Friday, October 31, 2008
Wednesday, October 29, 2008
This "amulet" on a silver chain will be around my neck tomorrow. I don't always wear it when I travel but it does have special significance. Over 30 years ago, a friendly, older woman sitting next to me on the flight between New York City and Aruba showed me her semi-precious stone collection. She told me I could pick one I liked. This one is "sodalite". I think of it as "the traveler's good luck charm". For years Mom had it in her possession after I gave it to her when she took a long journey from Houston to Alaska. We've always said the stone had magic powers and would watch over us. Whatever. I'll wear it and feel I've covered the bases. Mom may or may not remember the stone but I'll show it to her today when I say my goodbyes to both she and Dad. That'll be a tough one.
We'll have a computer with us on the trip and I may or may not post; will play that one by ear. I almost deleted my entire blog today such was my disdain for all my creative aspirations. I am blocked and empty for ideas. Time away may be just the thing. I'd love to say my heart belongs to Florence but it belongs to Seattle; until it no longer does.
PS I've voted; thank goodness for the absentee ballot! I'll be watching the news from 5000 miles away. My post on election day (already prepared) will tell you who got my vote. No one, even those who vote the opposite way will be surprised. I love ya'll anyway and I know you love me too. Such is the nature of our lives.
Tuesday, October 28, 2008
I titled this post "A New Office" because in the the last week, I've moved from my spacious office that I've called home since 1994 (whoa 14 years) down the hall to a new office which I share with another. I accept this. Totally. The new doc, hired over the summer, is now calling my old office home. When space is limited, the new hire who works full time needs the private office. As for me, I'm in clinic only one day a week and the rest of the time I'm in the adjacent hospital. I don't need that private office lying dormant when the new hire sits in a cramped shared space. Acknowledged.
Sharing an office is new to me; back in in my fellowship days there were four of us in one huge office and we all heard each others phone calls, rants, and raves. No privacy there but then again, we were all 20 somethings and who cared? We didn't. My new office mate is lovely. I've known her for years but I feel inhibited. No longer can I curse freely in my office, make private personal phone calls, cry, eat candy bars or just sit and stare out the window. Well, I can but....you know, it's different. We're cramped and constantly trying to keep our desk chairs from hitting each other when one of us leaves the room. I hear her on her phone and have to block it out in order to think or type or whatever it is I'm trying to do. I guess the main thing is I have to be polite. Lots of times I don't feel polite.
Change is the nature of every day; usually small stuff, sometimes big. My new office space is a bigger change but I'll look on it as an exercise in finding a new normal.
Monday, October 27, 2008
He is so frail. He's coughing a lot and no longer able to walk. He gets from chair to wheelchair with assistance. This has all happened in less than a month. He knows it and we know it; the end is coming.
I spent a half hour filling pillboxes with medications for the next month for both Mom and Dad. I sat in their room, balancing medi-sets on my lap and filling the AM/noon/PM slots with their respective prescriptions. I had to wonder if this would be the last time I'd be filling my Dad's boxes of meds. He has one large pink pill that smells wonderful. Most pills have no smell at all (they often taste bad) but this one smells like a cross between fruit and candy. I always take a good big whiff out of the bottle just because. OK, I'm weird.
Before I left, I asked Dad what he'd like me to fix for him before I left for Florence. I gave him some options but wasn't a bit surprised when he shook his head with an enthusiastic "YES" for the oldest recipe in the family archives; dried beef gravy served over boiled potatoes. Now if that isn't an old depression era recipe, I don't know what is. Inexpensive, tasty, filling and one of those meals that gets better when it sits in the refrigerator for awhile. So, I made it tonight, added lots of frozen peas (he loves those and they give the gravy a wonderful color) and will boil the potatoes tomorrow. I'm glad the adult family home is OK with me bringing in different food for them to eat. When there isn't much that brings joy, eating familiar comfort food that they've enjoyed for decades seems like a good choice. Mom says she pulled this recipe out of her head back in the days when she could barely afford to buy ingredients for a meal. It is pretty tasty, I must say.
The days wind down and it'll soon be time to say goodbye to them; a big hug, a kiss, and a prayer that I'll see them again on my return. One never knows what lies ahead. "It is nature, Kate", I've been told, "and you just have to accept it." I do accept it. But it's still difficult to let go and surrender to the plans of universe, whatever those may be.
Friday, October 24, 2008
Today I woke up early, trying to take the advice of someone who said that getting up a few hours early and going to bed a few hours early at night helps with the time change. We'll see. D, of course, will not change anything about his sleep/wake cycles and remind me that all this kind of stuff is mystical b.s., especially when I'm wiped out from the time zones and he's raring to go. Oh well.
Yesterday I walked around Green Lake to break in my walking shoes; a glorious 2.8 mile circuit on a crisp fall day. Here's what it looked like out there on the loop. There were lots of people out but you'd never know it from this picture of an empty trail, one of those rare moments at Green Lake where it's just you and the path ahead. Within seconds of this shot, people walked into view. Happy to report that my new shoes are great (and nice looking too). I have a pair in black and in brown so as my dearest daughter says, "Choices, Mom, choices."
Things on the home front with Dad are about as prepared as we can get. He has rallied somewhat, he knows we are leaving for ten days, and he is happy for us. I've done some major work (in progress of course) on myself to disentangle enough from the daily grit of overseeing his care (not as a doctor but as a daughter-doctor). There are good people who will pick up the baton, be the eyes and ears, and take action when appropriate. Making big changes and then leaving town before I get sucked back into the fray provides a healthy transition for me.
So now it's on to packing the suitcases. The hardest part is the cat who watches the bags come out of the closet and knows that we're going to leave him. He'll also be in good hands though. Chris will be here to house sit. Thank you, Chris. No wild and raucous parties while we are in Italy, OK? Just kidding.
Yes, I'm excited. I'm so excited that I'm not particularly scared to fly. Now that's something to be proud of too. Flying is not my thing but it sure beats any other way of getting to Florence, by a long shot. Let those jet engines rev up and those wheels start to roll down the runway.
Thursday, October 23, 2008
I'm grieving differently every day. Today I feel a calmness. But as the next days pass and we ready for the trip to Florence, sadness will creep in as I face the unknown and realize that I have absolutely nothing to do with whatever may happen. I must be the witness and the receiver.
Tuesday, October 21, 2008
The curious and mysterious manifest in unpredictable ways (such a theme in my life of late) as the day to day events evolve. Several nights ago I could not imagine that my Dad would live longer than another few days. Today he looks the brightest I've seen him in several weeks. But things can change quickly, even over a few hours time. I'm learning not to draw too many conclusions. My experiences as a doctor, witness to countless deaths gives me a frame of reference but since my Dad is not my patient all my perceptions, conclusions, and predictions have questionable meaning.
As he rallies (slightly), I have to wonder what it must feel like to be on the receiving end of all this focused attention. Out of town family arriving, his pastor visiting, local family dropping by, new faces from the Hospice Services team must be a very strange experience. Add to this house calls from his personal physician and his dentist. Amazing. If it were me sitting in that chair watching people come and go, inquiring about my health and status, making small and large talk (on heavy topics such as end-of-life plans), I'd likely feel pretty weird inside. He doesn't say much but that isn't surprising to me. He has always been a private, inwardly directed thinker. I'd love to know but can only pray that his mind is comforted by all this loving attention and care.
He understands that I cannot wear the dual hats of doctor and daughter any longer. I'm obviously not his doctor but I have run interference for him in the confusing maze of our medical system. I've (perhaps) been a catalyst for superior care delivered at astonishing speed and efficiency simply by being present at all his doctor's appointments, by his bedside in the Emergency Room, and available to talk to any and all caregivers 24/7. In the last weeks I've found myself too involved and making decisions on his behalf that clearly belong to his personal physician. Sometimes it's just much easier to "do it myself" because I can. But that doesn't make it right. I get that. We move ahead with new plans that I hope I can live with; this will be my next challenge to quell the doctor in me and stick to being daughter.
We are moving into a phase where I'm hopeful that I'll be able to surrender some of the hands on care to qualified people and be a daughter to my Dad for whatever days are left. As he told me on Saturday, "I didn't realize I was that bad off." That one broke my heart for I can see with eyes that know what he does not. I cratered in that moment. Had my honesty been a dagger or a gift?
And so I ask, what must he think of all this? My hope is that he feels loved, cared for, protected and revered. All I know for sure is that he is my Dad, I am his daughter, and that I love him. Deeply.
Saturday, October 18, 2008
He is dying.
People look to me for guidance and answers so I pull out the Doctor hat. I toss it aside when the garble that comes from my mouth makes me cringe.
What use calling his doctor? He can't tell me anything I haven't told others or myself again and again.
He is dying.
Unable to tell me what my heart longs to have: his wishes. He cannot articulate his wishes beyond an abstract drawing, open to interpretation to those in the museum of thought.
His best times are before mid day. I reluctantly venture into this terrain on this gorgeous, sunny fall day. I suspect he knows that the leaves are crisp and falling, the trunk and branches remaining, ready to face the winter.
He is dying.
Friday, October 17, 2008
Mom still enjoys animals and I suspect she always will; the wild and the domesticated. Come one, come all. At least once a week, she and caregiver Catie drive down to the Ballard Locks with a loaf of bread, tear it into pieces and watch as the gulls summon each other in raucous caws to the woman who brings them sustenance that day. Despite the occasional dirty look from someone who views the gulls as winged nuisances in contrast to her love of their spirited attention, she ignores these people and continues to take delight. For this, I'm grateful.
I found this poem yesterday which captures the idea quite nicely.
A Woman Feeding Gullsby David Wagoner
They cry out at the sight of her and come flying
Over the tidal flats from miles away,
Sideslipping and wheeling
In sloping gray-and-white interwoven spirals
Whose center is her
And the daily bread she casts downwind on the water
While rising to spread her arms
Like wings for the calling of still more gulls around her,
Their cries intermingling at the end of daylight
With the sudden abundance
Of this bread returning after the hungry night
And the famine of morning
And the endlessly hungry opening and closing
Of wings and arms and shore and the turning sky.
Thursday, October 16, 2008
Heading south toward campus, my car
stops suddenly, abruptly, almost
on its own. My right foot
has found the brake pedal
before my eyes can admire
a very young possum strolling
across our right of way
at his personal intersection
of human cross-purposes,
some of whose breaks are squeaking
behind us now. The possum
pauses, lowers his gray-pink-
and-sooty snout to drink in
the odor of something
among the fallen and flattened
sycamore leaves. I've seen
too many of him lying down
even flatter than seemed
possible beside roads
and in gutters. I realize
my car's mere presence looming
over him won't quicken
those four deliberate paws,
won't urge him out of danger,
but before I can think or make
some warning sign, two cars
are honking. He lifts his head
that sound to some distant sound
somewhere deep, far back
in his old, new mind, then begins
strolling forward again
and up onto the grass
among the unloaded, locked,
and abandoned bicycles
and empties and leaflets left
by fraternal and sisterly
orders on their own ways
to and from understanding
or back to forbidden gardens
and holes in the ground. Again
a car behind me honks.
And another. It's what geese do
heading south at the beginning
of winter. They want to know
the one in front still believes
they're there and are trusting him
to be sure where they're all going.
I found another great poem by David Wagoner about feeding the gulls, something that still gives my Mother joy at age 91. I'll post that poem tomorrow. At this time, poetry seems to be the path of least resistance in this blog. When all I want to do (but won't) is rant and rave and scour out misery, I'll let someone else's words lead me into another world of thought.
Wednesday, October 15, 2008
Let's see what you think.
The Peace of Wild Things
When despair for the world grows in me
and I wake in the night at the least sound
in fear of what my life and my children's lives may be,
I go and lie down where the wood drake
rests in his beauty on the water, and the great heron feeds.
I come into the peace of wild things
who do no tax their lives with forethought
of grief. I come into the presence of still water.
And I feel above me the day-blind stars
waiting with their light. For a time
I rest in the grace of the world, and am free.
In this eleven line poem, there is such depth and insight into the terrors of the mind but better yet, a way out. It's called Trust. It is the trust in those day-blind stars who don't show themselves again until the dark of night. Yet, they are always there.
I've been pondering this heavy topic of "forethought of grief" a lot, more than is healthy to be sure. An active mind that looks ahead to imagine all forms of tragedy, sadness, loss, and discomfort lives in a world where trust is a minor player, a weakling.
What peace (of mind) do we forfeit as we move further and further away from "wild things"? Does sitting in their presence help to restore our trust and daily freedom from forethought of grief? Everyone is wired differently. Many who read this will likely wonder what in the world this is all about. But some out there will lock on and say, "that's me" or "that's sort of me". It isn't a fun world to live in, is it?
But, I also acknowledge it is a choice.
Some say, the choices we make have some positive feedback loop, a payoff, or we wouldn't persist in the rut of dysfunctional thinking.
Damn, but I'd like to know what that payoff is.
At any rate, enjoy the poem. It's one of my favorites.
Tuesday, October 14, 2008
1. In this month focused on breast cancer awareness, does a 91 year old woman need a mammogram? The answer is: "it depends". I have little energy to address her request and render a thoughtful opinion. The path of least resistance is to just "go ahead".
2. Does a 91 year old woman who broke a hip a year ago and who has worn flat shoes ever since really do herself a service by wearing a pair of fashionable black pumps with 2 inch heels? The answer is: "it depends". But again, I will go and rummage through the closet to find them, deliver them, and hope she forgets to wear them.
3. What a 91 year old woman does need is several new pairs of pants; jeans and such, that fit. They will need to be hemmed I'm sure as her body, like mine, is long torso-ed with short(er) legs. I will do this; it makes more sense than the mammogram or the heels.
4. What a 91 year old woman also needs are some good books, short fiction or non-fiction with larger print. She has read three in the last few weeks; a renewed interest in reading after a dry spell. This I can provide as there are several good books on my shelf she might enjoy.
5. Let's throw in a flu shot for good measure. This is another good idea.
6. Now, when we get to what a 91 year old man needs, I've drawn a complete blank other than that he needs to be loved. Open to broad interpretation, this need makes my head spin for lack of direction.
I have no idea what I am doing but do it I must.
Saturday, October 11, 2008
My very smart and able husband passed the Washington State Bar Exam.
Congratulations! You rock! You M.D. J.D.
I am so proud of you!
Friday, October 10, 2008
Persistent Spirit, remind us that life is tough
and love is gentle.
Prod us to grow more human,
not through lessening of our struggles
but through an expansion of them
that will free us
to rediscover our gifts.
Deepen our hurts
until we learn to share them
and ourselves openly
and our needs honestly.
Sharpen our fears
until we name them
and release the power we have locked in them
and they in us.
Accentuate our confusion
until we shed those grandiose expectations
that divert us from the small, glad gifts
of the now and the here and the me.
Expose our shame where it shivers,
couched behind the curtains of correctness,
until we can laugh at last
through our common frailties and failure
laugh our way toward becoming whole.
from just going through the motions
and wasting everything we have
which is today, a chance, a choice, our creativity.
let how much it all matters
stretch us tight beyond our security
so if we are moved inside
to tears or sighs or screams or smiles or dreams,
they will be real
and we will be in touch with who we are
and who you are
And who our sisters and brothers are.
by Jon Luopa
UU Church, Seattle
Thursday, October 9, 2008
I met Pate in 1985, in Houston, when she joined our medical team as a physician assistant in Nephrology. She is a very smart and capable professional.
We were what I like to call acquaintances for over a year, maybe two; cordial and supportive of each other but not exactly close friends.
I knew our relationship was destined for greatness when, at a party eating Doritos and spicy Pace picante sauce, I dared her to take a cup of hot sauce and drink it. Without dropping a beat she said, "I'll do it if you do it." In an instant, I knew she was my kind of gal. We both drank a cup of picante sauce by the way and there are pictures to prove it. Something like this can really seal the deal in my book.
Since then, despite great distance (she lives in Tampa, about as far as you can get from Seattle) we've shared endless stories, laughs and tears. We've had some pretty big fights too but weathered the storms with grace. We've teased each other mercilessly, pointing out our large and small differences and debating all sorts of issues from the meaning of friendship to religion and politics. We are tolerant of our differences and celebrate the respect we have for each other.
We've watched our children grow from babies into young adults over this time. We've taken trips together, sent snail mail letters, emails, packages, and through it all have managed to avoid the telephone as much as possible (I'm sure to her frustration).
Pate is her last name; she says I'm the only one calls her this but I think the name suits her well. The best part is, she doesn't mind.
I love her like a sister. She makes me laugh. Always. She can poke fun at herself and she's good at apologizing too. She tells stories like a master.
Pate loves a great meal. She likes to drink rum-cokes with a squeeze of lime and will always indulge me when we're together. People everywhere like Pate; she can talk to anyone, including taxi drivers, store clerks, and people on the bus and make them feel comfortable. She has many gifts.
I love her very much. Happy Birthday Pate!
Wednesday, October 8, 2008
Today I woke up at 5:30 AM, early for me but I felt alert and rested which is really weird but I won't question something good. No headache either and that's also very good.
My back is likely on the mend and the physical therapist thinks it's the result of poor ergodynamics between me, my chair and computer terminal at work. The work of doctoring has changed so much in the last 3-5 years; we spend inordinate amounts of time gazing at a computer screen, reading small print, scrolling through medical records and documenting our visits with patients on-line. We dictate less and type more. (Pity those who did not take a typing class as I did in high school.) The end result of hours spent over desk top computers takes its toll over time. I'm pleased that this sore back deal is a fixable issue; someone is coming to make an assessment of my work space and "adjust the mechanics". If my back gets better, I'll be a believer.
Today dawns clear and cool in Seattle. I've decided not to distact myself with all the fixed, negatives in my life right now but look at what's right. Indulge me a bit as I recite them; it's therapy and may spring me back into blogging life after a hiccup hiatus from writing.
1. I have a great family; nuclear and extended.
2. My home is my castle; I feel safe and warm and have good places to curl up to rest.
3. D and I are traveling to Florence in a few weeks to visit Laura and I'm excited about the preparations; where we'll go, what we'll see and how we'll use our time there.
4. Mom and Dad are in a safe place.
5. There are good eats everywhere.
6. My cat is cool.
7. The leaves are turning beautiful shades of orange, red, and gold.
8. I can chat by IM with Laura most days and that's nice.
9. I just finished a great book called In the Woods by Tana French (highly recommended, engaging, psychologic murder mystery set in Dublin).
10. No migraine or backache for me today!
Friday, October 3, 2008
I know from the deepest place that I'm struggling because I feel so uncertain about everything in my life right now. I feel like a cork bobbing in the currents, devoid of any control over my destination or the journey. I'm being moved about, sometimes gently, sometimes harshly all over the friggin' map.
Physically, my back is acting up; in knots and spasms. After some tests showed nothing significant, doc gave me a muscle relaxer to try. It works but it also makes me so drowsy that I'm far more interested in lying in bed than in writing or reading.
Mentally, I'm slowly coming to grips with Miss Laura being overseas for the next eight months. She's on her own and she's obviously ready but my anxieties don't quit just because I try to remind myself of these facts on a daily basis. I worry.
I'm also facing the deaths of my parents, each day a bit closer to the end. As I see the time pass, I grieve for their losses in physical and mental stamina and I know it will only get worse. I suspect that when one goes, the other one won't be far behind. No matter the preparation, their deaths will be very tough for me. I hate myself for not taking advantage of the time left, by not being fully present for them. Sometimes I can do it; often I can't and visits are so difficult for me. Then comes the guilt and sadness knowing that soon they'll be gone and I'll be left wishing I had done differently by them.
My work weighs heavily on my mind, the uncertainty of where I'll be in a year, and just what I would do if I didn't have to work. Unfortunately, I'm in a place where I see nothing blooming on the horizon, nothing exciting. I'm stuck with a job that saps my energy even when it's only part time. What happened?
No wonder I'm struggling to write creatively when my mind is consumed by dark issues and a sore back to boot. I may just acknowledge my long streak of posting every day since July 19th and lay low for a few days until some creative thoughts emerge from the deep. I've been told by someone wise that I need to trust. That's a tough one for me but obviously the key. Trust that whatever happens, I'll be able to weather the storm.
At least the cork in the current analogy keeps my head above water most of the time. Corks don't stay submerged for long. I'll post again soon.
Thursday, October 2, 2008
On a lighter note, there's always food when I visit Mom and Dad. After the coffee and pecan balls tossed in powdered sugar, Ms. Adrianna brought out a Costco sized bag of Fortune Cookies. We all took one. Out of the corner of my eye I saw Dad put the entire cookie in his mouth.
Mom's fortune was: "You have a wise spirit, an advanced intellect and faith in human nature." (She was pleased with these words.)
My fortune was: "Your golden opportunity is coming very soon." (Sounds good to me!)
And Dad? His fortune got eaten, chewed, and swallowed. I worried about him choking but apparently these fortunes are pretty flimsy and amenable to being eaten without a lot of fuss! We'll just never know.
Wednesday, October 1, 2008
D is not a cat person but I've never seen him shoo Boo away.