Wednesday, November 27, 2013

Granny Nanny

She’s been old all my life.

Funny how you see things, smell things, live things every day, but they don’t always directly affect you.

I don’t know my patients. They are who they are when they present to me, they are not who they were before they did.

Yet, today was different. She was not who she presented to be, she was the shell of the woman I have always known. The old woman who always had a smile and a twinkle in her eye, a twinkle that seemed to become more mischievous the older she became.

“She smells today.” My mother noted.

I know that smell. I smell it every day. But not here. I do not know it here.

She had trouble opening her eyes. When she did she couldn’t see clearly. Couldn’t hear. Couldn’t understand what she saw, what she somewhat heard.

She kept asking who I was, she thought I was Chara, the one with the boy. I didn’t correct her.

Her hospice aid, Gigi, came and bathed her and gave her excellent care. She knew her. She said she was her pal.

Funny. I take care of perfect strangers all the time and here was my own, lying in her bed, on hospice, and I was watching her pal, Gigi.

I went to the kitchen and listened as the hospice nurse explained to my great aunt about the medications in the hospice kit. This is for this, this is for that, this helps with this.

Funny. I was hearing a lecture about medications I give regularly.

It was time to leave.

I went and sat on her bed.

“I’m ready to go, but I guess the Lord isn’t through with me yet”, she said. I smiled.

“Are you Phil’s?”

“Yes,” I said, “I’m Tara”.

“Oh, you have a boy”.

“No, that’s Chara, I’m Tara”.

“Oh”. She smiled. “That’s right, that’s Chara”.

And there was that twinkle. And for a moment she knew who I was. For a moment I was Tara.

I rubbed and patted her back.

“Oh, that feels good. I may go back to sleep,” she said.

I kissed her head and rubbed her back and looked at the body of my 104 year old great-grandmother.

Funny when the patient is yours. When the patient isn’t a patient. Funny to know who she was and not who she is.

“I’ll see you later” I whispered.

And left her for probably the last time.

Sunday, November 17, 2013

Beginning and End

I found myself standing at the foot of the bed, wondering about the day of their birth.

I wondered what the mother thought, how she felt as she held that new life in her arms. I wondered if she was full of joy and hope and excitement for this new life. I wondered if she, like Mary, had a song in her heart.

I wondered if there was a father in that room, smiling at the scene. I wondered if he bent down to kiss the crown of that head. I wondered what he felt.

I wondered because I found myself standing at the foot of the bed on what would be the day of their death. There was no mother, no father, no siblings, no children. There was no family for this life, this soul.

We waited until our shift was settled and then we went to our work. We: the nurse, the respiratory therapist, and me. We were the sole people surrounding this life who now lay in the bed.

I took the tube from the mouth and we stood there. We watched the rise and fall of the chest. We watched the monitor reveal the heart beats. We didn’t want her to be alone.

We waited.

My phone rang. Another patient needed something and I left the room.

I became busy.

My phone rang again. It was the nurse. The patient was no more.

I again found myself at the foot of the bed. I donned the stethoscope. I listened a final time to the chest. There was no rise and fall, no heart beat. I pronounced the patient, reported the time of death.

And then it was done. The life was over.

I stood alone in the room with the patient and wondered the course of their life. Wondered where the family went. Wondered where this body would go.

Hours later I passed the room: it was clean, the lights were on, the bed was made. It was waiting for the next life to come, as though the other had never been.

But it was. I remember.

Sunday, October 6, 2013

Combat Zone

We were trying to do emergent procedures in two rooms, three other rooms were actively crashing, and a patient down the hall was in acute delirium.  The night was hellacious.

It never stopped.

It has been like this the last few weeks.

One moment we were coding a patient, the next I find myself alone, with their child, in a waiting room, telling them that they had died.

Another moment it seems like a blood bath. Attempt after attempt after attempt after attempt and then finally success at the Seldinger technique.  

Blood pressures bottoming out – pressors, fluid, pressors, fluid?

Rising lactate levels: 11, 14, 7. Mortality risks rising comparatively.

Rapid Response. Rapid Response - ICU Transfer. Rapid Response. Rapid Response.

“X wouldn’t want to live this way”. I find myself standing alone with the family. We withdraw heroic measures and introduce comfort care: ativan, morphine, extubate, pressors off. Death rattle, death rattle, death rattle. . . . death.

I’m not sure whose blood is on my scrubs.

At times, I find myself under such physical, mental, and emotional stress that it is like I’m in a combat zone.

When I was done with work on that third morning that is exactly how I felt: as though we had been in combat all night.

The stress can be addicting. I was off that fourth night, but I offered to work. I didn’t, though.

After hours of day sleep I was relieved; the extreme exhaustion had finally hit. It was a church night anyway. I got dressed. I left the house with my exhausted mind and body to be around “normal” people and smile and be polite and sing. But I found myself driving to the grocery store, buying milk and heading home. How can one be around “normal” people when they don’t feel “normal”.

It is now days later. I went to church this morning. Time allowed me to be “normal” again. I’m going back in tonight, re-entering the combat zone, or maybe just a quiet boring night.

Oh the ebb and flow of the ICU.

Thursday, September 12, 2013

Someone Will Always Be There

It never stops. They are always there: the patients, lying in their beds; the nurses, caring.

There is never a time when someone isn’t there, never a time when the unit isn’t fully employed with people actively caring.  

When I’m away I sometimes think about the unit, the patients. I wonder how they are, how they’re doing.

Every unit I have every worked in has patients lying in beds at this exact moment with a full staff of nurses caring for them. They have never stopped.

It’s daunting sometimes to think about, to know that it will never stop, that they are always there, that there will always be a need.

Weekends, night time, holidays, Saturday morning, Thursday afternoon, Monday night, Halloween, Thanksgiving, Christmas, the Super Bowl. There is never a moment when there is not a need.

There is a responsibility of those who know to teach those who don’t know, this ensures that someone will always be there.

Teaching allows me an opportunity to always be there without having to always be there. Teaching provides an opportunity to create a legacy.

Teaching bridges the present with the future.

So, I find myself coming to a new bridge to cross, a new challenge to meet.

My goal has been to learn and experience and grow so that I would have a deep wealth of knowledge in varied areas of healthcare to share when the opportunity approached and the time was right.

The more I’ve learned, the more I realize how very little I know.

I’m excited about the coming months, the coming semester. I look forward to the spring of 2014 and the promise it brings, the opportunity it holds, the changes it will yield, and the new bridge to cross.


Thursday, September 5, 2013

Caffeine and Diphenhydramine

Caffeine and Diphenhydramine

I look forward to the day in which these two agents don’t dictate my sleep/wake cycle, but the sun and the moon do, days that aren’t slept away and nights that are for resting.
It seems as much as life has continuously changed the last few years that it really hasn’t changed at all. For all my doing and traveling and going and learning I’ve really stayed in the same place.

Around the world and back again. But was I orbiting the world or was I allowing it to orbit me?

We had a retirement party for a coworker the other day. I watched the video of times gone by and remembered some of those times from my previous time at Vanderbilt. I wondered what it would be like to be somewhere for so long? I remember what it was like to be somewhere for so long.

I never imagined that my work would become my life. I thought my children would. But my child is furry with four legs, not a red head with two. I so deeply love her, though.

I’m excited about the future, about life, about work. I’m excited about the paths coming up. I’m excited for new experiences, new horizons, and new challenges.

Life is such a gift and I’m so thankful for all that it brings, and all the amazing opportunities I've had.

I am truly truly blessed.

Wednesday, September 4, 2013

Diary of an ICU Nurse and Why Doctors Die Differently

There are a lot of truths in this article: Diary of an ICU nurse.

And this one: Why Doctors Die Differently

I suppose there are moments when each of us who work in the intensive care setting has to ask ourselves what we are really doing for, or more appropriately, to our patients.

Dying is hard. Watching a loved one die is harder, it hurts.

We are all going to die. How do you want to die?

It really isn’t a joke. We all say we are going to tattoo DNR (Do Not Resuscitate) to our chests. We all tell each other to not let “them” do this to us. Funny though, we are “them”. We tell each other not to do what we do to other people to ourselves. And the saddest part of all is that we mean it.

We don’t want 911 called. We don’t always choose chemo. We don’t want CPR or ACLS. We all would choose to die.

We all would choose to die.

Choose.

There is no failure in death. There is no failure in allowing the natural to occur. There is no failure in receiving one’s fate. Yet we fight it.

Life is a beautiful and most precious affair. The goal is to not demote or negate its beauty. But death is a part of life. And believe it or not, there can be great beauty, great comfort, great peace, and even great joy in a quality death.

Hospice and Palliative care are greatly needed and greatly underutilized options that can help achieve a quality death.

Please talk to your family. Please talk to your ICU team. Please ask the hard questions. There is no reason not to and so many reasons to do.

Wednesday, August 21, 2013

Clouds of Truth

The clouds have been amazingly beautiful the past few evenings. The temperature has been right. The air has smelled sweet, like Tennessee in the fall. It’s been nice. Peaceful.

I’ve stared at those clouds and the shapes they form and the ease they move with the wind and time. They are stark white against the evening blue sky.

I’ve recently been engaged in a conversation with a friend. A while back we’d had a falling out. Funny though, I didn’t know.

Our perspectives are usually about our self. We read and understand life based on the paradigms we subscribe to or ascribe to. We receive information and then compute it based on our own paradigms. We interpret information based on the world views we have adopted.

Sometimes people share an argument and unknowingly adopt the same side. They present their sides so differently though that you believe you are in opposition to one another when in truth you are the same or similar.

Hard heated talks that become easy and simple and light are a true gift. Friends are a true gift. Reconciliation and communion is a true gift.

Truth is a funny thing. It remains constant like that beautiful sky. But life comes in and people and confusion and personalities and misunderstanding and culture and time and what you have are clouds. Somewhere between the mix of clouds and the beautiful blue sky lies the truth.
 
 
I suppose if you stay with it and watch and wait you may find life in time to be nice. Peaceful. 

Wednesday, August 14, 2013

Death and Dying

She smiled, that sad knowing smile, then she hugged me.

"Get some rest." I told her.

And then the newly widowed woman rejoined her family and walked away.

Since February of this year I have had 10 friends lose a parent. I've often wondered how that is. How does one lose a parent? How does one keep living? How does one continue to experience life without them?

I do not know the answer to these questions.

In college I once dreamed that my mother died. I remember waking in my dorm room. I was scared and confused. My chest was heavy and tight. I found it hard to breathe. It was a dream. I quietly began to cry. It was a terrifying nightmarish dream. It wasn't true. But for 10 of my friends it now is. I don't understand how they feel. I cannot relate.

Sometimes, I help people die. I help provide a quality death. I walk the family through what will happen, then it does, then they go home. Death really is that simple. It is the effect of death that is not simple.

"Get some rest." I told her.

And the newly widowed woman rejoined her family and walked away. It was 02:00 in the morning. She was going home. She was going to bed. And for the first night of the rest of her life she would get in that bed alone.

How can you "get some rest" when the place you rest is the quiet place that so profoundly tells you he is gone.

I often wonder if anyone will sleep with her. Working nights, those families leave to go home, to go to bed. I wonder if any of them think about the sleeping. I wonder what happens when they leave my unit. I wonder if they wake in the night to find their chest heavy and tight and unable to breathe, only to realize it is a truth and not a dream.

She smiled, that sad knowing smile, then she hugged me.

They always hug me. Why? I do not know them. I will never see them again. I try to say the right things. I stood with them through one of the most terrifying, horrific nights of their life. Over time I will not remember them. I will not remember the families or the patients or even why they died. I often wonder if they remember me, if they see me in their memories; that girl in the room.

But I suppose I hug them too. I suppose we receive each other.  

I think I will stop counting at 10.

Tuesday, July 16, 2013

Majoring in Minors

It’s the act of focusing on things that don’t matter and forgetting or overlooking the things that do.

I suppose in some ways the act of majoring in minors is probably one of my biggest frustrations. When people get caught up in the politics, the red tape, the outliers, they forget about the point.

Minor things are important, they have a role, but they aren’t the Major thing.

I once knew a nurse who worked on the weekends, but was always coming to work for meetings during the week. She was very involved in nursing protocols, patient management, and overseeing transfer orders. When she was on she would frequently call to let me know of all the minor details involved with her patient’s orders and administrative concerns, but she didn’t call concerning her actual patient’s care or health status.

I found it frustrating that this nurse showed such extensive attention to minor details and very little to the major, or the patient.

One Saturday morning I received a call from this nurse. She called about a patient: some minor detail needed to be changed in the orders, could I please change some of their medications, and when was this patient being discharged.

“Have you seen this patient yet?” I asked

“No,” she said, “they don’t speak English and I haven’t called the interpreter yet.”

I had seen her patient at 6:30; it was now 8:00. She’d been here over an hour and still hadn’t seen her patient.

“Oh!” I said. “Well, your patient does speak English. They need some morning pain medication. I’ve already discussed their discharge plans with them. And I won’t be changing their medication because they’re insurance won’t allow it.”

“Oh.” She said.

The patient was the major.

Details are important. Attention to detail is extremely important. But details are facts about the patient, they aren’t the patient.

The patient needed pain medication, needed to know who their nurse was for the day, needed to be seen, needed to be cared for.

Sometimes life gets in the way and we forget to live it, embrace it. We get focused on work and money and insurance and bills and groceries and … and all those minor details.

Yes, all the details are important. But you have to learn to see through the details to the majors, to what matters.

Monday, June 3, 2013

Better

The patient had come up from surgery lethargic and still somewhat out of it. As the night wore on, though, he did not stay that way.

He was in pain. He was somewhat confused. The confusion resulted in restlessness which exacerbated his post-operative pain. His restlessness continued and eventually resulted in his arterial line being ripped out. There was blood everywhere. We eventually had to place him in restraints.

He was yelling and demanding for more pain medication. We did our best to manage his pain, but he was a chronic drug user and it was hard to find the right balance between just enough and too much.

He was angry. He was yelling and cursing. He was trying to hit his nurse. She called me to the room. She needed help, she needed assistance, she needed orders.

He had ripped out another IV and was trying to rip his catheter out of his penis and pull the monitor leads off of his chest. He was wild. He continued to curse and yell. He was partly confused but as I stood there and looked in his eyes I knew that he mostly was not.

He was angry. Things continued to escalate. He was yelling, spiting, hitting, cursing. There were six people in the room and we were all holding him down. We placed him in 4 point restraints.

I hate cursing. I beyond hate it.

The last few years I have worked in environments in which people talk like sailors, men and women alike. I’ve heard the f word used over 20 times a day as an adjective, a verb, and a noun. (I don’t even understand how that makes sense.) My office is frequently made up of people saying these things and there is really nothing I can do about it - I have to continue working with these people. I don’t have to listen to it from a patient, though. I don’t have to listen to him berate his nurse.

“Stop talking!” I said. I pointed a finger in his face. “You will not talk anymore. You will not say those words and talk ugly about your nurse!”

He started mumbling.

“Stop!” I was beyond frustrated. “You will not talk.”

The room was still. Everyone stared at me.

I felt frustrated. I felt angry. I felt bad. I had shamed a grown man like he was a little child. I felt like a principal lording over him.

He started mumbling again.

“Stop talking! You will not talk!” I yelled at him.

I felt horrible. He was embarrassed. But, all of a sudden he was calm. We could now give him the meds he needed and relax him.

In time everyone started to file out of the room. They were no longer needed.

I was so frustrated with this man. Why did he behave this way? Why did he respond like a child? Why did he treat his nurse the way he did?

I went back to his room later. I wanted to check on him and his nurse.  

“You need to apologize to your nurse,” I said. “You should not treat her that way.”

“I’m not apologizing to her!” he said.

“Well you should.” I said. “You need to be better. You need to be better than this. You need to act better than this.”

I stopped myself.

Better.

I don’t know this man. What is "better" for him? Was this "better" for him? Did he know what "better" was? Did anyone ever model "better" for him?
 
Maybe I should have modeled "better" for him instead of shaming him.

Funny how even the most horrific and frustrating events can cause us to evaluate our own thoughts, behavior, judgments.  

Friday, May 31, 2013

Hand in Hand

15 years ago this week I graduated from high school. It was a day I had dreamed of, hoped for. I was so excited. My grandparents came. My family was all there. They were there to celebrate us. Chara and I.

We entered the world together, we went to school together. In fact, I never went to school alone. From pre-school to my senior year, Chara had been there all along. This wasn’t my graduation, it was ours. Like so much of my life, momentous occasions were shared with her and not by me alone.

I was so proud to have her with me. We marched onto the field and I was content to know that she was right behind me.  


Walking on the field.

I dreamed of the moment that it would be over. I dreamed of us throwing our caps in the air and hugging one another in a joyous embrace; celebrating what we had accomplished, congratulating one another, and simply sharing the moment.

But that’s not what happened. When it was over I turned to her and she wasn’t there. She’d run off to find her stupid boyfriend.

Chara and I went to different colleges. We went to school alone for the first time. I’ll never forget when she called in the fall of 1998. She was crying on the other end, she was saying things to me that she had just realized now that we were apart. I didn’t know what to say. I hadn’t realized she didn’t know.

Later she did come to my college and we did graduate together. I do not remember when it was over. I think she was still there. I think I was afraid to look.

Chara got married that December. It was a bittersweet day for me. She joked she was giving me a brother. I feared he was taking my sister. When the ceremony was over and she walked down the aisle, she stepped out of her shoe. Three people passed it. When I walked down the aisle it was still there, waiting for me. I saw it as a gift from God. She did still need me, even if she was married. I picked it up and took it to her. When I found her, I saw him, her husband. He was crying, deep beautiful tears of joy. He loved her, he was blessed, he was happy, he knew she was a treasure. Okay, I thought, you can have her.  And my heart softened.

In time, Chara became pregnant. She said she wanted me there, needed me there. It made me shy, it made me happy, it made me blessed. I saw Jonah’s little body come. I cut the cord. I suppose her momentous occasion were shared with me too.

And she asked me to be there when Caroline came, too. I cut the cord. She looked like a little red raccoon.

I moved East. I’ll never forget when we talked the fall of 2010. This time I was crying and saying things. She didn’t know what to say. Chara just sat there and loved me.

And then Sadie came. Chara waited for me. I cut the cord.

It was the fall of 2012. She called me. Happy Birthday I said. Chara was confused. I was excited. I had signed us up for the 2013 Memorial Half-Marathon. She thought I was crazy, maybe I was.

We got up early. I picked her up at 5:30 and drove downtown. It was cold. They said there were over 24,000 people. I was there with one. We ran, walked, jogged the whole race side by side. We were out of shape. We were laughing and experiencing and living together. It was a great great day.

This time, I wasn’t afraid to dream. I imagined crossing the finish line with her. Hand in hand. And so, as we got closer, I reached over and took her hand. She was there. She hadn’t run off. She didn’t pull away. We crossed the line together, hand in hand; our time was exactly the same.
 
2013 Memorial Half-Marathon
Oklahoma City, Oklahoma
 
And I know that I am blessed.  

Monday, May 6, 2013

FCCS: Round Two

This past weekend I took FCCS again. I have to retake the class every 4 years to maintain my certification.

There were ACNP students sitting near me talking about classes and clinicals and tests. It was interesting to sit there next to them and hear what they had to say, to hear the exhaustion and stress in their voice.

Funny to be sitting near them at this class. The last time I took this class I was the ACNP student.

Hearing the same information 4 years later with more experience and understanding was good. I learned and appreciated it more. Sometimes I would really like to go back through my MSN program again. Knowing what I know now and hearing it all over again would probably be more beneficial than hearing It the first time I heard it. I would really like that; if I had the time and the money.

I have a phenomenal memory, always have. But you remember things that you know. When you don’t know something, even when you’re told, you don’t always remember or retain it.

In retrospect, I’m not sure that Vanderbilt’s MSN program was in my best interest. It’s a great program for some people. I suppose that school, in some ways, has always been a little hard for me. I’m a ponderer, not a slow thinker, but I need time to understand and retain. I think the speed, intensity and my lack of experience made my time at Vanderbilt even more stressful and I didn’t retain like I would have had the program been different.  I hadn’t understood these things. But hindsight is always 20/20.

FCCS was good. I enjoyed it. I think sometimes I’m too hard on myself.

Monday, April 15, 2013

Hurt from Smiling

I went back to the beginning today. I went to NHC Place. Saw old friends. Walked old halls. Smelled my youth and energy of days long ago. Of days not so long ago.

When I left, my face hurt from smiling. I loved my time there. Loved myself there. Loved who I was. I was dissatisfied with the work I did though, so I went and sought more and different. I loved myself in the different times, too. Loved what I did; what I do.

I miss old people.

I worked 6 night shifts over a 7 day period recently. When it was over, and I woke from my slumber, I realized I really hadn’t spoken with, interacted with, been validated, or connected with another (on a personal level) in those 7 days.

That makes for exhausted, lonely time.

I thought about my life the last few years and thought about patterns and choices and found this to be a common theme. When you spend your energy spinning wheels you find that you don’t go anywhere and in the end you have created a deep hole; even when the spinning wheels serve a deep, noble, good purpose.

I talked with a good friend today and he defined me as being in the “mid-life crisis” phase of my life. This made me laugh.  What he said made sense.

My sister is about to give birth to her fifth child.
My niece is in 2nd grade. I miss her.
My nephew is planning his birthday party that’s 6 months from now.
My niece likes to babble.
My niece said when the baby comes she’ll potty train, but not until then.
My niece has a tender heart like her mother.
My sister is entering phase 2 of her school program and doing well.
My niece has pretty long hair and the smile of an angel.
My niece is walking and climbing and being ornery.
My niece likes to hold onto the things that she likes.
My niece is sassy.
My sister is getting ready to run a half with me.
My mother is truly a Grand mother.
My father works hard.
My grandmother was in the hospital.

Life goes on whether we work or sleep.

I visited an old friend today. She has dementia. She didn’t know me. I held her hands and we talked. I prayed with her. Hugged her and kissed her bye. She thought she might go see the tulips. I hope she did.

 
I miss Opal.

Life is learning to live in the tension.  And to be at peace in it. And to know your place in it.

Thankful for Ruth.

Sunday, April 14, 2013

Beds That Have No Answers

It’s curious where you find people sometimes: their perspective on things and their attitude towards life and their individual circumstance.

I met an individual who received a life altering opportunity, a priceless gift. All they could do was complain and complain and complain. They did not seem to exhibit thankfulness or gratitude. It was quite disappointing.

I met another individual who had fallen on extreme circumstances and was beginning the next stage of a horrific journey. They were in pain, but they smiled. They acknowledged their blessings. They flirted with truths. It was quite humbling.

What makes people who they are?
What makes people respond to life in the way that they do?
Is it culture?
Is it nature?
Is it nurture?

I do not know.  

I remember a time when 2 individuals laid in ICU beds after both experiencing horrific crashes. One, a drunk driver, was left with a broken bone; it was fixed and healing. The other, hit by a drunk driver, was left paralyzed, on a respirator; broken and decompensating. Their crashes were not the same, yet, maybe they were.  
 
How and why are questions we never find finite answers to. Life does not afford us that gift. We are left with unknown reasons and ponder ideas in search of a truth that we usually never find. I think sometimes we find more truths in our questions than in our answers.

It’s phenomenal the impact observation can have on us, if we allow it. Watching and observing human conduct, human nature, human attitude, human response. There is much to be learned in those around us.

I was recently listening to one of my favorite artists, Dar Williams, and her song, “The Mercy of the Fallen”. There is a line that reads:

There’s the wind and the rain, and the mercy of the fallen,
Who say they have no claim to know what’s right.
There’s the weak and the strong and the beds that have no answer,
And that’s where I may rest my head tonight.
 
 
Sometimes the weak are the strong. And sometimes the strong are the weak. But all lay in beds that have no answers. I suppose that is the truth that plagues me.

Sometimes we have to turn off our minds, yield to the lack of answers and rest our heads. There will always be disappointing and humbling experiences. I will continue to encounter them as long as I do the work that I do. But there is a lesson to be found in each of them.  A lesson to grow from.

I suppose finding the lesson for the purpose of growth is the answer.

Tuesday, March 26, 2013

Sitting

Ruthie’s gotten lazy. But then whose fault is that?

My Dad recently sent me an e-mail with the heading being “I’m guilty”. This peaked my interest and when I opened the e-mail it was an article titled “Sitting is the Smoking of Our Generation”.  I read the article and it gave me lots to ponder.  

On my most athletic day, I ran 10 miles, swam for 3 hours, and quarterbacked an intramural flag football game. I was fit. My body was fit. I was 22.  

Now I’m 33. I’m not fit. Working crazy hours had resulted in weight gain at times and at others weight loss. I frequently eat unhealthy meals on the run or grab quick foods from the cafĂ©. I’m chronically exhausted and spend a significant amount of my “off” time sleeping, napping, or watching TV in a zombie like state.  

I would never smoke, truthfully I abhor it. But, to my horror, I sit. I’m a sitter.  
In less than 5 weeks I’m running in a half marathon. Chara and I are running the Oklahoma City Memorial-half marathon on April 28th. When I signed up, I thought about my 22 yo days and was hopeful that I’d jump on a fitness bandwagon and reacquaint myself with my old athleticism. But I needed to get moved, then I needed to get adjusted to my new job, then I needed to get adjusted to working nights. Now I just need to get motivated.  

I can blame my schedule in part. It’s crazy and chaotic and prevents routine. But, in truth, you don’t have time until you make time. I need to make time.  

I’ve thought about canceling my cable (I watch entirely way too much TV), but there are days when I truly must recover and I use TV to aid that. I thought about getting off of FaceBook (I spend way too much time on FB), but I stay connected to way too many people from way too many places I have lived.  

Plain and simple, I just need to move.  

Motivation is usually ignited by passion. I need to find ways to get passionate about moving.
 
Ideas?

Monday, March 25, 2013

Foggy Memories: My Journey Back to Senatobia, MS

I claim Tennessee as my home. I claim to be a Tennessean. I was born in Memphis, in Shelby County.

 But the truth is, I didn’t actually live in Tennessee until I was 15 years old.

The truth is, we lived in Mississippi when I was born. I was born in Memphis because that was the closest hospital. So, I can say I’m a Tennessean, but the reality is, I got my start in Mississippi.

 
We lived in Senatobia, Mississippi from 1978 to 1985. I was born in 1979. Those years were exciting, unpredictable, extremely stressful, foundational, and beautiful. I have foggy memories of these times. They’re more known’s than memories: faces, smells, feelings, senses, comfort, love.  Known truths, known peace, known comfort, known community, known trust, known expectations.

The ages of 0 to 5 are times we don’t always remember, but we learn so very very much.

This weekend, after 20 years, I journeyed back to that place. I went to Senatobia. I saw those faces, smelled those smells, knew those feelings and senses, felt that comfort, and embraced that love.

It was odd to be in that place as an adult, to meet those people again for the first time. Some memories came to me, distant foggy memories, but mostly the known’s flooded my senses.

So many people said to me, “you probably don’t remember me…”, but the truth is, more often than not, I did. I knew their faces. I knew them.

So many people said, “You will never know what your family meant to us”. And the truth is, I don’t. I wasn’t on their end and was too young to appreciate that.

But, what they will never know is what they meant to my family. They will never know the reverence their names have had the past 28 years in the Sanders home. They will never know the infinite impact their example's have had on our lives. They will never know the sincere and deep appreciation I have for their kindness to my parents and my sisters and me. They will never know the place they hold in my heart despite the passing of time, despite my significant youth.


I drove past our old house yesterday. I saw 4 little girls. I saw old pictures come to life. I embraced the known’s of my life.

Thank you Senatobia, Mississippi, for giving such a beautiful foundation to the foundational years of my life.

And may it not be another 20 years.

Wednesday, March 13, 2013

Being Where You Are

You can’t be in two places at the same time. You can’t achieve one thing by doing another. You can’t have your cake and eat it too.

I think this is where I’ve been.

The problem with that is that you become paralyzed. You sit on the fence and therefore never declare yourself, your stance, or your goals. You can’t more forward for looking backward.

New beginnings frequently result in self-reflection, which often results in self-evaluation, which, hopefully, results in self-growth.

I always want to be better, stronger, but especially smarter.

I can’t move forward by looking back.

You take what you’ve left behind, the positive and the negative, and you build on it. You use experiences and gained wisdom to build a better, stronger, smarter future. You don’t forget where you’ve been, what you’ve learned, or how you previously functioned; but, you don’t let the past dictate your future.

There is positive and negative to everything. It would be great if we could take all the positives and build something and forget all the negatives, but life doesn’t work that way. Positive and negative rest within things; having non-compatible means allows for the opposition to be seen, allows for truths to be gained.

Working at Vanderbilt is nothing like working in Dallas. Working at Vanderbilt is a lot like working in North Carolina. Working at Vanderbilt is nothing like working in North Carolina. But I’m not in Dallas or North Carolina. I’m in Nashville at a different hospital doing a different job at a different time.

Some shifts you are amazing and rude all in the same night. Some situations lend for peaceful confrontation and mending, some situations do not. Thankful for those times when two professionals can talk respectfully to one another; take time to hear both sides of the story; each acknowledge the right and the wrong committed by both parts, and still walk away colleagues.

Our perspectives dictate our attitudes and actions. Perspectives aren't always reality. Sometimes, as easy as it sounds, it’s hard to be where you are. But sometimes the most important thing you can do, is to simply be where you are.

"Be still, and know that I am God
Psalm 46:10

Monday, February 25, 2013

Getting Settled

I said that it wouldn’t be until March that I was settled; and I am finding this to be a truth.  

It’s been good to be back in Nashville, to be home. I have found that it is exactly the same and I have found that everything has changed. It is true that the more things change, the less things change.  

I’m working nights. I’m sleeping days. It had been 14 months from my last night shift in North Carolina to my first one here; there is a readjusting, a relearning to that life. So far it has been alright. I have discovered that melatonin is wonderful and I have greatly benefited from it.

I have found this critical care job to be less stressful than my last critical care job as I am not solely responsible for the care of critically ill patients. There are positives and negatives to that. I miss being completely in control, of doing all the procedures. I’m so glad to not be completely responsible. Life is such a give and take.

I’m away from Ruthie more and her boarding/daycare bill has gone up. I hate that. I love her. She’s a dog.

It’s funny though; weather I live in Oklahoma, North Carolina, Texas, or here in Tennessee, day to day life is mostly the same. I still live with me, with Ruthie, with our stuff. I go about my business the same way and act my habits out as usual. The geography is different.

There are goals I have for this place, though.  I have been somewhat of a life-long nomad, but, for whatever reason, time allowed me to finally plant roots. They were planted here in Tennessee. So, when I left here I felt incredibly unsettled. That sense of unsettlement has followed me wherever I have gone. I didn’t leave on my terms; it just kind of happened. So, I want to go to a lot of places, eat in some of my favorite restaurants, walk around in old haunts, and drive down old roads with the windows down in the summer time and breathe in the Tennessee air.

But my main source of unsettlement rests in the people. I felt a great emptiness and a significant need to tell certain people thank you. Thank you for loving me, for encouraging me, for guiding me as I grew. Thank you for supporting me publicly and privately; thank you for kind words, sweet hugs, and for being my community.  So I aim to take time and tell these people, to finally let that unsettled feeling within me fall in to a cathartic peace. How can I not tell people who live within my heart thank you? How can I not tell them I love them? I have tried to pen the paper, but there are some words that are meant to be spoken, acts that are meant to be lived.

Time has been an interesting friend. The last 7 years have been a whirlwind of highs and lows, of awakenings, of healing, of sweet peace, of learning and growing, of understanding, of truly growing up and coming into my own.

Life is a journey and I want to make the most of everyday. I don’t want to feel unsettled when I leave here again.