42

42, the Answer to the Ultimate Question of Life, the Universe and Everything. This is truth according to ‘Hitchhiker’s Guide to the Galaxy,’ anyway.

Today is my 42^nd birthday, and I have to say I kind of agree with this statement. My youngest sister Kate brought the above snippet to my attention, and it’s been making me smile nonstop today.

My birthday has been spent on my sister’s farm, sitting outside on a rocking porch swing watching huge carpenter bees buzz by my face, listening to the sounds of frogs and other creatures I’ve never seen, and watching creepy turkey vultures circling some poor animal out in one of the fields.  This morning, standing in the shower looking out the window, tears streamed down my face, as I saw a blue jay for the first time…and it was so magnificently beautiful. I am holding out for a screech owl (which, I hear are oddly small and cute), and the experience of thunder and lightning (scheduled to be showing up past the midnight hour tonight).

Earlier in my life, when I went to visit new places, I sometimes used to long for that lifestyle to be my own. It’s easy to romanticize something far different from your own way of being and living. This is one that tends to stick with me however…a quieter life at a quieter pace. Mindfulness is easy here-the succulent taste of a sun warmed strawberry against my tongue, the sensual pleasure of closed eyes and a perfectly warm breeze rippling my dress against my legs, and whipping my hair against my face, the utter ridiculousness of looking at said hair in the mirror after a day in humidity has turned it into a blonde cloud of frizzy poof.

                                                                                

Staring over at irises in the garden swaying in the breeze as their shade of purple interplays with the greens and blues of other plants, my mind drifts to Vincent Van Gogh, and I imagine him a couple centuries ago, trying to capture their magic on his canvases. Then, to early perfumers who have tried to capture the scent of the beautiful flowers. Isn’t that the reason so many of us love scent…it ties us to memories and remembrance.

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Yesterday, I went shopping for some Levi shorts and grabbed the size I thought I wore, and was twice incorrect. I fell down on the floor of the dressing room and started laughing hysterically when I slipped on a pair of size 0, and they fit. It really was literally hysterical, due to a resolved twenty year thinking error that the right dress size was somehow going to make life better.  After many many years hating (and I do mean hating) my body, I was finally exhausted enough to throw down the white flag and surrender. Sadly, it took going through brain cancer to give me a complete body image overhaul. My body suddenly became something I cherished, and wanted to protect and nurture. 

It was likely I was going to suffocate or fly off the handle with rage if I had to hear one more woman say, “I was so bad yesterday, today I have to be good” when talking about eating food or a pleasurable food experience. Inadvertently, I was a member in a club I didn’t want to belong to-the ‘happiness is out there, and eludes us, and we can’t be happy with ourselves until we are at this place, and this size, and someday manage our food self-control…” I made a simple decision not to drink the Kool-Aid of
lies and misery any longer.  

This happened by reading books written by women I believed live well, and those who have demonstrated they know how to love living their lives. I made an effort to adopt the behaviors and practices these women engaged in, into my own life, and tried to live as they live. It involved an end to any form of dieting or restricting certain types of foods. I practiced mindfulness, I fixed my inner monologue and the way I spoke to myself, I challenged my irrational beliefs and expectations, and I planted a metaphorical garden of forgiveness for some things that needed resolution in my life (obviously not a real one…I kill plants). I took on the responsibility of my behavior as totally my choice-my actions formed my habits.

Over the course of two years I learned how to heal my body and mind, and God gave me the grace to move into a new stage of life. Lab results were not ignored- I hopped onto thyroid medication and bio-identical progesterone, and realized I was not powerless to change my health, and couldn’t blame genetics, my thyroid, or anything else in my life. I could become the woman I wanted to be, with determination, putting forth effort every day, and not getting stuck or stagnating when things were difficult. In my mind, it all comes down to wanting one thing more than you want the other. I wanted health more than I wanted the immediate comfort of trying to fill a void with food. The self-control to have a little of something delicious more than mindless excess began to come fairly easily.

I began cultivating things I wanted to learn about. My schedule is usually jam packed, and it’s difficult to find much free time at the moment. So, I work it into my life in small ways...ten minutes of my lunch break is often spent reading a new page about an author, or an animal, or listening to a snippet of an audiobook I like. Each day, I find little ways to create small pockets of joy and learning.

Most of all I think you have to have a really good sense of humor and playfulness to navigate suffering. As I was sitting on a grassy knoll this morning, my best girlfriend Christi called to wish me a happy birthday and to catch up.  Suddenly, a Fed Ex truck came speeding up the dirt road.  In happy exclamation, I said to Christi, “Oh yay, my padded underwear is here!” She took a moment to make sure I was saying what she thought she heard, and we burst into peals of laughter, while I explained…well, we can’t control where our bodies lose weight, and unfortunately, mine was lost from my bottom-to the detriment of my physical comfort. It actually hurts to sit down, because my bottom is really boney now. So, the other week I Googled, ‘how to help boney butt pain,’ and up came the suggestion of padded underwear.” The side-splitting laughter that ensued made a wonderful memory for us. I mean, we’re not talking crazy Kardashian level padding or anything, just enough to be able to sit down comfortably without pain. 

My goal over the next year will be to find some exercises I enjoy like Pilates and hiking to get stronger. Physical health is directed so much by our mental and spiritual health.  I had to learn this lesson pretty far into life- but I know that there is a potential I could live through several more life stages. If I live until 84, I have four decades of adventures and experiences ahead of me- I want to get there in the healthiest best shape I can.

I am quite glad for the lessons of cancer. That probably makes some people bristle- especially those who are dealing with it in some form in their lives-themselves or a loved one etc.  For me, it completely turned my life around. It took me to the deepest recesses of my soul, it turned my life inside out, and it solidified for me that love and connection are the most important things I need for the rest of my life. I was able to learn lessons that some people are not able to learn until they are elderly or on their own deathbeds.

I tell the teenagers I work with, “I wish I could go back and say xyz to my teenage self,” or “I wish you could hear this lesson that is important for you to know.”  When I have spoken with my friends who wish they could go back and say “xyz” to their 40 something selves…I have listened. I have taken the wisdom that many decades more of life has taught them, and I have adjusted my sails accordingly.

This birthday does feel like the perfect age to me. Staring down at the long scar marking my right thigh, my hand runs across it with calm satisfaction. I am more beautiful this year as a woman than I have ever been-strong, resilient, faithful, wise, silly, kind, smart, loving, playful… and, this beauty...has nothing to do with my pant size-that’s the hilarity of it all. This beauty comes in finally being at peace.


Celine's Dion's song 'I'm Alive' is my theme song for the year ahead. 

  

For Becky

I stared at the blinking cursor on my screen and had a moment...imagining all the people around the world simultaneously staring at their computer screens and blinking cursors...all the different languages and countries, homes and offices, and the pause before each writer began to type.

My hesitation, due to the fact that what I write won't do justice to the woman I am writing about. It's difficult to write about truly extraordinary people. Accomplished people are easy...rattling off a list of things they have done which are impressive and easily esteemed. But, to write about a truly extraordinary person is almost impossible- because capturing essence and lightness of being...forced into paragraphs, fails to convey the magnificence of who the person is. In this case, a woman of rare all encompassing beauty. A wife. A mother. A teacher. A friend. A mentor. A fighter. An inspirer. An encourager. An artist. A soul so imbued with kindness and love, as to leave indelible marks on all who crossed her path.

So, this is for you Rebecca Jackson Schwartz. My dear friend...as I sit at my computer with tears streaming down my cheeks, as my heart sends all the love it can in prayer, across the miles, to be with you in the twilight. I know you would smile at me, at Katy, at all of us...and tell us to seek what is most important in this life- to live well, to live in love, service to all, goodness, and kindness toward others.


For Becky: Beautiful sparkly brown eyes shine with love, and a smile that makes everything feel softer and eased.

For Becky: A fellow foodie, and an extraordinary chef and baker. She can make the most simple dishes look elegant and beautiful, and combines perfect flavors for discriminating palettes!

For Becky: Who taught me from the first week of my own cancer diagnosis, what my attitude needed to be to fight for my life. She reminded me that God had us in His grand design and plan. She taught me how to love others in suffering, how to surrender, how to be courageous, and how to have real hope. She taught me I could control my responses, when I couldn't control anything else. She taught me to try to do everything I could to live, but not to be afraid if I was being called home to God. Most importantly: she taught me not to lose my laughter, and demanded I laugh through the pain to survive it.

For Becky: Because her heart pitter patters as much as mine does for our Colin. For the days when I didn't have the energy to pick up my own phone or read a text. But I could smile through a medicated haze, hearing, "Look, Becky sent you a photo."  It's my turn to return the favor dear girl. 

For Becky: Who has loved Katy since high school. Who has been with Katy in the depths of pain as she struggled to cope with her best friends having cancer at the same time. Becky, who will love Katy through the rest of this life and all of the next. Becky, who will be in the stream of sunshine warming Katy's face, the moments of glad grace, and in all the stories about you, that Katy will save for your sweet son. Katy will carry your heart in her own.

For Becky: Who has lived this quote perfectly. Who fought cancer year after year after year, pain after excruciating pain, surgeries, treatments, chemo after chemo, in love and in gratitude. Who listened to me cry as I wished for a brief moment that I hadn't survived, because the physical pain was so overwhelming. Becky who calmed me as I said over and over, "How have you done it, Becky? How have you pushed through this? How do you keep the light in your soul?" Becky, who forced me to memorize this and live it with her.

For Becky: Who could keep a sense of humor in the worst of times. Who fought for justice for others with passionate resolve. Becky, who could bring kindness to anyone, who listened patiently, and who has been doing this every day I've known her. Becky, who many describe as, "the kindest and most loving person they've ever met."

For Becky: For the five minutes in which our entire conversation was a departure from our norm, singing a song to ourselves on the phone, with lyrics solely consisting of, "Fuck Cancer, Fuck Cancer, Fuuuuuccck Cancer!" (In a round)

For Becky: Who has an indomitable spirit, who has not given up, who has taken hit after hit, maintaining gratitude for her life and joy for the gift of living. Who reminded all of us, "You don't have to have physical health to be happy, you have to have love. If you have love, you will have a great deal of gratitude, joy, and peace."

For Becky: Who is the personification of this four-leaved clover 

For Becky: I will sing and pray the psalms of your beloved Tehillim for you, when you are too weak to lift your voice. I love you sweet friend, and love remains eternal. 

Psalm 102

O LORD, hear my prayer;

let my cry come before You.

Do not hide Your face from me

in my time of trouble;

turn Your ear to me;

when I cry, answer me speedily.

For my days have vanished like smoke

and my bones are charred like a hearth.

My body is stricken and withered like grass;

too wasted to eat my food.

Psalm 130

A song of Ascent

Out of the depths I call to You, O Lord.

My Lord, hearken to my voice; let Your ears be attentive to the voice of my pleas.

G‑d, if You were to preserve iniquities, my Lord, Who could survive?

But forgiveness is with You, that You may be feared.

I hope in the Lord; my soul hopes, and I long for His word.

My soul yearns for the Lord more than [night] watchmen [waiting] for the morning, wait for the morning.

Israel, put your hope in the Lord, for with the Lord there is kindness; with Him there is abounding deliverance.

And He will redeem Israel from all its iniquities.

 

Snapshot

     It's Framily Dinner night and several families are gathered for a communal meal and fellowship. I am sitting in the corner on a couch making a list of things I need to do the following day for work.  My friend walks in toward the latter part of the evening, with his beautiful wife, and precious little daughter. It takes me a moment to notice he is walking free of the crutches that have been his traveling companions for many moons.  He sits down next to me and gives an update on the current condition, prognosis, and pain level of his knee. It is the first time I have seen it without the usual swollen marked red angry inflammation. My friend was hit by a drunk driver, almost two years ago, while on duty as a police officer. He is still recovering and healing from the injury he sustained.

We begin to discuss very very very important things, such as the

multiple colors of kryptonite and the various powers and attributes they each possess.  In my best (I wish I was only feigning being this nerdy) 'Can you believe it?' voice, I chide, "some people don't even know there are other colors besides green and red. Sad, really."   We move on to debate Batman vs. Superman, a movie which I refuse to see on principle. I don't want to watch the good guys fight each other. It feels like superhero betrayal. My friend is trying to convince me otherwise about the film, but I am not budging. The subsequent areas of pressing analysis include critiques of Doomsday, Bizarro, Lex, and Zod. Then...I throw in my perpetual tangential issue of angst-the incredibly anticlimactic death of Captain Kirk (original series).  I am speaking in a fairly quiet tone, so that others in the room won't hear me talking about this. You know...so I can control the narrative of the level and type of nerdom I am willing to publicly acquiesce to. ;) 

His wife plops down across from me and I quickly switch gears as she and I begin gabbing and fangirling about two of our favorite shows currently on the air. Our hostess spent time working as an actress on one of the shows, and she joins us for a momentary recounting of fond memories and cast stories. I smile to learn my favorite I'm-not-a-doctor-but-I-play-one-on-TV is exceedingly kind and sweet in real life. I knew it! 

My heart warms as their precious little daughter brings over a Russian nesting doll, and lets out peels of delighted laughter as she discovers there are more and more dolls inside the largest doll.

(The next part of this post includes a graphic depiction of events, please discern before continuing)

Last week, I was laughing to myself as I read an article highlighting my personality type on the Myers Briggs (INFJ) as the least likely to successfully work in law enforcement. I am prone to agree. My time working for our local police department was a bit of a square peg/round hole fit...but it was also an invaluable experience that shaped me in the way I now look at and analyze many situations. There remains a depth of loyalty and altruistic care for the coworkers I spent 12 hours a day with...that is unwavering, even years after my time with them has passed. 

'We became friends at work,' seems like such a nonchalant statement. It's true, but it's barely descriptive of what that initial experience entailed. As I watched my friend quip brotherly barbs with another officer in the living room, my mind flashed back to the night I met him. A night that is seared in my memory, and one that has continued to have an impact on my life since then.

When I was fairly new to the police department, I was assigned as a rider to my friend for a (aptly named) 'ride along.' This constituted spending a night shift in a patrol car with him as he responded to emergency calls around our city. The idea being...it is an opportunity to see what the officers encounter while they are out patrolling the streets. We were going to be covering one of the highest crime areas of town.

Even though I understood the seriousness of what the ride along would entail the week prior, I don't think it really clicked for me fully until I was strapped into a bullet proof vest, walking downstairs for shift change. A kind of gravitas descended over my demeanor, followed by a nervous stomach, as I walked into that crowded room.

Sitting in the patrol car, he gave me a safety briefing, described a general overview of the night shift, ran me through the various firearms should we find ourselves in a life or death situation, and explained how to radio from the car if he became gravely injured. That was definitely a sobering moment.

Shortly into the shift, there was a report of a possible dead body in the trunk of a car. I still remember my mental self talk as we sped toward the address, "Okay, you'll be staying in the car for this, but you'll probably still see it. This will not be your first time seeing a dead body. You've seen several before. You've got this. Don't make his job harder by freaking out. Be cool."

Thankfully, it turned out to be an unusually large bag of gardening soil! We responded to a few other unsavory calls for service, and a couple that didn't need police assistance because they were civil matters. It's funny...most people don't realize how much of the work police officers do involves using well honed social work skills. Among the many hats they wear-social worker is right up there; they spend a significant amount of time providing brief counsel and resources to citizens.

Then, we went to the call. We ran code (lights and sirens) until we were in close proximity to a dimly lit large apartment complex. Exiting the vehicle, he beckoned me quietly to get behind him. I realized he had drawn his firearm. It felt like a surreal moment of déjà vu, plucked directly from scenes played out in movies and television shows. We walked up a couple sets of stairs, as he cleared each area, and we met his partner on a landing.

(Medics stage for their own safety before attending to injuries on scene. The police officers assess that a scene is safe, and then EMS can come in to treat the wounded)

We could hear the screaming/sobbing of a woman's voice as we approached the apartment door. The sight that greeted us was by far one of the saddest things I have seen close up. As we entered, there was a behemoth of a man standing in a bedroom doorway, wearing a pair of underwear. There was a short, thin, fully clothed man arguing with him. And, on the couch, was a young woman, clad in skimpy lingerie, sobbing, and covered in blood. My mind felt like it was underwater as it was trying to piece together what I was seeing...a pimp, a john, and a trafficked woman. I watched my friend and his partner move toward the men to arrest them, and my eyes turned back toward the woman. I glanced down at the box cutter lying on the table and realized she had vertically slit her arm from her wrist all the way up to her elbow. Time seemed to move exceedingly slowly, though in reality it probably wasn't more than a few minutes passing by. I remember my friend briefly nodding at me, as I was pulling black disposable gloves out of my pocket and walking toward her. I held her arm up, trying to put pressure onto it to stop the bleeding, and made a little pseudo tourniquet out of one of the other gloves, until the paramedics could assist her.  Her eyes pierced into mine with desperate pain and terror, as she rocked back and forth sobbing the words, "I want my mom! I want my mom! I want my mom!"

As I looked at the suspects in the corner, I felt imprinted with a new truth, "this will always be my memory and reference point on the subject of pimps and johns." At that moment I felt hatred for the two men, bearing no desire for justice, rather...some semblance of vengeance.

My friend and his partner, charged and arrested the two men. I felt a little awed that they could both respond in a perfectly calm and professional manner. The paramedics pulled away in the ambulance, treating the woman for her injuries en route to the hospital. I don't remember the other calls for the rest of that ride along. 

Being present at that call changed the trajectory of my next years of academic study-to focus specifically on vicarious trauma and complex PTSD. It changed the way I responded to an officer at the end of his or her shift, when I needed paperwork, but recognized they might be walking into the station from a truly terrible event, needing a few minutes to breath... There were subsequent ride alongs with other officers, the witnessing of different abject horrors, but none of them stuck to my soul like this one did. I've wondered on and off throughout the years if the young woman ever found a way out of her terrible situation, or if she ever found any peace in her life. She remains in the litany prayer of my heart.

A small hand reaches up to tickle my face with a rainbow fiber optic toy and my mind snaps back to the present moment. Mischievous brown eyes stare up at me, accompanied by a miniature grin, and bubbly giggles that fill the room with joy. The little girl in front of me has discovered her power of making rainbows appear on faces. Her enthusiasm is contagious, and all of us smile and giggle in unison at her antics.  She turns to look at her dad. "Be a pony! Be a pony!" His wife and I exchange a grin. My friend's face is relaxed and happy as he plays with his daughter. The only thing he needs to be vigilant about tonight is dodging rainbows to the eyes.  

In The Land of White Bandages

These are a series of vignettes I've written over the last several months. 


Our country's most successfully decorated Olympian: 
Michael Phelps 

Did you know Michael reached a point of severe depression, in which he seriously contemplated and planned his suicide? He had been smoking a lot of marijuana, was consuming alcohol excessively, and then proceeded to get arrested for driving while intoxicated. These events all played out in the public eye. In his own words: 
In the immediate aftermath of that DWI arrest, I cut myself off from family and other loved ones and “thought the world would just be better off without me ... I figured that was the best thing to do — just end my life."

At the age of 30, before her worldwide fame and renown, J.K. Rowling, author of the beloved Harry Potter series, had survived an abusive marriage, was divorced, diagnosed with severe clinical depression, and also reached a point of seriously contemplating suicide.

I can't remember when I started sharing these stories in my groups-but I've watched the shame abate from the eyes of many (teenagers especially) as they recognize fame and achievement don't serve as effective remedies or masks against depression and distress. As they imagine a reality in which Harry Potter might never have been penned, there is a little spark that does not go unnoticed as they begin to recognize their own lives have many chapters ahead to unfold.

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       At the first hospital, I watch the patrol car pull up outside. One of my former coworkers comes through the sally port door with his partner, escorting my patient. He gives me a professional nod and the slightest trace of a smile. We are too focused on the situation at hand, to be distracted with small talk or catching up right now.  "10-15, attempted 11-28 in traffic, 38 history" the officer says to me quickly, quietly, and solemnly in policese. I nod sadly and step out of the enclosure to consult with one of the other clinicians, and to grab the breathalyzer. When I reenter the sally port, our PNA is preparing to wand the patient and lead them through the metal detector. I begin my introduction and spiel: "If we take these handcuffs off, I need to know you aren't going to try to hurt yourself, or hurt any of us...will you agree to that?" 

After the police officers exit, all of my senses are honed and heightened as I watch for any signs of danger. The team is aware of where we are each standing, our proximity to the patient, and our hand positions. The initial clinical assessment is brief and needs to be very accurate. My team needs to be kept safe, the patient needs to be kept safe, and my clinical judgment needs to be thorough and sound before I give the okay for us to proceed into the hospital. Adrenaline rushes through me as I gauge for lucidity/psychosis/mania/acute drug withdrawal...any sign that violence could be imminent.  Imposter syndrome makes a momentary entrance into my psyche and shivers its way down my spine, and as I mentally chastise myself for the defeatist thought, it passes as quickly as it came. "St. Michael, the Archangel..." My silent prayer is always the same as the door closes behind us, and we all walk down the hallway toward the evaluation clinic.  

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       At the second hospital, the following day, it is a sunny dawn as I pull into the parking lot. Par for the course, I've already spilled a little coffee on myself (truly, a daily occurrence). A momentary rush of love warms me as I walk past the Jesus statue, with his arms outstretched like a welcoming orchestra conductor. "You and me, Lord...give me your strength for the day, and guide my words and actions."

It's a little sacrilegious, I know, but sometimes I imagine the statue is animated, giving me a little wink and thumbs up (like the buddy Christ from Dogma) complete with a "you got it, babe!" 

I make my way through the doors, as various doctors, nurses, technicians, and other hospital personnel rush past me through the hospital corridors. As I walk by some of the bleary eyed night shift staff, I am tempted to give them a high five as we pass one another. They hand us the metaphorical race batons with a "tag, you're it, go," as we prepare to sprint our leg of patient care. My hand moves up to my forehead to make the sign of the cross as I rush past the chapel. An unknown coworker smiles and beckons to me from the elevator she is holding.

My spirit is very tired today. Of my own doing. I haven't taken a day off in a long time between the two hospitals, and the much needed über introvert alone time to recharge has been fleeting. There is a secret spot on my floor, to be alone for a few minutes nestled amongst some plants. I begin to pray for the patients I am about to work with that day. My thoughts drift to some former and current coworkers from several agencies who are participating in a suicide awareness event tomorrow. 

As my eyes close, a rolodex of names flips through my mind...all

the patients and clients I have worked with over the years who have completed suicide. The many souls I have privately mourned in my HIPAA shrine of solitude...tears and prayer as I've read about their deaths through the years...or watched their faces staring back at me from local television newscasts, or heard a coworker whisper to me at shift change, "so and so was found dead last night." Internally, I scream. Internally, I weep. Internally, I feel defeated and curse the darkness. Externally, I convey barely perceptible emotion, a deep sigh and slow metered head shake left to right. The conversations often feel like a hellish version of Groundhog Day. "What?" I exclaim to the nurse.  "So-and-So was just here a month ago, and was doing so well!"  "Yep," "I know," the nurse responds with heavy familiar resignation and her own obligatory head shake. Duty affords us only that brief exchange and acknowledgement, as we each have pressing patient duties to attend to.  I stuff the news down somewhere in my compartmentalized mental landscape, to deal with later.

There was a facebook post on a friend's wall called 'describe your job in a sentence.' What popped to my mind was "cheerleader against death, in the land of white bandages."  I didn't post that on the social media thread. It's morbid. It's gallows humor...a way to joke and make light, a strong mental defense, so as not to drown in the sorrow of so many peoples pain. 

It hurts, Anastasia. Everything hurts. Tears stream down so very many faces. My eyes have grown accustomed to the sea of bandages; to the carved up arms and legs, to the ligature marks around necks, to the seizures from the toxicity of overdoses, to injuries I never fathomed before being here. When they tell me everything hurts, they are never referencing just their physical injuries. 

Life is hurting. Living is hurting. Everything seems like too much, and they are so weary and bone tired of fighting to live one more day of painful misery. Sometimes, they vent and dump their rage and sorrow that they were unsuccessful in their suicide attempts. Furious to have woken up on the other side of an overdose, a crash, a hanging, slit wrists. Often embarrassed, they feel deep shame at what their families and friends will think of them, and what they have tried to do to themselves.

The next few weeks will involve helping each of them to come up with plans to support their recovery, to attempt to inspire them to hold on one more minute, hour, day, through the depths of the gripping darkness...to convince them there are reasons to have hope for the future. Our teams work diligently to provide the best care we can. We strive to be effective healers, empathetic listeners and encouragers, and try to provide connection as they grope their way out of the blinding depression/anxiety/mania/etc... 

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       Sometimes, I feel like a sommelier of suicidality. This type of therapy for major depression with suicidal ideation...that type of therapy for borderline personality disorder with suicidal ideation, this intervention for mania or psychosis with suicidal intent.  It's really tough work...individualized trial and error to help someone find the right breakthrough and will to keep holding on.  

When I was much younger, people would often praise me ("I don't know how you can do that job, I could never do something like that!") for work that involved exposure to a lot of horror/suffering and things not spoken about in polite society. Their words once spurned me on to work harder...mentally arming myself with a badge of determination-tough, hardcore, able to withstand whatever was thrown at me, bring it on! It fed my pride quite terribly. But, I was naive, and ignorant then, and blithely unaware of the cumulative effects of vicarious trauma that would level me several years later.  

Now I am much older, painfully wiser, and incredibly realistic. I am in a profession that breaks my heart all the time, in a vocation that once in awhile leaves me crying alone in a utility closet after I've simply heard and sat with too much pain. But I wouldn't change my life in the trenches, nor the ability of keeping my heart soft, open, and malleable. I never want to be able to look into a pair of broken eyes, and listen to a shaky voice telling me about what it was like to be trafficked, while possessing the capacity to return that gaze with a blank stare, and a deadened internal response of numbness. The day that ever happens, is the day I need to walk away from this work.  

Time has taught me not to bottle the pain of what I hear for more than a day, and it has also stripped away any vestige of belief that I am super human in what I can handle. Sometimes, I simply need to cry, pray, listen to music, go for a drive, and then I am fine. I've learned to cling tightly to all the simple joys my life affords me, and diligently and unapologetically practice self care.   

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       One of my dearest and best friends is perhaps the most naturally empathetic man I've ever known. He might argue that being true, but it doesn't change the fact that he is. I lovingly call him 'a real life Gilbert Blythe' (If you've seen Anne of Green Gables, you'll be able to imagine the level of kindness and goodwill he possesses toward others). After grueling work weeks, I will habitually begin a lunch excursion with him by exclaiming in exasperated frustration, "I'm done! To heck with this! I'm going to go work at Nordstrom!" He will usually smile at me with an amused and knowing expression and join me in a sigh. He gets it--- as his vocational demands, and the suffering he has to sit with are equally grueling. 

Once, when I was ticked off that God kept putting so many people in my path when I was feeling like an empty cistern, my friend said very matter of factly, "Anastasia. There is no vacation from vocation." 

It is a sentence I repeat to myself often when things really sting or my heart is particularly black and blue. The phrase reminds me that this isn't my work at all...it is God's. I may be one of the associates in the vineyard, but I am neither the vigneron, nor the vine. 

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       Awhile ago, a woman I had worked with since her early childhood, (through various agencies) completed suicide after taking another's life. Thinking about this woman through the years has bothered me for the entirety of my adult life. When I met her as a child, and after spending time with her, she went quickly into the category of "child I had no idea what to do with, or how to help." I was once in a situation with her when she was a teenager, in which she got a hold of a weapon, and had an opportunity to take my life, had she been so inclined.  Because I was a constant figure in her life (one of the few), she chose not to harm me. But I will always remember watching her eyes make the determination as to whether or not she would follow through. She chose to hurt someone else later in the day.  

I believe we are made in the image and likeness of God, and that we are each inherently good. Yet, there have been a handful of children I have worked with over the last twenty years that seem to contradict that truth in every manner possible. It's not merely a matter of traumatic experiences and attachment issues shaping their reactions, nor merely a lack of empathy in their character; not even demonic possession...rather, it is an absolute and sheer delight in harming others, seeking violence at every turn, with no traceable or discernible qualities of what it means to be human. To cope with exposure to this thing the mind cannot process, I used to semi-joke, "well, Ted Bundy didn't wake up an adult. He was a child, and those lacks would have shown up for him in childhood as well."

Once, a coworker strongly upbraided me for saying that I believed this little girl was going to grow up to become a monster. What an absolutely heartless thing for any decent person to say about a child...especially after multiple paragraphs of me waxing poetic about empathy and hope. But I have worked with thousands of traumatized children with emotional disturbance, and there remained a handful, the one percent extreme that I could never internally reconcile or ever be at peace about. 

She did, in fact, leave a tornado in her wake, and sowed seeds of destruction and violence everywhere she went. She committed horrible and heinous crimes, society loathed her, everyone who worked with her eventually gave up on her, and some even wished her ill. I spent years praying for her, knowing with certainty that she would die by her own hand, or someone elses very early in her young adult life. I remain haunted that some of us could see her trajectory from the time she was a small child, and could do nothing to stop it-or stop her. I am haunted by the theological confusion she caused for me for so many years. I am haunted that we were right about her early death, and I am haunted imagining what her last moments on Earth were like. Haunted, until one day, finally choosing in my utter powerlessness, to turn her over completely to God's mercy and providence. 

Age and wisdom bring freedom from the bullshit they teach you in school, "you must never take your work home, because if you're thinking about a case on your off/personal time, it means your boundaries aren't strong or solid enough."  Granted, cases shouldn't be invading one's thoughts frequently or daily on off time, but if one's profession is to be steeped in tremendous suffering, if it is to really connect with other humans in their pain to steer them through darkness, if it means hitting your knees every day pleading with God to do something to help them, for grace...in their anguish, the chance of it always being nicely contained and wrapped into a small eight hour bubble is very slim. Especially, when you see and work with the same patients/clients throughout their lifetimes.

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       There have been and continue to be many beautiful moments encapsulated in my heart and in this work. I pause in the grocery store as a former adolescent patient bounds toward me with her friend. "OMG, that's totally my therapist! She's so rad."  I can feel myself grinning uncontrollably from ear to ear at the compliment I overhear...what higher praise from a young one? She excuses herself from her friend and before I know it, she throws her arms around me in an excited hug. She whispers to me, "I'm doing really good. Really. I mean it. A lot better! SO much better than before." She smiles at me warmly, waves, and skips off with her friend in a fit of teenage giggles. 

And I keep smiling to myself the rest of the way home.