​Today is my fairy god-mother’s birthday. She is who I thank most for who I am becoming. Tiana, as she liked to be called, was a force and she knew it. She was devoted to that which she liked and emphatic about those things she did not like- to include square plates and football. 
When Tiana was diagnosed with ovarian cancer she wasn’t surprised nor particularly upset. She wanted to be full and fierce or nothing. Her diagnosis returned her the control she had lost over her life as her children had grown, left home, and she and her husband divorced.  

She engaged the best doctors, care providers, and advisors, and when it became apparent that hers was not a fight to be won, she pressed me into service for what I now practice as a Death Doula. 
We sorted her affairs, her home, and her many possessions. We reviewed her life, reflected on her ‘who’, her values, and her legacy. She knew what she wanted her people to remember about her and she knew how she wanted to live on in their lives. She wrote letters, made phone calls, and distributed inheritances with her warm hand. She made meaning of her life and enriched the lives of those she loved. She gave me a gold bangle that, when I snapped it on my wrist, locked. It’s been there almost 8 years. She was pleased then and I believe she keeps it there still.  

She determined every aspect of her passing away and created an action timeline for her demise. She survived her chaos because she accepted it, made her self strong, her space safe, and so lived until she died. 

She returned her star dust to the universe in September 2012.  

I clipped “Something Else” by Rick Moranis from the New York Times on Sunday, May 16, 2010 and taped it to my office wall. I am as amused by the capital letter force of author Rick Moranis’ voice today as I was then. As whopping as 2020 has been to date, I remember when 2010 opened with big and scary times: the earthquake that destroyed Haiti; BP’s Deepwater Horizon oil rig explosion that was the most devastating environmental disaster in history; Apple debuted the iPad and Google introduced the driverless car; Iceland’s Eyjafjallajökull volcano erupted and grounded air travel; Greece’s economy tanked and masses rioted protesting austerity sanctions and bailout; Tea Party politics raged; and Dawn Brancheau was killed at Sea World.

The recent radical shifts in our world call on the brave to keep “a selective memory for remembering the good things, a logical prudence to avoid doing anything to ruin the present, and defiant optimism for facing the future.”~Isabel Allende, The Sum of Our Days.

Everything that lives dies 
Dying is the hardest thing we do 
Everything that breathes eats 
Dying is the hardest thing we do 
Everything that teaches grows 
Dying is the hardest thing we do 
Everything that loves spreads 
Dying is the hardest thing we do
Everything that wakes sleeps 
Dying is the hardest thing we do 
Everything that endures forgives 
Dying is the hardest thing we do. 

And when we die, the hardest thing our people do is not fear. 
And when we die, the hardest thing our people do is to grieve.
And when we die, the hardest thing our people do is to live. 

​Grief is an act of humanity. 

This curious tale of a creature who “went out one day when the grass was green and the sky was grey” was known not by beast nor bird nor fish nor insect and became celebrated by all when none could name him. Accepting him ‘in gratitude, with trust and allowing’ (Karen Newell, Sacred Acoustics) acknowledges that which is in one is in us all.

This is a time of transformational predicaments. We are in a collective experience that is intimately isolating. This time is only personal if we think it’s not in us. This time is only relational if we think it’s not in us. This time is only spiritual when we know it’s in us. Ernest Hemingway prophetically wrote “we are all broken...that’s how the light gets in.” (A Farewell to Arms).
 
An apocalypse is not a reckoning nor is it the end of the world. Literally, an apocalypse reveals: uncovering or unveiling the truth that was there all along but that we did not see before. I still see and will never forget September, 11, 2001. Our life and my liberties were threatened then and are now again and our well being is in jeopardy. I remember heroes - too many to count - rising to the occasion for the simple call to action “Let’s Roll!”.

So much of this life will always be beyond our understanding - “as obscure as the landscapes of someone else’s dreams” ~Karen Thompson Walker, The Dreamers. When I coach that the only way out of a predicament is through, we work toward transformation by learning, acknowledging, practicing and praying that ‘happiness is a choice...self esteem is a skill.’

I think it is wickedly hard not to take this time personally: to give without remembering and to receive without forgetting. So I mean to “fill the unforgiving minute with 60 seconds worth of distance run.” ~Rudyard Kipling, If.

I will start by counting my blessings and naming them. Naming might begin first thing...yesterday was, today is here and tomorrow will come. Naming is my way to witness as Amor Towles explained: “so that she can be addressed. So that she can be invited to tea; called to from across the room; discussed in conversation when she is absent; and included in your prayer.” (A Gentleman in Moscow).

We can and must transform our predicaments and so evolve to be ever more different and ever more the same and start to connect there. At the end of life all that ever really matters is this:

​Wishing glory to our United States on this Independence Day and peace to all souls.

Now we will count to twelve 
and we will all keep still 
for once on the face of the earth, 
let’s not speak in any language; 
let’s stop for a second, 
and not move our arms so much. 

It would be an exotic moment 
without rush, without engines; 
we would all be together 
in a sudden strangeness. 

Fishermen in the cold sea 
would not harm whales 
and the man gathering salt 
would not look at his hurt hands. 

Those who prepare green wars, 
wars with gas, wars with fire, 
victories with no survivors, 
would put on clean clothes 
and walk about with their brothers 
in the shade, doing nothing. 

What I want should not be confused
with total inactivity. 
Life is what it is about; 
I want no truck with death.
 
If we were not so single-minded
about keeping our lives moving, 
and for once could do nothing,
perhaps a huge silence 
might interrupt this sadness 
of never understanding ourselves 
and of threatening ourselves with death.
Perhaps the earth can teach us 
as when everything seems dead 
and later proves to be alive. 

​Now I’ll count up to twelve 
and you keep quiet and I will go. 

I have always liked to drive fast. I remember some time ago traveling on I95 South, a sports car appeared and blew past me. The license plate was WAWAZAT. A 1973 red De Tomaso Pantera was what it was. It made me look. It slowed me down. I have remembered the experience. The car did not really come out of nowhere. Neither did this pandemic.
 
What was it that brought us to now? How will we remember this time? What will it take to make this “pause” a “reboot”? “This historical memory is very critical because something happened that was incredibly scary. After the Spanish Flu Epidemic, we began forgetting...as soon as the dying stopped, the forgetting began.” ~Harold Ivan Smith, COVID19 and the Centennial of the Spanish Flu Epidemic.
 
“There is no pain so great as the memory of joy in present grief.”~Aeschylus. There will be much to remember about this pandemic if we ‘don’t count the days but make the days count.’ “Everything has its wonders, even darkness and silence, and I learn whatever state I may be in, therein to be content.” ~Helen Keller. “Lest we forget” ~Disegno Daily.“We run from grief because loss scares us, yet our hearts reach towards grief because the broken parts want to mend.”~Brené Brown.
 
Looking at our grief through rituals helps us to make our experiences mean something. Rituals let us hold space and sort our mundane from the significant persons, places and things of our affection. At my house, retail therapy is a ritual which excites our boredom and mitigates our frustration and disenfranchisement especially when bargains are involved. And subsequent therapy arrives delivered...and the receipt of the package...is it for me? What is this? Ooh la la. I feel pretty! This is when stop our working and celebrate. “Fashion never dies. It adapts, advances and evolves with us as a society, while helping us express ourselves as individuals. It’s more than just clothing, it helps us build our image of how we see ourselves as well as how others see us: it’s art, it’s therapy, it’s memories...” ~Ruth Shaw. 
 
“It is a serious thing to be alive on this fresh morning in this broken world.” ~Mary Oliver. It is serious business to be alive. We have already been given so many opportunities to make something of this!  One rallying cry of this time has been ‘we can do hard things,’ but the rest of the quote by Alan Packer is “it’s the impossible that takes a little longer.” To create meaning because of this- choosing to engage with our grief is a lifelong process. For me, this is about loving what is and so owning ‘that which cannot be fixed with butter or whisky probably should not be fixed.’ I’m not interested in the consequences of ignoring, deferring, or delaying rituals. That’s a friction I know metastasizes. Next week I shall jam the Maryland strawberries and preserve this spring. I will savor it on my toast. I will bake it into my pies. I will gift it. It will be my homeopathic story: “similia similibus curentur or “like cures like”. Or also maybe, it will fuel me to “be the things you loved most about the people who are gone.” ~Lisa Scrivens.
 
If this pandemic is a wake up call to us, I hope we will look hard, slow down, and remember- remember to remember.  My story features a pelican because of her symbolism: it is told that in times of need, a mother bird will pluck her breast until it bleeds to nurture her starving young. Pelicans are also known for their buoyancy and unselfishness. “How do you build a pelican? Do you study the beak? the labored flight? the pierced breast? No, first you study the pond.” ~The Bishop Craig B. Anderson, Ph.D.. I believe we are still in the benevolent stage of this pandemic and that an important dimension of resilience is prayer where “we humble up.” ~Caroline Myss.  The following meditation Encountering Grief is from the On Being episode “Finding Buoyancy Amidst Despair” and is led by Roshi Joan Halifax.

I have hope that we find fortune in this pandemic. I read the following parable 25 years ago and saved the publication it was printed in. I intended then to remember it. “Once upon a time a young prince was making a journey alone on horseback to another kingdom. He had come a long way and he had a long way to go. One night as he was crossing a stream he heard a commanding voice call to him out of the darkness. “Stop and fill up your saddle bags with the sand of this stream.” The young prince reined in his horse for an instant and deliberated. He was awed by the voice and wanted to obey but he was also impatient to ride on. So all he did was to reach down and snatch up a handful of sand from the bottom of the stream, put it in his pocket and gallop off on his way. The next morning he remembered the stream and the voice and the sand. Out of curiosity he reached into his pocket and lo and behold it was filled with diamonds. And so, as the story goes, the young prince was both glad and sorry. He was glad that he had stopped and taken some sand and he was sorry that he had been impatient and not taken more.” Faith is a tricky thing; first you have to believe. In the writing of this blog, I had a special correspondence with the raconteur of the parable and this he told me “Dear Réné, Your email confirms Einstein’s comment that “coincidences are Gods way of remaining anonymous.” ~Charles Scribner III.
 
Looking at this time. Slowing down. Remembering. Pausing or rebooting. Please enjoy “David Byrne’s buoyant countercultural hymn of optimism, resistance, and resilience” found at Brain Pickings by Maria Popova. 
​

Today, Tuesday, May 5, 2020 is six weeks and 6 days or day 48 of my count of our pandemic quarantine. Many of us will come through these days without any visible scars. I’m shattered to learn that others, like actor Nick Cordero had to have his right leg amputated after suffering complications from COVID-19. This experience may not change us as much as it reveals us.  For some, this time is pushing up all the old traumas. For others, this time is creating new fractures. Do we really have to make meaning here? If today is my last day is this how I want to spend it? Is my conundrum or my opportunity to calibrate my re-entry to our new world?
 
What if these days are whatever we make of them and what if that is enough? “The truth is that life is a grieving process.” ~Dr. Carter Stout. Aristotle taught to be is to do. Voltaire posited to do is to be. Sinatra sang do-be-do-be-do. What will it take to get over this? “We did not have and could not get the tools and knowledge to do our work.  And soon enough we were forbidden to do it by general fiat.”~Larry P. Arn Thoughts on the Current Crisis. My awareness is wobbly. I have a vulnerability hangover.  I’m breathing I’m breathing I’m breathing into Compassionate Abiding. Kindly.
 
And now we’re Zooming deep into technology. Rose colored glasses were never my style but I’ve just bought blue glasses. Blue is the color of my throat chakra. “Blue is also at the cooler end of the spectrum, where things slow down, allowing you to take time to be still.” Chakra Anatomy. 
 
“And she took the time to believe to believe in what she said and she made me love she made me love she made me love more.” ~Love More, Sharon Van Etten.
 
Children love us just as we are. “When you teach the children teach em the very best you can. The world won’t get no better if we just let it be.”

Once upon a time we had the smartest carpool. Six growing girls who were old enough to have a sense of themselves and young enough not to be afraid of themselves. They would quiz one another “tell me everything you know about (‘rocks’ or ‘rational exponents’ or the verb ‘vivir’).” The girls are now capable young women who are curious and listen generously. They want to know what you see, what does it sound like to you, what does it taste like to you, what does it smell like to you, and how does it feel. Asking how not why. Observing not judging. “There is but one solution to the intricate riddle of life; to improve ourselves, and contribute to the happiness of others.”~Mary Shelley. We need and need to be loving helpmates who will elicit what is strong and not what is wrong. We must discern what we have outgrown and what it is time to gift with a warm hand. What we will hold dear and keep is as important as what we discard. “Unfortunately, there are wounds that time doesn’t heal. Fortunately, healing is intentional.” ~Marie Empowered Through Grief.
 
Organic is defined by life and death and expressed as love or grief. We humans are organic and when stressed especially need to breathe deeply, stretch, move and rest. I am grateful to have a memory for perspective on this time. Years ago we did a whole house renovation refinishing the oak wood floors, stairs and bannisters and kitchen counters and repainting three floors- 9 rooms- of living space. On each floor, we moved everything into a middle room during the floor work so we had two phases to the work or two jobs. The floors and then the walls and ceilings. Brené Brown explains that ‘so much of emotion is biography’.  With all the stacked feelings I am right now, I am reminded to tend to that which I stand on as one job and to tend that which is around and above me as job two...or too!). “If we have no peace, it is because we have forgotten that we belong to each other.” ~Mother Theresa

Big trees grow slowly as much rooting down into the earth as reaching toward the sun. Trees in my purview have grown a lot in these 48 days. And one had one of its powerful limbs torn off in the wind and rain and smashed a car across my street today. Another death that will be lamented and grieved. But what will it create? What is reaching up in you?  What is smashing down in you?
 
“Perhaps the call ever more is to sit with the discomfort and not attach to it. Practicing Tara Brach's RAIN is almost more important now more than ever. So although it sounds simple, that's my main recommendation for you this week.” ~Kim Hennessee, Mend Acupuncture
 
These days are long but the weeks are short and the years rush past. “I wish I could tell you that it gets better but it doesn’t. You get better.” ~Joan Rivers
 
Sending my love.  Be well.  Take good gentle care of yourselves.

The first time I remember hearing the word caregiver was from my dad. My mother had suffered a tragic accident and had spent months in hospitals. She was finally ready to come home.  He committed to be her caregiver, as if you “watch the things you gave your life to, broken, and stoop and build ‘em up with worn out tools...” ~Rudyard Kipling, If.  My dad had a strong back, a missionary heart, and ears that no longer worked very well.  He loved my mother, and he loved our family.  His “practice of gratitude is not about dismissing sadness, anger, fear, or confusion. Rather, it offers us the opportunity to see that we often experience multiple feelings at once; to welcome joy into the same places where we hold grief; to turn our attention to what is quietly growing and breathing day by day, which, to our possible surprise, includes ourselves." ~ Kristin Lin, Editor, The On Being Project.  

“There are only four kinds of people in this world.  Those who have been caregivers, those who are currently caregivers, those who will be caregivers, and those who will need caregivers.” ~Rosalynn Carter, former First Lady, USA; Founder of the Rosalynn Carter Institute for Caregiving.

These quarantined days may tease us about what life might look like for us as caregivers. Time loses its authority. Days slip by and into each other as if all we have is yesterday, today and tomorrow. There is a desperation that there is always something more you think you need, more to do, that what you do is never enough. Exhaustion which comes from always listening for the call for help. “Courage is not simply one of the virtues but the form of every virtue at the testing point.”~ C.S. Lewis. Feeling inadequate for not being able to make a clean, happy ending. Grateful for one more day. Relief at having made it to the time for sleep where the paralyzed kneel to tend their gardens again and swing themselves back into the saddle to run with the hunt.  “We.needto.think.about.eachother.and.begrateful.and.to.sendlove.”~Alice-May Purkiss, @lifedeathwhat.  

Jessica Zitter, MD, MPH, is one of the architects of our End of Life movement. She believes that “Caregiving is the most important health care crisis no one is talking about.”  Her convictions and experiences are coming in a soon to be released movie, "Caregiver, A Love Story". Please enjoy the trailer here below. 

Save your gloves, you are going to need them. “If you extend acts of kindness, you bring order to the chaos” ~Karen Kedar, God Whispers.  

Be well. Be kind.  Take good care of you.  ​​

"Caregiver: A Love Story."

To be brave in these times is hard. Existentially hard. I am grieving. I’m feeling loopy, off balance and adrift in a surreal other world where everything seems inside out. Apparently we can’t save one another so we must avoid one another. This can’t be happening. But it is. I’ve got to make sense of this for me, for you, for us. Wearing my Dad’s belt today is helping. He was the bravest person I’ve known.  He loved his life and he saved my mother’s life and cared for her for 23 years. When he died, he giggled his way across. I remember one evening when his dog would not stop barking. A big fat snake had entered his kennel. Dad appeared with his leather to the elbow barbecue gloves and a pitchfork. I got the dog and he went up to the snake, scooped it up and walked to the woods where he heaved it back to where it had come from. I asked him where he learned to do that. He said, “Wall Street.”  I’m inclined to adore my heroes. I have faith and this is hard.

In Resilience, Eric Greitens coaches “Don’t expect a time in your life when you’ll be free from change, free from struggle, free from worry. To be resilient, you must understand  that your objective is not to come to rest, because there is no rest. Your objective is to use what hits you to change your trajectory in a positive direction.”  “People tell you, "Don't worry." That's usually friendly advice – and also unhelpful. It's better to tell people, "Worry productively." If you're going to spend time thinking about bad things that might happen, then use that energy for a purpose. Go ahead and visualize the worst that can happen. But instead of wallowing in your worries, imagine how you'll respond to them. Practice. Mentally rehearse what you'll do. Imagine and envision yourself making it through hardship. Your mind is built to prepare for problems. That's more than OK – it's good. The goal of mental rehearsal isn't to fill your head with happy thoughts about the future, but to prepare yourself to succeed in the real world.”  
“Fear is a core emotion. A life without fear is an unhealthy life.”  “Focus not on wiping out your anxiety, but on directing your anxiety to worthy ends. Focus not on reducing your fear, but on building your courage – because, as you take more and more responsibility for your life, you'll need more and more courage.”  “Recognition of the tragic character of life is part of what spurs art, energy, comedy, courage. Would you love people the same if they could never die?”

Now is THE time for reckoning “all the obnoxious feelings that grief entails” says BJ Miller, MD, of ENDWELL. But I’m hopeful.  I’m grieving. You’re grieving. We’re grieving. That is a welcome new reality for me. I’m not alone. And neither are you. We do have choices. Brené Brown urges “Love is the last thing we need to ration right now...and Expectations are just resentments waiting to happen.”

I am especially concerned about ventilators and how desperately we apparently need them.  “Healthy people think about how they want to die. Sick people think about how they want to live.”  Jessica Zitter, MD, MPH. We need to have conversations with our loved ones about how we live and about how we hope to die.

It’s time to have The Ventilator Conversation. Candidly. Soberly. Joyfully. While we can. It matters not what we choose- pro, con, or not sure.  What is important is that we open ourselves and our loved ones to what what our values are and what we value. We can be productive with our worry and pre plan for the end of our life: our death.  “The goal isn’t a good death but a good life all the way through to the end.” ~Atul Gwande, MD. And this is important: “Listen with the same passion that you have for being heard.” ~Harriet Lerner. 

“Talking about sex will not make you pregnant. Talking about death will not make you die.” Alua Arthur from Going with Grace, practices The Art of Embracing the Unknown starting  with ‘What must I do to be at peace with myself so that I may live presently and die gracefully?”

Do you remember how to eat an elephant?  Little bites. “We can do hard things” Glennon Doyle, one step at a time.  Slowly. Oh, and please fall apart. Learning hurts. I know it makes me feel better to get into it, roll around, and notice how it’s already changing me and who I’m becoming. “It’s not what happens when we die that matters but how we live these lives.” ~Eben Alexander, MD.

I am especially concerned about ventilators and how desperately we apparently need them. Now is the time to have The Ventilator Conversation.

"What The Word Needs Now Is Love" ~Dionne Warwick

 One year not so long ago, we did a lot of traveling following our Denver then English athlete in the final seasons of her lacrosse career. I carried and read many books on death and dying. My companion read a book titled The Making of The Atomic Bomb. I see now that Carl Sagan has read it and recommends it as “a stirring intellectual adventure...indispensable history of events in which our future depends.” The book weighs 2.15 pounds and is 896 pages long. I don’t think anyone ever asked to sit in the unoccupied seat with us.

I still read voraciously on death and dying. I took many notes reading, Advice for Future Corpses (and for Those Who Love Them): A Practical Perspective on Death and Dying. Author Sallie Tisdale recounts, “the comedian Laurie Kilmartin used Twitter to describe her father’s last days. Her comments were often funny and poignant: “Just promised Dad I’d be nice to Mom. Damnit. “ She noted how hard it was to be appropriate, to say the right thing. “Hospice says to reassure the loved one that they can go, that we will be ok. So me sobbing “Dad, don’t fucking leave me, was frowned upon.”

I’ve Seen The End of You: A Neurosurgeon’s Look at Faith, Doubt, and the Things We Think We Know, by W. Lee Warren, MD,  writes “losing a child is the most malignant disease I’ve ever encountered in my own life.“  “The most important surgery I would ever perform would be the stitching together of my faith, my doubt, and the things I thought I knew.”  “Resuscitation is a nasty endeavor. Because the heart has stopped it is very difficult for the Code Team to start IVs and many patients end up with large IV lines in their necks, groins, or both. CPR breaks ribs. Patients lose continence of their bladders and bowels. They vomit. In the end, even when we bring people back, only a small percentage of those patients survive to the end of the hospitalization; research suggests that only 16% of cancer patients who are saved by CPR are alive 30 days later”.  W. Lee Warren, MD is a brain surgeon, inventor, Iraq War veteran “and somehow I’ve been placed in the lives of other bereaved and hurting people, and I have realized in those darkest hours, the knife edge of survival or ultimate loss might be traversable only if one can see, no matter how dim, the light from a torch held by someone a little further down the same path.”  “One of the secrets to surviving the difficulties of life is to be honest with yourself about their effect on you.”

And the book Anxiety: The Missing Stage of Grief, by Claire Bidwell Smith demonstrates that she has “come to understand that one of the significant reasons anxiety manifests after the death of a loved one is from not allowing ourselves to fully examine the story of our loss.”  “I cannot help but look back on all of my experiences of loss, even the most painful moments of it all, with anything but gratitude.  Losing the people I loved most in the world and walking through the fire of grief broke me wide open.  Grief taught me compassion. Anxiety taught me peace and presence.  Loss taught me how to live and love.”

I think it’s the stories that empower us to make sense of it all.