Sunday, August 27, 2006

Grief - the Written Word

As I've mentioned before, JennyNYC and I have been working on a poetry project where we write a poem a day to one another. We are now up to about 115 poems. Though I haven't been keeping up to the every day pace the past week or so, I am still getting a lot out of the experience - both in expressing some of my more uncomfortable emotions creatively and in the inspiration that has come from reading Jenny's words. This is one of Jenny's more recent poems that she consented to letting me post on this blog.

by Jennifer

A mother comes in one day at the end of her rope.
Her two ten year old twin boys,
who I've been seeing for therapy
along with their mother,
are driving her nuts.
"Ever since their dad died
it's gotten worse and worse!" she explains.
"Their dad used to make all the rules
and make sure the boys followed them.
Now there are no rules,
and it's gotten out of hand.
They're nice boys
but I can't live this way."
The mother and I sit down and think up rules.
I tell her to stick with the basics,
both for rules and for consequences.
The boys join us in my office,
and we talk about how it is at home.
It turns out they don't like the chaos either.
Then I bring up the rules,
and after reading a few of them,
like, "No cursing,"
and "Brush your teeth before bed,"
the twin who is usually the unemotional, "tough" one, Sean,
throws himself onto the floor,
curls up into a ball,
and begins to sob.
It's late evening in the clinic,
and his lone, heartwrenching cry
fills the empty hallways,
as the three of us listen and look,
frozen witnesses,
shocked, worried, and awkward.
Sean's twin, Johnny, says, "C'mon, Sean,
these rules are easy," but Sean can't hear him,
lost in a painful moment.
Johnny muses aloud,
"He's crying more than he ever has
since Dad died."
Johnny and the twins' mother
slowly ease themselves to the floor beside Sean
and put their arms around him.
Knowing Sean's usual distaste for physical affection
I tense up, fearing that Sean will lash out at them.
But instead he allows his family to hold him
providing comfort and sharing in the painful knowledge
that his father is not coming back.

This is such a beautiful and moving poem. I can relate to this trigger for grief from my own personal experience with my divorce. I thought I'd worked through my grief, as my divorce happened over six months ago now and I've started dating and just generally feel much more centered and like myself again. But then my childhood best friend's grandmother died. She was a big part of my childhood. She was rather eccentric and being around her always put a smile on my face. Since my maternal grandmother died when I was young and my paternal grandmother lived in Florida (and was still living up a wild, youthful life), this friend's grandmother was much like a grandmother figure to me. But the trigger that came from her death had nothing to do with her really. I wrote and sent a condolance card to my childhood best friend. As I went to sign the card, I faltered. I hadn't signed a card since the divorce. For nine years, I had sent dozens and dozens of birthday cards, anniversary cards, graduation cards, and such - all signed with my name and my ex's. This was the first time I signed a card with my name alone. Alone. Solo. In moments like this, the last six months feel surreal, like a dream. How my life can change so drastically from the life I lived over the last nine years. I spent nearly a third of my lifetime with my ex. The things I am grieving are manifold. On top of the loss of the relationship and the family we had become, there is the loss of an identity - the loss of that "Me AND You" at the end of those cards.

Friday, August 18, 2006

Your Truth: "I Want to Drive Her Home."

"Your Truth" is a series of posts I have written describing end-of-life scenarios. These scenarios are in some way controversial - either due to an ethical dilemma or a particular communication challenge. Please read the scenario and then offer your thoughts on what you might do in this circumstance. Although these scenarios are all based on real-life situations, they are fictionalized so as to protect the anonymity of the person(s) whom the scenario was inspired by.

In this next scenario, we have a 82 y.o. Russian female who had a stroke that left her non-responsive (she is unable to speak nor move and her gag and corneal reflexes are absent). She had end-stage renal disease prior to the stroke. She is still in the hospital. The doctors have given her a prognosis of days to weeks to live. Her family, per her written advanced directive wishes (rare to have these done, but sometimes we're lucky enough to know what the patient would want), has decided to stop dialysis and start her on hospice care. The family would like to take her home to die.

The family is afraid, however, that she will die during the ambulance ride home. They are strongly opposed to her dying in an ambulance and so they would like to drive her home in their minivan. Despite education regarding the perceived improved comforts that would come with the ambulance ride (bed, pain medicine, gurney ride into the home), the family remain committed to driving her home themselves.

Now keep in mind that the minivan is not equipped with a bed and the patient would have to be phycially lifted into the minivan. Due to hospital liability issues, the nursing supervisor reports no hospital staff may help her into the van and therefore the patient must be transported home by an ambulance.

What might you do? What are the potential positive and negative ramifications of either option?

Friday, August 04, 2006

The Death Penalty

My blog is about death and dying, in general. But also as death has pertained to my own personal life. This has led this blog to focus largely on the issues of:

-symptom management
-issues with facing mortality

...and more.

Today, I met a paralegal who works for an attorney defending prison inmates on death row. I am opposed to the death penalty, personally. I have been opposed to it primarily on the basis of its misuse - the fact that those whom are executed are disproportionately minorities.

Inspired by my conversation with this paralegal, I decided to check out what the death experience is like for these prisoners. Having read about the actual process of euthanasia (that's really what it is) used in these cases, I feel even more strongly opposed to the death penalty. I will attach the link here, but I caution you, the descriptions of methods of execution found here are profoundly disturbing.