An Outdoor Sage

My guest post author this time is my very own husband, Steven Jon Kaplan, a pianist and fan of nostalgic melodies. While reminiscing about a mysterious guitarist in New Orleans, Steve shows us how music can be a salve in times of loss:

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During an evening stroll by the northern end of Jackson Square in New Orleans, I was enchanted by an old man with a long scraggly blond beard playing the guitar. His appearance belied his ability, and on second thought enhanced it, as it created the sensation of a timeless miracle. The tunes were selected to create a mood of melancholy reflection that captured each one of the thirty or forty listeners so completely that each believed only oneself and the old man existed. Proceeding from a bittersweet ballad to a lament of love lost, many in the audience threw dollar bills and sat on the nearby benches to enjoy the concert. As the Mississippi River swallowed up the last rays of sun, the remaining seating spaces became filled, with the admirers forming ever-widening rings of devotion.

Finally, when the crowd had reached an astounding size, the venerable guitarist, who I later discovered was “Grandpa Elliott” (Elliott Small), played “Fire and Rain” by James Taylor. He paused just long enough to acknowledge the mounting bills and coins in his guitar case before continuing on with the next sad reminiscence. If you spent a long enough time with Grandpa, you would hear all of the songs about the endearing folly of the human condition written from the mid-sixties to mid-seventies including: “Yesterday”, “You’ve Got a Friend”, “Cat in the Cradle”, “The Long and Winding Road”, ”So Far Away”, “When I Die”, and “American Pie.”

If you should ever pass by Grandpa Elliott on Jackson Square, be transported into a world of sweet harmonies, where things don’t turn out as you planned but at least the rhymes are working and each sorrow ends with a clear ringing chord.

Raised in Baltimore, Maryland, Steven Jon Kaplan is a financial advisor with a site of his own, https://truecontrarian-sjk.blogspot.com/p/reminiscence-of-week.html. In the personal part of the site given in the link here, he regularly shares reminiscences like the one above.

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The Camel Who Avoided A Broken Back

“Previous straws are more crucial than the last one. Take one away and the last loses its power.” (From an old Tweeted proverb of mine based on the much more ancient original proverb about that unfortunate mammal.) I recently realized from my own experience that sources of stress can be like those straws. They pile up in layers one at a time, each obscuring the previous ones yet taking a deeper and deeper cumulative toll. We sort of “get used to” each straw and try to ignore it or shrug it off best we can, especially while dealing with the latest incoming one. We lose track of our tally of how many straws have accumulated and to what extent each exacts its price, and this suppression of our awareness is what threatens our well being.

Let us ask ourselves, How many straws are we bearing now? Perhaps the first one is a family estrangement from 20 years ala Jacob and Esau. The second one might be credit card debt that never is completely cleared from month to month. Others vying for recent provenance might be watching Death stalk a family member, ready to snatch him from behind, or having to discontinue a work or personal relationship that has more and more dysfunction and less and less benefit. And then to top it off, bronchitis might come around to make a call on one of us.

As the straws gather up like the increasing numbers of leaves now stealthily taking over the ground, we habituate to the point that we forget about the first covering of leaves, never mind the ground itself.

No one can advise us which straw to tackle first, but it does not have to be in order of their arrival. Simply becoming more self-aware of the whole conglomeration of ‘em will help us in analyzing which one we should topple off first, making us like the lucky camel.

Folk Philosopher

Ricky, who designed and painted parts for rare cars and motorcycles, proclaimed: “I’m gonna drop dead in two months.” That is how he opened the conversation when I met him for the first time as my patient. Talk about cutting to the chase! Quickly adjusting gears from an opening greeting to this steep fall in topic, I asked if he was afraid of death. He replied, “I am not afraid of things I can’t change. I’m only afraid of things I could change but I don’t.” Ricky was not able to elaborate. He moved off to the relatively lighter topic of the motorcycle he built for himself and decorated by himself but would now have to sell (for obvious reasons).  Maybe he meant by his remark that he was afraid of living with guilt and regrets. Or maybe he meant he kept doing things that made him unhappy.

I can only speculate, but what grabbed my attention was that Ricky feared dealing with choices more than dealing with fate. Usually it is the reverse for most of us, is it not?  Perhaps for him, uncertainty and lack of confidence to better himself was scarier than the certainty of his fate. Can’t control it? Then no responsibility for what happens. There is just sweet surrender.

Maybe a small part of us in some remote corner of the psyche can admit to identifying with Ricky. We can be passive about certain things. Perhaps what we really fear is having less and less control over doing a given thing differently because we have built thicker and thicker emotional walls to surmount. This then blurs the distinction between fate and choice. I trust that our self-sabotage is far scarier for us than any Halloween image we may encounter tonight.

Grief Lesson For Petless People

If you think people say the dumbest things to you when you are grieving for family or friends, just wait until your beloved pet dies. Or if you are the one saying such things to pet owners, you won’t ever again be so insensitive after you read the guest post below by Dr. Dolores Spivack. A tear might just creep out of your eye.

I Miss My Cat    

When your pet dog or cat or bird dies, nobody sends you flowers or donates money in its name to a favorite charity, not even the American Society for the Prevention of Cruelty to Animals. If you get any condolences at all, your friends will say at best “Sorry and did you see the game last night?” Some people have even said to me “Your cat died, so now you don’t have a cat.” I miss my cat.

My cat, Mel, died two months ago after living all of her eighteen years with me. She was born right into my hands after her mother’s difficult labor. No bigger than a small potato, I massaged her chest with my pinky finger and Mel took her first breath in the palm of my hand. I then helped her mother clean her and nurse her.

At the end of her life, Mel only had one tooth and was almost totally blind. Because she shook her head so much after her second stroke, her ear shriveled leaving her only one ear. She was equal to about one hundred in human years. But, she could still navigate the house, find her litter box, and jump on the table. If, and when I reach one hundred years old, I want to be able to jump onto a table just like her.

I miss Mel. I miss her faithfully waiting for me to come home, even if all she wanted was her can of food. I miss her underfoot, even though I often stepped on her tail. I miss her scattering of toy mice I would give her as holiday presents. She couldn’t catch the real mice, only the toy mice. That made me laugh so much. The toy mice only collect dust now.

I knew she was important to me while she lived. I did not know how cherished and how vital she was to me now that she is gone. I find it difficult to explain to my family and friends how much I miss her. Often, when I wake up in the morning, I think I feel her cuddled next to me. Then I remember she died. I miss Mel.

My grief for Mel is as deep and sad as any I have ever felt for any human, friend or family. Why is that not acknowledged? For almost two decades, Mel made her presence known in my house; she ate her canned food with me while I ate my meals. While I slept, she cat-napped but for many hours more than me. She greeted me and all visitors with curiosity and a welcome. She was as much a part of my life as my family and she witnessed more of my life than anyone else. Why would it seem strange to mourn her loss so profoundly? All I ask of my loved ones is empathy at best or solemn silence at least.

When Mel died, I waited until I was alone to bury her. I knew I would cry long and hard. I wanted the privacy to cry how I wished. I felt no need to be strong. I placed her in the earth with the same hands that welcomed her when she was born. I sprinkled dirt over her shrouded body and tamped it firmly down while my tears made puddles of mud on her grave. I miss Mel so much.

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Dr. Dolores Spivack started a writing group to motivate her to finish her dissertation about New York City building codes. After successfully completing her PhD in Architecture, she has gone on to write creative nonfiction pieces like the one here. The survivors include a greyhound and Dolores’s husband. They both attend a yearly greyhound convention in Gettysburg. And yes, the owners’ dogs attend too.

Closing In

When I first came aboard hospice care, one of the most common topics patients would reminisce about was World War II. Fortunately I had enough historical knowledge for them to feel I was on the same page. Now, about fifteen years since I first worked as a chaplain, their reminiscences are more often about the Vietnam War. Same goes for music. Patients are starting to talk about songs I grew up with!

On the one hand, it’s nice to have more of a shared background with my patients. I can chime in with my own memories if they refer to Nixon or to the Moody Blues.  On the other, I don’t want to have all that much in common with my patients if you know what I mean. It is a reminder that as a sixty-something, I am edging nearer and nearer to the same final curtain that has started its descent upon them. I am also having to care for patients more and more often who are my age or younger.

A gentleman I met at an open mike event last week was bursting to talk with me. I had just read a portion from my hospice career book about a patient who liked to refer to me as “doll” and who knew the game for him was just about over. This gentleman who I will call Sebastian was in his seventies and was grappling with some recent deaths in his family. The memorable piece of his story was that he felt “selfish” for pondering his own mortality. In the same breath he told me that given his age, he fears death more than ever. In other words he felt guilty (See my last post on this most entrenched of emotions stemming from loss. That is, forget about trying to talk someone out of it). When I asked Sebastian what was selfish about thinking about his own death, he said, “I should be thinking of the person who died, and I should be helping my uncle.” As I think about this now, his dilemma was that his fears were overriding his efforts to honor the deceased and console his relatives. And when I told him it was normal to think about one’s own end in these circumstances, he said, “It may be normal, but it is still selfish.”  I nodded my agreement, because as I explained in my last post, it is useless to try to talk anyone out of their guilt. All I can do is ask probing questions and make comments that can increase self-awareness and self-discovery. Perhaps feeling selfish was his method for distracting himself from his fears.  Ah, the complexities of the human psyche! This reminds me we should never be so quick to think we have figured someone out and therefore know what they need or should do.

As for me, I do not feel selfish about focusing on my own demise as I serve my clients. In fact, it gives me more in common with them! But the downside as I hinted in the beginning is the fear of, among other things, a premature end. I am glad in my case that fear has won over guilt because fear can be tamped down as I learn from my patients, while relief from guilt is much harder to come by.

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To see my post about a client who did diminish my fears, see this entry from February 12th, 2018:  https://offbeatcompassion.wordpress.com/2018/02/12/how-to-have-the-final-farewell-without-fear/

Guilt: The Most Tenacious Emotion

Mr. Guilt gets it wrong so much of the time, skipping over people who should feel its punishing pinch, and injecting its emotional pain into compassionate people who should be fully at peace with what they are doing or have done. The public pictures chaplains hearing confessions of sin that people feel guilty about. But  patients and families under my care rarely have wrongdoing to reveal to me, such as skimping on care for a loved one in order to ultimately have more money for themselves, or confessing to assault, harassment or any other kind of crime from their past. Much more common is the guilt for things they should not feel any guilt about at all, and if anything, should be at peace with or even proud of.

I am thinking now of a patient Matilde, who has been so religious all of her life that “she almost became a nun,” a child of hers said. She is confined to bed. When I see her, she speaks Portuguese and she settles for my Spanish as a linguistic compromise.  At each visit, she laments that she cannot get out of bed and go to Mass. I assure her that God is everywhere, including her room, and usually this does not console her. But one time I said it again and went into more detail, and to my consternation, she started to cry even more. “What did I do now?” I  (guiltily) wondered to myself. Fortunately her sister was visiting and she could translate the amount of Portuguese the patient was saying that I did not understand—which I assure you was a substantial chunk. She translated, “I am crying from happiness, not distress, because you brought God to me.”

As moving as that was, assuaging guilt is the exception. Trying to do so might even let Mr. Guilt become even more entrenched. I have to remind myself that instead of talking a person out of guilt to let them talk about their guilt. This is really no different from how the helping professions should operate regarding any kinds of changes for the better they yearn for their clients to make.  We have to ask questions that will unearth hidden angles. We have to refrain from giving them the distraction of resisting our suggestions of “Don’t feel guilty” instead of exploring what ghosts past and present are fueling it. Clients have to find the end of their guilt trips on their own, and all we can do is illuminate the obscure segments of the journey.

Sometimes I am lucky enough to see Mr. Guilt being let out at his last stop when a client talks with me about their guilt during a series of conversations. There was the case of a patient’s son, who I will call Samuel. His mother, who will get the name Jackie, was a patient of mine for around a year. I saw that when he visited her, she would needle him about this or that and make sarcastic jabs at whatever came to mind. When I spoke with Samuel about this after his visits, over time he built up a story of family relationships with plenty of twists and turns for guilt to ride along in. I was surprised first of all when he said his mother favored him over his other siblings, given all her hobbling negativity towards him. (If that is favoriting, I wonder what his siblings dealt with; i.e. “With friends like that, who needs enemies,” as the saying goes.) Over time Samuel talked about his sources of guilt, amply supplied not just from within, but from his siblings. The gist was that they accused him of not giving his mother enough care, the right care, enough money, enough visits, and so on. No praise and certainly no encouragement that I supplied about his compassion, his constant visits from far away, no lamentations over the hostile texts and emails from the sibs which he had showed me, served to derail his guilt. Of course guilt stalks a favorite child, so I knew this was part of the story, which we discussed. I suspect even Joseph felt ill at ease as much as he reveled in his coat of many colors. Still, covering that did not make any headway either.

I soon refrained from praising him and discussing favoritism and over time uncovered a clue that at least took guilt out of the driver’s seat: “When you feel guilty, this lets your sisters do their job for them. They don’t have to feel guilty about anything they do; they just lay it all on you and instead of them beating you up, you oblige and do all the work of beating yourself up for them.” For the first time regarding his guilt, Samuel said he felt “lighter.”  A day later he emailed me that he was sleeping better. Ah, Mr. Guilt, I got you that time!!

In Praise Of Euphemisms

The way some people pooh-pooh euphemisms you would think they were a miniature form of fake news. When I was a chaplain intern I was admonished, “Don’t say ‘pass away’ or ‘ she is in a better place.’ Tell it like it is and say the person died or is dying.” I do get the point about being honest and direct about a painful and scary subject, and that such directness is a corrective to all the death avoidance in our culture. Euphemisms can even do great harm by breeding misunderstanding. I have cautioned families with small children that if they say “Grandpa went to sleep” the kids might be afraid to go asleep and suffer the same fate, or they might keep hoping Gramps will wake up. Clear language also may help the mourners grasp more quickly that their loved one is going or gone and that it is time to go forward on their grief journey.

But sometimes euphemisms may be exactly what the chaplain ordered. The problem with directness is that it can be, well, too direct. Is it always necessary to drop the unvarnished truth on someone all at one go? Maybe truth in small doses is more manageable. Sugar-coating has its place if the alternative is not to take the dose at all. After all, what family member can take in all at once that death is imminent? So many times I talk with family on the phone when their loved one is on hospice who ask me if the patient talked with me during my visit. This is after I see the patient  just prior to the phone call and observe that he is completely unresponsive and glassy-eyed, which means, to coin a new euphemism, he is about to become a part of world history. Rather than necessarily say, “I’m so sorry to say this, but it seems that your husband is about to die and probably has only  a day or two left,” I might say, “I think he is not speaking now because he is turning inward and preparing for the end.”  That is pretty clear without mercilessly rubbing in the details. And even with that, the family might go on to chatter about the patient feeling better tomorrow.

Sometimes I use euphemism as an entrée into general discussions on death. After all, the title of my book, which is about true stories my hospice patients told me, is a euphemism! (The title is Encountering The Edge.) And if you are a health professional reading this blog post, you may well know that humorous euphemisms are a part of self-care. So very many times I have joked with my own husband, a baseball lover that so-and-so is “in the bottom of the ninth.”

Next time you see that someone is in Act Three, Scene Three, consider euphemism as one tool among many for helping others as well as yourself find a byway when the main road is impassable into that most formidable of subjects, death and dying.