Pre-Order Available: The Healer’s Burden

I am beyond thrilled to share that this book I had the privilege to contribute an essay to, The Healer’s Burden: Stories and Poems of Professional Grief, is now available for pre-order. My essay is titled “Silent Intercession,” and I am so looking forward to slowly making my way through the rest of the pieces.

Here is a description of the book from the editors:

What is Professional Grief?

Ignore. Suppress. Hide. Work in high-loss healthcare environments commonly demands turning away from one’s interior experiences in order to rapidly turn toward the next patient. In a culture that discourages vulnerability, how can a care provider effectively deal with the challenging emotions that naturally arise when faced with death, especially now in this critical time of pandemic? Thankfully, The Healer’s Burden: Stories and Poems of Professional Grief makes a space to tend this occult grief, and not a moment too soon. In a broad array of artistic and accessible perspectives, healthcare workers from multiple disciplines bravely pull back the curtain on their experiences of loss. Despite delving into death, The Healer’s Burden eschews the twin traps of despair on the one hand and platitude on the other. Using principles of narrative medicine, the editors catalyze a much-needed conversation about professional grief by including thoughtful questions and writing prompts. This book is a must for educators and clinicians alike who wish to constructively engage with rather than avoid their experiences of patient death.

With a foreword by Rana Awdish, MD, author of LA Times best-selling memoir In Shock:
“Reckoning with grief is no small task. But ignoring it is no longer necessary. ”

I can’t encourage you enough to buy this book, and share it with the healthcare professionals around you. It’s such an important time for us to bring this conversation to light in this extraordinary year that is 2020.

Guest Blog Post for Crossroads: The Worthwhile Art of Careful Listening

In an incredibly noisy world – particularly for us introverts – the art of careful listening proves to make all the difference for my family friend hospitalized in the ICU who had only one silent but extraordinary way left to make his voice heard.

My short Crossroads blog post for The Intima: A Journal of Narrative Medicine explores this vital concept.

You can read the post here.

A Letter from a Parent to Teachers in the time of COVID-19

The school year started with all the assumptions we make about how life is going to go.

She’ll go to school, she’ll make more friends, the teachers will work their magic, I will have some breathing room for myself, repeat for nine months. At the end of the year, my child will have learned whatever she’s supposed to learn for her grade level and I’ll say thank you to the teachers with a gift card, and see you in the Fall!

Come March 2020 and the notice of shutdown of school campuses due to COVID-19.

I realized in an instant that I didn’t know how to work a teacher’s magic. In fact, I was humbled to learn it’s not just magic. It’s a freaking ton of hard work, tenacity, commitment to the kids, commitment to (and patience with!) the families, incredible flexibility with each child’s unique temperament, iron stomach for politics, creativity, and an understanding of their own worth as powerful shapers of future generations even when the majority of people take a teacher’s job so much for granted.

With all the other parents, I mainly fumbled and sighed and cried my way through the first few weeks of “homeschooling.” But our amazing principal and teachers showed up to our kids and our families with a revamped plan that must’ve kept them up all hours of the night to create (and re-create). Led in that spirit, my first grader didn’t seem to bat an eyelash at all the changes. She never melted down, never complained, only remarked now and then that she missed seeing and hugging her friends and teachers. But her teachers stayed positive, engaged, affectionate, appropriately strict, and very much at the helm.

As painfully long as some of the days were with managing kids at home all day every day with distance learning, I got to see through the Zoom classes how a teacher brings a group of children together in a spirit of hope and community with an unshakable focus on continuing growth and education. I got to know my daughter’s classmates and their parents. I got to know my own child better – how she thinks, how she works through struggles, what sparks her to speak up, what inhibits her, what excites her, what makes her sad. I got to know those things about myself better as a parent as well.

By the last week of school, I finally felt surprisingly settled into the new rhythm, as exhausting as all the demands were. And then it was time to wrap up the school year. There was a winding down of online coursework, but there could be none of the on-campus celebratory end-of-year activities. There was a drive-by the school to wave to teachers and staff, where I went to shout “Thank you!!”out the window and found myself trying not to wail with sobs instead. There was a brief pickup of classroom materials and a side hug with her teacher after asking permission, adjusting her mask and dousing her in hand sanitizer. Emotions were at times muted, at times surprisingly acute, mostly confusing.

Then came the final class Zoom meetings. In a talent show on the second-to-last day, another little girl in class said she had a song to sing about saying good-bye but how everyone remains in each other’s hearts. It was off-key and acapella, but at the end of her song, a little boy then burst into sobs. I looked over at my daughter and she was quietly fighting back her tears. It was her first sign of sad emotion since the quarantine started. I wrapped my arms around her, she turned off her video, and waited to compose herself before getting back into the Zoom meeting. She said they were just happy tears.

Today. The final day of school. The online class talent show finished up, and it was time for all the children and their teacher to say good-bye. They all clasped their hands together and pumped their fists back and forth from their chest to the computer screen, “sending love” as their teacher called it. My daughter stayed on until the last minute, as one by one each little square for each classmate’s face disappeared from the virtual classroom. She was already blinking back tears but as the meeting ended, she buried herself in my arms, and we were both crying together.

This year, our kids lost so much. But in this mysterious, imperfect, painful, beautiful, terrible, magical way, we have also gained so much. And teachers and school staff, I now know that you are the most hard-working and the most magical people I know. We did it, and we did it together, but you led the way with your grit and your heart. Our family is sending you all our love.

Blog Post for Cornerstone WLA: A Biblical Response to “You do You”

This pandemic has shone quite a spotlight on our deeply embedded American mentality, “You do you.” We have seen how painfully unloving and detrimental it can be when self and entitlement are at the core.

My latest blog post for Cornerstone WLA shows us through the example of Jesus how to approach the “You do you” mentality in a more loving, healthy way.

You can read the blog post here.

Essay for Spring 2020 Issue of Intima: A Journal of Narrative Medicine

My essay, Best Brother, published in the Spring 2020 issue of Intima: A Journal of Narrative Medicine, tells the story of a long-time family friend who suffered a severe spinal cord injury last summer and, like so many of our patients and families, was faced with sudden life-altering decisions in the ICU. But with a fully paralyzed body, a breathing tube down his throat, and a mind completely intact, how could he participate in any of those decisions?

The way his story unfolded was extraordinary. I never in my life would’ve seen it coming, the way he and his family found their way. It speaks a lot to the care from the medical staff as well, and what efforts they must have made to ensure his wishes were honored.

You can read the essay here.

The Year of the Nurse: A Tribute

What can I say in honor of my fellow nurses that hasn’t already been said? I wrote this for my team in particular at our pediatric hospital, but without doubt the heart of this applies to nurses everywhere.

I wish I could tell you how they show up to work each day. They’re my friends, I know some of their personal burdens and stressors, but they show up ready to give the entire next 12 hours completely to the care of others – namely sick kids and their grieving families.

I wish I could tell you how they start their work day, wiping down their stations because they’re all too aware of the bacteria and viruses that have landed their patients critically ill in an ICU. They see the intubated, septic patient who succumbed to that virus and so they religiously wipe down every surface they’ll be touching as best as they can… so they don’t pick up that same virus themselves or take it home to their loved ones.

I wish I could tell you how they walk into their patient rooms, minds full of all the details that need to be tended to for patient care, all the specifics of how to administer meds safely, all the awareness of how that particular patient and family are struggling emotionally and psychologically. They walk into their patient rooms and know they have to be the therapeutic person of focus and calm, despite the storms going on in their minds.

I wish I could tell you how they walk back and forth on their feet, getting supplies, getting meds, running to codes, transporting patients and all their lines, tubes, cables and pumps to emergency MRIs, hoisting patients, turning patients, holding their breath in case their patient is too unstable to tolerate such movements.

I wish I could tell you how they come up with the most ridiculous songs, stories, innovations, costumes, and setups to bring some sense of normalcy to a child whose hospitalized life is anything but normal, to bring a sense of innocence and safety and joy to a child who has become terrified of nurses associated with scary masks, gowns and sometimes needles.

I wish I could tell you how they stand at the bedside of patients taking their last breath, watching the mysterious, sobering, sometimes horrifying ways life can exit from a person. I wish I could tell you what their hearts bear in those sacred moments, but how they defer their own gutwrenching grief because they know even then, it’s still not about them, it’s about keeping the parent from fainting and helping the parent transition to the final goodbye.

I wish I could tell you how they go home, weary and worn, minds and hearts and feet still swollen from the day’s work, the day’s care… 

only to know that tomorrow, they will come back and do it all over again. Whether it’s a coronavirus pandemic or not, they will come back and do it again.

Because this is what we do. We are nurses. It is National Nurses Week. It is Year of the Nurse.

Bless the Merciful (repost from Sarah Bessey)

This prayer by Sarah Bessey is worth praying, sharing, lingering in.

And oh…for my fellow colleagues in healthcare in these extraordinary days, these paragraphs in particular are for you.

“Bless the ones who lavish grace and bandage wounds and figure out how to make ventilators in factories. Bless the ones who intubate and the ones who are crying in the stairwell, overwhelmed by caring. Bless them for they give dignity to the rest of us. Bless them because they see us and they love us anyway.

Bless them for standing in our thin places between too-much and not-enough, the places where our hearts are breaking and our fears are manifesting and we are so scared and so alone. Bless them for being the ones that show up in the fault lines to hold our hands and pray and weep with those who weep.

Bless them for their patience, for their uncanny ability to just keep going, for their ability to be present instead of checking out for something less demanding. Bless them for long days on their feet in uncomfortable PPE gear, sweaty and exhausted and filled with mercy for us anyway. Bless them for their determination in the face of suffering, for the patience in the teeth of our it’s-going-to-get-worse predictions, and their faith in our story.”

Example of Virtual Narrative Medicine Exercise

It’s been more quiet than usual here but that’s because I’ve been busy writing for my online Narrative Medicine program with Columbia University.

I thought I’d take a moment to share the (virtual) practice of Narrative Medicine that we have been participating in for the program. It’s a beautiful approach to using creative arts to stimulate personal reflection and discovery, especially as it pertains to my work experiences as a nurse.

This week’s exercise:

We read this short poem, “The Ship Pounding,” by Donald Hall. It’s a profound description of life in a hospital.

 

The Ship Pounding

Each morning I made my way
among gangways, elevators,
and nurses’ pods to Jane’s room
to interrogate the grave helpers
who tended her through the night
while the ship’s massive engines
kept its propellers turning.
Week after week, I sat by her bed
with black coffee and the Globe.
The passengers on this voyage
wore masks or cannulae
or dangled devices that dripped
chemicals into their wrists.
I believed that the ship
traveled to a harbor
of breakfast, work, and love.
I wrote: “When the infusions
are infused entirely, bone
marrow restored and lymphoblasts
remitted, I will take my wife,
bald as Michael Jordan,
back to our dog and day.” Today,
months later at home, these
words turned up on my desk
as I listened in case Jane called
for help, or spoke in delirium,
ready to make the agitated
drive to Emergency again
for readmission to the huge
vessel that heaves water month
after month, without leaving
port, without moving a knot,
without arrival or destination,
its great engines pounding.

 

A colleague then crafted a writing prompt, to spark personal reflection in light of the poem we read.

I had 5 minutes to respond to the prompt,

“Write about black coffee.”

My written response was the following:

“I think all the time about how my patients’ parents cope with their child’s illness, with life in a hospital so rudely and indefinitely interrupted by this diagnosis, the complications. Most parents struggle deeply with an internal lack of permission to leave the hospital room. “You should go get some food, or take a walk and get some fresh air, ” I tell them. “I’m here, I’ll take care of your child. You need a break from this room.” But they won’t go for long, just enough to get coffee. It’s always the coffee they will slip out of the room for, and then hurry back, somehow slightly reassured that maybe now the day, the whole nightmare, will feel more tolerable. They’ve got that one familiar comfort in hand.

But it’s rarely an expensive $5 latte they return with. It’s black coffee. As if they can’t allow themselves to be more indulgent, to experience any greater pleasure if their child is bedbound and suffering. It’s quick, familiar, easy, cheap, not too indulgent.

I recognize that, that sense of a survivor dealing with survivor’s guilt. Sometimes as the nurse, I only allow myself black coffee too.”

My purpose in sharing this is not to put on display my writing abilities, as Narrative Medicine isn’t about being an impressive writer. It’s about shaping a space for those of us who are so busy doing tasks and putting out fires in our work as patient care providers, that we sometimes neglect our own internal embers of purpose, connection and meaning. It gives a space and a way to stoke those embers back to life.

It’s beautiful.

Newly published article for American Journal of Nursing

We see a lot of really hard things as pediatric ICU nurses. But sometimes, we get to see miracles.
 
My article for the Reflections column in the American Journal of Nursing has been published, and is free to access through the month of November! It is also available on the site as a podcast.
 

what I wish I could heal as your nurse

Would you give me permission to tell you

without overstepping my bounds, personal, professional

that this is not your fault.

You were only trying to take good care of your baby;

you didn’t know,

you didn’t know.

 

I see the protest in your eyes,

Someone has to be to blame, and that someone is me.

If I had known, if I hadn’t done this, if we hadn’t done that

our baby would still be alive.

 

How can I help loosen the grip that this mistake

threatens to hold over your life?

Would you give me permission to tell you

Can I tell you, you are still a good mama

Can I tell you, you are still a good papa

 

Can I tell you, your baby would forgive you too if he had the words;

of this I am sure.

 

Can I tell you, he knew you loved him to the very end.

Your tears baptize him

and your blessings flow

 

and flow

 

and flow.