What a week.
Two long days in the office, made worse by the need to get all the paperwork done Right Now, since this is my last week. Every visit is sad or angry or in some way fraught. Every day is overscheduled with something in the evening, some kind of emergency, something else I'm supposed to be doing. Every little tiny irritating thing in my office is magnified, like a grain of sand in my shoe that rubs a blister before I'm done. Keeping my temper under control is a physical struggle
Home is no refuge; we're preparing for a renovation and have to pack up the living room and bedroom before we leave for vacation on Sunday. Sam is doing most of that work, but the chaos itself is seeping into my soul. Last night I woke abruptly about 30 minutes after I feel asleep, feeling as if I'd drunk a triple latte. I was up for another three hours, too tired to do anything productive and too antsy to sleep, restlessly surfing the Internet and listening to the dogs snoring.
So today, on about three hours of sleep, I had five home visits and two conference calls. One of the home visits was scheduled at the last minute, so I wasn't able to arrange them as I usually do to make a loop. I drove over a hundred miles today. And these were challenging visits. Patients who are intellectually aware of their prognosis but can't accept it emotionally, and can't make necessary plans. Patients who haven't been given all the information from their doctors and are agape when I make a comment about a CT result I thought they'd heard. Daughters who think their parents have given up too soon, and want their parents to restart medications that have no value. I didn't have my usual patience; I felt frustrated and impatient, and I'm sure that made the encounters even harder for everyone.
By 3:30, half an hour late to the fourth of five visits, I was wilted. I drove up into the country, not sure the GPS was even taking me to the right place, and followed a rutted gravel trail to a stone and clapboard house. I sat in the car for a few minutes, wondering if I should call the patient to make sure I'm at the right house, and the social worker I'm meeting came outside.
"Come over here", she said, and led me around to the back deck. I turned the corner and there was the countryside, spread out below me. Blue sky, green trees, neatly plowed fields, red barns, even a few silos here and there. I stood a moment and felt my soul start to uncrumple. Then we went into the house, where the patient and her daughter waited for us. They were as peaceful and open and welcoming as their vista had been. "I know what's coming, and I'm ready", said my patient. "My daughter is taking good care of me until then". We talked for a few minutes, and I leaned over and asked for permission to touch her. She nodded.
As I placed my stethoscope on her chest, she spoke. "Dear Lord, thank you for the blessing of Dr. Jay and the hospice nurses. I am so grateful they are here to help me. Keep them safe, and make them strong as they do their work". We all paused for a moment, and then as one, we said "Amen".
For the first time all day, I took a deep breath, paused, and felt entirely present.