Monday, October 31, 2011

"Neither snow nor rain nor heat nor gloom of night ... in sickness or in health...

Halloween goes on.

For friends on the East Coast, hit with a bizarre snow storm...
(thanks, Emily)


and for kids and staff in the hospital.














Because there are simply not enough days for all of us to ignore certain realities in our lives - and just enjoy playing and pretending!

Hope you got to see goblins and monsters at your door as cute as these, but I somehow doubt it! I think we cornered the market!

Happy Halloween!

18 years ago

It was a friend who pointed it out.

"The photo you used in your blog header looks an awful lot like Natalie".

And, upon closer consideration, she's absolutely right.
There is a general 'je ne se quoi' about the image that brings her all back.

Natalie was one of our dialysis patients when I was doing my 20+ year stint as the Renal Social Worker.

She was a failed renal transplant from another Pediatric hospital - with multiple complications along the way that left her not only unable to be considered for another one, but intellectually challenged as well.

She was 6 - and therefore 'sentenced ' to hemodialysis - until some additional catastrophic event set her free.

Her family was rural - with all that implies: 'salt of the earth', 'down to earth', simple, hardworking, unsophisticated, good people.
We all adored them.

Natalie had darling red glasses and a quirky, high pitched voice which, during her dialysis sessions, would frequently ring out in "Donna, read me a story."

We were buddies and, while I loved spending time with her, she was also an 'attention sponge' who could suck everything you had to give right out of your bones.

But my time with her gave her mom and the nurses a break from her demands and I love to read... so hours were spent sitting next to her chair, entertaining her with voices and variations on a books theme until she'd say impatiently "Donna, do it right; read it as it's written; you can't change everything!"

Frankly, as much as I enjoyed her, she was one of the patients I was eager to escape when a friend talked me into going with her on my first European vacation: 10 days in Italy followed by 2 weeks in Switzerland - what's not to like about THAT, right?!

I wasn't quite as skilled then at leaving everything work related behind me as I am now, so I was surprised, and pleased, when, other than my kids, few people or situations I left behind entered my consciousness the whole time I was gone.

Until one of our nights in Zermatt, in the shadow of the Matterhorn, about 4 days before coming back to the States.

Natalie came to me in a dream and I barely recognized her.
She looked SO good - and happy and healthy.

The color of her glasses was set off by the all white outfit she wore: a white angora sweater with cables down the front, soft and fluffy looking, with those little angora hairs floating around her in an aura, and white wool pants; set off with red shoes, perfectly matching her glasses.
She was too damn cute!

I remember thinking how impractical her outfit was since, on their farm, with all their animals, white wasn't going to last even a New York minute!

She said she hated to interrupt and she hoped I'd had a good vacation but I needed to get back. She was fine, "better than fine actually", but her mom wasn't going to be doing so well.
She asked since I didn't have to read her stories anymore, could I do her a favor and call her mom as soon as I got back to work.

I woke up - bemoaning to my friend that my brain was already back in work mode; I relayed the details of the dream.

Neither of us got the implication.
Like I said: back then, I wasn't where I am now.
I wouldn't have missed it today.

I felt compelled to call her mom the minute I got back to work; that's when I heard the news.

Natalie had died the night she came to me in Zermatt.
Her mother was grief stricken to the point of being suicidal.
She had been briefly hospitalized, medicated and released home.

I drove out to their farm later that week - and told them about Natalie's 'visit' in Switzerland.
I think it helped - all of us.
Through our tears, we laughed at her wisdom that 'you can't change everything'.
You can only read it - and live it - as it's written.

And hope that, at the end, you have a great outfit like hers!

Sunday, October 30, 2011

Unnamed

I hadn't thought of it in years, although I remember the case.

As he spoke, his eyes were shadowed by images and memories that have haunted him for years; the kind that raise questions that stay with you 'til death and for which you pray for answers in the next life.

It was over 25 years ago that the headless, naked body of a young girl was found in the basement of an abandoned house on the South-side.

No amount of searching or forensic investigation (still in it's infancy back then) yielded any clues.
No follow up on missing child reports, no DNA testing; nothing provided this child with a name or a face.

The police involved in the discovery and investigation were profoundly affected; several left the force; those that stayed always were on the look out for the clue, the story, that might finally point them in the right direction.

All of them chipped in their own money to bury her.

But they were bothered by her being alone and unnamed.

Two decades later, a local Prosecutor started the Garden of Innocence, a site in a local cemetery in which children who are abandoned (dead in dumpsters and duffle bags) or unclaimed in the morgue are buried with dignity.

The Detective wanted HIS girl to be with other children who had traveled a similar journey;
he wanted her not to be alone anymore.

So he received permission from the courts to have her dis-interred and re-buried.

The only thing was, he said, when they went to the site where she had been buried, there was no body and no casket to be found.

He, and colleagues, have watched the original tape of the funeral, paced off the distance and recalculated markers and space; all to no avail.
She is missing.

When I said that maybe she can't rest until she finds her head - after giving me a crooked smile which said that only someone with too many years of dealing with this kind of thing could make that kind of joke and be understood - he replied that it made as much sense to him as any other explanation that's been offered.

My faith, and his, teaches us that we are ALL named, known and loved by our Creator.
No matter how this life maims and dis-members us, He will re-member and reclaim us as His own.

I pray that, in the only sense that truly matters, she has already been found and is safe at Home.

Angels on the evening shift

She was 18 months old, the daughter of a prostitute on the East side.

While her mother had been 'entertaining' a client in the back room of the trailer they called home, she had gotten thirsty and found a clear glass with what she thought was water.

It was, in fact, the glass of a candle, containing the clear liquid oil into which the wick is submerged.
As she attempted to drink it, she 'sputtered and gasped', sucking some of the oil into her lungs; oil which then coated the (lungs) lining preventing oxygen from being exchanged - known as a hydrocarbon ingestion and aspiration pneumonia.

Her mom found her unresponsive minutes later (s/p cardiac arrest).
She was flown to our facility and placed on ECMO (a fancy ass heart/lung machine which does all the work of breathing/living for you).


During the initial phase of her admission, a history emerged of mothers inability to adequately parent over the years - due to substance abuse and a string of abusive relationships; factors which led to the removal of her 4 older children.

This child was unknown to the system only because mother began using an alias while she was pregnant and DCFS "couldn't find her".

After three weeks of her daughter being on ECMO, with no discernable improvement and many setbacks, the treatment team started focusing conversations with mom exclusively on the limitations of treatment, the need to accept the inevitable and face the fact that her child was not going to recover.
As was to be expected, mom was not particularly receptive to this line of thought.

After days of Pastoral Care , Social Service and nursing staff attempting to support mother beyond her denial and a consultation with the Ethics Committee, the Head of Surgery declared that time was up: "Critical Care has become Corpse Care" and he stated that mom had until Monday morning to accept reality. There could be one more team meeting "but then the machine was being turned off and futile treatment discontinued".

The edict came out on a Thursday.

Pastoral Care and I told mother what was to be expected and this time, surprisingly, she accepted the time frame graciously, saying she trusted something good would happen; she'd gone to church the night before "for the first time in years" and she knew something good was coming.

On Saturday morning, I got a call on my day off, asking me to come back in.
Staff told me mother had a psychotic break overnight and was hallucinating.

I arrived to find mother in the PICU waiting room, positively beaming.
She excitedly told me that Jesus had come to her "in this very room" and promised her that He would take care of things; she didn't need to be worried about Monday.

Mother spoke of being mesmerized by his eyes; eyes that "pierced her soul and in which she saw forgiveness and a love she had never found on this earth despite all the men she had been with."
Apparently, Jesus promised he'd be back on Monday and she could trust Him to keep his word.
I didn't - and don't - think it's my job to dissuade someone of their reality, so I simply listened.

Keep in mind that 'back in the day', I wasn't where I am today spiritually.
To say I was skeptical would be a gross understatement.

In fact, in my subsequent discussions with staff, we attributed her 'vision' to a fugue state - you know those half awake/half asleep times when you incorporate snippets of conversation or external reality going on around you (like thunder, ringing bells etc) into your 'dreams'?

In other words, we discounted her reality completely and denied that anything remotely 'spiritual' was at play.

Mother went out that very afternoon to get her hair done "so she'd look good for Jesus on Monday".
When she came back, she insisted on the baby being baptized immediately.
She then asked that Polaroid pictures be taken of both of them, together and separately, and taped to the end of the bed, so Jesus would know where they were; "We don't want Him to get lost and go to the wrong bed, do we?"
(Leading all of us to snicker of course that if he DID get lost, it wouldn't say much about him being omnipotent and all powerful would it?)

On Monday morning, mother cancelled the meeting with the Surgeon, saying it wasn't needed -leading to angry phone calls from him to me, telling me "to get her to get it together".

Phone calls were also exchanged all Monday morning between me and Pastoral Care: a running commentary of derision and what we perceived as humor - "Hello, this is Mary, have you seen my son?" or "Hey, it's Wendell, has my Big Boss shown up yet?"
Such rich fodder; we were really loving it!

Right before lunch, I was cornered by the Surgeon in the 'PICU cone of silence' (a glass enclosed/virtually soundproofed room in the heart of the PICU) and instructed to "go get mom so we could get this over with it".

Since Mom was patiently waiting for Jesus at her daughters bedside, finding her was no trick - even HE could have done it!

When I went to speak with mom, yet one more time, and said, in my best SW voice, that I was really sorry but we needed to start the process of turning the machines off soon, she stated that Jesus had come to her again and told her "to hang on for the angels on the evening shift".

Mom requested that we wait until closer to 5 pm "since Jesus said they'll all be ready then".

Picture, if you will, the Surgeons expression when I went back to him with THAT piece of information!

It rendered him speechless - at least for a moment.
But then he got into the mood of the day.
He asked if the angels were working on 8 or 12 hours shifts and told me I'd better pray that none of those suckers called in sick because he had no intention of waiting for anybody to come back from a celestial FMLA.
He turned to leave the room, saying to call him when Jesus needed help.

At 4:30pm, staff gave pt another hefty dose of scheduled sedation.
Mother, Pastoral Care, two nurses and I were at bedside talking quietly with mother, supporting her - and each other - as she spoke tenderly to her daughter.

At 5:02, this patient (who had enough sedation on board to knock out a horse and who had had NO response of any kind for over 30 days), opened her eyes, purposefully looked into a corner of the room, smiled, waved her right hand - and flatlined.

Mother immediately began crying, saying she'd hoped Jesus was going to perform a miracle and restore her child to health so she could take her to local churches and Praise Him - but if He wanted to take her home with Him, that was OK too.

All of us immediately began looking around to see which one of us had inadvertently kicked the plug out of the socket!

NO WAY can you die on ECMO...
not without massive mechanical failure!

As nurses were frantically doing system and equipment checks and mother was crying, holding her daughter for the last time, Pastoral Care leaned over to me and whispered, "You do know we're going straight to hell, right?"

We all did what needed to be done: people notified, paperwork filled out, mother hugged and sent home - and then we debriefed - for hours; trying to understand what we had witnessed and mocked; trying to make sense of what happened, what was real.

I can't say what conclusions the others reached then or on subsequent days of reflection.
I do know this experience was a turning point in my faith journey, especially about "all things seen and unseen".

No, I wasn't where I am now back then, but experiences like this have helped - or forced - me to be where I am today.
And it's been a blessing.

The view (and the viewpoint) is definitely richer here.

Saturday, October 29, 2011

Hereafter

Do you remember the movie last year, with Director Clint Eastwood, starring Matt Damon as a former psychic?

A movie that posed some weighty questions:
What do you think happens when we die? What awaits us after our life here? Can we reach those who have gone before?

Questions that have been on my mind alot lately...and not just because of Andys death.

For those of us lucky enough to work in pediatric health care, these questions form the substrata of our days.

Questions that are always there but which never fully bubble up to the surface until we're standing with a grieving family at the end of a code, after their child has been pronounced dead, or as we sit vigil with them in the PICU, watching nurses care for the remains for a physical body after science would have us believe that the essence of a child's personality - his or her soul - has already departed.

And, if you're really lucky in your 30 year career, you have experiences that can't be explained, that don't get written about or made into movies.
Experiences that convince you, beyond all reason or doubt that the final tag line in the movie trailer is absolutely spot on:
"If you're worried about being on your own, don't be - you're not."

I don't think it's any coincidence that our thoughts turn to these issues in the fall; in the month of October to be precise.

A month in which various cultures and faith traditions celebrate Halloween (for the pagans amongst us), All Souls Day and Dia de Los Muertes, the day of the Dead.

Our souls are more finely tuned to the physical world than we'd like to believe and, in a season when we're surrounded by death in nature (no matter how glorious), it's only natural that thoughts of our own mortality would surface as well.

Last year, I decided to write about a few of the experiences I've had with death and several of you have asked to have them posted again.

So over the next few days - these days leading up to All Souls Day - I'm going to repeat a few: each dramatic, a mix of the funny and the macabre and all true.
At least for me.

You can decide whether they're true for you too.

Safe Bet

Barbie wasn't the only one
to celebrate the Cardinals victory
last night,
nor the only one
to regret it
today.

11 and 94 in 2011

In case you hadn't heard, 'Cardinal Nation' is celebrating this morning.

Last night after a wild, improbable, never-would-have-believed-it a-few-weeks-ago ride, our boys clinched the World Series and, even for someone who usually doesn't watch guys play games with bats and balls, the energy and joy is infectious.

I live 8 miles from the stadium and you could hear the fireworks from here - and throughout many neighborhoods during the night - or maybe that was just the usual gunfire...whatever!

This is the teams 11th World Series win - hence 11 in 2011!

But there's another story involving baseball bats that made me feel even better yesterday.

The ones that made a seasoned Detective cry?

Well, apparently the pictures and the reality of it all made Grand Jury members feel the same way.

Yesterday, they returned indictments on all felony counts!!
52 felony counts for the mom and 42 felony accounts for the boyfriend - hence 94 in 2011!

Trust me when I tell you that, when 'the system' works, it's better than winning some game!

Don't mean to minimize all the money that was at stake last night, but we're talking childrens lives here!! As even Master-card would say - Priceless!

And, while they don't make trophies for Detectives, Prosecutors and Child Protection workers on the front lines... this one's for you!!


Strong work!!!
(Insert the roar of the crowd in appreciation here!!)

Friday, October 28, 2011

Hell Kitty

Admit it...

there ARE times when a little pumpkin is simply no substitute for an "O"!

...while ye may


the roses are beginning a fall blooming
in the garden
of my mothers nursing home

she was anxious to show me last night

i strolled slowly
leaving at the gate what was once between us

somewhere in that garden
i lay my burdens down
but if you asked me where
i wouldn't remember


i am getting physically tired
of holding in the light
what has long been gone into the dark
and it's stupid on my part

yesterday is gone
and so is the past

over time
life tends to grow one up

thank goodness

Thursday, October 27, 2011

Scenic ghost

I was thinking about him as I was walking the dogs.

Actually there is rarely a day that goes by that, for some instant, no matter how fleeting, he's NOT in my thoughts.

But the article in the reservation paper made me reach for the phone to call him

A South Dakota ghost town's future is shrouded in new mystery.
A Philippines-based church recently bought the town of Scenic for less than $800,000.
The Iglesia ni Cristo church bought the town and surrounding acreage just west of the Badlands from a longtime resident and area rodeo legend who had gathered the land bit by bit over several decades .
The church isn't divulging its plans for the property.
A person answering the phones at its offices in Daly City, Calif., said he couldn't share any information.
So far, there has been no church activity in Scenic to hint at what's to come.
The lack of information surrounding the sale has some neighbors uneasy.
But some are hopeful the church will make a good neighbor and are excited about the possibilities.

And then, I remembered.

I would have loved to hear his take on it...
what speculations there would have been.

Will there be a cult compound? Some secret training site?
Our curmudgeonly conspiracy theories would have been given free range.

Over the years, the Mission trip group, with Andy and I at the helm, have spent hours in Scenic; at least it felt like hours!

Getting gas, trying to find a 'loo' and having other Missioners stock up on dry, dusty ancient packaged snack foods before heading to the Badlands National Park.

The memories felt overwhelming.

I miss Andy.
I miss my friend.

There's no one else who would find this piece of trivia in a small reservation paper even remotely interesting - and, at the same time, understand why it's so curiously odd.

Only one month in to not having him around forever - and not ever going to Scenic with him again...

I guess it's not surprising that I can't stop crying and, today, the idea of going on another Mission trip without him seems unbearable.

Wednesday, October 26, 2011