Here.

I'm still here. Are you still here?

Gumption!

I was a lazy kid. No, I was a conflict-avoidant kid, too afraid to take on things that seemed "hard" because I feared failure. So, you know, a normal person. I changed my college major to writing because it came easily to me, whereas biology and art took more work (and frank talent) than I thought I could muster. Years later, I found it harder to slog through unrewarding and soul-chipping things (jobs, relationships, cleaning the grout) than just making a change or sucking it up.

I have a spreadsheet of every guy I've ever dated. It helped me see patterns--like repeatedly picking unavailable men (the adamant bachelor, the workaholics, the guy who moved continents every six years, the guy who couldn't express an emotion if it set him on fire, the pretentious whiny twit who had no room for anyone else's issues because he couldn't shut up about about his own perceived problems and the general stupidity of everyone else). Another pattern, I suppose, is my own bewildered judgment and tendency to rationalize the unpleasant until it hurt.

Where was I? Oh, patterns. They are tracings of the past, not roadmaps for the future. 

You can do more than you think you can. Unless you are pretentious and inept, of course. But you are probably neither because your are here, and therefore you are curious and insightful. 

Crows.

The brain is a marvel, and a terror.

When I was a CNA, I loved working with Wayne. He'd had a stroke, then another, and his dreams of rehab and returning home were replaced by dreams of goosing the next CNA. He was funny and sweet and kind of a stinker in the best way.

I was helping him eat one day, as we gazed out the dining room window. With his one good hand, he grabbed my arm, yelling "Get back!" I stepped back, seeing nothing. "The crows! They're after you!" I tried to calm him, reassure him that the crows outside had no interest in us. He stared into my face intently, trembling and sweating, "They'll come after your eyes! They want different things from different people, but with you," he whispered, "it's the eyes." I turned my eyes away from the window in spite of myself.

The dining room fell silent. I heard one old lady whisper, "She has beautiful eyes."

When someone is set in a delusion, telling them it's not true only makes them more insistent, more panicked. I'd learned it was best to steer into the curve, agree and try to move on from the trouble. He wouldn't believe the crows were innocent, amusing birds. Nor would he even consider that he may have had a bad dream or watched bad TV. No, the crows were organized and angry, and someone had sent them.

I steered into it. The cops were taking care of it, I said, Nope, the crows got all the cops. I told him the FBI set up a sting operation and took out all the leaders. He considered a long moment, sipping the juice I'd given him in the off chance blood sugar was the culprit. He made me repeat my embellishment, and made me swear to wear sunglasses outside, especially near birds.

He passed away about a year ago, after recovering from whatever it was that made him so frightened. It's funny what sticks with me, though. I still wear sunglasses, and I'm always exceedingly polite to crows.

When I grow up

When I was six, I wanted to be an astronaut. I also had passing notions of being a priest, until our parish priest informed me women couldn't do that. He told me I could be a nun. I told him that was stupid because nuns didn't get to do anything fun.

When I was 16, I wanted to be an astronaut and a biologist, maybe cure diabetes from space or something--I hadn't thought it through. But I had excuses upon excuses not to follow through--bad knees, bad eyes, women couldn't be pilots.

When I was 26, I'd changed my major five times, long ago abandoning stars and cells for ink. In that preceding decade, I'd had my moments, sliding down the halls of a convent in my stocking feet at midnight. They didn't encourage me to stick around. I made other plans. Coming out of a failed marriage and burning out in the classroom, I took a job writing for money. Women could do that.

When I was 36, I was still in the same career, moving up and settling in, almost happy with my work but never fulfilled, never feeling like I was saving the world. I'd had my moments, danced with politics (on live TV--my mother has the tape). After that birthday, I made my way back toward family, always wondering what I wanted to do next.

When I was 46, I'd found my calling, quit my job, and was waiting for a school to let me learn about cells and organs, people and drugs, insurance and regulations. The first year I applied to PA school, I was a little surprised to hear nothing. The second year, I started to steel myself for rejection and wondered if that dream was just another passing notion. It was a bigger shock when a school invited me to learn with them.

You know what would be cool? To be an astronaut PA at 56.

Want to make God laugh? Tell her your plans.

You know that old saying about how the mark of civilization or madness or intelligence or whatever is the ability to hold two competing ideas in mind at the same time and believe both? Well, I've been meaning to post about that. I've been pursuing this PA thing for four years now. Last year I applied to a few programs knowing I barely qualified but hoping they'd take me anyway (this did not work). This year, I applied to eight programs. Next year, I will be in PA school (plan A) or I will have passed the crossroads of Plan B.

I've already gotten a rejection from my top pick--and from a program I didn't even apply to. So, I've been wrestling with plan B and all its iterations: holding two certainties that can't coexist. B1 is to firmly believe I will be a PA, and I will keep gaining experience and keep taking classes until a program accepts me. B2 is to accept that I've given it a good run, and now it's time to go back to work where I'll get salary and insurance and retirement in a career that is acceptable but not as fulfilling.

The problem here is that I can't embrace one option while also pursuing the other. I'm not built that way. I don't think it means I want a PA career any less; it means I'm pragmatic about the odds of getting into this very competitive field. I'm sure there's a smattering of imposter syndrome too, some level of conviction that I really don't deserve to be there, or I can't really hack it, amidst all of those bright young students who surely grasp math and science much faster and better than I, who can survive on little sleep and much caffeine, who have done amazing things in this world.

But that is not the point today. Today I am over the moon that one of my top schools picked me--me! to interview. Plan A may just work out.

Big dreams, another year out

Two years ago I left my highly paid dysfunctional job to commit to being a PA. Well, I left to be a CNA and take more classes so I could apply to PA school. One year ago, I applied to five or six programs, knowing I met the minimum requirements, convinced that my amazing essay with my lifechanging story and my advanced age life experience would help me stand out from the charming young honor students. It did not. My top school regretted to inform me that 1500 bright, hopeful, driven people applied for just 50 seats. I assume those other applicants were bright, hopeful, and driven, because the application process is a bear.

This year, I'm much more humble, even with more experience and more hours studying. I've switched from CNA work to scribing for a PA in family practice. This new work has challenged and delighted me; I've learned diabetes, the disease, and about the million reasons people with diabetes can't just follow our list of recommendations and prescriptions. Medicine is about the individuals, their bodies and their quirks, more than the treatments we can offer. I like the variety of cases we see, and I love seeing patients come back. I love building relationships and working toward long-term wellness, or at least a measure of comfort. I've also learned how much I miss hands-on care. I miss feeding, bathing, and talking to my patients, who called me Tomato Lady because we talked about my garden all last summer.

It's surprisingly difficult to write essays answering such simple questions. Why do I want to to be a PA? It's like asking someone you love why they love you. Poor Cordelia, after all, was just as dumbstruck as I am. But of course PA schools are not foolish old kings, and my English degree is showing.

Old people say the darndest things

Sibyl, my patient with dementia, tenderly touches my face, "Oh, your eyes are red." She narrows her eyes, "Are you on drugs?"

By any other name . . .

"Evelyn! Evelyn! Can you help me?"

Sibyl started calling me Evelyn about a year ago. That is not my name, not even close. But she was suffering from dementia and wouldn't recognize me from day to day before that. Dementia made her sweet one moment, angry the next. When I first met her, she pulled my hair.

Somewhere along the way, though, I became Evelyn, a woman who would always help her or hug her, bring her cocoa or a warm blanket, or find her glasses or a new book. She was always sweet to me when I was Evelyn. 

I asked the other aides if she called them Evelyn too. No, only me. She called Kim other K-names, like Kathy or Karen. Angela became Andrea or April. Gary was just the Handsome Asshole. 

For months, I answered to Evelyn, always happy to do so, always wondering why that particular name.

Then her husband died. When her family came to take her to his funeral, she grabbed my hand and said, "I want you to meet my boys!" To her sons, she said, "This is Evelyn!" They peered at my nametag quizzically. I explained I also answered to the name on my tag.

Sibyl clung to my hand, beaming. "She reminds me so much of my sister! Her name was Evelyn too!"

It was one of the sweetest moments at that job. I have a sister, and I'd like to think that when I am old and my memory is fading, I'll know her still, even in other faces. 

Dementia is a trickster. Its spell of confusion brought her the comfort of her sister, true. 

But last week . . . last week dementia was cruel. Last week, she asked who I was. "Evelyn," I said. She shrugged. It was just a name. 

When somebody dies

I work as a nursing assistant now, a big change from my old career. I was worried about how I'd handle the death of a patient I'd worked with, and I was surprised that I didn't fall apart. I work in long-term care, mostly with the elderly, and I've come into work to an empty bed several times in the last year. In some cases, I got to say goodbye. In others, someone was under the weather for a day or two, maybe a few weeks, then gone. Those are the hardest.

The first time someone died on my shift, I stepped in and relieved her aide who wasn't ready for the next step--wash her body and prepare her for the funeral home. Rita had had a fall and gone on hospice only a few weeks before--and she fought death every inch. Rita was a tiny, feisty woman who did not want to ask for help. She was mad that her body was failing her, and scared. I sat with her in her last days. So when she passed, I was stunned at my own response. I was sad. I knew I'd miss her. I kept on, though.

But yesterday, I almost lost it. I was helping a new patient to bed, and as I pulled the quilt around her shoulders, I thought it looked familiar. Then it hit me--it had belonged to Maggie. When I helped Maggie from her bed to her wheelchair, we'd joke we were going to win the next Dancing with the CNAs. Each time she'd get up, she'd tell me whether it would be a waltz, a foxtrot, or maybe a jitterbug. We'd hum, and she'd cling to my shoulders while I eased her into her seat. During our last waltz, we had no idea she'd fade so quickly and I'd greet an empty bed.

When someone passes, we help their family go through their belongings. Many time, families tell us to keep their clothes or blankets or special pillows for someone who needs them. Maggie's quilt now warms a blind woman who can't see its colors, but appreciates its warmth. Penny's pillow cushions a tender wrist. Alexander's slippers help a man with a new hip shuffle safely behind his walker.

Maybe I don't have to say goodbye to these kindly ghosts who walk beside me.

Lily Marlena

A few years ago, I made a baby quilt for my nephew. The kitties decided to test it out. 

In 2001, my friend Mike called to say he'd found a sick kitten in his bushes. His cat was having none of her, so Mike got her patched up and brought her to me. Lily crept out of her carrier and nuzzled my grumpy old orange cat, Atticus, and presented her ears to Esme, my recently adopted sweetheart. They loved her.

Lily was a social kitten. I would come home from work to four or five cats on my porch, mooning over this beautiful girl. One of them, Leprechaun, moved in shortly after that.

She loved belly rubs on her terms, which were communicated via razor claws. Her purrs were impossibly loud, while her chirpy meows were barely audible.

She was all of seven pounds, but would post herself under the cherry tree, growling, determined to catch a squirrel. She never did, as far as I know, but we found a possum tail on the porch not long ago. Maybe she was successful in her last few weeks.

I miss her. When I come home, I look for a dash of white, then come up short.

A few weeks before she died, she sat on my lap for a long time, despite the draw of a gorgeous summer day outside, despite the big, curious dog next to her. I told myself to savor this--her spiderweb-silk fur, her crystal blue eyes squinting in contentment.

Three years ago, my heart stopped.

This is my application essay to physician assistant studies school. 


Three years ago, my heart stopped.

My partner George lay before me. I’d held his hand while he seized and coded, and now a kind nurse held me. With each zap of the defibrillator, his body arched off the bed. When his heart finally beat, mine could too.

In the summer of second chances, I watched George get stronger and think about what he wanted to do to make life and death meaningful. Approaching life from the epilogue changed how we thought about our next chapters. For George, that meant living life outside of work; for me, work is a vocation, a way to make a difference.

As I came to know George’s medical team, I spent our visits marveling at, and envying, his PAs. I told Robert, a cardiology PA, that he had the most amazing job in the world. He agreed. Our conversations turned from, “I wish I’d had a chance to be a PA,” to “I want to be a PA.” To me, that meant being part of a team focused on a person, not just a collection of symptoms—looking at both the immediate, critical needs and long-term health.

When I finally said it out loud, George, his medical team, and my own doctors all agreed, enthusiastically, that not only could I do it, but I would be great.

I’m not a typical PA student. I don’t have straight A’s. I’m in my 40s. But I do have a rich background.

My first time through college, I had a notion to be a vet or study genetics, but I also had the mindset of a first-generation college student who didn’t know how to study or ask for help. I managed to get a master’s in English and look for ways to make the world a little better.

I taught college composition, then brought in millions of dollars in grants for teaching, research, and underserved communities. I served on boards and commissions that give voice to the underserved and marginalized. My quest for social justice got me to the Democratic National Convention as a national delegate. I kept teaching, and I kept taking classes: Spanish, winemaking, and American Sign Language.

Throughout all of that, I helped my friends and family with their health issues. I’ve sat at bedsides and researched aortic aneurysm, breast cancer, postpartum depression, neuroma, and prion disease. My crohn’s disease taught me how difficult it is, for patients and providers, to make sense of a mysterious collection of symptoms and navigate disease management when there is no cure.

Three years ago, my heart took me in a new direction.

Two years ago, I took a long-dreaded chemistry class and surprised myself with an A. An international development class took me to Nicaragua, where I worked on water quality with AMOS. Dr. Laura told us that when she arrived, eager to cure tropical diseases, she learned the most important thing a doctor could do was teach. Ending poverty started with safe water. In our mountain village, my closest friend was Jaclyn, 9, a tiny, bright, sweet little girl who did not go to school because she needed to watch her baby sister while her mother worked. I left a piece of my heart with her.

One year ago, I left my job to become a Certified Nursing Assistant and immerse myself in school.

I shadowed a PA in urgent care, listening to congested lungs, looking at rashes, watching elegant stitches repair gashes, learning about gout and sprains, antibiotics and drug interactions.

With each experience, I found new things to love about our precarious bodies. It’s a family project. George quizzes me on anatomy; the boys look over my shoulder while I research.

Nigel, 19, met me at the door the night Donna died. I’d help wash her body. Nigel had heard me talk about the feisty woman whose hand I’d held in her last days. Something profound happened to her, and by extension me, and he wanted to process how a person lives 85 years, then stops. He could not have done this three years earlier, with his dad. I had to. For the space of a heartbeat, I faced life without him--then faced life with new meaning.

I know I will be a good PA. I’ve seen life and death. I’ve seen crushing poverty. I’ve seen students light up when I help them understand something they’ve always hated or feared. I held my mother’s hand through breast cancer, pestered a dear friend to visit a doctor so she could walk again, reviewed clinical trials with my rheumatologist, and helped neighbors calm fevered babies. My grumpiest patients light up when we talk tomato gardens, puppies, and those things that show them they are valued and wise.

And even my worst days, when my patients are sad, violent or dying and I come home with a sore body and heavy heart–even those days are better than my last career because I can count the ways I made someone’s day better, even if it was their last.

With PA studies, I love the rigorous education, the flexibility to generalize or specialize, the opportunity to teach, and the ability to help underserved communities. I will model my work on the most caring, thoughtful, curious, and tenacious health care providers and teachers I’ve known.

The icy fingers of fog blossom into flowers of hope*

I sort of forgot I had this blog. Heh.

It's been a little over a year since I launched. My last year at my old job was particularly unpleasant, what with a unhappy manager, gutted department, persistent gossip, and the gnawing feeling of not doing enough in the world.

So now I make less than one-third of my old salary as a CNA in a nursing home. Even my worst days, of poop and death and yelling, are better than my old job.

I'm applying to PA school, and if I get in this year, it will be on the strength of my essay more than my grades or healthcare experience. I made this decision relatively late. Most PA students are young whippersnappers in their 20s. I'm guessing that more than half say, with all sincerity, that they want this path because they want to help people.

This path chose me.

There have been a few times in my life where I just knew. Sometimes that knowing was crisp and sudden, like the time I went to a caucus and just knew I wanted to be a delegate--and somehow made it to the national convention. But this PA thing took a while. The idea crept in ever so gently--through a crack in my mind* that wasn't there until the moment I watched George's heart stop, then start again.

You know how you feel like you're looking at the world, then it changes 1/360th of a degree? Like that.

This is why I am not the novelist I sort of wanted to be way back in the day.


*metaphors--I abuse them.

Countdown

So I'm launching into a whole new career (or two). My current job is ending in 26 days, and I'm so blessedly relieved to be done with it. I'm losing my love of writing, and that is just not cool. I will miss the good people, mostly those in the middle and bottom of our weird hierarchy. I am mostly not bitter, but there are days when I'm dumbstruck, again, that people would behave badly and foolishly because I would not behave that way. I mean, I am perfectly capable of being bad and foolish, but in other ways. 

Anyhow, onto bigger, bolder things. 

In the last few months, I've been teaching in the GED program for migrant farmworkers and their families. Those hours have been the best of my workday. My students are working so hard, and this test is not easy, especially for those who've been away from school. 

In the last few years, I've been taking a class each quarter. A few years ago, it was winemaking and wine appreciation. Last year, it was Spanish. This year it's chemistry and an international development class that took me to Nicaragua. It's all leading to great things. In a few years, I will be making people feel better, one way or another. 

I will teach where they need me. I will take a ton of classes. I will save money and stop buying shoes and coffee and other luxuries unless it's urgent. I will not forget the lessons I've learned from Nicaragua, and I will be bold and compassionate. 

So that's it for now. To infinity, and beyond!