What Matters

Since September of this year, I have returned to hospice nursing, my true passion in my profession. I have said, many times, that there is a sacredness in caring for people and their families as the end of life here approaches. It is an intimate, private time where there is no room for pretense. It is a privilege to be present, and to be able to help.


 In the few months I have admitted hospice patients, I have seen love expressed in its purest form. A wife, learning that her 41 year old husband was actively dying, that his restlessness was a sign of imminent death, laid on his chest and, for at least twenty minutes, spoke of memories in their lives, remembering trips they had taken and times spent with their children. She did not pause as she recalled, for him, mental pictures of a good life, and somehow he was able to hear her and even respond verbally as she would say, "Do you remember how we.....?" No one told her to do this; it was a spontaneous act of love and a soothing gift in her attempt to help him become calm. Hearing her voice,he was able to stop struggling.


Yesterday my work took me to a nursing home. As I looked at the many elderly men and women sitting motionless and alone in wheelchairs as time ticked away, I thought: if it all comes down to this, being old and wrinkled and forgetful, what matters?  Instantly, the words of Elisabeth Kubler-Ross came to my mind. She is known for being the pioneer in the care of the dying, spending hundreds, if not thousands of hours at their bedsides. Being debilitated by a stroke at the end of her life, she spent her last two years contemplating the lessons she had learned, both in her work and in finding patience to endure being trapped in her body for so long. 


The final chapter, On Life and Living, in her final book, The Wheel of Life, ends with these words:


"You should live until you die. No one dies alone. Everyone is loved beyond comprehension. Everyone is blessed and guided. It is very important that you do only what you love to do. You may be poor, you may go hungry, you may live in a shabby place, but you will totally live. And at the end of your days, you will bless your life because you have done what you came here to do.


The hardest lesson to learn is unconditional love. 


Dying is nothing to fear. It can be the most wonderful experience of your life. It all depends on how you have lived. Death is but a transition from this life to another existence where there is no more pain and anguish.


Everything is bearable when there is love. My wish is that you try to give more people more love.


The only thing that lives forever is love."

Hard lessons

I have known, from previous experience, that life can deal you blows that knock the air out of you and leave you breathless and scared. Until your diaphragm starts to function again, only moments pass, but when you can't breathe a moment can last a very long time.
In the past several months, I have learned some painful truths that will leave scars on my heart, but not my soul.


You must do your work in whatever manner meets your own standards. And I know, in my soul, that I have given my best to my patients, co-workers and managers at Ohio State for many years. I was the person who would walk down the hallways and smile at people because I think it's the right thing to do. I would try to give comfort to a patient by bringing them a blanket or giving encouragement. I was not a perfect employee but I was an excellent employee. No one can take from me the memories I have where my help mattered- a little, or a lot.


But my heart- there's another story. Because, in my heart, I thought that this mattered to my employer. I thought my work mattered. I thought I mattered. This, I have come to realize, is false. In the machine that is OSU, I am nothing more than a replaceable small part. And the supply of small parts, regardless of quality, are all in the same jar to be pulled out at random.


I always called Ohio State my home away from home, and, as the saying goes, home is where your heart is. The days and weeks and months of applying for different nursing positions and falling into the "not selected" file have been hurtful. "There are a lot of nurses looking for jobs" was what a nurse recruiter said when I asked for help.


I will leave OSU on September 4 older and wiser, but my last wisdom gained there will leave a lasting impression that I will never forget. For now, I keep my gaze low so I don't have to see or smile at people I pass. I know, in time, I'll start looking up again. We are small parts with hearts that grow battered and heal over time, leaving scars so that it's never quite the same. But we alone own what happens to our souls.

Angel

Yesterday I was sitting on a bench outside the Health Science Library at THE Ohio State University Medical Center. I am not usually in the practice of praying for specific things, but just before I decided to sit for a moment and look out at the green space in front of the medical center, I had silently prayed for God to send a friend. It has been a difficult month here at my "home away from home" , leaving me feeling lost and of diminished worth. Before a minute had passed a woman named Mary appeared walking up to me.

Mary is a lovely lady and a friend who I have known now for 8 years. She asked me how things were going and I replied "not so good". Mary knows I left a position I had really liked in Emergency Medicine in order to do palliative care work. To my increasing dismay, this turned out to be one of the poorer choices I have made in my nursing career, as I have tried unsuccessfully now for 2 years to find a place where I fit in like I did there. Mary told me that she knew that this time in my life was temporary and said that I should be strong because she knew that something was going to come along that would be a good place for me. She lifted my heart by her words, even as I cried to hear them. She helped me to see past the way things are and to find patience, even for a day, to wait for something good to happen. She reminded me to have faith and to believe in myself. And then, after giving me a small hug, she continued on her way. I clearly heard a bell ringing softly, or maybe I just felt it in my heart. Angels are real. 

Mother's Day

I thought about titling this post "What Mother's Day Means To Me" just I like I would have done when writing a paper back in elementary school. I guess this blog really is about are my memories of motherhood, stretching back 28 years now- back in "the day" before paper diapers had gathers around the legs and babies could poop right out of the gap without getting a spot on the diaper....and there you have one of my memories. (Easter 1982, cute new baby Easter outfit worn for 15 minutes)
As a mom, I experienced all the highs and lows that come with raising healthy kids. I love(d) being a mom and always thought I'd be very good at it. Throughout the years there were many times when I asked myself what I had been smoking when I thought such a thing- in reality I was a terrible mother. Sometimes I wondered where the mothering I had done went during some teen years when I didn't think I knew my kids anymore. As I said, all the highs and lows.
Here are a few of the many moments that stick with me: The time I was scolding Peter when he was about 6 for some transgression. I was face to face and, while correcting him, noticed he was actually paying attention to me. "Finally", I thought, "I'm getting through to him!" I finished my lecture and waited to see what he had to say for himself. He said "Mom, did you know that if you look really close at a person's face it looks like they only have one eye?"

We has put our house on the market and had purchased cream colored area rugs so it would show well. The kids were in early grade school. I was upstairs when Peter's voice came ringing out "Oh, no Heidi, that's gonna STAIN". (Yes, it did- a whole glass of grape juice.)

My memories of Heidi aren't so verbal. Like yesterday I can feel her little pink corduroy overalls as I hug her, and see the times I spent putting on her stage makeup for one of her dance performances. I will never forget the sight of her bedroom in her teen years (omg!!) or the fun we had sitting in the parking lot behind a bakery we considered to do her wedding cake, eating the samples of white, chocolate and red velvet they sent with us.

The photo above is of, from left, Peter, Autumn (his bride-to-be in 23 days!), Heidi, her husband Ashley, Kayden, and Aaron, Ashley's 13 year old brother. I love each of these wonderful people and am deeply grateful to each of them for bringing their special personalities into my life.

I think often of Tammy, Ashley and Aarons' mom, who died suddenly and tragically 2 years ago. I hadn't yet got to know her very well, but we both were so excited for the little grandchild we were expecting together. She is especially in my heart on the nights when I rock her little grandson to sleep and think how she would have loved this baby and how proud she would be of her son as a husband, father and brother. "Ashley is a stand up guy" were her words the last time I saw her and I am finding how right she was.

And it wouldn't be mother's day for me without thanking my own mom and Jim's mom, who has her wings, for all their love and sacrifice.

And last, thank you to my furry children who keep me young and give me reasons to laugh every day!

Gifts

A busy happy life...... Leah, our 17 year old high school junior, is playing rugby. We are learning about a sport we knew nothing about. Leah, on the left (with her painted friend and team mate) loves it.

Kayden and Gramma had a sleepover Saturday night because his mom and dad were attending parties for Autumn and Peter, respectively, in preparation for their wedding May 23. Kayden is holding a basketball and a hammer. He is obsessed with balls of all kinds, but especially basketball. When we walk around the neighborhood he points out EVERY hoop he sees and wants me to lift him up so he can put a regular size ball in the hoop like his dad does..... The hammer goes to a new toy (of course)- a maze that balls travel through after you hammer them down through holes. He did a good job and didn't even try the hammer on the cats or dogs.

The furry family are all doing ok. Nell was taking a sun nap and the window pane painted a tattoo on her side.(Picture inspired by my friend Kurt who takes really cool pictures of sun and shadow. Hail to the master!) Mollie is feeling more at home and loves her back yard. I had put in a stone walkway where Lady and Winnie had worn the grass thin and Mollie has decided that the other side of the yard is her path of choice....sigh....

So many gifts to brighten each day.

On the road

"Begging!" implores the email messages coming into my mailbox. "Only one leg to fill- please help!" And so it goes for the coordinators who volunteer their many hours setting up amazingly complicated transports shuttling dogs and cats across the northeastern US and into Canada. Animals who currently are housed at shelters that euthanize or ones that try not to but are filled to capacity must leave or die. It's that simple. Along with the information about the legs left to fill- 2 drivers needed for leg 4b from Columbus to Mansfield, meeting place the east side of Walmart at exit 19 for 6 dogs- come pictures and descriptions of the animals- Buddy, a 40 pound black lab, sweet boy, thinks he's a lap dog, travels well- who need a lift. I scroll through the pictures and descriptions of these furry people, animals who would love a person to greet after work or to have their bed on the floor by a little kid's bed, and know that if I- and people like me- don't step up and volunteer some time and gas there won't be a tomorrow.

Sometimes I wonder why animals mean so much to me. Why not orphaned children or refugees who have survived disaster? I don't know. I do care very much about the orphans and refugees and do what little I can for them and I accept that in this life loving animals is what I am to do.

Charlie

Our happy little bunny, Charlie, left us this morning to join Jessie, Patience, Winnie and Lady in the heaven where animals go. The trees are always green and the weather mild with soft clouds, golden sun and soft rain showers to make the tender lettuce leaves grow. Peeled banana bits hang from trees, ripe and ready for a little nibble and hay grows fresh every morning, blowing sweet and fragrant in a soft breeze. Friendly hawks, as well as all manner of feline and canine companions provide companionship and romp or swoop over the peaceful place where all bunnies are free and happy and well.

An Olympian Winter

As of March 1, winter is over in my world. Snow covers most of the ground and the last two nights saw temperatures in the 20's but it is still spring for me. The first spring bulbs- tiny white snow crocuses- have appeared. The cardinals and chickadees are singing in the dark early morning and yesterday there was a pair of Canadian geese trying out nesting areas by the river.
We have had a cold snowy winter and spent much of it- evenings at least- hunkered down in our snug little house. Ohio saw near- record snowfall in February. I imagine it will be weeks before the mountains of now gray snow will melt away, piled from shoveled driveways and parking lots. We definitely had record ice cycles hanging from the house. Before I knocked them down last weekend, a few went from roof to the ground. They were beautiful when caught in the rare moments of bright sun, sparkling like crystal, clear and blue.
Jim and I always enjoy the Olympics and the 2010 Vancouver Games were no exception. During the day I looked forward to the evening when our work was done, knowing plans for pizza and a few hours of skiing, skating or skateboarding were in store. Oliver, our tuxedo'd gentleman cat, also anticipated these evenings atop a warm TV.

Visitors

Last night there were two visitors at our home. One was invited and one was not. One was a known member of the family and the other was a stranger. I was aware of the first being there in the night, but the other crept stealthily under cover of darkness to rob me if there was something worth taking and I was unaware of his presence until the morning.
Kayden was over for another big night of fun. He had Sesame Street Ernie pasta for dinner, a new addition to his toddler diet that I forked into his baby bird open mouth. We had our usual fun, including our version of Olympics 2010. We have prayer flags hanging in our living room- 6 in all- bright blue, pink, orange, green yellow and red. Kayden loves to be launched up to a height where he can touch each flag as I call out the color. He laughs and I laugh and my arms get a workout and he is learning colors. It gets a gold medal every time. When Kayden's mom and dad picked him up this morning, there was ample evidence of his visit all around the house.
My other visitor probably had dinner too, put out for birds and squirrels to help them eat while the ground is covered with snow. He also may have performed Olympian feats attempting to access the dinner. However this guest, leaving only the smallest evidence that he has visited, slipped quietly away in the night.

Home

No one will ever accuse me of having a home that looks like a magazine, with throw pillows artfully arranged, gleaming hardwood floors, and everything in its place. We will never need an alarm system to protect our valuables because our valuables all wear fur coats or are pieces of art made mostly by our kids- neither exactly hot items to pawn.
And yet, all of this surrounding me daily is precious and priceless. I can't imagine sitting on the couch without at least 2 animals on my lap or beside me; it just wouldn't be home. I wondered this morning as I filled bowls with fresh water and cat food, handed out treats to the dogs as they came in from the cold, and cut banana pieces for the rabbits, how it would feel to get up in the morning and have no one to take care of but Jim and me. It was like trying to imagine walking with one leg- out of balance and missing something necessary. I smile when I look at our "dining room" because only the rabbits actually dine there. Charlie and Stuarts' pen sits below the bay window and Jeffrey and Nutmegs' is opposite. There is generally some hay on the floor, if not from our dropping a piece when we fill their pans twice a day, then from the cats who pull it from the pens and eat it or bat it around.
In addition to its occupants, this home surrounds me with warmth and comfort. Like an old friend, I trust these walls to anchor and support me and to provide a place where I know I will always be welcome. I love our flower gardens in the warm months, and my mind's eye sees the bright colors in the summer sun even as I look upon our snow shrouded yard. Even now, as the furnace hums its soothing sound, I look forward to the breezes of April blowing through windows opened wide. Now we enjoy the flickering light of candles in the still dark February evenings and eat dinner by the fireplace, but soon the fireflies will replace the candles and we'll spend time late in the day outside on the porch swing at sunset. And in between, we will continue to go out and live our work day lives in other places with other people, knowing that, if we are so blessed, we will return home again to our beloved cottage on Sheffield Road.

Good times with my buddy

Kayden and Gramma had another sleepover last Saturday night. Kayden is a great dancer, so first I put A Charlie Brown Christmas CD on and we did some head bobbing and turning in circles to some of those songs. But next I went for some tunes with a stronger beat and selected Louisiana Gumbo. When he first heard it, this look of "Wohhhh!!" came over his face and he really cut a rug, which, of course, had me laughing and snapping pictures.

His walking and balance skills have improved immensely. He can squat and pick something off of the floor without holding on and is becoming faster crossing the room. When he arrived he had on these cute little Michael Jordan shoes that made a little thunk thunk thunk noise when he walked- still flat footed. His language perception is growing too. He can point to a nose (his, yours, a dog's in his picture book) and eyes and ears. He says "hi!" and ""uh" for up (as in pick me up). Mostly, however, his word of choice is "doh" ~ Homer Simpson style. "Doh" is used in a variety of situations: when accompanied by a pointing finger, it means "Let's talk about this item I'm pointing at". When he is eating, it means he wants more. Heidi is afraid he is going to pass right by the "mamma" and "dadda" stage of speech and go straight to "Mom", as he seems to prefer single syllables.

As it always does, our evening ended with his bath and rocking him to sleep- the latter not being a popular decision at first, as Kayden apparently thought there was still play time left. He did eventually go to sleep, his silky curly hair brushing my face.

When you only have 100 years to live

I've never understood why people- usually women- refuse to tell their age. Yesterday was my fifty first birthday and I have known women who would have given anything to say that but didn't get the chance. Shari, a patient I grew to know and care about, lost her life to cancer last week. I don't recall her age but she was younger than me. She and I sat together about a month ago and she cried because she knew her cancer treatment wasn't working. Even so, she couldn't bear to stop driving to the hospital and spending time she didn't have receiving chemotherapy because she simply wanted to live. Even as I tried to suggest hospice care for her, knowing the chemo was not only futile but was also making her feel worse, I respected her decision to go on. "I can't give up" she said.

I think of the actual people who are the "Five killed by a roadside bomb in Iraq" or one of the thousands just lost in Haiti. Just like that, and your time here is over.

Today I celebrate the first day on my way to 52. Each morning I see the sun rise is a gift that I will never take for granted even if I live to be 100.

Keep the Cheer Going

It's a rainy Sunday at home. Jim is lying on the couch watching the pregame for the Jets vs Chargers. As I tap away on the key board, Nell naps on my lap and Mistie snores softly beside me. Mollie would like to go outside- again- but we are limiting her time in the yard today because she comes in all muddy.

I'm remembering the Christmas just passed, a wonderful time spent with those we love. Inside and out, Christmas lights brightened the dark of winter. This year our street had more holiday lights than I ever remember here and I smiled every evening as I drove home, cheered by all the little sparkly bulbs. Not only did they display more lights, but people also seemed to leave them up later than in the past, keeping Christmas cheer as the long month of January began. Thinking about this, I wonder if, after the difficult year, we all yearned for sources of happiness. It certainly was so with me. As a matter of fact, we have decided to keep a little Christmas tree on our mantel. The lights warm my heart.

Our new friend, Mollie

We have a new friend. Her name is Mollie and she is a Collie-Great Pyrenees mix. Her coat shows her Collie heritage; she has the colors of a sable but perhaps with more cinnamon than tan . Her face and her demeanor are far more Pyrenees. She is calm, devoted and as was indicated it in the description of the breed, she would not take first place in an obedience class. She is about three years old and her first years are known only to her, as she was found wandering and covered in burrs. From the road she was taken to a dog pound where she was discovered by a Collie rescue and removed to a foster home to await adoption. She was with her foster mom for a little over a month when Jim saw her picture on line. We met at a pet store about 2 hours north of Columbus- after we had been approved by a home visit from the rescue group- and invited her to be a part of our family. I felt so sorry for her as her foster mom handed over her leash to us and walked away, as Mollie knew only that one more person in her life was leaving her with strangers.

Today is the beginning of her fourth week with us and we have passed the usual markers of a new animal joining the herd. The cats have stopped hissing and hiding when she is in the room and now walk calmly by, paying her no attention. Mistie, not being a dominant sort of dog, never objected to Mollie's arrival but misinterprets Mollie's attempts to play as the last minute of her life and runs to hide behind me. As Mollie seems to want a canine to play with, we are making arrangements for "play dates" (I hate that phrase. Why can't kids just play together without a date?) with a neighbor dog and Peter's dog.

So far, we know that Mollie likes to be outside, doesn't have much interest in toys, loves to go for walks, and has a bark that would scare me if she wasn't my friend- good for the nights when Jim is working and I'm home alone! We have relaxed our previous "no dogs on the furniture" rule and allow Mollie to lay with us on the couch and get into the bed. At first, I was going to nix that, given her ~80 pounds and envisioning trying to sleep with her taking up 75% of my space. However, she usually lays at the bottom of the bed and always goes down to her dog bed. She is a dear furry person and has become my shadow, waiting at the stairs if I go up and welcoming me home with a wagging tail.

When we met at the pet store I knelt and told her that we welcomed her into our lives and that I hoped she would be happy with us. I promised her that she was coming home. Each day, she seems to know better that she is, indeed, home.