Crossing the Bridge

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2024-02-03T10:06:00.000-06:00

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Self-Care

2022-10-26T17:09:00.002-05:00

I sit outside on this fall day. The sun is shining on my face, warming me. A gentle cool breeze blowing. Pups wresting and rooting around. The smell of my remaining flowers fills the air. Mums beg to be pruned.

Today is the first day that I have felt somewhat “normal”.

The last few nights my mind has awaken me with thoughts, details running through. I do not usually wake from thinking. I sleep in order to stop thinking, but these last few days I have stopped sleeping so as to think.

I spoke with my counselor the other day and it was more helpful than I anticipated. She explained the various signs of trauma that I could be experiencing, for which most of them I am or have.

I have felt confused.

I realized, though, that while I have seen a lot of trauma, I have not experienced a lot of trauma and ultimately that is the difference.

There are so many details and truths and facts that are locked away as no one should know them or even see them in their mind.

I am sad.

The last few days have been focused on self-care. Self-care looks different for different people.

I am a nine on the enneagram, otherwise known as a peacemaker. This means I live in constant tension between the desire to be unbothered by life and a desire to right all the wrongs that I encounter; which inevitably requires action and inconveniencing myself .

Whenever I look at the defined self-care prescription for enneagram nines I cannot help but laugh, but only because I know they are true. They include: sleep, naps, siestas, routines, doing a whole lot of nothing, a fortress of solitude, massages, time to process and to be, mindful breathing, fresh air, and cozy Saturday mornings.

So the last few days I have done just that slept and napped and focused on routine and doing a whole lot of nothing and staying alone in the quiet and taking time to process and to be and to mindfully breath and sit out in the fresh air and sleep in the last few days as if they were cozy Saturday mornings.

I am ok.

2022-10-22T18:29:00.001-05:00

When I got to work this morning, my pen wasn’t working. I went in search for a new one and had a fun ridiculous conversation with the unit secretary about the value and use of 0.7, 0.5, and 0.38 pens. She laughed. We drank our coffee.

I rounded and saw all of my patients. Said hello to everyone who was working. I ate a banana.

I ended up in a patients room later and over the course of the morning she had gotten sicker and was requiring more invasive medications. She went on to become more unstable requiring cardioversion with an appropriate conversion response.

These events resulted in numerous people being gathered around. People I know, people I work with all the time. We went about our jobs enjoying each other’s company. Laughing, joking, going about our work and doing our jobs. As we worked we heard the loud speaker pop on.

Working in Critical Care we are more attune to the loud speaker as there are often announcements of various types of Codes that require the response of various Critical Care teams to respond to other areas of the hospital.

This announcement though was one we had never heard before and one in which we weren’t sure was even real.

Code Active Shooter.

We have talked so much in meetings the past few months about raising our awareness to threats and about various policies to implement, but as of yet we had done nothing of significance.

Code Active Shooter.

Working in a level one trauma center it is not uncommon for us to have assault victims, assaulters, gunshot victims, and other patients who arrive after experiencing some precarious event. We often have police in our ICU. I arrived this morning, in fact, to one such police officer sitting camped out near my desk and asking for coffee, for which I directed her.

Code Active Shooter. Labor and Delivery.

Pagers and phone calls erupted the unit. This was no joke. There was in fact an active shooter on the premises. We were in a state of lock down. No one was to come or go. We were to stand down and stand by.

As we stood waiting another page echoed our halls.

Code MERT. Labor and Delivery.

A Code MERT is when someone who is not admitted to the hospital needs emergent medical attention. Knowing there was an active shooter we deduced that a Code MERT could only mean that someone had been shot. Later we would find this to be true, but it was two someones, not one.

As we continued to stand down and wait, another page echoed our halls.

Rapid Response. Labor and Delivery.

A Rapid Response or RRT is when someone who is admitted to the hospital needs emergent medical attention.

I often accompany the Rapid Response Team. We looked at each other and geared up to go. We were told to wait until it was all clear. And once it was we went.

As I stepped onto the Labor and Delivery unit, the active shooter, who was no longer active, but was now himself shot, was being rushed to the Emergency Room.

I surveyed the area and there was blood everywhere. Drops trailing down hall ways with pools residing in various places.

Nurses were leaning into walls, sure to fall without the support of them against their shaking bodies.

A handful of new mothers stood in the halls with their newborns cradled in their arms.

Police flooded the halls.

The Rapid Response patient was taken to the emergency room and treated.

I stayed for a time more. Desiring to help but no help was warranted. I headed back to the ICU when I encountered hospital administration who asked me to come back. We debriefed in Labor and Delivery. We continued to evaluate the patient census and the health care workers well being. Statements were made, facts discussed, and needs identified.

After some time I walked back to the ICU. I wondered if I wasn’t tracking blood all the way back with me as I felt covered in it from all I saw. Though, honestly I don’t think there was really any on me.

Once back in the ICU, I called the unit to the front and relayed the information that I knew to them. I tried to say the right things. I wonder though if there are right things.

I went down to the ER to see if they needed anything and to show support of our staff. They were now covered in blood from the trauma we had all experienced. They worked tirelessly despite him.

Again I stood with nothing to offer, nothing to do.

After the dust settled I stood at the front of the ICU. The unit secretary sat there and we did not discuss the trivial value of pen sizes. She asked if I was okay really. She came over and gave me a deep hug.

“You’ve seen a lot of trauma in your young life” she said.

She has seen me on many traumatic days. She has watched me over the years on day shifts and night shifts. She has often given me deep hugs.

Since the events there has been an overwhelming outpouring of concern, love, support, and comfort. I am tremendously thankful and encouraged.

I am okay. Truly.

I have, as my friend said, seen a lot of trauma in my young life. But today what I feel is mostly confused. I feel numb. I feel so very tired.

I’ve come home to my pups and some chips and queso and will retreat in a few hours to my bed for glorious sleep and true rest.

I stopped asking why a long time ago, long before COVID.

Honestly, the why doesn’t really matter. It does not change what happened. It does not change what is.

And so, I will forever find rest and solace in these words and be thankful:

The steadfast love of the Lord never ceases,

His mercies never come to an end;

They are new every morning;

great is thy faithfulness.

“The Lord is my portion,” says my soul,

“therefore I will hope in him.”

What I Always Wanted to Be.

2022-07-26T14:28:00.003-05:00

When I was a senior in high school we had a career day where we had to go out into the community and shadow a professional.

It was such a struggle for me to find someone. I did not have a clue what I wanted to do with my life, where I wanted to go to school, what I should study. I took numerous aptitude tests and none of them helped guide me into a complimentary field.

I went on to college and earned an undergraduate degree that I have never used. Upon graduation I went to graduate school and earned a master’s degree in something I only used for a short time. Then, years later, I returned to graduate school and earned a second master’s degree in a completely different field.

So, I spent ten years in college, have three different degrees in three different areas, and have student loans that I will never pay off.

It took me a long time to figure out what I was supposed to do.

But deep down I have always known what I always wanted to be.

From the earliest days of my life, I have always always known that I wanted to be a mom.

As a child I had so many dolls. They all had names and stories. I cared for them and carried them and changed them and loved them. They were mine.

As I grew older I always helped with children at church. I cared for them and carried them and changed them and loved them. They were not mine.

For years, I babysat and nannied so much. I cared for them and carried them and changed them and loved them. They were not mine.

Then the babies came. With time I found myself with eleven beautiful nieces and one amazing nephew. I care for them and love them. As much as they are, they aren’t mine.

All my life I have wanted to be a mom.

I have dreamed such vivid dreams, of holding my newborn baby in my arms and seeing his sweet little face.

I have had hopes and goals and fantasized and dreamed for and about.

I have named him and loved him and wanted him.

But he, but she, but they, are not mine.

A few years ago I gave myself permission, and in doing so, I learned how silently unhealthy parts of me were and how too much time had passed. I may have given myself permission but it was too late.

Letting go of a dream is hard. Letting go of a life-long goal is hard. Letting go of an identity is hard.

Letting go is hard.

Two weeks from today, I will wake up on the day after.

The day after my total hysterectomy.

Part of me says, it doesn’t matter because I am too old anyway.

Part of me says, it doesn’t matter because I love sleep too much anyway.

Part of me says, it doesn’t matter because I have my dogs anyway.

Part of me says, it doesn’t matter because I am single and it would be too hard and impossible to figure it all out anyway.

Part of me says, it doesn’t matter because I am a good aunt and they’re partly mine anyway.

Part of me says, it does matter. And I am so sad. and disappointed.

I did not know that I could cause the greatest heartbreak of my life, but here I am.

A friend says that maybe I have other things to birth and give life to. And maybe I do. Maybe there are books to write and a house in the woods to build and more dogs to love.

But for these next few days, I will sit in the presence of now, grieve what wasn’t, count the blessings of what is and go to the one who provides rest.

Food. Weight. Weight loss. Exercise.

2020-09-27T15:27:00.009-05:00

I love food.

All food.

I love to try new foods and go to new restaurants and learn about other cultures and try their foods. I love French food and Moroccan food and Afghan food. I love Indian food and Seafood and Tex-Mex. I love food.

I have always loved healthy foods. As a child I would opt for the salad bar over pizza. I love most all fruits and vegetables and especially love the rare occasion when I get to try a new one. I love to cut them and cook them and find different pairings.

Food and the experience of taste is one of the most amazing gifts from God and maybe one of my favorite blessings.

We eat to live, but there are times when I have lived to eat.

I love sugar. I absolutely love sugar. There are times when I am obsessed with sugar. Any form: candy, cake, ice cream, hard candy, chewy candy, sugar, honey, etc. And one is never enough. One turns to two turns to five turns to ten.

As a younger person, I worked out all the time. I was extremely active with sports and running and playing with friends and swimming and with whatever activity the day held. Being active and having built up toned muscles led to having a high metabolism. Eating was a pleasure with no bounds. I ate healthy foods, butI also ate a great deal of non-healthy foods.

Time changes things: life, habits, schedules, metabolism, muscle mass, choices, bodies, eating, health.

Sometimes, life changes some things while other things do not.

So, with time, my schedule slowed down, my eating maintained, my habits became more sedentary, my metabolism slowed down, my muscle mass dwindled, and I slowly began gaining weight.

I realized I was changing, but truthfully, I wasn’t concerned or worried or interested. This had never happened to me before and I was in a bit of a state of denial. Despite having a Bachelor’s degree in Exercise Science and a Master’s degree in Nutrition, I did not really know what to do or how to change.

With time, I realized that I fed my dogs cleaner, healthier food than what I was consuming.

I saw myself in pictures and did not understand what I saw. In my mind’s eye, I was still healthy and fit and trim and the pictures I saw did not represent the me I believed me to be.

Working as I do, I have free access to a significant amount of food at all times. It is not healthy foods: unlimited soft drinks, chocolate, chips, crackers, cookies, etc. It would be nothing for me to go through a 13 hour shift having consumed an excess of free foods and think nothing about it. We even joked at work that I was a trash can and would eat anything.

A coworker mentioned this to me one day. Something in the way she said it sounded different this time. I heard her different. Why would I ever be okay with someone equating my body with a trash can, least of all me? God created me as His beautiful workmanship, a temple, and I was allowing my body to become a trash can.

Concurrently, I found myself neck deep in an ICU filled with dying COVID patients. Nothing we did helped them. No meds we administered made a difference. Week after week, month after month, we watched them die.

The ones who had diabetes, hypertension, and obesity were the ones who did the worst. These were preventable chronic diseases that these patients had simply from making poor choices.

The same poor choices I was making.

I could not help anyone with COVID; only God can do that. But I can help myself. I can make better choices. I can change my behavior and prevent these chronic diseases from taking root in my body. I can honor God with the temple He made me to be and stop treating my body like a trash can.

Around this same time, a friend posted a book that talked about the psychology and neuroscience of eating. Susan P. Thompson, a PhD in Brain and Cognitive Sciences, wrote, Bright Line Eating. From the moment I began reading, I realized that her writings aligned with many of my core beliefs around eating and food. From an anatomy and pathology standpoint, her writing made sense to me. Almost immediately, I bought into and believed in the psychology behind what she wrote. I knew that this was the key for me beginning my journey out of treating my body like a trash can and into the temple I was called to be.

From the start, I have been adamant about not calling this a diet. When you go on a diet, then you go off a diet. I do not diet. I eat. What I wanted was a new way of eating, thinking, behaving. I wanted to change my habits, my mind set, my lifestyle. While I was hopeful to experience some weight loss, that was not my ultimate goal. My goal was to be healthy, to be happy, and to be free from eating in the manner in which I had been eating with no respect for myself.

So, on June 22, I committed to change my life and eat in a more God honoring, self-honoring way.

I committed to more vegetables, more fruits, eating three meals per day, no sugar, no flour, and no snacking.

There were moments in which this was difficult, but within a very short period of time it became automatic.

I ate my portions and I was satisfied, not painfully gluttonously over full. I found that I wasn’t hungry between meals, but calm and more relaxed. I found that my mind wasn’t obsessed with food and that I was mentally free to think on other things. I contentedly looked forward to the next meal without worry.

Foods began to taste better than they ever have.

I was not exercising and the weight literally just fell off. I simply stuck to the meal plan. Weighed my foods, planned my meals, and was more filled than I have ever been in all my life.

In just under three months, I lost just under 30 lbs. I feel so good and I am so proud of myself.

I believe in exercise. I believe in moving. I believe in taking care of one’s self in all the ways that one should.

But you cannot do everything at once. It takes work and effort to change habits. It takes willpower.

To change everything at once is to expect too much of oneself. If I had been trying to incorporate more exercise while also trying to change my eating, I strongly believe I would have failed at both. I am not strong enough to have the willpower to do it all.

As I said, I believe in exercise. Now that I have lost most of the weight and this new way of eating and treating myself is becoming a lifestyle change, I can begin thinking about incorporating exercise.

I am not quite ready yet, but I am almost there. I believe in taking one step at a time.

And I am so very glad that I did.

Sabbath

2020-03-24T10:46:00.001-05:00

I am off today. I slept in. I am resting. I am cuddling with my pups.

I have been at the hospital, in the ICU, the last 5 days.

I have been in the room with, talked to, interacted with, and done procedures on patients who are positive for COVID-19.

They are sick, they are not doing well.

We are finding that patients tend to do worse in their second week of illness.

We did not know that. There is so much we do not know.

The increased anxiety has seemed to level out the last few days as we are all settling in to our new normal. People are less panicked and more reasonable. But things are still manageable now, I do not know how it will be when it is not.

We are continuing to try and plan and prepare and learn. We are learning more every day just from simple experience and trial and error.

I am thinking on things differently now. For so long we compared COVID-19 to influenza that I came to assume some things that were not true. I assumed that you get COVID like you get the flu. It comes, you deal with it, it is gone. But I am not sure that is true. We do not know what kind of lasting effects it could have, what kinds of chronic illness it could result in or could be. I dismissed that if I got it I would not die from it, but we do not know that, I do not know that.

I have never been concerned or scared to do my job. But I am becoming more and more aware of how dangerous and deadly this is. I will continue to do my job but not without concern.

People must continue to stay home. People can be contagious for up to 5 days before showing symptoms.

I fear it will be many months before this is over. I believe we need to quarantine for a long time to keep safe and to keep this at bay. I believe we are still only in the beginning stages of this virus in our area.

I have plenty of food and toilet paper and electricity and entertainment.

I have a phenomenal dog walker who caters to my pups and is so incredibly supportive of me.

I have good friends and family who are checking in and offering prayers and encouraging texts and messages and sending love.

I have dear ones who have sewn masks and left them on my door step.

Part of me wants to be at work today. Part of me knows I need time off to rest and recharge. Part of me is confused by the reality of what is happening.

All of me is thankful for a steadfast God above.

HIV, HEP C, PPE, COVID-19

2020-03-21T20:14:00.000-05:00

In the fall of last year I suffered a needle stick. I knew as soon as I felt the needle that I was in trouble.

It was early in the morning and I responded to a code blue, a cardiac arrest, as I do on a regular basis. The patient needed an emergent line; this means I needed to access a large vein in his groin. Usually, we place central lines in a sterile fashion wearing a gown, gloves, a mask, and a bouffant and the patient is draped with a sterile cover. But in emergencies, I only don gloves. Sterility is not important when the patient is actively dying.

I knew this patient. They were on my service. I knew they were HIV positive. And when the needle pierced my glove and my finger I knew I would be starting six months of frequent lab draws and prophylactic medications. Fortunately workers comp covered it all, the two meds I needed were each more than $2000 per month.

Time has passed. I am HIV negative. I have completed the meds.

Last week I found myself in a code. A patient was having a cardiac arrest. They needed emergent access. I found the vein I needed. But in the process I sprayed myself with the patient’s blood. I was literally covered in it. I knew the patient. They were on my service. They were positive for hepatitis C.

Fortunately this patient has an undetectable viral load and I do not need to worry. This is good because there is no prophylaxis for Hep C.

PPE is so important. PPE, Personal Protective Equipment. I have never had a time in which this resource has not been available to me. As evidenced above, there have been times in which I have chosen not to don this equipment. And times in which that choice has put me in danger. Most of the time I wear the gown and the mask and the gloves and put on all the things and do all the things.

I have thought a lot about HIV lately. Wondering what it was like for those health care providers in those early days. Caring for patients who had a virus that no one understood, that was killing people, that had no cure. I’ve wondered what the hospitals wards were like, what the anxiety and stress level was. I wondered who the nurses and healthcare providers who volunteered in those days to take those patients were. I’ve wondered what motivated them, what scared them, and how other people treated them.

Years and times and science has passed so that I can now walk into an HIV positive patients room during a code, only wearing gloves, suffer a needle stick, and take meds for six months to find that I am not infected by this devastating virus, to move on, to exist as though nothing happened.

Years and time and science has progressed so that I can now walk into a Hep C positive patients room during a code, only wearing gloves, find myself covered in their blood, and find that because they have an undetectable viral load I need not worry. I can wash myself and move on as if nothing ever happened.

And now we have COVID-19.

I have seen my world change the last few weeks in ways that I have never seen before. Health care workers are full of anxiety and confusion about how to best care for the patients with this virus. We are taking volunteers at the beginning of each shift and they are donning the PPE that we currently have available, making the best decisions that they know how to make, but not knowing if they are the best choices are not. We are watching people die from a virus that we do not understand and that has no proven treatment and no real cure. And more and more people are coming.

More and more health care providers are themselves contracting the virus. We all wonder who will be next. If we will get it.

In time we will run out of PPE, rooms, beds, ventilators, medications. I fear in a shorter time than we know.

I do not know what the days will look like then. I do not know that reality.

HIV.

Hepatitis.

COVID-19.

These are all viruses. Antibiotics do not work on viruses. Time will teach us what does.

I love my job. I have always loved my job. I still love my job.

Moving Forward

2019-10-21T11:01:00.003-05:00

I suppose I have been dreading, or maybe grieving, turning 40 for years. Fearing that once it arrived I would be deemed a failure for not having achieved so many of the things I had anticipated. Namely, having children. But it has come and gone and I am doing fine. I have made peace with the things I have not achieved and have embraced the things I have.

Last week, I ventured out with two of my sisters for my 40^th birthday. We took a road trip through Oregon. We explored the city of Portland, ate Moroccan food, ate at Camp 18, toured the Tillamook creamery, sat and watched the sunset over the Pacific ocean, drove the coast, missed the sea lions, went to a disappointing buffet, found the end of the Oregon trail, got lost in Powell’s books, resided on the Salmon river, bought some art, stood in awe of Multnomah falls, shopped at the Goodwill, ate a VooDoo doughnut, drove to the state of Washington, and stopped in at Ikea.

It was a beautiful trip. We drove winding country roads and saw the ocean and the mountains and rivers and streams and brilliant leaves. Beautiful tall trees, blue rocks, stellar jays, We ate ethnic foods, and ice cream, waffles, lots of clam chowder, and a doughnut that was okay. We talked and laughed and rested. We rested. We sat in awe of the beautiful creation that surrounded us everywhere we looked.

I have lived in many different places and climates and landscapes. I have always been so deeply fed by the beauty of this earth and the creation that it is. Sitting outside is often a respite to my soul. Being in Oregon was a feast of beauty that will reside within me for some time and feed my soul for a while. I am not sure how I ended up in the wasteland that is Dallas that boasts significant concrete and limited trees. But even in this wasteland, there is beauty to be found, it just requires intentional looking.

Moving forward, I reflect on the 40 notes to my younger self and I rest in #40. I know that I am loved and I am so very thankful.

Turning 40: Notes to My Younger Self. #40 What I Know to be True

2019-09-26T09:26:00.000-05:00

#40. What I Know to Be True

Life is hard.

It has not turned out as I had expected.

Sometimes, I am angry that things have not been different, been better, been more fulfilling.

I do not understand so many many things.

I have been hurt.

I have hurt.

But.

But life is also beautiful.

Some things have been better than I could have ever expected.

I am still learning to work through my anger and disappointment and find fulfillment.

I do not have to understand everything.

I am healing.

I apologize.

What I know to be true is that I am deeply loved.

I have real relationships with real people who love me, I have a job that I love and that I am really good at, I have two amazing dogs, I have good relationships with my 12 nieces and nephew, my parents love me, my sisters love me, and I have a good church family.

I am steadfastly loved by God and have been redeemed by Him. His graces is renewed for me every single day.

My dear dear dear young self, life looks different than we expected, but it is good and you are loved. You are growing and learning and thriving. Life is hard, but it is so beautiful. People are so beautiful. You have good people, good community, and a good good life.

As you arrive today at your 40^th year of life, dwell in these truths and always always always be thankful.

Turning 40: Notes to My Younger Self. #39

2019-09-25T11:30:00.000-05:00

#39. . . .

There were so many things I wanted to write about. Things about relationship and moving and people and pain and healing and death and dying and love and joy and grace and peace and home and friends and self care and honor and wisdom and strength.

So many topics I did not get to. So many things I did not say.

Yet, as I sit here, attempting to write the next to last post and fumbling through the title I had already decided on, I feel that I really have nothing in me to say tonight. The previously assigned topic is lost on a paper full of words that sound empty and trite.

I had an appointment earlier today and then I came home. I had intended to do a lot of things but ended up not doing much of anything. I talked with some friends, watched too much tv, watched my pups play, and made some dinner.

I recently worked quite a bit, so I needed a day of rest. But the day is drawing to a close and I feel tired. I do not feel rested. I think the exhaustion of working nights is catching up to me, it so often does.

My parents sent me flowers a week or so ago. They are beautiful. But they are also dying. Some have wilted and are downcast, others are still strong and tall. I suppose life is like this vase, full of health and death and beauty and wilt and strength and downcast.

Earlier I wrote about hope. Now that feels so foreign to me. Which, in truth, is why I have sat with the concept so much this year. Trying to make hope feel real, feel true, feel hopeful.

My dear young self, there are some days when you find that you do not have much left. You will fill empty and tired and done. Listen to yourself. Rest when you find that you are telling yourself to do so.

Turning 40: Notes to My Younger Self. #38 Hope

2019-09-24T15:30:00.000-05:00

#38. Hope

Therefore, I will hope in Him.

Hope. In. Him.

Hope.

This is the last idea noted in the Lamentations statement.

²²The steadfast love of the Lord never ceases;
    his mercies never come to an end;
²³they are new every morning;
    great is your faithfulness.
²⁴“The Lord is my portion,” says my soul,
    “therefore I will hope in him.”

Lamentations 3:22-24

So, what is hope?

I have spent a lot of time this past year really sitting in the idea of hope. Dwelling in the concept and trying to really understand what it truly is.

Hope is a feeling of expectation and desire for a certain thing to happen.

Hope is having confidence in God.

I suppose, then, my question is hope or confidence in God for what? Hope for peace, for comfort, for resolution of struggles, for forgiveness, for love, for grace?

I think there was a part of me that envisioned hope as a wish. Wishing that life would be perfect and without pain or confusion or disappointment. Maybe I thought if I put my hope in God, then these things would come to pass.

But wishes are often associated with that which is impossible or applied to things that have already happened.

So, what is hope?

Hope is having confidence in the future. Hope is having confidence in the long term. It is changing your perspective from the short term, from the here and now, to the long term, the future. Not just believing, but knowing that God will be there.

Hope is confidence in His steadfast love, His grace, His faithfulness.

Having confidence in Him, having hope in Him, is knowing that there will be peace. Knowing there will be peace in the long term, in the future, helps me to have peace in the short term, in the now.

My dear young self, know that it will all work out in the end.

Turning 40: Notes to My Younger Self. #37 Steadfast Love

2019-09-24T11:00:00.000-05:00

#37. Steadfast Love

To lament is to grieve, to be filled with sorrow.

So, to title a book “Lamentations”, one would not think it had a great deal of encouragement to provide.

Lamentations is a small book found in the old testament with five chapters, that are actually five poems. Each poem is grievous and filled with pain and suffering and questions and frustration.

This book of 5 poems focuses on a people who are in Babylonian bondage after consistently disobeying God and not honoring their covenant with Him.

But, right in the middle of this small book, a remarkable set of verses can be found. A lonely man, who is speaking on suffering and grief, on behalf of the Israelites actually finds hope in the suffering. He identifies the suffering as a form of Gods justice for not obeying. But he feels that if God can be be committed to justice for the committed evil, that he can be also be committed to his covenant promise of love.

And so, out of that observation, the lonely man makes this beautiful statement:

22 The steadfast love of the Lord never ceases;
    his mercies never come to an end;
23 they are new every morning;
    great is your faithfulness.
24 “The Lord is my portion,” says my soul,
    “therefore I will hope in him.”

Lamentations 3:22-24

I have thought about and meditated on these words.

I have thought about how the words are found in the middle of this book. This book that is full of grief and pain and suffering, of laments. And yet, right in the middle, this ever present balm is found. I have often likened it to the eye of a hurricane, peace amid the storm.

So I think on these words and meditate on the words.

The words have become my anthem.

steadfast \STED-fast\ adjective. 1 a : firmly fixed in place : immovable. b : not subject to change.

His steadfast love is firmly fixed in place, it never ceases, it cannot end. No matter what I do, His mercy and grace and steadfast love is there and is renewed every day.

He is so faithful to me, so steadfastly faithful.

Therefore, because of Him, I can have hope.

My dear young self, life may feel like a lament. There may be pain and confusion and suffering and shame and grief, but He is ever present and steadfast. His love for you will never cease, no matter what.

Know with all of you that the steadfast love of the Lord never ceases, His mercies never come to an end, they are new every morning, therefore, have hope in Him.

Turning 40: Notes to My Younger Self. #36 Forgotten Memories

2019-09-23T11:00:00.000-05:00

#36. Forgotten Memories

The night was crazy.

Codes. Blood. Drugs. Compressions. Blood. Crash Carts. Maxed vasopressors.

If felt like it would never stop.

The whole thing was sad. It was a situation where we knew we would work all night and the patient would still die. We did. They did.

It was a lot of work.

As the events went on throughout the night, more and more family arrived. They stood and watched. They cried. They held each other.

One of them pulled me aside. I did not know her.

You were with us the night my father died, she said. You were wonderful, she said. She hugged me. She held my hand. She wanted me to really hear her and absorb what she said.

I did not remember her. I did not remember her father. I did not know how long ago that had been. I did not remember his diagnosis or the reason he came to the hospital or the reason he died. I did not remember.

She rejoined the family of the dying patient. I did not see her again.

In time I will forget this crazy night.

In time it will be a forgotten memory.

My dear young self, we have chosen to live a life of service and to work in a service profession. It is beautiful work that we are honored to do. But it is hard work. There are hard shifts. There are crazy shifts.

In the beginning, you will remember every thing and every patient. You will remember all the smells and sights and sounds.

But in time, you will forget. It will all become forgotten memories. The faces will fade, the stories will fade, the scenarios will fade.

A part of you will grieve the loss.

But, in truth, it is the loss that helps you to continue to do what you do. You were never meant to carry all of the faces with you. Holding on to them will prevent you from being able to receive new ones. The forgotten memories are a gift.

Turning 40: Notes to My Younger Self. #35 Life Choices

2019-09-22T13:30:00.000-05:00

#35. Life Choices

It is not uncommon that I am asked if I am going to go to Medical school or if I am disappointed that I am not a doctor.

When I was younger I knew that I could do anything. I was always encouraged by my parents and teachers and friends. I knew that I could grow up to be anything.

But I did not know any doctors.

And I did not think I was smart for a very long time. I am not a good test taker and I often struggled in school, so this had to mean I was not smart.

I thought about medical school briefly in college. But I thought people like me did not go on to be doctors. People like me; people not as smart, not as rich, not as privileged.

I had a few friends in college who were going to medical school. I was excited for them.

I knew I wanted to be something medical, but I really did not know what.

I did not want to be a nurse. I had this idea in my head that you wore a white dress and a little hat and walked around doing menial tasks. I did not want that.

I thought about being a physical therapist. That would compliment things I liked and would be interesting. But I knew some people who were physical therapists and they all told me not to do it. I never really understood why.

I did not even know what an occupational therapist or a speech therapist or a paramedic or pharmacist even did. So, in my ignorance, they were not options.

I learned what a dietitian was. That sounded somewhat interesting. So, I decided that would be it. I worked and finished 7 years of college (4 undergrad, 2 graduate, and 1 year of an internship) to become a registered dietitian.

When I finally started working as a registered dietitian, I was proud of where I was and what I was doing. I was working in long term care and I loved it. I loved my patients and coworkers and enjoyed what I did.

I worked with a nurse practitioner. I really did not understand what she did or what being a nurse practitioner meant. I asked and the more she explained, the more I realized that was what I wanted to do. The more I understood her role and her job, the more my heart sank.

So, in time, I got my things in order and went back to school to become a Nurse Practitioner.

I enjoyed being a dietitian and it is a noble and good profession. But it did not compliment what I wanted to do with my life. I wanted to be more involved in patient care.

I always felt, deep down, that I was called to do more.

School was good. It was the hardest, most intense, two years of my life. I hated it and loved it and was so happy when it was over. And so sad as well. It had given me the opportunity to prove so much to myself. It had given me the opportunity to be challenged and work and be pushed. I grew. I thrived.

Being involved in health care, I have learned a great deal these last ten years. I have worked with many medical students and residents and have had the opportunity to train and educate them as well. I realize now that I am and was smart enough to have gone to medical school and I could have been a doctor.

But I am not a doctor.

I will never be a doctor.

I went the long way around to do what I do. I got other degrees and did other things and in the end figured out what I wanted. It could have taken less time and been a shorter more efficient trip had I known a lot of things in the beginning.

If I had known then what I know now, would I have made different life choices?

It is a hard question to answer and one that I do not know for certain. But probably. I probably would have done a lot of things different if I had known then what I know now.

But not knowing then what I do now, I made the best choices that I knew how to make at the time.

Life choices are just a part of life. You do the best you can with what you know when you know it.

Do I regret not being a doctor? Sometimes.

Could I have been a doctor? Yes.

Am I proud of who I am and what I do? Yes.

Am I doing my best at what I am doing? Yes.

I am good with where I am, I am proud of who I am, and I know that I am doing what I was meant to do.

Even if I took the long way around.

Turning 40: Notes to My Younger Self. #34 Intention

2019-09-21T16:30:00.000-05:00

#34. Intention

I walked in to work tonight and found myself thinking about how I really wanted to get serious about working out again.

A few moments later, I found myself in the physicians lounge eating some cocoa puffs.

As I left the lounge and walked on to the ICU, I realized this juxtaposition and laughed at myself.

Sometimes life is like that, we have good intentions about what we want to do or who we want to be or where we want to go, only to find ourselves doing the exact opposite of that which we intended.

I remember one of the first times I read the passage in Romans 7, I felt like my thoughts were on the page.

"I don’t really understand myself, for I want to do what is right, but I don’t do it. Instead, I do what I hate. But if I know that what I am doing is wrong, this shows that I agree that the law is good. I want to do what is right, but I can’t. I want to do what is good, but I don’t. I don’t want to do what is wrong, but I do it anyway. But if I do what I don’t want o do, I am not really the one doing wrong; it is sin living in me that does it."

Often we are not who we want to be or do what we want to do.

We have good intentions, but we are human.

My dear young self, there have been many times in life in which you have beaten yourself up for not being better or stronger or smarter. You have lost sleep and worried and struggled with your imperfections and berated your failed intentions.

But, find peace in knowing you are human. You are not alone in your imperfection and failed intentions.

Forgive yourself, give grace, appreciate the intent, and try again tomorrow.

Turning 40: Notes to My Younger Self. #33 Learning to Be Still

2019-09-21T08:30:00.000-05:00

#33. Learning to Be Still

We read in the Psalms to "Be still". Other versions read to "Cease Striving".

I did not really understand what that meant for a long time.

I had always presumed it meant to physically be still and not move, to rest.

When I first got Ruthie in 2010, I was living in North Carolina and working my first Nurse Practitioner job. At that time, I worked 24 hour shifts and was often tired on my days off. Ruth was still very much a puppy and had a lot of energy. She needed a lot of attention.

In time, we made it our daily habit to go to the dog park.

We went every day that I was not working. It did not matter if it was raining or snowing or excessively hot. We went every day.

She would run and wrestle and dig holes.

I would go and sit and watch her play.

And sometimes she would just sit with me.

I learned to hear the birds and feel the breeze.

I learned to be still.

My dear young self, being still does mean to be physically still, but even more than that, it means to be mentally still. It is the act of letting go of worries and stressors and exhaustions and fears and depression and anger and confusion and disappointments. It is the act of submitting your whole self to God and resting in His presence.

Another version of the Psalm reads: "Surrender your anxiety! Be silent and stop your striving and you will see that I am God."

I spent literally hundreds of hours between 2010 and 2011 at that dog park with Ruth. I sat there. I learned to be still. I learned to see God.

Turning 40: Notes to My Younger Self. #32 Be Kind

2019-09-20T11:00:00.000-05:00

#32. Be Kind

I went to a benefit dinner a few years ago and the speaker talked about regret.

He had interviewed a man who was dying and asked what his biggest regret was. He did not talk about missed items on his bucket list or unacomplished goals.

He really only regretted one thing.

He regretted moments in his life when he could have shown kindness and did not. He regretted moments in which he could have chosen to be better, but did not.

I have sat with this idea ever since that night.

When could I have shown greater kindness? Why did I not? Did I regret not doing so?

Growing up, I was jealous of an individual. I was angry about this and often treated them rudely and unkind. I was often ugly and unfair to them. I laughed when I should not have. I was often not kind.

I wonder how this impacted their life. I wonder how it affected them. I wonder how it changed them.

I am deeply sorry for this.

I regret it. Deeply.

Kindness is not difficult.

The only difficulty is ourselves. We get in our own way and prevent our own self from doing the right thing. We prevent our own kindness.

My dear young self, seek opportunities to be kind. Seek opportunities to be better, to do better. And when you are not kind, and you do not do the right thing, for whatever reason, apologize, ask for forgiveness. When we are old we will regret being unkind long ago, lets not regret being unkind in going forward. Lets be better.

Turning 40: Notes to My Younger Self. #31 Student Loans are a Scam

2019-09-19T16:00:00.000-05:00

#31. Student Loans are a Scam

I always knew I would go to college.

I felt like it was expected, but it was also something I wanted.

The funny thing, though, is that I really had no idea what I wanted to do or study or major in.

I took the ASVAB and other aptitude tests. I asked friends, sought mentors and guidance, but I was never really sure what I wanted to do with my life. Nothing brought any real direction and my compass had no north.

In truth, I had no real business being in college when I did not have an end goal. I should have gone to a community college, taken some credits, worked and saved money.

The problem with student loans is that they enable you to spend money without purpose.

I worked hard, showed up to class, made good grades. But when you are working without goal, you are spinning wheels that are not moving forward.

Later in life, I finally knew what I wanted to do, but it was after 8 years of college and a masters degree. How much money was spent before I knew what I needed to know, only to accumulate more debt in order to do what I wanted to do.

Now, 10 years after graduating with my second degree, I am in profound student loan debt that will never go away.

Despite paying over $1000/mo for the past 10 years, I am now in more debt than I was when I started.

Did I seek counsel and get advice before acquiring the debt? Yes. But the counsel was that it would be easy to pay off with the money I would make.

My dear young self, I am sorry that I did not know better before. I am sorry that you will be saddled with crippling loans. I am sorry that you did not understand the game of education.

I appreciate how hard you will work. Know that it was not for naught.

Turning 40: Notes to My Younger Self. #30 I Am a Bad Ass

2019-09-19T09:30:00.000-05:00

#30. I Am a Bad Ass

You will grow up to be a bad ass.

And I am so proud of who you are.

That is all.

Turning 40: Notes to My Younger Self. #29. Redemption

2019-09-18T18:19:00.006-05:00

#29. Redemption

For many various reasons, 2009 was the hardest and probably the worst year of my life. I was lost and depressed and a variety of events left me feeling deeply alone and confused about life and love and purpose and happiness. I did not know who I was, where I was supposed to be, or what life was supposed to look like.

As that year progressed into the fall, my depression grew worse. I found myself isolated. I lost a significant amount of weight. I cried all the time. I had no energy.

The funny thing about that year, though, it that as profoundly as I was hurting, no one knew. No one had any idea how deeply I was suffering.

I look at this most brilliant picture of me. I look so healthy and happy and filled with joy. But this picture was right in the middle of that time.

2009

And no one knew.

No one knew.

As time passed, and 2010 rolled around, I eventually found solace in a few people, in moving across the country, starting some much over-due counseling, and in getting my most steadfast balm, Ruthie.

There have been many things in 2019 that have caused me to ponder and reflect on that time ten years ago.

The difference, though, between 2009 and 2019, is that people know.

Redemption is a beautiful thing. It is the ability to save, to regain, to take back.

In 2009, I did not have the strength, the vulnerability, the faith, or the wherewithal to redeem my life back from the darkness that stole it from me. Fear of judgment and overwhelming shame left me crying on the floor, alone.

In 2019, I have a beautiful community who act as my strength. They have helped me redeem my life with love and courage and understanding and patience.

My dear young self, know that a time will come when darkness will steal life from you. Know that the redeeming love of God will provide a community of people to encourage and love you back to life.

Turning 40: Notes to My Younger Self. #28 Maintaining Boundaries

2019-09-18T12:00:00.000-05:00

#28. Maintaining Boundaries

I played basketball in high school. I loved it. I was not so good in games, but I loved practice and working out. I loved being part of a team.

Knowing the plays and the rules were vital. If you did not understand the rules, you could not play the game.

One of the main regulations of the game is staying in bounds.

This meant that you had to know where the boundaries were at all times. You had to play inside the boundaries. You had to live inside the boundaries.

Within the game of basketball, boundaries are easy to maintain.

Within life, not as easy.

I have not always set boundaries. I have not felt the need to set them.

But there are times that life will call for boundaries to be placed. Places and people and situations that you will need to have boundaries placed about them.

Not having navigated some aspects of life with boundaries means that I did not necessarily learn to stay in bounds. So, when new boundaries are placed it can be painful and devastating.

Not being able to relate as you had before can be confusing and hard, but mostly it just hurts.

My dear young self, some things in life will be harder than you ever knew. Working to be better and stronger will require boundaries that you never anticipated. You will hurt. It will be painful. You will desire to step over and across the line in an effort to retrieve a balm for the overwhelming pain you feel, but doing so will exacerbate the original insult and things will become harder than they were before.

Life is hard. Boundaries hurt. Maintaining boundaries is not easy. But you have to learn to live inside the boundaries. Hopefully, with time, you will.

Turning 40: Notes to My Younger Self. #27 You Do Not Have to Go to a Christian University to be a Good Christian

2019-09-17T18:19:00.001-05:00

#27. You Do Not Have to Go to a Christian University to be a Good Christian

Growing up I always knew that I would attend a Christian University. I was not sure as to which one for some time, but I knew that it would be one associated with churches of Christ.

Nearly everyone in my family, who had gone to college, had gone to a Christian University.

They recruited us at church and we would go to summer camps and weekend events and buy their t-shirts and pennants and other assorted paraphernalia.

When most people asked where I was going to college, I assumed they were actually asking which one of the Christian schools I was going to.

I really never even considered going to a state school or a community college to get my credits.

Going to a Christian school meant making lifelong friends who were just like me, it meant finding my mate, it meant going to heaven.

Only, it did not mean those things. I did make some really good friends. But I did not find my mate. Having gone there is not going to get me to heaven.

Going to a Christian school meant daily chapel and devotionals and Bible classes and curfew and room checks and same gender dorms.

I am thankful for the Biblical influence and the Bible classes and daily chapel, but it did not mean a better education or as many educational opportunities.

Going there meant private tuition cost, it meant higher student loans, it meant more debt.

My dear young self, you have the ability to be a light where ever you go, to grow in whatever environment you are in, and to be a Christian in whatever place you find yourself. You have always had that ability.

In retrospect, I wish we had understood that before and made different decisions, cheaper decisions.

The purpose of college is to have strong educational opportunities to prepare you for life. I am sorry we did not understand that more effectively before.

Going to a Christian university is not bad, I just do not think it was the best decision for you.

You do not have to go to a Christian university to be a good Christian. You do not have to go anywhere to be a good Christian.

Turning 40: Notes to My Younger Self. #26 Genderization

2019-09-17T15:58:00.001-05:00

#26. Genderization

In the early 1900s baby boys were put in pink and baby girls were put in blue.

A 1918 article from Earnshaw’s Infants’ Department store read: "The generally accepted rule is pink for the boys, and blue for the girls. The reason is that pink, being a more decided and stronger color, is more suitable for the boy, while blue, which is more delicate and dainty, is prettier for the girl."

Somewhere in time, that changed.

In the early to mid 1900s authors began to use testicles as a metaphor for courage.

“She needs to grow a pair!” or “He needs to find his balls!” are statements now commonly heard in reference to courage. Somehow, testicles became equated with courage. Does that mean that only men can be courageous?

There are significant differences between men and women. Differences that are not only found in anatomy but in other things.

But, it is hard to know sometimes when something is truly masculine or truly feminine when so much of gender identity is defined by culture.

Some other gender characteristics I have identified throughout life have had to do with food and colors and forks and clothes and items our culture has deemed masculine or feminine.

Often I would hear comments such as, “that’s women’s food”, “I don’t eat off of pink plates”, or “that stuff is for girls”. These comments made me feel that “women’s items” were bad, less than. It was as though the mere use of these items had the power to de-masculanize the user.

The idea of items being bad because of their associated gender, was just another instance in which I felt less than for being female.

The concept that a thing had the power to de-masculanize was confusing to me.

The truth though, my dear young self, is that all of that is lies. You cannot genderize colors or courage or food or inanimate objects. Just because our culture and environment deems something to be more masculine or more feminine does not make it so.

Knowing this leads to even greater confusion. Because if gender is not found necessarily in cultural norms or environment, then where is it found? What does it really mean to be masculine? What does it really mean to be feminine?

These are questions worth contemplating. But what I want you to know is that you are deeply loved as a woman of God, in whatever way you have learned to express your femininity. I also want you to know that while some people may feel threatened by inanimate objects and colors and clothes you do not have to fear, for God sees you by your heart and not by objects that surround you.

Turning 40: Notes to My Younger Self. #25 Being a Woman

2019-09-17T10:51:00.000-05:00

#25. Being a Woman

Growing up, I believed that I possessed less value because I was a woman.

I felt less desired by God, less capable, less able, less worthy.

Not being able to possess any type of leadership role in church, despite being a very gifted leader, for simply being female, made me feel oppressed, less than, insignificant.

Perceiving that my value could only be found in being a wife and a mother made me feel dependent on a man and on actions to be worthy. Not achieving those things has left me to feel like a failure.

A confusion has dwelt within me as to why I am not as equally valued for simply being that which I am.

While there are many beautiful and, honestly, sacred truths about being female, my tendency has, unfortunately, been to focus on those things that have made me feel oppressed and less valued.

I am not ashamed of being female. I am just ashamed of being less worthy.

This past year, I have spent some time studying patriarchy and egalitarianism and tradition. This personal study has helped me to view some things differently, to change my perception and have some paradigm shifts.

My dear young self, so much of the perceptions that have shaped your view of yourself in the lens of your gender have come from a patriarchal tradition. While there is some value to be found in patriarchy, I believe in egalitarianism.

In time, you will come to see some things differently and realize that the tradition of patriarchy that you have primarily been surrounded in, has gifted you the confusion, the loss of value, the idea that you are less able or less worthy.

This was never intended by God.

You are worthy and strong and courageous and equal and valued. You are so valued.

These are new concepts that we are still evolving to appreciate. Be patient.

Turning 40: Notes to My Younger Self. #24 Finding Your Own Truth is not Always an Easy Journey

2019-09-16T15:00:00.000-05:00

#24. Finding Your Own Truth Is Not Always an Easy Journey.

Growing up as an ISTJ on the MBTI, I have always appreciated facts. I love bullet points and snippets of information. I hold to them and am guided by them.

Life truths have been no different.

As a child when I learned a truth, I held to it. It was black and white and I had no conception of grey. It was or it was not.

With time, as I have grown older and learned that there is in fact much grey, many truths that I have held to have been challenged.

Growing up, I believed that drinking alcohol in any way was wrong, it was a sin. So, I committed to never drinking, to always abstaining. But with life and time, I have learned different. It is not a sin to drink alcohol, it is a sin to get drunk. Those are very different truths.

Growing up, I believed that it was wrong to raise hands in worship. I should not do that. But with life and time, I have learned different. It is not wrong to raise hands, in fact, it is affirmed in scripture. Those are very different truths.

Growing up, I believed that everything we believed was truth. I believed everything we did was truth. I assumed our truth was always God’s truth. But with life and time, I have learned different. My goal in defining truth is always and will always be, what does the Bible say, what does the Bible mean. What is God’s truth? Assuming that my preconceived idea of truth was always God’s truth can actually be very different from Gods truth.

My dear young self, challenging our preconceived truths and working to find our own truths that align with God has not always and will not always be an easy journey. The desire to hold to our tradition and the fear of being wrong is paralyzing. But the desire to know God, to truly know God, and to know his truth is a worthy journey.

The journey to finding His truths may lead us many different places and we may travel some different roads than we ever foresaw, but working to learn and know God, is working to know better so we can do better so we can be better.