last night i was charged with taking care of a woman
in the ICU with the following acute problems:
pancreatitis and gallstones, a big swollen painful belly,
esophagitis from a yeast colonization so she can't swallow,
an autoimmune disorder which destroys her platelets,
so her blood won't clot, repeated hemorrhages from the nose
and vagina, severe anemia, as you can imagine,
fevers, kidney damage, and very high blood pressure.
she has the following chronic problems:
AIDS, cervical cancer, chronic pancreatitis, epilepsy,
male pattern baldness, and paranoid schizophrenia.
i am not making this up. she's 37. she has eight doctors.
she's delirious and can't make decisions, such as, for example,
going out for a cigarette, which she really wants to do.
her parents are supposed to make medical decisions for her.
i found myself sort of surprised that she had parents,
as if such terrible things would be somehow prevented
by having parents. she was hallucinating that
her daughter was in the room, and somehow
i wasn't as surprised that she had a daughter.
does she have a daughter? she doesn't get
any visitors. social workers are trying
to find a nursing home that will take her.
then i admitted another 37-year-old, a guy
who had a bellyache for a month, diarrhea
all day every day, lost 20 pounds, kidneys
shut down, CT scan showed "pancolitis,"
meaning his whole bowel is on fire.
blood pressure almost two times normal.
oh, and he has cirrhosis from the hepatitis C he got
back when he was a heroin addict. oh, and
he smokes and drinks heavily. oh, and he's
schizophrenic, but he hasn't gotten any meds
for a month
because he's been
so sick.
in the night i woke up thinking about the
overwhelming burden of suffering borne
by the world, wondering how the earth shelf
on which we stand doesn't just crack into pieces
and fall in the sea, wondering how the air is not
thick with shrieks and cries and moans of grief
all the time, wondering how any of us can go on,
and whether those self-help books really help:
when bad things happen to good people, when things
fall apart, where is god
when it hurts.
i thought about defense mechanisms
Acting-out Affiliation Altruism Avoidance
Conversion Deflection Denial Displacement Dissociation
Humor Identification Intellectualization Isolation
Passive-aggression Projection Rationalization
Reaction-formation Regression Repression
Somatization Splitting Sublimation
Substitution Suppression Undoing
and then i thought about the song, Life is Still Sweet -
"...Just forget what I said last week. Life is still sweet."
we do forget what we said last week.
how can it be?
people tortured in prison still want to live. people whose
children were murdered still want to live - mostly.
suicidal people still love guitar music and have a favorite song.
schizophrenic people with cancer and AIDS still want to
go out for a smoke. we love the sun after rain. we laugh
at animals playing and kids throwing snowalls. we smile
when the first dandelions come out in the spring, we want to
hear the eleven o'clock news, we look ahead for brighter days.
i can't take it. it breaks my heart that life is still sweet.
my faith is that, as the wise man said, when you get
your heart pierced, then it can let more love in, and
i only hope i don't get some bad kind of heart failure
because i already
let in so much.
