Tag Archives: Life

Do’s and Don’ts Around People Who Are Wounded And Reeling

Posted by Dia in Living and Dying and tagged with , , , ,

L’Absinthe by Edgar Degas

I was thumbing through the journal I kept during the hospice years and came across this entry:  [Identifiers have been changed BTW.]

“Gertie was visibly shaken yesterday.  Her mom’s youngest brother, aged 94, died this past weekend and, as she stared down at the coffee table she told me, “I’m afraid she’ll go now, too.  She’s the last one you know.”   Grammy’s appetite has been off and Gertie doesn’t think she’s eating enough to survive.

She’s not.

All the other times when Grammy was going through one of her diminished-appetite spells, Gertie would worry and I would try to gently explain that loss of appetite is natural toward the end.  But she always acknowledged and dismissed the fact simultaneously.

The truth is she’s just not ready to lose her mom and I’m now beginning to suspect she never will be.  Watching her yesterday—the way she stared off into nothingness as she spoke, eyes turned inward, searching and frightened—I wondered how long she’ll survive herself, once her mother is gone.  I even wondered if she’d go first. [Gertie was 83 at the time.]  For such a strong, stubborn, tenacious woman she is remarkably fragile underneath it all.

And quite ill herself.

So yesterday I said nothing.  Didn’t ask her, “Are you ready for this?” Or say, “You know Gertie, she may be getting ready to go now.”  Of course she knows.  Shock is already starting to creep in, an early mist rising to help shield her from the unbearable loss lying just ahead.  Instead I just sat there, as still as I could.  Quiet.  Listening.  Trying to catch and contain as many of her scattering pieces as I could.

I didn’t want to move or breathe or do anything to disturb the tendrils of mist gathering around her.   She is so achingly delicate.”

As I read it all came back to me in a rush; how grieving people (and those who are catastrophically ill or dying) are sacred.  The wounding and shock caused by any kind of profound loss makes a person vulnerable; and a society’s traditional job is to close ranks around them, shielding them until they have a chance to stop reeling and reorient.  To get through the worst of it and find their footing again.

In older times this understanding of the sacredness of those in deep grief was fairly common, but I think we may have grown a little fuzzy about it since then.

Although…I do think most people still feel this sacredness instinctively.  I often see it in the awkward pause that happens after someone confides they’ve lost a loved one, or that they have a catastrophic illness.  The person receiving the news is usually aware that something huge just fell out of the sky right in front of them, but they frequently appear confused as to what they’re supposed to do about it.

So even though I frequently fail to follow these myself (they’re appropriate…not easy) here are a few of the Do’s and Don’ts about how to interact with a person who, through no fault of their own, has become temporarily sacred:

The DO’s:

1)  Do no harm.  The disorientation of the deeply wounded is the emotional equivalent of a compromised immune system.  Even if they try joking about it or brushing it off as embarrassing, remember that their shields have taken a hit and are not functioning properly.  Be gentler, be kinder, be slower, be quieter.

2)  Do acknowledge their wounding.  Go ahead and be silent for a moment, then look at them (really look at them…don’t shuffle your feet and look at anything else but) and say I’m sorry.  Then be quiet again. That’s it. This is the traditional ceremonial acknowledgement of wounding in our culture and, when genuine, it’s enough.  Even if it’s been years since their loss took place, it’s still okay to say this.  You’d be amazed how long some wounds can last.

3)  Do follow their lead.  If they feel like talking about it and you have time, then listen.  (Listening is actually one of the greatest gifts you can give.  People usually need to tell the story of what happened, or is happening, multiple times in order to coax events out of the weird, limbo world of shock and back into practical reality where they can harness and deal with it.)

On the other hand, if they don’t want to talk about it, then it’s okay to let it go.  They don’t have to.

And if, as is often the case, they don’t know what to say and stumble around awkwardly searching for words, then just be quiet and patient while they figure it out.  Let them know you’re fine with awkward. Wounded people are bewildered and need extra time. Giving it to them willingly is like encircling them with a protective charm.

Which leads us to the final Do:

4)  Do be willing to be silent.  Sometimes words just aren’t big enough and, in that case, compassionate silence says everything necessary.

Then there are The DON’Ts:

1)  Don’t give advice unless specifically asked.   Everyone has to find their own way through this one.

2)  Don’t abandon or ignore them.  Even if you feel awkward or uncertain yourself, being willing to stay anyway is worth it’s weight in gold. Wounded people already feel a little disembodied and unconnected.  Ignoring them could make this experience chronic or permanent.

3)  But Don’t rub their noses in it either.  Everyone grapples with grief and loss differently and if they prefer to deal with their emotions privately, then respect their ability to know what they need most.

4)  And finally, Don’t try to save them from their task.  You can’t…and it’s not necessary anyway.  Wounded people are vulnerable, not incompetent.  Believe in them. The journey of illness and loss is hard but it can be strangely deepening, too, and those who navigate it with courage and grace enrich us all.  It’s more than worth our while to give them whatever help they need.

copyright Dia Osborn 2011

Hmmm…An Agnostic Reports A Light While Dying

Posted by Dia in Living and Dying and tagged with , , , ,

I recently heard a fascinating dying story.

A woman told me how her elderly mother…either a scientist or an engineer (I can’t remember now, sorry) who was hours from death, drifting in and out of consciousness and totally non-lucid even when she was conscious…began to report on what she was experiencing internally, in a disembodied kind of voice.

It seems the discipline of a lifetime dies hard.

What struck us both was that the last thing she communicated was an experience of light.  She said There’s a light.  Twice.  Which seemed surprising because her mother was a firm agnostic.

The conversation paused briefly as we mused over this.  I mentioned that I’ve heard a lot about this experience of light (of course, who hasn’t?) but the scientist hanging around in my own head, while curious, has remained unconvinced  without further evidence.  The fact that her mother was a scientist and agnostic definitely carried some weight.

To which the daughter, who seemed to share her mother’s rational sensibilities, responded that it didn’t necessarily mean anything more than that her mother was having a visual experience of light.  There’s no way to know for sure what was causing it, and certainly no way to know if it was a sign of anything else.  And I got that.  There really isn’t.

But still…it comforted me.  I mean, seriously, out of all the possible experiences I can think of having to go through during my own transition, heading for light is definitely up there in the top three.  It sure beats seeing something like monsters coming to get me, or heading for a giant buzz saw, or disappearing into a gaping, empty, black void.

Light is good.  I’m all in for light.

And…if any such light turns out to be the precursor to something more cool?  Well, even the non-committal scientist in my head grins at the thought and says, IF that’s the case, then she’s totally on board, too.

Photo by Zouavman Le Zouave at Wikpedia

copyright Dia Osborn 2011

That “thing” in the header

Posted by Dia in Living and Dying and tagged with , , , , , ,

Someone has finally asked about it.  I was beginning to wonder.  It’s been up for the last…what?…nineteen months now, and just when I was concluding from the uninterrupted silence that nobody else found it as arresting as I do, Nel over at Life’s Infinite Possibilities (with stunning headers of her own btw) said…

What’s that “thing” (for lack of a better word) on your header?

Here she is in full.

I believe she was an arthropod of some kind but I can’t be more specific than that.  I found her exposed just as pictured, over on the coastline of the Olympic Peninsula three or four years ago. A seagull–or perhaps one of the many eagles that inhabit the place, I don’t know–had taken a couple bites out of her before being interrupted, maybe by the hubster and I as we meandered up the shore.

By the time I reached her side, she was still alive but mortally wounded. I found her extraordinarily beautiful…the colors so vibrant on an overcast, dreary March day that they took my breath away.  She was a tiny, dying spot of brilliance in a wild landscape of muted grays.

She also vaguely reminded me of female genitalia.  Like orchids do, only with an arthropod’s twist.  It both tickled my sense of humor and made me ache for her vulnerability all the more.

After I took the photograph I cupped her oh-so-gently in my hands, walked down to the water, and placed her right-side up again in the sea. She curled a little when she felt the stones beneath her…the cradling of the water…and I like to think she was happier there. Safer. Like the difference between dying peacefully at home, surrounded by the familiar and loved, versus upside down and alone in a car crash on the side of an anonymous interstate.

Here she is right-side up and back in the sea.

A little farther down the beach we also found a dead seal that was only beginning to decompose.

I originally planned to use this photo in the header but it never felt right.  Looking back now I think it’s because my primary focus here is on dying rather than death.  Both are profoundly beautiful to me, but with as much as I love the stars and stillness of deep night, it’s the elusive magic of twilight…that impossible alchemy that occurs as something is changing its very state of being into something else…that haunts me.  I guess that’s why I’ve always been drawn to transitional environments like coastlines and twilight hikes and storms and hospice. Because they provide portals into the strange, limbo world of transmutation where I can then observe and try to document its mechanics, firsthand.

copyright Dia Osborn 2011

TRUE OR FALSE? “Talking about dying will kill you.”

Posted by Dia in Living and Dying and tagged with , , , , ,

FALSE.  Talking about dying is non-toxic and perfectly safe for all ages.

I hit this wall a lot though, because deep down the majority of people believe it’s true.

In polite company, when it comes up that I’m writing a blog about…well…the “topic” (maybe if I don’t say the word, you won’t run)…I usually get a blank stare, long pause, and visible squirming, followed by an abrupt change of subject. Some people even turn around and walk away without saying a word.  (Which I admit makes this topic a valuable extraction tool in a pinch.  For anyone seeking to escape a chatty person, its eerie power of repulsion does have uses.)

In any case, there’s rarely an opportunity for a follow-through discussion.  The conversation is dead before taking its first breath and, so far, this hurdle has stumped me.  That’s why I spend so much time poking around the carcass in my mind afterwards, trying to find another angle which might induce more people to join me.

For instance this morning I was chewing on the common question; I’m not dying yet.  No one I know is dying yet.  So why should I think about it now?

This, of course, is the unstated question behind most blank stares and…I’m not gonna lie to you here…it’s a good one, possibly the most important question of all.  In spite of my flippancy, I fully understand why people don’t want to have this discussion: Talking about dying is a courageous act.  In order to do it, you have to stop running, turn around, and face the very monster that IS someday going to kill you and all your loved ones.  Let’s face it, as conversations go, it just doesn’t get much braver than that.

So when I broach the topic to someone who’s half-dressed at the next locker, or trapped next to me for three hours on a plane, or suddenly choking on their turkey over Thanksgiving dinner, I understand their reluctance.  I do.  I realize I’m asking them to start thinking right now about a real-life horror flick that at best they can delay, but will never escape.

Which brings me back to the question, Why should they?  The reasons had better be compelling.

Well they are.  And actually there’s just one:

It’s so they don’t have to spend their whole lives dragging the deadweight of this secret dread behind them.  Once a person learns how to talk comfortably and freely about dying, they can finally stop looking over their shoulder and relax a little. Living every hour, every day, year after year, with a yawning, existential, chronic fear…even if it’s kept pinned down in the subconscious most of the time…is draining and toxic.  Denial can help for a little while, sure, but ultimately it has huge downside.  Huge.  Trust me on this one.  As a long-time phobic I know.

Courage is a far better option and, while it’s harder to muster initially, it makes up for it by having no downside.  None.  In fact, courage not only eases the fear around talking about dying, it actually makes the event itself a whole lot easier to deal with when it finally arrives.

So when I grin at a 31-year old cashier and say Hey!  What do you think about this whole dying thing anyway?  It’s not because I’m the Grim Reaper’s administrative assistant trying to schedule an appointment for her.  It’s only because I’d like to ease some of her fear about the whole thing.  I’m willing to stay and hold her hand.

Facing into any fear shrinks it, and facing into this fear–as early in life as possible–can improve every day that follows in a way that most people don’t even know is possible yet.  I mean, how could they know when nobody ever talks about it?!

Sheesh.

So, what would make you more likely to stick around and have this chat?  If I said:

1)  I write a blog about dying.

2)  I write a blog about talking about dying.

3)  I write a blog that can help ease your fear about dying.  (Actually, is that even true?  You’ve read this.  Are you less afraid of dying now?  More afraid?  Unchanged?  Are you at least more willing to talk about it?  Are you even there?  Hello?  Hello?)

If anyone else has ideas about how to broach the topic of dying in a way that doesn’t repel everything within a hundred yards, I’m totally up for suggestions.  (And please don’t feel you have to be serious.)  Comments are even more welcome than usual on this one.

Thanks.

copyright Dia Osborn 2011

P.S.  The terrifically fun photo above is from Ambro’s Portfolio.

Suicide in Ohio results in the death of dozens of exotic animals.

Posted by Dia in Suicide and tagged with , , ,

What a tragedy.

I just learned that a man in Ohio who kept a large number of wild animals as pets, turned them all loose late yesterday afternoon before turning a gun on himself.  The carnage continued from there.  Witnesses called in sightings of roaming lions, tigers, wolves, and bears, after which local law enforcement, with consultation from the Columbus Zoo and other agencies, were given the order to shoot on sight.

As of this writing, the majority of the dozens of wild animals the troubled man set free are now dead.  Of course it could have been even worse.  Additional innocent bystanders in the area, both human and animal, might have easily added to the count.  I’m grateful…I really am…that the ripples of this bloodbath were stopped before they could spread any farther.  But I’m still sobered and deeply saddened by this unspeakable waste of life.

And also…uneasy.

There are clear signs that suicide rates are on the rise since the recession began.  Yet, even while the levels of economic stress and fear are heightening instability, federal and state funding for mental health (which was nowhere near enough to begin with) is now being slashed or eliminated entirely.  Needless to say this is not a promising combination.

IF YOU’RE CONSIDERING SUICIDE: Please, if you’ve wondered if it might stop the pain, or if those you love would be better off without you, or if you just feel so out there on the edge that you’re not sure you can take anymore, please…before you take a last step that can never be undone, make at least one phone call; to a loved one or a friend or a hotline.  (I’ve listed some suicide hotline numbers below.)  If it doesn’t work, you haven’t lost anything by trying.  But if it does work…if, with some help, you’re able to find a way through the current darkness back to a life you love…then not only will you be safe but you’ll also have protected everything you care about most from any taste of the kind of carnage that happened in Ohio yesterday.

FOR FRIENDS OR LOVED ONES:  And if you’re worried about someone else, you can also call one of the numbers listed above.  Or click here for an excellent article with information on what to do if you think someone you know may be considering suicide.

With things as stressful as they are right now, and with the social safety net growing ever weaker, we need to look out for one another more than ever.  I realize the temptation is to get angry over what happened to these beautiful animals and look for someone to blame.  But it would probably do more good to look for others who are still in need of help instead.  Maybe we could prevent something like this from happening again.

My heart goes out to everyone surviving yesterday’s events; Mr.Thompson’s wife and family, their friends and neighbors, the police who were forced to shoot the innocent animals involved, the officials who had to make the difficult decisions, and the remaining animals who have to endure the trauma of loss, fear, confusion, dislocation, and possible euthanasia this has caused.  I wish everyone involved strength, clarity, and forgiveness in navigating the coming days.

SUICIDE HOTLINES:

National Suicide Prevention Lifeline:  In the U.S., call 1-800-273-8255

Veterans Suicide Hotline – Confidential Help for Veterans: Call 1-800-273-8255 and Press 1     http://veteranscrisisline.net/

Or go to  http://suicidehotlines.com/ for a list of hotlines by state as well as a hotline for the deaf.

Sometimes the small picture IS the big picture.

Posted by Dia in Living and Dying and tagged with , , , , ,

Actually, most of the time it is.   But it’s easy to forget.

There’s nothing quite like the reality (or threat) of dying to help clear up any misunderstanding on this point.  I saw that a lot.  In almost six years of working with hospice I never once saw a person at the end of their life still wishing they could meet a celebrity.  Or win the lottery.  Or grab fifteen minutes of fame.

You know what they did long for?  (Besides wishing they didn’t have to die of course.)  To see their child or friend one last time.  To make sure their spouse or partner knew…really knew…how much they loved them.  To still be a part of the circle. To be in their own home, surrounded by their own things, and cared for by people they knew they could trust.

It hit me every time, how all the events that were happening in the big wide world…things that just a little while ago had seemed so huge, overwhelming, and important to them…telescoped down to the tiny, the few, and the essential.  It was a revolutionary insight.  I’d somehow completely missed this lesson before; that the small things ARE the big things.

Something reminded me of it again this morning.  A couple of YouTube videos have been hanging around my inbox for quite a while now.  They’re both on the long side, ten minutes or so, and…really…who has time for that shit?  I can’t get to all the real stuff that needs doing.  The only reason I didn’t delete them outright was because they were from people who might ask if I’d watched them.  And I suck at lying.

I’m pretty good at procrastination though.

But this morning the guilt set in so I watched them both.  And, lo and behold, what used to happen in hospice happened again.  I had the weirdest sensation of the world turning inside out (where big things get small and small things grow huge) and then I suddenly remembered what’s really important.  Yes, the broader world is something of a mess right now, but there are always plenty of little things going on in it that are perfect and beautiful and right.  And if I just remember that, then all the chaos in the universe can’t stop me from being grateful for my life, or for the many small but essential miracles that fill it.

So…if you ever have some extra time:

The first video is the story of the spontaneous boat lift that happened on 9/11, when a random flotilla of boats materialized out of nowhere to evacuate the hundreds of thousands of people trapped in lower Manhattan that morning.  (If you only have time for one video, make it this one.  It helps heal something that’s still, after a decade, surprisingly raw.)

The other video is a David Letterman segment about a young woman and her horse who got between a charging grizzly bear and the boy it was about to kill, and actually charged the bear.  Twice.  They saved the child’s life.  It’ll blow you away.

Editor’s note:  The original embedded video was taken private so I’m supplying a link to the interview which has been posted on Youtube instead.

copyright Dia Osborn 2011

Bone Monsters And The Evolution of Vocabulary

Posted by Dia in Living and Dying and tagged with , , , , ,

In the spirit of Halloween, here’s a spooky story.  And because I am who I am and can’t help myself, there are a few thoughts on dying that follow. (It’s like a tic.)

Without further ado I give you:

My Son And The Bone Monster

One night long ago, on a full moon in July, Father was away on a business trip leaving me, his pregnant wife, and our just-turned-three-year old son alone in the house to sleep.  It was a warm and peaceful summer night, not the kind where spectral things usually wake and wander, yet my sleep was restless and I woke up several times during the night to glimpse something shadowy passing down the hallway outside my bedroom door.  Each time I shook it off and went back to sleep, thinking it was just my imagination playing tricks on me.

In the morning I was jolted from slumber by the high-pitched screaming of my son, and I threw back the covers, leaped out of bed, and ran down the hall before I was even half-awake.

I entered the room to find him wide awake and sitting bolt upright, his back pressed hard against the headboard of his bed.  The bright morning sun streamed through the windows illuminating the entire room, yet he was looking into the empty corner near the foot of his bed as though he could see something.

As I approached the bedside he dragged his eyes away from the corner, looked at me and screamed, “It’s a bone monster!  A BONE MONSTER!!”  And I, of course, responded by doing what every good mother does; I tried to reassure him that nothing was there.  That the suspicious corner was actually empty, that bone monsters don’t really exist, that he’d just had a nightmare.

But he only shook his head in frustration, looked me straight in the eye, and said in a low, urgent, rational kind of voice, “No, Mommy.  Not that kind. This is a REAL bone monster!!!”  His voice rose back up to a scream by the last word and he raised his arm and pointed into the empty corner, as though the proof was right there before both our eyes.

That did it for me. The hair rose on the back of my neck and I climbed onto the bed, scooped him into my arms, and pressed my own back against the headboard.  I flashed back to the strange impressions I’d had during the night, of shadowy things passing down the hallway toward his room, and the coincidence gave me just enough pause to quit telling him he wasn’t experiencing something.  His terror was certainly real.  He’d done a remarkable job for a three-year old of communicating that he understood what a nightmare was and that what he was currently experiencing was something else.  I respected the effort and decided to bail on a rational approach and go with maternal instinct instead.  Here’s what She had to say:

Honey, he’s facing a monster here.  Imaginary or not, are you gonna let this thing fuck with your child?

Well, not when you put it like that.  No.

So I planted myself firmly on the bed, gripped my trembling son against my chest, and crooned ferocious words of protection into his ears.  It’s not gonna get you, sweetheart.  I won’t let it.  I will rip that freaking monster bone from bone…tear its head off, smash it down in the street, and run over it with the car a million times…before I’ll ever, EVER, let it get anywhere near you.  And trust me, I meant every word.

I continued along these lines until Bone Monster seemed to throw in the towel and leave.  I realized we’d won when my son suddenly relaxed, looked up, and told me he was hungry. Hallelujah.  We got up, got dressed, and traipsed out to the kitchen to make pancakes.

As far as I know, the Bone Monster has never returned.

Now, I don’t know why my son and I saw the things we did that night but, since it never happened again, not knowing doesn’t matter.

What’s more interesting to me is that my son called what he was seeing a Bone Monster.  Frankly, the term confused me at first.  (And apparently, only me.  Everyone else who hears the story immediately recognizes that he’s describing a skeleton.)  But when I realized what he’d done…that in lieu of the word skeleton which he hadn’t learned yet, he’d put two words together that he did know, bone and monster…the linguistic elegance of the feat just about knocked my socks off.

Think about it for a second.  The two words he chose had a lot of depth.  Both are multiple use, ancient words that have existed in pretty much every language since the dawn of time.  Bone is steeped in anthropological and folklore traditions as well as modern medical and scientific understanding while monster, still used to describe everything from childhood scary things to giant construction equipment to the heads of despotic political regimes, is quite simply one of the greatest words of all time.  (In fact, with the emotional relief its capable of delivering, I think monster ranks right up there with obscenities.  It can be that powerful.)

So separately they pack a punch, but putting these two words together created a description that was unbelievably sophisticated.  It conveyed not only a physical description of what he was seeing (a collection of bones-sans-flesh that were still arranged in the original shape of some kind of creature) but the intense emotional impact as well (monster–communicating supernatural animation, malice, and immediate threat.)

And it was all because he didn’t know the word skeleton yet.

But children do this all the time, you might argue.  So what?  And of course you’d be right.  Small children are wizards of language right out of the gate, which is probably why we usually take the sophisticated achievement that it is for granted.  I honestly don’t know why I woke up for a minute and saw it this time, but I did.  I goggled.  Positively gaped.

But here’s where it gets even more interesting.  The thing is; It’s not just kids who do this, falling back on old words to describe new things.  It’s what we all do, whenever we try to communicate about rare experiences. Common names don’t exist yet for uncommon things so if we’re going to try and talk about them anyway, we always have to cobble together existing language in a new way.

And, finally, here it comes…

This is what I feel like I’m up against when trying to talk about my work with the dying.  I mean, I have to use the word dying.  I have to.  Physiologically, that’s just what’s happening.  But it’s also a misleading word, because when I say dying most people hear horror + terror + suffering + death, and then they shut down and that’s the end of the conversation.

For a lot of people dying is the Bone Monster.

But it means something different to me.  After working around it a while, caring for and learning from the people who were doing it, the word dying gained more grace and lost some darkness.  When I say it now there’s still horror in it, of course, but there’s also something strange and luminous involved that takes my breath away.  Its terror is countered by first hand observation of our inherent reservoir of courage, and its suffering is buoyed by my discovery of unsuspected strength.

And death?  It’s still there, too.  But now its death + the dawning awareness that our lives are so irrevocably entwined…our dreams, emotions, cells, and breath are so deeply woven into the physical fabric of the world itself…that on some weird, tangible level that I can see and touch and smell and hear and yet still can’t name, we’re indestructible.

I guess for me, dying is the whole package now, instead of just its worst parts.  I think of it as both Bone Monster and everything that protects us from bone monsters at the same time.  It reminds me of my son’s bedroom that morning; where there was a terrifying source of darkness in the corner, but there was also a fierce, radiant bond of love on the bed. That radiant bond exists in the rooms of the dying, too, and I saw it over and over again, a benign force that seems to emanate from everyone involved but also from the environment.  Almost as though it’s structural, like something we’re made out of.

Sorry, that’s the best I can do.  I don’t have adequate language to describe it except in the most primitive terms, which is incredibly frustrating and part of the reason why I started this blog.  I realize I keep harping on this over and over again.  I think it’s just my way of trying to work out some viable language.

Currently, we have hundreds of common ways to describe the horrible aspects of dying but almost none that describe the beauty involved.  It’s no wonder so many people are still dying bad deaths.  Maybe if we start developing some language for the good parts, too, it’ll get easier to start building good deaths for everyone?

copyright Dia Osborn 2011

Disappearing Pools And Our Deep Love Of Places

Posted by Dia in Living and Dying and tagged with , , , , ,

Sunken Gardens inside Lehman Caves

Editor’s note:  This post is a sad one.  Sorry.  I tried and tried but just couldn’t get it to come out any other way.  I know a lot of people who are struggling with these kinds of losses right now (I don’t know, maybe we all are to some degree, there are certainly sweeping changes afoot…) and, while fear and anger are perfectly natural responses, I personally just needed the room to feel sad.  Thought I should let you know.  Dia 

Sometimes we develop relationships with physical places that feel as intimate and necessary as anything we share with people.  It can happen with a childhood home, the family farm, a neighborhood, a church, or a sports stadium.  A stretch of coastline or a forest behind the house.  A garden, an old tree, a park, or a mountain.

Opportunities for this kind of bonding are pretty endless.

And once we sink our roots into one of these places, losing it for any reason can also be as wounding as the loss of a human relationship.  Yet these kinds of wounds are seldom recognized or acknowledged for as serious as they are.

I’m not sure why we’re so resistant to admitting that losing anything other than a first generation relative can be devastating, but we are.  I’ve seen people reel just as much or more from the death of a friend, a pet, or the loss of a home, as from that of an immediate family member.  I’ve watched them struggle just as hard to climb back out of the resulting hole and rebuild their lives afterwards.  But I’ve rarely seen them granted the necessary room to grieve.  Our reluctance to accept and dignify these other losses is both powerful and entrenched.

(But then again, we barely give each other room to grieve the loss of a close family member so I suppose this isn’t surprising.  Y’know, we really need to stop doing this to ourselves.  Communities riddled with chronic wounds aren’t healthy for anyone.)   

I bring this up because I lost a place like this a few years ago.  It was a still, dark pool hidden in a cavern deep underground, and the loss of it is still haunting me.

My mother’s people come out of Ely, Nevada in Spring Valley.  It’s one of those little towns out in the middle of nowhere that you drive through and wonder Why in the world would anyone live here?  Five generations of my family have though.  Four inhabit the cemetery.  Seven have walked the streets of the place and, even though I never lived there myself for longer than a summer, I bonded to it like it was home anyway. It was the central, unchanging hub of my early nomadic life, the one and only place my family returned to again and again, no matter how many times we moved or how many homes we abandoned.  Its high desert, mountainous lands became the geographical North Star off which the rest of my life was mapped.

Surprisingly, underneath those dry, desert lands…winding through a vast system of tunnels and caverns carved out over millions of years…is water.  A lot of it.  And when these subterranean aquifers are relatively full (as they have been for aeons), they seep up to the surface as springs, creeks, and small lakes that support an ancient and delicate ecosystem that would quickly perish without them.

This secret water also collects in countless pools underground that are, for the most part, eternally hidden from human view.  But a few of them are accessible.  When I was growing up there were a number of such pools in the Lehman Caves at the base of Mt. Wheeler which is a little over an hour’s drive from Ely.  The caves were discovered back in 1885 and when my great grandparents first moved to Ely in the early 1900’s, they used to go over and take the “tour” that was available back then.  It involved miner’s carbide lights and crawling through tight cracks (with colorful names like Fat Man’s Misery) to access the spectacular caves that are a part of the system.

Lehman Caves, Mt. Wheeler, and its surrounding lands are such a treasure in fact that they were placed under protection in 1986 and declared Great Basin National Park.

Every generation of my family since the great-grandparents has toured the caves, and it was during my own childhood visits that I became acquainted with a particular pool.  I could never see very much of it because the water stretched back into a recess outside the range of the electric light illuminating the walkway.  But what I could see of it was dark and absolutely still.

Now, some of the pools in the caves tend to ebb and flow with outside water conditions, but this pool had been there far longer.  It stirred something old and unsettled inside me as I learned about it.  How the pool was thousands of years old.  How it had always existed in total darkness and never reflected anything.  How it had never known a current because no wind ever touched it, no living thing ever swam in it, and no water ever flowed in and out to create one.  It seemed so lonely and pure to me.  So dark and foreign.  And yet, in some deep, secret place way down inside me, it was familiar, too.  Like being so sad, for so long, that finally you don’t even mind anymore, and so can be happy again at the same time.

Everything about it mesmerized me.  I wanted to slide my fingers into the water and wiggle them in that dark wetness but didn’t, because the rangers said it would harm the pool somehow and I didn’t want to hurt that still, silent, ancient thing.  It had a tangible presence that enfolded me in a sense of age and weight and peace.  It both soothed and suffocated me a little at the same time, and as a child I responded.

I fell in love with it.

Eventually, I grew up though, and there followed a gap of decades where I didn’t return.  When I did finally go back, I discovered something unexpected and devastating.  My secret, ancient pool was now half empty.  It was slowly draining away.

As the explosive growth taking place hundreds of miles to the south in Las Vegas demands more and more water to support its expansion, aquifers from farther and farther north are being tapped to supply it.  The local water tables are dropping as a result and the dark, beautiful pool I fell in love with as a child is just one small example of a much larger kind of collateral damage taking place.

The system of large, interconnected aquifers that exist throughout the Great Basin is fragile.  If more water is pumped out of it than is flowing back in, the system sustains structural damage.  Caverns can collapse without the support the water gives them, but an even greater harm comes when the layers of soil dry out and ground subsistence sets in.  The sinking, hardened, compacting earth no longer allows enough water to filter down from the surface to refill anything.  There comes a point where the aquifers can no more be recharged with water than a dead human skull can house another living brain.  As with biological life, the ancient, geological processes that created these systems only work in one direction.  In a very real sense, aquifers can die.  Indeed, this has already been the fate of the aquifers of the Las Vegas valley itself, which is why the desperate city has been thrusting its pipelines northward.

And standing there that day in the Lehman Caves, watching my dear little pool slowly drain away, I couldn’t bear to think about what was happening, much less see the evidence of it with my own eyes.  I finished the tour, climbed in the car, and then left the cave, the park, and the state behind me and stayed away for a few more years.  Eventually though, I couldn’t bear that either and I’ve gone back to the park a number of times recently, but I still haven’t been able to make myself go down to the caves.  A park ranger told me that the pool I loved is gone now and sometimes I wonder if I’ll ever go back in.  I spend my time up on top of the mountain instead, where the vast changes taking place below haven’t shown up yet.

In my years with hospice I learned how to be around human dying, how to navigate all the emotions that our final passage entails, but this is different.  Geological dying is so achingly slow.  When a person dies, no matter how important or how beloved they are, it happens and then it’s over with.  Even a long dying process finally ends and then survivors can move on with the tasks of grief and rebuilding.  Sooner or later they can climb back out of the shadowlands into sunlight.

But this? These aquifers, these ancient systems, take so much longer than that.  The disappearance of my pool was only an early symptom of a dying process that could continue for…I don’t know how long.  I don’t even know how to define when they’re alive and when they’re dead.  What does the death of a geological system look like?  They don’t have heart beats and brain waves so what am I supposed to measure instead?

I think that I’m still reeling from the loss of that pool because on some deep, genetic level I can’t make sense out of it.  I don’t have any ancestral memory for this kind of thing.  My predecessors didn’t survive global shifts of this magnitude and speed often enough to pass down the instincts I now need to navigate them.

I guess what I’m really trying to understand is this:

What am I supposed to do now?  What is the last person standing at the end of a thousands-and-thousands-of-years-long line of people supposed to do when the music suddenly stops with her?  What is my duty as witness here during the dying of a small, dark pool and the larger changes that it entails?

And as I wrote that last sentence the answer suddenly came clearer.  I guess that is what I’m supposed to do now…just bear witness and continue to love these places.  I need to do the same thing I did while working with hospice.  I never turned away from those rooms, never refused to look at those who were dying or tried to pretend like they weren’t.  I didn’t ignore or abandon them.  I was there to help and to care.  To listen and touch them as many times as they still needed to be heard and touched.  To witness their dying and affirm their lives, and to catch and contain as much of the wonder and miracle of them as I possibly could, so I could carry it forward in my own life afterwards.

I guess it’s time for me to return to the empty pool now.  I need to go back and touch its dry, limestone bed, to remember and say good-bye, thank you, and I really, really miss you.  And, for both our sakes, I also need to keep visiting, touching, and caring about the caves and mountains and high desert lands that I love so much.  Because no matter whether it happens in my lifetime or some far-off day in a different age, the dying of these places was never meant to stop my loving them.

In closing, here’s a photo of one of the larger, ebb-and-flow pools.  Beautiful, no?

Great Basin National Park Photos, Lehman Caves

copyright Dia Osborn 2011

Links about the impact of a pipeline:

Will Federal Study Save Great Basin National Park?

Sparks Tribune:  Wandering Water

Dane the Mangy Rescue Mutt And A Surprising Miracle With Homeopathics

Posted by Dia in animals and tagged with , , , , , , , ,

Poor guy.  Poor us.  It’s been a struggle since May.

Dane is a big, black, mixed breed, Humane Society adoptee that we’ve had for (let me get the paperwork out to check) five and a half years now.  He’s almost seven years old and weighs in at over a hundred pounds.  He’s smart as a human toddler, playful as a puppy, imaginative (seriously…he pretends), loves children, kills small animals, is a mortal danger to cats, is cooperative and good natured, can’t get enough of people, and is constantly underfoot because he likes to be in on all the action (unless he’s sneaking tomatoes out in the garden at which point he becomes all but invisible).

He’s also had more medical problems than any dog I’ve ever owned.  We’ve dealt with everything from excessive drooling, incontinence, and hair loss to multiple accidents and epilepsy.  It’s always something with him.  Always.

But this year has been the worst.  He blew out his back knee in May, which was kind of catastrophic for both he and I because we haven’t been hiking together since.  His recovery has been complicated and slow, and I’m trying to come to grips with the fact that he’ll probably never be able to romp across hills and mountains the way he used to.  (Of course, said romping is probably what destroyed his knee in the first place, but still.)  If he can someday at least sniff and explore along trail-sides, I’ll consider us very lucky.

Around the same time our orthopedic problems were developing, we also lost control of his epileptic seizures.  Dane has grand mals and, not only was their frequency drastically increasing, they were beginning to consistently cluster in multiple events.  For those who don’t know, clusters are bad because they don’t give the brain enough time to cool off in between seizures, which can lead to brain injury and even death.  This was happening in spite of a drastic (and I mean drastic) increase in medication.  The seizures also contributed to re-injury of his leg, and the pain levels from that were growing increasingly difficult to manage.  He was losing his appetite, refusing to eat and, sometimes, even refusing to take his (many, many, many, many) meds.

The situation was clearly Spiraling Out Of Control (SOOC) and it was at this point I decided to change vets.  Old Doctor had been our vet for sixteen years so switching wasn’t easy.  However, other than surgeries and continuing to increase the dosage of his meds, (which clearly, to me anyway, wasn’t working), Old Doctor had no other options in his tool kit.  And when I asked him if he was willing to work with me in looking for other options, he told me no.

Wha…excuse me?  No?  Just…no? 

I was admittedly a little nonplussed but still appreciative of his honesty.

So I plunged back into the searching-for-a-new-vet world with a heavy focus on alternatives and eventually discovered our new vet, Dr. Out-There.  (You want options, baby?  I’ll give you OPTIONS…)  This woman was a banquet…a freaking cornucopia…of other possibilities, and after walking up and down the buffet line a few times I settled on a couple of new treatments to try.

You know what she suggested for his epilepsy?  A homeopathic remedy.  A small blue bottle of some kind of tincture with a dropper as delivery system.  Now, I’m not unfamiliar with homeopathics.  I’ve occasionally used them over the years on myself and the kids, with varying degrees of success.  But for advanced epilepsy?  Frankly, it seemed like a stretch.

However, I dutifully went home and administered the required dosage (plus a little more because one or two dropperfuls just didn’t seem like nearly enough) and, lo and behold, Dane has not had a seizure for 42 days!  Not one.  Which has floored me.  They were coming nine days apart in clusters but now?  Nothing.

(So far anyway.  Knock on wood.  I hope I’m not jinxing this by writing about it.)

It’s been like a miracle.  I can’t begin to describe the relief we’ve been feeling around this house since they stopped.  We’ve also had an orthopedic brace custom-made for his leg and it’s made a huge difference in terms of protecting his knee from re-injury and giving the joint support while it slowly heals.  (It’s also kind of sexy looking.  People keep walking up and telling us that, from a distance, they thought he had a bionic leg.)

The pain is still an issue but we’re able to manage it with a fairly low dose of acetaminophen.  And as for his appetite?  Well, it’s still off but it turns out that has nothing to do with pain.  Far from it.  No.  Our boy isn’t eating his dog food because he’s eating gallons of garden tomatoes instead.  (And yes, gallons is a literal measure.)

At first, I couldn’t figure out why I hadn’t gotten one ripe tomato off of five heavily-bearing plants all summer long.  Then I started finding the chewed-on but uneaten green ones he left lying around because he’d eaten so many by that point he’d actually grown picky and would only eat the red ones.  (He’d turned into a connoisseur.) That was when I realized what was really going on.  He wasn’t hungry for his dog food because he was engorged from grazing in the garden.

Well this clearly had to stop so, after erecting a bewildering maze of barriers (which utterly failed), Dane was placed on strict house arrest with only monitored visits to the backyard.

But he’s still refusing to eat.  You see, he got used to the chicken bouillon and other moist and delicious tidbits we were putting in his food to try to get him to eat and now he’s not interested in plain dog food anymore.  He’s become a picky eater.  He walks up to the bowl, sniffs a couple times, then turns and walks away to the backdoor where he collapses and lies looking longingly out at the tomatoes.  (Did I mention he’s dramatic, too?)

But…ha ha!  Little does he know he’s dealing with a mother who nipped the picky eater tendency in the bud with her other two human children early on in their little lives.  This cunning mother has a technique called hunger and, given enough time, it always, always works.

I’ll admit that he’s still wining so far because I think he’s sneaking windfall apples back behind the straw bales when he’s supposed to be pooping.  But it doesn’t matter.  I’m patient.  Unlike Dane I know that, sooner or later, this other food source will dwindle and then, my friends, he’ll be at my mercy.

Oh yes.  He’ll eat his dog food again.  And like it.  This, I promise.

To close, here’s a little video of him in his better days. 

copyright Dia Osborn 2011

The Difference Between Email Forwards and Blog Forwards

Posted by Dia in Living and Dying and tagged with , , ,

Snopes.com

In my pre-blog life I was a serial email forwarder, an affliction which had a few stages to it.  (Did anyone else go through these or was it just me?)

1)  There was that heady flush of realization as I started receiving my first forwards. Whoa! Did you see all the information and creativity just floating around out there?!  Stuff that I’d no idea existed and no access to before my first email account.  At this point I knew…I just knew…I had to pass it all along.

2)  Followed by the scary warning email phase.  (Predators in mall parking lots, governments publishing cell phone numbers to marketers, flashing headlights gang initiations…oh my!!)  I passed these on because I cared dammit.  I cared!

3)  Hard on the heels of this came the righteous discovery of Snopes and other urban myth websites (for which everyone on my contacts list was deeply grateful.)

4)  After which I turned to the jokes and inspiration lists…with one caveat.  I would not, not, forward chain emails.  The “send this to ten people and something amazing (or terrible) will happen” type.  These things are totally passive aggressive and, really, I must draw the line at guilt.

5)  Then came Videos.

6)  After which I reached the Links stage, the final phase.  This was the point at which I’d grown from a forwarding sapling to a mature tree, achieving maximum speed and efficiency.  I discovered I could litter the inbox of everyone I knew with simple URLs, like seeds, that they could then open and read for themselves.  (Or not.  Usually not.)

I was completely out of hand and knew I needed intervention.  So when a professional contact suggested I start a blog, the idea fell on fertile ground.  (I guess this is also the creation story of how The Odd and Unmentionable came into being…The Odd Book of Genesis.)  And it worked.  I had a new focus and my forwarding days came to an abrupt and blessed end.

But wait.  Did they?  Have I really stopped passing along ideas, humor, creativity, and information or have I now reached the most respectable (and respectful) phase of this impulse?

As I was preparing today’s post I realized I’m still forwarding other people’s ideas and creativity in various blog posts, only now I’m 1) doing it with full acknowledgement and links back to the source, and 2) placing it into the public arena where the horse can drink at will (rather than bombarding anyone foolish enough to trust me with their email address.)

I guess that ole’ desire to share just won’t be denied.  Nor should it be of course.  I shudder to imagine a world where we were all gagged and no longer able to trade insights.  That would be hell.

So, for today’s forward, here’s a moving and provocative piece I found blog-forwarded over at Rangewriter.  (Linda covers a broad range of topics.  The common thread to all her posts is the consistently thoughtful, beautiful writing.  Wander her blog if you get a chance.)

Because her post was perfect just the way it was, I lifted the whole post…with her permission…and re-posted (i.e. forwarded) it here.  So, from Bronnie to Bill to Linda to me to you:

Bronnie Ware’s Essay (from Rangewriter)

I came across the following essay on A Dying Man’s Daily Journal. (Quick editor’s note:  Another amazing blog.  Worth checking out.)  He had reposted it from an email he recieved. It is so perfect and so central to what I believe, that I want to share it and pass the word. Thank you, Bill.

By Bronnie Ware

For many years I worked in palliative care. My patients were those who had gone home to die. Some incredibly special times were shared. I was with them for the last three to twelve weeks of their lives.

People grow a lot when they are faced with their own mortality. I learned never to underestimate someone’s capacity for growth. Some changes were phenomenal. Each experienced a variety of emotions, as expected, denial, fear, anger, remorse, more denial and eventually acceptance. Every single patient found their peace before they departed though, every one of them. When questioned about any regrets they had or anything they would do differently, common themes surfaced again and again. Here are the most common five:

1. I wish I’d had the courage to live a life true to myself, not the life others expected of me.
This was the most common regret of all. When people realize that their life is almost over and look back clearly on it, it is easy to see how many dreams have gone unfulfilled. Most people have not honored even a half of their dreams and had to die knowing that it was due to choices they had made, or not made. It is very important to try and honor at least some of your dreams along the way. From the moment that you lose your health, it is too late. Health brings a freedom very few realize, until they no longer have it.

2. I wish I didn’t work so hard.
This came from every male patient that I nursed. They missed their children’s youth and their partner’s companionship. Women also spoke of this regret. But as most were from an older generation, many of the female patients had not been breadwinners. All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence. By simplifying your lifestyle and making conscious choices along the way, it is possible to not need the income that you think you do. And by creating more space in your life, you become happier and more open to new opportunities, ones more suited to your new lifestyle.

3. I wish I’d had the courage to express my feelings.
Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming. Many developed illnesses relating to the bitterness and resentment they carried as a result. We cannot control the reactions of others. However, although people may initially react when you change the way you are by speaking honestly, in the end it raises the relationship to a whole new and healthier level. Either that or it releases the unhealthy relationship from your life. Either way, you win.

4. I wish I had stayed in touch with my friends.
Often they would not truly realize the full benefits of old friends until their dying weeks and it was not always possible to track them down. Many had become so caught up in their own lives that they had let golden friendships slip by over the years. There were many deep regrets about not giving friendships the time and effort that they deserved. Everyone misses their friends when they are dying. It is common for anyone in a busy lifestyle to let friendships slip. But when you are faced with your approaching death, the physical details of life fall away. People do want to get their financial affairs in order if possible. But it is not money or status that holds the true importance for them. They want to get things in order more for the benefit of those they love. Usually though, they are too ill and weary to ever manage this task. It is all comes down to love and relationships in the end. That is all that remains in the final weeks, love and relationships.

5. I wish that I had let myself be happier.
This is a surprisingly common one. Many did not realize until the end that happiness is a choice. They had stayed stuck in old patterns and habits. The so-called ‘comfort’ of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content. When deep within, they longed to laugh properly and have silliness in their life again. When you are on your deathbed, what others think of you is a long way from your mind. How wonderful to be able to let go and smile again, long before you are dying. Life is a choice. It is YOUR life. Choose consciously, choose wisely, choose honestly. Choose happiness.

“We tend to forget that happiness doesn’t come as a result of getting something we don’t have, but rather of recognizing and appreciating what we do have.”
-Frederick Koenig

Thanks to everyone involved in this chain of insights, especially those who were dying.

copyright Dia Osborn 2011

How Thinking About Dying Is Helping Me Navigate Life

Posted by Dia in Living and Dying and tagged with , , , , , , ,

Rudder

This week I got a surprise dividend from all the time I’ve spent thinking about;

1) how I’d like to die, and

2) how to explain it to a loved one making choices for me.

But in order to explain the dividend I have to go back to the beginning of the year.

As I relayed in False Positives Are The Tenth Circle of Hell, starting in January the hubster and I endured four stressful months of an unnecessary prostate cancer scare.  What I didn’t mention in that post was that, during Month Three of this ordeal, I went in for my first mammogram in eight years and afterwards received a call back informing me that I needed to come in for further scans.  The radiologist had questions and wanted a second look.

I felt like I’d just been slugged.  I was already grappling with the onset of a depressive episode because of the fear and uncertainty surrounding the hubster’s prostate scare and I quickly realized there was no way I could simultaneously navigate the stress of a second scare without going down for the count.  I decided to postpone dealing with mine until I found out what was going on with the hubster’s.

Which was easier said than done.  The aggressive barrage of phone calls and letters that followed pressuring reminding me to schedule an appointment for further treatment only pressed me deeper toward the depressive episode I was fighting to stay out of.  (What’s up with that anyway?  People with real cancer don’t get that level of follow-up.)

Finally, we received the news that in spite of an elevated PSA, the hubster’s prostate was actually perfectly healthy.  The last four months were “just” a scare.  As I described in my post about the incident at the time, I didn’t feel relieved.  I felt conned.  Not by any of the people we dealt with…everyone was genuinely concerned and trying to help…but rather by a system that had gone horribly wrong for us.

Clearly, I needed to understand how it went wrong so I could navigate my own health scare differently.  I started researching.  What I discovered dismayed me.  First, I learned that the PSA test isn’t even FDA-approved for cancer screening, and the fact that it’s been widely deployed for that purpose has been the subject of controversy for over twenty years.  The jury is still out on whether the benefits of mass testing justify the resulting high rates of over-diagnosis, false positives, and over-treatment.

Then I moved on to mammograms and found some equally disturbing news.  Mammography neither prevents nor cures breast cancer and, while there does seem to be a modest benefit in decreasing mortality, the length of time screening actually extends lives has yet to be determined. Yet estimates for false positives run anywhere from a conservative 60% to a radical 90% of all callbacks, and some say over-diagnosis of breast cancers that would have regressed on their own may run as high as one in three.  Over-treatment is rife.  But the harm caused by all this is only just beginning to be studied.

Now, there are a lot of people who feel that if even one life is saved by all this over-doing, then any harm it causes is worth it.  And I really appreciate the fact that they value life that highly.  Because I do, too.

However, being one of the harmed myself now, I can’t help but feel some reluctance to continue the project.  While I’d dearly love to help save that one life, too, I can’t afford a descent into depression every time the system makes one of these frequent mistakes.

So with all this on my mind, for the last six months I’ve been considering what other course I could chart for myself; researching, sifting, weighing, and waiting for the voices battling in my head to reach some kind of consensus. On the one shoulder I’ve had all the aggressively pro-mammogram voices screaming, Go for the call back, woman! You could die! You could DIE!!  While on the other shoulder I’ve had my own voice warning, Careful Dia. You could easily slide into a depressive episode here that you can’t climb back out of.

(BTW, for those of you who asked what I meant by exercises for developing emotional endurance, this is an example.  I had to sit and hold hands with some incredibly uncomfortable, even frightening emotions while waiting for my eventual answer to put in an appearance.)

Then this week, I suddenly remembered a choice I made seven or eight years ago about dying that immediately and completely put all the voices to rest.  In her book Talking About Death Won’t Kill You (great title, no?) Virginia Morris offered a question to use when trying to talk to elderly parents about end-of-life choices.  She suggested we ask them:

If something happens and I wind up having to make medical choices for you, would you rather I erred on the side of doing too little or doing too much?

First let me say, this question is worth its wait in gold.  I kid you not.  I’ve posed it to a lot of different people over the years and the answers I received have frequently surprised me. I think this one question alone could save a boatload of suffering, if everyone only knew and asked it.

But back to what my own personal answer would be if I was asked, the instant I heard the question it was a no-brainer.  If anyone ever asked me, I’d tell them to definitely err on the side of doing too little.  Always.  I’m just not wired for the game of brinksmanship involved in trying to grab as many extra moments as possible at the risk of getting hopelessly entangled in the medical interventions that make them possible.  While that kind of extra time is worth the risk for some (particularly those with small children or other dependents who still need them) at this point in my life it certainly isn’t worth it to me.

It’ll be enough for those who love me to know that I have no qualms about giving up extra time…years if necessary…if it means being able to live a full and vibrant life, journey through a meaningful dying time, and then die a peaceful, simple death at home surrounded by people that I love.

So.  What does this understanding I’ve come to about the end of my life have to do with the current choice I’m facing in the middle of it?  Well, as you’ve probably figured out by now, it’s essentially the same question, only in a different situation.

Faced with a questionable mammogram but high rates of false positives, would I rather err on the side of doing too little or doing too much?

And as soon as I realized what the real question was, I immediately knew the answer.  I’ll choose for the least medical intervention possible, because that’s who I am.  It’s actually the same choice I’ve been making my whole life, only without realizing it.  Clearly, it’s the one I’m most comfortable with.  

It’s why I gave birth to both kids at home and navigated two decades of depression without antidepressants.  It’s why, when dealing with any illness or injury, I start with the least invasive treatment first and then work my way up from there.  It’s why I’ve spent so much time exploring less-invasive forms of medicine to supplement my use of modern medicine.  And I think it may even be part of the reason why I was so drawn to work with hospice; because it’s the way to die that usually involves the least amount of intervention.

The whole realization was kind of blinding.  I mean sure, I’d been hoping for some kind of resolution but I certainly wasn’t expecting an answer that big.  Suddenly my entire life, as well as a huge chunk of medical decisions I’m going to have to make going forward, just got a lot simpler.  And why?  Because of something I learned about myself while considering how I want to die of all things.

That’s the surprise dividend I mentioned.  Not bad, eh?

So what will I do about the current situation going forward?  Well, I’ll practice weekly home breast exams and watchful waiting until my next check-up in December.  Then I’ll discuss the whole thing with my doctor and get his input on where to go next.

And then (this is unrelated but something I’m kind of excited about)…if he’ll let me…I’d like to initiate our first conversation about how I want to eventually die a good death and see if I can get him on board with talking about the whole idea.  (I don’t think it’ll be a big leap.  Dying is totally the topic on the table as soon as you start talking cancer screening.)  I like Dr. R.  He’s a nice guy and a good doctor and if he’d be my primary till the day I died, I’d be happy.  We’ll have to see if I scare him off though.  I’ve never done this before and don’t really know what that kind of conversation is supposed to look like, but still.  There’s no time like the present to try, y’know?

copyright Dia Osborn 2011

Update:  10/10/11  Looks like I’m not the only questioning  what’s going on.  New recommendations are being mulled over for PSA tests.  See following article for details.

PSA Exams Should End in Men Without Cancer Symptoms, Panel Says: 

A draft report, released today by the Health and Human Services Department’s Preventive Services Task Force, recommends against so-called PSA tests for men who don’t have symptoms that are “highly suspicious for prostate cancer.”

You mean him, dear?

Posted by Dia in Friendship and tagged with , , , , , ,

Most people have a few friendships that are based on different things.  Some are for having fun, some share a common interest, and then there’s always that one required for long, long talks that last well into the night (with or without accompanying beverages.)  These relationships may develop in childhood, at work, in the neighborhood, from traveling, from school, or even these days, online.

But the mother of all friendships is the one that’s forged in the furnace of life.  I have an old friend like this, a woman with whom I share a level of bonding similar to that between comrades on the battlefield.  We’ve been through a lot together.

A lot.

We first met when I was seventeen and she was nineteen, working together in the kitchen of what, in those days, was essentially a spiritual commune.  We wound up attending the same college, settling in the same small community, making similar bad first marriages, and bearing babies which we then helped each other nurse, care for, and even once…after an explosion of domestic violence…hide through the bad divorces that followed.

Afterwards, we were merry divorcees together for a couple of years, sharing in the wild and uninhibited adventures that a sudden release from oppression often unleashes. We ran laughing and naked together through woods and creeks, danced (also naked, it was a theme) around bonfires under moons, had lots of sleepovers drinking smuggled moonshine on late nights around the lake, and shared endless stories about the amazing lessons in kindness, respect, new ideas, repeating old mistakes, letting go, saying no (and saying yes, Yes, for godsakes YES!!!) we were learning from dating a variety of other men.

The stories from this period are nothing if not fun to tell.

Eventually, way down deep, beneath the many layers of wounding and rebelling, adventures and healing, we both discovered our inner loyal, monogamous selves.  We each found a trusted partner…really, really good men…remarried and, even though we’ve mostly lived apart for the last twenty years, have continued sharing and supporting each other through the wild adventures of our offspring who (seem to have inherited the fearless/high risk/high mistakes gene and) have amazing stories of their own to tell now.

I count this friendship, along with motherhood and a happy marriage, as one of the greatest gifts of my life.  I don’t how I got so lucky.

It’s long been the dream of this friend and I to wind up living together and seated in twin rocking chairs on a front porch somewhere in our old age. All the other details are sketchy (those wonderful husbands dead and kids traipsing across Argentina perhaps?) but every once in a while something pops up to help fill in the gap.

She just sent me this joke about three old ladies in a retirement home and, judging from the history the two of us share, something along these lines seems likely:

Three ladies were sitting in their retirement home reminiscing.

The first lady recalled shopping at the grocers and demonstrated with her hands, the length and thickness of a cucumber she could have once bought for a penny.

The second lady nodded, adding that onions used to be much bigger and cheaper also, and demonstrated the size of two big onions she once bought for a penny a piece.

The third lady said, “I can’t hear a word you two are saying, but I remember the man you’re talking about.”

Oh honey, do I ever.  Love you always, dear.

copyright Dia Osborn 2011

Funeral Processions and Other Reminders We Don’t Want

Posted by Dia in Living and Dying and tagged with , , , ,

Funeral Procession by Ellis Wilson (1950), Aaron Douglas Collection, Amistad Research Center, Tulane University

Yesterday afternoon, while driving home from the dry cleaners, I was stopped at a major intersection by the longest funeral procession I’ve ever seen crossing in front of me.  Fortunately for everyone involved, I arrived just in time to see the hearse leading the procession go by so I understood what was happening and relaxed into the wait.  But I’m afraid that if I hadn’t seen it, being in my usual hurry, I probably would have missed all the other, subtler cues and, since I needed to turn right into the very lane all the mourners were using, would have done something stupid like trying to cut in.

It’s been so long since I’ve seen a funeral cavalcade that I’ve apparently grown fuzzy on the signs and protocols.  I mean sure, I drove in one during my hospice years, but that’s different.  I knew perfectly well why all the cars were lined up and all I had to do was follow the one in front of me.  But encountering one randomly out on the road required a little more awareness on my part; first, an ability to recognize the nature of the event, and second, a correct response.  Without the hearse, I’m pretty sure I would have failed at both.

Once upon a time I used to know that the cars in a funeral procession all have their headlights on, even during the afternoon on a bright sunny day.  (Check.)  And that funeral attendees generally dress up in crisp, dark colored, Sunday-best clothing, even in the middle of the week.  (Check.)  And that all other vehicles not in the procession are supposed to stop and wait until the the last car has passed, no matter what color the light is. (Check.) And if I somehow missed all these other clues, then the motorcycle cop sitting in the middle of the intersection aggressively waving his arm at me should have dispelled any remaining confusion.  (I wasn’t going to go.  I was just inching.)

It must have taken a full three or four minutes for the full procession to pass by, and as I sat there and witnessed the rolling continuum of face after silent, somber face looking forward in their car without smiling or chat, I unexpectedly started to feel the loss of this clearly beloved life myself.  All of a sudden it hit me; a life was now gone.  A LIFE. GONE.

Poof.

And suddenly, there in the middle of my buzzing, mundane, household errands (that noisy rabble of small concerns that are forever hijacking my life) a breath of something ancient and cold blew across my neck…and blessedly woke me up again.

I was glad and grateful for it.

It’s so easy to fall asleep and forget how brief this opportunity is that I have.  To be alive.  With others.  With fingers to touch theirs faces and lips, and a voice to sing with, or whisper, or cry out in pain.  With eyes drenched in moonlight, ears drowning in music, flavors exploding all over my tongue, and a nose wrinkling over a whiff of some faint stink that thankfully passes as quickly as it came.

These are miracles…miracles!…so how in the world do they get eclipsed by a stupid hour of busy tasks I won’t even remember by nightfall, much less at the end of my life?  It’s just weird, how easy it is to take the raw wonder of being alive for granted.  And scary, how forgetting it runs the risk of stranding me in a sad and shallow life.

*     *     *     *     *     *     *     *     *    *     *     *     *     *     *     *     *

Later on while thinking about the whole thing, the question hit me.  Why is it that I haven’t seen a funeral procession in so long?  What happened to them all?  Are they really fewer and farther in between?  Is it a tradition that’s fallen from favor?  Here are a few possibilities that sprang to mind:

1)  The rise of cremations and scattering of ashes has become a popular alternative to burial in a cemetery.

2)  Memorial services (as an alternative to the traditional funeral, procession, and graveside ceremony) take less time, offer greater scheduling flexibility, and also pair easily with a cremation choice.

3)  Then there’s the fact that police escorts for funeral processions are being scaled back as municipalities find themselves strapped for cash.

These are all likely reasons to be sure, but I can’t help wondering if there’s something more insidious going on, too.  Over the decades, as a culture, we’ve taken to disguising and hiding the trappings of death as we transfer our attention to the increasing hope of medical cures.

For instance, in spite of the rise in hospice care, the majority of people still die in hospitals.  But think for a moment, how many times have you actually seen a body in there?  Ever wonder why?  It turns out there’s a special fleet of gurneys that hospitals across the nation employ, cleverly designed with a secret compartment where the dead can be tucked away from public view.  Then, when they’re removed from the hospital morgue to funeral homes, they’re generally transferred through low traffic areas and back doors.

So instead of people having to step respectfully aside–momentarily hushed and awed–as a still, sheet-draped form rolls down the hallway in quiet dignity, everyone can instead hurry along uninterrupted, brushing past a seemingly empty cart hiding all evidence that one of the greatest mysteries in existence has just occurred.

Could it be that funeral processions are disappearing for the same reason?  To eliminate unpleasant reminders?  And is this wise?  Do we really want to transform our world into a place where there’s nothing left anymore to wake us up?

I realize that a big part of the reason for hiding death is to spare us the experience of fear, dread, and helplessness that facing it entails.  But really, does anyone think that strategy is working?  It doesn’t seem like we’re less scared.  In fact, it looks like our fear is mounting which, when you think about it, is the more logical outcome.  People are always more frightened by what they can’t see than what they can. Once freed from the tedious burden of hard facts, a fearful imagination usually launches into the stratosphere, heading straight for the heart of the worst possible scenario.  Honestly, I think hiding the fact that people are still dying, thereby stripping us of any chance at familiarity, is actually making things even worse and scaring the bejeezus out of us.

Maybe we’d be better served by slowing down a little, taking a deep breath, and gently lifting the sheet again for a closer look.  Yes, that would be sadder, scarier, and harder to do.

Definitely.

But it would also be braver and more dignified.  Which is who we really are anyway, so why not just do that?

In closing, for those of you who, like me, may be a little sketchy on the correct protocol for funeral processions, here are a few links that might help:

Funeral Procession Traffic Laws

Should You Stop For Funeral Processions?

Right-of-Way of Funeral Processions

copyright 2011 Dia Osborn

A Childhood Portrait Reminiscent of Alice in Wonderland and A Question Of Emotional Endurance

Posted by Dia in Living and Dying and tagged with , , , , , , , , , ,

I’m the baby, fair budding to become a sunflower, second from left.  The young Queen Mother to my right is my only sister, while the boy doing the Winston Churchill imitation to her right is my middle brother.  Then there is the Eldest on the far left dignifying the portrait with his expression of Supreme Effort.  The youngest among us (who recently discovered this little treasure) was not yet born.

ABOUT WRITING:

LAST WEEK I RAN AWAY TO THE MOUNTAINS, and I think this is the first time I’ve ever missed posting on or around my Friday deadline.  Not a first-time I’m proud of or would like to repeat anytime soon.  I know there are tools available for scheduling a post to publish even when I’m gone so really, there’s no excuse.  (Not that I think it’s a life or death issue but still, the discipline is important for me as a writer.  So, note to self: research “scheduled publishing” tool and use it at least once before the end of the month.)

There.  Now on to the Easter Portrait.

ABOUT THE PHOTO:

My youngest brother became Guardian of the Box of Old Photos when my mother died a couple years ago and, during the ensuing sifting, has turned up a couple of gems like the one above.  We had no idea this thing existed.  Indeed, there are a whole series of Easter portraits that he’s uncovered, with a wide variety of outdoor backdrops (let’s play Guess What Military Base We Were Stationed At!), but this one clearly takes the cake.

The photo is of us but actually speaks volumes about my mother.  She was, like most women of her generation, trying to keep up with Jackie-O and, other than at Easter, we were always dressed in jeans and t-shirts, a fact that makes this snapshot-of-an-age even more absurd and delightful.

Ultimately though, I think it’s the accident of lighting that makes it most striking–we’re so illuminated it looks surreal, like we slipped down the rabbit hole in a string of held-hands and landed all dressed up in Wonderland.

ABOUT EMOTIONAL ENDURANCE AND THE DYING:

Moving on, I wanted to take a minute to answer a question about my last post.  In her comment afterwards, Linda over at Rangewriter asked what I meant by “emotional endurance.”  I thought it was a great question and, because emotional endurance is such a vital tool for dealing with difficult challenges of any kind, I wanted to address it in a regular post rather than just in the comment section.

Emotional endurance is just what it sounds like; the ability to endure one’s own emotions.  (Obviously, pleasant feelings don’t require much effort.  What I’m talking about are the painful ones like sadness, despair, anger, shame, loss, bitterness, guilt, regret, helplessness, etc.)  This skill was actually prevalent among the older generations but, during the current, unfolding age of budding-pharmaceutical options, has increasingly fallen into disuse.

And unfortunately, as a treat-and-cure cultural mindset has gradually replaced the older accept-and-endure one, the threshold of discomfort, pain, or uncertainty most people can continue to live and thrive with has fallen considerably.  Now…please.  I’m not saying medical advances aren’t a miraculous gift and blessing; they are.  Anyone who’d want to turn the clock back a century is, in my humble opinion, extreme.

However, there’s also profound value to be had from the old skill of knowing how to contain, endure, and navigate heavy emotions without needing to immediately escape them.  And nowhere was this made clearer to me than in the rooms of the dying.

In hospice I saw person after person after person, (all elders BTW,) deal with levels of emotional pain and loss that absolutely staggered me.  And, with only a couple exceptions, they ultimately did it without requiring antidepressants or a hastened death.  Over the course of their lives these people had somehow learned to navigate huge waves of overwhelm, fear, pain, and sorrow without losing sight of the beauty, love, and value that also populated their end.

I cannot begin to tell you what an eye opener this was for me.  I had no clue…no clue…how much stronger we are than I’d ever imagined, and if I could only pass on one bit of insight from all the wisdom I learned from the dying, that would be it.  Allow me say it one more time, because that’s just how important this is:

We are far, far, FAR stronger than most of us currently understand or believe.  By a multiple of thousands.  I know this, I’ve been there, I’ve seen it.  And I’m not talking about the rare hero, warrior, or saint, either.  (Although they are totally amazing.  Whew…)  No.  I’m talking about the rest of us.  All the ordinary, everyday, getting-along people like you and me that weren’t created for greatness; those of us who just want to raise our families, work a good job, have some hope, and live a decent life.  Us.

What I’d love to see is a cultural return to the recognition and development of this skill for emotional endurance, all the while keeping the growing arsenal of available treatments and interventions ready as back-up, just in case.  Y’know…for those rarer yet dangerous periods when life erupts into something that really is too much, too hard, too destructive, unendurable.

Can you imagine what we’d be capable of, what our lives would be like, what our world could become, with the power of inner endurance and medical relief at our disposal?

copyright Dia Osborn 2011

A Good Skill Set For Depressives (With or Without Drugs)

Posted by Dia in Depression, Living and Dying and tagged with , , , , , , ,

I’ve been living with clinical depression for a couple of decades now.  It can be challenging terrain…lots of sheer cliffs and deep canyons that are way too easy to get lost in, especially in the beginning when they can feel inescapable..but after twenty years I’ve learned how to get around.  Mapped out the local territory, made friends with the natives, and built a beautiful life there that I really love and am deeply grateful for.

I’ve done it without antidepressants.  And before anyone gets their panties all in a bunch, I’m not opposed to pharmaceutical treatment. (I so dislike that whole battle.  It’s divisive, distracting, and a waste of precious resources.)  It’s just that, back when I slipped into my first severe episode, I didn’t know what was happening to me.  Depression wasn’t the by-word it is today.  It took a while just to figure out what I was dealing with and, once that became clear, I still couldn’t afford long-term, continued access to drugs.

So it was fortunate I’d already pieced together an alternate treatment plan that was working for me.  It’s complex, eclectic, and tailored specifically to my life and strengths, so there’s no point in going into detail here.  But there were a handful of important skills I had to develop in order to make the whole thing work and I suspect they might be helpful no matter what treatment plan a person turns to.  So just in case that’s true, here they are:

A DEPRESSIVE’S SKILL SET:

1)  Develop emotional endurance.  A lot of it.  Do exercises.

2)  Trust your instincts, you’re not crazy.  Some studies have suggested that depressives actually have a more realistic view of the world than non-depressives.

3)  Question your conclusions.  Depressives can take that aforementioned realistic view (especially in a severe episode) and translate it to mean everything is futile and unbearable when it’s not.

4)  Develop emotional endurance.  Really.

5)  Depression annihilates confidence so cultivate stubbornness instead.  (Desperation is also a surprisingly effective motivation for short hauls but it’s tough on the adrenals.)

6)  Did I mention develop emotional endurance?

And 7)  Look for light.  It’s a discipline that can save you.  If you can’t find any immediately, then hang on to memories of old light until you can.  Living with depression is a lot like living at night.  Colors fade out and disappear during a descent, and the whole world falls into shades of gray.  But once you figure out where to look and start to see them, the stars in there will knock your socks off.

The Pillars of Creation

copyright Dia Osborn 2011