I was talking to my dad the other day and he was telling me about my little sister, Jamie, who is seven years old. This was the story he told me:
"Well, the big trauma last night was that her slinky got tangled, and she couldn't get it untangled. So I helped her, and then it was kind of deformed. So then she was crying and crying and, part of the problem is, Jamie kind of thinks the slinky is alive. And I can't blame her, because I kind of put that idea in her head. I talk to the slinky, ask it what it wants for dinner, tuck it into bed... So I think we're going to have to euthanize the slinky."
Saturday, October 25, 2008
Tuesday, October 21, 2008
Anonymity at the gym
I know, posting twice in a day, it's wild! I was thinking some other deep thoughts today and just had to share them.
Such as, I LOVE not knowing anyone at the gym. If the lady who takes my gym card at 6 in the morning had a personal relationship with me, she would probably say, "Hey Sara, you kind of look like crap this morning. Maybe you need more sleep...or makeup...or a brush or something but um, I would be embarrassed if I looked like you right now, so quick, sneak out before anyone sees you." I can't tell you how happy it makes me to suffer through my 15 minutes on the treadmill (because, for some reason, I can fully run a half marathon but only make it for 15 minutes on the treadmill - IT'S ALL MENTAL), stretch, lift my very light weights, and then take a shower and endure the few awkward naked minutes in the locker room, without seeing one single person I know. So happy! Because then no one has to know that I am a total wuss at the gym! No one cared enough to notice that I only ran for 15 minutes! Except that I just revealed it. Crap.
Such as, I LOVE not knowing anyone at the gym. If the lady who takes my gym card at 6 in the morning had a personal relationship with me, she would probably say, "Hey Sara, you kind of look like crap this morning. Maybe you need more sleep...or makeup...or a brush or something but um, I would be embarrassed if I looked like you right now, so quick, sneak out before anyone sees you." I can't tell you how happy it makes me to suffer through my 15 minutes on the treadmill (because, for some reason, I can fully run a half marathon but only make it for 15 minutes on the treadmill - IT'S ALL MENTAL), stretch, lift my very light weights, and then take a shower and endure the few awkward naked minutes in the locker room, without seeing one single person I know. So happy! Because then no one has to know that I am a total wuss at the gym! No one cared enough to notice that I only ran for 15 minutes! Except that I just revealed it. Crap.
"Optimist."
Ok, so I know that the second to last post was a little bit of a downer, but thanks for reading and hearing me out on a tough day anyway. I can't stress enough though that working with kids was actually more emotionally draining for me than this job. People tell me thank you, for example. Or, "Talking to you helped me feel better." The other day a patient's wife (who is so cute and I wish I could make her my adopted grandma) even gave me a hug and said, "I love you!" No, I love you! How sweet is that?
Anyway, I hope that this post doesn't end up being a downer, because it's not meant to me, but a really interesting thing happened today that I thought was blogworthy. Actually, events started to unfold yesterday when I was talking to one of our patients, a really sweet 80-year-old man who would have me write my name down in his notebook every time I saw him so that he could remember my name. I asked him how he was and he said he was thinking that he would be headed to the "great beyond" soon, and that he didn't have much time left.
Now, a week ago in lecture (the psychology fellow and I go to a lecture every week) the nurse practicioner was teaching us about the last 48 hours of life, and said that people often seem to know when they are about to die and will sometimes talk about it. Sometimes if they are delirious, they might make reference to dying in obscure ways, like saying that they're "waiting in line", or trying to "get on the train".
So, when this patient started talking to me this way I paid attention. I said, "What's making you feel that you are getting close?" He said that he was feeling very sick, and he had been confused a lot that day, and just felt that it was time. He even asked for the telephone and his phone book so that he could call his relatives and say goodbye. He also asked to see the Chaplain, which I arranged. He told the Chaplain the same things he had told me, and said that he was not afraid of dying and that God had helped him his whole life. After talking with him, I said, "I'll see you tomorrow." He just snickered and said, "Optimist."
This morning when I got into work I checked our roster to see if he was still alive. He was! Oh good, I thought, maybe he was just having a bad day. I went to say hi in the morning but he was sleeping. Later this afternoon, about a half hour before I was off work, I was working on some notes and just had a thought that I should go check on him and joke that I had been right, I would see him today! I walked down the hall and my supervisor and a CNA were there, and they said, "Oh, did you hear? Mr. So-and-so just died." My supervisor and I went into his room and said goodbye to him, and I reminded the nurses that he kept his wallet in his pillowcase, and that was that. He was gone, and he had known the day before.
I guess I felt privileged though that he could share that knowledge with me. He had not been a patient that liked to make idle conversation, so I wouldn't usually go in to talk to him unless I had a specific purpose. I didn't have one yesterday, but he called for me as I was walking by and asked me to hand him his phone book, telephone, and re-hide his wallet. When he told me that he thought he was at the end, I pulled a chair over and sat next to him. He said, "Oh, you don't mind sitting down for a little while?" I told him no and that's how we were able to have this conversation.
In my last semester in grad school I took a "Death and Dying" class, which is how I became interested in palliative care in the first place. I used to get so frustrated with the teacher for not being more specific about how he would work with the patients and what exactly he would say, as if there were some magic formulas. His big emphasis was that it was most important for the patient and their family to feel that you are present with them. I thought, "Thank you for taking my out-of-state tuition and giving me a lame social work term rather than some actual models and interventions." I have really found that to be so true, as silly as it probably sounds. I should probably email him and apologize for rolling my eyes every time he said that. Anyway, like I said, hopefully that wasn't a downer because it was actually a positive experience for me, very special.
Anyway, I hope that this post doesn't end up being a downer, because it's not meant to me, but a really interesting thing happened today that I thought was blogworthy. Actually, events started to unfold yesterday when I was talking to one of our patients, a really sweet 80-year-old man who would have me write my name down in his notebook every time I saw him so that he could remember my name. I asked him how he was and he said he was thinking that he would be headed to the "great beyond" soon, and that he didn't have much time left.
Now, a week ago in lecture (the psychology fellow and I go to a lecture every week) the nurse practicioner was teaching us about the last 48 hours of life, and said that people often seem to know when they are about to die and will sometimes talk about it. Sometimes if they are delirious, they might make reference to dying in obscure ways, like saying that they're "waiting in line", or trying to "get on the train".
So, when this patient started talking to me this way I paid attention. I said, "What's making you feel that you are getting close?" He said that he was feeling very sick, and he had been confused a lot that day, and just felt that it was time. He even asked for the telephone and his phone book so that he could call his relatives and say goodbye. He also asked to see the Chaplain, which I arranged. He told the Chaplain the same things he had told me, and said that he was not afraid of dying and that God had helped him his whole life. After talking with him, I said, "I'll see you tomorrow." He just snickered and said, "Optimist."
This morning when I got into work I checked our roster to see if he was still alive. He was! Oh good, I thought, maybe he was just having a bad day. I went to say hi in the morning but he was sleeping. Later this afternoon, about a half hour before I was off work, I was working on some notes and just had a thought that I should go check on him and joke that I had been right, I would see him today! I walked down the hall and my supervisor and a CNA were there, and they said, "Oh, did you hear? Mr. So-and-so just died." My supervisor and I went into his room and said goodbye to him, and I reminded the nurses that he kept his wallet in his pillowcase, and that was that. He was gone, and he had known the day before.
I guess I felt privileged though that he could share that knowledge with me. He had not been a patient that liked to make idle conversation, so I wouldn't usually go in to talk to him unless I had a specific purpose. I didn't have one yesterday, but he called for me as I was walking by and asked me to hand him his phone book, telephone, and re-hide his wallet. When he told me that he thought he was at the end, I pulled a chair over and sat next to him. He said, "Oh, you don't mind sitting down for a little while?" I told him no and that's how we were able to have this conversation.
In my last semester in grad school I took a "Death and Dying" class, which is how I became interested in palliative care in the first place. I used to get so frustrated with the teacher for not being more specific about how he would work with the patients and what exactly he would say, as if there were some magic formulas. His big emphasis was that it was most important for the patient and their family to feel that you are present with them. I thought, "Thank you for taking my out-of-state tuition and giving me a lame social work term rather than some actual models and interventions." I have really found that to be so true, as silly as it probably sounds. I should probably email him and apologize for rolling my eyes every time he said that. Anyway, like I said, hopefully that wasn't a downer because it was actually a positive experience for me, very special.
Monday, October 13, 2008
What a dork
I totally drove into my garage with my bike on the bike rack on Saturday. I think my bike is ok, but I haven't recovered enough yet to actually check too closely. Definitely the bike rack is not ok. My car is ok...
Feelings of self-loathing...
Feelings of self-loathing...
Wednesday, October 8, 2008
All in a day's work...
Today we had a patient die.
Yesterday we had a patient die.
Another died over the weekend.
I talk to at least one very distraught, crying person every day.
I hope I am being a comfort. I hope that just by listening and being there for people, and helping them get unpleasant tasks out of the way, that I am accomplishing something.
But you know what? Death and illness and losing your independence, or your spouse, or your dad, or your role at home...these are hard things. I have seen a very tough older man cry when telling me that he can't mow the lawn at his church anymore because of his cancer. For all the times that we are frustrated that we have yet another chore to do around the house, at least we can do it!
Today I was talking to a older guy who is a little gruff around the edges, but very funny and sarcastic. He was telling me that it was depressing for him to be in the hospital at this time of year because he would usually go to the woods in northern Wisconsin and spend lots of time outdoors, hunting and hiking. He told me about a time that he was standing next to a tree, partially hidden, in the woods, and a wolf walked about 5 feet in front of him and never saw him. He said it was an amazing experience. It's always interesting to me to hear what life stories stand out for our patients when they are having to face their own death.
It's easy to forget that the elderly were once like Tim and I are now: young, healthy, strong, very independent, full of hope and dreams of the future.
You never envision your future with illness, loss, isolation, loneliness, or bitterness as part of it.
This job is teaching me to keep the perspective that none of us are immune from life's trials, as much as we would like to insulate ourselves. The only way that I can see to prepare for the tough times is to do so spiritually. Through prayer, and asking forgiveness, from God and from others, by going to church and to the temple, by reading the scriptures and serving, even serving those that make you uncomfortable. These are all areas that I can always improve in, that's for sure. And maybe by letting the little things slide? By choosing not to be offended and to cherish those relationships, even those that are difficult to maintain. I also want to be so much more appreciative, and to let my loved ones know that I am thankful for them.
These are just some of the things that I am learning in this fellowship. Clearly Heavenly Father had a reason for putting me at the VA, at this time in my life.
A couple more things:
1. Talk with people you love about how you want to die. It sounds morbid, but it's not going to get easier in the event that you are actually dying, so let them know now.
2. Make your advance directive. The most important part is where you designate your health care power of attorney. This is the person who would make decisions for you about your health care should you become incapacitated. It happens! And doctors DO NOT like making decisions for patients that are non-decisional. Also, if there is an option on the advance directive regarding nursing home placement or community based residential facilities (think assisted living), think about it before checking that you don't want your health care agent to be able to place you in one! People are living longer and taking longer to die from chronic illnesses. It can be very difficult to maintain someone in your home if they require full care. Home hospice (at least in WI) is only there to SUPPORT the caregiver. They are not there to do much of the tough stuff of caregiving.
3. If you are in a position to save money, or if you have money and assets (I am not there yet!), put money aside for your funeral and burial costs. It is hella expensive! And I see so many families that have to worry about, "How are we going to afford to bury Dad". Make a will. Designate a financial power of attorney. This is a separate document from your health care power of attorney. And it is only good while you are alive, so you will want to make important people in your life either joint account holders with you, or arrange for them to receive your money in your bank account upon your death. If they're not on your account, if it's not spelled out in your will, things get sticky (again, at least here in WI-things may vary state to state).
Well, thanks for letting me share these things with you. I'm hoping that this job will help me learn some important things now rather than later.
Yesterday we had a patient die.
Another died over the weekend.
I talk to at least one very distraught, crying person every day.
I hope I am being a comfort. I hope that just by listening and being there for people, and helping them get unpleasant tasks out of the way, that I am accomplishing something.
But you know what? Death and illness and losing your independence, or your spouse, or your dad, or your role at home...these are hard things. I have seen a very tough older man cry when telling me that he can't mow the lawn at his church anymore because of his cancer. For all the times that we are frustrated that we have yet another chore to do around the house, at least we can do it!
Today I was talking to a older guy who is a little gruff around the edges, but very funny and sarcastic. He was telling me that it was depressing for him to be in the hospital at this time of year because he would usually go to the woods in northern Wisconsin and spend lots of time outdoors, hunting and hiking. He told me about a time that he was standing next to a tree, partially hidden, in the woods, and a wolf walked about 5 feet in front of him and never saw him. He said it was an amazing experience. It's always interesting to me to hear what life stories stand out for our patients when they are having to face their own death.
It's easy to forget that the elderly were once like Tim and I are now: young, healthy, strong, very independent, full of hope and dreams of the future.
You never envision your future with illness, loss, isolation, loneliness, or bitterness as part of it.
This job is teaching me to keep the perspective that none of us are immune from life's trials, as much as we would like to insulate ourselves. The only way that I can see to prepare for the tough times is to do so spiritually. Through prayer, and asking forgiveness, from God and from others, by going to church and to the temple, by reading the scriptures and serving, even serving those that make you uncomfortable. These are all areas that I can always improve in, that's for sure. And maybe by letting the little things slide? By choosing not to be offended and to cherish those relationships, even those that are difficult to maintain. I also want to be so much more appreciative, and to let my loved ones know that I am thankful for them.
These are just some of the things that I am learning in this fellowship. Clearly Heavenly Father had a reason for putting me at the VA, at this time in my life.
A couple more things:
1. Talk with people you love about how you want to die. It sounds morbid, but it's not going to get easier in the event that you are actually dying, so let them know now.
2. Make your advance directive. The most important part is where you designate your health care power of attorney. This is the person who would make decisions for you about your health care should you become incapacitated. It happens! And doctors DO NOT like making decisions for patients that are non-decisional. Also, if there is an option on the advance directive regarding nursing home placement or community based residential facilities (think assisted living), think about it before checking that you don't want your health care agent to be able to place you in one! People are living longer and taking longer to die from chronic illnesses. It can be very difficult to maintain someone in your home if they require full care. Home hospice (at least in WI) is only there to SUPPORT the caregiver. They are not there to do much of the tough stuff of caregiving.
3. If you are in a position to save money, or if you have money and assets (I am not there yet!), put money aside for your funeral and burial costs. It is hella expensive! And I see so many families that have to worry about, "How are we going to afford to bury Dad". Make a will. Designate a financial power of attorney. This is a separate document from your health care power of attorney. And it is only good while you are alive, so you will want to make important people in your life either joint account holders with you, or arrange for them to receive your money in your bank account upon your death. If they're not on your account, if it's not spelled out in your will, things get sticky (again, at least here in WI-things may vary state to state).
Well, thanks for letting me share these things with you. I'm hoping that this job will help me learn some important things now rather than later.
Monday, September 29, 2008
This is the face of a cold-hearted killer
Giselle, our cat, has been busy murdering small animals this summer. She kills with no remorse, and I think she even likes it when the mice fight back a little bit before she deals the death blow. Apparently all of the bloodshed has led to some gastric upset for our kitty, as the other day she puked on our couch. Under the pretense of having to rush to work, I made Tim clean it up (but really, Tim, I had to get to work) and as he was doing so, he says, "You're not going to believe this, but there's part of an earthworm in here, and it's still moving." Which reminded me of the bird that swallowed the spider that wriggled and tickled inside her...perhaps my cat will die.
The other day as we were apologizing to our next door neighbor for the headless rat he found in his yard, he said, "It's ok, we don't have mice!" And Tim said, "Or birds!"
What a little killer.
Thursday, September 25, 2008
Climbing Mt. Everest
Ok, just kidding, we did hike Half Dome in Yosemite though. And it was like my own personal Everest.
Not because it was an 18 mile hike. Not because it took 10 1/2 hours, and my toes hurt the whole way down. And not because I got ridiculously sweaty, like in the picture below.
It was because I had to conquer these horrible things. These are the cables that take you up to the top of Half Dome. Let me give you a description of the cables from our book, "One Best Hike - Yosemite's Half Dome": "The cables are multi-stranded steel, about 1 inch in diameter... They are attached to 3-foot stanchion poles and resemble a banister. The poles rest in holes drilled into the rock. Note that I said "rest". They will come out if you pull up on them... At the base of every pole pair is a long two-inch-by-four-inch piece of wood placed perpendicular to the path. This allows you to stand every 10 feet and take a rest." Oh PS you are hiking up and down at a 45-degree angle. Here's another favorite quote from the book, "Be advised that although it has seldom happened, people have fallen to their deaths by slipping from the cables. A 2000-foot drop looms not far from the cables." Well friends, I have a small but intense fear of heights, and as I was coming down these cables, I slipped, and for a moment was on the outside of the cables. On sheer granite. With a looming 2000-foot drop. Needless to say I fully embarassed myself by saying, "Help me!", at which point a kindly Brit grabbed me, and then I proceeded to cry hysterically for what seemed like a long time.
Look at these great pictures we got at the top though!
Totally worth a near death experience. Almost.
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