Most of the time, a resident gives warning signs, little clues, of their soon approaching death. There are the verbal, often loud, statements to Jesus, asking why he hasn't taken them. There is the pill-refusing, a backwards kind of suicide, as I think of it. Perhaps it's the heart that doesn't sound quite right through the stethoscope, or the fluctuating blood pressures. Maybe even the urine has a different odor. Most of the time, though, there is simply an aura around that person, a sort of pheromone alerting those around them that they will soon be leaving. Sometimes, sometimes, there is the unexpected, the deaths walked into blindfolded. The times, as staff, we leave a resident who is just fine and return to find them struggling for their lives.
A few weeks ago, I found a resident of mine dying in his own bodily fluids, snoring loudly because his soft palate had collapsed, blood oozing from his mouth, unresponsive and naked. I prepared to send him to the hospital after ordering my CNAs to clean him up and get him ready, called the ambulance STAT, gathered a packet of information for the ER nurses and a half an hour later I was back to the normal routine of the job. As though nothing had happened, arranging and organizing the room as though the gurney was never there, making the bed as though he had never laid in it. Pretending and smiling so that the remaining eighteen believed they were the only ones in my thoughts. He died two days later, never having regained consciousness. An intracerebral hemorrhage. He hadn't really had a chance, but he waited long enough for his wife to come to him.
Before that, on a day where I was alone for the last few hours of my shift, I knocked on the shower door looking for the resident who had gone in about an hour before. I had his 4:00 meds for him and I remember thinking it unusual that he wasn't yet back in his room. His clothes were laid out, waiting for him, but he hadn't returned. So, I was at the door, knocking without response. My gut dropped and I could feel the hairs raise on my neck. Knowing something wasn't right. I opened the door, calling out his name, hearing the rushing water spattering on the tiles. And there he was. Sitting sideways on the shower chair, slumped backwards, shoulders resting on the shower wall. During whatever event he'd endured, a massive heart attack probably, he'd vomited, as they so often do, and it laid precariously on his chest. He was breathing, although extremely gray in color, and it was that rattling sound. The sound a human makes when they are technically dead but their body is just alive enough to work off base instinct. I didn't send him to the hospital. He had a no resuscitation code. He was cleaned, clothed and put in bed to wait for enough doses of Morphine to help him pass.
Then, before even that, there was the old-time nurse. I'd left her sitting at a dining room table, a cup of hot coffee warming her hands, her snarky smile watching me as I left. I'd gone to grab her a sweater from her closet, a habitually cold resident who preferred to wander the halls with many layers. I walked back in and found her sitting on the couch, her cup broken on the floor and the coffee spilled. She was bent over, her head between her knees, bright red blood between her feet. She attempted to apologize when she vomited again, more blood. Then she looked up at me, a woman in her late eighties who didn't want anyone touching her to help her, a woman who refused her medications because she was just fine, looked at me and asked for the ambulance. I'm dying, she said, and she was right. She died that same day, only hours after she arrived at the hospital.
Death, and dying, is a part of my job. People ask me, how do you do it? How are you not depressed? How can you keep walking into a building where you've seen so much? There is really only one, entirely morbid, answer for those questions. You get used to it. Oh, sometimes, when I walk into the shower room I have an image of that man lying in the chair. Or, while I'm eating lunch in the dining room, my eyes will manage their way to that spot where the blood once was. Sometimes my husband will snore in a way that makes that man's face swim in front of my eyes. But, you get used to it. You get used to the little hauntings, the little ghosts that have to be carried. After the funeral, after the belongings have been parted with, after the family has mourned, who else is going to carry them?
Wednesday, November 25, 2009
Sunday, November 15, 2009
Effect Essay
Perhaps due to my chosen line of employment, and the innate sense of irrationality I house, I've always had a fear of my father getting older without really having known him. There was a distinct moment, when I found myself in the shower one morning, crying because of that fear. I felt wracked by the realization that the skin of childhood had finally come off, shed almost, and the new skin was vulnerable and soft. The lenses my eyes looked through were different. Not as hazy, more sharp, life having more jagged edges than I'd noticed before. And, suddenly, I wanted him. My life has never been without his presence, either emotionally or physically, but I found it different to know and love someone as a dependent child than as an independent adult. So I decided to seek him out.
It'd been a long time since I'd studied the Bible. It'd been a long time since I'd even opened one. I still had the one that I had as a child and it had it's place on my book shelves next to all other religious texts I owned. But, it was more out of tradition, out of respect, than any kind of interest. Despite my current lack of interest then, a Bible study is exactly how I reached out to my father. He is a very spiritual man and I can be a very manipulative woman, knowing full well that he couldn't resist just one more chance to save his daughter. Perhaps he is the manipulative one because a study that, in my mind, was supposed to transform into a social hour absent of the Bible, has remained a study. And I have come every week loaded with an armful of questions from my own studies at home, when I am alone, opening the book to find answers. I am reading the Bible again, on my own, seeking out its comfort, secretly stashing it in my book bag to quietly read during lunch. I have found myself starting my mornings with a scripture, carrying it in my mind during the day.
During every study, my father begins with a prayer. Despite always meeting at the same public place, bowing my head and listening to his words, has never seemed awkward or embarrassing. At first, though, I used to tune the words out, absently and vacantly saying "Amen" at the end. The whole study was a farce to get to the real thing I wanted, my father. After a couple of months, it finally dawned on me that to be close to him, to truly be close to him, one had to attempt being close to God. And, when spending any amount of time with a soul so convinced, living with such belief and faith, I find it difficult to ignore. Now, when he prays, I bow my head and close my eyes, and feel them getting hot as I listen to his fervent requests and pleas. I have even picked up the habit of prayer myself. At night, when thoughts used to flog me endlessly, I'm praying instead and often falling asleep during that prayer. Sleep is suddenly sound and peaceful and I wake with a sense of meaning. After a few weeks of prayer at night, I've begun what I call "walking prayer." At particular moments of stress or anxiety, such as at work, I will literally walk down the halls and silently pray.
Now, this woman who loves the sound of a swear, who loves inflammatory remarks for the sake of the reaction, who loves rebellion and it's intrigue, who loves to hate and judge and snicker like the next imperfect soul, has found a moderator. The wild child who would rather have spit on a book than let it tell her what to do, is now opening its covers for just that purpose. Through my father's weekly guidance and love, there is meaning found and answers discovered in a book that some people no longer believe to be God's Word. To me, at this point in my life, it is.
My coworkers and husband have noted a sense of contentment in my demeanor lately. They've commented on my ease of presence. I'm not consumed so hastily by my own anger, have attempted to be less judgmental, more forgiving, more tolerant. The perpetual grip of loneliness that we all feel has been loosened by the sense of knowing that, as my father tells me, if you seek God out, you will find Him. I thought I was only seeking out my father, that I would not allow us to grow old without knowledge of each other, but it was really a twofold result. I found my father, I found his passions as his eyes fill and his voice cracks as he reads a passage. I found his hopes, his purposes, his intentions. And, with one phone call, with one study, I have begun to find mine. That old skin I've shed replaced with something hard and sturdy and full of belief.
It'd been a long time since I'd studied the Bible. It'd been a long time since I'd even opened one. I still had the one that I had as a child and it had it's place on my book shelves next to all other religious texts I owned. But, it was more out of tradition, out of respect, than any kind of interest. Despite my current lack of interest then, a Bible study is exactly how I reached out to my father. He is a very spiritual man and I can be a very manipulative woman, knowing full well that he couldn't resist just one more chance to save his daughter. Perhaps he is the manipulative one because a study that, in my mind, was supposed to transform into a social hour absent of the Bible, has remained a study. And I have come every week loaded with an armful of questions from my own studies at home, when I am alone, opening the book to find answers. I am reading the Bible again, on my own, seeking out its comfort, secretly stashing it in my book bag to quietly read during lunch. I have found myself starting my mornings with a scripture, carrying it in my mind during the day.
During every study, my father begins with a prayer. Despite always meeting at the same public place, bowing my head and listening to his words, has never seemed awkward or embarrassing. At first, though, I used to tune the words out, absently and vacantly saying "Amen" at the end. The whole study was a farce to get to the real thing I wanted, my father. After a couple of months, it finally dawned on me that to be close to him, to truly be close to him, one had to attempt being close to God. And, when spending any amount of time with a soul so convinced, living with such belief and faith, I find it difficult to ignore. Now, when he prays, I bow my head and close my eyes, and feel them getting hot as I listen to his fervent requests and pleas. I have even picked up the habit of prayer myself. At night, when thoughts used to flog me endlessly, I'm praying instead and often falling asleep during that prayer. Sleep is suddenly sound and peaceful and I wake with a sense of meaning. After a few weeks of prayer at night, I've begun what I call "walking prayer." At particular moments of stress or anxiety, such as at work, I will literally walk down the halls and silently pray.
Now, this woman who loves the sound of a swear, who loves inflammatory remarks for the sake of the reaction, who loves rebellion and it's intrigue, who loves to hate and judge and snicker like the next imperfect soul, has found a moderator. The wild child who would rather have spit on a book than let it tell her what to do, is now opening its covers for just that purpose. Through my father's weekly guidance and love, there is meaning found and answers discovered in a book that some people no longer believe to be God's Word. To me, at this point in my life, it is.
My coworkers and husband have noted a sense of contentment in my demeanor lately. They've commented on my ease of presence. I'm not consumed so hastily by my own anger, have attempted to be less judgmental, more forgiving, more tolerant. The perpetual grip of loneliness that we all feel has been loosened by the sense of knowing that, as my father tells me, if you seek God out, you will find Him. I thought I was only seeking out my father, that I would not allow us to grow old without knowledge of each other, but it was really a twofold result. I found my father, I found his passions as his eyes fill and his voice cracks as he reads a passage. I found his hopes, his purposes, his intentions. And, with one phone call, with one study, I have begun to find mine. That old skin I've shed replaced with something hard and sturdy and full of belief.
Sunday, November 8, 2009
Division Essay
I have contracted yet another cold and have become a walking warehouse of Puffs Plus tissues, Alkaseltzer Cold and Sinus, slippers and robe. Symptoms are limited to the sinus passages and has been producing a fluorescent yellow nasal mucus. The color of my highlighters, the color of my African lovebird's bright belly. There is pressure at the upper bridge of my nose, eyelids puffy as though I've just endured a round of mourning, and am experiencing aggravating alternating rounds of congestion and post nasal drip. Absence of sore throat, fever, body aches. This is what I'd tell my doctor if I went to see her, but I won't. I know what her answers would be, I know what the treatment is. You can not cure a viral infection. You can only treat the symptoms. The body must do the work. I tell the couch this as I lay there and groan, my husband getting ready for the football game, saying to me, "baby, I've never seen anyone get my colds than you." It'd make sense, though. I am the perfect storm, the ideal host for germ generation.
"Well, I take that statement back," my husband says, after a little thought. "You're still very young." Normally, this would be considered an insult. My youth is not a handicap, I will not allow it to be. Nor is it an excuse for ignorance. Yet, with the overwhelming evidence before me, it'd be foolish not to recognize that this time, this one time, my delicate years are not in my favor here. My husband, more than twice my age, rarely falls ill. He's had time, years, to build immunity to the majority of strains we're exposed to daily. I have not. When a new pathogen invades, my body doesn't understand what it is, only understands that it's foreign. So it attacks, and attacks hard, in order to develop that immunity, that recognition for the next go-around. In a sense, immunity is a form of maturity and all maturity takes time. And it takes a lot of trial and error, a lot of getting sick.
"And," my husband continues, "you work the ideal environment. You're exposed all the time." I simply nod to that one, put another tissue to my aching nose and feebly question my commitment to nursing. I think about the last day I worked. Thought about how many of the residents were coughing, spewing airborne particulates, wiping dripping noses and touching things. I cringe. It's not that I don't practice precaution, I certainly, neurotically, do. I carry antibiotic alcohol gel with me at all times, and after touching a resident or a particularly common item, I put it on as liberally as lotion. Then there's the handwashing itself. Before and after using the bathroom, before and after eating, after sneezing, after coughing. As well as at any random moment in the shift when I feel it's just the right thing to do. My hands sting by the time I get home, and if they don't, I know I did not wash them enough. Then there's the constant mantra, "don't touch your face, don't touch your nose, don't eat with your hands, don't wipe at your eyes, leave your glasses alone." Yet, in the end, all precautions aside, I and no one else, can choose the air we breathe. I can choose the work, but not really. I love what I do, and believe I'm simply on a hyper-road to immunity.
"Then," I hear my husband still going on, "you take things so seriously. You're always stressing out about something." I turn my face into the pillow on this one. It is so true, beyond true, it is pure and simple reality. Choosing a high-activity, high-stress lifestyle will never bode well in the pursuit for high immunity. Not even a steady diet of Vitamin C, antioxidant juices and high protein will spare me. I ruminate, I stress, I organize and reorganize. I hold myself to standards and expectations of performance in all areas of my life that I would consider foolish of anyone else. It's not a negative trait, really. It's simply one that needs tempering and moderation. One day, my husband and stepson endlessly leaving lights on will not bother me so much, money and bills will not cut me to the core so easily, feelings of self-worth and adequacy will not be questions so strong. I will mellow, as my husband says, with age. I will find my niche, I will be less wound, more calm and centered. I admit, I may not be as hard off as others, but until I ease my struggling inability to cope, I'll leave my doors and windows wide open for those buggy invaders.
I reach for another Puffs Plus. "So this is why I get sick all the time?" I ask him. He nods. Although I already know this, it's a relief. My easy contraction is simply a combination of circumstance and environment. The threefold triangle: youth, employment, a hectic life. A recipe for my susceptibility. So I will wear these common colds with a bit of uncommon pride because they are due to what I didn't have only a mere few years ago. Perhaps it is a fair trade. A full nose for a full life.
"Well, I take that statement back," my husband says, after a little thought. "You're still very young." Normally, this would be considered an insult. My youth is not a handicap, I will not allow it to be. Nor is it an excuse for ignorance. Yet, with the overwhelming evidence before me, it'd be foolish not to recognize that this time, this one time, my delicate years are not in my favor here. My husband, more than twice my age, rarely falls ill. He's had time, years, to build immunity to the majority of strains we're exposed to daily. I have not. When a new pathogen invades, my body doesn't understand what it is, only understands that it's foreign. So it attacks, and attacks hard, in order to develop that immunity, that recognition for the next go-around. In a sense, immunity is a form of maturity and all maturity takes time. And it takes a lot of trial and error, a lot of getting sick.
"And," my husband continues, "you work the ideal environment. You're exposed all the time." I simply nod to that one, put another tissue to my aching nose and feebly question my commitment to nursing. I think about the last day I worked. Thought about how many of the residents were coughing, spewing airborne particulates, wiping dripping noses and touching things. I cringe. It's not that I don't practice precaution, I certainly, neurotically, do. I carry antibiotic alcohol gel with me at all times, and after touching a resident or a particularly common item, I put it on as liberally as lotion. Then there's the handwashing itself. Before and after using the bathroom, before and after eating, after sneezing, after coughing. As well as at any random moment in the shift when I feel it's just the right thing to do. My hands sting by the time I get home, and if they don't, I know I did not wash them enough. Then there's the constant mantra, "don't touch your face, don't touch your nose, don't eat with your hands, don't wipe at your eyes, leave your glasses alone." Yet, in the end, all precautions aside, I and no one else, can choose the air we breathe. I can choose the work, but not really. I love what I do, and believe I'm simply on a hyper-road to immunity.
"Then," I hear my husband still going on, "you take things so seriously. You're always stressing out about something." I turn my face into the pillow on this one. It is so true, beyond true, it is pure and simple reality. Choosing a high-activity, high-stress lifestyle will never bode well in the pursuit for high immunity. Not even a steady diet of Vitamin C, antioxidant juices and high protein will spare me. I ruminate, I stress, I organize and reorganize. I hold myself to standards and expectations of performance in all areas of my life that I would consider foolish of anyone else. It's not a negative trait, really. It's simply one that needs tempering and moderation. One day, my husband and stepson endlessly leaving lights on will not bother me so much, money and bills will not cut me to the core so easily, feelings of self-worth and adequacy will not be questions so strong. I will mellow, as my husband says, with age. I will find my niche, I will be less wound, more calm and centered. I admit, I may not be as hard off as others, but until I ease my struggling inability to cope, I'll leave my doors and windows wide open for those buggy invaders.
I reach for another Puffs Plus. "So this is why I get sick all the time?" I ask him. He nods. Although I already know this, it's a relief. My easy contraction is simply a combination of circumstance and environment. The threefold triangle: youth, employment, a hectic life. A recipe for my susceptibility. So I will wear these common colds with a bit of uncommon pride because they are due to what I didn't have only a mere few years ago. Perhaps it is a fair trade. A full nose for a full life.
Sunday, November 1, 2009
Process Essay
At some point after entering healthcare and realizing its emotional mine-laden environment, I took up the hobby of hunting down really good books. It's a coping tactic, mostly. To enter into another world full of life, life that essentially doesn't matter. It's become a useful escape, a chance to be just a little more literary and an excuse to tuck away from life for a while. To recharge the batteries needed to deal with the occasional monotony and frequent responsibility of caring for others. It's a ritual now, and every couple of weeks, usually on a payday, I will search for a little piece of gold between two covers at the bookstore. I enjoy the research, the hunt, the succulent success of finding the next perfect novel to fill my downtime.
First, while I'm nearing the end of the last book I purchased, I do a little research of what to read next. I'm not like my husband. I don't enjoy picking up any old tattered thing and, even after I'm sure I hate it, keep reading for the sake of completion. I find this to be an insulting waste of my time. So I look things up, I dig around a bit. One place I've come to enjoy is a website called Shelfari. Each member has their own "shelf" and will write impromptu book reports of what they've put on it, or will at least rate the quality. With the wonders of technology in favor, the site will also suggest what to read next based on what I've already read and have placed on my shelf. Since we tend to be creatures of habitual likes and dislikes, this is very useful. Some websites ask a series of questions of what I'm looking for, funny or sad? safe or disturbing? sex or no sex? I pick my categories and a list of books to consider is generated. Other sources I only rarely admit to looking into is The New York Times Bestseller List and even Oprah's Book Club.
After I have a list of a few potential "readers" in hand, I schedule a day to head to Borders, heaven on earth, to browse the shelves. I like the scheduling part. It's a beautiful thing to see "Go To Borders, 1:30" next to "Pap Smear, 8:05" and "Groceries." Amongst all the must-dos in life there are the occasional, glorious want-to-dos that keep us humping along. I usually go on a Friday, park far enough away to take my time smelling the crisp air as I walk, enter the double doors with the brass handles, through the alarms and stop. Briefly, only for a moment, long enough to take in the smells of coffee, breakfast brownies and cakes, and to hear the rustling of pages and soothing tap of laptop keys. I clutch my list, excitedly as a child in a toy store, and say with satisfaction, "I'm just browsing," as a staff member comes to help me. I'll find all the books on my list, usually consisting of four or five choices, and pile them up in my arms. I have found in bookstore culture that it is perfectly acceptable to sit down on the floor, which is usually a rug, and browse through your picks. As long as you and your shit is not in the way of passing patrons. I like this little trait. It's intimate, homey, and completely socially unacceptable anywhere else. So I bid my germ phobia goodbye for a half hour, rebel against my Purell and sit cross-legged in the fiction section. I begin to acquaint myself with what I've picked and start whittling away at the list until one sole survivor has made the cut.
Then, at this point of the ritual, the process, I put all other books back and make my way to the section where the rug turns to wood floor and the shelves are replaced with tables and chairs. Here the techies swarm, eating up the free wi-fi like hummingbirds to flowers. Sometimes there's an elderly man reading a paper newspaper and a couple or two having croissants and coffee for brunch. I order a coffee with a funny flavor and settle in. This is where I read several pages, as a minor preview, to see what I'm getting into. This, in a sense, is foreplay. I need to vibe with the author, I need to be sucked in, to become unaware of my surroundings as I sink into the words. Within the first few pages I need to be intrigued, piqued, moved, before I will even consider continuing. I am with books, as in most areas of my life, high maintenance. When I've read enough to be satisfied and secure with the purchase, I finish my coffee and head to the checkout counter. I will hand the lady my Borders Rewards card and she will ask, "Did you find everything alright?" Yes. And savored every moment of it.
Most people find my book-searching methods painstaking, neurotic and mildly obsessive. Perhaps, but they can keep their ideas. These are the same people who smoke on their breaks, drink to oblivion on the weekends and become compulsively ill whenever the caseload gets too high. Not I. Stress punches at me just like it does at anyone, maybe sometimes more. During each shift however, no matter how much a hurricane, I have the richness of that book to look forward to. To end my day. Curled in a warm bed with my husband snoring next to me, I read into my own sort of heavy abeyance that won't leave me sick in the morning. My book searches are the moments devoted entirely to myself, time taken to be alone, to enjoy solitude. To, as Franz Kafka said, ..."break the seas frozen inside our soul."
First, while I'm nearing the end of the last book I purchased, I do a little research of what to read next. I'm not like my husband. I don't enjoy picking up any old tattered thing and, even after I'm sure I hate it, keep reading for the sake of completion. I find this to be an insulting waste of my time. So I look things up, I dig around a bit. One place I've come to enjoy is a website called Shelfari. Each member has their own "shelf" and will write impromptu book reports of what they've put on it, or will at least rate the quality. With the wonders of technology in favor, the site will also suggest what to read next based on what I've already read and have placed on my shelf. Since we tend to be creatures of habitual likes and dislikes, this is very useful. Some websites ask a series of questions of what I'm looking for, funny or sad? safe or disturbing? sex or no sex? I pick my categories and a list of books to consider is generated. Other sources I only rarely admit to looking into is The New York Times Bestseller List and even Oprah's Book Club.
After I have a list of a few potential "readers" in hand, I schedule a day to head to Borders, heaven on earth, to browse the shelves. I like the scheduling part. It's a beautiful thing to see "Go To Borders, 1:30" next to "Pap Smear, 8:05" and "Groceries." Amongst all the must-dos in life there are the occasional, glorious want-to-dos that keep us humping along. I usually go on a Friday, park far enough away to take my time smelling the crisp air as I walk, enter the double doors with the brass handles, through the alarms and stop. Briefly, only for a moment, long enough to take in the smells of coffee, breakfast brownies and cakes, and to hear the rustling of pages and soothing tap of laptop keys. I clutch my list, excitedly as a child in a toy store, and say with satisfaction, "I'm just browsing," as a staff member comes to help me. I'll find all the books on my list, usually consisting of four or five choices, and pile them up in my arms. I have found in bookstore culture that it is perfectly acceptable to sit down on the floor, which is usually a rug, and browse through your picks. As long as you and your shit is not in the way of passing patrons. I like this little trait. It's intimate, homey, and completely socially unacceptable anywhere else. So I bid my germ phobia goodbye for a half hour, rebel against my Purell and sit cross-legged in the fiction section. I begin to acquaint myself with what I've picked and start whittling away at the list until one sole survivor has made the cut.
Then, at this point of the ritual, the process, I put all other books back and make my way to the section where the rug turns to wood floor and the shelves are replaced with tables and chairs. Here the techies swarm, eating up the free wi-fi like hummingbirds to flowers. Sometimes there's an elderly man reading a paper newspaper and a couple or two having croissants and coffee for brunch. I order a coffee with a funny flavor and settle in. This is where I read several pages, as a minor preview, to see what I'm getting into. This, in a sense, is foreplay. I need to vibe with the author, I need to be sucked in, to become unaware of my surroundings as I sink into the words. Within the first few pages I need to be intrigued, piqued, moved, before I will even consider continuing. I am with books, as in most areas of my life, high maintenance. When I've read enough to be satisfied and secure with the purchase, I finish my coffee and head to the checkout counter. I will hand the lady my Borders Rewards card and she will ask, "Did you find everything alright?" Yes. And savored every moment of it.
Most people find my book-searching methods painstaking, neurotic and mildly obsessive. Perhaps, but they can keep their ideas. These are the same people who smoke on their breaks, drink to oblivion on the weekends and become compulsively ill whenever the caseload gets too high. Not I. Stress punches at me just like it does at anyone, maybe sometimes more. During each shift however, no matter how much a hurricane, I have the richness of that book to look forward to. To end my day. Curled in a warm bed with my husband snoring next to me, I read into my own sort of heavy abeyance that won't leave me sick in the morning. My book searches are the moments devoted entirely to myself, time taken to be alone, to enjoy solitude. To, as Franz Kafka said, ..."break the seas frozen inside our soul."
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