May 16, 2005

Even with a living will and a DNR order you may not die in peace.

Shortly after my father retired at age 65, he and my mother signed Living Wills to be used in the event they were in a terminal situation. My father died almost 30 years later.

Hospice was called in during the last week of my father’s life, during which he suffered a number of small strokes. The people working with Hospice are devoted, not to prolonging life, but to guarding the quality of life for the terminally ill patient and his family. For this reason a yellow “Do Not Resuscitate” order was pinned to the wall above his bed. Hospice will not care for anyone unless the order is in place.

My mother is now older than my father was when he died. Recently she moved into CountrySide, an Assisted Living Facility. She is currently sharing a two-bedroom apartment with Tess, who just celebrated her 102nd birthday. We are waiting for a one-bedroom unit to become available.

My mother is in a wheelchair; she has never re-gained the confidence to use her walker after the series of falls that forced her removal from her own home. Other than that, she is in very good physical condition, taking only one daily medication in contrast to the handful consumed by most of the other residents. Her mind is clear and her short term memory reasonably good. She is alert and doing very well for her age.

Tess is in even better physical condition but suffers from degenerative dementia. In a less well-staffed facility she would be confined to the Alzheimer wing, a little-talked-about area which exists in every ALF or nursing home. But CountrySide is an upscale place and the staff keep an eye on her during the day, feeding her in the staff Break Room and seating her in the hall near the nursing station for most of the time she is awake.

Tess does not have the aggressive behavior often evident in this disease, but she is prone to the compulsive repetition frequently seen in AD sufferers. Tess travels the hallways with her walker whenever she can slip away from her watchers. Up and down, up and down, up and down the halls, forty times a day. This is probably what keeps her in such good physical health.

Knowing this about Tess, I was surprised to see a DNR order on her bedroom door. The edges were curled as if it had been there for a long time. I inspected it more closely and saw that the date was several years old.

I had been under the impression that a DNR was only issued when the patient became terminal. After all, didn’t a Living Will dictate that life should not be prolonged by artificial measures?

My friend, Michelle, is a nurse in the Urgent Care section of our local hospital. I went to her for information.

”We see them all the time,” she said, “the people who don’t have a Do Not Resuscitate order. They are usually older people who have had a heart attack or a stroke. They are all blue, with lots of tubes attached to them. And the families are upset because this is not what their parents wanted.”

”But doesn’t a Living Will cover that?” I asked. “That’s what my mother has, what my father had.”

”No,” Michelle said. “A Living Will means we may not prolong life with artificial respiration or intravenous feeding. But we have to try to save someone’s life if we can.”

”Explain that to me in more detail, please.”

”Quite frankly,” Michelle told me, “when people your mother’s age come in because of a stroke or something like that, they usually have another episode within a day or so. Then we have to do defibrillation or perform CPR. And that’s horrible. Old people have very fragile bones and it is easy to break their ribs. I’ve done it myself, several times. It’s terrible. I hate it. Most health workers do.”

I was reluctant to talk to my mother about this. She has often mentioned her Living Will and the peace of mind it gives her. When she went into hospital we had my Durable Power of Attorney renewed, and the attorney suggested I also obtain a Health Power of Attorney. My mother willingly signed both of these. This means I can make health decisions for her. Still, I was reluctant to ask her doctor to issue a DNR order. What would he think of me?

”Ninety-nine doctors out of a hundred would approve of you getting a DNR now,” Michelle said. “It’s better than waiting until something happens to her.”

I checked with other health care professionals and they all agreed with Michelle. My own doctor told me that often ambulance teams ignore a DNR order; that there was no guarantee she would not be resuscitated.

In a way, what he said was a relief to me; the ultimate decision probably will not be mine. I picked up a DNR form from CountrySide, filled it out, and took it to my mother's doctor for his signature.

So now it is done. But I still feel like I’ve signed her death warrant.

I went to my first zazen (Zen meditation) session tonight, taught by a British woman who was taught in Japan by an Eastern Zen master and in Western Australia by a Western Zen master.

This teacher is the only Zen teacher in my city. There may be other groups (I haven't found any others yet), but this woman is the only approved teacher within two hours drive of my house. I am glad I found her.

The evening was held in a normal suburban house, in a large room with wooden floor boards and not much else other than some wall hangings and the usual zafu - zabuton combination.

Having not had instruction on sitting before, and also not having practiced a long (or regular) sitting in my own home, I was a little nervous (worried?) that I would have pain during the evening. It was, after all, a 2 hour zazen practice.

But it turned out to actually be 4 25 minute rounds, each followed by a 5 minute kinhin (walking zazen).

My feet went to sleep in the last 5 minutes of every round, but soon came back awake when I stood for kinhin. I am thankful that atleast I didn't fall over my own numb feet.

I really, honestly enjoyed it, even including the starting of a dull ache in my back (damn you weak back muscles!). The zazen experience is certainly different when sitting with others and the little added formality helped to set the mind in the right mood for sitting - aware.

I think I can say that tonight I have begun on a deliberate path of change. I have resolved to continue this regular zazen - both in my own home and at these weekly meetings. Hopefully this change will help me to learn (and defeat?) what I perceive as my greatest weaknesses: lack of self control / self discipline; lack of motivation; and lack of self respect.

I'm a streetwalkin' cheeta with a heart fulla napalm

I was in the Dunkin' Donuts here on campus. (This just happened five minutes ago.) Some skinny little student was staring at me, as if dumbfounded that I was eating a donut. I don't normally eat donuts--or really any sweets. I don't keep them in the house. I don't even like to keep soda around. But this girl was staring at me, surprised to see me eating. I kept me mouth shut and tried to ignore her.

I kept thinking.

I wanted to say--

Do you think I don't know what I look like? Bitch, I know I'm fat. I know I wear ugly clothes because I can't afford new ones and anyway, I'd have to shop at the fat woman's store. I know I have stretch marks on my stomach and under my arms. I know I can't even fit into most chairs. I know just how big and ugly my ass is.

I know that thousands of dollars worth of laser treatment still hasn't gotten rid of my facial hair. I know I look like a circus freak. I know I have to shave every day.

I know what sort of horror it is to look at me. So stop staring, motherfucker. Because I may be fat, but I can fucking fight, and I'm ready to go at any minute.

The fat person next to you may just be a bomb waiting for the perfect moment to kill you. So step away from me, you dumb, anorexic bitch.

UPDATE:

A friend of mine suggested I may have polycystic ovaries. Unfortunately, there is a cure for that. I'm already on a watch for cervical cancer.

After driving a few friends out to score some smoke last night, I stashed my car keys somewhere. We ended up getting the weed, so we go to my study with my friends to smoke down a bit. Needless to say I was stoned out of my head. By the time we had finished the bag of herb. It was time for me to give my fellow smokers a ride home. I am totally obliterated, so of course I can't find my keys. After combing the house over and over for the keys my friends decide to walk home. They only live about three miles away, so it's not a horridly long walk for them. After they leave I begin to think of where my keys could possibly be.

I had to work today, so I was quite worried that I may have to call in sick. This morning I once again decided to search for them. And guess fucking what. They were right on top of the refrigerator. The night before I had swore up and down that they were not even in the kitchen. But I was pretty damn stoned. I guess I just didn't see them.

Update on the crazy old lady at work:

It turns out that the money at cigarettes that came up missing were stolen by this woman. Now is that karma or what?

My mother is a woman of mystery

I have not seen her since I was 2 1/2. The last thing I ever remember of her was the Volkswagon that she had. I do not remember anything else of her. I only have one picture of her to carry my memories by.

She and my father were wed in 1973. They lived in Houston,Tx. He was 18 and she was 14.They spent the first two years of their lives together partying and whatever the early years of the seventies brought on. Then on April 7th, 1975, I was born. This normally would be a good thing, but it spiraled the chaos into further turmoil. They were divorced some time in 1976, which left my mother in Houston, and my father to move back to his mother in Waldo,Ark. I lived with my grandma and step-grandfather while my dad was finishing up his tour in the Army.My mother had visitation every other weekend, in which she would pick me up and take me to Houston to spend time with me and let my "other" family see me.

After a year and a half of this, I guess with all the drugs, and whatever kind of fucked up thinking she had, she killed herself on Sep 8,1977.(my little girls birthday,2003 :( )(Arkansas cemetaries:Lafayette County:Lakeside Cemetary:Calhoun,Sara Jean Davis)

I have tried many times to discuss this with my father, but to no avail. I know that this hurts him, but how does he think this makes me feel? We have briefly discussed this, and he gets upset and does not want to talk about it. He says that he wants to protect me from anything that has happened or might what happen. That is also the reason he says I have never met my mothers side of the family. He says he married her to drag her away from all of them, but it didn't work, she still fell into that volcano.The last time we discussed this he told me not to bring it up again, as this was the last time. Don't I have a reason to know the past?

Well, I have grown a little older and a little wiser since that last confrontation. I finally decided to leave my old man alone and let him sit in his own misery. I guess that I just could not see how hard that affected him, and that it just drudged up old memories for him. Maybe he thinks that he drove her to the fact or in some way contributed to the factor of her doing it.

Now I am more complacent with the idea, and I have unlimited resources to try and find my hidden family.

Maybe this is the drive I have to try and be accpeted by everyone. Or maybe why I am so scatterbrained and sometime's can't finish a complete thought.

I guess there are many things that drive us to do the things we do. Maybe it is a loved one that we miss, or some other tramatic experience that has pushed us to the edge to be accepted, or be driven to work as much as we do.

All in all, even though my mother is gone, I want to thank her for everything that she has given me to make me unique.

Happy birthday, Dad.

...Thinking about you today, I realized that I don't remember any of your birthdays. I guess I must have told you happy birthday that last May; maybe that memory of going to the movies with you and Laura and Margaret is from your birthday. Or maybe some other vision remains tucked away.

But today, I can't think about any of this without being really, really angry. You are not with me to celebrate anything anymore. Not your birthday, or my graduation; you didn't even know that I would get into college let alone to Northwestern. You're not here to comfort my fears about the future. You're not here to tell dumb jokes so I stop taking life so seriously. You're not here to help me learn to be an adult in this crazy, mixed-up world.

I will never call anyone else Dad. I will never take anyone else's name.

And I will never forget you, no matter how angry I am.

I say goodbye to you a little more every time.

Saturday night we went dancing at Ozio on M street. I had called her Saturday afternoon just to say hello. She asked, What are you doing now? Just sitting here smoking a cigar, I said. It's about to rain like a mofo. She said, I'm in my car driving home, but I can be at your place in 30 minutes. Stop smoking. Let's go out to a bar for drinks and we can smoke together.

I'm smoking a cigar. You like cigars? I thought you only liked cigarettes?

No, I love cigars. Get dressed. I'll see you in half an hour. Beep.

We headed downtown to 18th and M around 9 o'clock - still early. She had an apple martini and I had my usual. We headed up to the top floor. A party was happening. Everyone was young, hip and urban except us. She's a white Russian. I kept forgetting she hadn't really done the urban thing until she whispered THERE ARE SO MANY BLACK MEN HERE. I almost choked on my Ashton. Well, yes. This is downtown DC, after all. Waitress? I'll have another. And she definitely needs another.

Things didn't really get rolling until eleven, when a few couples started dancing. Half an hour of techno, then half an hour of dance, then the rest of the time was hip hop and urban dance. The sound system was deafening, but it was fun. Sonic waves rearranged several of my more important organs. By midnight everyone was on the dance floor, and several martinis later Marina was on top of her game.

Having almost white hair and being about 5'7" and 110 lb with a very narrow waist, she received her share of stares, but she stayed with me for the entire evening. She adored dancing and enjoying the American experience.

When we sat down, Marina had a funny look on her face when several young white women began freaking with the black brothers out there. I didn't think much about it, but when I looked over at Marina's face, she was obviously uncomfortable. Are you okay? She said, I feel dizzy. Can we go now?

Outside the club, our ears adjusted to the deafening silence. She took my arm and moved close. You are not afraid here? No, Marina. We'll be fine.

Those dances were just too sexually suggestive for me, she said. They don't dance this way in St. Petersburg. Or perhaps they do now. It's been a long time since I went dancing. Perhaps Vitaly and his girlfriend dance like this. I can't think about this now.

We walked to the car. Young revelers played under the streetlights as if it was daytime. She loved the city. Is like St. Petersburg or Moskva, she said. On weekends, always the young people they are dancing.

Last night's dinner party was the completely opposite experience. It was suburban fun, if you're part of the wealthy elite. Miss Vah needed a dinner date. It was the first time she'd been back to Victoria Farms since her divorce. She had to sell her mansion and move to Reston.

It was a progressive dinner party, the sort of party you have when you live in a friendly suburban neighborhood. Vah was cooking the main meal. I joined her at the second house. The driveway was two hundred yards long at the end of which sat a fairly modest 5 or 6 bedroom two story house with a cedar shingled roof.

The men were all good looking and gregarious. The women were all tony and interesting. It's a stereotype, but it's true, I swear to god. They made me laugh. The owner of the house was a former "DASD", which every good Pentagon employee knows means Deputy Assistant Secretary of Defense. I almost choked on my pulled pork and plum sauce. He was so normal. The guy next to him was a riot - an good Irish Catholic with a twinkle in his eye and a vice president of a large engineering firm in this area. He went to the University of Alabama during the Bear Bryant years.

An icy blonde had caught my eye earlier on that evening. Vah and I were sitting in the kitchen close to the dessert - Asian pears, made with bourbon and maple syrup, sprinkled with some green mint. It was fantastic. We were chatting quietly when the icy blonde walks over and introduces herself. She was tall and thin, a product of the 1970s version of San Francisco.

The glacial facade melted when she began talking about music. Turns out we both love The Band. When I said I adored The Weight, she actually smiled and opened up a bit. She began telling stories of her past. When she was 19, she'd nannied for one of the musicians in Yes, a popular instrumental band of that era. She had loads of funny stories to tell from the wild years in London. She enjoyed finding someone to talk with about music, instead of career, family, and all the other things she was too bored to talk about.

Vah was a good schmoozer and mingler, and she encouraged me to do the same. We mingled and met a bunch of new people. Linda, who had worked for United Airlines for so long she still called herself a Stew. She worked the international flights. Travel was her passion. Dave, who was taking a sabbatical to Asia for two months. B--, a chief engineer who worked on classified stuff. Tom's daughter, a cute little Chi Omega sorority sister at USC. The girls were buying Coach this year. Kate Spade is so two years ago. The well heeled sorority girls were wearing Steve Madden shoes. I know this only because I have daughters of my own.

The evening was cool and the wine was in plentiful supply. Vah knows her wines. I tried a glass of red - to me there is only red wine or white, and I cannot differentiate any further than this without lying through my teeth - but before I could get the glass to my lips, Vah asked was this the Spanish merlot? I said, Hell if I know. She said, because if it is, it goes down smooth, but in 30 seconds it will kick you in the ass. Another guy at the table was just about to drink his when he heard this, and said, but it got an 80+ rating.

That's not too good in this crowd. He knows his wines too, but he was checking Vah's reactions. It was easy to underestimate her. She's a good looking woman, very young looking. She shouldn't know wines as well as she does, but she was raised in Europe and attended her parents' wine tasting parties since before she was old enough to drink. The girl knows wines. She wrinkled her cute little nose. 86? God. That is swill. She said it like it was a fact. Mike smiled. Okay, she's good.

I said what the hell. Took a sip. Smoothe, just like Vah said. A bit of a cigarry finish, smokey. Everyone looked at me. 30 seconds later came the kick. Let me tell you, that was some kick. It was like Spanish fly on afterburners. I broke into a sweat and had some more fried rice, hoping to dilute the effects of this rocket fuel. Looked at Vah. She smiled. Told you. You should never doubt me.