The book's official Canadian publication date was September 26, and to celebrate I had a small launch party last Friday. The venue had limited capacity, so I invited just a few of everyone important to me: a few colleagues from the refugee clinic, a few patients, a few parish members, friends, family, physician mentors, Pete's colleagues. There will be a public launch at Banyen Books on November 30, and an event in Langley this fall (details soon).

Many thanks to Brooke of Brooka Photographic for capturing these images (and my headshots!): 


My agent, Robert Mackwood, started with a few words. I had many people to thank: Robert, my publisher (Brindle & Glass), editor (Lynne van Luven), Pete and the kids, colleagues and patients. I did a short reading and opened it up to questions. The back and forth that followed was my favourite part of the evening. Great questions, and kind comments. It is quite something to look out and see your high school chemistry teacher next to the Arabic interpreter from the refugee clinic, your rector next to the surgeon/poet/painter who served as Associate Dean of Student Affairs when you were a medical student, and your sister next to a former patient. 


I gave a shoutout to the interpreters I worked with at the clinic. Doctors and nurses get their share of praise but interpreters deserve more recognition. In that clinic, they heard everything I did, and more. 


When a physician writes about her work at a clinic, should patients be invited to the book launch? I write in Chapter 29 about the challenges of determining where the doctor-patient boundary lies, when a patient invites me to his wife's birthday party. It's not always clear. I asked the opinion of two colleagues, and invited a handful of patients whose consent I had sought to include specific stories in the book. I was so pleased that they came. 


It was a great night. I felt loved and supported. It was a rare moment when I felt that the work I'd done - the decade at the refugee clinic and the book - was exactly what I was meant to do. Thanks to all who came out. 


Credit to Emelle's for the catering, the MSAC for the venue, and Banyen Books for the bookseller. 


Ariana and I take the pedal boat out for an evening tour of the little lake outside our cottage in Val-David, Québec. We've flown out for a week to celebrate Pete's parents' 45th wedding anniversary. Ariana has twelve cousins here, eight of them girls. I see her at breakfast and bedtime. The rest of the time she's at the pool, in the lake or on a bike. I've given up on untangling her hair until we're back in Vancouver. 

We churn away from the dock and through the lily pads. There's a puddle of water on my seat seeping through my jean shorts and a bug alights on my right shin. Ariana's hair is backlit by late sun slanting through the brush on the shore. The boat's steering mechanism is fickle and we chug along in overcorrected zig-zags. We're the only noise. The shores are deserted. 

"Sometimes I get these feelings that I can't control, " she says. "Like sometimes I feel really sad for no reason." She's eleven. She's more self-aware of the subtle changes of adolescence than either of her older siblings were. To me, this acknowledgement is a greater milestone than buying her first bra.

"How long does it last?"

"I don't know. Twenty minutes." Our legs cycle in unison. For a small vessel a pedal boat leaves a massive wake. "Like right now, I'm thinking about how I always really liked doing stuff with you, but I actually wish I was doing this with my friends." 

That smarts. I know it's not meant to. She's trying to sort out her confusion over her growing connection to peers and loosened ties to me. It's a normal part of paediatric development.

"I know," I say. "When I was your age my friends were more fun than my Mom, too."

I do know. I still feel the sting. 

*     *     *     *     *

Val-David is hosting 1001 Pots, North America's largest ceramics exhibition. Saskia and I walk over to the village from our cottage. We pay two dollars for admission and receive a stamped ceramic disc the size of a quarter, good for five weeks of in and out privileges. The displays are outdoors. There's rainwater in the sake cups and leaves blown against the teapots. 

We drift along. There are butter bells, casseroles and jardinières filled with plants. There are cups shaped like monkeys with ears for handles. There are tiny bowls glazed white with edges thin and scalloped as a crepe, and bowls in burgundy with a rim as thick as my finger. It's morning. It's cool and quiet. The people with name tags - all with hyphenated first names like Marie-Eloise - are serene as they tend to displays and visitors.

Saskia's one table over examining a container shaped like a cactus. She's wearing shorts overalls and a Blue Jays cap. Her hair is in a half ponytail. It looks casual but she's almost sixteen and I know every detail is deliberate.

"I don't know which one I like better," she says. "The cactus or the hedgehog." The artist has mastered spines. 

"The hedgehog," I say. "I like how it's curled up." Then, "Saskia! There's no one I'd rather do this with than you." 

She looks right at me. "Me too."

We wander to the rear of the grounds, to the Jardin de Silice, where wire cages of chipped bowls and smashed plates form walkways and a courtyard lined by a chicken run. The broken ceramics are displayed with the same pride that the intact ones were.

"Do you know what wabi-sabi is?" Saskia says.

"No." I love learning from my kids. 

"It's the Japanese idea that there's beauty in imperfection. I think about that all the time."

"This reminds me of the time we were walking in the woods, and you told me that you loved that it was such a mess, but still so beautiful," she says. "Do you remember that?"

I do. She was eight or nine years old and I'd been reading Emily Carr's journal "Hundreds and Thousands." We'd been walking through Wickenden Park in Deep Cove when I'd turned us ninety degrees from the path ahead to look straight into the woods. "Emily Carr would paint in the forest and note what a mess it was," I'd said. We'd stared into the tangle of salmonberry bushes, rotting fallen trees with baby hemlocks pushing up from them, the newest growth of sword ferns arching pointed and green from a brown nest of last year's leaves. She'd been amazed, and she'd laughed.

I'm so happy she remembers. 

They come and they go. 

The fat purple fig of public health

Here's some New Year's reading for you: 

I saw my life branching out before me like the green fig tree in the story. From the tip of every branch, like a fat purple fig, a wonderful future beckoned and winked. One fig was a husband and a happy home and children, and another fig was a famous poet and another fig was a brilliant professor, and another fig was Ee Gee, the amazing editor, and another fig was Europe and Africa and South America, and another fig was Constantin and Socrates and Attila and a pack of other lovers with queer names and offbeat professions, and another fig was an Olympic lady crew champion, and beyond and above these figs were many more figs I couldn't quite make out. I saw myself sitting in the crotch of this fig tree, starving to death, just because I couldn't make up my mind which of the figs I would choose. I wanted each and every one of them, but choosing one meant losing all the rest, and, as I sat there, unable to decide, the figs began to wrinkle and go black, and, one by one, they plopped to the ground at my feet. 

                                                                                                        - Sylvia Plath, The Bell Jar

Yes. I've always wanted each and every fig. In my twenties it felt like I could have them all, eventually. I turned forty and saw that the time remaining was finite. I sat there a while, having to choose, unable to decide. I considered Pete and his career, each of our kids, and our life in Vancouver. I cycled through all of the options, repeatedly. 

A year ago I wrote:  "And so 2015 felt to me like the year of endings, but not quite of beginnings. The beginning of beginnings, maybe. The Year of the Lull. An intermission. It was restful but I'm restless. I'm about ready to lay down the ten year plan. 2016 will be the year of decisions. It will be the year of beginnings. Fingers crossed, one of those beginnings is the foreword to my first book."

I did decide. I chose a Public Health and Preventive Medicine residency at UBC, and, as I learned on a 9 am phone call back in June, it chose me back. It's a five-year specialty training program, but I get full credit for my two years of family medicine residency. I started in September. Every night at dinner the family learns about rabies, or the Canada Health Act, or a kindergarten in Tokyo with a circular playground roof where the kids spontaneously run 4km of laps every day. All four of my kids can tell you about Typhoid Mary. 

I didn't write a word for four months. I'd been writing several hours a day for much of the year prior. My phone has a lot of pre-September photos that look like this, me and my muse, with reams of paper in the background. Then not one photo until Christmas vacation.

But over Christmas break, I did write the foreword to my book. It has a publisher! The manuscript has now gone to the editor. It looks like we have a title in our sights. Formal book announcement coming soon. 

Which figs will I let wrinkle and go black? A regular full-time family practice in Vancouver. A practice focused on care of the elderly. Unhurried days in a quiet house, at least for the next three years. The other areas that appeal to me - refugee health, medical education, mental health - will likely reappear as part of my public health career. 

*   *   *   *   *  

Deep Cove and I renewed our vows. Pete and I considered moving back into Vancouver, close to UBC, but the kids are thriving in their North Shore school. It's K-12, which means all four kids are at the same school. So we've stayed put, and I commute. It's 48 minutes each way, four days a week. It's not a problem. I have my best ideas in the car. 

We advertised for a nanny/housekeeper for three days a week back in September, but got no bites. We ended up with no hired help this fall. I bought a Dyson vacuum instead. I've decided that I'm a permissive doctor by choice, a permissive housekeeper by necessity, a strict parent, and a ruthless editor (of gardens, words, personal belongings). Quite balanced overall.

Things are peaceful on the home front. I study a lot, but I'm around. The amount of homework I do and the pleasure with which I do it is not lost on the kids. They're five to fifteen - a sweet spot, I think. They're increasingly independent, but have not yet made any decisions of which I disapprove.

*   *   *   *   *  

2016 was a good year for me. The restlessness is gone. I feel engaged and focused. Doing the work is a whole lot easier than deciding which work that's going to be. 

Land of Enchantment

I just returned from the Taos Writing Retreat for Health Professionals in New Mexico. I attended last year, too. 

New Mexico first piqued my interest when Natalie Goldberg referred to it so fondly in her book “Writing Down the Bones.” I try to piggyback medical conferences onto travel destinations, and alternate evidence-based review conferences with those exploring the art of medicine. I was due for some humanities, so when I learned of the Taos retreat last summer, I registered. A dozen medical professionals gathered for a week to write at the historic home of art patron Mabel Dodge Luhan, in a small town north of Santa Fe? This was my tribe. 

And they were. There was a urologist turned novelist from the Midwest, a San Francisco-based hematologist from the biotech industry, and a medical anthropologist nearing retirement. There was a soft-spoken neonatologist that I’d met at a writing course in Iowa the year before, and a witty radiologist from Michigan that I hoped to meet again (and who returned this year!). We were a diverse group, but our pleasure in gathering to read and discuss Donald Hall’s poem  "The Ship Pounding" was the same.

We spent mornings in the classroom, and had the option to meet individually with faculty in the afternoon to discuss writing, wellness and/or career. The rest of the time we were free to write and explore.

Most of us last year were at a career transition point. Several wanted to reduce their clinical load, some were planning retirement, and one was about to start a position in Alaska. I’d resigned from the refugee clinic months earlier. I was professionally disoriented, with plenty of ideas but no direction. I had written a book proposal but was second-guessing it. I left the retreat last August with a much clearer idea of professional and creative next steps.

I decided impulsively two weeks ago to attend the Taos retreat again. It seemed like a meaningful way to bookend the last twelve months. I flew out with my almost completed book manuscript in my carry-on, and five weeks remaining before the start of a residency in Public Health at UBC. I wanted one last vacation and some peace in which to finish the book.

I holed up in a hotel in Santa Fe for four days first, with chapters spread out over the tiled floor and visits to museums, galleries and historic sites when I needed to fill the well. I spent every meal with a novel. 

Then I headed to the Taos retreat for the week. The faculty, food and lodging were top-notch, again, and It was another great group. Of the fourteen attendees, three were men, thirteen were American but didn't want to talk politics, nine were physicians, one was a CEO and three knew what a Calvinette was. Want a group to cohese rapidly? Give them a safe place to write and share their work with each other.

I didn't get DH Lawrence's bathtub, but I did get Mabel Dodge Luhan's bed. I woke to sunshine every morning. There were afternoon thundershowers and pre-dinner drinks. I wasn't looking for career direction, but I got some. And on the morning of my last day, I emailed my agent my manuscript: 47,292 words. 

2015: Intermission

As we approach spring break, here's a post that's been sitting in my drafts folder since Christmas vacation.

I signed with a literary agent a few months ago. After resigning from the refugee clinic, I took April and May to write a book proposal. ("But how did you -- ?" Google.) I signed with Robert Mackwood of Seventh Avenue Literary Agency in August, dropping my contract into a mailbox in Quebec City while on vacation. I spent the fall at the kitchen table writing. It's been lovely. It's been lonely.

 © Martina Scholtens. Charlevoix, Quebec.

© Martina Scholtens. Charlevoix, Quebec.

This summer, I took a one-week creative non-fiction course at UBC with Mandy Catron, and attended the Taos Writing and Wellness Retreat for Health Professionals in New Mexico. Both confirmed how much I love writing. Both made me wonder if taking time from patient care to write is indulgent. I'd spend two hours discussing memoir, then guiltily calculate how many patient visits I could have fit into that time. 

In November, with the Syrian refugee crisis, the niche area of medicine I'd worked in for years received unprecedented attention. The website I developed during my maternity leave with Ilia received a funding injection. I jumped on an opportunity to do consultant work, helping the province prepare for an influx of refugees over the next few months.

2015 was supposed to be the year I decided on my next long-term career commitment.  My consultancy work has an expiry date on it. Writing will always be ancillary to my career, not the focus of it. In December, still no closer to choosing from four or five very different career options (all medical, none related to refugees), I hired a career coach. Give me three more months. 

This was our tenth year in Deep Cove. I love the depths here, of the water, mountains and mood. It's quiet and beautiful. We ski Mt. Seymour, we hike the Baden Powell trail and we paddle in Indian Arm. And yet ten years strikes me as the perfect number on which to end. 

2015 marked my last year with a preschool-aged child. I've been home with Ilia three days of the week this fall. I love our slow days, the hum of the fridge in a quiet house while she paints at the kitchen table and I plan dinner. She turns five next month, and joins the other three at school full-time in the fall. That will end fifteen years of staying home with the kids part-time. 

And so 2015 felt to me like the year of endings, but not quite of beginnings. The beginning of beginnings, maybe. The Year of the Lull. An intermission. It was restful but I'm restless.

I'm about ready to lay down the ten year plan. 2016 will be the year of decisions. It will be the year of beginnings. Fingers crossed, one of those beginnings is the foreword to my first book.