Tag Archives: grief

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Dissolution

I am sorting, Beloved.

I dream that my sister has drowned
in the ocean. A sailboat went down.
There were others on board.
Two friends ready me to dive and find her.
I don’t want to scuba dive, I am not trained.
I don’t know how to use the equipment.
I am afraid I will drown too.
I see her daughter, who is four.
Her daughter knows from my face that her mother is lost.
My friends say, “You will be able to find her.
You can find your sister.”
“But she is dead,” I say.
“I don’t want to find her.”
I know that they are right, I could find her.
But I might be separated and lost, in the depths.
I don’t want to die too.

I wake up.
The dream sticks.
My friends wanting me to wear a borrowed wetsuit
and scuba gear and go down untrained.
My sister floating in the depths, dead eyes open.
But she has been dead for years, I think.
And this is the sea of dreams
my unconscious
the greater unconscious
everything.
So why isn’t my sister’s body dissolving?
Changing to a skeleton.
A skeleton coming apart over the years.

I don’t need a wetsuit
or scuba gear
to dive in the sea of dreams
I can breathe in the unconscious
I have been to the bottom of the sea
many times before.

My niece is four in the dream.
She was thirteen when her mother died.
I think she was lost to me long before that.
The dream knows.
Her mother was lost to me
when my niece was four.
Drowned.

When the dream returns
I will say yes to the dive
I love the sea and the ocean and going deep
I don’t need a wetsuit
I don’t need scuba gear
I don’t need to find my sister’s body
She is gone
Dissolved
I let my past go.

I have not dreamed of the ocean

since.

__________________________________

I really don’t know where my sister is, because of the family schism after she died. Are her ashes somewhere?

This poem wanted to be born. For the Ragtag Daily Prompt: Who knew?

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On guard

My nurse’s breath catches. “Oh, no,” she says.

I am new here. Less than a year. “What?” I say.

“We have Janna Birchfield on the schedule.”

“Who is Janna Birchfield?”

Tonna leans back in her chair at the nurse’s station, a high set desk that runs behind the front office. We have new glass barriers along it to make it more hipaa compliant. It is also more claustrophobic. She throws her pen down. “She’s one of the most hostile people here. She’s known for throwing a brick through her second doctor’s plate glass window.”

“Ah,” I say.

“She was Dr. M’s patient but apparently she and Dr. K got in a screaming fight in the hallway. She is banned from that clinic. So we are the last clinic in town.”

My nurse knows the local stories and she has seen a lot. She doesn’t have a lot of unconscious monsters. Yeah, there is some impatience and some anger there, but she’s pretty good. No real fear, nothing cringing at her feet.

“Hmm. Let me talk to Marnie.” Marnie is our office manager.

Marnie and I talk. I read the last notes from Dr. M and an account of the screaming fight with Dr. K. I call Dr. K. I don’t know of anything that scares her and she is tough. I rather enjoy envisioning her yelling back at this patient.

The day arrives and Mrs. Birchfield is put in a room. Vitals are done. I go in.

Janna Birchfield is big. She weighs about twice what I do, and it’s muscle rather than fat. She looks solid. Not like a body builder, just strong. She tops me by nearly a foot. She looks sullen and unfriendly.

And I am looking at her monsters. Three are guarding a fourth, at her feet. Fear is there, anger is the biggest and posturing, like a body builder, in front. The third is morphing back and fourth: envy and hostility. The fourth is in a stroller, guarded by the other three. Asleep? Unconscious? Well, yes, duh, but it’s not often that a monster is so undeveloped that it is still an infant. Not good.

“Hi, Miz Birchfield. I am Dr. Gen.” I hold out my hand, moving slowly and smoothly. Her monsters alert, fear flinching and anger ready to punch. I stand with my hand out. She eventually touches it, glaring.

“Hi,” sullen.

“We need to talk about the clinic rules first.” I say calmly. Anger puffs up and her shoulders rise as the monster swells and takes control, her elbows rising and hands are fists. Her eyes don’t turn red, but nearly. “I have heard about your argument with Dr. K.”

Furious voice, “She screamed at me. She’s a horrible doctor! She got me thrown out!”

I am smooth and calm, “I am not going to discuss Dr. K,” I say. Honestly, it’s even more fun to think of Dr. K taking this on and not budging an inch. Dr. K is my size, small. “In this clinic, I need you to understand that you are not allowed to yell at anyone at the front desk, in the hallways or on the phone.” Anger flees immediately, small again and she looks confused. “You may not yell at the staff, at the other patients, or at anyone on the clinic property.”

“Why would I agree to that?” she says. She is mostly confused because I am not scared or angry. I am not behaving the way she expects, the way most people behave around her.

“If you are upset, the only people you can yell at are me or the office manager and you need an appointment.”

“They are rude to me!” Basically she means everyone. “You can’t make me do that!”

“Take it or leave it.” I say. “You need to agree and keep the agreement, or we will discharge you immediately. If you say no, leave now, and I won’t charge for the visit.”

Her monsters are confused. Anger has shrunk back down and they are conferring, heads together. Confusion has shown up as well, morphing though different colors and stripes, stars and paisleys. She stares at me, frozen hostility. I just wait, sitting in front of my laptop, serene. This is going well. She isn’t yelling and she hasn’t left.

“What if they are mean?” she says.

“You will make an appointment with me or the office manager, and we will help you.”

“Ok,” she says. The monsters are still surrounding the carriage, but really, now confusion is in charge. We work through the rest of the visit, as I get to know her a little. She has had a hard, hard life.

I let the front office and the nurses know the rules. The office manager and I let them know that this is a contract with the patient and she has agreed. They feel protected. They feel protected enough that they are nice to her. She behaves and starts, infinitesimally, to relax. She is still angry and hostile in the exam room but it’s not directed at me. It is directed at the entire world, the rest of the world outside the clinic. I try to help her medically but also let the monsters have their say. The visits start with anger and hostility but tend to subside into confusion. I am not getting at the fear or whatever is in the stroller. It is one of the large old fashioned ones, heavy, navy blue, where an infant can lie flat. Clearly it does not fold up to go in a car or anywhere else convenient. There are no toys hanging from the top or across it, no stuffed animals. Only a form under the blankets, always still.

I may reach that form, or not. I do not know.

For the Ragtag Daily Prompt: paleontology.

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Love and grief

I got a letter from a family member, talking about happy memories of my father, mother and sister, who are all dead. How much fun they were and my mother’s influence taking them to museums, art museums and the Smithsonian.

It’s a bit difficult to answer, since my memories are much more complicated and tangled.

I wrote a poem called Butterfly Girl Comes to Visit a long time ago. It is about my sister. My mother could charm a room full of people and enthrall them with stories. Sometimes the stories were about me and my sister and actually making fun of our feelings: fear or grief. However, my mother was so good with an audience that I didn’t break the stories down until after she died. She was 61. That involved exploring a lot of really dark feelings. My sister and I even asked my father what our mother was really like: his reply was “Morose”.

I inherited my mother’s journals. My sister told me not to read them because they were “too depressing”. I don’t agree. They explain some things. My parents often fought, screaming at each other at 2 am while I was in high school. The family story was that my father was an alcoholic. As an adult, I wondered why she would fight with someone who was drunk. Her journal says “I drank too much last night,” over and over. Well, that would explain it, right? It takes two to tango. Or fight.

My sister could also charm a room. That is the sparkle in the Butterfly Girl poem. There was a period where she would tell me that I couldn’t talk about certain things, that she was fragile, that I was hurting her. This is after I gained control my feelings and had actual boundaries: I could refuse to fight with her. Before that, she could set me off like dry tinder. Her first husband called me once, saying, “I can’t not fight with her when she wants to fight. What do I do?” I replied, “I can’t either. I don’t know. I am so sorry!” I think it took until I was in my early 30s to refuse to fight with her and took a lot of conscious work. A fiance that broke up with me right after college told me I was an ogre when I was angry. I took that seriously and worked on it. My parents were not good role models for dealing with anger or grief or fear.

I am not much in contact with my maternal family. One person said that we could be in contact if we only said nice things about my mother, father and sister. I suggested we never mention them at all. We did not reach an agreement. I realize that our society wants to speak well of the dead, but to really be someone’s true friend, I think we have to accept that people may be angry at the dead as well. I gave this handout, Mourner’s Rights, to a patient on Friday. He is in the midst of grief and we talked about it. He thanked me and said, “I am grateful to talk to someone who knows about grief.”

My parents moved to Washington State in 1996. My mother was diagnosed with stage III ovarian cancer in 1997. I moved to be near them when her cancer recurred, arriving on Y2K. My mother died on May 15, 2000, four and a half months after we arrived.

My mother was only in that area of Washington for four years. She made such a charming impression that I had people tell me how wonderful and charming she was for a full decade. I was working though the complex feelings about her and tried very hard to thank people, even though I did not feel thankful.

I have not answered the letter yet. I want to return a gentle replay but I will not play the “only happy memories game”. I don’t mind my dark feelings. The family member would mind my dark feelings, I think. It is nice to be a physician and to be allowed to let patients talk about their dark feelings. Our culture wants to deny them, remove them, be positive. That is a disservice to love and to grief.

People are astoundingly complicated.

For the Ragtag Daily Prompt: astound.

The photograph is of my friend Maline, me, and two of her husband’s family members. Maline was one of my alternate mothers, a friend of my parents. She died within the last few years.

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Content

I never do know where a poem is going when I start it. Usually I start in the dark. To my surprise, those poems will end in the light. Apparently the reverse is true too.

Content

At the moment I am feeling content
deeply content
with monsters

At the moment I don’t need more
then this
me
a few friends
and all the monsters

I can’t fix the monsters
healer, right
the people come
over and over
and won’t admit
their monsters

the monsters sit on the floor
of the exam room
clinging to the person
chained to the person
the monsters wail and cry
while the person
ignores them

It has taken me all these years
to let go of anger
fury
rage
that almost no one
admits to monsters
or tries to heal them

Except the addicts, drunks, crazies
they see them too
many try to destroy their vision
with alcohol or drugs
or persist on telling others
about the monsters
until they are drugged

Yesterday I look on line
for local music
not bluegrass
thinking that I would like
to find a place with grown ups
quiet

I think, how silly I am
to look for grown ups in a bar
and then I try to think
of where to find some grown ups
and I think THERE AREN’T ANY GROWN UPS
it’s all just children
who’ve grown big

I do not like drama
there are no movies
that I want to see

I like clinic
where I try to help a little
sometimes a lot
sometimes a person might remove
one knife
one chain
one arrow
from their traumatized
terrified
bleeding
monster

And really
that is why I am here
and that is all that I can do

__________________________

For the Ragtag Daily Prompt: journey.

Meanwhile, rat joy: https://www.bbc.com/future/article/20241128-i-taught-rats-to-drive-a-car-and-it-may-help-us-lead-happier-lives.

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Return again

Return again to friends and home and stumble
My house wraps around me familiar then grief
There is so much grief here: death makes us humble
Mother, marriage, sister, father, time a thief
Has stolen them and more to come, a long lived life
Means loss on loss. Memory wells up, deeps swells
We thought we would be different, wise, no strife
Yet the world burns, children bombed in warring hells
Our children know our failure and our malice
We thought we’d be adults and show the way
Our intentions of a wired on-line palace
Yet anger and greed now rule the day
As a child adults are drunk confusing fools
Now my adult children wonder why we are such rigid tools

For the Ragtag Daily Prompt: rigid.

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Love gently

Honey is older, nearly thirty years since that first feeling of being bitten by ants. She is back in corporate medicine, as a temp. Temporary, short term, maybe that will work better.

It is a joy to go in a room and be alone with a person and their monsters. Theirs and hers. Sometimes the younger ones haven’t experienced it, they are terrified if one of their monsters becomes a little bit visible, they hate seeing them. Honey tries to be gentle. If they only want to talk about the sore shoulder and not the stress and violence, well, she leaves the door open a crack. Sometimes the monsters cry.

Older people may be stiff to start with, but when they realize their monsters are seen, acknowledged, this isn’t another robot doctor in to say increase your diabetes medicine, lower your diabetes medicine, tell them a plan without ever connecting, the older ones lean back, sigh, and relax. The monsters play on the floor, Honey’s monsters playing with theirs, happy, engaged.

The hard part is the clinic staff. Honey is with them daily. The medical assistants are young. They kick their monsters aside as they walk down the hall. It is terribly hard and heartbreaking to work at her desk, with the medical assistants’ monsters cowering under their desks, kicked, abused, silent tears and holding bruises. Honey’s monsters mind. They climb into her lap and hide their faces in her shirt, under her jacket, peer over her shoulder. They don’t understand! Why can’t she be nice to THESE monsters?

Honey whispers to her monsters when the medical assistants are rooming patients. “I am so sorry, loves. If I acknowledge these, the monsters of the women working, I become a demon. It is very hard to share an office, no wonder I worked in a clinic alone for eleven years.” Honey has been through that. It is still inconceivable that some people don’t see the monsters at all. Is it learned blindness? Or just not developed unless someone had to learn it? Unless someone grows up in terror and seeing the monsters is the only way to survive.

Honey thinks some people learn to see them as adults, at least their own monsters. Hard enough to do that, without seeing the monsters clinging to other people.

Honey is tired of her monsters crying in sympathy with the staff’s monsters. She thinks maybe there are small crumbs that she can leave for these demons. Little gifts. Her monsters can creep under the desk when she is the only one in the room and leave something. A flower. A dust bunny. A crumb of a crisp. A small rock. A little gift to let them know they are seen and loved. A poem. A prayer. Just a tiny bit of love.

_____________________________

For the Ragtag Daily Prompt: crisp.

The photograph is me all dressed up for the 1940s ball.

______________________________

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Wild

I keep wondering at the stubborn part of me that will not let go.
 That wants to reconcile with all, no matter what they’ve done.
 I go inside, deep and deeper, in the depths all is slow.
 That part is the holy part that longs for the One.
 I have been told to let go of things, forget, no more longing.
 But the longing is a sacred place, a longing for the Beloved.
 I think that excising it would be a horrid evil wronging.
 Handle gently, with care, with love, and gently gloved.
 I meet someone who says, “You are very in touch with your inner child.”
 I know it’s not a compliment, I smile and pay little mind.
 My Child is my connection to the Beloved, fierce and mild.
 Jealous judging rolls right off, people can be unkind.
 I won’t excise the holy core, the Beloved inner child.
 I feel the Beloved’s laughing play and joy, heart running wild.

_________________

For the Ragtag Daily Prompt: realize.

https://www.playingforchange.com/videos/words-of-wonder-get-up-stand-up-song-around-the-world

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Long way

I am a long way from my ocean and from home.

I looked for a job close to home and then the temp company mentions a job in another state. “Where?” I said. They told me and I said, “I’m interested!” We started the process. I always forget what the process is like. It is hella annoying. There is miles of paperwork. We had a delay from the state, because I need a license for each state and they weren’t meeting until after the start date and then they said, “We’ll let you know in two days.” and THEN they said, “We’ll let you know in two days to two weeks.” So I had three weeks of being half packed and trying to just flow with it. I finally got word, yes, ready, two weeks ago Monday. By Friday morning the cats and I are in the car and headed out.

Now I have worked for a week here. The US currently has 500 different electronic medical records and I supposedly learned my 8th (or 9th) on Tuesday. About six hours of training on the computer and my brain shut down after four. However, the support on Wednesday was good and I started seeing patients. I was careful to say, “If I look grumpy, it’s at the computer, not you.”

So far mostly good. Except, one cat got out two days after we got to our destination. He is chipped and I am still walking miles and calling. The local lost pet group is trying to help. I miss him quite terribly. The door popped out of the carrier when I put it down. I feel like a cat mom failure, but things happen. Elwha is big and strong and I may yet get him back. Sol Duc was sensible enough not to run, but I had to secure her before going after him.

For the Ragtag Daily Prompt: flow.

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Spirit take flight

Death from memory loss is a mixed bag for families.

In the past, the average time to death from Alzheimer’s was 8 years. I don’t find a number on the CDC website, CDC Alzheimer’s. I find these statistics:

  • Alzheimer’s disease is one of the top 10 leading causes of death in the United States.2
  • The 6th leading cause of death among US adults.
  • The 5th leading cause of death among adults aged 65 years or older.3

The site also says that the number of people with Alzheimer’s doubles every five years after age 65. Sigh. Those numbers are the same ones that they taught me years ago, in a different format. 6% at age 60, then 2% more every year. By 70, 26%, by 80, 46%, by 90 66%. Like hypertension, if you live long enough, you may well get it. And yet, I have had patients over 100 years old with intact memories.

The death of a family member with memory loss can have complicated grief. On the one hand, loss and grief. On the other, a burden is lifted. If the person is in memory care, the cost may be very heavy. In our town, the memory care facility costs $7000 per month. That is a heavy burden to carry when the person no longer recognizes the family or speaks. The family may feel hugely relieved when their person passes and at the same time, feel guilty. This is someone that they love and loved. And yet, they are relieved by death. I think of it as a patient of mine described it: “The grief group at the hospital said that my husband isn’t gone. I said, yes he is, he just left his body.” It is very very hard for a family to watch their loved one deteriorate, lose skills, become confused and/or frightened and/or paranoid and the process can happen for years. With an average death at 8 years, some people live beyond 8. Maybe 12 years. It is very hard.

Blessings on those who care for the memory loss people and the families who do their best for them. Alzheimer’s is one sort of dementia, but we now have many. Pick’s disease, frontotemporal dementia, Parkinson’s dementia, multi stroke dementia, alcohol induced dementia, illegal drug dementia, primary progressive supranuclear palsy, and others.

The spirit has already taken wing and let the body follow.

For the Ragtag Daily Prompt: wing.

My son took the photograph while he was visiting.

Here is the top ten causes of death in 2022: https://www.cdc.gov/nchs/data/databriefs/db492.pdf.

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Matter

If something doesn’t matter, is it anti-matter?

Lily’s person moved two days ago, much closer. Supposedly to a place where Lily the cat can go, but instead of a private room, there is a roommate. It took me a month to get Lily cat to let me pat her, so the roommate won’t work. We are all very very frustrated. And next week daily treatments for Lily’s person start, thirty minutes away, without enough warning to get volunteer drivers. So it will be me. I am tired. But I suppose it’s anti-matter, right? We were given 24 hours notice by the nursing home and by the physicians about both the move and the treatment and they wanted to start the treatment the same day that she was moving. Whether we can provide all the transport seems to be irrelevant.

The stealthie is from Whidby Island. Right, I’m just an irrelevant shadow as far as the medical dysfunctional machine is concerned.

For the Ragtag Daily Prompt: irrelevant.