Lessons at the Stadium

Last night we took our son to the big football game between our beloved Minnesota Vikings and our most love-to-hate team, the Green Bay Packers. It was a big night for our son. He is a walking Vikings statistic generator obsessed fan. His love of football is around the clock. It starts in the morning with him putting on yet another Vikings jersey, throwing his football in our foyer, continues at school where he brings his football and football gloves to play a game with his friends at recess, and continues after school with more football playing, and ends at night reading statistics and talking about Sunday football, Monday night football, and Thursday night football with my husband.

He was on cloud nine when we stepped into that Vikings stadium last night. His wide-eyed stare, his toothy smile, his body tingling with excitement. I don’t think he stopped showing his left-sided dimple all night long. He loved every second of those over three hours of heated, edge-of-our-seats game play. He screamed loudly with complete elation with each touchdown. He SKOL-chanted in rhythm with his fellow Vikings fans. “This is the best night ever!” he screamed into my ear.

With every stadium game comes the adult jeerers and nasty comments about the rival team. Multiple times, the Vikings fan behind us made cracks about the opposing team’s quarterback, calling him a homosexual or gay. He yelled, “Why don’t you love your family! They will accept you for who you are!” While sometimes humorous, he crossed the line time and time again. He was so crass and loud, that it was unavoidable. My son turned and stared at him multiple times. There was no judgment in his eyes, only curiosity. As he had never heard those words strewn together and thrown aloud with such force. I heard the fan’s girlfriend lean over and quiet him trying to get him to show consideration for all the kids in the stands. “What?? Hey, don’t bring your kids to a Vikings game if you don’t want to hear the truth!” he drunkenly yelled. I did not see a productive conversation moving forward if we confronted him about this. So, I took note of his words so we could talk about it later. At one point, my always inquisitive and thoughtful son leaned over and asked me why the opposing team’s quarterback didn’t love his family. This was all news to him.

After the game on the drive home, as we came down from the high and exhilaration of a Vikings win; I turned to my son and asked him if he knew what it meant to be a homosexual or gay. He said he did not. We talked about kids that have two dads or two moms. We talked about how people can love whomever they would like, but that there are people that don’t agree with that. That though we know that you can love whomever it is you want, others who are close minded and close hearted will loudly make fun and judge people for decisions they don’t agree with. I told him that everyone is entitled to their opinions but there is a way to be kind and there is a way to open your heart to all kinds of people. I explained that that fan behind us was not one of those people that choose an open heart and kindness, and that there were many people just like him. I told him it was our job to support and show love for all kinds of people and stand up for people and their choices when they cannot themselves.

At the end of the day, I am thankful we were there to hear the truth. The truth is that we cannot shield our kids from other people’s close-minded, hateful rants. What we surely can do, is not brush these experiences under the rug. When the homophobia, racism, sexism, bigotry is loud around us, we need to be louder. I don’t mean yell back and be obnoxious in the stadium louder. I mean address these truths head on. Talk to them about these hard things and equip them with the right tools to process and react to this ever evolving, dynamic world.

We cannot just think that our kids are innocent and will find their way to the best conclusions. They are listening and learning every step of the way from everyone around them–for better or worse. Make this an active process, not a passive process.

The Vikings won. My son opened his eyes to another face of humankind, and because of it, he grew a little bit more into the man he is becoming.

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The Man That Scares Me and The Man I Love

Republished at: https://www.kevinmd.com/blog/2018/10/the-man-that-scares-me-and-the-man-i-love.html

There is a man. He is in my house. I don’t know where he came from. But he just came into my house. And now he is living there. And I am afraid of him. I do not know who he is. There is a man in my house. I am so scared. I don’t know why he came. But he is there. And he tells people he is my husband. And he is not! He is not! And no one believes me. Do you believe me? He is not my husband. I am so scared. Do you believe me? I am a good person. I have seven children. I am an honest person. There is something wrong. I know there is. I know there is.

 My patient. Age 68. She perseverates about this man. She is insistent. She was found wandering in the hospital parking lot. No one is with her. She wants to let out her fear in screams, but her voice is thin and frail. She is so frightened.

 They told me she has early onset Alzheimer’s dementia a year and a half ago. Last week I found her standing outside in the rain. A few days ago she had walked down to the neighbor’s house three doors down at 11 o’clock at night without a coat on. Today, she had an accident in the bathroom. She hollered for me to come to the bathroom and then hurried me away because she said she was going to clean it up. I went to check on her and she was gone. She had taken the car and left. She drove herself here.

 My patient’s husband. He is soft-spoken. His left hand tremors as he stands. His face is slightly glossy and his expressions are muted. I explain that she currently is confused. She thinks he is not who he is. She may be frightened to see him.

Sometimes she gets like that. She yells at me. “Get out! Get out! You don’t love me! You don’t love me! You son of a bitch! Get out!” It hurts my feelings. It does. It really hurts my feelings. And then sometimes she tells me she loves me. She thanks me for being her husband.

He speaks with a hollow, flat voice. He stares at me with foggy, pale blue eyes. His sadness and defeat lean into me. He tells me to wait for his son. His son is arranging for her to go to a center. He’ll have the details to tell me.

We’ve been married 44 years. We have seven children. And 16 grandchildren! She is my world. Can I go in?

 We stand outside her room, and his eyes fall on the closed door handle. I tell him that she seems frightened at the moment, but he knows best. If he thinks she will be comforted by the sight of him, he is more than welcome to go into her room. If he thinks it may make matters worse, he is welcome to wait in the waiting room. Whatever he thinks would be best for her.

Well. I think I’ll try, Doc. If she shouts and hollers and shoos me away, I’ll go outside. But if I go in quietly, sometimes I can talk to her and she is okay with me staying there. And then sometimes she warms up to me. I’m going to try.

 He is soft spoken but resolute. I peer through the crack he leaves in the door as he slowly inches in. He leans over the railing of the bed. He straightens her white crisp hospital sheet. She looks at him and I can’t hear their conversation, but that is relieving. He settles into the seat next to her side.

The next time I enter the room, the husband has left with family to rest and the patient’s son sits at the bedside. He loves his parents and he tells me that they are arranging for her to go to a memory care center.

He won’t be far behind her. He can barely take care of himself, let alone her. It’s just been too much for him, you know?

 The last ten days has been draining on their family. This seems like a quicksand downhill plunge. They have been in and out of hospitals. She was at her neurologist’s three days ago and there is nothing to do. Maybe these new medications will help. They will take time. In the mean time, they are chasing her in the rain.

I come back when the work-up is finished. I am relieved. She has a urinary tract infection. I am not relieved there is something wrong with her but I am relieved there is something fixable. You see, urinary tract infections can make you more confused than normal. Confusion can be the absolute only sign that you have an infection. And there it was. The last ten days of rapidly losing this adored wife, this beloved mom, this treasured grandmother, explained with a urinary tract infection. IV antibiotics were started and I admitted her to the hospital where she would not wander into the rain and she would get better.

I am not saying this is the end of their battle, that it won’t still be a declining slope, but I am saying that maybe they haven’t completely lost her the way they had thought.

I go back into the room to tell them. She is no longer tense and tearful. She is relaxed and loved and safe next to her son. I tell them about all the things I have done. Laboratory studies, CT scan, and that she has a urinary tract infection that is very treatable. She laughs out loud and all sense of that frightened woman I had met before seem to be drowned right out. She holds her hand up high in the air to give me a high-five.

Wow! Good job, Doctor!  So thorough! Thank you!  

She laughs joyously like I have just uncovered the eighth wonder of the world for her to see. I thank her for the first high-five of my day. We all chuckle together like old friends and it feels good.

There it was. A glimpse of her real self. All the charisma, all the spunk, all the warmth. There was the woman he has loved for 44 years. There is the woman that raised seven children with all the strength in the world. I see her now. I can see why this is so hard. To see her, then lose her, then see her. It would hurt my feelings too.

Hold close to those you love. Remember all you love about them. Tell them often. Let what you love imprint itself onto you, because you never know which way life may turn.

 

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The Audition

The hoops to being an “on-top-of-it” parent are endless. Remember to pack a lunch every day. Check their homework every night. Help them brush their teeth two times a day. Cook dinner for an entire family. Orchestrate on time after school pick-ups and drop-offs with accompanying sports equipment, water bottles and snacks. Remember to pay the monthly daycare bill. Sheepishly solicit uncles, aunts, grandparents and neighbors to donate to the current fundraiser. Check to make sure they remember their winter hat and gloves on the first cold day of the season. Check to see if they need new boots and coats. It is exhaustingly endless. But somehow we scramble and hustle and keep the barreling train moving forward. Sometimes, the wheels rattle and sometimes they screech and sometimes we wonder if they are falling off, but somehow, we keep things moving forward.

Last week was just like every other stretch of hurling myself over each hurdle of the 100-meter sprint to the end of the next 7-day stretch. It was Sunday night and I was bracing myself for a week of having an out-of-town husband-teammate. I was rallying to keep myself afloat by studying our family Google calendar as if prepping plays for the Saturday morning football game. My eyes flitted onto the upcoming Sunday. “Auditions” it said. My heart took a freefall down the cliff to my stomach. You see, I have a bad habit of burying anxiety-ridden thoughts to be searched for later, and I had done exactly that a few weeks ago.

My seven-year-old daughter had been asking since the start of the school year about auditioning for a “specialty dance” at her dance studio. My seven-year-old daughter—my quiet, thoughtful, unwavering-as-steel little girl wanted to audition for a small group dance. Who was I to deny her of her greatest ambition to date? You go girl, I enthusiastically fist-pumped, in my best she-is-fierce-hear-her-roar impersonation. That is, until I got the instructions for auditions. “Choreograph 6 – 8 8 counts of dance, any style, any music. We can’t wait to see your creativity!” it read. I was horrified.

First of all—for point of reference—you should know something about me. I have no sense of coordination. Here are a few facts about me:

1. I am the person who sprains her ankle walking on flat ground. Routinely.

2. I once fell from standing height while standing still at a wedding because I had put on heels for the first time after spending my entire intern year in residency working, eating, and practically sleeping in sneakers and scrubs.

Do you get what I am saying? To say that I have never been much of a dancer is to let me down gently. I certainly have never learned a piece of choreographed moves to a beat, let alone know the first thing about choreographing a number myself. My anxiety dug a hole in that mud pile in my brain where I hide unwanted terrifying thoughts and snuck this bit of palpitation-inducing information deep into its trenches.

I carried on week by week, just trying to be that scraping-by parent I was so seasoned at being. But now here I was, 7 days from The Audition. I DON’T EVEN KNOW WHAT AN 8 COUNT IS. My panicked brain screamed at me. I frantically searched for a reputable life-line. I asked my daughter, “What is an 8 count?” “A what?” She looked at me blankly. “What is an 8 count in dance? Like, do you count to 8? What is it?” She looked back at me as if I was speaking in Klingon. “An 8 count. Do you know what I am talking about? What is it?” I quickly realized this was leading nowhere fast. I set it aside, and busied myself on the train. We pushed forward with the bedtime routine. Homework, baths, teeth brushing, pajamas, bedtime stories. Two more bedtime stories. And just one more bedtime story. And just one more bedtime story. And by that time, I was ready to put myself to bed. So, the kids went to bed, and I’d love to say I had a productive night of learning about 8 counts, but let’s be honest. I went to bed.

Monday morning. 6 days till game time. WHAT IS AN 8 COUNT??? Brush teeth, put on school clothes, breakfast, check backpacks for weekend homework, library books, get your coats, gloves, hats—don’t forget your coat. Your snacks are still on the counter. Put your snacks in your backpack! Where is your coat? Do you have your gloves? Shoes. Wait, why don’t you ever come downstairs with socks? Get socks!!! You need to go potty? Take your gloves off. Where did you put your gloves? You just had them! Here. Here are a different pair. You want your Frozen gloves? Well, I’m sorry. You just lost them. Seriously, though. You just had them! Never mind. Hurry! We are late! Get in the car!

9 hours later, I have finished a shift in the emergency department. I have emergently sent someone to cardiac catheterization lab for a heart attack. I have put a chest tube into a patient with a collapsed lung. I have diagnosed appendicitis in a patient with abdominal pain. I have put a broken arm in a splint. Guess what.  I still do not know what an 8 count of dance is.

My husband is out of town. My daycare provider is on her honeymoon. My nanny is in Kentucky. My friend, part of my life-line team, and second mom to my kids has picked them up from the bus stop, and is feeding them dinner before taking my daughter to dance. I get off work in time to meet her for dinner, and finally, finally—someone who knows what an 8 count is. She educates me and I feel like she has given me the map to finding something as profound as the fountain of youth. I KNOW WHAT AN 8 COUNT IS. Thank you friend. Thank you for picking up my kids. Thank you for feeding them. Thank you for not laughing at me when I asked you what an 8 count is. Thank you for offering to help your super dance-challenged friend choreograph a piece. Thank you a million times over.

Monday evening comes around. I am armed with my knowledge. I still have no beat and do not know the first thing about dance moves. I watch old clips of dance studio numbers. I get swept up in how good the dancers are and forget to pay attention to what will work for choreographing a dance for my daughter. I have no idea what I am doing. I am in a frenzy. My husband gets home from Philadelphia or Sarasota or wherever his out-of-town trip was this time—I seriously cannot keep track. I thrust my arms in the air and dramatically groan. “I give up! You need to do this! I can’t do this!” before he has a minute to put down his carry-on luggage and take off his shoes. I am passing the buck, because truly, my husband can stand without spraining his ankle and can pick up choreography and help our daughter with her dances in a much more effective way than I have ever been able to. He has officially and involuntarily been promoted to choreographer. He is startled or maybe frightened by this seemingly hasty but unwavering promotion I have bestowed upon him.

I go to bed that night irrationally assured and unequivocally certain that I will awaken in the morning to a choreographed, adorable number that my husband has masterfully slapped together. He is literally good at everything (except completing a full load of laundry from start to finish—blogpost for another day). But this. Oh, this he will excel at. I know. I just know. Because, well, we truly have no other option.

The morning alarm hurls its horrible short sirens through our peaceful slumber. We fall out of bed, time to get ready, time to get the kids ready, more than half-asleep, we are already late, I’m sure. My husband breaks the news. He spent a harrowing 60 minutes last night trying and came to the conclusion that it is in fact impossible to choreograph 6 – 8 8 counts of dance moves to create an audition piece. We can’t. He says. We just can’t.

Okay. Let’s take a minute. If there is one thing that makes me know I CAN is someone telling me I CANNOT. The fire has been lit and I am the woman for the job. I demote him from his title, and re-promote myself. The buck stops here.

So, I do it. I truly can’t even explain how it came to be. I just DID. I choreographed 8 8 counts of dance moves to a beautiful song called “Superman” picked by my strong-as-steel seven-year-old daughter. It is Tuesday, and she has an audition piece. She is beyond thrilled. I see the excitement shiver up from her toes to the sparkle in her eyes. She practices on repeat each day. She is in love with her audition piece.

Fast-forward 6 days and it is Sunday morning. It is the day of her audition. She picks her audition outfit. She performs for her brother, sister, mom and dad. My insides are weeping with pride. She is beautiful. She is brave, she is powerful, she is IT. She walks into her audition with not a nerve in her clean, long lines, and she let’s them know: She is strong-as-steel.

We have yet to know if she will do a specialty dance. That will be announced in the following weeks, but wow. I’m not sure that part of this story truly even matters.

This head-strong, quiet, seven-year-old of mine gave me my greatest challenge to date, and I gave it right back to her. If I didn’t realize it before, I realize it now. This is the building of a strong, fearless girl. I am up for the challenge. We beat down that audition. Regardless of the outcome, deep down, I wholeheartedly know we have already nailed it.

Therapeutic Tears

Also published: https://www.kevinmd.com/blog/2018/05/a-doctor-cries-therapeutic-tears-with-her-patient.html

He wasn’t particularly likable on first encounter. He wasn’t apt to answer questions asked. He had a long pause and a long drawl and a tangential, winded story–and back story–all of which he was bound and determined to tell to its detailed completion. With an irregular heart rate in the 170’s and a respiratory rate in the 30’s, I tried to steer him in the direction of concise answers so I could obtain as much information as possible and do my job. This is an emergency. He is an emergency. An emergency who had waited until the last possible millisecond; we did not have the luxury of time.

But he was not to be rushed. My mind raced around his long pauses. My hands flitted around. Feeling his pulse, feeling his distended abdomen. Feeling the smoldering, red, hot cancer that took over his right thigh. I had never seen anything like it. It took my breath away and chilled me with impending fear of the extent of disease yet to be uncovered.

I tried to redirect him, but each interruption was met with a pause, and an indignant return to where he had left off in his storytelling.

It had been three years since he found out. Then, it was just a small bump. They told him it was cancer. It was easily covered up with clothing and easy to deny. He muffled it’s pervading presence with his stubbornness. He was indignant. This wasn’t happening. But it continued to happen. With or without his permission. It grew and grew and grew. And now, it was an undeniable monster. Growing on his thigh, in his liver, in his lungs. Filling up all his space, causing him to take staccato, labored breaths. Fighting to steal some room for oxygen every moment of his days.

His heart medications had gotten mixed up, confused, or refused. It was hard to completely tease out what had happened, as he wasn’t ready to be completely forthcoming. His stories took us farther away with every follow-up question asked. Now his heart worked in an overloaded chaotic state.

Infection had found its window of opportunity and seeped its way in to make sickness sicker—his organs on the cusp of failing.

His last name ended in an “-er”, like “Tyler” or “Kramer”. I brought the consent form for the procedure, he turned his head sharply towards me; we were practically nose to nose, as I had leaned in close so he could hear me in his good ear. “That’s not me. My name has no ‘S’” he said. I looked at the name I had written a top the consent form. I had mistakenly added an “S” to the end of the “-er”, like “Tylers” or “Kramers”. “You’re right”, I said. He gave me a gruff, indignant grunt.

We did what we could to stabilize him. I prepared for a procedure. “Have you done this before, Doc?” He looked suspicious. “No.” I said resolutely. “But I just looked it up on YouTube, and it looked really easy.” He was startled and appalled. I winked and smiled. “Oh, you got me. You got me good. That was good.” He let out a bellowing laugh like a man with all of his breath and strength. It filled the room. We both needed to share that.

I spent my time in Room 7 with him. Fluids, antibiotics, labs, imaging, procedures, talking. I softened. I grew to see his heart. His light. And I grew to like him very much.

I ultimately admitted him to the hospital. He may not have too much more time.

The next day was a day off clinical work, but I was at the hospital for meetings. My mind settled time and time again on Mr. “-er” with no “s”. I wandered between meetings up to his hospital room.

It took him a second to register who I was. My hair was down, and I wore normal clothes, not scrubs. “Oh hi Doc. Well, what are you doing here?” He asked breathlessly.

“I was just thinking I wanted to see how you were doing.”

“You want an update? Well, I can’t says it’s looking good Doc.”

He recounted his last 24 hours.

“I think I waited too long, Doc. And now my wife, you know. She’s home. She needs someone to take care of her. So, you know. We have to figure out how to tell her. My son was here, you know. He slept here last night. You just missed him.”

We sat for a long time. I watched his monitor. An irregular fast heart rate still in the 140’s. I listened to the rapid jagged, sharp breaths he sucked in and out.

“This must be tough. You have to remove yourself. You can’t let yourself feel. You see terrible things. All the time. But you have to Do, not Feel. It must wear on you.” In a moment about him, he made it about me.

“Well,” I said. “I just want you to know you have touched my heart.”

We cried. That awful stifling cry where so much needs to come out of what feels like a pinhole. I gripped his forearm with its weathered, dry skin. My finger scraped the edge of the medical tape that held his IV in place. He patted my hand with his other hand until the blood pressure cycled and forced him to straighten it out.

“Oh Doc. Thank you. For your therapeutic tears. They are warming. You worked last night, and now here you are. Right next to me. What a doc you are. What a doc you are.”

He lay with his eyes closed. Tired. Silent. Just his labored breathing.

Mr. “-er”, no “-s”, you are on my mind. Know that I’ll be here. Right next to you.

How Was Your Shift?

Also published: https://www.kevinmd.com/blog/2018/03/emergency-physicians-shift-really-went.html

She is 61 and she can’t help but smack her lips together repetitively. She has no teeth and the curvature of her spine makes her a miniature version of what she once was. Her frizzy hair is a purple-gray tone, and there are dark particles of something in the knots alongside her left temple. Her clothes are too loose and there are food stains on her shirt. The ambulance arrived at her home and there were pills strewn all over her floor and scattered pill bottles. She tells me that it wasn’t her. That someone had been in her apartment. That they were putting different pills in those bottles that weren’t hers. That pills were showing up on her floor. She was being followed when she went places. Her lips smacked harder as her anxiety mounted. She had to flush all the pills down the toilet because they weren’t her pills and so she didn’t have her own to take.   I ask if there is family I may call.  She stares back at me with hollowed eyes and does not respond.  She had just been released from the hospital a week ago for paranoid thoughts, but it is clear she will need to come back in.

He is 70 and his anxiety is like a storm cloud exploding in the room. He is overwhelmed because he cannot pay the bills and someone has stolen his identity. His furnace is broken and he is afraid the pipes will explode. He is concerned there is a carbon monoxide leak in their home and they are all being poisoned. At times he cannot speak because he is so overcome with his panic. He stutters and spits and cannot get the words out. I hold his hand and rock it back and forth as if to relieve the tremors that riddle his body.  I tell him it is okay over and over as I hold on; at times he appears momentarily calmed and is again able to speak until the next wave of emotions takes prey over him. His family arrives, and there are tears of fear, pain and love filling their eyes. None of this is real. No one has stolen his identity.  There are no broken furnaces and no carbon monoxide leaks. He paces at home and cannot eat or sleep. They have even called the fire department to the house to prove to him that there is no carbon monoxide leak. But it has not helped. These delusions have become his reality.

He is 57 and drinks every day and lives on the streets. He comes in one to two times a week for pain. Sometimes, he says his pain is so bad he wants to shoot himself. He says he has guns at his son’s house. This time he said he fell and his hip hurts. I help him take his pants off and he smells of urine and stool. Where can he go to take a shower? There are no bruises, scrapes, or cuts, but I x-ray his hip and there are no fractures. He says he won’t actually shoot himself if he can have a sandwich and bus tokens to go. He asks for a sandwich and bus tokens with every visit. He says his pain is 10 out of 10 and immediately falls asleep. It is the warmest and quietest place he will sleep until he comes back next week.

He is 20 and he overdosed on heroin. He was not breathing when the ambulance arrived. They gave him medication and resuscitated him and now his heart is racing and he looks bewildered as if he is on fire with anger. He says he knows it is dangerous. He has seen his friend dead in a car from a heroin overdose with the needle still in his arm. Maybe this is his rock bottom. I ask him if he is ready for me to help him get help so he doesn’t die too. He was really close this time. He says he understands what I am saying and he appreciates it. He says he is ready to stop, but he just doesn’t need help today.

These were four people I met on my evening shift last night. There are endless more stories like theirs. I don’t know where they were before they got to here, but I know life has not handed them anything. Their days are constant, steep uphill climbs. It may be addiction. It may be mental illness. It may be violence. It may be homelessness. It clasps its grip around them and won’t let them go. Day to day it swallows them and pulls them back down deep. There is little voice that advocates for and represents them. There is endless judgment that looks down upon them.

Friends and family will ask me how my shift went. I often don’t know what to say. Sometimes I feel I can help and do great things. Sometimes it is a vat of endless hopeless stories in a system with limited resources that continually seems to fail in one way or another. We will keep showing up and keep doing what we can, but it certainly is not enough.

The MIA Parent

Also published: https://www.scarymommy.com/want-people-know-about-absent-parents/

In hushed voices, I heard them. The seven-year-old boy stood, still in full practice hockey gear, hockey helmet pressed against the window of the double doors, waiting for an adult to arrive. “His mom is never here, poor thing.” came one hushed whisper. “If I knew which bag was his, I’d help him change myself!” came the hushed response back.

This parent thing is a hustle, isn’t it? Making it on time to this hockey practice, to this football game, to gymnastics practice. Remembering to pack a cardboard cereal box for the next school project, remembering to buy Valentine’s cards for the school Valentine’s party. Remembering to sign permission slips and pay for the school party. RSVP’ing to your son’s school friend’s birthday party, then hurrying to the store the day before to buy a birthday gift. Not forgetting to pack the mid-morning school snack when packing the lunch you made last night. Buying the right dance shoes for your daughter’s dance competitions. Getting new skates for your son’s growing feet. New snow pants for your seven-year-old daughter that has been squeezing into too tight pants for an embarrassingly long amount of time. Having dinner ready. Making sure your kids have their shoes and boots for school. And a hat. And gloves. Lining up all drop-offs and pick-ups so your kids are never the late ones or the last ones to get picked up.

Maybe your hustle looks different than my hustle, but it is all in the wizadry of scheduling and mental notes floating in our minds when it all falls into place day after day after day.

Listening to those moms at that hockey practice, I felt a pang in my heart. I felt a pang in my heart for the multitude of times I was that MIA mom. When I am that mom that cannot drop off and pick up my daughter at dance practice. When I cannot stay and watch my son play football. When I cannot be the one to pick them up or drop them off at school. When I could not be there at their 1st grade winter party. That time I almost missed my 3-year-old’s first daycare program and nearly broke my back figuring out a way to make it there.

That MIA mom has been me time and time again. But I do want to make one thing clear. I am not always there, but I am always there. I packed the snack in my daughter’s dance bag, I counted her shoes to make sure she had her jazz, ballet, tap shoes. I laid out those dance clothes you see her wearing. I made sure my son had his mouth guard, full water bottle, and flag football jersey and all flags accounted for and laid out on his bed before I left for work. I pre-prepare dinner for my kids, even when I cannot be there to eat with them. I laid out their boots, coats, hats, gloves in front of the garage door, I fastened their snowpants to their backpacks. I packed my daughter’s daycare pillow and blanket for naptime and hung it on the door. I hunted down the school library books in the darkness and jammed it into my son’s bookbag all before I hurried out the door for work at 6 am. You may not always see me, but I am always there.

My physical absence has no correlation with how much I care about my children. No matter where I am, my presence and heart are always with my family. All of our families look different. But the bottom line is that we cannot compare or judge one another by our outer appearances. We all have different capacities and priorities come in all different forms. They come in the form of work, in the form of aging parents, in the form of friends, in the form of spouses or single parenting, or other siblings. Everyone’s circus is made differently.

Two weeks ago, I was in Whistler, Canada with my husband. He was the chair of a conference, and I, along with friends, were along for the ski adventures that laid on those gorgeous mountains. I ran into a friend who asked me if this was the first time I had left my children behind for an extended period of time. It was not. I explained to her that while it was not without its flurry of emotions of guilt, anxiety, sadness to leave my children at home, it was also with excitement, happiness, and anticipation that I looked forward to dedicating undivided attention to my husband and friends. I explained that I felt it was healthy for my kids to realize that the world did not revolve around them. That I loved them intensely and loved spending as much time with them as possible, but I am also committed to tending to the other parts of my life that make my life full and make me a whole person. She tilted her head, mind blown, and said, “I’ve never thought about it that way.”

Sometimes it is out of our control. I have to go to work when I have to go to work. But sometimes, a night out or a weekend away is something worth prioritizing. The bottom line is my life revolves around my kids, but it also revolves around showing them the strength of who I am as an individual and reminding them that they are one part of a greater world around them.

I believe that we all want to be there for our kids, the best we can. The best we can sometimes means we are late to pick them up from hockey practice because their younger sibling has gymnastics practice across town that consistently runs late. The best we can might mean we have a baby-sitter take them to dance practice when I work predominately evenings. The best we can might mean we spend a weekend away with our spouse to care for our marriage. The best we can might mean clearing our day to volunteer at their 1st grade Valentine’s Day party. The best we can might mean saying no to a work meeting to be there for our daughter’s first dance competition.

Being the MIA mom does not mean you are not doing the best you can. I know that better than anyone. So, to that MIA hockey mom or dad. I see you and your presence in your son’s well-fitting hockey helmet, jersey, and skates. I know you are present and the best you can do with your circus is absolute perfection to me.

Grandpa by Claire

Grandpa hasn’t picked us up in a long time. When he gets done in the hospital I’m going to show him something. I wish it hasn’t been a long time.

These are the words my three-year-old said out of the blue tonight when I was tucking her in. A wave came over me; I sunk my face farther into her Lightning McQueen pillow and let my tears disappear into the red fabric underneath my cheek. I was thankful we were snuggling in the dark, crammed together in her toddler bed.

11 months ago when my father-in-law died, one of the things that brought me the greatest grief was the thought that my children’s memories of him would fade with time. Especially my youngest that adored her grandpa so much. My heart ached thinking that these memories of what Grandpa looked like, how Grandpa laughed, how Grandpa hugged would become blurrier and blurrier with time. As if with each year, we would lose more of him as the memories became more faint.

Out of the blue tonight, my youngest reminded me that Grandpa is still alive through her. The grief resurfaced from the undercurrents of the daily bustle. The waves stopped crashing and the wind settled, and the hollow that he left burned like fire.

I listened to her musings. The shadow of her face cast against the column of light that spilled through her cracked bedroom door. She looked so thoughtful as she pondered how long it had been since she had seen Grandpa. I wondered for a second if I should ask her what she was going to show Grandpa. But it was too beautiful and too heartbreaking of a moment; I decided to let my big-hearted three-year-old have that special moment with her grandpa to herself.

The holidays are nearing, and by nearing, I mean that we will be smacking face-first into them here as we turn the corner. It is a time when everything about the people you love is heightened. You are thrust together in a haphazardly coordinated fashion. You have idealistic expectations while simultaneously bracing yourself for the worst. You are excited to celebrate the best time of year with those that mean the most to you all the while knowing that they will likely get under your skin in 7 seconds flat. You have an idea which of your inadequacies will be immediately brought to your attention under the guise of “we’re just worried about you.” You will try to dart behind the children for distraction. Unless parenting is one of the points of criticism you are trying to deflect.

All cynicism and family dynamics aside, the holidays are a time of magic. Of festive lights brightening common, everyday fixtures. Of holiday stories, decorative cookies, and yearly traditions. It is a time to come together and celebrate and show with our own touch how we love those that we love most.

Unless someone we love most is no longer here. Then holidays become harder. Especially that first holiday without them. A void we never anticipated being part of the holidays sits loudly in the center of the room and throbs in our hearts. We see the joy of the holidays through a lens of aching—part of us remaining idly empty.   We move through the motions and we daydream about rewinding time to last holiday when the greatest stressor was what your inappropriate uncle was going to say in front of your kids. You crave being able to fret about the petty things that had occupied your thoughts, because that meant there were no waves of hollowness widely sweeping over you and making you gasp for air like there are now.

It is hard to feel festive when loneliness so definitively puts its arm around your shoulder. It is hard to let the excitement and joy win.

Tonight, I learned from my three-year-old. The best way to keep my father-in-law a part of our lives is to flood these holidays with his memories. To make him an integral part of our celebrations. To make sure he doesn’t fade in the eyes of our kids. To create new memories with the memories of him. This holiday, we won’t let the loneliness sidle up to us. We’ll inch it out with his presence in our hearts and in our traditions. Grandpa will be with us. And we will show him something over the holidays so it will not have been so long since we last saw him.