DC comics and brave old souls

108 has a full thicket of white hair, a healing hip, and sassiness to burn. She looks deceptively prim, but only because her breathing has deteriorated to the point that she must be sitting straight upright to maintain her oxygen levels. I apologize that my morning assessment interrupts her Batman marathon, but she is almost 90 years old and replies that she is used to the unexpected by now. While I draw labs she pats my hand -as if to comfort me while she struggles to inhale- and reminds me that smoking is the stupidest thing I could ever do, so dear lord, would I please spare myself? I agree, then chart her lung sounds as coarse.

She is not getting worse, but after 16 days she isn't getting better. She doesn't complain much, but I know she's miserable and her mind is always roving outside the walls. When I chart in the room she tells me about her garden, and what she likes to cook, and the places she's traveled. Her dream, she says, is just to go back home and sit by her flowers, and have her children come to visit so she can make them dinner. It is a simple dream, but as she plateaus her hope in it fades. She becomes quieter about what she will be doing in a month, and starts giving me her favorite recipes to try out on my own family. When I mention to her that it takes bravery to be sick, she smiles her slightly mischievous smile. It does, she says, but all of life takes bravery. 

She closes her eyes then, takes a rattly breath, and surprises me. "I don't know what comes next for me or if there will be much at all, but I know what has come before, and it was good. I was given the future I dreamed of when I was your age. I don't have to worry about it anymore, because it's permanent for me. Sometimes I wonder if I'll ever go home again, or sit in my garden, or make dinner for my children. But I can remember having done it before, and I know that even if it never happens again, I have been able to do it once, and it can never be undone. It is a gift, to have a past like mine."

Planning for the future is really the hope to create a past.  It's beautiful the way she says it, but she brushes off my wonder by reminding me that she's had almost 90 years to come up with all her lines.  On my break I come back to watch The Dark Knight with her, and she says the Joker is her favorite character, but Batman is her favorite person because "he knows what's up with how people really are." We laugh and disagree, and are glad that we happened to meet for just a tiny while. Lives overlap in time and space, and I do not think it is an accident. She agrees. 

"'Instead of possibilities, I have realities in my past, not only the reality of work done and of love loved, but of sufferings bravely suffered. These sufferings are even the things of which I am most proud, although these are things which cannot inspire envy.' "

-Viktor Frankl, Mans Search for Meaning

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Posted in future, identity, nursing, the past

Blessed be the shimmers

There are mint plants twining next to my window, and on sunny days I like to toss up the dash so they can become better acquainted with the sun. The lingering aroma of fresh mint permeates everything, and it  would be easy to imagine (unless your imagination is paltry) that you were relaxing in a tube of toothpaste, or possibly dozing near the edge of a tea vat.

It is these wonders of life ( the fresh mint moments) that add together to overwhelm me with his grace. Frequently they sneak between the cracks of mention. It feels incomplete to hear of happiness without background, like skipping to the last page of a book. Yet, in spite of it all, there is joy and undeserved, inexplicable glints of More.

This quickly wells up into awe: I have done nothing extraordinary but been given such goodness on earth.  I live in unearned safety and plenty with those I love, which is such blessing beyond what I could dream to attain. What grace to experience his goodness in my present life.  

He is so good to us, to me. There are some days when you have to stand near the window, close your eyes, and just marvel that he has blessed you with sweet mint plants. These are just one good little shimmer midst the dark, the chaos, the decay. It is simple for me to lose sight of the vastness in these daily blessings.

“Now it is a strange thing, but things that are good to have and days that are good to spend are soon told about, and not much to listen to; while things that are uncomfortable, palpitating, and even gruesome, may make a good tale, and take a deal of telling anyway.”- J.R.R. Tolkien in The Hobbit

"He leadeth me beside still waters, my cup overflows." Psalm 23

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Posted in joy, nursing

Sometimes the hardest thing is to quit

102 was the first patient I cried over at the hospital, which is strange when I think about all the things I probably should have cried over and didn't.  I have worked with him dozens of times. Yesterday, he looked at me for the first time. Not through me, not glazedly forwards, but at me. I checked his eyes- they reacted to light, briskly, round 6mm pupils that shrunk equally under my penlight. I was taken aback. I spoke his name. He raised his eyebrow. The facial expression made no sense, but it was there, movement. It felt, I imagine, like seeing the first smile of a baby. 

I worked with 102 again today.  He looked at me, those clear green eyes that last week had been looking at things unseen to us. He looked like he knew what he was looking at, and he moved his face with expression, the face that has been droopily absent of movement beyond a grimace for months. His family told me that they were changing his code status to Do Not Resuscitate, and moving him onto hospice care. I wanted to grab a hold of them, to make them look into his seeing eyes, to watch him slowly squeeze a hand, but I couldn't do more than suggest and support. The Wife had sat with him for 3 hours that afternoon, just quietly holding his hand on her day off work. She told me that she didn't know if she was doing the right thing, but she had decided, because it seemed like the only thing to do, what he would have wanted. She said they'd been there for  months, and seen almost no progress, and had taken the suggestion of the neurologist to move to comfort care only. Insurance coverage for their stay runs out in 3 days, and they do not have money. They do not have anymore energy for hope. 

The mother of 102 is less sure. She thinks her son might be responding, and she gently suggests tests, more tests. She can't believe a perfect body can be vacant of life while it breathes on without aide. Maybe they were doing the wrong thing, maybe...

Maybe, I had seen that neurology exam. I watched her come into the room, wave her hand in front of his face and tell him to close his eyes, wait 3 seconds and then leave. She had not watched his pupils, held his hand, taken into account his napping. I had stopped her in the hall to beg for a further assessment, but I was brushed off. There was no change, she said. She had seen it in her exam. And now, he was leaving, stopping therapy, to fade. I suggested a second opinion is always within their power when they feel unsure, but I can say no more.  They are the decision makers, the family. They know 102 in ways I do not understand. There is nothing I can do about it.

The spunky little blond daughter doesn't know yet that we're letting her father die. She is making plans for when he gets better. They won't tell her the truth until she finished the school semester and participates in her soccer competition. In the meanwhile, she introduces me to her dad's distant friends on skype, and tells me about what she and her dad are going to do over the summer. I am to remain silent about reality.

That is my job, to be quiet, caring, confidential.

But they can't keep me from crying in the medication room.

102 is only in his 30s, so young young young. And he is alive inside, I see it peeking through, like a branch in winter waiting to burst once more into the foliage of spring. If only they could wait. But the world does not fall asleep until my patients are ready to ride off into the sunset.  Healthcare plans and insurance are not Prince Charming. They wait for no one: not dead branches, not unsure mothers, and definitely not nurses wiping away angry tears as they dispense Tylenol into med cups. 

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Posted in ethics, nursing

Working in The Pit

It has been quiet on the home front, where I split my time between sleep, commuting, and work. In some ways, I am as tired as ever, but the RN job has given a meaning to tiredness in a way that television shows, studying and long walks cannot.

The inpatient unit electrifies me, so choc-full of tales just pulsing away under my fingertips. I've been meaning to sit down and write more of them out before I forget, because they make such wonderfully complex characters, these people. However, it's difficult to a) get the time and b) respect the ever looming threat of HIPAA. I end up having to fudge and reinvent everything so that the people I talk about are not the people I see, which is a little sad, because eventually I forget the real details. In retrospect, I don't know if the reality is more important than the feel of their stories. I can't preserve history, but I can memorialize moments, problems, emotions that are common to more than one person.  Perhaps they both have their places.

The work is difficult, and busy, and I don't always care for it, but those stories are what make me want to stay. I want to know what happens next, and it's frightening to know that I influence the plot. There is so much more weight to a story when it involves a soul. 

It puzzles me to think that my daily tasks occur in the defining events of people's lives. The people I meet are those who are questioning themselves, their loved ones, their purposes. They are trying to reassemble shards of lives unready to be interrupted. These humans are fragile. They hold me in awe. Yet we have the audacity to push them forwards, to wash their changed bodies, to chart the fluctuations in the endless taking of vital signs.

 The simple collection of human experience on the unit takes my breath away. It is the non-glamorous plodding to clean up train wrecks, suicide attempts, accidents, attempted murder, strokes, surgeries gone awry. These are not people who expected illness at all. They were people  on vacation, making dinner, visiting grandchildren, driving to soccer, having babies, performing at concerts. 

They are not always good people, or good situations or good endings, but they are good stories. Beautiful stories. 

As C.S. Lewis says, "There are no ordinary people. You have never met a mere mortal. Nations, cultures, arts, civilizations, these are mortal, and their life is to ours as the life of a gnat."

I look at my patients, and I know this is quite true.

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Posted in ethics, faith, nursing, storytelling, writing

Slightly dour holiday thoughts.

I’m not big on judgment, which is a little bit of a lame thing since I suppose no one is when it comes to themselves.  No, my Christianity has rather been formed around a holy but loving/grace filled God who is  not permissive, but slow to anger. However the Bible says that God does judge, and we are guilty.  I am guilty.

Consequently, I sort of dislike reading about judgment in the Bible, although I’m simultaneously fascinated with God’s wrath. I've been reading a lot about judgement lately in the Old Testament prophets, partially because this makes me uncomfortable. This leads to the following verse about Sodom, of Sodom and Gomorrah fame, which was wiped from the face of the earth after abominable sin without repentance:

“‘Now this was the sin of your sister Sodom: She and her daughters were arrogant, overfed and unconcerned; they did not help the poor and needy. “ Ezekiel 16:49

I can’t get this verse out of my mind. It’s running tired little laps around the edge of my skull. I’m not sure what to do about it, or why, aside from that I means something (Deep, I know.) Being a selfish poor steward was reason for annihilation—not any number of sins I had imaged cause for a severe judgment. They were rich but self-absorbed. 

Forgive us, Lord.  I am guilty indeed. 

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Posted in conviction, mortality, redemption, verses

Mind Games

HA! I've invented a game. Or probably re-invented, since it is suspiciously similar to classic “pretend” except there is acute illness involved. Maybe it’s just a plain old coping mechanism. But really folks, who wants to say “Hey look! I've invented a Coping Mechanism!” when asked what they've been up to? Humor me. I need humoring.

I ache pretty constantly, and now, as the sprinkles on top, there is sharp random pain to accompany nausea and tachycardia.  This is where that elusive Game comes in (you thought I’d just used the word "game" to trick you into reading this depressing post, didn't you? No fear, it’s real). Stabbing pain has made it deliciously easy to be the Little Mermaid (Not Disney’s, but the original story). Close your eyes. You have feet that feel like knives are cutting them because of the deal you made with Ursula, but you attempt to move gracefully so that the prince realizes you were the one who saved him and doesn't marry that  fake princess thus leaving you to be turned into sea foam. As you can see, this game of pretend can be a little involved…but hey. My mind. My rules.

Another symptom is transient lower extremity numbness and tingling.  For this, it’s insanely helpful to be a war veteran with a wooden leg. However, he continues to walk tall and proud because he lost his leg in a noble cause, and apparently sometime in the 1800's before we had any good prosthetics…

I haven’t yet figured out what to pretend when LE numbness and pain occur simultaneously. Maybe if Ariel  didn't transform into a human completely and was left with only 1 leg, and thus had to build a peg leg out of drift wood? As stated, this scenario is still in need of refining.  

When I have insufferable fatigue for no good reason, I’d like to believe that it’s because I’m walking through a field of enchanted poppies right outside Oz.  Body aches are leftovers from blows sustained while cavorting about in clunky armor, or surviving a plane crash. Grinding headaches are hangovers from getting drugged by enemy spies—work through it, Love, you've got a mission to accomplish.  Nausea is because you've been climbing Mount Doom, just had your finger bitten off, and can’t even remember what strawberries taste like.  Don’t sweat it. You’ll get back to the Shire eventually.

Most of all, that’s what helps: I’ll get back to the Shire eventually.

The imaginative buffer helps give purpose to what my body feels, keeps me living life even though I just want to curl up in my bed and not move for hours on end.  In the meantime, I need to get more reading done so that I can keep on with literary allusions to sustain my increasingly ravenous mental games.

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I'm thankful that I'm not stalked by paparazzi.

          "Human nature is displayed in every word and action. When I do something wrong, I can't honestly say, 'Oh that's not really who I am! I don't do that kind of thing! " Obviously, I am wrong, because I just did do it. It is precisely in these moments of unexpected actions that I really am me. Not a "perfect" me messing up a little, but the real me walking out of the look each of us put on. It is my real heart, acting in human sin (or conversely in the overflow of God). Often, there is more revealed in one unexpected action than in many expected actions together."

         This is an "old" thought from 2008, but I stumbled upon it again today.  I have a shamefully human habit of judging others by their actions, yet measuring  myself by my intentions. It's uncomfortable to remember that others may judge me only by my actions. Even when my actions and words are not what I was intending, they are nonetheless a reflection of my heart. I would do well to examine their source.

        Also, I'm glad that tabloids find me too boring to thoroughly investigate.

                         
“Our life always expresses the result of our dominant thoughts.” -Søren Kierkegaard
Keep your heart with all vigilance, for from it flow the springs of life. Proverbs 4:23 

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Posted in faith, identity

Convenient deafness?

          It’s easy to whine about how much time you waste, but more difficult to understand exactly why you waste it.  In the end, I tend to believe that my time wasting comes down to a few basic causes: 1) I’m lazy. I shirk difficult things in favor of less rewarding but more instantaneous fluff. 2) I care about myself more than God or others. 3) I don’t even know what the goals are/ I find them unpleasant. All three answers are distressing, to say the least. And then you get down into the gritty applications.

          For example, I am aware that spending hours on facebook is considered a waste of time. But is spending hours reading books also a waste of time?  Is sitting around blithely talking to others about absolutely nothing also a waste of time? Is cleaning a waste of time?  When it comes down to it, of course, the answer will always be something along the lines of “Do all to the glory of Christ, and do his will.”  Unfortunately, this doesn't necessarily mean that cleaning or facebook are precisely good or evil. I wonder if it’s possible that “wasting time” is really a different concept for each person, depending on what God has called us to. I also wonder if it means that I must always be purposeful at every moment and, if so, what my exact purpose is.

          Of course, it is easier not to know. To know requires one to choose, action or inaction. Maybe this is why we are frequently “unsure” of what God wants us to do? It’s like when a parent calls a child to do some task they’d rather not, and the child shows up dreadfully late, lamely excusing “Oh. I didn't hear you. You’d asked me to do something? Whaaat?”  Not knowing seems to occur astonishingly often when homework and chores are involved. That isn't to say all not knowing is an excuse—sometimes our hearing does fail.  But I wonder if at times my despairing “I don’t knoooowww what God wants me to do” has less to do with being unsure, and more to do with unwillingness.

          I’d like to end this post with some neat, moral nugget or answer, but I don’t have one. This is just one of those thoughts I've been mulling over in my mind and haven’t concluded yet because coming to a decision requires so much brain power, and I generally fall asleep before one is reached.

          (On the other hand, perhaps I just prefer not to know.)

The LORD came and stood there, calling as at the other times, "Samuel! Samuel!" Then Samuel said, "Speak, for your servant is listening." 1 Samuel 3:10

“The Bible is very easy to understand. But we Christians are a bunch of scheming swindlers. We pretend to be unable to understand it because we know very well that the minute we understand, we are obliged to act accordingly.”

“It is so hard to believe because it is so hard to obey.” ― Søren Kierkegaard

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Posted in faith, future, goals, identity

Pestilence and general life updates

 As previously stated, new ideas are currently a little scarce in my brain.   This is partially my fault, as I haven’t  been giving my poor mind ample chance to collide with new things.   However, it’s also partially due to being diagnosed with Lyme Disease a couple of weeks ago (this is where the pestilence comes in).  To commemorate this grand event, I began antibiotics and a variety of other pills multiple times per day, delighted to finally understand the weird symptoms.  On the downside, there’s the whole “by the way, you’re going to feel a whole lot worse before you start feeling better” thing for the next month. Such true words, my dear practitioner.  Gjecghkskjdafl....

This has changed up the life plan a little and, loathe as I am to post blanket updates, some things need to be said: I will not be traveling this fall, due to a few reasons.  Nor have I even begun applying for an RN job.  My current job is wonderfully flexible enough that I can go a few weeks without a shift, so I've been absent for a while there as well. 

Mostly, I've been sleeping a lot, reading as my attention span lets me, and attempting to be helpful when I feel good. This sounds a lot more fun than it is—it’s mostly just boring, painful, and lonely, to be honest.  The family in general has been wonderful and kind about having their well educated oldest back home/sleeping all the time, and I can’t get over how very blessed I am by them.

In the mean time, I might write some about being sick in general, because pain and malaise have a way of invading thoughts and distracting one while reading. Bear with me. I swear I didn't set out to create a blog entirely about death and disease (as much as evidence to the contrary continues to get posted).

I'd like to think that God may be using this to grow me to more empathy, and that sort of thing is generally a good prequel to beginning a career in healthcare anyways.



ADDENDUM: Thank you all for the kindness and prayers. Just to clarify, there's absolutely no reason to feel sad/concerned about my general survival or contagiousness. Mostly, this is just giving me a mildly legitimate reason to whine. ;) And we all know how much I love to do that...

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Posted in "bad" days, future, mortality

Resonance versus plopping

I used to write quite often.

Now-a-days I still get that primal writers urge to express ponderings or tell a story, but I find the only things that will escape my mind are frustratingly trite and bland. Small-minded words seem to plop themselves down on the page, beer bellies and all, where I used to effortlessly entertain more courteous and thought provoking guests. Eventually I look at the page in disgust, bemoan my inability to be magical, and resort to YouTube videos or endless refreshing of my Facebook feed.

Every once in a while, I do still read. At moments, some fiber inside shivers with memory at beautiful, marvelous words. When sweeping descriptions, ponderous challenges, and humorous anecdotes run across the screen, my little heart suddenly beats in my throat. In music I guess we call it resonance: When you play a note, and the harmonious strings hum at the kindred sound waves tripping past them. I resonate with words. The letters ramshackle up a portal where we can catch a glimpse of something similar, oh so the same! "It's me! It's me too!" whispering that someone out there understands. Somewhere out there was a person dreaming and observant, with new perspectives and questions like the ones trying to escape from my own head. Those trapped words are being heard from someone else's fingertips, even when I can barely stutter out what I mean. They clarify my wanderings, and give a title to the tiny fragments of world still begging to be named.

Perhaps that’s the power of good writing: its ability to transport you to a new realm, but also to make the place you are less distant. It can open your eyes to unseen worlds, yet transform your own day into something more manageable. Mostly, good writing has the ability to take those minute daily things, or those grand overwhelming things, and mix them into one and the same so that you can see both when you shut the pages.  Sometimes, I think this is why the Bible can be so fascinating to us if we give it the chance. Aside from other divine purposes, it remains also as wonderful literature. It has this ability to mix the ethereal and the average yet remain so immortally resonant with our souls and the truths we see peeking out around us.

In my head, I always have these great ideas to write about. Unfortunately, some require research, and more reading, which I then halfheartedly quit about ¼ of the way through because I’m fascinated by a new shiny bit of knowledge. It’s really not very enlightening at all. In spite of this, maybe someday I’ll hit the nail on the head, and write something resonating, something daily yet eternal. [Imagine a sheepish grin right about here...I'm counting on spontaneous greatness.] Until then, I’m just going to plop thoughts down. 

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Death, media, and my weekend.

The latest surprise in my world was finding a dead body. That isn’t to say I’ve never been with someone when they’ve died. As a nurse, that sort of thing is taken for granted. There’s just something very different about stumbling upon a dead stranger in the dark.

Along with two other drivers, an EMT friend and I were the first at the scene of a crash in a rural area this last weekend.  It was sometime around 2am, and to cut a long story short, we eventually found the driver, pulse-less and cool beyond resuscitation.  That is the undramatized version, devoid of all the details that make a moment so real, yet so eerily strange.

Later came the getting over the shock, the “was-that-really-real?” moment of processing followed by guilt at not feeling more sympathetic for the man, then mild horror and sadness for a few minutes before shelving it in our minds with all those other seemingly surreal life events.

What shocked me more than the actual event was the way people I knew responded to the story.  For some reason, to speak about a mildly violent death is somewhat taboo, which I find ironic in a society which has a massive amount of media depicting death and gore of some variety. One of my friends excused themselves mid-story: they felt sick. The very friend who occasionally spends hours per week playing Halo and watching horror films was disturbed by a traffic accident so clean it would have been rated a low PG-13.

While many Americans will see fictional characters die umpteen times, feel distaste for the plight of starving African children, and vote for capital punishment, we will know little to nil of the last moments of our own friends and neighbors.  I will not see photographs of the murder-suicide that happened at the local park.  I will see smiling memorials, a closed coffin, or perhaps a made-up, waxy-clean version of a human shell.   While we could sit through the Dark Knight Rises without feeling squeamish, set Average Joe in a clean hospital room with a dying person, and he will feel numbness, panic, helplessness, discomfort, and horror that no screen can ever convey.

I’ll disclaim here that this is a vastly complex (and fascinating) issue.  We must factor in coping mechanisms, the WAYS in which media portrays death, religion, human nature, general cultural attitudes, the effects of trauma, etc.  It deserves books, and books have been written. Yet for all of our arguing about violent culture, I wonder if we understand raw death less than ever.  We have distanced and sterilized death until it is little more than losing a video game, not a final breaking between body and soul but a sort of clean disappearing act that all humans eventually do and we are allowed to shrug off. 

As real death becomes more and more a mystery, our morbid fascination with this enigmatic instant grows and spills over into our conversation, our humor, and yes, our media.  Eventually, these distant reenactments, these far off representations we have grown comfortable with, become our only knowledge of death itself. Meanwhile, our own impending deaths become increasingly awkward, frightening, and taboo subjects.  Do not bore us with another television story about murder, for we have seen it once already, seen them all. Yet allow a shooter into my theater, allow me to stumble across an unfortunate driver, force me to spend hours listening to death rattle breathing of a loved one, and any numbness I’ve felt towards death must eventually melt away for a little while. Is it any wonder that during weeks after 9/11/01, church attendance spiked?

Old statistics predict that by the age of 18 you most likely will have seen anywhere from 18,000 to 26,000 movie murders, if you are a near-average American [1].  Yet for many, one dead body with almost no blood on the side of the road remains a traumatic experience.  Violence, murder and death are all blights which have stalked us since Cain killed Abel, and I do not think our attitudes towards them ought to be dismissed with simple explanations. However,  I wonder if at times our callous jokes, our glorification of violent villains, and our ability to shrug off war photographs  does not spring from our saturation with death knowledge, but a near-adolescent lack of firsthand experience with it. 

I spent 20 minutes waiting for the police in the dark with a dead man this last Friday. Even for someone who sees death at a higher rate than most, this unnerves me a little in retrospect. Death left its procedural hospital, and found its way into my lake shore weekend.  Does violent media numb us to this? I’m not sure.

In such moments, a screen does not protect us from reality.

Sources cited: [1] Senate Committee on the Judiciary.  Children, violence, and the media: a report for parents and policy makers. September 14, 1999.

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