On a Morning Walk ~ Gardens Work

A garden I passed on a walk.

Slippery slopes

sneak up on you

on a spring warm day

in the afternoon

when silence falls

between cars passing

when quiet contentment

jostles on slippery slopes

with uneasy restlessness.

“When I see a slippery slope, my instinct is to build a terrace.”

~ John McCarthy

Uncertain Relief

I have heard each of the phrases: ‘breaking the surface’, ‘coming out of a tunnel’ and ‘coming out a hole’ many times over the years usually speaking of lifting depression. My post today is descriptions of what each of those could feel like to those that have suffered acute depression, and possibly even suicidal thinking. A patient of mine, a young girl, from another hospital at another time told me ‘I know my depression’. We were discussing what happened for her to have recurrent suicide attempts or frequent hospitalizations. Relapse is a phase of any chronic disease. Doing the work to ‘stay afloat’, to feel the warmth of the sun or to take part in a beautiful world in a world of painful reality is the work of those that need to be welcomed back. Here is:

Uncertain Relief

Breaking the surface of water

after nearly drowning amid

waving, leafy seaweed and sinking 

into soft welcoming mud at the bottom

surprises constricted and burning lungs

with a cleansing breath of welcome air.

Discovery that to remain afloat and keep breathing 

strikes panicked flailing and fear.

Coming out of a long long tunnel

after years of just walking and walking

in it’s comfort and dark shelter 

dripping moisture echoing and beating

a gentle kindness despite 

the scurrying of unseen companions

surprises eyes accustomed to darkness.

Discovery of life's brilliance and colour,

while coming into focus, is too sharp and painful

Coming out of a deepening hole

after years of nesting at the bottom

welcomed by the protection of solid walls

pleased with a circle light from above 

until uncomfortable and curious 

attempts to climb walls with few handholds,

digging and scraping finally creates footholds

surprise fills the senses with raucous colour and harsh birdsong

Discovering a world grown foreign is frightening, threatening to overwhelm.

“The only thing that makes life possible is permanent, 

intolerable uncertainty; not knowing what comes next.”

~ Ursula K. Le Guin

Crisis of Care

In 1966, I stood in a linen closet crying because I was just too scared to do a bed bath…..on a man….kind of old - probably about 40. That was the crisis I had to deal with. 

Telling my dad that I was quitting nursing was the alternative. Just over twenty years later, there was another critical point in my nursing career. Yes, I continued in nursing. That crisis was on a medical unit in Regina. I wanted to know how, with nursing process, to care for patients in alcohol withdrawal. So I moved to Texas. There was no nursing education specific to alcoholism, however I did get experience in a treatment center. Nurses were in treatment centers, not hospitals. And yet, alcoholics and those with drug addiction frequently require medical care for the medical effects of alcoholism and/or drug addiction.

Today, there is another crisis in the world of nursing. In the world of health care workers at any level.  On the streets, in the ambulances, in emergency rooms. Fentanyl, prescription opiate and illicit opiate abuse. I’m not sensationalizing when I say the people are dying out there. Withdrawal management, better known as detox, is alive and well whether in hospitals or detox facilities. I have told many patients over these last many years that I will take care of them as many times as is needed. I have told them that relapse is not a shame but part of the process of addiction. This brings me to the next crisis in the world of active addiction. It has become so much bigger than that first bed bath. And it really is not my crisis.

We, within health care, have the knowledge, tools and abilities to treat the medical effects of this dreadful condition that spirals into so many other medical conditions. We are saving lives…..over and over again. For those that still have loving families, employment and community support systems there is some hope. Hope that a new life, a good life, is a possibility. And then there are those whose bridges have all been burned or are at least severely damaged. Those that are homeless, jobless, with no family. And yet we save lives.

I am reminded of Ebenezer Scrooge when he relegates them to ‘work houses and prisons’ and ‘if they would rather die then let them’. Is that where we are now? And yet we still ‘save lives’. And where do these lives go? The ones that are homeless, jobless, and with no family. Has society even thought about the personal addiction treatment that is needed alongside valuable medical management? In five decades, my limited view of how we have progressed past the stigma, to identify the chronicity of this condition, is that we are still blinded by the brilliance of controlling substances. We seem to have completely forgotten the individuals, the families that have been devastated by the conditions of alcoholism and addiction. 

To begin to mend this crisis, treatment centers, outpatient clinics and more importantly affordable homes are required. Housing and funding. For those that have housing, their ability to maintain clean and sober time increases, the quality of recovery is improved. Is this an easy task? No. It will require a complete restructuring of our attitudes and our ways of thinking in our increasingly complex system of health care.

“Sometimes you need a little crisis to get your adrenaline 

flowing and help you realize your potential.”

~ Jeannette Walls, The Glass Castle

Care

Care
Washing a face
Stained and running with tears

Care
A blanket warm and toasty
When the world feels cold and barren

Care
A firm voice speaking gently
When self talk is harsh and unforgiving.

Care
Humble acts of just plain kindness
When relapse takes it’s toll on mind, body and spirit.

“Too often we underestimate the power of a touch, a smile, 

a kind word, a listening ear, an honest compliment, 

or the smallest act of caring, all of which have 

the potential to turn a life around.”

~ Leo Buscaglia

Repost of: A Letter to Bernie

Hi Bernie,

How are you and what’s it like in the great beyond? If your mom and dad are there with you, please give them my best. I think of you often when I’m at work at Detox. You were one of my very first patients in Chemical Dependency. Later we worked together while you went to Texas Tech and got your Master of Education and following that we worked together again - you as one of the counselor’s and educators, me as one of the nurses.

Two of my favourite memories of you are the first time I took care of you and later on something you shared with us at the treatment center where we both worked.

As my patient you were stubborn and arrogant, unwilling to even look at the types and amounts of pills you were taking. Mention of your dad, just put your back up because you were ‘never going to be like him’. And you weren’t ~ he died of lung disease, but was sober and had been sober for many years. In those early years you knew nothing of relapse, and maybe didn’t really believe it could happen to you. And so, you unfortunately relapsed after a long period of clean and sober time, yet dying of this nasty, horrible disease of active addiction.

We were all so proud of you at the treatment center. In between the time you were my patient and your too early death, we watched you go through a treatment program, graduate university obtaining a Master of Education, and returning to where you had begun your journey - but this time as one of the counselors. That surrounds the second memory. It was your belief, and I concur with you, that all recovered folks in the early years of sobriety are ‘flaming co-dependents’. You worked well with patients and their families bringing them hope and help, directing them to the supports that they required to maintain their lives when they had chosen sobriety.

I was greatly saddened when I learned of your death after all of the work that you put into your recovery and the recovery of others. The manner of your death was so very unfortunate, but the good that you did in the years before your relapse was profound. Just know that lessons you taught me from that beginning stubborn arrogant individual and later on, from the very professional counsellor are still used and shared by this nurse.

Thanks for all that you gave to me and to others,
Take care,
Susan

“Relapse is part of the disease of addiction. It’s something that’s 

going to literally slap them in the face when they walk out the doors.”

~ Nicole Lockhart

Intention to Survive Relapse

Intention to survive
buried deep 
slows downward spirals 

to cling to life again.

Intention to feel life again
suggests a frightening life change
without showing 

the steps to take.

Intention to be brave 

in the face of sobriety
is not considered courageous
may not even be considered.

Intention to survive
edges through a soiled conscience
as a steep upward climb 

begins once more.

“People will do amazing things to ensure their survival.”

~ Patricia Briggs, The Hob’s Barga

Expectations

Cleaning up today

in the kitchen

drawers and cupboards

with time will need

cleaning up again.

Someone with addiction may have that problem ~ cleaning up more than once, I mean,

cleaning up comes with an expectation ~

once cleaning up has been done ~ it’s done.

Never having to be redone ~ ever.

If a relapse should occur

some may see it as 

a mortal sin

a failing

or desperate fear may flood

a spouse or sibling

son or daughter

grandparent, aunt or uncle

If the relapse

becomes just like previous times of

drunkenness and violence

jails and hospitals

expectations shift rapidly downward.

If the relapse is just 

one drink, maybe one joint, or just a couple of pills 

or maybe smoking just a hit of heroin instead of mainlining

It’s ok! Isn’t it?

An old saying in the addiction world:

one drink is too many

a thousand isn’t enough.

(That goes for drugs too.)

“Expectations are dangerous when they are both too high and unformed.”

~ Lionel Shriver, We Need to Talk about Kevin”

A Letter to Bernie

Hi Bernie,

How are you and what’s it like in the great beyond? If your mom and dad are there with you, please give them my best. I think of you often when I’m at work at Detox. You were one of my very first patients in Chemical Dependency. Later we worked together while you went to Texas Tech and got your Master’s in Education and following that we worked together again - you as one of the counselor’s and educators, me as one of the nurses.

Two of my favourite memories of you are the first time I took care of you and later on something you shared with us at the treatment center where we both worked.

As my patient you were stubborn and arrogant, unwilling to even look at the types and amounts of pills you were taking. Mention of your dad just put your back up because you were ‘never going to be like him’.  And you weren’t ~ he died of lung disease, but was sober and had been sober for many years. In those early years you knew nothing of relapse, and maybe didn’t really believe it could happen to you. And so, you unfortunately relapsed after a long period of clean and sober time and died of this nasty, horrible disease of active addiction.

We were all so proud of you at the treatment center. In between the time you were my patient and your too early death, we watched you go through a chemical dependency treatment program, graduate university obtaining a Master’s in Education, and returning to where you had begun your journey - but this time as one of the counselor’s. Your time as a counselor surrounds the second memory. It was your belief, and I concur, that all recovered folks in the early years of sobriety are ‘flaming co-dependents’ and have a lot of work to do to repair relationships. You worked well with patients and their families bringing them hope and help, directing them to the supports that they required to maintain their lives when they had chosen sobriety.

I was greatly saddened when I learned of your death after all of the work that you put into your recovery and the recovery of others. The manner of your death was so very unfortunate, but the good that you did in the years before your relapse was profound. Just know that lessons that you taught me from that beginning stubborn arrogant individual and later on, from the counselor are still used and shared by this nurse.

Thanks for all that you gave to me and to others,

Take care,

Susan

“Relapse is part of the disease of addiction. It’s something that’s 

going to literally slap them in the face when they walk out the doors.”

~ Nicole Lockhart

An Up Side

If there is an up side to Addiction ~ it is recovery

Recovery of health

mental and emotional

physical and spiritual

Recovery is ~ these human facets

each woven together creating a strong suit of chain mail

surrounding and supporting an individual while

picking up the shattered and scattered pieces of life

mending relationships that seemed past mending 

learning to let go of those relationships long past any mending

developing community with family and often new friends

building and rebuilding from the inside out.

Recovery is sometimes accompanied by relapse

renewing old feelings of shame, guilt and remorse

having a more solid foundation of changed

attitudes and behaviours

physical health and spirit.

Mistakes made are lessons learned

Trips and slips ~ signs that construction is still needed

Is recovery easy?

Habits of a life time compounded by substance affected learning and living die slow and painful deaths

Qualities hidden in the years of abuse of substance, person and relationship grow slowly as the soil of a life is weeded, watered and nurtured.

Is recovery found alone?

The lessons of recovery offered by friends, family and professionals

are merely supports throughout recovery.

Recovery is as personal and profound as active addiction has been.

“One must not forget that recovery is brought about not by the physician, but by the sick man himself.  He heals himself, by his own power, exactly as he walks by means of his own power, or eats, or thinks, breathes or sleeps."

~ Georg Groddeck