A Day in the Life...

Yes, I’m a hospice nurse. So no, it should not surprise me that I witness death more than occasionally. And yet when I do, it is sometimes deeply surprising, deeply mysterious, and depending on the circumstances, deeply unsettling.
This morning, I had an early call from the daughter of my dying patient. From what she described, I knew he was close, possibly on the very brink of death, and I told her I would be there as soon as I could. I drove the 40 minutes through Friday morning traffic and I confess to having yelled more than once at a driver who was less than speedy to turn a corner or start up at a green light.
When I got to his house, my patient was indeed close to death. His family were gathered around his bed. This man had been vital and almost fully functional when I first met him just eight days ago. Now he was transitioning out of his body, out of his life. Pancreatic cancer. My private name for it is the rapacious beast. I have another less polite name for it also.
It was an ordinary Friday morning. As he took his last breaths, I saw someone walking their dog on the road outside his bedroom window: the uniquely ordinary as a backdrop to the extraordinary scene unfolding in the room. The sacred and the profane.
I tried to keep him comfortable. I tried to comfort his grieving family. I told them that what we were seeing was not unusual, and that he was probably beyond feeling distress. We say these things, we hospice nurses, and we hope that they are true.
I left them and went upstairs in their house to put in some medication orders. I just felt bad about leaving them there, and as though I should stick around just for a few minutes. Finally, there was nothing more for me to do and I went downstairs into his room to tell them I was leaving. As I got there, I witnessed, as they did, his final breaths. I watched him die.
Eight days before I had chatted with this man about his hospice prognosis, his goals for care, and his plans to fly across the country this week to see family. The rapacious beast had other plans. I stood in his bedroom as his wife and daughters said goodbye to him, and I felt like an intruder. I had a job to do - to confirm the absence of a heartbeat or breath, to note a time of death for his death certificate, to call the mortuary and arrange for the collection of his body. It all seemed like an intrusion on this family’s terrible grief.
I thought about my own mom’s death in 2015, how it felt to me that day as though the world had changed forever. I remembered wondering how anyone could be having an ordinary day that day, when my world had shattered. Today was like that for this family. I was witness to the shattering of their lives.
When the time seemed right, I took care of the details I needed to and I left them.
I had four more patients to see. As I drove to the next visit, I realized my own grief was too strong for me to stuff it down and just go about my day. I pulled my car over on a side street and sobbed. People were out walking their dogs. There were men doing roadworks. I sat in my car and felt wracked with a sadness that wasn’t even fully for my patient or his family. Sometimes it’s like all the deaths, all the losses mount up and the sadness of one triggers the accumulated sorrow of all of them. I called some members of my team hoping to talk with someone. Eventually I connected with my awesome team leader, and I cried on the phone with her and she listened and talked me through the meaning of our work. She reminded me of our capacity as hospice workers to help people who are suffering. And she honored the heaviness of what we do.
Then I drove on to my next patient, and the next, and the next. Happily, like pretty much every day doing hospice work, there were funny and absurd moments throughout the rest of my day and I probably laughed nearly as much as I cried.
Plus it’s Friday, so tomorrow I will get on my bike and ride out into the wilds of West Marin where the Spring flowers are bursting out on the roadsides and hawks soar on the thermals and at the edge of our continent the waves just keep on washing up on the beach like there’s no yesterday and no tomorrow.

Riding Fool

I keep expanding my blog description as I find new things I want to write about. Now it’s “the curious life of a poet novelist hospice nurse and riding fool.” Let’s hope I don’t take up any embarrassing crafts or things will just get out of hand.

In the spirit of writing about what is most up for me, I want to write about my ride today. I’m in training for the Climate Ride (road bikes, 5 days in May, 320+ miles south along the California coast taking in the Avenue of the Giants, Mendocino Coast, and a final day ride over Mount Tamalpais and across the Golden Gate Bridge into San Francisco). Even writing about the ride gets me excited. This is a dream of mine. I’m having to raise $3k for climate action to participate so it combines two of my biggest passions, and it’s becoming a little more of a reality every day.

Today I needed to do 50 miles. I woke at 5 and pre-ride anxieties crowded in. What if I get a flat today? What if I’m just not up for 50 miles? What if some moron in an F150 tangles with my bike?

I was riding with my buddy Michael. As I drove my bike to his place in San Geronimo, the thick fog dispersed and sun broke through. Felt like a metaphor. The moment I got on my bike and clipped in, I felt it again: that clarity of joy and delight at being out on the road in the chill air and crisp sunshine with nothing between me and Marshall but a couple hours of pedalling.

Being on the road allows you a sweet abundance of time to think. There’s no phone, no work emails to check, and you can’t see how badly in need of cleaning your house is. Today as I rode Highway One north from Point Reyes Station, I began to understand what I had read about ‘becoming one with the bike.’ That was just words to me when I first read it. Today I realized I was shifting gears up and down without thinking. Tap, clunk. Tap, clunk. My body was responding to the flow and tilt of the road without having to think: left upper shift is chainring up, right lower shift is cog down, which is harder, for downhill. Today, after months of riding, my hands were just shifting the gears in tune with how I saw the road’s character ahead. This left me free to think and dream and let lines for a new poem form in my head.

As we rode, Michael told me about the Climate Ride he just completed in Death Valley. He described the optical illusions that occurred on the steep hills there: how riding up for a long period, his eyes would start to tell his brain that the road ahead was downhill, so his brain got really confused because he was having to pedal so hard to ride down hill. The reverse was also true on the downhills. I know Death Valley intimately, but have never ridden there, only driven and walked, so this was fascinating to me. I tucked the information away in case I need it on the long hills of the climate ride.

Towards the end of the ride, Michael observed that I was riding faster. I thought I was really slowing down. The long north side of Nicasio Hill, I felt like I was riding through molasses.  “Must be the eggs,” I said. As I get close to the end of a long ride, I always start to plan how I’m going to cook my feast of eggs when I get home. As we spun down the south side of the hill and into the San Geronimo Valley, with Michael’s house and my car in sight, I realized it was more than just the promise of protein: it was that pure heady rush of joy and accomplishment that I feel at the end of a long ride. It was the acknowledgment of how lucky I am to be healthy and strong and able to ride my bike for 5 hours on a Sunday. And it was thankfulness that I live in paradise and that the morons in their F150s gave me a free pass today.

Cat Finishes Novel For Me

Conversation with my cat just now:

Me: Get off the kitchen table.

Boo Radley: It’s okay for cats to be on tables.

Me: No, it really isn’t. Get off.

Boo Radley: Well. I’ll be here on the table if you need me.

Me: Really? Could you make me a cup of coffee?

Boo Radley: No.

But that’s not really what I wanted to talk about. Today is rainy, and I am home sick with nothing to do but curl up on the couch and work on my novel. It is at the tricky stage of having been endlessy prepped from every angle to show to the publisher. Every angle except for the minor detail of the ending. 

Never my strong point, endings pose a variety of challenges. They have to be brilliant, for one, and leave the reader feeling that that was hands down the best novel they have ever read, if not the best ever written. And they have to be deeply satisfying, providing just the right amount of closure to every door the novel opened, but without being predictable or cliched. They have to be stunning. Did I mention the bit about the best novel ever? Yeah. So no pressure.

The first draft of this novel ended in a kind of cliff-hanging way. I was going for a sort of Italian Job effect (the first movie, not the Markie Mark remake). And I think I achieved it. The sad part is, as an ending, it pretty much sucks. The main character is heading off for an event the outcome of which is unknown and deeply significant. I know the outcome, because I am the author. But I didn’t tell it to my readers. Because that would be, I don’t know, spoon feeding? Because I wanted to leave it mysterious? Because I actually couldn’t decide between the two possible outcomes? It was all of the above, really, but it leaves me with the problem that the ending to my novel sucks. Thus, it will have to be rewritten before I can show it to the publisher. See paragraph about endings above. 

In an effort to recraft the ending, and because I could not bear to stop writing about my characters, I have written some material beyond the original ending. Right now, that material stands at 140 pages of dense type. I really, really loved these characters. The good news is, I have plenty of material to pick and choose from to retool my ending. The bad news is I have no idea where I should go with it.

Happily, I have a bad cold, I can’t go to work today, it’s raining so I actually want to stay indoors, and oh yes, I have a cat who is there when I need her. She’s currently napping on the piano, but I feel confident that when she wakes up, she will help me solve the ending to my novel. Cats are known for their narrative and character development skills. Boo Radley has a deep understanding of the arc of a story. When she stares at me, I believe I can almost see the perfect ending to my novel in her eyes. Either that or she’s thinking Do I have the energy right now to leave the piano and go nap on the kitchen table?