the coming winter

The morning was cool and along streets and lanes, leaves had begun to turn, some lay already, scattered and crushed, and with them, the first scent of fall. While tonight, down the hall, Dylan dresses, preparing to leave, to go out for the night. "No dinner?"..no. Still the icebox sits filled with food and I have been shopping on a more daily basis, attempting to not over-buy. Attempting.

Mother was through today, on her way to St. Louis to visit family. October is just around the corner and we will be taking a week to drive to Phoenix and back. To see the beautiful Patrici get married. To stop. To tour. It will be: Mother, Margie (her cousin recently widowed), Simon (my English-photographer-nephew, quite brilliant really) and me....

Which makes me smile, thinking of Margie, her exuberant personality, her stories. The day her second graders were 'driving (her) crazy'. And while she was always a good teacher, that day, she just was not coping well with a classroom full of eight (?) year olds. And so, during the morning recess, while the class was outside, she was in the break room taking a valium. Yes. She is/was a woman of that generation. The generation of women, now in their seventies, many of whom still take 'a valium', periodically. "Whew, the rest of the day went really well", she said and laughed and smiled, pushing her hair back out of her eyes, while her husband Bob, stood to the side with the men, smoking and drinking.

Cigarettes and cocktails. The post-apocalyptic fifties, the feminist sixties. There is a picture of me, pre-teen, skinny-armed, wearing a t-shirt given to me by my radical-bra-burning aunt from Michigan, and written on it is, 'i am the product of a non-sexist household'. A few years after that, I would be stoned out of my mind and nearly flunking out of a high-school where they stopped honors classes after our freshman year, and where everyone was lumped with everyone else in an attempt at what, I don't know. It was the seventies. A decade of drugs and disco and horrible clothes and then the sex pistols and body slamming at big-town clubs. Margie and Mom and their co-horts and friends were younger than I am now and it doesn't seem possible. There is a strangeness to time, as if death, inconceivable, is not real.

Last night, two of my patients were of the generation of mother and Margie. One, a woman, feeble, but getting around and still taking valium, "I take half a pill before bed, and if I can't sleep then I take the other half." She was prescribed only half. I gave her the additional other half. She still didn't sleep.

The other was a man, eaten through with cancer, lungs filling with fluid, fighting, fighting pain, pressing the button on his morphine pca (analgesia pump). His family had gone home, out of the room, away from the evidence of pain, of anguish, of holding on, holding on (they had been there all day). He held out his hand, I took it, standing there at his bedside holding his hand while he grimaced through the pain. Morphine, diluadid. Damned if you do and damned if you don't. Make them comfortable is the adage of hospice, but this wasn't hospice, but a hospital room. With his other hand he gripped my arm. There was life still in his fingers, warmth of hand against skin. He let go and pushed the button again only to hear the thin beep-beep-beep. failure. locked out. "Do you want me to get you something more for pain." He nodded yes, his eyes closed, then opened. The pyxis (drug dispensing machine), was tucked away, a short distance down the hall: dilaudid. and then later, more, useless for air hunger, good for pain. "What's your last name?" he asked after the second dose. I told him. "Oh", he replied, as if he should have known.