Friday, January 21, 2011


I couldn't sleep Monday night. I was tired and had to get up & moving early the next morning for my staff meeting, but I just lay there: tired and awake, a hostage to my racing mind.

That really blows.

It was the meeting that was keeping me up, actually. You see I had this fabulous idea to add something to our agenda, a short "sharing," if you will, to help do some team building (we could use it -- 2010 was rough on us) and staff development. Anyway, the point of this new agenda item is for each staff member to talk briefly about one thing that has shaped the way she approaches patient care. These stories are often funny, just as frequently heart-wrenching, and always meaningful. We all have a story, and story-telling is one of the best tools for teaching and strengthening relationships, so I am all for it. But since I'm the boss, and since it was my idea, and since we had never done it before... I had to go first.

If you know me at all -- and I suspect you do if you're actually reading this -- it will take you no more than 2 seconds to determine what, and who, I was going to talk about.

And.... your 2 seconds is up.

The truth is that Mom's illness was, among other incredibly crappy, shitty, sucky things, a huge learning curve for me. Let's just say that all those things I "knew" about talking to sick, scared and overwhelmed patients & family members -- like how they are overloaded with information, and are in shock, and have different priorities than we do, and don't care how smart we think we are -- suddenly and vividly made a whole lot of sense. Because it really is all those things - plus denial, and anger, and desperation, and heartbreaking sadness.

I can have a conversation with a young clinician about how all of that is true, but through the filter of my mom... well, it's nearly impossible. And I knew it would be, which is why I spent three weeks not thinking about what I was going to say only to lay awake the entire night before trying in vain to come up with some sort of clinical script to get myself though.

Would you like to know how it went?

Well of course you would. It was agonizing. I apologized for the inevitable and did the ugly cry before I even started, and wondered the whole time if I was making any sense, sending any kind of take-home message that my staff could try to internalize for that next hard conversation with the parents of a fragile, failing baby. I desperately didn't want to sound preachy or patronizing, and suspect I succeeded because it's difficult to sound anything other than pitiful when you're sobbing. I noticed some of them tearing up, some of them a little uncomfortable, some of them sympathetic. One of them, a friend who went through a very similar experience with her brother shortly after I lost Mom, actually clapped for me. But all of them heard me -- at that, at the end of the day, was the point.

It was just the train wreck I had anticipated. Later that night I told Rob about it, explaining my tossing & turning from the night before and wondering out loud when I'll be able to talk about that time without it feeling so fresh. I sometimes wonder if that time will ever come. I hope it does.

I hate those nights I way awake chasing my thoughts. I never catch them and the race always leaves me exhausted the next day. My only consolation, at least this time, is that my story might help shape the way our therapists think about care. To remember that behind the diagnosis isn't just a patient but a rush of emotions, and that our roles as caregivers start where these families really are -- not where we need them to be. To understand that when it's all said and done, the very best clinical skills are absolutely worthless unless they are coupled with the insight and compassion to honor their fears and and hold each of their hearts in our own.

It's hard work we do, but we are blessed to do it.