One of the big guy's images.

I visited my girlfriend on Sunday evening.  I made crème brulee and wanted to drop it off for her. Her husband invited me in and I walked into the family room.  I saw an old Chinese man sitting on the coach, except it wasn't an old Chinese man, it was my girlfriend.  I didn't stay long, their dog was sick and my girlfriend wasn't feeling great.  When I got in the car and drove away I couldn't stop crying.  I couldn't believe I didn't recognize my friend. 

I don't know how to let go of someone I love who is not part of my family.  I can't park myself there.  I'm not her family but I want so badly to take care of her, to take care of all of them.  When I was there on Sunday evening her three girls were all sitting in the family room as well, freshly showered, in their bathrobes.  What was so comforting for me was how peaceful it was there.  Three teenage girls, a sick dog, a sick mom and a father who's taking care of everyone and their home still felt peaceful.  I guess I need to find a way to say goodbye that doesn't invade my friend's family's space. 

Tomorrow I have a job interview in Nuclear Medicine.  The job entails organizing and arranging care for a group of patients with neuroendocrine tumors.  The clinic/hospital that I work at is one of only three in North America that provides lutetium therapy to patients with neuroendocrine tumors.  The job would allow me to grow and learn as a nurse.  I've been studying and doing research for a couple of weeks for my interview.  I really hope I get the job.

I ran into my girlfriend at work today.  When I talked to her yesterday she had mentioned that she was starting a new chemo drug today but I forgot, or rather, I got so busy that I forgot.  And when I went on my break, there she was, sitting near the front door.  Her husband had dropped her off early on his way to work. 

She's so tired.  Tired of appointments.  Tired of having cancer.  Tired of chemo.  Tired of making other people sad.  Tired of feeling tired.  She looks worn out.  The chemo isn't working.  I'm pretty sure this new chemo won't work.  Actually that's not true, I'm very sure the new chemo won't work.  I know the stats, I know her prognosis.  I asked her if she wanted to continue on with her chemo and she said she wasn't sure.  When I asked what her husband said, he said that it was up to her.  Her three girls want her to continue with the chemo.  Her girls are thirteen, fifteen and seventeen.  I don't know if they understand what they're asking of their mother.  Teenagers still believe in immortality. 

I told her to try it if she wants.  She can always change her mind and stop the chemo.  I know I wouldn't continue on with chemo.  I'm a chicken shit.  I hate suffering, physically or mentally.  Palliative chemo involves both mental and physical suffering.  My friend knows she is dying but still can't believe it I don't think.  I don't think I could either.  It's one thing to say, yes, we're all mortal and another to say, this is my last Christmas, my last winter, my last birthday. 

She also knows how much suffering she's causing all of those who love her.  We all know she's dying and we're all grieving.  A part of me would just want to get it over with.  Another part of me would want to hold on to every last day, every last smile, every last hug.  I'm guessing that's how she feels as well.  The worst part would be knowing that the only thing that will ease the suffering of those who love her, is her own death.  We will weep, we will remember her and life will go on, our grief slowing becoming a part of the fabric of our lives.  How do you reconcile all of these contradictory feelings and emotions?  And what do I say to her? 

It's the start of a new year.  I'm off today, have been off for a week and I've had a chance to catch up on odds and ends.  Last year I updated my will.  I've been meaning to write a personal directive but have put it off because well, it makes me think about my own death.  But today, the first day of a new year, I had time.

I've been nurse for a long time.  I've seen many people die, some deaths were good deaths and some were not.  I vote for a good death.  Both of my parents had relatively good deaths.  They were both afraid to die but both died peacefully without medical interference.  When I was a young nurse I had a patient, probably about my age now, who was admitted with advanced metastatic breast cancer.  She hadn't seen a doctor and her family didn't know about her cancer until she was admitted to our unit.  When she came to us her breast was hard and green.  Two days later she coded.  I was there while she died and then while they coded her.  Her family was in shock and I have no idea how they coped with their loss.  All I remember is that the doctor running the code stopped it when she read the patient's chart, but not before the patient had her ribs broken from the chest compressions and a cutdown line put in her arm which left blood all over the bed.  When the code was stopped, the patient continued to have agonal respirations which made it look like she was still alive, even though her heart had stopped.  It was brutal and undignified.  It's also part of the reason I never worked in ICU;  it's the ICU nurses who respond to codes.

When I worked on an end stage dementia unit, virtually all of our patients were no codes.  Patients ate and drank until they either aspirated or stopped.  Aspiration leads to pneumonia.  Not eating or drinking leads to death.  These patients died naturally;  the way people have died for millennia.  When they were no longer able to eat or drink they died, peacefully. 

My girlfriend is dying.  She's three years younger than me.  We talk about her death sometimes.  She's not afraid to die but she doesn't want to suffer.  None of us do I don't think.  So this morning I set out my wishes in writing for my children and the big guy.  I don't want my life to be prolonged.  I want to be independent until I die.  I want to die naturally and peacefully, hopefully in my own garden or at least in my own bed.  I believe that this life is only one stop in my soul's journey and that my death will merely be a transition for me, not the end.

 

One of the big guy's images.  Pyramid Lake, Jasper.

We're heading there Sunday, except the lake will be frozen and covered in snow.  Today I am still in my pyjamas which feels rather decadent.  I ate cookies and bacon for breakfast and homemade spring rolls for lunch.  I had a good, rather long cry because my family was not together for Christmas and because my youngest daughter is still handicapped and doesn't understand that it's Christmas, or care for that matter.  And the big guy held me while I cried. 

I am one of those people for whom reality seldom meets my expectations.  I even have a little stone block on my bookshelf which says, "Happiness is wanting what you have.", and still I resist.

Right now the sunshine is streaming through the windows.  There is a hockey game on the TV and the big guy is gently snoring on the couch.  The cat is sitting beside the humidifier, staring intently at it, waiting for it to gurgle.  I get to spend everyday with the man I love.  I am blessed and still I feel unsatisfied.  It is getting better, but ever so slowly.  I try and fail.  Try again.  The mountains help.  When we're in the mountains I slow down and accept what is. 

Miss Katie's roommate had a meltdown last weekend and put her head through the wall, or maybe her foot, I'm not really sure.  Katie had a sympathy meltdown of her own because when Angie gets upset, Katie gets upset.  Katie has a permanent lump now on her forehead from banging her head against the wall or the floor.  She also has another lump on her hand because when she's upset, she bangs her hand against her teeth. 

I can't stop any of these behaviors.  I've tried and tried but they continue.  And now that Katie no longer lives at home I have very little day to day contact with her.  I see her once a week.  We go bowling.  We have lunch.  There is a lot of talking and a lot of signing and then she goes home. 

Katie is very well cared for.  Her caregivers are truly wonderful people who have the patience of saints but I don't know how her live goes.  I don't get to tuck her in to bed at night.  I can't make sure she has a poop everyday.  I can't make sure her teeth are brushed properly every day.  I do cook for her but I don't get to sit with her after her bath and have her lay her head in my lap while she eats popcorn.  I miss that.  I don't miss the constant vigilance required to care for her though.  Nor do I miss the feeling of being in prison. 

So Katie living away from me, for five years now, brings feelings of ambivalence.  I wish I was the kind of person who could care for her every day but I know I'm not.  I cared for her for many years and now I can't.  But I do miss brushing her hair and tucking her into bed.

I had a patient last week with a tattoo on her arm;  it read "Love is the anchor of the soul".  I believe that to be true but I think that I must first love myself and trust myself.  I grew up in a family in which I was told "Don't feel that way.  Don't say that."  What was real and what was presented as real didn't always match.  I found it very confusing.  I still find it very confusing.  If I don't like someone, I don't like them.  I don't pretend to like them sometimes and then talk about them behind their back.  I get confused when people do this and yet I know this is how the world works.

Mostly what I learned from my family was to not trust myself.  God, I hope my children trust themselves, although how they might have learned that would be a mystery as I certainly couldn't have taught them that.  Living with my ex-husband also taught me to not trust myself.  I was the "unstable one" in our relationship, or so I was told.  Except I wasn't.  My boss at work told me that my "negativity was bringing the whole department down" and I believed him.  Except when I look around it's untrue.  I have asked co-workers, is this true?  Am I bringing the department down and their answer is always no.  More craziness.  More moments to distrust myself.

So when I feel a knot in my stomach, a pounding in my chest, I try to ignore it, make excuses.  It's me. 

Along with this learning to trust myself, I'm learning how to accept and love myself as I am.  I don't have to be perfect to be loved.  I am loving and compassionate.  I am also passionate and when I feel emotions strongly, I cry.  I cry a lot.  When I'm upset, I cook or bake.  When I'm bored I'll bake.  I like to keep busy and I like to walk outside so that I can hear the trees.  I love dogs but I don't want to live with one because I don't want the responsibility anymore. I like my house clean and tidy.  I like my workplace clean and tidy too.  I am forgetful and sometimes I don't pay attention.  I like to exercise and enjoy the feeling of sore muscles the next day.  Sometimes I get lost in the past or in the future and forget today.  I am very organized.  I believe the best of people.  I am easily swayed.  I am all these things and more and I don't have to change a damn thing to love myself. 

The big guy and I went to a lecture yesterday morning given by Gabor Maté about Compassion and Social Inclusion.   "Dr. Maté has extensive experience working with patients in Vancouver’s Downtown Eastside and has championed a compassionate approach to supporting vulnerable populations . Dr. Maté will speak about compassion, addiction and inclusion."

There is a video making it's way around the internet right now about a homeless man, Ryan Arcand, in Edmonton who plays the piano. Dr. Maté started off talking about Ryan and the fact that people are surprised that this man not only plays the piano beautifully but that he also composes his own music.  This man, Ryan, is creative and produces works of art.  Then he went on to say that Ryan is no different than any one of us in the audience.  He has a soul.  He has dreams.  He has fears.  He is a human.  There is no difference between us except the things that we put there, between us.  Things like he is homeless.  He is an addict.  But those things are not him anymore than my fears are me.

Dr. Maté believes that addiction comes from some kind of childhood trauma, that it is an attempt to ease fears, to soothe, to feel better.  He pointed out that none of these things are bad things.  We all want to stop our pain, to feel better, to feel included, but the problem with addictions is what happens afterwards, the negative things that come after that initial feeling better. And we all do it.  We all want to feel better, we all want to stop the pain, ease the fears, feel a part of something.

Which is where compassion comes in, compassion not only for others, but for ourselves.  In fact the compassion that we need to feel for others can only start with ourselves for if we cannot be kind and compassionate with ourselves, how can we give that to others?  We also need to understand that we are all the same, there is no distance between us.

The talk he gave meandered through politics, modern culture versus tribal culture, addictions, racism, sexism, trauma, disease and most importantly, cultivation of compassion.  I cried more than once and he made me think.  I didn't agree with everything he had to say but I what I took away from his talk was the importance and need for compassion in our world. 

Two weeks ago I listened to a woman on the CBC radio show Tapestry discuss compassion and self kindness.  I didn't know what Gabor Maté's talk was about when I signed up to attend his lecture but as luck would have it, or perhaps the universe, the two went nicely together. 

I am a slow learner but it would seem that I about to learn how to become compassionate with myself and others.  I didn't learn kindness as a child but I am hopeful that I can learn to be gentle and kind with myself, hopeful that my children can learn as well because I was not able to teach them what was not taught to me.  And so it goes.