Engagement Shots:

Engagement Shots:

back to the spot of our second date…where what was supposed to be “a quick informal lunch” turned into Abby making Tyler explore dead-bodies and ride a carousel…

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March 9, 2012 · 12:44 pm

Engagement Shots:

Engagement Shots:

Back to the site of our 2nd date…

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March 9, 2012 · 12:39 pm

hope.

Kampala, Uganda. The government run, nations’ largest hospital, is always full. I wasn’t allowed into some of the surgical areas, they were off limits for foreign tourists per the hospital administration, who were fearful of bad international publicity for their substandard conditions. But the hallways and cement wards were overwhelming enough.  I was greeted by smelly, bleeding bodies stacked shoulder to shoulder up the stairs to the main entryway. A giant multi-tiered cement warehouse, housing sick flesh. Every open space was filled with a body, each carrying their own disease or the their own pain-filled malady. A bed itself was a luxury. Women birthed babies on the floor in rows with shoulders touching in a small dark cement room.  Patients post surgery lay on cold floors bleeding into their dressings with limited to no pain medications. The lucky ones had family present to actually bring them water and food, not supplied by the hospital, not to mention, buy them medicines from the pharmacy, also not provided by the hospital. Physicians would order medications, and families would have to go out and buy them in order for them to be administered. Bodies filled hallway floors leading to more rooms with bodies lining walls, with infection jumping freely from one debilitated soul to the next. One room for the hospital rinsed catheters to be re-used over and over again. Another room washed metal bowls used as toilets for the bed-bound (or floor-bound in most cases here). Nurses were few and far between, rushing from one critical patient to another. Here it was better to be acutely ill and on deaths’ doorstep, for only then did one get care. Poverty to this degree is heart-wrenching and paralyzing to someone who would want to help or contribute. Exposure to this extreme environment has left me deeply grateful for simple luxuries: fresh clean water, a bed, a toilet.  I wear gratitude like a thick pair of glasses now days, always seeing the world through the lens of grateful awareness.  Awareness of how blessed and privileged we are to have a safe place to go to when we are sick and in need.

            But we have poverty of our own.  Our destitution is not as glaringly obvious, but every bit as demoralizing. Every day I meet patients who are buried under mounds of medical debt, dependant on the government to reimburse the hospital for the expenses they incurred. Patients I treat daily who may not know where their next meal is coming from or how they will afford medications.  I treated a patient last week who had not been seen by a primary physician in 7 years because he did not have insurance. He spent two weeks with us, seriously ill with multiple organ dysfunction, body crippled from years of neglect. I regularly discharge patients I know will see again soon, simply because I know they will not be able to afford to stay on the medications needed to keep them alive.  Patients who wait until their illness becomes life-threatening to come in for treatment, because they fear the astronomical bills that will continue to pile up. Bodies filled up with unhealthy foods, over-worked and under-rested, stress-dominated life-styles. Cycles of life-style decisions feeding rampant epidemics of diseases, coronary artery disease, diabetes, peripheral vascular disease, chronic obstructive pulmonary disease; all products of poverty driven decisions.  Poverty of pocket and of heart. People smoke because they are stressed. People are stressed because they are either working too much or not enough. Smoking leads to multiple diseases I treat every day. But I cannot say if I lived through the some of the same situations that many of my patients do, I might not smoke to cope too. I treated a patient last week who dealt with a chronic lung disease attributed most often to long-term smoking. She also struggled with chronic pain and anxiety that she took piles of medications to control.   She had gone through an abusive marriage, terrible divorce that left her bankrupt, and was currently living with family who were verbally abusive and neglectful.  She had no money, no where to go, and was stuck in an unhealthy living situation, all the while crippled by disease. Mid-sixties, she just felt like she would be better off dead. Poverty at its worst: a heart without hope.

            I hate dealing with the money and budget side of healthcare. But it cannot be avoided. I work for a not-for-profit organization, with roots dating back to nuns who served alongside Florence Nightingale, committed to helping the poor and underserved. We treat everyone. Our doors are open to the lost and broken, the uninsured and homeless, the neglected and marginalized. But money still worms its way into our conversations and attitudes. And I wrestle every day in the tension. The tension of conserving resources and saving money and being a responsible steward, and seeing stories of people in need and wanting to give with abandon knowing there will never be enough to go around. For nurses at the bedside the tension comes with numbers, numbers of bodies in beds. Our tension is birthed when bodies become numbers. When faces and stories become bills and minutes on a clock. Quick to the next and the next, assess and treat and get them out the door, there are more waiting. The faster the better, we start to feel more like factory workers producing products on a line than healers caring for human hearts and bodies. Confronted with vast need, I see my own poverty, my own nakedness. All the passion and energy and smiles in the world, will never be enough to fix it all.

I need hope. Hope that the bodies I touch feel valued, even in the rush. Hope that my limited resources poured into an ocean of need actually make a difference. Hope that a smile, a touch, an extra minute given that I can barely spare, can comfort, can spark healing. Hope that the desperate prayers I shoot up in crisis are heard. And answered. By the Author of life. By the Giver of all hope. 

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ground hog day.

Everyday was a bad version of Ground Hog day for Jane. Memory loss kept her living the same day over and over again. She woke up and knew enough to recognize that she was not at home, but she couldn’t remember from day to day why she was at the hospital or what was happening.  Every morning it was a nightmare for her. Trying to figure out who we were and why we weren’t letting her go home. Every day we would tell her again that it wasn’t safe for her to go home alone, that we were trying to find her a safe place to stay, but 10 minutes later she was worried about the same things again. Legal complications and safety concerns kept Jane with us for an extended period of time.  Putzing and cleaning, she would arrange and re-arrange that hospital room day after long day.  She followed the same routine for several long months. Everyone on staff knew Jane.  We would all stop in and say good morning, but she didn’t remember any of us from day to day. We knew everything about her, what she liked, what she didn’t like, but every day she felt like she woke up among complete strangers.  A bit like a geriatric rendition of the movie “50 First Dates”, every morning she lived through the fear and frustration fresh each time.

No family came up to visit while she was an inpatient, several of them had their own serious health issues, but regardless, Jane was pretty much alone. Our staff became an odd family of sorts. When Christmas came around, there was a Christmas present with her name on it under our short plastic tree at the front desk.  But Christmas was like any other day for Jane. Just like many patients in the hospital, Christmas didn’t change anything. It was just another day. Another day she was stuck away from home, away from familiarity, away from where her life made sense. Even though she didn’t recognize us from day to day, she became family to us. Even though her memory failed her, we greeted her every morning like a close acquaintance. Thanksgiving, Christmas, New Year’s, they were all the same at the hospital. People still get sick and die. People are still hungry and needy and painful and life’s joys and tragedies go on like any other day.

But even though it seemed like she didn’t know the difference from one day to another, as Christmas approached, she seemed happier, more upbeat, more hopeful. She started walking in the hallways, smiling, giggling a bit. Her daily struggle to figure out where she was and what was happening gradually eased as the unfamiliar became strangely familiar. And she got to open presents on Christmas. Just a little wrapped gift under a fake tree, but she loved it. We had hung stars in her room with jimmy-rigged oxygen tubing and found some old red and green garland to make it feel more joyful and festive, and she loved it. Made me think of this quote, “Hope is a great thing. Maybe the best of things, and good things never die.”

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hello again.

I started crying on the phone. I talked to her by accident. I was just trying to help another nurse and got blindsided with the moment. A patient had come in late in the night and needed surgery in a fairly urgent time frame. The surgeon had come around early in the morning and made some decisions, but because of how sick the patient was and his history of mild dementia, he wanted to talk to some family about the surgery before he proceeded. I made multiple phone calls, to several more distant family members, but we had not been given much information. We knew he had come in from a nursing home that we had been told he lived at with his wife, who also purportedly had severe health problems as well. I tried all the family, with no success. My last attempt was to call the facility to see if they had any more information, however, the phone number I found was not to the nursing staff like I had been told. I dialed a number thinking I was going to talk with a nurse and find out clinical information, when a thick muffled voice answered a very labored “Hello” to my ring. It took several minutes of awkward conversation to deduce that I had accidently reached his wife, who, I soon figured out, struggled with severe expressive dysphagia related to a stroke. My first response was to apologize and ask to talk to the staff instead of her to get the information I needed, but the tone in her voice stopped me. She was so excited to hear his name. “How is he?” She asked arduously. “How is my sweetheart?” I could barely understand her and had to have her repeat everything she said at least once. Her tongue was thick and childish sounding, every word a struggle and stutter for her to form and express. I gave her a brief abbreviated version of his condition, and one would have thought I just gave her a million bucks. “I did not know.” She mumbled. “I didn’t know. How he was. Can you tell my sweetheart I love him? Please tell him I love him!” She had been up all night, wondering, worrying, with no way of hearing or finding out if the love of her life was alive or hurting or alone.  “Thank you. Oh oh thank you.” Repeating over and over her gratitude at hearing his name, his condition, his livelihood. And then came the question that took me completely off guard and brought my tears, “Thank you so much! Thank you. What is your name?  Do you have Gooheed in your heart? Do you love him?” It took me several unsuccessful attempts to figure out what she was asking, “Do you have God in your heart?” she asked me again. I stopped. Here this woman was severely debilitated, alone, unable to even be with her husband of 60-plus years while he went through surgery, and she wanted to know me. Caring to know how I was, to know about my heart, if I was someone who loved God. I think she could sense it in me. I was too busy, to deaf, to self-focused to sense it in her, but she saw through that in our brief rushed conversation. A strange woman I have never and will never meet, here on this earth at least, called me out. Of a hole that that I hide in at work. It’s safer, for all of us, to stay busy, to not offer your heart, to focus on tasks and skills and projects and numbers, and miss the deeper, the eternal voice at work underneath it all. “Yes,” I answered after a moment of silence, “Yes, I do love God. He is in me, in my heart.” I could hear the excitement in her broken voice as if she had just made a new best friend, “Oh, I will pray for you!”  I was so humbled by the thick jerky inarticulate voice. My stress and agenda and task list melted as I held the phone close to my ear, wanting to soak in the brave hope she offered. She should have been the stressed angry one, but instead she was the one offering me hope and peace, gratitude and compassion. I had a hard time hanging up the phone. I wanted to stop that moment and preserve it. I wanted to learn from her. Learn how to hope the way that she did. God help me. This is what I want.

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the book.

there are words inside. good and stupid and silly and meandering. lots off-track and inconsequential. some of them i want heard. seen. some of them i never want exposed. i really don’t even know if they are worth anything to anyone else. seems funny to offer something to others not asked for. but somehow i feel like there is something inside that wants to come out.
i want to steward this well. pursue. not passively sit by the wayside…but i want what’s right. not rushed or forced. or fake. or surface. i want substance to come out…i don’t want to scratch the surface or only squeeze out half the abscess…i want it all. all the puss to come out. deep debridement. anyone can write. and they are all statistically logistically technically better than i am. but i want to write. i want to bring movement. bring healing. bring conviction. bring insight. depth. awareness.

i want to write what is true in me. original. unaffected. unaltered. unadulterated.
maybe one word at a time. one thought. one idea. one moment. not for anyone. or to anyone. just offer up what i see and hear. and not worry. about how people might respond. or not.
but this is something i dont want to just think about. masticate on indefinitely. i want to move on it. into it. grab hold. and chase it. dig in. sink my teeth. fight.
risk something. invest something. i dont want to have this self-inflated prophet complex, i dont believe necessarily that what i have to say will change the world…but i do believe that God has put a thing in me that would be right for me to offer.

i want to create as a reflection of a Great Creator…reflecting His depth of wisdom and wit and insight and truth.

i want to bring healing. hope. restoration. redemption. bring the Kingdom near.

to open eyes to SEE.

{what i want it to be}

i want it to be an honest reflection. of what i see. who i meet. what i am taught. what i wrestle with. and maybe in that wresting, invite others to grapple and enter. i want it to be fresh. raw. real. honest. genuine. an honest overflow of thoughts and emotions and questions that stem from time with God and people. about hurt. healing. anger. disappointment. addiction. freedom. suffering. joy. gratitude. about the coverup.  of these layers. that hide stories. the layers of fear. and doubt. and loneliness. and brokenness. that are buried of piles of cover-ups. i want to help peel those layers, those cover-ups back…to see people as they really are. in their nakedness. in my nakedness. to discover and tell the real stories hidden, buried, and unheard.

so here it starts. to unfold. will start to post chapter excerpts from my book.

“naked {hope}.”

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30 minutes in the life of {a nurse.}

Yellow florescent lights run in tracks along the ceiling down the hallway in straight lines, stark incandescence highlights each body with equal harshness.  Busy blurs move along under those lighted tracks like cars in the fast lane on a busy highway at rush hour. In and out of rooms, some stopping at mounted wall computers like stop-lights, squinting at and punching out numbers. White coats, white papers, white shoes, white faces. Busy business to be done by all.

The slow lane lumbers along beside with the stop-and-go shuffle of walker traffic. Each inching painfully along, blue slipper steps alternating between aluminum walker legs, dragging beeping poles and swinging bags of colored juices behind.  Some with spindly spider legs fragilely supporting the bird body up above, some with weeble-wobble noodle legs wavering uncertainly, some with swollen tree-trunk limbs stiff shuffle thumping, but all achieving wondrous success by merely standing on those two legs and moving one foot in front of the other.

Sharp left-handed turn into room 704, red cardiac monitor alarms blinking like traffic lights ahead.  Naked white lump of flesh tied up in a tangled mess of red, green, white, brown, black wires wiggling every which direction from under piles of white stiff hospital blankets. Iridescent blue veins stand-out barely covered by paper-thin tissue-paper white skin, while wiry bony fingers pull and fuss, trying unsuccessfully to break free from the wired mess.  Pleasantly confused naked bodies, let calm coaxing helping hands straighten and organize cords and tubes, boost and fluff and re-tuck. Red call light placed in laps with reminders, while loud coughing and beeps erupt from next door.

Mr. 705. Brisk busy steps in a professional rush to the next crisis. Hunched over, sweat streaming, each rasp of a breath sounding and looking labored and desperate; it’s another naked body needing air. Phone calls, doctors paged, new tubes, the hiss of high-flow oxygen titration, another body boost up, a body unable to sit up on their own to get air into lungs. Now: coach the breathing, slow down, talk down the breathless hysteria. Morphine and Ativan IV push STAT from the medication Pyxis rushed back to the room, a saline flush squirted into the air spraying a cool mist onto the flushed naked face.  Smiling face doesn’t let scared body see stress or worry or urgency.  Hand on shoulder, lips to ear, coaching and calming, breath-by-breath reassurance until two sets of lungs, two mouths, two bodies breathing as one. Slow. Even. Perfusion. Ventilation. Oxygenation. The surrounding chaos outside frozen in time, the only real moment is this; eyes connecting, breathing slowing, a calm transferred, until oxygen exchange is successful.

Phone blast.  Re-enter hall traffic, cut-through phone calls and buzz at the desk, dodging stretchers coming and going, loaded with undiagnosed bodies headed to tests determining fates.  Multiple IV beeps blaring from multiple rooms interrupt any hallway navigation.

Ms. 719. code brown. Rigid obtunded naked body covered in brown. Stool everywhere; shoulders to toes. Log-rolling resistant unbending limbs, warm white washcloths drip soap-suds all over the naked soiled body, stiffly unaware, blissfully oblivious to her naked exposure. Judge Judy’s constant background blabbing blocking buzz from the conflict two rooms over. Blue latex-free gloves scrubbing red raw excoriated skin with careful methodical precision. Fresh white sheets tucked and folded with puffs of white powder layered between skin and bed. Perfectly propped pillows, call it good; at least for the next two hours. Deep sigh. Knock on the next door.

Ms. 721 screams. “Help! Will someone please help me?! They have taken my purse and I am late to the theatre!”  Confusion hanging thick in the air, no logic or reason welcome here. Bright red lipstick and brown painted eyebrows pop awkwardly from pale white bony cheeks, moving in unnatural frenzied wiggles as she frantically searched the room, trying to make sense of something in her perplexed non-reality. Pink finger-nails a nostalgic link, connecting to another world far far away, a place that only existed in her head. Hands held. Concern heard. Medication given. Try only a half-dose of xanax tonight. And more busy wash-clothes to fold.

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