My Life as a CNA #3: Love Not Charity

The scrapbook my mother made for school when she
was eight years old in 1931 in Old Saybrook, CT.

When my mother was eight years old, in 1931, her assignment from some inspiring and resourceful classroom teacher was to create a family scrapbook.

It's a remarkable document, captioned in my mother's youthful penmanship, replete with some of the only labeled photos of our ancestors I've found amidst bags and bags of curled and unnamed images. It includes a handwritten list of the genealogy on my maternal side, and photos of my grandmother's house where not only my mother and her two siblings but I as well were blessed to have grown up.

My grandmother and then my mother held onto this priceless archive until my mother's death in 2014, although its existence had been long forgotten by the time of my arrival in the 1960's. I never saw it or knew of it until, after her death, I began to sift through the boxes stored in my mother's basement. The treasure of things not discarded.

Each day I am at the nursing home, I am reminded of how much, and who, we throw away.

Elderly people--similarly to, as is often noted, babies--require a great deal of love and caretaking. Many return to that undeveloped innocence where they no longer are able to independently perform their basic mammalian functions of toileting, walking, and eating; nor the more advanced aspects of our humanity such as speaking, singing and dancing.

The biggest difference between babies and the elderly? Babies are our futures, reminding us that life is eternal even when our own is not. The elderly--our ancestors--lives are in the past. They remind us that our deaths are inevitable and coming quickly.

Increasingly, in our White U.S. culture, elderly humans--because they are not rich in future-time--are becoming, alongside the poor, the homeless, the incarcerated--the expendable. We push them aside and into corporately owned, for-profit facilities because we have created a culture in which we have neither the resources nor the time to properly care for them in our/their homes. In some cases, we are forced to institutionalize them to ensure they receive the medical care they need in a manner for which the state will pay.

Blessedly, there is a loving abundance of care and caretaking in nursing homes. I've witnessed how this work is a labor of love for the women and men with whom I have had the honor to serve during my training. I've watched in their faces, and felt in myself, the constant stream of emotions that loving and caring for the stranger elicits: it is rewarding, fulfilling, challenging, difficult, exhausting, and thankless work.

And still, while we do not discuss it, we do not fool ourselves. We go home late at night or early in the morning anxious and worried, imagining our own futures. Like the CNA's who care for them, our residents ARE the poor: they are the ones on Medicaid and Mainecare who cannot afford assisted living or private in-home care. They are the definition of the Greek word elachistoi: "the least of these" as it appears translated in the gospel of Matthew 25:40--you know, one of those key parables where Christians are told "...whatever you did for one of the least of these brothers and sisters of mine, you did for me..."

The literal meaning of elachistoi is “the smallest or most insignificant ones," or, in another manner of speaking, the expendable ones.

What I've noticed in the nursing home staff, and in myself, is that our very often invisible, forgotten caretaking for these elachistoi is not some type of romantic idea or charitable act. It cannot be. It must not be.

For they are us. 

The Blessings of Fragility

 

I went to bed feeling blessed, with the wind roaring and the cold, cold snow still falling after a delightful blizzard dinner of roasted chicken, brussels, and glazed carrots. In other words, our power held!

How lucky we are to be warm, to be together, to be fed. There are too many who are alone tonight; who are cold tonight; who are unhoused tonight; who are unfed tonight. It really just takes every one of our efforts to inadequately try to be sure those with the least among us are cared for. We are blessed, too, to have that work.

And I awoke feeling our fragile and temporary it all is--and how this is at the root of our blessings. When we can hold it and not fear it (thank you, Thich Nhat Hanh). When we can love it and not have it make us angry. Especially in a nation in which anger seems often to feel like a birthright to the White settler-colonialist culture.

With the power still on, we watched the Sundance Award-winning film CODA last night. CODA stands for Child of Deaf Adults. The movie is a somewhat traditional, quintessentially "American" tale--a young woman from the working class fishing community of Gloucester, MA, overcomes all obstacles to attend a music conservatory for college--but it is beautifully done. The fishing details, the sense of place, are evocative if, as-ever, romanticized. There is also a remarkable scene where the filmmaker allows us to experience what it is like to be deaf in a hearing world. But it was the 17-year-old hearing protagonist's deep connections to her deaf family, and the conflicted emotions she feels in leaving them for music school, that resonated deeply with me.

I miss my mom and my dad. I wish I had been better able to cross the huge distances that developed between our lives as I came out, went to college, became an artist and an intellectual.

My dad was functionally deaf. He didn't lip read or use sign language, but did have a hearing aid in one ear which allowed him to hear enough to get by. But he couldn't stand being in crowds: the background noise was just too much confusion for him. And, like the family in CODA, he could not really hear live music. And my mom, for a variety of similar reasons of brokenness, did not like to go anywhere without him.

(c) 1987 Kathryn Kirk

They delighted in each other, in us, and our small, tight family. Our world was very small. 

Since my dad couldn't hear, they didn't attend all the concerts I was in nor any of the sporting or other events. As an adopted, queer kid wanting a bigger world, this just made me feel abandoned (although I could not give voice to that) and angry (to which I gave plenty of voice). 

My understandings of their fragilities and vulnerabilities came much too late. We spent years disenfranchised from each other, with sparse visits. And then, as they were older parents, they began to become ill and simply needed our love and care in return. While I was able to provide some of that, I too often resembled the son in the Harry Chapin song with which I grew up in the 1970's, Cat's in the Cradle.

Mae and Evert--like all of us, when we settle into it--were broken in their own ways. As mid-century White Americans, they were not married until their late 30's. Unable to have kids. One deaf and one with wayward eyes. First generation high school graduates of immigrant parents. And they had, and gave my brother and myself, many privileges as well--not the least of which is being White and educated in the U.S.

And love. And perhaps most importantly, they gave us their frailties: blessings on which to base our own development of compassion, empathy, and love.

#gratitude

#love

#blessings

#frailties

My Life as a CNA #2: Strokes and Insights

 

This photo, from the mid-1960's, shows my maternal grandmother, Mary Urban Endrich, standing strong as ever in the magical flower and vegetable garden she kept between her house and ours -- the pink ranch in the background.

I know this is the mid-60's because Mary is already somewhat diminished here. A giant of a woman in both personality and form, she began to have a series of small strokes -- today we would call them TIA's (transient ischemic attack) -- when I was four and five years old. The big ones that finally took her from us were in 1970-72; she was only 74 when she died, and I, whom she had taught to read and write and garden and work a farm stand, only 11. 

Mary in 1961 at her full, pre-
stroke size, greeting my
arrival.

The big strokes caused her daughters, my mother and godmother, to move her in with us. Fifty percent of the time she was in NJ with my godmother and her family, 50% of the time with us. She and I shared a bedroom, so at an early age I got a good look at the damage strokes can cause to our beloved people. Her inability to speak, her permanently contracted hands, her rapid weight loss, her shuffling gait.

The majority of residents in today's nursing homes are those with some form of dementia or stroke victims. And the majority are women. Many of these can no longer independently perform their ADL's (activities of daily living) and require nursing assistants to feed, dress, toilet, and bathe them. A good many are confined to beds, unable to stand or walk on their own.

As a family, we cared for Mary until her body quit. The body is a tenacious thing and, 50 years later as we have extended life spans, even more so now than then. We were also there full time to tell her we loved her, and to remind her of the good life she had lived. 

In this way, we were also there to help her to die.

As CNA's, we're here to care for every resident just like family. In the absence of family members, we toilet, feed, dress and exercise people in the last portions of their lives. Yet it is different today. There are nearly six million patients with Alzheimer's in this country, and within 20 years this number is estimated to rise to 55 million. Alzheimer's and dementia break the connection between a body and its memories.

Can we know how to die when we cannot remember that we have lived?

As a culture, as we've become increasingly disconnected from the natural world around us, the cycles of living and dying can feel removed from us. Watching a flower bloom and die, we are reminded of how temporary life really is. We all die so that others can be born.

I still miss Mary every day. She is a huge part of who I am. Until her last breath she would point to me and say "the girl is good" no matter what I did or how impatient I was. Her love for and belief in me was no small thing to have. While I would have loved for her to live to see me go to high school and college as she wanted, I'm really glad we could all be there to help her die in love and dignity. And I hope that by caring lovingly for our many elderly residents who can no longer speak, or walk, or eat on their own that we are doing the same for them.

#NursingHomeLife

#CNALife

#LivingAndDying

The Beloved CommUNITY

 "Holy One, help us to truly become the Beloved Community."

Rev. Gerald "Jay" Williams, Ph.D., Union Church Boston

in his invocation for the 52nd MLK Day Breakfast

Every day is a good day to dance and sing in praise of, and to fight for, our common humanity. Especially as we annually honor the Dr. Martin Luther King, Jr.

To truly become community requires UNITY. To build unity across our differences requires perseverance -- the type of stubborn, dogged relentless that can only be powered by our faith in and hope for a peaceful, just world in which all are perceived and treated with equal respect.

Building unity is hard: we are all so different! And there is richness and vibrancy in our diversity. Too often, however, we make the mistake of holding onto our individualism to the detriment of the common good.

Unity doesn't mean we all need to believe or say the same things: it simply means we have to believe enough in each other and our communities to let go a little bit of the individual selves to which we cling so tightly.

So today, in honor of MLK: what will I let go of in order to create unity and strengthen our beloved community?

#unity

#belovedcommunity

#MLKDay2022

My Life as a CNA #1: Swifts Premium Meats

My dad was a big guy.

I'm talking the broad-chested, big armed, big bellied kind of working guy. The kind of guy who literally, early in his working life, could heave several hundred pound sides of meat up into the Swifts Premium Meats truck he'd been hired to drive.

Then he got married.

He wanted to be home, not out driving. He wanted to make a good salary in order to build his own home on land given to him and my mom by his mother-in-law, and to adopt some kids.

My dad and his favorite "things" in the late
1950's: his mother, his wife, and his Chevy.

So he went to work as a machinist and sat at a work bench day in and day out with a loupe strapped to his forehead and machine oil covering his hands. By the time I came along in 1961 he'd got eczema, got fat, and dreamed of getting out. It took him another 10 years of drafting, research, and scheming about franchises and the great outdoors before he was able to invest his and a bit of money from his mother into the new development of a K.O.A. (Kampgrounds of America) campground in Mystic, CT, 25 miles away.

It was clear that being a factory machinist was making him unhealthy. Like almost everyone in those days, he was a heavy smoker. And the weight he was gaining just felt inexorable to us all.

My mother had a recurring nightmare, one she told me and my brother as little kids at the time, that as he was coming in the back door in the evening after work a murderer -- holding her hostage behind the door -- would shoot him. This was probably a lot more about her own fears than my dad's reality, but the message to her was that my dad was so big that death would not be able to miss him. She feared for his life, that his size would take him.

And it did.

I just had to confront my dad's life and death again, 20 years after he passed from complications of diabetes-caused amputations, in my first clinical shift as a Certified Nursing Assistant (CNA).

I served three older, White male patients during my first shift. They all had diabetes, and all had circulation problems in their legs and feet -- just like my dad.

When I walked into the first room, I could hardly stop staring at those so-familiar legs. If you're a severe diabetic, the excess sugar in your blood stream impedes your immune system while simultaneously causing neuropathy, putting one at greater risk for an all-too common and dangerous bacterial skin infection of the legs known as cellulitis. 

This man's legs looked just like my dad's: swollen until they looked hard as newel posts, and a deep bluish red.

I wouldn't be exaggerating if I told you I wanted to cry: for this man, who had already lost a few toes so that his feet functioned in more of a club-like fashion; and for my dad, who died in 2002 after having his second below-knee leg amputation resulting from uncontrolled Type 2 diabetes. Obesity is one of the major factors in the onset of Type 2 diabetes as it causes insulin resistance. And obesity in the U.S. is a systemic social disease -- not a personal one alone. 

My next stop was to assist a very obese man with his toileting. Again like my dad, his weight-driven diabetes was creating infections and had made him unable to independently perform some of his key activities of daily living (ADL's in CNA jargon).

My nursing partner and I took care of him that day, as we said, "like a king." The duty nurses loved all these patients: they knew them well. The gentlemen, like my father, were in and out of the hospital regularly, living long term with the impacts of their life choices.

During my father's first hospital stay sometime in the 1990's, when they told him they were unable to heal the open wound on his foot that had been festering for months despite excellent care, he began to throw things at the nurses assigned to him. He was so angry that medicine was unable to fix a problem he knew would ultimately take his life.

But the only one who could have fixed it was him.

The Always Unfashionable Patriarchy

The author in first grade circa 1967.
As she grew older, she played football
but chose not to see herself as intimidating.

It's again unfashionable to talk about "patriarchy" -- if indeed it ever was, for a millisecond perhaps during the 1970's and 1980's, "in fashion."

But damn, as I become an older woman stepping out of the hierarchies of power, I experience daily its continued and oppressive dominance as a player in our White colonialist racist culture.

Patriarchy -- the hegemony of men over women -- is a cultural power structure and conjoined twin of capitalism because the hegemony of men over women has always, like capitalism, been about the power of property and power over the labor of those who create and cultivate it.

Who's got it, who's not.

What's annoying and frustrating to me these days are all the White men who conceive of themselves as "progressive" and talk-the-talk of diversity, equity, inclusion and change but whose actions still belie they are all about power and control. These defensive and offensive actions create a toxic environment of bullying, condescension, transactionality and ego-centeredness of the individual in which many of us know we no longer have to work, play, or live. 

Just one example: within the last year, when I was onboarding a White man to a new position in a company I founded, he made a point of telling me he was aware he was "intimidating" due to his size. He claimed to have been a football player. Obviously a small one -- maybe a running back? -- as he was barely taller than I and I in no way found his stature "intimidating." 

I laughed. I knew the goal of his passive aggressiveness: he wanted me to be intimidated. The same dude had rudely shut down another of the female founders during his orientation process.

THIS is what the "great resignation" is really about. The pandemic made a whole lot of workers and even volunteers, including in the nonprofit sector, aware we don't have to put up with this as "assumed normality" anymore. No being chided or lectured or "merely" condescended to by male staff or board members. No placating privileged and entitled donors of any gender. No being disrespected based on one's gender, the color of one's skin, or one's age. No being underpaid for same. No falsely attending to the transactional when we all know the relational is what matters. 

The pandemic, thankfully, forced many of us to break from the norms of White colonialist culture to belatedly realize that our families, friends, and relational personal lives are more important to which to attend than these priorities, values, and behaviors of a labor market constructed by White men to dominate, exploit, and justify their own inequitable gains. As one of the most important anti-racist documents in the arts stated it: we see you.

Imagine walking through the looking glass and into a different world. A world in which the values that have been ascribed to the feminine -- listening, questioning, collaborating, cooperating, respecting life, the planet, and the ancestors just to name a few -- govern our interactions: business, political, and social.

We can all, regardless of gender, walk through that mirror at any time. That's all feminism is: a choice. A choice of what world we want to live in, what values we want to promote, what behaviors we will tolerate. It's the courage and the privilege of saying "no" to terrible boyfriends, husbands, employers, boards and values. But we can't minimize the ramifications of saying no. They can be considerable: loss of income, loss of family, loss of prestige.

Let's wake up to unity. Too often we don't see that the values we ascribe to "all we have" overshadow the more important values we give up in order to have what we do.

#justsayno

#EndThePatriarchy