I'm stiff and sore today.  Yesterday there was a Code Blue in the parkade and we're the closest department to the parkade.  I ran faster than I knew I could.  The man was at the far end of the parkade and thankfully he was only dizzy and fell down, not dead.  My boss was the third person to arrive.  He asked how I got there so fast and I thought, but this is my job.  This is what I do.  I care about my patients.  They mean something to me.  I remember their names.  I remember their tattoos.  I remember their faces.  This is what I do.

Two days ago we had a woman come in by transport from a small town.  She was in horrific pain and vomiting.  We got her pain and vomiting under control and she had her MRI.  She has leptomeningeal disease;  it's a rare complication of cancer in which the cancer spreads to the meninges of the brain.  I've only seen it once before but it is memorable, the symptoms, how the patient presents.  It's also terminal.  I sat in the control room while she had her MRI, watching the O2 sat monitor.  The tech showed me the tumor in her brain, the leptomeningeal disease, the part of her skull that had been eaten through by the tumor and I wept. My poor lady is dying much more quickly than her family and friends realized.  Her husband is trying to get his crops in before the snow hits.  My lady was admitted and then came down again yesterday for an emergency central line insertion.  I stayed late to help.  It won't make a difference but both my lady and her family need some hope.  They can't let go yet.  I can understand that.  Acceptance comes at different times and in different forms for everyone.  She's four years younger than me.

After work last night we visited our granddaughter.  It was her birthday yesterday.  Babies are good for the heart.  Baby hugs.  Baby laughter.  My stepdaughter has a dog as well so I also get dog love when I go there which is almost as good as baby love.  We came home and fell into bed.  My god I'm tired lately. 

My middle daughter is coming for Thanksgiving next weekend, just for a night or two, depends on school and work.  I miss her still.  It's been four years since she moved out to Vancouver.  Our relationship is much better now.  She's almost twenty-five and it seems she has let go of her anger towards to me.  Looking back I understand now that she was angry at me for leaving her father, although I didn't understand that at the time.  She was seventeen when I left him and I was only thinking of myself and my own survival.  I imagine she thought I was selfish, ripping our family apart.  She lives with her dad now and has a much better understanding of the reasons I left.  I'm looking forward to her visit.  I'm hoping we'll have time alone, just the two of us. 

My son will be coming too for dinner.  We haven't talked much since July when he got very angry with me for calling him on his lies.  He did apologize but I still don't trust him.  His lies now tend towards lies of omission.  I'm tired of lies.  Tired of pretend.  I love him but I don't trust him which is a hard thing to admit about one of your children and an even harder thing to hold in your heart.  Love means trust in my mind but apparently not.  I don't think he understands this and wonder if he ever will.

The weather has cooled here.  It truly feels like fall.  Two days ago I walked in the river valley, admiring the fall colors, the yellow of the poplar leaves standing out so beautifully against the blue, blue sky.  And then last night the wind came up and the temperatures dropped and most of the tress now stand naked, ready for winter and their long sleep. 

And me?  I don't know.  I'm older and wiser, a little.  I keep my mouth closed more than I used to and listen more.  I still feel so deeply the pain of others that it wrecks me some days.  I'm still trying to understand suffering, still trying to accept suffering I guess.