This is where I live. Where I can hear the ocean. I walk the paths of my childhood dreams. Over the hills of green and brown I follow the footsteps of my ancestors. The ancient redwoods tower over me and protecting. Winding picket fences, lichen and jade moss covered following the contoured land - the spine of a dragons back protecting its treasure.

Metta Institute.org

From Charlie Garfield:

Listen from the heart
Speak from the heart
Act from the heart

View from my window

Metta Institute.org / Creative Collaboration / April 3, 2013

Aloha -

I am attending my third in a series of about 8 retreats / teaching for End of Life practitioners (people involved in hospice or palliative care) at the Santa Sabina Retreat Center in San Rafael, California.  It was a beautiful day and a real treat to drive up here from San Francisco.  San Rafael is beautiful - I would love to buy a house here!  So do many people and this is why it's so expensive.

This third course is about creative collaboration.  We talked for over an hour or two tonight about what are some of the barriers to collaboration at our various workplaces.  Over and over people mentioned many of the same things.  What struck me about the SFVA ER was that we share much of what was mentioned.  For example, people's communication styles (IF they communicate), our own ego's (is it about what they want or what the patient needs?) and much, much more.  Too many to list this late in the evening.

It felt very right to be here again though as I walked in.  We have over fifty people what are taking the full eight courses and all in all it is an expensive (but fair!) proposition.  I am paying for this out of my own pocket and it is over $8000!  But I knew without any doubt after the first few hours last year that it would stretch, challenge and teach me. 

Seeing familiar faces helps.  After all, there is a bond among those who have been around so much death and suffering and yes, joy.  It's a package deal after all. It is not for everyone.  Sometimes it is not for me yet I do it over and over again.  We all get there, some slow, some faster.  It's nice to have someone there who gets it, who can help not only you but the ones you love who are left to live and remember you!

It grows late and I must go.  It is such an honor to work with the people at the ER and especially so with the fine people here at this retreat.  May we all be so blessed.

D

Long time Brah

Missing Hawai'i badly.
The people
Culture
Smells.
Breeze.

Missing it all.

Able to let go
Not so sure.

Need to split myself in two
Integration of da kine

Stuck tween many worlds
Part of them all
Belonging to none
Yet belonging to all

Or at least trying.

D

NYT's article: Ultimately I think

That this world is largely empty of real or true meaning. There is no intellectual underpinning for its existence really c full of sound and fury signifying nothing.

I long to be proved wrong. But I get the fascination and draw of this world. But at the end of our lives I think we always look back and ask if our lives were well lived? Did I matter? Did I help? Did what I do in my life make a difference to others in a positive way?

I know I'm asking those questions more often and with a sense of quiet urgency and largely unconstrained by past concerns that are less and less important.

What I'm pushing for is to make some kind of lasting contribution with meaning. Therein lies the challenge to us all.

Love ya!

D

http://nyti.ms/WKOYe0

NYTimes: Michelle Harper, a Woman of Mystery

Is the ubiquitous, flamboyantly dressed Michelle Harper this generationfs Holly Golightly? Or is she its Sylvia Miles?

Precious the Cockatoo, a patients beloved pet.

Tearing my Right Meniscus & Learning Patience and Pain

As I am confined to less mobility, somewhat housebound it is past time for an entry here.  A few weeks ago I was mountain biking on the bluffs of Gerstle Cove State Park - very close to our family ranch on the East side of Salt Point State park.  I took a very easy, slow speed tip-over / fall onto my left side.  Good enough, no damage done from that.  As I was unclipping and then twisting to get up and out of the ditch I was lying in I heard my right knee pop a bit and had a bit of pain.  Stopped what I was doing, straightened it out and then was able to get up and ride for another hour with no pain.

A few hours later it locked up and the saga began.  Realistically though this was not from my bike tip over for I had pain over a year or more while pivoting and had not been able to sit cross legged for the last few years due to pain (especially noted when I wanted to have a yaqona ceremony).  So the bike just exacerbated a preexisting injury.  I put up with it for a week without an MRI and then with no resolution scheduled the MRI.  Now I love MRI's and almost all imaging technology even though I am untrained it seems such a 'cool' thing to be able to see the inside of a body - especially your own!  That said it is not the spectacular 3 D, cleaned up and super enhanced CGI stuff we get out of Hollywood.

My official diagnosis is a bucket handle tear of the Right Meniscus which for those who do not know is the pad between the bones of your upper and lower leg.  If the damage is bad enough they can take it out.  As they related to me this was one of worst tears they had ever seen but it was repairable with sutures.  I have the arthroscopic images and after orienting myself it was very impressive to see the tear and actual abrasions / channels I had worn into some ligaments.

Dealing with the Aftermath

I chose the word aftermath quite deliberately.  The lead up to and the surgery itself was nothing.  Recovery has been harsh - truly difficult for me and the number one issue has been pain.  Other issues have been greatly lessened mobility, a greatly lessened feeling of independence and the corresponding need to rely on others for assistance.  I find myself continuing to be surprised by my reluctance to not depend on others - I find it difficult to ask for help so I am working on that.

The pain - as an ER nurse (and I am proud of being in the ER so am taking credit for that because not just anyone can work in the ER!) we ask our patients to rate their from 0 - 10.  Zero being no pain, 1-2 is uncomfortable and 10 the worst pain experienced in their life.  You know where I am going with this one don't you!?  Well ladies and gentleman - this was my 10!  It did not hit until later that night after my local block well and truly wore off.  I ended up just weeping - not only from pain but the mental frustration, the unexpectedness of it's severity and the attendant anticipation of more to tome and for some time.

In 'my' ER, I am known as one of the more compassionate and involved staff (not always a good thing depending on the situation).  To the point where I go beyond what other nurses do, when the time is available, to hook patients up with additional resources but also to the point where many of the other RN's give me a hard time about being too nice or understanding or 'soft'.  Some RN's simply are task performers - that is bullshit and I don't want them in 'my' ER.  I want passionate, involved, proactive, caring nurses that can do it all and not just 'get' a difficult IV stick.  Why talk about this now?  Because inevitably every thing I go through in life has the potential to make me a better person but also a better nurse.  This experience is a good one then - as much as I may hate the pain and curse the situation.

The positives are that I now have a better idea of what a 10/10 pain is for me and I have done some good technical learning also.  The negatives are that I have had to resort to Vicodin (only side effect was itching!)  for the pain and my initial use really was high - considering I had never used opiates in the past.  I said NEVER didn't I?  So I used 40 in six days.  Sometimes two an hour.  It was crazy but the pain was almost unbearable at times.  I was doing my best to 'man up' but also not to take that fallacy to the extreme either!

I am just over a week out from arthroscopic surgery.  I follow the usual regimen, RICE (rest, ice, compression, elevation).  Mobility is slightly up and improving.  Vicodin use way down which I am very happy about!  So I continue my ibuprofen and am also using Bromelaine to help with the inflammation.  I am better on the crutches but boy do I miss walking and riding.  The plus side is that I am going to get back into the pool as soon as possible.

I miss my work mates something fierce.  I'll go back the day after Christmas, as non-weight bearing as possible and doing a lot of administrative work.  We have this whole goal of doing a nurse first contact in the ER instead of a registration first contact so I will be pioneering that whole idea and developing some protocol around that. 

That's about it for now.  Even now my pain level is up to about a 4-5 but my tolerance for that pain level has gone up.  I am grateful for that as I am for so much else.  Thanks for reading,

David

Driving from the ridge on Skaggs Springs Road. Beautiful sunset, music and many thoughts. Remembering the past and then remembering how it felt to anticipate the future. Feeling that frisson of lovely optimistic passion run down my spine knowing that I was at the beginning, the beginning of a life and that it was all spread out there before me - waiting,waiting,waiting. I treasured that unknowing and recognized it even then. I still long for the unknown and the attendant excitement.  Ties to our lives and the community are so rewarding but at times I tired of the comforting embrace of all that is so knowable. I live a passionate and rewarding life that has its share of excitement, danger, peace and incredible beauty. I am a fortunate man.  Yet for me there lingers, and always will, that certain sense of much yet to be done, so much still undone. And yes, I embrace, long for it because it is still waiting, waiting, waiting. I will not die without having done so much more then I thought I was capable of. 

I'm waiting at home
Tending the home fires
Banked against the coldness of broken hearts.

I may not be the man you wanted but hope I'm the one you need ……
When cold winters wind blow
the ages of our years upon us
I'll be the one, I will be the one.

So hasten home
Less sleep and the years
Take me beyond your reach
And I'll not know the beating of my heart
Pressed against yours

Nor the touch of your skin and tears
Mixed with
Intermingling with
The endless wash off wave and tide that
Beats the beat of a pulsars heart
At the end of the universe and time

I'll be the one if you'll be the one
We'll circle round interminably you know
The inexorable pull of loves gravity
Pulling us home
Pulling us home
Again and again
pulling us home.

I Wish it Had Been You

I wish it had been you
That had sped the plough
And sowed the seed
And harvested the soul
Of my memories of you

But alas it is I
To lay my hand upon your furrowed brow
And wash the aching loss of a grieving heart

It is the nurse and doctor and I and you and my brother, sister, father and lover . . .
that speeds the morphine,
that slows the heart,
to ease the pain
of love torn apart

I wish it had been you
But it is me and it is you and you and you
That plants the ground,
Upon which love grows.

I wish it had been you.
I wish it had been you.


September 2012
Written at a workshop on Palliative care by the Metta Institute.org

Driving South Meyers Grade

Why I love and live where I amc

View from my window

Santa Sabina center, San Rafael, California

Wise Relationships, Palliative Care and Hospice Course

Aloha . . .

From tonight (Wednesday, Sept 12, 2012) to Sunday at 12 I am at the Santa Sabina Retreat Center (also on the web) with the Metta Institute.org on a course or retreat/study in Wise Relationships.  This is more aimed at Wise Relationships in the sense of working with the dying in hospice or palliative care.  But, of course, any kind of work like this benefits in all realms of one's life. 

This post will not be terribly well organized - lots of thoughts running through my head from the last week.  So I shall start with this - tonight Frank Ostaseski talked about the meaning of when people at this retreat clasp their hands together and bow.  Not only to honor of course but to pay homage, to acknowledge and so on and so forth.  But he said that one hand could be thought of as Wisdom and the other, Compassion.

I loved that and I want that to be me.  I fail miserably most of the time but hey, it's practicing right!? Compassionate wisdom and wise compassion . . . yeah baby.

This last Monday was my birthday.  I took the day off.  Partly in preparation for this course but also to process, think about and flush out the prior week which was  a very hard on on the work and personal front.  I drove to the Camp David West Sunday night and spent the night alone . . . but I was not alone.  I watched the stars for the longest time and I was not alone in my heart.  The ridge is a place of eerie beauty but not strange beauty but just so so beautiful.  I awoke the next day and it was one of those days, you know, where every little thing you see and hear is so crisp, present and real that it just leaps out at you begging to be noticed.  Every little thing I saw begged to be just watched and studied.

I was without thought really, not focused, no busy mind but just accepting, observing, being present, full of wonderment, appreciation and love.  But most of all, gratefulness for the opportunity to be alive and lucky enough to have clean water, no one trying to kill me or my family, good health and stability and so much more.  Yeah, those thoughts really did cross my consciousness!

So while I was alone . . . I was not . . . I was at home not only in my home but in my heart.  And all this can be so hard to explain to someone who just may not get it, who may not be in touch with whatever the hell I was in touch with.  But for me it was the ever present realization that I am a part of the larger picture, the web of interconnectedness that binds all of us and all things together.

I did not want to leave . . . to drive in cruel traffic, separate from the wash of ocean on rock, the cry of the hawk, the quiet rush, rush, rush of the Raven's wing over my head wending through Redwood trees hundreds of years older than I.

I struggle even now for the words that will fly straight into your heart.

What I know is that I needed to be there . . . alone or not.  The challenge, among so many, is to be able to reach that special place and realization where ever I am.  So I work and continue to work on that.

I left on Monday.  I stopped at the top of Myers Grade looking South and the view took my breath away.  It was so ungodly beautiful I just broke out in tears - just think - to have lived long enough and seen so much but to be touched to my soul by such beauty.  I am so very lucky.  Of course I did have Jan Garbarek's Officum album on and it was a long hard week (hmmm, lots of those of late but that is not all bad!).

I took Highway One all the way down to San Francisco and despite having lived / traveled over much of the planet it is one of the most beautiful drives or experiences there is. 

So that's quite enough for now I think! There's more to follow - these courses are vital, thought and feeling provoking and most of all provide the tools one needs to do the job in the ER or hospice and life in general.  I signed up for all of the courses - not cheap - but it is an investment in sanity and my ability to help others.  Gladly done . . . with out regret . . . with pride.

Thanks for reading . . . malama pono,

D

Falling

Falling

Wow. 530 Monday morning I'm awakened by two yells/shouts. Run downstairs, Audrey down, goose egg popping up below left eye. She - disoriented, scared. Me - anger at the injustice visited upon us in our dotage, flashback to Vesta, our mum in that same cold tile floor in so much worse condition.  Grateful for what is now and what has been. 

So a quiet drive to the ER knowing all is ok but unwilling to be fatally wrong. We laugh together  call bonnie.  Hours pass, go to bakery, feed ER staff, pour boiling lava hot coffee down my gullet. Wait. Wait. Call bonnie. Wait. Medically clear. Go to Bonnies. Practice forgiveness, for her ,for Vesta, for me ….  Did I do enough?  

Then delivery of Audrey to assisted
Living for practice run of one week, maybe two. Eat dinner there. Shop for her. Drive home.  

Practice forgiveness. Fail miserably. Want beer. Don't. Hope to sleep without dreams or fear of a woman's screams … late at night.

Love to all. Missing your company. ALL of you.

Hugs,

D

PS:  when I'm really really old. - I want sequined crotchless black velvet depends. Purty please.

Practice, practice, practice. 

Cycle Ride Golden Gate Bridge

Hawaii

Interviewing with Hospice Hawaii of late. Exciting, hopeful, working hard and it feels like a great match.

The view from our window

Buca di Santa Antonio restaurant

Had the best, or on of the very best meals of our lives here yesterday. Now - a repeat performance. Wine is Funbiano 2010

View from our window, Lucca, Italy

Hotel Celide, Lucca, Italy

View from the Uffizi gallery

The Ponte Vecchio bridge in foreground looking west.

Hope alls well!

A view from our window

La Scala Opera House, Milano, Italy

The Alps on the way to Italy