Category Archives: Stages of grief

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Unfiltered

An old friend died this morning. She was a college friend of my parents and has known me since birth. I will miss her quite terribly.

She and I took a road trip in September. She had lost thirty pounds, not on purpose. I thought I had better do the road trip while we could. We went from Michigan to visit five households of old friends in Wisconsin. I lived with her and her family for a year during college in Madison, Wisconsin in the early 1980s. She is a beloved mentor.

She also introduced me to all sorts of groups. She has an amazing record collection.

I went with her to see Warren Zevon in Madison.

The painting is my photograph of one of her oil paintings. It is about 3 by 5 feet and gorgeous.

Dona nobis pacem and much love.

For the Ragtag Daily Post: filter.

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Diagnostic quest

Some diagnoses take months or even years. How can that be?

A patient comes to me with right shoulder pain. His pain is “out of proportion to the exam”. His shoulder exam does not fit with a rotator cuff tear, he has good range of motion, it is weird. I hospitalize him and ask orthopedics to see him.

The orthopedic surgeon agrees with me. It is not a musculoskeletal shoulder problem. We do xrays and labs. We do a chest xray as well as a shoulder xray because on the right side of the body, the recurrent laryngeal nerve goes down to the diaphragm and then returns to the shoulder and neck. So sometimes shoulder pain on the right is referred pain from a problem or tumor or pneumonia at the base of the lung.

His chest xray is normal.

We are having trouble controlling his pain even with morphine.

I call the general surgeon. My patient has some small lymph nodes in his supraclavicular spaces. We actually have lymph nodes all over, but many are hidden deep in muscles or under bone. We can feel them in the neck, the supraclavicular space, under each arm and in the groin.

The surgeon says there isn’t anything large enough to biopsy.

I call the oncologist in the next county. We are too small a rural hospital and do not have an oncologist at that time. I say, “I think he has cancer, but I can’t find it.” The oncologist listens to the story. He agrees. We do a chest and abdominal CT scan and some blood tests. The patient has had his colonoscopy. Nothing.

I send the patient to the oncologist’s bigger hospital. They can do some tests that I can’t. A bone scan and a PET scan.

The oncologist calls me. “I think you are right, but we can’t find it yet. Send him back when there is something to test.”

My patient goes home with pain medicine.

He then calls me every week or two. “It still hurts,” he says. “Please come in and let me do another exam,” I say. “No,” he says and hangs up. I am a Family Practice physician so his partner is also my patient. She comes in and rolls her eyes. “He complains, but he won’t come in!”

At last he shows up in the emergency room and now he has enlarged supraclavicular lymph nodes. The general surgeon biopsies them. It is an undifferentiated carcinoma. That means we don’t know where it is from. We don’t know the primary.

The oncologist says, “Send him down, so we can do the tests again.”

The patient is at home and refuses.

I call the oncologist back. “He’s refusing.”

“Oh.” says the oncologist. “Well, we can treat it with chemo blindly. We can try to figure out the primary and treat it more exactly. Or he can choose hospice.”

Ok, yes, three choices. I call and leave a message to go over the choices with him.

He comes up with a fourth choice: he refuses to talk to me at all.

I call his partner. “Yes,” she says, “He’s grumpy.”

“We are happy to help with whatever choice he makes.” I say.

“I’ll tell him.”

He continues to refuse to talk to me or the oncologist. Eventually he goes back to the emergency room and goes to hospice at the local nursing home.

I tell the oncologist. He comforts me. “Yes, sometimes we are pretty sure there is a cancer, but it has to get big enough to find.”

I am not comfortable with that but medicine is way more complex and messier than people realize. Sometimes it is really nice to have a patient with something where I know what it is AND it can be treated. Appendicitis. Gallstones. Strep throat.

But sometimes it is complicated and can take months or even years. Stay present and keep checking in.

Diagnostic quest.

_____________________

The boat is returning to the water after work in our boatyard. Healed and seaworthy.

For the Ragtag Daily Prompt: quest.

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Preparedness

I am at a friend’s: she doesn’t have matches.
I am at a friend’s: she doesn’t have bandaids.
“You need a tsunami kit,” I say. “Now!”

My daughter made a tsunami kit for college
with a life straw, an emergency blanket, ace wraps
and bandaids. A leatherwoman for tools with a knife.

Watching after the earthquake, it’s the crowbar I think of.
It is in my back yard, under the apple tree.
If we have our earthquake, I should be able to find it.

Or if I can’t, you know where it is now.
Please, take it to help someone
if I can’t.

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Prayers for people in Turkey and Syria

I took this photograph with my phone yesterday before I heard the news.

The ambulance has been out for a week or so, along with the doll tent. Two doll babies, the doll doctor, various pieces of equipment. I took the photograph because the cats keep “helping” and it keeps looking a bit like a disaster. Sigh. I wish they were just doll disasters with giant cats wandering through, not real earthquakes.

I wrote Flooded after the tsunami in Japan, about PTSD and about feeling helpless watching. I think we all have a little post-Pandemic PTSD and are more hair trigger and more ready for fight or flight.

Send prayers and money and huge blessings on on the first responders that are heading there or are already there.

For the Ragtag Daily Prompt: strange.

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Walk with rabbits

Some days I can’t chuckle
when the news rolls in
my heart could buckle
shootings again

US gun habits
What’s up doc? Dagnabbit.

Shootings on the year of the rabbit
dancers dead as they celebrate
Why are guns such a habit?
I refuse to fill my heart with hate

Gun sales stab it
Year of the rabbit

Forgive but do not reconcile
let my resolve not buckle
mental health takes a while
let no demented chuckle

Fearful gun habits
online snared like rabbits

They argue they must defend their homes
daughter teacher on the line
fearful males online alone
think that guns will make them fine

Fear is a habit
Stop being rabbits

Leave your basement
Help another
Walk the pavement
Earth as mother

Make it a habit
To walk out with rabbits

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For the Ragtag Daily Prompt: chuckle.

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rebirth

I take joy in the birth of the sun each morning and the winter promise of light and warmth and spring.

Joy to you and yours today!

I took this in late September, 2022. In the winter the sun does not rise above the bluff on North Beach.

For the Ragtag Daily Prompt: birth.

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Winter bless us

Winter bless us year end dark and freezing
winter turn us inwards prayer for joy
prayer for joy for young ones all are seizing
others mourn loved deaths, eschewing toys
darkness let us settle loving all
silence let us turn our thoughts to peace
walk in wind and birds, iced trees so tall
few are out to gently walk the streets
the frozen ground holds lives that lie in wait
in freezing seeds hear the call and know
let every human drop their arms and hate
while seeds lie in wait to grow
let winter’s silence fill our hearts with joy
let peace descend, war melt to children’s toys

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A poem for Christine Goodenough after reading her Winter Delights.

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Reconcile

I have been thinking about family a lot this week. My mother’s family has been gossiping about me now for a decade and not one of them has ever talked to me directly about my father’s will. They have a story. They never checked it. It stars me as a villain. They seem to think I controlled attorneys, which is laughable.

I forgive them.

However, I think a decade is enough. I forgive them but I no longer want to reconcile. For ten years I hoped that they would talk to me. I have asked them to, more than one person, more than once. They say that they want to believe what they want to believe. I offered to send copies of bank statements to back up what I said. No. And a cousin silenced me by saying, “Don’t make me hate my sister.” The message is that I can be part of the family for some of them, as long as I remain silent as a tomb on this topic.

No. I won’t. And it’s just like all the silencing that goes on over the world. People say they would not stand by while someone is hurt, but my family sure seems to enjoy having me be the silenced gossiped about villain. I am sick of it. They can go to where ever it is that karma will take them: gossip, after all, is a sin.

And so I am reconciled. I am reconciled after a decade to adding these people to my list of dead. Our friendship is dead, my family feeling towards them is dead, I am not asking or waiting or hoping any more.

Forgiveness is a solo job. We forgive others.

Forgiveness is NOT reconciliation. You should not take an abuser back. You should not let someone treat you badly and refuse to listen to you and refuse to apologize. I know one person whose apologies run something like “I am sorry that you took offense to what I said/did.” Um. That is not an apology. That is putting it on me, it’s my fault for taking offense. The person has no intention of changing and does not actually care how I feel. I am not okay with that. The person is forgiven but there has not been a reconciliation.

With my maternal family, I am letting it go. I would like there to be more peace in the world but as long as people cling to having villains, to believing gossip, to perpetuating gossip and hatred and meanness, I do not think we will have peace in the world.

But in letting this go, I have peace in my heart.

Peace you and please peace me.

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Weight

Sorrow weights my chest like lead: breathing
is hard. Today I can cry for a minute or so
and then that is over. Sorrow teething
tearing at me from inside like a crow’s
beak sharp pointed poking grabbing tearing
winter break approaching everyone goes
insane buying drinking drugging bearing
the cost into the New Year deepening woes
I miss the dead: father sister mother
Read my mother’s journals when I am ten
She writes about art and us and other
friends dead. Her voice clear again.
My mother is my age when she dies.
Her younger voice: memory smiles and cries.

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In the dark

I choose to dwell in the dark with the monsters.

I came here because I wanted to understand how people could be monsters. People turn in to monsters sometimes. Not the crazy people or the serial killers: just normal people. They have enormous fights in their families. They get drunk or use drugs. They kill themselves with cigarettes. They sit unmoving in front of the television. They fight family or close friends. Families sue each other over the parent’s will. They fight over the stuff or over mother or over who will take care of father. They disown each other. They say β€œI only let nice people in my life.” That leaves me out. And I don’t want anything to do with anyone who says that. That is monstrous. Do they turn the other cheek? Do they love their neighbor as themselves? No. They are monsters.

I kept studying the monsters and studying them, until I found my own. I rescued mine from a deep hole. The monsters were babies. They were filthy and frightened and crying and abandoned. I washed them and diapered them and fed them and wrapped them in blankets. They stared at me, sullen. They had no idea how to respond to being cared for. I had to learn to love them. I loved them right away, even though they were monsters. I cared for them and they grew up, loved, happy, adults.

And then I see the monsters in other people. People hide their monsters, stuff them in dungeons, neglect them, deny them, scream at them. The monsters realize that I can see them and they start crying. β€œHelp us! Please! Let us out! We are cold! We are hungry! We are neglected!” I learn not to talk to the monsters until the person is gone. The person may never talk to me again if I acknowledge the monster. They think I am the monster. I’ve reminded them of theirs or named them! Most people hate it. I learn, slowly and painfully, that I can only talk to the monsters after their people leave. The monsters hang around. They tell me their stories. They tell me their misery. I hold them while they cry, heads in my lap, howling and breaking things. But eventually they have to return to their person, to their jail, to their suffering.

I like the monsters better than the people. Some people wear the monsters on the outside. Veterans, almost always. To keep people away. They come to clinic and try to scare me. This is very very difficult because I like the monsters. I am delighted to meet the monsters. This is startling and the veteran promptly calms down. I am not afraid. I like the people who wear their monsters on the outside: they are not hiding them. It’s the ones who hide and abuse and torture their monsters: I do not trust those people. And I feel huge grief and sorrow, pity for their monsters. I can’t fix them. The people must each turn to their own monsters. Let them come to consciousness. Face them, comfort them and at last, love them. And this is hard. It is very hard. It is a life time of work. It is emotional maturity. It has nothing to do with educational level. It is hard work worth doing.

I choose to dwell in the dark with the monsters. Because they need me most of all.

Blessings.