Sunday, March 21, 2010

Where things stand

It's surprising and lovely that some of you have asked me to keep posting on this blog and I very much wish to do so. I have been posting occasionally at Open Salon with a more quotidian focus, but I have wanted to maintain this blog for posts about end of life issues. And there's the rub, although I hope I can push myself through the block.

Having lost my job doing palliative care, I have lost a great deal more. Perhaps more than I want to admit to myself. And in the interim since that loss and today, I have turned over another decade, I am now 60 years old. There are two paths I might follow here to explain my situation.

On the one hand, I am working again as a nurse practitioner at Planned Parenthood. I have learned a few interesting things about young people, and have even blogged about it. The best thing I can say about my current employment situation is that I am very grateful to have a job. However (and this is only me, only my feeling, keep in mind) the work feels meaningless. If I stretch, I admit to myself that I provide needed services, a sounding board, consul and advice, and appropriate medical care to women and men in that phase of life we call "the childbearing years." I provide care to people who are mostly young and sexually active. The problems that accrue from choices about sexuality are in my face literally. A sixteen year old with herpes. A bisexual man whose wife is pregnant. Genital warts. Abortion. Women on hormones, women with hot flashes, women with weight gain and depression from birth control methods. Men considering vasectomy, men with HIV infection. It's not an unfamiliar world, I worked for many years in women's health and HIV care. So I have to face why this work has so little meaning for me now.

Leaving that aside for a moment (perhaps for another decade), I feel very fortunate to still have a role in end of life care, as a volunteer with Compassion and Choices. As a client services volunteer, I am assigned clients who wish to pursue their right to hasten their deaths using the death with dignity legislation passed in Washington a year ago. I am their companion through the process, helping them to talk about their end of life concerns, end of life tasks, guiding them through the understandably cumbersome requirements of the law, steps towards obtaining a lethal dose of barbiturates, to use or not as they choose, and attending them at the time of death, if they request. I have attended several hastened deaths now, and have had many conversations with people facing death and their choices.

Choice is certainly a common theme here. The right to control our sexuality, our reproduction, the birth process, the death process. It's all cut from the same cloth, right? I think so, it feels so to me. Yet it is still death that is calling me. Not living, but dying. I am not interested in sex these days, for many years now, living alone happily and feeling that the loss of sex is just another loss along the road. The road towards death. I heard someone on the radio talk about our human prospects for immortality and I thought, Feh!

Morbid, huh? I do think that's what I don't like about the job. Too much about living and the concerns of living, while I am so much more comfortable dwelling in the concerns about aging, bodily disintegration and disability, preparing for death, dying, mourning loss, understanding life from this perspective. Understanding death as a part of life. An appropriate concern. A useful paradigm for my life as it is now.

Well, that's where I am, grateful for a job, yet wanting to go back to my home at the end of the road. So many people work in jobs that don't suit their longings. So many people have lost jobs in the past few years, many never to work again. To be hired at 60 is almost remarkable. I never fail at being grateful.

But still.


  1. Thanks Risa for the insight into where you are. I would presume you are not alone in your viewpoints about choices. Blogging about it helps other people find like-minded people.

  2. I think the beauty of working with the dying is that we take way so many lessons on how to die, the choices we may face and in so doing we learn personally, how to die - consciously. That is a gift. Or so it seems to me, at age 61.

  3. You have an open way of telling about yourself, Risa. It is refreshing and authentic. Bless you for loving on people at Planned Parenthood and in palliative care.

  4. I think life is about many things, but most notably loss. I think you and I may share particular perspectives and experiences in this regard.

    My own professional loss was so traumatic that I'm not sure when/how it'll settle with me. It wasn't the kind of gentle waving goodbye I would want with any loss as it was the sense of someone else ripping something away from me, then casting me out - which may be how loss is mostly experienced.

    Ugh - that sure sounds like self-pity, doesn't it? So be it. It certainly does suck.

    Anyway, I guess one of the things that really draws me to the experience of death is the sense that it's really, really important.