Thursday, April 21, 2016

Friday, April 15, 2016

Learning to recompose

"I'm sorry," I struggled.  "She's favorite."

"Fair enough," he said.

This was outside her room, and I needed a minute. 

She told me, "You have cold hands," and I apologized, because for chrissake, the poor woman has been poked and prodded and nauseated, terrorized by the unknowns of her diagnosis, displaced into a foreign environment far away from her coping mechanism (cigarettes), and I can't even provide her with a warm handshake. 

Then she adjusted quickly and said, "That's alright, honey," patting my hand with her other hand, still holding my right in her right.  "My mother used to always say, 'Cold hands, warm heart.'"  She started rubbing my hand with both of hers to help warm me up, which is what the nurturers always do.

Then he joked, "What does it mean if you have warm hands, then?"  which is the only reason I did not break down and sob. 

She laughed.  I laughed.  She said, "I don't know about that.  You'll have to find that out from somebody else."  He said, "Oh, okay," and smiled at us both, then I took my hand back, gratefully.

It got to me, because grandma used to say the same thing to me about my hands.  "Your hands are so cold," she'd say so concerned, like I was near death and should see a doctor.  But then she'd say, "You get that from me,"  followed by the reassuring, 'Cold hands, warm heart.'  Not scientific at all, but reassuring.   Something women have been telling other cold handed women for generations.

I have spent my life apologizing for cold hands, and now this woman remembers me for them.  She said it again the next day, like all of our faces are blending together, but the coldness of my touch is how she knows me.

He was saying something to me outside her room.
"I'm sorry," I struggled.  "She's favorite."

"Fair enough," he said.  And he waited a moment for me to recompose.  Then he said, "Have you noticed how she emotes these pure feelings?"


"She's a dear lady."

"She is.  She reminds me of many."

When I got to the elevator, I was alone.  The doors closed, and I struggled to breathe until I reached the lobby floor. 

© Copyright 2016 Angeline Larimer

Thursday, April 07, 2016

Cliffs and Gratitude

I was alright until he asked me, "Are you alright?" 
My first tears were at 7:45 am, because of the way she said, "I trust you," to him in front of all of us.  Just a pure response.  One that's so heavy on him, but it's what I would say to him, too, if I were her.

The words haven't been decided upon yet between patients and their doctors -how to make it more human-to-human, less slave-to-pharaoh.  What do you say?  It's so much science language at the worst possible time in one's life to pay attention to science language. 

The diagnosis is the trip.  The treatment is the freefall.  No control, blurring faces, tubes, beeps, strangers, rules, pain...

The best part about the science is that the words are so emotionless, you can grab onto them, like roots hanging outside a cliff, and catch yourself from falling.  Whatever the platelets are, or how well the pain medication is working, and how many more days of chemo - distract, choke it down, concentrate on what the resident is saying.  Pretend it's someone else in the bed.

She was there.  The one I signed for as a witness on her DNR request.  I didn't recognize her at first.  Lights were low.  Her glasses were off.  The gowns strip away so much personality.  But then she spoke in that sweet self deprecating grandma voice and I knew.  I wanted to jump in front of the group, take her hand and stand there with her, just to help absorb the awkwardness of being observed by so many strangers.  But I stood in line with the others, folding my hands, listening, observing.  (This is so intense at times, I find that my shoulders ache after an hour of rounds.  When I fold my hands together in front of me, I push them down as I'm listening to what each patient is going through.  Two hours of this, my shoulders are on fire.  I worry I might dislocate one eventually, and end up in a bed myself on a separate floor.)

One of the first things I noticed in her room was the Diet Coke on her tray.  'Don't drink that,' I thought.  'It's so bad for you.'

This is not my world.  It's not my place.  The narrative medicine class talked about writers taking advantage of other people's vulnerable moments to further their writing, and that's not why I was standing there at 7:30 am with a bunch of residents who have too much to do and no idea why I'm there bungling around amongst them (wringing my hands)...

And she doesn't even know me.

He asked her about the Coke.  "Is that the same one you had from yesterday?"

"No.  It's my third one." 

I winced.  She's got leukemia and diabetes and I winced about the Diet Coke. 

"Ok.  I'm just making sure you didn't have that sitting out all night," he said. And the attending resident went on to explain her problems list for the day.

"I don't pretend to know about any of this," our lady kept saying. 

"Oh, I think you pretend not to know," he cut in kindly.  She swatted her hand at him, and he came to her bed and tapped her knee gently.  Then he waved us all along, and promised to be back to see her soon. 

I couldn't not say hello to her, so I stepped out of the exiting group to take her hand.  "Hi, Mrs. D.  Do you remember me from last week?  I met you in the clinic with your family."  She held onto me longer than one does.  It's how I knew she was scared, and trying to keep it together.  She said, 'Oh, yes,' though I don't think she did - not with how stressful her last five days must have been.  I said, "It's good to see you," and she said, "Thank you, honey.  It's good to see you," and I got teary-eyed again, but was pretty sure she didn't see that, because she was still processing her new reality - the hospital room - the tests - the beginning of four long fucking weeks. 

I was staying too long.  The group was moving along, and I am their guest.  I said goodbye, and moved outside the door.  As the nurse closed it slowly, I could see Mrs. D. drinking her Diet Coke, a terrified look on her face.  Maybe the Coke would stop her fall. 

By the end of the day, I'd seen two more bone marrow biopsies up close, sat in meetings with four families all given sad news about the test results, watched a grown man cry, watched two daughters cry, three wives, a couple of sisters, and yet got winked at by several receivers of the hard news.  Three times.  Three different socioeconomic backgrounds.  Two genders.  After they shook it off, the sting, listened to the facts, then came out of the depression long enough to make a joke or two, they winked at me to reassure me.  And another called me honey.

There was a couple celebrating 55 years together this year.  They've been traveling, prioritizing family and friends.  "On my 80th birthday, I'm having a dinner for 100 of my closest friends, and I'm just going to sit there and enjoy listening to them."  They made me laugh so many times, I forgot.

They have other stories besides the cancer.  They've lost people in their lives, or are the main breadwinner, or have a schizophrenic child living with someone else while the treatment is happening...  They're not just lumps in a bed, or fifteen minutes in an observation room.

"Is he a religious man?" I asked before going in for one of the last of the day.  This man has been a marvel.  He's made it much longer than predicted.  More than a year.  'Partial remission,' it's called.  Against all odds. I asked the question because of how the patient was described as being so calm about it, and so sure that he had more time...

"I don't know.  You should ask him.  I'll find out if they mind sticking around and talking to you," the doctor said. 

As soon as we walked into the room, I saw the big wooden cross around his neck. 
He's a storyteller.  His son and wife reminded me of myself and how I get when my dad starts talking.  I listened, and two hours went by.  They're all new stories to me, so it was a pleasure.  The son and wife chimed in fairly often, as well, and it was nice.  Good people.  Kind.  They kept asking, "What else would help you?" and I said, "Whatever comes to mind," then more stories.  Finally, I managed something that might have been useful,  "Were you lonely in the hospital during your treatment?"  "No, never.  I just wish they didn't do their rounds so early in the morning." 
I never had to ask about his faith.  He told me about it many times.  He was at peace with dying, he said, but still praying for the doctor to do his magic.    I happened to know that the doctor carries a heavy burden whenever someone tells him that.  It's tremendous pressure to walk around with.  "I pray for you all the time so the lord can fix this thing through you," must be exhausting on the soul.

Because they aren't all saved.  They're given more time, often, but cures are hard to come by.

"I'm going to go get a tea and walk around a bit to clear my head, then come back and do some dictations and then call it a day."  And then he said, "Are you alright?"

Earlier, he'd said I have an expressive face, which worried me, because often times he warns me that he's about to give difficult news to people.  He gets right to it, but there's still a few seconds of hopefulness in the air when we first walk in.  They've been nervous for days or weeks, praying and hoping, and then the news happens.  I don't want my face to steal from them.  Everything changes after that news.  'I guess this means our plans for the summer will have to wait.'  'Yes.  I'm afraid so.  I'm sorry about that.'  'Yeah.'  And then quiet so quiet.  That long moment of silence.

"Are you alright?" he asked, as if he was about to order a crash cart.  His nurse looked worriedly at me, as well.  I must have been pale, or the lines on my face much deeper.  I thought I was doing pretty well, actually, until he asked me that.

"I'm fine, but my daughter gets out of jazz band in a half hour..."

"Go!  Of course.  You have children who need you.  Have a good evening, then.  Would you mind doing me a favor, though, and presenting the poem tomorrow before rounds?"

I nodded.  Honored.  Bewildered.  "Sure.  Of course."

I cried in the car, alone, music blasting.  Not a sob, but a decompression.  I didn't even think about it.  Water just fell out.   I got it over with before I got to the school.  As soon as I could, I hugged both kids, and greeted Tom at the door later that night.  "You've had a day," he said - my face again.  It's aged.  A lot.  He told me to get my coat on, and we went grocery shopping until midnight, both of us in sweatpants comparing labels of olive oil.  He pulled a coupon for cat food out of his jacket pocket and took ten extra minutes trying to find the exact kind.   He hates having to check-out his own groceries, feels it keeps taking away jobs, but it's all that was available at midnight, so we worked together.  He scanned.  I bagged. Then he took my hand as we pushed the cart out to the car, and we drove home to our kids.  - Heaven.

The other side of this experience - how grateful I feel all the time.  How glad I am to be with my family.  How blessed I feel to listen -not rushed or distracted.  We make plans, like the couple of 55 years.  I make eye contact.  I don't get annoyed.  Everything is meaningful again.

A Lament

We who are left, how shall we look again
Happily on the sun or feel the rain
Without remembering how they who went
Ungrudgingly and spent
Their lives for us loved, too, the sun and rain?

A bird among the rain-wet lilac sings—
But we, how shall we turn to little things
And listen to the birds and winds and streams
Made holy by their dreams,
Nor feel the heart-break in the heart of things?

Wilfrid Wilson Gibson
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