Last night we went to church . We got dressed up and took pictures in front of the tree all dressed up . We got to church and found our usual seats . The place was full . It was full of folks that come to church every Sunday and of folks that want to come to church on Christmas Eve . I love going to church on Christmas Eve because I see a bunch of folks that I don 't normally see at church . Not that I really care , but I love to see the crowd and feel the energy of church . As the crowd quieted down and the service started , I looked around . To my left was the usual Sunday morning crew . . . they sit the same place every Sunday and so do we . I looked farther down the row and I saw a young woman wiping tears . She was a beautiful girl and I didn 't recognize her but it looked as if she was alone and she was hurting . The service went on and I tried not to stare but I couldn 't take my eyes off of her . The tears were being held in , and as they snuck out of the corner of her eyes , wiped as fast as they were coming out . . . she was in pain and it was hard not to see . Christmas eve is a festive time for most folks and to see someone in pain is difficult and to say the least , uncomfortable . For some reason , I could not take my eyes off of her . As the service went on , I thought about why such a pretty girl could hurt so much . . . why she was alone and what could possible be so sad . I sang the songs , recited the prayers , and watched her . She continued to cry through the service and I continued to watch her . All at once , during the collection , she jumped up and headed out of the church . I handed my son my bulletin and followed her . I couldn 't let her leave my church . . . my place where I go to worship God without connecting with a hurting person . What kind of person would I be if I didn 't offer a kind word and a human connection ? I thought about how I would feel if my daughter was the one in the church crying and no one stopped to give her comfort . . . She had gone to the bathroom to wipe her tears and gather herself . I opened the door and stared at her for a few seconds . Finally , I got the courage to say something . . . " I 've been watching you and you are so sad " . . . before I could say anymore , I gathered her in my arms and told her that I was glad she was with us and did she want to come home with us . She just sobbed for a few seconds , gathered herself , told me she was so glad she was here too . I told her I was usually at church on Sundays and she should come back . She hugged me again and walked back in to church . Made me think of a Christmas even in 1992 , when I was 7 months pregnant with my first child . This story was the Christmas eve sermon . I hope you enjoy it . . . The Story of the Christmas Guest by Helen Steiner RiceIt happened one day at December 's endSome neighbors called on an old - time friend . And they found his shop so meager and mean , Made gay with a thousand boughs of green . And old Conrad was sitting with face ashine . When he suddenly stopped as he stitched the twine . And he said " My friends at dawn today , When the cock was crowing the night away , The Lord appeared in a dream to me . And He said , ' I 'm coming your guest to be " So I 've been busy with feet astir , Strewing my shop with branches of fir . The table is spread and the kettle is shined , And over the rafters the holly is twined . And now I 'll wait for my Lord to appear ; And listen closely so I will hear , His steps as he nears my humble place . And I 'll open the door and I 'll look on his face . " Then his friends went home and left Conrad alone , For this was the happiest day he had known . For long since his family had passed away . And Conrad had spent many a sad Christmas Day . But he knew with the Lord as his Christmas guest , This Christmas would be the dearest and best . So he listened with only joy in his heart , And with every sound he would rise with a start , And looked for the Lord to be at his door . Like the vision that he had had a few hours before . So he ran to the window after hearing a sound , But all he could see on the snow covered groundWas a shabby beggar whose shoes were torn . And all his clothes were ragged and worn . But old Conrad was touched and he went to the doorAnd he said , " Your feet must be cold and sore . I have some shoes in my shop for you . And I have a coat to keep you warmer , too . " So with grateful heart the man went away . But Conrad notice the time of dayAnd he wondered what made the dear Lord so late , And how much longer he 'd have to wait . Then he heard another knock , and he ran to the door , But it was only a stranger once more . A bent old lady with a shawl of black , And a bundle of kindling piled on her back . But she asked only for a place to rest , a place that was reserved , for Conrad 's great guest . But her voice seemed to pleadI didn 't see her again after the service . I was busy wishing all my friends Merry christmas and enjoying lovely energy of the night . But I thought of her and her blue eyes filled with tears as I went to bed last night . I also thought of how uncomfortable I was when I stopped her and how she clung to me and laid her head on my shoulder . It may not have been an answer to her problems but I hope it was a human connection , a feeling that one person on earth noticed that she was hurting and that they care . Because we all do . . . I know we care about each other and sometimes it 's just too uncomfortable to stop , look someone in the eye and let them know it . I can say that I was shaking in my ballet shoes . . . but , I continued to hear that little voice that told me to go and I 'm so glad I did . Therefore , if you are a hospice nurse , you are busy and I am . I have a bunch of folks that have made the decision to put as much life in the days instead of days in the life . I admitted a man who was told that while there is no more curative treatment , they could try different things to " buy " him more time . About a month ago , my social worker and friend made the trek to his house to explain what hospice care is and answer all of his questions . We left the house understanding that he was still deciding but knowing that he would probably be calling us in the future . Well , as I said , he called and it was when he was in a crisis and his family was afraid . After two visits and a shuffling of his medications to address his symptoms , his wife called me to thank me . She said he was doing better than he had done in the last 3 weeks and they even got a chance to " cuddle " and enjoy time with each other for the first time in a long time without pain and symptoms . I hung up the phone and gave myself a " high - five " . That is what hospice care is . . . I have another gentleman that has ALS . He is losing his muscles in his chest and is breathing very shallow . He is also having trouble swallowing . But , to watch him with his family , you wouldn 't know there is a thing wrong . He is hunting , going to wine tastings , and parties for the holidays . Sure he gets tired and he sometimes needs the wheelchair to get to the party , but he is there , spending every minute with his family and his kids . He is not some guy with ALS , who is not gonna make it . . . he is a husband and father and he is living every moment he can to the best of his ability . I like to think that we are helping him with that by visiting , giving him strategies for swallowing , conserving energy and enjoying life as it is . He also knows that I will be there when he can no longer do those things and I will help him and his family through that too . That 's also what hospice care is . . . I am so inspired by these folks . . . they make the most of what time they have . They get up in the morning , knowing that they have a terminal disease . . . then they put one foot in front of the other and live the day . Do they have bad days ? Sure . . . but don 't we all ? Maybe we aren 't dying or maybe we are . . . Life in our days or days in our lives . . . a thought provoking statement , isn 't it ? These days , I am keenly aware when I am just going through the days of my life . Running from thing to thing , not really listening to what is said to me , and trying to get things done . So as the holidays approach and family comes to town . . . instead of running crazy to make things perfect , slow down and think about if this was the last time you got to spend Christmas with them . . . make sure you notice the little things , the memories , the time well spent just listening . We never really know what is in store for us and as one of my special widows told me . . . " We don 't get do overs even if we wish we did . " Here 's to life in the days instead of days in the life ! We flew from Denver on Sunday before Thanksgiving and on Monday , we set out to work . We met the family that we were building for on paper but not face to face . On Monday , when Lilian and baby Carlos showed up at the work site , our group stopped and met our new friend . She was very quiet and smiley . . . and I could tell she felt uncomfortable with us . The next thing I noticed was how baby Carlos was in a sling of sorts , close to his mothers heart at all times . He was kind of a shy little guy it seemed and to be with her , almost always skin to skin made him more comfortable . . . even happy . I thought about my kids , now 21 , 19 and 17 on the trip with me and what a pleasure it was to carry them around when they were little . . . to have them close to my heart . Lilian was no different than me when I was a young mother . . . but of course , she was . She and her husband and baby didn 't have a house . They lived in a shack of sorts , and slept on the floor . I asked her , through a translator , where she and baby Carlos slept and she pointed to the floor and when I pressed her , she said Carlos slept in the sling on her . Again , sleeping with his momma and close to her heart . While I can 't say if that is the most comfortable for her , I can say that I envy that closeness . My three went into a crib across the hall in a warm house that kept out the elements . The building , the people and the acceptance and love that we received from the Guatemalan families was wonderful . A perfect way to spend a thanksgiving week . When we arrived home to the US on Saturday , I couldn 't stop thinking about the good and the bad of the trip . The water isn 't drinkable really , and the plumbing is not good enough to flush toilet paper . . . the families , a lot of them , live in makeshift shacks and food is scarce most of the time . There is no getting around it . . . they are very poor . But , I also think they are very rich . It is obvious that the families adore each other , they seem to accept lives with little and they smile and laugh harder than I have seen in a long time . The kids run the streets in dirty clothes with runny noses . . . and are squealing with delight . Silly games are the best , like an old lady chasing them or sneaking up on them or just throwing them in the air . Momma 's nurse their babies when they are hungry and don 't have to hide or go into a bathroom to do it . It is evident that there is a joy in living simply and living in acceptance . Interesting thought really . . . acceptance . To live your life as it is . . . not to wish it was different or look at other folks and wish you had their lives . I don 't think it 's giving up on wanting things to be different . . . but when you know that the life you have is the life you have . . . you live it the best way you can . . . I admitted a lady on Tuesday that was battling breast cancer since 2002 . It had come back and she was not going to battle it this time . She was going to accept the diagnosis and go on . We talked for a long time about her battle and her decision and what she was to do now . . . live as she wants , eat what she wants , take as much medication for comfort as she needs all with the knowing that she is not going to be here with us very long . Her husband , on the other hand , had some trouble with acceptance . He wanted her to try another round of chemo , of radiation , or whatever she could do to stay alive and fight . . . to stay here a little longer . It was a poignant few minutes when she explained that she was not willing to endure the side effects of the chemo and radiation to put off what eventually is . With tears in his eyes , and his hand on her knee , he told her how much she meant to him and how he really didn 't want her to leave him alone but . . . it was her decision and he supported her . It was his time for acceptance . He called me Thursday morning saying he thought she was gone . I arrived and confirmed his worst fear . She was gone . She had decided she was done , told him before bed night before that she loved him and always would , and went to sleep . When she woke in the morning , she sat up and died in his arms . She died in the arms of the man she loved for 35 years and the man who didn 't want to let her go . The sadness and grief of this man was overwhelming . As we sat and drank coffee in their living room , he and I talked about acceptance . . . about as much as we wish things to be different , it is the way it is . He talked about his girl and how he knew she was done . . . how she had decided that Monday that enough was enough . He recounted how she told the doctor as much when she named a few more treatments she could try . She was done and as sad as she was to leave him , he took comfort in the fact that she died in his arms and that he could love her so faithfully until the end . I took comfort in that too . Life is never easy . . . really . You plan things and they fall through , you get that phone call that changes everything . . . you sit in a doctor 's office faced with the choice of treatment or not . Those are things that everyone will experience in their lifetime and the things that bring you to your knees . I guess it 's all in the expectations . If you think that you will have a life without suffering or pain . . . you probably will be disappointed , even humbled . But , if you understand that this life comes with pain , sadness and suffering and figure that you can accept that , do the best you can . . . you can get through it . We are all going to have things that bring us to our knees , be it a terminal disease , being poor and sleeping on the floor , or getting the pain and honor of having the love of your life die in your arms whether you are ready or not . . . Next Sunday , at this time , I will be in Guatemala with my three children and 8 other fellow seekers . We are going to build a house for a family there and see what is to be seen and for me , feel the spirit . I am so excited that I can 't see straight . I get to go to another country and change a family 's life in a profound way . Changing life in a profound way for someone with nothing in return . . . that 's my take on these trips . As I have said in posts before this , I don 't want to come in on my high horse and show these folks about Americans . . . how to be Americans and what we think we do better . I would argue that in the two countries that I think are the poorest , they are also the most loving and caring to each other and their families . I always leave those places thinking that while they don 't have the things I have , they sure have the love of family and friends . This trip is different though . I am going with a group of high school and college age kids . . . and one other adult . They are all so smart , and so bright and so aware of each other . They come from different backgrounds , religions , spiritual beliefs yet they all agree on one thing . . . that to change the world , it must be done by them , one act at a time . They all study different things . . . engineering , international affairs , how to survive in high school , and some are exploring life without college . . . yet they all have a servant heart cultivated in those different backgrounds . I am going to learn so much from them . I think adults like me get afraid of doing the radical things that need to be done to change the world . We get stuck . . . we go to the gym , go to work and make dinner . . . sometimes not even noticing the hurting in our path . It seems easier to me to go to a third world country to see the need then shut the voices in my head in Conifer and stop and help . Sound familiar to anyone ? Today was a day I never want to relive again . Early this morning , I got a call that scared the life out of me and then had me counting my blessings . Everyone is fine , no one was hurt and everything that was lost is replaceable except for a sense of safety . As I sat in church and thought about the " what if 's " of the day , I listened to the sermon , about " accompaniment " or meeting someone where they are and walking with them . It stopped me in my tracks and humbled me because that is what I try to do with my patients . . . to meet them where they are and be with them until the end . I drove to Boulder after church to check on my boy thinking about what to say , how to comfort him and help him understand that this episode over and he could be safe again . I couldn 't find the words to make it better but thought about doing things to accompany him . . . to walk with him in the fear and meet him there . We went back to the scary place and walked and talked . I could tell he was okay but not okay and didn 't want to dwell on the episode . I could also tell that he was getting stronger and more angry as we walked . Sometimes anger is a healing thing . . . and I think today it was . Sometimes I get full of myself when I think about how I serve people and how lucky they are to have me . . . today , I realized that no amount of service or kindness or trying to be a good person can ward away the difficulties of life . There is no magic and there is no amount of money that can make things better when they are not better . What there are in this life to make things better is relationships and love and accompaniment . . . someone who is willing to meet you where you are , be it homeless , angry , poor , tired , or scared and show love to you right there . I am lucky , I am safe and my kids are too . My kids and our group going to spend Thanksgiving week in Central America counting our blessings loving the folks there . I just hope they can find it in there hearts to accompany us . . . meet us where we are and love us anyway ! I had planned on sleeping in this morning . . . no patients to go visit early , no plans until noon . But , as usual , the other occupants in my house had plans and they weren 't conducive to staying in bed . So , I got up . The days last week were long and unsure as I worked with a family to control symptoms , understand things are happening and helping them understand the situation . The daily visits were filled with tears and " whys " and " what if we did things differently " . . . the general wishes of a family who doesn 't want their loved one to be leaving them . I found myself praying as I drove . . . for the right words , for the patience to listen , for the family to find comfort and peace with the rest of the precious time . There are weeks when I cannot understand what else there is to do other than sit at the kitchen counter , drink coffee and listen . I feel as though I have said it all and to repeat those directions . . . it just doesn 't seem like the right thing to do . Many times , I write it all down on a piece of computer paper . . . how to give medications , what to check for , what do when things happen , and at the bottom , I leave my cell and home number and tell them to call me . As ineffective as that seems . . . that is all I have for a family that is hurting so much that they can 't think . This was a week like that . . . My husband asked me if I wanted to go out to dinner and I jumped at the offer . . . I felt way too emotionally exhausted to cook and the thought of a margarita sounded like heaven . As we drove to the restaurant , he asked me about my week and I felt the tears spring to my eyes . . . some weeks , doing this kind of work is so hard . As meaningful and special as it is , some weeks , I feel woefully unprepared to be so intimately connected to families at such a difficult time in their lives . . . and even though I am doing so much to help and comfort them . . . it isn 't enough . Jim and I sat and made small talk . . . me trying to talk about something other than death , dying and the kids . They brought out my giant margarita and I took my sip . It was what I think they are going to taste like in heaven . I thought of my patient and family and was hoping they were having a relaxing time together as well . It was a nice moment in time and I was happy to have it . A few minutes later , my cell phone rang and it was one of my co - workers . She called me to tell me that she just left that family 's home and they had the sweetest time together . They had just done a video and spent three hours reminiscing about the beautiful , messy , perfect yet imperfect life that they all built together . She said there were tears and belly laughs and time spent in the bedroom , all close , all talking and all remembering what they have . Once again , tears sprang to my eyes as I listened to this co - angel - worker that took time on her Friday night to help them take another step in the journey . I hung up with her , apologized to my husband for being rude and then told him to story . . . I am convinced that one day we will all be in the shoes of that family , or we have been once and may have to be again . I know it will be hard , it is hard and we all get through it in our own way . But , as I always say . . . if we , any of us , can make that journey a little easier , a little less harsh , then we have made a difference to another person . That , my friends is what life is about . . . Today , I went to see a gentleman that I have grown to adore . He is in his last stages of cancer but is not ready to leave his loud , chaotic and lovely family . He wants to stay here although he hasn 't really been out of bed much and has daily pain . I walked in the front door and the place was so still , quiet . . . and peaceful . I could hear the TV on upstairs , but no voices from people in the house . At first , I felt like an intruder . . . but fought the urge to announce myself . I sat in the kitchen looking out the window , watching the sun peak around the clouds , listening to the hum of this home . It 's been a rough couple of weeks . Lying in the hospital , trying to figure out what lies ahead and hoping the medical folks are all wrong , makes life beyond rough . This man was told he was going home to die and the records I read about the state of his body seemed to second that opinion . But , get a man home to his own bed , his loving wife and family and watch the sweetness of family love heal all kinds of ills . Yes , it took some doing to get him mostly comfortable , to take the pain medication as needed without taking too much and to recover from being told he is not going to last very long but he did it . Today , because he is not ready to leave , decided that he needs to get stronger . He wants to walk around his bedroom and progress from there . He slowly sat on the side of the bed and turned a nice shade of green . We cranked his O2 up and cheered him on . After about two minutes of trying , he had to lie down again . I got him situated and told him that some days , it just doesn 't work . . . and he let me know that he just needed a minute and he was getting out of that bed . I realized that this man fought cancer this way , raised his family this way , loved and lived his life this way . He lived ferociously and he is gonna die that way . Okay , then . . . I thought . . . that 's what we are gonna do . He sat up again , took 10 deep breaths and grabbed his walker and before I knew it , he was across the room . He turned nice and green again , was grimacing from a painful spot on his back , and was running low on energy but . . . he made it to the bathroom and sat down on the bench . Then , he took a few more deep breaths and headed back to bed . His determination will get him through the transition from life to death . We got him comfortable and began to talk . He understands what is happening to his body and that this is probably close to the end of his time here . He just prefers to ask for information when he is ready and not a moment before . Far be it for me to do anything else . He is dying as he lived and it 's my job to help him do that . It has to be so difficult to know that sooner rather than later , you aren 't going to be in the day to day workings of life . I often wonder how people can be so straight forward , so brave when they are facing death . I think anyone who looks death in the eye , declares that at the end , they want to be home with family and then continues to live well is amazing . The nice thing for me is . . . most days , those are the kind of folks I get to hang out with . Went to church today as I try to do every Sunday . It seemed very routine and I was going through the motions . After it was over . . . I was so glad I went . Through the years , I have sat through services that have stirred my heart and services that I have cleaned my entire house , washed the car and put dinner in the crock pot . . all in my head while not feeling any spiritual feelings . I went to church today feeling like I had too much to do , not enough time to do it and I would be able to sort everything out while at church . I had no expectations at all and if you want to know the truth , felt like a total hypocrite . I have been less than kind during the week , haven 't thought of service in the holy sense and ran my mouth way too much . This week was one for the books . . . I dutifully went through the prayers and listened to the gospel . It was the reading about the 10 lepers that were healed and the one that turned around to thank Jesus for healing him . . . yeah , I have heard that one before . The gentleman that I didn 't recognize got up to preach . . . " Here we go " I thought and drifted into my head . He began to talk about how he was ill and it rocked his world , and when all was said and done , he was healed . . . he got better . He then talked about how he had such gratitude because he had gotten better and it had changed his life . He weaved it into the story of the lepers and how the 9 ran off and lived their life , just as before . . . . busy and unaware . He talked about how health is not an entitlement , that we are lucky to have it and it isn 't a given and when we are healthy . . . it is a gift . He talked about the leper , who was a samaritan , was marginalized and how he stopped to thank Jesus before he ran back to life . He related it to being in the valley and not taking things for granted . . . living a life of gratitude . . . that when we live a life of gratitude it is living a life of praise and prayer on a daily basis . I 'm not gonna pretend that being thankful on a daily basis is an easy thing or that it can be done all the time . But , I think what he was talking about what remembering what is important . Most of us know that our family , our loves and our time is what is important . But , I would be a liar if I said that certain things are not important too . I wouldn 't ask the folks impacted by the flood how important things are because as much as we can say things aren 't important , that picture of grandma or your son 's first tooth is a thing and if it floated away . . . . well . . . It came back to thankfullness for me . . . not because I have this perfect life without pain and difficulty . . . we all do , in some way , don 't we ? But , when I can look at my husband and be thankful . . . for his kindness when I am out of control , or when my 16 year old asks me to do the puzzle with him . . . I am thankful . Or . . . when I go to a patients house , who is dying , and watch his family feel thankful that he is home and they get to care for him , as difficult and sad as it is . . . I think that is what the point is today . When you have been in the shadow of the valley of darkness , it makes you appreciate the light . . . even when it seems like it 's not that bright and is dimming by the minute . . . Sometimes , you are the leper . . . and then you are healed . I guess the question is , do you run back to your life and everything is the same or do you try to be thankful . . . to live in gratitude ? I always try to remember that no one gets out of this life without heartache and sadness , so why not try to treasure the times when everything is good and try to be thankful ? All of the writer 's say the same thing . . . " Isn 't it so hard to do this work , " and " How do you do this ? " As I responded to the writer on Tuesday , " I 'm not gonna pretend there isn 't a bottle or two of pink wine consumed to soothe my tender heart . . . and I know that is not the best way to cope , but it is not really that sad . Hard . . . yes . . . but sad . . . not always . " He went on to talk about me and what kind of person I must be to do what I do . . . and I felt uncomfortable and told him so . He asked me what d I want I wanted the article to be about . . . so I began . I told him about Hospice care and how people who don 't understand feel like they are giving up . I reject that notion because it 's simply not true . Hospice care is about living . . . more comfortably and in less fear . It 's about having control of the time you have . . . not sitting a chair in an infusion office being treated when they tell you it isn 't helping and just making you sick , or being in a hospital when all you want to be is at home in your bed surrounded by your family , your pets and your stuff . I spoke of our mission to help the family to feel supported while their loved one is dying . The thing about being a hospice nurse is not that it is so hard or easy . . . we know that we are walking into . . . a family that is devastated , tired and wishing things were different . But , because we know that , it is our starting point for everything we do . We don 't go in and tell them , in their home , what they are going to do . We also know that when a person has fought hard and has been told this is what they need to do and they do it while enduring the disruption of life , nausea , baldness and fear . . . what they really want back is control . They want to feel better than they do , get a handle on pain and nausea and spend every moment they can with their family . We know that and they don 't even have to tell us . . . I say this to patients and family a lot and I always mean it , " We are going to help you " . While it is about symptoms . . . feeling less pain , nausea or whatever is physical that you need help with , it 's also about changing the definition of cure , or success . It 's not my place to change anyone 's mind or make a patient do something they don 't want to do , but talking about things that are scary and have been avoided seem to give patients and family a different kind of comfort and a decrease in the fear . I think of Hospice patients and their families as superheroes . It takes a certain love and courage to acknowledge the path before them and then follow through . I am humbled daily and consider myself lucky to have this job and that I get to do what I do . I witness humans doing what is good , right and holy on a daily basis . Yes , I know I witness incredible pain and suffering . . . from families losing a loved one or a patient not wanting to leave but , I get to help , to support and sometimes just wrap my arms around a caregiver and let them know they will make it . . . even when they think they can 't . So when people say that phrase , " You have to be a special person to do that kind of work " I challenge them . I am the one who gets to help , to watch the strength of love and family along with faith to get them through life 's unbearable sadness . They are the ones that are special people and I just walk in at the right time to be with them . So , when I knock on the door and then open it . . . I always say , " Hello , it 's me , Terry , the nurse " and walk in knowing I am lucky and honored to be right where I am . I sat at the kitchen table , uncomfortable from the get - go . The patient was sitting to my right , eating a pudding from a plastic cup . She finished it and slid the cup and the spoon across the table to her daughter in law . Her daughter in law slid it back to her and she said . . . " I want another , I 'm hungry . " The daughter in law turned to me and explained that her mother in law was on a fluid restriction , and she couldn 't have any more because it would make her thirsty . I thought to myself , " what would it hurt , the lady is 85 and if she wants more pudding , then so be it . " I looked over at the patient and she smiled from ear to ear . . . not a tooth in her mouth and the twinkling blue eyes shone bright as she said to me , " I 'm not going back to the hospital , am I ? " The tension cleared in the room and we began to talk about the patient 's health now , her life and what led us to this very moment . As the patient 's son interjected about his mother while his wife talked , I was struck with how hard this decision is for him . He was a quiet man , and while it was beyond difficult to care for his mother with her medical issue and advanced dementia . . . the thought of losing her was unbearable . He knew he wanted her home with him and not in a nursing home , he knew that he didn 't want her to suffer , and he knew that she wasn 't getting better . What he didn 't know for sure was that at some point , she wasn 't going to be with him anymore and that thought , as hard as it is to care for her , was unthinkable . So we sat and talked . . . we talked about who she was and who she is now and how while he could decide not to take her to the hospital when her next problem arises , it isn 't him making the decision to keep her alive or let her die . . . it 's her body , it 's her age , it 's how life goes when the body is beginning to shut down . While he said he understood , he continued to rub his forehead and sigh . We explained what we can do to help him in this situation , how he can change his mind , how hospice is about life and comfort and symptom control and having as much dignity and comfort as possible until the end . We left our cards , I advised him to call me with questions and told him to do whatever he needs to do to decide . " Call me " I said , " and if I can help you with anything even if you decide to take her back to the hospital , I would be happy to help " and left . I appreciate how deeply this decision affected this son . Daily , he and his wife care for this woman who frequently doesn 't recognize who they are , where she is and how to even use the restroom . They hardly sleep , they go to work , and care for his momma . I am sure it is beyond difficult to do that day after day . But , we can only hope when or if we become like her . . . our family will still love us enough to struggle when deciding on continued treatment . I got a call today that they want to sign her up for hospice care . They are tired and want help . . . they are still not ready to lose her and I told them that we will help them any way we can . . . even if they change their mind when she is at the end . My hope is that we can help them get time that is sweet , not so stressful . . . . sleep at night , no fighting about food and drink and we can take away her fear that she will go back to the hospital . . . Once again , I am forced to think about how difficult life is . . . how time marches on and even when you wish things were different , it is what it is . But , I feel very lucky when I work . . . not because my family is healthy or my life is just as I wish it would be but because it 's not . But , it 's seems to me , I see , over and over that the struggles and difficulties make us who we are , and make us love each other harder and cherish each other more . The stuff that makes us question who we are and who we want to be on every level . . . In that time , I have spent time with my children , settled them in college , attended multiple deaths , multiple meetings , got a raise , went on a cruise and attended my second to last back to school night . I had a mani - pedi , watched my husband and son do a " motor job " on an old truck and pull the engine out of the subaru . I have eaten numerous meals , lost and gained the same five pounds and kept the white zinfandel business humming . Why am I writing this long list of almost nothing ? Is it because I think that you are interested ? Actually , no . . . I am sure you are not . Yesterday during a meeting at work , the chaplain talked about the Jewish High Holy days and what it means . She talked about that so we can be sensitive caregivers to all faiths , to all people , and understand them a little better . The article was written in a little town newspaper and I am lucky enough know the Rabbi that was interviewed . She read the article : Jewish High Holy Days " motivate us to see the possibilities of change . . . to say , ' I am sorry and want to do that differently . ' A month before the High Holy Days bggin , Jewish people begin reflecting on their transgressions and making amends to others . " We have for responsibility for wrongs " and " We all have room for improvement . " The holy days are to atone . . . to remember who they are in relationship with God and people and live their life in such a way . I think that is beautiful . It speaks to grace , forgiveness and being who you are in this world , being the human being that you are supposed to be or should I say , who you are created to be . People of faith often get judged because we are not good enough . It 's not good enough to go to church on Sunday and then screw your neighbor over during the week . That is not what a person with intergrity or faith would do . Sure , we have seen more high profile " people of faith " make terrible decisions that hurt people . It 's not good enough to say you love all people then act like a bigot during the week . That is not what we are taught to do on Sundays at our houses of worship , is it ? That may very well be who you are but why do you pretend to be someone else on Sunday ? Listening to the article and then reading it this morning , the same thoughts came to me over and over again . " Are you authentic ? Are you who you want to be and if not , why not ? " If I was anyone that I could be . . . who would that be ? Interesting to think about , huh ? What are the wrongs that I have committed since last time this year ? Too many to count , I am sure . Who do I need to atone to or as I call it , " make peace " with ? I 'm sure there are many there too that would include friends and family . In the Jewish tradition , I 'm going to take time to think about change . . . atonement . . . making peace . Not sure who I need to call and I have to say , if I wronged you , please let me know so I can make it better . It 's time for my personal tune up . . . the find my authentic self and live that way . . . every day , with no excuses . Care to join me ? I remember the first night I had her at home , fell asleep in my bed , and when I woke up , Jim had her wrapped like a taco in her little blanket on his chest in bed . I was so moved by how he was holding her . . . comforting her and I knew we were never going to be the same . And we were not and still are not ! We were connected back then , committed to raising a good person and that was that . We knew we would love her , but we didn 't understand the depth of that love , that soul jarring , soul changing love that is indescribable . Then they grow up . The decide they want to do things that you would rather they did not do . From swimming , to band to a nose piercing . . . and you figure out the best way to deal with stuff . I always wonder if I did okay . . . if I said too much ( of course ) or if I should have let them just figure it out without my opinion . I remember when she was looking at college , I so wanted her to be close . . . to go to CSU or CU so I could visit and I would be able to know what was going on . She picked CU and I was so happy . . . an hour and one half away if I jumped in the car . But summers were different . . . she worked at a camp three hours away and I saw her once . That wasn 't in the bargain . I missed her terribly and wished she just got a job closer . The saving grace was I still had the two boys at home to fuss over and love too much . Then this summer . . . the choices were Africa , where she applied for an internship but did not get it or Guatemala . I was trying my hardest to be a big girl and be supportive but I really wanted her close . . . so I could see her . . . hang with her every so often . Then she picked Guatemala and I knew I needed to support her . Whenever she would ask my what I thought , I would tell her it was her call , that she needed to go out and experience things . . . and what I didn 't say is , " what about your mother ! " So she did it and she is coming home and I am sure she is a different person . When you live with nothing , serving others for nothing in return . . . how does that not change you ? I thought about her today when I went to see a patient that is not going to be with us too much longer . After the crisis was averted and the patient was settled down , I told the family it was time to " love him up . " The wife and the daughter sat down next to him and started to tell him things , taking turns . . . The wife told him what a wonderful husband he was and how it was okay for him to go . . . how they were going to miss him but he didn 't need to stay for them . Then the daughter reached up and kissed him on the cheek and whispered things in his ear . In his less than responsive state , he turned to her , opened his eyes wide and smiled . She continued on through a veil of tears talking about how much she appreciated him and how lucky she was to have him as her father . The daughter is young , not even out of her twenties , and it is obvious that they adored each other . I walked into the kitchen to give them some privacy and gather myself . The grandmother was pouring coffee and offered me a cup to which I accepted . . . then she said , " I lost my husband 10 years ago and this brings so much back . Life is so hard , actually , it is always hard and when you have a time when something is good , you have to remember that and let it sustain you through the rest of it " . I agreed with her . . . sipped my coffee and thought about what she said . I see death . . . I do death . . . on a daily basis . I help folks die and I help folks love their dying ones out here . I love my job , I love being with people when they need comfort , strength and sometimes to truth even when hearing it is devastating . It is a connection . . . a bond between hearts , souls and what 's in between . I thought more about what that grandma said . Life is so hard and sometimes I make it harder by wasting time with things that I have no control over . . . like where my kid goes to college and if she experiences life different than I think she should . . . or , God forbid . . . she has a nose piercing ! My Queen arrives home to my house a week from today . She is done " bumming around " Guatemala and will be headed back to her senior year in college . She has been writing a blog weekly or so about her thoughts as she served in a third world country . This is the last in the series and I am so mixed about her coming home . Not because I don 't want to see her but because it seems like even though she worked so hard . . . she was served by the people . The laughter and love that she got from her little " family " in Guatemala is a memory that will sustain her in the hard times of life . I know she is a different girl now than when she left and I am so proud of her . . . The first Friday in August , since 2006 , one or more of my children would begin band camp . In 2006 , I dropped off the Queen at the high school at 9 am and told her I didn 't want her doing this . . . I didn 't want her to be in marching band . I told her it would take too much time , and I didn 't think it was worth it . When I picked her up that afternoon , she was so excited that she was part of that group and off we went . In 2010 , she was in front of the band . . . leading them . She marched for all four years of high school and is a senior in college and is planning on marching there this year too . My middle son was a harder sell . I remember my daughter talking to him on that first Friday of August in 2008 about how fun it was going to be . He was very sceptical and told her so . They left the house with her saying , " Okay , if you don 't love it after today , I will let you quit . " Well , you guessed it . . . he was all in after day one . He too , marched his whole high school career , tried out for Drum Major and is still marching in college . He just loves the social aspect and playing his instrument . My youngest son , as you probably know , marched the Tuba last year and I was over the moon . He was so impressive in his uniform with that shiny instrument on his shoulder . It was a great season for me . . . The third week of June is the first taste of band camp for the upcoming school year . I got a phone call from him after about day 2 of camp . . . " Ma , I wanna quit band and I am going right now to talk to the director . " I put him off saying he needed to come home and talk to me about it and that I didn 't understand . . . He came home and we sat down on the couch in the living room and he explained why . He had valid reasons and he was interested in trying new things and taking harder classes and things like that . Because I love band so much and watching my kids play music , I was categorically against it . He was staying in band and that was that . He went the next day and didn 't mention it again . I was so relieved that " he " decided he would stay . . . The next day , he came to me again and said he really didn 't want to do band his junior year . He wanted to play baseball , take up golf , work on the truck with his father and do other things , I finally listened . He wanted to be his own person and he has been trying to differentiate himself from his siblings without a fuss . Since I can 't deal well with change , I wanted him in the mold of the last two . No changing and being himself here . . . Well , today is the beginning of band camp for the school year . . . and guess who is still in bed . My other two would have been leaving the house about now , so excited about marching another year . They would have come home sun burnt and fall asleep on the couch from being on their feet , in the sun , marching and learning a lot of new info . I would have woken them up for dinner and heard the whole day . . . the music , the show , the people in their section , who can march and who needs work and how the year was going to be . This year is going to be different though . I will not be planning menus to feed 140 , being on call all of August so I could not be on call in September and October . . . It 's okay though . . . really . Am I going to miss the work ? Sure I will and I will miss the kids . . . but I also have to hand it to my son for pushing the point and letting my know who he is . I am not an easy person to go against and I heard that time and time again when I told other parents that my boy wasn 't in band this year . " That must have been really hard for your son to tell you " they said . " You love band and he must have really been worried about what you would think . " I guess I was a lunatic at times . But I was so proud of the hard work that the kids do . And , if you ever see your kid march a show in competition , see them come off the field with a gleam in their eye and the confidence that they did the very best they could , you understand what I mean . Here 's the thing , I got the privilege of that feeling for 7 years and it never got old . Never . . . Sometimes , I would cry from the intensity of the feelings of pride for the kids . . . it moved me that much . But , it 's really okay and actually , it is gonna be good . I am going to get to spend more time with my boy one on one . I did all that volunteering so that I could spend time with my kids and rarely did I spend but a minute or two with them . It was spent on the whole gang , and the other parents . I have to admit , it was a very social time for me . when he gets up and we will talk about the plans of the day . There are things he has to do . . . things to take care of , like summer homework , changing his schedule at high school to another class and figuring out fall baseball season . I guess what I am saying is , if he is at peace with this change then I need to be too . But , for anyone who knows me . . . I have to work on it . Today is like any other Thursday . . . work , gym , make meals , etc , etc . Nothing too exciting but nothing too bad either . Kind of just a regular gray color that feels like what life is for me lately . If it sounds like I am on the depression continuum . . . I would have to agree . Then , I looked at my phone and pulled up instagram . I immediately saw the picture that my Queen posted and sat for about 5 minutes staring at it . What a beautiful picture of regular folks doing regular things . Not necessarily easy , glamorous , fun or designed to make you laugh but just living life . That picture made me smile for a long time . I admitted a lady yesterday that has ALS . That is the fancy term for Lou Gehrig 's disease and it is not easy , definitely not glamorous or fun and I would think difficult to even smile at times . As I spent time with her and her husband , I noticed that there was something about both of them that drew me in . I wanted to help them anyway I could . By the end of our time together , I asked if I could come over today to visit with her again and sit with her while her husband got out of the house to do some volunteer work . She mentioned that she didn 't like to be alone and he needed the time to do something that filled his soul . I showed up today and walked in the open front door to find my lady in bed . She was comfortable and had a view of a beautiful mountain meadow that deer and elk would stand around eating grass . When I commented on the meadow , she scribbled , " aren 't I lucky to have this nice view ? " I agreed . She can hardly talk , swallow and her muscles are getting very weak and she is aware of the beauty of the meadow ! After I checked her out , I pulled her rolling walker up next to the bed . She called her dog on the bed to lay by her while we visited . I talked and she talked but when I didn 't understand , she scribbled and did hand gestures so we could get to know each other . We talked about decisions she needs to make , and how she can have control when she feels like she has none . I asked her about her husband , their 50 years together and how he too will have to understand her wishes and she understand his . It was quiet and I figured she was probably tired and I would get ready to go . But as I bent down to pack up , asked me about my family . While I love to talk about my family , I wondered if she was just being polite and asked her if that was the case . " No " she blurted out and reached for her pad and pen . I told her I would love to talk about my family and I pulled out my phone . I showed her pictures and the picture on my blog . I told her the story of my queen , where she is and what she is doing . . . and she clapped her weak hands together , smiled so big that her eyes almost shut and put two thumbs up . The only word I can describe her as is joyful . She was joyful for me and my family . . . while she slowly gets weaker and needs more care . Humbled . . . . We finished our visit , I bent down and hugged her and thanked her for talking with me . I told her that I am so glad that I am getting to take care of her and would see her on Monday . Then I looked around her modest home and left . There is a certain quality of life that we all strive for . For some of us , it is a perfect house , lots of cars , toys and things . For others , it 's a close family and health . And , for others , it 's being content in the moment , where we are , with what we have and with what health we have . I seem to get these people that I am supposed to be helping that leave me speechless ( and that is not easy . ) People that I learn so much from about hope , love , living and dying . I can only hope I give half of what they give me back . I worked today . . . 6 visits for 7 patients . It was a humbling day . As I drove , the song . . . " Closing time " came on by the Semisonics . The part of the song . . " Every new beginning comes from some other beginnings end " struck me and sat with me all day . I had plans with a patient 's wife , a friend that I knew from the days of pre - school for dinner . I was nervous and worried about how she was doing since the love of her life has been gone for 2 months . I had the honor of caring for them in his last days and knew she was tender and was missing him terribly . We met at a local restaurant , hugged and sat down . I asked her how she was and she began to tell me of her life now . She regaled me with the tales of broken down cars , bills to pay and things that her love did that she has taken over . She told me of the big house and the deck sitting alone wishing he was there . She told me of the wins . . . . getting the car fixed , paying the bills and being strong to honor him . Then she told me of how she remembered his last day . . . did she do enough . . . did she tell him how much she loved him before he left ? I told her of walking into her home and watching her hold his hand and gently stroke his fingers as we talked about his illness . I told her of the tear that rolled down her cheek as he told me that he was done fighting and was ready to be comfortable at home and not pursue more treatment . I told her how I envied her strength because it was obvious to me that she wanted him here longer . I told her when he turned to her after he made the statement , she smiled at him as if she was " all in " . By that time , we both were tender and tearful . I continued to remind her of how she fought for him . . . for treatment , for cure and when that was not a reality . . . for dignity , comfort and a quiet , peaceful death in his own home , his own bed and with his wife beside him . I told her that she did everything right and that we can only wish that would happen to us when it is our time . I fought with her over the check . . . and won . " You owe me " I said and left it at that . Paying for dinner is a small price for having the honor to care for a man with such a kind heart and lovely family . . . I drove home and my cell phone buzzed . . . " you are such a good soul " was the message from my friend . I sent back a text telling her how much I enjoyed the night and the company . A good soul . . . I sure hope so . . . You know when you go to something and expect nothing but leave a changed person ? When you are in a rut and you feel like you can 't do one more thing and then you do and it 's one of the best things you 've ever done ? Has that happened to you ? Well , last week , it happened to me . Last Wednesday , my work had a mandatory " team building " session for two hours . It was scheduled for 3 - 5 and we were enticed by knowing when we were done , there was to be beer and wine and " heavy " appetizers . The email to notify all of us went out a few weeks ago , when I wasn 't on a " change my life and get thinner " plan so I was stoked . I even asked the boss what kind of " heavy " appetizers I was to expect . But as the day rolled around and I became more committed to my health plan , I dreaded the whole thing . I sensed that the crowd that showed up felt the same way . " Are we doing a ropes course ? " one of the physical therapists said , and then another co - worker said , " Are we gonna stand around , hold hands and sing Kum - ba - ya ? " to which we all laughed nervously . All I could think about was the appetizers in the other room and how was I gonna make a clean get away . . . The meeting started and I could see where the management team was going . We are a great agency , a great place to work but we could be better and we , as employees , could be happier . Sometimes , since we do such emotional and difficult work , things can slip . . . our work can and our relationships can . There is no doubt that I let my personal relationships slip when I am so emotionally drained from supporting others . They threw around terms like integrity , value added , and win / win . I liked what was being said , hoped that we all heard the same thing and wished it was almost over . I was starving , the food was in the other room and the beer and wine was chilling on ice in the room we were in . I was thinking this wasn 't a " win / win " for me . . . Then our communications person began to talk about a trip she had been on and how it had changed her son 's life . She took him to a country with much less than ours and he noticed how happy these folks were . He talked to his mother and wondered how can that be . Then she used the term " abundance mentality " and my ears perked up . Sounded like an interesting thing to really listen to . She read the definition : Abundance Mentality flow s out of a deep inner sense of personal worth and security . It is the paradigm that there is plenty out there and enough to spare for everybody . It results in sharing of prestige , of recognition , of profits , of decision making . It opens possibilities , options , alternatives , and creativity . Wow . . . being a person or a business who works with integrity and caring , that understands that we all deserve to be happy and have opportunities . . . yes , I whole heartedly agree . It hit me . . . that 's what this meeting is about . It 's not about making tons more money and having us work harder , because Lord knows , we all work pretty hard . It 's not about some nurse being better than another and getting paid more and bringing in more . . . it 's about all of us being the best we can be , working as hard as we can and when we can 't , having another one of us there to pick up the slack . It 's about having a family life and personal time to be a productive , positive member enjoying what we have . And , finally , it 's realizing our precious worth in this agency , in this town and on this earth so we can serve others joyfully . That 's what this whole team building thing was about . I have worked in a lot of different areas of nursing and found my way back to this one . I loved each one at the time and felt like I was serving . But to go into a person 's home , become part of the family and be a nurse is the best . It feels like service but it also feels like what a person is supposed to do . What it doesn 't feel like is a job . I am very lucky and sometimes I do get tired and sad and use the wrong coping mechanisms to deal with these things . I learn time and time again that no one is perfect . Abundance mentality is a new concept to me . I mean , not so much the concept of supporting your fellow man and giving to folks with less without thinking there will be none for you . . . but the definition of it . It makes sense and makes me more aware of how I can strive to do my job and live my life every day . . . not worrying so much that if I give someone a piece of the pie , I might not get enough , but knowing that I can go out and find more pie or just be happy with the small piece that I get that day . Oh , wait , I am not eating pie anymore ! But , the fact remains the same . . . if we go about our lives serving others without expecting in return , then the world will be a better place . I also know that I feel better and more content when I am serving others than worrying about who 's gonna serve me . It just makes my life simpler and I like it that way . Thanks for listening to whats been rattling around in my brain . . . On a whim , I walked through the book section to see what they had on the shelves . I remember last time I was there , they had a bunch of books about heaven that I wanted to buy but were too expensive . This time , they had the one I was looking for , " Proof of Heaven , a neurosurgeon 's journey into the afterlife " for 12 bucks . I decided to buy it as I have been hungering for heaven these days . Not in the way it sounds , but in the peaceful , comforting way that helps me do my job . You see , I know a lot of folks up in heaven and I wonder what kind of time they are having . Plus , it 's just nice to be able to talk with my patients if they ask me what I think . It 's a comfort for folks when the end is near . So , I read everything I can get my hands on that has to do with heaven . I went to the cashier to pay for my flowers and my other things I picked up on the trip . The cashier was overwhelmed and it took her forever to push the buttons on the computer for the lady in front of me . Another cashier came over and tried to get me to go to her register , but I told her to let the guy behind me go first as I love reading the National Enquirer and it had the best and worst beach bodies edition on the cover . . . I wasn 't moving . Finally , the cashier started ringing up my stuff . She got the flowers , the cat litter , the body wash and then stopped short when she picked up the book . She looked at it for a long time and then ran it over the glass . " Have you read this book ? ' I asked the lady . . . feeling like I was supposed to say something to break the silence . " Yes , actually I just finished it the other day . " I asked her what she thought of it and the story began . She just lost her 35 year old daughter to diabetes three months ago and was still in shock over all of it . She told me she was raising her 15 year old grandson and her and her husband had to sell their home and move to the city so as not to disrupt his life anymore . I stood there in silence and listened . I looked for the line behind me at the register and there was no one waiting . . . so I just let her talk . She talked of what a lovely person her daughter was and how she was sick for the last 10 years but they didn 't think she was that ill . She got pneumonia at the hospital and they called and told her she was gone . Just like that . . . I told her I was so sorry and it must be so hard to be raising a teenager after you 've done it . She told me the hardest thing for her was watching this boy miss his mom . Then she put the book in the bag and told me how she felt so much comfort after reading the book . How she was so unsettled and wanted to know her daughter was okay and reading this book helped her go on . While I gathered all the stuff I bought up , I kept saying I was so sorry . . . so sorry for her pain and that she lost her lovely daughter . Then I headed out into the parking lot and took a deep breath . . . Last night , I got in bed and read until I couldn 't keep my eyes open . I got to a page where I found what I needed for the day . . . the part when the neurosurgeon was in a coma and wasn 't in his body . He was gone from us and was learning what he needed to learn , what we all need to learn : That 's what I think of when I think of heaven . Pure love , something that I don 't think I can fathom . Maybe that 's what I felt for a minute when each of my children were born but then the pureness of it was drowned out by the humanness of the world we live in . Sometimes , I think I get a glimpse of heaven when a person is in his last days and I watch the family love him / her until the last breath . After I read until I can 't keep my eyes open tonight , I am going to offer up a prayer of comfort , peace and strength for my little cashier lady at Walmart , for her daughter and her grandson . . . and while I 'm at it , I 'm gonna throw in peace on earth and more kindness and unconditional love for the world too .