They loaded the back of the truck with skis, snowboards and gear they needed to spend the weekend on the slopes. They joked and jabbed at each other while loading, but it was an easy banter and I could tell they are pretty good buddies.
As I drove the truck full of young men for an hour to the ski area, the snacks came out, one had a bloody nose and all of them laughed pretty hard at some of the stuff said. It was a sweet time to remember back to a time when life was ahead of you and you didn't have to be a grown up.
We found our condo, unloaded all the gear and they were gone...off to get a few runs in at night before the place closed. Two of the boys stayed back to catch up on homework...calculus and literature. They were quiet and thoughtful as we sat peacefully in the condo doing our own thing. So nice...
I lead with that story because up until 3pm yesterday, life has been very intense. I have been taking care of families and patients that cannot believe that there isn't something to do to help their loved one stay on this earth longer. They cannot accept comfort without treatment and that soon their hearts will be broken in half from pain. No way, no how...
While all that intensity is noble, when a patient has fought so hard and is so tired and makes the decision to spend every last minute at home being comfortable, it is a negative thing. The patient feels like they are letting the family down or that they they want to leave them even though they are just tired. When a person chooses comfort care neither is true...they are letting no one down and they do not want to leave...they just want relief.
Listen, I am all for treatment and for doing whatever you need to do to get well. I am, really. When my collegues and I walk into the home of someone who is still fighting, we honor that and do whatever we can to help. We don't talk end of life and we pray we don't see them again. And sometimes we do see them again and sometimes we don't.
Families are so random, so different in how they love each other, communicate with each other and handle crisis. For a group of humans so invested in each other, there is no right way...there is only the way that family does it. So while I describe the time as intense, I guess a better way is "intense with feelings." The feelings are all over the place and they change from minute to minute. The family and I could be counting our blessings that they are at home in bed comfortable and then guilty because there must be something else they could do...from contentment to guilt to fear to love and peace and back again.
For most of my families, we wanted to have a nice Christmas or nice holidays with the kids home, grandkids home and friends over. We were very successful and the time was described as "wonderful". Each visit after the holidays were spent rejoicing in the time spent with family, saying what needed to be said and making the most of it. Now, three weeks later, my patients are tired and slowly shutting down. Their race is coming to an end and although we all knew it was coming, it is just so difficult.
My collegues and I spend a lot of time encouraging these folks and telling them how they are doing such a great job taking care of their loved ones, but that isn't enough, and it isn't enough that they are home and comfortable either. They want all of this to be a bad dream that they want to wake up as soon as possible. While I can try every trick in the book to make this time better and easier, it is a bad dream and also a hard time that is real.
Believe it or not, I totally understand. I have lived a lot of this as a family member and it feels unreal. And, honestly, if I want to be truthful, nothing anyone said made it better. The only thing that made it less painful was time and the fact that I felt comfort from caring for my mother as she died in a hospital bed in her livingroom. It took years for the pain to stop stabbing and turn into an ache at the thought but then remembering how she was with us and she was comfortable helps.
So....when I got in the truck and got on the highway, the thoughts in my brain turned to living, to teenage boys, to thinking about how to feed them all and turned away from dying. Yes, we are all going to die and yes, I believe we should have the choice to fight until our last breath or give in and find relief any way we can. I also know that even families that meet me at the door with the family problems love and adore each other in their own way. Yes, they do. My job is to help in any way I can to make this transition easier for the patient and for the people the patient loves. Then, when I do that, I have to let it go. I have to turn my thoughts to the living, to my family, my husband and daughter and boys and the time enjoying and raising them. Because some day, hopefully in a long time...they will care for me.
Around 8:30, the cell phone rang and the boys let my know they were on their way back and "we are starving." I put the 4 frozen pizzas in the oven along with the 50 mozzerella sticks and set the timer. 15 minutes later, the condo door opened, snow pants, ski boots and coats were shed on the floor and they loaded their plates with junk food. The banter started again as I sat in the corned looking at the fireplace and putting the week behind me. I said a small prayer in my head for the families of my sweet folks for peace and good time and threw in the same for me.
This morning, I could feel the testosterone pulsing as they woke up, started getting dressed and raiding the kitchen. My almost 50 year old body's estrogen can't even compete a little for balance but really, who cares? The day is sunny, the snow is perfect and hopefully those boys don't have a care in the world...as it should be when you are a teenager with your whole life ahead of you.
Enjoy time now and every chance you get it...and today, I will do the same, as I hold a little spot of tenderness for my families loving and caring for their loved ones this weekend.
We'll tawk tomorrow,
I love you all,