In a few short days, I will be moving across the country. I am beyond thrilled. Where I am going is a beautiful place, and where I am leaving is the me that I was, not the me that I am now. So it feels right. All week, I have been sorting out my belongings, keeping only the best of the best, a few of my favorite things, because I am moving into one third of the space. This move from gracious, three-story brick Southern townhouse to open, loft-style urban Northwest apartment is not what I expected to be doing at this point in my life. And yet, that too, feels ultimately right. The experiences you don't plan so often turn out to be the best ones.
As I sort through basement and attic, office and garage, I have to laugh at all the ages and stages of my life, and I am grateful that with each passing year, I become simpler, deeper, more satisfied with less. Even things I thought I could never part with, I find myself laughing that I ever kept them in the first place. Boxes and boxes and bookshelves of books, enough to stock a respectable library, must go, for there is no longer room. I must keep only a few favorites, and donate the rest to the Decatur Public Library. Surely they will name a wing in my honor. But, I have read them. With rare exception, I will not read them again. As the water flows over the stones in the river, I will not pass that way again. The classes that I taught, the research that I did, the courses that I took, are over. Those houses, those trips, those hobbies, they are the me that was, and it is well and truly over. I can let it all go now.
The experiences I had, the people I loved, the things I have done, I carry within me as a rosary of experience. In my memory, I can touch the stones and remember. I do not need outward reminders. In my basement, a huge stack awaits donation pick-up, and I shall take the tax write-off. More will follow. Furniture, even furniture that I liked, will go, because it no longer fits my reality. And the curious thing is, the more I give away, the more sure of my choices I am, the easier it becomes, and the freer, lighter and calmer I feel. In life, as in travel, there are those who travel light, and those who wish they did.
Copyright 2011. All Rights Reserved.
Monday, October 24, 2011
Tuesday, October 18, 2011
What We Do For The Least of These
Three times a week, he waits for me, sitting in his broken wheelchair, behind a glass door. He is legally blind, cannot hear, and has lost both legs below the knee. For weeks I have been trying to get him equipment. I have made calls on his behalf, trying to locate the equipment he needs that Medicare will not pay for. He is not the first, nor is he the only, of my patients who needs a new wheelchair. The brakes are now broken, and his wheelchair ramp needs repair. I repair what I can, eye glasses, Hoyer lifts, walkers, canes, tub benches. I realize I need better wheelchair repair skills than I currently have.
Another man, behind another door, who has no use of his left side due to stroke, sits in a borrowed wheelchair that is too small for him and is contributing to scoliosis of the spine. He is barefoot, wears a dirty t-shirt with a hole and pants that do not zip held up by one suspender. Nothing has been washed, he is in the same clothes he was in the last time I came. He has no sliding board to assist in the transfer from wheelchair to bed, no tub transfer bench to assist in washing himself. His son is asleep in another room and cannot be roused. The smell is unbearable. He is proud as he tells me he does his own washing, in a bucket, with bits of soap.
I spend ninety minutes on the phone, making every call I can think of, yelling at people I do not know, trying to make some progress, trying to make some meaningful change. The answer always seems to be the same, no matter who I call. They need something from someone else, before they can do their job. I am banging my head against a concrete wall. My patient is not a theory, he is not a statistic; he is an elderly man who cannot walk who needs a bath, a clean set of clothes and sheets, and a wheelchair that fits. For the love of Christ, it cannot be that difficult.
And yet, it seems to be. At the end of the phone line, sitting somewhere in an air conditioned office and wearing clean clothes, a "representative" tells me that they can do nothing, yet again, for my patient. I am told that my patient needs to make calls, fill out paperwork, and the most they, the representative, can do is "drop off a brochure." I am dangerously close to losing it. "Well," I say to the representative, determined to choose my words carefully. "My patient has no family available to help, has severe mental and physical limitations, cannot walk, is sitting in a borrowed wheelchair that is causing curvature of the spine, pisses in a cup and cannot wash himself adequately after shitting into a plastic bag because that is what he has available, but by all means, DROP OFF A BROCHURE."
After ninety minutes, I am late for my next appointment, and must move on. "You must call, and follow up. You must ask your son for assistance. It can be better. But you have to be a squeaky wheel on your own behalf." We are both frustrated. "At least you tried," he says. You've done more in an hour than anyone else has gotten done in four months." I don't feel like I've gotten anything done. He is sitting in the same wheelchair, and he will be wearing the same pants the next time I come. We have done no actual therapy, because his need for equipment is so great, it has to be first priority. He has plenty of brochures, but nothing has changed. I will be quizzed by a bean-counter about my use of therapeutic minutes.
Around the country tonight, people will watch the evening news, and shake their heads, and get angry, thinking of all the people out there trying to "cheat the system." System? What system? I see old men in wheel chairs with no legs who cannot make phone calls on their own behalf because they cannot hear, and who cannot get anyone to follow-up on completing paperwork or sending a fax. I see elders in America who are so poor they are washing their own torn t-shirts in a bucket, who cannot get assistance unless they pay $400 of their $900 Social Security check to a program to bring them "down to Medicaid-eligible."
I call everyone I know who might have equipment lying around unused. I call the donation houses to get my patients wait-listed for a wheelchair that fits and bathroom equipment so they can take a bath safely. Medicare will not pay for "bathroom equipment." I want a number-cruncher, and the American voters who think all of my patients are out to cheat the system, to come with me on patient rounds. I would like to show them the challenges these people are facing just to get out of bed and take a bath every morning. I would like to show them exactly what we are doing for the least of these, our brothers.
Copyright 2011. All Rights Reserved.
Another man, behind another door, who has no use of his left side due to stroke, sits in a borrowed wheelchair that is too small for him and is contributing to scoliosis of the spine. He is barefoot, wears a dirty t-shirt with a hole and pants that do not zip held up by one suspender. Nothing has been washed, he is in the same clothes he was in the last time I came. He has no sliding board to assist in the transfer from wheelchair to bed, no tub transfer bench to assist in washing himself. His son is asleep in another room and cannot be roused. The smell is unbearable. He is proud as he tells me he does his own washing, in a bucket, with bits of soap.
I spend ninety minutes on the phone, making every call I can think of, yelling at people I do not know, trying to make some progress, trying to make some meaningful change. The answer always seems to be the same, no matter who I call. They need something from someone else, before they can do their job. I am banging my head against a concrete wall. My patient is not a theory, he is not a statistic; he is an elderly man who cannot walk who needs a bath, a clean set of clothes and sheets, and a wheelchair that fits. For the love of Christ, it cannot be that difficult.
And yet, it seems to be. At the end of the phone line, sitting somewhere in an air conditioned office and wearing clean clothes, a "representative" tells me that they can do nothing, yet again, for my patient. I am told that my patient needs to make calls, fill out paperwork, and the most they, the representative, can do is "drop off a brochure." I am dangerously close to losing it. "Well," I say to the representative, determined to choose my words carefully. "My patient has no family available to help, has severe mental and physical limitations, cannot walk, is sitting in a borrowed wheelchair that is causing curvature of the spine, pisses in a cup and cannot wash himself adequately after shitting into a plastic bag because that is what he has available, but by all means, DROP OFF A BROCHURE."
After ninety minutes, I am late for my next appointment, and must move on. "You must call, and follow up. You must ask your son for assistance. It can be better. But you have to be a squeaky wheel on your own behalf." We are both frustrated. "At least you tried," he says. You've done more in an hour than anyone else has gotten done in four months." I don't feel like I've gotten anything done. He is sitting in the same wheelchair, and he will be wearing the same pants the next time I come. We have done no actual therapy, because his need for equipment is so great, it has to be first priority. He has plenty of brochures, but nothing has changed. I will be quizzed by a bean-counter about my use of therapeutic minutes.
Around the country tonight, people will watch the evening news, and shake their heads, and get angry, thinking of all the people out there trying to "cheat the system." System? What system? I see old men in wheel chairs with no legs who cannot make phone calls on their own behalf because they cannot hear, and who cannot get anyone to follow-up on completing paperwork or sending a fax. I see elders in America who are so poor they are washing their own torn t-shirts in a bucket, who cannot get assistance unless they pay $400 of their $900 Social Security check to a program to bring them "down to Medicaid-eligible."
I call everyone I know who might have equipment lying around unused. I call the donation houses to get my patients wait-listed for a wheelchair that fits and bathroom equipment so they can take a bath safely. Medicare will not pay for "bathroom equipment." I want a number-cruncher, and the American voters who think all of my patients are out to cheat the system, to come with me on patient rounds. I would like to show them the challenges these people are facing just to get out of bed and take a bath every morning. I would like to show them exactly what we are doing for the least of these, our brothers.
Copyright 2011. All Rights Reserved.
Tuesday, October 11, 2011
My Life as a Perp
The music: Bad Reputation, by Joan Jett and the Blackhearts
Lately, my permanent record has been taking a beating. Yesterday I came home to find, in my mailbox, a "False Alarm Citation and Warning: False Alarm of Automatic Response Alarm Systems" because one week prior, I had inadvertently set off my house alarm while dashing out my basement door on the way to my afternoon patient rounds. It is rather dark in my basement hallway, and while juggling computer, treatment bag, keys, phone, Mi-Fi, calendar, a bottle of raspberry selzter, mail and gently toeing three cats out of my way, I hit a wrong button, and then another, and then another, in a frenzied attempt to turn the damn thing off. When the alarm company called to tell me the police had been dispatched, I asked them to cancel and explained my mistake. I had no idea I was setting off such a furor at city hall.
This black mark landed squarely on my already-much-besmirched reputation, as it followed right on the heels of a moving violation I received two weeks prior when I was involved in what I hope to someday remember fondly as "The Great Left Turn Incident of '11." Right now, I remember it simply as "Getting My Bumper Smashed By A Cheeky Young Turk Going Too Damn Fast Through The Intersection." I admit I am not yet quite at peace with either of these two incidents. I hit a wrong button in the dark, and I turned left. Now, I am, apparently, a perp, and although generally I have always tried to see all sides of any story, I am starting to feel just the tiniest bit oppressed by The Man. If I had a tin cup, I would be running it along the bars of my cell, pausing only to strum and sing a soulful rendition of "Folsom Prison Blues" on my guitar.
I suppose it was really only a matter of time. My parents saw the writing on the wall early, and warned me about it, that night I attempted to tip-toe up the stairs four minutes...no, wait, four hours...past my midnight curfew. Once midnight came and went, I reasoned, as only adolescents can do, that since I was already in trouble I might as well make the most of it. Upon my return, as I crept up the stairs accompanied by the, Lord Have Mercy, Christ Have Mercy, rosy-fingered dawn, carrying my shoes, I found both of my parents standing, arms akimbo at the top of the stairs, sputtering, "Where HAVE you..." and "What in the HELL have you..." and the ever-popular "If you think for ONE MINUTE you're going to...". Now, I have only myself to blame, 'cause Lord knows, Mama tried.
And it's made me wonder, this week, about forgiveness, and how maybe we could all use just a little bit more of it in our lives. I pressed a wrong button, I turned left, I had fun, I laughed so hard I forgot to look at my watch, and I loved somebody. I'd do it all again, and in fact, since I'm still stumbling around like an idiot in a thorn bush at the age of...old enough to know better, but young enough to still enjoy it...I probably will. Not really such a walk of shame, at least not in my book.
Copyright 2011. All Rights Reserved.
Lately, my permanent record has been taking a beating. Yesterday I came home to find, in my mailbox, a "False Alarm Citation and Warning: False Alarm of Automatic Response Alarm Systems" because one week prior, I had inadvertently set off my house alarm while dashing out my basement door on the way to my afternoon patient rounds. It is rather dark in my basement hallway, and while juggling computer, treatment bag, keys, phone, Mi-Fi, calendar, a bottle of raspberry selzter, mail and gently toeing three cats out of my way, I hit a wrong button, and then another, and then another, in a frenzied attempt to turn the damn thing off. When the alarm company called to tell me the police had been dispatched, I asked them to cancel and explained my mistake. I had no idea I was setting off such a furor at city hall.
This black mark landed squarely on my already-much-besmirched reputation, as it followed right on the heels of a moving violation I received two weeks prior when I was involved in what I hope to someday remember fondly as "The Great Left Turn Incident of '11." Right now, I remember it simply as "Getting My Bumper Smashed By A Cheeky Young Turk Going Too Damn Fast Through The Intersection." I admit I am not yet quite at peace with either of these two incidents. I hit a wrong button in the dark, and I turned left. Now, I am, apparently, a perp, and although generally I have always tried to see all sides of any story, I am starting to feel just the tiniest bit oppressed by The Man. If I had a tin cup, I would be running it along the bars of my cell, pausing only to strum and sing a soulful rendition of "Folsom Prison Blues" on my guitar.
I suppose it was really only a matter of time. My parents saw the writing on the wall early, and warned me about it, that night I attempted to tip-toe up the stairs four minutes...no, wait, four hours...past my midnight curfew. Once midnight came and went, I reasoned, as only adolescents can do, that since I was already in trouble I might as well make the most of it. Upon my return, as I crept up the stairs accompanied by the, Lord Have Mercy, Christ Have Mercy, rosy-fingered dawn, carrying my shoes, I found both of my parents standing, arms akimbo at the top of the stairs, sputtering, "Where HAVE you..." and "What in the HELL have you..." and the ever-popular "If you think for ONE MINUTE you're going to...". Now, I have only myself to blame, 'cause Lord knows, Mama tried.
And it's made me wonder, this week, about forgiveness, and how maybe we could all use just a little bit more of it in our lives. I pressed a wrong button, I turned left, I had fun, I laughed so hard I forgot to look at my watch, and I loved somebody. I'd do it all again, and in fact, since I'm still stumbling around like an idiot in a thorn bush at the age of...old enough to know better, but young enough to still enjoy it...I probably will. Not really such a walk of shame, at least not in my book.
Copyright 2011. All Rights Reserved.
Thursday, October 6, 2011
The Time We Took For Granted, In the Life We Gave Away
Music: Life is a Bittersweet Waltz, by Leon Redbone
"With all of its' glories, and all of its' faults, it seems life is a bittersweet waltz."
I sat today with an dying man, and I fed him with an eye-dropper. He has not been eating enough to keep a bird alive, and so we have resorted to tricks used to actually keep birds alive. He is tiny now, shrinking daily, has trouble drinking liquids and prefers to spend his time sleeping. Today, his blood pressure began to fall, and he began shivering. I covered him up quickly with a blanket and held his hands for a moment, and then I took his blood pressure, heart rate, respiration. "Talk to me. Tell me a story." He opened his eyes, and smiled at me, a lop-sided smile. Bell's Palsy has made the other side of his face droop. In the few weeks I've been treating him, I've come to love the little lopsided grin, the bald head, how he lifts his eyebrows when he recognizes me. "Come on now. Be a gentleman. Don't leave me alone on the dance floor." I tease him as I take his blood pressure. "We need to lay him down now, it will help his blood pressure come back up," I call to his granddaughter, who is caring for this elderly man and his wife. Both need care around the clock.
Over the weeks, I've had gentle talks with the granddaughter. She is carrying a heavy load, carrying for a special-needs son as well as her grandparents. Both are confused, and need moment to moment direction in all tasks. I see both for physical therapy, and it is a task. The granddaughter does not get a break, and has been getting little sleep.
I have talked to her gently about options for care, trying to ease her mind while trying to ease her burden. Today, we go further, and discuss discharge from restorative care to palliative care. Although I am more practiced now talking to family members about end of life issues, it is never easy. I am not ashamed to say I cry with them, I can't help it. No one cries alone in my presence. There are times when human touch and a shoulder to cry on are all I can truly give. If they want me to pray with them, I pray with them. If they want to talk and cry, I let them talk and cry it out. People need loving support in these decisions, they need to know it is okay to choose hospice, that they have not failed as family members. Today, the admission that things are not going to get much better, and comfort and joy, in the time that is left, should be the only goal.
We ease the tiny man into bed, his alertness changes moment to moment. I take his vital signs again, and discuss monitoring issues with his caregiver. Rather suddenly, he stops talking. "Is he okay?" She peers anxiously. Without showing alarm, I check his pulse, and stick my stethoscope in my ears for a breathing check and blood pressure.I touch his check and rub his sternum. His breathing is shallow, and suddenly he opens his eyes. He had fallen asleep. His granddaughter and I both started laughing, our cheeks wet from tears moments ago.
She seems at peace with the decision, and as I leave we hug. "Thank you. Thank you for everything," she said. I feel I have done little, except listen and support. "You bet," I replied. "This is why I'm here."
Copyright 2011. All Rights Reserved.
"With all of its' glories, and all of its' faults, it seems life is a bittersweet waltz."
I sat today with an dying man, and I fed him with an eye-dropper. He has not been eating enough to keep a bird alive, and so we have resorted to tricks used to actually keep birds alive. He is tiny now, shrinking daily, has trouble drinking liquids and prefers to spend his time sleeping. Today, his blood pressure began to fall, and he began shivering. I covered him up quickly with a blanket and held his hands for a moment, and then I took his blood pressure, heart rate, respiration. "Talk to me. Tell me a story." He opened his eyes, and smiled at me, a lop-sided smile. Bell's Palsy has made the other side of his face droop. In the few weeks I've been treating him, I've come to love the little lopsided grin, the bald head, how he lifts his eyebrows when he recognizes me. "Come on now. Be a gentleman. Don't leave me alone on the dance floor." I tease him as I take his blood pressure. "We need to lay him down now, it will help his blood pressure come back up," I call to his granddaughter, who is caring for this elderly man and his wife. Both need care around the clock.
Over the weeks, I've had gentle talks with the granddaughter. She is carrying a heavy load, carrying for a special-needs son as well as her grandparents. Both are confused, and need moment to moment direction in all tasks. I see both for physical therapy, and it is a task. The granddaughter does not get a break, and has been getting little sleep.
I have talked to her gently about options for care, trying to ease her mind while trying to ease her burden. Today, we go further, and discuss discharge from restorative care to palliative care. Although I am more practiced now talking to family members about end of life issues, it is never easy. I am not ashamed to say I cry with them, I can't help it. No one cries alone in my presence. There are times when human touch and a shoulder to cry on are all I can truly give. If they want me to pray with them, I pray with them. If they want to talk and cry, I let them talk and cry it out. People need loving support in these decisions, they need to know it is okay to choose hospice, that they have not failed as family members. Today, the admission that things are not going to get much better, and comfort and joy, in the time that is left, should be the only goal.
We ease the tiny man into bed, his alertness changes moment to moment. I take his vital signs again, and discuss monitoring issues with his caregiver. Rather suddenly, he stops talking. "Is he okay?" She peers anxiously. Without showing alarm, I check his pulse, and stick my stethoscope in my ears for a breathing check and blood pressure.I touch his check and rub his sternum. His breathing is shallow, and suddenly he opens his eyes. He had fallen asleep. His granddaughter and I both started laughing, our cheeks wet from tears moments ago.
She seems at peace with the decision, and as I leave we hug. "Thank you. Thank you for everything," she said. I feel I have done little, except listen and support. "You bet," I replied. "This is why I'm here."
Copyright 2011. All Rights Reserved.
Monday, October 3, 2011
Sanctify Me
Saturday afternoon, I went in search of anchovies. Because Friday night, I had decided that the one thing I truly, positively wanted to eat over the weekend was a fresh Caesar salad, made from scratch, by me. Saturday morning, after an hour-long massage during which I may have actually seen God (or at least called out Their name a few times), I wandered happily through Whole Foods, sniffing, tasting, touching everything in my path. I uncapped and smelled essential oils, I ran my hands over mangoes, I inspected berries, I inhaled cheeses. I said yes to every hummus and organic cracker sample on offer. I don't trust people who say no to pleasure when it is freely given, it smacks of a stingy soul. I come out of any market not just smelling like a rose, but smelling like rosemary and mint, Tunisian olives, sandalwood candles, Bob Marley One Love incense and a little cinnamon-clove oil behind each ear.
Saturday evening, home from a long,hard day of mind-blowing sensory indulgence, I drew the drapes, lit the vanilla candles, poured myself a glass of Cabernet and commenced to cook. As I gathered my ingredients and turned on Cat Stevens Footsteps in the Dark and listened to old favorites "Katmandu" and "The Wind", the words of the Catholic communion rose on my breath. Take this bread, and eat it, I thought, as I prepared the garlic and parmesan-dusted croutons. Take this wine, and drink, I thought, as I poured myself another glass of the Cabernet, finding a ridiculous amount of solitary enjoyment in making a Caesar salad. For this is my body, as I chopped up the lovely little salty anchovies, their bodies, which they had given up for me.
As will often spontaneously happen around dinner time when you are cooking, a friend rang. Was I interested in coming out for drinks and dinner? It was my complete pleasure to reply, no, not tonight, but why don't you come over and let me cook for you? Slow food, enjoyed in, what could be better? And so my enjoyment of my dinner was doubled, as I chopped the Romaine, rubbed the bowl with garlic, whisked the olive oil and anchovies, shredded the chicken, squeezed the lemon, grated the Parmesan, and my friend and I shared the stories of our week as we shared our wine. Never one to rush courses, I like a separate plate for each one, to fully appreciate each item. Sometimes I talked, sometimes my friend, sometimes there was silence as we savored and contemplated. Silence is key in a good conversation, it is the space between the notes that defines the music.
The strawberries, peaches and mangoes were perfectly ripe, fragrant from sitting in my warm car as I dawdled through errands that afternoon. I chopped slowly, carefully, deliberately, as the priest offers up the host in the Mass. As I dribbled the Chocolate Balsamic Vinegar over the sugared fruit, I once again heard the Mass in my inner ear. Do this, I thought, in memory of Me.
Holy communion in an ongoing act of sharing. Of sharing what we have, of sharing who we are. Cooking, if done correctly and well, is a sacred act. An act of communion with yourself, with your mind, your body, your sense of touch, smell, and taste. It is an act of communion with others, preparing something for them, watching them enjoy and experience something they have never experienced before. This is where I find God, in the body. In what the body needs, in the true humanity of the Divine in all its forms, and in the divinity of humanity. Take this bread, and eat it, for this is my body. Take this wine, and drink, for this is my blood, given up for you. Do this, in memory of me.
Copyright 2011. All Rights Reserved.
Saturday evening, home from a long,hard day of mind-blowing sensory indulgence, I drew the drapes, lit the vanilla candles, poured myself a glass of Cabernet and commenced to cook. As I gathered my ingredients and turned on Cat Stevens Footsteps in the Dark and listened to old favorites "Katmandu" and "The Wind", the words of the Catholic communion rose on my breath. Take this bread, and eat it, I thought, as I prepared the garlic and parmesan-dusted croutons. Take this wine, and drink, I thought, as I poured myself another glass of the Cabernet, finding a ridiculous amount of solitary enjoyment in making a Caesar salad. For this is my body, as I chopped up the lovely little salty anchovies, their bodies, which they had given up for me.
As will often spontaneously happen around dinner time when you are cooking, a friend rang. Was I interested in coming out for drinks and dinner? It was my complete pleasure to reply, no, not tonight, but why don't you come over and let me cook for you? Slow food, enjoyed in, what could be better? And so my enjoyment of my dinner was doubled, as I chopped the Romaine, rubbed the bowl with garlic, whisked the olive oil and anchovies, shredded the chicken, squeezed the lemon, grated the Parmesan, and my friend and I shared the stories of our week as we shared our wine. Never one to rush courses, I like a separate plate for each one, to fully appreciate each item. Sometimes I talked, sometimes my friend, sometimes there was silence as we savored and contemplated. Silence is key in a good conversation, it is the space between the notes that defines the music.
The strawberries, peaches and mangoes were perfectly ripe, fragrant from sitting in my warm car as I dawdled through errands that afternoon. I chopped slowly, carefully, deliberately, as the priest offers up the host in the Mass. As I dribbled the Chocolate Balsamic Vinegar over the sugared fruit, I once again heard the Mass in my inner ear. Do this, I thought, in memory of Me.
Holy communion in an ongoing act of sharing. Of sharing what we have, of sharing who we are. Cooking, if done correctly and well, is a sacred act. An act of communion with yourself, with your mind, your body, your sense of touch, smell, and taste. It is an act of communion with others, preparing something for them, watching them enjoy and experience something they have never experienced before. This is where I find God, in the body. In what the body needs, in the true humanity of the Divine in all its forms, and in the divinity of humanity. Take this bread, and eat it, for this is my body. Take this wine, and drink, for this is my blood, given up for you. Do this, in memory of me.
Copyright 2011. All Rights Reserved.
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