Thursday, December 16, 2010

Homesick

Most days that I work at the hospital, I am filled with anxiety, dread and a sense of "don't want to" as I prepare for my day. Days start early - I have to be there by 6:45 AM - and they run long, until 7 PM or later, with only a 30 minute break (and two theoretical 15 minute breaks that just don't happen most of the time). I dread on an intellectual level the kind of work that is done. Cleaning up human fecal matter is difficult work. Bathing someone whose entire body aches to the point they would rather be filthy than moved as much as being bathed requires is difficult work. And usually there is at least one very demanding patient who needs attention the least from a medical standpoint but demands attention the most due to internal emotional needs, and that can wear you down if you are not careful. I guess these things turn over in my head and make me fear from a boundaries standpoint. I give up a lot of "self" during my days at the hospital. There isn't time to wonder what my kids are doing or to worry about things that tend to worry me. My focus is absolutely required to be in the present here and now. If it isn't, things get missed and someone is let down, either the patient or the nurse I am trying to help out, who I have found is just as important to my sense of accomplishment as the patient is. It seems to be a challenge to me, to win over the most difficult patient or co-worker, to find out what their unmet needs are and at least acknowledge them if not help relieve them for a day. I find, at the hospital, I am a natural wizard, a "people whisperer". Outside of the hospital, I am socially inept I think. People like me, but not enough to call me to go out for margaritas, and I don't make close friends easily. A lot of the time I have no idea what makes people tick, and get me into a crowd situation where politics start to come into play and I am hopelessly lost. I have no idea how to successfully negotiate those waters. I tend to be a "both guns blazing" kind of girl, which tends to make people use words to describe me such as "abrupt" or "terse". I am blunt I guess.

But at the hospital, I am noticing a pattern to my days. I wake up and am filled with dread. I sludge through my morning ritual and turn the music up in the car on the way to the hospital to boost my energy. I come in, tackle the morning job of getting vital signs, and set myself little goals. Have a positive first contact with the patient. Get faster while maintaining accuracy. Do it all with the lights off because I remember how unpleasant it was for someone to come in, flip on the lights and act all happy before the break of dawn while someone is in the bed and frighteningly sick. So I do these things. And take note of who my "total care" patients are - those would be the ones who cannot feed themselves, toilet themselves or even turn over in bed by themselves. I introduce myself to the nurses I am working with, ask brief questions about the patients, tell them anything they need, just ask me. Then I get to work fetching fresh linens, helping people get their breakfast ordered and trying to set some kind of schedule to my day. At this point, time starts to fly and relationships are made, both with the nurses and with the patients. The old man with no teeth and the scary facial hair who I want to avoid in the morning is the person I can hardly bear to say goodbye to at the end of my shift. The nurse who was glaring at me when she learned I am new and a student is thanking me and asking me if I am coming back tomorrow before we both leave for the night. And I get told I am good at my job. Sometimes the vehemence with which the nurses thank me stuns and embarasses me. I don't think I am particularly good at my job. I just do it happily, which I do think matters as well. I think, if I am projecting myself into their shoes correctly, that it makes their day a little better for their needs to be met expeditiously and with a smile and a "no problem" rather than a sullen expression and barely civil grunt. I honestly don't think I do my job better than any of the other techs there. I do think, though, that I do it happily and I think that is probably a big difference sometimes. All I know is that I leave without fail...and I truly meant WITHOUT FAIL at the end of my day feeling like I spent 12 hours doing task that truly matter in the spiritual sense of the word. And I feel good about myself. And I feel humbled in the sweetest of ways. I leave with perspective on the world and its woes and my place in it. I learn every single day that I am not the only person on the planet to have gone through a catastrophic event. And I learn despite all the awful memories of this time of year four years ago wandering around my head, that somehow I came through all that with something left to give, and a ticket to happiness that few ever find.

On some levels it makes me horribly homesick for Joseph. I will never understand why it took a blow like that to shake me into the person I am meant to be. I am not sure I will ever forgive myself for that. And on other levels, it makes me intensely grateful to have the knowledge I do, both of self and of others. Finally, finally, finally I have found something I am extremely good at - something practical that I can do that battles my inner tendency toward depression, that gets me past aching feet and fretting about the size of my butt and whether or not my lipstick stays on or my hair falls just so. I am moved past my vanity and pride, into a place where there is more of value contained in one look or touch or word than in all the bank accounts I could own. And what is more, it makes life less fearful. Because compassion and strength are two things that I have learned the experiences of life cannot topple, steal, corrupt or pollute. I can't lose them and nobody can take them. It wells up from some hidden place inside me and while I am engaging in these activities at work, flow out of me like an endless season of spring. I cannot explain it. It baffles me. Truly. I am one of the most impatient, selfish, rude, disorganized people I know. But put me in the hospital next to someone who desperately needs to be seen and heard and somehow, some way, I see and I hear. I do not know how that is. I dread that job every single day. And I come home happy with what I have done. Every. Single. Day. No exceptions.

I don't know where I am going with this. I sat down to write and this is what came out.

This time of year is hard. So very, very hard. I find myself having to actively fight off intense sorrow and a desire inside to wallow. Wallowing is one of the most unhealth activities human beings engage in. It is selfish and does nothing good or useful at all. I don't want to be that person. But I am sad - intensely, almost debilitatingly sad. I miss him. I am angry that he isn't aging. That he is still just 13. I worry still if he knows how I love him. If he is happy and okay. I wonder and worry these things daily at this time of year. I cry easily. I am needy. Clingy. Overly sensitive. Working at the hospital is a godsend. Finally, I can manage to see I am not the center of the universe. And that comes as a relief. If I am not a victim, I have power. And if I have power, then I can do all these things - without missing the forest for the trees. I have wondered many times this week if my patients ever suspect that they are healing me.

Sunday, December 12, 2010

Faith Vs. Doubt

I am not terribly religious. I was watching footage of Elizabeth Edwards, who died this week, and some things she said really struck home for me. One of those was the expression that God is not what she thought He was. That He is a God of salvation and redemption, but that after her son died, she could no longer pray. That He was no longer a God who saved people from their natural fates. Oh yes. I could relate to that. My moments of pure prayer since Joseph died have been few and far betwee. However, since he died and particularly since I started to find myself, I do find moments of communion with God, in which I am not really praying or conversing, but more sitting within the spirit of what I know or have felt God to be.

Every now and then I get a sign or a sense that there is a higher purpose in my life. Something has happened of late that I wish to discuss here, and I will let you decide for yourself if it is the hand of God or merely coincidence. I suspect far more.

One of the requirements for third semester nursing is that we do something called "service learning". In essence, we are required to put in a certain number of hours volunteering nursing services within certain approved organizations. As I looked at the possibilities, saw much of this involved doing things for kids - Friday Night Friends (babysitting), the pediatric clinic, diabetic camp - things like that. Well, as much as I love kids, I think I would rather stick a fork in my eye. Pediatric nursing, thus far, is definitely not for me, and the idea of doing my service hours for something that does not contribute to my career in any way or at least my sense of satisfaction was depressing. I went to the faculty in charge of this and asked if there wasn't something else. She gave me the name of a woman in charge of a cancer program that seeks to enrich and support the lives of cancer patients, family members and caregivers...far more than just a support group. Needless to say, my pulse picked up with excitement and I called this woman that very day.

When we finally connected, she told me she was not sure what she neededd would match up with what I neededd to do to meet my school requirement. Now, mind you, this individual has NO idea where I come from other than the college, no personal knowledge of Joseph or Alex or my blog or anything.

Then she told me. What they are looking for is someone to do a seminar for the group on the benefits of journaling through the cancer experience.

Now, I will tell you....since JOseph died, my moments of faith have been few, far between and very very frail. And yet, there have been a few moments of "no doubt about it" signs that Joseph still knows and loves his family and that he is still with us in another sense. This definitely falls under that category.

So it seems I will be doing a seminar on the benefits of journaling/creative writing through the cancer experience and then subsequently leading classes on how to get started, how to utilize this tool to make the whole ordeal a little easier to bear.

My hair stands on end. I am not a woman of strong faith. But now and then, God lets me know I am being steered in a definite direction. And I have no doubt at all this is one of those things.

I love you Joseph. I miss you most at Christmas time. Help me be strong. Help me know what people need and help me learn to use my experiences not to focus on myself, but to help others get through where their lives are right now.

Thursday, November 25, 2010

A Grateful Heart
















It is Thanksgiving Day 2010, and I am a little shocked as I come here to see I have not posted for six weeks. Six weeks! I only have 20 followers and with that sparse of posting it is no wonder!

It looks like a real Thanksgiving outside today. I was a little worried, as yesterday we were 20 degrees above normal with a high of 84. It was hot and humid and not ideal for celebrating Fall and the coming of Christmas. But today it is going to fall throughout the day, until we rest in the mid 30s by this afternoon. That is much more like it.

As I look back on this past year, it is clear to see this is a "muscle" year. Meaning we have had a lot of forward momentum and a lot to muscle through. I am now two weeks from completing my first year of nursing school, with one year left to go. It is hard to believe this time last year it was still just a spark of excitement and one more year from now it will be pretty much completed, or at least this phase of it. I am seriously considering becoming a nurse practitioner now. I am so thankful for the opportunity to go to school. To be the kind of person who does not let her age or her sex stop her from not only dreaming but achieving. That I live in a country where women are encouraged to be educated and where men for the most part expect that we will be. The news is full every day of places where opportunities are not available, either through economy or ignorance, and my own ability to take advantage rises to the forefront of my mind when I think about things that have blessed me this year.

One of my greatest, most unexpected blessings has come from my patients. I always knew I would enjoy caring for people and I have looked forward to the intellectual challenge that dealing with health problems brings. Joseph and Alex have taught me that I am good at that. What I did not anticipate, and what has blessed me immensely, is the complete and spiritual peace that descends upon me when caring for others at the hospital and the overwhelming inner joy when I leave each day, feeling as if something I am doing with my life really, truly matters. If I had to guess or gamble on it not that many years ago, I would have emphatically bet that I was not a person capable of coping with bodily fluids or grieving families or individuals angry at the world, life and God. Finding that I am and learning how rare that actually is has given me a sense of self that is priceless in every way. I honestly get more back from my patients than I could ever possibly give to them. The vulnerability of illness, the loss of bodily functions, the loss of dignity, of pride or even just of the illusion that life shall go on forever in a state of well-being are all really, really tough times in a person's life. Few of us get through life without suffering such things on one level or another. How thankful I am to be put in a place that I can help while my own life is still functioning at a level that makes it possible. One of my greatest fears is of losing my health in such a way that makes carrying on this work impossible any longer. It becomes a great internal motivator to care for myself gently, a process that remains a work in progress. So it makes my top 5 this year of things I am thankful for. I am thankful for the opportunity to be useful to others and for the privilege of serving them at the most vulnerable times of their lives.

Socializing, companionship and relationships remain way up there when I think about things I am grateful for. This year has brought me a whole gaggle of new friends. My fellow nursing students have been there to commiserate, to comfort, to strive forward with toward a mutual goal. There is friendly competition, companionship and a bonding that comes only when something is being suffered through together. And there is a fair amount of suffering in nursing school. We all have moments we have to miss with our families and wilt beneath the guilt and the pressure. We are all up against the gun of judgement every single day, week upon week, learning things that aren't just "check the box and forget it", but things that may one day make the difference in what we can do in our practice and for our patients. I have never been immersed in a more passionate, determined group of people and I feel so fortunate that so many have thought enough of me to elect me to a leadership position and to maintain friendships with me that I hope will last long beyond school ending for us. And so I say to my fellow students, that you have made me laugh when I wanted to cry, have made me tear up with mirth at inappropriate times, have held me up when I have felt small, weak and insignificant and have blessed me immensely with your own determination and goals. We are an eclectic group and I admire you all so much for your own individual reasons. Thank you for being part of my life. Thank you for sharing your passion and dreams with me. Thank you for fueling my own.

I could not be doing so much to change the course of my future without a great deal of support from home, and my husband (how thrilling it still remains to call you that) has more than risen to the occasion - he continues to bulldoze the way, to lift me up and applaud me as I soar. It is amazing, feeling myself accomplish so much I never thought possible, but even more amazing when I turn and see it all through your eyes. I do not know what I ever did to deserve the intensity with which you love me, but I am thankful for it each and every day. You are my refuge, my stronghold, my amazing lover, my steadfast companion, my ass-kicking coach, my mentor, my deepest friend. I admire you on so many levels, but become humbled to the point of near silence (which is impressive, I know - not many things strike me speechless) when I see how you admire me. We are approaching our first anniversary and that fills me with so much happiness I cannot even tell you. I still thrill that I get to spend the rest of life with you. You so frequently maintain the big picture vision that I can lose in the details of my life right now - the patterns of success that feel elusive to contemplate when faced with the challenges that pull at me in school and sometimes in life in general. Nobody pulls me out of a funk better, nobody reminds me I am a good person more, nobody holds the mirror up to me until I am forced to look and acknowledge and find peace both with the past and with the present. I am a better person because of you. What greater gift is there than that? Thank you for loving me and living your life with me. I would say yes again and again and again.

My mother, my ex-husband, my children all remain parts of my family that top my list of blessings. I am supported, loved, laughed at and with from so many angles. When I see who I am become part of who my children are, it fills me with hope. When I see who THEY are, developing and growing beyond who I ever could be and beyond what I have in me to create or influence - as I watch them growing and creating themselves, it becomes so obvious to me that I am part of something great and good and spiritually profound. And that is one of the greatest blessings of life. I only have a few years left until they strike out on their own. I am thankful to have the privilege of mothering them. I am thankful to be raising them in conjunction with a wonderful man, a deep and warm friend who also supports me, forgives me, looks to me as a partner and shares so much of himself with me. Stewart is an amazing father, teaching compassion, commitment and moral fortitude with a strength I do not know I could ever achieve. We have walked through the fire of Joseph's loss together and have shared a deep commitment to our atraditional family that is rare. I am so thankful to be a part of this wacky, unusual, deeply loving family. Stewart, thank you for your partnership. For continuing to love me in your own gentle way. For being such a wonderful father to these amazing boys.

And Mom, we understand one another and get closer with every year that goes by. It almost defies words, the depths to which I love you and I can't imagine how bereft I would be if you were not here to share the direction my life has taken in the past few years. Thank you for your joy in my happiness. Thank you for being the kind of woman who showed me how to pick up, move on, grow and recreate oneself, deep into territories of life that sometimes society feels should mean laying down and letting it all stagnate. You are vibrant, alive, brave...and so warm, so nurturing, so forgiving, so fun. I love you so much Mom.

My best friend, Heather, remains for me a source of strength, of deep and soul-filled sharing and tender, soft understanding. I appreciate so much how you share yourself with me, the journey that you have been on an echo in many ways of much of my own. I cherish you. I know we don't have a lot of time together, and in some ways that is what makes it all the more profound, the depth to which I love you. It is a relationship that is continuous and stable, not defined by the finite. Thank you for loving me back, for talking me down from high places, for saying the truth as you see it, when you see it and for helping me learn. Thank you for sharing so much of yourself with me and for leaning on me now and then. I get a lot out of being your friend, more than you probably know.

As I have grown older, the childish divisions that sometimes crop up between siblings for silly reasons have faded away and with Joseph's death, a great sweeping hand cleared my mind, my heart and my life of a lot of internal flaws. I am so thankful for both of my brothers and for my Stacey (my older brother's wife), who all have watched me flower from a person who was small in so many ways into someone who is less fearful, less critical, more joyful. I have felt these open arms of family engulf me and I thrive in that sphere of well being. I am thankful for all of you, but especially Jeff and Stacey, who despite busy lives have carved out time for me and who have demonstrated so much happiness for the good things happening in my life. I love you intensely and feel so lucky to have such amazing people tied to me with family bonds. You add a unique and beautiful flavor to my world and I am thankful for you more often than you know (or probably would be comfortable hearing about). You are fun to hang out with, fun to laugh with and are just incredible parents. I love you.

I am thankful for the continuing relationships I have with people I have worked with - Vickie, Denise and Lucy especially. It is so easy for life to fade important things like friends into the background until they disappear entirely. Thank you for making the effort to keep me in touch, for understanding the chaos school has made of my life and for celebrating with me when things go right. I feel your support and care all around me, all the time. There are people in this world who never form a spiritual bond with people they worked with, and though that is hard for me to fathom, the knowledge of it reminds me that I have been so blessed in each of you. Thank you for watching my life move onward, upward and for cheering me on. In the harder moments I have looked at what each of you give to me and felt the warmth of it holding me up.

I honestly can say I am one of the luckiest people I know. There was a time in life I not only would have NOT been able to say that, but I was quite bitter about it. People who made different choices than me were the enemy and my personality was such that rather than face those things I would strike out. Somewhere in the past eight to ten years, I evolved. I am thankful for inner peace, for being content enough with my own choices that the choices of others no longer baffle, anger or threaten me and I am thankful for a sense of almost automatic forgiveness for the failings of humanity in general. It allows me then to be more forgiving of myself. It gives me a peace that cannot come from the absolution of others, but rather only can come from absolution of self. I truly believe the world is full of good people; that most people want to do right by themselves and by others, and that most people are going to make a lot of mistakes in pursuit of happiness, some of which will be painful to watch. I believe in the sanctity of the human spirit in every individual, the ability to rise up and overcome and that the greatest power on earth is forgiveness. And most of all, I believe the key to happiness, the one all of us miss at some point (sometimes daily on my part) is to live in a state of gratitude. It is impossible to be bitter, angry, jealous or dejected when one is aware of one's blessings. Not just lip service aware, but humbled in the heart aware, the kind that makes you feel like a Hallmark commercial inside. Cultivate that and you cultivate peace that reaches far beyond just the internal.

If you read this blog, I am thankful for you.

And last, but not least, I am thankful for this little furball named Layla, who has filled my life with play and laughter, snuggles and warmth and the dubious blessing of fishy kitty breath. I am the victim of unrelenting, passionate kitten love and that is pretty amazing too.



Happy Thanksgiving everyone. I hope your day is fantastic.

Friday, October 8, 2010

Bless Us All, We Made It To Friday


I keep musing on how much I am wishing my life away the last few weeks. Oh please let me just make it to the weekend....oh please just let me survive until the end of the semester....I can't wait until Saturday night....Will Christmas ever get here....? I wonder if that is why I am having so many internal feelings of just being off pace right now? It is not like me since Joseph passed to look away so much from the present. I think maybe I need to work on that more, which will be a challenge. The present is intense and uncomfortable a lot of the time in a lot of areas. I need to rediscover my joy.

One thing that definitely makes me feel pretty darn joyful today is this goofy kitten Joe got me for my recent 40th birthday. I like cats a lot, but having been raised by a farming family, animals never quite take on the level of stature as a lot of people's pets. I will probably (hopefully?) never be the Cat Lady. But I have to admit, this hyper ball of fluff has me bowled over. She is, in fact, the perfect cat. Playful and impish. But cuddly and affectionate. She TALKS to me! If I say her name, she comes running. If I say "Hi!", she has this certain sound she makes that definitely means "Hi!". And if I whisper it, she says it under her breath like she is whispering too. And I am laughing as I type this, because being all about one's pet is just NOT me, or rather, never has been before. She has just brought a lot of cheer into this house. I love hearing the boys laugh at her antics. Alex will laugh to the point of making no sound but a high pitched squeak. And she likes to get into Nick's room and sleep on his pillow next to his head. Alex say he is so happy he can finally say he does have a pet now when people ask him. And Joe, who is often alone during the day while I am off frantically pursuing my life's dream, unfailingly has her on his lap purring away when I get home. It has shown me a side of him I have not gotten to see before - gruff and nurturing. Very sexy.

So Layla (the cat) definitely helps keep me rooted in today. She is a blessing to our family. She is pretty hyper, which is normal for a four month old kitten and I have worries about the Christmas tree this year. Should be interesting.

I think one of the other reasons I am feeling all angsty and discontented inside is the inner sense of coasting. To be honest, I am not working as hard as I could be on school. I search for time to myself and time with my husband and kids and frequently let things go that I probably ought not to in terms of review and reading and in depth studying. Its that ever present struggle to find balance, and the truth is, I am a lazy soul deep inside. I will always flow toward the easiest path. But I am learning, the easiest path doesn't make me happy. I am happiest when I work hard and see results. So this sense of avoiding the hard work is making me fretful. I am doing okay in school but could be doing better. I may challenge myself to put in two weeks of good hard studying of the type I feel I ought to be doing on an idealistic level and see if it nets a better result than I am seeing now.

I am looking forward to some social time this weekend. Mani-pedi with my sister in law, Stacey, then a fancy night out with my husband. Stewart and the boys are headed to Camp Sol, the grief camp we usually attend as a family. I am tossing around some feelings of guilt, as I chose not to go this year, for a couple of reasons. The main one is that an entire weekend away from studying just isn't going to happen at this point in the semester. The other is that as much as I enjoy that time to just focus on Joseph, it is always, always draining emotionally and there is always a recovery period needed, which is additional time I don't have to give it right now.

So there you have it - the dull editorial reporting of the facts of my life. Some day I will get back to being a philosopher. ;)

Monday, October 4, 2010

I don't like Mondays

Nursing school this semester has been a challenge for me. It is no secret among those who know me well that I am more of a sprinter than a marathon runner when it comes to tough things in life, and I am having to face some of those issues within myself. Right now Christmas of next year seems a LONG way off.

The semester was set up oddly and it is taking a toll in terms of my internal anxiety and sense of well being. We all do a six week rotation through psychiatric nursing this semester, and I drew the straw that had me there doing it first thing. So basically I have not even been to my regular hospital or clinicals yet other than at orientation six weeks ago. I start this week. There have been horror stories pouring out of the group left and right regarding the depth of paperwork this new clinical instructor requires, that humiliation is used in teaching and that the nurses on the floor of that hospital are evil and mean and eat students for lunch. All of this is workable to me - I have always been the type of person who can get along with the crotchety provider etc. It is the massive paperwork that has me most concerned. The rumor mill holds that people are staying up until as late as 2 AM to have this stuff completed in time to turn in at 6:30 AM to the instructor at the clinicals site. Since I am not sleeping particularly well as it is, the thought of my very interrupted sleep schedule going off the deep end that completely has me totally freaked out. I generally am falling asleep around 9:30 or 10 at night, then wake up around 2:30ish and can't get back to sleep. Cumulatively I am starting to see myself suffer from this, both in terms of motivation and confidence, not to mention just an inner sense of discontentment that I cannot put my finger on.

I am anxious to get back on the floor at the hospital. Psych was interesting, but it doesn't give me the same internal sense of fulfilling something I am supposed to be doing as being at the bedside does. I am missing that aspect of my education. I have not been back to my externship since school started. Starting clinicals this week will get me back doing hands on care, and that always does a lot for my weary spirit. I need it.

We have our second exam today. I am not sure I am ready - attempts to study felt largely unsuccessful due to anxiety and fatigue. My last exam was fine, but not nearly good enough of a grade to carry me if this particular exam doesn't go well. We have so many extra projects and papers and side bars of activities going on. I will be super glad when the end of October arrives and most of my "extra" stuff has been accomplished and all that is left is to just go to lecture, to clinicals and do my lab skills. The boys have a ton of stuff going on too, and Stewart (their dad) has started back to school as well. Joe is semi-retired at this point and I find myself very relieved. I go to him for hugs, for reassurance, for loving, for my regular kicks in the ass that push me toward where I really wanted to go anyway. He cooks for me and helps around the house and takes care of our finances so that we stay on course through my schooling, things that get hard to pay attention to when in a program this intense, but that also contribute to the middle of the night fretting I seem to be stuck doing. It is impossible for me to fathom right now how I would be coping if I didn't have him for support.

I am hoping I get a chance to start an IV on a real person soon. I am doing well on the rubber arms in lab, but I can't tell if that really means anything when it comes to a flesh and blood vein.

So this week is going to be a humdinger in the sense of starting regular clinicals with an instructor who is now used to students being six weeks along. It will be good to get that over with. Saturday night Joe and I are attending a fundraiser gala and get to be all dressed up. I am vascillating between wearing my wedding gown (which was really just a while evening gown) or wearing a little black dress. We shall see which makes me feel most goddess-y that evening. My sister in law and I have tentative plans to get mani/pedi's that day, which at this moment sounds decadent enough to bring tears to my eyes. I am just so stressed out inside. Let the next few days go smoothly. Please let me not let myself down on this exam.

Thursday, September 23, 2010

Aging Gracefully? Ha!

Team Joseph is this weekend - a 5K that we do to honor his memory, for a charity that helped us more than once while he was ill. I look forward to it every year, but it seems lately like everything I do is a pathological exercise in guilt. I didn't give it a lot of attention this year and we didn't raise anywhere near what I hoped to. And I was hoping for more than 100 team members, but we managed only 42. I keep telling myself I will have REAL time to devote to the charities of my choice once I graduate from nursing school and until then, my job in earth is to be the best darn student I can be and get through this.

My love affair with nursing school is on hiatus right now I am afraid. All that honeymoon giddiness has tempered into a nice solid sense of unending fatigue and iron-clad determination. I am more afraid this semester, probably because the things we are doing are more important than taking blood pressure. Today we learned how to start IVs. I got it on the first try...on the rubber disembodied arm we practice on. I am dying to try it on live flesh. Which sounds kind of sick. But I miss the hospital. I miss the patients, the trepidation, the thinking on my feet. I miss the sense of what I am doing matters right now, today, in this person's life. That has become my therapy.

I am turing 40 on Sunday and just not dealing with that well. I am not sure what is up with that. It just keeps washing over me and I both start my day out silently weeping in solitude and ending it up that way. I guess the passing of a decade for me is drawing up a lot of sorrow. Entering my 40s is hard. I am not ready to be old yet feel so old inside. I am not ready to age physically - I just now figured out how to make myself look good. I just now lost all that weight. I am not ready to be dismissed as a person simply because I am getting old. But most of all, I just am not ready to move out of my 30s and pass another milestone, one that is actually taking me by surprise. I keep thinking about how I got pregnant with Joseph before I was really prepared to be a mother and how I told myself time for me would come when he graduates from high school, and how I would be a young mom with a son graduating when I am only 40 years old. Well, here I am, 40 years old. There's not going to be a graduation this year. And I miss my boy. A lot.

I feel him with me more though. I am praying a lot more. I am not going to preach to anyone via this blog. I hate it when people try to convince me of anything political or religious. I want the right to think for myself. I hate nothing more than evangelicalism, mainly because it seems to be served with a huge cup of hipocrisy on the side. So no preaching here. But I will put out there - I am finding once more for the first time as an adult a sensation of having God's presence very near to me. And that is new, different and very comforting.

Joe has been doing a lot of work on the house. I can't believe we have been here over a year already. The boys are well settled into their rooms and we are making steady progress on the things we want to get done here. I say we. I mean Joe. I am not doing anything except writing care plans and reading and going to class.

Joe bought and planted white and yellow roses out front for me. It is still very temperate here and they have just taken root and gone to town. I can't say how happy it makes me to look at them.

Nick is doing fantastic in school so far this year. He is struggling a bit in honors chemistry but heck, its honors chemistry. I am proud of him just for daring to take the course. He is also on rifle team with ROTC, playing with orchestra, participating in youth group at church, working toward confirmation and he is just a few requirements from Eagle Scout. Alex is in honors courses for almost every class and doing well. He got cast in the school play but is not happy that his role doesn't require him to talk in a gutteral voice. I suspect he will get over that. He is enjoying playing trombone in band and played for his first football game this week, which he very much enjoyed and was surprised that he did. I'd love to see him stick with band all the way through high school. I think the marching band has a great deal of fun together.

I hope the weather holds for the 5K. I have two good friends coming from out of town to walk it with me, which is nice. We will spend some girl time together and I think it will be a relaxing weekend. Sunday night is dinner at Mom's house for my birthday. She wants to know what I want her to make me, which makes me giggle. I am turning 40 and Mom still wants to make me a special birthday dinner, which is awesome. I am hanging up my books for a few days and letting myself just enjoy this time with family, friends and memories.

Tuesday, September 14, 2010

fa-fa-fa fatigue

My head is pounding and my eyes are drooping, but I know that if I don't type tonight, I will be up again at the buttcrack of dawn trying to figure out why I am not sleeping well. Because I'm not. I fall asleep as if sleep were a drug and get about four hours, which is about what my poor mind apparently requires before it shifts back into high gear and bids me rise. Not a good pattern to be in right now. How am I supposed to learn to care for others or even actually do so on four hours of sleep or less?

We went to psych court today, which was a sad experience. I wept a bit while I was there, inwardly anyway. It was too crowded and populated to cry for real, but I wanted to. All those lives lost to a mind that does not function appropriately. I wish so much modern science could unlock the mysteries and if not cure things, then at least make the medications, which treat them very effectively, not have such bad side effects that the poor souls in need of them just can't stand to take them and contemplate feeling that way the rest of their lives. I actually stood there today watching a particularly heart-wrenching case and thinking "There IS something worse than cancer".

I am stumbling my way through so far. We had our exam on Monday, the first of the semester and I am waiting for grades to post. I suspect a nice, solid mediocrity is in wait for me on that one, which I also suspect I am going to be real okay with and yet feel guilty about. Nursing school is pretty tough. My standards change a bit.

Tomorrow we go to Terrell State Hospital, a state run mental hospital. I am more moved by these souls that I ever would have given credence to. Interestingly, they have lead me back to prayer on occasions, because the things I have seen wrong in the mental wards have been such that the lack of a cure is just pity inspiring. Beyond what I have seen in oncology and pediatrics. I do not know how to explain it. But it feels good to pray for them and to know God sees the real soul beneath the illness. This in turn comforts me, that perhaps in the darker moments of my life, the ones I have less pride in, perhaps God has the same sense.

I am so tired I can hardly type. I wanted to take a bath tonight but the idea of drawing it and waiting for it to fill and then sinking into it...and then having to get back out, dry off, hang up the towel and go to bed literally feels like far too much effort to accomplish. Yet I lay here in the dark and cannot shut my brian of enough to take advantage of the early bedtime. So maybe jotting this little note will do the trick. I am still loving school. I am in a phase where I am learning a LOT, about things I never even contemplated let alone acknowledged I did not now.

I am missing Joseph acutely. I am loving Nick and Alex with active mother-passion. And I am thankful for my large, sane, loving family. I would not trade a single thing.

Wednesday, September 8, 2010

The Semester That Smelled Like Roses

Which would not be this one. No rose scent here...I think the bush died in the summer heat. I think I am into the fertilizer phase of my plant-as-a-symbol-for-life-dream analogy here. Kinda stinks. Kinda smells like poo.

Not all THAT much. But I came to realize over the summer of increasing hospital experience that things like drug cards are a whole lot of busy work that actually seems to get more absorbed via conversation and experience than through little pieces of wanna-be cardboard. I am figuring out that yes, I can read stuff - but I am much more likely to remember it if I talk about it and utilize it. And with the huge volumes of information we are responsible for, that'd be a lot of gabbing for it not to be about something like shoes, chocolate or men.

In all seriousness, I am much more even so far this semester in terms of mood. In fact, I posted on Facebook just yesterday that my lack of anxiety is causing me anxiety. I feel though as if I am absorbing more easily than last term and am more able to filter out what is important and what is just academic noise that lets them make thousand page textbooks that sell for hundreds of dollars with new editions every other year.

We are doing our psych rotation now and I have spent the last two days observing on the psychiatric ward of a local hospital. I have seen things that cracked me up, delighted me, made me cheer the sturdiness of the human spirit, things that make me want to cry from the unfairness and waste that this kind of illness can represent and I have spent a few moments honestly afraid for my personal safety. What has thrown me a bit (besides the fact that I was very firmly recognized as being Grimace from McDonald's. Flattering. Does that mean these scrubs make my butt look big?) is that I am enjoying it.

Psych nursing isn't for just anyone. It is a different creature in and unto itself. Most people would rather not. It has me a bit thrown to discover that some things I thought I would respond to (such as the mother/baby unit), I would rather stick a fork in my eye and that other things which I had no affinity for or attraction to (geriatrics and psych units) I get fulfillment from and respond to emotionally. The psych thing has me a little thrown. I honestly didn't expect it to be anything I was drawn to, but I am. I don't think I want it more than oncology, but it is something I do not push out of my mind as a possibility for my life either. And that, I suppose, is good, given that every diagnosis comes with a need for knowledge on the human mind and that there is no medical facility on earth that is not full of drug addicts or people needing psychiatric support, either temporarily or permanently.

I think what this is all saying to me, as I evaluate myself, is that I need to be needed. I need to serve the underserved. I feel peace when I am called out of myself to be more than I saw myself to be. My drug is personal courage and internal fortitude. Some people go to the edge of an cliff with a giant rubber band tied around their ankles and say to themselves "Jump you Wuss!" and then do it. I go to the bedside of a patient who has soiled themselves and do the same thing; or the den of grieving family watching a loved one die, or the desolate, isolated cave of someone coping with a diagnosis that is going to change everything they came to define their lives by, whether psychiatric or physical and perhaps even challenge them against things that they have held as prejudices or just false beliefs.

I used to pray when I was young that God not give me an ordinary life. I have laughed at myself with a wry irony many times that could border on bitterness in my darker moments, dark humor in my lighter ones. I guess this is all part of that prayer being answerd, and that I would not have been desiring it if it were not really where I was meant to be after all. I mean yeah...I wanted to be an actress. I wanted to go to Hollywood. I wanted to perform and hear the applause and make money and see my picture (looking fabulous of course) in magazines. But I wanted that in a wistful and childish kind of way. This is a want that literally burns. It is fused to my bones. It is like a drug. I get into that situation and I am euphoric. Let me so do to the least of our brothers. Whether I do unto God thereby isn't really the point to me. My faith is a shifting target. The crux of the matter is that I do unto me. In other words, it is a conscience I would have put money on being trambled and dead by now, given the way my definitions of right, wrong and shades of gray have shifted in the light of my age and experience. It is a sense of right. It is right that I do right.

But drug cards? Not so much.

Some things we just have to survive until we get to the real work of our lives. We earn it.

"We could never learn to be brave or patient if there were only joy in the world. " Helen Keller

Helen's been speaking to me a lot these days.

Tuesday, August 31, 2010

New Courage

I woke this morning still searching, still praying, still pondering how this day is going to go. And I did a little reading online and found the following blog:

http://oncrn.blogspot.com/

I am going to add it to my list of favorites along the side.

It drove home how much I relate.

That I am exactly where I am supposed to be right now. And if I wasn't supposed to be here, I wouldn't be. Period.

Is this going to be hard? Yes.

Do I need to spin myself into this panic over that fact? No.

I have faced much harder than this. And look. Look at me. Here I am. Still alive. Still whole. Still singing. I have come out other side. I have survived the valley of the shadow of death. Who am I to be so afraid to peer back into its borders and recognize I am called to return, to help others through it? What kind of ego does it take to make my own fear this important, this huge? A big one. One that has no place here. If there is one thing I am realizing over and over and over again through this journey, it is that my requirement for this life is to be small. To step back. To hold up. To support. It makes me joyful inside. And it is time I started trusting what I have learned so far to date and to stop dreading and doubting...doubting life...myself....my purpose...my strength.

My head is up and I am returning to a place where a massive victory happened. Yes, my son died there. And here I am. Going back to that place. Facing it head on. Because I am bigger than cancer. I am bigger than death. I am small beneath the archaic wonders that cycle through this world, but in accepting and embracing my smallness, I slip beneath the radar and arrive squarely at the side of those who need me most. My life has more meaning than I ever imagined it might. It is time for more lessons and I am ready in spite of my trembling.

This is a big day. A good day.

Monday, August 30, 2010

Dangerous momentum

Sometimes it becomes apparently to me that I am on some divine journey. Whether you call it God or Allah or Fate or just choices, sometimes what is happening in my life seems to be something greater than myself. And when I am honest, really really honest, that is what drives me. This sense that I can take all this mess that was cancer and children and mistakes and history and turn it into something brilliant and artful and meant-to-be.

I am less certain tonight. Tonight, I am wishing to put on the brakes in a big way, as if I have been zooming down a brilliantly clear highway, only to realize those lights in the distance are not stars, but brake lights, and I am about to slam into them without even pausing to wonder or evaluate.

I drew Medical City for clinicals this semester. It is randomly assigned, our clinical location, and that is the hospital in which Joseph was treated and in which Joseph died. I am excited. I am petrified. Ultimately I think, in my better moments of bravado, that I want to work there one day on the transplant unit. Yet tomorrow I face down the truth of it, walking through those doors once again and knowing for the next 15 weeks I will spend 10 hour shifts there in those same halls, smelling those same scents, seeing the same restaurants and corridors and turns. Knowing he walked those places with me once. And tonight....tonight....

I am meek.

I am afraid.

What have I been thinking?

How will I do this?

So much is at stake. So much work to do. So many impressions to give of competence and readiness. So many lives beyond my own, relying on me, hoping for me, perhaps even waiting for me. People in need. Will my need inhibit my ability to give?

Will my pain get in the way of my desires?

Will my grief interrupt my learning?

I am afraid. I am remembering. I am wishing for divine strength, for ultimate hope, for absolute peace. There was a time, toward the end of Joseph's days, when I quit praying for miracles and started praying for peace and acceptance. For him. For me.

I am praying for those things tonight. And I am praying he give me his hand. I cannot do this. Not by myself.

Monday, August 16, 2010

A Letter to the Enemy

Dear Cancer,

I haven't written to you in a while, but I am aware of you every single day. You have been the personal cause of a great deal of misery in my life and the lives of those I love. Most recently, you have made me pretty short on fuel in the tolerance department and it is causes a bit of strife in my household. It is getting better, because I refuse to let you ruin anything else in my life that I personally can control. But I feel like you should know what you have done to me lately.

Thanks to you, right now when all the other parents of the kids who were in Joseph's grade are taking them out to get their senior pictures taken, I am staring still at the last portraits I had done of him - ones in which he had no hair, because the effort require to purge you from our lives required that he sacrifice that. I feel the loss of this milestone acutely. I woke up this morning thinking about it.

Thanks to you, I don't get to go pick out a tuxedo for senior prom with Joseph this year. I am not researching colleges with him and I am not figuring out a way to buy him both a car and a computer before he leaves. It may sound like a blessing in disguise, but it is not. Those are problems I can solve. His death is beyond my power. YOU took that from me and I am mourning as if it just happened all over again as the loss of those things hit me.

Thanks to you, we aren't ordering a class ring, won't be ordering a graduation gown, announcements or invitations. We won't be planning the party of the century, but instead will be turning our heads and putting them down, just trying to get through the spring when those particularly anniversaries will finally, finally pass us by.

Thanks to you, I am keenly aware that my youngest son is now the exact age my oldest son was when you decided to come back again. You weren't welcome in our lives the first time. You weren't welcome the second. And I am also aware my youngest is in the last grade in which my oldest attended any kind of class at all whether from school or the hospital. I am also painfully aware that with his next birthday, my youngest will be the age my oldest was when he died. And on the next birthday, everyone in my immediate family will have outlived Joseph. I anticipate the 13th birthday of Joseph's namesake, his cousin, born four months after his death, is probably going to be a more sad affair than happy for me as well.

I have you to thank, Cancer.I can say without remorse, without any lack of resolve and without any sense of wrongness that if you were a person, I would indeed have no trouble....no trouble at all.....with putting a gun to your temple and pulling the trigger.

I hate you, Cancer.

I hate all you stole from him, all you stole from me.

This should be a happy time and a happy year. My oldest should be taking the next big step into adulthood and I should be feeling nostalgic and proud, not bereft and griefstricken. I hate what you do to people's lives. I will have the final say, even if you come to visit our lives again. You see, all the horror you brought to us, the pain, the blood, the emotional anguish, has only fueled the resolve of this family and of me personally in particular to take the devastation you wreak and turn it into something deeper and wiser than you might think possible. I will live my life as much as a light to my patients and my family as I can. And I will help them vanquish you. Because even if you take a life from this world, you cannot touch it in the next.

So fuck you Cancer. You can kiss my ass. It's a big one. Find a spot and enjoy.

Without remorse,SR

Wednesday, August 11, 2010

Toy Story III

Joe took me to see the new Toy Story movie yesterday. Toy Story III. Oh my. I wept through such a huge part of it, more than is probably "normal" for that flick. It brought back so many things and my heart is just aching, my limbs heavy, my mind fuzzy. Andy, the boy in the film, is pretty much exactly Joseph's age. We were addicted to the first two movies; Joseph had the Buzz Lightyear that made all the fancy noises and had the wings that would pop out. We saw the first movie in the theater with him when he was little and bought the VHS of it as soon as it came out. Seeing all of those characters again, hearing thier voices just brought it all back. I was crying during the opening scene pretty much from the git go. Thank goodness the movie has been out a while and the theater was mostly empty. The thrust of the movie was of the toys adjusting to what would happen to them now that Andy was 17, grown and heading off to college. Whew. Big exhale. So so so loaded with emotion for me. And I found myself engaging in magical thinking, rewriting the movie in my head, wondering how it would play out if Andy had gotten cancer while still young enough to enjoy his toys now and then. And how the toys would have adjusted if Andy had died instead of grown up and outgrown them. And then, of course, it hit below the belt in that this is the start of a new school year. We probably have one more of this anniversary to get through. It is stunning how hard this time of year is and it is the one that always seems to sneak up on me. At least this particular one has a finite life. Joseph would have been entering his senior year. He would be 17 years old and graduating come May from the same high school his father and I graduated from. And I admit, every second I find myself alone I am crying like a baby. But this is finite. After this year, there will be no feeling that I should have more school supplies to buy, more shoes, more clothes. The pictures of the first day won't seem as unbalanced anymore, because Joseph would have moved on to college and would not have been in them anyway. Next summer may be hard as we muddle through hearing about other kids in Joseph's class heading off to their universities of choice or start classes at our local community college. And I know it will punch me now and then as I hear of them getting married or starting families. But the regularity of it will no longer be there. Something in me is both sad and yet relieved. One less outward sign of his absence.

This year feels particularly hard, as my own first day back is the same day as the boys. I won't be able to be there when they go to class or there taking pictures, as I will be starting my own class, my own semester, and my start time is actually prior to theirs. I have so much homework to do, so many things I need to get into my head prior to the 23rd, but this week I feel so disjointed and fuzzy, scattered and unable to concentrate. It felt like that movie pretty much put its finger on it for me. I am not very "together" right now. And I am lonely in the darkness of this sorrow. It feels like something silent and voiceless in me retreats into shadow and just cradles there until the storm passes. It is isolating, waiting for the dreaded moment to pass, knowing it comes forward like the roar of an oncoming train, making the heart pound with fear, dread and adrenaline.... and then passes in a whisper somewhere through the soul, leaving you breathless and stunned. The anticipation is always, always worse than the actuality. One of the little lessons I have learned in the years since Joseph died. But it is lonely too, drawing this firm line between myself and others. Part of me hates that; part of me just wants to be quiet and alone anyway. Kind of stuck.

Camp Sol, a local grief support group, has a back to school get together every year where the families eat together, do some craft projects and then break into groups. The boys love going. Not my favorite thing, support groups, but maybe this year I should see what I can get out of it. I am stumbling right now. I think perhaps it will center me a bit, to see if nothing else how far I have come as I meet other, more newly bereaved families. Joe's son is up this weekend anyway and they are probably going to go golfing, so I will not be missed. I work a 12 hour shift today and nothing takes me out of myself more than being at the hospital, so I look forward to that. We are going out to sushi with my brother and his wife tonight, and tomorrow night we have an awards ceremony to attend in which I get one of the scholarships I have been granted for the upcoming school year. Things to look forward to; things that take me out of myself and remind me there are happy people in the world and that there is much opportunity and growth still to savor. I will be okay. The next couple of weeks may be rough. Maybe it is time to get the bin of Joseph's belongings out, go through the few toys I held on to and finally let them go. After all, they are waiting for a child who will not return and as much as Joseph loved them, he would like those things to be played with and cared for. I think I just might do that.

Saturday, July 31, 2010

To Everything Turn, Turn, Turn

My poor Joe isn't feeling well. He has caught a virus and sniffles and snuffles something fierce. At 5:30 this morning was ready for some more ibuprofen. I was awake anyway, so I brought it to him with some juice and tucked him in good, then wandered down here for some precious solitude. I really do love my alone time, which always feels a tad selfish when I think about it. I don't know why I treasure so much being by myself. I think it is because I am always thinking thinking thinking and I really enjoy my thoughts. I am constantly writing and composing in my head and sometimes the activity of the world interrupts that to a degree that is actually imbalancing for me. It is one of the reasons I really enjoy going on my long, long walks. I can turn on my headphones and just think my way around a 4.5 mile course. Which in turn meets a lot of needs in me - solitude, exercise, a continuous thought pattern, sun exposure, a sense of accomplishment. Interestingly, this has nothing at all to do with a desire to not see or be with my family. I love that too and I am loving them constantly. It is just something in my nature, to enjoy silence and peaceful co-existance without a constant need to entertain.

I was reading back this morning over my entries from August 2007. My goodness, how far I have come! It is funny, when you are the one living it, its just life. There is no sense of progression really. Its just on and on we go. Its one of the best reasons I have found for keeping a blog. I can look back and have measurable progress. Here I am, about to start my second semester of nursing school and a happier person. Joe and I are now married (yay!), the boys are in high school and middle school respectively. We have a new home (but have been in it a year already. Can you believe that?). Life is good.

We took a five day trip to Nebraska last week to attend the wedding of my cousin, TJ. He is the youngest of my aunt June, whom I have always been close to. I love my family. I really, really do. The wedding was so fun. Nick and Alex absolutely cracked me up. They were dancing maniacs! Most boys their age are so afraid of looking uncool - not my kids. They danced and danced and danced and when the slow songs came, they took turns coming to get me to dance with them. By the end of the evening, they were spinning me 'round and looking smugly pleased with themselves. I had a new black BCBG dress that had an awesome swingy skirt and I felt gorgeous in it and my strappy sandals, so it was a fun evening to dance the night away to every song. It pays to have so many uncles and male cousins and a truly adoring husband as well as attentive, appreciative sons. I don't have any pictures of the dress or really even of the evening. I was too busy dancing to take any! I'd love to have posted them here. Nick is super tall now and Alex is headed that way.

I have to admit, I would love to move back to Nebraska. It isn't going to happen - the boys let me know in no uncertain terms how they would feel about it, and Mom and Stewart are here in Dallas. But a girl can dream. Omaha is so green and lush, with hills and contour to the land. Every house looks different, unlike here with the cookie cutter neighborhoods. Eh, the neighborhoods here are pretty I guess - all brick homes and people really keep up their landscaping. I just miss the contour to the land, the greenness and having four distinct seasons. This time of year in Dallas is just miserable. Too hot to be outside for month upon month - we have to huddle indoors and pray for relief and pay the power bill. I don't know how the settlers did it before there was air conditioning. I bet everyone was super cranky all the time.

School starts for me on August 23 and we have exams the first week of class. I have started studying (finally) and am looking forward to seeing my classmates again. I am so glad I took a position at the hospital over the summer. It has kept my confidence level fresh. I am turning 40 on September 26th and I am going to have an 80s party here at the house (most likely) to celebrate. I need to get busy planning that and send out save the dates. I am stupidly not happy about turning 40. I am not ready to get old...and looking back on August of 2007, I am actually kind of pleased to feel that way.

Friday, July 30, 2010

A good death

Today my attention was drawn to an article that evokes a very passionate response in me. It embodies all the reasons I want to go into oncology and hospice; it draws attention to some issues that directly impacted our family when Joseph was failing. It is an article in The New Yorker magazine by Dr. Atul Gawande regarding hospice and end of life decision making.

I am almost tripping over myself in my desire to say what I am feeling just now.

We sensed when Joseph was going downhill. His father and I knew things didn't look good. We requested a conversation in which we could address our desires if this should be the end for Joseph, prior to putting him on a ventilator. But that conversation did not happen, despite our inviting it. His physicians were not ready to have that conversation, even when we were. They too were invested in his getting well. And we are grateful for that. I have no critisism for Joseph's doctors or the hospital in which he was treated. But the issue remains - he spent the last four weeks of his life on a ventilator, made immobile by neuromuscular drugs that blocked his neurological impulses because he was so agitated. We live now with the questions of whether that was the right thing to do; whether he was trying to let us know he was done and ready to be done. And we did not get any time to say goodbye. Even though we watched him fade day upon day, we were unprepared for that decision and his death. It seemed to come up very suddenly. The week prior there were words of optimism. Then suddenly there was consensus. The doctors had reached the inevitable conclusion and were finally able to tell us so.

I wish so much his final days had been of better quality. The night before he was placed on the ventilator was probably the hardest night of my life, and yet the most precious. It lives in a golden glow in my memory now and brings me to tears to even think on it...tears of sorrow, gratitude, strength. He could not breathe and he was in pain. Yet he was so accepting of help, of comfort from me and so without fear. As long as I was there to help him, he was strong and brave. He requested pain medication and more oxygen and for me to stay close. I wish now we had more time together like that. He was obviously dying. We struggled toward the miracle, stumbling and uncertain, knowing it was akin to trying to win the lottery in a last desperate attempt. It would have been a kindness for the doctors and nurses to say it was okay if Joseph was done, that the hospital would help us let him go with peace and warmth and honor, that we weren't bad parents for wanting him to call this shot and that we weren't killing him by foregoing the ventilator, that he was going to die anyway. I wish so much his last days had been different. I would love to see better training for medical personnel in starting these conversations and better acceptance across the board that it is honoring the wishes of the individual who is dying that is paramount - and usually those involve a desire to be free from suffering, to be surrounded by loved ones and to be in a peaceful environment, preferably at home, without being a burden to anyone.

Read the article and let it make you think.

http://www.newyorker.com/reporting/2010/08/02/100802fa_fact_gawande?currentPage=all

My family has been informed - no ICU for me if I am deemed terminal with little hope of long term survival. I don't want that lottery ticket. We all die eventually. I want it on my terms if it comes to that.

Monday, July 19, 2010

Middle of the Night

Oh man. It is one of those up in the middle of the night kind of things, aching, hurting, questioning and guilty. The sadness has been with me a couple of days now after writing Joseph's story out for Heroes For Children. He's an Honored Hero this year for their 5K fundraiser in September and they wanted his story for their website. Joseph's picture is up there as well. All of this makes me very happy, but writing it all down has lead me down some sad, dusty pathways. I can get so tortured wondering what his last moments were like, wishing I had done some things differently before he got sick, regreting things and missing him. Can you belive it still can hit me that fresh, three and a half years later? It has been several days of this aching, right on the fringe of my consciousness. It woke me up in the middle of the night tonight. Is anybody ever a good enough mother in their own eyes? I know I certainly am not and was not.

School starts again at the end of August. It feels like it has been too long and my stomach knots up with uncertainty. I am positive that is simply because I have not really started studying yet. Our schedules came in the mail a couple of weeks ago and contained a big list of homework we have to do prior to the first day of class. I was so happy to see it, but I have not started on it yet and I need to for my own sanity and sense of confidence. My externship over the summer has gone well. I am getting exposed to so many different kinds of patients, so many different kinds of illness. I am learning a lot, the central theme of which is being much more comfortable at the bedside and dealing with a wide range of personalities and needs. Interestingly, I have been hit on at the hospital more than I ever have in my life. Must be something about the scrubs? I am always trepidatious when I have a shift coming up and then always so glad I worked when I get there. I love being in the hospital. I often get floated to floors other than the one I was hired to be on and I have no complaints about that. I figure the more contacts I make and the more I get exposed to, the more likely I am to find work after graduation and the more well-rounded I am going to be in my profession. New graduate nurses across the nation are experiencing very high unemployment. Hospitals just aren't hiring, or if they are, they are specifying they wish at least one to two years experience minimum. The nursing shortage will come back in time, but it certainly isn't here now.

I am back to working out more regularly. I have taken to four-ish mile walks listening to my headphones. I love doing it. It gives me guaranteed alone time to just think and process my life. And I tend to eat better when I have done it. I'd love to shed another 40-50 pounds before I graduate. I am working 12 hour shifts and my legs hurt something fierce once I get home and sit still. It scares me to be honest. I will be royally peturbed (to put it politely) if I have chased this dream too late and I am too old to handle floor nursing. Getting more fit will at least increase my odds of being able to do it.

On a happier note, I am thrilled with how much weight I have lost thus far. I ought to post before and after pics on here. It is dramatic and Joe is always good about reminding me of it. I have fun picking out my clothing now and enjoy going into my closet to select my outfit for the day. So opposite of when I was near 300 pounds and dreaded going out in public.

It is hotter than heck here in Texas right now and getting outside to exercise is tough. I hate hot weather and I hate getting sweaty. Of course, sweat is necessary when working out, but there is a difference between getting sweaty and dripping all stinky and flushed and eyes burning from it running into them. I bought all new work out clothing as both reward and motivator and that helps - the new moisture wicking fabrics are wonderful. I've been wanting to post a punchy blog about getting out nearly naked in public. It is so hot that I have gotten to the point I do not care who I offend - my shirt is coming off when I do these walks. I walk at a brisk pace, around 4 mph and I was getting to where it was hard to see from sweat rolling into my eyes. Misery. It was hard the first time I did it - walked in just my shorts and a sports bra. I mean, let's face it. Out of shape and (nearly) 40 is not exactly pretty. That's a whole lotta jigglin' my friends. But interestingly, it also filled me with a kind of gleeful freedom. It was SO much cooler and more free and felt slightly rebellious. Fat chick takes off clothes in public, thumbs nose at society. The truth is, I am not THAT fat anymore. Playboy isn't banging down my door, but nobody threatened to shoot me while I walked either. Nobody drove by hanging out their car window screeching "Yo yo DoughGirl!" In fact, nobody seemed to pay me much attention at all. How many other things in life do I needlessly overthink to the point of paralyzed, fouled up self esteem? How many other ways do I hide and actually hurt my own quality of life? Something for me to ponder.

Ah, I am just so sad inside, here in the middle of the night. I miss Joseph. I have regrets about the past. I am nervous about school. It has been a cranky, crabby, moody summer. I don't like this lull in my goal chasing. Time to start studying. Between that and the hospital, I am betting I will feel better.

Here's before and afters (or rather, durings, if you will):

This first one was taken on Alexander's Make-A-Wish trip to Disney World. He is swollen from being on steroids. I am swollen from being on.....well....food.



This picture is of Me, Joe and Joe's granddaughter, Marisa, this past Christmas.


Saturday, June 26, 2010

Life By Design

I have been restless - caught in an ebb and flow of emotion that is never truly still. It feels as if I ride a rollercoaster of adjustment as the inner workings of this journey through grief twists and turns down new avenues. It is apparent to me now that much of my grief has been distracted by my schooling, that I have put it away in the name of achievement. I am not unhappy that I have done this, but these moments of 'in between' that I have until school starts again allows for some of the sadness and confusion to wander its way through the hallways and empty rooms of my mind. It is a mental vision I have, this wing of my life where Joseph resided, growing pale with dust and disuse, peppered with things that were him. I do not reach for him as I used to and the sense of yearning is fainter now than it had been. Instead I examine what I can take from this forward with me and even just contemplate the sadness of what I and all grieving parents carry. It has been three and a half years since we said goodbye and the old adage is true, that one comes to know who one's true friends are through times like these. My attention has been drawn to the fact that I am not the only one who has suffered a loss and I have been accused of attention seeking via Joseph's struggles and shortened life. These accusations wound me deeply, more deeply than the friendship lost through their having been said, though that too now I am grieving. Quietly, in my own head, I turn these potentials over and over in my hands, seeking to find if there is any truth to them. Certainly it is not the kind of person I would wish to be, nor would I wish to gain power, preference or favors based on the life my child lead and my role in it. I have believed with all my heart what I have shared on this blog has been in the name of putting words and face to the realities of what all of us have suffered in our grief. I have felt positive about the path my life has taken and how I have chosen to honor my son and, in truth, my own strength. It to me would be a sin against whatever power created me to have the ability within me to rise from this and assist others to do the same and not to use it. I do not want to believe that any of this is selfish, though I suppose truthfully all methods of achievement actually are inherently selfish somewhere within them. I don't think I search for accolades, but admit I have continued to enjoy the childlike thrill that comes with having them. My life has been a roller coaster of fate and fortune, from the seven years prior to Joseph's death that included my divorce from Stewart, my father's strange and unfortunate illness, his strange accidental death, Alexander's brain tumor and then Joseph's diagnosis, recovery, relapse and passage, peppered with job losses, the losses of grandparents, the heart issues that nearly stole my older brother - it has been a wild ride that got so intense as to induce nothing but numbness. Everything now feels like a wonder; every shred of happiness, every time something goes right sparkles with the magic of blessing and I am easily overwhelmed with incredulity and gratitude. I admit, it also brings with it an impatience toward the less spiritually mature, to those who would seek to draw the joys this life can provide away from those who dare to seek it, with those who would form opinions based on ignorance and bitterness. None of us has the right to be bitter. It may be understandable in many situations, yes. But it serves nobody and robs the world of goodness and light, particularly the light that is the individual who struggles in its grasp. That being said, I do not know how I have escaped it myself. Perhaps simply by allowing myself to hurt? Allowing the reality of my loss to hold me and allowing myself to hold it in turn, to feel it rather than turn to the dark, false comfort of cynisism. Sorrow truly lived is a catalyst that brings us forward, out of ourselves and provides an excellent foundation for change and for growth...and when truly blessed, for compassion and empathy. Sorrow avoided and resented festers within, a wound that has no exposure to light, to air, to healing. I do feel that the place where Joseph has been, the gashes torn by his suffering and twisted by his death, are healing. I absolutely know though they will yield the kind of healed injury that will always ache when the wind blows from certain directions and when seasons change in my life...and sometimes ache deeply. It affects everything I do and it has created the person I now am; perhaps even completed it. I am more content with the individual I have become now than I ever have been before. Assimilating that is actually difficult; one can grow addictively used to being unhappy. I do not always know what to do with it. And my impatience with the selfish and the inexperienced is perhaps inappropriate. Of course others who have not gone through a similar experience cannot relate or understand the brutality simple words can have. To expect otherwise would be foolish and to wish it otherwise on them would be cruel. But the reality of our journey, as individuals who grieve, is that we are fated to carry these wounds, and others will step on them, rub salt in them and deny them to the point that their own needs dictate. It too must be accepted somehow by we who carry it that our grief grows more private and tightly held with every passing year, more individual, more sacred and we must somehow find a way to protect ourselves emotionally from the wayward spouting off of those who simply have no idea. There is no way for outsiders to know - it does not pass us by. It is part of us, woven into our fabric and no insistence of "long enough" will change that, no accusation of selfishness will make it go away. It is not selfish to grieve for my child. It is not selfish to stand up for the rights of others who grieve for all the losses a major illness or other tragedy can bring, even if they did not yield to death in the end. Perhaps to the outside looking it, it does look self absorbed; after all, nobody can grieve for Joseph as I do. They can in their own way, but I cannot assimilate theirs any more than they can assimilate mine. It is individual to the relationship held. And my relationship with him was of the deepest, most bonded sort. I will not be ashamed of the depth of my sorrow nor the actions that sorrow has spurred in my life. If anything, I am proud and I am grateful. I will, however, be careful in the future to whom and when I reveal it.

Thursday, June 10, 2010

Lost? Sort of?

I am in a period of intense adjustment now. School is out for the summer; I am so proud of how I did and cannot say enough how good nursing school has been for me. There has been a light of hope and purpose inside me since starting nursing school that I have never known, even long before Joseph's illness. There just is no substitute for the mental wellness that comes with working hard toward a goal and then beginning to see it come to fruition. I still have 18 months to go - three semesters than I am fairly certain will fly by. Time is moving fast now, a fact that always seems to hover on the fringes of my mind. I have so much I want to do in my life and so many things to accomplish, and the shortness of our lives never really had meaning for me until the last few years, when so many of my loved ones have gone on. It actually can cause me a great deal of anxiety when life requires me to pay attention to things that I have not deemed "Important" in the grand scheme of things. It doesn't help that I am three and a half months from turning 40, which is bothering me far more than it should. Talk about something that should not be important! Truthfully though, it is important more in the sense of time marching by than in any sense of being "not young" anymore.

Since school ended, I have been awarded an externship in the cardiac step down unit of a local hospital. I had my first day on Monday. The excitement and anxiety of this has been difficult to describe, and I am constantly in a state of mulling and thinking, perhaps brooding by some definitions. I miss school being in session, where I am completely saturated not only in the clinical and theory side of what I am doing, but by my fellow students, whom I honestly adore, and in the support of staff and textbooks and feedback. Entering this externship was the first step to flying without a net and I have been terrified.

The day I started was in and of itself exhausting, both physically and emotionally. I have never dealt with so much poop in all my life, nor gotten that closely involved in the care of people that needy. Sure, I have done clinicals, but I can say without a doubt that I did more in that 8 hour shift than I did the entire semester in clinicals....and subsequently, learned more, both about how the hospital works, what patients need and perhaps most importantly, about myself. I can safely say I never got that up close and personal with body fluids in clinicals, mostly by chance. I just never had a patient with some of these issues during that time. I have been terrified since contemplating nursing school (we are talking years here) of how I would react when confronted with the more unpleasant (read here: smelly) sides of nursing care. I have a very sensitive nose and a gag reflex that can at times be a bit unfortunate in its virulent timing. The last thing I would want to do is help some poor soul living the ultimate loss of dignity and start gagging over them. In any case, I am proud and somewhat incredulous to report that I actually did very well. My mind just seems to go to a different place when I am providing patient care. I don't process it on the same level as changing the diaper of a child who is not mine or something. I am cognizant of the chance for infection, not only for myself but for other patients on the ward. I am cognizant of the need to restore dignity to this individual as efficiently and matter-of-factly as possible. I actually didn't even notice the smell, which amazed me, as my olfactory senses are quite advanced. If I had a mutant superhero power, I would be called something like The Sniffer. But I did well on Monday and I am looking forward to going back again. I do my first 12 hour shift this coming Monday.

At the end of my shift that first day, I went to my car and collapsed into the front seat. My mind was working 100 miles an hour, processing things I saw and did, cataloguing those moments I wanted to remember, making note of others who did things differently than I, both those I would like to emulate and those I really really hope to never be like. I was so preoccupied, and started up my car with only the thought of wanting to get home, get something to eat (finally) and to tell Joe about my day. There was not a thought of Joseph in my head to be honest; I don't think about him every second anymore (though I definitely do every day), even within this journey that contains so much of him within me. But it appears Joseph was thinking of me, as this just feels like way too much coincidence to be chance. The car started, the radio came on, the announcer's voice went away and right in that moment the opening piano strains of Come Sail Away came on the radio. I dissolved into releasing, wracking sobs and just sat and listened to the song, and felt the courageous presence of my son all around me.

Those who have been reading me since Joseph was sick know how that song came to symbolize him and his journey to our family. It was amazing to hear it come on the radio - it seldom does.

And so I continue on this journey, rather moody and brooding of late. My whole life feels to be in upheaval. I am so used to being so good at what I do and this is a strange and new adventure, retreating back to a place where I need a great deal of instruction and patience from others as I learn. My old life is phasing out; my new life slowly phasing in. I am discontented with school being out and it makes me feel lost and lonely, perhaps even a bit directionless. I am turning 40, which makes me feel as if time is just rushing past, and I need to hurry hurry hurry to accomplish all the meaning I want my life to hold, to get to the good part where I am doing what represents who I am inside every day of my life, when I am doing what makes me to-my-soul happy. I feel like a wraith, haunting the home I live in, waiting for the wind to change back to academia. It is good I got the externship, as I think I would really be having a hard time if I didn't have at least something of that world to keep me busy and growing. So much of all of this brings Joseph into me more fully, has me facing the loss of him and yet continuation of him from new and different angles. Rather than trying to find places to "put him" and still function, I now feel I am more finding ways to hold and carry him.

Sunday, May 9, 2010

Mother's Day

This is one of those days that usual knock me on my ass. After all, it was Joseph who first made me a mother. This year somehow was different. There weren't the quadmire thoughts of grief and regret and remorse; more just an internal sense of gratitude. A good amount of time has been spent on my part dissecting the reasons why this year has been any different, and I have no answers really. I just have a stronger foothold in the sense of carrying him with me. A stronger knowledge perhaps of the frailty of the human body; that none of us get out of here alive maybe? Regardless, I am more at peace.

That being said, I have had a bit too much wine tonight. Finals are tomorrow and to say that I am tense would be an understatement. Nevermind that I have excelled through the semester. Nevermind that I have proven to myself over and over again that I belong here. It is finals week and my self doubt and anxiety are enjoying this special time for celebrating their existance. It is the most wonderful time of the year for mental disorders, finals week. I am not the exception. I am the rule.

Nick chose to cut his hair into military style yesterday. What is perhaps most startling, along with the fact that he is content with it not hanging like a red curtain in his face, is the smile he has been wearing ever since. I would have rather sawed off a toe than to have done something my parents openly wanted me to do at his age. But he saw the benefit for himself in his own goals, and did it, and still let himself revel in the fact that his mother enjoys his nongreasy hair now that it is short enough to maintain with some semblance of personal hygiene.

Alex had a trip to the local water part with his class band this weekend. He didn't do a good job of putting on his sunscreen and is suffering the consequences. Both of them are redheads and I don't know how to get through to them the importance of not getting sunburned without scaring the crap out of them. Even the tops of his feet were sunburned. And his soft, tender earlobes. I can only pray it is its own lesson. Inadequate SPF application = PAIN.

We didn't celebrate much today. Stewart came over last Saturday night and we had dinner together and watched (save me) Dr. Who, which the boys love. Mom and I have plans to stay next Saturday night at a swanky hotel in Frisco and then to indulge on Sunday in spa treatments, shopping and movies while Joe is out golfing. The fact that this is finals week has pushed everything else either early or late and I am lucky to have such an understanding family.

I survived my first semester - at least I ASSUME I did - I don't expect to fail the final. Having the summer off kind of stinks. I would rather keep going. We just now got to where we feel like we have anything to offer to patients in the way of teaching or nursing care. Two and a half months off will be just enough to make us feel inadequate again. But the school has a good reputation and NCLEX pass rate. Time to push the "I Believe" button and let life happen.

I love being a Mom and a woman. I am thankful for the opportunities and blessings both things impart.

Happy Mother's Day everyone.

Sunday, May 2, 2010

Fear

Tomorrow is the day I have been dreading all semester. It is our last day of lecture for this semester, and the topic is going to be "Death and Dying". And while everyone is listening to the physiology of death and the physical changes of dying, I will be sitting there with my mental images, having watched the changes take place in my once dynamic and engaging son. As they talk about the emotions of the patient as they look death in the face, I will be recalling a conversation in which my 13 year old informed us of his wishes if he were to ever be on a ventilator in a state where recovery was not possible. When they talk about the aftermath, the care of the body, the potential familial and caregiver reactions and how to help them, I will be swamped with the memories of that hollow aftermath. There are others in class who have felt loss. I am not the only one. I wonder if they are afraid tonight too?

When I started back at school, my classes took me to many places that were hard for me to face. The immune system in particular was disturbing as I saw all the ways it was supposed to work and thus all the ways it did not in my child. The way cancer cells work, the Paris Hiltons of body cells, immature and refusing to grow up, doing nothing but sucking up resources and propagating their own kind while contributing nothing useful to the function of the whole. The kinds of viruses and the risks of immunosuppression, the way lungs work and the oxygen carrying capacity of the blood. How narcotics function...all the little chinks in the armor of my determination and the careful facade of my polite and dignified grief. I have done well with them all. And I have enough experience to know - these moments of abject fear are more in my mind than in reality, and their actual happening have always been far less traumatic than my own mental build-up and fear of them. And I hope that is the case again tomorrow. But right now I am wondering why I chose a seat in the middle of the class, third row back, the row where instructors tend to stand as they lecture and where I am least likely to make a quick, dignified get-away out of the line of curious eyes. I know I won't fall apart. But I am pretty sure that will be a matter of pure determination.

Maybe I am just tired tonight, but I dread this. Joe took me out tonight. We had sushi and mini margaritas and went to Home Depot and bought Knockout roses for the backyard. We rented a movie and drank a little wine and laughed and flirted and played. I was so relieved to get out of the house that my eyes teared up when we left. I needed that respite. And I am sure it has helped with the intensity of dread I am feeling right now. But it doesn't change that it will happen. I can only look forward to this time tomorrow night, when it will be over and life back to normal with nothing further in the immediate future to spark this panic that I have not felt in quite some time now. I will be glad when tomorrow is through.

Sunday, April 18, 2010

Rainy Days and Sundays

Joe has gone to Indianapolis to visit his newest granddaughter, Ms. Lucy Mae, who was born last weekend. I am wishing I could have gone with him. The relationship I am forming with his daughter is rich, deep and fulfilling and completely unexpected. I had no anticipation that we would ever be close. I wasn't opposed to it, I just felt it unfair to put that expectation on a child. It is one of those life nuggets, those precious blessings that come out of nowhere and hit you unawares with the sudden realization that bad things do not always happen. Sometimes good things do as well. I know she is going to be a wonderful mother, full of life and creativity and deep, abiding emotion. I yearn to hold the baby and to smell her little head.

The end of the semester is growing intense. I can't believe in two and a half weeks finals will be over and the first part of nursing school done, that I will have survived my first semester. The last couple of weeks have been somber and trying for me. I had the first skill test that I didn't do well on - everyone has at least one - and I am going to have to remediate. It hit me in the gut, the way my nerves took over, the way my hands shook, the fool I made of myself in front of others as I piece by piece fell apart. This whole pursuit of goals thing leaves you so exposed; I am so accustomed to having this tough exterior of capableness. I recognize no part of this experience means I am less than capable. It just was humbling to say the least, to fall apart that completely. It has punched me in the gut and made me face a few things about myself, about my ego and my expectations of myself...and...well, about my grief. I was tearful and upset far longer than I needed to be after it was over, with an internal sense of panic that made it hard to catch my breath and get back into the game. A pervasive sense of failure and, as I examined myself and my reaction, a sense of having failed Joseph. I have linked this journey so completely to his that apparently my success at it has come to mean to me some need to make up to him....things....??? I don't know what. For not being a perfect mother. For not being able to cure him. For not having him with me now. Who knows. All I know is that it became apparent to me that I need to both give myself a break and I need to restructure my motivations a little bit. It is fine for me to do this in his memory and to carry him with me through it, but it is not fine to hitch my entire ability to carry on after his death to it.

The two days following this fiasco were amazing, filled with opportunities that took me beyond my humdinger of a mood and into a knowledge base that I am excited to find is filling out now a little bit. I got to watch my first surgery and be present at a C-section, which was incredible. In simulation lab I got to put my budding nursing thought process to work and help "save" the life of our high tech, high fidelity mannequin patient, who is able to talk, blink, go into distress, arrest, etc. He has blood pressure and pulse and respiratory movement and sounds....it was incredible. If you do the right things, he starts to stabilize and if you do the wrong things he goes downhill all the way to the point of death. It is the only lab of its kind in North Texas and we are lucky to have it at our school. I get very excited talking about it. It is a chance to practice skills in a very realistic setting and see what happens without actually hurting anyone. They have one that actually births a baby vaginally, completely with rupturing membranes, measurable, palpable contractions and a baby with its own vital signs at the end. They have pediatrics and adults and all different scenarios to go through, plus the room is video equiped so you can watch yourself afterward and have a conference to go over what happened and why. This was my first event in simulation lab and I gained a lot of confidence in myself back from doing it.

So today is rainy and I am alone and studying while Joe is up cuddling little Lucy. I looked forward to the time alone, as there seems to be so few quiet moments these days, but I find I miss him being here in the house with me. The dreary weather is making me brood a bit.