Tuesday, March 31, 2015

Pastel beyond the Pale

Saturday, my neighborhood had its annual Easter Egg Hunt; an event that seems to have less to do with the Christian holiday than it does with festivities in the Roman Coliseum. With the scream of the starting whistle, hundreds of children barreled toward the candy colored plastic eggs strewn haphazardly around an open field. Elbows flew, teeth were bared, hearts broken, hopes and fingers stomped. Within thirty seconds, a torrent of tears were streaming down children’s faces; a battle field of skinned knees, stolen treasures. What did they have to show for their efforts? Sugary candy and toys that posed choking hazards to children under three, all the kids were under three. As Easter Egg Hunts go it was a rousing success, and none of the pastel clad children seemed to mind that it was a balmy 31 degrees out and overcast. If you strip away the kids, and the toys, and the laughter, and the tears, you are left with eggs and bunnies; universal symbols of fertility and new life. The thing of it is, February sets records for its cold temperatures and March has continued this frosty trend. While the symbols spoke of new life, the world remained dead. No flowers have bloomed, grass is still brown and brittle, trees have yet to bud. This Easter Holiday confronted us with new life in a world still frozen in wintery gloom. But the kids didn’t mind. They knew spring is just around the corner. We who are caring for the dying spend our working days and nights in the winter; in the times where lives become barren. Each day we encounter and care for those whose potential on this earth is all but spent. For the loving, for the caring, which each of you are, this can be brutal. The winter of death can chill us to the bone. But there is a lesson in those children bounding over frozen ground after those eggs. With winter all around, they looked to the spring just out of view, the pastel beyond the pale, the feast that will mark the end of the famine. May we who stand by the bedside always live in the hope that even as death comes, it never comes alone. Just beyond the horizon, just coming into view is its constant traveling companion. The trees will bud again, the flowers will bloom again, because wherever death goes, new life is never far behind, and there is comfort in that. For more check out gracefulmournings.com
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Friday, March 27, 2015

Whispering to Ghosts

Sometimes early in the morning, my boy will wake up calm. He usually is far from calm, screaming and raddling his crib like a caged animal. But every so often he gently pulls his consciousness from sleeping to awake. During these rare occurrences, instead of crying out, he will start the day talking to himself. At eighteen months old, what he chooses to say is very interesting. Alone in his crib, he will list off a litany of the names of people he has met: Mommy, Daddy, Baba, Nana, Grandma, Grandpa, Shannon, Zack, Angela, Hope, Abbie, Max, Elmo, Ernie. Each day this list grows, and as every new person is added the list just gets longer. So far, nobody has dropped off. Lying in bed, while part of me just wishes he would just shut up so I could grab another minute or two of rest, I wonder why he does it. Why would a child, to whom the entire world is new and exciting, spend his time thinking about second cousins once removed who he met for a couple of minutes at a Bar-Be-Que? Some people will tell you children are born innocent. They are not, or at least my son wasn’t. But he is unsullied and uninfected with the cares and desires of this world. He has yet to be confined by societal pressures, or the dreams and cares of others. What he thinks about is his own, and what he chooses to think about is the people in his life. With the entire world stripped away, what matters most to the boy when he first wakes up, is the people in his life. In naming them, he somehow calls them back to himself. His tiny little bedroom is filled with memories of all his buddies. I might not say their names, but I have found myself doing the same thing with people who have long since went to the grave, people who made an impression in my heart and stamped themselves upon my soul through the alchemy of connection. I might not call out a litany of names like the boy, but even whispers in the spirit call them back. I miss them some times, Mary’s whit, Joe’s heart, Fran’s wisdom. Once and awhile I think we need to bring them back, to give the dead a place before our minds once more, to breathe life into the dry bones, and from that draw the strength continue to care for those still alive.
*Goggle Image Search

Tuesday, March 24, 2015

Working Their Way Out of the Dark

*Google image search When was the last time you watched the stars burn at night? Stood far out past the immaterial canopy of head lights, LEDS, and 60 watt bulbs? Out past the glow of the universe we have built for ourselves and held your gaze deep into the blackened world beyond that veil? The world where eternal points still burn. I rarely get the chance to see the stars, but when I do I watch them with the zeal of a convert. It is amazing how the longer a person looks at the sky allowing their eyes to adjust to the infinity of space, the more the brilliant points of light slither their way through the inky void and into perception. It is as if they know you’re looking. Ancient universes of indescribable power and beauty find a new home in the watching eye, given new birth in the gaze of the beholder, working their way out of the dark. In these moments, the night sky opens its gates and its treasures spill out. Truly looking at the life of another is not unlike gazing at the stars. Seeing past the clouds of ourselves and our hang ups, looking past the dark night of our prejudice and pain, our distractions and diversions to see the bits of beauty and light in another life poking through. What does it mean to be the last to see the simmering beauty of another life? The last to perceive the points of light that pierce the night sky of the dying’s existence. It is there in the revealed glow of another we meet the divine. In the light of the other, we touch that which is beyond ourselves. When we spend our time truly looking at the other, allowing the light of their life to tear the veil that separates us, when they enter our hearts, it is there we gaze on the very face of God, and our task becomes our blessing.

Monday, March 23, 2015

Moments and Monuments

Two men sat together as they often do, chatting. One had a lost a loved one but time had passed. Raw wounds had become jagged scars, searing pain had become a dull longing ache, an ache the man now knew would never leave him. This bereaved friend turned to the other, “I want to thank you,” he said. “For what?” his friend replied. “On the day she died, when I called you said: ‘I’ll be right there.’ It wasn’t so much that you came that mattered, it was words. At a time of complete confusion, you gave me something to count on.” The friend looked up, tears building in the rim of his eyes. “How do you remember what I said?” he asked. “Everything from that day is painted on my heart,” the bereaved replied. For the most part, human memory is a series of fading impressions and lingering senses. A nebulous cloud of information we draw on to pull the scattered past back together. Most memory is fraught with discrepancies and mistakes, more a haphazardly put together reproduction of hazy events than picture of true history. That is, except for those most painful parts of our lives. True trauma and tragedy is often marked by a perfect recall of the event, such that sentences spoken in haste can be recalled word for word years later. Talk to someone about the last breaths of their mother, spouse, child, not a second of that time will have slipped their mind, not an instant disappeared back into the ether. Though these captured instants happen at times of great strain and difficulty, they are often accented by words and deeds of astounding beauty and heroic care. These memories are etched forever on the walls of time. These moments become monuments; canvases stained forever with the pigments of pain, comfort, and of release, preserved for the ages. As we walk in these timeless lands, may we always be guided by love instead of fear, with bravery and with mercy. And in so doing, those instants will hang forever on the walls of the minds of those we have served, framed by pain and loss, but masterpieces of love and compassion nonetheless.

Thursday, March 19, 2015

Order of Service

On Sunday, as we always do, our remnant of the faithful gathered in a worn and old church. Faded glory and ancient wisdom hung thick in the air as the musicians played the meditation before service. Just as the music quieted and the preacher drew his breath to begin, the crash of two cars colliding outside the church rang through the sacred hall. Nobody was seriously injured in the accident, though the people involved were far from happy, and within a moment or two the police were on the scene. The church service had to continue, and so the hymns were sung accompanied by sirens as well as piano, red and blue flashes added to the flicker of candles and the jeweled rays of sunlight passed through stained glass. The chaos of the world slipped right into the order of the service. This could have been distracting, the holy spell of the temple broken by the profane world nudging through the door, but it wasn’t. The shrill screams of the sirens made the beauty in the melodies more pronounced. The chaos of flashing lights and raised voices made the peace and order of the service appear more fragile and more precious than it had before. Order added balance to the chaos outside and chaos added body and depth to the order of the service. A dying person is in the street, out at the accident, amongst the brokenness, the noise, and the fear. We show up among the dying with more than meds, more than strength, and more than skill. We bring expertise in the face the unknown, calm in the face of calamity, hope to confront disappear. We walk the dying from the chaos of illness into the sanctuary of care. It is there in that place where order and chaos, life and death bleed together. It is there that miracles happen. That is the place we are blessed to do our work.

Tuesday, March 17, 2015

The Smiling God

Can’t remember when, probably at some dusty market, I picked up an Icon of Jesus. It now hangs on the basement wall. In the painting, as in many icons, the Christian deity is kind-eyed and sourpussed. The serious face gazes out from the ten by five inch block of wood the image was painted on. I have been told the faithful of the Christian Orthodox church see icons as sacramental, as imbued with the spirit of God. That in some real way the painting on the wall is more than pigment and wood, but the very essence of Jesus. In some way, Jesus lives within the artwork. Bowing to her children’s demands, a woman who had lost her husband donated every stitch of clothing he owned within a week of his death, save one undershirt. It was tucked away in the corner of a drawer, neither the woman nor her children noticed it during their cleanse of the home. Worn threadbare, the shirt had been a point of gentle contention between the two. She told him to throw it away, she knew he never would. Today she sleeps in that shirt, because it is a close as she can get to lying next to him. We do not die whole. We leave pieces of ourselves scattered through worlds we have inhabited. Slivers of our souls have leached into old T-shirts, drops of our spirit left in ripped and worn copies of our favorite books, flashes of our very lives imprinted on old photographs. But the biggest portions of ourselves we leave in those we have known. Each of you who has cared for another now harbors pieces of them inside of you. We are homes for wandering souls. When I heard this woman’s story, I went home and took a look at that icon of Jesus. That sternfaced deity. I relaxed on the couch, turned on the music I like and once comfortable called back to mind the pieces of all those I have cared for and have left this world. They drew breath once more, if only in my mind. We sat together, and after some time I glanced up at the face on the icon and though it was impossible, and it only lasted a moment, the stern-faced God seemed to smile back. *Google image search

Friday, March 13, 2015

Lake Michigan Frozen

*Google image search
Walking by the banks of the great inland sea, away from the ramblings of lives in motion. To the right birch trees stand white and bear the bones of the earth jetting out in endless reaching. To the left the frozen waves, the stilled motion of the breakers held perpetually in a moment, clawing against the chaos. In the suspended instant, the world dances, spinning and struggling in since time immortal. A husband and wife, after sixty years of marriage, begin a new ritual of holding each other’s hands through the dark. They hope the grasp will keep the specter of death at bay during the night. A son throws himself on the body of his mother as life slips from her, holding her against the ceaseless pull of the inevitable. A mother returns to the hospital in the middle of the night hoping to hold the child who only took a single breath in this world. She holds the child, feeling for what life may be left in the tiny frame. Each holding on to a moment, each clawing against the chaos. To be human is to light and tend a candle in the ceaseless storm, to hold on to smoke, to make a moment stretch on forever. There is beauty uncomprehended in that hope and love without end. So if in the course of today or tomorrow you should come upon the dying or those tending to them and should you have the time, hold their hands, remain by their sides as they claw against the chaos. In doing so, you will be privy to true humanity and a precious frozen beauty.

Thursday, March 12, 2015

Breath

My kid had pneumonia. It made breath the first and last friend, the constant companion, that which quickened the dirt in the garden, a struggle to take in. It hurt him, it killed me. After the doctor’s visit, my dear wife took the kid home, and I went to the pharmacy to fill the prescriptions. I handed over the scripts and the pharmacist said it would be twenty minutes. Up until that point the day had been nothing but fear and rushing. Appointments were set up, schedules were adjusted, a child was watched with an unblinking eye. But then for twenty minutes I had nothing to do but wander around the brightly-lit store. I looked at items I would never buy, and thought thoughts that weren’t about life or death. It was beautiful. In that wandering there was comfort. When the order was finished the pharmacist handed me the medications in a brown paper bag. Taking it in my hand, I felt its material. I heard the crunch of the paper, and I was immediately transported to childhood, carried back to days of taking my lunch to school, it contents not albuterol and antibiotics, but peanut butter and hostess cupcakes. For an instant my senses brought me to a time without worries and fears. In that escape there was comfort. Eventually, my mind wandered to the contents of the bag. Medications, little tablets and vials of solutions, each proves the existence of illness and the pain that comes with it. Each pointing to the hope that the pain can be healed, that the horror can be kept at bay. In that hope there was comfort. My fears were largely unwarranted, the concerns of a newish dad thinking the worst. They were fears none-the-less, and that twenty minutes to wander, that brown paper bag, and those medications were comforts. Those in fear for the health and the life of their loved ones, caught up in the midst of a crisis do not experience the worry as a momentary thing. They are awash in it, buried under the swells of terrible thoughts half thought and the heaviest of worries. For them any reprieve from the pain is no small thing, it is the greatest of gift. Today give that gift. Allow all those who are worn out to wander from the bedside and realize that the world is larger than the sick room. Give them an instant to escape their fears. Take over the worry, and they can breathe again. Give them a hope for peace and an end to suffering. In doing so, you will add some comfort to this world. That is precious and a beautiful thing.

Wednesday, March 11, 2015

Mourner’s Song

Some cultures demand it, others shudder to hear it. Some see it as a measure of the love lost, others as weakness. I can’t recall the first time I heard it. I don’t remember the dead, don’t remember the family, the place, or the time of day. It must have been in the hospital, outside of some room where the specter of death had just passed. I do remember the sound, the first hearing of a song sung a million times, always heard different and always absolutely the same the mourner’s song, the cry of someone who has lost another. The gut wrenching call of those who have had a piece of themselves ripped from their being and from this world. For some it is a loud guttural response loud enough to be heard through closed doors and around corners. For others the mourning song is something more internal, a soft cry, or perhaps relieved laughter. Whether it is screamed out for all to hear, or a dirge played for an audience of one in the theater of the heart, the mourner always sings. Mourning is nothing more than a love song without a melody, the arraignment of a life lost played in one cacophonous instant. The love that has lost its object demands a body, and it takes it shape in the sounds of mourning. Just like all of death, the mourner’s song can be something ugly, something hard to hear and frightening. It can be difficult to dwell in that place with the mourner, even harder to do it day in and day out. But there is more to the mourner’s cry than the ugly. Beauty can be found there. The mourner’s song is built on notes of laughter as much as tears, on love as much as loss, on joy as much as pain. Any song worth singing, any tune worth playing is buried somewhere in the mourner’s call, and in that way the song of the mourner can be the most beautiful of music.

One in a billion

One in a billion As I understand it, and I understand it poorly, we, this, all that is and all that ever will be, is the result of imperfection. Matter is born of heat and light. All matter was born with a twin. For every drop, every ounce of matter, a drop and an ounce of antimatter was created. And since the dawn of time there was sibling rivalry such that matter and antimatter when they touch they destroy each other. If the laws of physics were perfect, if the universe were symmetrical and uniform, then as quick as the universe could give birth to matter it would mourn its death. Nothing would be left, but as it turns out for every billion pieces of antimatter created there is a billion and one pieces of matter created. In other words the universe is imperfect and because of that we exist. Each of us is one in a billion. We are the left over, the aggregate result of the imperfect laws of physics. Bob was imperfect, the son of a patient. Bob was not a strong man or a smart man. By many standards his life had been a failure; a string of jobs begun and lost, a grown man living at home with his mom, he had few friends and little to show for himself. Bob cared for his dying mother, a task which had seemed beyond his capacities. She was older but not small, she suffered from pain and respiratory distress. She needed help with bathing and toileting. Even for those with training and strength, the task of caring for a dying person is a struggle. It seemed Bob didn’t have it in him, that he was too imperfect for the task. Nancy was an RN assigned to the case, and her vision was bigger than most. Where others would have seen only the imperfections, she saw unique strengths, where others would see only the failure, she saw the potential. Nancy saw in Bob’s strength and imperfections the building blocks of a caregiver. With thought and patience, Nancy built Bob up. Bob’s mother died peacefully in her home, with the best of care given by her own son. After the grief and the time, Bob was a different man. He had pride in the care he had given; he found meaning in the love that he showed. From that day on Bob was stronger, more confident. Through Nancy’s help and the care he gave, Bob found his worth even in his imperfection. From then on Bob recognized that he is like the rest of us one in a billion, and new life was born out of death. That too is a miracle. *All names have been changed.

Tuesday, March 10, 2015

Pilgrims

This weekend my wife and I moved our kid form his crib to a big boy bed. The move was not well received. To the little guy, the bars of the crib were a comfort, something he could rely on to hold him up, to keep him safe as he slumbered, something he could depend on. Taking away his crib, while necessary, cut into his comfort, pared back his safety, removed a sliver of his trust in this world. Perhaps a first step on a road that can and often does lead to distrust and cynicism. We are born dependent. Reliant on our caregivers for all things. It’s a good thing babies don’t know anything of the world they enter. It’s a good thing that my son was ignorant to the fact his crib was some cheap off brand contraption, put together in haste by his father who is about as handy as a gold fish. More than the bed, it’s a good thing my son was born with no inkling of how petty I can be, how lazy and selfish. If he knew, how could he depend on me? If babies were born with a working knowledge of human weakness, childhood would be a terror of dependence without comfort, need without trust. It’s a good thing children are ignorant of human frailty, our patients are not. It is an audacious thing we ask of them. These newly dependent people, from whom freedom and strength has been stolen. We ask them, not innocent children, but seasoned adults, often adults who have faced down the horrors of a normal life and the pain of a terminal illness to depend on us, people who they have never met before, and what’s more amazing is they do. We are welcomed as honored guests into strangers’ homes. The world, with all its problems, gives us little reason to trust the other, and so there is a touch of the divine and a hint of miracle in the way our patients and families receive us. Today, may we walk in reverence as pilgrims on holy ground, as servants at the temple of the bedside, and know the honor of being entrusted with another’s life and with another’s death.

Friday, March 6, 2015

The Loud Speaker Dirge

The overhead speaker at a hospital sings. Its song is of life and death. It can rush staff to a stopped heart when calling out its codes, and it can warm hearts still beating when it plays that little nursery rhyme jingle at every birth. The speaker reminds us that within slivers of time and moments of space lives begin and lives end. I had a patient named John. He was the kind of guy you either loved or hated, most hated. He was gruff and sarcastic, hilarious and often mean. Years of disease wrapped a barbed wire around his tender heart. He struggled with illness for what seemed like ages, and for ages John drove everyone around him nuts. That is, until his grandson was born. The birth of the child did not extend John’s life. No, the 52-year old died three months later. The birth of this child did, however, allow John to die peacefully. This child, this squirming little ball of neediness and love, let John know, in unbroken flesh, that there was more to life than his death. After the birth, John’s anger gave way to gratitude, cruelty to kindness. John was a man without any faith, but the birth of this child gave his last days meaning. The new life that entered this world allowed John to leave it. Life itself opened the door for John to die well. If we leave out the great by and by, set aside notions of what comes after this world, all we are left with is the hospital speakers. The call to attend the dying and the encouragement to rejoice at new birth. For John and perhaps for all of us, that is enough. So when our task grows hard, when it seems the only song that plays is the funeral dirge, may we remember that somewhere hospital speakers are playing their happy little jingle. There is always new life.