Throwing away the cookie cutter

One oft-heard tenet of my training is to go with the patient. When working with kids, it means that they chose the activity and direct the play. I, in turn, am a facilitator, an observer and when called upon, a participant in the fantasy world that the child creates. Children's play is often a surprisingly literal enactment of their world. What does their play tell me about their life? Is the play lifeless or repetitive, or out-of-control, or unstable, or full of painful events or hidden perils?

Recently at the beginning of the hour, a woman announced that she was unable to sit down that day. She had to have the door open and the radio turned off. In fact, if she had her druthers, she'd be outside walking. It was a lovely unseasonably warm day, so out we went. She thought she'd only need to walk around the block. I told her about a terrified little girl that had to be walked around the block three, sometimes four times, before she wound down enough to play inside. That day we ended up walking for 50 minutes. Over and over she apologized because she thought her problem was so silly. I corrected her because her difficulties were keeping her from enjoying her life and doing the things she had previously done with no difficulty. In fact, her life sounded pretty miserable to me.

Someone driving by might think we were just two ladies out for a stroll; however she was telling me about her world; a world where she was afraid to be alone, afraid to ride in the backseat of a car, afraid to drive by herself, afraid of being in a room with too few windows, and in constant fear of something happening to a member of her family. Her world is a prison in which she is rarely at peace. We discussed nutrition, the pros and cons of psychotropic medications (she has a cabinet full of them, most unopened), and small steps she might make to gain a bit of control over her life. Mostly she talked, we walked and I listened. This is hardly a by-the-book, standard cookie-cutter approach, but it was a most productive hour. So I've dusted off my walking shoes and will take them in to the office just in case we need to take another walk the next time she comes in. We will continue to walk as long as she needs to.

Merry Christmas!

by Jan Gossaert_Early 16th century




I just love the heavenly host hovering in the sky in this painting. The angels seem to be the only ones in this scene who really understand what's happening. They seem to be clapping their hands with joy. Everybody else looks most serious.

Little graces have abounded today. Youngest daughter and boyfriend arrived safely after a long trip filled with flight delays and a missed connection. Miraculously their luggage all arrived after being routed through O'Hare. Earlier I walked into Mother's room on the nursing unit to see a single red rose with a card which read "From someone who is thinking of you". One of the nurses told me that a rose was delivered anonymously to everyone of the patients on Long Term care. So many kindnesses have been extended to Mother and the others on the unit, most of whom have no idea who to thank.

Gifts are all wrapped. The tree still needs decorating. Oldest Daughter and my favorite son-in-law are en route. Good Lord willing our house will be full tonight. Well, not quite full. There is one free bed in the boy's room. Life is good. My family is healthy, normally content, employed and no one is in jail. We have food in the kitchen and will be able to pay our Christmas bills. According to NORAD, Santa is somewhere over Siberia, so Christmas is on the way. I send wishes to you for a joyful Christmas and a wish that your eyes be opened to the miracles around you.

It's beginning to look a lot like Christmas

The last month has been really tough at work. Two new couples and two new individuals have come in plus two old patients have circled back around. The hours have been long and intense. Yesterday I set a personal record of nine hours solid without a break. That is nothing compared to my colleagues but it was a new high water mark for me.

I've never been too fond of working with couples but it seems this is my season for learning how.This week I thought I'd have to get the fire hose out on two occasions when things got heated between husband and wife within the hour. And then, of course, there is Christmas. All the old hurts,disappointments, and shattered illusions now rise to the surface. Several of my people have a history dead babies in their lives and all the baby themes of the season are particularly hard for them. One lady's husband died the week before Christmas many years ago and since then, there is no joy in her heart this time of year. And of course there's money. It's a lousy time of year to be struggling financially.

If one lives with an alcoholic, Christmas brings more drinking and consequently more fights. One woman's earliest memory was of her Mom pulling a knife on her Dad during an argument over where they should place the Christmas tree. One man recalls Dad and Mom having knock down fights about when they put up the tree. Usually Dad won that fight. The family had to wait until Dad came home from the bars on Christmas Eve to put up their tree. And current difficulties like broken relationships, feeling unloved, loneliness, being poor, being sick, being laid off, being sad are all magnified in the light of the holly-jolly, jingly-bell frenzy surrounding us. One thing that keeps this unrelenting misery from becoming overwhelming are the touches of God's grace that filter through the muck. Yesterday it came through the CNA who told me she's crocheting an afghan to give to my mother for Christmas. Or through the man who left a big bag of cereal treats on my desk which I was able to share with my patients all day long. One woman told me of receiving a $500 dividend check yesterday just when she was wondering how she'd pay for repairs to her car. The bill came to $495. At such moments, my heart is lifted, I am encouraged and my prayer is "Thanks I needed that".

Owl on the prowl

This evening, a great horned owl perched in a branch above our roof. His hooting called me out of the house and it was still light enough to get a proper look at him. According to my owl authority this fellow is claiming our house as his territory. The staking of territory is a preamble to nesting. Perhaps he'll hang around to raise his family. There are lots of rodents who come in to the back yard to pick up what seeds the birds drop from the feeder, so an owl family should not go hungry here. Last Christmas eve, a pair of great horns flew in to serenade us on our front porch. It was a one of a kind Christmas present.