A Terrible Brain

I wonder if you are suffering inside your soul because of your disease, or, if like dementia, you are unaware of how ill you really are.
  Do you know what you are doing or are you in a dream, when you grasp a pen and sign my so insignificant piece of paper that could enable me to help you better? 
But you don't sign, you make arcs and ellipses and scribbles and write down a date from several days ago and the paper cannot be considered valid.
What could it be like to hear whispers in your head?
To see things no one else can see, to believe that someone can read your thoughts?
Is it terrifying?
Do you get used to it?
Is it the voices that cause you to tear your hair, to appear animal like, to act in a most primal way, or is it fear?  Could it be repaired?
Others laugh, or say "oh, he knows what he is doing". But I look into your eyes and see the terror inside, along with the forgotten potential, along with the hope that your mother had for you when she took you to her breast so many, many years ago.
I see you, do you see yourself, do you know who you are?  You are not just "the crazy one" in the green suit, the wild eyed "freak.".
You are no worse than me, I am no better, we are intertwined you and I, you teach me and I teach you......

Grief in Guilt

Today I met a woman accused of killing her long term boyfriend.
It had happened a couple days ago, with a knife, during an argument.
She was tearful and quiet, sad, in mourning.
Mourning the loss of her companion, her "best friend" she called him,
"We did everything together".
She missed him so much, despite the ongoing abuse.
She missed his company, the good times, the hanging out together, the intimacy.
Her grief was no different and no less poignant than any other person's loss,
It was bottomless and all encompassing,
It hurt to the depths of her soul, although the death was her doing.
The words were no different than those I have heard over the years,
the sadness and loss perhaps deeper because of the guilt.
I longed to reach out to her, to put my hand on her shoulder, even to put my arms around her,
but I couldn't, although I think she knew that I understood her and that I saw her pain.
A different kind of grief, a strange and cold setting,
A place where there is no forgiveness or understanding,
but in that moment, we were two women, two humans,
sitting in each other's company, remembering her boyfriends life,
Able to feel the sadness and longing, without the guilt.

Being Human Can Mean A Lot

Someone appreciated me today and it was uncomfortable.
I didn't do anything different than what I do daily, I talked with my patient,
I smoothed his brow, I held his hand,
I asked him if he were scared and he said "no."
I talked with his family and friends, I laughed with them,
and then I held their hands when they cried.
My patients friend then turned to me, with tears in his eyes and thanked me.
He hugged me and told me how grateful he was that I was there.
There was a lump in my throat because I was just being human, sharing their pain,
sharing their loss, sharing their laughter and their presence,
but somehow, it meant the world to him.
I should feel comfortable with appreciation, but I'm not.
Not yet. Maybe never.
Maybe that is why I am here, just to be myself and in being present, and sharing in life is in itself a comfort to those in need. No fanfare, no professional opinions, no certifications, just human.

Who Was I?

Today I was mistaken for somebody else by a dying man.
I had been with him for almost an hour and had to go.
I took his hands and said quietly "I have to go now"
I thought he was sleeping, but his eyes flew open
He looked straight at me, alert and in the clearest voice I had heard the whole visit,
"Oh please don't go!"
So I stayed a bit more, and he clasped my hands as though I was most beloved.
Then he pulled my head towards him and kissed my cheek and said " I love you."
So I told him I loved him too. Maybe I was his daughter in that moment,
Maybe an old friend, a younger version of his wife?
He then asked me to return as soon as I could, said goodbye and closed his eyes.
I hope I was someone he needed to say goodbye to,
to kiss and to hold his hand.
He will be gone soon and I will never know who I was to him but I'm glad I was there.

The Windmills of the Mind

Pick's disease is a progressive frontal and temporal lobe dementia characterized by marked personality and behavioral changes. It sucks. It claims its victims in 2-10 years and most require 24 hour care and likely in an institution.



She shuffles and goes out the door, around the paths that snake around outside and back in again. She stops, briefly, seemingly unsure of how to put one foot in front of the other again. She is found under a tree, she can't move, she is stuck and I give her my hand and we walk out onto the path again.

I help her eat lunch and she is like a mechanical bird, eating around the plate until there is a pile in the middle. If the pile is spread out, she stops. I pile the food again for her and she commences eating again, and then, birdlike, she sips from her glass, doesn't get any drink but the act of sipping is done, then a bite of food, around the plate, then the sip, then the bite, then the sitting and waiting, again and again. I wipe her mouth, she looks at me with eyes so blue and I recall the picture I saw of her when she was herself and I feel sad.

She begins walking again and I chuckle that this is the only exercise I'll get all day, walking hand in hand with her, around and around, stopping, sitting, getting up and going around again.

Her family is devastated, they have lost her and she will never return, there are pictures, and memories, they are too painful to remember somehow for them, they remember her blue eyes and their own eyes fill with tears or become angry because although she is still on earth she has gone and they can't find her.

I can't reach them. I try. But I can't. So I walk with her and I help her eat and I sit with her and hope that somehow she knows that this stranger can feel her families pain and her pain, wherever it may be, and wants to help her to the other side, peacefully.

Lessons From a One Year Old

She runs outside with the greatest of glee,
Taking off in her pink foam sandles, pink shirt and just her diaper,
thrilled to feel the warm evening air on her skin and being free to explore without the confines of a stroller.
She wanders along the road's edge and examines a brick,
She looks at some weeds and picks off the leaves and laughs.
We carry on meandering down the road, happy for a quiet street and an empty house
as she finds the ramp on the vacant house and runs up and down it, squealing with joy.
We stop again in front of another house that has reflectors at the end of the driveway
that sparkle like huge red lollipops and she actually bends down, touches one and licks it,
and I can't help but laugh while cringing at the dirt.
Pinecones are stepped on for their crunch, different leaves are examined, felt, and picked,
and she does a little dance and spins around, so happy.
I notice more on these walks, resist the urge to hurry her along, and appreciate the scent of flowers,
mown grass and spring.
For awhile time has slowed and she teaches me the beauty of a simple, warm spring night. 

What I See

I see you as you sit behind the screen on a small stool in your paper suit, or your prison garb or your dirty clothes and I think how different your life could be.
I wish that you could see what I see, through your addiction, through your smudged face, your unruly hair.
I see your sparkling blue eyes, though red, are beautiful. That even though sometimes you make no sense, I can tell you are smart, your vocabulary gives you away.
I see that you have a sense of humor, that somehow through homelessness and chronic addiction you have survived, that you are more resourceful than I am, can live on two dollars when I have difficulty living on much much more.
I see the person that you are underneath your illness, that your petty crimes are how you survive, how you make it through another day with no money, how you feed yourself, or your habit, or your children, and that is all you know how to do......
I wish you had been given a chance, but you didn't have one, even in the womb, as drugs crossed into your body through the umbilical cord, as endorphins coursed permeated your environment as your mother was punched by your father.
I do what I can, and I hope it helps, I don't know if it will and I know that it might only help for a little while but at least it might help you find something that for some people is forever elusive, hope.
With that shred of hope, my wish for you is that it will grow, and lift you, and bring you to a place where you can see yourself as I see you, a precious human being, a person with a purpose, a person who can really live.