Cliff Jumping

A new friend and I were walking to the shuttle stop after the end of our first day of class yesterday (Was it only yesterday?  I swear, it feels like it was a week ago.).  Our collective nerves were crackling like live wires as we tried to wrap our heads around, well, everything.  "I feel like I'm standing on a cliff," I burst out.  "And, it's like, I climbed up here on purpose, I struggled up the freaking mountain, I did everything I possibly could to get out to the very top of this cliff, with the idea being that I was going to jump off, and now I'm here, and I'm so scared and I don't want to jump!  I desperately do not want to jump."
"Yes, exactly!" my new friend agreed, and we elaborated.
"And even though you know, you know that you'll be okay in the water down below once you jump, you know that you'll figure out how to swim and you know that climbing up to the cliff was the right choice, right now, it feels like the last place you want to be."
"But you can't go back."
"Nope."

I want to be in nursing school.  I really, really do.  But when I think about how for the next three years, there will always be homework to do, and how for the rest of my life, I will be taking people's lives in my hands and doing the best I can to care for them and I will not do everything right, and people will hurt, and people will die, and there is nothing I can do about it - when I think about that, oh you have no idea how badly I want to turn around and scamper back down the mountain to my nanny jobs and my no homework and my few responsibilities.

The leap from the cliff has already begun.  Classes started yesterday, and along with every single thing I learn, comes the more terrifying reality of how incredibly little I know.  Yes, I now know what the risks of IV feeding are, and why we are sleepy after we eat, and what the difference is between the pharmacokinetics and the pharmacodynamics of a drug.  But I sure as shit don't know what to say to a patient who has just been given six months to live.  I don't know how to comfort a mother whose child has just been diagnosed with cystic fibrosis.  I don't know how to feed someone who has leprosy and gangrene without gagging, I don't know how to take care of a dying baby without crying, and I don't know how to come home when faced with all of the ways I can't help my patients and get up again the next day still committed to help in the ways that I can.

I will walk into the hospital next week for my first clinical shift.
I will be assigned a patient.
I will walk into his room, introduce myself, and tell him I need to take his vitals.

And with that, the leap will be complete.
Yes, the water is rushing to meet me, but I'm going to try to enjoy the flight.

Nurses Treat People

Orientation lasted all of this past week, and by Wednesday late afternoon, we were fading fast.  Put 82 nervous, exhausted, hyper-caffeinated and tremendously awkward graduate school students in a windowless lecture room for three days straight, eight hours a day, and by the third day, it will all start to fall apart.  By the time we had been herded into room 118 one more time for this, our last presentation of the day, nobody much cared who it was we were listening to.  Turned out it was the chief of police, which meant we all sat up marginally straighter and propped our eyelids open with a little more effort.  The chief of the New Haven police department spoke, and then so did the chief of Yale Police, and then we watched a slideshow about how to use the emergency call boxes, and then we heard a speech about not walking and texting (yes, I'm serious), and then it was almost 5 PM and we all wanted to cry.  My butt was numb.  I was starving.  The room had started to quiver as people furtively began gathering their things as it became clear that the presentation was coming to an end.  The chief of New Haven police stood up one more time, a burly and intimidating man to say the least.

"I want to say one more thing, before we go."  The shuffling got more furtive, and a few whispers were shushed.
"I have to tell you all, we do at least thirty presentations like this at the beginning of each academic year, and I mean it when I say this to you - this, coming here to speak to you all, is my absolute favorite."

The shuffling stopped.  Silence fell.

"I've been a cop for more than thirty years, and there are two kinds of people that I respect more than anybody else: my fellow officers, and nurses.  I've known a lot of nurses.  Hell, most of the cops I know are married to nurses.  We go into these fields for the same reason - we want to help people and keep them safe.  There will be people that don't appreciate what you do, just like there are people that don't appreciate what cops do for them.  Don't ever think that I - or any of my fellow officers - are one of them.  What you all, as nurses do for people is beyond anything I could imagine.  I talk to doctors, to surgeons, to the incoming medical school students every fall - let me tell you, there is no one, no one like you all.  Don't you ever forget what a special job you all have.  You have the respect of me, and every single one of my fellow officers.  We all know that the saying is as true as they come: doctors may treat patients, but nurses - nurses treat people.  Thank you for your service.  We are all so grateful."

The silence rang long after he finished, and there wasn't a dry eye in the house.

Unrest

Our usually peaceful household has been well, a lot less peaceful over the last few weeks.  The unrest is separate from the stress of moving and unpacking (which is largely over), as well as  the seemingly small yet strangely exhausting tasks of buying silverware, lightbulbs, groceries, car insurance, etc, all in a new place.  It also has nothing to do with the potential for adjustment that the Nanny and I might have anticipated from transitioning from living in the same building in separate apartments to now living in the same apartment, in bedrooms connected by a Jill-and-Jill bathroom (I figure it's only a Jack-and-Jill if there's a Jack involved.).  No, this unrest, this disruption to the calm, this excitement, if you will, comes from one creature, and one creature only.  Tucker.

Photoshop skillz by Nanny

Tucker, as it turns out, is having a midlife crisis.

I can think of no other explanation.  Though he seems a bit young for such a major life event (he's four and a half), I can no more deny his emotional turmoil than I could deny the truth of global warming (which, depending on your political leanings might not be all that demonstrative of a comparison, but I digress).

He meows at all hours of the night, his dreams apparently disrupted by his own emotional duress.  My bleary explanations to him that there is food in his bowl and that his litter boxes are clean are met with stony glares.  Obviously, I don't get it.  I go back to bed, obviously indifferent to his pain.

During the day, despite frequent exercise chasing his toys, he'll tear around corners in the house after his sister, Lucy.  How dare I infantilize him with my pathetic offering of yarn toys, anyway.  Only after Lucy has exhausted herself running away from him will he occasionally settle down for a one-eye-open nap.

He graces us with his regal presence anytime we go into the bathroom.  Don't try to tiptoe so that he won't hear you.  That's insulting.  Are we less than thrilled to have a furry, purring companion during all bathroom activities?  That's absurd.  Soak up the love while it is given.  Turn on the faucet too, in a small, yet steady stream.  Make sure it's not dripping.  Leave it on for as long as he needs it.  Don't pretend you have something more important to do.

He retires to rest again.  After all, nighttime will be here soon, and with it, a new chorus of mournful meows.

Perhaps this would all be solved if I could afford to buy Tucker a red convertible and some expensive sunglasses.  Doesn't every hardworking man deserve some fun?  A chance to cut loose?  To leave his responsibilities behind?

Tucker, your six-dollars-a-bag organic dental treats are going to have to do for now.  Sorry.

Love,
Mom

Are We Home Yet?

Home is a difficult concept, yes?  It is charged.  Mostly with expectations.

Expectations for who we are when we are there, as well as expectations for what home should be like, always and unchanging.  Unrealistic, of course, because everything changes.

The sky changes, every day, and we hardly notice.  But enter the house whose very consistency and constancy you cling to, and a new chair, or a different rug can make your whole world feel off-kilter.

I have a tattoo that says, "I am home."  Like a lot of tattoos, this one says something that I claim to believe but really, probably is more like something that I want to believe.

I want to feel at home, wherever I am.  In my body, and in the world at large.  Often, I don't.  Usually, I feel like the world is one big whirling party that I'm too scared to join.  Or, if I do join in, I become some caricature of myself that mirrors and compensates and bows to every idea or influence or person and I long to jump back out, to catch my breath, to stand at the window and watch some more.

Home is a lot of things.  It's the big things, like a structure, with doors and keys and a mortgage or a rent payment.  And it's the little things, like a clock on the wall, a plant in the kitchen, and a cat on the bed.  It's the people you invite in.  It's the food you cook, the arguments you have, the tears you cry.  Mostly, it's the time that it takes for all those things to happen.  Just like a relationship doesn't blossom overnight, a house is not a home without some settling of the dust.

Patience is not one of my virtues.  Suffice to say, I would never get a tattoo that claims I am so.  But few things change with the rapidity and spectacularity of a sunset.  If they did, would we appreciate them?  Would we even notice?

I'll leave the porch light on.  We'll see who stops by.

Moving: A Helpful Guide

Dear anyone planning on moving, ever:

When preparing to move yourself, your friend, and your two crazy cats from one city to another, please refer to the following list for some examples of probable occurrences that will make all of your previous planning efforts look pitiful and elementary by comparison:
1.  It will be 90 degrees while you are packing (and unpacking) and there will be no air conditioning.  You will also have inevitably already packed the fan(s).
2.  Your moving truck company will call you the day before your move to confirm your order.  The confirmation will be incorrect, stating both the wrong time and the wrong location for truck pickup.
3.  No one at said moving company will give a flying Fig Newton that you have a strict schedule to adhere to, given that you have hired moving help in both cities.
4.  The night before your move, you will suddenly realize that you neglected to set up gas OR electricity in the new house.  Oh, but don't worry - you scheduled someone to install the wireless internet a week ago.
5.  Also, the night before your move - you will succumb to a raging yeast infection that requires going to the pharmacy for Monistat.
6.  You will be unpleasantly surprised by the enormity of the truck you rented, upon seeing it for the first time.
7.  You will develop a sudden and unwavering faith in all divine beings, in the hope that one or all of them will take pity on you and keep you safe while you maneuver the twenty-six feet long, eleven feet tall moving truck.
8.  You will give yourself (and your fish passenger) loud, inspiring motivational speeches during the most terrifying three hour drive of your life.  These speeches will occasionally be interrupted by outbursts of cursing so filthy that they would make your mother blush.  This usually happens when someone cuts you off, honks their horn at you, or otherwise raises your blood pressure even further, but occasionally these outbursts will be more self-directed, e.g., "WHY DO I OWN SO MUCH bleep-ING SHIT??? SO MUCH THAT IT FILLS THIS INFERNAL, bleep bleep bleeeeeep TRUCK??!!"
9.  Eventually, you will arrive.
10.  You will sigh a huge sigh of relief.  You will dance.  You will even sing a little.
11.  You will watch, exhausted, while your cats explore their new domain, and you will hope to God that this was the right choice.
12.  You will watch, exhausted, while all of your stuff is moved into the house.
13.  You will give these moving men your last dollar bills.  Literally.
14.  You will rally, unwillingly, and take the moving truck back and NEVER, EVER DRIVE ONE AGAIN.
15.  You will go back.  You will tear up as you turn your key in the lock and step over the threshold.
16.  You will survey the boxes, pledge to be ruthless in your sorting as you unpack, and get ready for bed.
17.  You will be home.

On the Road Again

This is the fourth time I have moved in the last two years.  That's not counting the packing up and storing of all my stuff at the end of each academic year at Smith, and the subsequent unpacking into a different room the following fall.   I'm so unbelievably, down-to-my-bones tired of moving.  I'm tired of finding boxes, of cramming everything I own into them, of tape getting stuck, of losing my marbles over how to get everything done, of paying exorbitant amounts of money for moving help and U-Haul trucks, of signing new leases, of breaking old leases, and of never feeling at home.  I'm tired of it all.

I know that this is what being in your twenties is supposed to be about, on some level: being unmoored, portable, and (relatively) spontaneous, given that I am unattached, unmarried, childless.  I certainly wouldn't argue that moving a family of five is more difficult than moving myself, a friend, and two unruly cats, but I still crave stability.  I want to be able to attach things to the walls without Command strips because I don't have to worry about getting a security deposit back in six months or a year.  I want to actually unpack things, instead of just stowing overstuffed plastic totes under my bed or in a closet, because I'll just have to pack it up again, anyway.  I want to be able to give someone my address without the caveat that by the time they send something, most likely I won't be there anymore so they should probably send it to my parents' house instead.

All of which leaves me with a wary sense of excitement and tentative relief at the prospect of where I will land on this move.  After all, the first floor of a cute little Victorian house on the outskirts of New Haven will be home to me for at least the next three years.  I can settle in there, I hope.  I can set up my printer, I can find a place for my Crock-Pot, I can maybe even start going to the dentist twice a year, like you're supposed to do when you live in one place long enough to keep appointments like that.

And really, I know there are worse things.  I really do.  I know that even setting aside the horrendous troubles of the world at large and other people's pains that I'll never try to compete with, I myself have gone through a hell of a lot worse than moving.  I know that.  But when I stand in the kitchen, here, and remember how sad and desperate I was when I moved in, and I remember all the times I've cried on this here floor, and I take a bite of the lunch I just made out of things I'm trying to use up in the kitchen so I don't have to pack them (i.e., rice with eggs and Sriracha sauce) and the rice has the nerve to be undercooked because I can get into Yale and I can't cook rice, what the hell is wrong with me and I start to cry, again - it just seems like a bit much.

In a few days, this will all be over, I tell myself.  You just have to keep pushing to get through the next few days.  Put everything in a box.  Don't worry about it not being organized, just label it so you know.  (This is how you end up with boxes with labels like BEDSIDE LAMP, TUCKER TREATS, WEDDING DRESS, HUMIDIFIER, WAX PAPER.)  Keep taping up boxes until it's done.  Try to sleep a bit, then go pick up the moving truck.  Drive.  Don't think about how scary it is that you're driving a 20-foot long vehicle, alone.  Just drive.  Move things into house.  Hope the moving men speak English.  Return scary huge truck.  Go back to the yellow house that is now home.  Collapse.  Get up again.  Commence unpacking.  Find a place for everything.  Make your bed, and if necessary, bury your head in your pillow that smells like your shampoo and Tucker's sweet fur, and the old t-shirt you sleep in.  Cry again, if you must.  Then get up and keep going.  Because it will work out, I tell myself.  It has to.

Looking the Part

I feel like a fraud.

I stood in the dressing room at our local uniform store, awkwardly tugging on the navy blue scrubs that I was trying on, and cracked the door open.  "Mom?" I called, in a wavering voice.  "Do these look okay?"  I sounded like I was twelve.  Not twenty-four, and certainly not old enough to be entering nursing school, where I will all too soon be put in charge of something small and manageable, like someone's life, for instance.

I have the navy scrubs, two sets of them.  I have the sensible shoes, that will support my back and wipe clean with a towel.  I have those things, but I feel like I'm pretending.  Like I'm playing dress-up.  I'm terrified that on my way to my first clinical shift, someone is going to collapse on the sidewalk or in the coffee shop that I'm walking past and someone will stop me and say, "Please, can you help?!  You're a doctor/nurse/you know what you're doing, right?!"  No!  I don't!  I don't know a thing!  And yet, here I am, marching off into rooms filled with unsuspecting patients, asking them to proffer me their wrists, so I can search for a pulse, their upper arms so I can over inflate a blood pressure cuff on them, and their shivering backs, so I can listen for breath sounds that I can't interpret, anyway.

There are two things, however, that I am bringing with me, that I do think will help.  The first is my grandfather's Timex watch.  My grandfather wore this silver watch for as long as I can remember, and my mom held onto it for the past sixteen years since he died, tucked away in her drawers.  When I mentioned that I needed a watch with a second hand for school, she pulled it out.  A new battery and a new wrist band later, I am outfitted for pulse-taking and contraction-timing with the most perfect watch I could ever want.  I think of him when I look at its reassuring hands, and I remember how safe I felt in his lap.  Maybe I can bring a little of his calmness and steadiness to my work.

The second thing I am bringing is my mother's stethoscope.  My mother put herself through nursing school long before I was born.  She did it as a single mother, while raising two little boys (my older brothers), with no money and almost no help.  She fought an uphill battle in order to be able to provide for her family on her own, without depending on anybody else.  And through sleepless nights, and government checks, and the aftermath of divorce, she did it.  She did it, and she believes that I can do it too (though under considerably easier circumstances, I might add).  And I am so grateful that every day, as I struggle to learn and to measure up, and to prove to myself and my professors that I can do this - I will have her reassuring presence with me, hanging around my neck, or resting in my pocket.  The stethoscope that helped her realize her dream will now become a part of mine.

Just Say No

I've been filling out more than my fair share of medical paperwork over the last few weeks, what with trying to get everything cleared for Yale and all.  It's all very standard stuff, but there is one question that continues to trip me up, every single time I see it: please list all medications you are currently taking.  Obediently, I put pen to paper and start to list the four or five prescriptions I have in my name.  Give or take a few seconds, and I'll pull up short and remember - I'm not taking any medications these days.  Not a one.  For someone who has been on one form of a psychopharmaceutical or another since I was nineteen, it's a little bit unsettling.  Also, given the manner in which I went off of my medications, I consider myself more than lucky to be doing as well as I am.  Suffice to say, it was not one of my more responsible moments.

Moving to another city presents many challenges, and finding psychiatric care - that I could afford - when I moved to Boston proved to be a challenge.  I halfheartedly started seeing a new therapist, but balked when she mentioned an every day intensive outpatient program for eating disorder treatment.  I had already had one job blow up in my face as a result of being honest with my employers about things I struggle with, there was no way I was about to come clean to my new bosses in order that I might leave work an hour early in order to make it to IOP in Harvard Square every single night.  Add to that, I was still speaking to my New York therapist on the phone every other week, and there was no way I could afford to keep paying two therapists.  So, I reasoned that doing phone therapy twice a month was sufficient, especially since I was seeing a new psychiatrist to manage my medications and my plummeting moods.  The first session I had with her was exhausting.  I left feeling like I had been poked with a sharp stick for an hour, never mind the fact that I had paid her $350 to do it.  With instructions to return in two weeks, I drove home in a driving snowstorm and promptly crawled into bed.  Two weeks later, I paced the floor of her waiting room with barely contained maniacal energy.  She ushered me in, took one look at me, and said, "This has got to stop."  I clamped my hands down on my thighs to stop their frantic twitching and asked her what she meant.

You're twenty pounds underweight, she told me.
You're headed for a manic break, she said.
Your medications can't work for you if you're not eating enough to metabolize them, she scolded.
We might have to put you on lithium.

I think my heart stopped.  I tightened my grip on my emaciated thighs as I started to shake uncontrollably.  Lithium.  It's not for the faint of heart.  Lithium is an excellent drug, one that entered the scene of psychiatric treatment in the 1950's and was found to be very effective at managing manic depressive illness, particularly in controlling manic episodes.  It comes at a cost though.  Lithium has a narrow therapeutic/toxic ratio, meaning I would need weekly blood draws to measure my plasma concentrations.  Side effects include a perpetual dazed feeling, hand tremors, dizziness, nausea, possible birth defects and permanent kidney damage.  A toxic dose is deadly.  The most common side effect, however, is weight gain.

I can't I won't I can't I won't, I chanted in my head, and the rest of our $300 session passed in a blur.

I never called her back.  I never returned her calls.  Two weeks later, my medications ran out and I didn't have any refills.  I went cold turkey off of five serious medications, each of which I should have been weaned off of over a period of weeks, and possibly months.  She left me angry (albeit, concerned) voicemails and I deleted them without even listening.  I won't pretend that any of this was a good idea.  My moods swung wildly.  Without sleeping pills, it was weeks before I slept through the night.  I had days of such paralyzing depression that they reminded me of how I had felt before I went into the hospital three and a half years ago.  I had nighttime anxiety attacks so bad that I would grip my headboard until my knuckles turned white, trying desperately to breathe, focusing in on Tucker's glowing eyes in the dark while he sat with me, never leaving my side.  Eventually though, the storms began to pass.  I could feel sad, and it wouldn't knock me to my knees.  I could feel happy, and it wouldn't lift me ten feet off the ground.  I could cry over Alix, and still get up for work the next day.  Even hearing about my dad's diagnosis only spurred me to try harder to pull myself out of the eating disorder's grip, until eventually, I resembled a healthy human being again.

Two weeks ago, I sat down once more in a psychiatrist's office (not the expensive lithium-suggesting doctor of this past January) and laid bare my history.  "I just want to see whether you think it's okay that I'm not taking anything," I told the nice, earnest-looking resident.  "I don't want to do anything irresponsible or stupid when I'm starting a new school year like this."  He listened closely to my colorful history, asked all the right questions, and finally told me that no, I didn't need to be on any medications right now.  He cautioned me, though, and made sure I understood that the very nature of bipolar disorder is that it is cyclical.  That there's a greater than ninety percent chance that I will need medications again at some point.  I already knew that, and I told him as much.  He told me to pay attention to my moods this fall, when the days begin to shorten and Seasonal Affective Disorder begins to set in.  He told me about exercise, and good sleep habits, and the benefits of surrounding myself with supportive people.  I stifled a yawn, and told myself he was trying to be helpful.  There was no way for him to know that I could have given that speech myself.

I don't know how I feel about the likelihood that I'll be popping handfuls of pills again at some point down the road.  Maybe he's right, and it will happen, or maybe he's wrong, and it never will.  Regardless, I am fully enjoying being unmedicated for the first time in five years.  And the last medical form I filled out, where it asked me to list all of the medications I am currently on?  I drew a smiley face on the lines instead.

The Bird Whisperer

Even Lula has a Southern accent.

All of the Things

• Everything really is bigger in Texas.  Like big oil, and how gas prices are at least fifty cents cheaper here than in Massachusetts because of it.  Also, the bananas.  Are huge.  Not kidding.  I carried three of them through the supermarket today and felt like I was gathering props for a low-budget porno.
• Today was the first Monday that I haven't been at work with my girls since I started in January.  It's a bit surreal, to say the least.  Also weird: depositing my last ever paycheck on Friday, and knowing that the next time I'll be working full-time, it will be as a midwife (or nurse) - NOT as a nanny.
• I've been reading up a storm in an effort to stockpile memories of pleasure reading before school starts and the only things I should be reading are textbooks.  Some recent favorites: NurtureShock: New Thinking About Children, by Po Bronson and Ashley Merryman; Wild, by Cheryl Strayed; and The Night Circus, by Erin Morgenstern.
• The following articles/opinion pieces made me think:
• The Busy Trap
• This, about "having it all," but then (thank goodness), 
• This, about taking the whole crazy thing less seriously sometimes.
• I saw this movie last week, Your Sister's Sister, and it was the best movie I've seen in a long, long time.  Can we have a show of hands from all the little sisters in the world whose older sisters didn't teach them about ahem, the need for trimming?  Go watch the movie, you'll understand.
• Fun things I am doing this week in Texas, to be included in an upcoming post:
• Ze wedding! (technically, this already happened, but since it's the reason I'm here, it deserves some proper attention)
• pie-making
• hair-cutting
• day trip to Austin (we're going to the bat bridge!)
• Rangers game
• Half-Price Books
• good Southern food/real bbq
• swimming
• sleeeeep

And those are all of the things.  Please tip your waitresses, I'll be here all night.