Faceless statue in Prague, outside the Estates Theatre. Superstition suggests that if you take a picture of this statue with a flash, a face will appear in the photograph. I did not attempt with a flash.
In 1972, MIT meteorologist Edward Lorenz posed the question: “Does the Flap of a Butterfly’s Wings in Brazil Set off a Tornado in Texas?” In chaos theory, this question came to be known as the butterfly effect. In layman’s terms – how much of an impact can a simple, routine activity (such as a butterfly flapping it’s wings) have on a larger scale? And, if it does have an impact, can we predict when and where the outcomes will be seen?
In nursing, we don’t have a radar that shows us the whirlwind influence of our proverbial flapping-of-wings. We see our patient that is right in front of us and though we can romanticize about how we’ve made a difference once they have left our care, it’s hard to imagine that our seemingly mundane daily tasks have any lasting effects because there are so many factors that are immeasurable and intangible.
Realistically, you can’t follow the air pattern from a single butterfly to a typhoon that is millions of miles away, just as you can’t follow your patient home to observe whether they learned from your patient teaching or quantify if their gratitude increased because they were inspired by your compassion.
I spent five years working in mental health. During that time, I saw many patients struggling with the chronicity of their illness through repeated hospitalizations and volatile behavior. I spoke to them with patience and treated them with respect, but they often associated me with the negative experience that they were struggling with. They swore at me. They called me names. They threatened me. Sometimes, they attempted to act on their threats. I don’t blame them. After all, it’s not my place to determine how much value they should place on my efforts.
Many times, I thought: how can I continue doing this when all of my efforts appear to be futile? I try to mentor them on appropriate management of their emotions and symptoms, but so many of them keep requiring this almost-barbaric control of being locked in a building so that they remain safe. What quality of life is that?
It felt like a game of Russian roulette, except there’s only one chamber that is NOT loaded and that’s the lucky patient that gets better and lives a great life. I never see them again and I probably don’t think about them because I’m too busy cleaning up the mess of the next unfortunate person pulling the trigger.
Don’t get me wrong – there were countless moments that were very uplifting. There were people that were genuinely thankful. One patient burst into tears and hugged me for getting her a cake because she said that her family stopped acknowledging her birthday. One time I sang Bohemian Rhapsody with five of my patients because they wanted me to help them cheer up one of their peers. (I’m no Freddie Mercury, but it worked.) I received letters, cards, and drawings from patients thanking me for being present and caring through their moments, days, weeks, or months of tumult. If they did not come back to the hospital, I usually never heard from them again. I had to rely on the hope that they were flourishing, but it still felt like the impression that I made on my patients was both transient and fleeting.
As I sat in the nurse’s station one day, in the throes of an existential crisis, I saw a picture of Maslow’s Hierarchy of Needs taped to the wall. Someone had highlighted the bottom two categories of the pyramid – physiological needs and safety. That’s when I realized that my efforts were not without merit. Providing the most basic needs can be the catalyst for our patients to progress towards self-actualization.
Scientists did not intend for chaos theory to become an inspirational belief that we can shape history through our actions. In fact, Lorenz sought to deconstruct the notion that there is certain cause-and-effect in nature because he found that the smallest factors are too imprecise to accurately link to one specific result. If one Brazilian butterfly can cause a Texas tornado, who’s to say which butterfly of the millions that inhabit the earth is responsible?
So, what if I turn my focus from the hypothetical tornado across the world to the tangible movement of my own fluttering wings? After all, just because a flower blooms for a limited amount of time does not negate the fact that it needs the butterfly to pollinate it. Through this symbiotic relationship, the butterfly is provided the sustenance that it needs and the flower can reproduce and bloom year after year. Likewise, I have found fulfillment through the resiliency of my patients. And through this notion it became less important to me that I change the world and more important that I positively impact the life of the person that is before me, as they are, in this moment.
Each night I lay in the exact place that you first told me you loved me. I occupy the same space, but I am not the same.
That was almost a decade ago. It should come as no surprise that 3,650 some odd days provides ample space and circumstance for individual evolution. Each moment, saturated with inevitability, seeps into our core while we pay no mind. The subtlety of change sneaks in, uninvited yet blindly accepted.
I feel the ambivalence of nostalgia often – the oscillation between grasping for memories too distant to pull into the now, and the calming assurance that some day I may reach for this one in the same way. I do this not only with people, but also experiences, emotions, even sounds. If you have ever heard a song that resonates so deeply at one time in your life, but later hums along meaninglessly; if you’ve ever wished to reconnect with an old friend as if you were still 16, but soon realize that unfamiliarity has replaced the laughter and tears you’ve shared, you understand.
These sublime instances will always fade into insignificance without our blessing. We have no choice in our acquiescence because the person that was once captivated by another person, experience, emotion, or song is ceaselessly transforming into a new entity within each fleeting moment. We ignore change until enough unique nuances culminate into a form who’s presence can no longer be denied. That is where our choice comes in – we can reject this unwelcomed stranger or reserve judgment and greet our new selves, knowing that we will be asked to face this choice again and again regardless of our decision.
For five years I ignored the insidious alterations within myself and resisted this stranger until I made choices that were not aligned with the person that I believed myself to be. Despite my defiance, the stranger carried on as strangers do, living its life unabashedly free of my approval. For months, I did not fight it. Like a child who fears the unknown of darkness, I lay motionless with the comforter pulled tightly over my face until every muscle in my body ached from immobility. I deluded myself into the fallacy that this was my existence now – forever hiding while the stranger wore my clothes, walked around my house, lived my life. In this new space, I heard muffled I love you’s; this time, from unfamiliar voices that spoke without conviction. I could not cry because I was terrified that the stranger would hear me and its apathy made me uneasy. Even worse, removing the comforter would mean confronting this invader and acknowledging that it was my own carelessness that allowed its entry in the first place.
When the numbness of inaction became too tedious, I revealed myself to the stranger. I impatiently tried to discern its motives. I lectured it about the consequences of entitlement and nefarious behavior. I hoped that I could agitate the stranger, disturb the ease in which it had settled in, demand it to leave me alone. But its presence was resolute and I submitted to that determination – a prisoner now allegiant to its captor. I proved my obedience by embracing its sins as my own, whipping my own back and denying myself of sustenance, all under the guise of self-preservation. Meanwhile, change continued its unwavering quest towards infiniteness.
Over the years, many people have tried to release me from the chains of self-judgment. However, they often did so through validation of my inadmissible actions or by admonishing the people I affected by them. I vehemently denied both.
Then, one night, the bold statement: “You have to forgive yourself.” My best friend dropped me off at my house after yet another night of fun that ended with me in tears, desperately searching for answers to questions that I refused to ask. I collapsed into bed, into this very space where our vulnerability became a shared communion, and I remembered the peace of surrender. “You have to forgive yourself,” I repeated. Here I can pardon myself because I am new.
No longer do the pangs of nostalgia wash over me as I lay in this space. The memory is there, but just as the resounding song loses its meaning and friends become unknown, this too is devoid of the vivid emotion once attached to it. As I reflect, I do not strive to relive those days because I finally understand that it is futile to experience a stranger’s narrative, even if that stranger is yourself.
Symbolism pervades much of life as we know it. If adversity is likened to a rainstorm, the rainbow is the emblem representing that the hardship has passed. The blinding desolation of night will be perpetually followed by the rescue of dawn. We are taught to believe that beauty, hope, and resiliency are often cultivated in darkness or when a specific sequence of circumstances fatefully align.
The symbol for the 30th wedding anniversary is the pearl. Much like the “diamond in the rough”, pearls are formed out of seemingly mundane circumstances romanticized into the charming notion that a banal spec of dirt, through time and patience, undergoes a transformation into the elegant pearl. The metaphor is that three decades of companionship forges a magnificent gem that continues to grow and evolve as it remains in the safety of the oyster’s shell.
The less glamorous reality begins with a piece of a debris that haphazardly invades the oyster’s shell. The oyster is a living creature with innate protective processes, much like humans. The debris is an irritant, but since the oyster is unable to remove the unwanted substance, it instead deposits layers of calcium carbonate around it. Rather than discard what chance has delivered, the oyster preserves it. Regardless of however aesthetically bland it may have been prior, the oyster ensures that its new existence is one of lovely iridescence.
I like to believe that these same forces of nature act on human connection. Rather than the notion that two individual people become one through connectedness, they take advantage of serendipity to form a separate entity that protects both individuals and endlessly expands while the two remain together.
Pearls are notorious for their strength and resiliency. Their beauty is not wrought from daintiness or fragility. The crystalline layers of calcium carbonate are similar to the wavelength of light and thus, light reflected from the outer surface interacts with the light reflected from the inner surface to produce a lustrous palette of color. The foundation created initially from the oyster’s self-preservation becomes a process of harmonious collaboration and eternal transformation.
The oyster is not blessed with the vision necessary to observe its own pearl. The elegance of its creation is best observed by the eyes to which its light is reflected.
How magnificent that I am the observer of a pearl three decades in the making.
Happy Anniversary, Mom and Dad.
They say that when you work in mental health it is important to not take the job home with you or else you will risk your own mental stability. They also say that you have to be crazy to work with crazy people. I say that I disagree with both theories.
A month ago, my job sent me to a conference on Trauma-Informed Care. Those that spoke at the conference were doctors, social workers, and occupational therapists and they presented on a multitude of approaches to incorporate in mental health settings (hospitals, schools, etc.) with the end goal being to minimize or eliminate the use of restraint and seclusion. The overall theme was to have a better understanding of how traumatic experiences physiologically change one’s reaction to their environment. In an 8 hour day, it was one small statement that came to be the most profound in rekindling my love and desire for my career. A man named Jay Indik, LICSW from Cutchins Program for Children and Families in Northampton, MA stood in front of the audience and began his part of the presentation by posing a question: “How many of you are here because your job exposes you to traumatic experiences because you care about the well-being of others and want them to live meaningful lives?”
That statement is what bridged the gap between myself and my clients. They have been exposed to trauma at least once, but most likely many times throughout their lives. In turn, they have learned maladaptive ways of attempting to get their needs met. These strategies, whether it be self-harm, verbal violence, or physical violence manifest themselves while they are on the unit and I choose to be there and endure the trauma that they are then inflicting upon me. But this is not a bad thing. This is the learning moment that separates those that can handle working in an acute care setting and those that can not. Those that can not are unable to oppose the tendency to feel helpless when traumatized. Those that can make it in this field are the ones that take their own trauma, put it in a crystal jar, analyze it and use it for positive change in themselves and others.
I have been verbally abused day in and day out, even physically assaulted, but the day that I felt the most knocked down was when a client called in to question my ability to do my job effectively. She witnessed an interaction between myself and another client that triggered her. She was sobbing, shaking, and visibly anxious and she told me that I was wrong. I took a deep breath, put aside my own insecurities that she was calling into question, and I apologized. I apologized and I truly meant it. I then went into the office and burst into tears. I felt hopeless. I felt like I had failed. But I did not fail because I took that moment and I learned from it. By using my moments of vulnerability as learning tools, I model for my clients an appropriate way to cope and to move forward and to be stronger.
Yes, my job is stressful and at times utterly depressing, but despite the frustrations and the fear that my line of work rouses within me, I have come to a deeper sense of self through my interactions with clients and peers.
They are wrong. I am not crazy for wanting to work with this particular clientele. I am one of the few that truly believes that what binds all of us together in this messy world is the need for unconditional love and acceptance. I take my work home with me every day because I feel grateful and fortunate for my life and I think it would be a disservice to not share my strengths with others in order to minimize their struggle. I take work home with me and I think about how I can improve on myself in order to better serve others. Most likely they will walk out the door of the hospital and never think of me again, and that is beautiful. I don’t expect or strive to be anyone’s hero. I want them to find that hero within themselves.
Eyes closed, crouched in Child’s Pose, I have come to an interesting conclusion: Yoga can be stressful.
Inhale. I think about a negative interaction I had at work today. Exhale. Am I doing this right? I inhale the problems of the day deep into my lungs. I exhale the ability to fully relax my mind.
I know most people find inner peace and relaxation when they practice yoga, but I’ve learned that I have an extremely hard time turning my brain off for an activity unless I am overexerting myself. When I go to the gym, for example, my brain can go into autopilot because I am listening to a carefully selected playlist of upbeat or angry music and I don’t have to think about how to correctly position myself every 30 seconds.