The Good Doctor

Posted on March 18, 2013 by harasprice

The nursing care facility I worked at had a contract with Hospice to wrap palliative care services around residents of the facility as an option for families, so that end of life care could be provided in the same place their family member lived. It may seem unusual to some people to want to stay in a nursing home, but to many residents, this is preferable to a transfer to an inpatient unit or hospital. Occasionally, we admitted someone for the express purpose of providing hospice care in a long-term care setting. We preferred to admit people to a quiet, private room. But sometimes we would offer an available room up to a family even if the circumstances weren’t ideal. And, so it was for Charles and his family.

Charles had been a well respected lawyer, and had successful children who lived and worked mostly out of town. His wife had died several years ago and he had lived alone until recently, when the onset of advanced, metastatic cancer was detected after numerous falls and an eventual broken hip. He couldn’t go home, and he didn’t want to leave town. He had months or weeks to live and wanted to stay in his community so friends and family could visit. We offered Charles the one room we had available, a lovely private room, although it was located on a wing of the unit mostly occupied by people with Alzheimer’s disease and other dementia.

Charles and his family were lovely people, and were kind and compassionate to confused neighbors who may occasionally wander into his room accidentally. We had him on a room relocation waiting list, but Charles condition was rapidly declining and he and his family settled in to his surroundings and made the best of it.

As social worker for the unit, I had gone over all advanced care planning and end of life wishes with Charles and his family. He wanted no life sustaining measures, no feeding tubes or other artificial nutrition/hydration, no hospital transfer. Only pain medication for comfort. We worked with Hospice staff and the pharmacy to be sure pain medications were available in alternative delivery forms since his swallowing was affected. Charles and his family had made plans for a peaceful death, a good death with choices respected. But, death did not come as quickly as they thought or hoped.

Days went on and it was hard to manage the pain without medications that would affect his breathing. It was a fine line, and we worked with this resident and family to respect their wishes but have no regrets, either. Too much pain medication can hasten death and that was not what he or his family wanted. His children began keeping around the clock vigil to be sure that he remained pain free. Nursing staff worked hard to keep wandering residents out of that wing, to give Charles and his family space.

One morning, I was visiting with Charles and his daughter and one of the residents with Alzheimer’s followed me into Charles’ room. I tried to redirect him, but he was insistent. This resident, I knew, had been a doctor and was having a moment where he was confused and thought this was his patient. Charles’ daughter seemed to understand and patiently allowed the other resident to enter. We both watched in amazement as this resident strode gently over with perfect bedside manner and listened to his pulse, stroked his hand, and told him that they were taking good care of him, to simply rest now and know he was in good hands. The Good Doctor then shuffled out. According to Charles’ daughter, he continued these periodic visits all throughout the day and evening. He gave “orders” to the nurses and solace to the family. Every visitor was moved to tears. Charles died, peacefully, the following day.

I made sure to visit my resident…the former physician…in the morning to check in on him. I asked how he was doing and told him how grateful Charles’ family had been for his care and concern. “That’s my job…” he said while he shuffled off down the hallway. He resumed a card game with a staff member and didn’t ever seem to recall his brief return to duty. I was sure to pass on the loveliness of this story to his own family, though.

The Good Doctor, making his rounds and checking on his patients left a lasting impression and created comfort for more people than he ever realized. Charles’ family spoke of it both in his eulogy and the card and flowers they sent to the unit staff. He had played a pivotal role in this situation becoming a good and peaceful death.

Sometimes light and love and comfort come from unexpected places at exactly the times we need them most.

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Holy Ground

Posted on March 17, 2013 by harasprice

I was 20 years old when I met Rev. Paul Henderson, then chaplain of Episcopal Church Home in Buffalo, NY. Father Paul, as the staff and residents called him, was a older and slight man with an incredible wit and sharp tongue. He also had the wisdom of age, a heart of gold, the compassion of the divine, and a flair for connecting with people of all walks of life through his humor and humility. At the time, I was not Episcopalian nor did I know anything other than the fundamentalist teachings of my youth that no longer seemed relevant to my life. I worked in the activities and recreation department of a nursing home, and I was working on my undergraduate degree in social work. At that time, I had no idea that I would return to this same nursing facility several years later as the Director of Social Services and take on even more experiences and responsibility, nor did I know that I would companion the last days of life of many people. Never did I imagine that I would help the grieving transition to live in a world marked by loss as well as growth. And, I had no idea when I first met this small, wiry aging chaplain the role that he would play in helping shape the course of my career. I had not taken those steps yet, and those chapters of my life had yet to be written.

On this day, before all these other events were to come to pass, I was a young worker helping move chairs in the dining hall so that Father Paul could hold Holy Eucharist on Wednesdays, as was his custom in the skilled nursing facility. Holy Eucharist was also held on Sunday in the lovely old chapel, but many of our less mobile residents could not make that journey. So, the 4th floor dining hall became our mid-week cathedral. It truly did, too, right down to the adult care facility altar guild members who would roll in the portable altar and set it to perfection with flowers, candles, and linens.

I always liked working this event as a part of my activities job. Somehow, the space that had served breakfast a couple hours earlier became a quiet worship space, in a way that was authentic and transformative. Father Paul would welcome every person…every nurses aid, nurse, housekeeper, janitor, dietary worker, resident, family, visitor, stranger…to God’s table. I learned in this space that all truly were welcome. Sometimes, I received communion in that space myself, which seemed a bit odd at first, and then not odd at all. Father Paul was the linking thread that made this not a health care center…but a home…to its residents. Through wit and wisdom, he built a community. We all respected him.

Father Paul also made it clear to the staff that he was to be called in the event of any nursing home residents’ imminent or actual death. The nursing facility was his parish, and he knew and held dear each member of the community. We had a very formal ritual around death that differed from any facility I have ever worked at since. He would come in at any hour and keep vigil with the dying, and in death he would companion the body first to the chapel and then in a prayerful procession reciting prayers to the hurse or other transport vehicle. No one who died was alone. He would minister to grieving families, too, but his true gift was with the dying person. He had presence, and regarded dying as a holy experience. I only saw him angry twice: the first, at morning rounds when it was announced that a resident had died the night before and he had not been called. The charge nurse shrugged off his rebuff by saying, “it was late, and you’re old and need your rest…we didn’t want to wake you.” A string of expletives directed to nurse, the Director of Nursing and Administrator insured no nurse ever made that mistake…or made such a patronizing decision…ever again. Ever. The next time I saw him angry was years later, when he was forced to retire from his position at age 72. That didn’t ultimately stop him, either.

From the time of the nursing staff outburst, I had started to develop a fascination with Father Paul’s dedication to the dying. I asked him once why that particular aspect of his ministry was so important to him. “It’s Holy Ground” he told me. “No one needs to be afraid, or alone. It’s simply my privilege to be there to accompany their journey. We all deserve that” He was a rare soul, someone who could be so close with death so often, neither becoming emotionally entrenched nor hardened. I deeply admired that about him.

Maybe he saw some similar spark in me, or maybe my questions gave away my interest. Maybe he intuitively knew that I had already watched family and friends walk this journey: my great uncle to a drunk driving accident, my great aunt to painful scleroderma, my other great aunt to an easier slipping away after a life of prayerful living, the murder/suicide of my neighbors, the sudden death of my favorite teacher, the friend I loved who was now dying. These were the journeys of my own spirit that I held inside. A few days later, he saw me in the hall and simply said, “Agnes doesn’t have long, will you come help me.” And, I became willing to walk this holy ground as a part of my job, too. I learned the dynamics and importance of ritual around dying. I found myself able to stay present, to build connection, to bear witness to the final moments of living. I was becoming a social worker, not a priest, and so the way I connected was different. But, being humanly present is inherently spiritual and implicitly therapeutic. My time with the families of the dying was particularly important to me, to know when to be present and when to step aside. When there was no family, I took on the role of the one who could be present. Sometimes, I even came in off shift and sat in the room, creating a compassionate space for the dying person while the nursing staff awaited Father Paul’s arrival. As I walked this holy ground with others, I found myself able to work through the losses in my own life, to find myself healing and understanding, too. That was a gift.

There are countless points of light that emerge in working with the dying. I have several stories to write over the next several days, describing the points of light that emerged during specific encounters over the course of my career in three states and multiple organizations. And, several about the encounters with death in my own life. But, today, I am grateful for the wise intuition of my senior colleague, friend and mentor Paul Henderson who encouraged me to step onto Holy Ground and to not be afraid.

All along the journey of life and death, there is light.

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Sleep of reason

Posted on March 16, 2013 by harasprice

I have spent the past two days at a Diversity of Thought colloquium we hosted for our doctoral students and faculty. My department prides itself on breadth of thought and multiple ways of knowing, and several years of planning went into a very emergent two day experience with inspiring postmodernist scholars in residence. This wide perspective was a huge draw for me when I was on the academic job market. I am deeply grateful to be an academic in general, and to have found an academic home where terms like “hegemonic domination” and “socially constructed reality” are as much a part of the vernacular as “grant proposal” and “empirical results.” Yet, I admit, all the academic headiness also presents a certain struggle for me, which is probably why I found my attendance at the colloquium frequently interrupted by pragmatic requests to meet with students, resolve a concern with my community research partners, or best yet….to sprint across campus to pick up 100 journals (research incentives) that had been delivered to the wrong office. Oh yes, and my daughter was off from school for a teacher conference day, so I had her in the office as well. In short, it has become clear to me that I love the idea of living in the world of ideas, but I constantly fight a deeply seated, core belief: doing has to be more than sitting and thinking and talking. Grass cannot grow beneath my feet.

So, I have spent the last day thinking about this. Two images come to my mind. The first was presented by one of the symposium faculty, as we took in a piece of artwork by Goya, translatedThe Sleep of Reason Produces Monsters.. This image sticks with me, and creeps into my waking and sleeping mind. I immediately quipped, half jokingly, to a doctoral student, “remind you of writing your dissertation?” But it reminds me of what happens to my core when I take up writing without pausing, stopping, reflecting. The product becomes all-consuming, and its intention is lost in the well reasoned details. It can generate self-deprivation, a workaholic sense of business (or “busy-ness”), a misplaced emphasis on how much I produce rather than quality of thought.

The second image it conjures up for me is biblical, the story of Jesus visiting the homes of his friends Mary, Martha, and Lazarus. Jesus is teaching, and Mary sits at his feet taking the words, sharing in the discourse. Martha is the one fixing dinner, tidying up, being the hostess. Martha gets chided for this role, while Mary is proclaimed the devoted one. This story has been so hard for me to take in over the years. I yearn to be Mary….sitting and taking in the words. But often, I am Martha…busy doing and keeping other people happy, fed. Attending to the other, rather than the work of the soul. But, Jesus tells her, there will be time for all of that. That is the crux of the story for me….taking the time to be present in the world of thought and knowing intuitively when we can be still, and when we must take action. It’s the ultimate work-life balance.

So, I sit on this Lenten day taken in the juxtaposition, the conundrum, the process of living and learning. What I can say is that rational thought without contemplation is empty. I am learning that lesson this season, and in my career. I don’t have this one resolved. But maybe, perhaps, the social construction distracts us from the process of deep self learning. I will think on that, in my carved out moments of solitude.

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Building fires

Posted on March 14, 2013 by harasprice

Several years before I had made any career decisions, I worked over my high school summers as a camp counselor. I first had the impressive title of “Junior Counselor” which paid nothing, and later “Senior Counselor” which paid just slightly more than that. To the girls that were under my watch, I was “Chief Sarah” and my senior (by a couple years) co-conspirator was “Chief Pam.” In retrospect, we had a mighty fine camping experience, filled with lots of mud, creeks, leeches, tents, bugs, hikes, home crafted water-slides, and camp outs. Good times were had by all. Or at least, by most.

My favorite activity of the week was the “wilderness camp-out” on which we took girls of all ages. Here was the plan: take a dozen girls (ranging in age from 6 – 12, depending on the week), their sleeping bags, pillows, bug spray, personal items, fire building tools, and dinner supplies into the deep woods. Hike all around the Lake that was the basis of our camp, and look for a flat(ish), cleared(ish), inviting area in which to create a wilderness camp site; build the site and transform it into our “Chipmunk Clan” abode; conduct crisis intervention after instructing the girls how to build a hole and pee in the woods; reassure a dozen girls that no wolves, bears, or aliens had been sighted in this location…for at least the last couple weeks; collect wood; build a fire; cook dinner for a dozen girls over the aforementioned fire; sing some songs around the fire; talk about the questions of life, God, and human existence around the fire; sleep under the stars when the fire dwindled.

The good stuff of life. Truly.

I have many, many fond camp memories. But, today I was thinking about building fires. This was a major lesson, and a challenge, on the overnight camp-out. For most of the girls we worked with, fire building was something they had never done, nor thought about. They first looked up to Chief Pam and Chief Sarah to make the fire for them. But, the “chiefs” knew it needed to be their fire. We would give advice, a bit of hands on help, and strike the match. It generally took several attempts at the fire to build one that would light. With some groups of girls, I can only credit divine intervention to get to that point. Around the same time I was a camp counselor, we read Jack London’s “To Build a Fire” in my high school literature class. I knew beyond the shadow of a doubt that Jack London had never been in the woods with a dozen girls. This would have required a completely different set of survival skills.

Before one can build a fire, one must have wood. So, the first task for the girls was to gather firewood. We had developed a whole series of rhymes to help the girls find appropriately dry (and right sized) firewood: “If it’s snappy, you’re happy!” and “If you can’t break it, Lake it!” were commonly chanted. “As long as your arm” was the measurement rule, although whose arm should be the standard measure was another issue entirely.

Once we had the wood, we described several fire-building techniques centered on maximizing the flow of air, distribution of heat, and increasing sizes of firewood to insure a working progression of the fire to the size where we could actually cook over the flames and coals. As we built these trial fires, many of which would not come to full fruition, we talked about what was happening.

“See those big flames from the pine needles you put on?? Is there anything for them to spread to so that the hot, quick flames can catch a longer, slower burning fuel…find something else to catch, otherwise they will just heat up and burn out and we still won’t have dinner.”

“Are you sure that stick was really dry? I think maybe it wasn’t snappy enough….see how the smoke just keeps building up? Green wood doesn’t burn, and it will just smolder and create a lot of smoke and no fire. We still won’t have dinner.”

“Wow…that was starting to be a great little fire. But that big log was just too much for it…it put out the fire and smothered the embers. Maybe next try we can try to increase the size of wood more slowly. We can’t make dinner on a huge log that smothers a tiny flame.”

We allowed plenty of time for fire building, because it is supposed to be a learning process. The inspiration wasn’t that dinner was something fabulous (often, it was hot dogs with boxed macaroni and cheese and canned baked beans), or even that the perfect coals would make the best s’mores. OK, on second thought, maybe the s’mores were actually motivating. But the real motivation was to create something out of nothing, to seemingly bring to life the element of fire on which we could cook food to nourish ourselves, create heat to warm ourselves, create light to keep the darkness at bay. In a scene reminiscent of Tom Hanks in “Cast Away,” this group of young girls would yell for joy, “I made fire! We made a fire!” I guarantee that was the best tasting hot dog, mac & cheese, beans…and undoubtedly, s’mores…that they ever tasted.

Looking back today, this literal creation of sustenance from the small light of a match onto paper onto tinder and kindling and branches and logs…that is an awakening to the primal forces that are still part of what makes us human. Our quick reactions to situations can burn out before any real change can be created. Our not-yet-dealt-with emotions can create billows of smoke and cloud our judgement because we’re all too quick to think we can burn them up and be done with them. Our over-eagerness to jump in and fix it can lead to trampling on the small sparks of innovation, new beginnings, small points of light that need fuel in order to catch on and grow.

Sit back. Be willing to learn the process of building the fire. Appreciate its warmth and glow, and the nourishment that it can provide. Tell stories around it with diverse and interesting people. Explore life, love, and God in the warmth, the flames and the light.

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Waking

Posted on March 13, 2013 by harasprice

Although the time in which I wake has varied greatly over the years, the process of waking has always been one that fascinates me. There have been times when an angry alarm clock jolted me awake, other times when my favorite music turned on to greet my morning. For years, I didn’t need to worry about mechanical devices because the cries of a hungry baby or the tugs of a toddler wanting to play welcomed me to a new day. Any way it happens, our body moves from resting to awareness. And, we have an opportunity to seize that moment.

This morning, I awoke a few minutes before my alarm would have gone off. I love it when that happens. As my body drifted into consciousness, I became aware of sensation, stretching my legs and arms and fingers. I try to take note of what my senses experience first. This morning, I heard birds of spring that seemed to fill the air with song. I pictured them in my mind, tiny songbirds and larger scavenger birds. The coos of a morning dove. It was still dark, but the instinct of the birds told them it was time to rise. I was delighted to make their acquaintance this morning in my ear, drowning out other noises of nearby cars and the hustle/bustle of my city surroundings.

When I was growing up, morning seemed still and quiet. This is not only nostalgia speaking: it really was still and quiet in the country where my family lived. Usually, a train whistle jarred me awake (or my mother when I was young, multiple alarm clocks when I was older). If I spent the night at Gramma’s (or in my early years, when we lived upstairs) the whole world was bustling early because farm work is early work. The first sense I experienced waking there in the morning was the scent of breakfast…usually bacon and eggs…which inspired my young body to get up and dressed. My Gramma rose before anyone else. Same thing with my Dad. Same now with my spouse. I find that ironic, since most people consider me an “early bird” but that depends largely on context, it would seem. Sometimes work or chores made them early risers, but particularly for Gramma, early rising seemed to be a way of life, an intrinsic aspect of who she was and how she moved through the world. I wondered, when I was young, about the reasons grown ups woke so early. It seemed bizarre to me, naturally inclined to burn the midnight oil as I was then. Truth be told, I now love both. Six hours of sleep seems optimal in my world.

This particular morning, after the birds compelled me to rise, I put on my exercise clothes, and went for a walk/jog in their midst. My waking was well before my 5:30 alarm clock was set to go off, and I was grateful for that. I prefer morning and I to greet each other on our own terms. There was no sunrise yet, but daylight savings time is irrelevant to nature and nature seemed to be awake and in full motion. After spending some time with the birds, squirrels, and cats of the neighborhood…and centering my own thoughts with some walking meditations…I came back in to hot coffee and reflective writing. Bliss. This quiet aloneness of morning nurtures my soul and recharges my mind from the frenetically swirling thoughts of the rest of my work day.

Now, I know exactly why my Gramma woke so early. I picture her strolling her farmhouse before all the activity of the day set in. I can practically walk those rooms in my own mind, and sometimes I still do. Although I didn’t spend the majority of my years in that house, they are the first years I can consciously remember, so these images left a lasting and comforting impression. Early morning is a time for gathering inner resources, storing potential energy, setting one’s course for whatever emerges. That is true on a farm, in a small town, and in the city.

Waking is opportunity. And that, everyday, is a small point of light.

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Prodigal Mother

Posted on March 11, 2013 by harasprice

I have been thinking today about a story that doesn’t really belong to me; it is the story of two people that I took in mostly by observation and just a touch of interaction.  It is their story, although I have long since lost contact with them.  So, I am telling it from my point of view of the omniscient narrator of experience, and inferring from their actions and other documents what may have happened behind the scenes.  This is the story of a woman I will call Barbara, and her mother, whom I will call Dorothy.  Their names and a few details have been changed.  Their story remains a point of light in my life.

Dorothy had never lived anywhere that she could remember, except the big building on Forest Avenue.  She couldn’t recall what she had for breakfast or for lunch.  Sometimes she would notice a bird fly by her window, or a person pass her door.  People’s faces did not look familiar to her.  She sat in a wheelchair, and had minimal control of her extremities.  She didn’t even seem to notice me when I came to see her for a pre-admissions consultation visit.  Dorothy had lived at the state Psychiatric Center since she was in her early 20’s.  She was 14 when she immigrated; she was married within a few weeks to a man her parents had arranged for her meet when she arrived in the United States by boat, alone.  They told her she would be his wife, and an American.  She didn’t speak English.  She had her first baby within a year of her arrival; she was 14.  She had 8 other children, one after the other.  By age 22, she was having difficulty with life and no one knew what was wrong.  She had mood swings and didn’t want to care for her children.  She tried to injure herself, and started having headaches that were so bad they would turn to seizures.  The doctors labelled her as histrionic, back in the day when that was considered a diagnosis.  Her sister came over from her home country to care for her children; their father left and eventually remarried but provided some money for the children’s support.  At age 23, Dorothy was taken away from her children permanently and placed into a psychiatric institution.

There, she had been strapped to a bed and given repeated treatments with Electro-Convulsive Therapy (ECT) when it was a new and experimental approach.  It didn’t help her.  She was given drugs and confined to small, padded spaces but she still was a threat to herself.  In 1947, they performed a frontal lobotomy; part of the frontal region of her brain was surgically removed in an effort to control her mental health.  She was left without memory, partially paralyzed, and emotionally flat.  She remained a resident of the psychiatric center for 50 years.

In the early 1990’s, as psychiatric centers were being down-sized, the skilled nursing facility where I worked developed a partnership to transfer former psychiatric residents into residential health care.  Many of these individuals had not lived outside an institutional environment for many years.  Most did not have living family.  As the Director of Social Services for the nursing facility, I would work with our Admissions office to insure safe transfer of residents who met admission criteria, and I would deal with the angry outbursts of staff who did not feel capable of caring for people with long-term psychiatric diagnoses.

When Dorothy came to live in our skilled nursing facility, the staff members were skeptical given her history.  However, she was severely weak, immobile, and completely mute.  She made occasional gestures.  Her history evoked a kind of sympathy even among staff for whom (I once remarked), “you would complain if we admitted Jesus Christ to the unit because you’d have to deal with the nail marks in his hands.”  OK, maybe it wasn’t that bad.  But mental health stigma prevails everywhere, even among those who need complete custodial care.  Not everyone was happy with the integration.  But, Dorothy was living with us now, and once the initial admission shock wore off, the staff grew fond of her.

One Monday at morning rounds, a nurse casually spoke about Dorothy’s daughter.  I stopped still.  I didn’t know Dorothy had a daughter.  No one at the psychiatric center had mentioned any family.  The nurse revealed that a woman had been coming for the past several weeks, every Sunday afternoon, bringing a book or the paper and reading to Dorothy.  Dorothy still never said anything, but was relaxed and seemed to be enjoying the visits.  The woman came and left quietly, and hadn’t left any contact information.

The next Sunday, I made it a point to come into the office and stay on the floor to meet Dorothy’s visitor.  Staff pointed her out to me and I stopped in, introduced myself, and told her I would like to talk with her for just a few minutes before she left.  About an hour later, she finished her visit and we walked to my office.

Barbara was a well-dressed woman in her late 40’s.  She was Dorothy’s youngest daughter.  She had never met her mother, although she grew up with her aunt’s stories of when she and her sister were younger, back in the “old country.”  She wasn’t ever told directly of her mother’s mental health condition; she was told that she was very sick and had to be taken to the hospital and she had never come home.  Some older siblings remembered that she wouldn’t get out of bed and sometimes had mood swings.  When Barbara was old enough, she put herself through college.  She majored in psychology.  She went on to graduate school, and she eventually became a clinical psychologist; her practice was in a nearby city about an hour away from her home town.  The family stories never sat right with her, although her siblings told her to let it go, and move on.  The family believed they would be better off just thinking of their mother as dead.   Barbara did some digging around and learned that her mother had, indeed, been institutionalized.  When pressed, her aunt acknowledged that her mother was probably still living, but begged her not to get involved.  Barbara looked up her records, and finally found her under her birth name (not her married name).  She reunited with her mother just a short time ago.  

Barbara visited on Sunday afternoons, bringing the paper or a book she was reading and sharing that slice of time with her mother, the mother she never knew.  They really couldn’t have a relationship in a bidirectional communication sense, the way that you or I might think of as a visit.  But, Barbara found a segment of time that she could share with the woman she once thought was dead, and now learned was living.  “This hour is a gift ” Barbara told me that afternoon. “I am able to see my childhood differently.  I am able to understand that she didn’t leave us; she was taken from us.  I am able to tell her, in my visits, that I became who I am because there was always a question that I could not answer about her, about myself.  I ended up learning about the entire realm of human cognition and emotional regulation, about the history of psychiatric treatment.  All this has helped me know her.  And now, I am allowing her to know me.”

I know I was at a loss for words then, and still at a loss for words now.  This daughter could have walked away.  But, at some unconscious level, she had been waiting and growing and working and learning in unknowing preparation for their reunion.  When that reunion came, it was not sad or even bittersweet.  It was a homecoming, a gift.

And so here I am now.  Twenty years later, this brief interaction just one of hundreds of clients and families with whom I have worked over the years.  And yet, I sat in church yesterday and heard the Gospel reading, the parable of the prodigal son.  And all I could think about was this small point of light, the daughter sitting and reading to the mother that she thought was lost forever.  But, she had returned. And in that reunion was joy.  

And light.  

Luke 15:1-3, 12-32

So Jesus told them this parable:

“There was a man who had two sons. The younger of them said to his father, ‘Father, give me the share of the property that will belong to me.’ So he divided his property between them. A few days later the younger son gathered all he had and traveled to a distant country, and there he squandered his property in dissolute living. When he had spent everything, a severe famine took place throughout that country, and he began to be in need. So he went and hired himself out to one of the citizens of that country, who sent him to his fields to feed the pigs. He would gladly have filled himself with the pods that the pigs were eating; and no one gave him anything. But when he came to himself he said, ‘How many of my father’s hired hands have bread enough and to spare, but here I am dying of hunger! I will get up and go to my father, and I will say to him, “Father, I have sinned against heaven and before you; I am no longer worthy to be called your son; treat me like one of your hired hands.”‘ So he set off and went to his father. But while he was still far off, his father saw him and was filled with compassion; he ran and put his arms around him and kissed him. Then the son said to him, ‘Father, I have sinned against heaven and before you; I am no longer worthy to be called your son.’ But the father said to his slaves, ‘Quickly, bring out a robe–the best one–and put it on him; put a ring on his finger and sandals on his feet. And get the fatted calf and kill it, and let us eat and celebrate; for this son of mine was dead and is alive again; he was lost and is found!’ And they began to celebrate.

“Now his elder son was in the field; and when he came and approached the house, he heard music and dancing. He called one of the slaves and asked what was going on. He replied, ‘Your brother has come, and your father has killed the fatted calf, because he has got him back safe and sound.’ Then he became angry and refused to go in. His father came out and began to plead with him. But he answered his father, ‘Listen! For all these years I have been working like a slave for you, and I have never disobeyed your command; yet you have never given me even a young goat so that I might celebrate with my friends. But when this son of yours came back, who has devoured your property with prostitutes, you killed the fatted calf for him!’ Then the father said to him, ‘Son, you are always with me, and all that is mine is yours. But we had to celebrate and rejoice, because this brother of yours was dead and has come to life; he was lost and has been found.'”

 

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Ruth’s Birthday

Posted on March 10, 2013 by harasprice

When I was an undergrad, I took a course in Social Dynamics of Poverty. I still remember the lessons I this class, and my instructor Dr. Shirley Lord…both course and instructor left a lasting impression. If it were taught today, it would carry the “service learning” designation that has gained popularity. We were required to volunteer for at least 40 hours during the semester at a social service or community based program which provided direct services to people living in poverty. The year was 1990. Deinstitutionalization of mental health facilities was at its peak. I chose to volunteer at a former YWCA that was now largely occupied by people released from the state supported psychiatric center a few blocks away with no where to go. Their SSI was sufficient for a low rent room at the former Y. Low rent and no frills. My two bedroom college apartment shared with three other students seemed luxurious in comparison.

I had intended to fulfill my 40 hours as a general program volunteer and check those hours off as quickly as possible. However, the housing director informed me that if I wanted to be truly helpful, I would commit to being a mentor/companion to one of the residents who needed something more than the system could provide. She told me I had to stick with it the entire semester. I agreed, although I admittedly felt a sense of dread. It seemed too hard, too much of a commitment. But I felt bad saying no. The need was evident. So, I was given a room number and a first name. I went to the third floor and knocked.

“Ruth??” I knocked again, “Ruth…my name is Sarah…I am a volunteer.” She cracked her door. She was barely 5 feet tall, even in orthopedic shoes with platforms. She was an older woman with silver gray hair that looked like she had cut it herself using a bowl and a pair of dull scissors. She had piercing green eyes. She looked me up and down through the door crack. “You’re young. I’m old. Come back Wednesday.”

Dejected, I went to the housing director and asked what I should do. She looked at me as experience looks at naiveté and said, without changing expression, “Sounds to me like you should come back Wednesday.”

Point taken.

On Wednesday, I came back. I knocked on Ruth’s door again. This visit lasted approximately two minutes. It concluded with, “Come back Wednesday. Next week. We walk to coffee.”

My weekly visits went on and on like this. We walked to a greasy spoon diner where 50 cents could buy us both a cup of (bad) coffee. At first, it was hard to find anything to talk about. She didn’t like to be asked questions. She was very suspicious. She would eventually begin to tell me about people. Then events. Later, memories as best she could recall them. She had been on psychiatric medications for so long that she had a characteristic shuffle, like many other of her apartment dwelling peers. She had very little connection to the issues and current events of the larger world around us . She often smelled terrible and wore clothes with food spilled down the front. Her teeth were yellow. Sometimes, although rarely, she would smile.

When I started visiting Ruth, I was marking off my required volunteer hours in tiny little fragments. Accruing 40 hours seemed like an eternity. But, I kept showing up. And so did Ruth. We had let each other in.

Two years later, Ruth and I were still having our Wednesday visits. Sometimes she didn’t feel like getting out of bed, and she would tell me “Go away. Next week.” Other weeks, we would walk the city streets together and talk, and I would get a glimpse of an entirely different world in which Ruth lived. Our visits had changed me. Her world and her person became very real, and very respected.

One of the last and most memorable visits we had was on the occasion of Ruth’s 75th birthday. I told her we would have a party on the sun porch and she could invite her friends. I arrived with a cake I had baked (because I myself could not afford to buy one from a bakery…I could only afford a cake mix, on sale. But, I had an oven). I brought a big glass jar full of lemonade with lemon slices floating in it. I bought her a ballon and a bunch of daisies in a vase. She sat at the table, inviting people over, eating cake and drinking lemonade together until every bite was eaten and every drop consumed. She took her flowers and balloon and shuffled off to her room. “Best cake I ever had. Bring lemonade again. I never had a party before. First one. Very nice.”

It was her first birthday party, and her last.

Ruth had many more days after that when she couldn’t find motivation to get out of bed. She went to the hospital, and later, to a nursing home. She didn’t recognize me any more by the summer I left for my MSW program. But our visits have remained with me as a point of light, simply for what they were. Authentically human. Life, in the present.

Keep showing up. Light will emerge.

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Visual Meditation

Posted on March 9, 2013 by harasprice

Today’s small point of light…

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Her Voice

Posted on March 8, 2013 by harasprice

It is International Women’s Day. I was grateful to begin this particular day on the Health Commissioner’s Infant Mortality Work Group. In this role, I am able to be a voice, an advocate, for efforts to improve infant mortality. This topic has become important to me as both a social justice issue, a women’s health issue, an economic equity issue, and a human rights issue. I had the opportunity to speak 1:1 with our new state health commissioner, and I raised to her the central importance of a holistic and systemic understanding of women’s experiences. Her concerns echoed my own, and it was clear to both of us that there was much work still to be done. As I spoke, both in our individual conversation and the work group meeting as a whole, I began to realize I was speaking in Her voice.

Her voice is the voice of a woman whose mother and grandmother and sisters and cousins had a baby die, and she can’t attach to this pregnancy or to her care because people have treated her as less than human, less than educated. Her community has been written off, treated as beyond hope. She gets referred to as “them.” I listen to her anger and frustration with systems of care. I take in her words, take them in to the depths of my own soul, and realize this is not an individual issue. It’s a community issue, a human issue. Our issue. Her voice is equity.

Her voice is the voice of a woman who has been beaten up by her boyfriend and after he beat her, he made her have sex with him, repeatedly and without a condom. And she now has this pregnancy that she doesn’t know what to do with, and she wrestles with the ramifications to her core values if she terminates the pregnancy, or if she continues onward. Everyone has an opinion about what she should do. But she has a pregnancy, and she has pain, and she has a huge decision. She is speaking with me of this in the confidentiality of my office. I hold her in deep respect and regard, and we explore the directions of her self-determination. Her voice is choice.

Her voice is old, beaten by age. She had a baby that died and she never even saw it because the health professionals whisked it away. She doesn’t even know if it was a boy or a girl. She grieves at age 80 as if she was still 18. I talk with her as my client, before I even knew I could be an academic or maternal child health advocate. She will inspire me to take on those roles, although neither she nor or I know it at the time. Her voice is the life course.

Her voice is calming, and draws in the young mothers she works with. She has been in their shoes and survived…thrived, in my opinion…and could be anything in this world she wants to be. What she wants to be is their support, their navigator, their encouragement in the midst of challenge. So, she earns a low salary and makes a difference in their lives as a home visitor. She takes in the knowledge I have to offer, as I take in hers. Her voice is mentoring.

Her knowledge and experience have brought her to a position of prestige. Her vocal advocacy for women has brought her to a culminating decision as to where she will serve the most good, and when that good is no longer being served. So, she publicly steps down from her former role as Health Commissioner and now works in external advocacy for the women of the state. She is the first one to have invited me to join this group, to speak to her and to other members about women’s mental health as integrally related to our physical well-being. Her voice is leadership.

Her voice is a beam of light that illuminates my path today.

Her voice resonates in my ear, and my spirit.

My inspiration.

Her voice.

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Night in the NICU

Posted on March 7, 2013 by harasprice

My daughter’s birth, as one might expect nine years after the fact, is wrapped in a blissful cloud of memory where I remember the arrival of her presence more so than the pain or endurance of the process. But there are two particularly memorable events surrounding her birth that solidify for me the first moments when I knew, with illuminated clarity, what it means to be a parent.

Act 1: Separation and Attachment

One of the great gifts that labor and delivery nurses seem to posses is finding subtle ways to help mothers shift focus to their own recovery during the immediacy of childbirth. I wanted to cling to the sweet little, wriggling mass of person that had just emerged into the world, but my body needed to recover. The sage experience of the labor and delivery nurse recognizes the human, mammalian instinct to stay connected. So, they subtly suggest that its time for Dad to do his part of the work, to cut the cord and help with the first bathing. Thus, Dad and nurses can take the baby with Mom’s blessing, and Mom can get some nourishment, rest, necessary separation. Why necessary separation? Because for nine months or thereabouts, there has been continual, physical connection between mother and child. My body was home to the tiny multi-celled embryo that would divide and grow and become a fetus which could nourish on my body’s supply of food and water and oxygen. Eventually, the formation of the fetus is completed and the birth process (and it is a process) prepares the way for the baby to emerge into the world, to take on independence in breathing and eating and free will of being human. The process of separation requires faith, in the form of letting go…to the Universe, to a nurse, to a co-parent, to God. But parenting is also about attachment. And, as attachment theorist John Bowlby points out again and again, separation and attachment are intrinsically linked. So, these thoughts swirl in my labor-tired mind as I feel the separation from this tiny person, and long for her presence. She returns, swaddled and clean, gone for a short time but also an eternity. She wraps her perfectly formed fingers around my pinkie finger. We are connected again, in recognition of each other’s personhood and our relationship to each other. This dance will be repeated again, and again, and again. It has a deep human poignancy because I already know, and she will learn over the course of her life, that there will be a final separation at some point in our future. It is a good thing, though, that we do not how or when. The precious and fleeting nature of life allows us to be truly present in the gift of living. This awareness of deeply connected relationship allows us to live fully both in separation from and connection with each other.

Act 2: Protection and Vulnerability

We are ready to go home, a mere 24 hours after your birth. I have been discharged, and they check you over head to toe. And take you away. And check again. It’s a fever, they tell me, and they cannot let you go home. My mind swirls with all that I know could go wrong. You are small and fragile. My body was your home but could have exposed you to Strep B in spite of that antibiotic drip coming from the bag on the pole. Or it could be something else, worse. Or it could be that you are just warmer blooded and unique. We don’t know, so I am sent home and you are taken to the NICU. But, I don’t go home. I go to the NICU right behind you. I take up residence on a couch in the hall or a rocking chair by your bassinet. I insist on my presence to feed you when you are hungry, to hold you against my skin. I burst into the NICU at nighttime when I see the old-school nurse put you on your stomach to sleep and take on my professional health educator role amid my postpartum emotion to instruct her about Back to Sleep. I cry, my spouse tries to console me. A nurse who has been in my shoes before comes to sit with me, and we share stories. I realize in her stories that I am not the first parent here in the NICU nor the last. I am visited by the social worker because the staff are frustrated with and worried about me for not leaving your side and going home (although home is here, with you). I laugh and have a good chat with the social worker, who was once my student (the staff did not even know that I teach social workers; to them I am just a Mom in the NICU). I am teaching them, too. They are trying to protect you from some unknown germs but I know you are vulnerable. I am teaching them the way that I have been programmed to parent, and teaching them that parents come with all kinds of capacities as well as limitations. But, I am also learning. I am learning how to be a protector and advocate, learning how to cry before total strangers, learning when to stand firm and when to bend with the wind, learning to accept help and support. Learning to be your Mom.

Even at night in the NICU there is still a small point of light.

It is called motherhood.

It is from God.

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