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There's a pilgrimage in Spain a number of folks I know have made in the past couple of years. One man, a patient of mine made the journey this past fall. His recount left me rather suddenly in tears yesterday.

He, his wife and two children made the trek in September walking som 140 Km together. Their boy, just 5, occasionally resorted to his stroller, but mostly hiked. It's my patient's second marriage.

He also carried his daughter with him. This is the child from his first marriage, the one he lost at 16 two years ago in an accident. He brought the urn with her ashes, to make the pilgrimage with them. He carried her in his pack every step of the trip.

I found I couldn't stop my tears. I sat and cried with him two years ago, aching then from his pain, an ache no parent should ever know. That he had the ability to channel his grief this way, to take her ashes with him for this pilgrimage touched my heart in a way I hadn't expected. He talked to her as he walked, saying many of the things he needed to say, trying to close unfinished business with her, expressing both the love and the pain he still holds.

And as my tears quietly streamed down my cheek to disappear into my beard, he laid his hand on my forearm and reminded me of my words to him two years ago. "Share your joy and it's multiplied, share your pain and it's divided." He then placed his hand over center of his chest.

This trip he did just that. He talked. To her. With her.

And it brought him much of the solace he needed. As I lie here this morning and think about his face, and the clear peace I saw there when his hand rested back upon his chest, I cannot help but remember another lyric; "....you'll be with me, like a handprint on my heart."
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September is often an emotionally difficult month for me. The 26th will mark 17 years since my father passed. In ways it feels like it's been forever; other times, it seems like it was only yesterday. This morning, something Pop said to me in the weeks before he died, came home to roost. While he was in his dying process from leukemia, he remained amazingly mobile; on several occasions I escorted him down the hallway from his hospital room, to the shower where I helped him bathe. It was something I was grateful to be able to help with, something he would permit neither of my sisters to do for him. That act transported me some 35 years earlier, when I was the five-year-old being bathed, after he plucked me from the hole in the ice where I had fallen through, though this time I was the surrogate parent. One afternoon, as I toweled him dry, he turned and said, "there is a lot to be said for simply having a stroke and going out." I responded, "you know Pop, there's no guarantee that the stroke would take you." He became pensive and a few minutes later continued, "you're right, of course. Still there is much to be said for it."

This morning while I rounded on my one inpatient, I saw several people I knew pass me on their way into another patient room; they were somber, and some were in tears. I diagnosed a man in my practice with breast cancer a year and a half ago. He was 2 1/2 years my junior. Despite his cancer being metastatic to several of his lymph nodes, he had done well and finished his course of chemotherapy in June. He was hospitalized six weeks ago to remove the subcutaneous port through which he had taken his chemotherapy. Apparently, Sunday he suffered a massive stroke to his brainstem. They transferred him out of the intensive care unit to palliative care just last night, and he expired this morning before the palliative care physician did rounds. I walked into the room to find his grieving widow, his stoic son, and a bevy of friends and relatives, many of them my patients. I put my arms around his widow and allowed her to weep on my shoulder. "Era mui rapido," I said, " menos tiempo para sufrir." She nodded and wiped away her tears. She shook her head, the irony that he was cancer free, yet now gone, lost on neither of us. Pop's words echoed in my brain and my heart, as I felt a lone tear trace its way down my face.

I pray she can take some modicum of solace that his suffering was so short. That, and I'm grateful she was not there for a discussion I had with him right after I diagnosed his breast cancer. I was fussing at the time over his blood pressure, which he'd had for a long time and had never treated appropriately. He asked me why BP was so important, in the face of his breast cancer, to which I told him that his un-managed hypertension, "could kill him just as dead." He laughed at that, and acknowledged I had my point. "I hate having to comfort grieving widows," I told him with a smile, and with an amused smirk, he promised to do his best not to put me in that position.

"I'll hold you to that," I said, not really expecting this would be how it would all play out.
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There are things about this profession I don't enjoy.
behind the cut, an untimely loss. )
osodecanela: (Default)
It'll be a week tomorrow that Aaron died. I keep expecting to turn around and find him shadowing me. I keep expecting to walk into the bedroom after my shower and find him lying on my side of the bed. I'm still having a hard time, and the tears still come when I don't expect them, but each day gets a little easier.

Arjuna is amazingly helpful. I find I'm hugging him often and not pushing him out of my face as much when he decides I need doggie kisses. Noah however is treading very lightly since Aaron's passing. He's even more skittish around the pup, with no Aaron, the Protector to defend him.

For each of you who've extended your warm thoughts, prayers and condolences, my heart felt thanks. Your words and wishes have given me a degree of solace & have made this loss just a bit easier. Please accept a psychic hug from me to each of you. Please forgive me for not thanking each of you individually, but I'm still quite raw inside, and even writing this brief missive has left me choked up internally and very misty.
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Spring has come to the Bay Area, well Summer actually, though I doubt these rather extreme temperatures will last. It was in the 90's today for the second day running. I'm in San Francisco till tomorrow night for continuing medical education.

Drove down last night, and stopped at Bill and Ticor's for supper and a massage. Good food, good company, good friends and a good rub - absolute heaven. Thereafter, I headed down to the city to crash with Ruth (the friend who officiated at our wedding last summer). She lives about 1/2 mile from my seminar. Classes were solid, as usually is the case with this organization. They specialize in updates for primary care providers; much of what they offer is sponsored by Harvard, UCLA & the U of Wisconsin. The colleague who usually crosscovers my OB when I'm out of town, but could not do so this week, happens to be here as well. I do enjoy sitting with her; she's good people.

I'm a bit ticked with myself. I packed a pair of sandles, thinking that might be a good thing for my tootsies. My eczema on my toes has been making me nuts, as of late. Unfortunately, they're all I brought with me for footwear and they've already caused a blister on each foot. Decidedly not a bright move on my part.

Had a chance for coffee with Dwayne here in the Castro, after my classes were over and before he took on his evening massage clients. Short visit, more of a tease actually, but it was good to connect with him, even if only briefly. Thereafter, I parked myself at Starbucks on 18th (aka"Starbears", to log on to the complementary wifi. Needed to reload my Starbucks Card in order to log on (t'was down to $0.15), and sitting here it hit me. The last time I sat at Starbucks was with Sarah the day her Mom died.

Sarah is a dear friend, who's mom (all of 4 years my senior) died Jan 2nd, as I arrived to visit her at Kaiser. Her death was mercifully fast for someone with lung cancer. I had not expected to be there when she passed. More importantly I had not expected Sarah not to be. She and her sisters were taking turns keeping watch at their mother's beside, and Sarah had taken the night shift. She had only gone home to sleep 4 hours or so earlier. She and her sister are still working hard to cope. While their father and step-mom (both of whom were there when Chris passed) were nearby, Chris raised them as a single mother. I think of her often, and yes, I still get misty when I think of her.

My thoughts tonight are with friends who're dealing with pending losses and tragedies. One is likely to lose his grandfather soon, a grandfather he adores. Another friend has gone home to care for his father who has gone onto hospice care. The third friend is dealing with issues of domestic abuse in her extended family. She is fortunately not the victim, yet the knowledge is rubbing salt into old wounds, to an extent re-opening them I fear.

More, I cannot ignore how struck I am at all the handsome faces of the men around me, and just how many show the brand of the anti-retrovirals. I am greatful for it's presence, yet saddened by its need.

And so I shall sit and hold these good people in the light, in the hope they will become whole again.

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