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Clouds Parting

This post describes, in part, the effects of a degenerative neurological condition called Huntington’s Disease. Any negative behavior on the part of my wife should be attributed to that condition. Any negative behavior on the part of myself should be attributed to my need for God’s ongoing grace.

I guess you could say that it all started with Frannie wanting to get her hair dyed. She had always had brown hair and, perhaps as a way to express her independence, she decided to dye her hair red – not a bright fire-engine red, but a nice natural burgundy color. So after some internal family turmoil (which is not part of the story) she purchased the dye and I agreed to help her dye her hair. The clear understanding was that no matter how it turned out, it was her decision, and her own responsibility

When the time arrived to “do the deed”, Frannie came to my room to let me know that she had everything set up. So I got up, took two steps, and the next thing I knew I was sitting on the floor cross legged with a bump on my head and Frannie kneeling next to me saying, “Are you Ok Dad? Are you Ok?” I had momentarily blacked out. After sitting on the floor for a few moments I got up and laid down on my bed.

My first thought was that I had recently lost several pounds and so perhaps my high-blood pressure medicine was at too high a dose. So I decided to stop taking it and wait a couple days to see how things fared. Two days later when I took my BP again, it was still very low so, at the urging of two daughters and a sister, I went to the local Emergency Room here in Pearland to get it checked out.

In the end, after interminable tests, two different sonogram examinations and numerous samplings of various bodily fluids, the determination was that my BP meds were too high which, through a series of interactions that would have potentially stumped Dr House, had left me severely over-medicated and under-hydrated.

The other significant side-effects of all this drama were that I was in the hospital overnight. From that brief respite, I discovered that Janet did just fine without me hovering around every second, and Frannie did an exceptional job handling things while I was out of commission.

PS: Frannie did get here hair dyed, and it’s really lovely!

Years ago, I wrote a monthly column for our church’s newsletter called Everyday Epiphanies – a title that I always liked due to its slightly oximoronic flavor. After all, epiphanies are supposed to be epic discoveries typically accompanied by things like burning bushes or God engraving commands in to your living room carpet with fire. They certainly aren’t “everyday”. This memory comes up for me today because this week has been one of epiphanies for me, but ones coming from very everyday sources.

My first insight was that when God is telling you that it’s time to sit down and slow up for a bit, you need to do it. Otherwise, He will sit you down – sometimes cross legged on the floor. The point here is that just because you have a job to do, that doesn’t mean that you are indispensable. God never sends you into a situation without backup. In my adventure this week, my backup turned out to be my daughter Frannie. And to show how deep a bench God has, He backed her up with a large supporting cast including my daughter Catherine, my sister Margie, our pastor, and a family from church that I’m not totally sure that I know.

Before this week, I had major concerns as to how well Frannie could handle things in a crisis. Now I do not. I see now that when push comes to shove, Frannie has the backbone to do what needs to get done. I am very, very proud of her.

The other insight that I gained this week was about the basic nature of mourning and grieving. The source of that epiphany was a short video clip that I posted to my timeline on Facebook. The video is the end of an obviously, much longer musical piece by a Croatian cellist named Stjepan Hauser. The music itself is the climax of an operatic aria, the title of which I don’t remember though I seem to remember hearing Luciano Pavarotti sing it.

The video is very moving in that it shows a variety of people: first responders, shop clerks, everyday people removing their masks and smiling. These images, combined with the music brought tears to my eyes – so I shared the video. However, when you share something like that, Facebook wants you to comment on it when creating the post, and the problem was that I had trouble describing my feelings. The music was very triumphant, but nothing has, of yet, been won. In fact, there is still a long way to go. Moreover, I’m not even sure that thinking about this in terms of “victory” and “defeat” is the right paradigm because both imply an end to the story. We may “defeat” this virus, but there is always more that needs to be done. In fact, there is an unending list of diseases (both contagious and not) that need to be conquered.

Likewise with grieving, there is no “end” to the process, there is no point (here on this side of the veil at least) where you can say, “Ok, that was a nasty job but it’s over, and I am free to move on now.” – a statement that pretty much sums up the myth of “closure”. Closure is the idea that at some point you will get to a place in life where having lost a loved one will no longer hurt. The only problem is that grief doesn’t work like that. Over time the open wound may heal, but like an injured joint that aches when the weather is changing, things are never quite the same as they were before.

In the end, I described the video as “coming out from under a cloud”. In this view, the cloud doesn’t go away, just as the pain, the loss, and the risk of disease, never goes away. The difference is that I no longer choose to live in the cloud’s shadow or let my life be ruled by it. Consequently, I may still have the pain or the fear, but I have decided to stop being the pain and the fear. Instead of railing against the darkness and rain, I will now begin moving towards the light.

Going through this transition is hard and unfortunately there is no set formula for how to do it. Moreover, it is no simpler helping someone else go through it either. As much as I would like, there are no A, B, Cs on how to do it that I can give you. But I can tell you that it requires many of the things that we have talked about before. Things like empathy so you can truly feel their pain; love to enable you to go through it with them; and a willingness to leave behind formulaic “solutions” in favor of (lots of) prayer that provides the insights to replace the formulas.

In Christ, Amen ☩

A prayer for when you are living under a cloud…

“Blessed are You, Lord God, King of the Universe. It is right that I should at all times and in all circumstances bless You for light and joy that You bring into my life. But today I want to bless you especially for the support you give when my life seems dark and cloudy. Thank you for those You send into my life to support me, especially {  name supporters  }. Please show me how to pass along this divine gift to others. Amen”

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Of Heroes and Hypocrites

This post describes, in part, the effects of a degenerative neurological condition called Huntington’s Disease. Any negative behavior on the part of my wife should be attributed to that condition. Any negative behavior on the part of myself should be attributed to my need for God’s ongoing grace.

This week has been bad. I don’t know how else to put it. Bad is bad. The latest brouhaha was over whether Frannie could go over and see one of her friends. Janet’s pronouncement? “No, you can’t go because you didn’t ask my permission!” Just to be clear, Frannie is 29 years old. At that point I stepped in and pointed out that Frannie is an adult and doesn’t need to “ask permission” anymore. Things went downhill from there. This came on top of a week that started with me taking Janet’s phone away from her twice to keep her from calling and haranguing Frannie. Then when Janet caught onto that, she started sitting on her phone to keep me from confiscating it. In the end, I had to tell Frannie to just turn off the ringer on her phone.

Then today, Frannie and her friend made arrangements for Frannie to spend one (1) night at the friend’s house. When Janet heard about it, she “forbid” Frannie to go. Frannie was crying, Janet was yelling over and over about all the issues that Frannie and I had already discussed and had solved, like: “Who will take care of your dog?” and “If you go over there, who knows what she’ll have for you to eat? You’ll get FAT!” In the end, I had to tell Frannie to just go upstairs and ignore her mother.

Whether it was right or not I don’t know, but after Frannie was gone, I told Janet as directly and as controlled as I could that Frannie does not need her permission. And that her opinions and advice on matters were no longer required or desired. I again tried to explain to her the degree to which her only daughter is terrified to be alone with her. Then I went upstairs myself and cried.

This is not how marriages are supposed to be.
This is not how families are supposed to be.
This is not how life is supposed to be … but here we are …

Semper Prorsum

If you’re wondering about the title of this post, let me put your mind to rest: I am not going to be talking politics or public health policies – though an alert reader may find corollaries to both. Rather, I will be talking, as I usually do, about how these apparently disparate topics bear on being a caregiver.

One of the earliest conversations I can recall concerning heroism was with my father. Career Army, he fought in both WWII and Korea, and tried to volunteer to go back in to “help out” during Vietnam (but that’s a story for another time). Being too young to understand either what I was asking, or his response, I once asked, “Daddy, were you a hero in the war? Did you get any medals?” He answered that no, he wasn’t a hero. And as far as medals go, “I told them, I killed all the damned people you wanted me to kill. Don’t expect me to feel better about it because you hang a chunk of metal around my neck.” The thing to remember is that my father didn’t regret a moment of his service to this country, he just fully understood the cost of freedom: some people live and some people die – on both sides.

In a parallel vein, I saw a press conference this past week where an Italian doctor was asked about the heroes saving lives in hospitals, sometimes at the cost of their own. In trying to give his answer, the doctor broke down in tears and just sobbed for several seconds. When he finally regained his composure, he managed to get out his answer: “In our hospitals there are no ‘heroes’ or ‘heroines.’ Behind the masks are just everyday men and women doing extraordinary things for their fellow human beings.” His point is, of course, that heroes are not some supernatural form of life, but rather just people who do their jobs regardless of the cost. I don’t know what hospital he was from, or what his name is, but that man is my brother.

The other thread of this post is about hypocrites. Now, you might not be aware of it, but the English word “hypocrite” is derived from the ancient Greek word for actor “hupokritēs.” Something I just learned recently was that what the word literally means is something to the effect of someone, “who performs behind a mask.” The reference is to the fact that in ancient Greece, actors in plays wore masks so the audience could immediately recognize the character they were playing. This idea, of course, melded in my “unique” brain with the doctor’s statement and got me wondering about masks in general.

For example, where do I – or for that matter any of us – get the masks that we wear? Is there a difference between masks that I acquire for myself, and masks that I am given? How do I take the masks off, and if I do, what will I find? What are the risks of going out without a mask? I will leave most of those questions for adventurous readers to dive into because, truth be told, a book could be written about each. Instead I want to look at how these related ideas of “Heroes” and “Hypocrites” relate to being a caregiver.

Someone on the outside of the situation, in essence looking in, sees a hero. They see someone battling adversity and terrible odds to snatch from death even a tiny bit of life. They see courage, faith and stamina. In short, they see the hero mask. However, the caregiver acting behind the mask, the hupokritēs if you will, has a different view. They see unending effort that is only occasionally successful. They see fear, uncertainty and, more often than not, exhaustion. To those behind the mask, there is no grandiose crusade to make things better, there is just survival.

One problem that can arise is when the one behind the mask hears the acknowledgements of those outside. The outsider’s visions of reality can be so fundamentally different that all the caregiver can see in themselves is hypocrisy and a profound lack of authenticity. Or to put it another way, they literally feel like they are just “playing a part” and if their life was somehow turned into a movie, they would show up in the credits as simply, “Caregiver 1.”

Of course the outsiders usually interpret a caregiver’s aversion to attention as modesty, and describe them as “self-deprecating” when in truth, we are just trying to avoid the pain and embarrassment that we believe will result when people discover who we really are. And by the way, this same dynamic can even apply when one caregiver looks in on another caregiver’s situation and decides that they are so much better than I am. While I’m a fraud, they really are heroic! And so it goes, each person seeing the next as being in some way fundamentally better than they are at handling the same rotten job at hand.

Predictably, the result of all this unhealthy self comparison is guilt – not unlike what I talked about all the way back in our conversation on “Righteous Guilt.” You can fall into thinking that if my loved one just had someone to care for them like      {Insert Name}    then they would be so much better off.

The truth, however, is that our placement here on earth is not an accident, so while there will always be room for improvement because none of us are not perfect, there is no room for guilt because God, who could have picked anyone for your job, knew that you were the perfect fit.

In Christ, Amen ☩

A prayer for when you are not feeling particularly heroic…

“Blessed are You, Lord God, King of the Universe. It is right that I should at all times and in all circumstances bless You for the lengths that You go to daily in order to support me. But today I want to bless you especially for picking me to perform the job that I am doing. Thank you basing Your choice on Your foreknowledge and not my track record. Amen”

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Doing What You Can

This post describes, in part, the effects of a degenerative neurological condition called Huntington’s Disease. Any negative behavior on the part of my wife should be attributed to that condition. Any negative behavior on the part of myself should be attributed to my need for God’s ongoing grace.

One of the challenges that Janet’s illness has always presented is that I am an engineer. In case you are not an engineer, or don’t know one, the thing that you need to understand is that engineers are genetically predisposed to wanting to fix things. In fact, if the truth be told, that’s probably why most of us became engineers in the first place.

The challenge, obviously, is that there is nothing about HD that is fixable. Regardless of what therapies Janet tried or the medicines she took, the eventual prognosis remained the same – perhaps delayed a bit – but still the same. So if physical death is, in the end, inevitable, the only thing that I can see left to do is to make the transition as easy as possible by giving Janet a sense of completion for her life.

You see the thing about my wife is that, above anything else, she has always considered herself a teacher. So the first thing I did was to contact the teacher association where she was a member and let them know about her health. In the letter to them, I first reminded them that she was president of their organization from 1978 to 1980 – in addition to holding down other positions in leadership.

Next, I reminded them how (teaching in the days before computers and official recognition of “special-needs” kids) Janet worked every night to manually develop customized lesson plans (now called IEPs) for each one of her math students. She was also on the association’s Legislative Affairs committee where she worked tirelessly for education reform and even addressed a state legislative committee hearing at the state house pressing for the rights of special needs kids.

By the way, if you are a girl and liked to play sports in high school or college you owe a personal debt of gratitude to Janet. While teaching and coaching girls’ basketball (Janet in her prime was only 5’4”), she worked hard for the passage of a Massachusetts state law that guaranteed equal funding for girls sports – a law that went on to serve as the blueprint for the Title IX federal statute.

A few years after she was president of the teacher’s association, she left public school teaching due to layoffs, but she continued teaching in the corporate world until our daughter Frannie was born with learning disabilities. In first grade, the “experts” told us that our daughter would never learn to read or write, and math would be totally incomprehensible to her. In response to that report, Janet’s teaching job became working with our daughter to get her through school. After working with her mother for 12 years, our daughter graduated from high school with a real diploma (not a certificate of attendance) and for confirmation at church, she read the Gospel lesson.

In response to this information, Janet got a very nice card from the association acknowledging the contributions that she made to the children of Weymouth Massachusetts. The card was signed by the current association president.

I also contacted the woman that was her housemate when we met. The woman, who is Jewish, wrote Janet a wonderful letter and promised to remember her in special shabbat prayers of healing and comfort the Mi Shebeirach (מי ייתן). In addition, a few days later, my wife got a letter from a different friend who heard of her ill-health through the grapevine.

So what was the point of this effort? Simply this, Janet can no longer read on her own so she had me read these letters to her – literally dozens of times. They remind her of the impact that her life has had, and the love that it has fostered. With conditions like HD, the patient can experience a profound sense of depression and hopelessness in the end stages of the disease. The letters and tributes that she has received are physical evidence that she can see and hold in her hand that her life had value and meaning. They are gifts to her from people to whom she gave so much.

But I got something out of it too. After 35 years together you would think that I would know all there is to know about her, but not so. I learned new things about who she was, and the things that she did for others. For example, I learned that her former roommate had been going through a tough patch in her life and literally had no place to live, and without hesitation, Janet took her in. I also learned about how she stood up to sexual harassment in the workplace by a fellow teacher who seeing her drinking from a water fountain and mistaking her for a student, patted her on the butt and told her, “Better get to class young lady…”

Finally, I want to mention that more than 2 years ago, Janet made the decision to donate her body to the McGovern Medical School at the University of Texas to help future doctors learn human anatomy. When she made arrangements for this donation, Janet referred to this as her “last teaching assignment”.

Of course all of that is, metaphorically speaking, the silver lining in a very dark cloud. And a cloud that is, unfortunately, being largely ignored. Despite the propensity of people to mouth the words similar to those from the great poem by John Donne, For Whom the Bell Tolls, I am often reminded of a line from Orwell’s novella The Animal Farm where the fascist leader of an animal revolt (a pig name, appropriately enough, Napoleon) proclaims, “All animals are equal, but some are more equal than others.” Even so, we find ourselves today categorizing and prioritizing things that should not be graded, things like equality and human worth.

At times it feels like there is a world wide shortage of equality and the only way to make someone new equal is to take equality from someone else. However, his presumption ignores the fact that equality is not something granted to you by some law or government, but is a gift that you receive from God the moment that you come into being. In the same way, there are people who will read my words above and become angry because they will interpret my praise of the person that my wife was as in some way diminishing the life and legacy of their loved one – again as though there isn’t enough “human worth” to go around for everyone on the planet.

So let me leave you with this thought to ponder. The kind of Orwellian redefinition that we see in society today has no impact on our loved ones that are gone, and very little on the ones like Janet who remain, but are at the end of their journey. Janet has ceased caring about what other people thought, or thought about her, a long time ago. The question is what impact these changes have on those of us who remain behind – and whether we are going to tolerate them? Maybe we aren’t headed for an apocalypse after all.

In Christ, Amen ☩

A prayer for when you wonder what good is left in the world …

“Blessed are You, Lord God, King of the Universe. It is right that I should at all times and in all circumstances bless You for the light that You bring into an otherwise dark world. But today, I want to especially bless You for people like {insert the names of those you are thankful for} who carry the torch of Your love to others who are residing in the darkest of places. May the lives have been so enlightened, rise up and call your light-bearers ‘blessed’. Amen”

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Mary lost her son, a story of Holy Week

This post describes, in part, the effects of a degenerative neurological condition called Huntington’s Disease. Any negative behavior on the part of my wife should be attributed to that condition. Any negative behavior on the part of myself should be attributed to my need for God’s ongoing grace.

This week I’m doing something that I have never done before. You can call it a mindful memorial, a tribute, or just trying to deal with the reality of being surrounded by death from various neurodegenerative diseases – the actual label doesn’t really matter, I guess. On any given day, the various support forums carry a litany of death from a multitude of causes that have nothing to do with viruses, and so unfortunately draw little attention.

These brief notices are typically written by the deceased’s caregiver and naturally talk about how wonderful their late loved one was – which is as it should be. But something can get lost with that approach to memorialization: the caring people left behind. These short obituaries talk about the deceased’s challenges and bravery in the face of adversity, but rarely mention the sacrifices that the caregiver makes to allow their loved one to reach the end of their days with some dignity. Neither is it mentioned that these extraordinary measures are undertaken knowing that they won’t change the long-term prognosis even one single bit.

So this week I want to talk about one particular HD-related death from the standpoint of the patient’s caregiver – his mother. Please don’t see this choice as in any way denigrating the contributions of people with other relationships. Fathers lose daughters, children lose parents, and spouses lose each other, and they all perform noble service.

Rather, my choice of subject to stand in for the hundreds of thousands of caregivers worldwide was simple and pragmatic. It is someone that I know personally, and her son is also the fourth family member with HD that she has cared for.

The mother’s name is Maria and she might be familiar to some of you. She lives in Italy and over the past month I have posted several prayer requests for her and her son Giuseppe. So many of you have responded that Maria was, at one point, left speechless. She thought she was the only asking God to give her strength. Not quite! And for the record, I am incredibly proud of the family we have assembled here.

To make a long story short, Giuseppe had JHD and like so many of his countrymen, contracted the coronavirus. Maria spent many long hours living at the hospital helping to care for him. In fact, at one point she went 48 hours without sleeping or eating, and ended up collapsing on the floor. She said the nursing staff was initially afraid that she had suffered a heart attack, but she was just exhausted.

Then during Holy Week, the end came. Since then, there has been an unending stream of details to be managed and arrangements to be made. As I was thinking about this today (Wednesday, April 15th), I started writing. Even though I never met the young man, I had come to feel very close to him, despite his being on the other side of a very large ocean. So the writing was initially to clear my own head and help deal with my own sense of loss – though, to tell the truth, I felt a bit embarrassed to even mention my feelings.

Eventually, my feelings fell to the wayside and the writing morphed into a series of thoughts on motherhood in general, and Maria’s loving dedication to her family in particular.

I have been thinking about it and it seems to me that, for mothers, raising children involves a long series of “letting go” events. For nine months you carry them in the womb but even here, at the very beginning, they are a separate person, so there is a relationship with the child, a connection. The paradox is that they are at once, in you and yet distinct from you. They have their own gender, their own blood type, and their own heartbeat. While this heartbeat may from time to time synchronize with yours, it is unique.

This point becomes obvious at birth when the umbilical cord connecting the two of you is severed and they can become a fully independent human being. But still, you feed them from your breast and change their diapers. Then one day you have to let go of that connection because they no longer need the same degree of attention. I well remember the poignant moment when my Janet realized that she had just breast-fed our son for the last time. But he made it clear that, while milk was all fine and good, he wanted solid food – and lots of it!

After that, life seems full of letting go events that strain, redefine and restructure the connection: potty training, starting school, dances, dating, graduation, college, marriage, and parenthood – each with its own unique set of letting go moments.

But sometimes something goes wrong with that neat plan, and there are other things that a mother has to let go of. When Maria realized that Giuseppe had the Juvenile form of Huntington’s Disease, she had to learn to let go of his laughter and smiles, and eventually the personable young man that he was. Then in a kind of hellish regression, she had to return to feeding and changing him, and doing her very best to care for his most basic physical and emotional needs. But then, doctors and nurses became involved.

I will always remember the message I got from Maria when Giuseppe was being taken to the hospital. I am just learning Italian, but even without running the text through Google Translate, I recognized the words or phrases for “my son”, “hospital”, “intubated”, and “panicking”. The resulting online prayer request is when many of you became acquainted with her name, and there were dozens of you. (Thank you Pamela at the Huntington’s Disease Prayer Support Group!)

Eventually, in the final stages, Maria had to face letting him go completely in death. But even then, her mother’s love was so strong that she continued hanging on, becoming a living “la Pietà” mourning a son, not of marble, but of flesh and blood. She cradled him, craving one more moment of human contact. Soon even that was gone, as people explained to her about “contagions” and the necessity of cremation. She had to let go of even his physical body. In the end, it appeared that all she would have left to show for a lifetime of love and commitment, was just a few handfuls of ashes.

But no, God does not leave His children so destitute. Maria also has memories: The warmth and intimacy of suckling him that first time in the delivery room. The look of brave determination on his face as he headed off for the first day of elementary school. The pride he showed at graduation, and many, many more treasured moments that “moths cannot eat nor rust destroy.”

But in addition to the memories, God also has promises for the future. Promises of renewed hope and love that can, frankly, be so hard to hear while we are in the midst of the mourning. However, we can be confident that these promises have no “expiration date” and their time will come. For example, as people of faith, we have the assurance that death is not the hopeless end to an essentially meaningless life. Rather, one of the great lessons of Easter is that, as strange as it may sound, in death there is healing. When Jesus appeared to his disciple following the resurrection, He still bore the marks of the crucifixion. The difference was that they were no longer bleeding wounds, they were healed and Jesus was none the worse for wear. And so it is for Giuseppe and all our loved ones: There is no HD in heaven.

But for right now those around Maria are supporting her, and while she is so tired and full of grief that she doesn’t at times know which way to turn, she is not the kind to stay down. The life of a Christian in this world is not about “either/or” but “both/and”. We aren’t confronted with the alternatives of either sinner or saint, or either being faithful or grieving. In both cases, we are “both/and”. Always remember that the opposite of grief is not faithfulness, but rather apathy.

So if you have been praying for Maria, please continue to do so – which if you thinks about it is another case of “both/and”. She is both in need of prayer and already under infinite God’s care. To protect her from total despair, God is continuing to fill her heart every day with fresh hope, and the rod of steel that He placed in her spine means that this time of pain and sorrow will not leave her permanently bowed down.

This loss will not be the end of her, and the testimony of her story is yet another assurance that ours won’t be the end of us either…

In Christ, Amen ☩

A prayer for when you mourn…

“Blessed are You, Lord God, King of the Universe. It is right that I should at all times and in all circumstances bless You for your wonderous promises. But today I want to bless you especially for understanding and sanctifying our grief. In scripture we see Jesus first weeping at the tomb of his friend Lazarus, and then reassuring the two grieving sisters that in Him there is life regardless of how things look at the moment. And then again, we have Jesus’ reassuring words, ‘Blessed are those who mourn, for they shall be comforted.’ Thank you for the opportunity to experience the grief of separations so we might experience an even greater joy at our reunions. Amen”

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Thoughts from a fairly good friday

This post describes, in part, the effects of a degenerative neurological condition called Huntington’s Disease. Any negative behavior on the part of my wife should be attributed to that condition. Any negative behavior on the part of myself should be attributed to my need for God’s ongoing grace.

Perhaps because we have all been confined here at home due to this virus, or perhaps just because things always get worse, this week has been something of a mess. Early on, I had hopes that things might get a bit better because Janet and I talked on the phone with her neurologist and Janet agreed to try an additional medicine (Klonopin) to help with her mood and chorea. Unfortunately, in the 24 hours between the phone call and being able to pick up the medicine, Janet changed her mind again and decided that she would try it, but only after her bowels got sorted out. Translation: She’ll take the new med when pigs fly!

Subsequently, I have spent a lot of time this week crying over losses – a situation exacerbated no doubt by my inability to sleep through the night. The world seems overflowing with things to fret about. Things like dear friends being in peril, from viruses – and other things. Then there are the hopes that seem to revive and then deflate, all within a few hours. As roller coasters go, the one I’m riding now pretty much stinks. The problem of course is that with a physical ‘coaster you get to experience thrills and chills, but in a safe environment where no one is ever really in danger. Unfortunately, with the one that I’m on, people really die. The “thrills and chills” come from trying to figure out whether they are going to die now or later.

People who have been following this blog for a while know that my Janet most-likely inherited HD from her father. Long time readers will also remember that he and I never got along very well. In fact, harsh words often passed between us. Or they did at least until one day when Janet and I went to see him while he was in a hospital towards the end of his life. At one point he got Janet and her mother out of the room on the thinnest of pretenses:

“Mena, why don’t you take Janet and show her the cafeteria in this place, it’s very nice.”

The cafeteria? Really? What could this be about? As soon as they were gone, he called me to his bedside and held out his right hand. When I took it he said,

“I just wanted to tell you that I’m sorry. You are a good man and I am glad you married Janet.”

I thanked him, and shook his hand. After that we sat quietly until the ladies got back from their “tour” of the hospital’s culinary facilities – each of us deep in our own thoughts. A few weeks later, Janet’s dad was dead.

The reason that I am bringing this up, is that this morning, Janet (in a rare moment of mental and verbal clarity) told me that she was grateful for all the things I had done for her, and that I had been a “good husband”. Soon, however, the HD closed back in and I was back to being an insanely huge mistake in her life.

Please excuse the language, but roller coasters are a bitch.

Today, as I write this, it is Good Friday. To modern Christians, it is certainly a strange name for an admittedly strange holy day. It commemorates the death of Jesus on the cross. Especially now, in the midst of a pandemic panic, why would that death, or any death for that matter, be considered “good”?

And what are we supposed to do with Good Friday anyway? We certainly don’t run around telling one another, “Merry Good Friday!” The problem with Good Friday is that the holiday and the name come from a time before we (individually) became the center of the universe. It was born out of a culture where sacrifice was seen as a noble thing – and not at all stupid, offensive or degrading. But mostly, it came from a time when people were able to maintain perspective about the importance of experiences and situations.

In some ways, a lack of perspective may be a uniquely American problem. After all, our mere 250 years of existence is quite literally the blink of an eye in the overall flow of history. Not long ago I was talking to someone from Italy about the virus and my concern for the health of her family. Her advice: “Don’t worry ahead of time. God takes care of things.” In these situations, Italy has the advantage of millenia of historical perspective. Within just the past 100 years, they have had to deal with not one but two world wars that were fought at least partially within their own national borders. Unlike the US, for whom both wars were “over there”. And when the pandemic did come knocking, they did what needed to be done, but didn’t abandon community. Instead they moved to their balconies and had nightly distributed concerts and community sings. They played, sang and cheered for each other because they knew that when this plague passed – and plagues always do – life resumes. So while the loss of life is tragic, only the loss of community would be truly catastrophic.

By contrast, here people are in a tizzy over the fact that 100,000 people could die from this virus while ignoring the fact that this total is still thousands short of the death toll that the seasonal flu racks up every year. To be clear, if the death toll rises that high, every one of those deaths will be a tragedy, but how about a little perspective? Look up the number of people who die from things like heart disease, cancer, suicide or even childbirth. Moving closer to home, what is the annual death toll of degenerative neurological diseases? Although there are arguments over the exact number, some reports show that for Alzheimer’s alone, the US total could be over 500,000. Every. Single. Year.

Perspective…

Another thing that would be nice is to be able to get the facts of what we are going through right now with a lot less sensationalism. The other day I saw a news story that described in excruciating detail (and with pictures!) how right now, all over the world, there are literally millions of medically untrained senior citizens providing the day-to-day care for loved ones with terminal diseases! This revelation might have been earth-shattering to the 20-something that “discovered” this fact, but for many of us, it’s not a revelation, it’s our life. Want to see a really scary number? Research the number of these “untrained senior citizens” (i.e. caregivers, like us) that die every year, decades before our peers. In one sense, this lack of recognition feels very familiar – I was, after all, in SAC (Strategic Air Command). Who knew or really understood what we did either?

Furthermore, consider this very blog. Who in blazes am I to be advising others? I’m just another medically untrained senior citizen who is trying to pass along what I am seeing and feeling and experiencing, and praying to God that I am doing even a few things right. I don’t enjoy flying by the seat of my pants, but what else is there? If Janet didn’t have me, she wouldn’t have anyone.

The bottom line is that we are all amateurs on this bus. We all have things to contribute and to learn. None of us are really prepared for the jobs into which we have been thrust. We all lean on and depend on one another. We all have a dirty job but we do it, even though it often means sacrificing years off of our lives. So perhaps Good Friday is, after all, the perfect time to acknowledge the “good” work we do. But it is also, without a doubt, the time to remind ourselves of a few things.

First, we don’t live in a “safe” world. None of us are guaranteed even the next five seconds. Something could happen before you finish reading this paragraph, and anyone who says otherwise is lying to you. Bottom line: life has a 100% fatality rate. The question is not whether you will die, the question is whether you will live before you do so. Second, this work isn’t about us – that is why it is called service. Consequently, whether we realize it or not, what we do does get noticed. Even without accolades from important people, ribbons or medals, what we do is seen by Someone. Third, we are never really in this fight alone. In addition to the globe-spanning support community that we have created for ourselves, The One who notices, is also The One who blesses, strengthens and sustains us. In the end, that support is our only real source of hope. And without that hope, we are (as Paul pointed out) above all people, most to be pitied.

In Christ, Amen ☩

A prayer for when you feel that the world is on your shoulders…

“Blessed are You, Lord God, King of the Universe. It is right that I should at all times and in all circumstances bless You for the world in which we live and the protection that You give us. But today I want to bless you especially for the strength and insight You provide to me. It is so easy for me to fall into the trap of believing that I am just a small cog in a very big machine. I know that most of the time, I can’t comprehend what it is that You are up to, but thank you for showing me the pieces that I can understand. Thank you for the courage to continue on when I seem surrounded by darkness and pestilence. I pray, Lord, that You will show me how to be a beacon of light and hope. Amen”

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So What’s There to Lose?

This post describes, in part, the effects of a degenerative neurological condition called Huntington’s Disease. Any negative behavior on the part of my wife should be attributed to that condition. Any negative behavior on the part of myself should be attributed to my need for God’s ongoing grace.

This past two weeks, the worldwide Coronavirus panic, has impacted the Porter household in a couple ways. First, my company has been determined to be in a critical industry, so my job is safe. However, it was also determined that I don’t have to be onsite to do my work, so I am working out of the house for the foreseeable future. This week is the first full week that I am home.

The second impact has been to answer an unfortunate question. I have been trying, for some time, to sort out exactly what relationship still exists between Janet and I because it doesn’t take a genius to realize that things are clearly not as they were on our wedding day. As I have shared here before, I have been reading and thinking a lot about what psychologists call ambiguous loss, and I have gotten as far realizing that I am stuck somewhere between being her “husband” and her “male nurse” – two positions with very dissimilar job descriptions. So I have begun trying to understand what I have already lost, and what else the disease will likely consume as it continues to progress.

The first time I really began to understand what HD meant in concrete terms was shortly before we moved from Ohio to Texas and our son came for a visit. He and I were out together one day doing some shopping and I took the opportunity to try to explain to him some of the troubling behaviors that I had noticed were developing in his mother. So I cautiously explained all the things that I had observed, being very careful to include only situations that I could easily justify to him. I was so careful because I was sure that his reaction would be, “Oh no Dad, you must be wrong! Not Mom!”

Instead, what I got was a shrug and, “Yeah, but Ma has always been like that…”

As we continued talking, it became clear that my college-age son had a much better insight into what was going on than I did. He explained to me that when I was away for work she would “make nice” while I was home on the weekends, only to let loose again when I went back to work. It was clear that my son’s memories went back a lot further than her diagnosis.

Eventually I had the opportunity to listen to webinars on the HDSA website that talked about the progression of the disease before the patient is diagnosed. One of the things that researchers had begun recognizing was that while the physical symptoms were typically what drove the patient to go see a doctor, the emotional and cognitive problems could start much earlier, often decades earlier.

The most immediate result of this information was the realization that it was possible – indeed likely – that our two children had never known their mother when she was not exhibiting the effects of HD. That was shocking enough, but as a result of my recent inquiries into what I had lost, I came to suspect that the same might be true for me as well. Perhaps, on our wedding day, Huntington’s Disease was already in the picture, already playing a role.

Goodness knows, in hindsight, there were warning signs aplenty. A friend that has known Janet for years once told me, for as long as she has known Janet there were times when she could be “difficult” due to her temper. Then there was the fact that Janet never liked holding hands while we walked. She said that it threw her “off-balance.” I always took that explanation to mean that she just didn’t like holding hands, but now I wondering whether HD had already started degrading her balance, just a bit.

So if I circle back to my original question, “What have I lost?” And I discover that the loss might not be so ambiguous after all. One of the things that I have clearly lost was a fairy-tale past where everything was “OK” before the disease. I realize I made a lot of excuses for her over the years, such as the time when I explained to the cop living next door to us in Ohio that I had a black eye because I walked into a door in the night. He just stared at me with a look on his face that said, “Do you have any idea how many times I have been told that crap?” But all he said was, “Are you sure that’s what happened?”

Looking back, it’s very likely that the Janet I miss, the “real” Janet that I have talked about so often, never really existed at all except in my hopes and dreams. The real Janet was the person that she would have been had she been able to free herself from the baggage of her father’s abuse. That was the battle I was prepared for and was more than willing to fight. Unfortunately, that was not the battle I got.

Just as she inherited the HD gene from her dad, she also “inherited” the anger. However, that inheritance did not come about through the action a DNA molecule, or even a probate court. Rather, it was passed on through an endless series of assaults, such as being slapped across the face multiple times because she didn’t know what page of the missal a particular prayer was on, or being verbally derided for not knowing what country produced cinnamon. And if that load wasn’t enough, when the HD began to manifest itself, she got new anger of her own. Anger about a world out of control, anger about failed expectations and unfulfilled promises. Every day now, anger piles on top of anger to create an unstable emotional tower that is doomed to fail when it can no longer support its own weight.

So where exactly does that leave me? What I’ve lost is a fairy tale. What I’ve gained is a large dose of castor oil-flavored reality. The “smart money” would probably tell me to cut my losses and get out before it gets worse. The only problem with that advice is that I have never been particularly “smart” in that way. In point of fact, I still believe in such quaint and corny ideas as integrity and keeping your promises – even when the only thing left of the original relationship is The Promise.

Consequently, I will for now let “husband” fall to the side and find fulfillment in my new position as “male nurse”. So should I consider that move a demotion? No, not really. You see my core desire has always been to give Janet what she needs, and she doesn’t really need a husband right now, what she needs is a really good nurse.

In Christ, Amen ☩

A prayer for when you are a little slow…

“Blessed are You, Lord God, King of the Universe. It is right that I should at all times and in all circumstances bless You for always knowing and providing what the cosmos needs. But today I want to bless you especially for truly understanding what is needed in my world. There are so many times that it feels like I am slow to understand hard truths, but then I see that it’s just that You made me idealistic and hopeful. Thank you for making me who I am, and using me just that way. Amen”

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Ambiguous Loss

This post describes, in part, the effects of a degenerative neurological condition called Huntington’s Disease. Any negative behavior on the part of my wife should be attributed to that condition. Any negative behavior on the part of myself should be attributed to my need for God’s ongoing grace.

So what can I say about this week? Should I go into the details of what it is like to be quarantined with a woman that says the words, “I love you” but in actions says the exact opposite? No, there is no point in plowing that field again, so let’s talk about something else. The weather? No, that is too local. Politics? No, that is too divisive.

I have it: Risk. That is a good topic, but it is a dangerous one. To risk is to put something, perhaps everything, on the line. Risk means to put up or shut up, to commit yourself regardless of the cost. Risk is a timely topic right now too, as every newscast seems to be about it.

I haven’t mentioned it before publicly, but I have started learning Italian. Why? Partially because it is a risk, though an admittedly small one. But love, marriage and life – those are big ones. When Janet and I were going on our honeymoon, we decided to go to Tahiti because Janet had a job where she flew a lot, to the point that the airlines were almost paying us to go there. While there we met an Italian gentleman Signore Mantovani. As I recall he was some sort of official with the EU. He was alone because he had just lost his wife after a long illness and was traveling, revisiting all the places they had gone together as a couple. When he heard Jan and I were newlyweds he immediately “adopted us” taking us on obscure tours that he knew about and one night took us to dinner.

For those of you who have never had a real Italian dinner, it is not a quick sit-down to a plate of spaghetti at Olive Garden. A real Italian dinner is an all-night affair. So we had been “dining” for a couple hours and had just finished our appetizers and a bottle of very good wine, when Signore Mantovani looked at me and said, “You know what the problem is with Americans?” I had to admit that I did not know. He said, “You eat too fast! In Italy, we talk a little, we eat a little, we have some wine – and then we talk some more. In Italy, dinner holds us all together! Dinner isn’t about feeding the body. It’s about feeding the soul.” What he meant, of course, was that in Italy eating is always about more than food. Meals are about famiglia, family – and that understood in the broadest possible way. The dinner table is where traditions, lessons, love and recipes are passed on from one generation to the next.

Questo è per te Signore Mantovani!

Last week, I mentioned a term, more or less in passing. I had heard it from a friend online but have since found out that it is a real thing. The term is ambiguous loss, and it provides the title for this post. To my surprise, a psychologist, Dr. Pauline Boss, has been writing on this topic for nearly 20 years. One of the points that she makes in her work is that while “ambiguous loss” certainly applies to situations such as people suffering from dementia, there are also many other sources. For example, for someone who is divorcing, there is an ambiguity about the loss in terms of what exactly is going to be the relationship going forward. Likewise, she has worked with wives of MIAs about the ambiguity of their own marital status. Are they still married, or are they, in fact, widows. Even a child leaving home for college can produce a sense of ambiguity. Do we set a place for them at Thanksgiving, or should they be included when you say “we” (meaning the family) are going to do something? In the end, we see that ambiguous loss is actually much more prevalent than the “normal” kind where we can, for instance, see a body lying in a coffin.

For this reason, I have been looking into the matter further and the result is (at least) this post. While I haven’t done a book report since high school, that is what you are getting this week. Specifically, I’m going to be talking about Dr Boss’s first book on ambiguous loss called, appropriately enough Ambiguous Loss, Learning to Live with Unresolved Grief. This book is available on Amazon in hard copy or as a Kindle download, which is how I read it.

The first thing I want to point out about this book is that, while its primary audience is the psychological “clinician,” Dr Boss has a writing style that is nevertheless accessible and very easy to read. For example, the “case histories” that she presents are as likely to come from her own or her family’s experiences as from those of a client. Which is another good point, she never refers to the people or families that she sees as patients. Likewise, she doesn’t refer to her sessions as therapy because, in her view, words have meanings and to use the word “therapy” would imply that there is something wrong with the person or the family that needs to be fixed. In truth, she points out, the problem is not dysfunctional people but a dysfunctional situation. It is the situation that needs to be addressed. Consequently, rather than being the problem, the people are always part and parcel of the solution.

Dr Boss, likewise, doesn’t try to rephrase discussion of psychological matters in “layman’s terms.” She says, and I agree wholeheartedly, that talking down in that way is condescending to the people with whom she is working.

In addition to the psych-jargon and condescending attitude, also missing from this book are long drawn out discussions of the brilliant solutions that she developed for a family’s problems. Instead she presents solutions that people developed on their own to address their own needs. For example, she cited the case of a woman whose husband had an advanced case of Alzheimer’s Disease and who, despite not remembering who she was, was continually making sexual advances to her. In the end, the accommodation that the woman developed on her own, was to remove her wedding ring and put it in her jewelry box. She had realized that the thing that was causing her so much grief was the ambiguity between the conflicting roles of “wife” and “caregiver.” This simple act of removing the ring gave herself permission to temporarily set aside the wife role so she could concentrate on being the caregiver that her husband needed. Eventually, when her husband died, she retrieved her ring and took up her new role as “widow.”

Now obviously this solution will not work for everyone, but that very fact demonstrates an important point. Just as the loss is ambiguous, so are the rules that govern dealing with the loss. Therefore, the person or persons grieving will often have to cast a wide net to obtain the information that allows them to (prayerfully) synthesize for themselves a way forward. Such input can come from psychological professionals, family/cultural traditions, and their faith community.

In another case history, Dr Boss points out a fact that in hindsight is rather obvious: ambiguous losses are cumulative. In other words, most of us will go through multiple losses that would fall into this category and ones that are not resolved adequately add to the mental load imposed by the later ones. This stacking of loss upon loss can mean that dealing with a current loss can easily turn into an archeological expedition digging up and healing old unresolved grief that is being triggered.

So what is my final evaluation? I would say that this book would be money well spent for anyone who is being troubled by uncertainty – and who isn’t these days? You won’t find in it pat answers or how-to “recipes.” What you will find is information that will help you understand, and come to grips with, what is going on in your life.

As I was finishing up this post, it occurred to be that right now the whole world is in the midst of dealing with a massive ambiguous loss – so ambiguous that we can’t even be sure what it is that we might have lost. I am speaking, of course, of the pandemic that may (or may not) be raging across the globe. Is this the greatest threat to civilization since the bubonic plague, a hoax thought up by a shadowy global elite to enslave mankind, or a biological warfare experiment that went horribly wrong? Whom do we trust for information? Friends, family, media that can be owned by the government that it is reporting on, or the proverbial “guy in a bar”? Due to the ambiguity inherent in this situation, these ideas, whether we believe them or not, can and do create question marks in our minds that we have to deal with.

And then there is the question of what we may (or may not) be losing, or be in danger of losing: our life or the life of a loved one, freedom, country, religion or perhaps something larger like our sense of community and trust? Clearly we all have a lot of work to do.

In Christ, Amen ☩

A prayer for when you are feeling uncertain…

“Blessed are You, Lord God, King of the Universe. It is right that I should at all times and in all circumstances bless You for the certitude that You provide. But today I want to bless you especially for ambiguity. You are at once the central exclamation point of my life and the biggest question mark. There are so many things of which I can be absolutely certain, but at the same time so many things about You that are (to use the theological term) mysteries. Lord, help me to learn to be comfortable resting in the mysteries of who You are, and give me Your words to reach out to others. Amen”

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Extraordinary Times

This post describes, in part, the effects of a degenerative neurological condition called Huntington’s Disease. Any negative behavior on the part of my wife should be attributed to that condition. Any negative behavior on the part of myself should be attributed to my need for God’s ongoing grace.

Janet continues doing well on her medicine in terms of sleep but emotionally things are getting worse. Apparently, saying just about anything will now earn me an invitation to, “go to Hell”. I’m ashamed to say that one time I replied, “Too late, I’m already here!”, and then had to apologize. She is also getting increasingly sensitive to loud talk – which strikes me as odd for someone who is (a) half Italian and (b) loves to watch political programming on TV.

In other news, the world’s obsession with the Coronavirus caused some interesting issues this week. I know that by now it’s almost a cliche, but we really couldn’t find any toilet paper. In addition, after last Sunday our church decided to move our services completely online. As the situation stands now, where we are in Texas, all the restaurants are closed except for takeout. The schools are closed for the remainder of the year, and I loosed a rant on the world via Facebook decrying the number of “simpering idiots” in my country. It has been a long week.

To state the obvious, we are living in unusual times, and such times call for unusual actions. I typically use this space to talk about matters related to grieving and caregiving – particularly in the context of neurodegenerative diseases. However, I think that the time has come to have a conversation that looks at this calling to care in a broader context. And the place to start that conversation is with the question of empathy.

Empathy (noun) – The ability to understand and share the feelings of another person.

For the past 3 or 4 decades at least, we have been bombarded, as a culture, by a plethora of self-help books and programs that (whether religious or secular) all preach the same basic message: “Take care of yourself, no one else will.” In fact, this idea has become so prevalent that to feel in any other way is sometimes seen as a pathology, an illness to be treated and “cured”. We are told that it is not up to us to worry about others – we have “professionals” that will do that job for us.

History shows that this philosophy can survive pretty well as long as the majority of the people who believe it are not experiencing any major problems themselves. Unfortunately, that is not the situation that we are in now. While we are not responsible for the virus itself, we are in the middle of a mess that is, to a large extent, of our own making. We have lived for so long thinking that we can depend on surrogates to take care of the needy, sick and infirm that we have forgotten that Jesus said those were things that we were to be doing ourselves. Then suddenly, the load gets too great, and the systems which we created so we didn’t have to get our hands dirty, collapse. I wonder how many people will die because neighbors have forgotten how to care for each other.

Another challenge is that going back to the 1930s authors such as Ayn Rand have taught that selfishness is good and caring for others is bad because it makes them weak, and in turn makes the society that harbors them, weak. The result is a kind of functional eugenics that is based on one’s ability to perform, rather than their DNA. I have even heard modern authors speak in favor of banning all charities, public and private, for this very reason. In addition, there are cities here in the US, where giving to the homeless is actually against the law. I wonder how many more people will die because those in power deem them to be of no further use to society at large.

Take those two sources of mortality together and you will certainly have a very large number, and a number that will continue growing indefinitely, unlike the deaths from the Coronavirus which will eventually subside.

So what are we to do? What is the solution? Those of us who care for people with neurological conditions have, I believe, a unique perspective on this problem. The source of this perspective is that we deal with people on a daily basis that can be obstinate and self-centered, and are absolutely convinced that they are in the right – just like the people who irrationally go into stores and buy up all the toilet paper, hand sanitizer or food. We know that the way to effectively deal with irrational people starts with empathy to understand on a deep and personal level, the feelings that drive their irrational behavior. In this way, empathy serves as the glue that holds society together and keeps it from degenerating into a mindless mob.

It’s time for those of us who are caregivers to step out of the shadows and start talking about what we do, and why we do it. We need to start making the case for empathy, for caring, and for being truly human. But that empathy needs to be built on a firm foundation, else it will become just one more “flavor” of pop psychology that is all the rage today, but is quickly forgotten tomorrow. The only foundation that really matters is reality. For example, the founders of the United States, started this way,

“We hold these truths to be self-evident that all men are created equal, and are endowed by their Creator with certain inalienable rights…”

In this opening to the Declaration of Independence, the authors laid a powerful foundation based on the “self-evident” reality that we live in a created world. And moreover, the Creator who is responsible for this world is still fully involved with the creation, as seen through the on-going endowment of gifts to all of humankind. Oh, and don’t miss the threat to tyrants that is implicit in the word “inalienable”.

When you start from this same place, empathy becomes yet another gift from our creator God to help us draw closer to each other. But beyond that bare definition, what does it really mean to be empathetic? And how do you learn to be more empathetic?

Taking the second question first, there is actually a lot of discussion going on as to whether people even can learn empathy. Some say “Yes” because it’s just a skill like any other human skill. Others say “No” asserting that when you were born you were either empathetic or you’re not. My view of the matter is somewhat different from both, I would say that everyone is empathetic to one degree or another because the ability to feel empathy is something that is built into our human nature as part of our humanity. In the past I’ve written about what I referred to as “fingerprints” that God left on our being when we are created, I believe this is another one. So perhaps the better question might be how do I learn to express empathy more and not continue to suppress who God meant me to be?

The key is a mindful practice of the definition given above, combined with prayer. Growth in this aspect of life doesn’t happen by itself. You need to be intentional in your daily interactions with others, looking for their needs and asking for God’s guidance. Above all, being empathetic does not mean to simply feel sorry for someone, empathy is actually feeling and understanding the emotions that they are feeling. Likewise, empathizing with someone does not mean automatically that you agree with them – just that you understand where the feelings are coming from. In a way, this is sort of like the distinction that we draw when dealing with negative behavior from our HD loved one. We say things like, “It’s not your mum saying all those bad things, it’s the HD.” In the same way, empathy allows us to understand and recognize the feelings behind the behaviors of people with whom we have profound differences. This clarity, in turn, allows us to see that they aren’t a horrible person but rather that they are fearful, or afraid, or injured in some way.

It seems that you can’t turn on the TV without hearing someone decry the “lack of civility” that someone else (it’s always someone else) is causing. However, the real problem is more often a lack of empathy, which leaves open the door for the demonization and judging of people. Whether this lack of empathy is the result of an inability to care, or apathy over the need for caring, these last few weeks have demonstrated that the reason doesn’t really matter. Losing the ability to empathize with others will kill us all.

In Christ, Amen ☩

A prayer for when you are feeling angry…

“Blessed are You, Lord God, King of the Universe. It is right that I should at all times and in all circumstances bless You for Your continued involvement in the world that You created. But today I want to bless you especially for giving us the ability to empathize with others and in so doing, help to bear one other’s burdens. In this work we have the ultimate example of Jesus to guide us, who came down from heaven, and taking on the body of a man, lived a life of empathy. Show me how to follow this example, use me to heal the culture of fear, hopelessness and death that surrounds us. Amen”

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Which Way is Up? (Part 2)

This post describes, in part, the effects of a degenerative neurological condition called Huntington’s Disease. Any negative behavior on the part of my wife should be attributed to that condition. Any negative behavior on the part of myself should be attributed to my need for God’s ongoing grace.

This week has been hard. The new medication is helping a bit with Janet’s chorea and she is sleeping like a baby every night. However, other issues are continuing to worsen. The anger has been much more pronounced and she is very demanding in terms of what to do and the order in which to do it. Our daughter Frannie, understands that when Mom changes her mind and gets angry, that it is the HD. But on some level, she doesn’t care anymore. She just wants Mom to hear her and believe what she says. For myself, everything that I hear about on the news seems in a lot of ways be our home dynamic playing out on the world stage.

It occurred to me that maybe all the news readers have HD, or Alzheimer’s or something and that is why they can never get the stories right. But no, that’s crazy, right?

A long time ago (or at least what feels like a long time ago) my second post to this blog was titled, “Which Way is Up?”. That post was supposed to be about some of the disorienting changes that took place in our lives after Janet got her diagnosis. Although it started off that way, the post quickly developed a mind of its own and wandered off in another direction – which wasn’t necessarily a bad thing. It did, however, leave this topic unresolved and recently I have seen a lot of newbies on the support forums who are struggling with this transition. Consequently, I’m circling back to give a little more of a voice to this early time in our HD journey.

After Janet got her diagnosis, we moved back to Ohio pretty quickly so her first real HD appointment was going to the Center of Excellence at the University of Ohio Medical Center. During that first appointment we understandably had hundreds of questions about the disease and the sort of care that would be needed. So someone advised that a great way to get our questions answered would be to attend a local support group meeting, and we arranged to go to the next one. Unfortunately, no one spoke to us to prepare us for the meeting, or help us to set our expectations.

Their group at that time had a couple late-stage patients attending. Needless to say, we were totally unprepared for what we saw, and we went home terrified – each for our own reasons. At that time Janet’s major physical symptom was that her feet were twitching at night. She couldn’t imagine needing to be strapped into a wheelchair so her convulsions wouldn’t throw her out if it. For myself, I had no idea how to care for someone with that level of need.

When, a few years later, we had gathered enough courage to attend another meeting – this time in Texas – we were better prepared and understood things much better. First, we understood that everyone with HD is on their own journey. Some have extreme chorea, some have hardly any. Some slowly forget everything about their previous life and drift off into a kind of non-being, some become so emotionally disturbed that they must be committed to an asylum. Still many things are common for most, like anger or perseveration.

Which, by the way, brings up another good point. If you are a caregiver for someone with HD you will be learning a new language. I know your neurologist appears to speak the same language you do, but in fact they are speaking a specialized dialect called “doctor”. So you will be learning a lot of new words – like perseveration. Over the coming years, you will also be earning a minimal degree in nursing as you learn to deal with your loved one’s daily medical and personal care needs. And that’s to say nothing of all of what you will learn about how the medical systems in your country work, which it should be no surprise, is very different from the way the politicians tell us they work.

My advice? Get a notebook and keep notes of everything you hear and learn. There will be a test on it later.

During this time, I also learned the real meaning of the term “degenerative”. It means that often today, no matter how bad it may be, today may be the best day that Janet will have for the rest of her life. I also learned that “degenerative” can be a kind of perverse blessing in that as Janet slowly grew worse and worse, I had the time to grow up and grow into my new role. If you are the caregiver, there will be days when you want to give up and surrender or simply give in to the anger, depression and anxiety. While I could tell you to not give in because it doesn’t work, I won’t bother because everyone does from time to time – or they do until they learn for themselves that it doesn’t work.

So does anything help? Yes. Prayer (constant and unending), counselling (to help you learn), fellowship (to gain perspective) and medications (to get you through the rough patches) – these can all help.

The thing that has been the hardest for me to remember is that who Janet and I were 12 years ago, is gone. But as bad as it has been for me to watch what Janet has gone through, I can’t begin to imagine the horror of being her, and everyday feeling some piece of who you are, slip away through your fingers.

When Janet and I first got married, there were many things that I didn’t understand about Janet’s personality. However, Janet came from an abusive home environment so I thought that eventually Janet would come to learn that in this relationship, at least, she was valued and treasured. But that never happened. I learned instead about Huntington’s Disease, and I learned that her father wasn’t just abusive, he was sick. Finally, I learned that Janet had the same illness, and many of the same symptoms.

So, I guess, I have made peace with the way things are. Or at least I have made peace to the degree that peace is possible. How does one ever make peace with seeing the one you love disappearing before your very eyes, yet while their body continues to exist. I have heard that this process is called “Ambiguous Loss” because your loved one is gone, but then again, they aren’t. One of the things that I have consistently tried to express throughout this blog, is that there is no going back. Who you were and who they were, no longer exists.

Given all this doom and gloom, there are those around me who, like Job’s “friends”, seem to suggest that I should just curse God and die. In addition, there are those that claim that HD is unequivocal proof that God does not exist, or if He does exist he is in reality a demon. But I reject both arguments. I reject them because, as I’ve explained before in the blog, they start from faulty assumptions about the world. But just as important, while there are many dark places where I am traveling right now, there are also many bright spots. While some of those bright spots are the many wonderful programs and facilities that are available to support you and your loved one, for me though the brightest spots are always the people. On the support forums, God has gathered together many, many really good people. For example, there are people from the USA, the UK, Australia and Italy that I have never met face to face, but who, if it came right down to it, I would nevertheless trust with my life. In addition, the internet is global in scope so if you have a problem, someone is always awake, no matter what the local time is for you.

So there is my message for the newcomers: have faith, learn as much as you can, don’t stress over letting go of things that you can’t hang onto and, to quote the line from the play, Who’s Afraid of Virginia Woolf, “Fasten your seat belts. You’re in for a bumpy ride.”

In Christ, Amen ☩

A prayer for when you are new, confused and afraid…

“Blessed are You, Lord God, King of the Universe. It is right that I should at all times and in all circumstances bless You for Your love and presence. But today I want to bless you especially for not abandoning the world that you created perfect, but which, today, has so many problems. Thank you for living among us as “Emmanuel”. Thank you for using me to help heal the brokenness in this world. Show me the way forward. Amen”

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…but what else do I need?

This post describes, in part, the effects of a degenerative neurological condition called Huntington’s Disease. Any negative behavior on the part of my wife should be attributed to that condition. Any negative behavior on the part of myself should be attributed to my need for God’s ongoing grace.

This week we had an appointment with Janet’s neurologist. It went well, though her weight had gone down 2 lbs. Janet started a new medication this week that should help her with mood, chorea and sleeping. So far it seems to be helping a lot with her sleep. Last night she went to bed about midnight and didn’t wake up until about 10:30 am! Mood is continuing to be a problem. Last night she was yelling at me and Frannie about cough medicine. She said that I lied because I forgot to get the cough syrup that Frannie requested when I went to the store on the way home from work. Then when I found a bottle of a different brand at home and Frannie told me that it was ok and would work fine, Janet started yelling that Frannie was lying too. At that point I stepped in to protect Frannie and things went downhill from there…

After the party that I discussed last week, things went well between the two of us until Janet’s dad heard that I was (a) divorced and (b) a Lutheran. To this day, I’m not sure which bothered him more. I found out later that before we met Janet hadn’t been to Mass in 15 years, and although we had only known each other for 6 months, I somehow became responsible retroactively for the entire 15 years of her apostasy. In any case, one Sunday we were at her mom and dad’s house and they asked Janet to come with them to a back bedroom. A few minutes later she came out and announced, in no uncertain terms, that we were leaving – Jan was clearly angry. When we got out to the car she told me that her parents had been grilling her about my past life. She tried telling them that we had discussed it in detail and that was all that was necessary. But not for her dad, he just kept getting angrier and angrier. Have I mentioned that we think her dad is where she inherited the HD?

The whole next day at work, the conversation kept replaying in my head and every time it did, it bothered me more. So I decided to go back and talk to them about it – without Janet. By the time I get to my future in-law’s house, I was angry too. When I sat down to talk to her dad I reiterated that she and I had discussed everything so she was going into whatever was ahead with her eyes open. Consequently, if he had any questions about my past he was to talk to me directly and he was not to harangue Janet about it.

So he demanded to know whether I was paying child support. I assured him that I indeed was paying support. But he pressed further, “How much are you paying?” Looking him in the eye, I told him, “None of your damned business. Next question?”

For a moment, I was afraid that I had overplayed my hand. You see a few years before Janet’s dad had suffered a stroke and I was momentarily afraid he was going to have another one. His face turned a bizarre reddish-purple color and the veins on his forehead were bulging. So reckoning that I had made my point, I left. Later, when I arrived at Janet’s house, she met me at the door and related to me the contents of a phone call she had just had with her mother, and asked me if what her mother just told her on the phone was true. I told her it was, and she hugged me around the neck.

In the past, I have talked several times about the loss of identity that can occur when you lose a loved one and are grieving that loss. For example, after 30+ years of marriage, you might have come to identify as one half of a couple. But when that relationship ends you can be left wondering who you are now. Of course with diseases that produce dementia, your loved one doesn’t even have to die for you to experience that sort of identity crisis. As their personality changes, or worse, dissolves completely, you can be left in a state where you question everything about who you are, what you are doing and whether your work is actually accomplishing anything useful.

I believe that crises of these sorts all lead back to a common root: needing to be needed.

So to explore that point a bit, let’s start with the situation where your loved one is still alive, but is rapidly deteriorating. Oftentimes when a loved one is newly diagnosed with a degenerative disease, they respond with thankfulness and gratitude for every little bit of service that you provide them. But then things start to change. Due to the effects of the disease, the warm feedback stops and your loved one becomes sullen, uncommunicative or even openly hostile. Instead of the original, “Oh thank you, honey, for getting that sandwich for me.” You have to deal with, “So what took you so long?!” – or worse. To address this case, let’s take a riff on a famous kōan:

“If a tree catches fire in the middle of the forest, and there is no one there to see it, is a fireman needed?”

Clearly, one tree can catch another, thus leading to a wide-spread conflagration, so in one sense, yes, a fireman is needed. Now, let’s say that by chance, a fireman happens by and seeing the flames, puts them out, and saves the forest. The thing is, as that fireman proceeds on his way, he may be basking in a real sense of accomplishment, but it’s very likely that he won’t feel “needed” because there was no one around to acknowledge that need or express gratitude for his actions.

Here we see in stark contrast the two aspects of needing to be needed. One is the objective question of whether or not some action is actually warranted. The other, subjective point, is how your actions are perceived. From this explanation we can see that most scenarios where a caregiver complains about not being needed are actually cases of where they don’t feel needed – an important distinction.

Consider that saying, “I’m not needed”, is voicing a statement that is almost entirely about you: You are not adequate for the task at hand. You are not important. You are not enough. However, saying, “I don’t feel needed.” is a comment that is all about the care situation. In fact, the assumptions behind such a statement are that you are adequate, and you are important, and you are enough. The problem is in the reaction. That is a much different, and far easier, problem to solve, and one that we have talked about before.

Curiously, this dichotomy can even exist in the situation where the loss is complete because the loved one has died – though it looks quite a bit different. Now the objective view affirms that you indeed are not needed because the person needing you has died so there is nothing more that you can do for them. But here, the subjective view can come to your rescue by pointing out some important things to consider.

Above all, there is the matter of perspective. Maybe you aren’t feeling needed because your worldview is too small. Instead of wringing your hands over being “useless”, try asking God, “What is there for me to do?” Alternatively, you can look at the challenges that you have recently faced and reconsider them from the standpoint of the question, “What was God preparing me for?” Now admittedly that might be a novel perspective for some, but I have found that it’s the novel perspectives that give the most interesting answers. Oh, and given that there is no such thing as a coincidence, don’t forget to consider the talents that you have picked up along the way – even a trivial one like knowing how to knit…

To illustrate, many years ago when we lived in Tucson Arizona I heard a story on the radio about how dangerous hypothermia can be for people living in the streets – even in Tucson. So in response, I came up with the idea of creating an interdenominational project to knit stocking caps for the homeless men, women and even families. Each cap came with a tag inside it that said:

“This cap was not bought in a store. It was hand-knitted by someone who believes that you are worth the effort it took to create it.”

For distribution, I went to the Salvation Army. By the end of the project, they had handed out over 700 caps that we created.

Now I assumed that this project would do great things for the folks receiving the caps. What surprised me, though, was the gift that it was to the knitters. For example, one the ladies was from one of the big Catholic churches downtown. She and her husband had been active members for many years and when he passed, she embraced new role as widow, and threw herself body and soul into serving the parish. She chaired committees, headed up charities and out-reach programs, you name it.

Then one day her doctor told her that she had a very bad heart and that she had to stop all outside activities – she wasn’t even allowed to leave her apartment to go to Mass. In one day, she went from being involved in everything to feeling literally quite useless. And to make matters worse (from her perspective at least) it quickly became apparent that all the parish organizations that she had been in were managing quite nicely without her.

A few weeks later when the priest came by for his weekly eucharistic visit, he told her about this guy who had contacted the parish office with a project to knit stocking caps for the homeless. Maybe that was something that she could do since knitting isn’t at all strenuous. So she called and I explained the project and why it was needed. Even though it had been years since she had knitted, in the end she agreed to try. The next day I went to visit her and give her some yarn to get started and a pattern.

To make a long story short, she attacked this new project the way that she had everything else in her life and soon she was turning out caps at an amazing rate. It didn’t take her long to use up the yarn I brought her. So she had friends run to the store and she bought more yarn on her own, and people she knew from the parish brought her even more when they heard about what she was doing.

With this simple thing she found new meaning and new usefulness. But mostly she found people who truly needed her.

However, all this discussion begs the question, “What is it about being needed that we find so important?” Well I believe that when God created humankind He, metaphorically speaking, left His fingerprints in the wet clay. And I believe that one of those fingerprints is our deep need to serve others. The reason we need to be needed is that it’s built into who we are as people. In fact, it’s so much a part of who we are that to deny it we have to in essence deny our very humanity. Perhaps this is the one of the root problems of big cities and other environments that teach us to ignore others and just look out for ourselves: survival is framed as being dependent upon us not being human.

So to close I want to quote Ralph Waldo Emerson. I feel with its pithy, very New England tone, this statement puts the point particularly well.

“The purpose of life is not to be happy. It is to be useful, to be honorable, to be compassionate, to have it make some difference that you have lived and lived well.”

In Christ, Amen ☩

A prayer for when you don’t feel needed…

“Blessed are You, Lord God, King of the Universe. It is right that I should at all times and in all circumstances bless You for creating me in Your image. But today I want to bless you especially for the divine mark that You left on my soul that enables me to not only enjoy serving, but allows the serving to sustain me, like emotional or spiritual food and water. Correct my too-small perspective and clear my eyes so that I might see the work that you have set before me. Dear Father, make me useful. Amen”