Crossfit saved me.

This morning I woke up and felt like crap.  I wanted to stay in bed, bring the blankets to my face, and just sink deeply into the mattress until I disappeared.  The majority of this feeling was because I stayed up way past my bedtime (Roots 'n' Blues festival... totally worth it).  Regardless, it isn't far from the feeling I have felt many times before, and it reminded me of how far I have come.

For the last few years I have felt that way far more than I haven't.  Sometimes in the afternoon or evening when I would get home from work.  Sometimes for entire weekends when I knew I should be doing something productive.  Really, ever since my mom started getting sicker.  There is a lack of motivation that comes with despair.  When you are faced with a situation that is truly insurmountable, TRULY insurmountable, your bed and sleep seem to be the only solution.  At least for me.

When mom died in February, I truly felt at times as if my body was just wasting away with her.  I knew there was so much that I needed to accomplish but I just couldn't bring myself to do it.  I felt despair, exhaustion, anger... the entire spectrum of feelings.  I still feel that way a lot of times.  I have spent time over the past 7 months since she died thinking that I should go to therapy, that a counselor might be the solution to the "normal bereavement" associated with losing someone.  I would call people, do the "interview" that comes with the first time meeting a counselor.  None of it felt right.

Then I found Crossfit.  Sure I have been active over the months since mom died.  It was something that I wanted to try to do to keep me sane while studying for boards.  Exercise has always made me feel good.  But Crossfit has changed my life.  I realize with this post that I am running the risk of exposing the Kool-Aid stain on my upper lip... yes, I have chugged the Crossfit Kool-Aid.  I'm still not "paleo" but I have begun the steady trend toward cutting out gluten.  My aunt Molly would be proud.

What is Crossfit?  I think this video says it well:

This month marks the first time that I literally forgot to be sad on the anniversary of mom's death.  Instead, I was at my local "box" working out with some of the coolest, toughest, and funnest people I have had the pleasure of getting to know.

This morning instead of pulling the covers over my head and letting the day take over, I climbed out of bed and made myself go to Crossfit.  I still feel like crap today... but that is again because I'm not 21 anymore.  What I don't feel is sad, depressed, or lonely.  I have found the best therapy for me and I have learned through Crossfit that there are no bounds to my mental, physical, and emotional strength.

Waves.

Mom passed away on February 12, 2012.  Since then I haven't been able to blog, I haven't really been able to take the time to stop and think about things.  That is until recently.  I have decided to take a short period of time off of medical school to process the loss of mom.  Four months late, but still equally cleansing.

I kayaked in La Jolla, California this week.  My uncle Ted and I try to do fun activities like this whenever I come out to see he and my aunt Molly.  As we navigated the waves in and out of the shore it made me start to think.  Grief is a lot like the waves on the ocean.  To which you say to me "that isn't an original thought at all, Mariah."  This analogy has certainly been made many times in the past.  But what triggered this thought to me was not the ebb and flow of waves, the coming and going of emotion, but rather the tricky way that ocean waves behave.  A wave that looks huge and terrifying can be completely manageable, while a wave that seems silly enough to turn my back to can knock me flat and send water rushing up my nose.  I would welcome a peaceful ebb and flow over the erratic and unpredictable nature of grief.

I think of mom all of the time.  Today it was during a Zumba class that I took with my aunt Molly.  We were dancing in front of a mirror to Latin songs while the instructor lead us in moves that my body just was not made to do.  I thought of the hours and hours that mom and I would spend in our living room doing Richard Simmons Sweatin' to the Oldies.  I imagined that she would absolutely LOVE this class and we would be laughing our heads off every second of the way.  This is one of those manageable waves, the ones that I can dig in and dive through and feel ok on the other side.

The other kind of waves, those hit me when I least expect it.  I am learning now to embrace them and take them on as they come.  I am confident she gave me the strength I need to tackle anything that comes my way whether I feel prepared or not.  I guess most importantly I am learning that every crappy wave that hits and sends me spinning is a chance to stop, think of her, and remember just how glad I am to have had the time I did with her.  

The medically-minded caregiver.

I am inspired today by a professor of mine who has created an informational and open blog about his cancer diagnosis.  He is using it as a teachable moment, and by doing so has touched people all over the world.  You can check out his blog at: http://dbocancerjourney.blogspot.com/  to learn more about his journey.

I don't anticipate reaching nearly that many, but hopefully some of my closer friends who are medical professionals can take note of this blog post for when they are caring for their own family members.  There is a huge burden of expectation placed on the medical professional who is also a family member of an ill person.  In my case, the burden is primarily self-imposed, but it is also evident in interactions with mom's care team.  As a medical student, I am constantly afraid I am missing something medically with my mom.  I feel this way because I am the person most present in her life, and I know (a little) about the human body and the normals and abnormals of disease.  It is probably also because she is such a unique case (her age, her presentation, her progression).  If her pupils look funny or her gait has changed, I am immediately trying to figure out what has gone wrong.  It is a painful and taxing process.  I am sure this is the case for anyone who is in the medical field and simultaneously caring for a loved one.  You know about the mistakes made everyday in medicine.  You know all too well that doctors are incredibly fallible.  You want to protect your family member from medical errors, polypharmacy, neglect, and misdiagnoses.

For me, I am always worried we have missed something big.  That there is an underlying process causing mom's illness that could have been stopped.  That when we do a post-mortem on her we will find that if we had only done _____ test we would have been able to save her memory, that I would have had her for 20 or 30 more years.  It is a painful burden to feel this way, but I am certain that I am not alone in this feeling.

Probably the most important piece of advice I have ever gotten was from a physician friend when I was talking to her about my feeling a loss of control in mom's care.  I sat down with her and was beside myself with grief.  I explained my fears that mom's care team was missing something.  That because she had been moved so much and had been passed off by so many, I was certain she was falling through the cracks.  I told her that I felt like it was my fault that this was happening because I am mom's advocate, her constant in this fluctuating process.

This was when she gave me the very best advice I could have heard at the time: "You can't do everything, Mariah.  When you are the family member of a sick person you must check your medical degree at the door and be the family member.  You cannot try to figure everything out because in the process you will drive yourself crazy.  All you can do is equip your mom with the very best medical team, and step back and TRUST them.  It is NOT your fault if something goes wrong in her medical care, it is NOT your responsibility to catch medical errors, and you can't control everything."

Medicine encourages perfection.  It pulls in people who won't settle for anything but the very, very best. Combine that with the love of a family member, and even more importantly the love of a parent, and that perfectionism runs rampant.  It is important to give to your loved ones, to be there for them, to support them.  I guess what I am learning now is that it is also important to let go and trust others.  That doesn't mean being blind to blatant mistakes.  I will always be mom's biggest advocate and will certainly fight for her to continue to have the very best care.  However, I am working diligently to give up the reigns a little bit.  To be her daughter that just happens to be a medical student, rather than a medical professional constantly on the watch when I come to see her.

Because when I come wearing my "medical professional" hat, I miss moments like this:

Innocence.

Today has been a rough day, and I come off of the heels of a rough weekend, and a rough several weeks.  Earlier today, while riding in the car, I stared blankly out of the window – deep in thought.  As my eyes drifted back into focus I caught glimpse of a little girl staring back at me out of the window of a school bus.  She stuck out her tongue and made a ridiculous face at me.  I just stared back blankly.

I often envy others who seem free from cares.  Typically this is in the context of studying for medical school.  I will gaze out of the window of a coffee shop and see a group of college students trekking down the street just having a blast, not a care in the world.  I am embarrassed to admit it, but when I am really in the thick of things at school I want to wring their necks.  I envy their freedom to do what they want and their lack of responsibility.  Of course I chose my path, and I realize how irrational these thoughts are, but it is amazing what 12 hours of straight coffee and studying will do to even the sanest person (not that I am sane).

Today this little girl made me feel something entirely different.  She made me wish for my innocence again.  She made me want to forget how terribly hard life can be.  I don’t blame children for their innocence.  Rather I want to bottle it up and take a drink when I really feel overwhelmed.  I just wish for the days when I didn’t know how difficult things really are. 

My mom has taken another turn for the worse.  I have watched as the system has continuously failed my family as we try to navigate the ins and outs of her care.  She is a unique patient, I get it, but she is a person nonetheless.  She has a story, a pathway, a tragic plunge into the darkness that has now overtaken her.  She is scared and tired and alone in her mind.  I am left to be her storyteller to anyone who will listen to me. 

The problems I am facing lie with communication, or lack thereof.  Isn’t that always the case?  I feel alone trying to help her survive what seems to be an endless battle with medications, and nurses, and EMTs, and social workers, and probably worst of all, doctors.  It is like the game of telephone that you play when you are young.  The more she is shipped around.   The more people who get involved in her care (more accurately, lack of care) the more the story changes.  In this litigious society we live in, no one wants to take the blame when I catch their mistakes and oversight, and certainly no one wants to seem neglectful.  No one wants to seem too busy to take the time to get to know her, to get to know me.  But very few people have. 

In med school we are taught from physician lecturers to care for the caregiver, to take the burden off of them whenever possible.  Let them know it isn’t their fault, that they shouldn’t feel guilty or sad, and that they aren’t alone. 

Only once in the last several years, yesterday in the ER, did I feel complete support from someone in the healthcare field.  An EMT held me in her arms and just told me how very sorry she was and how hard this all must be.  And I wept.  I wept for the realization from a medical professional that this is just not fair.  I wept to know that SOMEONE noticed just how hard this is and just how scared my mother and I are.  I wept because that sort of embrace should be the norm, not the exception.

I am on a plane right now to California.  I reluctantly left with my mom still in limbo with her care moving forward.  I need this time away to think and reflect.  There is one thing I do know, with loss of innocence comes a gain of perspective, and for me a burning desire to make things right.  My mother’s story will be told and she will be comfortable, safe, and respected if it is the very last thing I do. 

I draw strength.

I draw strength from my mother's smile and the twinkle in her eyes.  As of late, it is not uncommon for both to be absent, but occasionally I catch a glimpse and when I do, I try to capture it on photo.  Today I celebrate the beauty of my mother's smile and the way in which it keeps me going when things seem too hard to handle.  Here are a few photos from the past couple of months:

I think I bored her with all of my photo taking!

Playing it cool.

Sharing kisses.

This photo is particularly meaningful.  My mom hasn't cried with me in months.  She hasn't really registered who I am much lately.  But last Friday, she knew who I was.  She looked me in the eyes, and we both cried together.  She told me she loved me to the sky and back.  

In dreams.

As of late I have had vivid dreams about mom.  It is weird to dream about someone who is still living but to feel as though they are visiting you from another place.  In my dream last night she was starting to lose her memory.  Unlike the real life scenario, in this dream she told me she was scared.

She has always been so proud, so strong, and so put together.  Save for a few moments of vulnerability throughout the years, she has never admitted fear to me.  I could see it so clearly on her face when I would visit her, but she never said it.  

Last night, in my dream, she did.  And in response to her fear, I looked her in the eye and told her that we should just dance through it.  And we did.  We danced through the aisles of the large convention hall we were standing in (it was a dream... who knows why we were in a convention hall).  People stared but we were laughing so hard we didn't even see them.

Mom is gone now.  Her body is still there, but the soul that inhabited it has dissipated away.  In person I try to calm her fears, to tell her it will be ok.  When she cries softly "Please help me..." I wish that I could grab her hands and just dance her around her room.  I hope that it is in fact her soul that I am speaking with in my dreams.  Or maybe our dreams are melding into one so that she knows what I am saying when I say it to her.  Because I want to believe that I can calm her fears.  I want to believe that at night, when I lay down to sleep, I am meeting my mom to dance.   

Bedtime for Bonzo.

Tonight as I closed my books and shut off my desk lamp I said aloud to myself "It's bedtime for Bonzo!"  Immediately my mind shot back to bedtime rituals of old.  This was my mom's affectionate way of telling me it was time for bed when I was young.  I am sure it was met with a series of moans and groans from me, but truly, being tucked in was one of my favorite pastimes with mom.

• Sometimes it was a bedtime story.  Usually a Canadian classic such as "Make way for ducklings" or "Love you forever" (which is incredibly pertinent for me now - read it).  
• Then it was a lullaby.  My favorite was "Here comes the sandman," though she had several.  
• Then came my favorite - the multiple mini-kisses on my face.  Each day we would add another kiss until we would forget how many we had gotten to (I think one time we made it all the way to 2 months), and we would start all over again.  They were tiny little kisses that tickled and made me laugh.  
• Finally it was time to be rolled up in my blanket.  She would shove her hands on either sides of my blankets until I was wrapped in a blanket cocoon.  While she did this she would say, "snug as a bug in a rug!"  
• As she left my bedroom she would switch off my light and turn on the multicolored Christmas lights around my door.  My nightlight.  

I feel all of these sensations as if they were yesterday.  I miss being tucked in by mom.  I wonder sometimes if I miss it more because I know she won't ever do it again.

Now I tuck her in.  I brush her hair aside and give her mini kisses all over her forehead.  She giggles.  I sing her lullabies and tell her I love her to the sky and back.  

I guess that this is the normal progression of growing older.  Roles change, we adapt and find new ways to gain fulfillment.  I just think sometimes, on nights like tonight, I long to be tucked in like the old days.