Hospice Nurse Single Mom Riding Fool and Hopeless Optimist Tries Hard to Resist Inspirational Quotes

I mentioned the story behind the title of my blog in my very first entry. But after several years, it might bear repeating. When Jessie was about three, I was wheeling her down our road in her umbrella stroller. We were approached by a neighbor, an old guy with a crooked back and a wry smile whom we often met out for his daily walk. As he passed, he said hi and I said hi and Jessie piped up from her stroller “hellogoodbyeonedaytheend!” She’s always had a knack for summing up the situation, that one.

I feel it’s ridiculous, but next week I’m going to turn fifty-two. Hello?? The phrase just a number certainly rings true for me. I no more feel fifty-two than ninety-five. Strangely, both of my grandfathers and an uncle died at that young age, so it has always been a number that carried a lot of weight in my family. I remember when I was a kid and my mom told me her dad died young: I thought, not that young! Now I think, holy crap, that young?!

Just over two years ago I got divorced, and that’s about the biggest Goodbye you can say, apart from the Last Goodbye. Being a hospice nurse, I see more of the last goodbye than most. So that’s goodbye taken care of.

On reflection, and especially if I live to a hundred and four, I think I’m sort of halfway through. I think I’m right at the start of One Day. So what does that look like? 

I know I posted a few weeks ago about setting up my OK Cupid profile one Sunday morning. And I know I went a bit quiet after that on the whole online dating thing. The truth of it is, I have met someone. In fact, the first guy who messaged me that morning, about a half hour after my profile went up. We texted for four days, and I caught a bad cold and then we met for dinner in an Italian restaurant. I chose it because although it was right by the freeway and had a cheesy sign with a map of Italy on it, I’d eaten there once and it had felt like a little slice of Tuscany. Before I went in to meet him, I sat in my car listening to Song for a Friend by Caamp. Don’t count your heart out baby, you’re good for another round. I listened to it to give me courage, but I also remember thinking that my life was about to change; that this was the last five minutes before my life took a whole new turn. 

After dinner, we kissed in the parking lot and I instantly gave him my cold. He was a champion: never complained, said it was worth it. I drive by that restaurant most weekdays between patients and I think about OK Cupid and how the phrase beginner’s luck doesn’t even begin to cover it. 

I remember when I read Eat, Pray, Love. I was enthralled and entertained by the Eat section. Italy, heartbreak, food, tears, laughter...what’s not to love? Pray was a little harder to get through. The ashram was very fascinating but the spiritual awakening a little tedious after a while. And love? I just lost interest. I mean, I was thrilled for her. After all she had been through I had lots of sympathetic joy that she met someone and it was fabulous. I just didn’t really enjoy reading about it. It was as though the spark was gone. The edges that kept her brilliant and funny were worn smooth by her new bliss, and the book just went off the boil.

A new love affair is hard to write about in a way that might interest anyone besides the two people concerned. Best kept to oneself, I think. Suffice to say that both of us deleted our OK Cupid profiles during that first dinner and we haven’t looked back. So there’s that.

One Day is looking pretty damn clean and sparkly from my vantage point. I’m about to turn a new age, the year is still fairly young and shiny, and Spring is just starting to show her colors and do a little dance on days when the rain lifts. There are daffodils and poppies, the acacias are golden and the magnolias beginning to open out their crazy big blooms. The world is tilting alarmingly towards derangement. But I have feelings in my poor old worn out heart that I never thought I’d be lucky enough to have again, and being a hopeless optimist, I’m very inclined to agree with John Lennon that everything will be okay in the end, and if it’s not okay, it’s not the end. 

However, I’m also particularly vulnerable in my weakened state to inspirational quotes off the Internet, which is a very clear sign to me that I should hold off writing about love. But if you can forgive me one, the one I’m holding to right now because it perfectly expresses my cheery hospice nurse philosophy is: love fiercely, because this all ends.

Hospice Nurse Makes Up How Her Day Was

Sunday I went on a bike ride with three of my good riding buddies. It was a familiar loop, I know every dip and crest of it, and when I wasn’t chatting with one of them I had time alone on the road for thinking. When I think of riding alone, the term clears the mind occurs, but it’s not quite accurate. For me, riding clears away the junk in the mind so I am free to focus intently and yet in a dreamy subconscious sort of way on what I really want to think about. Sunday, what I wanted to think about was what happened on Friday at work.

Sometimes I come home from my job and I’m talking on the phone with a friend and they ask how was your day? And I have to pause before I start telling them how my day was. Because truthfully, my day can sometimes only be described as crazily surreal and weird. And if I just launch into it, it might be alarming to folk who go to work and then come home and never encounter people in their last days or hours of life with the peculiar symptoms and the madly poignant painful sweet heartrending moments and conversations.

Last Friday, a patient of mine availed of the End of Life Options Act. In other words, she took medications to legally end her life. This was not a suicide. It was calmly and thoughtfully planned, and it was executed in accordance with California law.

Throughout the week I kept thinking: Friday, I’ll go see my two morning patients, and then go be with her while she ingests the meds. So I’ll drive to her house and I’ll be with her while she dies. I’ll watch her die. I walked through it over and over with myself, trying to anticipate what it would be like, how I would feel, how I could best support her and not let my own emotions get in the way. I’ll be there in her bedroom by the bed, I thought. I’ll talk with her a bit like we have talked on all my visits in these past few weeks, and then she will take the meds, and then she will slip into a deep coma and death. And that will be her last hour, and that will be her partner’s last few minutes with her, and that will be my Friday afternoon at work.

So as I rode by Nicasio Reservoir’s lush plenty on Sunday, reveling in how full it was after our bountiful rain, and exulting in the rush of being on the bike on the open road in the brisk headwind, I thought about how Friday afternoon went down. I cannot share any details, due to privacy laws, but I can tell you how it was for me.

The visit lasted three hours. My patient took the meds and they worked. It all felt simultaneously matter-of-fact and hugely surreal. After she died, I made the few calls I needed to make. I sent the emails I needed to send. I documented her death and discharged her from hospice, meaning she was deleted from the entire system, cancelling all future visits and notifying everyone involved in her care that she had died. Nobody was notified that she had taken the medications. Aid-in-dying medication ingestion is a private matter that is not shared with anyone other than those the patient wants to share it with. Her death certificate would have her hospice diagnosis on it as the cause of death. What went down in that room stays in that room.

When I left her house, I stood in the street outside for a few minutes with the social worker on the team, who had also been present. It was a brilliantly cold and bright February afternoon. Neither of us could come to a decision about what to do next. Our options were: 1) drive down to our hospice office and debrief on the visit; 2) go home; 3) have coffee somewhere and debrief between the two of us. 

We stared at each other for a while, and at the surrounding houses and gardens on the very ordinary street. We laughed at our own indecision, and quickly sobered as we realized how strangely paralyzed we felt by what we had just experienced. Finally, we agreed on the third option. It just didn’t feel possible to either of us to go into the office and be around people who might be having a fairly ordinary day. And neither of us wanted to go home quite yet and be with our families, for the same reason. As a hospice worker, sometimes it’s best not to lay your day on your loved ones. 

After we had coffee together, I felt I could go home. It was the Friday afternoon of a long weekend. I knew I would spend some of it with my daughter, take a bike ride with my riding buddies, and have time with my new love. I had support. I thought I’d need to grieve a lot for my patient, but I found that as the afternoon wore on, I felt lighter and lighter. I had cried at her bedside, holding her hand. I had shed tears after I knew she was dead. But she was free at last: it was what she had yearned for and was ready for. 

As for me, I had met a woman of extraordinary courage and strength. I had got to know her in a very intimate way, and she had asked me to be present at her death. Hers was an ordinary sort of bravery: not the stuff of medals or awards, but the kind of grace and beauty of spirit that I feel is the best of being human. And if there was any appropriate way to celebrate her life and her death, I felt that I could do it by riding the windswept open roads of West Marin on a sunny late Winter Sunday with the hawks and the new roadside waterfalls and the very beginnings of wildflowers that herald the Spring. 

Single Mom of Teen Wins the Lottery

Lately, as in today, I have noticed how talented my teen is at maternal put-downs. This is not news to me. She has been a teen for four years now, and before that she was a sassy kid. But the volume seems to have been turned up. Maybe because her boyfriend has gone away for three months, so we’re spending lots of time together. And I am, as you may recall, a very annoying person.

The first moment came when I was expressing an opinion I happened to have. Mom, she said, do your thinking inside your head. Perhaps I was rambling a little in the expression of the opinion. But can it have been all that terrible to hear? Apparently so.

Later, I was online perusing jackets I don’t need and came upon a really cool looking one. I showed it to my teen. Isn’t that cool? I mistakenly said. Yeah, she said, doing that thing with one eye that says Hell No. If you want to look like a conquistador. She fumbled conquistador in such a way that told me she didn’t know what the hell it was. I challenged her. She admitted to having no idea. It’s one of those Spanish types, I told her, who killed all the Aztecs and Incas in the 1500s. She smiled triumphantly. Well exactly! And there I was, foolishly impressed by a jacket that would make me look like a marauding genocidal 16th century Spaniard. Why is it so hard to win against a seventeen year old who doesn’t even know her history?

Later still, we were both sitting on the couch. She was watching a movie and I was texting. I decided to try something, just for a laugh. Switch out that lamp on the kitchen table, would you? I said. It’s shining in my eyes. And while you’re up, will you get my book from beside my bed? She looked up from her movie. Her look said, you’re kidding, right? Then her mouth said it. You’re kidding, right?

I was not kidding. As I patiently reminded her, there have been many many instances of her asking me to get things that are actually closer to her than they are to me. Or bring something in to her in her bedroom where she is sprawled on the bed doing nothing, even though I am working at the kitchen table. Or get something from a faraway place - not even in the house, sometimes. She did not recall any of these events.  

She went back to her movie. Apparently our short discussion of things beyond her recall had also erased her memory of my request. After a few minutes, I mentioned wistfully that I was really yearning for chocolate, but we didn’t have any. I admit, this was duplicitous of me, as I happened to know she has a Toblerone in her room. But the thing is, it’s dark chocolate and I only like milk chocolate. The 7-11 near our house has lots of milk chocolate. I mentioned this. I’ll go to 7-11, she said, still watching her movie. I’m not beyond running errands.

Ten minutes went by. Half an hour. I was absorbed in my book by then, the book I had fetched right after I turned the lamp out. She was absorbed in her movie. The chocolate stayed at 7-11. In the end, this is a good thing, because I am addicted to chocolate and would probably have eaten way more than a normal person should eat. Plus it was pretty nice just being on the couch together. 

You could say I have poor parenting boundaries, but that would make me sound weak and ineffective, so I prefer to think of it as picking my battles. She did cook me dinner while I was working, my teen, and it was completely delicious. I had to get up from the couch and physically show her the pasta that was sitting staring at her in our pantry. Then I had to identify that the mushrooms in a container she found in the fridge were indeed the mushrooms that I had said were in the fridge. But having dinner cooked for me is sort of icing on the parenting cake. The lamp and book thing was just a wild experiment: I didn’t really expect it to work. Sort of like when you buy a lottery ticket. And when I examine things closely, I realize that I already won the lottery. What are the odds of winning it twice?!

Riding Fool Tries Hard to be Miserable

It is a biking phenomenon how many of my fellow riders look like they really are not having all that good of a time. There they are, spinning down the mountain at 28 miles per hour, sun in their face, wind in their hair, and they look positively dour. Not only that, but many of them seem affronted by my perpetual grin and cheery hellos. It is a mystery that confounds me. Are they perhaps doing their taxes while riding? Hashing over old breakups?

On today’s ride, I thought I would carry out an experiment to see if I could be miserable while out for a spin. I tried thinking about my taxes, how bad the damage might be this year, but it didn’t stick. I worried about a fragile patient for a while. But the air smelled so damn good after the rain, Mt. Tam was crisp and inviting on the skyline, and then I rounded a corner on Azalea Hill and ran into my friend Ken. We gave each other grief for a bit (“I’m really out of condition.” “Happens at your age.” “Can you actually remember being my age?”) Then, fortified by the mutual derision, we went on our merry ways.

I grinned at a few more glowering riders, and they glowered back. When I got to the Alpine Dam, the spillway was so full and lush it was like a mini Victoria Falls. I tried dwelling on old breakups. No good. So I thought about a patient visit that took up most of my Friday afternoon. This was what I like to term a BFF visit: bodily fluids and firemen. 

The fire department of every city provides a service called non-emergency lift assist. You access it by calling 911 and asking for the fire department. And although non-emergency might make it sound like they take their good old time getting there, in my experience, they generally arrive really fast. These guys arrived in less than ten minutes to pick my patient up off her bathroom floor, and they were the usual stellar representatives of the human race. 

Any time I have had to call the fire department or paramedics for patients, I have been struck by how kind, thoughtful, gentle, and yes uniformly handsome they are. And it’s not just the dark blue outfits. These guys are just the kind of folk you want around you in a crisis. Calm in a shitstorm. And did I mention handsome?

But part of my job as a hospice nurse is to be completely professional and fail to notice when paramedics are drop-dead gorgeous. In fact, I practice a certain nonchalance around them so they will know how very professionally professional I am. This time, I kept my demeanor by focussing on texts from my supervisor. Are the firemen still there? After they left, my patient and I discussed which one was the most visually pleasing. It was the first time she’d smiled all day.

On my way back up Pine Mountain from the dam, I put my Lookie Here playlist on shuffle. It helps to have music on that long slow uphill, even though I have stopped wishing I was on downhills when I’m climbing because I love the climbs almost as much. Okay, now I am getting pretty annoying.

The thing about my bike’s phone holder is that the plastic cover is quite thick, so it’s difficult to get the phone to respond to my finger. Plus trying to work the phone while riding, well, I get a bit wobbly and it freaks the drivers out. So I just have to put up with whatever song comes on. You could say Sara, why don’t you make a special playlist of upbeat songs just for riding, but you may have seen in a previous post how that works out for me. So I can safely say I was the only person on the mountain today riding to O Children by Nick Cave and the Bad Seeds. Yes, that’s the song Harry and Hermione danced to in the tent in Harry Potter VII at the nadir of their hugely unlucky young lives. If lugubrious is motivating to you, you’d have been in business.

As for me, I was so busy having an excellent time, I didn’t really care what shuffle threw at me. Mezzanine by Massive Attack? Bring it on. It would be a good song to dig a grave to, but also to ride up a mountain to on a day like today. If you are me. Which you can feel free to be thankful you are not. Except that when I got home, with the endorphins coursing, I sat down to a meal of...food, doesn’t really matter what it was, it all tastes fantastic after a ride. The sun was streaming into my living room, and the fire was teasing the chill out of my bones, and even though I have to do some tedious work this afternoon, and I could also start my taxes, and I’ve had breakups in my life almost too numerous to count, I was grinning to myself as I thought about that ride and I just couldn’t pull off miserable. Not even close.

Single Mom of Teen Attains Enlightenment

A friend of mine just posted on Facebook about a deck of cards to ‘help cure writer’s block for journaling.’ Made me laugh, because I have sort of the opposite problem. I feel that I will need to move a bigger place soon, just to accommodate all the journals I have filled in the past two years. Still, what can I say: cheaper than therapy.

But it got me wondering if there is maybe a deck of cards out there that helps you with meditator’s block, because that is something I experience. I largely experience it in the sense that I never ever meditate. Not at all. But, a bit like yoga, I feel that since nearly everyone in the world bangs on about how it has helped them, it could possibly help me too. I just have a complex history with the activity.

My mother once distinguished herself while meditating. I went home one day in my teens and found her asleep in one of their uncomfortable high-backed dining room chairs, halfway between the dining room and the hall. When I woke her, she sheepishly admitted that the chair placement had been advised by a meditation expert who claimed it would prevent her falling asleep while attempting to reach a state of enlightenment. I suggested she give her bed a whirl, and try not to feel bad just because she presented as a deranged old trout. She said she’d try, and not to tell anybody.

I feel that I enter deeply meditative states on the treadmill while keeping up to the beat of Underworld’s Born Slippy. But maybe I am missing the mark because they don't seem to play that one much in meditation halls. It is my opinion that they should, as it would liven things up a bit and drown out the snoring. Also those people who turn out when it gets really quiet to do very irritating things with their throats.

I feel that journaling is pretty meditative for me as well, see comments above about therapy and moving to a larger place. Also, you can drink wine while journaling, and this is generally discouraged during most meditation practices. But again, I have the uneasy sense that an activity which is within reach of most ordinary folk is somehow beyond me.

I sort of wish that meditating put me to sleep. It would come in handy at 2, 3, and 4am. But it seems to have the opposite effect on me. A kind of a methamphetamine effect. Whenever I have sat down to meditate, I have become troublingly filled with a specific sort of energy I never feel at any other time. It is an energy that says clean the mold off your shower walls with a toothbrush. Yes now!

In the end, maybe the purpose that meditation serves in my life, rather than calming my mind and centering me, is to ensure that I live in a very clean house. Could that be perhaps considered a sort of path to enlightenment?  Or is it like how someone once said that women who make most of a difference in the world never have clean houses? 

I’m not sure anyone ever said this, it just sounded sort of right, so I Googled it. Not for the first time, I was faintly horrified by what my Google search turned up. Dirty secrets: Why there is still a housework gender gap. I really didn’t intend to open that Pandora’s box. The Difference Between a Happy Marriage and a Miserable One: Chores. Okay, now we’re getting judgmental. Maybe I should just try cleaning my house instead of using Google to tell me how to feel about my life? What a concept!

So I just got up off my couch and tried cleaning every single tiny pane of the windows in my front door and my wonderfully huge tiny-paned windows that were a large part of the reason Jessie and I fell in love with this place and rented it while it was still primarily a building site. 

Turns out, and please feel free to keep your I told you so’s to yourselves at this moment, that no amount of cleaning small-paned windows with liberal amounts of washing up liquid and kitchen towel can make up for more than two years of grime, no matter how little you want to meditate. I know that I should have newspaper and Windex, that combination works a lot better. But I thought I had the amphetamine energy going for me. Now I just have a selection of tiny window panes in various stages of smear. Ever the optimist, I am looking out at my garden through the ones that look the best. Isn’t that the way to approach life in general?

But eventually I will have to address the dirty window issue. Some of my window panes now look worse than they did with nature’s smattering of raindrops and dust. They are the clear result of someone who attempted to clean with the wrong products and a frightening attack of please-let-me-not-have-to-meditate methamphetamine rush. 

The great news is, I am the parent of a teen. Eventually she will come home from whatever exciting adventures have been consuming her time this weekend. She will need something: food, water, money, a place to sleep. I will have leverage: I possess all of the above. None of them, however, are freely available to her until she has cleaned every pane of our windows so we can actually see out of them. 

There are two possible outcomes to this scenario. One: my daughter diligently and effectively cleans our windows so we can see out, thereby earning herself dinner from our fridge and a place to sleep tonight. Two: my daughter negotiates a way to sleep in her own bed tonight, our windows stay dirty, I stay up late, baffled and confused, trying to devise healthy parental boundaries and wondering, sometimes aloud, what just happened? Am I enlightened yet? Jesus H. Christ, please just let me wake up and be able to see out my windows!

Single Mom Spends Retirement Savings on Lunch

I had lunch with my teen and her friend the other day. They were between classes at the local community college, I had a rare break between patients. We met at Woodlands Market. You know, the one that is near a community college full of impoverished students and yet is in Kentfield, so a simple sandwich costs $59. I bought them lunch. After I paid for it, they were less impoverished than I was.

Having consumed her tiny containers of salad that cost $6.59 each, Jessie was keen to eat an orange. Her friend had just finished one and was building a tiny house with the peel. Jessie headed back into Woodlands but returned with no oranges. Mom, there are twenty million children swarming in there! I pointed out that the children were probably all older than her, as she is a high school senior taking college classes. But it turned out the local grade school was out for lunch, so they really were children. And she was right: I stood up and peered in the doors. They were swarming.

This provoked a discussion about how she herself has only four-and-a-half months of childhood left. We pondered this. What will it be like to become an adult in a single moment? I have a friend who told her daughter when this moment occurred now you can vote and go to jail! I’m hoping only one of these applies in the case at hand. Because apparently you can’t do one if you have done the other.

As lovely as it was to sit outside Woodlands Market eating expensive food in the late January sun and thinking about the end of childhood, the moment inevitably arrived and we had to return to work and school. As the teens ambled across the parking lot to Jessie’s car, I heard my daughter say languidly why do we have to pack so much IN? 

In her defense, she really does pack a lot in. But she often does it in this languid sort of ambly way, so it can look to an outsider like quite the relaxed life. I long ago learned that this is just her style. She has an incredibly full schedule: she just makes it look kind of easy. This can work against her. For example, when her mother overheard her lamenting how much she has to pack in, her mother laughed out loud. Right there, in the parking lot of Woodlands Market. Look at you both, said her mother, compounding her less than supportive response, you’re hardly RUSHING AROUND. As uninvited as this opinion was, even they had to laugh.

Then I headed off for my toddler fix. A patient of mine has caregivers with a 2-year-old. She has a fascination for my retractable hospice badge, so I brought her one of the retractable clips. It was purple plastic with a long piece of elastic that stretches out so you can bring your badge up to those panels that open doors for you at your workplace. I clipped a random piece of paper to it so she would have a badge. 

She walked around the house importantly with her new badge, looking down lovingly at it and now and then pulling it all the way out and letting it sproing back so I had some moments of horror that I would be directly responsible for some horrid eye injury. But then she started to get creative, as only 2-year-olds can. While following her mother around the place, she pulled the badge right down, stuck it under her right foot and slid along with it under her foot for a while. I would never have thought of doing that with my hospice badge. Two-year-olds. You can learn so much from them if you just stop and watch.

While I was there, the Medline supplies arrived. This was a rather large cardboard box full of adult diapers, paper pads and various lotions and shampoos. I don’t think the Medline delivery guy had ever before gotten such an exuberant response to his prosaic delivery. Mommy, look! Presents! Apparently this happens every time supplies arrive. She pushed the box laboriously across the living room floor and after her dad opened it for her, took the contents out one by one, each item accompanied by shrieks of mommy, look!! 

It was better than Christmas. Look mommy! FitRight Ultra Large Briefs with Anti-Leak Guard! Look! Medline Soothe & Cool Cleanse Shampoo & Body Wash! After the goodies were all spread out on the floor and we had admired them sufficiently, fun with the box ensued. It was large enough for her to crawl into, so for a while it was her house. Then she put it over her head. A large cardboard box with tiny feet tottering round the house banging into things and giggling. The hilarity was without end. Now and then the box with feet would pause for a minute and I knew that inside, she was gently pulling her retractable badge in and out, in and out.

Eventually I had to wrap up my assessment of my patient, order his med refills and tear myself away. As I drove past the community college, I thought of my almost-adult daughter sitting in her environmental science class, soaking up knowledge, taking notes, packing it all in. The kid has been on her way to being an adult since she was eight years old, but in a few short weeks, it will be official. Look mommy, off to Europe! When you are the parent of a high school senior, people drone on endlessly about empty nests. They forget to mention how astonishingly wonderful it is to watch those fledglings fly.