Brave face

Dear life,
It's not always easy is it?
We greet and part, kiss on the cheek,
hand in hand slowly slipping away.
We rise when we must
sometimes wondering how we could possibly handle more.
I've seen so many families
locked in the impossible stare of Grief.
Grief, a bold faced beast.

I've never seen a more beautiful organism
than that of family.
Never a more delicate flower
a more peaceful day
a more turbulent storm.
All we have is each other
until we no longer have that.

Dear heart,
I know you are breaking.
I know you are watching your father die.
Letting go of your mother
and Lord help me
saying goodbye to your daughter.
I can't help but wonder
how can our hearts handle so much?

I am but a small voice, one nurse,
doing my best when my best is no where near good enough.
I can't make people stay.
Sometimes, I can't even make the pain go away.
My heart breaks too.
I have to relive my own losses,
grieve for the losses that I will one day endure.
I see it all in you.
I tell you that you are strong.
And you are because you have no other choice.

I will help you through this, because it is what I have chosen to do,
because I've always known on a grand scale
that our lives are meant to go away.
But sometimes grand scales are hard to see
in ordinary moments.
Even though we know that we must,
letting go is the hardest thing we'll ever do.

It's only in facing the great beast of Grief
that I've ever understood
what "brave face" means.
I will keep wearing mine,
and I will gently remove it where thankfully,
I no longer need to be brave.

The observer.

Sometimes we don't let our brains stop and think.
Sometimes we let the world stop them from connecting back to the themselves, the brains to their owners, the heart to the soul. The observer gets lost in the business.

I do observe, and sometimes the things that I see need time to settle, or need to be reviewed. My brain functions in my own unique way, carrying it's own form of sadness, strength, solace, numbing abilities and renewal. But that is my brain.

My inner observer does nothing but observe. She watches the beautiful face of my nearly 5 year old whenever she can. She notices how enchanted I become. She notices that the swelling in my heart could never be put into words, that no love could ever be documented, only observed and felt. This love carries with it it's own kind of brain activity, and the observer in me notices how worried a human I can be. And she notices how terrible it feels to worry.

My inner observer sits on death beds. I realize this is a strange observation, but I sit at the bedside of the dying for 12 hour stretches. I observe my own empathy, my own occasional indifference. I observe that my empathy is strongest when the family is there, and the person dying becomes more than just a failing body. I observe a curiosity to know that the dying are really great life stars, going out into the ether, becoming untouchable to us. I observe that often, at the end of the long day of watching death come, my heart and brain want to numb themselves and not reflect.

The observer in me knows that I do not always want to observe. Sometimes I don't want to feel things, and sometimes I observe how adept at numbing my own brain I have become. I have to observe this, and not judge this. The observer is the ONLY aspect that does not judge. She only watches. Neither with love or self pity. She just looks on. Notices. And occasionally her noticing catches the attention of the brain, and the noticing and the brain can align, if only for a few moments.

My observer knows that there is an undertone of melancholy that exists in life, in my life. But I do not observe a resistance or an avoidance to the melancholy that creeps in. My observer knows this is a an important time for my brain and my observer to align. Sometimes there is sadness. Sometimes there is joy that is so rich that it makes me nearly sad. It's like tides in a moon cycle; I can observe how easily affected I am. How my brain finds such solace in music or how, when alone, I can allow myself the space to release through tears. My brain knows that without exercise the delicate balance of keeping it together becomes unraveled, and that through physical activity I can renew myself, again and again.

I find it all good, truly, the sad and the joy. The observing and the avoiding. Light can not know itself without dark. Life is full of so much. My observer watches it all and says it's all okay.

She is the wise one.

Portraits of a beautiful person.

In my job I am blessed to know some amazing people. I meet them in an intimate setting: as their nurse as they navigate their terminal illness to the end. It can create personal heartbreak, yes, knowing that the people you grow so fond of are not long for this world, but it all feels worth it. I meet amazing people that do amazing things. I meet people ready to see the end, people fighting their diagnoses, and people that simply live each day to its fullest, with a unique intention that a terminal illness can bring.

I have been blessed with the honor of knowing a woman named Christi. Christi is very much alive, and during my months as her nurse her optimism has been simply enchanting. She was dealt such a crappy card in this life, but she smiles like no one I've ever seen. She is kind, she is appreciative, and really, I have grown quite fond of her. I have returned to my favorite local hospice agency, so she is no longer my patient; she is now my friend. As her friend she has given me permission to photograph her, not only the beautiful, shining self that she is, but the harder, more sick parts that are very much a part of her reality. She does not hide her cancer, it is a part of her now, just as her pain pump that is constantly infusing medicine into her is a part of her. Just as her colostomy and nephrostomy tubes are a part of her, the cane that she must use because her gait is too unsteady to walk without it. Just as the smile that she gives when she sees you is a part of her. The compliments she always doles out, and the attitude that keeps on looking at the positive; these are a part of her. She is multi-facted. She is beautiful. 

Thank you Christi for letting me take these special photos of you and your mama. Thank you for letting me be a part of your life. Thank you for making my life even more meaningful having known you. You are a special human being.

 

 

 

We are all made of stars.

In this life I am surrounded by death.

We all know, in an esoteric way (or maybe in an in-your-face way), that death is ever present; that everything born starts to navigate itself back to the waters of death. Renewal, vibrancy, bold goodbyes and death, such are the seasons of our lives and of our Earth. We know this, and yet our minds do not want to accept this. We fight this and say that things are not fair. And of fairness this may be correct. But life is not born of fairness.

My vocation in life has been in dealing with matters of death. "How can you be surrounded by so much death" people ask me? But in fact, we are all surrounded by death, in varying degrees, of varying intensity. I see people in their last stages of life and there are elements of this that mystify me, that call into being my purpose, and that emphasize my own inner Knowing. This Knowing, the kind that is hard to articulate, is not born and does not die. It guides my own hands and words and actions as I help so many confused and grief stricken people enter their journey away from their bodies.

When I sit with a person that is dying there is a point where I know that they are not in that body. There is a gauntness to the face, a glaze over the eyes, a stiffness in the body. Yet we, as hospice caregivers, often tell people that hearing is the last to go. I believe this to be true.

Just yesterday I sat with an actively dying woman. There was no need for blood pressures or oxygen saturation readings or temperatures. The trajectory of death was in such full effect that it stopped me, busy, million-places-at-once me. I sat at her bedside for a long time and I laid my hands on her chest. I knew she was not in that body, even though I could see her jugular vein faintly beating. I could feel her presence, not the dying presence (for I do not believe that presence dies), but HER. I could feel her watching and listening and I could feel her not being attached to this withered, cachectic frame of bones and skin. It was as though I was touching organic matter, born of the Earth and entering back into the Earth, but that the true Self was still there, boundless and alive.

This woman had lived a long life. She had careers and children and grandchildren. Christmases and trips around the world. Youth and suitors and long flowing hair. She had a past that was rich with memories and experiences.

We will all die, and this fascinates and saddens me. It reminds me that this is a GIFT, this LIFE. We get to feel happy and sad and joyous and full of grief. We get to travel and sing and dance and hug one another. We get to do handstands and crossword puzzles. But my favorite part is we get to walk among each other and feel each others' lights. Connecting. Listening. Emphasizing. Caring. Loving.

What a miracle this is.

I do not live my life under a religious doctorine, and I will never say that one way is the absolute Way. But I will say this. There is a light, inside of my body, around my body, entering and leaving my body, and because I am human I will call it MY light. But when I look at the stars in the evening sky, each one casting its light in the darkness, creating a blanket of wonder and light and beauty....well there is a connection there. I can not articulate it. I can feel it.

This is the day

My heart used to ache on this day. This is the day that my father died. This is the day that I received the horrifying call from my sister that I needed to come home, that dad was dead. This was the day that I somehow managed to get from San Francisco to Maine, by myself, with frequent interruptions of nonstop crying. This is the day that I first learned what grief was: real, intense, there's-no-escaping-this grief. This is the day I lost a parent, one of the most familiar and loving people in my life. This is the day. November 7. It comes every year.

This is my 9th year of recognizing this strange anniversary. It's strange to have "a day" that stands out among your other days, and stranger still to be able to comparatively track your own heart's grief. This used to be a terrible day for me. Grief used to be so palpable, so on edge of my heart that simply noticing it would release a well of tears. But things have changed, and my heart has taken that grief and processed it. Slowly and gently, grief transformed. Slowly and gently grief lost its hold to gratitude. Slowly and gently I arose from underneath those sad waters and I had a healing in my heart, and a better understanding for the immensity of grief and love.

Today is the day that my father took his journey to the other side. It is the day that his soul left his failing body, released to freedom and to a place that all of us will one day visit. I'd love to know where he is. Does he still exist? Is he ever present or he is only alive as energetic memory?  I don't know. But what I do know is that what happens when we LIVE is carried on in so many innumerable ways, pulsing and taking new forms far after we die.

Today I want my sister and brother and mom to know how much I love them. And to dad, if you're still checking in...thanks. You made me a better person. I miss you. I love you. And I am so grateful that YOU were my dad.

- Summer

Being gentle.

I just went through an emotional ringer. At the risk of sounding a bit vulnerable I will tell you that I spent Saturday curled up in a ball on my bed, headphones on, and I cried and cried, just like a baby. I'd let the music take me away, then come up for air. Cry a little more. Come up for air. Cry. And then, after about an hour and a half of being a puddle on my bed, I started drying my eyes. I felt different, lighter. I cried things out that I needed to GET OUT. I needed that space to let myself go there, to that sad, sad well that is somewhat always lurking on the horizon. I wanted to visit that place yesterday, that sad well, because I could feel it all festering out of my body in ways that were not desirable.

One of the wisdoms that I have softly gained through the years is to look at my emotions when they come up. Not to BE the emotion, to WATCH the emotion. And usually from there, if I'm loving myself as I should, I listen to what I need to do. I don't always do this right away. Sometimes it takes some time of noticing undesirable qualities that won't go away. As I laid in my puddle yesterday I could hear the words "be gentle with yourself". It was like someone was whispering it in my ear. And I was.

I remembered, so poignantly, that sometimes crying is the absolute best thing you can do.

After awhile I picked myself up.  I was so grateful that my husband had graciously given me this much needed space to be alone. I went outside and I walked. I felt the sun on my face. I cried a little more but instead of tears from an unnamed grief, they were born of gratitude. I was alive, and moving, and the sun was healing my soul, and life was good and I knew it.

Even though I generally consider myself to be a happy and positive person, there is always a well of grief on the horizon. Maybe it's just because I'm sensitive. Maybe it's empathy for others that are grieving. Maybe it's grief in missing, or maybe it just lurks there for everyone. I do not know. I just know that it's there, even when it's so far out of my view. This is okay.

I'm human. I cry and grieve. I laugh and am joyous. It's not all good and it's not all bad. It's life. You do the best you can.

Stay grateful. Be gentle.

- Summer

Blazing

The tree in front of my house is blazing red. It's magnificent. To transform like that, from bare bones to a deep, lively green, to that bold red hue...it's elegant. Stunning. And fleeting. Each morning I go outside and find more and more leaves laying on the ground, turning a soft brown, saying goodbye to another perfect season.

I think of my life in chapters. Chapters can be defined by years, by experiences, by seasons. I've had some really swell chapters, really swell. Others were less desirable. All of them have come and gone, blazing like my red-leafed tree.

I feel a sadness as my tree loses more and more of its color. It's a saying goodbye. And it's a simple reminder. What if right now, these very days in which we are going through our normal, everyday motions, what if these are our red blazing moments? As a witness to so many dying peoples' experiences, I see autumn, their leaves unraveling from their bodies, stripped of their rich colors. Soon gone to winter.

I think it's my job in life to be blazing. In my routines, in my friendships, in my every day encounters, I have the option of letting these moments pass me by, unappreciated in their simplicity and in their mundanity. Or I can be bold and red. Not overbearing and intense. Just appreciative. And happy.

Life comes and goes for each and everyone of us. But right now we are all here, and we all get to be totally awesome.

In connecting...

I'm breathing today,
actual breaths in my actual lungs which are actually rising and falling
and this is my own miracle.
There are moments in life when the poignancy of this
sits on your lap with your face between her hands
and the everlasting truth of this ever present moment
is suddenly the shiniest star you've ever seen.

We walk through this world with our heart lights
shining like beacons, ready to love.

The way we touch each other,
with soft skins and smiling faces,
with caretaking and desire
habits and moments taken for granted,
these are the gems of our lives.
My heart, pressed against your heart,
listening and being heard,
pausing for a moment in the completeness of our shared space.

We are powered by connection.
but vulnerable in our humanness,
possessing the knowledge that all warm hearts will one day grow cold
and that love with not always be felt in arms embrace.
Our loving hearts become sad, full of grief and sorrow.
We long for beating hearts.

Outside, the trees continue to whisper,
the blooms open and they close
the tide ebbs and flows
night falls and day rises.

And our hearts, in those poignant moments,
open up to the beating heart of the Earth,
and her continual reminder

that love never dies.

When someone you care about is grieving....

There are things that you say when someone dies. Rest in peace. I'm sorry for your loss. Thinking of you. These are all important things to say when someone has lost a piece of their heart, but for me, even though those words are entirely appropriate, they feel trite, small. Of course the problem is not in these words but merely in the finiteness of language.

What I want to say to the family of my friend who has just died is something that I can not say in words. I want to stand next to them, hold their hands, and not talk. I want them to know that I (among so many others) am here, that they are loved, and that it is okay to cry, to get angry, to plead, to mourn, to grieve. It's okay to hide yourself under a wall of blankets. It's okay to scream. It's okay to not entertain the swarms of people visiting. I want to be there in person, with a hand on their backs, shedding my own tears but saying nothing. Because when it's all said and done, the grief can be done by no one other than the grieving.

As a hospice nurse I have seen so many people die. I have sat with grieving families, held the space for people to cry, watched the very raw emotion of grief unfold in loved ones. But grief, no matter how well I understand it professionally, always feels different when it happens to me and to people that I love.

I am states and years away from this loss, and I acknowledge that I am but one person, one person among the countless others that love and care for this family. But I can only speak for myself.

To my high school boyfriend and lifelong friend, my heart aches that you have lost your brother.
To his parents, my heart aches that you have to live through the nightmare of burying a child.
I wish I could say or do something to make this not hurt, something to make the sting of this new reality be somewhat less biting. But I'm stuck with the limitations of language and the prayers to hold you up in love as you navigate this sad, sad loss.

Bittersweet life.

Feel it.

This scary, beautiful, heartbreaking world.

Tornadoes and cancers and moms who will no longer be picking up their children.

We're not kids anymore. These things are so real now.

Last night I sat with a grieving family, a large family, intensely divided in their decisions about what to do with my patient. My patient who had cancer yes, but had been living her life well. My patient who came to the hospital with a pneumonia. Who through the course of the week had suffered enough respiratory failure that she required an intense and uncomfortable oxygen administration in order to keep her alive. During my shift it was the middle of the night and emotions were raw. Eventually her husband took me aside and told me it was time to take the breathing treatment off. So as I was discussing the plan with the doctor, he went to her, his wife of whom he had just celebrated 50 years. And her, under her bipap machine but still completely alert, she held him, tears running down her face, down his face. He crawled into bed with her and they knew it was the last time they would hold each other. It was one of the most raw and tender moments I have ever seen. And with a nod from the husband I administered the morphine. I took off the ridiculously uncomfortable breathing machine, and with her family by her side, she started to slip away. It took longer than most thought, and during that time her family gathered, and cried, and even shared in some laughter. Their matriarch was dying. Two hours later she took her last breath.

Each moment that we have each other is a treasure. Each time you pick up your child from school is a blessing. I think many of us know, on some sort of a spiritual level, that you have to appreciate the present moment. But that knowledge often escapes us. Often we are focused on our memories and our plans, and in doing so we lose sight of the precious moments that are happening now.

I know I am not alone in my struggle to find peace with the fact that so many children just died while a tornado ambushed their elementary school. Peace in tragedy. It's such a dichotomy.

And yet, it somehow happens.

We are born into a world where everything changes. Where things grow and things die. We open up our hearts to love, we feel connections to each other, and we do so at our own risks. We are vulnerable creatures, and sometimes our coping mechanisms are unhealthy.

I like to think we do our best.

I will tell you, as the silent observer last night as I watched my patient die, I couldn't help but feel touched by the amount of love that was in that room. A matriarch was passing, and the family was there, grieving, and she was not alone. And she knew she was loved. It was the kind of death scene you see in the movies, the kind where you get to say what you need to say, where you get to say goodbye to warm flesh and blood.

It's the kind of goodbye we should wish for. But not the kind of goodbye we are promised.

I heard a saying once that the only way to pass a storm is to go through it. With the tornado that occurred yesterday this is quite literal, but for us observers, this is so importantly metaphorical. There is pain in this world, and we will feel it because we are loving creatures. But it is my belief that the pain can not be avoided. You must take it head on, let it wash over your body, come out of your eyes, come out of your muscles and your bones. Feel it. And then, let it go.

http://www.theatlanticwire.com/national/2013/05/oklahoma-teacher-heroes/65461/

Ding!

The routine,
OMG what time is it?
6am? 730?
Husband says goodbye.
Get up, stretch.
Get coffee.
Start breakfast.
Have child's breakfast laid out to avoid temper tantrum.
Child gets up. Wants modifications.
Morning mitigations start.
Run around getting ready.
No time for shower, wash hair over bathtub.
Ding. Work emails start.
Did something happen to one of my patients?
No, ignore.
Work clothes.
Work bag.
Ding.
Stethoscope.
Computer.
Cell phone. Shit I didn't charge it.
Bring car charger.
Ding.
Don't forget daughter's coconut milk for school.
Poop, everyone stop and poop.
Ding. Ding. Ding.
Get daughter dressed.
This shirt, no this shirt.
I WANT SOFT PANTS!
Mom you hurt me, say sorry.
SAY SORRY!
Negotiations. Time outs.
Ding. Now I REALLY need to go.
IT IS TIME TO PUT YOUR SHOES ON!
I want to wear my sandals.
NO SANDALS, SNEAKERS!
Mom is this the right foot?
No
I want to wear them on the wrong feet!
Fine.
Gather your stuff.
Shit where did you put your cell phone.
Rampage house to find it.
Ding. Found.
Shit where are the keys.
ELLIE TRY TO FIND MOMMY'S KEYS.
Found.
Coconut milk, work bag, daughter's school bag,
Ding.
Ok let's go.
Shit I forgot my sunglasses.
Ok let's go.
Shit turn off the porch light.
Ok let's go.
I WANT TO GET IN FROM THE FRONT!
Fine.
Get in.
Ding.
Buckled in.
Shit I forgot my wallet.
Wait here.
Run in the house.
Run back to the car.
Get buckled in.
Ding.
Drive.

On being happy

Old people are funny. Sometimes they're cantankerous, sometimes their witty, sometimes they go on and on and on and on about their days of yore. I like old people but my busy world and their slow routine don't always mix. I am around them a lot. I enjoy getting to know them, truly. But I come into said old person's home, interrupting their rather uneventful day, and I am a barrage of questions and movement, assessing, answering my phone, emailing, charting, medicating. Sometimes even in my listening I can be distracted. What I must be to them. A flibbertijibbet! A will-o'-the wisp! A clown! (love you if you get this reference).

Watch this little interview snippet below with Terry Gross from NPR's "Fresh Air" and Maurice Sendak. He talks about his greater appreciation for life, how he has fallen in love with the world, and his advice for Terry is "Live your life live your life live your life". 

I mean, we're all out here living our lives. We're not dead. But we can be disconnected. When I think of living my life I can jump to the freedom of being on vacation, of camping, of discovering a new city. Yes this is good living, but it is not every day living. Yet I think, know, that in every day living we can experience the same sort of wonder that we have in the relaxed vacation style state. It requires a very simple technique: Stop. Watch. Listen. Feel. 

There is a pulse to life, even the stillness of my living room at this early hour, there's a pulse, a gentle hum of electronics, a gray sky beginning to change color, the thunk of the newspaper being delivered. Maurice, in his golden years, learned to love this. And this is a lesson we can learn from a "happy old man": Live your life. Even the parts you don't like, the parts you wake up dreading, embrace them as a moment that you GET TO HAVE. You are NOT DEAD. That's pretty great, right? That can change in a moment. Just yesterday I sat with a patient and watched her die in front of me. That will never not amaze me. And it ALWAYS makes me appreciate the fresh air, the trees, the pulse of the blood in my own body. 

I like being alive. And I much prefer being happier while I'm doing it. 

You are here.

Do you ever look at your life and wonder "How did I get here?"

I never thought my life would be centered around so much grief, grief of dying families, grief of my own. I never thought that GRIEF would be such a pervasive emotion in my life. I always thought myself to be a happy person, a positive person, yet here and now, my heart tries to navigate its own way through other peoples' dark places, as well as my own. 

I'm not a broken person. I don't believe any of us are broken people. But as we get older things start sticking, neural pathways are carved deeper, and the stories we tell ourselves start to feel true.

There is a lot of sadness in this world that also contains so much joy.  Every person you meet is hurting, in someway, in some capacity. Some are very vocal about their pain. Some keep it hidden. Some are excellent at working through it. Some internalize and let it fester.

But to each person that gets up each morning and that goes out into the world, I call you a warrior. Life is fucking hard sometimes. People hurt us. People die. People say mean things. People kill each other. It's hard to be sick. It's hard to be a caregiver. It's hard to take without giving. It's hard to give without taking. It's hard to know if our decisions are the right ones. It's hard to hurt other people with the decisions that we make.

Now that I'm a mom and can't take off and do whatever the heck I want whenever I want to do it, that adds up. Sometimes I want to take my car and drive straight for the mountains and climb to the top of one of them and let myself yell out my feelings, my anger, my grief, my frustrations, my responsibilities, my hurt, my pain, my past. That's how I want to rid myself of things I call bad. But this is hard to do now. I work. I mother. I have a partner. I need to make money. I need to listen to people that are so darn sad. And I need to listen to them with a present mind, the only kind of mind that does anyone any kind of good.

So what does this all mean? Am I different than you, my reader? Am I different from my patients that are dying? Am I different from my patients' families who are suffering? Am I different from my three year old daughter who screams and cries because she wants to lay on my arm? No, I am not different. We all suffer. It all means something to us. Our individual suffering is our own house of pain and we can live inside of it and shut out the world and let those stories we tell become more and more true for us, or we can be warriors and put our big girl/boy pants on and get out there. We can leave our houses and walk among each other, knowing that we are all carrying some kind of grief. We can walk with our heads down or we can walk with eyes up and even smile at each other. The point is, we keep walking, moving, participating, trying. We are all the same in so many ways. We all suffer, because we are all human. And we all love, because that's what we do. 

I am writing this because I want to feel BETTER. I want to walk in the world with my arms wide open, not hugging them tight to my body to diminish the person that I am. I am a warrior! I fight, every day, to do the right thing. I don't always succeed, but I always keep trying. And this unites us. We all get a new day. We all get to start from scratch. We all have a map that says "you are here" and you can take that map, recognize that this is where you are now, and go wherever the heck you want.

We are all warriors. And we will all be okay.

The Powerful Force of Grief

The Powerful Force of Grief
By Summer Nicklasson, RN, CHPN

Grief is something that happens to all of us. Anyone who goes out into the world and loves will eventually feel loss. The loss may seem overwhelming for some, tolerable for others, but for each person it is an emotion that cannot be skirted or forgotten. It comes up and hits you in the face, demanding its attention.

As a hospice nurse I see a lot of death. People often say to me "I don't know how you do it", to which I reply, "It's not my family. I can handle that". Grief to a family member and grief to a hospice nurse will surely look different. To me, it's an accumulation of loss and sadness that yields to the tightness in my chest and the solid, cathartic cry that I need every few months. For families, it's the loss of a person you loved. Very often a solid, cathartic cry is just not enough.

I did experience a great loss once. In my late 20's my father passed away. It was difficult and heartbreaking and my first taste of the great beast of Grief. My sadness was profound, and I walked in the world of people who were NOT grieving, who really had no idea how I felt, and I noticed how isolated grief made me feel. I realized, in retrospect, that grief is a terrific force, a monstrous headwind that you must walk through. On the other side of the headwind is a new you, perhaps a more jaded you who experienced such monstrous grief, but there is a peace on that side. It could be within arm’s reach, or it could far, far away, hidden behind the layers of tears and memories and achings of your heart. After the death of my father it took me a solid year to feel even somewhat normal. Years later I would still cry when visiting my memories. Now, over 8 years later, the emotion I most associate with my father is gratitude. He was a good man, and the people that you lose are good people, each with their own offering to the world. The loss of a human being is a loss for all humanity. It's not something that is easily forgotten.

My point is that grief happens, and sometimes it happens hard. So you do your best. You get up each morning, you get dressed, and you go through the motions. Sometimes this might feel hard. Sometimes you might just want to stay in bed. That is okay. Be gentle with your grieving heart. Sometimes all you need to remember is to just breathe.

There is no limit on grief. There is no perfect formula letting us as humans know how long we will grieve. It's an individual, unique experience. It is your experience and whether big or small, heavy or light, long or short, grief is your own headwind to walk through. I'm here to tell you that you can do it. If there are people you trust that want to help you, let them. If there is a support group that beckons to you, go. Just know, that one day when you are ready, (whenever that may be), you may wake up and realize the holes that grief carved are now filled with gratitude.

Death of a good man

Death of good men happen every day,
and we all know this, and count on this.

I know a man who died last night,
a man I came to know,
a man with depth in his eyes
and a creative and wise soul.
I remember his tender touch as he took my hand in his
and told me he knew that I cared
and how my heart opened up, wanting, even more
to do what I could.

But pain, physical, can transform
into a true demon.
And it was with a forlorn heart that I watched this man
morph into the kind of existential pain
you pray you never know.

His family and hospice team gathered around him in those last days.
Yesterday, while a harp played and the beautiful, soothing voice
of our music therapist rang out
I watched his eyes go from panic to calm,
from living to dying..
It took time.
I prayed as I sat with him,
that if there were angels, they would guide him
and show him the peace that he needed so badly.

People are here, and then they're not
Where they go I do not know
I guess. I see clues amongst the dying.
Ghosts that visit.
Angels, I think.

The face of a good man that dies no longer looks like a good man.
A body, devoid of soul, does not look human.
But herein lies the power of memory
of those beautiful eyes
piercing, with wisdom,
now gone, into the ether.

One love.

This morning when I woke up the air felt lighter, my chest felt free of dread, fear. These feelings started happening last night when President Obama won the election...that bitter, bitter election. I felt the release when we saw that Ohio was blue, and the words flashed on the tv screen declaring the winner, and I whooped and hollered and actually kind of cried.

I had gotten wayyyyyy too wrapped up in that election.

It's true that I'm glad Obama won. I appreciate his ideals, and the majority of my friends seem to as well. But there are some that don't. There are some that felt today the exact way I would have felt if he hadn't won. And I felt sad for that. I felt sad to see Mitt Romney giving his concession speech knowing he put so much of his life and soul into that campaign. I didn't want him for president, but I'm still sad that he had to feel such a bitter LOSS.

And now the commercials are gone. The attack photos are not being posted on facebook. I was so sick of the name calling. Of the lying. The manipulation. I felt sick to my core, and though I know it's a game they play to get the win, I wasn't impressed with either candidate's thick and prevalent negative ads. I think it was destructive to our own collective consciousness, I really do. With so much that is wrong in the world, all of the heinous crimes that have been committed, with the natural disasters humbling us and striking with such greater consistency, this negative campaign seemed like sweet fuel to a burning fire. We needed none of it, and no one is better for it.

Except that our man won. Somehow, after the euphoria of the win, it all feels bittersweet. I feel like we all felt a loss, whether it be your candidate or your ability to go about the world free of such negativity. I feel like I want to see all of my Republican friends in the same room and have one big group hug because I want to not feel so segregated. We are one, right? One country. One collective consciousness.

One love?

YES.

Love.

I have my own patients, 11 of them, and I see them all every week in the comfort of their homes. They have allowed me to be privy to their inner circles, their families, their raw and very intense emotions. A former pro football player laying in a hospital bed unable to walk on his own. Another sweet and gentle soul, young, losing a quick and fierce battle to cancer, riddled with bone metastases. Another kind mother, starting to unravel, becoming incontinent, unable to take care of her own basic needs. This is US. These people are US. They will be. And these people, they are all alike...they are all dying. They are all acutely aware of what is important in this world at the end of the day...the love. Politics is pushed aside and the priorities become family, pain management, learning to find GRACE when your body starts shutting down.

Sometimes I need to remind myself of this. Death is sad, and it's a loss, but it's one of the things that unites all of us. No one will escape it. And as someone who sees so very much death, it's a damn good reminder that I am not dying. That this is living. And that living should be filled with all the things that mean the most to you. The things that really, YOU ALREADY HAVE.

It's one perfect, golden love. And I'm positive we share it, when we can dig ourselves out of our own minds.

The Power of a Hug

Last Tuesday at one of our team meetings at work, a social worker colleague led a group of us in a meditation, a death meditation. In this meditation, we visualize and attempt to experience the death of our bodies, feeling the inert energy of dying, being the observer to the process. It was profound. When I let the feeling come back into my body, when I felt the pulse of my own beating heart, I realized how sad the experience was for me. This whole exercise was of course wonderful in a sense of cuing in on a dying person's experience, something that as caregivers who have seen so much death, we can occasionally lose sight of.

But as I got up and as the meeting adjourned there was one thing that I craved more than anything else at that moment. A hug. My God did I want someone to just wrap me in their own presence and JUST HUG ME.  I wanted to feel the shared energy between myself and someone, anyone. But I didn't make that need known, (I'm sure I could have found a hug if I had actually stated that i wanted one) and so I continued on in the details of my working day, realizing that as I left my team meeting and got in my car that I was flying solo for the rest of the day. No hug.

I did end up getting a hug later that day, but it was one that I offered and it was with one of my patients, someone that I felt needed to feel the unconditional love that a really good hug offers. So there it was. With a sick and truly emotional broken man, and me, a healthy but occasionally emotionally broken nurse.

Sometimes the world feels difficult to navigate through. It seems there is one massive tragedy after another that presents itself, from wildfires, the Aurora shooting, the sweet Jessica Ridgeway case. Now we have all of the negativity associated with this election. I will tell you that honestly, sometimes my heart HURTS. I have to actively steer my thoughts away from the negativity. I can't let myself think about Jessica Ridgeway, but you know what...I want to. I feel like she should be remembered but it creates so much visceral grief; I just don't know what to do with it.

This world scares me sometimes. For as much beauty it can contain, and MY GOD it can be beautiful, its shadow side is frightening. I know that I have created personal defenses to protect myself from pain. Unhealthy ones. I know that when I'm sitting with a patient and I DON'T feel a sense of compassion, it DOES happen, that I get scared for where I'm at, spiritually. My social worker friend called it compassion fatigue. Whatever it is it is evident that it exists because sometimes my heart feels like someone is actually sitting on it.

I know it's good to remember that I get to control what I concentrate on. Thoughts come pummeling through constantly, but I get to cherry pick the ones in which I want to place my attention. I get to choose the positive experiences, the love, the GRATITUDE. I'm reminding myself of this (because sometimes I forget).

If you are reading this, please remember to be nice to each other. Social media is such a powerful phenomena and everyone out there with their opinions, shielded from actual human interaction by a screen, it is here that I think people can be the most mean. This election seems to be bringing out real raw feelings with people, and what we are seeing on things such as Facebook and Twitter can really just be straight up mean. I, too, have been caught up in the drama of it all; it's hard to avoid. But more than the energy directed at getting one man into office, I want to see the healthy energy of love and solidarity that we have with each other as humans. We need each other.

And maybe while you're at it, give someone a hug. Sometimes they need it more than you might know.

The Ghost of Grandpa Dick

Yesterday day I watched a big, bearded, formerly burly trucker, who also happened to be my patient, lay on his deathbed. He looked small in the queen-sized bed, always adamant about no hospital bed. He had a lot of pain that we were managing with morphine and he was chronically hypoxic (lacking oxygen). But he was alert. He was oriented. He wanted to know what we were talking about.

He had a big family of brothers, most of them unable, emotionally and/or physically to make the trek to Colorado. But one brother did. One older, balding man who told this nurse many stories of loss. This brother was vigilant by this patient's bedside.  I could see that his heart was breaking.

When all the nursing stuff was done I just sat back against the wall and I watched. I watched this formerly burly trucker hold hands with his older brother. I watched him look him in the eye and say "I'm not scared. I love you". I watched the tears that fell from his family. I watched the looks of love in the room, the ginger touches, the pain in their eyes. I sat against my wall and thought how did I get here? How did I get to be in this man's room, privy to his dying scene, privy to the love and deep pain that permeated the space?

As he lay dying it became clear that this man was in two different worlds: the world of the living and the world of the dead. He was talking about his Grandpa Dick, a man that I later learned he had never met. His brother knew him before he died. This patient described Grandpa Dick and said he was at the front of "the people", waiting for him.

Grandpa Dick. This happens a lot, where people see other people that have passed. This phenomena blows me away more than I could ever articulate. It is consistent. The dead appear. The dead are present in the dying space. They often visit with the dying hours and even days before the person dies. I have another patient who just last week started getting visits from her mother and sister, both passed. This happens with such strong regularity. If you didn't have a faith in afterlife it makes you question it, it does. How does Grandpa Dick appear when he doesn't even have a memory formed of him? How can he describe him without knowing him?

The man died in the early morning hours. He was a good man and I miss him.

My hunch is that now he's with Grandpa Dick.

slanted light

When the Sun hits the Earth, 

slanted light,

the world is sacred.

Bathed in silky, honey gold,

dew drops glistening, 

the morning songs of birds,

it is here that my heart feels whole.

Before the children wake up, and 

the work duties begin. Before the 

cleaning and the doing and the getting 

to places on time, it is here, hovering

below the surface of the busy world

that magic is happening.

I long for this time,
when I don't need to look good
or be a certain way or try to please anyone.
Where all that I am is only perfect,
where I can be
the wild, loving creature that I am.

I forget this, sometimes, 

and in hurried fashion try to compose myself

for a day of responsibilities.

I miss the magic when my heavy heart

is too busy to stop 

and remember the healing that is

hovering below the surface.

Today as I felt my muscles move my bones 

along a path bathed in honey gold

I felt tears welling up inside, wanting 

to spill out. Grateful, for the reminder

that wholeness is here for the taking,

.here, when the Sun hits the Earth,

slanted light

and the world is sacred.

Death: when everything goes RIGHT

I lost another patient. He (maybe a guy, maybe a girl, but I'm disquising it for HIPAA) was only 50. Fifty and INCREDIBLY vibrant. We used to talk about his adventures, climbing large foreign mountains, his photography, his really great taste in decorating. I liked him, a lot. We had some very poignant existential conversations.

(One time I spied on him on facebook. I actually do that quite a bit on my patients. I learned about really truly amazing things this guy had accomplished. I was very impressed.)

Watching a tumor in the brain grow is difficult. A myriad of things could happen, it just depends on what part of the brain is affected. Things start happening that are not normal. With him it was difficulties saying what he meant: word salad. You knew he understood but he couldn't get the words out to acknowledge it. Sometimes conversations took a good amount of patience and a certain finesse in trying to make the conversation less frustrating.

Eventually, and in a rather slow fashion, there was paralysis, a growing need for assistance in all activities of daily living. Eventually barely even able to speak.

And then the normal trajectory occurred: bedbound status, inability to swallow, sleeping all the time and eventually a comatosed state.

But throughout this process was a family that was advocating for his best care. He had his "team" which was me (the nurse), a social worker, and chaplain who gathered together frequently to figure out what modifications needed to be made to support his current status (which was constantly changing). There were music vigils (an AMAZING perk at The Denver Hospice where I work) where a a harpist played and sang soft, soothing music while family gathered around him, holding hands and crying, not needing to use confusing words. He ended up having several music vigils. He had visits from a priest, and most importantly he was always surrounded by people that loved him.

He died peacefully on Wednesday night with his entire family at his bedside, ready to say goodbye, loving him dearly.

It was the perfect death.

I often feel sad in this job. I get attached to people or I have empathy for their family, making the death of my patient feel very heavy on my heart. It's impossible to avoid the sadness sometimes. Being so close to death can be so intense on a person's soul. But sometimes, and often on the rarer occasions, everything goes right. Sometimes the patient and all that surround him find peace. And in those occasions the sadness is not as prevalent as the gratitude: gratitude for the person, for my job, and for the experience of being there to help make it perfect.

We are all going to die, and as I watch people do it with grace, it makes my own mortality feel sacred.

I sometimes go back in forth in my belief systems on what happens when we die, sometimes claiming to be an atheist. But if I were to be true to myself, true to my what heart feels itself knowing, then I believe that spirits really do soar, far beyond the cold capabilities of a dying body.