My mum at seventeen which would have been in 1942.  World War II was three years old.  She had met my father two years before this photo was taken.  She looks so young.  When I was visiting my aunt in September, I spent a lot of time with my cousin.  She told me about my granny, mum's mother.  I only met my granny twice in my life, both times were in the 1970's so granny would have been in her seventies.  She seemed like a stern, scary old lady. 

I listened to my cousins tell stories about granny and mum.  What I found out is that my granny looked like a stern old lady but apparently she was a lovely old lady with a great sense of humour.  Granny had resting bitch face.  My mum had a great sense of humour as well and I think that is the greatest gift she gave me. 

My cousin grew up on a farm in southern England and granny lived in a small house down the road from them.  When mum visited she would stay with granny but they would spend a lot of time at the farm with my aunt and cousins.  In the evening, after supper, mum and granny would make their way back to granny's house, down a dark country lane.  My cousin was sent to watch them and make sure that they made it home safely.  My cousin told me that watching the two of them walk home was like watching two drunks walking home;  they were laughing so hard that they staggered.  Mum and granny loved each other very much.  My aunt told me that when mum left for Canada after the war it almost broke granny.  I can imagine.

It's wonderful to hear these stories. 

 

I have a friend with breast cancer.  Actually I had a patient with breast cancer who became my friend with breast cancer.  She was first diagnosed twelve years ago.  The cancer has now spread.  It's in her bones, her brain and other places I can't remember.  Yesterday she was in for a CT scan which involves drinking two litres of water with contrast.  Just as she was about to go in for her scan she vomited everywhere.  I go back to the waiting room to find her vomiting in a garbage can, vomit all down the front of her;  she's soaked.  She said she was fine and would have the scan done soaking wet but her husband and I vetoed that.

Her husband got her a clean gown, pants and housecoat and I took her into the bathroom to get cleaned up.  I washed her and dried her and helped her put her arms in the gown.  She sat on the toilet while I took off her shoes and changed her pants.  As I was kneeling in front of her, putting her shoes back on her I asked her if she was always so easy going and she said yeah, pretty much. 

As I was laying in bed this morning I realized the difference between her and I, and probably why I love her so much, is that she is not suffering, despite all that is going on in her body.  She can't change what is happening to her but she is not a fly trapped in a spider web, struggling to escape.  She just accepts what happens.  She gets up and lives her life.  It's much slower now than even six years ago when I first met her but she sews, she visits friends, she enjoys her life.  And most importantly to me, she isn't suffering.  I am in awe and I am thankful she is my life.

And my suffering, my suffering is in my head which for me makes it harder because the part of me that I need to use to reduce my suffering is also the part of me that causes so much of my suffering.  Today is a better day.  I'm watching the sun rise as I write this.  A new day brings hope and a chance to do better.

I had a wonderful day yesterday.  I helped a doc insert an arm port, the first ever in Edmonton.  The doc is an amazing man whom I love working with.  He is kind, dedicated and extremely knowledgeable, mostly though it is his kindness which shines through.  He helped a patient yesterday, a young woman who is dying of cancer;  he made her life a little better

I got news that there is an agency that is willing to take on Miss Katie as a client;  strangely enough it is the very agency I had hoped for.  The big guy and I meet with them next Monday and Katie could move in to a new home in five weeks.  Her behavior, or rather her mood has improved radically on the valproic acid.  She can pay attention longer, she's less anxious overall and she's enjoying life much more.  I am thankful. The new agency will care for Katie alone at first, implementing the behavioral strategies as advised by the behavioral consultant before moving a roommate in with Katie.

It's not just Katie whose behavior has improved, I am also working at changing my behavior around her.  The big guy pointed out to me that unless I am looking at Katie, I am in effect plugging my ears.  She signs and uses body language to communicate so you need to be looking at her to "hear" her.  Only took twenty-six years for me to learn that but I guess better late than never.  I have been working at paying much closer attention to her, looking at her, looking into her eyes and she's much better.  He's right.  Of course he's right, he's often right.  He pays attention to people.  He pays attention to Katie and he notices things I can miss.  I've also started singing to her more as suggested by the behavioral consultant.  Katie likes music but it's not really the music she likes, she likes to be sung to, she likes the interaction and if the song makes no sense, she likes that even better.  She understands humor, gets that it's the disconnect between what is expected and what is delivered that is funny.  And she has a beautiful laugh.

I'm also on holidays for the next ten days which is lovely so I'm sitting here, writing, thinking about taking the dog for a walk before it gets too hot.  Right now both animals are curled up on the chair beside me, fast asleep.

Time to fold laundry, walk the dog, paint a wall and some trim, maybe even work in the yard a little.  Happy Friday.

I haven't written in a long while.  Life has been busy with work and family but maybe that's an excuse.  I don't make the time to sit down and write. 

On the way home we stopped at the Abbotsford Tulip Festival and took photos.  It was beyond beautiful.  Naturally I burst into tears.  It amazes me how much beauty there is in this world, and how much ugliness at the same time.  I know the colors don't look real but I haven't touched them.

Katie broke her arm almost six weeks ago and had to have surgery.  She has done well, all things considered.  The bone is healing slowly but it's healing.  It doesn't seem to cause her much pain anymore.  The medical marijuana that we started her on shortly before she broke her arm is helping her anxiety.  She's more like her old self, smiling, relaxed, friendly.  Not afraid and defensive.  We still have kinks to work out but it's coming.  She also had to move in the middle of all this and is doing well in her new home.

And me.  I'm happy enough most days.  The days are shorter.  The leaves are ready to burst forth.  Work is better now, most days we are fully staffed which helps.  My patients still teach me something new everyday. 

I still forget to relax and enjoy my life. This need to work and work and work to makes things perfect when life can never be perfect; when life is supposed to be messy and enjoyable.  I try.  It's just hard for me to sit still and be.  The closest I come to being is when I'm walking which is something I guess.  A start. 

My granddaughter helps me to remember to be as well.  To play and enjoy life.  Note to self, spend more time with little people.

A patient came into today with his wife and son.  This patient had lymphoma and we have treated him for the past two years.  Today was his last treatment with us and the anniversary of his diagnosis.  His wife couldn't stop smiling. 

I'm thankful for that. 

It's been a difficult year.  We have worked for the majority of the year short staffed.  My boss believes that all we do is start IVs.  He knows we do a few other things but my main job is to start IVs and help radiologists insert central lines. 

Except that's not my main job.  My main job is to care for my patients.  That means I listen to my patients.  I look at them as they stand up and as they walk down the hallway.  I check to see if they're tired, if they're in pain, if they're better or worse than when last I saw them.  Is there a family member with them, when they always used to come by themselves?  Are they leaning on a cane?  Being pushed in a wheelchair?  Are they having pain?  Is their breathing okay?  Do they have a fever?  Do they need to lay down? 

I need to understand at least a little about their type of cancer and there are as many different kinds of cancer as there are different types of cells in the human body.  I need to know that breast cancer spreads to the bones and lungs and liver and brain.  I need to know that small cell lung cancer spreads to the brain.  I need to know that Burkitt lymphoma is the fastest growing human tumor.  I need to know that ovarian cancer can cause kidney problems.  I need to know that colon cancer spreads to the liver and that rectal cancer spreads to the lungs. 

Our patients come back to us over and over again.  We see them get better and we see them get worse.  They trust us.  They rely on us to answer their questions and to hold space for them.  So when a patient starts crying because her girlfriend and lover of twenty-five years was found dead of a heart attack and it was supposed to be my patient that died first, I sit and listen.  When a terrified six year old needs an IV started, I tell her a story about my own little girl, Miss Katie, who doesn't like needles either.  And when a patient tells me they won't be coming back because the doctor has told them this is the end I hug them and I cry. 

Biopsy patient's end up with chest tubes inserted because their lungs have deflated.  Transfer patients from out of town can be too sick to send back.  Patient's can have so much pain they can't move.  There are fevers and chests filled with fluid and obstructed bowels and leptomeningeal disease.  There is pain and fear and fatigue. 

And we don't just care for our patients, we care for their families as well.  Because often times it's harder to watch someone you love suffer than to suffer yourself. 

So when I hear my manager say they don't want to cancel any lines just because we're short staffed, it hurts because I know I will have less to give to my patients.  What I want, what I need is for someone to care about me so that I can care for my patients. 

This is how I feel so often;  a small boat, which is fine as long as the seas are calm but there are always storms.  There are many days when I struggle to just stay afloat.  I'm not depressed now but it always lurks there, in the background, ready to strike when I'm at my most vulnerable.

External stress, lack of control in particular, rocks my boat.  Work has been short staffed again.  Last Monday, my first line patient of the day was a woman two years older than me with metastatic colon cancer.  I asked her if her chemo had started and she said no, there was no more chemo.  She was here for MAID.  I had no idea what that was so I asked her.  It's an acronym for medical assistance in dying.  My eyes teared up and I started crying. 

Her body was riddled with cancer.  She was in constant pain and it was only going to get worse.  She opted to end her life when the time was right for her, not when the cancer had destroyed her.  I apologized to her for crying and we were able to talk.  She had terrible veins.  The doctor and she decided to put in a central line to ensure there were no problems on the day of her death. 

I fully support a person's right to choose their time of death and to be honest I think that when people are given back that control, it can allow them to live more fully until they do decide to die.  My patient died on Friday, with her friends and family beside her.  She was at peace with her decision and it was not an easy decision to make she told me.  She died at home, her husband beside her.  A good death.  It's what we all hope for.

When we don't have enough people at work it's difficult to spend time with the patients who need it but I refuse to rush some things.  It is a disservice to my patients but it takes it's toll on me.  This past week I decided to stop rushing.  Coworkers, techs, docs, managers, they'll all have to wait because the work I do is important and I'm not going to short change my patients.  They deserve better.

And this decision helped me to right my boat.  The water calmed itself.  The storm was self induced.  I just need to remember this.  I can calm myself.  I can slow down.  I can make a difference in the world one person at a time and that's important. 

This is one of my favorite photos of Miss Katie, taken before the anxiety and self abuse took hold of her.  She has no calluses on her wrists from banging her mouth and no permanent bruise on her forehead from banging her head against the walls or floors.  The big guy warns me not to turn my back on Katie and he's right but a part of me can't let go of this imagine of my beautiful, happy daughter.  I grieve for my lost daughter all over again.

This is Miss Katie out celebrating her birthday with three lovely young women who used to be Katie's caregivers.  Three sisters who still care enough to take Katie out for supper on her birthday.

This reminds me that there is love and kindness all around us.  Sometimes I can forget.  It's so easy to see the meanness, the hatred, the fear.  It's so easy to go there but I don't want to.  I want to see the goodness in others.  I want to believe people can be their best selves.  I want to hope.

I'm on holidays this week which is lovely.  I have time.  Time to waste, time to be productive, time to do as I please and that is a gift for which I am deeply grateful.