I had a five figure disappointment today. Small, in the scheme of things, having to do with real estate and the mistakes of others. I will not presume to bore you, Dear Reader, with those details. But as the barometric pressure of change continues to increase uncomfortably around me, I reach for familiar creature comforts as I navigate the landscape of disappointment. Above my kitchen sink is a shelf filled with old friends who have seen me through the worst of the worst: Clementine in the Kitchen, by Samuel Chamberlain; On Rue Tatin, by Susan Hermann Loomis; and My Life in France, by Julia Child.
I re-read these books at least once a year; these are the gods to which I pray. They are spotted with olive oil, smell of garlic and rosemary, and have endured the occasional-gee-I-got-a-little-carried-away splash of burgundy or cabernet sauvignon on their pages. I have cried on them, fallen asleep on them, slept with them against the advice of others. I have woken up with creases on my cheek, and a renewed song in my heart, having stayed up until the wee hours reading them. They are my besties, my BFF's (book friends forever) and they have never let me down.
They have gotten me through difficult jobs, job searches, new jobs, deaths expected and unexpected, demanding illnesses of family members. They have seen me safely and happily through cancer biopsies, an unfortunate but frequent occurrence in my life. When I first received the news that I needed to have a stereotactic biopsy for breast cancer, these were the books I read in the waiting room as I waited to have the drill pound for 120 cold, uncomfortable minutes into my chest, and started PT school a few days later, right pectorals packed with ice packs that I hid under a sweatshirt so no one would know. I read them again, the next year, as I went through a second surgery for removal of more tissue, "just in case." Every time I sat in the hospital waiting room, and watched the other women leave just as the nurse came out and said, "The doctor would like to speak with you", I gripped one of these books in my hand. Bury me with a flower and my rosary if you feel you must, but if I am not gripping one of these books in my hand in my casket, I will haunt you forever, and garlic will not ward off my spirit, it will only attract it.
So tonight, as I mull a minor disappointment that will surely pass out of my life as quickly as it came, I re-commit to old friends. I peruse and plan culinary joy for the rest of the week: Truite Meuniere. Turbot au Vin Blanc. Moule Mariniere. Potatoes will be roasted to perfection, garlicky vinagrettes will be created and poured over everything in site. Camembert and gorganzola will be warmed to room temperature. Baguettes will be warmed to sop up every bit of every delicious sauce. Radishes will be buttered and salted, pears and apples will be soaked in brandy, and I predict that by the end of the week I will feel so good again I will be waving the Blue, White and Red Tricolor of my heartland with the music of "Les Miserables" on my lips. If you don't drown your sorrows in olive oil, garlic and wine, well then god, I don't even wanna know ya.
Tuesday, May 31, 2011
Sunday, May 29, 2011
On Riverfront Street
I suppose I could blame it on the cold pinot grigio and the dozen raw oysters I consumed at Bernie's on Riverfront Street, but I'm not going to. As I stepped out into the amber light and lengthening shadows of a late Savannah afternoon, the heat grabbed me like a more experienced lover, inviting me to release inhibition and recline into whispered, moss-covered suggestion. I was on my way to catch "The Trolley of the Doomed Ghost Tour" when I made eye contact with the street busker for Miss Sylvia's, Fortunes Told and Tarot Cards Read. He was interesting to me, a young African-American man who was lame on his left side. My left hemisphere began to diagnose and dissect, my right hemisphere was just intrigued and drawn in by the fact that he was smiling at me. I suppose I should break this habit I have of talking to total strangers on the street, but curiosity, and pinot, will take you places a well-behaved woman would never go. Perhaps that is why they write so few stories.
Would I like my fortune told? Why not, I thought. I'm here. Let's see what this experience is really like. "But I'll have to come back. I'm taking this tour first." The tour held little appeal, apart from the fact that I got to sit down, and they handed out fans. I left in the middle and headed back toward the busker, and Miss Sylvia. At the top of the shady stone stairs, I stepped into her parlor, and yes, I crossed her palm with silver. Or rather, I crossed her machine with my MasterCard. The digital efficiency lessened the effect, as did the fact that she was a very young Hispanic woman whose patter was as well-worn as her pink Hello Kitty t-shirt.
Oh come on, I thought. A complete skeptic I may be, but I do value a good performance. The busker was more interesting. I should have stayed and talked to him, or asked Miss Sylvia how she got into the business. Was she filling in for her mother? Each statement she made was easy to back trace, like a Scott Turow novel you solve by page ten, because you know basic biology. I wasn't expecting much, and I guess that's exactly what I got. Like a lot of things in life, it doesn't really work if you don't really believe in it. I believed in the raw oysters with cocktail sauce and horseradish, and I believed in the cool of the water fountain I plunged my feet in afterward. I believed in the sunset on the river, and the black and white composition book in my hand. I believed in the heat of a Southern afternoon, the cobblestones under my feet, and the history of human exploitation burned into the bricks of the cotton exchange building. But I didn't believe I'd go back to have my fortune told again, not by anyone other than myself.
Would I like my fortune told? Why not, I thought. I'm here. Let's see what this experience is really like. "But I'll have to come back. I'm taking this tour first." The tour held little appeal, apart from the fact that I got to sit down, and they handed out fans. I left in the middle and headed back toward the busker, and Miss Sylvia. At the top of the shady stone stairs, I stepped into her parlor, and yes, I crossed her palm with silver. Or rather, I crossed her machine with my MasterCard. The digital efficiency lessened the effect, as did the fact that she was a very young Hispanic woman whose patter was as well-worn as her pink Hello Kitty t-shirt.
Oh come on, I thought. A complete skeptic I may be, but I do value a good performance. The busker was more interesting. I should have stayed and talked to him, or asked Miss Sylvia how she got into the business. Was she filling in for her mother? Each statement she made was easy to back trace, like a Scott Turow novel you solve by page ten, because you know basic biology. I wasn't expecting much, and I guess that's exactly what I got. Like a lot of things in life, it doesn't really work if you don't really believe in it. I believed in the raw oysters with cocktail sauce and horseradish, and I believed in the cool of the water fountain I plunged my feet in afterward. I believed in the sunset on the river, and the black and white composition book in my hand. I believed in the heat of a Southern afternoon, the cobblestones under my feet, and the history of human exploitation burned into the bricks of the cotton exchange building. But I didn't believe I'd go back to have my fortune told again, not by anyone other than myself.
Friday, May 27, 2011
Not All That Glitters
Over the past few days, I've been exploring new features for this blog. I've visited many fellow bloggers, and discovered that they are all much more flash than me. There are beautiful photographs, incredible designs, slide shows, and some have thousands of followers from around the world. There are tweets, badges, live feeds, villagers dancing around bonfires, and on one, a tray of virtual champagne and hors d'oeurves popped out...No, I'm kidding about the bonfires.
And it made me wonder, what would Faulkner do? Did Tolstoy need to know if anyone was reading? I hear George Eliot and Ernest Hemingway sent very few tweets. Jane Austen sat quietly by her fire and wrote amazing pieces, stellar studies of personality and place, without getting immediate feedback. Flannery O'Connor and Carson McCullers used good old fashioned pen and ink and hunt and peck manual typewriters, the kind I learned to write on. It belonged to my mother, and I still have it, along with her Pendleton wool jacket, my father's gray mohair zip up sweater from 1957 and an old-fashioned letter opener from my grandmother that has tiny carved elephants on the top. Elephants for memory, and because they have very tough hides, two useful things for any writer.
So the ultimate result of my three-day, comparison blog-hopping extravaganza is this: there will be no flash here. If all goes well, if the winds are right and I keep my sails trim, there will be substance. It is essentially, as Dorothea Brande discusses at length in Becoming a Writer (1934) "appointment writing." I return, with a sigh, to my own virtual leather armchair and glass of cabernet, to try to capture an experience, a moment, a personality, or event that has beauty and meaning and touches the universal. I return a happy and contented writer, grateful for my few followers who for some reason are kind enough to listen to me.
There is value in the old, the simple, and the straightforward. Perhaps one day I will write a piece that Faulkner would have wanted to read, that Hemingway would have pondered before he used it for target practice. In the meantime, pour the wine, spill the ink, and remove that damn live feedjit gadget. With all due respect, I don't need that kind of pressure.
And it made me wonder, what would Faulkner do? Did Tolstoy need to know if anyone was reading? I hear George Eliot and Ernest Hemingway sent very few tweets. Jane Austen sat quietly by her fire and wrote amazing pieces, stellar studies of personality and place, without getting immediate feedback. Flannery O'Connor and Carson McCullers used good old fashioned pen and ink and hunt and peck manual typewriters, the kind I learned to write on. It belonged to my mother, and I still have it, along with her Pendleton wool jacket, my father's gray mohair zip up sweater from 1957 and an old-fashioned letter opener from my grandmother that has tiny carved elephants on the top. Elephants for memory, and because they have very tough hides, two useful things for any writer.
So the ultimate result of my three-day, comparison blog-hopping extravaganza is this: there will be no flash here. If all goes well, if the winds are right and I keep my sails trim, there will be substance. It is essentially, as Dorothea Brande discusses at length in Becoming a Writer (1934) "appointment writing." I return, with a sigh, to my own virtual leather armchair and glass of cabernet, to try to capture an experience, a moment, a personality, or event that has beauty and meaning and touches the universal. I return a happy and contented writer, grateful for my few followers who for some reason are kind enough to listen to me.
There is value in the old, the simple, and the straightforward. Perhaps one day I will write a piece that Faulkner would have wanted to read, that Hemingway would have pondered before he used it for target practice. In the meantime, pour the wine, spill the ink, and remove that damn live feedjit gadget. With all due respect, I don't need that kind of pressure.
What is the Sound of One Blog Clapping?
Hello My 6 Intrepid Followers! I need your help. Since I am new to blogging, I am trying to figure out the features, and frankly, my talents lie more with bones, nerves, muscles, epees and pens than with computers. I notice that now my "Followers" seem to be gone, and I don't know why. My Widgets are disappearing faster than bottles of wine at a book club. If you are reading this, would you please leave a comment as to whether or not you are getting the posts? Has my blog fallen in the forest and no one has heard?
Thursday, May 26, 2011
The Closer
It's started to happen again, and I'm not sorry. When I got the email from my supervisor asking me to take over a patient who had requested another therapist due to a personality clash, I smiled and adjusted my Ray Bans. "Yeah, baby. This is why they call me...The Closer." Okay, I really adjusted my new Danish frames with the progressive lenses, but just play along. This is not the first time I have been called in on a "difficult" patient, and sooner or later, it happens everywhere I go. I find that these patients are usually simply in a lot of pain, physically, mentally and emotionally. Many of my patients have lost their feet, or their legs. At the very least, they have lost the ability to control them, and everything about their life and how they thought it would turn out has changed forever. I don't know about you, but that would sure put some sandpaper up my ass.
It's a not very well-kept secret that physical therapists develop bonds and relationships with their patients. We have to, or else it just doesn't work. Part of my job is to get people to drop their act, their bravado, and do things they are damn scared to do, like walk with no legs. We are all up in their business for weeks, often months. I come in to people's lives when they are at their lowest, and friends, it ain't pretty. There is nausea, vomiting, depression, anger, anger, and often, a little side dish of anger. It's a point of minor perversity that I consider it an honor, a privilege and a calling to work with these people. I'm sort of a tour guide through hell; I bring the map. "Well look at that. God brought you a little white girl. Now what SHE gonna do?" I can see it on their faces, and often they say it right out loud. "Dude, you and me gonna walk. I ain't dropped one yet, and I'm not starting with you. So go on get READY."
This week I am discharging three patients who walked through hell these past months, with me right by their side, calling out the terrain. I have never been prouder. One of these fine Brothaz today told me that he had thought to bring me a yellow rose on discharge day, but had thought of it too late, and would I accept the sentiment, a hug and sincere thanks? I did. Another patient simply wanted discharge day to be his chance to show off to his therapist, and he had a whole routine planned. Tomorrow I will discharge a third very special Brother, a bilateral amputee who now stands, and walks proudly on his new prostheses. These men were in wheelchairs, in power chairs, and now they walk. I live for that moment, that moment when they can walk away from me.
My patients often tell me, "I really hate to see you go." "I know, but you can do it without me now", I tell them. I am routinely amazed and touched by my patients, and how much they want to show off for me on the last day. They want to hold doors for me, and proudly announce "Ladies First" and with a flourish, "After you." These moments are so poignant, because now they can do these things again, they can be strong again, they are no longer "disabled" but "abled", and it means the world to them. And to me.
It's a not very well-kept secret that physical therapists develop bonds and relationships with their patients. We have to, or else it just doesn't work. Part of my job is to get people to drop their act, their bravado, and do things they are damn scared to do, like walk with no legs. We are all up in their business for weeks, often months. I come in to people's lives when they are at their lowest, and friends, it ain't pretty. There is nausea, vomiting, depression, anger, anger, and often, a little side dish of anger. It's a point of minor perversity that I consider it an honor, a privilege and a calling to work with these people. I'm sort of a tour guide through hell; I bring the map. "Well look at that. God brought you a little white girl. Now what SHE gonna do?" I can see it on their faces, and often they say it right out loud. "Dude, you and me gonna walk. I ain't dropped one yet, and I'm not starting with you. So go on get READY."
This week I am discharging three patients who walked through hell these past months, with me right by their side, calling out the terrain. I have never been prouder. One of these fine Brothaz today told me that he had thought to bring me a yellow rose on discharge day, but had thought of it too late, and would I accept the sentiment, a hug and sincere thanks? I did. Another patient simply wanted discharge day to be his chance to show off to his therapist, and he had a whole routine planned. Tomorrow I will discharge a third very special Brother, a bilateral amputee who now stands, and walks proudly on his new prostheses. These men were in wheelchairs, in power chairs, and now they walk. I live for that moment, that moment when they can walk away from me.
My patients often tell me, "I really hate to see you go." "I know, but you can do it without me now", I tell them. I am routinely amazed and touched by my patients, and how much they want to show off for me on the last day. They want to hold doors for me, and proudly announce "Ladies First" and with a flourish, "After you." These moments are so poignant, because now they can do these things again, they can be strong again, they are no longer "disabled" but "abled", and it means the world to them. And to me.
Monday, May 23, 2011
Not All Who Wander Are Lost
If I had a nickel for every time I've been asked "Just you?" or "Are you lost?" or "When are you going to settle down and stay in one place?" I would be a very rich woman today. Yes, folks, just me. Just one for the table. Just one for the boat ride. Just one booking in. Just one for that dance class, that ghost tour, that doctoral program. I'll be paying, and if you treat me right, I'm a great tipper. No, I don't want a table in a dark corner by the bathroom, thanks, put me right out front. No, I did not bring a friend to eat with, or dance with. Would you like to eat or dance with me? No, I had no problem embarking on, and succeeding in, another career in my 40's. I am not lonely, and I am not confused. I am wandering, and I am not lost.
Being a solitary traveler, especially a female one, will teach you many interesting lessons you will never learn sitting home at Windy Corner pining for a more interesting life. This past weekend, it taught me to cherish and indulge that streak in myself that for as long as I can remember has made me nothing but tail lights with a very worried mother. At the very beautiful and delightful Inn at 909 Lincoln in Savannah, I met three of the most fantastic women I have met in a long time. I now convinced that meeting them, and the 3-hour breakfasts we enjoyed together, was the ultimate purpose I made the trip. Brilliant, talented, with fascinating histories, careers and stories to tell, each of them inspired me, and made me feel right at home, which is not a feeling I have very often. It's funny how you can feel more at home sometimes with people you have just met than with people you have known a long time, if you share similar histories and viewpoints. Thank god we find each other in B and B's. Usually, we own them.
One of the most interesting points to come out of our conversation was this: Why do we all get so many damn questions about traveling alone, taking up new activities, embarking on a new career path or tweaking an old one to make it more satisfying? Why is it considered so sketchy or questionable to do many different things in life, live in many towns, have many different jobs and things you are good at (or at least enjoy) doing? There we sat, four successful forty-somethings, trying to figure it out.
My own viewpoint has always been this: Whatever I have done in life, wherever I have been, whomever I have met, has made me who I am in this moment. Shit happens, and from shit comes growth. Growth happens. I made a different decision because I learned something new. I was inspired, moved, and then I grew a pair and pointed 'em forward and made something new, something better, happen. So did these three wonderful women, whom I so briefly met and yet will always remember. Not all who wander are lost. We know exactly where we are, and where we are is a very happy place.
Being a solitary traveler, especially a female one, will teach you many interesting lessons you will never learn sitting home at Windy Corner pining for a more interesting life. This past weekend, it taught me to cherish and indulge that streak in myself that for as long as I can remember has made me nothing but tail lights with a very worried mother. At the very beautiful and delightful Inn at 909 Lincoln in Savannah, I met three of the most fantastic women I have met in a long time. I now convinced that meeting them, and the 3-hour breakfasts we enjoyed together, was the ultimate purpose I made the trip. Brilliant, talented, with fascinating histories, careers and stories to tell, each of them inspired me, and made me feel right at home, which is not a feeling I have very often. It's funny how you can feel more at home sometimes with people you have just met than with people you have known a long time, if you share similar histories and viewpoints. Thank god we find each other in B and B's. Usually, we own them.
One of the most interesting points to come out of our conversation was this: Why do we all get so many damn questions about traveling alone, taking up new activities, embarking on a new career path or tweaking an old one to make it more satisfying? Why is it considered so sketchy or questionable to do many different things in life, live in many towns, have many different jobs and things you are good at (or at least enjoy) doing? There we sat, four successful forty-somethings, trying to figure it out.
My own viewpoint has always been this: Whatever I have done in life, wherever I have been, whomever I have met, has made me who I am in this moment. Shit happens, and from shit comes growth. Growth happens. I made a different decision because I learned something new. I was inspired, moved, and then I grew a pair and pointed 'em forward and made something new, something better, happen. So did these three wonderful women, whom I so briefly met and yet will always remember. Not all who wander are lost. We know exactly where we are, and where we are is a very happy place.
Friday, May 20, 2011
Life in the Slower Moving Traffic, Please Keep Right Lane
As she handed me the keys to my room overlooking the garden at The Inn at 909 Lincoln, my hostess ushered me into the historic and well-appointed sitting room to offer me some travel tips for my three-day weekend in the Garden City. "A trolley tour is a good way to start your stay. Try Savannah Dan, here's a brochure. Do you like historic houses?" She pulled out a map and started marking it up. "Here's the Owens-Thomas House...and the Juliette Gordon Low House..." "Mmmm..." I murmured. "Yes, lovely."
I didn't tell her that I had already been to those places, and that as a weekend refugee from Atlanta, what I really want is to find a nice quiet sepulchre to lie down in for a nap. Then I want to bounce on my bed, have a long, slow delicious bath that smells like the jasmine outside, and a stroll in Forsyth Park. I want to have a cocktail at the Velvet Elvis, look up the Lady Chablis and see if s/he is still "hiding her candy" and drop in on Paula Deen for dinner. I want to sit in shady squares, people watch, contemplate the Spanish moss that hangs from the branches of the live oaks overhead. I want to lose myself in the soothing coastal accents that swirl around me, the narrow brick-lined streets, the human scale of the place. That I want to happen upon Johnny Mercer's house (two doors down), not follow a map to it, and sing "Skylark" under my breath for the rest of the day. I want to wander, I want to be surprised, delighted, in small things, and pretend I am the only one who knows about them.
There is an old joke that runs something like this: "In Atlanta, if people want to get to know you, they ask you what you do for a living. In Macon, they ask what church you go to. In Augusta, they ask who your momma's family is. But in Savannah, they ask you Honey, what are you drinkin'?"
Ah, Savannah, my kind of town. Anytime. Mmmmm. Every time.
I didn't tell her that I had already been to those places, and that as a weekend refugee from Atlanta, what I really want is to find a nice quiet sepulchre to lie down in for a nap. Then I want to bounce on my bed, have a long, slow delicious bath that smells like the jasmine outside, and a stroll in Forsyth Park. I want to have a cocktail at the Velvet Elvis, look up the Lady Chablis and see if s/he is still "hiding her candy" and drop in on Paula Deen for dinner. I want to sit in shady squares, people watch, contemplate the Spanish moss that hangs from the branches of the live oaks overhead. I want to lose myself in the soothing coastal accents that swirl around me, the narrow brick-lined streets, the human scale of the place. That I want to happen upon Johnny Mercer's house (two doors down), not follow a map to it, and sing "Skylark" under my breath for the rest of the day. I want to wander, I want to be surprised, delighted, in small things, and pretend I am the only one who knows about them.
There is an old joke that runs something like this: "In Atlanta, if people want to get to know you, they ask you what you do for a living. In Macon, they ask what church you go to. In Augusta, they ask who your momma's family is. But in Savannah, they ask you Honey, what are you drinkin'?"
Ah, Savannah, my kind of town. Anytime. Mmmmm. Every time.
Tuesday, May 17, 2011
In which miracles are performed, WD40 is debunked, and yet another science nerd is eyed suspiciously
My day is not complete until I am eyed suspiciously by at least one person, and preferably three. Luckily for me, this quota is not hard to meet on any given day, given my range of super powers, fluent (if chemistry-laden) vocabulary and the ability to cure chronic dizziness with a single corrective maneuver.
Last week a patient I have been treating described a hallmark symptom of BPPV, or benign positional paroxysmal vertigo, a common condition of the vestibular system in which the otoconia are displaced in the semicircular canals, producing a differential in the right/left firing rate, nystagmus upon testing with the Dix-Hallpike Maneuver and sensations of nausea, dizziness, room spins and occasional vomiting. If your eyes are glazing over and you are seeing my lips move but hearing "Blah blah, blah blahblahblah" you are not alone. If you can hear me, just keep nodding, and squeeze my fingers.
It's one of my very favorite conditions to treat, because it's so immediate, satisfactory, and usually leads to downright worshipful behavior on the part of your patient. Like many corrective maneuvers regularly performed by physical therapists, it has been known to produce shock and awe. "I can't figure out what you DID!" "It worked, but I don't understand WHY!" "The dizziness is GONE!" I freely admit that after this kind of success and praise, I am sorely tempted to strut, swagger, brag and preen. Oh hell yeah, I think. I'm BAD. I'm NATIONWIDE. Hot Chocolate singing "You Sexy Thing" begins to play in my head, as I suppose it does for all super-heroes.
This lovely daydream and charming musical interlude lasted a full 15 seconds until I was shaken back to reality by the very same patient who was now eyeing me with suspicion as I tried to explain about the otoconia, hair cells, nystagmus and why WD40 would not help joint pain, but how the body's equivalent, hyaline cartilage and hyaluronic acid, probably would. Dyed-in-the-wool organic chemistry nerd that I am, I very nearly pulled cotton balls and tongue depressors from my bag to make a convincing 3-D model, but I managed to restrain myself. Have just cured the patient of room spins due to displaced otoconia in the endolymph, I didn't want to make his eyes spin from boredom.
Last week a patient I have been treating described a hallmark symptom of BPPV, or benign positional paroxysmal vertigo, a common condition of the vestibular system in which the otoconia are displaced in the semicircular canals, producing a differential in the right/left firing rate, nystagmus upon testing with the Dix-Hallpike Maneuver and sensations of nausea, dizziness, room spins and occasional vomiting. If your eyes are glazing over and you are seeing my lips move but hearing "Blah blah, blah blahblahblah" you are not alone. If you can hear me, just keep nodding, and squeeze my fingers.
It's one of my very favorite conditions to treat, because it's so immediate, satisfactory, and usually leads to downright worshipful behavior on the part of your patient. Like many corrective maneuvers regularly performed by physical therapists, it has been known to produce shock and awe. "I can't figure out what you DID!" "It worked, but I don't understand WHY!" "The dizziness is GONE!" I freely admit that after this kind of success and praise, I am sorely tempted to strut, swagger, brag and preen. Oh hell yeah, I think. I'm BAD. I'm NATIONWIDE. Hot Chocolate singing "You Sexy Thing" begins to play in my head, as I suppose it does for all super-heroes.
This lovely daydream and charming musical interlude lasted a full 15 seconds until I was shaken back to reality by the very same patient who was now eyeing me with suspicion as I tried to explain about the otoconia, hair cells, nystagmus and why WD40 would not help joint pain, but how the body's equivalent, hyaline cartilage and hyaluronic acid, probably would. Dyed-in-the-wool organic chemistry nerd that I am, I very nearly pulled cotton balls and tongue depressors from my bag to make a convincing 3-D model, but I managed to restrain myself. Have just cured the patient of room spins due to displaced otoconia in the endolymph, I didn't want to make his eyes spin from boredom.
Friday, May 13, 2011
The Devil You Know
Human relationships can turn on a dime. This week, I was blindsided by a patient in the middle of a hallway, and twenty-four hours later, my mouth is still hanging open. In the middle of a hot, busy day I was verbally attacked by a very angry man in whose eyes I could at first do no wrong, and suddenly, because I was handy, I could do no right. I am bruised, battered, sore, angry and what little trust I had managed to scrape together has been shattered. I feel I should have seen this coming. I know I committed the critical mistake in life that I try so hard not to commit in fencing: I let my guard down.
A fencing opponent will always telegraph their intentions, as will any human being. The trick is to learn to read your opponent accurately, to recognize their tell. What is it about the person in front of you that gives their game away? My fencing buddy Brad will drop his forearm, his son Kyle will increase the pace of his footwork. Omar will march down the strip and simply extend his arm, which is about seven feet long, and then turn his back and walk away, leaving me bruised and muttering "Bastard" under my breath. I know my own "tells". I first retreat slightly, inviting attack, then counterattack swiftly.
Thinking back to my first encounter with this patient, I should have been warned. He spent a lot of time telling me how much the staff at the hospital disappointed him, how little they cared, how they didn't listen to him. Perhaps because he was my last patient of the day, and I was tired, I showed sympathy instead of recognizing the litany for what it was: his tell. A patient who will spend their time telling you how badly others have treated them has a chip on their shoulder, and will forever judge you, the next clinician, against impossibly high standards, standards no human being could meet. I certainly could not, on a hot afternoon in a hallway when I was already late for my next patient. And not giving them the reaction they are looking for will make them even more angry.
For myself, I find it easiest just to shut the situation, and whatever feelings are involved at the moment, off, like a water faucet. No one will benefit from going on and on about it right now. Best to calm down, put it aside and deal with it later, and privately. Unfortunately, this seems to piss a lot of people off. So when this patient got angry and heated, I simply became more clinical, by degrees. The hotter he got, the colder I became. In no mood to placate, I withdrew. It made me sad to watch his shoulders slump.
Everyone we meet in life teaches us an important lesson. This I believe. This patient reminded me not so much to keep my guard up, but to recognize a "tell" when I see one. To remember to read more accurately the needs each person is telegraphing. Now I have seen more clearly, and when I see it again, I will recognize it.
A fencing opponent will always telegraph their intentions, as will any human being. The trick is to learn to read your opponent accurately, to recognize their tell. What is it about the person in front of you that gives their game away? My fencing buddy Brad will drop his forearm, his son Kyle will increase the pace of his footwork. Omar will march down the strip and simply extend his arm, which is about seven feet long, and then turn his back and walk away, leaving me bruised and muttering "Bastard" under my breath. I know my own "tells". I first retreat slightly, inviting attack, then counterattack swiftly.
Thinking back to my first encounter with this patient, I should have been warned. He spent a lot of time telling me how much the staff at the hospital disappointed him, how little they cared, how they didn't listen to him. Perhaps because he was my last patient of the day, and I was tired, I showed sympathy instead of recognizing the litany for what it was: his tell. A patient who will spend their time telling you how badly others have treated them has a chip on their shoulder, and will forever judge you, the next clinician, against impossibly high standards, standards no human being could meet. I certainly could not, on a hot afternoon in a hallway when I was already late for my next patient. And not giving them the reaction they are looking for will make them even more angry.
For myself, I find it easiest just to shut the situation, and whatever feelings are involved at the moment, off, like a water faucet. No one will benefit from going on and on about it right now. Best to calm down, put it aside and deal with it later, and privately. Unfortunately, this seems to piss a lot of people off. So when this patient got angry and heated, I simply became more clinical, by degrees. The hotter he got, the colder I became. In no mood to placate, I withdrew. It made me sad to watch his shoulders slump.
Everyone we meet in life teaches us an important lesson. This I believe. This patient reminded me not so much to keep my guard up, but to recognize a "tell" when I see one. To remember to read more accurately the needs each person is telegraphing. Now I have seen more clearly, and when I see it again, I will recognize it.
Tuesday, May 10, 2011
Rules Redux
In a line from M*A*S*H that for some odd reason has always stuck in my head, Colonel Potter tells Hawkeye Pierce, "In war, Rule #1 is Young Men Die. Rule #2 is Doctors can't change Rule #1." In other words, sometimes things will happen to patients that are beyond your control. You know this going in. You remind yourself of it on the way out. People use and abuse their bodies for years, and then bring them to hospitals, like Humpty Dumpty, hoping to be put back together again. Oh, how we wish we could.
The first time I lost a patient I was seventeen, working as a nursing assistant at a nursing home in my home town. It was my second day, and a patient on my wing passed away. I was assigned the task of washing the body and preparing it for the funeral home. I had just met her, talked to her, the day before. I had nightmares for a week. Whenever I tried to talk to someone about the experience, they suddenly got very upset and started talking about how "they just couldn't work in a nursing home." And I realized then, no, I guess you couldn't, and that's the difference between you and me. I stopped trying to talk about it, because people just got upset. I went on dates and fell asleep because I was tired from work. I never saw the end of any movie, and often fell asleep again in the car on the way home. I was such a fun date, what with all the falling asleep and wanting to talk about dead people.
With years of training and practice, I no longer have the nightmares I did in the beginning. When a patient takes a turn for the worse, you automatically click through your encounters and check your practice, and know that ultimately you did everything you could possibly do. You temper the feelings with reminders of the patients who got better today, the progress seen. The signs and symptoms caught just in time, the subtleties recognized and referred, the relief given. You have that talk with yourself again, about how it's not all your responsibility, not all under your control. It's hard, though, when you've treated a patient for a long time, and watched them come so far, to see them have a set back. You just have to keep repeating Rule #2.
The first time I lost a patient I was seventeen, working as a nursing assistant at a nursing home in my home town. It was my second day, and a patient on my wing passed away. I was assigned the task of washing the body and preparing it for the funeral home. I had just met her, talked to her, the day before. I had nightmares for a week. Whenever I tried to talk to someone about the experience, they suddenly got very upset and started talking about how "they just couldn't work in a nursing home." And I realized then, no, I guess you couldn't, and that's the difference between you and me. I stopped trying to talk about it, because people just got upset. I went on dates and fell asleep because I was tired from work. I never saw the end of any movie, and often fell asleep again in the car on the way home. I was such a fun date, what with all the falling asleep and wanting to talk about dead people.
With years of training and practice, I no longer have the nightmares I did in the beginning. When a patient takes a turn for the worse, you automatically click through your encounters and check your practice, and know that ultimately you did everything you could possibly do. You temper the feelings with reminders of the patients who got better today, the progress seen. The signs and symptoms caught just in time, the subtleties recognized and referred, the relief given. You have that talk with yourself again, about how it's not all your responsibility, not all under your control. It's hard, though, when you've treated a patient for a long time, and watched them come so far, to see them have a set back. You just have to keep repeating Rule #2.
Sunday, May 8, 2011
We Were The Hungry Holler Girls
Friday, May 6, 2011
Every Time a Bell Rings
"Every man on that transport died! Harry wasn't there to save them, because you weren't there to save Harry...Strange, isn't it? Each man's life touches so many other lives. When he isn't around he leaves an awful hole, doesn't he?" - Clarence, Angel 2nd Class, from "It's a Wonderful Life."
It's May, springtime in Atlanta, so naturally I'm thinking about Christmas. Rather, as I reflect on my rich, full, crazy-making week of humbly serving all mankind, I am thinking about Clarence, Angel 2nd Class. In the classic movie "It's a Wonderful Life", Clarence is guardian angel to George Bailey, a man reflecting on the ultimate importance and value of his life. Clarence grants George the opportunity to see what the world would be like if he'd never been born at all.
My patients have touched me this week, and taught me so many important lessons. I'm not sure exactly why, but more and more, I find myself slowing down and listening more, moving slower, touching more, directing less. I think it is because I know now they trust me implicitly. It's an incredibly humbling thing when a very frail, fragile patient in pain trembles, then relaxes under your hands. Although friends might tire of hearing me talk about my work, I can tell you, it never gets old. And this week I discovered, that for as much as I try to give them, they give me so much more. I am a better person for serving them.
I learned deeply this week that the most important thing you can give someone is your attention. Although that might sound obvious, I wonder how many of us actually do that, in the moment we are with someone. Many times in patient encounters, I have had one eye on the clock (productivity and units are expected), one eye on the chart (I live in fear of missing an important detail) and one eye on...And therein lies the dilemma for any health care professional. But for some reason, this week, I just stopped. I stopped DOING, and started BEING.
I found that what my patients wanted most from me was my full attention, and what I wanted most was to give it to them. I gave compliments on improvement, and watched the face of a blind elderly man beam and blush like a schoolgirl. I required slightly less of a post-op patient, and before my eyes she improved. I admired a stack of old photographs and heard the history of Atlanta and the Civil Rights Movement from a man who lived it. In the process, they saw me too, and told me things about myself that surprised me. This was what they wanted all along. They wanted appreciation, and relationship.
A very, very fragile patient of mine taught me this week one of the most beautiful lessons I have ever learned. After several weeks of concentrating on strengthening, coordination, and initiation of movement, I suddenly felt how much she was trembling and all I wanted was to take her pain away. So I gently eased her into a reclining position, and took her to another place with my voice, teaching breathing, visualization, relaxation. And after the treatment, this tiny, tiny angel from heaven beamed, and said, "Oh! I FEEL better! I feel GREAT!" Not surprisingly, I get treated like royalty when I arrive to see her.
I will forever be grateful to her for teaching me that the most important thing I can do FOR my patients is to BE WITH them, and to really SEE them, with loving eyes. Everyone melts a little when you look at them with eyes of love, and more and more I realize how rarely that really happens, how rarely we take the time. Sometimes, I'm not really sure anymore who was sent to save whom. But I do know I'm beginning to feel a little like George Bailey, surrounded by angels.
It's May, springtime in Atlanta, so naturally I'm thinking about Christmas. Rather, as I reflect on my rich, full, crazy-making week of humbly serving all mankind, I am thinking about Clarence, Angel 2nd Class. In the classic movie "It's a Wonderful Life", Clarence is guardian angel to George Bailey, a man reflecting on the ultimate importance and value of his life. Clarence grants George the opportunity to see what the world would be like if he'd never been born at all.
My patients have touched me this week, and taught me so many important lessons. I'm not sure exactly why, but more and more, I find myself slowing down and listening more, moving slower, touching more, directing less. I think it is because I know now they trust me implicitly. It's an incredibly humbling thing when a very frail, fragile patient in pain trembles, then relaxes under your hands. Although friends might tire of hearing me talk about my work, I can tell you, it never gets old. And this week I discovered, that for as much as I try to give them, they give me so much more. I am a better person for serving them.
I learned deeply this week that the most important thing you can give someone is your attention. Although that might sound obvious, I wonder how many of us actually do that, in the moment we are with someone. Many times in patient encounters, I have had one eye on the clock (productivity and units are expected), one eye on the chart (I live in fear of missing an important detail) and one eye on...And therein lies the dilemma for any health care professional. But for some reason, this week, I just stopped. I stopped DOING, and started BEING.
I found that what my patients wanted most from me was my full attention, and what I wanted most was to give it to them. I gave compliments on improvement, and watched the face of a blind elderly man beam and blush like a schoolgirl. I required slightly less of a post-op patient, and before my eyes she improved. I admired a stack of old photographs and heard the history of Atlanta and the Civil Rights Movement from a man who lived it. In the process, they saw me too, and told me things about myself that surprised me. This was what they wanted all along. They wanted appreciation, and relationship.
A very, very fragile patient of mine taught me this week one of the most beautiful lessons I have ever learned. After several weeks of concentrating on strengthening, coordination, and initiation of movement, I suddenly felt how much she was trembling and all I wanted was to take her pain away. So I gently eased her into a reclining position, and took her to another place with my voice, teaching breathing, visualization, relaxation. And after the treatment, this tiny, tiny angel from heaven beamed, and said, "Oh! I FEEL better! I feel GREAT!" Not surprisingly, I get treated like royalty when I arrive to see her.
I will forever be grateful to her for teaching me that the most important thing I can do FOR my patients is to BE WITH them, and to really SEE them, with loving eyes. Everyone melts a little when you look at them with eyes of love, and more and more I realize how rarely that really happens, how rarely we take the time. Sometimes, I'm not really sure anymore who was sent to save whom. But I do know I'm beginning to feel a little like George Bailey, surrounded by angels.
Wednesday, May 4, 2011
Thank you sir, may I have another?
Sometimes, you just have to fire your patient. Oh, rarely of course, and for cause. But it does happen. You find yourself clearing your throat, placing a gentle hand on their forearm after you've taken their vital signs and reviewed their chart, and saying those three little words, "Let's be frank." Because, you see, they just won't LEAN IN.
I'm talking here about participation, showing up, bringing something to the party. Like a shy or indifferent party guest, they just sort of hang around the corners of their therapy, without ever fully committing to it. It's very frustrating for the therapist. Give me the patient who will get down, get messy, fling it out there, make eye contact. Those who will laugh, cry, air their dirty laundry in public, send you off with a cupcake with too much frosting, scream, pound the mat, introduce you to their cat, and then work. And work some more. Spare me the patient who can't put down their remote long enough to commit to themselves or their therapy. Really? I'll just leave you two alone, shall I? Someone here needs a little discipline, and when you are ready, here's my card.
It's definitely true I am not everyone's cup of tea as a therapist, and that's okay. I can usually tell in the first five minutes which it is going to be, and the patients I bond with (many) are true devotees of my brand of therapy. In fact, they joke about it with me. They call me calm but tough, fun but focused, and joke that I never let them get away with anything. Those who want to lie to themselves will dislike me almost immediately. My only real requirement is that they show up for themselves, commit to themselves. I want them to lean in, and the sooner the better.
The fencing fleche is all about leaning in. The whole maneuver requires you to lean so far forward that you fling yourself into your opponent and run past them on the strip. You overbalance your body weight at a forward angle and fall forward very fast. It's a move I have not yet mastered, and don't try to use very often. I know that when I use it I feel off balance, which is disconcerting. I can see the same thing in my patient's eyes when I gently but frankly have to talk to them about their commitment to their own recovery. Some of them are just not there yet, like I'm just not there with the fleche. The only way to get comfortable with it is with regular practice. And now if you'll excuse me, I need to go practice falling forward with a sword in my hand.
I'm talking here about participation, showing up, bringing something to the party. Like a shy or indifferent party guest, they just sort of hang around the corners of their therapy, without ever fully committing to it. It's very frustrating for the therapist. Give me the patient who will get down, get messy, fling it out there, make eye contact. Those who will laugh, cry, air their dirty laundry in public, send you off with a cupcake with too much frosting, scream, pound the mat, introduce you to their cat, and then work. And work some more. Spare me the patient who can't put down their remote long enough to commit to themselves or their therapy. Really? I'll just leave you two alone, shall I? Someone here needs a little discipline, and when you are ready, here's my card.
It's definitely true I am not everyone's cup of tea as a therapist, and that's okay. I can usually tell in the first five minutes which it is going to be, and the patients I bond with (many) are true devotees of my brand of therapy. In fact, they joke about it with me. They call me calm but tough, fun but focused, and joke that I never let them get away with anything. Those who want to lie to themselves will dislike me almost immediately. My only real requirement is that they show up for themselves, commit to themselves. I want them to lean in, and the sooner the better.
The fencing fleche is all about leaning in. The whole maneuver requires you to lean so far forward that you fling yourself into your opponent and run past them on the strip. You overbalance your body weight at a forward angle and fall forward very fast. It's a move I have not yet mastered, and don't try to use very often. I know that when I use it I feel off balance, which is disconcerting. I can see the same thing in my patient's eyes when I gently but frankly have to talk to them about their commitment to their own recovery. Some of them are just not there yet, like I'm just not there with the fleche. The only way to get comfortable with it is with regular practice. And now if you'll excuse me, I need to go practice falling forward with a sword in my hand.
Monday, May 2, 2011
Under My Hands
Recent world events have my countrymen rejoicing, and although I certainly join them in support and well-wishes to those who have risked, and given, their lives, limbs and sanity to bring a terrorist to justice, I find it hard to feel the same excitement. A man is dead, and men and women died in making that happen. In retribution for the deaths of many, the maiming of many, years of war in a region plagued by war. More death, more injury, more pain. Some days, like today, I just wonder where it will end, if it will end. I have a weakness, I admit. As a clinician, I have a habit of seeing people as equal. I simply see them as bodies. All blood is red, all people experience pain, an amputee will have the same trouble learning to walk again whether that amputee is American, Pakistani or Afghan. The bones, the muscles, the nerves are the same. I know the body of my enemy as well as I know the body of my friend.
Today, as people rejoiced over the death of one man, I tried to bring comfort and strength to patients who are closer and closer to death. Everyday I think, it is my job to make sure it doesn't happen today. Not on my watch. It's humbling, and terrifying sometimes, to feel what I feel under my hands: skin and bones and sinew and stench and terror and hope and denial. I rejoice with a patient whose weight has climbed to 69 pounds, I rejoice with the patient who has shed 4 pounds and whose congestive heart failure has improved. I speak in comforting tones to a patient with metastatic cancer, and teach breathing, movement and relaxation/visualization techniques to lessen the pain. Between patient calls, I listen to news about celebrations surrounding this long-awaited death. A man is dead, and we are so happy. I find it hard to switch gears, to be happy about one death at the same time I am working so hard to prevent the death of another.
I don't kid myself about any redeeming factors of this man, I simply find it hard to celebrate his death, the same as I find it difficult to celebrate any death. As a woman, I would be a second-class citizen in the world he would create. As an outspoken and educated woman, I would be a threat, and the sword I wield in America as a hobby I would strap to my thigh under my burqa or chador for protection. I don't personally feel any safer because of this death, but then again, I wasn't really afraid to begin with. I felt more concern today on patient calls, in neighborhoods and on blocks where drive-by shootings occur. I don't want to get caught in the cross fire, should there be any. But I make the wisest choices I can, and continue to show up where I am needed.
Perhaps this death simply puts a period at the end of a sentence that has run on too long, and lets us move on. I will watch the celebrations from the sidelines like I usually do, writing, contemplating, processing, treating the injured should that be required. All blood is red, and there always seems to enough of it to keep medical personnel busy, no matter which side you are on.
Today, as people rejoiced over the death of one man, I tried to bring comfort and strength to patients who are closer and closer to death. Everyday I think, it is my job to make sure it doesn't happen today. Not on my watch. It's humbling, and terrifying sometimes, to feel what I feel under my hands: skin and bones and sinew and stench and terror and hope and denial. I rejoice with a patient whose weight has climbed to 69 pounds, I rejoice with the patient who has shed 4 pounds and whose congestive heart failure has improved. I speak in comforting tones to a patient with metastatic cancer, and teach breathing, movement and relaxation/visualization techniques to lessen the pain. Between patient calls, I listen to news about celebrations surrounding this long-awaited death. A man is dead, and we are so happy. I find it hard to switch gears, to be happy about one death at the same time I am working so hard to prevent the death of another.
I don't kid myself about any redeeming factors of this man, I simply find it hard to celebrate his death, the same as I find it difficult to celebrate any death. As a woman, I would be a second-class citizen in the world he would create. As an outspoken and educated woman, I would be a threat, and the sword I wield in America as a hobby I would strap to my thigh under my burqa or chador for protection. I don't personally feel any safer because of this death, but then again, I wasn't really afraid to begin with. I felt more concern today on patient calls, in neighborhoods and on blocks where drive-by shootings occur. I don't want to get caught in the cross fire, should there be any. But I make the wisest choices I can, and continue to show up where I am needed.
Perhaps this death simply puts a period at the end of a sentence that has run on too long, and lets us move on. I will watch the celebrations from the sidelines like I usually do, writing, contemplating, processing, treating the injured should that be required. All blood is red, and there always seems to enough of it to keep medical personnel busy, no matter which side you are on.
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