serenity

you're not ready to use the past tense when you talk about him.

you don't know how to process the beautiful and harrowing truth that life just goes on.

time....patience....i know.

my friend - she's surviving. in so many ways, she is what she has always been. she's suffering, yes - she's also poised and beautiful - she's rock solid in her faith and her role as a mother.

she's jackie o.

then you see the kids and feel that all your crying isn't enough - that you should be bleeding. your boys are always asking you what super powers you would choose if you could - now you know - you'd make yourself a giant sponge and absorb all the pain and sadness and fear from these kids so they'd feel whole and safe and happy again. then it would just be a matter of finding a place to wring that sucker out.

you have a wonderfully surreal life moment when, in telling your patient that you'll be out for her next visit, you start crying because it's for the memorial service of your friend. she doesn't know that's why, but has never seen you cry and wraps you in an incredible embrace. you proceed to tell her the whole story because you have no professional boundaries whatsoever. you've provided her care and empathy and an ear for the last year and a half, and now it's almost as if she welcomes the opportunity to return the favor. tragedy is a leveling force, that's for sure.

you realize that there is nothing to say and nothing to do to make this better.
so you pray that god will grant her the serenity
to accept the things she cannot change
the courage to change the things she can
and the wisdom to know the difference.

and you ask the same things for yourself while your at it.

always

you're driving home. you call your husband to say you're stuck in traffic. you see lights and a helicopter in the distance and know that someone is having the worst day of their life.

hours later you get a call. it's your oldest friend who's having that day. it was her husband in that helicopter. her husband who died. your friend is a widow at 36. with six kids. six.

you hear the words the woman on the phone is telling you, then you can't hear anything because someone is screaming. it takes a minute before you realize it's you. your husband comes running, 'what happened?! what happened?!'. you tell him and watch his face fold and his body collapse onto the bed heaving and shuddering.

you know you have to go see her, but you're hesitating. you tell yourself you're hesitating because of the snow, but really you're just afraid you won't come back.

you enter the hospital you left hours before. you feel like you're staggering and wonder if you really are. you see the waiting room and feel your heart drumming and hear it thudding in your ears. the room is full. full of women your age, heads in hands, hugging, gasping for air. full of men your age, hands stuffed in pockets, pacing, rocking, sniffing. she sees you and crumbles. you feel her weight pull on your shoulders. you feel her wails in the side of your neck. you hold and tell her you'll be here always - both of you knowing full well there's no such thing as always.

you've been in the presence of death so many times. you've held its hand and felt its breath and showed others the way the best you could. now you realize that sudden, unexpected death is a different beast altogether. it's violent and explosive. it's rip your heart out of your chest raw.

you return home. it feels like something has burned a hole in your stomach. your eyes feel swollen, like there's cotton balls shoved up under your lids. you're walking funny. you go in their room and lay a hand on each chest - feel the rise and fall for just a minute. they don't know yet. you envy their peace.

you crawl in bed beside your husband. you'd crawl inside his skin if you could. you wordlessly intertwine and press and sink into each other, but can't seem to get close enough. with puffy eyes and clenched hearts and tangled bodies, you flirt with sleep. you hear a whimper occasionally and you aren't sure if it's him or you.

the day after finds you even though you tried to hide. you hold their hands and tell them what you know and how you feel. you learn a lot about your kids this day...what they're afraid of...what they believe in...what they worry about...how their minds are organized.

'so who will be my soccer coach now?'

'who's going to help max put on all of his hockey gear?'

'how can you be so sure he's not coming back?'

'how long will your heart be heavy?'

you feel, in this moment, that you can't possibly heal...that you'll never stop crying...that pure joy is gone. and that's just us. just a filament of the grief they must feel.

dear one, i'd give anything to wake you up from this nightmare.
whatever always is, you have me for it.

skin

the largest organ...the barrier...it breathes...it protects...it blushes...it gets cut and heals...it sweats...it glows...it toughens under the sun's rays...and wrinkles in water

the skin of my patients shows they've been to hell and back.

there are scars. thanks to biopsies, catheters, needle sticks, vaccines, rashes, iv's, skin grafts, feeding tubes, trachs. vivid, wordless legacies that recall suffering and fear...and healing.

there are colors. if you've never seen them, i'm glad for you. few things rattle me as much as running into a patient after a few months and seeing a sick complexion. their eyes and their smile and their hug tell one story, but their skin tells another. it's a yellowish, grayish, non-humanish hue that can bring tears to my eyes in an instant. a color that makes me want to know if they've been down or if they're going down. that makes me want to ask, 'what the hell have we done to you?"

there are messages. it turns yellow when the liver has been insulted. it gets bumpy and itchy when the immune system doesn't approve of a certain drug. it gets baggy in strange places to show weight loss. it goes numb when a nerve has been injured. it gets rather ornate when the blood is not clotting well. it lets go of heat to inform us of a fever. it's a good communicator.

to hell and back. back being the key. they are back every week. and friday nights they flip throug my mind like a slideshow. a show that i have often tried to cancel or unplug or drown out with red wine. i'm letting it play tonight - it's healthier, i know. not that there's not wine involved - which i hear is healthy also.

night

sometimes i wake up suddenly for no particular reason. and even though it's the middle of the night, and i have to get up early, and i reeeeeally want to be sleeping, it quickly becomes clear that it's just not going to happen. so i reluctantly leave my warm bed and the steady even breathing of my husband. show off.


i get up and pad around quietly. i always feel like i'm robbing my own house. like if i got caught i'd have some explaining to do. i lie down next to the warm little bodies i tucked in several hours before, and do a little re-tucking. i listen to them breathe. i feel their heads to be sure they're not cold. i tuck the hippo back up under the arm and turn up the heater a notch.


i remember a time when most of my friends were single and/or living fairly carefree lives and you could call at any hour. it wasn't unusual to make or receive calls in the middle of the night. now i sit and wonder who i could call. everyone i know has kids or works early or really wouldn't want to be woken up just to chat. and since when do i like to chat? i don't . i think it's just the acute sensation of being alone with myself. so rare these days. my instinct is to reach out. sometimes it's too scary to reach in.


i think. and wonder. and worry. and read. and stretch a little. and yawn. and read some more. and get some water. and wonder about all that worrying. and worry about all that wondering.


i'd love to have a drink. but my genes aren't to be trusted with such things. plus, i don't think 'drinking alone at 2am more' was one of my resolutions. or maybe it was - right behind start smoking and eat more lard.

witness

dear doctor,

for what it's worth, i saw it all. i saw the dread in your eyes, and your chest deflate when those labs popped up on the screen. i saw you squeeze your fists together and gently rest your head on them. then i saw you psych yourself up with a sip of your coffee and a deep breath.

i saw you wince at the hope and lightheartedness in the room when we walked in. i saw you greet them and eek out a smile. when you started talking, and he grabbed his wife's hand, i saw you pull on your collar with one finger tip, like someone had just cranked your tie tighter. i saw your foot, that ususally circles calmly while you talk, swinging sharply back and forth.

i watched you dig for the right words. when they didn't come, i saw you slide your chair closer, put your hand on his knee - and then hers. we all heard you say, 'we're not through fighting this". i saw them exhale for the first time - probably more from your hands than your words. i saw them sift through fear and devastation and gratitude for your care - leaving them with a morsel of hope to nourish them through this next phase.

i watched you leave and return to your desk. when i put my hand on your shoulder, i felt it sink and saw your chin fall to your chest for just a second.

then, like a prize fighter, i saw you roll your shoulders back, pull once more on your collar, pick up the phone and dictate your note.

one down, twelve to go.
it's going to be a long day.

for what it's worth, it's so important what you do. and you do it well.

thanks.
and peace.

wonder

i wonder.
a lot.
about this whole life and death business.

you call because you care and you worry and you wonder.
but beware, it could go something like this:

me:
hey, did mr. d get discharged?

her:
(awkward oncologic silence)

me:
oh my god! what happened?!

her:
i’m so sorry. he died on sunday.

me:
oh my god……..anyone else?

her:
mr. c. last night. i’m so sorry. i was going to call you.

me:
oh my god…… geez……… shit.

note to self: do not call while on vacation to check on patients.
information you learn could negate the ‘vacation’ part of the vacation.

so let me get this straight. life goes on without me. and so does death. and i can’t always be there. not that i want to be or anything would have been different if i had. it’s just that i’ve sort of been assigned as their personal escort through this last phase of their life – and i should have been there. damnit.

‘what’s wrong mommy? did one of your patients die?’
‘actually two died.’
he hugged me and brought me his stuffed hippo and asked the obvious question,
‘so, do you wanna play yahtzee?’

mourning fog. you feel like banging one side of your head like after swimming – maybe the grief will leak out and you’ll be able to hear and think again.

but you blow through the grief express lane. then you roll a large straight – in one roll! you coast on your yahtzee high for awhile.

there was foreshadowing before i left and i made a special point to see mr. s. he was the one i was really worried about. the frail one. it feels like we’ve been waiting for the other shoe to drop with this guy for weeks – and that sucker just won’t drop. he keeps hanging on. more than that – he’s actually improving. that said, he’s old, sick, and tenuous. he hugged me and told me to relax. i told him how well he is doing, how well he has done, and how much i admire him. i said farewell without saying good-bye.

but i couldn’t see everyone. and i didn’t see the two that died. and now i can’t. that hurts and frustrates me in a way i can’t quite describe.

these patients…..god, they are fragile. literally clinging to life by a thread. a thread that we may be able to fortify or weave into something stronger – or a thread that could be unexpectedly snipped in an instant.

it was a glorious vacation. it was memorable in so many ways – for the blue skies and good air and fresh fish. memorable too for the loss and the book that found me afterwards. the books i need have been finding me for years. it works out great. Eat, Pray, Love fell in my lap – well, right after i bought it. it was a perfect companion to my 24 hours of soul searching that needed to take place. i didn’t connect with her story as much as her voice and the idea….eat, pray, love – what a mantra. what a mantra for grief management...or just for life. it’s one of the best i’ve found yet.

full day

taking care of cancer patients every day makes me:

inspired

appreciate my body

wonder how i will die

want to get a cbc everytime my gums bleed

cry sometimes for no reason. or for every reason. depends on how you look at it.

hug excessively

a wee bit self-righteous about my work being harder than other people's

grateful

invigorated

want to snort lines of antioxidants

exhausted beyond comprehension

really bad at the whole planning for the future thing

a more sensitive parent

irritated with god

...sometimes all before 9:00am