Not that you could tell from this blog.
Life is full and life is good, but life isn't offering me much time to write at the moment. I'm not as overloaded as I was when I wrote this, but the only way I can preserve adequate sleep and time with Eve is to skip blogging - and reading blogs. At the moment I have 1000+ unread posts in my Google reader. I have actually had unread mail in my inbox for a week at a time, which is unheard of for me. At one point, I was three weeks behind on the NYT puzzle. That's all OK, but I need to figure out how to make this sustainable if I'm going to continue.
I'm also pondering how I write about Eve as we sit on the cusp of puberty. Most of my posts about her have been taken directly from life, and the conversations that we're having now are more complex and private. She shuts the door and says "don't let Daddy come in, Mommy. This is girl stuff". I want to honor that closed door, but I also know it would be helpful to me to think and write about the issues that are surfacing as we talk.
So don't take us off your RSS feed. I'll figure this out, and I'll be back with some sort of regular posting schedule, but probably not until after June 12th. That's when Sam and I celebrate our 25th anniversary and upcoming 50th birthdays with a big party. I said I wanted a weekend that was as much fun as our wedding, and that's what we've planned - all our favorite people, all in one place, for dancing and food and conversation and joy. I can't wait.
Now you'll excuse me as I return to cleaning out the dining room closet. Eve is washing the outside furniture and Sam is weeding the back garden. Later we'll rinse the dust off at the pool and somewhere along the line I'll listen to the Yankee game. Life is full and life is good, and I wish the same to all of you.
Monday, May 31, 2010
Saturday, May 22, 2010
Who Provides Us With Sustenance
~ by Jay
הוֹדוּ לַיהוָה כִּי-טוֹבנֹתֵן.....לֶחֶם, לְכָל-בָּשָׂר
Praise The Eternal, who is good....who gives sustenance to all of flesh (Psalm 136, the Great Hallel)
This morning we paused after we chanted Psalm 136, and the Rabbi repeated one line: who gives sustenance to all of flesh. What is sustenance? she asked. Sustenance is what feeds our heart.
What feeds our heart.
Food is a complex and difficult issue for me, as it is for so many of us. Sam and I struggle with our own eating habits and simultaneously try to help Eve develop a healthier relationship with food and with her body. Every parent has a middle-of-the-night fear; mine is that my beautiful perfectionist daughter, already aware of her shape and her slimness and the way clothes fit her, will come to believe that food is her enemy and that being fat is worse than being dead.
That's the middle of the night; in daylight I am shopping and cooking with Sam and negotiating with Eve - no, you don't have to eat the meal Mommy and Daddy are eating and you can make something else for yourself with protein, but that doesn't mean you can have a bagel with cream cheese for dinner. Yes, you need to eat some of those carrots. No, we're not having ground beef for every dinner and yes, sometimes we will ask you to eat chicken or salmon even if that's not what you're in the mood for right now. And do you realize what a privilege it is to have a refrigerator full of food, even if you don't think there's anything in there you want to eat?
Eat, but not too much. Eat what you want, but don't eat that. Respect your friends and their families, but don't expect to have that kind of junk food in our house. I bite back the judgments and instructions that fill my head and let her make as many choices as possible. So far, Eve seems to be doing fine with the physical sustenance. I sure hope we're feeding her heart.
For years I also had those conversations with patients: eat regularly but don't eat fat/sodium/wheat/foods with purines. Don't eat too much. Don't eat right before bed. Lose weight, but don't starve yourself. Exercise, but don't hurt yourself. And yes, I know you barely have enough money to feed your kids, let alone buy fresh organic produce for yourself, which would require time that you don't have to chop and cook, and storage space that doesn't exist in your apartment.
Praise The Eternal, who gives sustenance to all flesh. Who feeds our heart. How can we feed the hungry hearts and bodies around us?
One of the things I love about hospice work is that now, when my patients say they want ice cream, all I have to say is "what flavor"? My patients are dying. They get to eat what they want, when they want it. Milkshake? Sure. Chocolate pudding? Absolutely. Pancakes? Let me get that for you. Ham and cheese with potato chips and pickles? We'll have to order that from the deli down the street; give us an hour.
And then they stop eating. They're not hungry. They can't swallow. They can't stand the sight of food. Please, don't make me eat that. It is our instinct to feed the ones we love, to tempt and cajole and urge and plead. She has to eat to get her strength back. And when families accept that strength isn't coming back, that the road is only headed in one direction, they struggle. We can't let her starve.
Praise the Eternal, who is good...who gives sustenance to all flesh.
As death approaches, our flesh rejects food. Ice cream sticks and burns and can't be absorbed. Swallowing juice is painful and causes choking spasms. Even the effort to suck up on a straw is exhausting. As difficult as it is to put down the spoon, that is what we need to do when we love someone who says "please don't make me eat that".
We can put down the food and still act as the Eternal does, to give sustenance. Sustenance is what feeds our heart. Nurturing doesn't have to include food. I nurture Eve when I help her learn what her body needs. I nurture myself with a hot shower, an hour with my feet up reading a book, a long talk with a friend. My patients are nurtured by a soft pillow, a hand to hold, a cool compress, the sound of beloved voices. My values are nurtured when I support the local organic farmers and food banks.
Praise the Eternal, who is good, and pray that we, who are made in God's image, can give sustenance.
כִּי לְעוֹלָם חַסְ
God's love is everlasting!
Praise The Eternal, who is good....who gives sustenance to all of flesh (Psalm 136, the Great Hallel)
This morning we paused after we chanted Psalm 136, and the Rabbi repeated one line: who gives sustenance to all of flesh. What is sustenance? she asked. Sustenance is what feeds our heart.
What feeds our heart.
Food is a complex and difficult issue for me, as it is for so many of us. Sam and I struggle with our own eating habits and simultaneously try to help Eve develop a healthier relationship with food and with her body. Every parent has a middle-of-the-night fear; mine is that my beautiful perfectionist daughter, already aware of her shape and her slimness and the way clothes fit her, will come to believe that food is her enemy and that being fat is worse than being dead.
That's the middle of the night; in daylight I am shopping and cooking with Sam and negotiating with Eve - no, you don't have to eat the meal Mommy and Daddy are eating and you can make something else for yourself with protein, but that doesn't mean you can have a bagel with cream cheese for dinner. Yes, you need to eat some of those carrots. No, we're not having ground beef for every dinner and yes, sometimes we will ask you to eat chicken or salmon even if that's not what you're in the mood for right now. And do you realize what a privilege it is to have a refrigerator full of food, even if you don't think there's anything in there you want to eat?
Eat, but not too much. Eat what you want, but don't eat that. Respect your friends and their families, but don't expect to have that kind of junk food in our house. I bite back the judgments and instructions that fill my head and let her make as many choices as possible. So far, Eve seems to be doing fine with the physical sustenance. I sure hope we're feeding her heart.
For years I also had those conversations with patients: eat regularly but don't eat fat/sodium/wheat/foods with purines. Don't eat too much. Don't eat right before bed. Lose weight, but don't starve yourself. Exercise, but don't hurt yourself. And yes, I know you barely have enough money to feed your kids, let alone buy fresh organic produce for yourself, which would require time that you don't have to chop and cook, and storage space that doesn't exist in your apartment.
Praise The Eternal, who gives sustenance to all flesh. Who feeds our heart. How can we feed the hungry hearts and bodies around us?
One of the things I love about hospice work is that now, when my patients say they want ice cream, all I have to say is "what flavor"? My patients are dying. They get to eat what they want, when they want it. Milkshake? Sure. Chocolate pudding? Absolutely. Pancakes? Let me get that for you. Ham and cheese with potato chips and pickles? We'll have to order that from the deli down the street; give us an hour.
And then they stop eating. They're not hungry. They can't swallow. They can't stand the sight of food. Please, don't make me eat that. It is our instinct to feed the ones we love, to tempt and cajole and urge and plead. She has to eat to get her strength back. And when families accept that strength isn't coming back, that the road is only headed in one direction, they struggle. We can't let her starve.
Praise the Eternal, who is good...who gives sustenance to all flesh.
As death approaches, our flesh rejects food. Ice cream sticks and burns and can't be absorbed. Swallowing juice is painful and causes choking spasms. Even the effort to suck up on a straw is exhausting. As difficult as it is to put down the spoon, that is what we need to do when we love someone who says "please don't make me eat that".
We can put down the food and still act as the Eternal does, to give sustenance. Sustenance is what feeds our heart. Nurturing doesn't have to include food. I nurture Eve when I help her learn what her body needs. I nurture myself with a hot shower, an hour with my feet up reading a book, a long talk with a friend. My patients are nurtured by a soft pillow, a hand to hold, a cool compress, the sound of beloved voices. My values are nurtured when I support the local organic farmers and food banks.
Praise the Eternal, who is good, and pray that we, who are made in God's image, can give sustenance.
כִּי לְעוֹלָם חַסְ
God's love is everlasting!
Thursday, May 20, 2010
What I'm Writing
~ by Jay
I'm not writing blog posts. Instead, I am producing
- Narratives for hospice certifications and recertifications.
- Admit notes and daily progress notes on the patients in the hospice house.
- Goals and objectives for the hospice block rotations for the fellowship, which starts in six weeks. Ack.
- PowerPoint slides for Emergency Department Grand Rounds, delivered today (Oncologic Emergencies. Don't you wish you had been there?)
- An application to become a Fellow of the American College of Physicians,
- My medical staff reappointment application.
- A one-page article reflecting on my first year as Medical Director.
- Emails to friends having surgery, dealing with aging parents, helping other friends deal with dying spouses, and coping with abnormal mammograms.
- Emails to Eve's teachers about the misleading math homework she's been bringing home and her resulting misconceptions regarding mean, mode and median.
- Shopping lists as we prepare to host dinner for the visiting rabbi for the second weekend in a row.
- Checks to pay for the various parts of the anniversary party we're planning for June. And for summer camp. And for the school taxes and county taxes and swim club renewal and car insurance, none of which I'm comfortable paying online.
Sunday, May 16, 2010
Stop And Think
~ by Jay
One night early in the second year of my residency, I found myself standing at the bedside of one critically ill patient while talking to the nurses in another unit about the care of another critically ill patient. The situation in front of me was new and terrifying: a malfunctioning pacemaker that I couldn't figure out how to turn off. The problem in the other unit was old news: someone having a heart attack who had low blood pressure. Happens all the time. I knew what to do with that, so I did it - over the phone.
Both men survived the night (and recovered completely), and I realized as I signed out in the morning that a year previously, as a new intern, I would have been as terrified by the patient with low blood pressure as I had been by the malfunctioning pacer. At the moment - for the first time - I realized how much I had learned in the intervening 12 months. I had a new sense of my own competence. I went home and slept well, the anxiety of internship finally somewhat abating.
This afternoon I received an Email from a friend who is helping someone through a terrible time. Her friend's husband has ALS, and has been living at home on a ventilator. He has decided to stop the vent, and my friend has questions - should he have morphine? Should the children be there when he dies? Will there be noise?
The note was heartbreaking. I struggled to put my support into words, and then I dashed off two paragraphs about meds and funeral homes and children's bereavement.
My friend, who is also a doc, said wow. And thank you. I thought huh? That's no big deal. That's obvious.
Then I read back over what I'd written and realized a year ago I didn't know any of that. This past year has been another internship for me, albeit with far less anxiety. I am again struck by how much I've learned and how difficult it is to notice that as I go through my days.
And again, with that realization, I am going to sleep.
Both men survived the night (and recovered completely), and I realized as I signed out in the morning that a year previously, as a new intern, I would have been as terrified by the patient with low blood pressure as I had been by the malfunctioning pacer. At the moment - for the first time - I realized how much I had learned in the intervening 12 months. I had a new sense of my own competence. I went home and slept well, the anxiety of internship finally somewhat abating.
This afternoon I received an Email from a friend who is helping someone through a terrible time. Her friend's husband has ALS, and has been living at home on a ventilator. He has decided to stop the vent, and my friend has questions - should he have morphine? Should the children be there when he dies? Will there be noise?
The note was heartbreaking. I struggled to put my support into words, and then I dashed off two paragraphs about meds and funeral homes and children's bereavement.
My friend, who is also a doc, said wow. And thank you. I thought huh? That's no big deal. That's obvious.
Then I read back over what I'd written and realized a year ago I didn't know any of that. This past year has been another internship for me, albeit with far less anxiety. I am again struck by how much I've learned and how difficult it is to notice that as I go through my days.
And again, with that realization, I am going to sleep.
Wednesday, May 5, 2010
Echo
~ by Jay
No, the title does not refer to the echoing emptiness that has lately been this blog...
I heard an echo this morning. A voice from the mid-1980s came floating back to me. It's my friend Rich, and we're sitting in a cafe in California, sometime during my residency, and his early years on the tenure track. It's a month or so after the morning Rich finally invited me to his home, and introduced me to his partner, Gil, and came out to me.
Rich was not the first of my college friends to come out, and each of them did it hesitantly. I was wounded and insulted by their reluctance - how could they think it would make a difference? Why on earth would they be worried about my reaction? What kind of bigot did they think I was? I said this to Rich - why would you think it would matter to me?
Rich looked at me and said, quietly, "It changed how I thought of myself. It was impossible for me to imagine it didn't matter to you". I heard him saying "this is not about you, Jay. This is about me, and my own process. Stop thinking about yourself and look at me". And I did, and I never, not once, said that to anyone again. I came to recognize the struggle some of my friends had to accept their own sexuality, and the risk they all took when they told us - when they told anyone.
Today I listened to the echo of that conversation, and I heard my own words - it doesn't matter - and I winced. It does matter. Of course it matters. Of course it's different. Not because I value my friends less, but because I appreciate and understand them more when they can be honest with me. It matters, too, because I can be an ally as well as a friend.
Rich taught me calculus in college, and he has taught me many more important lessons since then, and that conversation from 25 years ago carried a lesson for me today. Everything matters.
I heard an echo this morning. A voice from the mid-1980s came floating back to me. It's my friend Rich, and we're sitting in a cafe in California, sometime during my residency, and his early years on the tenure track. It's a month or so after the morning Rich finally invited me to his home, and introduced me to his partner, Gil, and came out to me.
Rich was not the first of my college friends to come out, and each of them did it hesitantly. I was wounded and insulted by their reluctance - how could they think it would make a difference? Why on earth would they be worried about my reaction? What kind of bigot did they think I was? I said this to Rich - why would you think it would matter to me?
Rich looked at me and said, quietly, "It changed how I thought of myself. It was impossible for me to imagine it didn't matter to you". I heard him saying "this is not about you, Jay. This is about me, and my own process. Stop thinking about yourself and look at me". And I did, and I never, not once, said that to anyone again. I came to recognize the struggle some of my friends had to accept their own sexuality, and the risk they all took when they told us - when they told anyone.
Today I listened to the echo of that conversation, and I heard my own words - it doesn't matter - and I winced. It does matter. Of course it matters. Of course it's different. Not because I value my friends less, but because I appreciate and understand them more when they can be honest with me. It matters, too, because I can be an ally as well as a friend.
Rich taught me calculus in college, and he has taught me many more important lessons since then, and that conversation from 25 years ago carried a lesson for me today. Everything matters.
Subscribe to:
Posts (Atom)
