – there are far too many to count.

We are in an unprecedented time in this century. A global pandemic has been announced and “social distancing” has been strongly advised. As a public health nurse, I agree with this approach. It slows down the spread of the virus, giving hospitals and health care workers opportunity to catch up and be able to treat those who are the sickest. But those health care workers – doctors, nurses, pharmacists, community health workers, physicians assistants, nursing assistants – they don’t have a choice. They work to keep the rest of us safe. They don’t have the luxury of “social distancing.” Some of them, inevitably, will get the virus. It’s the price they will pay for helping. My prayer is that they will not die, but will instead be cared for by people who are as kind and dedicated as they are.

Social distancing is something of a privilege – a privilege reserved for those who live in single family dwellings, a privilege for those who have the resources to stock up on many months worth of supplies. Millions around the world don’t necessarily have this privilege. Maybe we also need to rethink the phrase “social distancing” a public health term used to apply to actions that a health department deems necessary to slow the spread of disease. Could we change that phrase to physical distancing instead? Social distancing gives us room to ignore the other, caring only for ourselves, all in the name of containing a virus.

A culture, like the United States, that prides itself on individuality could happily distance themselves physically and socially, but maybe some of us need a little prodding to go help others. There may be a neighbor who is really suffering, and you may be the one to help them. There may be someone who needs a ride from the airport, and you need to go pick them up. There may be families that need you to not socially or physically distance yourself so that you can bring them food and supplies.

This social distancing may be the right thing for the majority of the population, but there may be some of us who will be called upon to give up that distancing and help others.

It will be easy, if that happens, to opt for fear, to use social distancing as an excuse. I’ve said it before in this space – fear is not good currency. Fear is more viral than the virus itself. There is, and will always be, something to fear.

In the past 24 hours, I’ve watched some of my family members and friends come together to help another part of our family who have been rerouted from their home in Thailand. They are tirelessly gathering clothes, food, a car, and other resources that this family needs. Any one of them could have said “No. We have our own families to care for, to feed, to stock up for.” None of them have done that – they have stepped up and they have stepped in. I am beyond grateful for this coming together, moving in to help instead of moving away.

Please hear me – I don’t advocate being foolish. I don’t advocate walking in to harm’s way just to be noble. But I do think there are times when we need to put others above ourselves, and in this country, we have a lot to learn about what that looks like.

Social distancing may be the kindest thing for some people; for others, we may have to step up and move in. May we recognize the humanity of the other more than ever. May we have wisdom on what is needed, and above all – may we fight fear and be kind.

And these thoughts from C.S. Lewis are apt, though written long ago:

It is perfectly ridiculous to go about whimpering and drawing long faces because the scientists have added one more chance of painful and premature death to a world which already bristled with such chances and in which death itself was not a chance at all, but a certainty.

CS Lewis

This is the first point to be made: and the first action to be taken is to pull ourselves together. If we are all going to be destroyed by an atomic bomb, let that bomb when it comes find us doing sensible and human things—praying, working, teaching, reading, listening to music, bathing the children, playing tennis, chatting to our friends over a pint and a game of darts—not huddled together like frightened sheep and thinking about bombs. They may break our bodies (a microbe can do that) but they need not dominate our minds. CS Lewis on the atomic bomb

Fearfully & Wonderfully Body Scanned

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“Take off all of my clothes?” My voice intonates the last word as a question, rather like a child who asks her teacher if she has to complete all of the homework assignment.

I am sitting on an exam table under fluorescent lights in a clinic.  I feel cold, not only because it is an unseasonably cold April, but also because there is a deep loneliness associated with clinic visits and full body scans.

You lie naked as a stranger examines every bit of your skin. They concentrate on freckles, moles, and imperfections with frowns and furrowed brows. A magnifying glass assists them on the troubling areas and a computer helps them document what they see.

I feel an indignity as I wait, a feeling of vulnerability and loss. An indignity manifest in a naked body, the words of Adam and Eve reverberating through the centuries “I was naked and ashamed.”

I am acutely conscious of my own frailty and humanity during these times. I am astute at covering my imperfections, at dressing and acting my part in the world where I daily interact. But these moments erase all of that.

And yet, I have come here voluntarily. I have come here because I know that a short time of discomfort is far better than a diagnosis of a skin cancer. I know this well because a few years ago I was diagnosed with a skin cancer. Caught early, I now bear a beautiful scar, a war wound of sorts reminding me that scars are evidence of battles fought and souls made stronger.

We live in a world where our aging bodies betray us and tell a different story than the story that we feel. We watch as through the years people begin to respond to us differently. First, we are masters of the universe, we are young, and we are beautiful in our youth, even if we are not beautiful in our looks. We walk through this time with little thought to the older among us, or to the ones who have bodies that do not work as ours do. We may interact with a grandmother or a cute, elderly neighbor, but in our age-segregated society, we do not really know them. Out of embarrassment, discomfort, or just plain ignorance we avoid those who are trapped in bodies that do not function the same as ours do.

Then middle age comes along and the jokes begin. “Look how she’s aged” we whisper with giggles, certain that we don’t bear those same marks. But then, we catch sight of ourselves in car windows, and we wonder who we are and how we got so old, so fast. We continue to live, but the reflection that looked back at us from the car window showed us a reality that we would rather avoid.

And then the phone calls begin to come. One friend has had a heart attack; another friend is given four months to live when cancer is found throughout their body. Friends are diagnosed with diabetes and heart disease, arthritis, and cataracts. Funerals that used to be for others are now for us and ours.

We are eternal souls in temporary bodies that will need a new heaven and a new earth to redeem a broken process.

We still think we are immune – except for those now yearly physicals or body scans, where we lie naked before God and a stranger. Perhaps it is in those undignified moments that we realize that we aren’t so different from our friends. Then someday, the phone call will be about us. It’s in those times that we realize the reality of our humanity. Our scars, our freckles, and our moles on our earth suits are more pronounced, and we wonder how it will all end.

My faith tradition affirms that I am “fearfully and wonderfully made”.  And I don’t think that just means the young and able among us. Even as those who are fearfully and wonderfully made, we still need medical exams and physicals, body scans and preventive health checkups. We who are fearfully and wonderfully made need to brush our teeth and wash our bodies, eat healthy foods and exercise. In coming to earth in a human body, Jesus too was bound by his earth suit. He got hungry, tired, and dirty. He needed food, rest, and soap. He watched people get sick and die, and he didn’t heal all of them.

We are eternal souls in temporary bodies that will need a new heaven and a new earth to redeem a broken process.

How does one embrace every stage of life, appreciating what was and what is? How does one move gracefully through these seasons, putting trust in the Creator not the created; believing that there is something profoundly beautiful in our aging bodies? What does a theology of aging look like? What does holiness look like as I face my birthday and my body scan every year?

Before I have figured out the answers to those questions, the body scan is over. I am told that I don’t need to come back for another year. I am left alone with my body and my thoughts in a room that is still cold.

I get up and get dressed, inhaling a breath of thanksgiving. I am fearfully and wonderfully body scanned, and right now, that is enough.

Immigrant Families – A New Report

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Photo Credit: http://www.fhcw.org/en/Home

In the last two years, the immigration debate has become louder and arguably less civil. Political platforms and decisions based on fear have dominated the conversation, but behind the conversation are approximately 23 million people. The number includes those lawfully present as well as those who are undocumented. It includes around 12 million children who are legal citizens born in the United States, but whose parents are non-citizens.

How does the current climate affect the health and daily lives of these millions of people?

Kaiser Family Foundation wanted to find out more, and so began work with a research company to interview families in 8 cities in 4 states. They also interviewed pediatricians who work closely with immigrant families in these cities.

Their findings are significant and troubling. Among those findings are these:

  • Fears of deportation and overall uncertainty have increased in the last year. These fears extend to those who are here lawfully.

“I feel unsettled. Even though we already have the green card, if we do not apply for citizenship, I don’t think we can be at ease.” –Korean Parent, Chicago, Illinois

“Uncomfortable and unstable; we feel that in any moment a new rule could be issued leading to expelling us and sending us back.” –Arabic-speaking Parent, Anaheim, California

“There’s no stability. [The President] could write a tweet on Twitter tomorrow and turn things upside down.” –Arabic-speaking Parent, Anaheim, California

  • Children are facing increased fear that their parents will be deported and/or that they will end up having to uproot their lives and go to their parent’s countries.

“My children would come home from school and say that at school they were saying that all parents would be deported…” –Portuguese-speaking Parent, Chicago, Illinois

“All the children, even if they were born here, are fearful. They fear that anytime they’ll come back from school and won’t find their parents there.” –Latino Parent, Chicago, Illinois

“In Brownsville we have about 1,700 homeless children in the schools. Many of those children are homeless because of a parent that was deported or placed in detention.” –Pediatrician, Texas

  • Pediatricians and participants said that bullying and discrimination at work and at school has increased in the past year.

“They get bullied…told things like, ‘now you and your family will have to leave.’….And so, even though those kids don’t actually have to worry about their immigration status, I think obviously a child, they don’t know the details of how the system works.” –Pediatrician, Pennsylvania

“I work in landscaping, and we’re working and they see you working…and they just start yelling stuff at you…” –Latino Parent, Fresno, California

  • Families are making changes in their daily lives and routines base on fear.

 

“I am also concerned because if anything happens to us on the street, if we get assaulted or something, we won’t even be able to call the police because they will see we are immigrants.”      –Latino Parent, Boston, Massachusetts

“…but now around six or seven in the evening you won’t find anyone in [the neighborhood]… due to the fear we all feel about what is going to happen.” –Latino Parent, Chicago, Illinois

  • Increased fear in kids is resulting in behavioral issues, mental health problems, and psychosomatic symptoms.

“The kids who come in with concerns that you can kind of trace back to anxiety are usually the upper elementary age students, like the 3rd, 4th graders, to middle school students… 7th and 8th grade, who have nonspecific complaints like abnormal pain or headaches or decreased appetites… And then, in kids that are in the junior high to high school age range, it’s a little more overt: sadness, decreased appetite, not wanting to engage in usual activities, decreased in-school performance, those sorts of things.” –Pediatrician, Arkansas

  • Across the board, pediatricians are concerned with the long-term consequences of this environment.

“I think that we are going to have a generation of kids, who, especially in our immigrant homes, who are going to have more adverse childhood experiences than they would have. So, I think that we’re just setting up this generation of kids to have higher incidence of chronic disease, higher incidence of poor mental health, higher incidence of addiction…” –Pediatrician, California

“I think a huge worry is that children who have problems that are minor and fixable now… that, if those children go untreated, those could end up being bigger problems in the future that are going to be harder to treat and are really going to impact the child’s quality of life.” –Pediatrician, Pennsylvania


The health and well-being of immigrant and refugee communities is something I care deeply about. Yes, it is my daily work as a public health nurse, but it is more than that. It is something that is deeply embedded into who I am as a person. I have only benefitted from the many in my life who are immigrants and refugees, and it is troubling to me that there is documented fear and anxiety that is affecting the daily lives of those I care about.

What might we do to change this? What might we do to help those whose anxiety is affecting their health and the health of their families? The answer is bigger than any one of us, but some of the things that can help are these:

  • Know the law* and be able to point people to the law. Some of the fear is based on rumor. It is important to squash rumors and to point people to laws.
  • Sensitive locations. Both ICE (Immigration and customs enforcement) and CBP (Customs and Border Patrol) consider hospitals and other health care facilities to be “sensitive locations.” Both agencies have issued memoranda that say that immigration enforcement actions are to be avoided at sensitive locations, including at hospitals and other health care facilities, unless urgent circumstances exist or the officers conducting the actions have prior approval from certain officials within the enforcement agencies.
  • Right to remain silent. While immigration enforcement at health care facilities is limited by the “sensitive locations” guidance, immigration agents may enter a public area of a health care facility without a warrant or the facility’s consent and may question any person present, but those people have the right to remain silent.
  • Reassure your patients. Educate and reassure patients that their health care information is protected by federal and state laws.

An appeal to those of us who are Christians:

Caution and compassion are not incompatible; instead it is reasonable to assume that they work well together.  The state is not the master of the church. If you are part of a faith community, none of this prohibits you and your faith community from reaching out to those who may be affected. They do not prohibit you from reaching out, in love, to refugees and immigrants in your midst. It is a lot easier to wear a sign and yell than it is to make a hot meal and take it to strangers, to check in with sick neighbors, to pray for those who are anxious and fearful. We must be willing to do more than react emotionally. We must be willing to put our loudly voiced news feeds into real action.

“The ability to love refugees well doesn’t require a certain party affiliation. It doesn’t require you to vote a certain way. But it does require us to show up, to step across “enemy” lines, and to choose love over fear.” from Preemptive Love


*See this document for more information.

Note: Communicating Across Boundaries has never been, and never will be, a political blog, but I see this not as a political issue, but as a human health care issue. The brief is much longer and more detailed than this blog post. This post is simply to raise awareness of the issues that result from an environment of fear and anxiety.

Some Thoughts on Teen Pregnancy

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If you were giving a talk on teen pregnancy to a conservative, faith-based group who cares, what messages would you want to convey?

A couple of years ago I asked this question of someone in our family planning division at work. I was serious. I wanted her perspective. She did not hesitate.

I would tell them we live in a sex-saturated society, and everyone else is talking about sex – they need to be part of the conversation. I would tell them that you are not giving a teenager a mixed message if you tell them what you believe and what you would want them to do, and yet arm them with tools and knowledge about contraception if they make a different choice.”  It was a great conversation.

So armed with this, as well as facts and figures that tell more of the story of teen pregnancy I ended up leading a discussion at our church.

Along with the facts, I wanted to give a face to the story. I chose to show a clip from a documentary called “The Gloucester 18”.

In 2008 Gloucester, Massachusetts – a seaport city known for its lobster, fishing and The Perfect Storm found itself in the center of a world-wide media frenzy. Reporters from as far away as Australia and Brazil descended on the town with cameras,microphones and all the other apparatus needed for a sensational story. The reason?  There were four times the number of teen pregnancies than previous years and word had surfaced that 18 teenage girls had made a pact to become pregnant. As the nurse practitioner at Gloucester High School said “People love scandal”.

News networks preyed on this story like hawks and the girls and their families were deluged with phone calls from CNN to Dr. Phil.

So what is the real story behind these Gloucester teenagers? More importantly what’s the story behind teen pregnancy in general?

What we know:

We know several things. We know that teen pregnancy is a complicated issue and those that ignore the complexity are living in denial. “Just Don’t Do It” or teaching kids about sex by showing them Barbie and Ken in a shoe box seem to be  ineffective ways to deal with teens and sex, teens and pregnancy. While the United States has seen a significant decline in recent years, the lowest rate in 70 years, we still have the highest rate in the developing world, surpassing Great Britain, France, The Netherlands and Sweden.

We know other things as well….

  • that 50% of teen mothers get a high school diploma by age 22, compared with 90% of teen girls who do not give birth.
  • that teen childbearing costs U.S.taxpayers about $9 billion each year.
  • that girls born to teen mothers are about 30% more likely to become teen mothers themselves.
  • that children of teen parents are more likely to do poorly in school and to drop out of school
  • that half of teen pregnancies end up in abortion – if we care about abortion we need to face and care about the issue of teen pregnancy
  • that southern states have a higher rate of pregnancy than northern states
  • that less teens are having sex now then in 1988
  • that when money is put into sex education and birth control, the abortion rate goes down.

So when the discussion comes around to “Do we expect abstinence only programs to work in the world as we know it” I would say no. Any good sex education program has abstinence as a part of the curriculum, but the operative word is part not the entire curriculum.

Back to the Gloucester 18 – a face to the problem.  The truth is, there was no pact. There was no conspiracy to all get pregnant at the same time. Most of the girls found out about a pact by watching the nightly news. The stories portrayed are poignant and real. In the spirit of a good documentary there is a raw and compelling truth that comes through and you can’t stay detached through facts and figures because they now have names and faces and most of all, babies. Beyond the newspaper stories were kids having kids. Girls searching for meaning and purpose, girls looking for stability and love, girls trying to please boyfriends and parents, friends and school authorities. Girls who were still trying to grow up and ended up facing the task of motherhood and parenting.

God doesn’t force his boundaries on anyone; He may long for us to stay within them, but He doesn’t force us.

As much as I may want to wave my wand and make teenagers make different choices, I don’t have that ability. But I can understand the problem, present my view passionately and at the same time be willing to recognize the world we live in, a world we must respond to in ways that are wise. We live in a broken world, a world that is not as it should be. Our world is made up of people who have choices. God doesn’t force his boundaries on anyone; He may long for us to stay within them for our own protection, but He doesn’t force us. So what should my response be? Compassion? Common sense? Tough Love? Interest? All that and perhaps more? 

As I think about the issue of teen pregnancy and teen sexuality I think about sex as a china cup. A fragile, expensive china cup created by a Master Craftsman, with a unique and beautiful design. But once passed from the Craftsman to us to care for, the china cup broke into many pieces. And each of us try to put together these broken pieces, try to put back a pattern and restore a sense of what was.

Teen pregnancy is just one broken piece of the many. Can the Church be part of a solution to put it back together?

Note: This blog has been revised from a post written in 2012. I chose to repost because of the decision to cut millions of dollars from prevention programs.

The Full Time Job of Healing 


I am on medical leave. For the first time in many, many years I have time. I am not moving. I am not job hunting. I am not on limited vacation time. Instead, my full time job right now is to heal. 

It is one of the hardest jobs I’ve ever done. 

Here’s why: 

  1. Healing takes discipline. It takes discipline to set aside time for physical therapy. It takes discipline to eat properly, discipline to not just veg out and binge on television shows. It takes effort to get up in the morning when you hurt, discipline to put your feet on the ground. I am not disciplined and at heart, I’m pretty lazy. I would far rather have a quick fix then a slow, steady process. But healing has its own agenda and schedule., and it demands discipline. 
  2. Healing takes rest. So much of physical and emotional healing is about resting. And true resting is when both your body and soul are at rest. I find myself trying to rest, but my mind buzzes anxiously with thoughts about what I think I should be doing, how I think I should be reacting. Rest is uncommon in the Northeast. Instead, what is applauded is achievement, academic success, graduating from top schools, busy and successful career paths. Rest is something that we don’t talk about or give permission for, instead opting to glorify busy. But healing demands rest. Our bodies have undergone trauma – whether it be from surgery, from illness, or from an accident. The body’s needs for rest increase. Our bodies also need proper nutrition to augment the rest. 
  3. Healing takes humility. Giving up control is hard. Having to have others help you dress, bathe, cook, drive, clean, even put on your shoes is deeply humbling. Actively watching out for self-pity is also humbling. It’s easy to clothe self-pity into “well I’m just being honest about how I feel..” But at the end of the day, it’s still self-pity. It takes humility to follow the guidelines and restrictions of others, to trust medical personnel. It takes humility to allow strangers into your home to see how you live, and to give you suggestions and ideas of how to live better. It takes humility to accept that healing doesn’t happen on the timeline we request. It takes humility to respond to questions about our bodies, to use assistive devices when we go out the door. 
  4. Healing takes time. Above all, this is true.  Neither physical nor emotional healing comes quickly. Instead it’s a long journey.  Yes, there are things we can do to heal as quickly as possible, but ultimately it still takes time. 

And so I have time – and my only job during this time is to heal. 

Years ago, I listened to a recording of a woman who spoke on suffering. It was a powerful talk and I probably listened to it over fifty times in the course of the next few years. One of the many things she said was this: 

Our churches are full of wounded and hurting people who have never taken a season to heal. 

These words are profoundly true – true for the ones who need physical healing, true for the ones who need emotional healing. 

So I will not fight this season, nor will I wish it away. Instead, I gratefully accept my season to heal, and the gift of time. 

Everyone’s Gone!


Sun shines through lace half-curtains, creating a whimsical shadow on the floor. Through open windows, birds are loudly and happily communicating the joy of what life brings to them. 

It is a picture-perfect day – and it is also absolutely quiet in our home. 

Everyone is gone. 

For the past eight days, there have been many people in and out of the apartment.  One daughter, who flew from Chicago to help me post surgery, my gorgeous grandson, with his crinkled nose and interest in all of life, other adult children, friends, visiting nurses, physical therapists, and occupational therapists. Toward the end of the week as my youngest son’s graduation came closer, even more people arrived – my parents and my brother. 

Yesterday, graduation day could not have been more beautiful, and we proudly watched our son, first deliver the Valedictory speech, then walk across a stage to shouts and cheers as he was awarded a Bachelor of Arts degree from Hellenic College. 

Recently I remarked to my husband that we are at the stage of life where things are not going to get easier and better. I think for years people think “When this happens, then we will feel settled” or “When I’m in my [insert age] then life will work itself out.” Those sentences can be substituted with a plethora of different scenarios, but the underlying assumption and expectation is the same: Things will get better. Life will get easier. 

My epiphany with this recent surgery and the assault on my body and emotions is quite simple: things won’t get easier. Life won’t necessarily get better. 

I don’t write this with any sort of pessimism or self-pity. I am profoundly grateful for life’s gifts. I am acutely aware of the shortness of life, of some of life’s tragedies. But now is the time to take each day and recognize that the health and strength I have today will at some point weaken, simply because of the aging process. The activity I can keep up with, the common good I can seek will inevitably become smaller and less significant. 

There is, in all of this, a profound sense of loss. That which I have been given, I slowly lose. It is the Old Testament book of Job that  bluntly reminds me of this reality: 

Naked I came from my mother’s womb, and naked shall I return.The Lord gave, and the Lord has taken away; blessed be the name of the Lord.” (Job 1:20–21).

So this post surgery time comes as a tremendous gift – a gift of healing for the body, a gift of rest for the soul, a time of contemplation of losses. 

I read these words from another: “Nothing is a given — everything’s a gift.”

Who am I to complain in losses when what I lost wasn’t mine to begin with? – Ann Voskamp

Everyone is gone. At first, the words feel sad and empty. But the longer I sit in the quiet, the more comfortable I become relaxing and meditating in the gift of now. 

Hospital Time


I’ve woken early today. Only the birds sing outside, alerting me that it is spring. 

I have been on hospital time since Friday. It’s a strange, twilight time where what we think of as important vanishes, in its place comes a subdued submission to all of life. 

Hospital time is well-known to many – the cancer patient going for weekly chemotherapy; the dialysis patient praying for a kidney; the family of the child in an accident, an induced coma taking the child away for a time. 

Hospital time is part of the human experience, a definite part of aging. We are seen by doctors, recommended to surgeons, and humbly, like sheep being led, go to classes and appointments, lest we be the .3% who doesn’t do well. 

On Friday last week I entered into hospital time. I had a 3-week lead time, so in a sense, hospital time came on slowly, incrementally. 

But on Friday, it was real. Friday I was stripped of my normal identity and became a woman who was being prepared for surgery. With the signing of my paperwork, hospital time began. 

Outside, the world rushed on. Social media erupted over something, the stock market rose and fell, news stations put their overly dramatic news teams onto things both menial and important. 

But none of that mattered. What mattered was hospital time. 

When I think about Eternity, I think about hospital time redeemed; a time when all creation is healed and time surrenders to the Creator. No longer are our moments filled with rage at injustice, fear of the unknown, sadness of loss, or worry about the millions of things that are out of our control. Because time is redeemed and reconciled to our creator. 

In the meantime, I am still in my other world of hospital time, taking the moments to heal and rest, realizing that life will go on without me at its center. And in this time, I am enveloped in grace. 


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