Monday, March 31, 2014

Back Page Collection

One of the activities keeping me busy over the past months as I was not blogging was freelance writing. Some of my work has been for a German publisher and has to be bought to read -sorry 'bout that. But I have been contributing more regularly for Richmond's Weekly Magazine, Style Weekly.

I have a long, strange history with Style. My mother worked as an editor there in my youth. Naturally I considered those the glory years of the publication (until they started paying ME).

I was named one of their Top 40 under 40 one year, a huge honor. But the way the piece came out caused a bit of... let's say animated conversation. All agreed the photo by Jay Paul was jaw dropping in loveliness, however.

Style reported on my final day at one of the churches I served. That was pretty cool.

And now whenever they want something unpredictable, they call me and I write for their Back Page. Long strange trip it is. I hope to keep truckin' with Style.

Here are the 4 columns I've done so far. If you like them, let Style know. I like their assignments they offer me and their checks always clear.

Sci Fi Socio Political Parenting Piece (With Ed Harrington's very creepy graphic. I love it.)

New Year's Resolutions 2014

Some Sodomy Humor

How Obama Can Win the 2012 Election (Voter sex piece.)

Techno Bust

continued again it in the complete and total engraved answering machine you must be bad.

Hmmm, well never mind on the voice recognition plan for blogging.  I'll check back in later when I am done lamenting the lack of engraved answering machines in my life.

I must be bad.

Sunday, March 30, 2014

The Mayor of the Hospice Unit

Most people think of dying at home when they think of hospice. Then again, most people don't want to think of hospice at all.

Although I work for hospice, I work mostly in a hospital. On the hospice inpatient unit our job is to find solutions to complex pain and symptom issues unmanageable at home. Well, that is the medical side of it. As chaplain, my job is to be with people and their loved ones in a way that reminds them of what they value and hold dear. Yes, I have the better job. No, I'm not one bit biased; I just hate suction tubes, suppositories, and the math involved in pharmacology.

It is not uncommon for us to have patients for only a day before they die. It is not uncommon for us to have a complete turnover in our unit within a week. Hospital staff think, "Well, duh. That's our life every day."

The difference is that hospitals have the goal of prolonging life. Our goal is to relieve suffering, provide compassionate connection, and prepare for death. The difference in our goals changes the style of care. An example of the difference: when I worked on regular units in hospitals and patients died, there were often many staff in the room because some sort of emergency code had been called. Everyone is talking, rarely is anyone talking to the patient. Family is asked to step outside. People have side conversations about their shift, the president, a sale at Kohl's; nervous conversations based in the fear of failure.

Vigorous attempts are made to save a life, an anonymous life. When the patient dies, comforting of the staff takes place in private because an environment in which success equals life has difficulty balancing the reality of grief and loss. (Don't get me wrong- if I should choke while we are eating tapas, get me to the hospital quickly. I'm just saying the perspective is not warm and fuzzy.)

In hospice when a patient dies we move slowly and deliberately. Prayers are said if appropriate, soothing words if not. There are no alarms or bells, few tubes or machines. If family is present, they are surrounding the patient and only a couple of staff are in the room at the same time. We all know the dying person's name.

Unless we are singing or praying, we the staff are very quiet. Afterwards we may give each other hugs, or thank one another for the care we gave that patient. In the best cases, we have come to know the family, so we better understand what this particular loss means to them. We talk about the patient again after death to assess the bereavement risk for the family, and if we were there, to share our opinions on whether it was a "good death" (when the patient dies in a way that was in line with their hopes). This latter part is important to us because we want every patient to die well, but know that this is not something we can truly control. The assurance that the best end occurred is a great comfort to hospice workers.

Which brings me to the Mayor. The Mayor was a member of the Greatest Generation. He was on our unit for a couple of weeks getting symptom management. He sat up and received visitors like a priest receives confessors. He smiled when staff came in. He read books and magazines. He was sound of mind, strong of character, and a gentleman in every way.

We planned to send him home with his medications stabilized to be with his family for his final weeks or months. I went home from my shift on a Friday after saying good night to the Mayor. It's a habit you get into with certain patients. When they are fully aware of their surroundings you give them the respect that you would give them if you were a guest in their home. Before you leave "their place" you say goodbye. At least I do.

When I would check out with the Mayor, he'd look over his reading glasses, put out his hand for a shake, and bid me a happy evening. He also always thanked me for coming to see him, even though he had visitors every day. What a guy.

I came back Monday morning and went to say hello but the Mayor had gone home. It was a great way to start the week. The Mayor had become well enough to go home and live in the comfort of familiar surroundings. Or so I thought for about thirty minutes. And so did several of my co-workers. We were all smiles.

In team report we covered the deaths of the weekend. The Mayor had not gone to his home in Richmond but to his eternal home. We were shocked and distraught. How could this happen?

Now you are probably thinking, "You work in hospice every single day and you get distraught when a patient dies? One patient?" Well, yeah. It's called a breakdown in compartmentalization and here is how it works.

We can all agree - working in hospice is not easy. There have been 12 patient death weeks at our unit. And I mean work week not 7 day week. There are a limited number of ways to deal with that and remain engaged and open to the next 250 patients, much less 250 more families. In general, we do it through routine.

Our patients mostly die according to a couple of patterns. We learn the patterns and we say goodbye to them incrementally according to the pattern. We can handle it as long as it stays within the emotional safety of the rhythm we know which is usually one of gradual decline in communication and interest in the outside world. Just as a baby becomes increasingly interested in the world beyond what she can reach as she grows, the dying person becomes less engaged the closer she comes to death.

Until they don't. Like the Mayor.

On the last day of the Mayor's life he ate three small snacks, read a magazine, hosted family and guests in his room, and took a nap. As he was getting ready for bed he began to feel ill. He was sitting on the side of his bed waiting for the nurse to assist him to the bathroom. She entered and he shared that he didn't feel well. They talked. She checked on his vitals and she realized that the Mayor would not be following the pattern. She told him. He talked to her. She held his hand and laid him on his bed. She talked quietly to him and he to her until he died. It all lasted ten minutes.

The Mayor didn't die as we or he had hoped or planned. He was in a hospital not home. He was without his family. He had not finished his plans.

But he died with someone caring for him. Someone holding his hand. Someone who knew his name. Someone who mourned him when he was gone. Staff all hugged each other quite a bit that day we found out how the Mayor had died. Then we went into other people's rooms and remembered to give a little extra eye contact, hold their hands, and say goodbye when we left for the day. The dying may never end with hospice but neither does the learning.

Newcomer Introduction

Wanna know what I've been to since conception? First - you need a better hobby. Second - well, ok.

Life History or at least the good parts.

1970's - Idyllic childhhood in Richmond, Virginia filled with urban living, roller skating, dancing,reading and marching to the beat of a tune heard only in my noggin.

1980's - Discover boys, DIY fashion design, poetry, Prince, and an interest in theology. Go to college. Fail to fit in. Revel in that.

1990's - Throw away youth on formal education including seminary. Learn that hate is a word reserved for: endless committee meetings, traditional worship styles, cookie cutter weddings and funerals. Determine that organized religion can easily disintegrate into a 4 letter word. Tap into an unknown gift of calm and comfort in the face of death. Go into hospice work because death is not the worst thing that can happen to a person.

2000's - Have babies! Love babies! Have babies suck the life out of me. Brainwashed by unknown forces (aliens? ghosts? zombies?) to go back into parish ministries within "organized" religion for over 6 years. Transform the concepts of death rituals and worship experience for a small set of religious liberals who reward me greatly. Blog, rebuild some crucial closets and bathrooms of the Gulf Coast after Hurricane Katrina, learn a ridiculous amount about death, dying, grief, funerals, cemeteries, and death related legislation. Leave parish ministry in search of sanity, time with the "babies", and a family business.

2010's - A roller coaster. High points include teaching hundreds of students on a variety of topics, writing, protesting uterus obsessed legislation, mentoring the "babies" in State Fair arts and crafts competitions, learning to play full body tambourine in New Orleans. Low points include family tragedies and marital dissolution. You can't have everything, right?

These days - Revel in the opportunity to provide my offspring with an idyllic childhood in Richmond. Rejoice in urban living, roller skating, dancing, reading and marching to the beat of a tune heard only in my noggin.

Saturday, March 29, 2014

Luddite Lament

"And now I'm back... from outer space... you just walked in to see me here with that same look upon my face..."

 I have been locked out of the Jots world for MONTHS. Madness, chaos, misplaced passwords, rabid procrastination, technology continuing to advance while I wonder where I put the instructions for my stereo.

Oh, yeah, and now that I am back I see all the stuff I was trying to fix on this thing when I locked myself out. Ugh. No wonder it took me so long to get back. Luddite life - you never really put it behind you.

Well, this loooong silence no doubt separated the wheat from the chaff as far as my dear twelve fans are concerned. I have so much to update the remaining three of you on! There have been publications. There have been radio shows. There have been T-shirts designed! There are zines in the works. There was the world's zaniest birthday cake. Most importantly, I neither broke any part of my body nor had any catastrophe.

The only bad news is that I work six jobs in order to keep my children in shoes that fit. They are very tall and I daily wonder how that happened. The balance is that one of those jobs is paying for health insurance. I can't afford a co-pay yet but... baby steps.

So, if all goes well (toes and neck hair crossed) this is the first of several entries bringing us back together and caught up. Please feel free to say hi in the comments. I've missed you three.