Final questions

Have you ever had one of those days where you woke up feeling like total crap, but you knew you had to power through the day because there was no way to get out of what you had scheduled? Yep, that was me today. Maybe I felt this way it’s because I didn’t take a supplement yesterday like I was supposed to and it’s catching up with me. Maybe I slept wrong and the headache that I felt coming on soured my mood. Heck, maybe it’s because I’ve been making an effort to eat healthier and my body decided to revolt with a resounding, “I DON’T THINK SO, NONE OF THAT GOOD FOR YOU CRAP IS COMING IN HERE!” Regardless, I felt like dog doodoo.

Nevertheless, I washed down some acetaminophen, made sure I took said supplements, and hopped in the car along with my breakfast meal replacement smoothie (yay for healthier food choices…). By the time I got to the office, the headache hadn’t materialized, but the rest of the crappy feeling was still there. I won’t go into details about some of the legitimate reasons for feeling crappy. You know, HIPAA regulations and whatnot. Suffice it to say, there are a couple actual medical things going on so at least I have half a good reason for feeling lousy.

My day was booked solid with patient visits, and although my total visits amounted to only four, when adding in charting and driving time to each, there was barely time in between to pee. And let me tell you, when you’re on the road visiting patients in their homes, you can’t exactly ask to use their bathrooms. You end up weighing the bathroom pros and cons of McDonald’s vs. Wendy’s vs. Taco Bell vs. Burger King vs. random gas station. Gas station bathrooms are definitely out, as I cannot recall one I have ever been in that was not beyond gross. Today, Taco Bell won out because I’m a Diet Pepsi drinker and of the fast food places, this is the only one serving Pepsi products. ***SIDEBAR*** Have you ever felt guilty just stopping at a fast food joint for the bathroom access? I mean, do you do the quick dash in, hoping staff won’t notice you, and then do the covert retreat back out the door, knowing you should have gone to the counter and at least gotten a $0.50 apple pie or something to compensate for the water, toilet paper, soap and paper towels you used? Being on the road every day for work, this though goes through my mind more often than I would like. Today though, I made up for it by actually ordering something after my pit stop. All is now right again in the world of give and take.

Of my visits today, I am most reflecting on my 85+ year old patient, who is spunky, energetic and opinionated. It’s always a pleasure visiting her because she has something to say about everyone and everything. Today though, I was visiting at her request, not just stopping in for my regular bi-weekly chat. Today my patient seemed distance and sad. She had requested I come by because she was struggling with the death of her sister just a few weeks ago. My patient is one of 7 children, who, prior to her sister’s recent death, was one of the 5 remaining. Two brothers died over 40 years ago in their twenties, so it had been the 5 left for many years. That seems to all be changing, as not only has her sister died, but the remaining siblings are each in very poor health, in varying stages of decline.

Not that my patient is the picture of health herself. Hell, she’s on hospice, so she, too, is declining. The difference though, is that my patient is still mobile, has her cognition intact, and she still has plans for her future. She’s getting more tired and confused each day, but by and large, more active than her brothers and sisters. So as I sat across from her, I listened as she contemplated her sister’s last days, their life together, and all the things she didn’t say to her. I could see the emotion play across her face. At one point, she put words to that emotion and revealed that it is so very hard for her now because she knows she is going to die. Before it all seemed like something that would eventually happen, but that eventuality is coming soon. She also struggles with why she still has so much energy when her siblings do not. It’s the typical, “Why me?” question, only in this case, it’s Why NOT me? She wonders why she has been chosen to feel better and be physically better than her siblings.

Our conversation led to talking about the number of days in our lives, and how we do not know that number. We talked about God, and whether He allows things to happen to us, even though He can change things, or if He sits by like a parent and watches us, hoping we make good decisions and choose wisely. I believe our days are written for us long before we are even born, but what we do with those days is up to us, and how our days play out is largely a creation of our own. We can choose to not pick up that cigarette, or alcoholic drink, or that syringe. We can choose to not go out with that controlling person, or we can leave the abusive home. We can choose to be on time for work, to hold doors open for others and to help someone carry groceries from the car to the apartment. They are all choices we make which affect the very fabric of our lives. But I don’t believe we can choose when our lives will be over. Yes, we could take our own lives, but if our life was meant to end that particular day, then it would have, whether by our own hand, my someone else’s or by accident.

These are the questions which are the foundations of debates across the world. I could contemplate the vastness of life, choice, faith and God for eternity and still not be anywhere closer to the truth than I already am today. So as I sat looking at my patient, I could see her memories flashing through her mind as she stared off at various times. I could see her wondering what life was all about, if it was worth it, or if she had done what she was supposed to do. She was contemplating her life, knowing someday soon it would all be over. The questions she had were visible, yet unspoken.

I could see her questioning her faith a bit as well. After all, what type of faith would we have if we blindly went with it, without asking a single question or challenging ourselves. God is big enough to take our questions, our anger, our confusion and our resentments. The hardest part about faith is continuing to have it, even when outside forces press on us to abandon it, and the questions seem too hard to answer. That’s when faith matters the most – when it seems we have it the least.


A work in progress

So it seems my blogging hit a wall this week, and I’ve barely had time to devote to it. My apologies, although only being a couple weeks into it, I’m sure I have not disappointed too many. Life just gets in the way of things sometimes, and before you know it, days have gone by.

But so much has happened, I could probably writer for hours. It would bore you to death, but I could do it. Several of my patients have died this week, including the wonderful man who mistook me for a 20-something. His death was peaceful, although all things considered, he did not want to die. He may have come to terms with his eventual death, but he did not want it, for sure. I was glad to have spent the time with him that I did, and I hope he found some comfort in the words I spoke to him.

I also received some good news from my church body’s synod office. Things are moving quickly toward official commissioning as a Deacon, and there is much planning involved in making this happen. More news coming soon I hope. By and large though, I’ve spent the majority of my time attending the school events for my children. My oldest’s high school musical is now complete, and I don’t think I’ve laughed that much in a long time. It was nice to get out of my head for a while and just enjoy seeing all of the kids work together and have fun performing. I remember being in that exact same place, having done the musical during my high school years. Memories like those are cherished.

Today though, was spent about 90 minutes from our home at another high school, where my youngest was performing in three different choir groups at the Solo and Ensemble contest. When it was all said and done, they had delivered excellent performances. I know it’s not easily when you’re 12-14 years old, your voice and looks changing, and you’re asked to get up in front of other people.

Well today, I got to see middle school at it’s finest. In the span of just 5 minutes, I saw a boy with a mohawk, another boy with teal hair, and a third with his hair in a ponytail on the top of his head. All great kids, I’m sure, but obviously each trying to figure out their own personal style and personality. I spent a good deal of time (as we waited for hours in between performance times) listening to the kids as they laughed, talked and prepared for their judging. My child’s friends were a mixture of personalities as well. A pack of cards was introduced from my child’s backpack, and it was as if the kids had never seen such a thing before. Once of the boys had never played cards, and didn’t even know how to hold them in his hands. He was a sweet kid, polite and quiet, but yet goofy and funny as well. Before long, he was winning at hands of rummy. He’s the kind of kid I want my child to be friends with for the long haul.

The girl at the table though, was a force to be reconed with. She was bossy, loud and overbearing. The chaplain in me could see she was compensating for something else in her life, but I didn’t really like to watch her behavior up close. I was amazed that the sweet boy I met today was more than willing to jump up and do her bidding at a moment’s notice. (And before you say it, No, it wasn’t because he likes her) All it seemed she had to do was sigh and say, “Oh darn, I forgot my bag in the gym,” and give this boy a look. It seemed liked he had done this multiple times before, so it was no big deal, and off he went to the gym. When he returned, she whined, “Oh, you didn’t bring my lemonade.” Never mind that she had another drink in the bag as well.

As the day progressed, her behavior became more rowdy, but the kids didn’t seem to mind. Even my child retrieved something for her on the way to the bathroom after she shouted, “Hey, my lemonade!” as my child walked away. While she was polite and said thank you, it never seemed to occur to her to actually get up and get her items herself. The truly sad thing is this: I knew I needed to bring her home with us because she lives only a few blocks from my home. Initially, I had grandiose ideas of taking both kids out for an early dinner to a pizza place. But once I witnessed her behavior, I decided she didn’t deserve this kind of treat. I spent a good portion of the afternoon wondering if I was being to harsh.

As we prepared to leave, she debated with me why we were leaving, even though both kids were finished with their performances (She evidently wanted to stay until the end to watch one of her friends perform). I disagreed, so we began walking toward the exit. Unfortunately, she needed to retrieve her ear buds, which a friend had borrowed. As we walked toward the performance rooms, she again sighed and said, “I really don’t want to have to walk up to the second floor.” Sure enough, the sweet boy I had met quickly came to her aide and said he would do it. She then walked back to the gym with my child, who had found her friend already and retrieved her ear buds. Evidently she was then ready to go, but I reminded her that it was rude to leave after their friend said he would go looking for the ear buds. She smirked and said, “Oh, yeah. Right.”

So I ask you – was I right in my decision to not stop for said dinner on the way home? Should I chalk it up to kids being kids and middle school being that “discover who you are” time of life? I still don’t know. I’ve been doing a lot of thinking and reflecting on my own life, and don’t recall being quite that domineering or rude. It seemed to come so naturally to her! I seriously debated with myself the entire way home, and, after dropping her off and a snarky “thanks for the ride,” comment from her, was glad I had stuck to my decision. But some doubt still lingers. If there really is something going on behind all of that attitude, etc., shouldn’t I make more of an effort to nurture her and make her more comfortable so she can share what’s going on?

I don’t claim to be a perfect Christian, or a perfect human being. I have so much work to do to become a better, more loving person. Today was a tough day for me in that regard. I was judgmental and irritated. What’s worse, my child witnessed my irritation first hand, which required conversation about it after we dropped her off. So my prayers tonight will be for wisdom and understanding, as well as for the ability to offer grace to others. I am a work in progress.

When stuff gets real

I knew the time would come when parts of my work life would bleed into my personal life. I cognitively knew the day was coming, but emotionally? I am so not prepared. Every day I can sit with patients and families, talking about death, talking about fears, talking about decline. So why is it, when faced with that same situation at home, I become a confused, tearful mess? Oh yeah, it’s because I’m human.

I can have empathy and sympathy for my fellow human beings. I can listen, support, encourage and challenge anyone who needs it. But I’m finding that now, I also need someone to do that for me. I need someone to help me navigate this dark path, looking for the eventual light. Simply, I need my own chaplain.

Now, I know I’m probably just overreacting at this point, with my mind pulled in a million directions at once, yet landing on no specific thing. I recognize that I want to get up and start doing, even though there is not much yet to do. Most of all, I know where all of this is leading, and I just want to fast forward through it all to the very end. I don’t want the suffering to happen. (Not suffering for me, but suffering for my loved one.)

This is when we are truly confronted with our beliefs about suffering and defeat. This is where we must decide how faithful we are to whatever greater power we believe in. This is where, in all practicality, the rubber meets the road. Will this faith carry me through or will I abandon it in a fit of anger and self-pity? Will I be able to reach out to my God with all of my rage, sadness, tears and questioning, or will I just turn away because, why would any god let something like this happen?

Over the past 24 hours, I have been praying…A LOT. My prayer is that God showers his favor on my loved one, however that favor may happen. Ask big, receive big. But I’m not naive enough to think that just because my loved one may still experience this decline and suffer, that God has not answered my prayers. God’s favor comes in many forms. My perception of suffering may be different from my loved one’s. Maybe the favor will be in that I will be more supportive and encouraging. Maybe the favor will be in this suffering being short-lived. In the end, I believe I know my loved one will be accepted into heaven – where there is no suffering at all. For now, I need to hold onto that faith. I need to trust that my God will see me through this to the light.

Blissfully Unaware

How is it possible that the best part of my workday yesterday was with the patient whom, in many ways, is in the most unfortunate circumstances? But, I guess it’s all about perspective, and maybe her situation is not so unfortunate. After all, she is safe, cared for and seems to be happy.

See, I spent quite a bit of time with one of my patients in the memory care unit of a facility. She has Alzheimer’s Disease, and while otherwise healthy, cannot remember much of anything outside of a few things about her husband and son. She is relatively pleasant, generally has a smile for me, and is willing to engage in conversation…most of the time.

Yesterday was a wonderful adventure outside onto the patio, where the sun was shining and there was an abnormal spike in the temperature, causing it to be a lovely 78 degrees. There was a refreshing breeze as well, which made the totality of the opportunity too good to pass up. My patient no longer walks on her own, but she easily maneuvers in her wheelchair by “walking with her feet.” Sometimes, it was hard to keep up with her!

As I walked beside her, we talked about the sunshine, the breeze and the newly growing plants and flowers. All of these topics did not require any specific memories from her, so it was easy for her to respond to questions and to formulate opinions. Yes, that plant is beautiful. I love the fresh air. It is really bright out here. It is when I ventured into deeper topics that her conversational abilities shifted. She would begin sentences, but then not be able to finish. She would “cover” her lack of cognitive functioning with comments like, Oh, you know what that is.  Or, I never liked that because, you know… I didn’t press her to continue, but let the conversation flow where it did. She could not remember details of her life, such as if she ever rode a horse, or flown in a plane, or been on a boat. She could tell me the basic information required about how she was feeling, if she had to use the bathroom, or if her stomach hurt, but she could not offer anything deeper than the present here and now. More than that, she still did not recognize the pathway we were walking on, even though it was basically a circular one and we had made the trip around it no less than a half dozen times. When she asked, “Where does this path go?” I was struck that for the rest of us who have not lost any memory or cognitive functioning, we take so much for granted.

As I think about this visit, I am affected by all that it implies. There is so much we can lose in life, and so much we can also gain. What we each lose is different. For some, the loss is a limb, a breast, or the ability to walk. For others, the loss is a job, a home or even a child. Sadly, for many, loss is a combination of many things, including a limb, a job or a child. Which loss is the worst though? Obviously, any loss each of us suffers is the worst, because we are going through it. No one could possibly understand our personal loss, because that loss is not personal to them. One would think our empathy would increase for our fellow man in light of this knowledge, but somehow, our society has seen our empathy decrease, because we become selfish in the light of that loss. We refuse to see others and their understanding of what it is like to suffer a loss, and instead assume we ourselves need to be coddled and babied. No one could possibly understand, right?

Some say the loss happening with Alzheimer’s Disease is not the worst because, At least they are unaware of what is going on. On some level, that might be true.  But what happens when all cognitive abilities have ceased, and what is left is fear and uncertainty? Your limbs may be working, you can feed yourself, and you can still manage to go to the bathroom on your own, but you don’t recognize anyone, nothing is familiar and nothing makes sense? Would any of us want to be in that situation? Sometimes this notion of blissful unawareness is anything but blissful. And realistically, it is not a state of unawareness because we would be aware of one thing: fear. That’s not a state I want to be in for an extended period time.

Thankfully, my patient is not yet at that point. She still smiles, talks and can, for the most part, carry on a conversation. But I’m sure there are others in her residence who are not as lucky, and who are moving swiftly to the state of fear, losing all other abilities. My patient is my reminder that each of us lives in our own little bubble of the world, interacting with others minute by minute. I don’t want to continue to live in this bubble. I want to live in the larger world, seeing as much as I can and feeling as much as I can. And I want to recognize the differences between us as opportunities to come together and to get to know how we can be supportive of each other in our losses, whatever they may be. I don’t want to live my life blissfully unaware of those around me and their struggles. More often than not, seeing the struggles of another person brings perspective on how to get through the struggles in my own life. The bonus is, now I can be a comfort to someone who is coping with a loss of their own. So the best part of my day yesterday was realizing there is still hope for things to be better, one realization at a time.

A process is a process

Life’s lesson for today is simply this: Nothing is ever easy.

In my line of work, it stands to reason that things won’t be easy. The dying process is difficult, often messy, and something very few people look forward to. As someone supporting those in their final days, I am forever wondering how mine will play out. Not the faith part, nor the part where I end up in heaven, but the drudgery of dying. That is, assuming I do not die in a random accident of some sort or drop dead from a cardiac arrest, I imagine my decline will be typical that of millions of others: losing physical abilities, such as walking, toileting, eating, etc., and then eventually just becoming unresponsive and quietly taking my last breaths (with tons of pain medication on board of course!)

But amid all of that, there’s the practicality of it all. Where will I be when I die? What will my life’s circumstances be like at that time. Hell, we all think we’re going to be perfectly lucid, laughing and chatting it up with friends and family right before crawling into bed and falling into a peaceful sleep for all eternity. We’re all smoking something if we really believe that!

The dying process sucks!  It’s hard to do – both for the patient and for those who care about them. There should be dignity in death, just like there is dignity in beginning life. Yet, far too often, people die alone at home or in nursing homes, no family or friends visiting and only a random nurse checking on them every few hours. How many people are “discovered” to be dead, because no one had eyes on them at the time of their death?

I suppose it begs the question: If we (those of us who practice a faith) know where we are going to be in the end, does it matter the process of getting there? If our time in heaven is devoid of pain and suffering, do we remember the suffering we experienced on earth? And if we do remember it, isn’t that itself a form of suffering, which wouldn’t exist in heaven? Which means why or how could we possibly remember it?  Whoa, that’s a circle of chaos I don’t have the mental energy to contemplate at 9:30pm on a weeknight.

I can’t imagine we get to heaven any quicker if someone is by our bedside as we are dying and holding our hands as we breathe our last. So maybe the dying process isn’t so much for the person dying as it is for the people around them still living. For a good many of the people I have been with who are actively dying, they seem to be unaware of their surroundings and what is happening – even with their own behaviors. It is those around them who feel uncomfortable and talk about the person “suffering.” It really seems as if everyone else feels they are suffering, and the dying person is comfortable. That said, my lucid self has no desire to be actively dying, restless, in pain, and having difficulty breathing. (Again – more drugs please!)

I don’t know where I’m going with all of this. These are things I think about as I am spending time with my patients, specifically those who are actively dying and are not responsive. The dying process sucks, and our society seems to be trying to do everything it can to avoid it. (To which I laugh heartily because there hasn’t been anyone who’s avoided it yet!) I want to embrace it, whenever the process begins for me. I want to feel the emotions of knowing my loved ones will be left without me – the sadness and fear that brings, but I also want the overwhelming feeling of knowing I will be accepted into heaven and made whole again. That is the part that doesn’t suck, and that is the part that I try to show my patients every day.

Frustration and Outrage

You know what really grinds my gears? Wanting to go off about something, but knowing there’s no point because those on the receiving end of such outbursts will just not get it. Such was the case yesterday when, as I was driving from one patient to the next, I find myself behind a black SUV with temporary tags. This wasn’t a brand new vehicle, mind you, just one that seemed recently purchased as a used car. Nevertheless, I am behind said vehicle at a stop light, when all of a sudden, the passenger side window of the SUV rolls down and out flies a carryout bag and drink cup. Before I could stop myself, I’m screaming, “What the hell?!?”

The light changes and we continue on our way, me fuming, and the occupants of the SUV completely unaware of my rage. Now, I have to admit, there were more choice words shouted out in my car, as well as contemplation of widely known hand gestures, but I tempered myself before that literally got out of hand. As I zoomed around them in order to physically put them out of sight and hopefully out of mind, the trash-thrower-in-question just stared at me. We came to stop again, side-by-side at the next stop light, and thankfully, they then turned down another street.

I realized that, for the most part, my world is fairly simple. I choose to see my world as a positive one, where everyone is essentially good, until it is proven otherwise. I want to recognize the beauty God has created, despite the negativity constantly displayed both in person and on tv/movies/online. I guess that’s why I am so outraged when I see blatant stupidity rear it’s ugly head right in front of me. It causes me to ask myself: Am I in denial about the reality around me? Is the world actually a crappy place to be and I just choose to not see it? Do I have a right to be angry and outraged when I see something like this, or should I just resign myself to the fact that this is the world we live in and I need to get used to it?

So I’m interested in your thoughts. How do you choose to see the world – in a positive light with the occasional negative segment thrown in, or, that it’s all going down the drain and you’re just keeping your head down to get through it? When we ask ourselves these questions, I think it causes us to go deeper in search of our meaning on earth. What are we here to do? For those of us with a faith practice, what has God/our higher power placed us here to accomplish and/or be? I refuse to believe I am not supposed to see the good in others and to continue to try to make this world a better place using the gifts God has placed within me.

BUT…at present I do not have a frame of reference for what I am supposed to do when that goodness is challenged and the negativity appears. Biblical scripture tells us, “Whoever does not receive you, nor heed your words, as you go out of that house or that city, shake the dust off your feet,” (Matthew 10:14). These are words I do practice, but again, I question how I am supposed to feel in the wake leaving these situations. Is it right to be outraged? Should I shake my fist at the defiance of common decency and respect for what is right and good? More importantly, who am I to assume that I alone know what is right and good?

There is so much that is wrong with our world…from hunger, to disease, to terrorism, to abuse…the list goes on. I’ve often felt that, no matter how long we are on this earth, those things will continue and we will never eradicate them. Yet, I feel we must constantly try. I choose to fight for a better world, one that I can be proud of and one I know God had created for us. Sometimes my fight is in the form of doing for others and living up to my defining belief that “Whatever you did for the least of these, my brothers and sisters, you did for me,” (Matthew 25:40). And, sometimes it is in the form of outrage and venting on social media. Neither are perfect in their results, I know. But hell, if it all was perfect, I wouldn’t have anything to writer about, would I?

The Golden Ticket

I spent all day yesterday seeing patients, having conversation, listening to patients and families. But in the back of my mind throughout the day, I was thinking about my plans for the evening. Having children of high school age means personal time is spent ferrying them to their various activities and school obligations. With the springtime comes the spring musical the high school performs. This year, my son will participate in the musical, Sister Act. You know, the one about the nun who hides out in the convent to escape her mob boss boyfriend? If that doesn’t ring any bells, it’s the one based on the movie with Whoopie Goldberg, and she ends up transforming the nuns into a zippy choir. Anyway, that’s what our local high school has decided to present. I’m looking forward to see it, and my son is excited to be involved.

This weekend, though, both my niece an nephew are performing in their high school music, Willy Wonka, The Musical. Yes, it’s Willy Wonka and the Chocolate Factory come to stage, with all the bright colors and crazy Oompa Loompas. I was looking forward to seeing how it all came together, and I was not disappointed. There were a few technical glitches, as expected with a high school performance, but overall the kids did a wonderful job.

As I sat listening to song after song, watching my niece and nephew give it their all in the performance, I was struck by the innocence of it all. They were blissfully unaware of the difficulties life brings, the challenges they will face, and the eventuality of their own deaths. For them, their life is now, here, in the moment. They have no reason to worry about anything major, especially not while performing for an attentive audience.

Were we all like that at one time? And if we were, when did that feeling of blissful ignorance leave us? When did the day to day drudgery begin to overtake us and the weight of the world begin to matter? It seems, in my humble opinion, that we spend the first part of our lives just enjoying the beauty of the world and all God has provided for us. We spend our early and middle adulthood trying out best to keep our heads down and just get through each day without any crises. Then we come to the later years and we somehow come back full circle to a carefree “whatever happens, happens,” existence (notwithstanding the very end of life difficulties and actively dying). You know what I’m talking about…the zero filter comments that start with, “When I was your age…” and usually end with some derogatory comment about clothing that’s too tight or hair that’s too long, or attitude that isn’t respectful. Either that or the regular offering of opinions not asked for about things that are not their business. I’m sure we have all been on the receiving end of an older person’s “wisdom,” when they decide to tell you you’re not going to succeed at that job, or that new girlfriend is from the wrong side of the tracks. They don’t care what they say, because they have nothing to lose. They have lived their lives and nothing they say or do is going to turn back the clock and add years back to them.

So there I sit, listening to the Candy Man song, which asks, Who can make the sunrise, sprinkle it with dew, cover it in chocolate and a miracle or two, the Candy Man can. I see the bright young faces and dancing on the stage. I realize how wonderfully apropos this musical is for these kids. It’s all about sunrises, dew, chocolate and miracles – the best things life can give. And the Candy Man in our lives is the God who showers us with these blessings. How wonderful that we start our lives with carefree exuberance and at life’s end come back to another carefree existence. The true miracle though, is if we could learn how to make the middle just as enjoyable and carefree as the beginning and the end. That would be the veritable Golden Ticket Charlie Bucket found in the the musical. What a blessing that would be.