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After midnight

In a dark mood, I went to bed early. Figured I’d sleep it off or at least get some sleep before my double header of hematology and rheumatology tomorrow. I didn’t realize my phone ringer was off, I’ve been leaving it on in case of hospital calls, but I must have turned it off for the Rise and Resist meeting. At five past midnight, I woke up suddenly for no particular reason. The cats were all snoozing quietly in their spots, the heater was humming along softly, making a hopeless effort to keep up with the night’s bitter cold. It felt like I had been awakened by an invisible disturbance in the energy. Confused, I reached for my phone and saw a missed call from my Very Sick client. I called him back and found him distressed. “I want to go home, I’m tired,” he said, with no understanding that his life literally depends on the heart and blood pressure medications flowing into his veins. I tried to explain, “your heart needs the medicine.” “They already gave it to me,” he said,...
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Standing by

Today was a march, but I needed to spend the day tracking down and sealing off drafts because the temperatures are supposed to drop into the teens tonight and stay very low most of the week. Before I started on that, I had to set everything up for a cold weather overnight at work – assign staff, notify the church, get the word out to clients. When the weather is below 20, one of our staff members opens the space at 8pm so that clients with nowhere to go don’t freeze to death on the street. It’s nothing fancy, sleeping bags on the floor, but it’s warm and safe and even our clients who will not stay anyplace else trust us enough to come inside for the night. I was just finishing up the overnight preparations when the Very Sick client’s uncle called. “We’ve decided to have them try extubating him,” he said, “and maybe lower the heart medicine.” I’m glad this is the direction they have chosen, but then he says, “we’re worried that his father might try to block this. If that happens, ...
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Grey Sunday

It’s an overcast medium-cold drippy day. Everything - the sky, the slightly choppy water in the Narrows, the Verrazano disappearing into the fog - is so persistently grey you wouldn’t know if I had taken a picture in black and white or color. This kind of weather makes me feel like one of those storybook princesses who pricks her finger and falls asleep for months. I work today, so I shove aside the boulder of inertia and start getting ready. Jeff B, the volunteer who works with our Very Sick client calls. He says the client’s father has asked him for a ride to the hospital. He’s a little confused about why the father is asking for a ride from Harlem instead of taking the train. “Maybe this is his way of asking for support,” I say, and this rings true for Jeff. “I told him I could get him after church,” he says. “And he said to me ‘you’re a man of God, we can pray over my son together.” Jeff is nervous about this, because he is a liberal Christian and he doesn’t know ...
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Saturday

This has been a rough week, loss all around, on every level, while the underlying energy churns, unsettled and vulnerable people are thrown off kilter. Some clients feel like balloons trying to drift off away from the Earth, and the only thing holding them here is as fragile and tenuous as a string wrapped around my wrist. I try to plant my feet, feel my roots extending into the earth, make sure that too many souls tugging skyward don't lift me off the ground. I think of a phrase my dad used when dementia was stealing his words, "down to the nothing," - for him it meant naked, as in the doctor having him undress "down to the nothing." For me though, it describes the stripping away of my inner layers, like the loss of a planet's gaseous envelope, its life-sustaining atmosphere, leaving a rocky barren world exposed to harsh interstellar radiation. I'm grateful today is Saturday and I could spend the day in bed in a pile of cats, bathing in their soft,...
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Decisions

The meeting was almost an hour late starting. The senior doctor started out by explaining the situation carefully, making sure everyone assembled understood each part - the kidney failure, the weak heart, the low blood pressure, the need for assistance breathing. His uncle took the lead for the family, which seemed like a familiar role. He asked the questions, and then the aunt chimed in with a few. His mother stayed silent. I could hear in the questions that they were searching for hope, a situation in which he would recover. "In your experience, what happens to patients in this situation?" "I don't have a crystal ball, but individuals in his situation die," he said bluntly. "His heart was already weak, and now it requires this strong medicine. The only cure would be a transplant but because he wasn't consistent with taking his medicine and going to dialysis, that's not an option. He could stay like this in limbo, until another complicati...
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Letting go

This morning when I picked up the phone, the NYU social worker said carefully, "he's really not doing well." "I'm glad you called," I said. "I couldn't reach anyone yesterday, but I wanted to talk about whether it's time to withdraw life support." I had been struggling with the idea all day yesterday, even discussed it with Rev Micah. "We have a meeting set up tomorrow to discuss that with his mother, aunt and uncle from Connecticut and we're hoping you can join." I agree, though I am worried his family might not be ready to let go. They haven't been in the trenches with him, day in and day out, the way we have. They haven't heard him screaming in pain through the phone, or sobbing about how tired he is, or listened to the chaos when he tried to hang himself in the hospital. Cage, the volunteer who runs our HIV group, went to visit. He found him awake, they must have lowered the sedation, and said he seemed to ...
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DNR

Walking into his office, my doctor looked at me and said, “I almost asked how you are, but after last week, I know.” In a way, he’s struggling more than I am with the murder of Renee Good. Everyone has a point at which they realize, on a visceral level, that it could be them. I’ve known that for a long time, but for Dr. P, who had felt safe in the bubble of his privilege, seeing a white suburban LGBT person killed was the moment. “I saw the stickers on her car,” he said, “and I know that kind of suburban lesbian mom.” I tell him about the march, and he says, “I think I really understand civil war now.” He explains that now he knows what it’s like to have a position on something that is so fundamental to who you are that there is no flexibility, no possibility for compromise. He asks what’s going on at work, and I tell him about my client, the ICU, the intubation, that I am thinking of making him DNR. He’s seen this plenty of times and he agrees with me, that resus...
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