I am listening to this CD in the car as I travel from patient to patient.
It is a very good book. I like it a lot.

It tells of life and what is remembered of the past; memories of decisions (and at times, one decision)that the whole rest of life hinges on and how one act, one lie, one happening can affect the whole rest of it and everything in it, about it, and around it...and eternal intrinsic happiness.
Once it happens there is no erasing it. How do you go on?

I recommend it.

March

I am listening on CD to the book March (about "the Little Women's father, Mr. March)...written by Geraldine Brooks. Every now and then an author comes along that literally makes me shake. This book, especially how it is told by the terrific voice actor, Richard Easton, is superb.
I will read everything she ever wrote without a doubt.

To me, life is grand when I can take my daily walk all bundled up against the fresh, new, winter cold with a book on my ears like this one.
Other than my home, my family and God I truly cannot love anything more.

When I first got into home care nursing it was because I had a new baby and didn't want to work long hours at the hospital. My first job was great. It was perdium...meaning, I only got paid for what I did, without benefits, without obligations. I was the "diabetic" nurse...I would go out in the early morning to give insulin and check blood sugars. I would be home in time for my husband to go to work. I'd spend the day at home in love with my baby. When my husband would get home, I would run out to do another visit or two and then we'd have dinner together. Perfetto. I made really good money and was able to spend most of my time with my family. Bravo. There were times when I would get called to see a hospice patient in my territory. This made me very nervous. I was thin skinned and not able to hold my tears if they are welled up in my brain. I always avoided caring for oriented cancer patients.

I remember getting a call to do a wound care for a young lady with breast cancer. OK...wounds..something fixable..I can do that! The lady lived in center city in a high rise apartment building. She was young, only in her early 40's, very well educated and made a very good living in advertising. Her large apartment was a show place for her art deco furniture, huge brightly colored paintings and objects imported from Italy, France and Japan. A terrace outside her kitchen and another off the bedroom were full of flowers and plants thriving in the afternoon sunshine. It was a clear day with a light breeze for added comfort. Everything seemed perfect.

"Can you please get me some tea?" she asked. I looked around and realized Beth was talking to me. "Oh, of course". "Is it in the kitchen?" I asked.
"Well it isn't in the bathroom", she said. Did I hear that right? Is she mad at me? Now I was getting nervous. I do not like when someone watches how well you do your own job. I knew this was going to be a dressing change/wound care from hell. Some patients just like to yell at you the whole time, telling you that this isn't the way it is done, you are supposed to do it that way, or I should just do it myself. Dying patients are angry, especially young dying patients. Beth was obviously alone; no kids, no husband, no parents (they lived in NYC), few friends... so the anger was probably worse because of that. I asked how she liked her tea (the bag was in a cup on the counter) but she didn't answer, she was in the shower. I thought...great, now I have to wait for her to get out of the shower. I didn't realize, because I was not given a thorough report beforehand, she needed to shower to remove the old dressings and to prepare her for a fresh wound cleansing and gauze and then 6 inch Ace bandages to hold everything together and keep her tightly wrapped until tomorrow when it all had to be done again, every day. Everything was on her bed: sterile gauze, sterile kling wrap, gloves, Ace bandages.

Beth faltered out of the bathroom and shivering went directly to the tea. She apologized for yelling at me and said she is always so cold after the shower. She cannot make the water too hot since it burns her skin and hurts. "Shall I close the window?" I asked. "Please" she said.

When she removed her robe her extra thin body was bony and wiry and pale. From her shoulders to her ribs was raw, excoriated skin and I winced before I caught myself. "It hurts more than it looks like it does" she said. "It looks painful" I said. "Do you take pain medication?" She pointed wearily to a table full of pill bottles..."It's all pain medication". "I took it when you called so the treatment wouldn't hurt so much". "Please call me 30 minutes before you are planning to come here so I can take a couple Percocett" she said. "OK, Sure" I said.

2 years ago she found a lump, she had it removed, she had radiation and chemotherapy that almost killed her. Then she got better and she approached her life with a rebound energy that she really appreciated. She had a great career and a fun life. And then it all stopped. 6 months ago she felt a dimpling and another lump on the other breast. Not only was it too late to remove but it spread to the outside of her body and her bones. The wound care was palliative. She would never recover. She was bitter and angry and after hearing the whole story I wondered how she wasn't more so. I wondered how the hospice nurses do this all the time.

She is alone. She refuses to move back with her parents or have them come here to nurse her..she wants some control.

I cried the whole way home.

I did a few more dressing changes and treatments before the month ended and the flower petals fell and turned brown. Beth died within 7 months of her reoccurence.

That was 16 years ago. I have since grown thicker skin and can help a dying patient without falling apart. Beth helped me with that lesson.

Thank you Beth.

"I believe in the supreme worth of the individual and in high right to life, liberty and the pursuit of happiness. I believe that every right implies a responsibility, every opportunity, an obligation; every possession, a duty. I believe that the law was made for man and not man for the law; that government is the servant of the people and not their master. I believe in the dignity of labor, whether with head or hand; that the world owes no man a living but that it owes every man an opportunity to make a living. I believe that thrift is essential to a well ordered living and that economy is a prime requisite of a sound financial structure, whether in government, business, or personal affairs. I believe that truth and justice are fundamental to an enduring social order. I believe in the sacredness of a promise, that a man's word should be as good as his bond; that CHARACTER, not wealth or power or position, is of SUPREME WORTH. I believe that the rendering of useful service is the common duty of mankind and that only in the purifying fire of sacrifice is the dross of selfishness consumed and the greatness of the human soul set free. I believe in an all-wise and all-loving God, named by whatever name, and that the individual's highest fulfillment, greatest happiness and widest usefulness are to be found in living in harmony with HIS WILL. I believe that love is the GREATEST thing in the world; that it alone can overcome hate, that right can and will triumph over might."

I make the most of all that comes and the least of all that goes.