Catching Hope

Looking for the grace of God that surrounds us

Speaking of hope….

my patients need it.  Or maybe I need it for them.  Can you hope for someone else?  I think so.

My first little boy looked up at me with cracked, dry lips and angry, sad, pain-filled eyes.  His mommy kept stepping out of the room to cry, then come back in to offer what support she had for him.  “It’s so hard,” she said.  “First the refugee camp…we didn’t have food every day.  And the attacks.  Then we come here, and he–”

I administered the injection meant to boost his dwindling white cells, gave him pain medication for the long bone pain that inevitably comes with the cancer, wanly smiled at their pastor that had come to visit and was oh, so glad he was there to offer the kind of support that I just didn’t have the time to offer.  Or just couldn’t figure out the right way to offer it, no matter how hard I tried and wanted to.

My second child, five months old, sat on one side of the floor in her carseat, bottle propped next to her, in a dirty used-to-be-white onsie stained with spit-up and bottle drool.  She was set aside, just about forgotten.  I picked up her seven pound, 12 ounce body and held her close, because no one else would.  Child Protection will come soon….but is there any more hope for her than that?

I forced a tiny tube down the nose of my third patient today.  A little six-month-old, who escaped death by a hair’s breadth multiple times in his short life, and now needs a tube threaded down in to his stomach because somewhere along the lines of fighting the pneumonia, the infections and the IV tubes he never had the time or the energy to learn how to eat.  Alarms beeping, baby crying, mom trying to comfort….and my hands shaking as I hook the monitors back up and spend the rest of the night worrying about how he is.

I try to fight for my patients, try to have hope for them.  But in the utterly terrifying sadness of cancer, the despair of neglect and the gnawing worry of wondering if I made the right clinical decisions and if I really made the gravity of the situation clear enough to the doctor, sometimes I don’t know how.

I don’t know if the heaviness in my heart is sadness, pain, anger, anxiety…or just the love that causes and encompasses it all.  I pray for the love of Jesus to fill my heart for my patients like these, so that I can fight for them practically as well as through prayer.  But sometimes, some nights like these, it seems impossible….

“Speaking of hope,” Jesus says, “I have it.  It is found in me.  I love you, I love them, and my love is NOT despairing or heavy or angry or sad….it is just love.  My yoke is easy and my burden is light….ask me and I will help you to carry them.  And I, the Great Shepherd, will carry you.” (Romans 8:38-39, 15:13, Isaiah 46:3-4, Matthew 11:28-30, Ezekiel 34:11-16, John 10:11, 14, 13:1).

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According to my pathophysiology book….

We are all going to die.

Of something.

Odds are totally stacked against us.

This may seem common sense, however, as I have read further into my pathophysiology textbook (which tells me all about the inner workings of what makes us die), I am finding that to avoid this rather unfortunate phenomena, we must live in a bubble and eat nothing.  Except perhaps the occasional carrot stick and sip of purified water.  [note: NOT celery, despite it’s reputation as the Ultimate Health Nut’s Food.  Apparently even celery can have negative effects, between the high probability of pesticide residue, the relatively high sodium content (if you have high blood pressure, that is), and I might personally add the annoying little strings that get caught in your teeth.]

Here’s the partial running list of odd things I have discovered that contribute to disease.  While occasionally overstated : ), these are documented risk factors for disease, when consumed/experienced in large amounts:

*Animal fat.  Causes disease of the gut, including cancer if eaten in large amounts.  (toss out the lard, folks! guess the Chick-Fil-A cows are right after all….Eat Mor Chikn.  the LEAN kind of chicken.)

*Being tall.  Height and leg length, to be exact.  Long legs have a documented association with cancer.  (Not sure what you can do about this one–unless someone has figured out how to alter the gene pool….)

*Hot tea: in excess it apparently strains your gut too much and can give you anemia.  Pernicous anemia, to be exact, which to me sounds like a cross between a persnickity old woman and some variety of a garden cabbage. (It’s better not to ask where that thought came from, because quite frankly I have no idea either.)

*Steak or other charbroiled foods.  The old saying holds true, if it’s black and tastes terrible, don’t eat it.  (OK, maybe that’s not an old saying.  But now it is.)

*Long-term exposure to cold (we Minnesotans have known this for quite some time.  Then again, perhaps those that move to Florida for the winter have a better practical understanding of this one…) or repeated exposure to vibrating machinery in the workplace.  Both of these can cause spasms in your hands that turn your fingers blue.

*”Chinese-style salted fish”.  (Not even sure what this is). But apparently if it is fed to infants, it correlates with disease of the nose and throat.

*A cold or flu virus.  Those little guys can stick in your system and pop back out to to say hello in new and updated forms such as shingles or mononucleosis.  (Hence, I would remind you of the aforementioned “bubble” living idea…)

*Too much sunshine.  Can cause skin cancer. (I should have added in the introduction to this post that when in the aforementioned protective bubble, sipping organic water and munching on the occasional pesticide-free carrot stick, one should protect exposed skin as well…)

*Not enough sunshine.  Lowers the Vitamin D level.  (Note: to rectify this with the previous post, I guess there is a very delicate balance between not enough sunshine and too much.  Ask Aristotle, the master of the “Golden Mean” of the middle ground…)

And speaking of the middle ground, at least on this point, I think perhaps Aristotle had a good idea–that is of living in moderation.  Some sunshine but not too much.  Some steak but don’t petrify it black.  That sort of thing–common sense living.  Which, incidentally, after all, does not consist of living in a bubble and subsisting on carrot sticks (in my humble opinion, anyway!).  : )

Also, there are some things you can do something about (such as smoking, weight control, avoiding Chinese-style salted fish, etc.).  Common sense living dictates that you modify what can be modified in your lifestyle.  Other things you can’t help, when all is said and done (being tall, for one!).  So, I guess the conclusion is to do what you can to preserve your health (protect your body as the “temple”–1 Corinthians 6:19-20) but understand that we are all fallen creatures under the curse of sin.

This is why, ultimately, we are all going to get sick and eventually die.  It’s really not the excess of celery sticks, the hot tea, or the animal fat.  It’s our sin nature, given to us by Adam when he and his wife ate the forbidden fruit.

But we can rejoice, and not only rejoice but rejoice with HOPE, because the Second Adam has come and redeemed His children–both soul and body.

Romans 5:17:  For if, because of one man’s trespass, death reigned through that one man, much more will those who receive the abundance of grace and the free gift of righteousness reign in life through the one man Jesus Christ.

Praise our Father that He has given us hope!

(All medical facts come from the book, “Understanding Pathophysiology”, 4th Edition, by McCance and Huether, copyright 2008.  Except for the part about celery, which I found after a little bit of internet research on various sites.  Exaggeration and hyperbole directly from The Mind of Kristina Michael, RN, October 2010.)

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The End

I was reading in my Pathophysiology textbook recently and came across a picture…a picture I had to cover up because I could no longer look at it.

At first, it was in some morbid way, fascinating…the gaping wound, the structures beneath the skin that should never have been visible, the hesitation marks on the skin where he couldn’t quite get the courage to do it.

And then I looked harder, for a moment.

He had dark hair–I could tell even though the picture was only of a portion of his neck, because of the remaining stubble there.  I wonder why he didn’t shave before he did it.  If he even thought about it.  Maybe life was so out of control that even something as simple as shaving felt like too much.

From the little that could be seen, he looked young…time had not yet etched itself in to his skin.  I wondered what his face looked like…if there would have been clues on his face or in the depth of his eyes that would have told someone of his pain.

Instead, the horrible truth of what he thought of his life and how it should end stared at me through the page in wet shades of red.

I wonder why he did it.

I wonder if he had people that loved him.  Or if he just didn’t know that they loved him.

I wonder if he asked God why his life was the way it was.  Why it was so hard…why it felt so hopeless…

I covered the picture with a bright pink post-it note.  It didn’t really help the deep, painful, heavy sadness in my heart, because I know what is under it’s florescent opaqueness.  Just as the brightness of the post-it note is now highlighted on the page, his story–and what I don’t know if it–is highlighted in my head.  What is truly etched into the page, under the post-it note, is etched into my heart.  I can try to cover it up, along with the rest of the suffering of the world…

Or I can face the suffering.  Look it in the face, hate the sin that caused it, and pray for grace for this fallen world.

Pray for love in my heart for those around me–love that I say out loud so that those I know are certain that someone cares for them.

Pray for the people who have no hope, that Jesus would shine rays of joy into their hearts.

And pray for Jesus to come soon.

He will wipe away every tear from their eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore, for the former things have passed away.

-Revelation 21:6

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You know you’re a nurse when….(part one)

…you find both an N-95 respirator mask and a thermometer in your purse.  When you never take your purse with you while working.

???

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Chemo and Dragons and Heaven and Such

I was at a little 9 year old’s house yesterday, giving her her very first at-home chemotherapy treatment for her cancer.

She had a soft little stuffed dragon next to her–I asked his name and then commented on his shiny, crinkly wings.  “I wish I had wings and could fly everywhere,” I told her.

“I’ve always wondered som’thin…”, said my little patient.

“What’s that?”

“If we fly in to the sky, up and up, will we bump in to Heaven?”

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Another Day in the Life….

…of a home nursing visit with a little girl I’ll call Ella.

Ella is two.  She is totally non-verbal, because of some special connections in her brain that just don’t work quite right.

But Ella can say more than most two year olds can–without using a single word.

Ella is one of those little girls with a mischievous twinkle in her eye.  She loves nothing better than hearing stories about herself.  She laughs uproariously when she is happy, and claps her hands over her ears and furrows her little brow deep when she is mad.  She runs around the house with abandon, not looking where she is going.  I’ll never know how she has ever avoided a serious head injury.  Some days when I come, she is smiling and lifts up her hands, wanting me to pick her up and cuddle her.  Other days, she scoots behind her toys and looks at me with a totally fake shyness.  Our favorite thing is for her to sit on my lap and play with my hands–move the fingers, clap them together, and repeat.

Recently, I went to see Ella:

9:35 am:  Kristi picks up Ella from off the floor and holds her, so that she can listen to Ella’s heart and lungs.  Ella scoots off Kristi’s lap and giggles.

9:36 am: Kristi talks with Ella’s mom while she tries to capture the squiggling Ella.

9:38 am: Kristi has had success in getting Ella back in to “listening” range.  She tells Ella that she is going to listen to her breathing.

9:39 am: Ella is not breathing loud enough for Kristi to hear through her shirt.  Kristi tells Ella to take a deep breath.  Kristi demonstrates this skill.  Ella’s mom demonstrates this skill.  Kristi and Ella’s mom nearly hyperventilate trying to get the point across.  Ella gets a twinkle in her eye….

9:41 (and 15 seconds) am:  After multiple, repeated, probably-look-ridiculous-to-anyone-watching attempts to communicate that Ella is to take a deep breath, Kristi attempts listening again.  Ella giggles.  Then–silence.

9:41 (and thirty seconds) am: At this point Ella has abandoned all thoughts of compliance…and continues to hold her breath.  As a result, Kristi cannot hear a thing can just about hear Ella laughing on the inside…and mom can see the mischievous trouble in Ella’s eyes.

9:42: Ella can no longer hold her breath…or her laughter.  Kristi is able to obtain all needed information while Ella inhales to laugh.

On another occasion, I visited Ella’s house because she wasn’t feeling well.  I picked her up off the floor….

6:15 pm: Kristi picks up Ella.  Ella’s mom tells Kristi all about how Ella has been vomiting and not eating much today.  Kristi and Ella’s mom joke yet again about how Kristi has, as of yet, avoided the product of Ella’s rather impromptu, frequent, and unexpected bouts of throwing up.

6:24 pm: Ella’s mom continues to tell Kristi about how Ella is doing. Ella is playing with Kristi’s hands, smiling and nodding with big, sweeping head movements–as she always does when she hears stories about herself.

6:25 pm:  Ella hiccoughs.  And promptly vomits all over Kristi’s jeans and sweater.

6:26 pm:  Ella, glitter in her eye, laughs.  Not just a little, under-her-breath giggle, here, friends.  We are talking laughter.

Coincidence?  I think not.  And, of course, as a nurse who would never condone such acting out of behavior, I promptly burst into fits of laughing along with Ella’s mom solomnly cleaned up Ella and myself.

Oh, the joy that children bring…and how we underestimate them.  May we always have the eyes to see them as Jesus does–and may we be touched by their ever-abundant joy!

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Tears of My Own

I often find myself catching other people’s tears.

I catch the tears of mommies and daddies, as they cry for their children.  They cry for the pain that they carry every day as they battle….whether it is a temporary, transient illness–or something that is slowly killing their babies.  I try to walk with them, to hold them, to ease them through…whether it’s through their newborn’s sleepless first night at home or through their teenage daughter’s leukemia.  And as much as I can, I catch and hold their tears for them.

I hold the tears of their babies…sometimes while I fight to force a tiny needle into their tiny leg muscles.  Sometimes I pass a tissue to catch the tears as they adjust to the pain of a chronic illness.   Sometimes I don’t see their tears, but I can feel them in the air, heavy and unspoken.

I catch their tears.  Sometimes literally in my hand.  Other times in my heart. It is a gift, a very precious and unique gift, to be able to do this.

But sometimes, just sometimes, as I bottle up everyone else’s tears and tuck them away in my heart for safekeeping, I find (as the country song goes), that I’ve got some tears of my own.

And then I find an even greater gift–when Jesus takes my tears and tucks them away in to His heart.  He is the perfect tear-keeper.

“You have kept count of my tossings; put my tears in a bottle.  Are they not in Your book?” (Psalm 56:8)

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They Can Cry

I was struck today as I was doing some charting–I have a couple of patients that have severe brain damage and are minimally responsive. On rare occasions, they can manage a smile–which is more than many families can say about their children.

But what struck me was how easily and readily they can cry, in comparison to when they smile.  They cry when they hurt, when they have an unmet need, when they just don’t feel good–and, I suspect, when they feel trapped by the bodies they are in.

It reminds me of the image of God in them, when their raw emotions are showing through. It gives me joy when, with great effort, they smile…and saddens my heart that their tears seem to come so much more easily than anything else.

My heart longs for the day when there will be no more tears…and the day that, by grace, these two precious children and the thousands like them will have new bodies and faces that smile, freely and easily, as they rejoice in the arms of Jesus.

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In His Image…

Just a thought, as I gently placed my stethoscope on the chest of a seventeen-year-old boy a few days ago.

His body is deformed, little tiny legs and arms have contracted into awkward angles…his face shows very little, if any emotion.  His head is swollen at the crown in a huge, awkward protrusion.  His eyes appear blank and his mouth, instead of being used for talking and eating and smiling, pools with thin secretions from his barely-functioning lungs.  He cannot move on his own, except to occasionally shake violently with muscle tension and seizures.

And yet, through it all, this young man is in the Image of our Great God. His mother loves him dearly–our God loves him even more. And in His wisdom, He allowed for the oxygen to be cut off from his brain during birth, causing his current state. Everything, every single act, every single creation, that our God does is good. This young boy is in His image, for His glory.

And he is beautiful.

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To grieve

I’ve lost three of my kids in the past three weeks…and one more is very sick and in the hospital.  (Prepare for a few, completely scattered, thoughts.)

Sometimes it’s easier not to process things, then to look them in the face and allow yourself to feel.

I have always been one to ignore things I probably ought to process.  Repression, I think they call it in the psychological world.  (You know, one of those startling moments in your abnormal psych class in college where you sit there and think, “I DO that!  I thought I was normal!!”)

Quite honestly, though, seeing the hurt that surrounds us (for me, in my job; what we all are seeing from Haiti, the loss and grief that occur with just going through life), how does one get through a day without restraining at least some of what most people would consider “normal” emotions?

Not sure how healthy it is though.  Sometimes I feel rather heartless. like a stone statue in a cold and snowy graveyard.  Casually mentioning an item of interest from the day–you know, “I slept late and almost missed work…I ate tuna fish on rye for lunch…oh yeah and so-and-so died.”  Something is not right about that.   But when I say it, I hope that whoever is listening understands.

Understands that deep inside, there are feelings.  It is not always best to process the full extent of our own feelings within a given situation.  It is often too overwhelming to try to process it later.  But it is there, somewhere.  And will most likely come out in some way later.  And it, in no way, is meant to diminish the pain of those who are suffering.

Grief is never easy.  But we as believers in Jesus do not grieve as those who have no hope.

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