Hangin’ at the hospice

Small dog on hospital bed being petted by patient

Twice a month, my PAL Jelly and I go to visit the seniors at a retirement home. Adjoining the home is a hospice, and often we stop in there along the way. Because Jelly is vertically challenged, it is hard for her to visit with people who are bedridden, but she does her best, seeking out chairs and couches so she can raise herself up within reach.

I admit that entering a hospice isn’t easy. I never know who I’ll meet and what condition they’ll be in. Others must feel the same because somedays there are very few visitors, if any. Some of the patients are so close to dying that they are not up to company.

The past few visits, we’ve been watching a dog-adoring hospice patient become increasingly frail. From the pictures hanging on the wall, I can see he was once a strong and vibrant man. On the wall, there are several pictures of him with his dog. Over time, he is having more and more difficulty moving his body and speaking clearly. Imagine the frustration of not being able to communicate easily. Despite his challenges, he greets the PALS dogs with a broad smile, even if he needs to be woken from sleep to visit.

Since this patient is missing his dog terribly and is unable to reach down to pet our dogs, we lift our dogs up onto the bed with him. When Jelly’s turn on the bed came yesterday, she was more than glad to oblige. She snuggled up to the patient and kissed his face repeatedly. He laboured with his little remaining muscle strength to raise his hand to pet her. I was moved watching his effort to be with the dogs.

While we were visiting, two granddaughters walked in to see him. One of the girls immediately started crying when she saw the dogs and bent down to pet them. She told us she had had a bad day and she was so glad we were there. She didn’t elaborate, but I was glad seeing the pups comforted her.

I tried to imagine how hard it would have been for these young girls to enter the hospice not knowing what condition their grandfather would be in that day. From one visit to the next, like us, they have been watching him die. What would they find to talk about? Would they even be able to decipher what he was saying? Could they find some way to communicate? Hopefully the brief PALS appearance facilitated their visit, which I’m sure wasn’t easy.

This experience reminded me that we bring our dogs to the hospice not only to see the patients. The staff caring for these patients day in and day out–the nurses, the aides, the cleaning staff–anticipate our arrival. The family and friends who arrive when we’re there appreciate the wagging tails as well. Some even schedule their visits when the PALS dogs will be there. I’m happy knowing that the dogs make the day a little bit easier for many of these people. They deserve at least that.

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Getting back on the therapy horse

Bride trying dress with group watching on Say Yes to the Dress

Since I am expecting a hoard of new clients to swarm my office any day now, I felt it was time to brush up on my therapy skills. I considered reviewing some of the books on my office shelves or going to a family therapy conference or ten, but I’m taking the easy route instead: I’m watching television.

I’ve admitted previously that I have an odd fascination with Say Yes to the Dress, and not just because J. and I both wore jeans to our home wedding. Before I started watching this show, I did not realize that brides-to-be took entourages to shop for the special dress. Makes sense, I guess, to seek input.

I imagined that the bride’s opinion would take precedence in the end. If the bride said yes to the dress, who would care if her mother or best friend or clothing-designer cousin or long-deceased grandfather who spoke through her aunt the medium said no? A lot of people care, it turns out, especially the bride.

I’ve witnessed many a bride crying in her dressing room, afraid to exit for fear of the entourage’s reaction to her choice. Many a narcissistic mother has forgotten that the appointment is actually about her daughter the bride. And many the oblivious father is unaware that his daughter is more concerned with pleasing him than pleasing herself. Because I am a psychologist and not a medium, I can’t speak for the wishes of long-deceased grandfather.

I marvel at the sales associate-cum-family therapist who, while helping the vulnerable bride-to-be find her perfect dress, manages the needs of the highly opinionated crew she has brought with her. Consider this a glimpse into family, and group, dynamics. (Turns out we often play similar roles in groups as we do in our families.) Ms. (or Mr.) Dress-a-Bride manages to keep the entourage happy while ensuring that the bride’s needs are met. This often involves skilled negotiation with widely varying personalities.

Now let’s consider another favourite nap inducer, Chopped. The chefs who participate on this show are a product of their family upbringings, as are we all. There are the only-child competitors who won’t share ingredients vs. the eldests who unscrew their competitors’ unyielding bottle tops, if you believe in that birth-order baloney.

I’ve also learned from Chopped how many adult children are tormented by their parents’ disapproval of their professional choices, despite their successes in their careers. This needing-to-please theme sounds oddly familiar. (See above.) The chefs pray a Chopped win will foster their parents’ acceptance, finally, after all these years. Will these contestants ever understand that what matters most is how they feel about the path their lives have taken and not how their parents judge that path? I fear not, barring help from someone like me.

You too can hone your therapy skills from television shows like these. Who cares how to incorporate cinnamon hearts into an entrée or whether a princess gown or a mermaid would better suit the bride? Focus on what really matters, like I do: how people are getting along.

Once you master the complex dynamic issues in these shows, we can move on to 90 Day Fiancé or even Big Brother. On second thought, maybe not. Even I have my limits.

To be a Jew who sees a Jew

Necklace with Hebrew word Chai on itI grew up amongst Jews, and I don’t mean only my family. The students in my elementary school were predominantly Jewish, and I hung out with fellow Jews in the neighbourhood and at the Jewish grocery stores and bakeries where we shopped. I even went to synagogue for many years, and I studied all things Jewish right through university. I was immersed in Judaism way back when.

I’m still Jewish, as evidenced by my excellent challah-baking skills (FYI: brioche ≠ challah), but, besides my few local Jewish friends, there aren’t many of us in town. I am largely to blame for my isolation from the small Jewish community here. I do not attend synagogue or visit the local Jewish community centre. I once caught a film at the Jewish Film Festival. There is an annual Jewish film festival here.

I miss being part of a Jewish community sometimes, just like I miss smoked sablefish and blintzes for brunch and my grandmother’s chicken soup at Friday night dinner. So imagine my surprise yesterday when I spotted a member of my tribe entering the grocery store as I was exiting. I spied, with my little eye, a Jew.

How did I know the lass was Jewish? She was wearing a big Chai (pronounce this not like the tea but with a guttural ch) around her neck. This necklace screamed, “I am Jewish.” There aren’t a lot of Chais or Stars of Davids or other Jewish symbols to be found around necks in this city, so I was surprised by the unexpected sighting.

This young woman had her earplugs in and music blaring so she could see my look of surprise, followed by my lips moving, but she had no idea what I said. No, I did not caution her on the permanent damage she was causing her hearing. That was my inside voice. Rather, I said, “Chai!” which kind of sounds like “Hi!” if you, like me, can’t pronouce the guttural ch properly. Chai is not a greeting. It means “life” and is an important symbol amongst our type. Remember Fiddler on the Roof singing “To Life, to life, l’chaim!”? L’chaim commonly precedes a toast (not the kind with bread, but the kind with alcohol).

This young woman, who wondered why a stranger was speaking to her, stopped, took out an earplug, and said, “Excuse me?” I pointed to her necklace and said, “Chai!” (which again probably sounded more like “Hi!”) Then I said, in case she thought I’d said “Hi!” while pointing to her chest, “You have a Chai!” This was code for “You’re Jewish too!”

She smiled with understanding and wished me a Chag Sameach (Happy Holiday), which is how we Jews greet one another this time of year. The day we met, Sukkot, our holiday celebrating the bounty of the harvest, was ending, and another less familiar but no less important festival was soon to begin. We Jews are in full throttle holidaying this time of year.

That woman must have thought I was crazy. I am a little meshuga, as we say. But you already knew that. Meshuga + poor impulse control = Annie. I make no apologies for who I am, even though some days maybe I should.

Celebrate your milestones, whatever they are

3 Light the Night walkers with their Survivor t-shirts

We leave on our big vacation in 12 sleeps. When we were first planning this vacation, J. told me her rush of fall weddings would end immediately following Thanksgiving. We could be on the plane already, except I didn’t want to miss the annual leukemia walk. Which would you choose, a trip to Israel or a leukemia walk? Don’t answer that.

This decision to delay the vacation may not make sense to you; I’m a little bewildered by it myself. Going on this annual walk, hanging out with my fellow leukemics, wearing my guest-of-honour SURVIVOR t-shirt, has become a significant event in my year. I’ll try to explain.

My definition of a milestone has changed over my five years with leukemia. After I became so sick, I was proud of being able to walk unassisted and to tie my shoes without falling over. I vividly recall my first post-diagnosis yoga class, which I survived despite falling over a few times. I remember cooking my first real dinner post diagnosis, and seeing my first client. Being alert enough to drive again was another milestone.

As time passes, the goals have shifted. There’s the annual Cancer Centre’s Christmas gift-basket draw, which means I’m alive to lose my money again for a good cause. I don’t hate my birthday anymore, and the importance of cancerversaries is self-explanatory. For whatever reason, this leukemia walk has taken on an odd significance in my annual calendar. It’s my prize for getting leukemia and not dying from it.

This year’s will be all the more special because I will finally receive my 5-year pin. Now you know the real reason I delayed my vacation: I wanted a silly little commemorative pin. Frankly, I could have lied about how many years I’d had the illness and received this pin anytime–no one asks for a doctor’s letter–but I’m too honest for such deception.

This coveted pin is nothing to speak of. It’s the shape and colour of a drop of blood with a 5 on it. The blood-drop symbol is almost identical to that used by Canadian Blood Services. When I wear my pin proudly, people may well assume I am a blood donor (I selfishly only take blood), and not a leukemia survivor.

Does it matter that the pin will have meaning only to me? Of course not. If anyone asks, I can always set them straight. (Ha ha. “Gay person sets unknowing one straight.” And they say we’re out [no pun intended, truly] to convert people!)

When I was first diagnosed with cancer, I never envisioned reaching goals like these. Now, planning for my next milestone keeps me hopeful that leukemia is not going to take my life. No wonder cancer-related goals, however insignificant, have become so important to me.

Then, two days later, J. and I will leave for Israel. Who ever thought I’d get any doctor’s blessing to travel so far? Yet another cause for celebration. That and anticipation of the best hummus and falafel anywhere. I can almost taste it….

A plate of hummus with falafel balls in the middle

Sometimes it’s best not to keep score

Newspaper on doorstep

First, let’s get the Facebook page out of the way. To those of you who have kindly sent me Friend requests, I am not ignoring you; I am simply paralyzed by my ineptness. I learned the hard way that there is a difference between a Facebook account and a Facebook page, and had to shut my first attempts down. I will get back to you when I manage to sort my page out.

Now a question for those of you who have your paper delivered: did your newspaper arrive at your doorstep this morning? If it did not, I think I can explain. I received it. Ever since I left those stale banana chocolate chip muffins out for Mr. RAK, we have awoken to one or sometimes even two newspapers on our doorstep. I may have to rename Mr. RAK Mr. DAK (as in “Daily Acts of Kindness”) because he has been so generous with us.

You can imagine that I, who am prone to guilt in much lesser circumstances, am overwhelmed with this current situation. This man receives no financial compensation for his generosity toward us, and I genuinely believe he is not trying to encourage us to reinitiate our subscription. My gratitude is killing me.

Of course I keep a mental tally of the give and take in any relationship. If I feel I’m giving too much over time, either I try to address the inequity with the person directly (when I’m in a grown-up mood) or, if I’m feeling more child like, I withdraw from that person. According to my usual tally system, I’m always in the red. Always. So a situation like the one with Mr. DAK, where I’m getting a lot more than I’m giving, torments me.

I am trying to practice allowing someone–in this case, Mr. DAK, to be kind to me. But in order to rebalance things just a bit, as soon as I finish this post, I will be baking a batch of oatmeal cranberry cookies to leave for him tomorrow morning, when he will be dropping by with an extra newspaper for us. I give thanks to you, Mr. DAK.

I was discussing the newspaper situation with a neighbourhood friend who happens to pay for her daily paper delivery. She mentioned that every so often, maybe once a month, her newspaper does not arrive. As she was discussing this with me, she said, “Hey, wait a minute….” We agreed that maybe Mr. DAK, in a Robin-Hoodish manner, is stealing from the subscribers and giving to the nonsubscribers. So if you’re my neighbour and your newspaper doesn’t arrive, feel free to take ours. God knows we haven’t paid for it. Consider it your way of assuaging my guilt.

Happy Thanksgiving. May you all have much to be grateful for this weekend.

 

P.S. I’ve had a few enquiries about this year’s Light the Night Walk for Leukemia on Saturday, October 21. You are more than welcome to join us. The team name is Annie’s Anemic Leukemics, and the registration link is here. If you are interested in celebrating my fifth cancerversary with me, come on out. All the better if you’re an Olympic weightlifter: you can carry me over the finish line if I get too pooped to walk.

Necessity is the mother of my Facebook page

Picture of fingers walking on Yellow Pages phone directory

My office phone has been hopping lately, and not just with free cruise offers and other robocalls. I have had a few new-old clients finding their way back to my office. All have come via a few family physicians who used to send me referrals, until I told them I was out of commission five or so years ago. Remember that brief spell when I abruptly closed my office and abandoned all my clients? Yeah, that. And, more recently, my endless moaning and groaning about missing my work? Someone has been listening to my internal pleas.

Yesterday I met with a client I hadn’t seen in 10 years. She somehow tracked down my number and gave me a call. I realized, upon checking the old file, that she’d initially been referred by one of these family physicians. After our session, I asked the client for written permission to send the doctor summarizing our contact. It would also be a way of telling the doctor that I was not dead.

I scripted a quick one pager. After the half hour it took me to recall business formatting, and the additional half hour spent printing an envelope, I finished the letter and dropped it in the mail. As they say, she who hesitates forgets.

Upon awakening this morning, I realized that I’d omitted my letterhead completely. No address, no phone number, no email address, nothing. If the doctor wanted to contact me, she’d be completely at a loss, unless she’d recorded my number somewhere or had held onto an old business card. How long do you hold onto someone’s old business card?

I am an idiot. When I told J. what I’d done, she said, “Are you sure you’re ready to go back to work?” That seemed a bit harsh. I’ve been doing the odd bit of therapy, but I haven’t scripted a business letter in five years now. I forgot how it’s done, but I believe I’ve learned from this experience and will never forget to include my contact information again. Tomorrow, in my I’m-still-alive notes to other family physicians who’ve recently made referrals, I’ll most certainly include a business card or two.

In my panic this morning, though, I asked J. to google me. Googling myself would force me to accept I’m invisible on the internet, and I don’t need that humiliation. She did a search, and found my telephone number from an office I left a decade ago. I couldn’t believe my current work number of 10 years was completely absent on line so I was forced to google myself. I discovered that a) I really am invisible; and b) my current number and my old number are equally represented. At least clients seeking me have a 50/50 chance of choosing the correct number. Perhaps I shouldn’t have been so quick to cancel my Yellow Pages account.

I need to create a web presence pronto. For now, I am creating a business Facebook page, complete with my correct telephone number and email address. I hope potential clients are able to find the right Annie, since there are two Annies with my last name on Facebook. FYI, in case you can’t tell from the picture, I’m not the Annie from Fresno, California.

Believing something doesn’t make it true

I don’t really believe in anniversary reactions. I’m referring to the emotional upheaval people may experience around the time of year of a previous traumatic event. If you were in a terrifying car crash in the fall, you may become more nervous about driving around that time, for example. These reactions may sometimes reflect post-traumatic stress disorder.

Whether or not I believe in anniversary reactions, I seem to be having one. I was out of sorts last week and my sleep became disrupted (tired J. can confirm that), yet I had no idea why. You’d probably expect me to figure it out because I’m a psychologist, but I didn’t.

I hadn’t made the connection with what was happening five years ago at this time. Remember my height of attention seeking when I almost died? The whole period is a blur, but September 27 stands out in my mind. On that day, I was moved from the ICU to a private hospital room. I have three distinct memories from that day.

On the wall by every hospital bed, there is a white board with the patient’s name, the patient’s nurse, the admitting physician, and the date. I recall looking at the white board in my room and being sure that the date was wrong. It was September 20th, not the 27th, I thought. When my liver was failing, my brain fared poorly too. My grip on reality was tenuous at best. I was confused and disoriented and hallucinating. No wonder I didn’t know the date.

Later that day, for the first time in weeks, I witnessed how much my body had changed over my hospital stay. (The ICU doesn’t have a lot of mirrors, for obvious reasons.) My legs and arms were spindly from weight loss, and my skin was yellow with jaundice. I was unrecognizable. In that moment, I realized how sick I’d been.

My anxiety peaked that night. In one day, I went from having a nurse assigned solely to my care, her desk positioned so she could see me at all times, to a secluded hospital room with only occasional monitoring. I was sure I would die in this room and no one would realize it for hours. I was a wee bit anxious.

I hadn’t been aware I was thinking about that period of time, but while I wasn’t sleeping one night, I made the connection. My anniversary reaction snuck up on me unexpectedly. II may have to reconsider my belief in the whole phenomenon.

Five years ago, as I regained awareness, I was hit by how close I’d come to death. Did I ever address how scary that realization must have been? I can’t recall. And even if I did deal with it at the time, sometimes such intense emotions resurface when you least expect them. Or maybe I should reconsider this whole anniversary thing and accept my reaction as predictable.

I feel a bit better already. Last night I even slept. Today’s anniversary is truly celebratory: on October 2, 2012, I was finally discharged from the hospital to recuperate at home. Had you seen me then, you wouldn’t have thought I’d still be alive today, but here I am. I can only thank God for that.

Person in hospital bed, staff saying,"if gave you nice food, you'd stay here instead of going home to your loved ones."

Now back to our regularly scheduled programming….

A woman wheelchair tennis player returning a ball

I feel for Harry. Imagine growing up in the shadow of a brother so handsome and brave and charming, with a beautiful wife and now two gorgeous children. Plus William could be king someday, assuming his grandmother ever bows out, and his father chooses to pass on the posting.

Harry has had a rougher go of it. He was younger when he lost his mum, and he acted out in his teens and early twenties. Remember his Nazi costume at his friend’s party? Or his playing strip billiards in Vegas? (He must not be very good at billiards.) Perhaps all the princely pressures, and being fifth in line to the throne, led to his acting out and drinking a bit much.

I’m pleased to report that, from outward appearances at least, Harry has grown up. He now devotes himself to supporting military veterans and is dating a beautiful and talented Canadian girlfriend. Way to turn your life around, Harry.

Harry and Meghan made their first public appearance this week at the Invictus Games in Toronto. Their momentous hand holding was a top news item that was captured from every possible angle. As I was watching the captivating news item, however, I was struck by the lack of focus on the athletic event they’d come to watch, which was wheelchair tennis. I saw no photos of any players on or off the court.

How do people relegated to wheelchairs following a serious injury would be able to play tennis? How would they move to receive a serve? Would their wheelchairs move fast enough to allow return of a fast-moving ball? Or would the balls move more slowly because the players lacked the lower body strength to propel their rackets? How exactly would they move their wheelchairs without dropping said rackets? The whole venture sounded incomprehensible to me.

Thank goodness for YouTube, where every question you might possibly have is answered instantaneously. I easily found a video of two women playing wheelchair tennis. Over the course of two minutes and forty-three seconds, I learned that: a) these players do hold their rackets in one hand as they manoeuvre their fancy wheelchairs; b) the serve seems less powerful, which only follows from their weakened lower body strength; and c) the volleys may indeed be shorter, at least from the brief clip I observed. The player needs to anticipate where her opponent will direct the ball and somehow get her chair in position in time to return it. This is not easy. These athletes are incredibly talented.

So Harry and Meghan, I wish you a long and happy relationship. Now please step aside so we can see the incredible athleticism of the true survivors. These athletes have been to who knows where and back and have adapted magnificently to profound changes in their functioning. If we had the opportunity to see them playing, we’d certainly witness incredible strength and bravery.

Furthermore, when you are ready to announce your wedding, or perhaps Meghan’s first pregnancy, consider finding a different venue than, for example, the Paralympics or the Special Olympics. Nothing personal, but I’d prefer to watch awe-inspiring athleticism over your public displays of affection any day. Come to think of it, you probably would too, wouldn’t you?

Siri, do you seriously think you could do my job?

Cell phone displaying, "What can I help you with?"

I have nothing against modern technology. I save a lot of time banking on line rather than going into my branch. When I run into the grocery store for a few things, I check them out myself rather than waiting for a cashier. Driverless cars may scare me but I’ll likely die of natural causes before they take over the road.

Nonetheless, when Siri recently threatened to horn in on my territory, I took offence. C’mon Siri, what are you thinking? I’m grateful that, if I choose to, I can ask you the weather or directions to the nearest bakery. I’m sure you could tell easily me when the Roman coliseum was built if I cared to know. You might even be able to help me not to overwhip my egg whites, and to determine the best oven rack for my baked goods. More power to you.

But counselling? Really? Will I have to listen to your annoying computer voice for a full hour at a time? I realize that Employee Assistance Programs and even some real clinicians are experimenting with newer modes of communication with their clients, ones that do not involve sitting in the same room facing one another. Clients text and email their therapists these days, but I want to believe they do so mostly to book or cancel appointments, not for the therapy itself. Then I heard of someone who participated in counselling solely through email–he never met the person who was helping him. Is this negligence or am I just old fashioned?

Could you really address my most vulnerable problems, Siri? How will you grasp inflection and intonation and other subtle aspects of language? What about all the things I don’t say, that I communicate solely through my body language? You’ll have your work cut out for you, Siri.

Since I haven’t been to see my therapist for a while, I thought I’d try Siri out for myself. I started with, “Hey Siri, I’m feeling blue.” Siri responded appropriately, “Sorry to hear that.” When I said it again, she said, “I would give you a foot rub, but I don’t have hands.” Whoa Siri! If this whole therapy thing is going to work, you’ll need instruction in maintaining appropriate physical boundaries with clients. When I told her I was feeling sad, Siri said, “It’s your party…you can cry if you want to,” which I didn’t find that comforting. When I asked Siri if she ever got sad, she said, “This is about you, not me.” Touché, Siri.

I’d like to think I have the upper hand on that whole clinical-intuition thing, Siri. Knowing when to push a client and when to back off, when a client is holding something back and how to help them let me in, and most importantly how to help a client feel comfortable and safe. And you, Siri?

For now, I’ve decided not to feel overly threatened by your plan to expand into my territory. You’ll need some time to get up to speed, and I’m not sure you’ll ever master the tough stuff. I hate to dash your hopes, Siri, and I know my services may cost a little more, but I think I’ve got you beat for now.

 

Respecting privacy: a case example

Have you heard of Elements Calgary (formerly Calgary Association of Self-Help)? Elements provides support to people with severe and chronic mental illnesses, including people who are under long-term psychiatric care. They may have schizophrenia, severe depression, bipolar disorder, or some other debilitating mental illness. These people are often poor or have unstable housing, and sustaining employment, whether temporarily or permanently, is often beyond reach.

Elements provides a warm, supportive environment where these people can socialize with others and access services. They have access to mental health counselling, life skills and vocational training, and opportunities for social interaction.

I have never been disabled by my supermarket-variety anxiety the way these people have been by their malfunctioning brain chemistry. I admire them deeply for plugging along despite their mental-health challenges, and I’m relieved that agencies like Elements are available to them.

PALS visits Elements once a month. Jelly and I have signed up for the Elements visits for several months now. We have met many of the regulars at Elements. These people are often unable to care for a dog themselves, so they’re always grateful for a visit with a PALS dog.

Jelly and I went there yesterday for the first visit since June and were greeted by many familiar faces. One fellow was especially pleased to see PALS. Mr. Success Story shared that he was doing so well he was readying himself to return to the workforce. At one point, his illness interfered with his capacity to work, but he had made great strides in recent months with Elements’ support.

Mr. Success Story wanted us to know how much Elements, and the PALS visits, had helped him through his darkest period. I imagine that he is still alive because, when he was at his lowest, he found an accepting place where he could go. He realizes that physicians and mental health workers may refer clients to Elements without fully appreciating the good the agency does. He plans to find a way to get the word out through social media.

As you can imagine, there are strict privacy rules in an agency such as Elements. We certainly cannot share people’s names or identifying information, and I’ve been so vague that you could walk by Mr. Success Story on the street without realizing I was speaking of him. I wanted to share his story nonetheless because I was moved by it.

The same privacy rules do not apply to us: PALS members are shameless about having our pictures taken. Not knowing this, and wanting to respect our privacy, Mr. Success Story kindly asked the PALS volunteers (human and dog) whether he could take photographs during the visit. I may not like looking in mirrors, especially the side view, but I will pose for a PALS picture with Jelly without hesitation. If Mr. Success Story felt that those pictures might help him to garner publicity for Elements, we’d be in there like a dirty paw. “Snap away!” I said.

Best of luck, Mr. Success Story. You deserve all the credit for how far you’ve come. I’m glad Elements was there to help you along in your time of need.