Category Archives: family

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Experience

Friday I left for the Fourth of July, but not for fireworks. I went to help pack for a move. My family moved every 1-5 years through my childhood, and then I moved too. College, work, work, medical school, residency, first doctor job. Second job and I stuck: I have not moved for 25 years. Travel yes, move no. But like Martha, I am thinking about all those books! I am working on cutting them down to size and many fewer favorites.

Anyhow, I have quite a bit of experience packing and moving. When my family moved from upstate New York to Alexandria, Virginia, the movers stacked the plates with newsprint between. Every single plate in the pile broke. My mother was furious. She said the packers should have nested them on their sides, so they don’t break the one below. We shall see if my experience is useful or not.

I bubble wrapped this lamp and then packed it in a big box with more bubble wrap and a lot of t-shirts. Yes, I should take the shade of but it would have required a special tool that we didn’t have. Or a trip to a lamp store. There was not enough time. The moving truck comes Wednesday or Thursday. We were nearly done when I left to drive back to Grand Junction. Newsprint, bubble wrap, a pack for glasses and quite a few boxes. I hope it all makes it!

For the Ragtag Daily Prompt: pack.

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What to check before bringing your elder home from the hospital

I get a call from the hospital (this is over a year ago). They say, “Your friend is ready for discharge. What time can you pick her up?”

I reply, “Can she walk?”

“What?”

“She has three steps up into her house. Can she walk, because otherwise I can’t get her into her home.”

“Oh, uh, we will check.”

They call me back. “She can’t walk. She’ll have to stay another day.”

I knew that she couldn’t walk before they called. She could barely walk before the surgery and after anesthesia, surgery and a night in the hospital, her walking was worse. She had been falling 1-5 times at home and the surgeon knew that. He did not take it into account. The staff would have delivered her to my car in a wheelchair and then it would have been my problem.

She was confused by that afternoon, which is not uncommon in older people after anesthesia. She stayed in the hospital for six days and then went to rehab, because she still couldn’t walk safely.

Recently I have a patient, an elder, that I send to the emergency room for possible admission. He is admitted and discharged after two and a half days. Unfortunately he can barely walk and his wife is sick as well. The medicare rules say that he needs 72 hours in the hospital before he qualifies for rehab. We scramble in clinic to get them Home Health services, with a nurse check and physical therapy and occupational therapy, and I ask for Meals on Wheels. It turns out that Meals on Wheels will be able to deliver in two months.

The wife refuses to go to the emergency room. I tell her that if she does get sicker, that they both need to check in. The husband can barely walk and is not safe home alone. If one gets hospitalized, they both need it.

If you have a frail elder, be careful when you are called about discharge. Go look at them yourself, make sure that you see that they can get out of bed, get to the bathroom, walk up and down the hall. Can they eat? Do you have steps into your house or theirs and can they go up the steps? I got away with saying please check that my friend could walk because I am a physician, because I knew she couldn’t and because there was no one else to pick her up. Do NOT ask your elder. They may want nothing more than to go home and they may well exaggerate what they can do or be firmly in denial. You want them to be safe at home, to not fall, to not break a hip and to not be bedridden.

For an already frail elder, even two and a half days in bed contributes to weakness. And being sick makes them weaker. If they are barely walking when they are admitted, it may be worse even after just 2-3 days. I used to write for physical therapy evaluation and exercise when elder patients were admitted, to help them for discharge. Once I got a polite query from physical therapy saying, “This patient is on a ventilator. Do you still want a consult?” I reply, “Yes, please do passive range of motion, thank you!”

Your elder does not have to be doing rumbustious dancing before they go home, but they need to be able to manage stairs, manage the bathroom, manage walking so that they can get stronger. Otherwise a stay in a nursing home or rehabilitation facility may be much safer for everyone.

For the Ragtag Daily Prompt: rumbustious.


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All home

My daughter and her significant other arrive two nights ago and we open packages and stockings yesterday morning. Lots of laughter and chocolate and much contentment. Now I have a climbing harness in pale green! We did not climb yesterday, I was too tired. We did go for a park walk on an old golf course and had a delicious dinner. It is lovely to all be gathered here and trading stories and jokes and family silliness.

Today I am up early. We will drive down to see my two aunts and my uncle. The great aunts and uncle to the kids. A very delight!

For the Ragtag Daily Prompt: contentment.

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Austere choice

What could be more austere than rock?

Taken in Echo Canyon in the Colorado National Monument, Thanksgiving, 2024.

Austere choice

Why do I still feel sad when I think
that I am best off with my cat
and that I should eschew dating.
Why do I feel like I am rejecting love?
I don’t have that sort of love.
It’s not like I am rejecting anything.
I am rejecting looking for it.
I am rejecting active interest in a partner
other than my cat.
What is wrong with that?

I do not ever want to reject hope.
I am not trying to reject wanting.
Hope and want are the deep and terrible ache
for the Beloved. I do not reject that.
I am still open, Beloved, to what you send,
though getting more particular in middle age.
A writer says that he uses a pencil and a pad,
because no better tool has been invented.
I take the same approach to wanting love.
If the relationship is more work than my cat,
for less love, why bother? It seems silly
and until I go home to the Beloved,
so far, I am best off with my cat.

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The first thing Sol Duc does when we go out for a walk, is roll on the sun warmed dusty sidewalk. The house faces south.

For the Ragtag Daily Prompt: austere.

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Surreal failure

I am still thinking about Friday’s Ragtag Daily Prompt: failure. Now that I am middle aged (by my clinic definition, which put over 90 as older), I think the biggest failure of my generation is a peaceful world. For me, a peaceful extended family. I am good friends with my father’s family and my ex-husband’s family. But the maternal family, well. I have thought about that for the last two days: could I have changed that?

Yes, but at what cost? My sister followed the “family rules” on that side. She is dead from cancer. My mother also followed the rules and died younger than me from cancer. I can’t say that the rules cause cancer. But doesn’t our culture say over and over, be yourself? To fit in the family diaspora, I would have to play the triangulation game and gossip about others as they have gossiped about me. No, thank you, no. I don’t want to. They seem to need a family member to hate and have chosen me and labelled me and call me angry. I think they are silly and emotionally immature. At the very least, I would have had to keep my mouth shut and accept them gossiping about me.

The family failure and untrue gossip, with no one ever asking for my viewpoint, mirrors the US culture. Split and needing someone to hate. At this rate, we’ll need the hippies back, with flowers and joy and counter culture and dropping out. Someone fun, at least until the drugs wear off. Someone to say, we need joy back, we need friends, we need love.

It’s not just my failure though. The family failed. They make cruel choices and target people. It happened in my generation, my mother’s, my grandparents. I wonder if it is happening in my adult children’s generation. Who is the next target? Who will refuse to counter-gossip and fight with each source? My adult children are not part of it at all, because I had less and less interest in spending time with mean gossips and I did not want to expose my children.

Lies and drama and meanness and gossip. I hope my adult children’s generation does better. We went to Wicked on Thursday. I did not like it much. Too much drama. Why do we want drama? The world seems more and more surreal. Give me the lovely hike we did on Friday instead, Echo Canyon.

For the Ragtag Daily Prompts: failure and surreal.

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Print or cursive?

My father’s father was a pressman and the head pressman when he was in Knoxville, Tennessee. This is back in the lead type times, when the type had to be set before printing the newspapers. Before they moved to Knoxville, they lived in Connecticut. My father said that my grandfather helped develop the four color process for the comics. My father would get the new comic books, Superman, straight off of my grandfather’s press. Too bad those were thrown out!

I started cursive in school in about fourth grade and I did not like it. I learned, but I thought it was ugly. My father knew how to write in italics. I liked italics much more and asked him to teach me. I adapted the capital letters to make them easier and then I wrote my papers in italics when we were not allowed to print. The teachers objected but I pointed out that we weren’t allowed to print in the papers, but it did not say, “No italics.” I imagine that some teachers found me difficult.

My cursive is still stuck in about fifth grade and I almost never use it.

Meanwhile fast forward. A law is passed in Washington State that prescriptions cannot be written in cursive. However, it does not say that we have to print. The same loophole. I usually printed prescriptions anyhow, so that the pharmacist could read it. I got compliments occasionally for printing in a legible way. I didn’t spell certain medicines correctly, but the pharmacists never seemed to care about that. Now it is all by fax and since Covid started, even the controlled substances go by fax.

For the Ragtag Daily Prompt: print.

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From Washington to Colorado

Whew! My daughter and her friend leave Denver to drive here Tuesday night. They hope to beat the storm. I am anxious. After 4 hours they are past the second pass, but the bottleneck is the visibility. It is exhausting to try to peer through the blowing snow and the lines on the road are covered. They stop at a motel. Whew! I can sleep!

They got here yesterday and made pies while I was at work. No bottleneck Wednesday, clear road and clear skies.

Half-Fast at halffastcyclingclub asks how I ended up working in Colorado.

I work in Colorado fresh out of residency. I did residency at OHSU in Portland. My now ex says, “Let’s go somewhere sunny, I am sick of the rain.” I reply, “Fine, find me an interview.” He does. One of his co-op housemates from Madison, Wisconsin is working as an emergency room doctor in Alamosa and directs us to a group there. We go.

In 2000 we move to Port Townsend because the Alamosa job is making me miserable, my mother has ovarian cancer, I have a job offer, and my parents are in Chimacum, Washington. Our clinic folds, as do nearly all the primary care clinics, into hospital employed clinics in 2002. I work for the hospital until 2009 and then start my own small solo clinic. This makes the hospital very grumpy. I close in 2021 because Covid and I am not comfortable signing another lease. I go to work in a town north of Port Townsend, in the next county. However, I can’t enforce the mask rule there. I get Covid in 5 weeks and am on oxygen for a year and half, and out for two years. I start some part time work.

I did not think I would get better enough to work but I do. I contact a couple locum tenens companies and start looking for another position in Washington. A less abusive one. The town north of me had only twenty minute visits, no administrative time to read laboratory results, xray results, specialist notes, notes from the previous doctors and honestly, the patient charts were a mess and looked like hoarder houses. So now I knew what to look for and avoid.

At some point, the locums representative says, “What about Colorado?” “Where?” is my reply. I do not want to go too high in altitude after having to recover for three years. Alamosa is at 7500 feet. “Grand Junction.” I look it up and it is at 4600 feet. I have already visited my daughter in Denver and was fine, so I think it will fly. “Yes, let’s try it.” In the interview I am much better at scoping out the schedule and how they handle controlled substances and whether there will be time to do the work. I bargain for slightly shortened days. Being close to my daughter is one attraction and I have read about Grand Junction and the fabulous hiking and mesas and mountain biking.

And that is how I came to Colorado.

For the Ragtag Daily Prompt: bottleneck.

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Letters

I went to the post office Monday. I am in a rental house, and get packages every so often for the previous renter. This time I realized at the post office that one was misdelivered and was to the house next door. Ooops. But the post office said they would redeliver it.

I love snail mail letters. I have colored pens and stickers and stamps. The whole thing makes my inner child very happy. Once I got a letter from my mother-in-law saying that my letters are national treasures! I kept that letter.

I haven’t written myself a letter, but maybe I should. What would I write?

I sent the envelope above out, but it came back. I will be driving home soon and wrote to a friend on the way, but I must have the wrong address. I bought the stamps here. The stamp pads were expensive, though, so I only got two!

For the Ragtag Daily Prompt: post office.