Thanksgiving!

It has been somehow on my heart lately how much of a Negative Nancy I have become. What do you do when you have realized that you fester on all the things that go wrong, all those things that are not working, all that which is broken? Fix your heart on those things that are good, true, noble, right, pure, lovely, admirable, excellent, praiseworthy....









1. My thanksgiving was a hit! Great Food. Amazing Friends. Beautiful Weather!
2. I only had to work until 12 o clock today.
3. Bethany and I spent all afternoon together. Gossip. Advise. Coffee. Cookies.

4. I love my brother enough to miss him like crazy now that he is not here.
5. My mom and I can disagree but are quick to admit wrongdoing and extend grace/forgiveness
6. My mom always supports me as much as she can
7. I have a job, and a job that will generously accommodate my upcoming school schedule
8. I have a boyfriend that pushes me to expand my bubble of comfort. (as much as I hate it sometimes)
9. Whenever I think about John Stager I smile.
10. I get to read about adventures my brother is entangling himself in almost daily. And I am reminded how much I long for something to challenge me like he is being challenged.
11. I own my car (and all the new noises it makes)
12. The dogs are finally being quiet... not a peep from either one of them
13. My cold has finally surrendered to my immune system.
14. I am reading two books at once
15. I really love my church. The music is great. The sermons are thoughtful and penetrating. The coffee is hot.
16. I finally switched to gmail.
17. Apparently I feel good enough about my microbiology class to procrastinate studying for my final another night.
18. It didn't rain today and my feet stayed dry all day.
19. Jacob Zuma is going to take an HIV/AIDS test "soon" to promote AIDS awareness day.
20. I am seriously contemplating bed at 930 on a tuesday. Shower first maybe.
21. There are so many generous people out there
22. Its 40 degrees outside and I have a warm bed to sleep in.
23. Its 40 degrees outside and I can get in a warm shower before climbing into a warm bed.

well, its a sad little list... but I suppose I got to start somewhere.

A Day Out With the Pups

Wednesdays with Agnes, Thursdays with the Boys

Wednesday nights I spend with a new friend, Agnes, a beautiful 90 year old blind woman who has recently been diagnosed with Alzheimer's. All the time I spend with her she is lucid and amazing. I am learning to see as a blind woman does, through sound and touch, long descriptive glances, smells, cadances of footfalls, and tall steps (the only way to walk along broken concrete). Its one of my highlights in the week. Agnes always asks me to bring something to read. She loves Poe, poetry and short stories. But mostly poetry. Especially if it rhymes. Well, and Poe. I have read The Raven several times. She loves it. So do I. She loves ghost stories, and literature. and music. I forgot how much she loves music. We spent an entire evening in front of the stereo, the volume cranked loud enough to feel the base in our chests, listening to Mozart and Beethoven and Bach and Barbara Streisand.
She loves to walk around her neighborhood at night when the crickets come out. "Listen to them getting all warmed up" she says. "Ooh, do you hear that one, that sweet little tweet tweet. What do you suppose it is saying." I try to be clever and offer up potential pick up lines one cricket is muttering to another. She laughs politely. We've gone to Lake Johnson twice to walk mostly around. I always stop at interesting plants, hold out her hand and pull a branch down for her to feel the leaves, bark, or berries. "Golly! Tell me what it looks like." I try my best at describing color and texture height, breadth. "I just love this." She says. And I admit Lake Johnson is so much prettier with my sweet blind friend with me. She found the beauty I couldn't see until I had to tell her about it. "When I ask to go to one of my favorite places, know that this is one of them." She tells me. My heart swells up a little.

And if Wednesday is, introspective, simple, slow, sweet, female... Thursday is the opposite.

Male, loud, fast, robust. And in its contrast it is delightful and amazingly fun. Chris and I and his roomie, Joanna, host a dinner weekly at his place for some of our friends. We eat more than we should, talk a lot of smack, and then we try to beat T and Chris at Corn hole. We only occasionally do the impossible. The rest of the time they dominate the game. (Chris and T really should be split up). Thursday we had Meatloaf, homemade mashed potatoes, snap green beans, and fresh cookies out of the oven. This week it is Chili, cornbread and an undecided dessert. And cornhole. always cornhole. Its amazing how natural friendships develop over food and games. And I haven't watched thursday night television since. (well, any TV for that matter... I dont have cable or a converter box... and I even though our neighbor offered to splice us into his cable, my roomie and I declined. We are excited to be free from the TV.) I just wish I threw a better cornhole game.

Go placidly amid the noise and haste, and remember what peace there may be in silence.

As far as possible, without surrender, be on good terms with all persons. Speak your truth quietly and clearly; and listen to others, even to the dull and the ignorant, they too have their story. Avoid loud and aggressive persons, they are vexations to the spirit.

If you compare yourself with others, you may become vain and bitter; for always there will be greater and lesser persons than yourself. Enjoy your achievements as well as your plans. Keep interested in your own career, however humble; it is a real possession in the changing fortunes of time.

Exercise caution in your business affairs, for the world is full of trickery. But let this not blind you to what virtue there is; many persons strive for high ideals, and everywhere life is full of heroism. Be yourself. Especially, do not feign affection. Neither be cynical about love, for in the face of all aridity and disenchantment it is perennial as the grass.

Take kindly to the counsel of the years, gracefully surrendering the things of youth. Nurture strength of spirit to shield you in sudden misfortune. But do not distress yourself with imaginings. Many fears are born of fatigue and loneliness.

Beyond a wholesome discipline, be gentle with yourself. You are a child of the universe, no less than the trees and the stars; you have a right to be here. And whether or not it is clear to you, no doubt the universe is unfolding as it should.

Therefore be at peace with God, whatever you conceive Him to be, and whatever your labors and aspirations, in the noisy confusion of life, keep peace in your soul.

With all its sham, drudgery and broken dreams, it is still a beautiful world.

Be cheerful. Strive to be happy.

Max Ehrmann c.1920

lament of stuff

So, I know I am actually due to write part two of "Trampin' " but it is something that demands a long quiet moment and a laptop. Well, my laptop crashed a couple of weeks ago. So I am tied to my roommate's desktop (for which I am so greatful I have the use of), and I just can't seem to really write here. On top of my lack of computer, my bike was stolen Saturday night. Although worth less, I miss my bike more. I was expecting the eventual crash of my computer, but who would take what isn't their's? I am so sad and mad about my bike. Yesterday I went over to Chris' for dinner (which is where it was stolen) and I caught myself looking around for it, as if perhaps it was a lost kitten that just got too far from home and was looking to get back in the fold. If perhaps I just called it sweetly I could have it back.

trampin' with the boys (part one.)

On Friday I took the day off from work to hang with some of the boys from downtown. Today they are teaching me how to live homeless. I met them at the shelter at 8 and spent 24 hours on foot, on the street. Its perhaps a silly experiment. How much can you possibly learn when at the end of 24 hours, I get to shower off the streets and climb back into a warm bed.... but perhaps in the interest of walking a mile in someone else's shoes, I'll walk 20 miles in someone else's shoes and spend 24 hours without my phone, my wallet, my car, my comforts of home, and put my trust in the experienced shoes of my friends. And a bit to my surprise I met a raleigh I didn't know and saw a raleigh I had not yet seen.

I met Michael and Ricky outside the Wilmington Street Shelter at 8 in the morning. We chatted it up with the large group of guys hanging outside the shelter getting ready for the role call of their drug rehab program being hosted by the healing place. A woman that Ricky and Michael knew was watching the men line up to have their names checked off a roster sheet.
"Now this is where you get a man" she said.
"you don't have to worry about getting them clean, you just have to worry about keeping them clean."
She launched into her plan:
"Now, you don't want to keep them too comfortable. Get 'em and then get 'em a working right away. Get 'em up early, give them breakfast, make them lunch and have dinner waiting for them on the table when they get home. But don't let them stay home and flip channels with the remote sittin' all up in the air conditionin'. They start to love how cool and comfortable it can be. What they should be doing is gettin' out there to struggle. Struggle hard. And make it. And once they've made it, well, come on home, baby, flip the channels and sit right down."
She looked up and down the line perhaps picking out which man would best fit this role for her.

It was time for us to be movin' on. We had to get to the "office" (Cornerstone) to check for mail and to make a phone call or two.
We walked through the projects and through the tunnels on the greenway. In the daylight it is a beautiful walk, but it is not such a safe walk at night my friends tell me. The bridges and breezeways are hot spots for smokin' and drinkin' and dealin' and other riff raff. Best to be avoided.
Pete and Mike, two acquaintances of Mike and Ricky's were sitting on a park bench on the walk to the office. Pete was nursing a large bottle in a plastic bag of some kind of cheap beer. He had had a few before that one it looked like. He got up immediately though and offered me his seat. quite the gentleman. The gossiping started right away, lots of "god-damn's" and "maderfucker's" and the latest info on everyone all flung around quick and sloppy. Quicker and sloppier than I could keep up with. It was all I could do not to just look like the innocent white girl sittin' on a bench.
The conversation eventually turned to Martha, a homeless woman who was recently murdered and perhaps raped downtown raleigh. The volume and severity of the conversation elevated. Pete was swaying and leaning and pacing and speaking passionatly on his own personal, very large, apparently rocking soapbox. "Rape is absolultly inexcusable. period." And he kept throwing an appology in my direction, as if the conversation was too raw and explicit for my ears. quiet the gentleman. "When a man can get a woman for the short of a cigarette and a taste of a forty... rape is just inexcusable." He glances again in my direction and appologizes again.

Our gossip eventully winds down and it was time for us to be movin' on.

We left the greenway with two more in tow and progressed down Saunders street, the "dirty south" Mike called it. We crossed streets haphazardly and without looking really for cars. "tramps don't watch for cars, steph." We see Reggie, another downtown friend of ours, coming out of a convience store. We crossed to say hello and then ventured in the store for Pete to buy a couple of beers. We all walked in the small, unkept store and mingled about. The boys visited and exchanged a lot of smack with the attendant, who was familiar with most of them. Pete put two cans of beer on his tab (??) and Mike and I admired a large wedge of cheese under a bell jar.
"have you had hoop cheese before, steph?"
"I don't think so."
"Oh, it is so good. It just sits there and sweats and its so delicious."
"I don't think I am a fan of sweaty cheese."
"oh no, you'll love it."

Mike gets Sam's, the attendant, attention and requests a dollar's worth of cheese. Sam pulls a large cheese knife from under the counter and cuts two wedges off the larger wedge under the display glass, wraps it in a paper towel and hands it across the counter to Mike. Mike hands him a dollar and hands me the cheese to pull a piece off to try. He was right, it was sweaty but delicious. The boys were hassling Sam in an attempt to win the last little bit of hoop cheese from under the glass for free.
"Come-on, Sam, whose gonna buy that little ol' piece? Wouldn't you rather just give it to us so you can clean that up and get a fresh hoop?"
Sam would not budge. Instead offered various dildos from underneath the counter. Blue beaded ones, pink vibrating ones...I was suddenly uncomfortable and walked out with the boys soon on my heals. We were still tryin' to get to the office, and it was time to be movin' on.

So it was down Saunders, across cabbaras, up boylan to Cornerstone. Everyone was recounting memories as we traveresed the ghosts of a life spent poundin' the pavement:
"I had a job there in '78".
"I had some kind of summer job in '78, I think."
"It used to be all blacks and indians down here."
"There is an injury lawyer that lives there in that house. He gave me a case of wine once. It was some cheap ass ol' wine, but we drank it."

Its 10 o clock when we finally stroll into the office.
For a brief moment I felt Uganda in the air as we walked up. There was an older woman, tall and deeply black refolding and stacking clothes into a garbage bag. Her hair was intricatly braided, twisted and piled on top of her head. I think it was the way she was severly bent at the waist, butt in the air attending to her belongings with care, that resonated with me. She could have been in the village, loud print clothes, laundry and hot, humid air. That merried to my spirit of being "escorted" in a" foreign place" and whispers of Africa swept over me for a precious moment.
We opened the double doors of Cornerstone to a wall of cool air-conditioned air. We sign in and attended our important business. (I of course have no important business other than to blend as much as possible). No mail for Ricky, no mail for Mike, but Pete and Ricky have important phone calls to make. So Mike and I sit and visit, read News From Our Shoes brochures and enjoy a few moments of rest from the heat outside.

One of Mikes friends was cracking jokes and had us all rolling. The highlight was his "bubbles" routine. He acts out the whole process of some poor,nominated soul telling Michael Jackson's Bubbles that MJ has passed and won't be coming home. (this of course has to all be communicated through sign language) and the act is complete with Mike's friend acting out Bubbles' reaction, tearing up the chimp cage. No words can describe how inappropriate the joke was, nor how hilarious the whole production was.

But all joking aside, our important office business had to be completed and it was almost lunchtime, it was time to be movin' on.

Lunch was at the "Tavern on the Green" as Mike and Ricky called it, better known as "The Shepherd's Table Soup Kitchen." We stood in line outside the church where I met some more of "the boys" including T. T, Mike tells me, is sharp as a tack, and always talks in similes and metaphors. I had a feeling i was going to like him a lot. And I did. T is 19, has been on the street since he was 14. He just recently got into the program at the men's shelter and boasts that the program has really changed his life. Knowing the things I hear about the program makes me hesitant to give it any credit for anything, but who am I to dismiss credit where it might be legitimately due.
T is amazing guy. He may be 19, but his presence feels like a weathered storm that has finally blown itself out. His spirit is quiet and still. He watches attentively and I am pretty convinced that he sees, really sees everything around him. He cracks jokes and sits comfortably with old men, young men and woman alike. He looks at me with a bit of a puzzled expression. "Why exactly are you doing this?"
I honestly feel a bit embarrassed as I am trying to explain wanting to experience life on this side of things for a day. My explanation seems very trivial and naive as it is coming out of my mouth. I feel like a kid talking to a parent, even though I am almost 10 years older than he is. But he humors my intentions and warns me to stay close to mike and ricky. "Just be careful out here, okay?" I felt the weight of my naivity a little and assured him I'd keep my eyes and ears open. (although what I am supposed to be looking and listening for.... ???)
Lunch was actually really good: pork tenderloin, salad, candied carrots, chocolate cake, sweet tea, and a sandwhich to-go if you wanted it. We sat and ate till we were full and when there was nothing left to eat or say we got up and left... it was time to be movin' on.

.....to be continued.....

i heart michigan

I suppose my draw to michigan should have started with Chris (he is from michigan). But my endearment of michigan started with John Stager. John was a patient of mine. and I LOVED him. I mean I loved him. He lit up my entire day. And every time i spent time with him, he would tell me about michigan. He wove elaborate stories of a long life lived on lakes, with family and friends, adventure and quiet moments alone with his thoughts. i loved the michigan he painted.

then, Chris and I went to michigan. it was early summer. The temperature didn't get above 78. It was blue skies and sand dunes, lakesides and adventures. and hiking. TONS of hiking.

then there is the whole plummeting automotive industry. Poor michigan is always in the news: 15% unemployment, bankrupt auto industy, and a dying city, detroit. and so michigan is kind of this underdog that I can't help but sympathize with, and that somehow pulls at my heart strings, so that I want to watch it come back out of the ashes and be a great city again.

And so I love michigan. I mean I really love michigan.

eat, pray, love

So, for one reason or another, my sleeping pattern is all kinds of off kilter. (probably nerves-related). So the last two nights I have woken up around 3 in the morning and have not been able to go back to sleep. So, I read a book in three days. Which is not terribly fast for the amount of time that I was reading it, but fast for me. It usually takes me at least a week to get through a book (and that is when i am dedicated.)

So the book was called (I am a little embarrassed to admit): Eat, Pray, Love, a very pop-culture book. It turns out it was very entertaining and moderately infused with some nuggets of wisdom and eloquence. I have never really been drawn to India, nor Indonesia, but after reading this book, I would love to go visit both. Here are some of my favorite excerpts from the book:

"the resting place of the mind is the heart."

"There is a literal anatomy and a poetic anatomy. One is made of bones and teeth and flesh, the other is made of energy and memory and faith. But they are equally true."

"...in a beautiful place of worship, surrounded by grace."

"you gotta stop wearing your wishbone where your backbone ought to be."

"What is the alternative? To quit whenever something gets challenging? To futz around your whole life, miserable and incomplete?"

"Congratulations to meet you!"

"So now I take time every morning to search myself for specifically about what i am truly asking for. I kneel there in the temple with my face on the cold marble for as long as it takes me to formulate the authentic prayer. If I don't feel sincere, than I will stay there on the floor until I do. What worked yesterday doesn't work today. Prayers can become stale and drone into boring if you let your attention stagnate in making an effort to stay alert. I am assuming custodial responsibility for the maintenance of my soul."

"People follow different paths, straight or crooked, according to their temperament, depending on which they consider best or most appropriate- and they all reach You, just as rivers reach the ocean."

"Fear-- who cares."



Next Book: Three Cups of Tea

title change

Chris teases me about not at all really living my life "at the end of thin branches." and its true. My life is pretty sedate for the most part. I have whispers of adventures here and there, but I am not sure I would actually call it living at the end of a thin branch. I love the phrase though.

When my dear, sweet friend John Stager was still around, his daughter came into town. She told me how as a little girl she loved to climb anything and everything. She was especially known for climbing trees to the very tippy tip top and then inch her way to the furthest part of the branch that would bare her weight. Several times she snuck so far out on the limb that it finally gave under the weight of her and broke sending her crashing to the ground. I loved this story and the image of climbing to the top, inching out to the edge and swaying, swinging at the end of a thin branch. So that was the title of my blog.

But this week actually feels like the end of a thin branch. I am awaiting big news and I am swaying and swinging in the suspense. This kind of thin branch I am not excited to be on. I am teetering between preparing myself for the fall, and convincing myself that there is a enough faith to believe that the branch will hold, grow, and extend even further out. I would rather be still, and know. I would rather be in a beautiful place of worship, surrounded by grace. So, maybe as a moderately sedate life being called "at the end of thin branches" brought the thin branch, I can call this "a beautiful place of worship, surrounded by grace" so that I might find this suspenseful, nail-biting place a place of worship, and the outcome no matter what it might be, a place of grace.

VIDEO: Bottle banned

VIDEO: Bottle banned

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the man behind the curtain

H's home bothers me so much. He lives with his daughter and his grandson (grandson is probably my age) in an apartment in raleigh, but no-one really lives in that apartment except H. There are still boxes everywhere... long since unpacked, but just empty and cluttering up the space. Opened and unopened envelopes scatter the floor around each place to sit- the chair, the sofa, the computer desk. Its mail half attended to.
The place is just so cluttered and stale. Its not a place to live, or die. And yet he is dying here. And dying alone. His grandson left yesterday to go back to California, so now H lives at home alone all day while his daughter is at work. He is mostly blind and in poor enough health to be on hospice. But, he would rather have it this way than to be in a nursing home. "Absolutly NO nursing home!" He is insistant. Can't say I really blame him at all. I would probably be the same way.

But I hate that its not more of a home. California is actually home for him, and he longs to go back, but he is too sick to travel. I wish he was in a place with a giant recliner and pictures of a life well lived all over the wall. Instead its just cardboard boxes. I broke a lot of them down today and hung his clothes up in the closet. I made his bed and brought him an ice-cold coca cola. And he asked to sit in the shower. When his wife died a few years ago, he said he had the hardest time sleeping. So he would get up in the middle of the night, 2am, and run a bathtub full of water and soak in the tub until morning. "the Sorrow would diffuse out of my skin, into the warm bathwater, and go down the drain" he said, "at least for a little while." "And right now, I am just so sad." he told me.
So we pulled a plastic chair in the shower for him to sit on. (sitting him down into the bathtub is pretty impossible for him right now) and filled warm water up around his ankles and sat with the shower water running over his head, his face, down his back and body. He sat in the shower for almost a full hour (How the water was hot that long I will never know). The water-conscious person in me cringed a bit, (scott harrison would have my head) but the hospice employee won out- "whatever makes him feel better". I sat on the toliet with the seat down as he sat in the shower, and we talked through the shower curtain for an long while about everything.. race, life, love, education, regrets. And then for awhile we both just sat, with the sound of water running, rinsing away the weight of the sorrow. at leaste for a little while.

go learn something

Barb, one of my patients, gathered me up today and very somberly said:

"Now Stephanie, I didn't have a daughter that I could pass this along to, so I feel I should pass it along to you. I have some very important advice that my mother told me when I was a little younger than you:

"go learn something."

you won't be pretty forever. And believe me when you start to look like I do, you're going to want to have something intellegent to say. So, sweetie, go learn something. everyday."

"yes ma'am."

homewhere

I went home this weekend. I love driving around the bend on the other side of hickory and glimpsing for the first time the blue ridge mountains, smokey-blue and gentle in their contrast to the sky. Not the real mountains of the west, but whispers of mountains nonetheless, gentler, retired mountains, worn down with time. The familiar things of home are comfortable; Mom's cooking- cookies and bread, tea and fruit. Her long-winded, tangent-rich, epic tales of life in the backcountry. Its the drama of living with Kenny and the chaos of working for the leaderless state. You can barely ask a clarifying question or insert a parallel story to illustrate understanding.... she won't let you get in a word edgewise. So for 2 solid hours I sat inverted on the sofa (legs up against the back, head alternately hanging off the foot or resting on the very edge of the arm) nodding and listening to her. Fairly enough she is ready to listen to an equally long version of life from me... but now I am too tired.

Kenny is always Kenny. Saturday after work and after Mom and I got home from tooling about in town, he is dressed in shorts hiked up to the middle of his stomach, tall gym socks, a wifebeater, and an old gym sock tired around his forhead doing its best to catch the excessive sweat dripping off him. He eagerly greets us and is kind enough to entertain the idea of a bike ride. Its a family event. I convince them to join me on a trip around a long-winding block on my new co-op bike. We head out. "Honey, do you even call those tires?" Kenny asks as he inspects the ultra-thin tires on my new road-bike. "you couldn't pay me to ride that thing." he says. "one little rock in the road, and you're a gonner."

Sunday is lunch with Dora, moms new BFF. Dora is this wonderful retired engineer, probably Marion's first female engineer. She is a brilliant woman who spent her life running companies, running with the big dogs and taking no shit from no man. But she is still gentle, soft and kind as you think a woman should be. Her husband died 2 years ago, and so she keeps herself busy enough to outrun the lonliness and sorrow. She volunteers for the womens' shelter, for hopsice, for her church, and now has taken my mom under her wing. I hope I am as effective and productive in my evening years as she is.

Mom asked me where I felt home was now that I have spent almost 10 years in raleigh. Is raleigh home? Is home home? She asked the question and then first answered it for herself. She has been in the Asheville area for almost 20 years now, but it still doesn't feel like home. She misses the west coast. She misses living on water. She misses the rockies. She misses home. I thought about her question for most of my drive back to Raleigh. I do love Raleigh and there are certain things about it that feel home-like. I love Asheville and there are so many things that feel home-like. But I am not sure I was ever a person to call a place home. Home is my mom. Home is my brother. Kenny is even home. There are people here in Raleigh that feel like home, where my soul stands up and stretches, or lays down and rests. I feel like Neela, my dog, sometimes. She knows a place as home: when I pull into the parking lot of my apartment, she wines and paces the backseat, this place is familiar, its home. When we pull up into the driveway at my parent's house she does the same thing, this place is familiar, its home. But she is eager for the new places too. Somehow she can smell a trail we are about to hike, or an afternoon out of the house on an adventure somehow. And these places arn't familiar, but its as important as the comfort of home.

Don's Million Miles

Don will be in Asheville October 17 to promote his new book.

who's comin' with me?

it appears relegated blog posts are also a side effect of phlegmatic studying. I will capitulate to the temptation, nonetheless.

inventory of mosquito bites:
3 on stomach/chest
2 on back
to count the bites on my feet and legs is untenable.
1 on top of right shoulder... it is the itchiest.

quote from one of my patients today:
"you're a bitch, spelled with a 'w'."

and who cares what the area of the shaded circle inscribed in the square is??!!

never

never stand behind a sneezing cow.

its all a matter of physics: pressure, ballistics, path of least resistance....
...a real jaw-dropping experience, although not really recommended.

or so they say.

cannot get home soon enough

work on friday should never sound like this:

accused of being drunk coming into work
accused of hiding a knife behind my back that will be used to "cut" accuser
spit on
pinched
clawed
bit (again!)
hair pulled

and then I got praised over and over; called the best person in the world over and over for straightening out a set of blinds.

and then insulted
cussed at

this all done by an array of 5 different people.

full moon maybe.

I am ready to call it a day and go home.

Tutu at Carolina

Desmond Tutu Commencement Speech

james

you are 48.
you lay always in bed,
fingers interlaced over your chest,
eyes closed against the pain.
your wife died in december.
you will die too.
soon. june maybe.
your mother cares for your dying body.
socks on your feet.
a cotton gray t-shirt cut up the back.
diapers.
the nurse will change your bandages.
no one else can bare to do it.
infection is winning the prize of your flesh.
your skin is almost perforated along your groin.
one good pull and the skin would peel away from the oozing puss that drains and soaks your bedsheets.
everyone speaks around you in hushed tones.
and to you with words and phrases for a child.
i helped you stand once.
you got out of the bed to get to the toilet.
I was so surprised that you were taller than I.

cancer, child soldiers, water, homeless....but mostly water

This last weekend was crazy and went a little like this:

Fri: overnight in garner with Relay for Life
Sat: slept all afternoon, camp-out on the capital lawn with Invisible Children
Sunday: church in chapel hill to hear Scott Harrison, founder of charity:water speak, nap, the gathering, hurricanes game
monday: back to durham for work and then another lecture by scott harrison.

and so now water is on my mind. and service. and causes. but mostly water.
it seems like such a simple thing, clean water. and it seems to fix so many problems. well its a least a freakishly large step in the right direction.

Scott is a pretty captivating guy. His story is amazing and his vision for charity:water is equally so. He has really taken the water crisis in the developing world personally and has made it the vision of charity:water to get 1% of the 1.1 billion people who don't have water, clean, clear water. And then once they have tackeled the 1%, charity:water is going to take on 10%. I couldn't help but get caught up in the romance of the whole thing. I want to be a part of changing the world in such a measurable, practical way too! I bought my $20 dollar bottle of water already and have been seriously thinking about buying a case to hand out for birthdays, and other required gifts. what is better than giving the gift of water??!! I hear shannon's voice in my head right now.

I was telling Chris as we were walking back from "the gathering", that out of all the service events we went to this weekend, charity:water was the most captivating, and ironically enough, the one that I have potentially the most influence in just by sheer lack of other people to spread responsibility around with, the gathering, is the one I am least romanced by. I participate and i am at every meeting, but I very often wonder "why" exactly. And part of that is most certainly because the rewards are not as easily measured. I can't just help build a well in DTR and see within three weeks thousands of people who didn't have water, now drinking crystal clear water. The needs are a lot muddier then that not to mention the solutions. As phenomenal as"clean water" works as a metaphore, figuring out what "clean water" actually is and how to go about "digging a well" is not quite as easy nor as tangible or measureable. I am sure Hugh runs into this a lot. I do kind of wonder if it is possible to streamline it somehow in a way that targets more tangible, practical solutions. But, again, I have no idea what that looks like in a relational service.

so i think it is important to get your hands somehow in both. do something streamlined and practical. do water. and then get your hands and feet in the muck of people and the insolvable problem. water keeps you reminded and encouraged that solutions are out there... and the immeasurable labryinth of relationship building reminds you why we need clean water in the first place. well. thats what i think anyway.

and in the meantime, invisible children are still camped out in chicago, 5 days into the "rescue", and i am two days away from a 60 mile bike ride that i havn't trained for and that i don't yet have a bike to ride. hmm.

dying is not for wimps

"this whole dying thing is certainly not for wimps."
-hospice patient.

just a thursday

i arrived after she died but before the funeral home and was asked to clean the body so that the family could continue to pay final respects.
i hope i masked the mixture of horror and morbid curiosity that surged through me.
"of course, of course." i managed in an appropriately somber voice.
I walked back to the bedroom where Lillie had spent her last night surrounded by her closest friends and family laboring death. The room now was empty of all life. Everyone had left, the door shut.
I drew a deep breath, opened the door, stepped in and closed it behind me.
I have been working with the dying for almost a year and a half now, but this is only the second body I have seen.
a body looks so different from the person it once housed.
all the fluids of the body stop fighting gravity and surrender finally to the path of least resistance.
the blood settles to the bottom of veins and arteries and trickles down to the lowest place in the body like water running through an elaborate pipping system to reach the collecting pool. This leaves the skin pale and latex-like.
the bowels evacuate. Urine and stool ooze out as sphincters and muscles relax.
the mouth and eyes won't stay closed. Instead of a window to the soul, the eyes now sink back and look at nothing. The tongue,once the vessel of flavor and texture, voice and thought, is now dry and retracted to the back of the mouth.
I cursed my brother for dragging me to so many scarey movies. It was absolutely his fault I was fighting the fear that at any moment this body would gasp one final breath, or complete a quiet zombification, without warning, grab me with cold death fingers and pull me from the living to the undead. It was also his fault that I was wondering at this precise moment if the cold air was in fact the product of the air conditioning, or in fact, more believably, Lillie's lingering ghost. I reined in my imagination and drew upon a spindly thread of professionalism.
I drew a basin of warm water half wondering to myself if the temperature of the water even mattered now.
I submerged a soft wash cloth into the basin and squeezed out the water. I waited an impossibly long moment before I touched the body. "please please please don't be stiff." If rigormortis had settled in, I am not sure i could have maintained what sliver of professionalism I was managing.
I washed her face, her arms, her fingers, chest, stomach, legs, feet, and toes.
I crossed her arms over her chest and rolled the body to one side to wash the back.
what happened next scared the shit out of me.
as I rolled her on her side....
she exhaled....
a long, loud, rattly breath pushed out past phlem-filled lungs and her last breath, buried deep was expelled. I expelled my own horrified breath and waited with face cringed for a moment to see if she would breathe back in, if the heart would restart, if we all had incorrectly, prematurely assumed death.
a quiet moment and.then something worse happened...death escaped her body. it leaked out of her lungs, past her mouth and onto the bed. It was the life-choking phlem draining out of her lungs: thick, green, muck puddled up on the pillow.
I swallowed hard against my contracting stomach.
"now, now is not a good time to get sick."
a set my jaw and went back to the task at hand.
I washed her back, which was in its entirety a subtle purple from the pooled blood, like a fresh bruise, and removed the duoderm pads that bandaged the bed sores. i cleaned the wounds again, which looked so strange now that the body was no longer actively festering upon them.
I eased Lillie back down on her back cleaned off her face and changed the pillowcase. I put clean sheets on the bed, and pulled her favorite quilt up to her chest, propped her head up a little on a second pillow and tucked her in for the family to render any last words.
I left the room, left the house, and pretended that that is was just a normal thursday and that nothing out of the ordinary had just happened in that place back there a million miles ago

back to dying

i am surprised at how frequently i forget that i am in the business of dying. that every single one of my patients will die. and usually pretty quickly.

the average patient stays on hospice for 13 days before "expiring". 13 days.

it is some strange draw of straws that most of my patients i get to see for months before they decline and pass away. and it is in the inevitable descent that i remember that i should have been expecting this all along.

so, one of my most favorite patients is now "actively dying". everyone is expecting him to pass some time in the night. his recent rapid decline surprised us all. and i am not sure we, those who do this for a living, were quite ready. i certainly wasn't.

i went to see him today. i usually give the courtesy knock, open the door and find him reclined in his favorite chair, where he bellows out his standard greeting: "who are you?? what are you doing here?? which he then promptly amends: "i'm just kidding! , comehereandgivemeahug. but today he was in bed, unresponsive, and breathing once every 25-30 seconds.
i pulled him up in bed, put him in his favorite blue shirt, and counted breaths and seconds between breaths for an hour. his daughter arrived and i surrendered to her the chair beside his bed. on my way out i kissed his forehead and right against his ear said my standard departure: "okay, my friend, im off. be good, but not too good." and added "i love you, tom." as i felt the looming, approaching loss swell up in my throat. he actually opened his eyes for a moment and brought my hand to his face to kiss the back of it. i suppose that was goodbye.

im sorry that this reads a bit like a lifetime movie. i try to steer away from the mushy stuff... but then again, i forget that am in the business of dying. mush is inevitable. pun intended.

Duke Global Health

A couple events for my calendar (and yours if you are interested.)

USGH
Speaker: Andrew Boulle, University of Cape Town
Topic: Responding to HIV in Post-Mbeki South Africa

April 1, 2009 - 4:30 - 6:00 p.m.

Andrew Boulle, from the School of Public Health and Family Medicine at the University of Cape Town, will be the guest speaker.

University Seminar on Global Health
Peter Piot, UNAIDS
The Transformational Nature of the AIDS Response

April 23, 2009 - 4:30-6:00 PM

Dr. Peter Piot is the recent executive director of UNAIDS and Under Secretary-General of the United Nations. Under his leadership, UNAIDS became the chief advocate for worldwide action against AIDS. In July, he will begin as director of the Institute for Global Health at Imperial College in London. Among his many accomplishments, Dr. Piot is widely known for launching the first international project on AIDS in Africa and co-discovering the Ebola virus in Zaire in 1976.

Duke Global Health

windows.mirrors.

some insist to look only out windows and refuse to face the mirror.
-Ricky Caldwell

Beg. Choose.

i know a man who challenges the phrase: "beggars can't be choosers." he actually proves the inverse. he has limited resources- very limited. he has no home. no car. no money. although i think he did just get a job. but the cynic in me whispers, not so quietly "we'll see how long he keeps it." and despite his lack of resources, he is served sandwiches made specifically for him, pork chops, cooked to his liking; he is picked up and dropped off, hand-delivered to his important destinations; he is rarely lacking a love-interest (whether they know it or not). he turns down gifts, or re-gifts items not up to his liking or standard of quality.

here i am, someone with a job, with a car, with a home, with money and the corresponding bills, responsibilities, and obligations. i feel myself balking at his audacity to be seemingly content with his state of being, to be choosy about the things he wants, accepts. i am constantly challenging myself towards humility; to want less; need less; asking for as little as possible. and here he is wanting, needing, asking, choosing, getting and to this "humble provider's" great surprise, inflated with a sense of entitlement. this beggar is a chooser. and its working for him.

we are perhaps both caught up in a dance of just wanting what we don't have. i am longing to be stripped of the ties that bind me to my things, my responsibilities, my life. i am begging for some proverbial freedom that i imagine is just outside my reach and promises me...well, i am not even sure what. i am constantly trying to peel away some kind of world-approved-entitlement that is liberally handed out to "humble", do-gooders."

he has some version of "freedom", is tied down by nothing, and yet is begging to be fitted with objects that harness him to some kind of identity other than "homeless", "beggar". He inflates himself with his own kind of entitlement because he is not able to obtain the worlds'. it has become the world's fault that he is where he is. wanting the way he is wanting. lacking those things he lacks.

perhaps the problem with a contrived humility is that it keeps me from asking as audaciously, shamelessly, loudly as he does for the things I really might need. and the problem with self-appointed entitlement is that leaves no room for the sense of "want" that drives us to demand more of ourselves.

and perhaps it is not such a bad thing to be a beggar and a chooser. but the hard part is learning how to beg with your whole heart for those things that draw you closer to God's glory and to accept nothing short of it. beg. choose. and make it work for you.

the business of dying

i am sleeping at a man's house that is dying. he used to be a patient of mine. he is days away from death and the family had requested me to come be an experienced body, a stable, gentle body that could help make trips to the bathroom, change sheets, and just generally be there. so i am here. and humbled. i watch quietly from a chair in his bedroom the family trickle in, hug, kiss, whisper, sit, cry, reminisce. i keep asking if i should leave. "do you want a moment alone?" and no one wants me to leave. "no, please stay. in case he needs anything, you are here." i am humbled again as i watch intimate encounters with this gentle man who is dying. i am a fly on the wall, but the invited, wanted fly. how is this happening? when there is no family or friends, i take up the visiting chair, slip my hand into his and just occupy this space with him.
"when did you get here?"
"seven."
"how long will you stay?"
"all night."
"how many nights?"
"however many you need."
he closes his eyes and nods. i am not certain i am who he thinks i am, but in this moment i feel as if i am exactly what he needs, and that, even if it is not at all true, feels amazing.
i am so humbled to be here at this moment, in this place, with these people. how did i get here?