Hospital Musings

dad thumbs up

“Life is a moderately good play with a badly written third act.” – Truman Capote

“Do you wish to rise? Begin by descending. You plan a tower that will pierce the clouds? Lay first the foundation of humility.” – Saint Augustine

Last week my 83-year old father, who has advanced Parkinson’s disease, fell and broke his hip and arm. His legs froze, and he basically fell like a tree, hard on his entire right side. He had to have a partial hip replacement and a plate and three screws embedded into his right arm. He remains in the hospital, facing a move to a rehab facility to determine if he can regain minimal movement, prior to returning to his home in an assisted living facility.

Small Wins

Daily life on the elderly post-op orthopedic floor of a hospital is full of small wins. It’s a win if we take our pills without fighting. It’s a win if we have a bowel movement. It’s a win if we manage to remain calm and not fight the restraints or pull out the IV or catheter. It’s a win if we eat three spoonfuls of scrambled eggs. And it’s a big win, a bell-weather event, if we manage to sit up by ourselves and even stand for a moment with assistance.

On the surface, these tiny celebrations might seem rather pitiful and sad. Truman Capote had it right. Old age, in many cases, really is a “badly written third act”, and truly does suck. All the patients on my father’s floor were elderly and bed-ridden. And many were restrained to protect them from themselves. It was, by all accounts, a most depressing week. All I had to do for most of the hours of the day was to watch, encourage, and cheer these “small wins”.

One day while perusing Facebook on my iPad at my father’s bedside, I read these words of Elizabeth Gilbert: “The world is like a dropped pie most of the time. Don’t kill yourself trying to put it back together. Just grab a fork and eat some of it off the floor. Then carry on. If you can get some stuff done in the chaos sometimes, God bless you. If you can basically hold it together, propping yourself up with duct tape and glue, rock on. If you can manage to stay upright even one hour a day, you’re doing pretty great, as far as I’m concerned. And if you can be kind to the other stumbling fools around you half the time — well, that’s just heroic.”

In a hospital, life is reduced to its most basic level. It ticks by very slowly, and gives you a lot of time to think. When there is precious little dignity left with which to cloak oneself, and you are stripped of all your normal edifices and airs, the small wins really stand out. What if your life was suddenly reduced to achieving only small wins such as these? How would you face the day? Even if you are lucky enough to have not known such a humbling experience as an extended hospital incarceration, why not just send up more cheers for your own – and everybody else’s – daily small wins?

I have struggled for years with a very loud and bossy inner critic; with a propensity to beat myself and others up for all that has not been accomplished. Nothing to date has been able to break the cycle of the inner taskmaster. But five days in a hospital as a care giver might just have done the trick. What struck me about the time I spent with my dad in the hospital was that strangely, throughout the experience, I was not only kinder to others, but to myself as well. Even though I am a first- class introvert, I smiled and spoke to strangers in the hallways. I thanked nurses and aids profusely for their compassion and care. And perhaps most importantly, I forgave myself for not getting much done each day, for being tired at night. After witnessing the struggles of my father and his fellow patients each day, a lot of the normal stuff just frankly didn’t matter. The constant tape that usually plays in my mind – the one that says, ‘you didn’t do A, you gotta do B, why didn’t you do C?, get going on D’, etc. just stopped playing. Or at least the volume was turned down, and a new mantra ran over top of it, one that sounded something like, ‘Hey, what the hell, it’s OK. Give it a rest. Give everybody- including yourself – a break. Pick up a fork and just eat some of that pie. Say thank you, and just freakin’ celebrate those daily small wins. Everybody’s small wins. Because in the end, the small wins are good enough.’

Pride and Humility

It takes a village to care for the elderly. If you stay a while in a hospital, you will see multiple nurses, CNA’s, dieticians, physical therapists, patient safety personnel, physician assistants and discharge planners. What you WON’T see a lot of is a doctor. To see a doctor, you have to plan your interception strategy carefully. Someone takes the very early shift – before 6am – and another will take the late afternoon/early evening post. And sometimes you just give up and write a note listing your questions and concerns. The note gets put on the chart, and maybe the doctor will call you back. There are not a lot of doctors walking the halls of hospitals.

Nurses and CNAs, if they are nice, can be your absolute best friend. These folks work like dogs on an elderly ‘acute’ floor. Hourly vitals, administering medicine, cleaning a patient, repositioning a patient, feeding a patient, calming a patient, talking to anxious family members, etc. The cycle begins anew every hour. If your loved one has to stay more than a few days, you will cheer when you see your favorite nurse come back on duty. My father had some of the best nurses I’ve ever met. They are truly God’s angels.

During the first part of the week, our RN (registered nurse) was Darla. Darla was a most awesomely capable and compassionate nurse. On Friday, Darla was back, but working in the role of a CNA, as they were short- handed. An RN is a trained professional. Nurses do the work of doctors on these floors. A CNA is a nurses’ assistant; they take direction from nurses. CNA’s do the tough and very unpleasant manual work, including cleaning patients, changing diapers and bedsheets, etc. So it somewhat shocked me to see Darla working as a CNA. Why would anyone with a professional degree do that? I wondered how hard it might be for her to swap roles – to not be the one in charge, but take the orders and do the dirty work, even though you have the training and experience to be the one in-charge?

I have been dealing with some difficulties at work for the last 4 months. My role changed dramatically during an organizational restructure. It has been a change that I have not been happy about. I have found it hard to swallow, and, in my darkest hours, have been up close and personal with the sins of pride and wrath, and their first cousin revenge. I’m 90 days out from this organizational change, and I still want to kill someone daily. Pride and wrath have been eating me alive for the past four months. I’m not proud of it, but that is the truth.

Darla’s situation made me think a lot about the sin of pride, and about its converse, humility. I was never so forward as to ask Darla why, as an RN, she would willingly assume the role of a CNA. I just watched her actions. And those actions were unfailingly professional, compassionate and appropriate. She slipped in and out of the RN/CNA roles with no visible issues; no stress, no grating, no friction. No pride got in the way of doing her best, regardless of the role she played.

Pride is one of the seven deadly sins. The seven deadly sins are considered so awful because they are “capital” – they can engender, or seed, other sins and vices. I could see how pride had been literally eating away at my insides. How it was incubating bad behavior. How it was keeping me from being my best, from doing my best each day. And how, in the grand scheme of things, it just really did not matter.

Pride and its flip side, humility, are tricky. There is a place for pride, if it pushes you to try harder. In the case of my father, pride may be the very emotion pushing him to find the courage to wade his way out of the pain and fog of drugs, to force himself to sit up and try to stand. To rage, rage, rage against the good night, if you will. But there were just as many times during that week when humility was unfortunately his only choice. And it came very, very hard for him.

I guess it’s in the genes, and I get it honestly. Humility is hard, damn hard, but sometimes necessary for our own survival. There’s a place for pride, but even more importantly, there is a place for humility. Sometimes we are all just “stumbling fools” like Elizabeth Gilbert says, all propped up with only duct tape and glue. And that’s ok.

Be kind, kill the pride devil, eat some life pie right off the messy floor, and just carry on.

6 thoughts on “Hospital Musings

  1. Well said, my dear friend! Becoming elderly is not for the faint of heart. We’ll be there someday…. hope we will put our pride aside and encourage one another. XOXO

  2. Jeri, I don’t even know where to start. You are an inspiration at work and personally for me. Many of us shared your confusion about the reorganization and we still do. You were the glue that held everything together and now that you are in a new role…we definitely feel that disconnect every single day.

    As for the little wins, I think we all need to seek those. Whether we are children of elderly parents, parents (or grandparents) watching our families grow and become accomplished individuals, friends or co-workers ….recognizing and appreciating the little wins, I think is what life is or should be about. It feels good to celebrate successes and it feels just as good to the recipient as it does for the giver.

    And for those days that don’t go so well, I love the Elizabeth Gilbert quote about grabbing a fork and salvaging what you can from the smashed pie on the floor.

    This was a moving blog….you are an inspiring writer and photographer. I am thankful to be your friend and colleague!!!!

  3. Jeri, your writing touches me deeply. You have so many amazing gifts to share with the world and make it a better place. You ask meaningful questions, you think things through in a practical and heartfelt way, and communicate them with deep emotion and feeling. My love to you as you care for your father through this time of his life. It is interesting what we learn when we are forced to slow down. Thank you so much for sharing.

  4. Jeri,
    We all have much to learn about living life from elderly people. Their wisdom is priceless. I have been there with both of my parents and as a geriatric social worker back in the days of my first profession while working in a skilled nursing facility. These experiences help to evaluate our priorities, cherish the people in our lives rather than material possessions, know what things to let go of and what to treasure. Stay strong my friend. Thinking of you and your dad. Blessings and love.

  5. Great reflection and revelation Jeri! I have been there, as you know, and it is not an easy place to be. However, if we learn from it and become stronger individuals in spite of the difficulty, we can say it is all worth it in the end!

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