Giving Thanks

Click on the title of this entry and you will go to a NY Times article about women leaving careers to care for their elderly parents. There are a lot of statistics about the disproportionate percentage of women who do this - as compared to men. But that's not why you should read it.

Somewhere after all the niceties about this high-powered reporter moving home to help care for her father who has Alzheimer's (Can you say "book deal"?), is an interesting truth. As women approach their fifties, many are finding that they "no longer have anything to prove" and that the careet path is no longer fullfilling. The necessity of caring for one's parents helps these women to fill that cultural gap.

I am so thankful that I never felt like I had to prove anything in my job - I never asked for or sought more responsibility or authority - it was just given to me maybe because I was there or maybe because someone thought I could handle it. So I've never felt like I needed a change suddenly - now - as I reach retirement. I've just always wanted to be something different.

I am so thankful that I was able to help my parents and still have a job. Unlike the woman in this article, I had few resources and they had even less.

That is what is inherently wrong with this type of reporting. It is about an affluent family - there are many families doing this on one tenth the income.

Let's see articles about them.

I would be thankful for that, too.

"Fantasy/Reality"

My daughter used to chant that to me whenever I would go off on one of my tangents; such as the previous post about living at Hogwarts.

I do know the difference. Most of the time anyway. And besides I KNOW I can't live at Hogwarts, so, instead I'll move to "Moose County, four hundred miles North of Everywhere."

Insert a Big Sigh here. Can you tell I'm "reading" (an audiotape) another Lilian Jackson Braun book: "The Cat Who Talked to Turkeys"?

So now I want to be the female James MacIntosh Qwilleran. But first I would have to move up north and inherit a very very large amount of money.

I guess I'll just stay Mitzi.

Last night I dreamed . . .

. . .I was at Hogwart's.

Actually I was standing in the owl rookery overlooking Hogwart's and the vast valley around it. And then suddenly I was flying in a flock of owls.

Now I'm not going to look that up in any dreambook because I already know what is means. It means I want to live in a land of wizards and witches, in a land where good triumphs over evil (even if "good" has to work hard for it), in a land of mystical beauty and magical creatures, in a land where friendship is strong and true.

But, you know - every man can be a wizard and every woman a witch. Good does triumph over evil and we have to believe that for it to happen. There is mystical beauty right outside our door and some of us may already live with magical creatures.

And the last one - friendships? When they're true, they're strong - and that's not just in Hogwart's.

Hogwart's is all around us - we just have to believe in it to "make" it appear.

Excuse me. My owl messenger just arrived.

Drving Down the Turnpike of Life

My trip back and forth on the turnpike this week was quite different from my October trip. The undergrowth of the woods was visible now. The mountains, barren and bronze from the fallen leaves on the ground, were punctuated by spikes of evergreens.

Last year I wrote about the woods this time of year. I'm still thinking about that - about how I could see "into" the woods as I drove along.

The woods in late autumn are like a woman in the late autumn of her life. The glorious leaves are gone, but you can see deeply into her - see the comforts of her, the mounds of soft earth - see the hardness of her, the ragged rocks and sudden ledges. At this age, a woman shows herself as she truly is.

I have my soft earthy mounds and my ragged rocks. I still dream of lost loves and lost lives. But I snuggle into my life now, content for the most part, happy with the person I am.

I am a crone - the leaves have fallen and I will never again see spring. But there are still spikes of evergreen to be had. And I am pleased with that.

Travel is educating, even if it's only back and forth on the Pennsylvania Turnpike.

Let Me Die at Disney World

I am being completely honest.

I've been daydreaming about Disney World,"the happiest place on earth." Is it because I had the best vacation of my life there (with Heather several years ago)? Is it because I'm a child of the fifties (and in my fifties) and thinking nostaligically about the times I watched Disney's shows and movies? (Note to self: Go see Chicken Little ASAP).

Daydream: Send Heather enough cash for her to travel from Seattle to Orlando. Make arrangements for me to fly from Allentown to Orlando. Arrange for us to stay in a Disney Resort (maybe the one with the dolphin decorations or the one near Animal Kingdom). Have a week in Disney World, Sea World and Discovery Cove (swim with the dolphins again; well, Heather swims, I wade). Spend money that I should be saving for my retirement - one that may never come since I have to work until 67 for Social Security and have lots of medical problems.

Sounds great, doesn't it?
Splurge all my savings on a great last trip.
Yep - let me die at Disney World. Do they have a hospice on the grounds?

Sometimes I'm Just Too Tired . ..

...to write, even on this blog.
Long drive to the facility I was auditing, long day in the facility and long drive back to hotel. I could have gone out to dinner with other company people who were in the area, but didn't feel like more "face-time" - needed Mitzi-time.

I got take-out dinner and took it back to hotel. I was completely prepared to write after dinner and just couldn't keep my eyes open and my brain engaged.

Business travel is taking a lot of me these days. As I get older I want familiarity and stability. And, as funny and eccentric as it seems (I never said I wasn't eccentric), I miss my cats. I miss my books (the reason I carry a "bookbag" with me - filled with the books I'm reading).

I feel sorry for myself until I see the nursing home residents who are younger than me - much younger. A woman in a wheelchair who has been in the facility for more than a year - who has to go to dialysis three times a week - who has a home and cats she misses. At least I will be going home tomorrow.

Back on the road.

I want a Tabby . . .

. . .no, not cat - already have 2 tabbies.

I've just finished listening to "On Writing" by Stephen King (see yesterday's blog) and I've decided I need a Tabitha Spruce King. Tabitha is King's Initial Reader. Or is it "Ideal Reader"? I know it's one of them because he calls her his "IR." I just can't remember which label he uses, but either one fits. He says that everyone should have an IR or a couple of IRs who will tell you the truth - like your baby is ugly (my phrase, not Stephen's - and I feel I can call him Stephen since I've known him since the 70s - or at least his writing).

Your IR should not only tell your baby is ugly, but where and why your baby is ugly. Your IR does NOT rewrite or attempt to get you to rewrite in their image (also my phrase but inspired by Stephen's words). The rewriting is yours alone - very much alone.

Stephen also doesn't hold "much truck" (my phrase, but I think he must have used it because it's stuck in my head) with critique groups - especially daily critiques.
A writer should write the first draft with "the door closed" (S's words) and then the rewrite should be with "the door open" (his words again). Door closed is just you and your story. Door open is when the book is completely finished and your IR, your Tabby, reads it and tells you where it's ugly.

I have to agree with Stephen about critiquing in bits and pieces. I always felt that when I did that it was a book by committee, not a book by Mitzi.

So I'm not in the market for a citique group. But I do want my own Tabby.

Another love letter to Stephen

This is "another" love letter only becasue I'm sure I've written one before.
I must have because I'm listening to "On Writing" for the second time - so I must have written my "first" love letter to Steve after the first "listen." There is no way I could not.

I was sitting in construction on Interstate 78 ("the parking lot") Friday afternoon and Stephen's words of writing wisdom were echoing throughout the PT Cruiser. Since I had placed the car in park to save my foot from freezing up on the brake, I stopped the tape, got out a notebook (yes, I keep a notebook on the front seat with me - so what? I'm a writer)and began to jot down some of his advice.

When I finish the tape this week, I'm going to type up the most important bits of advice (at least the most important ones to me), print them out and tape them next to my monitor. I'm going to reduce them in size and paste them on a 3X5 card so I can carry them around. Hell - I may even tape them to my bathroom mirror so I read them every morning while I count the wrinkles.

So this is another love letter to Stephen.

Dear Stephen:
I love you for making me believe that I am a "real" writer - mainly because I'm already doing most of what you advise a real writer - or someone who wants to be a real writer - to do.
I love you because you transport me to different worlds - surround me with wonderful characters and tell suspenseful stories.
I love you because of "The Green Mile" and I love you inspite of "It."
But most of all, I love you for not turning into an overbearing pretenious son of a bitch who thinks that everything he writes is golden literature. In other words, man, you know who you are and what you do. You stayed true to yourself.
And you are so right - it's all about the story. Find the truth in your story - put your truth in your story - and it will be a good story.

I've gotta go, Steve.
My muse - the lady in the attic, reclining on her fainting couch, surrounded by roses (at least a few black ones - because my heart, like yours, looks into the open grave at times) - that muse is calling me. She knows my name all too well and comes to me at the damnest times, like an illicit lover trying to break up a marriage - she whispers to me to write my story instead of my work reports or policy and procedures.
So, Steve, when she calls me, nags at me, I must go.

Just know I love you.
Thank you for "on Writing."
Thank for "Carrie" and "'Salem's Lot" and "Cujo" and "The Shining" and "The Stand" and "The Dark Half" and every one of the other books I've loved.

Your friend,
Mitzi
PS I had some nasty "odiologist" drain my ears with a hypodermic needle several times - both ears - when I was six. And each time he lied and said it wouldn't hurt. I imagine him sitting in a examining chair (as I did) in Hell with some demon coming at him with a needle longer than my school ruler. But of course, it did save my hearing, so maybe it was worth it. Maybe. And maybe he shouldn't be in Hell - at least not for that.

"Good Night and Good Luck"

There's not too much I can say about this movie, other than every American should see it - as soon as possible. History is a rewinding tape that just keeps playing over and over because we have yet to learn from it.

"Good night and good luck."
Edward R. Murrow

So What?

I had no idea what to call this blog entry. The above seemed to be appropriate enough.
I’ve been reading a professional journal – a nursing professional journal.
There’s an article on nursing leadership, one on bladder cancer, one on Lunesta (a new sleep med that’s been all over the TV commercials lately), one on safety. But nothing on the realities of my nursing life.

So I need to ask: Where’s the information on the following:
1. Where do I get more staff?
2. How do I retain the staff I have?
3. What is the government doing about the ongoing nursing shortage?
4. Why do state surveyors interpret regulations so they strangle our facilities (as in why does a nursing home have to treat a resident as “suicidal” if the doctor and psych units say she isn’t and won’t assist the facility in the suicide precautions) In case you want to know – that was a rant.
5. How do we handle fourteen different formularies for Medicare residents? How do we call the doctors over and over until we get the right drug that’s on the right formulary. Remember: There is a nursing shortage and only a nurse can take an order from a physician.
6. How can nursing homes care for the residents who are under 60 (and we have a lot of them) under regulations written for the elderly?
Those are just a few of my questions.

If I had gone into teaching I would be retired by now.

Why is there a nursing shortage?
1. Do you want to work weekends, holidays, nights?
2. Do you want to clean up all bodily excrement?
3. Do you want to work on your feet, passing meds, giving care, walking the halls for 8 to 10 hours a day?
4. Do you want to look at, touch, redress, debride, smell and generally care for meesy things?
5. Do you want to give care (all personal care) to an elderly person who is so confused he or she may haul off and slug you - maybe even hurt you? And have to do it day after day after day after day.

Many “new” nurses leave after five years – because of the above. Yeah, decent pay to start but it’s not a profession one can retire from – at least not easily.

Yep – if I had gone into teaching I would be retired by now.

Nothing Will Be Left

The mining companies are cutting off the tops of mountains in Appalachia to reach coal-rich areas. Now one would think that was not so much of a big-deal - unless one lived in a hollow (the small valleys inbetween the mountains) and saw what lack of a mountain top does to the rest of the area - just little things like the woods and the streams and the meadows. There have been studies done on the damage to the environment; however, the environmentally-challenged administration has other ideas.

From today's New York Times (you can read the article by clicking on the title of this entry):

Last month, the Bush administration demonstrated just how regal King Coal remains when it issued a long-delayed report on mountaintop removal that callously announced that "these expensive studies" on damages to the countryside have become too "exorbitant" to be continued.

That's right: the Department of Interior bureaucracy, stacked with key political appointees from the mining industry, would bury the mountaintop abuses and complaints like so much slag under the government's deficit-bloated budget.

Now why am I so upset about this bit of Bush Boondoggling? My parents once owned 100 acres of mountain top and "hollar" in West Virginia - I spent many days there enjoying nature and the quiet. My daughter spent her summers there, learning about simple joys. I am so glad my poarent are not alive to see there paradise routined by corporate greed.

Can ANYONE say "solar engergy" - "wind energy"??? ANYONE?

Journalists, wherefore art thou?

In 1960 I cut my liberal, news-junkie eye teeth at the age of 13 on the likes of the Washington Post,confounding a conservative father born the same year as the new President.

As a young mother, still a card-carrying liberal, but no-longer starry-eyed my-country-is-right citizen, I marveled at "Woodward and Bernstein"'s exposure of a corrupt White House.

Once I had dreamed of being a member of that elite group - insiders, but not insiders, political journalists, who knew the movers and the shakers and reported on them, revealed the important machinations, told the pulbic the truth about their government (as opposed to the truth about the individual government officials) - journalists who recognized the difference between a break-end at the Democratic headquarters, not a semen stain on a dress.

And now, we have a government whose officials "leak" a false news story to the press (Sadam wanting to buy uranium in Africa given to Miller of the NY Times) and then different government officials (Rice, Cheney and Rumsfield) pointing fingers at the very same story validating their call to War.

Where is the hue and cry from the Fifth Estate. Even Woodward punits for Fox News. WTF is Bernstein? Are our journalistic souls left only to Arianna Huffington at
www.huffingtonpost.com or a badgering Chris Matthews on a rarely-watched MSNBC.

Where are the watchdogs of the press?
Where are the American people?
Oh, Thomas Jefferson - we have deserted your ideals.
We have a free press - but only for the government and not the govern.

A Patient Remembered

She had a small sore on the side of her nose.
I was a student nurse, working on 3-East of Easton Hospital when I was assigned to the patient, a young woman who had been admitted to have surgery on her nose. This was almost 40 years ago, when you were admitted the night before even relatively minor surgery.
I don’t remember if I prepped her for the surgery. I just remember having her for a patient. There was nothing remarkable about her, her nose or the sore – not at that time. The reason why I remember after 40 years is that I saw her again, years after our first encounter. And this time she had very little left of her face.
It seems that the sore had been diagnosed as cancer. I’m not sure what type. I was a student nurse and maybe wouldn’t have known anything about the type. I just remember that she had refused the surgery that could have removed all of the cancer. She may have needed a partial nose prosthesis. But she didn’t want that. She decided to go home and die.
Only she didn’t – not for many years. By the time I saw her again, I was a visiting nurse with a five year old daughter and my own possible diagnosis of cancer.
I had found a lump on my thyroid – did my own palpitation and discovered an unusual area. I had a history of radiation treatment as a child. In the early 50’s radiation was used as a treatment for enlarged tonsils and adenoids prior to surgery. At the age of six I had three of those treatments. At the age of 31 I could be diagnosed with thyroid cancer – the probable long term effect of those treatments.
A week before the scheduled thyroid surgery, I was asked by a social worker at the hospital to make a home visit. She had received a call from a man about his wife. He was having difficulty caring for her at home. He wanted her admitted to the local county nursing home, but she need a medical exam first. She hadn’t seen a doctor in more than 10 years. The social worker wanted me to visit her at home, get a medical history and try to convince her to go into the hospital for a complete work-up. I agreed to do it.
The house was a small Cape Cod in modest development. I parked my car and walked to the small stoop. Before I could ring the doorbell, I smelled it. The sweet-cloying smell of dying tissue, cancer, rot – almost the odor of decomposition – but not quite. Not yet anyway.

The husband answered the door and introduced me to his teenage son. He then led me into his wife’s bedroom. The smell was overpowering. The woman, now in her late forties, was sitting in a chair by her bed. She had a swollen belly, indicative of long-term alcohol abuse. She had a earplug in her ear; it was connected to an old radio. The husband and son had made a make-shift hearing aide for her. She needed one; the cancer had virtually eaten away at her ears.
And her face. Most of her face was covered by a flannel bandana, leaving only her eyes staring at me about the soft material. The flannel swayed in and out with each of her breaths and with each breath came another wave of the nauseating smell.
I smiled, took her hand, thin, bony with almost transparent yellowish skin and introduced myself. She could talk but she nodded her head. I took her blood pressure, pulse and listened to her lung sounds, all the while the soft sway of the flannel and the stink of death.
Then I asked her the important question – important to both of us. Would she let me see under the flannel? She nodded slowly, reaching up to lift the cloth.
From the base of what had once been her nose was only a gapping, dark red opening, her tongue partly gone, her soft palate eaten away. I took a penlight and examined the area – not wanting to offend her by immediately looking away and yet not wanting to se more. I clicked the light off, thanked her and slowly took the cloth from her hand and lowered it myself.
“You know it’s difficult for your family to care for you.” She nodded. “You know that you need a medical work-up before you can be admitted to a nursing home.” She nodded. “The best way to do that is for you to be admitted to the hospital.” This time she hesitated, but after a few seconds she nodded again.
I left my patient and went out to the living room to talk to the husband and son. I learned more about the woman in the room. She usually drank a half gallon of wine a day – for the pain. It was getting more and more difficult for her to even take blended foods. She slept sitting up in the chair. It was more than I needed to know but less than I wanted to know.
How did she let herself get to this? I wanted to ask. But I could see that the family was in more pain than my patient so I didn’t.
I called a physician who owed me a favor and made arrangements for the squad to pick her up and take her to emergency ward. I was adamant that she be admitted directly through the emergency ward and that she not be seen by every med student and intern in the hospital. That was her only wish – not to be put on display.
She was admitted that afternoon. She was placed in reverse isolation to prevent her from getting infected - because the huge opening in what was once her face could allow bacteria to invade easily. She was given pain meds, intravenous nourishment, antibiotics. Her family visited regularly and the nursing home application was started.
As the visiting nurses’ hospital liaison, I saw her daily – just to smile and wave through the isolation glass window – to let her know I hadn’t abandoned her.
The next week I was admitted for my thyroid surgery. The lump was cancer, the lobe was removed and I went home after a few days.
My patient with no face died in the hospital. All the precautions meant nothing. She developed an infection – possibly from the hospital environment itself – and she wasn’t strong enough to fight it.
She finally got her wish from that first hospitalization ten years before.

Where's Mitzi?

After a week of more than daily blogs, Mitzi is quiet.

Well, Mitzi is back to work ("WORK!" Maynard G. Krebbs) and during the time she is not working or sleeping, she will be writing.

Now, Mitzi must admit that she will watch a little TV every so often - but only for inspiration. Ahem . . .

And then there's the To Be Read piles of books that sit everywhere in Mitiz's living room.

So this blog will be not quite as busy as the last couple of weeks.
Try to survive.