Monday, May 08, 2017

My Worst Nightmare

This past weekend on call, I came face to face on Saturday night with a patient facing the situation that I myself most dread: old, impoverished, alone, with friend after friend dying. In severe physical pain, unable to care for herself. Terribly anxious. She said that one of her caregivers tells her repeatedly that she is going to lose her Section 8 housing and end up homeless, her worst fear. She detailed loss after loss: her departed friends, her estranged son, the daughter that moved far away, the fiancĂ© who died decades ago, the deity who no longer seems to be there. I sat with her for an hour holding her hand; her nails were painted bright red and her hair was freshly dyed blonde: in some ways, she has not given up. She mentioned that having a glass of wine helps with her pain and anxiety.

After I left her, I briefly considered looking for another tech job. But, no, I am on a completely different path and get continual affirmation that it is right for me. I may also end up physically ill, broke and in unstable housing, but I would at least like to avoid ending up engulfed in sorrow, complaints and negativity. Back in the sleeping room, I fell asleep doing metta practice for this patient. I believe every single second of practicing gratitude or goodwill is beneficial, and may even lead to fewer external losses. It is easy to imagine people avoiding a person who is focused exclusively on what is tragic and horrible. I do believe our greatest wealth is our friendships. As Delia says, “Connection is protection.”

I also decided to redouble my efforts to let go of F. I haven’t seen him in six months, but it seems as if I see him out of the corner of my eye all the time. I still can’t quite believe he is gone, but I don’t want to be brooding about this 25 years from now, so I will try to entertain fewer thoughts of him. Maybe one of these days I’ll even delete the final batch of his voice mails. I don’t listen to them often, but I like knowing I can hear his voice if I want to.

I must say, I felt a lot better (on my own behalf, that is) when I charted my visit with the sad and scared patient the next morning and saw that it’s not just sheer bad luck that has overcome her; she also has a longstanding substance abuse problem.

When I arrived for this shift on Saturday, the departing chaplain said he’d gotten precisely one page. He must have tampered with the pager before he handed it to me, because I got 17 pages, including a Code Blue, two deaths, and a mistaken page from a doctor, which came at 11:30 p.m., after I was asleep.

The deaths were both on Sunday, the first and last visits of the day. One was a woman barely into her 30s. The other was a patient who had come to the hospital to receive a new organ. His family expected a new beginning, not his sudden death during surgery. I explained to them that they were welcome to see their loved one, but that he would look exactly as at the moment of death, with any tubes still in place. Then I escorted them to the viewing room near the morgue and hung out there for an hour or so. Normally we prefer to do viewings during the work week, and we try to limit them to 30 minutes, but since this was such a terrible shock, I was instructed to let them take all the time they wanted. For part of the time, I hung out in the hallway with the two youngest members of the family, whose parents didn’t want them to see the departed relative. Later, one of the parents changed his mind and his 10-year-old went into the viewing room. I’m sure he will never forget this day. Of course, none of them will.

1 comment:

Anonymous said...

Sometimes it's helpful to take a *mindful* look (that is, to examine any unacknowledged lenses that we might be judging anothers experience through.. ) at how we are understanding karma. Often times there's a sneaky little way the idea that it's about everyone getting what's coming to them. this can be reassuring when we see something scary about anothers experience or behavior and we can rationalize how it won't happen to us... and a way in which privilege (the privilege of a life that didn't contain the same challenges that have nothing to do with the person as an individual as someone else) can corrupt how we understand another in more difficult circumstances. Maybe this person's substance use was related to feelings of alienation and disconnection to begin with, and her circumstances were always just difficult enough to prevent her from being able to get enough of a leg up to move through and past her fear. Working through serious difficulty does require a certain amount of safety somewhere - either in knowing we have the resources to deal with difficulty sufficiently or in having enough of a community that can forgive and allow that process to happen without rejecting them for struggling. People that have always had those things but don't recognize the privilege that this involves often times project that someone else's difficulty is merely the affect or their own attitude, and simplistic but well meaning people suggesting it's 'in their power' to simply change their attitude are spiritual bypassing. Certainly her behavior influenced how people responded to her, but is it her 'fault'? The way in which you stated it there is an air of blame or judgment coming through. True compassion sees through this and does not need to find separation. In Buddhist teachings it is very clearly stated by the Buddha that karma is quite complicated and not all of our circumstances are connected to our own karma. On an ultimate level we are entirely responsible for ourselves, but the truth is that there is no separate 'self' so we also hold a responsibility for others. The Buddha understood this and this is why is placed 'Sangha' as ultimately important in the process of waking up. It is strange to me why the conversation around 'privilege' seems to miss the actual dharma of privilege and the benefit of this kind of understanding is offered to only certain groups. I believe you would defend to the death someone being judged in such a way who fit into certain groups, and recognize the ways in which that person's experience influenced their current situation; and demand that those judging and dismissing recognize their privilege.