Bananas

bananas

During a visit with my father last October, I experienced a moment of mutual presence with him, a moment so rare between the two of us that I had to write about it, not only for me, but for you. Do you have a similar experience you are in need of sharing?

Bananas 

While I eat lunch with my father today, he stares at the bunch of bananas in front of him. “They’re so beautiful,” he says. “Their so yellow.” He smiles, then giggles. Who is this man?

Before my father’s dementia started progressing a few months ago, he never noticed the details of anything beyond his checkbook or savings account. We certainly never discussed the aesthetics of fruit. But maybe the plaques in his brain are leaking a chemical that allow my father to be deeply aware of seemingly mundane things like bananas.

He takes a bite of his sandwich, then comments on the bananas again: “I can’t believe how yellow they are.”

Until my father’s uncharacteristic awareness, I never looked closely at the beauty of bananas: cylindrical bodies, tapered ends, and sturdy stems attached to inflorescent stalks. When I eat a banana, I usually strip the peel off, whip it in the trash, and devour the fruit. I grab a banana on the go, when rushing to an appointment, or when driving to work. After I’m finished, I throw the peel on the passenger side floor mat, or stuff it into the cup holder.

My father touches the top banana, lightly, as if taking care not to disrupt its serene poise, yet needing to feel its yellow presence. I ask him if he wants one. He pulls his hand back. “No, I just like looking at them,” he says. And so we look at the bananas, together.

Bananas was previously posted at  Beautiful Things, a weekly column by River Teeth: A Journal of Nonfiction Narrative 

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Stages of Forgiveness

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*Years after eighty-six-year-old Russell Weller ran me down at the Santa Monica Farmers’ market, I possessed enough emotional fortitude to unearth the new articles I had collected about the accident. It was then when I decided I needed to find a way to forgive him. I’ve been told that forgiveness is over-rated, that you don’t have to forgive to heal. While that might very well be true, my want to forgive others for any wrong committed is part of my constitution. So I had to at least make an attempt to forgive Russell Weller. Otherwise, I’d be infected with a case of chronic bitterness and cynicism, and worried I’d be contagious. Who wants to hang out with someone with a transmittable illness she has the capacity to heal?

To forgive, one must first assign blame. But, as in Russell Weller’s case, if there is no act of intentional harm, where do you place blame and, therefore, how do you forgive? To add an additional elusive layer, how do you forgive someone you’ve never met? Is it even possible to forgive someone you don’t know? I reached out to Russell Weller’s family years after the accident, but they refused my request to visit him. In 2010 he died.

The following year, I enrolled in an MFA program. During my third semester, still befuddled as to how to forgive Russell Weller, I wrote my critical thesis on the topic: The Face of Forgiveness. I examined how a particular writer, who had sustained life-threatening injuries after a car struck him, navigated the indeterminate nature of forgiveness on the page. Because each circumstance varies, forgiveness cannot be defined in absolute terms. **Since forgiveness is a process, I arrived at the conclusion that it can be charted in stages:

1) Understanding of the accident/incident

2) Transference of anger and other emotions

3) Self-pity

4) Awareness of others’ suffering

5) Avoidance

6) Surrender

These stages don’t necessarily occur sequentially. Like Elizabeth Kubler Ross’ stages of grief –denial/isolation, anger, bargaining, depression, acceptance – the stages of forgiveness may overlap, or one may become stuck in a particular stage. For me, I became stuck in one or two, and skipped another one or two altogether. It’s also worth noting that the stages of forgiveness may not occur in a defined timeframe.

Stage 1: Understanding of the accident/incident:

I dedicated months to reading news articles and investigative reports, parsing out the details of the accident: What Russell Weller was doing in the moments before he sped through the market, his medical history, his driving history, what bystanders witnessed at the scene of the crash. Somehow, I believed by reading those articles I would get to know Russell Weller and, therefore, be able to forgive him, or not. But written words weren’t enough – they seemed static on the page. Even though some articles included his apology – “I’m deeply sorry for any pain that everyone went through” – I could not hear his voice, hear his remorse, anger, or fear. And with all the contradicting statements about Russell Weller’s character and what people saw or didn’t see, I only became more confused. I felt like a pendulum – swaying dizzily between sadness and anger.

Stage 2: Transference of anger:

As I read articles about the role the local entities had to play in running the market, any anger I harbored for Russell Weller quickly transferred to city officials who were responsible for ensuring the safety of pedestrians. I wondered why they didn’t have sturdy barriers in place, rather than wooden sawhorses. But, similar to my confusion regarding how to feel about Russell Weller, my feelings and emotions swayed – from judgment to understanding, from contempt to submission.

Stages 3 and 5: Self-pity and Avoidance:

I did not become victim to self-pity  – perhaps the perpetual warring dialogue in my head thrust self-pity aside. For the same reason, I skipped avoidance.

Stage 4: Awareness of others’ suffering:

As I continued my dogged search to find meaning within the chaos, I could not help but be lured into an awareness of others’ suffering.  I imagined the physical and emotional pain the other injured pedestrians endured, and the rage and anguish that tore into the families of the deceased. I viewed Russell Weller as injured, too – emotionally, mentally, psychically. I imagined Russell Weller’s grief: plagued by nightmares, isolated behind drawn window shades, sallow from regret.

The judge who presided over Russell Weller’s trial said he “lacked remorse” Because he didn’t cry? Why is it that we have a tendency to forgive others only if they exhibit unequivocal remorse: falling to their knees, drooping, sobbing? But a display, or physical showing, of remorse is not necessarily what matters to those harmed. Of course, a sincere apology does not negate the harm done, but sincerely spoken words of remorse are what matter. The quality of the voice matters: is it harsh, tense, creaky?

In 2011, I Finally obtained and viewed a copy of the videotape of Russell Weller speaking with police officers soon after the accident. I slid the video into the CD player, inched close to the television screen, so close I felt as if he and I were together in the same room. Though he did not cry, his full-toned voice quivered as he said, “I’m in trouble with my heart and soul.” He voice quieted to a whisper, as if he were in church mourning over the dead: “God almighty, those poor, poor people.”  That’s when I forgave Russell Weller. That’s when I surrendered – to Russell Weller’s remorse.

Is there anyone in your life you want to forgive? Have you forgiven someone who has caused you harm? How did you arrive at forgiveness?

 

*Originally posted at Speak Out! A blog about surviving traumatic brain injuries. Hosted by Donna O’Donnell Figurski.

**Stages of forgiveness conceived by Melissa Cronin

 

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Health Care: “The Right of Every Citizen”

healthcare_musings

I recently had the pleasure to meet Dr. Gene Lindsey, a compassionate and empathetic physician for nearly four decades, who has been a guiding voice in Massachusetts concerning healthcare reform. To be fully informed about the latest happenings in healthcare, I encourage you to read Dr. Lindsey’s blog, where you can also sign up for his weekly newsletter Healthcare Musings. In an email exchange with with Dr. Lindsey, he shared with me his experience visiting his ninety-four-year-old father this past winter. Because I want to understand the aging process, and write about aging here on my website, his story intrigued me. My ninety-one-year-old father-in-law, Tom, passed away not too long ago. So, at this time, topics related to aging and loss are of particular resonance. Please enjoy this excerpt of Dr. Lindsey’s story, “I Can Do it Myself.”

This past February, I traveled to Lincolnton, North Carolina to visit my father and to share with him a celebration of what would’ve been my mother’s 96th birthday, if she were still alive.

My parents “retired” in late 1982 when my Dad turned sixty-two. After twenty-five years of “retirement,” my mother’s health declined in her late eighties, and my Dad transferred more of his time to her care. By 2006, caring for her became more than a full time job, and the medical resources to manage her various conditions didn’t exist in their community. They sold their home and bought one in the Atlanta area near my sister, whose daughter and daughter-in-law were both nurses. In Atlanta there were more specialists, with more services nearby. With the support my sister’s family provided, my parents were able to live independently. My mother survived another six years before she died in hospice care in 2013, two months before her 94th birthday.

During the last seven months of her life, after she enrolled in hospice, she lived a remarkably comfortable existence. Most of the hospice care was in their home – Mom received inpatient hospice care only when my father needed respite, and again at the end. The entire six years was a tour de force, organized by my Dad and sister.

The role of caregiver gave great purpose to both my Dad and sister until my mother died. Not only had my Dad lost his spouse, best friend, and confident of seventy years, but he lost his real purpose for existence. Dad had no social supports in Atlanta other than family. He was intellectually isolated because he had given up his work and social contacts to care for my mother. Despite many offers for grief counseling from hospice, he couldn’t connect in an effective way. 

Atlanta wasn’t the place for our Dad, but he couldn’t live alone anywhere else. In May 2013, we gathered in North Carolina at my mother’s grave to honor her on Mother’s Day. My Dad’s neglect of his health was most obvious by his instability on stairs that weekend and his story of a few “slips” at home. When he returned to Atlanta, he fell and broke his hip. 

The next six months were pretty dreadful and included a prolonged hospitalization. Our father didn’t want assisted living. My brother agreed to become a caregiver and live with him. He asked only that he and Dad find a home in Lincolnton that allowed each to have space for themselves, and that we figure out how to cover him so he could have a week each month at his home off the Georgia coast, to attend to personal business and spend time with his grandchildren.

To make such a decision is one thing. To execute the move and reestablish support systems is another. By the time of the move, my Dad had a mounting list of chronic issues – many were the result of inactivity from grief, but he still had a long list, including a cardiac pacer, residual problems from a total knee replacement, and late complications from surgery for prostate cancer.

Last May, a year after the broken hip, and as things were settling into a good rhythm in the new home with my brother, my father fell again when he tripped on a curb. He fractured his pelvis and spent six weeks in the hospital, including rehab. All the gains over the last year seemed lost.

The core issue was what part of his condition was due to memory loss and other cognitive issues and what part was situational depression and grief that might improve with the right combination of meds and rehab? Previous attempts to use psychotropic meds had been problematic. It became clear that the depression and cognitive issues would be best managed with counseling. Experience had taught us that the liabilities of meds for anxiety and depression in any but the most miniscule doses far outweighed their benefits.

Healthcare in Lincolnton had changed since my mother was forced to go to Atlanta for care. In the interim, the county hospital was sold to Carolinas Healthcare Systems, a growing non-profit system. My Dad hadn’t been effectively integrated into the system before his second fall, but he was by the time of his discharge from an affiliated rehab. Back at home, he was seen regularly in outpatient rehab, and his emotional and cognitive issues were effectively managed between his PCP and the larger system. When he visited me for a month in August, he could walk a half a mile with a rolling walker, if allowed many stops to rest.

Now, six months later, he walks a mile a day, with a sure gait, though he follows the advice of his physical therapist and never leaves home without his cane.

Earlier this past winter, he walked his daily mile on an indoor track of an athletic facility. Those 18 laps were “boring,” as he clicked them with a counter. Two months ago, an expanded supermarket opened in town, and he discovered that five laps around the perimeter inside the store was a mile. Now, while shopping, he counts his laps by shifting a coin from his left pocket to his right one at the end of each lap.

While I walked through the store with him during my recent visit, the lady in the flower section stopped us on three of our five laps: first to say hello and ask who I was, again to ask my father to pray for her friend who was having her kidney removed, and a third time to ask his advice about how to approach the store’s management about getting more work hours. My father had the time to chat, and enjoyed the opportunity to serve.

The real measure of his recovery is that he’s socially interactive with people outside his family and no longer talks about his life being empty of purpose. He’s active in his church, and writes Lenten essays requested by the minister. He has also spoken with the folks at the local hospice about volunteering and loves to attend “old philosophers” meetings at a fast food eatery most mornings. He’s developed an interest in a homeless man, who is seen regularly around town pushing a shopping cart full of his belongings.

The thematic high point of the trip occurred when we went to get in the car to drive to the store to go for a walk. I offered him a hand, but he refused my help with a curt yet logical: “I can do it myself. I will do it better this time than the last time I did it; and if I do it myself this time, the next time I try, I will be even better!”

I’m reminded of what I was taught in medical school: Grief is a two-year process. I’m also aware that many elderly people die in close proximity to the death of their spouses. I also believe that my father is the great beneficiary of the evolving body of information that’s leading to the improved care for the elderly. My Dad didn’t know how to ask for help and our efforts were well meaning, yet the job is hard and at times feels impossible. But hard is not the same as impossible, and I’m grateful for the medical professionals who appeared on cue when beckoned by a PCP who knows the family and the patient, and shows by his efforts that he cares.

The care my parents have been fortunate to receive, and the support their caregivers have been presented with may not be perfect, but all I need do is think back to the limited resources available not that long ago. The challenge now is to make care that is at least that good the right of every citizen, including the man wandering the streets with the shopping cart, who has a name and a history my father now knows.

 

 

gene_lindseyGene Lindsey, MD, CEO Emeritus of Atrius Health, served as President and CEO of Atrius Health and Harvard Vanguard Medical Associates from 2008 through 2013. Dr. Lindsey has been an internist and cardiologist for almost 40 years, practicing at Harvard Vanguard Medical Associates and its predecessors since 1975. He has a long history of leadership during that time. In 1997, when Harvard Vanguard Medical Associates, a non-profit, 500-physician multi-specialty medical group was created, Dr. Lindsey became the first Chairman of the Board for this new organization.  In 2004-2005, when five groups affiliated to form Atrius Health (formerly HealthOne Care System), Dr. Lindsey joined the Atrius Health Board, and in January 2007 became its Chairman, a position which he held until he was appointed as CEO. Dr. Lindsey served on the Advisory Committee to the Massachusetts Health Care Quality and Cost Council, Special Commission on Price Variation, and now serves on the Advisory Committee to the Massachusetts Health Policy Commission. Lindsey received his medical degree from Harvard Medical School and holds a B.S. in Chemistry from the University of South Carolina. He completed an internship, residency, and was a clinical fellow in cardiology at Brigham and Women’s Hospital. Dr. Lindsey is a sought-after speaker on the healthcare topics of payment reform, accountable care organizations, practice innovation, quality and efficiency.

 

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Glassmusic: A Novel by Rebecca Snow – Review

glassmusic

In her debut novel, Glassmusic, painterly prose brushes the page in sweeping greens and blues. Weaved throughout that lush 1920’s Norwegian landscape, is the heart of the narrative: A coming of age story in which young Ingrid struggles to come to terms with the sexual assault she witnessed against her sister, Kari.

Ingrid’s blind father, who relies on her to see for him, teachers her to play music on water-filled glasses. Those melodies, along with guiding her father, are what protect her from her secret and ground her through her tumultuous childhood. Her mother, who is jealous that her husband needs Ingrid more than her, looks away from her daughter in disappointment. And her sister, Kari, inflicts her with physical and emotional harm.

Ingrid seeks companionship, and quickly trusts Stefan, a Parisian boy visiting from France. It is this relationship, and their individual interpretations of faith and literature that spur Ingrid to become more aware of the world beyond her own microscopic one. Along with her newfound knowledge, she explores distant fjords, hills, and woods not only to escape the memory of her sister’s assault, but also to figure out who she is and who she wants to be. Is she a protector of secrets and lies or a teller of the truth? As she navigates her way toward awareness, slipping over rocky terrain along the way, she realizes that she needs her family, and that her family needs her. More so, as a reflective older child, she realizes she needs to tell the truth.

In Glassmusic, Snow creates palpable characters rich with universal emotions and conflict: anger, pity, empathy, loyalty, forgiveness, jealousy, and identity.

Ingrid’s father says, “Talking is like music, you must practice. (123).” Perhaps the same can be said for making sense of the unfathomable – it takes practice.

 

Rebecca Snow’s debut novel, Glassmusic, was released from Conundrum Press in November 2014. Her poetry has been published in Blue Moon, Pooled Ink, and was added to the Denver Poetry Map.  She won first place for narrative nonfiction in the 2007 Writers Studio Contest. Her piece was featured in Progenitor. Snow received her MFA in Creative Writing from the University of Montana and teaches English at the Community College of Aurora. Originally from Seattle, she lives in Denver, Colorado with her son and enjoys hiking the great Rocky Mountains.

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How to Keep Your Brain Fit

 

memorizing_poetry

Do you enjoy memorizing poetry?

Do you recall your youth, when when your teachers assigned you poems to memorize? Shall I compare thee to a summer’s day? Sound familiar? Or maybe you have craftily blocked that time period from your memory bank. But, like our quads and gluts, the brain is a muscle too. If we don’t exercise our muscles they’ll turn to flab. Memorizing poetry, or a song or scene from a movie, is just one way to keep our brains fit. And the profits are worth the time invested (I know, you’re wondering what the profits could possibly be).

Memorizing poetry primes our brains for retaining other types of information like names of people or a list of groceries. Studies have shown that rote learning benefits the hippocampus, the part of the brain responsible for consolidating short-term memory into long-term memory (http://www.bestcollegesonline.com/in-praise-of-memorization).

Memorization helps us focus, and improves our working memory – the ability to hold multiple pieces of information in the brain at once – allowing us to comprehend what we read, see, and hear. According to Bloom’s Taxonomy, “the highest order of thinking occurs at the evaluating and creating levels which infer that the thinkers must have knowledge, facts, data, or information in their brains.” With the facts laid down in our brain, we are better prepared to evaluate information and think critically (http://www.edutopia.org/rote-learning-benefits.http://www.bestcollegesonline.com/in-praise-of-memorization).

A regular practice of memory training staves off cognitive decline. For those of you who are living with the sequelae of a brain injury, try memorizing a poem, even if it’s a short one, like The Red Wheelbarrow by William Carlos Williams (http://www.poetryfoundation.org/learning/guide/178804).

But how do you begin memorizing a poem? For me, I focus on two lines at a time, repeating them over and over. I close my eyes and visualize the words. For instance, a few years ago, I memorized my first poem, Once by the Pacific by Robert Frost. Here are the first two lines:

The shattered water made a misty din.

Great waves looked over others coming in

I started by envisioning myself walking along the beach, listening to the waves crashing to shore, washing over pebbles – the sound of “shattered” glass came to mind. “Shattered” became a signpost that carried me further into the poem. I immersed myself in the scene, watching the waves roll over one another. If you’ve been to the beach, you know how waves behave, so the key is to allow yourself to be there, in your head.

I tend to choose poems that resonate with me, the ones with which my body and psyche connect, like Once by the Pacific. Before I explain exactly how I connect with the poem, here are the remaining lines:

And thought of doing something to the shore

That water never did to land before.

The clouds were low and hairy in the skies,

Like locks blown forward in the gleam of eyes.

You could not tell, and yet it looked as if

The shore was lucky in being backed by cliff,

The cliff in being backed by continent;

It looked as if a night of dark intent

Was coming, and not only a night, an age.

Someone had better be prepared for rage.

There would be more than ocean-water broken

Before God’s last Put out the light was spoken.

For me, shattered, dark intent, rage, and more than ocean water broken conjure images of the Santa Monica Farmers’ Market, where an elderly driver hit me and dozens of other pedestrians. This poem catapults me back in time, just prior to the accident, a portent, if you will. You may wonder why I’d want to remember that moment, but the poem does much more than conjure tragedy ;it speaks to my love for the ocean. When I’m home in Vermont, hunkering down for another frigid winter, this poem transports me to the beach my husband and I visit a few times a year in Anna Maria island. Again, I close my eyes and see myself walking barefoot in the water, the waves massaging my feet, the salt marinating my wintered soles.

I’m currently memorizing T.S. Eliot’s Preludes – 54 lines. I’ve gotten part way through the third stanza. I’ll let you know how it goes.

What poems have you memorized, and what prompted you to choose them? What is your strategy for memorizing poems?

 

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