Abandonment

A “friend’s” brother has a dog – a funny looking dog – who was apparently left as a puppy. When you leave the dog alone, even for a bit, he goes crazy – barking, jumping up into the window to see you leave. It’s said. The poor dog has a fear of abandonment. He was left as a puppy, and now he’s afraid anyone who takes care of him or loves him or whom he loves will leave him for good.

Another friend of mine – an old teacher/priest – once said that, after observing plenty of people face death, that the only thing that seems to matter is how well you have loved and how well others love you.

Relationships are complex, for sure. And mistakes happen. But strong relationships are supposed to endure. They endure because they matter. Because the people involved care. Because when you commit to something, you stay committed. That’s supposed to matter.

When those commitments fall short, people get hurt. When they are terminated, people get destroyed. And that destruction takes its form in the feeling of abandonment. The feeling of being completely left alone by the one you love, and the one who used to love you. It’s terrifying how thoroughly you can be hurt by someone.

I’m the dog barking crazily. I’m a dog! I’m looking at the window at anybody I’m close to as they walk away, even if I know it’s just for a little while. I’ve now been abandoned.

Mistaken Identity

We’ve all heard stories about mistaken identity in the medical world. A patient gets the wrong procedure, or the wrong medication, or the wrong study…I can’t say I’ve ever been involved in anything even remotely serious – at least, not that I’m aware of – but I’ve had a few stumbles. I’ve had to ask patients which side we’re operating on, or make sure we’re doing the right surgery – it’s all part of the checks built into the system.

Just this morning I was trying to find a patient before the OR. The nurse handed me the chart and pointed to an elderly woman in a stretcher. There’s your pre-op, she said kindly. I opened the chart and started reading as I walked. Suddenly the chart was taken out of my hands and a new one put in its placed. Sorry, the nurse said, this is the correct chart. She gave a sheepish smile. No worries.

Yesterday afternoon I got an email that made me stop dead in my tracks and break out in a cold sweat. The title of the email was simply my last time, and the body of the email was a forward with several correspondences. I didn’t recognize the return address, but it seemed like he wanted me to review a conversation. He was a lawyer, a “family defense” lawyer. It seemed that his client – who shared my last name – was being sued for divorce by his wife. The emails were a series of conversations between lawyers who were trying to clarify the ugly details. Somehow it got forwarded to me by mistake.

I read it again. And again. And again. And every time my heart raced faster and my face got more flushed. This isn’t supposed to be me, right? Are lawyers trying to find me? Is my wife suing me? My heart was drowning myself out. No, it was clearly an accident – right? – check the names again. It’s just a mistake, but one that stung more than most accidents are capable of. It hurts to even think of it. It wasn’t me. Relax! It wasn’t me! But so close. Too close.

It’s a funny thing, to have your identify mistaken. And it’s odd to realize the different levels that it can be hurtful. There’s the simple insult of being confused with someone else. But there is also hurt in confronting the confused situation. Is it better or worse than my life? Is it too close to home? Is it possibly knife-piercing foreshadowing?

I hate being confused. I hate confusing others. Know me for who I am. And let me know you for who you are. Then, finally, there will be peace.

Community

An old teacher of mine – a friend, really – once reminisced on a job interview he had at a new school. And he remembers feeling this: that what made this particular school special was that he had an overwhelming sense that this would be a wonderful place to experience a tragedy.

It’s an odd notion to have during a first impression, maybe, but it’s an important feeling to have. Oftentimes it might be a school, or a church, or a workplace. But let me say this: it is also a wonderful thing to experience that feeling in a person.

I see a lot of tragedy at work. And I see a lot of different family dynamics take on that tragedy. I see people dying in the most dignified way, with their families and loved ones all around. And I see people dying who desperately want to keep fighting, and keep living. And I see people dye alone, without anyone there to love them except some doctors and nurses.

I often think – what will my death look like? Who will be there? I’m sure plenty of folks will stop by or be sad for a bit – but who will really be there with me? Holding my hand, and tying to make me happy, even at the last? And who wants me to be there at her death? Who really wants me there, offering my love, and my support? Anyone?

For a combination of reasons, I slept well last night. And I slept on my left, of all things, and even woke up that way. And today, for the first time in a long time, I felt just a little bit like myself.

Back Pain

Driving in the car this morning I realized how badly my back hurt. Back pain is something new to me – it wasn’t pleasant. But realizing why it was there in the first place was even less pleasant.

I love to fall asleep – I just love the whole process of coming to peace at the end of the day and realizing that tomorrow will come anew. The words of The Book of Common Prayer – so often uttered at Evensong in my childhood – wisp me away:

O LORD, support us all the day long, until the shadows lengthen and the evening comes, and the busy world is hushed, and the fever of life is over, and our work is done. Then in thy mercy grant us a safe lodging, and a holy rest, and peace at the last. Amen. (BCP)

So falling asleep is a peaceful thing. I hear these words and roll on my left side. I sleep on the right side of the bed – that’s my side – so I turn to my left so I can see.

The problem is I can’t turn on my left side at the moment because I don’t want to see. Because there is nothing to see – there is only emptiness. So I slide as far to the right as I possibly can and turn on my right. And it’s uncomfortable. And rather than hearing soft words of prayer and drifting slowly away, I grit my teeth and tense my back.

It’s no surprise then that driving this morning – a trip that is always shorter than I think it is – my back started aching. I tried driving faster, but I couldn’t help but notice that the ETA on the GPS never changed. How could that be? I even got stuck behind a truck near construction, and again the ETA never changed. I was trapped in that car for as long as it was going to take me. For a moment I felt I had lost any control on my life – on my sleeping, my psyche, my body, even where I physically was.

The only thing to do was keep driving. Eventually I would arrive at my destination. Eventually.

Burned

I’ve just wrapped up another month at the burn center. My rotations at that little specialty ICU over the years have managed to coincide with some emotional times in my life, and as a result they’ve proved the starting place for some important revelations.

Burn victims have the potential to be some of the sickest patients in the whole hospital. But aside from just that, one of the most difficult things for the families and friends is the total disfiguration of their loved one. Your skin is your largest organ, and when it’s violently removed it can have a devastating effect. Just last night I was asked by a women where I might find her dearest friend in the world whom she had traveled to visit. I didn’t know what to say – she was standing right in front of him. But his face was missing, and the tracheostomy tube at the base of his neck was a gruesome reminder that we were performing for him the most basic of human needs – breathing.

How could this be? Her pain was so clear. Just last week he was fine, working long and happy hours at his store, spending time with his family. She’d seen his recent picture on Facebook – on her computer she could still see his precious face and look into his eyes and feel that trapped happiness that was more temporary than he could have ever imagined. How can change come this dramatically, and this quickly? How is that even possible?

I have no idea. But consider this. As I started to walk away another family member, from two rooms down, popped his head out and tried to get my attention. He’d spent many evenings here, and I’d spent plenty of time speaking with him and his sisters over the long month explaining all aspects of our care. “Hey Doc,” he said as his eyes locked on mine, “thanks for giving us our mom back. She looks terrific.”

In every possible sense, the burn center is a transformative place. I guess I just never imagined myself being transformed there. Then again, if this line of work didn’t change me somehow, I’d wonder if maybe I wasn’t missing something. Lord knows, I’ve missed plenty of things before.

Answers

Last night I went to the bar again. Alone. I drank beers and watched the hockey game. I wasn’t saying much of anything – just keeping to myself, as I have been. A part of me wanted to talk, but I didn’t have the courage or the energy. Furthermore I didn’t have the right person to talk too. I prayed for comfort and peace.

A woman came and sat down next to me. She wasn’t quite old enough to be my mother, but she was pretty close. She was dressed kind of like a rural hippie professional, and when she ordered wine and pulled out a stack of papers and a pen, it became obvious that she was college professor doing some late grading. She made some idle chitchat – I was polite, but kept my eyes fixed on my beer.

Not what I had in mind, I said to myself, in the hopes that God would hear me. I don’t think this is what I need at all.

And that’s when she started talking. She actually lived in NYC, and taught sociology. She was down here visiting her mother, who lay dying at a nearby hospital. She, her brother, her aunt, and the medical community seemed not to be on the same page with regards to their loved one’s final wishes. “Organizational death” as she called it, was a terrible thing to witness. She went to tell me that this particular bar was where her family gathered after he father died, and she quietly – though desperately – hoped that maybe by coming here this particular evening her mother would peacefully die a dignified death.

Somewhere in there I understood that maybe, just maybe, I was actually the answer to her prayer, and that perhaps I was what she needed in that moment of grief. And I realized further that maybe what I needed wasn’t so much the right person to talk to or the right set of words to say – what I needed was to feel wanted. And at that moment, in that bar, I had a strong sense that I was, in fact, needed, and that I had a definite purpose, and a future to fulfill.

Footsteps

I took a walk today. Though I’ve barely spoken all day, I figured I didn’t have to stay in one place either. So I boiled some water, made myself some chi, put on my warm coat and scarf – an old gift – and walked.

I spend a lot of time looking down when I walk. I always do, actually, but more so these days. It probably started because I’m tall, so I naturally do things to compensate for that. I slouch. I know I have a tendency to stand with my feet relatively far apart, effectively lowering my eyes closer to the height of whomever I’m speaking with. But I know that when I walk I often just stare down. And I can actually picture my feet in different places. I can picture the hallways of one of our hospitals late at night, staring at my feet as they carry me to the next task - exhausted. I can picture my sneakers in a city in Haiti, in the mud of the earth, taking me quickly past the poverty and to the clinic where I attempted to do some good. And today I looked at my feet as they carried me away from my home and outside – away, anywhere.

Eventually I looked up. I saw lots of couples walking, some dogs, runners, bikers, and geese, which I’m told can bite if you get too close. I kept my distance. I looked out at the river as I finished my tea, with the skyline rising behind it. It was the perfect recipe to smack me with the sense of loneliness I was trying to avoid by walking in the first place.

So I came home. At least, I think this is home.