If I were to claim any part of her as my favorite, it might be her hands. They dance when she is alert, fingers waving,coaxing the air into becoming her own invisible instrument. When she is startled they bunch up into tight fists and she gives them a shake or two. Often a finger or five can be found in her mouth, shiny with drool. Lately she has started to explore the opening and closing of her hands. She touches fabric or skin or anything really, and her little starfish fingers joyfully leap forward only to immediately spring back to nestle her palm again. Open close, open close. And sweetest gestures of all happen during nursing, as more frenzied activity slow to sweet caresses. She feeds quietly, eyes closed and gracefully, ever so gently traces her fingertips along the outside of my breast, my sternum, my chin. The very light touch of her fingers, so tiny, not yet hardened by life’s labor, feels more like a brushing of butterfly wings than the touch of a human, but here she is, real and mine. 6 months after her birth I still check her breathing while she sleeps. You are okay? You are okay.
Sometimes, I feel as if nothing I do matters. I have struggled and fought and I have failed. Oh, have I failed, in a million small ways, and in a few pretty large ways too. Some days I feel weak and worthless. But yesterday helped me see a bit clearer.
Yesterday, I attended a memorial service for a patient. Her name was Angie, and she died at 45 from breast cancer. The ceremony was held in a garden space, where a stand of trees stood proudly in the middle of barren desert. In this oasis we were sheltered us from the Arizona sun, still so unrelenting even in late September. Native voices and drumming sliced through the air, carrying our prayers of healing and sobs of grief high in to the heavens. We honored the four directions, the circle of life and all its infinite passages. We held hands, a rainbow of humans from all walks of life, touched by this one woman. Years of addiction had scarred the hearts of some, yet there, under the shade trees, there was healing and love and hope for all of us. We were united in grief, united in being alive.
In this sacred space, I received kind words of gratitude for the care I gave to this woman while she was alive. I felt her community honor me as a healer to the sick and a friend to their loved one. Her case worker and strongest supporter during the last year of her life presented me with a print of a dragonfly, a symbol not only of the community where she lived but as symbol of transformation, of rebirth. It was how Angie wanted to be remembered. She is now in the spirit of the dragonflies. She is liberated and omnipresent and I believe she is still here. In a way, her illness gave her the medicine to be everywhere and everything, to transform from a homeless crack addict to an inspiration, a visionary, a healer.
I felt some apprehension about attending the service, as it promised to crack open my own barely contained well of grief (which it did). And sometimes it is hard to accept gratitude. I want to cast aside the humble thanks of others and say “its only my job.” But it’s not “only my job.” It is a blessing and an honor and a calling. I couldn’t save Angie from cancer, nobody could. At times I couldn’t even lessen the pain. But I walked beside her, I was at the door of her final passage. I was a part of humanity’s best side, the wide embrace, the soothing words that call forth light in the darkness. I was part of an easing of her burden, part of her finding wholeness even while she was dying. I was part of a miracle.
We all know about the shadow side of our civilization. We slaughter, we rape, we decimate, we wreak havoc on the earth. Sometimes, I can’t bear being a human, can’t face being a tiny limb of the global curse. But yesterday, I felt honored to be alive, to be a person, to be a part of a community wider than my own mangled thoughts, my own voice pleading in the darkness.
A single wave is meaningless, yet the collective tide can carve canyons and move mountains.
I am honored to be part of this mysterious force.
I spend my days caring for people who are living with loss. Sometimes its the loss of an identity as a healthy person. Sometimes its the loss of a long life expectancy. Sometimes its the loss of a breast. The loss of estrogen. The loss of energy, vitality. The loss of long, sexy hair that trails to the small of a back. The loss of trust, the loss of a belief that everything will be okay.
I don’t know what it feels like to have breast cancer, and I didn’t know how it feels to be a mother to a dying child when I worked in pediatric bone marrow transplant, and I didn’t know how it feels to be a homeless, chemically dependent and mentally ill AIDS patient when I was a med-surg nurse in a county hospital. But life has a funny way making us let go, and let go, and let go some more, and after all this letting go we turn to other humans, who murmur yes, I understand what its like to see the most precious dreams fly away, I have felt the texture of the walls and the weight of the thick black air of a world of darkness, and I have come out on the other side. I have always enjoyed my patients, but I’m a different kind of nurse now. Its subtle, probably not noticeable. But there is a slight shift in the air, a longer gaze in which I say without words I can better understand you.
Sadly, loss breaks a few of us and there are casualties along the way, but more often than not, it simply destroys that which no longer fits. We need the heartbreak in order to open up more fully. And with this miracle of the human spirit we can then weave together the threads of our sorrows with those of others. We bond. We make a web of connection, and it captures the joy and blessings of this bizarre, difficult, beautiful world. The details of our individual suffering is always unique, but in the collective experience of loss, we turn to each other with a soft and courageous stare and say I may not know, but I understand.
One morning this week, I spied a woodpecker perched on a tree outside of the Cancer Center. Such athletic, flighty creatures, it seemed odd that he remained perfectly still, appraising me and the rest of the world around him with his unblinking eye. Only a few feet away, I stared back and sipped my tea and my bones started rattling deep, deep inside:
I don’t want to go to work!!
Its odd, I almost always walk through the doors of the Cancer Center with a smile on my face, eager to see patients and start my day. But its been a struggle lately. I’ve been tired, and working so very hard. The endless stream of emails, prior authorization requests, distraught patients, hospice talks, conflict between staff members, and ever mounting pile of unsigned notes are taking their toll.
Or is it something more internal that caused me to be frozen under cloudy sky, unable to walk through the Cancer Center door? I haven’t been taking care of myself as well as I could, but its not all been miserable either- I have been eating pretty well, and taking my dear dog for runs in the dark November mornings.
And then there are the anniversaries that quietly haunt me. The anniversary of the day I napped next to my mother and noticed she was breathing differently. It was so subtle, it escapes description. But I knew something was different. And she smelled different too- not bad, just ever so slightly different. The dying process started with a whisper on November 13th, 2011.
And then on November 14th, I got the call at 6 in the morning that she was hospitalized with a bowel obstruction, and in a matter of minutes I was barreling down the highway again in my Corolla, headed to Phoenix and biting my nails I could make it there in time. Turns out, we had quite a bit more time: almost a month.
Then there was the cascade of events and phone calls and praying and weeping in lobbies that lead her to be sent home on November 15th with hospice care. It felt so right and so wrong and so unbelievable, a dream and a nightmare.
Life had a singular focus: my mother. There was no room for the stuff that doesn’t matter, like work stresses. There also wasn’t room for a lot of stuff that does matter.
So, this year I’m doing well. I smile a lot, and even have started worried about some of the small stuff again. But this year, on November 14th, I struggled to go to work. I stood outside of the clinic under a grey sky, longing to stay still and sip tea and stare at beautiful birds. I had little to offer to the patients waiting for me, but I gave them what I could. I needed not to give, but to receive.
It wasn’t an easy day for me. But perhaps the universe understood my plight, because when I came home there were two packages waiting for me: dried corn from my mom’s dear friend, and a book from my dear sister.
I don’t always get what I want, but sometimes I get what I need.
The epiphany occurred when I was 19 years old. It was a spring day. I was working at an abortion clinic, my part-time college job, answering phones and working the front desk on Saturday mornings and on Tuesday and Thursdays after class.
I secured this job through my mother’s connections with the pro-choice movement. The clinic manager had been a student intern in 1984-85 for my mother when she was the director of the Abortion Rights Council. When I interviewed for the job, the manager showed me a framed picture I drew her when I was 4 years old. It was a typical child’s drawing: hearts, people with large bug eyes, except it also had a phrase written in my childish scrawl “I cannot live without birth control!” Unsurprisingly, I got the job. Yes, I needed to walk through protesters to go to work, but I felt like they made the day more interesting . Plus I made 11 bucks an hour, far more than my peers did at their jobs in the campus library or cafeteria.
One particular Saturday morning in the springtime, the clinic was short staffed in the back. I was plucked to help out. In a five minute crash course, I was taught how to take a blood pressure, how to coach a woman to breathe and relax, and how to ready the procedure room in between patients.
I pulled the chart of a girl who was a year ahead of me at the private Catholic women’s college we both attended. I called her Scandinavian name in the waiting room, and led her back to the small room under fluorescent glare. I told her to undress from the waist down and gave her a paper gown that crinkled as she moved. I squeezed her thin arm with a blood pressure cuff and guided her feet into the stirrups. She laid back on the vinyl exam table, and her long blond hair spilled around her, creating a halo.
“Where do you go to school?” she asked. Maybe she had an idea that we had something in common. I hesitated in my answer, not wanting to make her feel any more uncomfortable than she already was. The suction machine groaned as she became un-pregnant. Her polished nails gripped my hand.
“St. Kate’s” I murmured.
She flashed a radiant smile between the uterine cramps. She was beautiful, tall and blonde, with straight white teeth. “Me too!”
She had sorority-girl beauty, and I was a bohemian with a nose ring. She was unhappily pregnant, I was making a few dollars to put towards rent on a ground floor apartment that was so close to the train tracks it would shake all night from passing freight cars. But there it was– two young women, holding each other’s hand, connected in a way that exists beyond words or explanation.
Five minutes later, it was over. She was shuffled off to the recovery room, and I was wiping away the blood that was left behind. The Sklar disinfectant spray made my eyes water. And in that moment, wiping down an exam table under the flourescent lights, it was clear to me. I needed to be a nurse.
The realization was sudden, and my hand started to shake. I thought I was going to be a music teacher. I had saved every penny for a concert harp, practiced for hours alone while my friends were out drinking. But there was no turning back. I had already experienced my first moment of nursing, and that was it.
I mulled over my secret for a few days, but then told my mother I was changing my major from music to nursing. She told me that she wasn’t surprised, it made total sense to the woman who knew me so well.
And then I called the young man I loved fiercely, but it was an obsessive love that delivered equal amounts of magic and misery. So we couldn’t stay together, and we couldn’t stay apart, and we danced back and forth like this for two years. At the time he was living in a different state, but we were making plans to be together again in the future.
I told him my new plans and he sneered. To be fair, this major change would require another year at college (and another year away from him). But he didn’t understand what was in my heart. He made some sarcastic comments, which gutted me. And it was over in that moment. I didn’t quite know it then- our impossible dance continued for a few more months, perhaps. But I found my calling, and I never forgot that in the moment he wasn’t there, couldn’t be there.
I needed to be a nurse. It was worth walking away from love, from my plans, from a life I had mapped out for myself.
And I followed through.
Even though my job is difficult, it is as much a part of me as my right arm. It has changed everything: how I think about life, how I spent the last moments with my mother before her death. I am a nurse, and I am more than a nurse, yes, but I can never not be a nurse. It sounds terrifying to have a job as such as integral part of an identity, but its not really a job, now is it?
It is a calling.
We are a team
Are we on the same team?
The thing is, I’m tired
And there are so many of you
There are too many of you
You’ll be okay
But I want to live!
I pray you’ll be okay
This must be what it feels like to die
Can a person really save someone else?
A single thread slipping through my fingers
A giant chessboard, smooth beneath a mysterious hand
So easy to float away
Pawns of fate, so helpless
But fate or not, I make my move
I hold on tight
We plunge ahead
Eyes wide with fear and wonder
Madness and courage
Fear and wonder
Some days, being a nurse in oncology exhausts me to the core.
No, I don’t know if you will puke, if you will have diarrhea, if you’ll get an infection. I don’t know if your cancer will come back, if your tumor is bigger, if the chemo is working, if the cancer is in your liver, your bones, your brain. I don’t know if you’ll live to get married, or to see the ocean again, if you’ll be able to have a baby, if you’ll see your grandchild graduate high school. If you’ll bury your spouse, or if your spouse will bury you. I don’t know if you’ll die in 6 months, 12 months, 12 years.
Clearly, I don’t know much.
But in this tiring day in clinic, I had the blessing of caring for a patient who has been through every permutation of chemotherapy known to (wo)man for breast cancer, who looked me straight in the eye and said:
I know I’m going to die. But I’m going to enjoy the life that I have, however long that is.
She meant it. She’s ready for the inevitable, but she’s grounded in the present.
We are so busy making plans for a future that may or may not come. We grind away at jobs in order to get rewards down the road, we delay the telephone calls, the new dress, the vacation. I’m not saying that planning ahead is a bad thing, but it must be tempered with a grounding energy and a dedication to this very moment:
Take a breath. Feel your chair beneath your body, the ridges on your keyboard. This is all there is, right now.
So own it.