Wednesday, September 22, 2010

The Super Harvest Moon

At 11:09 p.m. EST, the autumn equinox will be taking place. This means that the sun is in line with the equator, that great imaginary line around the girth of our planet earth. In fact, according to NASA, this year we are having a "super harvest moon." This has to do with the full moon (harvest moon) taking place within hours of the fall equinox. The sun goes down just as the full moon comes up on the horizon.

As a grandmother with a spreading belly, I used to be offended by my own expanding middle. Some of it I tried to write-off as the cost I paid for bearing children. I tried to steer clear of cultural messages about age, youth and beauty. But they seem to be as pervasive as the air I breath. My partner really doesn't seem to mind. It is my own hang-up that weights me down the most.

Healing around this is a continuing practice. By finding a character who is happy and chunky, I am making peace with my body. I have begun to take great joy in meditating with a small tubby little monk.

People often confuse the little chubby figure thinking it is a Buddha. But the skinny dude is considered a representation of the more traditional form of Buddha - Siddhartha Gautama, the guy we tend to think of as the Enlightened Buddha who sat under the Bodhi tree two thousand years ago.

I find the fat, happy little guy much more appealing and one who speaks to my condition. He is often associated with joy, abundance, and wisdom even though he is thought to have needed very little for himself. He seems more suited to my extroverted nature. His big smile just disarms me. Like Thich Nhat Hanh, a smile is part of the meditation.

It just happens that the image of the monk evokes something more earthy and robust in my imagination. I have a whole side of the family with bodies like his from whom I inherited their genetics. It was the happy elderly aunts with the soft arms, portly middle, tiny thick fingers, and gentle hearts who reverberate in my memory. Not all of them were so terrific. Some of them were senile, and in their senility could go either way - pleasant or mean. Please let me soften, ripen into old age as sweetly as Helen and not like Maude.

Dr. Bill Thomas, a geriatric physician and social change leader in eldercare, points out that the word senile actually has roots in sen and the word senescence which means to ripen, like produce in the autumn. Our culture misses reaping the harvest of our elders because we have segregated people in all kinds of ways.

This rotund monk has a Saint Nicholas-type aura about him. There are Chinese stories about how children flocked to him as he would hide or gave out candy.

This worn-out mother would like to be the one with no responsibilities for family, but cares deeply about the village, the children, and the elderly where ever she is at.

In the fullness of autumn, I find the vines dying off and the fruit coming into maturity. How can I joyfully live my life so that it benefits others? The statue of the monk inspire me to move beyond myself and let that inward work of meditation express itself in happiness - just as the harvest moon playfully chases the sun across the sky no matter how ancient they are.

Wednesday, September 8, 2010

As if we had control of the situation...

Life keeps plugging along, but I seem lost somehow as the clear skies of autumn reflect a brilliant blue. Babies grow into toddlers and then they start school. Okay, my grandson is starting a three-year old program, but still. Could it be possible that his mother's own start in preschool was 25 years ago already? How could that have happened?

My maternal grandmother, who has been home receiving round-the-clock care since a stroke 8 1/2 years ago, may be starting hospice care soon. She's been receiving total care at home for over eight years and is the last living grandparent. It is as simple as one of the family members calling the agency. Yet, after weeks of discussion, it hasn't happened.

The phone rang. My west-coast sister called before heading off to work. It was so nice to be her playful, loving sister on the other end of the line. After a delightful Labor Day weekend, she was bemoaning the fact that she had to go back to work. She likes the people part of the job, but says that she has been saddled with a database project that is taking forever. It sounded a bit like the back-to-school blues.

She asked if she got me up. It was 8:30 a.m. EST/5:30 PST, I say,” No, I've been up since 4:30 a.m.” As middle-aged women, sleep, or lack thereof, is always a topic for conversation for us.

We talked about sleep, our thyroid malfunctions, the kids, the weekend, work, our parents’ aging farmhouse, our aging parents,

...and how when our grandmother had her stroke there was an advanced directive that spelled out no feeding tubes, life support, nothing to extend her life; but, the hospital "lost" her advanced directive. It took two days to get the lawyer's staff to fax another copy. At the time of her stroke, due to pressure from her half-sisters at the hospital and the doctors' differing stories about the cause of her stroke, the doctors ignored her children and grandchildren and did what they could to sustain her life. Always remember, fear of lawsuits trumps patient wishes when there is doubt.

She didn't want this. And now, over 8 years later, it might be time for hospice.
The family and carers have been terrific at keeping her alive and relatively healthy. With all of the stents put into place before the carotid artery surgery, oddly her cardiovascular system was in better shape than it had been in years. But now she is having difficulty swallowing, losing more weight, experiencing more cognitive problems, and in a continuous battle with bedsores.

She's in pain. For the longest time, she was able to enjoy eating and going for a ride in her wheelchair van. She doesn't seem to be enjoying anything right now. With the bedsores, wheelchair rides are out of the picture. Grandma’s sky blue eyes are mostly cloudy and unfocused these days.

In the conversation with my sister, I learned that she had assumed that hospice had been started and was mentally on a funeral watch.

Sweetie, you need to relax. Put on a kettle for tea.

I'm thinking that this is like all good childbirths or any major transition. There is a sense of timing that is beyond our control.

To be sure, mom and the aunties are sorting this out and once hospice is called, the agency will be out promptly. But that still doesn't mean much change in care or that death will be sudden. Perhaps there will be more of a focus on pain management and an additional level of support for the family. But it still sounds like the family is working through their own questions before coming to some kind of decision.

As we talk about the family dynamics around major transitions, my sister shared her thoughts about advanced directives. She let it slip that she wanted to have the best drugs possible so that she could be numbed out, and if she had consciousness, she wanted to eat coffee ice cream in order for her to have some kind of quality of life. We laughed about how dry most advanced directives are and how we wanted fun ones.

I didn't have the nerve to tell her that if she got "good" hospice drugs, that she would likely become pretty constipated and that the only real satisfaction she'd get from coffee ice cream would be if it were an enema.

Caught up in the emotion of the conversation,I couldn't bring myself to tell her that I just want to make sure that I have my small blue cloud pillow to hold next to my chest and some funky blues music on my headset. Of course, I remember having these elaborate plans for music and creating a "mood" for my homebirths, and that stuff never happened. My kids were born too fast - both in the bathroom of all places. I didn't tell my sister that today I'm not sure advanced directives do much besides make us feel better and give us an illusion of control when we are most vulnerable.

I also couldn't seem to share with her that my daughter tells me that my grandson is enamored with outer space. He received a NASA baseball cap that is supposed to have flown on a space shuttle once. He reads about Curious George going on a rocket ship. When he is asked what he is going to do tomorrow, he responds, "I'm going into space tomorrow." Every day offers the delay of tomorrow.

It was getting time for her to go to work. She returned to bemoaning having to face the dataset. I found myself encouraging her to look up from her project and see the AIDS/HIV infected patients at her clinic and imagine what their advanced directives might look like if they got to enliven them.

Perhaps tomorrow we might need today's conversations to guide our family and friends through parts of a universal trip we will all take.

With demands pressing us to leave, we said our "I love you's" and got on with our day.

Tuesday, September 7, 2010

Where two rivers merge

Crying tears into the Shenandoah
where the force of one river runs into another
a memory triggers crumbling rock in my chest

Old sorrows ride
down the rapids and into a gorge
there is no turning back

I want to strip and dive in
but the birds keep calling:
Hold on, hold on, hold on

A fish reaches up and kisses the sky
breaking the surface tension
seeking the Other

I want to die
life is too hard
I don’t have a choice in the matter

Geese squawk noisily
Chasing each other between the chasm and here
Curiosity saves me again