To Grandma-A Reflection Read at Her Funeral

Oh Grandma! Where to start?! You were a refuge, your home was an oasis in lifes storms.

You were a woman ahead of your time, open minded and non-judgemental, willing to hear both sides of the story.

You showed us the importance of family, of spending time with each other and loving each other, no matter what-and there have been plenty of whats....

You were encouraging through many wrong notes, interesting rhythyms, and strange harmonies.

You maintained your dignity throughout each illness and told us when you were ready to go and then went, exactly when you wanted to, with your family holding you here on earth and the rest of your family welcoming you on the other side.

Words cannot express how much we will miss you, how much we will long for the sound of you at the piano, the sound of your laugh and your accepting spirit.

Be at peace grandma, your feet don't hurt anymore, you can see again, and can play each song as you once did. I love you, we all love you, and someday I hope to see you again.

The Arrival of Skye

Born 12/31 at 3:51am, 9lbs 8oz, 20 inches long! Born at home! Stay tuned for more blogging after maternity leave..........................Happy New Year everyone! Email me at roseandstarlight@yahoo.com.

Kick in the Pants

So lately the news has had this story about a young boy whose last wish was for people to donate to the homeless. It was a heartwarming story of courage and selflessness with the end result being that the child died in his mother's arms and swarms of Americans donated stuff to the homeless. In this holiday season and these times of economic uncertainty it was a lovely story of hope. That said, it always irks me that it takes a dying child's wish or some such tragedy to get people to open their eyes and see what goes on daily within our nation. The news reported that they had hundreds of phone calls asking how they could donate. Ahem, do people really not know what kinds of agencies need help?

Okay, okay, I'm a social worker, I know. I know where every homeless shelter is, I know stats on the number of people that are homeless, I know what every homeless shelter has on their wish lists. I know most every community resources available within a 50 mile radius of my hometown. But, do people really not know? Do they really have no clue how some people live day to day, standing in line for a bed, standing in line for a soup kitchen, ducking into food pantries hoping their neighbors don't see their bags of non-perishable food from church shelves.

The city I work in has 6-7 homeless shelters which have been overflowing since summer. The pennies people dump in the salvation army bucket at the doors of malls aren't going to cut it this year. Agencies are overwhelmed by the number of requests for help. Somehow this is all okay as far as legislators are concerned. Few policies have been made or changed to help these populations particularly considering our economic climate. Outreach workers visit people who live under bridges in this city, scout out those who are living in the woods and along the river. And, the rest of the population sits in relative luxury, in one of the wealthiest states in the country, concerned about losing their mcmansions, obsessing over providing their children with the best christmas ever. It's the children that get it, the kids that see what goes on and want to donate their gifts, whose last wish is that those who go without get something this year and it's the adults who may follow their lead of their children or decide to ignore the issue.

Singing Through Pain

She was in pre-med, her family had refugee status from a country in Africa. She was so excited that night in the living room with her friends that Obama was going to win. Then she collapsed, she bled out, and she died. No reason. No clue, no previous medical history.

Her family traveled most of the night from another state to see her. They cried out in anguish over this beautiful girl, their daughter, their sister, who looked as though she slept, her dark skin showing none of the patterns of death, none of the pallor. They huddled together, crying out in their native tongue over this horrible loss and I left the room to give them their time.

I sat in the hall, listening to a language I did not understand but knowing exactly what they said. And then, suddenly, there was singing, a beautiful song that wound from one voice to the next, each member having a verse, then singing together again. They sang and they sang, giving voice to their pain in the most beautiful way I have ever heard, in a dialect only they could understand. I could only imagine that they sang their daughter and sister's spirit back to their homeland, to their ancestors, to a place of peace.

I am so humbled to have been there to witness this, so privileged to have heard this family sing through their pain.

Safety Is Not in Numbers

So as I've said I work in a large inner city trauma center. We see about 83,000 patients a year in the ED. That's a lot. Not sure how many come in as trauma patients are sudden death but a fair number I'd imagine. Many of those are ones that I am directly responsible for in terms of providing family support. Lots of times, due to cultural reasons, every single relative and friend of the patient comes to the hospital. Frequently, this leads to a virtual wake happening in the family rooms of the ED. There is anger, falling on the floor, screaming, pulling of hair and gnashing of teeth. Sometimes it is managable, often it is not and becomes a safety issue.

I have found that I am less and less tolerant of out of control behavior. I respect culture, hell, I seek it out and find it interesting and enlightening. I gotta say though, is it really appropriate to disrupt an entire department by screaming and rolling around on the floor? I mean, I get it, I'm sorry for the loss, I am sure their heart is breaking but it scares other people, it escalates other family members, it often makes patients of family members. It makes it difficult to provide comfort. I also understand and respect that family wants to see their loved one, wants to be with other family members. I just wonder if it really needs to happen in the ED. We aren't equipped to handle 20-30 grieving family members whether they are in or out of control. We have two rooms, they aren't huge. They are far away from security and other staff, they are somewhat enclosed. We really have no idea who it is that we are allowing back into that area and what their intent might be. Our ED is in the inner city. We have gang members, we have many, many violent deaths. Often I am the only one down there with these people. I am not six feet tall. I am not muscular. My own children do not find me alarming even when I am mad. I am assertive but that is not going to matter to someone who is pissed off and wants revenge or has manufactured some sort of vendetta to avenge his father's death.

I bring my concerns to security who does not see an issue. This makes me so mad I could scream. We are not a rural hospital set in Amish country. Somebody did not get killed by being run over by a horse. They were murdered. They committed a violent suicide. They are part of the underserved population who may not have gotten appropriate medical care. They died at a young age, for a variety of reasons. Their families are pissed. Their families are shocked, they are at a loss, they are not very often in their right mind. Some families are okay to deal with. they cry, they may yell or scream, they may collapse but they do not adversely affect other patients or staff members.

A study was done at New Jersey hospitals using incident reports between 1992 to 2001 and it was found that 100% of the 50 hospitals in the study reported violent events in their ED's. 61% of employees reported threats, verbal abuse was reported by 90% of workers and almost one third reported assaults. Of assaults that occurred verbal or physical, 72% were not reported through an incident report. A survey of over 1000 ED nurses in PA indicated that during their careers 97% experienced verbal abuse, 94% had physical threats, and 66% had been physically assaulted. More than a quarter of psychiatric nurses believe that violence is to be expected in their line of work. So, really, I am not talking out of my ass. I value my life. I am the mother of three children who need me. I am not willing to risk my own health and safety because other people who do not do my job refuse to accept that allowing unrestrained numbers of people in an enclosed area is a safety issue.

Suffering is Over

A ten year old died today. It got me on so many levels. He was between the ages of my girls, he had blonde hair, he was cute, he had a terrible disability with many many surgeries ahead of him and multiple hospitalizations. He was apparently the life of the party, he was brave, he was the center of his extended family's life. He no longer has to suffer. It's possible that he is now standing and running on his own, he can eat by himself, he can breathe. I am hoping.

I cried right along his mother, I felt the despair of his father, I know his family will miss him terribly. I made them hand and footprints of his poor feet, his limp and white hands. The feet that never walked, the hands that weren't able to grip but were so loved, so treasured. His grandfather took the prints with love, he hugged me and kissed my cheek, he was so grateful for this small memory of his grandson's life. I was so honored to have made them, to have been able to be a part of this beautiful family for a short time, to have taken part in their grief and stepped over with this little guy from this world to the next.

More Facts

So reportedly the US is the richest country in the world. Supposedly. Let's see what that means. The US is ranked behind Cuba, Denmark, Israel, Germany, Norway, France and Sweden in infant mortality. So out of 1000 babies, 6.30 will die before age 1. We are ranked behind the same countries except for Cuba in life expectancy. We can expect to die at age 78.14 while France enjoys wine and cheese until age 80.87. That's totally unfair. 16 percent of out gross domestic product is spent on health care. The UK spends about 8.3 percent, and despite copious cigar smoking in Cuba, they only spend 7.6 percent. To break that down even further, approximately $6700 is spent annually on each American for health care. Now wait, I thought I was the one that spent that on co-pays and premiums. I had no idea the government contributed! Apparently that includes the 47 million folks that are uninsured as well. The projected expenditure for Medicaid and Medicare for the year 2017 is 1.26 trillion dollars. That's up from 559 billion dollars spent on those two programs in 2007.

Now what's kind sad is the fact that in 1945 President Truman had a plan for a national health program. Unfortunately for us the American Medical Association and the House of Representatives shot it down as a "communist plot." However, as early as the 1910's reformers had a national conference on social insurance and earlier than that, lumber, mining and railroad companies recognized the need for good health among their workers and offered it to their workers to keep up with production.

Let's look at some other statistics now. In my state, which is one of the wealthiest in the nation boasts a population of 283,000 that are food insecure throughout the year. 25% of those that visit food banks are working families. Our state food banks service 350,000 people per year. That's a lot. In 2007, 7.9% of people in my state were living below the poverty level. Guess what the definition of poverty level is? For a family of four you can't make more than $18,100 per year to get some state benefits. Um, that's pretty low. The median value of a home in my state is around $157k which equates to about a $1,265 mortgage payment per month which according to stats is unaffordable for about 60% of the state's population. So, even if you have a shitty apartment in a shitty neighborhood and are food insecure, but you make say, $18,300, you may not qualify for any state benefits because you are too rich. Makes sense doesn't it?

There is a great site called www.nationalpriorities.org. A pretty eye opening website I think. For example, my town contributed something like $168.2 million to the Iraq war effort. This amount of money could have provided health care for 55,577 people. You can put in your town and see what the trade off is for what has been spent on the war so far. Very interesting.

So we are heading into the cold season and oil is at an all time high. I worry about these families, hell, I worry about my own family. Food or heat, medicine or food, clothing or gas to get to work, its pretty scary and I have a good job. I've already hit up people in my department for old coats and shoes for the homeless closet, because God knows, we are going to need it.