Favorites

My sisters both accuse me of being my father's favorite child. (How is this a fault of mine, I don't know. This seems to be a choice he would have made, not me.) I never tried to be a favorite, and I honestly don't think my father had one. I do seem to remember being a favorite of various teachers throughout school, and I don't remember doing anything to achieve that status, except maybe doing the homework on time.

I think it's interesting that 'being favored' had such negative feelings attached to it. There was something wrong with it or it was the favored persons fault, and not the favorer. Which is why I vowed at age 10 to never to have any type favorite. I would be fair minded and see everything for it's individual beauty and value.

Why then, do I keep having favorites among my hospice clients. I suppose it's just as it was when I was young, I didn't try to like one person more than the other, I just did. I didn't want to have favorites, or to really like my hospice clients because I didn't want it to be too hard for me when the died. The truth of the matter is, I am helping to take care of someone at a very intimate time in their life. They are preparing for the end of it and to some that means embracing everyone around them, including me. For others it means, shutting out everyone one who is not essential...like me. How could I not embrace back those who share their last moments with me. Is it so wrong to briefly love a near stranger back at time so short and dear to them?

One of my first favorites, J., always brought a smile to my face with the way his eyes lit up when he saw me. Another was always concerned with me working too hard, and another held me close and told me I was his guardian angel mere days before he died.

There is a fluidity to these favorites, one passes away and another client starts to warm up to me, or we have a moment that gives us that moment of understanding. I don't choose them, they choose me I think.

Is really a favorite, or some sort of intimacy that breaks down our decades of protective walls and borders. The time of those walls has passed for the dying and being let in can feel like you've been favored, chosen, or become a friend of sorts.

I hope I can honor that giving of spirit that those certain clients feel they can share with me, and I will think of them as favorites, without shame.

With the slightest of touch...

Merely a month or so after I started working for hospice, I had my first "what I am I doing here" visit. The gentleman I was to see that day lived out in the country, past a lake, curving around the fields, and down a long gravel driveway. It took me close to 40 minutes to get there from town. I was always nervous visiting him because the first time I was supposed to see him I was two hours late.

Arriving that late was certainly a blow to my confidence, but it wasn't really my fault. The directions I received were atrocious, he lived out in the middle of nowhere, my cell phone didn't get any reception to call for directions, and it was winter so the roads weren't that great either... None the less, I felt a certain amount of guilt showing up that late, and I never quite shook it everytime I drove out there.

A few weeks into the visits, C. told me he wasn't feeling that great ever since he fell the day before. {REDFLAG} "fell, when and how did you fall..." {I tell myself not to freak out, but I am not a nurse and I know this is a serious thing. These are the kind of things that we are supposed to look for and try to prevent. This man was in his 70's and living by himself on a farm in the middle of nowhere. } He continues to tell me what happened and do what I'm supposed to do, call the office. The nurse that answered was in a meeting and told me to help him make an appointment to see his dr. So that's what I did. The appointment was made for the next day and a ride arranged. I finished with my visit and left.

The next week, his daughter had come to stay with him and stood and stared at me the whole time I worked with her father. It wasn't that she didn't trust me, but more that she didn't know what I was there for at first. C. Complained of neck pain and wanted me to work it harder. I knew I wasn't supposed work deeply with the elderly, so I did my best to make his neck feel better with out using too much pressure... but I started to doubt. This woman was watching every move I made, I still wasn't sure I did the right thing about the fall, and I still felt like I had screwed up with this gentleman from day 1.

All my fears were realized the next day when I was called by the director of the Hospice department. "C. has a hairline fracture in his neck. What happened with him at your visit" {ALARM! What! I worked on a man with a broken neck! Or worse, I'm the one who broke it! Oh god o God o GOD}

"Well, I massaged his shoulders..." I told her about the visit and I told her what I did after he reported the fall and that the nurse had told me to do. " I see. I will have to talk to the Dr and the Nurse about this further, but I don't think you should see him until further notice" {Oh god oh god oh god}

I lived in panic for two days. My mother, a hospice nurse, told me I did nothing wrong, and that it was most likely a pathological fracture (a break that just occurs on it's own due to illness. Often happens when cancer reaches the bones)..

..but still... what the hell was I doing here.

The reports came back and it was show it was not my fault. It was like my mother said. I did everything right (mostly). I should have gotten him to the dr sooner, but I was following the nurses direction (as I am supposed to) and the fracture was due to the cancer reaching his bones, which we were unaware of a the time. I was given advice on how to massage in that situation and continued on with my job.

That situation was very freakish. I think had I not doubted myself from the very beginning, I would have made better decisions, but that's only conjecture. I have found that you usually don't have clue what you would do in any traumatic situation until it actually occurs.

It gives me the shivers sometimes to think about how I thought I had broken a mans neck with the slightest of touch, but in the end, it was a part of my education. The kind you only get by doing and that can never be learned completely by reading it in a book or blog or what have you.

The Power of Perception

M. has cancer. They almost all have cancer of some sort. She had just gotten back from a long stay at the hospital and she and her family had decided to stop all treatment and enter hospice. She was weak, she could barely walk. She used a walker to get a around her condo in a house coat, because it took a lot of energy to get dressed, so she saved her energy and only got dressed when she needed to.

I started working with her legs and feet intially because she didn't like that they had gotten swollen with her long stay in the hospital. I told her I would do what I could, knowing full well that the swelling in the legs is a hard thing to reduce at this stage.

Two to three weeks later, the swelling in her legs and feet had noticably gone down and she thanked me. I was frankly surprised, but I knew massage could help, so accepted the thanks gracefully. A few weeks later, M. was walking around with out her walker and only usuing the furniture for support when needed. She was energtic and feeling very well, not to mentioned dressed when I arrived. She attributed this renewed energy and ability to walk to the massage. I smiled and thanked her for her confidence in me, but assured her it was her hard work that brought her to this point, not just the massage.

After a couple months I notice M. is out visiting friends more often and leading an active live. It wouldn't seem that she was part of a hospice program. At the end of the 6 months I arrive for a visit and M. is beaming. "I've got some good news and some bad news!" she says. "I just heard from the doctor, my cancer is in remission!" This is great news. It is rare that I get to see a client get better. "The bad news is, I won't be in hospice anymore, so I won't be able to get your massages! I know that it was your massages that helped turn things around!"

I thought about that. Of course I told her that massage wasn't the only thing that was working in her favor, but later I got to thinking about people perceptions. I thought about all those placebo tests and 'postive thinking'. This woman feels strongly that my work helped to heal her, at least into a remission. I know this is not biologically possible for massage on it's own to stop a cancer growth.. but her perception is different.

It got me to thinking about how other things in life don't really work if you don't believe in them either. I'm starting to wonder how much the medicine, therapy, doctors visits, etc play a role in healing and how much of it is your brain or just luck. Either way, M. is living up the days she has been granted and thanking me for the oppertunity.

The polite thing to do would be say "Your Welcome" so.. "Your welcome, M. I did my best and was happy to help you."

Small Towns and Childhood Mysteries

Two thoughts:

My first private client in this town died yesterday. I am glad. E. was in terrible pain even though we did what we (hospice) could to help her. Curiously, besides the day I was stuck to near tears by working with her, I am handling like I handle the deaths of my other clients. I think that is probably good.

Besides, a new patient was added to my roster. His wife is one of my clients. I guess I've lived here long enough where this is going to start happening more regularly.

*******

I guess growing up I heard the word cancer and never new what it meant. I knew that it meant you were eventually going to die. I knew that it usually started in one area and sometimes went someplace else. It was so mysterious and the implied meaning that it was terrible way to die was only explained by the sigh, nods and silence after someone said the word.

I know a lot more about cancer now. I know about the cellular process involved in mutations and 'mets' and some other biology stuff. Knowing that stuff doesn't really help though... All it tells you is what happened. It doesn't tell you 'about' it.

What I've learned from hospice is that cancer is painful, and the treatment the clients received before entering hospice were as bad as the disease. That people can live with this pain for years or they wake up one day after living in what they thought was a reasonably healthy body with a stomach ache and find that their body is riddled with cancer and subsequently die a week later.

How do you prepare people for that? You could live 5 more years or a week? There's not any way to know, really.

Some people just never wake up.

Yesterday, my cousin died. This is the first family death after starting work with hospice.

Of course the situation is completely different than a hospice related death. My cousin died suddenly for no appearant cause. My uncle is guessing sleep apniea, but I don't think they know for sure. The way I recieved the news was a bit of shock as well, because I haven't spoken to my uncle in two years, and that was at funeral of my grandmother, so there wasn't really 'talking' going on then, either. I didn't know who it was when he called.

I get calls telling me that someone died all the time. I got one this morning in fact. It's kind of like getting call that says, you can come in late to work today. It sounds odd and cold, and while your sad, you also know that your visit schedule has just changed and you need to make adjustments.

So when I took the call about his death, my first reaction was to make a note of it and say "okay, thanks for letting me know". It took me a second to realized this was more than that and then I completely flustered. I remembered to ask when the services were, but not where. And I didn't even think about getting a phone number encase there was questions.

I'm strangely sad and not sad about the situation. I can't say that I was close to my cousin, but that shouldn't matter. Maybe working with hospice has given me tools to handle personal dealths as well as those related to my profession. Maybe I'm cold and heartless... but I doubt it.

The Audience

When I walked into E's home, it was filled with children. Her eldest daughter was there with E's grandchildren and they were preparing their lunch of brats and potato chips. I smiled and walked around the scooter that was deposited on the floor and headed back to E's room.

E was sleeping through my work with her today, so I didn't get to talk to her very much. I like to talk to the clients while I'm there and learn a little bit about their history. I find that it usually is a good distraction for them, and it sometimes ends in laughter, which we all know is the best medicine.

I was having a little bit of a frustrating day today and was disappointed that she wasn't able to respond, but I tried not to let the time be about me, and stay focused on her care. As I was working I heard the mother say to the children, "why don't you go in with the massage therapist and watch her" My first thought was "are you kidding! I'm trying to work in here!" and then I heard the mother say "she can show you how to give grandma a massage"

Before I let myself feel inconvenienced or grumpy about it, I told myself. "This is why you are here! Do your job!" So I welcomed the five children into the room and showed them what I was doing. I encouraged them to give their grandma a massage and for them just to remember to be gentle and reminded them that it would feel really good. I told them to practice on each other"

I hope that I accomplished two things today. I hope that I gave these children a way to connect to their grandmother in the time that she has left. I hope that I helped them realized that you don't have to be afraid of touching a dying person. They are so young and this is the time when these ideas about life and death start to form. I hope I helped these children as much I am trying to help E.

Second, I hope that I helped the field of massage therapy. I wished I had been more prepared today to teach the children today. I want my community to know about the therapeutic affects of massage and the uses of it outside a spa. I think introducing this to the grandchildren could possibly change or form their views on the craft, which will change the future of massage.

It is a huge struggle for MT to be funded for hospice these days. I'm lucky that I actually get paid. Most hospices rely on volunteers, if they use MT at all.

It doesn't feel like a big day today. It feels like a long tired one. It feels like I didn't accomplish much, but maybe I did. Hopefully writing things like this down will help my realize the affect this work has on me and the world around me.

Frustration

I'm feeling very frustrated today. It having very little to do with the clients themselves, but the whole atmosphere of job. I am fairly sure that everyone runs into bureaucratic nonsense of being employed. Then why write about it? I guess because there is the added part where you are taking care of people, and their impending death is not waiting for you to figure out your vacation schedule.

I'm feeling frustrated because I wanted 1 day off, just 1. Just like everybody else gets. Well I got that day off, but I had to reschedule all my visits for that week on different days of the same week. I couldn't just not see them that week. Sounds reasonable, except I have three jobs, and few of these clients live close together. Well, I figure it out, but I screwed up, and had to redo it... but when I re-did it I forgot to tell the office and clients that I had changed it, so the client was expecting on the original day, the office was expecting me on the first rescheduled day and I showed up on the 2nd rescheduled day. Sigh.

This job is difficult enough as it is, and now I'm having trouble keeping track of what day it is. I'm so tired and it was so much work just to take one day off that I'm not sure that it will be worth it in the future.