Sunday, July 2, 2017

Bodhisattvas

June 2017 submission for CT Working Moms:


When I was sixteen years old, a series of poor choices resulted in my arrest.  The punishment designated by the court was 100 hours of community service, overseen by Reverend William T. Federici of First Congregational Church.  Unphased and unrepentant, I showed up (late, of course) for my first day of service straight from the beach: barefoot, sand covered, and bathing suit clad.  Rev. Federici said not a word about what brought me to his office.  He insisted that I call him Bill or Billy, and set about drawing me a diagram detailing the direct connection between the mind and the heart.  He explained something called “the heart of the perfection of wisdom,” and advised that I needed not just to open, but to empty my mind of the negative thoughts living rent-free in there.  For a disaffected teenager, it was quite a concept.
That summer, Billy turned an angry teenager’s world upside down. To my adolescent surprise, I discovered I liked him not because he was Christian (something guaranteed to make my Jewish mother twitch), but because he was the first adult I’d ever connected with who made being good something cool.  He somehow managed to be simultaneously irreverent and spiritually sound, his circle exclusive without being exclusionary.  Those 100 hours provided inspiration, not punishment, and profoundly impacted both my attitude and the direction of my life.
From the seeds Billy planted grew my own belief system, rooted in the principle that all people and animals are deserving of kindness. As a parent, I teach my children to celebrate and embrace individuality and differences, to identify and include anyone being marginalized or ostracized.  As a yoga teacher, I focus on bettering the self in order to better the world.  As a nurse, I seek out patients and populations whose diverse and complex needs are not being met in mainstream medical channels.
There are teachers all along the path, and inspiration can be found in everything and everyone.  Never have I been truly surrounded by bodhisattvas, however, until I began working in hospice.  To be clear, the Bodhisattva to which I am referring is *not* the lousy Steely Dan song (with all due respect to lousy Steely Dan songs).  In simple terms, the bodhisattva of Mahayana Buddhism is a person motivated by compassion to end suffering. Over the past several months, I have had the good fortune to work alongside many bodhisattvas disguised in civilian clothing, providing comfort and gentle care to patients and families during the last months to minutes of life.
Nearly all that I know about compassionate care of the terminally ill I learned from hospice aides. They have a sixth sense for where patients are in the disease process, and often juggle far more than a simple caseload.  Dede good-naturedly cares for patients seven days a week, with a genuine smile that is absolutely infectious.  Rather than groaning the time I called him at 7 pm about filling an emergency night shift, HE THANKED ME for the opportunity. Yesterday, Dede sensed that his patient’s passing was imminent. He immediately set about playing Mr. K his favorite songs, so the last hours of his life were filled with the sounds he loved the most.
Marilyn is a mom to small children as well as a full-time student, yet she still comes in – day or night – on short notice if a patient needs her.   Last week I returned to a patient’s room after notifying her family that it was time to come say goodbye. Marilyn had bathed and dressed Miss P in a fresh outfit, tucked her comfortably into clean linens, and expertly braided her hair.  The first thing our patient’s daughter noticed was how beautiful her mother’s hair looked.  She told us it had been a year since her mom felt well enough to have her hair done.  Miss P. was no longer able to speak, yet somehow Marilyn knew just what she would have wanted and needed.
A consummate professional, Saundra exudes competence and calm. We had a mutual patient I’ll call Michael, of whom we were both quite fond.  One day, I bandaged his wounds as Saundra tended to him. “Mike,” she said, “you’ve got a bit of stubble growing on your face. I need to find a razor and clean you up, because a lot of people are going to want to kiss you tomorrow.”  Without any input from me on the medical indicators of impending death, Saundra recognized that his passing was imminent. More impressive, still, was the tender way in which she’d thought to prepare him.
Last week, fellow nurse Corine and I found ourselves a solid hour past target departure time, neither of us willing to leave Mrs. A, who was still uncomfortable. Once breakthrough pain medication had been administered and the patient was resting peacefully, we made another attempted exit… at which point Corine noticed a loose bandage on the patient’s toe.  Mrs. A was not conscious, likely several hours from death. Had she covered the patient’s feet with a warm blanket and gone about her business, no harm would arguably have been done.  Corine, however, could not allow herself to leave any patient need un-met, regardless of how small.  It was beyond touching.
One of the most heartwarming moments I’ve witnessed in hospice was during a recent admission.  Community liaison Janelle walked a patient’s palpably anxious son through a series of difficult concepts. Her gentle demeanor took the fear out of the process, and he was able to fully evaluate all options and determine which approach he thought best fit his father’s needs.  At some point during their conversation, Janelle had learned that Mr. L was a veteran.  Just before leaving, she knelt down by the patient and thanked him for his service.
I’m pleased to report that I met my esteemed hospice colleagues under slightly more respectable circumstances than those which led me to my first teacher and bodhisattva. The lessons Reverend Federici taught juvenile delinquent Karen still hold true: being good *is* cool, and inspiring, and fulfilling.  Compassion is an inherent part of goodness and hospice, as is the desire to end suffering. Regardless of personal faith tradition or professional title, we are united in compassionate desire to eradicate suffering – and I think we’re doing Billy proud.

Wednesday, May 24, 2017

The Three-day Potty Training Method (is full of crap)

May 2017 submission for CT Working Moms




What the book says: Potty training can be crappy.  But it doesn’t have to be.
Reality:  Crap. Everywhere.
What the book says: It will be fun.  It will be worth it.  It’s only 3 days, you’ve got this!
Reality: It will be hell.  You will question everything including what you have done karmically to earn this.
What the book says: You and your child will remain inside the house for three days, during which time he will be naked.
Reality: Your naked child will spend three days trying desperately to escape your house.

What the book says: Once you find a high-value reward, the rest is a breeze!
Reality: You will discover that orange skittles are toddler potty-training crack.  You will also discover that if you give aforementioned child enough of them, you will be cleaning up poop *and* bright orange vomit from your floors.
What the book says: Potty-training has a significant effect on the development of your child’s personality.
Reality: If you spend enough time obsessing about your child’s poop, he may begin acting like a shit-head.
What the book says: Picking the perfect potty makes all the difference.
Reality: You will purchase 3 exorbitantly priced potties and two sets of child-seats for adult toilets, and your child will still defecate in his adorable new training undies and urinate in your bathtub.

What the book says: Instead of dreading potty-training, you will celebrate potty-training as the wonderful milestone it is for your child.
Reality: You will return from trying to potty train to dreading potty training on hour six of day three, which goes something like this:
Child sits on potty (produces nothing). Stands up, “flushes,” demands a Skittle.  Mommy advises that we get a Skittle after we potty.  Child glares, then sits back down on potty (produces nothing).  Stands up, “flushes,” grabs Skittle out of Mommy’s hand. Chews Skittle, beaming, while peeing on the floor.
*please note that all kiddos in this month's blog photos are either my own or our friends' children, all of whose parents gave their blessing to feature their tots.*

Saturday, May 13, 2017

A date with death

April 2017 submission for CT Working Moms:



I have a date with death: April 3, 2017. It’s not as ominous as it sounds, though – in fact I think it’s going to be a wonderful day.  This will be my first day as a hospice nurse.
Early into my maternity clinical rotation at NYU, I decided I should be a Labor and Delivery RN.  Having assisted in a few uncomplicated deliveries with epidurals on board, clueless as to what the agony of labor felt like, it seemed a fantastic career plan. L+D nursing, at first glance, appeared to be mostly cheerleading with some IV fluids thrown in for good measure.  Several weeks later, I realized I had been terribly wrong when the board in the staff room read: IUFD. After learning what those letters meant, I left the floor with sore feet and a broken heart – which were nothing compared to what the patient was suffering.
During the year that followed, I continued to identify potential areas of specialty, only to be humbled again and again in one way or another.  Orthopedics and sports medicine intrigued me, until I had to set up an operating room for one of the surgeons.  In addition to the usual scalpels, suture kits, and sterile gauze packages, the OR checklist also listed several kinds of drills, multiple clamps, and two power saws.  Until that day, I had not realized that orthopedic surgery was equal parts medicine and Home Depot.  I *hate* Home Depot.
Next up was Neurology, the first course where I was truly able to transfer classroom knowledge into patient care – so much that my clinical instructor took a liking to me.  Our professional romance soured, however, the day she led me first to the sinks and then excitedly towards an operating suite, promising a once in a lifetime learning experience with a world-renowned neurosurgeon. Upon entering the OR, I looked over just in time to see Dr. WorldFamous peeling scalp neatly away from the patient’s brain. I turned back around and bolted, barely making it outside of the bay doors before vomiting into a clean laundry bin.  Barfing on freshly-laundered surgical scrubs after fleeing a famous surgeon’s operating room was, advised my irate instructor, “puke icing on a shit cake.”
By the time I graduated from nursing school, I had discovered that unlike pretty much everything I thought I’d like, nonprofit-based nursing really was right up my alley. This led to a decade of work with the underserved (often confused with un-deserved), particularly in the areas of women’s and community health.  At-risk populations have been my favorite challenge, appealing to me for the same reason many would rather not get involved: the likelihood of a poor – both literal and figurative – outcome.
Which leads me back to hospice.  Over the years, I’ve witnessed the evolution of my own definition of a “bad” outcome.  Dr. Paul Kalanithi said: “My highest ideal was not saving lives – everyone dies eventually – but guiding a patient or family to an understanding of death or illness.”  Sometimes a good outcome doesn’t mean a cure, it might mean finding a way to make one hour of a patient's or family’s day less agonizing.  Which includes more than just clinical skills, often creativity and kindness come into play as well.  Bringing a dog to distract an anxious pediatric patient, for example. Staying a few extra minutes to answer questions, or just sitting quietly with a grieving spouse. My goal as a palliative care nurse is to provide physical pain relief whenever possible, and offer a measure of comfort to suffering patients and families.  I may not be able to extend anyone’s life story, but I’m hoping to brighten some final chapters.

Monday, May 1, 2017

Ladybug of love


Twenty years ago, I walked into dog rescue quite literally by accident.  While home from France for the winter holidays, I went with my bestie Carey to the Connecticut Humane Society to help search for her first dog. Initially reluctant to join her, I thought seeing all the undeservingly homeless dogs would break my heart. Which, predictably, it did.  The surprise plot twist was that I found myself walking out the door holding the leash of my own adoptee. Somehow, I was not deterred by the fact that I lived in another country, nor was I concerned that my mom had allergies significant enough to prevent any dog of the fluffly variety from setting foot (well, paw) in their house.  I left the shelter that day with Tucker, a 12-year-old golden cocker spaniel with a heart of gold. Over the next several years, we formed an unbreakable bond, from which I developed a boundless love for the breed.

The second cocker I adopted was Ladybug.  She was sweet and wiggly, and hailed from southern California.  Where Tubby (Tucker’s nickname, for obvious reasons) had been shy and cowered in the presence of strangers, Ladybug loved absolutely everybody.  She immediately snuggled her way onto my parents’ couch, and into the heart of everyone who crossed paths with her.  Five years old when we met, she brought us a decade of joy, and inspired in me a love of all things ladybug-themed. When Bug developed renal failure and subsequently died, I was inconsolable. The day we buried her, I returned to our house in Fairfield with our surviving dog, Jellybean. As I sat hugging her and crying in the kitchen, I noticed a little ladybug crawling across the counter. Although I’m not a big believer in signs, I found it incredibly touching and comforting.

Three years later, beloved puppy mill survivor Jellybean was found to have a brain tumor. I panicked and opted for aggressive treatment.  Despite our best efforts, she declined rapidly, and just a few short months later we said goodbye. Bean and Bug were the absolute best of friends, at least one part of them touching at all times. On the tearful drive home from the vet after bidding farewell to JB, I tried unsuccessfully to convince myself that she and Bug were reunited at a great bacon buffet in the sky. Then I walked into our house in Easton to find dozens of ladybugs crawling up the windows of the living room. I could hardly believe my eyes.  Was it possible that Ladybug had come to take Jellybean home?  I had no idea what to think, but it was at the very least an amazing coincidence.

Ladybugs have continued to make cameos in my life, each time around the passing of a dog.  Last summer, our hospice foster Lady left us, and again that day I found ladybugs in our house.  I tried to debunk the connection, reasoning that when Lady died, it was summer, which is ladybug season. However, when senior rescue Daisy Mae left us last week, it was January. Low and behold, just after hearing that it was her time, we found a ladybug on the counter.  The ladybug phenomenon is not limited to this house, or even this town. At the time my sister’s cocker Leo was dying, they were living in Portland, Oregon. Two days before he passed, she and I were on the phone when she found a ladybug crawling up her refrigerator.  48 hours later, I went outside in Mystic, Connecticut and found a ladybug on my car windshield – and I knew Leo was gone. At this point, it has happened too many times, in too many places, during too many seasons to be sheer coincidence. I’m not sure what I believe happens when we die.  If there is a heaven, though, our dogs are there – with Ladybug first in line to welcome everyone.



Monday, January 23, 2017

A letter to my son on his third birthday


Dear Timo,

How can you be turning three today?  You were only just a newborn!  A fragile, tiny, five-pound newborn who fit in your Daddy's hand. Exquisitely perfect and delicate, we were terrified to hurt you those first few weeks. Ok, who are we kidding, I'm still afraid to hurt you. Only now, I'm more afraid of someone else hurting you.  And maybe afraid for the someone else who does, too.  I have taken to saying that if I ever spend the night in jail as an adult, it will likely be over my reaction to something that happens to you on the playground.  Other parents laugh when I say that, perhaps they don't realize that I'm not joking...


In this past year, you've grown into an inquisitive, agile, impy little force of nature. You are still the sweetest child, sensitive to the feelings of everyone around you both human and animal, and eager to meet the needs of everyone from your Grandma (bringing her a hug and a frozen coffee yogurt immediately upon arrival) to your doggies. You are musical, and delight in dancing to your favorite songs - unless Mommy harshes your mellow by trying to sing along.  You've shed some of that gorgeous baby chub, and are now a brave and agile explorer, running, climbing, and splashing, your canine bodyguards never far behind. 

Perhaps the most beautiful development of the past year has been the blossoming of your friendship with your sister. She is the center of your universe. Watching her delight in engaging you - and you respond with such joy - makes my heart so full it sometimes feels like it might burst.  I hope that even as you both grow and cultivate your own interests and individuality, that you never lose that connection.  Your bond is unique, and, like you, so very beautiful.

Your smile can light up a room, and your very presence completes my life.  Thank you, little T, for the magic you have brought to us.  I'm very proud of who you are, and can't wait to see who you become.  I love you more than I could ever put into words.


Mommy





Wednesday, January 4, 2017

Shove your f***ing orange socks!

First blog as CT Working Moms Staff Writer!
Submission Date: December 30, 2016




It started out innocently enough.  We had a playdate with a few kids and moms I’d been wanting to see at the trampoline park Lili had been aching to go to. Almost two months to the day of her liver surgery, Lil had just gotten full clearance to return to normal activity, so after eight weeks of cautioning her against doing almost everything, I was determined to let her have a little fun.  I bent the rules and let the kids watch cartoons and eat egg and cheese sandwiches in my bed, so I could keep an eye on them while I packed up the 108493 things needed to leave the house with small children.  Once on the road, we promptly got stuck in traffic.  I tried not to stress about being late.  It wasn’t the end of the world, I thought, until Lili advised me that little T was “looking weak.”
This was Bad News.  T is phasing out naps, and not necessarily with my blessing.  He’s happier for more of the day if he sleeps for an hour or so around lunchtime, but despite my best efforts, he seems to be settling into a pattern of forgoing naptime in lieu of earlier eventual bedtime, and waking up later in the morning. Sounds blissful, right?  Not so much. Two unpleasant realities of his new routine:
1. T gets more exhausted during the day, which leads to frustration he lacks the capacity to control, ultimately resulting in never-before-seen, five alarm epic meltdowns.
2. When he does drift off (usually in the car, but only when I’m trying to avoid having him fall asleep) and has to be woken, he is not a little grumpy, which was the case up until about three months ago.  He is IRATE.  This fury does not quickly subside.
Although Lili and I tried desperately to prevent it, by the time we arrived at the trampoline park, T was mostly asleep. The parking lot, usually empty, was overflowing, so we found a spot at the warehouse next door and ran over in the pouring rain. By the time we arrived at the door of the place we’ll call Super Bounce, we were half an hour late and soaking wet, T was miserable, and I was frazzled.  When I opened the door, we stepped from the third to the seventh circle of hell, populated by wall to wall screaming, overstimulated children of all ages.  The overwhelmed desk clerk couldn’t find Lili in the computer, so we had to go fill out a new waiver at a separate computer station.  T refused to let me put him down, so I lugged him and the diaper bag over and typed out our information while he alternately tried to unplug the computer mouse and turn off the monitor. We got it done, and paid for an hour of bounce time plus the requisite $4 worth of Super Socks: bright orange, non-skid, generally ill-fitting ankle socks.  T *hates* them.
Next, we removed our shoes and headed up to meet our peeps, who I hoped weren’t already on their way out, given that we were now nearly an hour late.  Before we could even get to them, we were stopped by a hostile employee demanding to know what was in the 2 holiday-wrapped presents Lili was dutifully carrying. Seriously? Sneakers and a cat toy, I told her. Irritatedly, I wondered if the TSA had started policing trampoline parks.  Finally upstairs with our crew, T was warming up to a major meltdown.  Lili bounced away joyfully while I tried to exchange pleasantries with our friends over the increasing volume of T’s fussing and whining.
Another SB employee arrived to advise that T needed to be wearing Super Bounce orange socks.  I explained that we’d paid for them, but he was too combative to let me put them on. Not only was he not interested in bouncing, he actually had on non-skid socks of his own. The man said that I’d have to put them on him or we needed to leave.  Sigh.  I muscled the socks on him while he swatted at me, eventually throwing himself on the ground, rolling around and kicking.  Most unfortunately, a small child was in the line of fire and got karate-kicked into the foam pit.  The good news: the child thought it was hilarious.  The bad news: her mother did not.  I apologized profusely and moved him off to the side, firmly telling him that it was ok to be angry, but not to kick people. That led him to switch over from screaming to wailing.  

I wanted to dive into the foam pit, cover myself head to toe, and hide.  Instead, I sat down, tucked T under one leg, and rubbed his head while I waited for him to calm down. Shortly thereafter, our friends left one family at a time, until it was just me and T watching Lili launch herself joyfully into the air.  His last sob had launched a massive booger out of his nose and onto my hand. Not having any tissues readily available, I cringed but left it there, unsure of what exactly to do about it.
T rallied briefly and bounced across the trampoline squares in the big-kid-area towards his sister. Halfway there, he apparently remembered he was wearing the detested orange socks, and flung himself back down to flail and scream.  I headed out to retrieve him, only to be stopped yet again by the Super Bounce etiquette police, the same woman who’d hassled us about the Christmas presents Lili carried in.
Super Bounce Bitch: Ma’am, you’re not allowed on the trampoline unless you’re wearing Super Socks.
Me: I don’t have Super Socks because I’m not bouncing, just picking up my kid who’s about to get stomped.
SBB: Everyone on the trampoline needs Super Socks.  You can go to the front desk and get a pair.
Me: I’m not leaving my toddler alone while I go to the front desk.
SBB: Ma’am, you can take your toddler with you.
Me (considering wiping T’s SuperBooger on her): I can’t take my toddler anywhere unless I go pick him up, which you won’t let me do.
SBB: Ma’am you can go get him if you’re wearing Super Socks.
Me: F*** Super Socks!  Shove your f***ing Super Socks!
Blessedly, before I could say anything else that could get me forcibly removed from the premises, a loud buzzer sounded.  It was 12:00 and the bouncers were advised to move to a different area. That gave me the chance to grab T and get close enough to Lili to tell her that it was time to go.  I hustled us down the stairs, yanked off both kids’ orange Super Socks, wiped T’s booger on one, and deposited them directly into the trash.



Wednesday, December 14, 2016

Innocence is not lost, it is taken (Michael Keller)




One sunny day last fall, T and I zipped down to pick up Lili early from school.  Our eventual destination was the Bronx Zoo, which has discounted admission fees on Wednesdays and is a blast for both kids. We'd secured written permission for her to be dismissed just after lunch, and anticipated quick turnaround time at her elementary school since it's small and well-organized.

As we turned down Pound Ridge Road, I saw emergency vehicles blocking the school's entrance, lights flashing.  My heart immediately began pounding.  I pulled up next to one of the firetrucks and rolled down my window, only to find myself mealy-mouthed and unable to speak.  After a moment, I composed myself and told the fireman that I was there to pick up a student for early dismissal.  He pointed to where I could park my car, and told me to "be quick."

My mind raced.  What the hell was going on?!  It wasn't likely to be an injury or accident, because that would not require entrances and exits to be blocked off.  As I hustled in carrying T, we passed EMTs and policemen standing in groups in front.  We went to the window, I signed the book and asked the anxious-looking clerk if I could pick up Lilia Gomez who was in Mrs. Crupi's class.  She said that she wasn't sure they could release her yet because they were about to start a code-red drill.

A drill.  Thank God.  Hugely relieved, I pointed out fire trucks to T while we waited for the front office staff to sort out releasing Lili.  She eventually appeared, and as we walked outside, the kids hand in hand, I noticed that she did not seem remotely concerned by the mass of emergency personnel swarming her school.  Once in the car, I asked if she was excited to be getting out of school early to go on an adventure to the zoo.  "Well," she said, "I'm excited, but a little disappointed because we're having a lockdown and I'm going to miss it.  They're really fun."  

I was shocked.  Fun.  She thinks lockdowns are Fun.  Fun, in my opinion, is not synonymous with Lockdown.  One one level I found this heartbreaking, but also curious, so I initiated the following conversation:
K: What happens when your school has lockdowns?
L: It's really cool. We turn out the lights, crouch down away from the windows, and hide. No one can make any noise.
K: What are you hiding from?

L: Animals, usually.
K: Animals?
L: Yes. You know, sometimes a wild animal accidentally gets into the school, so we have to hide from them so they don't know we are here and hurt us.

K: A wild animal, like a deer?
L: Yes.  I hope we have another lockdown soon, since I'm missing this one.


I recounted stories of wayward deer jumping into a Greenwich Chinese restaurant and the seal tank at the Maritime Aquarium in Norwalk, and our conversation shifted away from emergency preparedness drills.  The exchange stayed on my mind long after my car pulled away from the school, though.  The kids enjoyed the zoo that afternoon, thinking of nothing but amazing animals (and the occasional snack).  My mind was still on the lockdown, and Lili's comments related thereto.

Late that night, I lay awake thinking things over.  I marveled at Lili's naiveté, and complete trust in the somewhat nonsensical explanation she'd been given for why her class had to play regularly scheduled lockdown "games."  I thought of the massacre at Sandy Hook, and the families - some of them known to us - whose children lost their lives, or (at best) their innocence.  I remembered the time, some years back, when I had been to a gun range and fired a gun.  How easy and inexpensive it was to rent or buy one, just flash a driver's license, fork over a little cash, and pick a target.  No test, no training. Just pay, point and shoot.  There were women's and even kid's themed gun models. Would you like a Hello Kitty AR-15 for your daughter?  Pink-handled pistol for your purse?


Lili was in first grade when the Sandy Hook School massacre happened, the same age as many of the precious children lost. T is about to start preschool, out of the my ever-vigilant sight, under someone else's supervision.  I believe that our schools are safe, I do. But I'm scared for our country, even our community.  How will we change in the next four years, without a president fighting for better gun control? What will we tell our children about the vitriolic, venom-spewing man leading our country?  If we preach a gospel of peace and love at home, will that be enough to balance out the increased outbreaks of violence and hate? When we encourage our children to trust the good guys with guns, our policemen, will they believe us?  Should they?

Sadly, I don't know.  This is not meant to be a political commentary. These are just the thoughts running around in my head, and sadly I don't expect to find answers to them any time soon.  For today, I will remember twenty children killed in the place where they should have been the safest, and the six adults who died trying their hardest to protect those little lives.  I will hug my baby boy tighter.  I will be grateful for all that I have, without forgetting all that was lost.