Saturday, December 31, 2005

Expanding Love at Year's End

On this New Year's Eve morning, I am visited by the words of His Holiness The Dalai Lama, from his new book, "How To Expand Love". In the maelstrom of corporeal life, sometimes well-timed words can cut through the noise with incisive clarity. May these words inform my next year of living.

Now that you have attained this auspicious life form so unique among the myriad forms born into this world, it is important that you do not waste it.

Meditation:

1. Reflect on the potential of your current situation for spiritual growth: you have a human body; spiritual teachings are available in your environment; you have the mental capacity to internalize spiritual teachings---you have pure diamond mind.

2. Value the current opportunity for spiritual practice.

3. Set as your motivation a wish to help not only yourself but all beings.

4. Aim to help others.

Simple but straightforward words which speak to me on the deepest level, underscoring my feelings about the reasons to live a good life. His Holiness The Dalai Lama and Mother Teresa of Calcutta speak to me most clearly, supporting the raison d'etre that permeates my world: humble service to the well-being of others.

Happy New Year to all, and to all a good year. May all beings be free from suffering.

Friday, December 30, 2005

Drawing to a Close

We drank champagne at work today. The masses clamored for the office to shut down early and our boss relented, even though he was planning to let us all go early anyway, just like he did last Friday, the day before Christmas Eve. The corks popped, we drank a toast, and the lights were turned off, leaving the last twelve months of love and labor behind us.

The turning of the year often naturally predisposes one to reflection and review. More than eighty people have been under my care this year, several dying quite peaceful deaths while surrounded by loving family and friends. The year also saw relapses and remissions of addiction, domestic violence, divorce, recovery from alcoholism, resurgence of cancer, improved health, and continued chronic physical and psychiatric illnesses. With so many patients, I can't say that everyone is better or worse---there is a continuum of recovery and rehabilitation, and they all find a different place along its trajectory, that place often changing from day to day.

Professionally, it's been a year of proving my mettle (to no one other than myself) and holding my own, often putting in more hours than I might like in a given week. More and more, the management of information has become part and parcel of my job, something they never really mentioned in nursing school. Still, I feel good about what I've been able to accomplish, the care I've given, the lives I've been able to touch, the students I've guided and laughed with.

Reflecting further, I also recognize certain skills and areas of assessment that I would like to develop: neurological assessment; cardiac assessment; further improvement of my Spanish, especially in relation to psychosocial counseling

I could go on, but it's just too uninteresting.

On the other work-front, I now have a three-week break from teaching---also known as stuffing the minds of nascent nurses with too many facts and potential scenarios. One more semester, and I plan to retire from my stint as college professor, glad to have learned that I can do it, and glad (in some ways) to leave it behind me.

Anyway, life at work evolves and shifts, but also remains quite constant. The basic calculations are the same, the cast changes from time to time, but the underlying feeling is continuous, and these three-day weekends? They're priceless. What is one golden lesson learned? Self-care is paramount. A sick and depressed caregiver is no use to anyone in this world.

Here's to another year of satisfying work, and continued gratitude for the luxury and blessing of having such work to fulfill myself and my place in the scheme of human endeavor.

Thursday, December 29, 2005

Poetry Spam

You've heard of poetry jams, now we have Poetry Spam. The spam email just keeps arriving in our inbox, and today was a new manifestation---no link to click, no ruse to ask me to update my account and password on some bogus website that looks like PayPal--it was simply a "word salad" (a psychiatric term used to describe the seemingly nonsensical verbiage of a person experiencing active psychosis). These emails may be maddening, but some are just downright entertaining.

To wit, here it is, in all of its raw and unedited glory, from my inbox to your optic nerve:

"cationic emulsion eminent evade oklahoma hunt cornelius moire exeter cone
inelastic lying colonnade fictive trompe aluminate antagonistic skat seton
trivial megabit continuation avow albrecht ethnic careful erasable department
liqueur metalwork crucial blasphemy dichondra gamecock shrike wrack kernel
bisque astigmatism bahrein barb miocene jumpy audit manipulate stubborn
simpleton egalitarian boron arnold corrode hick vine chub alcoholism eocene
bittern trivium fmc"


Nonsensical word salad or coded dispatch from the cyber-spiritual realm? The words which shout at me are inelastic, antagonistic, megabit, albrecht, blasphemy, simpleton, egalitarian, arnold, alcoholism. Taking those words and stringing them together, I devise the following:

"Employing inelastic antagonistic megabits of information, Albrecht's blasphemy---as a coarse and unschooled simpleton---was to thwart the egalitarian and chivalrous Arnold in his unrivaled demise towards wanton alcoholism."

So if you, dear Reader, are moved to try your hand at such blogorrheic wordplay, please comment below and post your own story using the words provided above. For this blogger so recently plagued with blogstipation, this email was a Goddess-send vis-a-vis being fodder for today's rather paltry entry.

A tout a l'heure.

Wednesday, December 28, 2005

Blogstipation

noun. To be unable to think of anything to blog about, i.e. writer's block for bloggers.

---as found on Samizdata.net

Monday, December 26, 2005

Our Son Also Rises

Our boy is home, arriving in a driving rain on Christmas night at 10pm by bus from Boston. Lovely memories of holidays past come to mind, and we settle into peaceful co-existence in the house once more---at least for a few days, anyway, before he returns to his adult and responsible life. Even the dogs seem more relaxed now that the pack is all together again.

A small but thoughtful gift exchange, relaxed lunch, a game of Scrabble with the grandparents---my parents---who are here for the long holiday weekend. Now he and Mary are both napping upstairs in their respective beds---I'm not sure which room the dogs have chosen to be in. Must be a difficult decision for them to make......

Sadly, I must return to work tomorrow while mother and son play and carouse, but I'll look forward to family evenings at home, leaving work as early as possible each night.

May all beings have an opportunity to know this feeling of familial warmth and well-being that currently permeates our silent home on a winter's evening.

Friday, December 23, 2005

Paradox

I use this quote by Mother Teresa as the "signature" on my email account...

"I have found the paradox that if I love until it hurts, there is no hurt, only more love."

What more can I say on the eve of Christmas Eve?

Tuesday, December 20, 2005

Extremophiles

Listening the other day to a radio show about "extremophiles"---organisms that live in extreme conditions (ie: bacteria that live in ice or in thermal oceanic heat vents)---I was moved to consider examples of human extremophiles.

Aside from the Inuits, the inhabitants of bleakest Siberia, desert nomads, and people who live at immensely high elevations, I was actually thinking of those who subsist and exist on the fringes of society:

Transgendered people live in what might be called extreme conditions, trying to live in a society where gender identity and gender roles are tightly held and adhered to by the majority.

Married gay people in Massachusetts live in a world wherein their legal rights as married people hold no weight once they cross the border into neighboring states. That said, unmarried gay and lesbian couples who share child-rearing, intimate connection, and financial commitment live in an extreme environment of injustice every day in countries all over the world.

The homeless are extremophiles extraordinaire, living on the literal fringes of society and culture, some by choice, others by virtue of untreated mental illness and sociopolitical apathy.

In the garbage dumps of Phnom Penh, Brazil,Mexico and beyond, hoards of children live in extreme poverty, subsisting from the sale or re-use of the wider society's detritus. Among this flotsam and jetsam they also find malaria, tuberculosis, HIV, hepatitis, cholera, typhus, and infected wounds which go untreated due to the lack of medical care and societal will to face the atrocity of families living in garbage dumps around the world.

Numerous people live without access to healthcare, clean water, and healthy soil. African-Americans in the United States are 80% more likely to live in an area affected by toxic waste and carcinogenic pollution, according to a recently published report by the EPA. Many African women still live with the nightmare of forced prostitution and ritual genital mutilation. If that's not extreme, I don't know what is.

The list goes on.

Some of you might think, "Oh, here he goes again, blabbing on about those less fortunate, dripping with bleeding-heart-liberal-white-guilt." That may be true, but it's a dirty job and someone has to do it. Often the ones who call people's attention to such things are shot down or otherwise castigated, since others ofen don't want to be reminded of such things, especially when in the midst of rampantly conspicuous consumption. I don't mind taking that risk, and if one person thinks more keenly about these issues as a result of reading this, then it's worth the writing.

There are many extremes, including extremes of always thinking about those less fortunate, and perhaps I suffer from that particular affliction. Be that as it may, my mind will often wander down the paths and alleys frequented by the spirits of the downtrodden and disenfranchised, and that's something I have grown to accept and embrace in myself, while also striving to assuage those feelings with acknowledgement of all of the good will that exists in the world.

At this time of abundance and consumerist fantasy run amok, it can only serve the conscience to remember what lies beyond those golden gates of extreme affluence.

Monday, December 19, 2005

O! Merciful Monday!

The week begins, not with a roar, but with a relative hum. While some of the usual suspects surfaced as expected, the intensity of said surfacing was subdued. Is it the coming of the holiday season? I would think not---things usually heat up about now. Let's just say it was a day in which there was room to breathe and think clearly. Any day like that is worth exulting over.

That said, the usual holiday and winter-time mood shifts are also making themselves known. Financial stressors, winter's tightening grip, and the shortening days all take their toll, but the coming Solstice actually signals the beginning of the (slow but steady) return of the light, the sun going down 30-60 seconds later each day after December 21st, taking us all the way to the heady days of late June's summer cauldron. But I digress in thinking of the more verdant times ahead....

Today I did what any prudent Nurse Care Manager would do: a patient has difficulty waking up early enough to shuffle her school-age children off to school, so I bought her an alarm-clock in the guise of a Christmas present. It was accompanied by toys for the kids as well, and I explained that the clock is actually a gift for the kids, although they would much rather oversleep and miss as much school as possible. Hopefully, my gift will pay dividends in improved educational outcomes and life opportunities for these young ones. You just can't care for the parent if you don't notice (and try to improve) the plight of the kids. Nursing is so much more than blood pressures.....

I was able to give good holiday news to another patient today. She went off of her AIDS medications (unbeknownst to me) for various psychosocial reasons about six weeks ago, and I was afraid that her virus would bounce back and mutate with ferocity in the face of such an opportunity. Luckily for her, the bloodwork came back unscathed and we will restart meds right away. A lovely Christmas gift of continued good health.

The day was capped off by administering a 100-question final exam to my beleaguered students. From the looks of things, people did fairly well. I consciously made the exam only modestly difficult, a welcome reprieve for them at the end of a long semester.

This entry is simply "a day in the life". Nothing profound, nothing earth-shattering. Just the fatigued chattering of a tired Monday-night nurse.

Buenas noches.

Saturday, December 17, 2005

Ghost in a Machine

Previous post details system error.

Progress report:

Nurse 9.0 reboot relatively successful.

No hardware malfunction found, except for chronic low-back pain and sundry medical problems (ie: gastroesophageal reflux disease, hyperlipidemia, and enlarged prostate).

Software occasionally malfunctions secondary to pharmaceutically-corrected clinical depression.

Nurse's "better half" is source of continued solace and joy, as is offspring.

Canine companions: ditto, although ageing rapidly.

If nurse is really a "ghost in a machine", care of said machine is paramount.

Off to bed.

Tuesday, December 13, 2005

System Error

+Warning: healthcare provider system error/
+Nurse 9.0 program malfunction.
+Available memory at 98% capacity.
+Hard drive malfunction.
+Input overload.
+Processor speed at full capacity.
+Suggest re-boot system, replace hardware, or call manufacturer.

Sunday, December 11, 2005

Blogorrhea

logorrhea \law-guh-REE-uh\, noun: Excessive talkativeness or wordiness.

Is blogging a symptom of digital logorrhea? Is it just a coincidence that logorrhea has the same suffix as another word describing excessive excretion from the other end of the alimentary tract? Do bloggers all have in common the need to expel and distribute their words out into the ethers rather than contain them in a journal gathering dust on the literal or digital shelf?

If anyone is guilty of this disease of words, it would be me, but in these days of media saturation and 24-hour news coverage, aren't we all unwilling subjects to such daily non-stop discourse? Blogging is the way for someone like myself to instantly publish and receive feedback, eschewing the need for editors, middle-men, agents, publishers, and the like. If an individual feels that there are just too many blogs and too many opinions floating around on the Net, then they can just surf on over to eBay and shop for vegetable peelers and lederhosen.

If blogging is a type of logorrhea---let's call it "Bloghorrhea", shall we?---then I vote for no verbal Imodium to be administered to stop its emission. The stream of words produced by bloggers is some of the freshest, most personal writing available (for free, no less!) to anyone with the curiosity to seek it out.

While I say this with all certainty, I also frequently question my own need to blog, to wear my heart on my sleeve, to share of my daily experience and revel in the fact of the dozens of pageloads which my site enjoys each week. It's simply a need to connect, to feel part of something larger, and to feel that there is a community of people out there who find some succor or interest in what I have to say. Some might see it as an exercise in mental masturbation and self-aggrandizement. This may be true, but I also see it as a vehicle for self-disclosure and self-discovery. And again, those who find my writing unnecessarily boring or redundant, are free to surf on by with nary a wave or nod.

As a nurse, I find a certain satisfaction in creating positive and self-reflective writing which portrays the reality of nursing, not just the media's view of what a nurse should be. Encouraged by the brilliance of Suzanne Gordon's new book, Nursing Against the Odds: How Health Care Cost Cutting, Media Stereotypes and Medical Hubris Undermine Nurses and Patient Care, I am emboldened to portray nurses---and men in nursing---as more than just the butt of jokes suffered by the male nurse portrayed by Ben Stiller in Meet the Parents.

So, if my blogorrhea is tiresome to some readers, I'm still proud and delighted to have such a democratic venue in which to air my opinions and thoughts. It is an enjoyable conceit, and I'm happily cruising towards my one-year anniversary in January. As Bob Marley once sang, "I've got so much things to say right now, so much things to say". And the probability of that changing is probably fairly slim at this point in time.

Blogorrhea, ad nauseum.

Saturday, December 10, 2005

Voices

Tonight, a poetry performance slam at a local college. Organized by Shaggy Flores, a Nuyorican poet and performer, this presentation by a multigenerational group of artists reminded me again why I need to continue to be an ally to people of color.

Even though, as a Jew of European descent, I can claim to understand oppression and suffering (though I am unaware of any of my family members dying in the Holocaust), my whiteness and the priviledge bestowed upon me based on that whiteness is something of which I cannot be reminded too often. While some will say, "give me joy and celebration---enough chest-beating and whining about oppression" (a paraphrase of what a friend said in an email today), I say, go ahead and remind us---beat us over the head about the African diaspora, the raping of Central America by the CIA, the hegemony of multinational corporations. Sleepy acceptance of the status quo is another opium of the masses, and I'm grateful that there are so many people out there willing to step up and remind us of the inequities of the world, since our silence certainly can be construed as complicity.

In order to continue to cultivate gratitude for my many blessings, I also must continue to cultivate awareness and understanding of the plight of others. Scores of Iraquis have died unnecessarily; millions of children go hungry; African-American men are incarcerated in record numbers while their white counterparts avoid jail-time; women still earn a fraction of the dollar earned by men; gays and lesbians can only legally marry in one state; thousands of African-Americans suffered needlessly in New Orleans just a few short months ago, and the suffering continues. (Would we have stood for that in another zip code?) I bemoan my credit card balances and second mortgage, but boy, what a priviledge to even have a second mortgage to moan about, let alone a house that shelters me.

I know that I periodically write about these issues here on DD: my relative priviledge and my need to remember others. It is a staple of my inner reflecting which filters through my writing and informs my work in the world. Some may see it simply as an example of classic "white guilt", but I see it more as a continuing lesson in humility and remembrance.

Friday, December 09, 2005

Thanks, I Needed That

Sometimes positive feedback can lift one's spirits and renew one's commitment. While pondering what to write about today, I considered several comments which came my way in the last few days and went straight to my heart.

At my workplace recently, there was a "consumer meeting" in which some of our patients voluntarily came to a group meeting to give their honest feedback about our program and what it means to them. My supervisor described how one of my patients---a gentleman with paraplegia from a gun-shot wound to the spine---emotionally exclaimed how this is the first time that he feels like a human being in terms of his healthcare. He said how amazing and strange it is to have a nurse who actually calls him on the phone from time to time to offer assistance and make periodic home visits. He said, "You have no idea how that feels." My supervisor admitted that, listening to this testimonial, tears came to his eyes.

Just today, I struggled to make it to work in a snowstorm only to receive a cell-phone call just before arriving that I was welcome to work from home and not risk coming out in the storm. Somewhat disappointed that I had missed an opportunity for a snow-day, I was rewarded in my efforts by being able to assist a patient in obtaining an urgent ultrasound and an urgent visit with one of our doctors. While she may have been able to make it to one of those appointments today without my help, she certainly would not have achieved both. Leaving work early, I was even able to drive her home, stopping at her pharmacy along the way to pick up her medications which she admitted would not have happened due to her disability, the snowstorm, and not having a car. Her gratitude was overwhelming, especially when she said, "No one cares like you do."

A student in my class to whom I have given some extra support and compassion said some embarrassingly laudatory things (thankfully privately) about me last night as she packed up her things at the end of class, and I found myself truly grateful for being "seen" by her, even though the support I have offered did not seem worthy of such unbridled praise.

While I may sometimes forget how the little things that I do for others can be very meaningful for the recipients---even when what I do seems so relatively minor---I also remind myself how the feedback which I receive from those whom I serve can only strengthen my resolve that my work is worthwhile and tangibly effective. For every patient who is unable or unwilling to show appreciation for what they are receiving, there are ten whose gratitude is like a balm, a reinforcement that helps me to continually recommit to my work. Feeling that how one earns one's living has value for others is priceless in its abililty to sustain one in moments of stress and overwork.

We were reminded by my boss just yesterday that our agency---and the specialized care which it provides---is being watched by many in the healthcare delivery industry around the country. The results of our work has been published in professional healthcare management journals,
studied by The Robert Wood Johnson Foundation and by the Boston University School of Public Health. My commitment stems from the fact that what we are doing may eventually serve as a blueprint for delivering compassionate and quality care to disabled and underserved communities of patients around the country. An opportunity to possibly be part of healthcare history is a driving force behind our collective passion for our work.

On this snowy evening, I can feel good about the energy I put out into the world, despite the headaches, frustration, and overwhelmed feelings which abound. These small doses of positive feedback will go a long way toward refreshing me in my continued pursuit of finding meaning in daily life.

I really did need that.

Tuesday, December 06, 2005

Wintry Musings

Nothing profound to say today. The weekend was spent in the bosom of extended family, a betwixt-holiday road trip to deepest New Jersey, land of my birth. Uneventful, lots of familial warmth and cheer, a safe return to the homestead and waiting canine companions.
________________________________________________________

The holiday lights brighten the evenings, a coating of ice and snow on the ground, temperatures dipping into the 'teens at night. The distant war rages on, although we are pleased to know that our mail carrier has just returned from an 18-month tour of duty in Iraq. How many of those erstwhile soldiers will not return this holiday season? How many will never return? How many will return damaged psychologically, physically, and emotionally beyond our ability to understand?

________________________________________________________

We all seem to dig deeper into our pockets as the holiday season approaches, and the non-profits and human service organizations understand the goodwill and guilt which creates such end-of-year largesse (not to mention the tax benefits). Some give generously throughout the year, while others reserve their tithing for the months of November and December with an eye cast toward that April tax return. Still others are simply moved by what we call "the holiday spirit", and that spirit does indeed move many to think beyond their personal borders and concerns.

That said, winter is also a time for self-reflection and turning inward, focusing in on both the self and the home-front. How insular we become, how cozy, how sedentary, how far from the summer days of lounging in the grass on the town green, wandering the forest trails, eating at sidewalk cafes, swimming in clear water.

________________________________________________________

Winter gathers in our bones, and we await the coming of the Light, the turning of the year, the turning of the primordial clock.

Friday, December 02, 2005

Thursday, December 01, 2005

Remembering a Friend.....

Friday December 2nd, we will mark the fourth anniversary of the tragic death of our dear friend Woody. The story of his death is told here, and the larger contextual aftermath is described on this site. His death is a story I tire of telling and hearing, the pain of how he exited this world still so brutal and visceral for our family of three. What I do not tire of, however, is remembering Woody's loving friendship and the joy he brought to us all.

In his inimitable way, Woody was a saint---that is, a human saint with many flaws and rough edges, all assuaged by his infectious enthusiasm and ability to see life through a distinctive pair of lenses, often bringing others along for the ride. He was the one who would spend hours with our young boy, eschewing the TV for creative and hilarious homemade games, artistic endeavors, and outdoor and indoor adventures which would sometimes sweep us---or the neighborhood kids---into their maelstrom. Like the Pied Piper, Woody could often be seen with a following of dogs and children, promises of fun yet to come seemingly falling from his pockets as the giggling children were swept along in his wake. Like Patch Adams or any famous clown, he could engage a group of children in hilarity and creative play within moments. It was magic.

In the adult world, if not successful in terms of career and professional ladder-climbing, Woody shined in other ways. One of the greatest lessons I learned from him in life was the willingness to attempt to make conversation with anyone. Even now, when faced with a potentially awkward social interaction, I often think to myself, "What would Woody do in this moment?" Especially when with the elderly---with whom he had an amazing gift of ease---I find it increasingly easy to speak and interact in a way which promotes connection and fosters empathy. I credit Woody with this skill, and will continue to hone it in my daily life.

Here is a more complete portrait which I posted on his forty-first birthday.

So far, the plan for Friday is to visit his grave with our son. We may also take in a Dali exhibit in Hartford, since the cemetery is not far from the city and Woody was a gifted surrealist. The cemetery is a lovely spot along a river, his ashes interred alongside that of his grandparents. His lovely parents will also eventually rest there as well, and the setting could not be more picturesque and old-world New England: old headstones sinking into the damp earth, wrought iron fencing from another era, huge oaks and maples towering above the graves, the seasons coming and going, leaving the detritus of leaves, melting snow, ice, spring rains, new grass, wildflowers, and the heat of the summer sun on the deep, rich,and fertile soil.

I have vowed to treat his birthday and deathday as holidays for the rest of my life. Last year, I had to teach on the anniversary of his death, and I deeply regretted that circumstance, one which I hopefully plan to never repeat. These anniversaries are important and precious. Although we can be close in spirit to the dead at any time, these special days hold an emotional and ritualistic power which deserves to be recognized and honored. It is on these days when the veils between the worlds may be thinner---perhaps not literally (or perhaps so), but at least in our own psyches. Marking a death anniversary is allowing a pause to overtake the daily grind, taking an emotional breath, acknowledging that a specific day holds import and emotional and spiritual resonance.

On a recent bookstore expedition, I spied a book about the Mexican culture's embrace of death, its veneration and recognition of the importance of honoring the spirit world. I was reminded of how colorful and celebrational their Day of the Dead can be, and of how it is as much about caring for the dead as for the living. I like to think that we care for Woody and his memory by honoring his passing---and his living---regularly, and our family is dedicated to never relinquishing the importance and spirit of that recognition.

To my dear friend, Robert Alan "Woody" Woodward (March 19, 1964 to December 2, 2001), I send the message that although you are missed with the sweetest sadness, you are remembered with undying love and the deepest gratitude for a memorable and venerable friendship like no other. I miss your physical presence more than I sometimes wish to allow myself to feel, but give thanks for the time that we did indeed share upon this earth. Be here now, Woody, as I drift into the dreamtime. May we meet again.