Showing posts with label Death. Show all posts
Showing posts with label Death. Show all posts

20100321

Edge of the Razor

“We are all equal in the presence of death.”

Publilius Syrus (~100 BC)


“Suffering is one very long moment. We cannot divide it by seasons.”
Oscar Wilde (1854 - 1900)

Time has no meaning in this white room with no view. The seconds cling tenaciously unable to relinquish their fleeting hold on the present as minutes coil like a snake twisting time into a distorted abolition of a once familiar marker of diurnal rhythm. Without warning the clock leaps ahead hours only to freeze motionless for another eternity. It is only a moment ago, but at the same time it seems difficult to recall when the world was normal, a past reality so distant it is a faded memory. Time is no longer linear but now is three dimensional providing deceptive views from each perspective, with each turn time is elastic and multifaceted looping back upon itself. The barely audible hums and beeps of the army of small robots mix with the drone of background stainless steel clanging and muted voices that seep into a white void.

All along death sits outside the window peering in as a beautiful soul pirouettes and dances in a faceless white mist hoping to once again find the way back to a bruised and battered body restrained to a bed in the corner of the alabaster room. The dark figure that waits outside is a lazy hunter praying on the weak and unaware as she lies motionless with a pert determined scowl painted across her innocent face. Evidence of death’s presence is apparent to all who enter this secure hidden world where life is resurrected from the damaged and diseased, where life hangs in the balance with a precipitous grip. Be it known to all that survival is a bloodsport of the most violent type. A violent bloodsport capable of destroying dignity to an extent few will ever experience. Deep purple bruises cover the entire surface of both her arms from the fingers to the elbows attesting to the dozens of needles that administered the plethora of medicines during the first few critical hours of emergency care. Both elbows have deep red raw abrasions from struggling against cotton sheets attempting to free her from the legions of wires, sensors, probes and tubes that hang from her fragile torso. Her graceful neck retain the long purple striations from the cold steel brace used to hold the head immobile during the procedure, the bruises are dappled with small punctures from stainless steel screws that still trickle and ooze blood down her forehead. A constant seep of transparent crimson liquid finds its way from beneath the surgical dressings down her temple where a ventricle drain in her penetrates the forehead to secure a small clear plastic tube that snakes deep into the frontal fold of her brain. Small cherry sized brown strains dot the pillow where the surgical incision weeps claret tears from between course black stitches running across her temple in a huge arc. Angry red abrasions surround both wrists where the instinctual struggle against the cloth restraints documents the raging battle of the subconscious mind seeking freedom from the madness of this alien and consuming fog.

As if observing a titanic battle from a safe distance while watching the sky flash beyond the horizon, we can understand the carnage that exists beyond our sight, but her visible wounds are only slight tangential indicators of the mortal struggle that rages below the surface, in the unseen world beneath the skull. This battlefield in no different from any battle as the fog of war obscures the tactical situation as the combatants spar against partially revealed positions both in defensive and offensive maneuvers. The struggle is best seen in the eyes that flash animal wildness and fear, darting around the room looking for a way to comprehend the endless nightmare that will not relinquish darkness for dawn. Eyes that only allow the person I know to briefly emerge for a smile before returning to the center of this brutal conflict. Behind her eyes is a void, vacant hollowness as she stares blindly hoping that the mere act of lifting each eyelid will allow light to illuminate the darkness that surrounds everything. I want to reach into those eyes and calm the scared innocent girl hiding in the fog, but she is a prisoner in a place deep within the recesses of her mind where no one can trespass.

The dreadful phone call that would once again completely change my life came at 12:30 just before lunch. Her mother was frantic as her voice crackled with fear and concern. “I just called 911, she is in severe pain and is shaking uncontrollably. She says it’s her head, I’m so scared. Oh my god she is going to pass out. I’ll call you when I know when she is headed.” Suddenly the phone goes dead as I continue to hold it to my ear hoping that what I heard was a mistake.

At that moment time once again stopped as ice water courses down my spine. I am flooded with a mix of disbelief, fear, concern, anger and sorrow that swirl in my mind as I mumble under my breath “…..why…..why….why again?” After about ten minutes of absolute frantic panic while pacing a small circle in my office I could no longer stand the silence and called her mother again.
“She is headed to Northland Hospital. Meet us there. I’m concerned she is in really bad shape. Oh god….Oh god.” Her voice drifts as the conversation is drowned by the sound of the arriving ambulance and the muffled sound of frenzied voices.

The traffic to the hospital is horridly congested and the two minute drive takes over fifteen minutes. Arriving at the emergency room I capture a small glimpse of her rigid contorted body being rolled on a gurney through the glass doors. Running inside the emergency room I am stunned at how crowded it is with dozens of people milling about looking for attention. In response to my inquiry, the attendant at the front desk says “She was just brought in and it will take a few minutes to get her checked in. Come back in ten minutes and I’ll take you back to her.” I scan the waiting room looking for a quiet isolated place where I can digest what is happening when I view her mother walking in from the parking lot, she was too upset to drive to the hospital and hailed a cab. Meeting her in the vestibule she begins to buckle at the knees as I grab her arm to provide support. Her mother is in shock as we wait our turn at the front desk during a staff change. When I recognize the new receptionist, but am unable to discern how I know her. I look down at her and ask “Excuse me, don’t I know you?”

She looks up and smiles “Yes I worked for you about 12 years ago.”

Embarrassed I offer an apology. “Sorry I’m a little distressed right now. My wife was brought in here a few minutes ago.” Without delay she checks and comes back to escort us to the room my wife is waiting in. Along the way she asks “So how are you doing?”

Caught a little off guard by the question I respond “I guess I could be better otherwise I would be somewhere else. I assumed you meet a lot of people you know under this type of circumstance.”

She nods and points us to empty room while explaining “She is getting a CAT scan and will be right back.” There is real concern in her face as she turns to leave.

My wife has always had one of the highest tolerances for pain of any one I know. A few years back after abdominal surgery and a complete hysterectomy, the day after surgery she was remarking how little it actually hurt. To prove her point much to my horror she began doing sit ups. In complete panic expecting to watch her abdomen to split in two at the incision, I pleaded with her to stop while she just smiled, completed a few more just to show me who was in control.

Her typical method for dealing with severe discomfort is sitting quietly without talking or verbalizing, never really showing any external signs of distress, just a calm quite stoic facade. As the attendant rolls her back from the CT scan I am totally unprepared for what I am witnessing. The definition of pain was defined to me that day like never before. I am witnessing a degree of pain that exceeds my total life experience by a factor of ten. It is an experience that won’t be described in words, while the images haunt me incessantly. Pain is usually described is a scale from 1 to 10 where 10 is the worst pain possible. Never in my life did I conceive what the worst pain possible could actually be. It is a pain that radiates out into the air inflicting severe discomfort to anyone in the room; no one is immune from the indiscriminate pain that permeates every pore in every living thing within sight and sucks the breath from your lungs just watching her.

The pain is searing white blinding in waves that pushes her deeper and deeper into a hell which has no beginning or ending. An unrelenting thunderous punishment that turns each moment into an eternity, as the rivets of cold sweat drains from the furrows in her grimacing face. Any stimulus such as light, sound or touch is like swinging a sledge hammer into her head as she repels with vicious contorted violence. A low guttural throaty animal growl emitting from her limp body which no longer sounds human as the pain screams with pointed daggers from this possessed body. Her muscles involuntarily brutally contract twisting her limbs into knots while flailing against the gurney as if she is being electrocuted. As the blood flows from the ruptured aneurysm in her brain, the pressure escalates squeezing the brain tissue against the inner surface of her skull, every neuron is firing warnings into an uncontrollable firestorm of electrical chaos. The mind, unable to withstand the lightning bolts of stabbing pain, begins to retreat from the outside world in attempt to focus its resources on own survival. Attempting to find refuge from the horror the mind begins the methodical process of dying. A riot of sensation overwhelms reality as portions of the brain begin to drown in rivers of adrenaline flooding the skull in response to the uncontrolled bleeding.

Without any ability to assist her, we watch in stunned horror as her weeping moans fills the bare white room. The emergency room doctor steps in though the door with a measured authority to address me without acknowledgement the broken body quivering in brutal spasms. His words pierce me with a steel cold confirmation of this usually fatal condition, “The CT scan confirms she has suffered a rupture and there is a subarachnoid hemorrhagic bleed. We will need to transport her immediately to St. Luke’s Hospital.

At that moment all hope of this serious medical being something minor or simple dissipates as fear punches me in the gut making me wobble at the knees. I am transported to three years ago when she was diagnosed with her first ruptured brain aneurysm, feeling an incredible senseless anger over having to relive this nightmare again. I look over at her mother, Mary who is in shock unable to comprehend the journey that has just begun. Mary’s arm is twitching slightly as her stares blankly at the pile of my wife’s discarded possessions. Suddenly a group of EMT’s fill the small room and begin strapping heart monitoring equipment on to the moaning patient, before the transferring her to another gurney. As they slide her on the blanket, to the other stretcher she yelps loud in a painful response to the activity. The sound reminds me of stepping on a dog’s paw as the shrill yell drowns the noises of a room filled with people in motion. The attendants are immune to the sights and sounds of pain as they methodically recite the scripted procedures in an ambitious detachment. I am informed that since the transfer to the next hospital will be under lights and siren no other passengers are permitted in the ambulance. A moment later she disappears into the chrome and red door as the lights flash red and blues turning the emergency room into a disco ballroom with distorted colors painting the white walls with blue and red comets as all the medical equipment reflect the dancing lights like a Christmas tree. Suddenly the room is once again silent and sterile white as I am swimming in confusion. Where have I left the car? What is going to happen next, as by instinct collect her mother by the arm and begin to wander the crowded parking lot in shock trying to retrace my frantic path? Helplessly I wander the parking lot looking for my misplaced vehicle.

The drive to the hospital is a brief respite from the crushing uncertainty. Both of us sit drained of emotion staring mindlessly out the windshield without attempting to focus on anything. The silence relieves both of us the need to articulate our thoughts. A vile ball of emotion attempts to escape from the pit of my stomach by clawing up my throat in a wave of sorrow. Concerned that any display of emotion will further destabilize her mother’s tentative hold on sanity, I summon the testosterone induced power of male indifference to quell this inconvenient display of weakness. While I’m sure the ride is filled with small talk about tangential conversations of no relative importance, I cannot recall a single word that is exchanged as the sounds drift past without piercing conscious thought. Mechanically we park the car adjacent to the emergency room door and rush past the information desk as the attending nurse informs us that she is in room #7 while pointing the way.

Pulling back the curtain for emergency room #7 exposes a beehive of chaotic activity as four or five doctors and nurses hover over the prone patient. Somebody introduces themselves to me as I immediately forget the name. Once I have been identified as her husband, the attending nurse corners me and begins to drill me with a litany of medical history questions. “Is she allergic to any medicines? What is her family history? What medications is she currently taking? When was this condition noticed? Has she exhibited any earlier symptoms? “ At the same time some other attendants are beginning a process we will hear a thousand times before she is finally released from the hospital, the neurological state assessment. “Can you lift your arms? What is your name? When is your birthday? Can you smile for me? Can you wiggle your toes? What is today’s date? Do you know where you are at? Can you lift your legs? Can you squeeze my fingers?” We will hear this drill every couple hours for weeks. It is a process to determine if there is a decline in the neurological function, an early indicator of another stoke. The small room is filled with people running in and out with charts, IV’s and blood pressure cuffs.

The attending nurse turns to me and says “Would you please talk to the administrator in the hall?”


Sure” I reply and find a kind slim black lady dressed in a fashionable jacket and skirt behind a small mobile desk that looks like a sheet music stand on wheels. She is here to secure the medical insurance information. God forbid anyone finds themselves in this situation without the proper documents. I wonder to myself if they would refuse treatment if we were uninsured? This is a very ominous discussion in which I am fortunate to have the correct information.

During the entire inquisition I am peering over my shoulder back into emergency room #7, completely detached from the conversation I’m engaged in. Anxious to get back into the room I hand her my driver’s license and insurance cards and politely terminate the discussion.

Standing next to the gurney I watch as they begin to control the severe pain my wife is experiencing while she shakes and moans holding her head. Large clear IV’s of morphine are injected into her in great quantity with the same apparent impact of saline. They begin to change the formulation to other opiates. One after another pain killer are piped into both of her arms. The nurse turns to inform us of the recipe of this particular injection, most of them I have no knowledge off. For ninety minutes they shoot various combinations of opiates into her while she seems to resist any attempt to wrest the excruciating pressure from her skull. Holding her hand I quietly whisper into her ear, hoping my voice will comfort and relax her, but the veil of pain is so dense she is unable to respond as she continues to drift further and further into herself and further from the chaos that surrounds her. The nurse systematically injects the next combination of hope, observes the results for a few minutes when leaves the room to consult with the emergency room attending doctor only to return ten minutes later with another IV.

Having lost count the nurse returns to announce the next injection, this one called “Fentinel”. Within a minute or two of the injection my wife has a violent reaction to the drug. Another creature emerges from the gurney as she begins to shake with uncontrollable spasms that rack her body like an epileptic electrocution. Every muscle in her body contracts propelling her physically into the air no longer touching the gurney, as the color of her face turns ashen grey. Her skin is on fire as sweat rolls off her in torrents which puddle discoloring the baby blue blanket she is lying on. I grab a wash cloth, run it under the cold water in an adjacent sink attempting to place it on her face to reduce the fever but her head is thrashing so violently I am unable to provide any comfort. For the first time in an hour my wife utters a few words in a tone that expresses the monumental effort that is required to talk “ ugh……I’m nauseous ugh…….I’m going to vomit……ick...

The nurse grabs a thin mauve crescent shaped plastic dish for her to vomit in as I try to follow her whipping head with the receptacle but her violent movements are too erratic. The tenor of her moans and cries are getting more desperate as she is in the process of dying the most painful death one can imagine. It is the most horrifying scene I have ever witnessed as her possessed body shudders in violent waves rolling on a turbulent sea. Nothing can come close to describe the excruciating pain we are observing in absolute helplessness. It is the center stage of the bloodsport of survival as the combatants of life and death take turns clawing at this suffering broken body. For what seems like an eternity time is frozen in this horrific torture with an over whelming sense of complete and futile impotence.

What is this violent motion doing to the ruptured aneurysm inside her brain that is pumping toxic poison blood into an ever increasingly crowded skull? “Oh my god, her body is killing herself. How much longer can she sustain this brutal assault before her brain no longer can regulate basic life functions such as breathing or heart rhythm?”

All I can do is hold a cold washcloth in my hand as my arm hangs limp and watch the chaos that swirls as the entire known world shrinks to the confined space of this small emergency room. It is as if the universe compressed itself into these four tiny walls, nothing exists beyond and there is no escape until death is defeated if at all possible. At this moment an entire life of effort and accomplishment, dreams and plans, possessions and mortgages have no relevance or meaning. Life is now reduced to counting heartbeats and taking the next breath of air, every worry and concern I carried into this day is reduced to trivia, trivia that is laughable in perspective to someone fighting for their life. I become ashamed that I allowed such meaningless thoughts distract me from the gift of life we are given and so severely assume it is our right of birth. My arrogance and selfishness I carried into today collide into the wall of reality and mortality.
I have now entered a state of shock as I blankly stare, so horrified, so afraid, so numb that it is as if I’m having an outer body experience watching from the corner as tears fall from somebody else’s cheeks. It’s the little things that reach out and rip your heart out bringing out the pain of loss so you engage the present cutting through the numbing shock. Sitting in the corner of the crowded room on the floor is a royal blue thin plastic shopping bag with white twine draw strings. The bag with white block letters that spell “hospital” is forlorn and abandon with its top folded over spilling its contents onto the floor. I stare at the bag realizing that it is all of wife’s possessions that were taken or removed from her. All those things that are so important to her are discarded almost as trash; I think to myself that she would never allow her purse, cell phone and wallet to be carelessly tossed unattended into the floor like this. It is a simple realization such of this that drives the moment through you like a searing white hot steel rod, exploding a tidal wave of uncontrolled emotion. I know this is all terribly wrong as I clasp my hand to my face and begin to sob heavily. This can’t happen…..this can’t happen right how. I need to bottle this rage before I collapse into a worthless pile. Everyone in this room needs me to be strong. I cannot ignite a wave of panic in myself that takes control; I must have a grasp on reality however tentative it may be. It takes every ounce of strength in me to wrestle this firestorm of fear back into the corner of my mind.

For over twenty five minute we watch my wife processed and controlled by this violent alien force, until the attending nurse comes in having concluded this reaction is not going to disappear by itself, that something needs to be attempted in sort the stabilize the patient so that she can be sent to have another CT scan. In a firm but yet compassionate tone she explains the choices and risks. “We have two options that we can explore in order to stabilize your wife. One we can give her an injection which will back out all of the Fentinil, but it will also back out all of the other pain killers we have given her to date. I do not want to do this because she will be in excruciating pain if we remove all the painkillers from her body.”

My jaw drops to the floor at her statement what do you mean she will be in excruciating pain? My god is there a level of pain more intense and excruciating than what I am witnessing now? Is that even possible? This is more pain than I have witnessed in my entire life easily by a factor of ten. I cannot fathom what that means, but most of all I know with absolute certainty that I will not bear seeing her in more pain without coming apart at the seams.

With a managed expectation of success the nurse offers the second option. “In some patients we have positive results in managing the allergic reaction to opiates with an injection of Benadryl. I would guess maybe one in five improve with Benadryl.

The decision is quite simple a small chance to manage the reaction or plunging my wife into certain hell of unspeakable torture. “Let’s try the Benadryl.” I offer as they attempt to restrain her thrashing arm sufficiently to inject the hope of finding a door to exit this nightmare. We wait quietly frozen into stone statues keenly observing every twitch and jerk of her torso trying to discern the slightest abatement of violence. We notice a gradual but steady improvement over the course of ten minutes until her muscles finally stop contracting and gently fall limp laden with exhaustion. For the first time in hours the horrid grimace melts from her face with her head nodding to the left as if drifting into a graceful sleep. The color returns to her face and the film of sweat that covers her flesh starts to evaporate creating dry patches like wet asphalt on a sunny day. I am stuck by the relief that people must feel when death steals the suffering. The seduction is clear; the promise of calm, the lure of eternal bliss beckons us to cross the line between life and death. From the last aneurysm my wife had, she indicated that it would have been so very easy to die that day, the temptation to walk through the open door was without fear or pain, as simple as breathing. For months afterward she would say that she can only hope that she will in fact die that way. This time she receives no free pass to the fields of gold, no graceful flight to the next life. This time she has felt the blistering brimstone of hell in all its fury and this is only the start of the journey.

For the moment there is a childlike quality of grace sweeping over her as her breathing become deep, as the heaving of her chest changes to a salient rhythm which is comforting to everyone in the room. I fall back into a simple metal chair on the corner of the room collapsing once the weight of the moment is lifted from my shoulders. Only now can I begin to peer into the next minute, the next hour, the impending surgery. Life is now measured in small simple digestible units of time, life is reduced to no more than small blocks of minutes or hours. I slump with my head almost touching my knees as my hands rake furrows over and over in my hair. The prospect of probable death or severe disability has not left, we are not anywhere remotely close to exiting this dark and ominous forest, like clinging to a sheer rock face in the middle of a monstrous cliff, we have only secured a small foothold, a sanctuary to rest briefly before the assault continues. My mind tries to process these incomprehensible images as my thoughts are ripped apart into random fragments before they are digested. Chaos is king as my mind flashes bits and pieces of information with no apparent reason or no particular order, like a computer overloaded to the point of dumping memory, spilling all of its contents onto the floor.

Our moment of rest shortly passes as my wife awakes to begin the guttural moans of pain and the process of dumping morphine back into her veins begins in earnest once again. We are informed that the operating room is stacked up with critical procedures and we will need to wait our turn to get an angiogram which will determine the location and extent of the hemorrhage, the first step before cranial surgery. For the next four hours we wait in a state of horror watching the pain course taking her from a state of brief awareness to unresponsiveness. The emotions of hopelessness and ineptness prevail over fear, panic, loss, anger and sorrow as the minutes slowly pass.

At seven in the evening the operating room is now free of the traffic jam which prevented us from entry. We once again prepare ourselves from the next level of anxiety and uncertainty as the next step in the discovery process begins. A small tube will be inserted in the femoral artery on the inside of the thigh which will then be pushed throughout the body until it reaches the aneurysm site in the brain. A dye will be injected into the bloodstream so that the veins will show in contrast revealing the extent of the damage. If at all possible the surgical team will attempt to clog the rupture with a threadlike titanium wire which is coiled into the aneurysm blocking the leakage of blood into the brain cavity. With surgical precision the attending nurse again informs us of the risks, the procedure could further damage the aneurysm resulting catastrophic damage, the risk of clots, the chance the patient could bleed to death from damage to the femoral artery, and on so the list goes on. This is the medical disclaimer to limited malpractice suits; here are all the things that could go wrong, just in case something does, we told you so. I don’t recall the exact probably of death from this procedure but it was in the range of 15%.




The family present is allowed a few minutes to say goodbye prior to quickly being whisked behind to white worn swings doors with two round windows that resemble a ship’s porthole. Stunned at the prospect of waiting for the procedure to be complete, we are lead down an abandon corridor devoid of architectural interest as florescent lamps bath everything in an eerie blue tint. The small waiting room has white walls and a couple of cheap warehouse artist paintings that are mass produced by the hundreds. It is most disturbing that they don’t match and actually clash as the colors fight each other across the sea of white. Three small office chairs and an industrial sofa framed in ochre colored oak struts are filled with the stress and sorrow of hundreds of family members and loved ones that have preceded us; they stand indifferent as sad trapped emotions ooze from the worn stained fabric. A soiled coffee pot hisses from a battered wooded stand as a black tar substance which in a former life was liquid meant to be consumed, simmers on the burner no longer capable of yielding stream.

Time taunts us as a small round clock hanging above our heads in plain view appears to be frozen unable to advance measuring the march of time. For a period of three and one half hours we are alone with our thoughts, wonderings what is happening in the operating room hidden deep in the bowels of the hospital. Trapped in an endless loop the questions roll past unanswered. How is she doing? Did they find the source of the bleeding? Is it better or worse than expected? When will we know the outcome? How much longer will we wait until we hear something? The strings of questions flash by in one long connected stream of consciousness only to loop back again and begin over, time after time. My stomach is raw with bitter acid from the flood of coffee I’ve consumed. My head pounds from a lethal cocktail of stress, adrenaline and caffeine. My muscles throb in exhaustion, stiff and atrophied. The others sit around me whispering in hushed tones of mindless conversations, as they use nervous chatter attempting to distract themselves from the unbearable isolation of the moment. I am unable to engage in any discussion and only half heartedly acknowledge they are talking with a feeble nod or fabricated smile that cannot hide the complete disconnection I am experiencing. Time is a burden that is crushing with no escape as my breathing remains labored and shallow.

Sitting in silence while staring at the white wall, I begin to follow the black scuff marks tracing them into abstract patterns as the door swings open a nurse in a pale institutional green surgical gown strides into the waiting room. Without hesitation she approaches and begins to report of the finding of the procedure. Her first words are carefully crafted from medical jargon as she speaks, informing us that “the patient has tolerated the procedure well”. Over the following weeks and months we discover the use of this term is standard, and begin to understand its meaning as “only a minor amount of damage or suffering has been inflicted to the patient while accomplishing the objectives of the procedure”. With simple childish expressions as if listening to an adult we sigh collectively.

She goes on to describe the findings, “She has had a bleed in the fold of the frontal lobe of her brain, right between her eyes. We believe it to be the anterior communicating artery. The surgeon was not able to determine how severe the rupture is, but she was not a candidate for coiling. She is scheduled for surgery at 10:00 am tomorrow morning.”

All of a sudden everything is moving too rapidly after seven hours of brutal uncertainty. I am unable to process the information quickly enough to formulate questions. Like an oil spill, the information slowly expands on the surface of the mind in a thin film encompassing its entire surface as I realize that my wife’s brain will continue to bleed for another twelve hours before any attempt at controlling the damage occurs. Fear once again grabs me by the shoulders slapping me violently. Three years ago they did not wait as she was rolled into surgery late in the evening, but we are about four hours later than last time.

I attempt to convince myself that this is a good thing, who wants an exhausted brain surgeon cutting into you in the early morning hours? This must be an acceptable compromise for the additional damage occurring from the continued bleeding in her brain. I must have faith in the judgment of this nationally renowned medical facility. There is great comfort in the fact that the same surgeon that saved her life last time will be performing the procedure this time, with an additional three years of experience under his belt. Is it possible that there is a benefit in having been there before, having traveling inside the skull, having seen the interior structure previously? It do not know for certain, but I am in despite need of some small assurance to cling on to, something to make the probability of death or disability to shrink just a little. Deep within my thoughts I realize the nurse is still talking and I have not been listening, as I refocus my attention.

She will be in recovery for another 30 to 45 minutes at which time they will take her back to ICU. The nurses in ICU will need about 30 minutes to transfer her from the OR gurney into the ICU bed and place the monitoring equipment on her. You can wait in the ICU Waiting Room on the fourth floor and the nurse will come and get you when she is ready to receive visitors.”

There is a brief moment of silence as the nurse waits to see if there are any additional questions, then hearing none she quickly disappears behind the white door sucking the temporary energy out of the room as she leaves. We all sit cow eyed digesting what we should do next. Glancing at the clock it is now 10:45 in the evening and the hospital is eerily empty. It will be close to 11:30 by the time we get to see her. After a brief discussion we all agree to only spent about 5 to 10 minutes with her in ICU to let her know we are there and praying for her recovery. It has been a long and torturous day for everyone involved and tomorrow only appears to be longer and more trying. With a laborious effort we begin the walk to the fourth floor without communicating.

The ICU waiting room is larger than the last with more extremely worn and stained furniture haphazardly arranged on a soiled institutional grey short pile carpet. Even at this time in the evening the room is crowded with visitors mournfully staring at a flickering television hung from the ceiling in one corner of the room. Although the sound has been muted the images flashing across the screen bath the sedentary visitors with a pale light which is the only movement apparent in the lifeless vaccum. Occasionally a whispered conversation drifts over the hissing sound of another coffee pot, while the same words are repeated over and over each day by the different familiar members imprisoned in this sad and lonesome room.

She squeezed my hand when I was talking with her; I think she can understand what I was saying.” “The doctors are taking him down for a CT scan.” “We won’t know the full extent of the damage until a few more days.” “We don’t know yet how long he will be in ICU.”

You watch the each one talk into a cell phone with vacant empty eyes as if confessing grievous sins against humanity to a priest, their voice heavy with emotion, attempting to be strong in a world without answers, only more questions. They sit rigid, motionless with shoulders curled forward from the burden placed on them. Children play on the floor between the piles of bedding and pillows oblivious to events which are transpiring around them. The experience is hell’s version of the movie “Groundhog Day” in which the same script is repeated over and over each hour unending, though the day, through the night without reprieve, only the actors sitting in the room change, but not the sad looks or the script. In am stuck by the observation that these same exact conversations have been occurring continually for the past three years since I was seated on this exact same chair during her first aneurysm.

A nurse poked her head into this abysmal cage of tattered hope and informs us my wife is ready to receive visitors. We walk past the hand sanitizer repeating a ritual of cleansing the germs that cling to us as if it was holy water until we reach a locked set of double doors with a simple black phone hanging on the wall below a security camera hanging from the ceiling. No one is allowed into ICU without being a relative. After announcing ourselves, the doors open automatically revealing rows of attendants and nurses behind a large counter surrounded by large individual ICU rooms. Each room has a couple of attendants responsible for observing the patient every minute of every day. There are ten rooms with glass store fronts as we are directed to room 4 while passing an incredible array of medical equipment scattered along the corridor, many of which the function of is not apparent. Peering into the room as we pass them, dozens of small colored lights and graphs on computer screens mix with the beeps and hums of audible warnings or messages from the equipment, but there is little evidence of human activity. The prone figures are clear from beneath the blankets but motion is nonexistent in the dimly lit rooms.

Many rooms have sitters who’s only job is to sit within arm’s length of the patient and observe any change in neurological state. These warriors are the front line of bloodsport of death as they trade two hour shifts, watching, protecting 24 hours a day until the patient clears certain critical thresholds of medical stability. I have grown to greatly admire these gentle guardians of wounded lives who silently with incredible compassion care for the patient as if they are family.

Rounding the corner we enter ICU number 4, to find the lights dimmed and a small group of attendants scurrying around a bed crowed with medical equipment. Recognizing that we have entered the room they melt into the background allowing us a personal moment to visit my wife. I am stuck at how small and frail she appears in the bed with only her face exposed as a web of wires and tubes frame her face but for the first time in a dozen hours the ponderous wall of pain is gone as she rests comfortably in a deep chemical induced state of bliss. It is the first moment of relief I have had since the horror began which seems like an eternity ago. Tears roll down my cheeks as the sheer relief of not seeing her in agony opens a flood gate of emotion. Death is welcome in this gentle softness; it has no right to take a soul while being tortured and tormented. We are all stripped of our dignity, no longer capable of deciding the circumstances of our demise, forces beyond our control regulate us to a pawn in the struggle for life. For the briefest of moments I think that is her were to die today it should be this way, in a blissful sleep, unaware, unencumbered by the humiliation of pain and suffering. The thought passes quickly as I reach over to kiss her on the cheek, tenderly caressing her bruised hand. Each of us has a chance to lean over whispering encouragement, hope, strength, confessing our sins of not being there enough, taking life for granted, spilling our hearts onto the stoic saint resting before us. It is a last opportunity to impart the healing energy of love as our prayers fill the darkened room.

It is time to let her rest and prepare for the surgery which is scheduled for 10:00 am in the morning. We coordinate our schedules and responsibilities for the next day as exhaustion sweeps over me in waves. I will pick her mother up and we will get there in time to see her before she goes into the operating room. I am filled with guilt as I turn to walk out of the ICU room, I can barely stand the idea of leaving, but logic tell me there is nothing I can do to help at this point. I understand that tomorrow will be just as trying and as long as today. I will need to be rested and mentally prepared for the uncertainty of the future. Silently we shuffle down the long sterile corridor into the nondescript grey parking garage, then driving by instinct to an empty house.

Suddenly the ringing of a phone rocks me from a deep slumber. I look around disoriented and confused only to realize I am lying in my bed. Reaching for the phone I glance at the clock indicating that it is 6:02 am. Terror clouds my thoughts as a voice asks “Is this Mr. Blue?”

“Yes it is” I groggily croak clearing my throat.

This is Carla and I am your wife’s head nurse. We just returned from having a CT scan and your wife has exhibited additional bleeding. We have moved her surgery up to 7:00 am.”

Dizzy and off balance I try to digest what I’ve been told. I need to get down there, but am certain that there is no possible way to get to the hospital before they take her into the operating room. With growing concern I provide verbal approval to begin the surgery without me being present.

Finding my footing I ask “So how long do you expect the procedure to take?”

In a confident comforting voice she explains the preparation time, the surgical process and the recovery time. “The doctor feels confident that the actual operation will require 4 to 5 hours at which time she will be immediately stabilized and returned to the ICU to recovery for another 30 to 50 minutes.” Once again guilt washed over me as I realize than no one from the family will be present to comfort her before the surgery, the fatal possibility that our last brief visit last night might be the last time anyone of us sees her again. Panic begins to flood my mind as I take stock of the fears and begin to once again push them back into that black closet and close the door. My mind cannot be allowed to wander into that minefield, not right now, it would be fatal to do so, I must remain strong and positive. This is a good thing that she will be attended too so much earlier than expected I try to convince myself. No time is available to ponder anything, action is the primary need, as I hang up and call her mother letting her know that I will be picking her up to go to the hospital in the next 15 minutes.

Without showering or combing my hair I pull on some jeans and a bulk sweatshirt knowing how cold they keep the waiting rooms. I realize with each movement that my head is pounding as if I’m fighting a severe hangover. Muscles in neck and upper shoulders are tender and stiff as if I’ve lifted weights all night. My stomach is knotted and sour with acrid bile. What is wrong with me, I collapsed in bed before having a drink and I was stationary most of the previous day? Suddenly is realize how powerful and toxic stress can be as it brings me to brink of illness. Unable to waste time on trivial concerns I jump into the car to pick up my wife’s mother and drive to the hospital.

Our drive to the hospital is solemn with an economy of words which release the mounting stress that building in everyone’s mind. The OR waiting room is on the other side of the hospital which takes an explorer to find hidden between the new construction and the convoluted architectural chaos that is most hospitals. Finally we arrive to find a huge open space decorated like a family den with a dozen or more couches and seating areas tucked into various niches of the room. The furniture is less worn and more stylist, a sea of soft earth tones and subtle pastels. The room contains about 15 separate families huddled into small quiet groups whispering in inaudible tones. We are greeted by an elderly lady with silver hair dressed in a smart navy blue business suit. Her name tag says Ruth as she looks up us from beneath oval reading glasses as she consults a clip board.

So who are you waiting for?” she asks without lifting her eyes from the table.

My wife was scheduled for surgery at 7:00 am.” I blurt realizing that I have no idea what time it is, failing to look at my watch in my rush to get to the hospital. The clock stares back at me stating that it is now 7:32 am.

In a familiar and caring tone the lady smiles melting the nervousness floating in the air. “Mr. Blue we have been waiting for you. Your wife is doing just fine. She is still in pre-op and the surgeons are consulting with each other based on this morning’s CT scans.”

The experience is designed to comfort the concerned and provide the most accurate information possible in the timeliest way possible. I can tell how carefully crafted this process is, especially for those who wait. It provides a sense of competency assuring everyone that their loved one is being treated with professionalism and respect. “If you will have a seat Ms. Grey who is our attending care provider will visit the operating room every hour, consult with the surgeon and then come out and inform you as to the condition of the patient.”

Slightly confused I thank her and find a small cluster of furniture vacate in an isolated corner of the waiting room. As if by habit I approach the industrial sized coffee vending machine which dispenses just about any type of brewed coffee you could imagine. I am surprised to find that the coffee is provided for free, as I think to myself what a nice gesture that is. It’s not like waiting in some cold hospital room but seems more like waiting in a family member’s living room where the coffee pot is a sign of hospitality. Grabbing a couple of cups I haul the precious liquid back to our isolated little camp of family and friends.

Once again I am too upset and nervous to engage the idle conversation that fills the holes of silence. Occasionally I look over and admire women’s ability to chatter in seemingly mindless dialogue as a way of group therapy to manage fear collectively. Males are prone to the solitary pursuit of comfort, finding strength in reflection and silence. Today however, comfort cannot be found on the emotional island I have marooned myself on. Today I have little patience as my mind drifts from fragment to fragment of visual images from yesterday. Attempting to reassemble the tattered and torn remnants of yesterday into a coherent sequence of events is impossible; it is like piecing together a shredded newspaper that has all the newsprint smeared and illegible. Each time I close my eyes I am assaulted with the most violent images of my wife in excruciating pain, all different each competing to be more violent and hurtful than the last. I find myself experiencing some form of post traumatic stress syndrome. Escape from this film loop of torture is difficult, reliving the more intimate side of my experience which was previously suppressed by shock and numbness yesterday is unfiltered and vivid today. The intensity of the emotional images are heighted by the concurrent understanding that at this exact moment someone is removing a section of my wife’s skull and probing deep into her brain with cold steel instruments in an undisclosed location only a few dozen feet away from where I am sitting. My mind flashes from yesterday to a constructed image of her lying lifeless tethered to the operating table as her brain once again is exposed to daylight. I imagine the blood as it seeps and trickles from the gaping wounds to congeal into small crimson puddles beneath her neck. I see the surgeon manipulating the folded grey matter of the brain as they hide beneath mask while mumbling barely audible half Latin phases. The operating room appears so cold and indifferent, without love, without judgment. Images of the horrific pain of yesterday clashes with the brutal uncertainty of the moment, each dueling for superiority in my thoughts as I don’t possess the strength to expel them, adhering to consciousness like a crude tattoo.

The dimension of time once again folds into a motionless abstract as the seconds stick and hang before disappearing into the past. Without warning a nurse in a baby blue surgical scrub removes her mask and heads toward us after the admission desk points us out to her. She is holding a clip board and walks with a confident authoritative energy of an individual on a mission. Her piercing blue eyes scan the group as she arrives assessing the temperament and emotion state of our small family clutter.

Is this the Blue family?” she inquires.

We nod affirmatively while turning our attention to the new figure standing before us. “I am the patient advocate for the hospital.” She begins “My job is to attend the operating room surgeon only to observe the procedure so that I can provide you detailed information on what is going on. I will not disturb the surgeons, but will observe without being obtrusive. ”

Measuring our level of comprehension she quickly scans our faces then continues “I’m sure the doctor has already talked to you about the procedure? Your wife is having intracranial procedure to repair a ruptured SAH hemorrhage in the anterior communicating artery, correct?”

I find a small island of hope and comfort in her deep tranquil eyes that engage so easily. Those eyes remind me of water near a coral reef somewhere in the Caribbean as I find myself transferring accumulated anxiety and doubt to her for safe keeping.

Your wife has now been in surgery for almost 2 hours. She is under a general anesthetic and is doing well. The surgeon has removed a section of her skull which has been wrapped in a cloth saturated with antiseptic and placed on the operating table next to her.” Concerned the nurse interrupts herself with a polite demeanor. “I’m sorry if this too much detailed information for you to hear please let me know, I will understand.” For the moment I am challenged with the graphic nature of her description especially knowing that at that moment it is my wife is enduring this invasive procedure.

Although there is a part of me that needs to know every aspect, every risk, every complication, I finally answer for the group “No that is fine. Go ahead and continue please.”

The surgeons are now probing the region looking for the aneurysm site. As soon as they observe the rupture they will decide what corrective procedures they will undertake. I can assure you that she is good hands and will be fine. Do you have any questions for me?”

The family is thunderstruck and silent as I ask the only question I have “My wife was diagnosed with a second small aneurysm on the right hemisphere which the doctors were monitoring, but it is not the rupture site. In the process of this procedure are they going to clip and repair the second aneurysm she has?”

Pulling the pen from her clip board the nurse begins to scribble down my question and responds “I don’t know, but I will ask the surgeon your question. I know that their first priority is addressing the ruptured aneurysm, but I will find out for you.”

As she turns to head back to the operating room I notice the big fluffy hair nets covering her shoes which make her appear to be floating on two petit baby blue clouds. As she leaves the energy in the waiting room lessens as I find my anxiety and desperation returns with a vice like grip.

Throughout the entire surgery our advocate nurse returns every hour with her clip board filled with new information as she works the room, talking to each family, informing them of the condition of their loved one and to answer questions. She becomes this little baby blue angel that appears from the sterile white walls to bring hope from the other side. I greatly admire this small curiously beneficial service she provides everyone captured by dire circumstances. While the detail is vivid making my stomach turn, I feel strangely connection to the activities outside my controlled environment. As the hours pass we exceed the 5 hour time limited first noted by the surgeon for the procedure. At the moment increasing waves of panic batter the façade of hope erected to protect our sanity. Is something wrong? Why is it taking so long? Is it worst than anyone could have expected? The nurse said everything was going good not more than an hour ago, has it all changed? The mind races to pose questions that have no answer but can only torment. Thirty minutes turn into sixty and sixty into ninety as the waves of doubt and fear grow immense. Everyone is concealing the growing panic that is welling from below while the women continue unabated the simple conversation about nothing in particular as if we were sitting at the dining room table on a lazy Sunday afternoon. Sour bile boils in my stomach as the fear pour toxins into my system.

Suddenly the angel with piercing deep blue eyes floats toward us on soft baby blue clouds. At last some news is forthcoming. I can perceive the intent of her message by the way she holds her body, the ease at which she strides across the room, unburdened by events capable of inflicting such horrendous pain. From across the room my anxiety melts, dissipating into relief that this moment of suffering is about to conclude and another chapter will be opened with all of its discovery and uncertainty. The nurse’s first few sentences flow over me without me being able to comprehend its meaning; they are just a foreign language that floats around me without penetrating. It’s not that that the message is overly technical or obtuse, but my mind has yet to uncoil itself from the deafening isolation it has endured from the past six and one half hours. My mind regained function as I intently focus on what she is now saying. “The surgeon has completed the clipping of the ruptured aneurysm and the supporting team is beginning the process of closing your wife up. She has tolerated the procedure well and all vital signs are strong.”

The words immediately remove the leaden weight that has been suffocating me as a rouge tear escapes running down my cheek in a defiant act of freedom. A huge breath of air is involuntarily pulled deep into my lungs as I hear the nurse says “Oh by the way the surgeon was able to clip the second aneurysm before closing her up. They will be taking her up to ICU to recover and you will be able to visit her in about an hour. It will take a while for the ICU nurses to transfer her from the gurney to hospital bed. They will also need some time to attach all the monitoring equipment to her.”

It is the best of all possible outcomes. Not only is the ruptured aneurysm repaired but the lingering possibility of reliving this experience because of the second aneurysm that we have been monitoring, the small time bomb that has been hung over our heads for the past three years is now gone.

The next hour or two is lost to me; I find it difficult to recall much of anything about what transpires in the intervening period. As if my consciousness has overheated and has shut itself off to prevent further damage, I listen a little more intently at the meaningless conversations that surround me, but I am acutely aware of the threshold that has been crossed. This chapter is concluding, but this chapter is only the preface, the introduction of the book that is to be written, a journey yet to be understood or comprehended, a journey with untold successes and failures, a journey that will test my faith like none before. Even in the darkness of the winter there is reason to celebrate the solstice for it is only time until spring returns in its entire splendor. For the moment I am grateful that this powerful soul that I have known and loved for more than half my life has once again cheated death, like so precious few that travels before her. She is truly a miracle set before us as proof of the incredible will to live. For what reason she has been chosen to carry this burden of suffering, I can only speculate. It must be that she is the only one that can bear the weight and tell the story, she is our testament that god’s will is manifested in all of us; we just need to nurture it.

Deep in my thoughts I am disturbed by the ICU nurse as she tells me it is now possible to visit my wife. Once again, as I have done three years before I enter the ICU ward to room number three. The room is darken with only some simple task lighting, the shades are drawn and there is a group of nurses and attendants scurrying around speaking in whispers, adjusting dials and tubes, hanging bags of saline. As I enter the room one by one they begin to noticed me and as they do in quiet systematic order turn to leave the room. I find myself now alone in the darken room as I approach the bed. The vast array of machines that cling to my wife’s motionless body is incomprehensible as it seems like hundreds of cords, tubes, lines, wires have enveloped her body. The room is filled with small blinking LED lights of red, yellow, orange and green as each machine hums and beeps barely audible tones. The whole scene is intimidating as I count eleven separate bags of liquid that are being pumped into this sleeping beauty. Beneath the bandages, blankets and equipment I can now see her face and she appears so fragile. She looks like a small weak baby in this huge bed. She appears as I have never seen her before.

Attached to her lips is a large loop of white medical tape that secures the breathing tube running into her lungs. I am helpless watching a large mechanical box next to her breathe for her as each inhale and exhale is punctuated by a click of gears. The tape appears to be pinching her upper lip and I want so desperately want to remove it. Bandages cover most of her forehead and skull, but I am truly horrified watching her involuntarily struggle against the foreign object forced down her throat. Her arms are tethered by the wrists to prevent her from grabbing any of the objects attached, but they continue to pull and tug weakly against the restraints. There is a pained insufferable expression of discomfort and despair furrowed in her face as she can only fight by attempting to gag and vomit hoping the expel this invader. At each attempt her body becomes rigid as her lips pout while the effort turns her face deep crimson, as she fights to breathe against this machine. Over and over she attempts to wretch out this nightmare of hellish proportions only to lose to this mechanical demon that is keeping her alive. This is the most horrifying image I have ever experienced and can only hope never to experience again. I stand overwhelmed with helplessness as I watch surrounded by darkness. If I was to live another century I could never conceive another trauma even close to this. To this day I find myself awaking in a cold sweat seeing the image of my wife struggling for a breathe of air.

One by one the family has come to my side standing next to me in silent horror of the cost both emotionally and physically over the past two days. We are all silent lost in our thoughts trying to understand where we go from here. We are ready to close this chapter and begin the next. It is time to go home and rest for we have weeks and months to discover the end of this journey. Before we leave for the briefest of moments my wife awakes and acknowledges our presence as if she is trying to heal our pain, she offers a small smile as I lay my hand on her chest. The human touch has the power to heal as her weary soul assures me that she is not going anywhere, that she will stay here for a little longer. It is a rewarding end to the most trying day of my life. Turning to leave I look over my shoulder at the poor soul tethered to the bed with all the machines keeping her alive and think to myself we have a long road ahead of us. We can only wait to see what tomorrow brings.




JULES: We should be fuckin' dead!

VINCENT: Yeah, we were lucky.

JULES: That shit wasn't luck. That shit was somethin' else.

VINCENT: Yeah, maybe.

JULES: That was... divine intervention. You know what divine intervention is?

VINCENT: Yeah, I think so. That means God came down from Heaven and stopped the bullets.

JULES: Yeah, man, that's what means is. That's exactly what it means! God came down from Heaven and stopped the bullets.

VINCENT: I think we should be going now.

JULES: Don't do that! Don't you fuckin' do that! Don't blow this shit off! What just happened was a fuckin' miracle!

VINCENT: Chill the fuck out, Jules, this shit happens.

JULES: Wrong, wrong, this shit doesn't just happen.

VINCENT: Do you wanna continue this theological discussion in the car, or at the jailhouse with the cops?

JULES: We should be fuckin' dead now, my friend! We just witnessed a miracle, and I want you to fuckin' acknowledge it!

VINCENT: Okay man, it was a miracle, can we leave now?

JULES: Whether or not what we experienced was an 'According to Hoyle' miracle is irrelevant. What is relevant is that I felt the touch of God. God got involved.

Pulp Fiction 1994

20090525

Where Dreams Go To Die


On loess bluffs high above the plain
towers a statuesque oak with no memory
as wind whispers patterns on placid water
songbirds sing of hope in azure skies

Dreams tethered with love drift on sultry breezes
chasing willowy clouds to summer’s soft shoulder
caressed by sheltering limbs they become prisoners
no longer seeking fulfillment of childish wishes

Desperately seeking inspiration in fleeting daylight
my love’s caring hands grow cold to the touch
as painful eyes betray longing in a broken heart
yet tears fall to be devoured by parched earth

Immersed in endless beauty of nature’s undeterred wealth
with little reason to struggle against destiny’s will
for sadness of loss can never scream loud enough
to free dreams from its solemn resting place

Cruel is unintended consequences of circumstance
where forces of time are blind to unrealized ecstasy
obscuring the grace of endless compassion
with indifference to the promise of tomorrow

Unbounded love shall not secure freedom
for stormy night fade silently from view
as rain kiss crimson lips of passion
knowing dawn will steal heaven’s joy

Beauty abounds for final embrace burns
as dreams dies fearing the approaching sunset
on loess bluffs high above the plain
mourned by a statuesque oak with no memory


Mr. Blue

20080202

Propitiation of Faith in the Blood of the Innocent



There is no pain, you are receding.
A distant ships smoke on the horizon.
You are only coming through in waves.
Your lips move but I can’t hear what you’re sayin.
When I was a child I had a fever.
My hands felt just like two balloons.
Now I got that feeling once again.
I can’t explain, you would not understand.
This is not how I am.
I have become comfortably numb.


Pink Floyd

“Suffering is one very long moment. We cannot divide it by seasons.”

Oscar Wilde (1854 - 1900)

In the silent darkness of the heart of the night my soul searches for strength to face the spilling blood of the innocent. Do the origins of faith reside in the uncertainties and cruelty of destiny? Is the path to spirituality and acceptance of the inequalities inherent in life found by the trial of fire and pain? Does atonement seek the path of least resistance in the suffering of those most innocent? How do I ebb the rising anger in my soul which consumes my flesh and clouds my mind like a vile poison? It would be easy to steel my emotions and allow my thoughts to drift to the blackness, a world without hope, a life without compassion, an eternity of isolation where pain is held at bay. What justice can be found in the continued torment and suffering of those pure in heart, those who represent the light of the world? I can not understand what lesson is to be learned from the spilling of the blood of those live with the grace of angels, those that have changed so many lives, those that embody all that are good and kind, those that have already suffered intolerable trials of spirit.

Once again the storm clouds of uncertainty approach as I look to the horizon, indifferent to those who stand in the path of fury. After six weeks of wistful calm a second medical opinion casts a shadow of doubt over us once again. A new series of tests on my wife’s mysterious black mass had resulted in another more ominous conclusion of cancer. As if all previous trials of suffering were unable to shake my wife’s unyielding positive view of life, this diagnostic message was targeted at the most consuming fear of all, a long painful and undignified death. Unlike all other tests of faith, she collapsed into a deep depression unable to confront the possibilities of what this might mean. It has been a difficult personal journey concealing our burden from all as we wait for the fog of uncertainty to clear revealing the invariability of the path before us. Standing in the shadow of the future we hold our breath wondering if it is possible that the propitiation of faith will cheat death from its ultimate reward and prevent the spilling of the blood of the innocent.

“You desire to know the art of living, my friend? It is contained in one phrase: make use of suffering.”

Henri-Frédéric Amiel


What though the radiance which was once so bright
Be not forever taken from my sight,
Though nothing can bring back the hour
Of splendour in the grass, of glory in the flower;
Grief not, rather find,
Strength in what remains behind,
In the primal sympathy
Which having been must ever be,
In the soothing thoughts that spring
Out of Human suffering,
In the faith that looks through death
In years that bring philophic mind.


William Wordsworth (1770 - 1850)

20071020

Lost in the Flood


Life is a long lesson in humility.”

James M. Barrie (1860 - 1937)

One year ago today my wife died, but through the marvels of modern medicine, a handful of luck and a one of the nation’s most talented brain surgeon she survived a ninety-nine in hundred death sentence. Since then everything has changed but everything remains the same. As we celebrate her first birthday of a second life, we are blessed to have a chance so few are privileged to experience. As pages turn it is not without a price to pay for what was lost in the flood.

In attempt to find comfort in the routine of her previous life, my wife shortly after her release from the hospital, dove head first back into her career against everyone’s better judgment. It was a period of denial that the event ever happened, a desire to prove the world was no different, refusing to accept that she was even lucky. I’ve come to realize she did not experience or comprehend the threshold of death. For her it was the easiest of progressions to stroll into the afterlife as convenient as slipping out of a jacket on a sunny day. Ultimately, it was my near death experience not hers. I had experienced it as if I had left my body hovering above her in the hospital.

For over thirty years her identify was one of a powerful executive, a consummate professional that was sought out for an unparalleled depth of knowledge and ability. Throughout a varied and diverse career she managed multiple offices with a staff of over thirty, established a new Midwest division of six offices for a national corporation and held leadership positions in every aspect of a complex financial industry for a dozen companies. She did all of this without post secondary education using her perceived inferiority as a strong motivational tool to push ahead of her peers. Driven to succeed does not adequately capture the years of working 80 hour weeks. For a lifetime she possessed a defining personal identity which was her foundation of self assurance. Between heartbeats on that day one year ago everything about who she was changed.

Twelve months of healing and evaluation has revealed the final extent of the collateral damage emerging from a shifting fog of uncertainty and hope. It has been a challenging time for both of us as I sit helpless watching her reconcile her new life against the old. In her solicitude, she excruciatingly compares her previous person with the limitations of the new. For months her primary focus was to hide each new disability as they became apparent while attempting to continue her career. Short term memory loss, reduced analytical capacity and significantly diminished reading comprehension unleashed a flood of emotions I have never seem as she struggled to hold on to an exposed root of self respect in a seething river current of personal loss. The detailed neurological assessments have uncovered her amazing ability to adapt, to compensate and how brain function while so fragile responds in mystical ways.

An area of significant impact was her ability to process the spoken word, part comprehension and part short term memory. As a result she has developed an acute visual perception. In order to process the spoken word she will write the message out in her hand with an imaginary finger so that comprehension bypasses the disrupted audio paths and is communicated to the brain visually. It astounds me on resilience our brain is, finding new pathways to repair damage. She was so good at compensating in other ways that the disability was hidden until the neurophysiologist tested a fully range of brain function.

Slowly over the months it became apparent that the collateral damage exceeded her ability to function at a high level in her career. The constant struggle and deception took the fight out of her as she reluctantly came to realize that she no longer wanted to work so hard making people believe nothing had changed. The experience has been only what I can describe as a recovery from a modest form of Alzheimer’s. It has given me a fearful perspective of the unimaginable horror of descending into Alzheimer’s without hope of recovery. It is with certainty that we all will at different rates descend into humility suffering indignity of losing what we cherish. If only by the grace of god, we live long enough whatever fortifies the core of your soul will be taken from you, beauty, mind, body, memories, family, privacy, independence, leaving us all naked at the door of death. Without ceremony we transgress to frail, tattered broken reflections of our former selves, a slow process yielding to nature. Each small loss of mobility, functionality, range, stamina and endurance signals the eventual slow waltz with life’s close. There is no apology for my morose ramblings for they are only a statement of truth whether or not we want to recognize the final and inescapable law of nature.

Gradually through a curtain of tears and fears she accepted the new direction life has taken, but the shift is still undermined by the loss of self assurance, confidence and self identify. This has fundamentally changed our relationship and the level of nurturing she requires. A previous relationship of equals, powerful and decisive, a collective balance is now in flux and redefinition. The fine balance of shared responsibility has been disrupted, at times taking on a parent and child persona as I am possibly overcompensating in a sheltering protective fashion. I find myself doting on her as if she is helpless which she is not, but I find her much more pensive and unsure of decisions. She is in the final stages of obtaining approval for long term disability which will complete her transition to her new life.

One of the remaining mysteries has been her loss of appetite for which I have taken her to specialists and physicians over and over without discovering a cause. Every time we recieve a clean bill of health. She has lost 40 pounds and is now struggling to fill a size 0. I think she has stabilized at this weight which is of no apparent concern to her. The extreme weight lost probably makes me more protection because she seems so frail. At a critical point during one of the visits to the neurosurgeon, he highly recommended that she quite smoking because there is a number of small defects on the other side of her brain and smoking is a significant factor in increasing the risk that these defects can develop into another rupture. He also suggested that she get a chest x-ray because an unexplained weight loss such as hers could be cancer. As we walked out of the doctor’s office she lit up a cigarette and looked up at me to say “I think that went well.” I have to admit it was one of the few times in our marriage I totally lost it. It was a blur but I think my first words were “What fucking planet do you live on!!!!!” It remains an unresolved issue, a small defiant stand on personal choice and independence she is unwilling to relinquish.

A requirement of the short term disability policy is that she stop working which was a struggle at first but now she quietly sits at home cleaning long forgotten items while spending time with her mother. The days drift by in a series of never ending errands and casual meanderings as her daily interaction with the outside world shrinks. After thirty years of making her clients successful, catering to their every need, becoming close in decades old relationships, I’m astounded how quickly they have all disappeared without a trace which makes me angry at their shallowness.

Although not obvious to her I watch each day like a hawk gauging her level of satisfaction and personal fulfillment always concerned that her departure from the spotlight will manifest itself into depression. On occasion she will look at her laptop with wistful eye of a life departed, but just as quickly her gaze will focus on the dust that has accumulated on its lid as she goes to get a dusting rag. Each day I pray she finds solace and balance in her second life. When the times are right I probe by asking her simply “Are you happy. Is everything going alright?” The answer always takes much longer than I feel it should, revealing an unresolved internal debate, but is unquestionably “Yes I’m happy”. I intentionally leave an awkward silent pause to allow for the recrimination or retraction that never comes.

None of us can know what the future shall bring. We all travel our separate road making decisions based on the moment. Even in retrospect I’m not sure we can judge if those decisions are for the better or the worst, they are just a milepost in a journey that ends sometime and someplace in the future. Personally, I’ve always had to reconcile my family legacy of early departures to the afterlife. As they say “We don’t make old bones.” This lifelong realization might be an underlying factor in my frantic pace; a life line that could be measured in years not decades if family history determines the odds and probabilities. What will I leave behind unfulfilled? As we all walk to the fateful edge of existence what dreams will be broken, what desires will haunt final our thoughts, what love will be lost in the flood?

As each natural disaster cleanses the land with undirected violence, sculpting the earth into new patterns we learn anew to navigate our altered world by the sun and heavens having faith in those things unchanged in a changed landscape. Adapting to circumstances while picking of the pieces of our life we walk into an uncertain future only knowing those things that we lost in the flood but always thankful, hopeful to experience another spring morning, another summer afternoon, another sunset, another starlit night, just another chance to breath.


"Cowards die many times before their deaths;
The valiant never taste of death but once.
Of all the wonders that I yet have heard,
It seems to me most strange that men should fear;
Seeing that death, a necessary end,
Will come when it will come. “


William Shakespeare (1564 - 1616)

20070620

Life & Death

Photo by Mr. Blue

"To know how to grow old is the master work of wisdom, and one of the most difficult chapters in the great art of living."

Henri Frederic Amiel

20061203

The Small Print



Everyone inherently knows that a brain aneurysm is deadly, but what does it really mean? With the shock of the emergency behind you, we begin to read the small print to find some truly disconcerting facts that are only disclosed on an as needed basis. It’s the medical profession’s way breaking the news to you slowly. Little by little a clear picture emerges of the devastation of this type of brain injury.

The first surprise it that the brain surgery is easy part of the procedure. Opening the skull and clipping the aneurysm is low risk compared to the recovery period. How can that be I wondered? Apparently surviving a ruptured aneurysm means that you suffered an subarachnoid hemorrhage or in layman terms blood pooled in the fluid between your skull and your brain. This is a very dangerous condition since red and white blood cells can not survive in the cranial fluid and over a period of three to four days the blood cells will die. As the blood cells die and decompose they can be viewed as small sacks of toxic poisons that are released into the cranial fluid. The most critical point of recovery is four to seven days after the surgery as the toxins from decomposing blood cells reach their maximum concentration.

As these toxins build in the cranial fluid they irritate the veins carrying blood to the brain. The natural tendency of the veins is to spasm and contract. If any vein becomes excessively irritated it will spasm and completely close resulting in a loss of blood to large portions of the brain or what is called a stroke. Where the aneurysm is located, degree of bleeding and distribution of the blood inside the skull dictate your chance of survival. During the operation the surgeon will attempt to remove as much blood any possible from the injured area. While some anchoritic hemorrhages are defused deep into the recesses of the brain tissue where vascular spasms are more probably, my wife was fortunate that most of the hemorrhage was contained in the frontal lobe.

The difficult part of the recovery is the waiting knowing that each day the risk of death is on the rise until the fifth to seventh day. Each day you sit unable to help, knowing that tomorrow might be the end. Quietly you are surrounded by elaborate machines and wires staring at the numbers displayed on a computer monitor afraid to look away. You learn to read the graphs and understand the beeps and alarms. This graph is oxygen level, that graph is heart rate, that number is blood pressure. That tone is a sensor alarm, this beep means a patch has fallen off. Each movement changes the graphs as your heart jumps into your throat wondering if the erratic graphic is just a temporary disturbance or a new serious condition.

The nurses in ICU tell us take we need to watch for changes in brain function. I ask what that means, what am I looking for? A change in brain function is a sign that the patient has had a vascular spasm or a stroke. Symptoms include slurred speech, disorientation, emotional eruptions, prolonged sleep, or weakness in extremities. Besides sitting watching the monitor you observe and scrutinize the smallest of activity. Is she blinking her eyes excessively? Should she remember what day it is? Has she been sleeping too long? Your mind is hypersensitive every moment as time creeps second by second.

Slowly the person you know so well periodically emerges from the fog, but it doesn’t come without effort and loss. At first there is no memory of our pets that she has daily cared for over the past five years. There is no memory of a private joke that been told thousands of times over the past twenty years. There are moments when she stares at you and doesn’t remember that you’re her husband. She asks her mother where her mother is. While she sleeps at night and you are alone in the ICU room you begin to ask yourself difficult questions. What if she doesn’t make it back all the way? What if she can’t work and requires home care? What if she dies? Sleep doesn’t come easy at night in ICU especially since to check brain function aneurysm patients are awoken every fifteen to sixty minutes throughout the night.

You stare in amazement at the list of twenty four drugs printed in large black oversized type that hanging over her bed indicating the drugs that are being pumped into her. You are hypnotized by slow methodical drips of the rack of IV bags, but most of all you just wait. Then out of the blue, the person you know is back to normal for a few minutes. There is so much small print that we never knew.

Probably the most surreal moment is reading the surgeon’s report of the operation. In clinical precision he describes how her brain surges from the skull to relieve the pressure from the hemorrhage. How a massive blood clot that shows signs of drying is evacuated from beneath first fold of the frontal lobe. How the aneurysm is masked by a second massive blood clot deeper in the brain tissue. How the aneurysm was clipped and lanced to remove another blood clot. How the patient “tolerated the procedure”.

Finally the attending surgeon explains the small print to you in terms that you can understand while your breath is stolen. “Of the past one hundred patients that were diagnosed with a cranial aneurysm and subarachnoid hemorrhage ninety died and eight are institutionalized with severe neurological dysfunction. Only you and one other girl have survived to resume their lives.”

The most astonishing thing about miracles is that they happen.”

G. K. Chesterton (1874 - 1936)

20060621

Moments of Grace

The summer sun is high in the sky as heat bakes the earth. I run to match his stride pushing a small toy lawn mower. He is everything I wish to be. He is the center of my world. He is the only hero I have ever known. Heavy summer air suffocates every breath as I try to keep up. We stand alone in a large field of mown grass on a sweltering July day. A white handkerchief is tied around his head to capture the sweat as it rolls down his forehead while he pushes a lawn mower down a long slope. He stops and turns to watch me running behind him. Slowly he removes a second handkerchief from the pocket of his Bermuda shorts and with a loving smile ties the white cloth around my head in a symbol of manhood. It was the smallest of gestures but it remains one of the earliest of my memories of my father.

My father was a strict disciplinarian where his law was absolute and unyielding. His rules were clear and the line between right and wrong never varied in all the years I lived under his roof. I was taught to respect authority in every person I encountered. Although my father was an easy man to respect, he was a difficult man for a young child to understand. A simple stare from his penetrating blue eyes could send ice water coursing through your veins. His emotions were controlled when mad, as the fires of fury burned below the surface. Known by all the cousins as Mean Ole Uncle Joe, dad’s sister would bring the cousins by to be disciplined by dad when they misbehaved. It was always clear that I was the next in a long line of proud people and I needed to act in a manner which would respect family tradition.

When my real mother died during my early teen age years, I pulled away from my father into a protective cocoon. I decided to become a man in the only way I knew how, which was to challenge my father’s authority in every way. I delved into the dark side of existence getting involved with drugs as a way to prove my independence and stubbornness. Only now can I come to appreciate how difficult these years must have been to my father, who demanded only that you do the right thing.

I recall many a night sneaking out of the house during the week to hook up with my friends to do drugs and sleep with the neighborhood girls. My primary defense was staying out as late as possible knowing my father would arise at 5:00 am to go to work in New York City. Arriving home I would turn off the engine of grandmother’s 1964 Valiant convertible a full block before the house so that I could coast into the driveway without a sound. Blasted I would sneak into the house in absolute silence at 3:30 am taking my shoes off in the process. I knew where every squeaky floorboard in the house was located carefully missing each one as I crept toward my room. As I slowly worked my way past the living room the most horrifying moment of life was seeing the bright red glow of my father’s Pall Mall cigarette in total darkness as he inhaled deeply waiting for me to return. It’s a wonder that I never died from shear fright knowing that the wrath of righteousness and respect was about to exact a fearful price from my soul. As the great Chinese general Sun Tzu said in the Art of War “On desperate ground, I would proclaim to my soldiers the hopelessness of saving their lives”.

All my sisters lived through the same experience of trying to out last dad. In later years we would all laugh at my sister’s boyfriend that got caught by the red glow hiding in the bush next to the driveway. Dad emerged from the bush with his cigarette and a cocktail, ran up to the car and pulled the door open. “Did my daughter tell you when she was supposed to be home?” In paralyzed fear he murmured “Yes sir.” Dad went on “And what time did she tell you she was supposed to be home”. In barely a whisper he said “It was 11:00 o’clock sir.” In a voice that would stop a charging rhino dad would continue “You must certainly realize that it is 12:30 and it was your responsibility to get her home on time, regardless of what she may have told you.” Both my sisters lost many boyfriends as dad’s reputation grew around town. Boyfriends learned to drop my sisters off two blocks from the house and make them walk home fearful of a run in with dad.

During the rebellious years in high school dad got me a summer job with his office, hoping to provide me some direction and self esteem. He was an accountant with LaBranche Company a stock brokerage firm located on Wall Street in New York City. He had talked the partners into giving me a summer job as a runner. A runner would spend most of the day on the floor of the New York Stock Exchange next to the traders. Before the advent of computers and electronic trading, the traders would complete a series of trades and the ticket orders would be given to a runner to carry them up to the main office so they could be registered with the company. At the time I was so opposed to wearing a suit and spending every summer day traveling with dad to New York that I turned the job down and decide to dig ditches for a construction company that summer. What a move in retrospect. Little did I know that runners rose to become traders on the floor of the stock exchange and traders could make millions if they were exceptional. How different might my life have been if I had chosen to become a runner in mid-1970? In all probability I would have promoted to trader by the start of the 1980’s, an era of junk bonds and Ivan Boesky. Considered the wild west traders made multi-millions of dollars and retired by the age of thirty. My ignorance of youth was blind to opportunity.

Continuing to distance myself from my father through college, our relationship grew more adversarial. He never really changed his expectation or opinion, it was me attempting to demonstrate my manhood by ignoring every value I was taught. His letters chastised me for living in sin with my girlfriend. I was indignant that he would challenge how I lived under my own roof. As an act of defiance I decided to marry my girlfriend in a simple civil ceremony without giving my family sufficient time to travel to the Midwest to attend the wedding. It was a childish ploy designed to show who was in control of my life. To my great surprise my new wife was accepted by the family with open arms and was granted all the respect in her new position as daughter-in-law. At the time I never understood that my father’s values were so blind to emotion, what was right would always be right.

Living in the Midwest after college I was returning home on a frequency of about once every two years. As my father turned 50 I began to contemplate the mortality of both of us. Assuming he would live to the age of 70 at the current frequency of returning home I might only see my father another ten times. This realization gripped me like an icy hand and I decided that I needed to change. I had established a perplexing rule that I would only call my father after he had called me. My stupidity and immaturity was revealed. If I wanted to communicate with my father, I should call no matter who’s turn it was. This moment of clarify lifted a great burden from my shoulders changing the course of my life.

Business travel allowed me to visit home as frequently as four to six times a year. This constant contact was the foundation of a deep and meaningful relationship, not only with my father, but with my entire family. We became extremely bonded as a family, enjoying each others company so much that we would all vacation together. Dad bought a vacation home in Hilton Head, then sold it after ten years and bought another place in West Palm Beach just so we all had a place to gather besides the home in New Jersey. Rich full memories fill my heart reflecting on both places.

The family also began a yearly tradition of renting a large home on a different island in the Caribbean or somewhere on the shore just so that we could explore life together. These remain my most treasured memories of life, exploring new cultures and lands, watching my brother and sister’s children grow up. The shorts we wore for dinner in Bermuda, the mountain hike that almost killed my stepmother in Puerto Rico, the blazing heat of the Grand Caymans, the surf that beat us senseless in Barbados, the group cooking at the shore in Avalon, the amusement park rides in Wildwood, the golf course at Sea Isle, all are special places for me now.

Dad had one of the most incredible work ethics of anyone I ever knew. Returning home from the war in Korea as a young man, he worked full time during the day and put himself through college in the evening while raising a family. He would additionally take on tax return filings for all the neighbors and local small businesses for a few extra dollars to made ends meet. Between March and April 15th Dad would disappear behind a mountain of paper on the dining room table. All the kids knew to walk by the table with great care since he was worn and irritable during those long six weeks. Too much noise or commotion would bring a serious reprimand. Even as a small child I recall Dad huddled over a pile of tax forms cursing Uncle Sam with a glass of Dewars White Label on the rocks in one hand, a Pall Mall cigarette in the other and a big chief number two pencil being gnawed away between his teeth. I can still vividly see the large bulging callous on the inside joint of his middle finger of his right hand where that number two big chief pencil would rest.

Obtaining his certification as an accountant he began working on Wall Street in New York City. For thirty five years he arose at 5:00 am to travel to the city and would finally return to the house after 6:30 pm. During tax season he would not be expected home until after 10:30 pm and would work Saturdays in the city. I don’t ever recall seeing Dad home sick from work in 35 years, although it must have happened. The only break from the office was saved for his vacations with the family, which was the center of his life.

As my professional life began to grow I was compelled to prove myself to my father in the currency I thought he understood the most, hard work. It was my way of restoring all the years of pain and disappointment I delivered to his doorstep. Bound and determined I would invest as much if not more into my career, proving to my father that was worthy of being his son, that all his wisdom had found a place to grow and prosper, that I was in fact next in that long line of proud people. He delighted in my growing business acumen and authority. During my frequent trips home we would sit up until the early morning hours as I shared stories about my challenges and successes. His face would glow with pride at my increasing ability to master my professional domain. Most of the time I would do all of the bragging while he would listen and smile overflowing with contentment. It became a special private place for the two of us where time would stop. We would look at the clock and realize it was past 2:00 am knowing that he would be rising for work in a couple of hours and I would be catching a plane to another location.

Struggling for so many years, dad proved that the American dream did exist in work ethic of Horatio Alger. He illustrated how the down-and-out might be able to achieve the American dream of wealth and success through hard work, courage, determination, and concern for others. At the time of his retirement at the age of 65, my father had earned more than enough money to spend the rest of his life without a concern achieving his dream of financial independence for his entire family.

During his first year of retirement mom slipped and fell of an icy sidewalk, shattering her knee cap. A surgery and year long physical therapy postponed any thoughts of retirement travel for the two of them. Dad waited on mom providing him a challenging unfamiliar role as caregiver. Slowly she recovered as they resumed their active retirement plans. The first real trip the family planned after dad’s retirement was to Colonial Williamsburg in November 1995. We spent a glorious long weekend playing golf in the brisk fall air, touring the historical restoration and huddled together around a roaring fire sipping port. The highlight was a formal dinner at the renowned Inn at Williamsburg. It was a spectacular evening in the ceiling to floor glass loggia overlooking the golf course. The colonial furniture decorated with pewter mugs, white linen and candles only enhanced the favor of a truly exceptional meal. We all marveled that for each of us seated at the table there were three persons waiting on us. I could only imagine that it was like dining in the White House at a state dinner. Dad appeared thinner during that trip and when asked he joked than he was losing weight from waiting on mom so much.

Six weeks later I had an evening flight Charlotte for a huge business meeting the following day, getting ready to leave the hotel room to have dinner with the client, my cell phone ran. It was dad calling to tell me that the doctor had discovered a spot on his lung and it was cancer. He said not to worry the doctor will get a better look at it next week. In a situation where I was unable to change my schedule I had to keep up appearances and finish the business meeting. The next 24 hours was the most trying times of my life as I acted congenial and entertaining through dinner that evening and then for a full eight hours of meetings the next day while a raging ocean of pain tried to escape by ripping my flesh. I will never forget how credibly difficult those few hours were, never having a private moment to grieve. On the plane ride home I could no longer contain my emotions. Silently I acted as if I was asleep so the flight attendant wouldn’t bother me and with my hand firmly clapped on my jaw the tears flowed down my cheeks for the two hour flight home.

On November 22, 1996, less than nine months later, my father pasted away. I think I made four or five trips to visit him during those nine painful months to say goodbye. It is only by the grace of god that I decided to renew my relationship with my father and in doing so was rewarded with sixteen cherished wonderful years. I believe that people enter your life for a purpose and when that purpose is fulfilled they leave your life. It is your responsibility to understand what that purpose was and to carry the message forward. I will always be angry at the world, that after working so hard his entire life my father was never able to enjoy the fruits of his labor. How unfair and cruel it seems, so beyond the specter of reason that a person so filled with compassion and love after a lifetime of providing for his family, he is taken from us so abruptly. If I ever needed a reason to fill my soul with darkness and bitterness, to despise and hate life this would be the reason.

My last visit with my father he shared with me his only failure in life and pleaded for me not to follow his footsteps. He said you must not spend your life saving for the perfect time to live your life, that day may never come. You must take the time to experience life each and every moment. I see the same determination and driven in you as I had, please take the time to travel, to be with family, to enjoy the quiet moments, to find those moments of grace. Having said what needed to be said; he removed the ring from his finger and gave it to me. All my life I have admired that golden ring which contained his initials. My father and I have the same initials and he always said I would wear the ring when he was gone. The ring was given to my father by my grandmother when he was a teenager. The ring always represented for me, being the head of the clan in Scottish highland tradition. As a child, I always dreamed about the day when I would wear the ring of authority. It seems ironic now that when I glance at the ring which I now wear, I can wish of nothing other than being able to see him again wear his ring.

There was single promise I made to myself after my real mother’s death decades earlier, which was not to suppress my emotions, that pain and grieving was the path to healing. I vowed to relinquish all defensive mechanisms I had developed over a lifetime and allow myself to feel the depth of my emotions. Dad’s funeral was difficult for me. The realization that you are the eldest member of the clan can be debilitating. Why didn’t I listen to all the family stories better? Why didn’t I pay attention? Why didn’t I care more? The burden falls on me to carry the oral history and we are never prepared. I am saddened by how much history disappears never to be known again.

The most difficult time of the funeral was carrying the weight his casket as a pallbearer for the first time in my life while a lone bagpiper played Amazing Grace on a distance hill. The weight of grief for every moment lost, for every moment forgotten, for every moment stolen from me sat on my shoulders. From that day forward Amazing Grace has always brought tears to my eyes. I know with certainly that I will be laid to rest by the pipes playing Amazing Grace completing another circle in that long line of proud people. Like my father, on that day I will take with me all the stories, memories and dreams of my existence from the world.

There are moments of grace in everyone’s life where the inner workings of the heavens are revealed. It happens in silence when all becomes clear, where the future is explained, where death is only an extension of life. After dad’s funeral family and friends gathered at the house to comfort each other, to celebrate life of a great man. The house was filled with faces I had not seen in years, faces that were touched deeply by this single man. Discreetly I slid out the backdoor to stand on the deck by myself for a moment of reflection. Staring at the sky, it was covered with thin layer of clouds that obscured the stars and moon. The moon was apparent where silver light filtered through the soft white curtains draped over the heavens. As I watched, the clouds parted revealing the most perfect radiant silver full moon twice the size as I can ever remember seeing. The moonlight filtered through the trees and bathed me in a warm glow. It was so powerfully spiritual because the clouds parted in a circle only large enough to reveal the moon, while the rest of the sky remained shrouded in grief and sorrow. As I gazed at the moon a calmness and peacefulness embraced me, washing any fear of the future from my soul.

Immediately I went back into the house to get my mother. We walked together to the spot on the deck where the moonlight bathed both of us. As I pointed out what was so apparent I said “That’s dad telling us that everything will be fine, that he is watching over us.” It was mystical, standing alone in the chilled November air bathed in moonlight as we hugged, letting the tears of sorrow flow. Looking again to the sky to say goodbye the clouds closed over the window in the heavens and obscured the moon not to be seem again that evening. It was a moment of grace when it was clear that dad wanted me to take care of my mother. To her I represent the living spirit of my father. When I am near to her, she feels the presence of Joe and it makes both of us happy. There’s an old saying that the older you get the more you become your father. I can only wish that to be true. Over the subsequent years she has reminded me many times how much I remind her of dad, after which I smile and chuckle exactly as dad would, which makes us both laugh.

Each day as I move forward in the hectic world, I savior the moments of grace where ever they are hidden. Moments of grace can be found in the light touching the ground, the rain on a hot summer day, the smile of a stranger in a crowd, the soft fog at dawn, but most of all in the clouds in the sky. If you look at the sky carefully there is always one place where there is stunning beauty, where the light is soft, where the colors are vibrant, where the door to heaven is open. Whenever I want to see dad I look for this spot of exceptional beauty, he’s always there in every sky, comforting me. This is my personal ritual each day looking to sky, finding the solace in knowing that I am in fact the next in that long line of proud people.