Thursday, February 20, 2014

Sacred spaces

Caveat - sorry guys, this is another one that's a bit graphic towards the end.  May be tough, especially on the animal lovers.  Read with caution.




Sometimes I feel like my job takes up so much of my time and energy that everyday things just fly by me.  Small moments, momentous occasions, holidays come and go, without decoration or celebration.  If I happen to get the day off, I'm more likely to sleep through it than make merry.

Take Christmas, for instance.  Diego and the baby were already in Ecuador.  We had no scheduled or emergency cases.  I ran into work, rounded in the morning, and was home by 10:30 am.  After several hours of housework, cleaning up the mess left by packing the baby up for Ecuador, I was exhausted.  

I fell into bed and slept for five hours.  When I woke up, I ate some potato chips and read until I fell back to sleep.  Just another day in the life of an overworked, overtired, overstressed working mom who happened to have a week long reprieve from her motherly duties (if not her work duties!)  Not your typical Christmas, for sure.  No reminder of the year coming to a close, no observation of the days growing shorter.  No songs sung or candles lighted.  No reflection upon the memories of the year to be had.  Just one day in a string of many grueling days.

There is no sacred space in my life.  No sacred time.  Especially since the baby was born, there is almost no single moment where someone does not need something from me.  No moment when I'm not "on call," ready to be summoned at any time.  I live on the edge...on the edge of the bed, edge of the chair, edge of the toilet and shower.  I feel like I am always on my tiptoes, ready to spring into action, always looking forward to just do what I need to do for today.  Just get done what I absolutely have to get done, praying desperately that not one single important thing falls through the cracks.

It's a difficult way to live.  I never quite catch up.  Things get left behind, usually my own personal health and wellness attempts...

Anyway, I was not completely looking forward to going to Ecuador over the holidays.  I did not think it would be restful.  I did not think it would be peaceful.  The universe had other plans for me, though.  First of all, my in-laws took the baby into their bedroom and he slept with them each night.  By the end of two weeks that he was there, they were exhausted, but I managed to get some rest at night finally.  And took several daytime naps as well.  Now they appreciate what Diego and I've been through for the past 14 months!!!

Our New Years' plans were made kind of at the last minute, to spend the evening with Diego's aunt and uncle, Nelly and Manolo, with his mom's side of the family.  As the night progressed, we played Bingo, told jokes, sang songs, and had presentations.  Fireworks were booming close by as the locals celebrated the anticipated coming year.

Me and Lia Renee show off our New Years smiles!





In Ecuador, the people build an "Old Year," usually a older, male figure, often some sort of controversial political figure.  The Old Year sits out in front of their houses with a funny sign for the week after Christmas.  On the night of the 31st, Ecuadorians prepare to burn the Old Year.  The young men of Ecuador dress in drag as the Old Year's widow.  In anticipation of his demise, they dance in the streets for money for their keep.  They make some pretty hot mamas!!!

As the night wears on, the count-down begins for the New Year to be born.  Twelve candles are lit, twelve grapes are eaten, the Old Years are thrown into the middle of the street amongst all the nearby neighbors and beaten with sticks.  Champagne is poured into plastic glasses.  FM radios play the countdown into the New Year.  10, 9, 8...The Old Year is soaked in kerosene...7, 6, 5...a torch is lit... 4, 3, 2, 1.  The torch is touched to the Old Year, who immediately goes up in flames and begins to burn with seething heat.  Auld Lang Syne begins to play.  We kiss, we hug, we laugh, and then we watch the New Year become a pile of charcoal.  As the flames begin to ebb, we jump over the fire.



Showing off our Old Year


The Old Year burns

Manolo shoots off fireworks




As I watched the Old Year burn, I could not help but think, "Thank goodness!  Good riddance to 2013!"  And everything before it.

To be perfectly honest, I am desperate to believe that 2014 is our year.

I had thought that 2012 was going to be our year.  But then things happened.  Hard things.  Life things.  Things I'd rather not remember.  But I'm going to talk about them here, today, because I want to close this time and move forward from the trauma of it, if that is possible.

Additionally, by chronicling them, I can accept that not everything that happened was negative.  There were many positive experiences that arose during those two years.  Laying it out helps me remember those and focus on them.

As 2011 came to a close, we continued to get discouraging news about my Great-Aunt Margy, for all practical purposes my grandmother, who had several recent hospital admissions for bad heart failure, and she died in early January 2012.

During this time, I was flying all over the USA interviewing for pediatric surgery fellowships.  So every day I was not traveling I was on call.  I was exhausted, from the traveling I thought.

Then in February we found out we were pregnant.  Not expected when I had already been off birth control for two years with no result, and never unwelcome, but very stressful.

Diego's grandmother Blanca had a massive stroke in March and died a few weeks later of pneumonia.

In April, we attended Margy's memorial service and buried her ashes.  I was 16 weeks pregnant.  I was not ready to let go of Margy, who was such a positive, beautiful, caring, protected soul.  We also buried the ashes of her husband Elvin and my grandmother and grandfather, with whom I never had much of a relationship.  It was a nostalgic event, the end of an era, laying the four of them to rest.  As we spoke with the priest about them, he said "I know it's hard to lose someone you love."  I just replied, "Love is complicated."

In May, we found out that I had matched for fellowship in Miami.  We were excited, but also sad to think of leaving Pittsburgh.  We started realizing that each event would be our last in Pittsburgh and we started saying goodbye.  We also traveled to Ecuador for a baby shower there with Diego's extended family.

In June, just after I began my 5th clinical year of residency, 22 weeks pregnant and 6 days prior to my 34th birthday, Winston coughed up a blood clot.  He was 12 1/2 years old and had been visibly slowing down, but neither Diego nor I had realized just how much.  That night, he collapsed downstairs while getting up to get a drink of water.  Diego spent the rest of the night on the couch beside his bed.  We took him to the vet the next day and a chest x-ray showed massive interstitial pulmonary infiltrates.  The vet couldn't tell us exactly what it was from, but the two most probable choices were disseminated cancer or a bad fungal infection.  Either way, the outlook was very bad.  We took Winston home that day with the plan to say goodbye and bring him back the next day to release him.  In those two days, he disintegrated before our very eyes.  He seemed to exponentially lose weight and hair.  He was so weak.  His body was failing him.

I knew we would do the right thing for him, but I have never done anything so hard in my entire life.  We took him in to the vet the next day after I finished my morning rounds and spent a couple of hours sitting with him on the side porch of our house.

Sitting on the porch


We took the long way there, put the window down, and he tried to stick his head out but was so weak he had trouble keeping his balance on the curves.  I wanted so badly for that ride to last longer.  Diego put Queen's song "Don't Stop Me Now" on through the radio and we tried to make his last moments last longer.

Winston's last joyride
At the vet, I sat with Winston on a soft blanket they had specially for us and held his head in my arms with his body on my lap.  We said goodbye.  They gave him a tranquilizer, and slowly, his head began to droop down until he was limp in my arms.  Still breathing, just fully asleep.  As he lost consciousness, I said to him, "It's time now Winston.  It's time to return to the universe.  We love you.  We will miss you."  Then they gave him the anesthetic.  I could swear I felt his soul leave him seconds later as his heart beat slowed down and then stopped altogether.  A little piece of me went with him.

We grieved for Winston so severely.  I could not believe how much hurt I could feel.  I was on call that weekend.  I went to and from the hospital but I had trouble caring for my patients.  I just did not care about their pain and suffering.  No one at the hospital cared about mine.  "Oh, your dog died?  How sad." No one mentioned time off, there was never any option for me to do anything but my job without complaining.  No sacred time.  No sacred space.

Months later, well after the baby was born, I would still cry myself to sleep after his nighttime feedings.  But, life just kept happening, at an unimaginable rate.  I could either keep up or get trampled by it.

In September, my cousin Hope was diagnosed with metastatic breast cancer.  She has pain in the right upper stomach radiating to her back, and went to see her new PCP, just having moved to South Carolina from Pittsburgh, thinking she was having a gallbladder attack.  She was still actively breastfeeding her fourth child.  A gallbladder ultrasound detected a huge mass in her liver.  She had a mass in her breast as well that she had not noticed while breastfeeding.  A bone scan showed spine metastases.  She started on chemotherapy immediately.

I still do not understand how the universe could be so wicked to her and her family.  Of all the people that deserve happiness in this world, she is at the top of the list.  One of the most genuine, heartfelt, caring people I've ever met who had spent the previous 10 years seeking out organic produce and hormone-free milk, buying local, and investing in her community.  Not fair. Just not fair.  Not that breast cancer is ever fair.  But this seemed particularly unjust.

In October, the dragon was born (unleashed?), and the following months were consumed with physical healing from a traumatic birth, difficulty breastfeeding which took months to resolve completely, and a baby who would not sleep for more than 2 hours straight.  I spent the rest of my chief residency in a fog of exhaustion.  I spent more time with my breast pump than actually nursing my baby.  I began to resent my job.  The dragon missed me so much that he would nurse all night long.  Whenever he woke up I would just switch him to the other side.  This set him up for a pattern of sleepless nights that left me desperate, but I knew breastfeeding was the best thing for him, so I kept doing it, one day at a time.

Being a mom infused me with plenty of new reasons to feel guilty.  In all reality, I knew I was doing best.  But I also knew my best was NOT good enough.  Not for my job, not for my baby, not for my husband.  And definitely not for myself.  As 2012 ended, I thought for sure 2013 must be our year.

I continued day after day, struggling just to do what I had to do for that day, neglecting myself and my own health, not to mention my husband.  In the 10 (if I was lucky) hours a day I was not working, I was consumed by nursing, pumping, or just being close to my baby.

In early January of 2013, I found out that a very close friend of mine, a few years younger than me, had been diagnosed with breast cancer.  They had found it in her lymph nodes.  She called me, terrified.  I did my best to help her, guide her through the medical process.  She has done very, very well I'm thankful to say, but in that moment, I knew 2013 was not to be our year either.

It was a difficult year.  I struggled through the final months of my chief residency.  The dragon grew and flourished.  He met or exceeded all his milestones.  He got all of his prescribed vaccines.  He drank every drop of milk I made.  I starting taking supplements.  I pumped as much as I could.  I withered under the stress of becoming a surgeon and feeding a human being.  I could barely recognize myself.  There was no sacred time.  No sacred space.  My entire being was invaded.

We moved to Miami in June, a 2 week escapade requiring us to downsize to a tiny apartment and get rid of two-thirds of our household goods, most of which I was thankful to lose.  Fellowship has been equally as intense as residency.  When the dragon started daycare in September he was sick every week with something new for the first several months.  He was up at night every hour, miserable, unable to breath, and I staggered under the weight of the exhaustion.  I read "The No Cry Sleep Solution."  I was desperate for even 4 straight hours of uninterrupted sleep and I despaired that it would ever happen, or at least not soon enough to keep me from injuring myself or someone else.

In October we celebrated the dragon's first birthday in Ecuador.  I finally stopped pumping in November when the dragon was about 13 months old and he has slowly been weaning ever since.  The nights are getting better.  He still gets up during the night, sometimes often, sometimes less.  But I don't nurse him for nutrition anymore, which has relieved the urgency.  I cherish every time, as I know it may be the last.

So, when I joined Diego and the dragon in Ecuador in December, I had no reserves.  I had nothing left to give.  His family helped me recharge a bit during that week.  Reconnect.  And then we burned the Old Year.  While his widow danced for money in the street.  We watched until the last ember had died out.  And we closed 2013.  May the memory persist only to remind us of how fortunate we are today.  It will take a while to recover from the fallout of the past two years, but we are making strides.  Advancing.  We watched the Old Year burn with so much hope for the New Year.  I would like to thank my Ecuadorian family for allowing me to share their sacred space and time.

Aunt Sanelly and Nelly




2014 is looking more promising.  The dragon continues to grow and flourish.  I am making efforts at taking care of myself and my husband, not just focusing on the baby.  I am running more, doing more yoga, and seeing a counselor.  I am getting more frequent massages and manicures.  I am doing the best I can do, just for today, but trying to make tomorrow better for myself as well.  I've only got so much fuel left before I burn out completely.  I have been running on fumes for so long. I need to top off the tank.

I passed my general surgical oral board exam.  Diego and I took the opportunity to spend a week in San Diego while I studied for the test.  Rafa and Mugen stayed at home with Oma and Opa.  We made some longs runs around San Diego from our hotel.

In front of the USS Midway

In Balboa Park

We were able to talk about what we want from the rest of our life, what are our family goals, what are our family values.  Really define and clarify what is important to us.  How we will make our time and space sacred, what our family rituals will be.  We remembered how much we love each other.

I am trying, desperately, to create a sanctuary, a sacred time and space for myself and my family that my profession cannot invade.

My profession is persistent though.  It does not relax its claws easily.  In the words of Coldplay, "Nobody said this was easy, but it's such a shame that it is so, so hard....."

I'm not going to let it beat me to the ground.  There is more to me, more than just the surgeon, and that more is screaming for recognition, acknowledgement, nourishment.  If I don't tend to the rest of me, I will burn to ashes like the Old Year and there will be nothing left of me for my poor widower.

I'd hate to leave him dressed in drag, dancing for money in the streets....

Running in Parque Metropolitano on New Year's Day