For the last year I have been including at least one client or people story each month on my pages. Sometimes I wonder what I will soon be writing about, thinking that I will be running out of stories, but then I find myself relaying a story to someone and realize that it is one I haven't yet put down in print...
Jay recently mentioned something about someone who is illiterate and it reminded me of a client I once saw at the state hospital to screen for coming out and working with one of my case managers. We worked with lots of homeless people, but this referral was concerning because the client lived in his truck and was taken to jail and then to the psych hospital after he pulled a knife on the police. He had a long history of not taking his meds when out in the community and so having him seen by one of my case managers was something I thought I would not do and so saw him expecting to turn him down for services. I was expecting this based upon my preconceived notions of who he was, my old tapes that played like old radio shows in my brain.
And so I met with a middle-aged man, one who looked down at the floor much of the time, who looked disheveled, who looked lost. I explained to him what my program was, that I knew he did not take his meds when he was out of the hospital and that I would not tolerate that, that I would insist that he be on injected meds that he would take every couple of weeks. He told me that he would not like to take those meds. I asked him about living in his truck, about what he did with his money. He slowly explained, looking at the floor, that he got money from going around to various hospitals and collecting recyclables, that staff there would save those things for him and maybe give him something to eat. That years ago he had worked as an aide at a nursing home but after a while he could no longer do that. I asked about his disability check, and he explained to me that he paid a check cashing service to cash it when it came, that he did not have a bank account. I asked him why, why didn't he just set up a bank account for his check to be deposited into? He said that he had gone to banks, this homeless, disheveled black man, and that they had told him they did not have accounts like that. He seemed so childlike when he said these things, like he simply took at face value what the bank workers had told him. As I questioned him about this and about why he lived in his truck and did not have place to live, he looked into my eyes and said with deep, deep shame "Ize don't know how to read, ma'am".
It was then that I knew that I would have to talk one of my casemanagers into working with this man. I asked him about pulling the knife on the police- he explained that he did not know what they were doing, that he was scared, that things were not making sense to him. I told him that if one of my case managers worked with him that they could help him to get a bank account, to get a place to live, and maybe to find someplace to learn to read. He looked at me and said "You know, I think I can take that shot medicine you were talking about, yes, I think I can".
Judy was irate with me. How was it that I could consider her working with this homeless man who pulled knives on policemen? She insisted on going to the state hospital herself to screen him. I was delighted. She came there with me, and we met with the client in the dayroom. He remembered me and he remembered that he would have to take shots when he left the hospital. I introduced him to Judy and asked him to explain to her why he lived in his truck, how it came about that he pulled a knife on the police, and why he did not have a bank account. He told her the same things that he had told me, and the shame that flooded over him caused her body to flinch, and she looked at me with dismay and said "You've sucked me into this". She knew then the same thing that I knew, she knew that this was a man who needed help, who had a good heart, who she actually knew how to help and that she could not resist helping him. We set up an appointment for him to come to the office to see her after he got out. It was relatively easy explaining to him the day and time he should come- he could always ask people what time it was, but explaining to him our address, where he was to come was enlightening. The business card with the appointment on might as well have been written in Chinese- it made no sense to him. We excrutiatingly explained where we were located by describing local landmarks- we had no idea if he could make it there.
On the day of the appointment we kept an eye out the window and about the right time we saw him across and down the street, going into stores and asking for Judy, showing them her mental health business card. And we went out to meet him as he made his so difficult way through this world to our door.
I really can't remember whatever happended to him, but I do know for sure that he did not pull a knife on Judy, that he made it to our office more than once. And I do know that, "but for the grace of God", he could be me. He was once a poor boy in the south whose future was not bright, but it did include the possibility of some earthly joy, some love, some family. Mental illness robs many of its victims of these things, and illiteracy can make this puzzle of a world nearly impossible to negotiate.
There is a land of the living and a land of the dead, and the bridge is love.- Thornton Wilder
Be the change you wish to see in the world.- Ghandi
Our work is at least half of our life, so much of our waking time on this earth. You are being paid to dream- don't forget that.
If you click on the work dreams picture it will take you to a site that pokes fun at all of those motivational calendars and such- maybe you will get a chuckle...
Feb. 2003: Am I going to run out of people stories? Don't hold your breath...
I have included the picture at left for this month's stories because they are not endearing stories- they are quite the opposite. They are stories of "bad guys", stories of disturbing encounters, stories about a part of the world I wish I knew nothing of, stories I have found myself telling over, and over, during the years. There are people who need to be locked up, who need to remain locked up- humanely locked up, but locked up nonetheless.
When I worked on the admissions unit at the state hospital I had a guy come in, being comitted after only being briefly out of the sexual offender unit at the prison. He had been stopped while in the process of abducting a little child from the yard of their home by a neighbor or passerby. I got to interview him. He very matter-of-factly explained to me that he had maxxed out on his prison sentence and that they would not allow him to stay any longer and so let him out. He calmly told me how he had waited out in the prison parking lot, hiding behind the cars. He was waiting for a particular female guard to come out so he could attack her and get back in, get back in to reunite with his lover who remained "inside". It was chilly, he got tired of waiting and walked down the street, taking the first opportunity he saw... but he had failed, and he was not inside the right place, the place with his lover. I'm not sure what happened after he left my unit- I would be very surprised to find that he had not eventually succeeded in commiting an act to get him back to where he wanted to be, "inside" the sexual offenders' unit.
While I was working at the state hospital I remember driving home and hearing something on the radio about a counselor at a mental health center being held captive at knifepoint- little did I know that I would get to meet that client a couple of years later. While working for the case management project I got a referral to come to the state hospital and screen a patient for admission to our program. I got there and found that the client had been admitted there as a danger to others, directly from the prison. He had maxxed out on his sentence and the prison thought he was too dangerous to simply discharge so they had him committed to the state hospital. Now, after almost two weeks there, the social worker thought he was just fine to refer to me, for one of my case managers to meet with in the community. And so I interviewed a charming young man, charming like all of the antisocial clients I have ever met. He got up in the day room and did a little dance for me (the hospital social worker thought he was cute doing this). I asked him about his plans for living in the community. He easily explained that he would not lie to me, that he would drink and use "a little" cocaine, but that this would not interfere with his medications, that he was sure his psychiatrist had told him that. I asked him about the incident that got him in prison, and he explained to me how he and the counselor had been friends, how he had been doing the counselor "a favor", that the counselor "wanted it". I asked him if he had ever been arrested before that, and he said he had but that it was a mistake, that he really did not rape his girlfriend, and that she too had "wanted it". When the social worker wanted to know if I accepted this young man as a client I told her no- she was disappointed.
These two men were very sick, so sick that they not only had no idea that they were sick, but they actually thought that their unthinkable deeds were not only justified but that their victims invited and wanted the acts. They were scary, truly scary. I have no doubt in my mind that they do not belong "on the outside". Right now, as I write, the state is being forced to place in the community dozens of sexual offenders now incarcerated on McNeil Island because the Federal courts have determined that these people have the right to get out, to be "on the outside". Isn't there a house for sale or rent next door to the home of that judge's grand daughter? Yes, that would be a good place to test his judgement. Sometimes the money is not, after all, where the mouth is. Or something like that.
Don't think about it too much.
March 2003: And more from the desk of "Super Computer Girl", otherwise known as the superhero that protects the elderly from falling...
I used to work with a mental health client who was infamous in our agency. She was very paranoid, could be difficult and time-consuming, plus tiring, so she would get handed off to every new casemanager. I guess the theory was that they would be fresh and have the energy to expend. She was quite aware of this and referred to herself as a staff trainer.
When I got there, well, she became my client. I have never considered myself a therapist. My degree is in social work administration and I feel my skills are mostly in assessing, crisis intervention and setting up services- like referring to a therapist. Many of the case managers who had worked with Zoe had been therapists; I wasn't so I just talked with her. She was a frequent flyer, going down to the state hospital pretty regularly. She had lived in one of our group homes but now lived in her own apartment, and when I would go over there she would complain about the neighbors, many of whom had moved out for some reason... She was sure they were up to no good, that they watched her. After a while there was a travel trailer parked in the parking lot, which I thought nothing of. Zoe remarked one day, pointing at the trailer, "Those people in there, if I only had a grenade, I would launch it at those guys...". I just gave her one of my "therapeutic" looks and said "you know what I think about that stuff". Boy, I am good.
I saw her frequently, mostly to try to keep on top of what she was up to and thinking so she and the others around her could remain safe. She told me about helping her dad to work on the car as a little girl, remembering the sound of the lug nuts in the bowl formed by the hub cap, and also how he would get angry, remembering the feel of the refrigerator pushed against the side of her face. She told me about her dad leaving them, and her quitting school to take care of her sick mom. Her prior therapist told me that a dentist had said that Zoe had two rows of teeth in front most likely from her mother drinking alcohol while pregnant for her. Zoe told me how her mom had gotten real sick when she was about 17, and she called the ambulance and it came and took her away. But she didn't know which hospital they had taken her mom to, and her mom was dead when she found the right one. Her old therapist was surprised, she didn't know about that stuff.
Despite my efforts Zoe did make it down to the the state hospital once while I was working with her. She brought home a boyfriend she had met there, a tall fellow with big cowboy boots and a scar running down one side of his face. After a while she told me she had gone and gotten a restraining order, and gotten herself into a battered women's shelter- when I went to see her I suggested that picking up men at mental hospitals might be an even worse idea than picking them up in bars. She thought I just might be right that time.
After I became a full-time manager I handed her case over to yet another new guy... and one day he found out she had bought a gun, and gotten a concealed weapons permit. I can't remember how he had found out, but he did tell me that the local police knew (they were frequent visitors at Zoe's) and they had her on a "two man response" status because they considered her so dangerous. They hadn't bothered to let us know. I called and tried to get mental health commitment folks to come to the office the next day when she was coming in, they said it was police stuff, and, well the police said it was commitment stuff. Zoe had always carried a knife in her purse, we were used to that, and she called it "friend"- she liked to mention that when she was feeling a bit boxed-in. I really did not want her in the building with a gun. I was in the office, having spent the morning on the phone trying to get someone to assist us when I saw her hat bobbing along, on its way up to our door. I hung up, dialed 9-1-1 and informed the operator that we had a client with a gun. The operator was very concerned- she had the police come afterall. They talked to and searched Zoe- her gun was at home. She did later agree to give it up.
Zoe was interesting. A smart girl with an awful past, a childhood whose terrors I had barely scratched the surface of. For some reason she had paranoid schizophrenia, for some reason she thought that she was not safe in this world. Oh yeah- while I still worked there Zoe told me that she had gone and gotten herself a will, and named me an executor. I left that agency in 1993, and haven't been contacted to execute anything yet.
April 2003: Life can catch you a little off balance once in a while, or even most of the time...
And so, how does one go about meeting all of these people with such stories to tell? Isn't it overwhelming at times? Doesn't it sometimes break your heart? Make you want to cry? Make you wonder what it's all about?
And the stories continue to come, piling up, one upon the other... Let's see. A couple of weeks ago I went to see and set up services for a nice man in his mid-60s who at that age found himself living with his parents, themselves now in their 90s. He had been having some pains and it had taken a while for the doctors to sort out what was going on, and when they did they realized that he had bone cancer in one of his hips. It was a metastasized cancer- the original site was the lungs. He had had his diagnosis for about three weeks when I saw him, and now his other hip was hurting, and it was far more difficult for him to walk. He worried that his elderly parents already had enough to deal with... His worries will be over soon, he got admitted to a nursing home the other day. Already. He was lucky though- he got to know what was coming, he got to think about what it had all meant, and he got to say his good-byes and make what peace there is to make.
A little later I met a lovely man from Vietnam, in his early 70s. He had come to the US in the mid-'90s, and he had brought one of his daughters with him, and his wife. Now he had brought over to the US two sons, one having arrived here six months ago. He was getting more frail, and at night he would have nightmares and go around the house yelling and afraid. His daughter would try to keep him safe while he was still asleep, and try carefully to wake him so that he could come back to now. He had been a prisoner of war for seven years during the Vietnam "Conflict". He would dream of being captured again, his captors stabbing him and slicing at his skin with their knives. He became a US citizen a couple of years ago. He spoke of his five other adult children still in Vietnam and how he wanted to get them all here, to the US. I think he did not finish that sentence, or maybe the translator trailed off. He said he worries a lot about getting them here. I think he worries that he may not get them here before he dies. Maybe he thinks their skin will not be sliced with knives if he can get them here.
Today I met a woman one year older than myself. She has cancer in her brain stem. She just found this out a couple of months ago, when she started having trouble with her balance and then one side of her face froze. Her adult daughter was helping her and she was planning to start five weeks of daily radiation therapy next week. She told me that she had asked about her prognosis but that the doctors didn't seem to know. "Even they don't know; they are not gods." She was emotional, she was crying. She was struggling to make sense of it all and spoke of having episodes of losing her "will to live". She knew that she might die, she knew that maybe the best she could hope for was a little more time. I told her that it would be alright, that either way it would be alright, because it would have to be. She thanked me and told me that I am kind. It is hard to believe that those words are ones of kindness. Sometimes saying what is true when the words bring tears to your eyes is about as kind as you can get.
Onions are strong. If you cut up enough strong onions your eyes will water. I like onions, raw and cooked. Regular ones, and sweet ones. And both, when sauteed in oil, are about as sweet and yummy as you can get. Life is full of strong experiences that make your eyes water. And it is so incredibly sweet. I saw a piece on a man in prison who had not been able to see his child for two years and then got into a program reading children's books. The books softened him, maybe like an onion being sauteed. His child listened to him reading the books via tapes. Then he finally got to see and visit his five year old daughter on her birthday. He said that the reading program had helped him get to where he wanted to be as a man. He said that if you keep wanting something, you will get it.
Sometimes we go through what seems like hell, but, in the end, you get what you need. I did.
Just keep on cooking...
May 2003: When I first started doing some work in hospitals, coming from working in mental health, the discharge planners struck me as depressed. I remember remarking to a friend that is was difficult work, that all of the patients were sick or dying.
One of the first cancer patients that I interacted with was a woman perhaps in her 60s, not old and not young. Her cancer had metastasized to her bones and her body was rigid- it took several people to move her.
She told me how she had become progressively unable to move and had begun using a wheelchair at home but had still not gone to the doctor. She provided daily care for her granddaughter, who was something like 8 or so. She had provided day care for her since she was a baby, while her mom was at work. She described a tender, loving, close relationship with her grand daughter and had not wanted to know for as long as possible what was going on in her body. Actually she basically already knew- she knew it was bad.
Now she knew for certain that she had only a month or so to live and that she would be getting even worse than how she was then. And she told me that she was thinking that she would not let her grand daughter come to see her, that she did not want her to "see me like this". She said this as if it were a decision that she had made, yet here she was telling it to me as if I needed to respond. I couldnít remember them teaching me in school how to respond to this kind of telling; all I knew was how it might feel to have someone you were close to still be alive but not be allowed to see them. It made tears come to my eyes, and that I think was the first time that happened to me. So I just told her what I felt about her idea, what my heart said. I told her that I could imagine her grand daughter growing up and regretting not having been able to see this grandmother she had felt so close to before she died. And I told her that I couldnít imagine her regretting having gotten the chance to say good-bye to this person who formed so much of her early experience of this life.
That was all I said. That is all I know. I was covering that unit just that day, and she was going to a nursing home where she would die. I, as so often is the case, did not get to know how things turned out or how what I said impacted her or her decision. Such is the work of the hospital discharge planner. I donít have a clue why they all looked depressed to me at first.
Remember: It is actually not possible to love too much, to give too much. Sometimes the love is not returned in kind and you feel that you have to cut your losses, but don't let that make you afraid to venture into love. You can't find what you don't give away, so give your heart away and don't be afraid to give your granddaughter one last hug, or be tempted to protect anyone or yourself from love. It is the stuff of life.
JUNE 2003: CINDY IS MOVING... TOO BUSY TO WRITE :)
July 2003: Fate and Free Will
I have talked about fate vs free will many times over the months that have now stretched into years (almost 2!) that I have been writing my pages. I talked about the passage in Moby Dick in which Melville describes mat weaving: it seemed as if this were the Loom of Time, and I myself were a shuttle mechanically weaving and weaving away at the Fates... The straight warp of necessity, not to be swerved from its ultimate course... freewill still free to ply her shuttle between given threads; and chance, though restrained in its play within the right lines of necessity, and sideways in its motions modified by freewill, though thus prescribed to by both, chance by turns rules either, and has the last featuring blow at events.
A year ago May I wrote of a conversation with my friend Margaret, when we discussed fate vs free will: She said that we are all connected, that we are all part of this web of life called humanity, and we all have roles or burdens to fulfill that are part of why we are here. Yes, there is free will, but it does not include everything that is.
And earlier this year I wrote of that great philosopher, Forest Gump, and how he wonders: could both be right, if maybe both are happening- that destined fate and random luck or free will are both happening at the same time.
Such diverse sources regarding all of this- and all three seem to agree that fate and free will are concurrent forces, both acting at the same time, running together throughout this experience we call life. Did I also mention Robert Frost? Two roads diverged, choosing one, and that has made all the difference. There is a song on commercial radio that is getting play now, and the singer's name escapes me, but he speaks in his song about how everything happens for a reason and yet how he still needs to, is required to, determine if he is making the right decisions. That is an interesting distinction. Yes, things happen for a reason and the lessons that are available for us to take into ourselves are never-ending. Yet within that web we do make decisions, and the lessons reflect that path we have chosen because we are all here for a reason. As my daughter Carrie told me, we are here for a reason but the reason is different for each person.
Deja vue is an interesting phenomenon. There are many theories about it ranging from it being filled with mystic importance to it simply being a result of electrical impulses in our brains (the latter explanation, of course, explaining nothing, but simply describing the event...). For me these experiences are important. They are reassuring. They tell me that I am on the right path- the path that gets me to everything that I am here for. This point of view does not threaten Western organized religion, even if it is experienced as threatening or misguided. There was a joke years ago in which a very religious person was caught in a flash flood and a number of rescuers came in boats, helicopters, etc. and each time he declined their assistance because God would save him if that was what was to be. Of course he dies and goes to heaven. When there he asks God why He had not saved him, to which God replies that he had tried many times but the man had declined each time... Life is full of meaning; to me God is life.
I recently met with an elderly lady at a nursing home and she kept interrupting me to exclaim how very much, how uncannily I looked so much and spoke so much and held my head so much like the family of girls her brother had married into. Later we met with her family and discussed options for her discharge; how to get her home with enough assistance or to senior apartments rather than just home alone- where she was not really safe. She balked at some of the ideas- actually at about all of them. She said that she was religious, that God would tell her if that was what she was to do. I asked her if maybe God had sent her a gal who looked like that family of girls so that she would consider what she had to say. She decided to go check out some senior apartments.
Last year Barbara and I went to a Samuel Beckett play, a one man play about life and death that I enjoyed immensely, and its dialogue was familiar in that it reminded me of what goes on in my head much of the time... I think about fate, free will and chance often- not always specifically, but it is an underlying theme in many ideas, in many choices, as I traverse this life and daily look at the signs and daily make the choice of which divergent path to take, over and over. Life is good. Life is. Be Here Now. Yes, Be Here Now.
August 2003: When I worked on a geriatric pych. unit at a hospital we admitted lots of patients with dementia of one sort or another. It was always interesting to have the families embarassed and apologizing for their mother's "sailor" language- mom had always been a lady, until now.
One elderly woman with dementia was subdued and I can't even remember why she had been admitted from her nursing home, perhaps she was wandering or something. Her daughter came in every day and the nursing home social worker told me that she came in every day to visit her mom there too.
When I met with the daughter to get some history on my "patient" the daughter told me about growing up with a verbally abusive, denigrating mother who had clearly conveyed to her that she would amount to nothing. As her mother became more and more "senile" she also became more and more subdued, and then sweet. She told me that her and her mother would visit daily and just sit on a bench there at the nursing home and hold hands. Now I have the mother I always wanted to have, she said quite simply.
Maybe Mick is right, maybe we don't always get what we want but [eventually] we get what we need.
Working at geropsych was interesting and educational, I was always learning something about dementia, depression or whatever- maybe a little about life. Lots of dementia patients seem to be living in an earlier time of their life and some were agitated, upset, confused, etc. The docs said there are lots of theories about what that is about, and Bill explained it nicely. He said that there really are two schools of thought: one is that as the mind basically disintegrates old areas of the brain are randomly activated and that is what becomes present for the patient, and the other explanation is that the brain is processing the patient's life and issues and those unresolved areas are what is present. Bill went on to say that it really doesn't matter, that you approach the patient in exactly the same way in any event, that you go to them where they are and give them reassurance and what comfort you can. Bill is good, a clever man at times.
More August 2003: Reality can be elusive, or confusing. I remember a sweet, confused elderly woman who told me the first time we met at the hospital that her vision had become very poor in her left eye. I dutifully reported this to one of my favorite nurses, who looked at me askance once again and said "that's May's glass eye...".
And More August 2003: One time when I was working at the hospital I was very busy and had been meaning to interview a new patient but had run out of time. It was almost time to go home and I was glad to look in the client's chart and discover that she had very advanced dementia- she probably could give me little information, so I could talk to her, make an entry that I had started the assessment and then call her family in the morning to get more information. Besides, she was probably very difficult to talk to aside from the dementia. She had become unsafe at home and had been placed in an adult family, where she promptly got psychiatrically commmitted from after getting agitated and breaking a window. From the psychiatric unit she had been placed in a secure alzheimer's assisted living, but again had been unmanageable and gone out a window. She had been transferred to my unit from the psychiatric hospital. Yes, a quick introduction, agitation and then I could go home.
I found her sitting on a seat in the hallway, and sat down with her. I asked her some questions and her rambling, disjointed answers did not flow with information that is easily coherent and I wanted to simply let it go at that, call it a day. But once again life is not quite so simple, just as we ourselves are not. She was telling me as much in her body language, in the nuance of her expressions and the way she sat with me as she did with words. I sighed to myself, knowing there was more than meets the eye and knowing that this little lady had something she needed to tell me.
She talked in stutters and starts, giving bits and pieces of information and answering as I reflected back to her what I thought she was saying. She had had an abusive childhood, full of fear and pain. Her mother tried to protect her some and she had wished she could protect her mother.
She left when she could, she got married and loved her husband, she had a son. Later her husband died and she remarried. Her new husband never did take to her son. Her son was belittled and abused. She was so glad when he was old enough to leave home, glad for her son. He left, made good for himself, became an attorney. She missed him so. Her husband died, and now her son visits her.
She wished she had been a better mom, that she could have protected her son. She wished she could make it up to him, that she coud let him know.
I reminded her that her son visits often, that he takes care of her financial affairs, that he seems to love her. I asked her if maybe she too had done the best she could. She shook her head, squeezed my hand. I said good-bye and left for home, late.
The next day after several rounds of phone tag I spoke to her son, a busy lawyer. I told him what his mom had told me. The astonishment rang loudly in my ear. He explained that his mother calls him Jim, even though his first name is Steve. I told him I had figured that out. He said he couldn't believe it, that his mom had not been able to string together a full sentence for so long that he found it hard to believe that she had told me so much. I told him that she told me her story with bits and pieces of sentences, words, looks, tears. I told him that I thought she could successfully go to another placement, that the story she had to tell, the story that kept wanting to come out of her and that called to her so, had now been told. He knew the story, he just had never heard his mother speak of it.
Over the next few days I spoke with her son several times as we arranged for her to go to another dementia placement. I thought she would do just fine in a regular adult family home but they were all leary of her with her history, so we found her another secure unit placement.
One day one of the nurses came and told me that my patient's son was here visiting and wanted to meet me. I walked into the room they were visiting in, the son facing the door and his mom with her back to me. As I approached I heard him saying, "Cindy mom, the lady we were taking about." She turned as I touched her shoulder and looked up at me. "Oh, it's you. You've been with me all the time." She never knew my name, but she always knew who I was.
September 2003: Speaking of sweat...
Recently I went out to the apartment of a client to meet him and do an assessment. I got the referral and had been wary because it only said that he was mentally ill and unable to take care of himself at times. We are always on guard, you know, keeping those mental health clients from trying to sneak in and get our services when their own system is supposed to meet their needs (which it doesn't, but that is another story...).
I had called the case manager at the mental health center and asked her what physical needs he had, such as walking or feeding himself. She hesitated at my brusqueness- maybe wondering herself if he was indeed ineligible. She said that, well, he had just been diagnosed with cancer, that he was taking chemotherapy for his blood cancer, that his walking, well, he was falling a lot even with the cane and wheelchair. I asked her if he sustained injuries from his falls. Well, he does come in with black eyes and bruises a lot, but no real injuries...
She went on to tell me that he has scars up and down his arms from self-inflicted cuts and burns. I asked her if these were suicide attempts or a form of release- they were for release she said. She told me that she thought she should also warn me that he used to always be drunk when she started going out two years ago and they had refused to serve him if he was drunk when she went out. I asked if he was agitated when drinking, or just drunk. Oh, just drunk, she told me, explaining that she was not comfortable seeing him at those times. Yeah, yeah, yeah- the least of my worries.
When I called him to schedule the visit he was very confused and I could not be sure if he had been drinking. I explained several times that I needed to come out and see him, and he finally said that it was ok but that he could not get his place clean in the next couple of days, before my visit. I told him that did not matter, that the purpose of my visit was to get someone to help him with that, but, that I did know that he had trouble with drinking and that I needed him to not drink before I came out. He told me that would be no problem, that he had not been drinking for about a month. I looked at his chart... yes, a month, about the length of time he had known he had cancer. Funny how mental health clients sometimes have such advanced illnesses once they are discovered, as if maybe their symptoms were not given a lot of validity for a while...
I got out there after calling to remind him I was coming- basically the same conversation over again, trying to explain why I needed to come out. He was about my age, long hair, bib overalls, looking a bit like a disheveled Neil Young... Everything neat, although dirty. We went through the excrutiatingly long interview that the powers that be have determined is needed for people to demonstrate to us that they, indeed, are our clients. I skipped around, trying to go to sections I thought that he could tolerate at the moment, given his obsessive disorder, his bipolar (mostly depressed) disorder, his anxiety, his discomfort with being around other humans.
We finally made it through the assessment and I explained to him about meals on wheels, about a caregiver coming in to help him, about installing a lifeline system so he could summon help if he couldn't get up after a fall. I explained also that I would try to see if he could get an electric wheelchair, since it was becoming so hard for him to get his manual wheelchair to the bus stop now. And I appologized for all of the forms I needed him to sign. He signed the first and kept on signing, saying that I had "done a good job". I demurred, and he went on to say that, indeed, I had done a good job and that he "of all people, should know... people bring me in all the time... ask me questions... come at me from here and there.. and they make me sweat".
Once again, an unexpected compliment, a jewel in the rough. I am good- I did not make him sweat.
I felt very good about my work and recounted the compliment many times to co-workers- regaled by my accomplishment of not making him sweat. Maybe I was absent that day, but I don't remember them telling me in grad school what a compliment it could be to have a client tell you that you had not made him sweat.
November 2003: I am pooped- only three more days of driving all the way down to Seattle to work. I will miss the many kind, friendly people who work in that office but I am glad to be moving on, both so that I do not have to drive so far and for a change in the work I am doing.
Today I saw a young gal and her mother at the hospital- it might be my last assessment as I finish up. Twice in the last couple of weeks I have met with 23 year old girls who now have different, new lives due to auto accidents. One is wheelchair-bound as a result and cannot release the wastes from her own body; the other now walks with difficulty using a cane, but cannot articulate the words she wants to come out of her mouth or open/see out of one of her eyes.
Both were working women before their accidents. Both have families who love them, who now have designed/rearranged their own lives so much more intimately around one daughter than they had planned. My oldest daughter is 21. I know it will be hard as I go to the hospital to see these women. How does one help? I offer the client and the mother so little in these interactons. Yes, it is true. How is it that God trusts us with so much?
"I don't know why we are here, but I'm pretty sure that it is not in order to enjoy ourselves."- Ludwig Wittgenstein
Maybe not to "enjoy" ourselves, but I think to be happy, and certainly to share love.
December 2003: Where have the stories gone?? I spent the last few months driving, and now I have one week under my belt, so to speak, of my new job- it is wonderful! The people are nice, they seem competent and I get off the freeway after only 25 minutes of driving! It is a miracle... maybe now some stories will come.
I write this little piece because I found myself telling it to one of my new co-workers. It was about the ten millionth time I have told it and it appears missing from my pages... so...
When I did discharge planning in the hospitals and as I worked in the community I would often have families and clients who wanted/needed a place to live and receive care. I would give them lists of places and after a while I found that I could send two people out to the same place and one would report that they wouldn't let their dog live there, while the other would say that they loved it. I got so I would even tell clients and their families this, what I had learned, and tell them just to go out, see the places, and pay attention to how they "felt" and go by that.
I have often told co-workers about what I think is a Rod Serling TV episode that I remember from my youth. In it a very sterotypic "hippie" guy is driving and then wakes up in a living room. The furniture is formal and antique, with ornate wood edges and little cushion or softness to it. Other people, mostly elderly, are sitting and reading. Others come in and sing hymms, read aloud from clearly uninteresting books and chatter about what appears to be nothing of import. The hippie is beside himself and, as it turns out, learns that he died and now he is in hell, while his cohorts are in heaven. They are in the same place, it just feels different to him than to them.
At times in this business I work in I find myself and others making decisions "for" others. I try to remember to be careful, because I really don't, even though sometimes it kind of feels like it, walk in the other person's shoes. You know. The thing they say? Something about assuming, something about you, me...
Curious things, habits. People themselves never knew they had them.- Agatha Christie (1890 - 1976)
More December 2003:
"Some day my marsh, dyked and pumped, will lie forgotten under the wheat, just as today and yesterday will lie forgotten under the years."- Aldo Leopold, A Sand County Almanac
I met a woman who told me a story of woe, having had a year of losses. Now, in her mid-80s, she was staring death squarely in the face. "Lot's of people have it hard... my husband and I were always blessed and we wondered when our turn would come and we would not be so lucky." Her daughter had explained her new diagnosis to her. "There isn't nothing they can give you to get rid of it, it just gets worse. I saw that in my daughter's eyes and then she told me. It was hard for her to tell me... later she was afraid she had told me too much, that it was too much for me to know." She was chatty, with so much to tell. We decided that the knowing was hard, but that the knowing also helped, that the longer journeys do best with some preparation, making our way to where today and yesterday lie... under the years.
More December 2003:
"My husband is still at home. He was blind in one eye and then that degeneration thing made him blind in the other eye... we thought that would be ok since I could still drive. Now I am so sick, and I have to be here. I miss him- he comes to see me a lot, but it is not the same, the touching... I miss the touching so much."
They do their duty. They drive up in their cars, they
chatter brightly and reminisce, but they don't touch me.
They call me mom, mother, grandmother, never Minnie.
- excerpt from Minnie Remembers by Donna Swanson (for full poem click HERE)
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Page Created November 2005
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