Wednesday, December 14, 2022

Gems on my Cloak


 

No matter how much preparation I think I have done, there is always something bigger and more corporate than me, with the authority to make things horrible if I don't obey. They constantly change the bar such that what was a safety net is unattainable. The bureaucracy whittles at each step to achieve their desired level of attrition.

I needed another tool.

The trifold states of CURIOSITY, FOCUS, or REFLECTION

 During times of great and terrible sadness, I reflected on what it would look like if I could somehow miraculously be grateful. In my mind's imager I modeled what a grateful person might think or say in order to channel endless gratitude in the face of loss. As much as I wavered between the two, I could not hold both at once. And so I spent as much time each day as I could in gratitude to give my sadness muscle a rest.

Similarly, an accidental discovery came about at a desperate time; my mother died and I was already showing severe syptoms of the tumor without knowing why, and could not control the bad thoughts that began to edge in… even kitten videos made me cry, and all my go-to's hadn't prepared me for this. after days of crying, something caught my attention on the web, and helped me stop. Whatever it was caused my jaw to drop in awe, a natural beauty of some sort, no doubt -- and for some brief time I was curious -- a respite from the constant, smothering hopelessness -- enough that my mind had the tiniest leg up. The multidimensional anger melted in the face of anything that showed me I was the dark hurricane at the moment, the yang eye, yes -- but that meant I was surrounded by yin if I could adjust my focus to see.

SADNESS =/= GRATITUDE
ANGER =/= ABUNDANCE
FEAR =/= WONDER

The field research was consistent, any time I realized my fear was running the show, I immediately changed focus to wonders of the world, unlikely animal cooperation and friendship, awe-insiring scenery, and beings of all kinds doing amazing and talented things. The perspective shift was enough to work me through what I already know, that everything is impermanent, and in a long enough life many tragedies can fall. This is why I know to keep adding new sources of joy and fulfillment, and to carry on the way the women in my family line have done for centuries. Perseverado!

 The same thing happened when I realized the abundance was poorly represented in my mind. When I paid attention, I noticed it was inversely proportional to my temper, but at first I excused it as lack driving the emotion. Regardless of not having answered my query, whenever anger was becoming an obstacle to effectively guiding my day, I ask myself what is missing, that would bring me a feeling of abundance? The answer is always different, but it seems to take me out of the angry lane and let me focus on what was around me, and it was magical how often I would find that solutions to problems would just appear, sometimes be in my hands already when needed. Some people say you see what you look for.

When I find myself thinking how I literally missed out on something that would have bettered my life, I force myself to think of times when things could have been much worse, or even near accidents I have escaped (there have been many). Seeing the balance of it all leaves me with a bigger picture: one much less designed to make me miserable personally, but leaves everyone sucking in general. But this was only to give myself space to process, to deal, so I could come to terms with the source of the sadness, the fear, the anger. 

If they are not dealt with, the wounds will be back.

Wednesday, December 7, 2022

DEVELOPING CULTURALLY COMPETENT CARE

 

 


 

IN THIS DAY, THIS AGE where hospitals now term their patients "customers" and cater to the service aspect of business more than practical nursing, the accountability is nonexistent while the authority runs rampant. The resources from authorities to individuals are dwindling, and has created a widening gap: the most readily available, technologically advanced self-care / preventative, prophylactic options ever for those with means, yet simultaneously we have the most expensive, least accountable hospital staff no longer trained in basic first aid


DEVELOPING CULTURALLY COMPETENT CARE IN YOUR FACILITY

Identify a need (e.g., better response/understanding of the special needs of vulnerable populations, especially undiagnosed, subtle conditions, including long covid symptoms);

Support creative solutions in your staffing -- training for inclusion, empowering research based, fact-driven options; e.g., equine training to identify predator/prey patterns;

Give each worker the TOOLS AND AGENCY to act -- circle back for accountability and effectiveness.

BATTLEFRONT TACTICS -- in our intelligence unit during the Gulf conflict, we needed to get info, try to cross-correlate with other facts for determining accuracy, and get urgent action-oriented updates to those in command, sometimes to end lives of hostiles and/or sometimes to save lives of allies in danger. The military loves to give even the lowest-ranking members the authority and agency to make split-second decisions that are hopefully rooted in all the training and briefings that came before. And yes, accountability -- whether or not the consequences seemed appropriate for the damage done was always a different story -- but they always found some party or other to be responsible, otherwise there was no way to keep more "accidents" from happening. NO AUTHORITY WITHOUT ACCOUNTABILITY!

 

HIRE FOR ATTITUDE, TRAIN FOR SKILL

My opinion is that we "interview" for our jobs, our businesses, our relationships -- every day. To me there is no time for laying down one's code, no laxity in the way business is conducted anywhere, anytime. It takes much more time and energy! "Win-win or no deal" wasn't just something out of a book once by Robert Kiyosake, it became the way I conducted my LIFE. From Jack Zufelt's 100% rule to Cynthia Kersey's Feel the Fear and Do It Anyway, getting the Big Enchilada from PBS full of philosophy by Wayne Dyer, listening to every horrible recording of Leo Buscaglia that I could get my hands on, is to name a few gems of real advice I found useful in a sea of vague palliative babble. But wading through helped me develop the due diligence at the tail of fact-finding, where most crash out or lose interest, or figure there is nothing more to see... the tail is where the fake shows out! Where the dust from under all the rugs eventually ends up. Following a line of thought or questions to a logical conclusion is a skill even more rare than counting change back -- the proper way, not demonstrating coin identification.

Developing agency of staff means modeling, especially in how to build knowledge around subjects. Here also is where following a line to its conclusion can be demonstrated. Agency is born out of the flow of information with a portable, reproducible system that builds confidence. We must recognize when a conclusion does or does not fit our goal, and act accordingly. Is this supplement good, neutral, or possibly even HARMFUL for someone with RA? Even the extant papers on various questions such as this one admit to MORE RESEARCH NEEDED but there is still helpful material (just have to slog through the unhelpful sometimes).

SAMPLE COMPETENCIES

DEVELOP the ABILITIES of vulnerable folk, support adaptations in physical ways

BEGIN WHERE THEY ARE but first at least find out! Ask questions!

STOP using average handouts, update your info! Personalize solutions, stop generalizing them, and for goodness' sake, stop treating things in isolation, instead of recognizing their interconnectedness. Here is a great place to lean on those conclusions you followed, seeing how that problematic thumb led to that opposite shoulder joint compensation, just like that old song...

Support creative solutions and CIRCLE BACK to close the loop, answer the questions of whether the actions taken were EFFECTIVE and WHY / WHY NOT? This builds on agency and models course correction and data set usage, importance of logging results. Allow agency to act -- intelligently.

VOCABULARY -- are the words you use inclusive? validating? sensitive to other ways of being?

Phrase your questions/comments to be INDUCTIVE not reductive -- KINETIC not static

TOYOTA PRINCIPLES; Kaizen; Sharpen your saw and others of Stephen Covey's Habits

Some websites "for disabled people" whose aim is to "build inclusion" still have ableist subtext; but accountability means NOT "giving room" for yourself to fail; the suffering of another should never be an acceptable cost! Ever! There is something in the phrase "give yourself grace" that smacks of privilege to me. During times of combat or extreme need, your "grace" is license to let feelings preclude action that could cost someone life or limb. If we are following the Four Agreements and always doing our personal best, patients will know. We can tell. Same goes when a caregiver gives themselves a break before doing everything they could during a time of need, including reaching out to other caregivers on the floor. We can tell when people are 'phoning it in,' doing the bare minimum if that.

Any move toward accountability will never feel like a mistake. Open space to make educated hypotheses and circling back for confirmation of success OR confirmation of need to redirect efforts is THE SCIENTIFIC PROCESS and last I checked, Health Sciences are still SCIENCE.

There is a push for leaders to be in charge of both employees and their learning, but this is a conflict of interest. Independent COACHES are needed to prevent further entrenchment of current leadership ideals. MEETINGS are overrated. MODELING is underutilized. Minds who contribute to or continue the status quo are poor sources of solutions. Coaches outside the structure provide more opportunities for equal teaching and learning moments regardless of status.

 

Lastly

As a counterpoint to the ableist perpectives surrounding us, years of overcoming obstacles and daily exercises in adaptive thinking have freed variously abled folks from tying our identities to our inabilities; we sometimes even 'Raku' into having our own special superpowers -- until it is the able-bodied who have become the developmentally delayed/challenged, unable to function in a changing world/reality even for a few minutes, underscored by the number of times we hear "Wow, I don't know how you do it."

The mental and emotional athleticism develops its own type of intelligence. This type of problem-solving and myriad approach to situations has only been mined by a handful of organizations. When groups balk at the "work" calling inclusiveness 'training' or bring up 'time and investment to payoff,' this only obfuscates the synergy created when many small changes begin to take care of the whole -- soon no effort will be required, yet nothing will go undone.

 

Saturday, November 19, 2022

My Stint as a Medical Refugee

The following is the true and witnessed account of the events occurring at the UW Montlake Center.

Names of my care angels are listed, but I have reserved names of individuals who have inadvertently and accidentally caused me harm. Some of them I did not ask purposefully.

 

ACCIDENTAL DISCOVERY

MAR 4 2022
My appointment with my doctor, Dr. Kirschner in which she orders thoracic MRI to get a current picture of my thoracic spine, which continues to be problemataic since the blunt force spinal trauma I sustained during my time serving in the Gulf War.

THURS MAR 10
MRI at Jeffco Main hospital

A phone call after this emphasized that new MRI needed for a "shadow" top of last one. Request forwarded to VA for immediate action.

TUES JUNE 14  
Three months later, MRI Jeffco Main hospital.

TUES JULY 19  
I have a call with Dr Ferreira, UW neurology, telling me I have a meningioma bilaterally on the crown of my head, its location on my saggital vein, and that there's a 3 month window before it is 100% occluded. He asks me if I'd been having symptoms, we talk about trying to differentiate 25 year back injury from a parietal tumor that has similar signs. In any case, he says not to wait, that he has a good surgeon who can fit this into his schedule quickly if I agree to the surgery. He said no other protocol would work quickly as we needed it to, since it was discovered so late, so I agreed.

MON JULY 25  I have a call with Dr. Ruzevick, an MIT grad and Johns Hopkins repute; we scheduled surgery for August 26th. There were other procedures they would need, an email with details was forthcoming. When I advised I have a few complicating conditions from my Army wounds, he assured me a nurse would call me for pre-operative instructions and to answer my concerns and prepare me.

FRI JULY 29
I received an email from a floating care coordinator, thomasxx@uw.edu

WED AUG 3
I return an email to Thomas alerting my team to a transportation difficulty on one of their many additional and necessary steops, and ask again who to speak with regarding the severity of my conditions. Never did get a reply.

THURS AUG 18
Made 2 calls to 206 598 5637 given in UW correspondence seeking a resolution to the one appointment conflict. Monday the 22nd they scheduled a COVID test that required me to get my sick little body from the surgical campus to a testing site near the Northgate Mall at 12:10 and make it back by 12:45 for my 1pm doctor appointment. This trip depending on traffic can take an hour or more and I would have to take public transportation in my condition. Without the test on Monday I couldn't have the angiogram on Tuesday the 23rd, and the whole schedule would be delayed an undetermined time, and by this time their estimate of remaining life was 6 weeks.
No replies.

SAT AUG 20  
Made a call to 206 732 3200 spoke to a few operators and one w said she would call me back with at least someone who would know what to do. She didn't call back.

SUN AUG 21 

Made calls to:
206 724 4489
206 726 1717
206 547 2369
800 568 2705
206 732 3200
206 598 5637

CARE COORDINATOR WOES
Somewhere in the notes, I have written my actual care coordinator was Ty, and I forget if one of those is his number or if I was transferred to him, but he was the person tasked with coordinating my care. I explained the seizures and other medical needs that seemed to be at odds with this particular part of their schedule, without provision for getting me there or an alternative for very ill people. His response was that my refusal to take a test would mean a cancellation of my procedures. Then I asked him why he was misquoting me and threatening to divert life-saving medically necessary treatment, and that there has to be some way to test me for the virus in the hospital. He said  and they make EVERYBODY travel ten miles north of the hospital to a PARKING LOT to get a nose swab that has to be then securely tested and delivered BACK to the hospital, the same hospital who was telling me how ill and close to death I was. He just kept saying there was nothing he could do.

MON AUG 22  
I got back on the phone, called
206 598 5637 x 2
206 59 9460
206 520 5055 x 2
206 732 3200
finally I spoke with some angel who had literal footwork to do, but finally got me authorized a COVID test that would be administered while I had my pre-op blood draw. She told me she wrote it in my notes of the electronic file, but cautioned me that the notes stack, so tell whoever is looking it's at the bottom.

TUES AUG 23
At the in-person pre-op with (nurse?) Anna, she asked me about medications and supplements, and cautioned no NSAIDS some days before the angiogram, which for me was the following day!  I asked her why was I hearing about this now, I may have taken some considered inside the disallowed timeline. She told me they would have to reschedule all my procedures!  Again in tears, I asserted these were life-saving measures that don't have much leeway, which was when the COVID test came up in the conversation. She said there were no notes authorizing a change in their protocol and now they definitely had to reschedule me. She asked why I couldn't just follow their directions, and I because I was between seizures at the moment, I had to explain  that I'm EXTREMELY ILL and have severe symptoms, especially seizures, some severe enough to cause open head wounds. Her reply was "Well, you made it here, didn't you?" Yes, from the hospitality building 3/10 of a mile away, I said, and had two seizures. How many were medically acceptable to get a COVID test, in her opinion?
After my insistence, she scrolled to the bottom, and found the authorization after all.

This is the same person with which I had to then entrust with my pre-existing conditions that they needed to know. But I was ready with my notebook and gave her the residuals of the back injury:
 
Myofascial Pain syndrome, Joint Hypermobility Syndrome and CENTRAL apnea, which is different from obstructive sleep apnea. IF I'M NOT AWAKE MY BODY DOESN'T BREATHE WITHOUT ASSISTANCE. I cited two sleep studies, one  at a Franciscan hospital, the other in the UW Medicine Sleep Clinic, that showed I wake up on average 22 times each hour, presumably due to progressively shallower breaths until a threshold causes waking. I emphasized it is due to this that they MUST WAKE ME before extubation, that I've done it before and  it is especially necessary after anaeshesia, VERY IMPORTANT;

vagus nerve damage, which has negatively impacted the sympathetic and parasympathetic responses, given me Multiple Chemical Sensitivity Syndrome, Fibromyalgia/Chronic Fatigue -- all of which when overstimulated, result in engaging my panic disorder. Symptoms progress to shock and shortly after, seizures; past complications include: organ infections, sepsis, shock, SEVERE panic attacks, and syncope;

gastroporesis- my own doctor in Jefferson County and a naturopath in Seattle have been helping me deal with the residuals of chronic dehydration and malnutrition, which needs to be taken into account when reserving food and water from me.
 

I asked for NO NARCOTICS AND NO MUSCLE RELAXERS due to their extreme effect, demonstrated time and again. Anna seemed to be taking at least some notes, not agreeing or disagreeing.

WED AUG 24
Angiogram scheduled 9AM
Did not eat much day prior due to gastroporesis, already beginning to have some signs of shock. TV screens in waiting room advise that if appointments take longer than 15 minutes to call you, inquire at the desk. Waited until 9:20 then made inquiry at desk, but response was that ALL angio patients for the day are called in at the same time and taken in order determined by doctors. There was more but my convulsions began and I lost conciousness.

**NOTE NEEDS TO BE MADE that when I woke after this procdure, the staff was right beside me and extubated me right then just as I had requested. It was expertly done, and my breathing became less labored as the anaesthesia wore off. Kudos to (I think it was Dr. Walker's) team!

SAME DAY

Results of the angiogram seemed to set me up for surgery the very next day, which was a day earlier than scheduled. They explained that something the doctors saw must have made them want to get me in sooner. For this reason I was not to eat or drink after 10 pm tonight, which left a tiny window for food. I couldn't eat much and sometimes what I could eat would come back up. I was already hungry and weak.

THURS AUG 25 9AM
A doctor not on my team came in, advises my surgery is going forward as scheduled on Friday, the following day, so no food after 10 pm today. They told me they were going to discharge me so I could sleep at the hotel, eat out, and check in an hour early for my 5AM MRI the next day, but I asked if instead I could just spend the short remainder of time resting in place, since as I've tried to be clear that MOVING causes great pains and seizures, and they let me. At least I got to eat.

FRI AUG 26  
Blood test, MRI, surgery

NARCO-LOCK
The surgery took apparently about 4 hours. Narcotics were used, as was protocol, as they told me later "you would have been awake and screaming during the operation." Instead, I woke up on a moving gurney surrounded by staff all giving me their own sterno-rubs, calling my name and trying to get me to breathe. They had already extubated me and I wasn't breathing or waking up so they kept shouting louder and rubbing my solar plexus harder. I could see their nametags, watch the light changing as we rolled through the hall, and I could certainly hear the panic when they talked to each other about what to do next. I couldn't move a single cell, but I could feel their various knuckles of different sizes, angles, takiing turns crushing my solar plexus, bruising me, just about to crack bones. About then, someone had put some oxygen on me I think, and with all my soul I reached my left forearm up just as a new person, a sweet nurse I had just met the day before, was about to give HER sterno rub and all I could do was curl my fingers and let my arm fall, scratching the back of her hand with my fingernails. She cried out, pulled back, and said, "That's gonna leave a mark." But at least they stopped.

 
AUG 27 - 30  
ICU with awesome nurses Tiffany, Liz, Cristina (and others) floor 5
These nurses were instrumental in the first few days after the surgery, since my systems were trying to adapt, poorly without much nutrition recently. I had checked in with the surgical team about the IV drip, and it was not a glucose solution but a more keto-friendly solution, which helped immensely as sugars exacerbate many inflammations. They went above and beyond making me as comfortable as they could, with ice chips and little extras, even holding my hand when I became overwhelmed with all the somatic discomfort, noises and lights.

The doctors came by and told me I was a good candidate for in-house rehabilitation once the insurance approved it. People came to work with me to get me mobile asap, and by the last day in ICU I was standing up 4x a day to wash my face, brush my teeth, and doing muscle strengthening leg work. Toileting required a strap under my arms for safety, arranging the bedside area and bedrails, and a nurse assist to get onto the commode. I had no feelings of fullness in bowel or bladder so made trips every couple hours to prevent accidents.


FRI SEPT 2 7PM  
moved to Rehab, Floor 8

FALLING IN THE CRACKS
The nurse Gina who put me into my room apologized for the difficulty getting me settled due to 1- ICU did not technically discharge me, they await insurance to approve in-house rehab; 2- Rehab dept could not then technically admit me,  and 3- this was happening at a shift change, day into evening -- AND a long holiday weekend, so they were having trouble getting hold of staff or get the info about me they needed.

DELETED DATA
The nurse also informed me whoever undertook this action also deleted my patient data, so they were unaware of my details, history at the hospital, or any medications. The medications prescribed included an antibiotic, an anti-convulsant, a steroid, a pain reliever, and heparin shots in my abdomen.

MENTAL PATIENT
Three shift changes over the next day or two, I heard the nurse on duty inform the new one that I was PSYCHOSOMATIC. My visitors tried to comfort me telling me it was probably in reference to other patients, but a nurse confirmed to me that it had been written in my chart by staff.

NO BATHROOM
When Gina was getting me settled in I mentioned that there was no commode in my room, and asked how I was to relieve myself. She showed me a "wick" which is a cucumber shaped device that begins to vacuum when liquid is detected, and then wrapped my bottom up in a bath towel sized absorbent material (a giant diaper) as the nurses were transferring me to the new bed they had another pee pad underneath me. My instructions were to pee myself then call the nurses to change me, and when I needed to poop they would hold a bedpan underneath the cheeks while I was still supine. Without physical therapy OR bathroom privileges, I was just supposed to literally lay there until my insurance approved the rehab.

CONTROLLED SUBSTANCE
Since I couldn't bathe or shower, I asked to have some peroxide to clean myself with, but I had to get a lecture on how dangerous this stuff is, watch the nurse dilute the 3% by half water, only to be handed old fashioned wooden pick swabs for my ears... the caution and clucking I got over that request still boggles my mind, how so much caution was taken over my ear cleaning and so little was paid to my actual disabilities and special needs. I was told "I'm not supposed to leave this with you but I will."

SAT AUG 3
I still hadn't resumed medications due to nurses unable to reach staff. I began to feel a great ache in my left chest, then became unable to move my left arm, and we called for the nurse. They still hadn't gotten my info. I began to have a seizure. A crash team was called in, and I heard Gina explain to the doctors on call about the deletion of my visit history. The doc in charge asked me when it was all over what they could do for me to make things better, and I told him to care for this disabled veteran like my life depended on it. Later one of my team's doctors came around to see me, but when I asked for some diagnostic to rule out any dangerous blood clots, due to a persistent chest pain an unusable arm, she told me no, she "didn't want to run any unnecessary tests."

SUN AUG 4
A volunteer woman got me into a wheelchair for the first time, and she wheeled me around the floor while a nurse brought in a shower chair. The sweet volunteer offered to wash my civilian clothes while the nurse helped me attempt to shower, but it was a short time of me rinsing myself down with the showerhead, as I had no postural control at that time and kept almost falling out of the chair. There was no way for me to clean underneath my fingernails, and since I still hadn't been able to wash my hands since the surgery, there was dirt and skin from scratching the nurse and probably fecal matter from wiping myself poorly the first few days after surgery.

MON AUG 5  

Grade A nurses Colleen, Monica, Kendrick, and phlebotomists Steven and Kyle

WHO ORDERED THE JACKHAMMER
Kendrick came on shift about the same time of morning that construction began on the 7th floor, just below. Some type of jackhammer or drilling into the concrete. My whole head was reverberating painfully, and there was a type of odd terror running through my skin from head to wherever my sensation ended in my thighs, that caused a type of convulsion I had not yet experienced, and I begain to flail around. At first I was offered a sedative, or earphones, and between gasps asked if I could be moved to a different floor, but since I wasn't still assigned to the rehab folks, they had no agency regarding me other than recording my vitals and neuro checks. Kendrick asked open ended questions and we came to ameliorate some of the effects of the banging with blankets and whatever other means we had available to us. The construction went on for 3 days and fortunately got a little farther away each day. Even the nurses were frustrated that the drilling didn't happen over the long quiet weekend, and there were only 11 of us patients on the 8th floor.

LIFELINE
The rehab psychologist Dr. Nick Dasher stopped by and listened to my concerns for my care, since I was going to be here for another month or two working hard on getting better, I would not have my dad the whole time to get me what I needed from the store for nutrition and palliative aids for the special needs for my vagus symptoms. He promised to have a talk with the administration regarding consideration for my pre-existing conditions.

THE REAL CUSTOMER IS REVEALED
The doctors came by every morning to update me they were still waiting on insurance. They could not put me on anyone's schedule to get therapy until 1) insurance came through and 2) I had to be entered into the Rehab system. The young doctor in charge of the rehab unit came by a couple times, telling me each time that I was still a rehab candidate, hang in there.

MON /TUES AUG 5/6  

ATTACKED IN THE DARK IN MY SLEEP
Uncertain of the date, but in the wee hours of the morning when the phlebotomists take their vials for the 7AM doctor meeting, a small man entered my room as I was sleeping and my dad also asleep in the cot beside me, and poked a needle in my arm without waking me, getting consent, or even asking me who I was, turned on zero lights, and didn't even speak to me.
I cried out, and my dad woke up, and asked what was going on. I asked the lab coated man if he was a professional, and he replied, "Huh?" I repeated my question. He said nothing and just left. Using the nurse button, I called the nurse in and complained about the situation. The following day or so, Steven, who regularly drew my blood, walked in and I told him what happened. He said something to the effect of that was the last time he could stand to hear this story, that this person is known for this. He asked if he could have my permission to file an official report, and I gave it. We put my name, patient number, date, and request for intervention in a plastic protective bag, sealed it, and he took it to his superiors.
The nurses make a plan to thwart this hospital worker from entering my room again, and the next two nights he returned but was in once instance escorted out by one of the traveling male nurses when I pushed the nurse call button, and the other night Monica diverted him before he could open the door. They called it a "training issue" but I never heard back about my complaint, no administrators stopped in to talk, and I really could have used some counseling.


HERE'S YOUR SIGN
Also in this time, from the first 24 hours on floor 8, I had gotten some whiffs of strong deodorant or detergent and notified the nurses of chemical sensitivity, which can cause me to have convulsions. They made notes and put a sign on my door. Every day there was someone with strong scent of some kind, never perfume, that brought on seizures until the input was taken away. One day it was during breakfast, when my dad had left to get my food, housekeeping came through with strong floor cleaner. To her credit, she worked quickly, but the deodorant hit me about the time she was done, and as she left she closed the door behind her. Some minutes later, one of the nurses who was walking by my door heard my faint plea as I lay in the bed seizing, and she helped me by opening the door and I asked also the shower be turned on for a few minutes to clease the air with steam. We had to do this a few times during the week when new staff came in my room without reading the sign Gina made immediately for me the first night.

ORDER UP
My concerns about nutrition I raised with my surgical team were never adressed. The menu for patients is mostly carbohydrates and cardboard, lots of fat, and had no alternatives for vegetarians. My dad bought me breakfast each morning and kept me in bone broth and other suggestions from my two naturopaths who I had paid to come to my room to help me at my urging.

RIOT ACT
One person claiming to be a therapist entered my room as I was coming down from one of the seizures, still trying to catch my breath and get into some level of homeostasis. She introduced herself (Barbara?) and began trying to interact with me, without referencing my great heaving and bodily distress, facial cues, or the toweling of my brow by my dad, who was helping me reconstitute myself. My inability to speak immediately led her to make further inquiries, to which I held my index finger up to indicate I understand, and to give me a moment, while whispering out that I had just been seizing and need to catch my breath. She told me she and her staff are very busy people and when they come by, I need to be ready to work, ready to give them my attention! I asked if she would allow me to breathe, and she informed me she did not have time, if I wasn't ready there were other people who are waiting, and there is no telling when she would be able to come back. Since post seizure time is crucial to stay calm, I told her she doesn't need to worry about coming back, in fact please don't.

NO FIRST AID TRAINING
As the swelling was finding its level, sometimes various body parts or systems would temporarily start or stop functioning, and one night neither of my arms were cooperating to get food in my mouth during the small window of time the gastroporesis was letting me eat. I called a nurse in, asked him to help me with the last few pieces. Although he seemed to try, he was admittedly bad at it and some ended up on the floor.
At one point I needed a sling for my arm to keep less weight pulling down, and went through 3 nurses all unable to fashion one from my safety strap. A fourth person came along and got it done immediately, I don't remember if it was a nurse or visitor.

PRN RX
there were a couple things the nurses were able to get for me, such as Tums, Tylenol, a couple others, that I had asked for and they had gotten permission for me to use/take. The requests turned into prescriptions that they were supposed to ensure I took, and having occasional upset stomach and taking what one needs at the time is what the nursing industry used to call PRN, "as needed." The nurses said now PRN means that it is added to the list of meds to be taken every time meds are given. They kept bringing me all of them but I refused to take things that I requested on their timeline. They stopped bringing those but it was hell to get it straight that I only needed antacids when my stomach was upset, not when it wasn't. They coudn't seem to grasp it.


WED AUG 7

IT'S ONLY A PANIC ATTACK
A therapist named Laura took me to the gym to exercise my legs. After her assessment she had a few moves for me to try, and she stopped when after a couple minutes I had reached exhaustion. She cautioned me to observe and respect my limits and be kind to myself, and said I was still a candidate for in-house rehab. There was nobody in the whole gym at the time and I knew there were only 11 people on the floor so nothing was triggering.
The next therapist was a nice man named Brandon but recent seizing, lack of ability to control my sympathetic and parasympathetic systems, and joint hypermobility had left me in a weakened state and I was not able to get dressed when he visited. He took me to the gym too, only this time it was in full swing, with maybe 20 people all dressed and working out. My panic disorder kicked into high gear. A lady on a treadmill saw him wheeling me through and when she saw my huge eyes and white knuckle grip on the arms of the wheelchair, she motioned her concern for me to him, but he waved her off (without checking into what she was trying to tell him) saying "She's fine, everyone is okay," but I was immobilized in the chair unable to breathe until we got to the back. I tried hard to stay focused and on track, but my already weak shoulders had been carrying ALL my weight since the surgery due to numb legs, and I couldn't perform what he wanted on the parallel bars. I tried to tell him I wasn't ready for the Olympics yet, and he wheeled me back to my room, leaving me with the assignment of 'standing knee lifts to chest' exercise. When I asked him how this is possibly appropriate for my level since I couldn't stand, let alone move my legs, he said "For when you're ready," and left.


LIKE A HANDGUN IN THE GYM
When the surgical team came to update me on insurance status, I mentioned my panic disorder is on greater edge being even more disabled than I'm accustomed to. Various environmental, physical, and mental stimuli combined poorly with not feeling heard or understood. Some staff had taken the time to hear about being crippled during the war, then losing a child and a husband, home and health to that cursed event so many years ago. They were the only ones who understood the intestinal fortitude it took for me to be there. I explained that there are mental reasons I need assistance and preparation before going into ANY CROWDS or noisy reflective places, or bad things happen, to me and/or others around me during violent panic times. The doctor responded with, "Everyone goes to the gym." In  fact, when she realized I was describing my first gym experience, she said that she had me moved to this floor with the purpose of going to the gym regularly. When she understood they hadn't been working with me at all, she left immediately.

I spoke again with Nick the rehab psychologist and explained that none of my warnings in the pre-op discussion have been heeded, and now bringing me in a crowded room in a hospital gown and in pain was like bringing a loaded gun into public, since none of us knew if or when it could go off. He said the administration had agreed to hear me out and there was going to be a conference.


THURS AUG 8 9AM

CANCELLED
One of the student surgeons who had been with the group but never interacted with me showed up by herself. She never did introduce herself so I don't know her name, but she obviously drew the short straw and came to me to say I had been taken off the candidate list for rehab and was instead going to be recommended to a skilled nursing facility. I asked why, and she told me I had my insurance to blame, that they are taking so long that all my forward progress has been lost and now I am welcome to stay until the VA can admit me to their nursing facility. She didn't know answers to my other questions and ended the short conversation saying, "Sorry, I don't know. Have a good one!" turned on her heel, and got out.

After collecting myself, I notified the staff I would be leaving on Saturday, and requested discharge instructions and medications be prepared. I began to carry out my own PT schedule and appropriate exercises that I made up as I went along.

FRI AUG 9
More inquiries into discharge preparations went unanswered. A nurse told me he would page the charge nurse and get back to me. After a couple hours I had my dad load me in a wheelchair and had him wheel me to the desk nurse and asked the same questions, saying I'm leaving in fewer than 12 hours and I have no more answers.  Perhaps because they hadn't actually checked me in and didn't want to tell me.

RECORDS STILL DELETED
When I brought up my concern over the loss of in-hospital records, staff assured me the permanent record would have it all, and the nurses were just unable to retrieve anything prior to my arrival on the 8th floor. Even so, the pharmacy who was tasked with preparing my meds was unable to see what they needed to issue my meds. Nurses said the records are transferred to MY doctor and that she would be able to see the whole thing. As of Septempber 28th my doctor still was not able to -- she can see that I checked in, and that I checked out, but not what happened in between.

SAT AUG 10 9AM
The nurses had informed me I would be taking steroids for a couple months after discharge, but this morning they said I didn't need them anymore. The one medication they said I absolutely DID need was not covered by insurance. Luckily my dad was able to pay over $50 for a couple weeks' worth of the anticonvulsant, while at my own pharmacy $35 covered 3 months' worth. It took until noon to get my medication, and with some words of care and advice from Monica on keeping up my good work, I left.

5 HAND IVs, 16 BLOOD DRAWS, 24 HEPARIN SHOTS
During the time on floor 8, the needle they insisted keeping in my hand for "emergency seizure purposes" kept coming out or getting sealed over, and each time they tried to put it back, staff would blow the vein 2 or 3 times and have to move it to somewhere else. I told them it was due to being dehydrated, and began to hydrate an hour before they came in to alleviate all the clots and bruising. Some of the nurses used insulin needles to administer the heparin, so I began asking the others to think about doing the same since I had MANY bruises on my abdomen and arms.
No matter how many seizures I had, sometimes multiple a day, there was no usage made of my needle they insisted on keeping one in my hand. When one night it had come out yet AGAIN the nurse just decided to leave it out, since I was about to get added to the Rehab floor for real any day and would not be able to participate with it in (even though they had tried a couple times with it in place). She didn't seem to agree it was necessary. I must have had 20 seizures during my stay but no meds were ever administered through the hand IV.

NEXT CUSTOMER
No fewer than 7 different calls had gone between myself and the radiology dept regarding the follow-up MRI. The hold messages referred to not patients, but customers, as in "Thanks for holdinging, we are assisting other customers."  The person calling the 8th time on Oct 11 to reschedule confirmed not a single one of those calls left notes, even though the last few swore to me they would.They questioned the system and apologized every time, but seemed so confused. Each person I spoke with seemed harried, tired, and on a palpable level, some fear. They seemed concerned that they would do something wrong, that if we were having this talk they had already done something wrong, or that I wasn't getting what I wamted and their customer service reputation was on the line.
When I asked a morning shift nurse how to get the check out process started, she wanted me to be more specific, and when we couldn't get to a common understanding of what I meant she at least tried to move the conversation forward telling me a nurse would help me with all that when it was time. My response was it's time now, I'm ready and you are not. She asked me if I wanted the social worker, and I asked if that was the procedure -- but each question of mine was countered with not an answer, not even a response, but another question. The point of the conversation seemed to be to keep me calm or address my feelings. It wasn't feelings I was concerned about, but plain old information, and none of the nurses knew what to say about how to check out. They could have told me they needed some time to figure out how, since again they didn't have me checked in, but to their credit, even with the point-blank verbal bludgeoning, they didn't once say, "I don't know," no matter what odd things they came up with to hide it.


AT THE END OF THE DAY
The things I have written here make me wonder why they operated on me at all; being just six weeks away from a total eclipse of my heart. Previous conditions made me a horrible risk for this surgery. Add to it, as they told me more than once, they had to kinda take the organ out a little from the skull, which can cause more complicatioons... in the doctor's words, "You've had *some* surgery." It is fortunate for me and my family that they didn't just put the mess back in and apologize to my dad for not having found it sooner. For my part, I feel fortunate that some happy accidents saved me for the time being. My point in documenting and sharing is supposed to help the PRE and POST the surgical team performing its miracles. To do so takes nothing away from Dr. Ruzevick and others in their fiat, something that could have easily turned out differently, worse, in so many ways. 

It is the before care and effectiveness of aftercare that led to great suffering, not the operation. And not all aftercare was bad; I told the nurses who gave top-notch care every day how much I appreciated them. My mother and her grandmothers were nurses and healers, and are who left me with their own standards of what constitutes care, but they are no longer here. They would have raised hell more than once, and I want to say they could have protected me and cared for my ailments the way they should be, the way they were taught, but even my dad being at my side 23 hours a day could not prevent things or reason with authorities, or FIND authorities (people with agency)-- the nurses over my time there confided they didn't feel they had agency to perform nursing duties, their hands were tied all manner of ways -- and that they were sad and aware that many surgical patients tough out the surgery but don't survive the aftercare and die within weeks. They see the industry has changed, is hurting patients and tying hands of medical staff, and lining the pockets of pharma, while catering to their REAL client, the insurance companies. They have the power to withhold, the power to approve. How they make those decisions has been under much scrutiny, and found lacking in fair practice while REAL LIVES are affected, altered, ruined. Until we can halt special interest monies, there has to be something one can do to get CARE and avoid TORTURE without labels or political implications, because if not -- and this is what we put up with -- ask yourself how and when a person CAN expect to be treated properly, without so much needless harm? What kind of system is rewarding this model? What kind of responsible government allows even one more person to suffer these daily atrocities? I suppose only until it happens to someone they love. Someone important. Someone else.

Friday, February 11, 2022

A Stillness That Refuses All Else

 


 

 Current climates have put our ideologies to many, many tests. How have we been holding up? Is focus sharpening within? Are we un-learning the hypocrisy taught to us (Leo Buscaglia), or contributing? Depends on the day! I wish Leo were here to remind us of those human things. Maybe these posts are my odes to him, my way of continuing his devilish advocacy of radical compassion and unconventional understanding. And long-windedness! Everything needed to be said though, so coffee up & belt in.


CURRENT PARADIGM AWARDS that have served extra duty recently:

1. Begin Where You Are
   - do something that has no barrier to its completion,  distance or resources
   e.g. -- mind exercises, isometric muscle movmement, story creation/memory
      *accomplishing something generates momentum, motion

2. Ride the Rainbow
   - when mental altimeter spins, identify your color, and see what else you can be
   e.g. -- can you see the edges between red and pink? blue and seafoam green?
      *facility with lateral (e)motion generates Agency (Buddha)

3. Heart to Heart
   - Listen to this Kenny Loggins song! healing souls through the ages
   e.g. -- being distant, then revealing it's from a feeling of loss
      *the way to a solution is acknowledgement and humility


In recent months, my bodily challenges flared up to more than I could handle; I was trying all my stand-bys, meeting with failure each time...  I became scarily exhausted... wrote a will... my strangle grip of panic was spiraling down, cutting me off from healing thoughts and absorbing vital mental energies. En route to the ER during a bad episode, a semi backed into our truck at an intersection, and then drove away; an odd water incident was unknowingly stealing the precious remnants of my family photos and irreplaceable belongings that have been saved through thin and thinner. The VA was pulling their shenanigans, running me thither and yon, labelling me mental and using it to deny the physical... That old saw The Resource Ratchet was tightening screws in all the places where I had lack. Spiritually a pile of bricks seemed to bury me. Nightmares of getting squeezed out of existence. Why do I feel like the leading role in a Robert Rodriguez version of Ed TV?


Turning to Doing the Next Indicated Thing (from the Traveler's Cloak post), I was surprised how often it was... to do nothing. Rest-- real repose. Not just some limitation of chance interruptions, but a stillness that refuses all else. In a key moment of mindfully suspending my disappointments, automaticity suddenly brought up an old forgotten piece of information, right in front of a doctor! It turned the tides for my health. Big hooray! But only because of the hours I practiced unclenching the mind fist that kept me contracted. I kept finding not just obstacles ini my path, but roadblocks, washouts. They were signs my paradigm was not grounded in truth. Trying to be that honest with some things was like being afraid of heights and looking down from a tall bridge. Being present asks us to acknowledge the mountains behind us, as well as the mountains to come. Perhaps one experiences stillness of mind only after everything else has churned the shit out of it.

There must be others like me who have somatic, mental, and spiritual wounds, who have had to 'Doctor Manhattan' themselves together time and again... you know, the guy in the graphic novels who had a physics lab accident and had to literally think his way back into existence from being scattered around the universe...  I have not been able to find a primer for this, and so am writing one. Years of research and application to share with others wandering in this forest. It has taken much personal work, and I have been very angry for a long time. So I keep refining, polishing, until the mirror reflects only what is. Stillness and depth are correlative for a reason. Depths and scary lurking thoughts can reveal things... Finding 'pay dirt' meant more work to be done. Flashbacks begin, and just like that, my positive person/self construct is in jeaopardy; my chosen reality erupts in confusion as painful reality demands light and acknowledgement... I am left wondering how to fit this truth into my paradigm. What algorithm in my programming is ruining my life? 


Chronically ill people have horrible, predictable bouts of depression; yet we keep believing we can think our way out of it, as if something just needs to fall into place. In exchange for receiving the minimum of help, we are always subject to someone's approval. As a prior national service officer, I used to tell my fellow disabled vets, stunned at the holes in the system and crappy choices that sounded insane, that the world-upside-down they were feeling was "a natural reaction to an unnatural situation."
I put another paradigm together, It breaks too. Made sense that the only way to bring any consistency to my life was to wrap around the truth. The TRUTH, duh. Okay, how do I do that, when everyone's is different? Measuring a crooked stick with another crooked stick seemed futile to me.

So, moment by moment, moving through these seemingly endless circles...  It can be exhausting. What you've heard about "doing the work" is true. We must re-choose everything, renegotiate our relationships to be mutually beneficial. ALL of them. To fun, to family, to food ... until you have answered all your questions and feel equipped to move about, able to handle what comes. Moving in the circles, I suppose, is how we are presented with 360 degrees of choices of where to spring forth, and make the circle a SPIRAL. Spirals are life. They are always moving, either growing or pulling apart... changing things and allowing adaptation. We are growing or we are deteriorating; sometimes both in different ways. People and systems can lie, but the spirals they leave behind bear witness.

Much rest is needed! This work can be heavy; the smallest kindness is cherished. Changing requires our permission -- our cooperation. I went through the 12 steps of the Program, singularly and without meetings, acknowledging Anger as my addiction. First steps were relatively easier, in hindsight, because then I hit Acknowledging a Higher Power. This was hardest for me, a recovered theist and atheist both. Science became the vehicle to seek higher truth. The simplest laws were my building blocks: objects prefer to stay in motion or at rest, information/matter is neither created nor destroyed, the universe tends toward entropy. It allowed me to correct many assumptions and even begin predicting some outcomes regularly, which is something ables take for granted.


Finding the ability to look objectively at longstanding paradigms -- my Truth, finally -- has taken the longest time and been the hardest to see. Now that I have acknowledged some of my most cherished hurts and listened to my deepest, infected and grown-over wounds, I understand why it was not possible for me to SEE before, much less to heal. In my working life, I was unable to take a helpful amount of time off; living month to month on pain wages, tolerating and drugging as much hurt as I could for my jobs. One day I collapsed, and was down with major symptoms for a month. The doctors were too busy arguing about what to call my condition and wouldn't sign off on me returning, and I lost my job. I refused to be homeless in the city, so I used what resources I had and followed through with some connections, landing up in the mountains to fight the VA for going on the 25th year.

This is all a recipe: mis-, dis-, or un-treatment --> an unbalanced organism; organism attempts to just make it to the next rock, but is it a sinker or a floater? Resources have precise caveats that split hairs, create hoops that were harder than having an actual job. How long can strained favors bend? In this way, friends are consumed, and bridges, and your friends' bridges... A human alchemy of specialized, commodified skills & experiences, family and friend circles, when subjected to the algorithm of changing events/needs in the world, and it only takes a flip here or a switch there, and BOOM! a successful, career-minded person somehow becomes home-free. None of the promissory notes cashed in, private or government, large or small, not for vets or women or ability dependent. Finding out that most every instance of "we support our vets" and "bring them home" was for the people they see on TV, not for broke-ass, family-challenged, unlucky ones like me. That was 2017. Since then, many horrible things have happened. But I have also had a chance to find a community in some of the smallest niches, and so feel blessed in many respects, too.

All some of us have left are our feelings and opinions. Those can become like children tugging at us, needy and unable to submit their requests in writing like professionals. But give them room, a voice, and an amount of free time, while you ask better questions in a detached way -- as if for a good friend. If you come up with some possibilities, try enacting them gently, when you have some bandwidth and a spoonful of try in your pocket. It's okay if it's not right away. YOU have to be the parent! Part of you may know what to do but is drowned out. Instead of letting high erratic emotions go on too long, or get unhelpfully spun up, give them a time-out, however you discovered is best when you were sewing your cloak. But sometimes, just sometimes, they are upset because you KNOW the correct path of action and are either unable or unwilling to take it. They can be right for trying to get your attention. I think I understand how cancer can be an illness of a thousand disappointments. Knowing what should be done, what is the healthy thing to do, but not having the intermediary mechanisms to achieve it -- from lack of time, money, energy, medical staff, and a million other things.


If you can't make any headway, ask yourself HONESTLY if there even IS room for there to be a win. The answer may be a surprise. Often when we have the courage to look, it means we then take on the burden of fixing it. Denial can be a defense mechanism, that really means I don't have enough to go around right now. The key is discerning, like the Serenity Prayer asks, between what is in your reach, and what can be disengaged for the moment in order to tend to important things. Prioritization is not denial. How many times have you heard people NEEDING to quit their job or go off the deep end, or are bordering on illness? What if you are forced to choose between having a job, and having great medium- to long-term health?

It is seductive to squander youth, but only because health can be forgiving; and due to genetic predispositions, what have you -- the able-bodied won't have the same looming threats as people with special needs: like work noticing your frailties, and the extra time it takes to do certain things, perhaps unofficially using them against you... We thought it was bad when not having team support meant you were last in kickball selections, but in this American adult world, those same people are able to use the same selection process when it comes to workplace politics. Now the world is experiencing all the things we vets have been crying out about, that our systems are fragile, unfairly weighted toward productivity, and in some places, cracked or broken altogether and not intended for widespread or long-term use. When the system is done with us, we fall off all the radars and no longer count as unemployed, underserved, or underhoused. There is no way to count the thousands of people not caught by any services, but I see tons of them on this here Olympic Peninsula all the time. Before, during, and after being upset that human beings aren't treated well and with every technology and understanding available, we still have to chop wood and carry water, and live.

When your attempts at managing your disappointments consistently meet with some wall or other, give yourself permission to plumb those depths, but safely. Recognize what it means to be patient, longsuffering: feeling badly, and yet, still do what needs doing. Pockets of hidden ego, cut off from healthy periodic inspection, inform tiny decisions. You know you're in their presence when an internal argument sends your humility into hiding, and you take an indignant posture instead of through the soft focus of judgement-free understanding. Take a moment to see how far up on the high horse some old ideologies may have hoisted you. Some go very far back. Deep rooted beliefs. Forgiving that sometimes the dearest friends, family, and trusted medical personnel can do great harm with the best of intentions. Allow yourself a sigh or cry of acceptance. These attachments that hurt us have also been our company for a long time. Be grateful and remember that they delivered you here, as you send them along.


The thing about cracks is that they subtract people from the conversation when they are most vulnerable: jobless, no health insurance, staying with friends on the couch, trying to make it back to safety. It is an all-day job looking out for oneself in the wild, where the nets of society have failed, and wits are all, unless one is lucky in the family-can-take-me-in department. For most, our voice is gone, our votes with dollars is reduced, everyday resources become a godsend -- it takes a lot of effort to do much more than try to be comfortable. I saw how tied I was to the circus, performing to stay employed as long as I was able, yet not getting the right help. Only after one leaves the cult can they see it truly. Refugees need the right support.

When there IS any voice to be heard on the matter, it is our neighbors, whom we live amongst, commenting on not wanting housing or shelter nearby for any riff-raff dumb enough to end up on the shitty end of a very shitty stick. The argument goes silent when the fact comes up that many of us are vets and/or in need of some sort of care, but there is no place for non-productives in this country. I'll go further and say the systems are designed to make us go away. It is known.

Poor diets and corporatocratic, ever-faster ever-more requirements and demands are setting this country's people up for a giant wave of disability and disease, as has been prophesied by nutritionists for decades. The medical system is admittedly geared for extreme disablement treatment, not for those living slightly "off" and needing to be treated gently, wholly -- this is not pharmaceutically profitable. This sounds kinda ranty, but all these factors caused a perfect storm of cracks that I MYSELF fell through, no second-hand media-fed rumors. One year I'm making six figures, the next three I can barely walk. It can apparently happen to anyone, and only those with means and family resources will survive, or those like me who are stubborn and resourceful in equal measure. 


Being a well-reared perfectionist with a top-notch work ethic, I had a lot of anger to work through when I couldn't be ME anymore. Previously such an active person, a trauma which should have paralyzed me instead left certain tissues to degrade in a manner unrecognized and difficult to treat. Friends go hiking without me, family doesn't know what to do with me...  with mom gone, the world became graceless, unforgiving, and unwelcoming. The less a human is able to do, the less they are able to fend for themselves, or get loving care. Cruelly, those who need the most help are also ugly reminders of the cost of our lifestyles, getting swept to the corners. My veteran brother said once, we basically gave our lives when we signed, relenquishing any claim to basic humanity foreverafter. He told me, "Sis, it is our burden to be the hated, the forgotten. I know that I'm still a good person in my heart."

As you can see, there was a lot for me to let go of, or even wanted to think about. Things I couldn't fix, but still gave free rent for occupying my upstairs. For just some moments, though, I let myself suspend the hellish reality I had been experiencing, to give my mind a break from focusing on a cramped, tangled knot. It helped free some processing power that was running in the background, unchecked and draining me. I imagined a place, small at first, where I was welcome. Where the lifetimes of my different experiences were woven in with a community, one who wished me good things and felt fuller for having known me. A place where I could contribute and be a neighbor. When I'm on a roll, I expand that to a whole town full of this, this soppy, corny, cheesyness -- but it felt so light to be there. I could breathe easier, I could imagine good things coming out of my interactions, and not be so reclusive. Just making room for it, I guess.

It served me to be able to a put the brakes on the worn-in path spiraling down. It is important to have a physiological break. Get a treat, read a funny, find a moment to yourself where even YOU aren't judging you, let alone anyone else, that you can ground in. This should be completely possible, but is so much harder than it sounds! self-care comes out of self-love. There is an undercurrent of poor self-worth in communities where resources are doled out via a system of judging and approving types of existence. We learn to think of ourselves and each other in the way the Machine sees us, and must endeavor to unlearn dis-care and begin demanding to be dealt with as a human.


The better I got at disconnected observation, the more clearly truth became visible. Suddenly I could admit fault freely, and engendered honesty in others. Only when the lake was drained did I identify my personal attachments to the outcome. This meant looking in the face of things I thought were good in my life, that ultimately kept me from moving forward. Before I went in with my "tweezers," I waited for a set of days where I could give this pain the room to unravel. This is also part of self-care, honoring that until then, you can try to triage your wounds in the meantime in order not to lose it and complicate your situation. Sometimes you get the choice, sometimes not. Be there for yourself when it does, like the bestest friend and advocate. No judging, only listening and protecting.

Increasingly, people are showing more Parking Lot Kindness, and some heroic community deeds! The contrary is also true, that pain and suffering follow the magnification principle, but this is not to be resented. We could distract ourselves with why, but the non-resentment part is how you disengage. THAT is the real work. I practiced inanimating a situation inside a clear blob so I could function while studying it, like the Ironman lab holograms, I tilt and turn, zoom in, connect ideas, and give space to make something work there first, where it didn't have the ability to hurt me or scare me anymore. There is a little meeting room in my mind where all sides involved are discussing and suggesting potential solutions, and in a supportive way. If peace with our struggles is supposed to be possible, it is only after being successfully imagined. Giving the situation permission to actually work out is the first step to it being able to change in life, even if it isn't right away.

These things refuse to be hurried, and are seldom honored by the world. This is where the Cloak comes in. How is yours coming along?