Friday, April 21, 2006

Radical Acceptance

I wasn't at my desk for five minutes when the telephone rang.

"Keith?"

"Good morning!"

"This is Doctor M. You won't believe this, but Patient So-and-So is dead."

"You've got to be kidding me." (I can't believe I really said that.)

"I'm totally serious. He was found dead on the living room floor at 6am by his brother."

"Jesus. Holy shit. What happened?"

"Holy shit is right. I have no idea. I just got a message from the medical examiner. He may call you too. Can you call his family and find out how they're doing?"

"OK."

I put down the phone as my email program opened to reveal an email from my wife. It was an invitation that she's sending out to invite our friends to a "living memorial" for our dog Sparkey next weekend, to give people a chance to say goodbye before he declines further. Tears stream down my face as I read:

__________________________

Greetings friends of Sparkey,

You are receiving this because Sparkey is getting ready to leave :( and he would like to see you before he goes. He had a dramatic health crisis on Easter Sunday and after a life saving stay at ___________ Animal Hospital, he is home safe, getting daily IV fluids, lots of TLC and, yes, his people are finally cooking real meat for him! (His sister, Tina, is surely loving this part!)The diagnosis is chronic renal failure, low thyroid, arthritis and too many atrophied muscles in his legs to be able to walk or run very well, poor baby.

Sparkey has loved his many visits from friends over the 13 years of his good life, not to mention the many walks, hikes and adventures that he's thrived on--and expected! He has also always enjoyed a good party and would welcome you with his now raspy bark, a wag of his tail, or maybe even a kiss in the mouth if you're really lucky.

Sparkey remembers all his friends and the kindness extended to him, so please drop by for a fond farewell:

Open House @ Sparkey's Home

Saturday, April 28th or Sunday, April 29th, 2006, 1-3:00 p.m.

(If these dates don't work and you really want to visit 'Bob', call to come at another time. He may make it another month, provided he is not suffering too much.)

What to bring: Any memories/stories you may care to share and your blessings for a peaceful passage. Sparkey would especially welcome a parting gift of cooked red meat, cooked chicken or fish with no bones, or two marrow bones from the butcher.

___________________________

Between people getting shot, a sudden patient death, my ailing dog, the smashed windows, this damn cold and cough that just won’t quit, it’s enough to make the weekend look like two days simply for recovery from the week’s travails, let alone getting anything useful done.
Death is a part of the landscape, and in a conference on Dialectical Behavior Therapy that I attended the other day, "radical acceptance" was one of the keys to personal resiliency. I felt that I could immediately put this idea to use:

I must radically accept that Sparkey is failing and his death is in the near future, if not imminent.

Patient So-and-So died, and it's not because I advised his mother to nurse his cough and cold symptoms earlier this week with fluids and acetaminophen. Guilt is so creative and insidious. He was a grown man and could have gone to the ER if he needed to. The autopsy will absolve me of lingering guilt, or at least I hope so.

My chronic pain and fatigue is something I must contend with--live with, even. Perhaps it can be overcome, or perhaps I'll eventually be chronically ill like my patients. I don't plan on it, but I just have to accept that this is where I am right now, and this cough and cold only add to the feeling of misery. (Doesn't it sometimes feel---in the midst of a protracted cold---that one has always been sick? Doesn't one's illness at times take on an almost cinematic unreality? Doesn't it simply color everything in its path and leave a washed-out grey in its wake?)

That said, recover and healing signify the day when the illness resolves, the head clears, and the light returns to one's eyes. Recovery and healing also signify the day when, opening one's eyes in the early morning, the thought of the recently deceased loved one changes from a heart-wrenching pain to a soulful ache with touches of sweetness to mitigate the grief.

The deaths, the illnesses, the travails, the blows visited upon the body and mind---these are all tests of our resiliency and ability to accept that which visits our lives. Acceptance is not for the meek---it can often be a radical step towards healing and recovery.

May we all take that step when it most needs to be taken.



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