Wednesday, June 19, 2013

When There's No Place To Hide

It was the best of times; it was the worst of times.  This is one of those posts again.

Last week a wound nurse came out and evaluated mom, the first visit by this nurse in the nearly 3 months mom has been in hospice care.  I guess the doctor’s initial evaluation that she wouldn’t be around long led the hospice people to not worry too much about healing her, but his surprise return after two months triggered a “I guess she’s stronger than we expected” opinion, and the subsequent directive to get the wound nurse out to evaluate the many wounds on her skin.

Mom originally entered the hospice program years ago after she fell and couldn’t walk again.  Then they determined she had less than 6 months to live.  About a year and a half later they said “well, it looks like she will be around longer than we thought,” and dropped her from the program. 

Mom never has liked doctors, hospitals, nor medicines, and so she quickly grew irritated at those who would take her blood pressure or listen to her heart.  “I’m okay,” she’d tell them.  And after they left she’d ask me angrily: “What are they doing here?”  But I continued to have a nurse visit every two months to evaluate mom.  And I noticed that a pattern began to develop.  If mom just was not in the mood, or the prodding went on too long, or sometimes even if she even just saw the nurse approaching the house through the front room window, she’d say:  “I’m tired.  Take me to bed.”  That was her hoped-for way of avoiding the situation. 

She began to use that ploy more often as time went by, expanding it to times when she didn’t like dinner, or even times when she was bored.  But with this latest round of hospice care, her ploy no longer worked.  Called out because of bedsores which wouldn’t heal, the hospice doctor proscribed bed rest 100% of the time, until the wounds healed --- which he didn’t expect would happen before her demise.  Saying “take me to bed” now meant nothing because she was already in bed.  And so when nurses visited, or her wound bandages were changed, or she had to be turned in bed every few hours to prevent further wounds, she was often irritated, and sometimes even downright mad, and sought to scratch those near her. 

But there was no place for her to hide.

With the visit of the wound nurse this past week, every one of the dozen or so wounds on mom was evaluated, and a specific treatment proscribed, each with unique types of bandages or salves or ointments, and some with special cleanings --- and each wound bandage was to be changed every day.  To begin, a nurse came every day, carefully going through the written procedure for over an hour, to train the caregivers to do the wound care ---- and to prod, poke, turn, twist, and bend mom.  Every day a nurse appeared, sometimes two, and they and the caregivers would huddle around mom for sometimes two hours.  And mom seemed to dread their coming, but she no longer fought their efforts.  As she was rolled from side to side to expose some open wounds --- and lay on others --- she just closed her eyes and said nothing, but sometimes she just whimpered.  There was no place to hide from the unpleasantness.

And mom, who had increased her hours of sleep before hospice was called (I think, in response to her body’s great effort in fighting the skin wounds and pain), began to sleep even more.  From 16-18 hours per day, it has grown to 20 or more hours of sleep a day.  And most nights when I visit her, she just can’t be woken to eat dinner.  I hope and pray this is part of the natural dying process, as her aged body slowly shuts down.  But what I fear is that all the prodding and poking has gotten to her, and she has found a new place to hide, tightly closing her eyes and mouth at the approach of anyone or anything. 

Dying is a natural thing, but I don’t want it to come about because mom fears living.

In her state of diminished mental ability, I don’t think mom is capable of evaluating her life’s situation.  She instinctually responds to get away from pain or discomfort.  And so in my care for her, I try to minimize it.  I don’t want her to hide from me.

Unlike mom, I have a degree of mental ability (or at least most days I do), and so I am able to consider my life’s situation.  Certainly I am not happy with mom’s dying process, nor my facing it alone.  Many a caregiver knows what this feels like; I am not unique in my feelings.  My life may seem hard right now, but when life is hard it is not the time to hide.

And being a faith-filled Catholic, I know I am not really alone.

My Jesus, I trust in You.

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Does there come a time in life when it has no value?  Does there come a time when the same ol’-same ol’ seems useless, when the loneliness makes you feel it matters not to anyone if you are alive or dead, or when the pain just seems too much?  I think these thoughts are common to many old people, but increasingly they are common to younger people also.  It is not an advertised fact, but suicide rates are way up in most age groups in this country.  Even some of the very young are saying that all the years they might have left, have no value.  And there are calls in many places to legalize assisted suicide ---- for any reason.

Certainly one obvious reason for the decreasing value placed on life is the decreasing thinking about the value of life.  My mom has dementia; she can’t logically consider the value of her life, but I think many other people just won’t.  Mom instinctively reacts to pain; I think that is also the case with many other people.  Taught to value all the physical sensations of life, from sexual arousal to good smells or tastes or comforts, many people have learned that life IS about what they feel.  And so when they feel bad, they perceive their life to be bad, and bad things have no value to them. 

But they don’t think about it.

If someone gave you a huge diamond, and it was written up in the paper and a huge party was thrown to honor you and the great gift, you’d feel pretty good that day.  You would wear that diamond wherever you went, and feel good about the notice of you that it generated, wherever you wandered.  You would feel that the diamond was a most wonderful thing.  But let’s say 75 years pass, and then for you, the diamond is “just that old thing.”  It might still glisten, but you’ve seen it so often --- and even the admiring looks of others --- that the whole thing is boring to you.  What then?  Is the diamond valueless?

Perhaps the diamond might be valueless to you, but is it innately valueless?  Would the world be better off without its beauty?  Would its value or beauty be any more if it were given away to someone else?  The answer is no to any of those questions.  The diamond has an innate value because of what it is, a rare and precious thing.  Only its owner can grow bored with it, but not the world. 

If we can understand that about a diamond, why can’t we understand that about our life, or indeed any life?  How can we think that a child in the womb is a beautiful thing, a gift of God, but if the owner of that womb grows tired of it, the child is useless?  If the mother has had children for too long and so she wants no more, how can it be okay to kill the next one?  If the mother has no children because she is not yet bored with her young playmates, or her work career, or her boyfriend who wants no children; if she is happy with her life and so doesn’t want to change it, how does that make the child in her womb less valuable?  No, like the diamond to its owner, the feelings of the owner may result in her putting no value on the life within her, but it has an innate value, just as the diamond does.  Millions of people could look at the diamond and marvel.  Millions of people could look at her baby and marvel.

And she doesn’t think about that. 

Like my demented mother, she reacts to what she feels.  What others perceive or feel matters not to them.  Like babies, they think love is something they feel, something they get from the world around them.  But babies are meant to grow up and learn, and learn that love is not something they get, but something they give.  They are meant to grow up and love like parents.  They grow up not to stay babies, receiving good feelings, but to learn and think, and to give good feelings.

I give you a new commandment; love one another as I love you.

Whatever you sow you shall reap. 

What should we sow, if not love?

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I perceive that there is a Cycle of Life, which all begins and ends with God.  It seems that life could be described as going through six phases:

Dependency/Need =>  Learning =>  Doing =>  Teaching =>  Praying => Dependency/Humility

Beginning with God, we enter this world as small Dependent beings, with all our needs to be met by others.  As we grow, we learn what we are meant to do in this life, and we do it.  For some Doing is a long phase of life, forty or fifty years, but for others, sports players for instance, the Doing is a small part of their life.  Teaching includes parenting, along with providing others what we have uniquely learned during our life --- we might write about it.  But at some point most people begin to think about death seriously, and Prayer becomes a greater focus.  And if you live long enough, you may become Dependent again, as my mother is.  Only this is a different dependency, and if you are aware of its coming, you must enter it with humility, remembering all you once did for yourself, which your body no longer permits you to do, will be done for you. 

And then you go back to God, from where you began.

There are a couple of other things going on during this Cycle of Life.  In the beginning, God gave you life, but all during that life you are learning how to give it away; you are learning how to love.  This isn’t a phase, but a thing which accumulates; it ages like the body, only not to grow old and withered, but finer, like wine.  If a life has been lived well, at the end it knows how to love as it has never known before, and it willingly gives of itself to God and to neighbor.  This growing in love is growing more in imitation of Jesus, who showed us how to love.  Each of His parables, every single one of them at its heart, was about self-giving love.  We have another name for this growing in imitation of Him; we call it growing in holiness.   Growing in Love, growing in holiness, growing in trust --- they are lifelong growth.

My Jesus, I trust in You.

I think that last point, growing in trust points to one other unique thing about this Cycle of Life we go through.  At a certain point we kind of go through a “hump day.”  Up until then, much of our life is largely up to us.  There comes a point, however, when we reach the peak of our self-dependence, and gradually turn more of our life over to God, and His plans for us.  This point too varies for each life.  Some decide in their teenage years to become a priest, while some decide in their sixties.  Some have a great conversion experience, which starts them on the road to trusting in God.  And for some, it is a very deliberate AND HARD choice, to stop trusting in themselves and begin to trust in God.  That growing in Love over a lifetime is a growing of giving of self.  That growing in holiness is a growing in accepting of God.  This concept of giving and accepting at the same time is difficult for some people to understand; they feel someone has to be in control --- and they feel more comfortable if it is them.  They haven’t learned to trust much at all.

I described beginning to trust more as like the “hump day,” and it might be good for you picture a hump (I won’t try to draw a picture here).   The hump looks like a line that gradually goes up over a period of time, peaks, and then gradually goes down.  Gradual is the key word; it is almost imperceptible from day to day, and it is only after a long period of time that you can look back at where you were on the curve and notice the large change.  If you imagine the hump drawing as being your lifeline, you can perceive that the early part is more difficult, as you begin to climb the hump --- that is when you are in control --- but then you begin to coast somewhat downhill, and things seem easier --- that’s when God is in control.  That gradual easing of burdens should feel good, like a sled-ride down a snow-covered hill, and it does.  Sometimes trusting in God almost makes you feel giddy.  And it should.

There are some people, however, (perhaps a growing number) who can perceive no “hump” in their lives, nor do they want one.  They are in control, want to be in control, and want nothing to do with God.  If they perceive that they have risen in their life through their struggles, like rising on the hump, they then see life continuing that way, always a struggle to stay on the top of the hump.  Instead of beginning to gradually go down the hump, they see a straight line in their life, always hard.  If they could be made to consider turning over their life to God, trusting, they would perceive it as a cliff, a straight drop from their control.  It would seem to be a thing to be feared, and resisted.  Trusting is God is an unknown to them, like the early civilizations which thought there was an end to the earth, and if you sailed far enough you’d fall off.  Looking back at the Cycle of Life, as I perceived it, these people resist moving into the last two phases of life, which are the ones phasing them back to God.

But willingly or not, they will go back to God anyway.  Like those who value only their feelings and see no innate value to life, they haven’t learned to love.  They haven’t learned this key lesson, to learn to love, for which they were born.  I think they are being somewhat like my mom in her dementia; they try get away from God in the final phases of their life. 

But I fear that in the end, like her, they will find that there is no place to hide.

I liked the bumper sticker which read:  If you want to make God laugh, tell Him YOUR plans.   


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