Closure

......there may be much more to tell but there is nothing else to write.

Sweet Reunion

Homecoming

What a gorgeous Spring Day in Seattle! And, doubly wonderful because today is the day Miss Laura returns home from Florence. I spoke with her late last night Seattle time as dawn was breaking in Florence. Loaded down with 3 pieces of over-stuffed baggage to check and one enormous carry-on, her biggest worry was offloading the luggage into the care of Lufthansa. That hurdle past, the rest she felt would be a breeze. At 2:50 AM I received a text "Made it into Frankfurt" and then at 4:20 AM " I'm on to America! Ciao Europa! :)". She touched down in San Francisco around 3:45 PM today pumped up about being home again. "Gee, people are soooo helpful and friendly here; everyone was offering to help me with my bags."

The last leg of the journey should pass quickly. We'll meet her at Seatac in a couple of hours and then head home with the 4 overstuffed bags and one tired but exhilarated world traveler. Her choice for dinner? Vegetarian stuffed shells (a family fave), Caesar salad, and for dessert, strawberry shortcake. You got it, hon. Can't wait to have you home again!

Chris and Heather will join us for dessert tonight. Family re-united. What can be any sweeter?

Mismash of Thoughts/Feelings

My brain is on thought overload and consequently immersed in an endless array of conflicting feelings. Sadness, anticipation, frustration, relief, edginess, and on it goes. The entire bubbling pot of feelings has me restless and exhausted, despite hours of sleep.

My body feels like someone has taken a "2 x 4" and hammered me. OK, that's a bit of an exaggeration but whenever the stress levels climb, so also does the physical reaction which for me involves muscles aches and stiffness. "Yoga, Yoga, Yoga...." I whisper to myself but as of yet, no forward movement takes me through the door of the Yoga studio. Paralyzed, I sit with coffee and aspirin and my swirling thoughts.....and then of course, the feelings that come from the thoughts.

I've thought of Laura countless times in the last days. She leaves Florence tomorrow for the long journey home; 4 bags stuffed with her belongings and much left behind for the next group of study abroad students to use. Today she shared with me that she took a long walk through town, by herself (which is unusual), and said her goodbyes to the Duomo, the Ponte Vecchio, San Lorenzo Market, and enjoyed her last gelatto (limon and raspberry). She was chewing on her last "kabob"; her choice for a late lunch when we talked on Skype an hour ago.

How can I explain the feelings of great anticipation when I think of holding her close to me after so many months apart and the simultaneous down to the bone sadness that brings immediate tears to my eyes when I think of her leaving Florence, the place she has called "home base" since September 2008? The sadness comes from a chapter closed, over, ended; only memories to carry her forward. And so what? Why the sadness? Deep inside I know that the young woman we launched from the airport in Portland bound for Europe last fall is not the same young woman we will greet in Seattle tomorrow night. Time....she passes and changes us all and we are caught up in the wave, ever moving forward to places we can only imagine but not control.

Bittersweet, I guess. What else could explain my tears every time I think of her homecoming?

On the local front, my thoughts (and then my feelings) focus sharply on my parents. How wonderful it is to have them situated in a home that is prepared to care for the changing, unpredictable needs of nonagenarians. How fortunate was our family to find this good place and to move swiftly to make the move happen in less than a week from the time they were accepted into the facility? I get it: we are very, very lucky. This is all good (rationalizing).

But...... (and someone smart once said, whenever you use the word but, everything you've said before the but, you really don't believe in. It's what comes after the but that's your hard kernel of truth in that moment. I believe this too.) For all the positive changes in my parent's lives over the past 5 days, I'm pulled away from the relief to wallow in the sadness and the change. Even good change is hard for me to take if it comes with a dose of reality. What was a five minute drive for a quick visit is no more; the travel time to the new home is 30-35 minutes one way. I won't be visiting as often (most say this is a good thing). They still have no phone (most say this is a good thing). They still don't have their US mail delivery or the NY Times (more hassles and time to be spent arranging and re-arranging). Every move comes with a long tail, I like to say......the physical move is the easiest part. Adjustment and re-alignment (of all those former services) feels like a turbulent ride.

And so, the overwhelming feeling when I think about my parents is not relief (as I suspect it is for my siblings), it's sadness. My heart continues to break open as I struggle to accept that there's nothing I can do to fix the fundamental problems. I long to look my mother in the eye, shake her gently and say, "Mom, Mom...wake up, it's me, your daughter. Where are you? Come back, come back. I need you. I still need you." But, it's not to be. That thief we call dementia, that robber of soul, is a tough opponent. If tears are any indication, I haven't yet accepted defeat; I'm still fighting and bucking against a steel wall. And Dad? He's tough to read. I feel for him, living in a home that specializes in dementia care. He will need to find his connections with caregivers who are grounded in the world he lives in and in family who visit.

I want so to fix things. Fixing things is what I do. But, I can't. And that makes me sad. Much like this photograph, of early spring buds, life is on auto-pilot. The buds mature and open, leaves come to life and then they die. The cycle goes on and on without our input.

Getting Settled

Moving day for my parents was three days ago. MM and I stopped by the following morning with a bit of trepidation, wondering what their first night in the new home would bring. We breathed a sigh of relief when everything seemed calm and uneventful. Uneventful is a good word. Dad was dressed in a shirt and tie (!) with a vest (a bit small having been put through the wash at the last place and shrunken to half its former size) but he looked great nonetheless. Mom was sleepy-tired and kept drifting off as we tried to carry on a conversation. I brought purple tulips, an African violet, and more Heineken to stock Dad's small refrigerator. All were appreciated. Their rooms looked bright, airy and laid out with familiar furnishings. Good job, MM and Kate! Here's a photo of MM posing behind Dad in "his" chair.

Mom and Dad still have no telephone in their room (some have told me that I'm a fool to put one in there) but I'm working on it nonetheless. Communication these last days has been limited even though Mom has used the house phone a few times for very brief calls. The NY Times is still not being delivered even after two followup phone calls but hopefully by tomorrow they'll get a newspaper. The U.S. mail should have been forwarded to the new address but so far, not even a piece of junk mail has arrived. I'll need to get on that project tomorrow. There's always a long tail on these moves; things that I proactively arrange have to be re-arranged. Always. Sometimes I wonder why I bother to set it all up ahead since it never seems to happen anyway. Grumble grumble.

They also don't have a TV in their room. This was intentional and designed to encourage their integration into the common areas of the house where there's a large TV and plenty of comfortable chairs. Old habits die hard though; Dad asked me tonight if I'd think about hooking up the TV in his room. I'll try to stall on that request for a bit. The set is hidden from view, on the closet shelf behind a closed door. Out of sight, out of mind? Doubtful.

After work today, I made the rush hour trek from work up to their new home for a visit. They were at the dinner table just getting started with their evening meal so I hid out in Mom's room for 20 minutes on my cell phone trying to enlighten the AT&T customer service representative that having the phone line switched "on" and having a working phone are two different concepts. It took him the longest time to understand that we'd need a phone jack in the room in order to plug in that pesky phone. OMG! He promised to have a technician out to the home within a few days to install the phone jack but only if I assured him that: (1) there would be someone at home and (2) that the someone would be over 18 years of age. By the time we were finished, he was thoroughly educated about the concept of an adult family home and the fact that there are people there 24/7, many who are over the age of 80!. That shut him up briefly but then he started in on a sales pitch for other products and services. Begging for a phone jack and a goodbye, we ended the call. We'll see what happens.

I know this is a good place; I can breath in the confidence and the professionalism of this home. My parents are in a safe place where the care is consistent and loving. The four cats who roam about, inside and out are a bonus. One, named Panda, took his place on Mom's bed tonight. She was tolerant of his choice and he, of course, acted like he belonged. Why not?

We move forward as best we can.

Happy Birthday, Laura!

Today is Laura's 21st Birthday! She's celebrating in Florence and yes, it's in the midst of final exam week for GU in Florence but there's still an opportunity to kick back and enjoy the day. Denny and I talked to her on Skype early this morning and she sounds well. Dinner plans with friends at a new restaurant this evening, an ice cream cake at lunch today, and a dozen red roses from her stateside boyfriend are just some of the experiences that mark the day.

I remember the day she was born; she didn't make her appearance until the last hour of the day, 11:41 PM if memory serves. I had worked all day seeing patients but had this funny feeling that something was "going on". After dinner at home that evening and a brief walk around the neighborhood with Houston's balmy, spring weather, we summoned my parents (yes, those parents that we just moved into a new adult family home yesterday!) to come over to stay with two year old son, Chris. Mom then came down to the hospital with my sister, MM to be there for the "big event". We left my Dad on his own with Chris.

I told Laura today that welcoming her into the world on April 21, 1988 was one of the happiest days of my life. Most mothers, I suspect, would say the same about those birthdays.

Don't we all remember our 21st Birthdays? There's something momentous about turning 21, above and beyond the fact that drinking alcohol is legal. 21 is the age when we are considered adults (although there are still some things you can't do at this age, like rent a car) and that, as I recall :) is a good feeling.

When I turned 21, I was also far away from my parents. It was 1975 in Ithaca, NY and I had just returned to Cornell for the start of my senior year in college. Mom and Dad were home in Aruba on that special day in my life. I celebrated with my friends. The day was good and I remember feeling grateful for all the blessings in my life.

To my dearest daughter: May you enjoy the day and know that you are much loved by family and friends. Breathe in the mystery and magic of Florence as your time there draws to a close. We can't wait to welcome you home in five more days!

More Thoughts on Moving and Home

Hours after my post from earlier today on the subject of yet another move for my parents to a new care facility, I've lost myself in thoughts of their prior moves. I found my posts from Move #3 and Move #2 in the archives of my blog. There are commonalities throughout; moving is upheaval and we struggle so desperately to find them a real home.

Home, that most special place where their needs are met and they feel safe, where they can relax and let go, where they have space that is all their own (even if small, spartan), where precious mementos and memories of happy days and times keep company and dance with the present, unfolding moments which become the rest of their days, the rest of their lives.

Isn't this what we all want when we go to that place we call home?

Move #4

Tomorrow Mary Margaret and I move my parents to a new "home", one with hope and promise for stability, good care, and peaceful days. We hope. This move will be the fourth in 2 1/2 years when Mom and Dad left their private residence, their (real) home replete with the possessions of a lifetime, those treasured ''things" and spaces and memories that make a house a home. How could we have anticipated what those 2 1/2 years would bring? None of us had a crystal ball or an ounce of experience as we did the best we could to answer the call for increasing care needs of beloved parents as they entered into their ninth (oops, I mean tenth) decade of life.

This is a bittersweet move, as they all have been. The separate pieces that make the whole of the move are thoughtfully choreographed and in these, we siblings (MM, JT and Kate) are highly experienced. Phase one: Selection and Preparation and Phase two: Moving Day are all about planning, phoning, arranging, organizing, discarding, packing and unpacking. These phases are also about "selling the idea" to the two who will be uprooted yet again for the hope of better care, stability, more calm and ease, all of which they deserve in their final years. Phase three, I call Adjustment and comes with a long and unpredictable tail stretching out for weeks, often months. Settling into new routines, meeting new caregivers, and putting down roots is often the toughest part of the journey. Living through the transition is hardest on the two who move but the effect on the three of us as we do all we can to "make it work" and "work well" is not insignificant. This is the penultimate challenge for the "Committee of 5", a term Dad coined way back when we'd sit around the table as the nuclear family and take on the issues, often thorny and emotional. Each time we move, we hope we've hit upon the ideal, or if not.....the best it can be. Sadly, each time we (eventually) learn that the fit is off, that the needs cannot be met, and we struggle to compromise, advocate, and improve what is, only to come to a place where moving on seems the best option. Again. And, again.

Am I skeptical? Yes. Should I be more trusting in the Universe? Probably. Is it still hard as hell? Absolutely.

I am not in control and can only do the best I can and let the moments play out as they will. I send a prayer that this new place will provide for, assuage and comfort broken hearts.

Story Telling

Today's Prompt Tuesday from Sandiegomomma offers up the following great sentence to jump start some creative writing.......

She lifted the smudged glass to her lips, stopped mid-raise with that familiar lopsided smile and whispered, "This is the last you'll see of me".

Placing the glass on the kitchen table, she held back the tears, knowing that this choice belonged to her; owned fully and embraced, not with fear but a sense of freedom. He was insistent, pushing her into a loveless marriage for the sake of propriety, honor, and a child who would be no longer. She watched his expression turn to disbelief and he lowered his head, bringing his face closer to hers.

"What will you do?", his response, spoken with a gravely, threatening edge.

"My life is what I make of it.", she remarked, committed to anything other than facing the lonely road ahead with a man whose violent power, cloaked in the passion of the moment, had changed her life forever.

He stood up, wordless. With the backside of his right hand he stuck the half full tumbler, sweeping it off the table. The dull thud of glass against the linoleum floor, the spray of water and ice cubes against the refrigerator door, and the sound of his steps followed by the slam of the backdoor brought her life into sharp focus. The day was brilliant blue, cloudless and cool.

She had the sense that her life was beginning again, brought into the world with gasping breaths born by the short exchange of words, the image of the tumbler careening downward onto the floor, the icy water lurching outward in spurts, and the sound of a door slammed shut by the force of his hand.

It was Spring 1938.

**based on a true story with author's creative liscense

Personal Thought for the Day # 18

If I would live in the present moment instead of railing against the past or fighting off the future, I would experience a wealth of calm and peace.

Easter Musing

No church for me today. In fact, I haven't been to Easter services in quite a while.

We did manage a lovely gathering of four generations in our family for a down home old fashioned lunch with ham, scalloped potatoes, corn casserole, beans and other wonderful dishes plus blackberry cobbler for dessert. Today was Mom and Dad's wedding anniversary too; their 68th.

Although the time spent together was special, the day itself was a sobering reminder that time has left its indelible mark on the health and stamina of our elders. I know they enjoyed the efforts we made to celebrate with them but everyone, including them, knew that it was just plain hard work to make it happen. I thought about pictures, something to commemorate the event but my camera gave out after the first shot; "battery exhausted" it said. I figured this was meant to be and that remembrances of this Easter would need to be archived in the "mind's eye".

Another part of my somber mood is about missing my daughter, so far away in Sicily, lonely and disconnected from her traveling companions, faced with a stormy, cool day instead of the sunny day they had expected, and all the restaurants closed for the holiday. Turns out they eventually found some place to eat; they'd burned through all their snacks by mid-day apparently and were on empty. She'll be home soon enough (2 weeks from tonight, in fact) but the waiting and the big push through exams and packing up after seven months abroad seems daunting; for her and for me.

It's almost dusk in Seattle. A rainy, cool day here as well although as the sun sets, the sky is clearing on the brisk breeze that blows out those low hanging damp clouds. I'm glad this emotional day is coming to a close. Another Easter passes. Maybe next year the mood will be lighter. Brighter. Less heavy with sadness.

Of Easter and a 68th Wedding Anniversary

Tomorrow is my parent's 68th Wedding Anniversary; they were married on Saturday, April 12, 1941.

Tomorrow is Easter Sunday, also on April 12 which means we have a double celebration this year.

Last year, after some simple research, I learned how the date for Easter is set by the cycle of the moon. Easter Sunday, the so-called Movable Feast is celebrated on the first Sunday after the "Paschal Full Moon". The Paschal Full Moon is the first full moon after the Spring Equinox. Easter could occur as early as March 22 or as late as April 25, depending on the year. Last year, Easter was very early, on March 23 and I remember it felt very odd. 2009 is a more typical year with Easter falling more solidly in early spring.

However, the merging of both Easter and my parent's Wedding Anniversary, has occurred on only one other occasion in their 68 years of marriage: in 1998. I also learned that in 1941, the year they were married, Easter fell on April 13th, the day after they were married. Mom and Dad honeymooned in New York City, staying at the Paramount Hotel. Their first full day together as a married couple was Easter Sunday. I asked them about this the other day; neither could recall that they married on Easter weekend or if they celebrated Easter in any way that year.

Last year their anniversary fell on a Saturday and I blogged about their day replete with memories that Mom shared with me about their wedding day. This picture taken last year showing them on their 67th anniversary, seated side by side has become one of my favorites because they both look relaxed and happy. So much has changed in a year. Life for them and for my siblings and me grows harder as their mental and physical health changes and their needs grow. I don't think I could get a photograph like this one today although I'll probably try.

I'm proud to know they've been married 68 years. Not always easy, even now, but they remain a couple who has weathered the storm together. They remain the elders of our family and we honor them. Dad told me he'll ask my sister to say grace on Easter Sunday since my son Chris, who usually offers the prayer at gatherings like this is in California this weekend with his new fiancee. Time moves on! This year that April 12 is Easter and an important day in the life of my parents makes the time together all the more special. We're planning a family event at the house on Arapahoe and I pray that those of us in town can make it there to spend special moments together.

Personal Thought for the Day # 17

I wonder if craving carbohydrates is a sign of anything. Or, is it just the "State o 'Maine"?

What do I Want?

No question about it; these last few months have sucked the wind from my sails leaving me with an image in the mirror that makes me turn away quickly; I don't like what I see. She's beaten down, tired out, and aging fast.

It started in 2006 and we are well into 2009. Almost three years of a roller coaster ride of emotion, pain of loss, need for physical stamina and hands-on attention, and never ending lessons that leave me feeling that all of us could have done this "better". I can't fault myself or my family; we just didn't know. We had no idea what the phenomenon of end of life aging was all about until we lived it, breathed its unpredictability, and negotiated with forces stronger than all of us combined. No matter money. No matter street savvy. No matter a nubbin of experience (being a doctor). No matter consultation and "best advice".

So what is it that I want from this place of not-so-quiet desperation?

The sad fact is, I can't even say. Because, I don't have a clue. I've learned not to wish for specifics or even generalities because if it's not in the cards, it's just not in the cards. This is a wave that (likely) requires less steering and more surrender. Ahhh, that fine line that I continue to explore.

The Behemoth

A commonality of all new home construction is the long, tirelessly slow phase of excavation followed by meticulous laying of foundation and pouring of slab, morphing into an interlude when the scene barely changes for weeks on end, yet there are people on the job site busy with doing. I know not what goes on in this quiet time, this calm before the storm, this gestation of the monster. Suddenly, the behemoth springs forth in a whirlwind of lumber, power saws and air hammers,erupting with forces strong enough to change the landscape on a daily basis.

Today, I look out my bedroom window to see the behemoth framed out, taken from ground level to peak in a matter of two weeks if that. Denny always reminds me that this is the fast phase, an eruption perhaps. I call it sad. Our view totally obstructed, this giant will dominate the block. Mrs. left a flock of her children and friends to roam the site this past weekend. I saw them perched on the upper levels, laughing and doing things that pre-teens do, obviously excited by the new construction and dreams for the future.

What brings joy to one, may take joy from another. Unless. Unless we choose to live in a state of mind that either views life as "tit for tat" or better yet, simply goes with the flow musing that "what goes around comes back around". Or, better yet, allows annoyances to be just that and moves forward without wallowing or dwelling in sorrow's kitchen. Someone that I love once advised me in settings like these to"just sit and wait". Just sit. And, wait. Another that I love once told me that "life is the great equalizer". And so, I will ponder....

April Prayer

April Prayer
by Stuart Kestenbaum

Just before the green begins there is the hint of green
a blush of color, and the red buds thicken
the ends of the maple's branches and everything
is poised before the start of a new world,
which is really the same world
just moving forward from bud
to flower to blossom to fruit
to harvest to sweet sleep, and the roots
await the next signal, every signal
every call a miracle and the switchboard
is lighting up and the operators are
standing by in the pledge drive we've
all been listening to: Go make the call.

ER

Tonight I watched the last episode of ER, a two hour special commemorating one of the longest running dramatic series on television. The show which aired Thursday I saved for tonight and watched it alone as I have off an on for the last 14 seasons.

I've an ambivalent relationship to this show, sometimes letting an entire season pass without watching a single episode. But then, something would lure me back into the fold. Many times I've poked fun at the larger than life portrayal of this most mysterious place called the Emergency Room. I've critiqued the story lines; the fast paced, overly dramatic scenes where doctors make life and death decisions in split seconds, spewing out orders for lab tests and X Rays at a frenetic pace. Many times I wondered if viewers really believe all this nonsense or if, like me they get caught up in the action and lost in the magic for an hour on Thursday nights.

I remember my many months of ER rotations, beginning as a medical student, through internship, residency and even as a junior faculty member, supervising the Internal Medicine house staff as they did their work in the ER. While in training our shifts were 24 hours on, 24 hours off for an entire month. That was over 25 years ago; the "shifts" are much different for trainees in 2009. After all, who would want a doctor in his or her 23rd hour of wakefulness to be handling critical decisions? The ER was a place of extreme unpredictability, often outrageously busy but just as often slow, almost boring. There were moments of terror and triumph and many moments of in-between. I'm glad those days of my career are over although I look back at my experiences there as critical to my training.

Whatever I may think or say about the television rendition of a busy inner city emergency room, there is one aspect that gets me in the gut every time, my absolute favorite part of the entire show, and the part that captures that murky intensity that is the ER. The opening credits.....especially during the early years of the show.

Chills. Brilliance. Awesome. Spot on.

Personal Thought for the Day # 16

The closer I get to the finish line; the vacation, the reunion, the holiday, the break from something that needs to end, the whatever it is that I WANT so desperately, the harder the waiting becomes.
24 more days; each one 24 hours long.

Blaming it on the Weather

OK, here's my rationale, my reason, my excuse, my whatever.....for why I did not get "out there" in March to bust butt and launch some serious training for the triathlon(s) coming up in July and August.

Did you know that the Seattle paper today reported March 2009 was the coldest March on record in the last 30 years? Well, no surprise. Those chilly winds, the incessant rain (and snow flurries), and the fact that my heating bill will be over the top (for the fourth month in a row) drives that little factoid home. And today? More of the same with highs only in the low forties and some flurries as I drove in to work. Huh?

We're into a new month now. I always like "flipping over" into the next month; it's a fresh start of sorts, I rationalize. Now, I've got to get out there and "do it" or bust. No matter that this body of mine feels like it has been through a meat grinder most days and aspirin is my best friend. If I was a decade (or two) older, I'd be convinced the underlying diagnosis for my woes would be polymyalgia rheumatica. This meat grinder myalgia syndrome of mine, alas, is the manifestation of generalized stress meted out on a mid life body.

Get out there, Kate. Go. And this ain't no April Fools!