open pasture

moocowinthecity 2022-01-20 No Comments

Traumatic Growth & Life Changes

It has been a hard five months. In September my mom had brain surgery to put in a shunt to treat normal pressure hydrocephalus. Then I lost a dear and older friend in the Gay community to cancer (we have so few older gay Men: the Reagan Administration’s handling of HIV, and AIDS largely to blame for that). That same night I found out that one of my family members has cancer, and another is fighting the same kind of cancer that my Aunt Teri passed away from. My Aunt Teri is one of the biggest reasons I became a Social Worker.

I went to the hospital with symptoms of a heart attack (thankful that it came back clear). We had to help my dog, Wiley, across the rainbow bridge. Mom had two E.R. trips in rapid succession, the second was a seizure which saw her in the Neuro E.R. for a few days, before she came home for at home rehab with Neuro O.T. and Neuro P.T. I took a leave of absence from work to take care of Mom and drive her to her rehab appointments.

I also passed my LCSW exam, and somehow managed to get a 4.0 in my doctoral program. Two days after my LCSW exam, mom wound up in the hospital again, after I found her (once again) non-responsive on her bed. Four days unconscious in the Neuro E.R., I can’t recall how many days on the Neuro Floor…we got the diagnosis of moderate/severe dementia.

I have been in full swing ever since: coordinating medical, insurance, financial, mental health, etc. in order to get Mom into a safe memory care unit.

In therapy we call this “traumatic growth.” These moments that are harder than iron, and sharper than diamonds, that mold us, that change us, that educate us. They are often cairns, or markers, on our lifepath.

I realized that I needed to slow down. I have literally been running my entire life (literally before I could walk).

So it was with incredible sadness that I turned in my letter of resignation to Horizon Health Today. My last day of work is on February 14, 2022 (when I come back from my leave of absence – there is still a LOT of work to get done between now and then for Mom’s transition and care).

I can’t say enough positive things, in any of the languages that I speak, about Horizon. It has been among the greatest honors of my life to work at, work with, learn from, and grow with Horizon. I would not be the counselor that I am without them.

As I start my next journey I look forward to parting as friends and maintaining a relationship with Horizon: whether as an outside instructor, or – at the very least – Horizon and the Bailey Team’s biggest cheerleader and champion in the community.

So what’s next? I meant what I said when I wrote about the “Death” of Private Practice. Agency practice has brain trust. The patients’ benefits and outcomes are currently incomparable. There are also downsides (it takes a LOT of energy, caseloads are high because they must be, your schedule isn’t your own, it’s rapid pace which has not gone unnoticed on my body, as I continue to work with my own physical disabilities).

To that end, I am pivoting my doctoral research to find a balance between agency, group, and private practice (what I am currently calling “Networked Communities of Practice”) to create a new model that is both financially and humanly sustainable, that can meet or exceed agency outcomes for patients in terms of achieving their goals and access to other kinds of service providers. We must fight back against burnout experienced by social workers and others in the helping professions, especially as we enter our third year of the ‘new normal.’

I am thankful for a friend and colleague (an incredible attorney) who is helping me setup my practice. I will be empaneled with United Healthcare, Oxford, Oscar, Aetna, Cigna, and Blue Cross/Blue Shield within the next thirty days. I have also partnered with the Open Path Psychotherapy Collective in order to provide affordable services for those without insurance coverage.

More to come.

For now, I am going to make a cup of tea, turn on some music, and slow down, and give myself permission to do and think nothing at all, but to just watch the winter evening and just notice…just breathe.

moocowinthecity 2022-01-02 No Comments

Gathering Dandelions

I am, in this moment in time, awfully sad. My heart aches in ways that I have never known before. My soul is bleeding, scarred, and bruised. These emotions, however, are profound, and I am allowing myself to sit – not wallow – in them. It is vitally important that I feel them, and rather than view them as an enemy, I must recognize them as a friend.

Because bleeding stops. Scars fade. Bruises go away. The lessons they teach us remain.

These emotions are here for an evolutionary reason: they help us survive, and they help us become better people, they give us a mere glimpse into other parts of our humanity that we don’t often access…because it hurts, and because it’s hard to access.

We cannot change the laws that exist within the universe, they are written by a power far beyond that which we can comprehend or control. We can learn about them, we can try to understand them, but we cannot change them. We cannot undo the past. We, for all we may want to believe, can’t slow aging or prevent our eventual death. We can’t change the stars, nor can we tell a tornado to stop.

Without profound loss, we cannot know the power of total and complete gratitude. Without the depths of despair, we cannot know the true power of hope. Without sadness as dark as the night, we cannot know joy that is so overwhelming our world lights up again. Without a total loss of control we cannot understand or even begin to recognize the boundaries that create safety for us.

These emotions, like all emotions, like all feelings don’t last forever. They help to transform us in a moment in time: whether a second, or a season. The feelings we have directly impact, and help to create, our behaviors. In recognizing, in gathering our feelings, like one gathers dandelions as a child: we can hold them, observe them, thank them, think on them, and then blow them into the wind, where they’ll take flight exactly as the laws of the universe (physics) have destined them to fly.

They will leave, and we will have been better off for having spent some time with them before we gave them flight.

moocowinthecity 2022-01-01 No Comments

Grieving The Still Living / Modeh Ani

This September my Mom, and best friend, had brain surgery for normal pressure hydrocephalus. She had a shunt put in, and was so excited to be feeling better, walking instead of shuffling, and a number of other symptoms seemed to move by the wayside. This, sadly, did not last long.

I found Fran having a neurological emergency on Sunday, November 14th. I conducted a MMSE (Mini Mental Status Exam). Mom couldn’t pass it: she didn’t know where she was, who she was, who the president was, what the year was, etc. I wasn’t sure what was going on, but I knew it was a neurological emergency.

She was rushed to the hospital, where she would spend a number of days, flittering in and out of being able to remember who she was, and who I was. Eventually much of her returned.

I took a leave of absence from work on November 15th in order to take care of her, to provide her support (caregiver, emotional), and to take her back and forth to Neuro OT and Neuro PT appointments, and to coordinate her care.

On Wednesday, December 22nd I found my Mom on her bed again, once again unresponsive, this time unable to move, unable to speak, unable to see me. The fire department helped get her out of the house, and we rushed to the Neurology Emergency Room, which I am so thankful to have here in Buffalo, and so close to my house, at our medical campus.

It was UTI induced Encephalitis. My mother NEVER had symptoms when she had a UTI, often only finding out during a urine specimen test at the doctors. She spent many days non-communicative and non-responsive in the Neuro ER. Finally, she re-awakened slowly.

At first she couldn’t recognize me, then she could, and slowly it became apparent that symptoms that we had attributed to other things for years (like forgetfulness was due to fibrofog, the stopping of paying her bills depression, etc.) was in fact early signs of dementia that we missed. Much like historians can put a complicated situation together in a narrative that we, decades later, can say “wow that makes sense, why didn’t the people living through the event see it?,” so too are chronic and progressive medical conditions often missed, or misconstrued. It makes sense now, because we can look back knowing all we know.

This last incident sped up her progression to Moderate/Severe Dementia.

My mother is now preparing for a new journey, as am I.  The prayer that we as Jews say each morning, the very first prayer, is Modeh Ani. It is the prayer where we thank HaShem for returning our souls to our bodies:

מוֹדֶה אֲנִי לְפָנֶיךָ מֶלֶךְחַיוְקַיָּם, שֶׁהֶחֱזַרְתָּבִּינִשְׁמָתִיבְּחֶמְלָה. רַבָּהאֱמוּנָתֶךָ

Modeh anee lefanecha melech chai vekayam, she-he-chezarta bee nishmatee b’chemla, raba emunatecha.

I offer thanks to You, living and eternal King, for You have mercifully restored my soul within me; Your faithfulness is great.

For whatever reason, HaShem needed my mother’s soul that day, and chose not to return it. Baruch Dayan Ha’emet: Blessed is The Righteous Judge!

So as I say goodbye to my Mom and talk about her in the past tense, I move forward referring to Fran, who I am now getting to know, and help through the process of getting placed into care, very nearby my house, as we work to determine what our new normal will look like in 2022.

My mother worked hard, every. single. day. to remind me how much she loved me, how proud of me she was. I have had the privilege of having her live with me for the past six years, and my memories of her are love and laughter (in that order). She loved so many of you. She spoke of you often to me, she saved your triumphs as screen shots on her phone, she speaks of you now, introducing many of you to those who surround her, those that can only be seen by her.

I am grieving trips that we had planned to take together (largely interrupted by COVID) and that we now won’t be able to. I will still take them, because I know she would want me to (her joy of life was contagious). I am grieving the incredibly brilliant mind that unravelled before my eyes: the first female systems officer at Citicorp, the woman who came up with the contingency plan in the late eighties/early nineties that Citicorp put into place on 9/11. The woman who read more books than I have ever seen, and who was an awarded fencer (ambidextrous). The woman who was so happy that ALL of her French returned to her the last time she visited Paris, so much so that airport security tried to move her to the citizens line at the airport. I am grieving the woman who ensured I had an education before the Americans With Disabilities act and who made sure I was at the table for my special ed meetings before that was even a thing. I am grieving the woman who made sure to find a synagogue with a special ed class so I could have a Bar Mitzvah. I am grieving the woman who loved science, as much as she loved getting kicked out of fine establishments (once by dancing on the bartop). I am grieving the end of 37 years of guidance, friendship, and of unconditional love as I have known it. I am grieving.

I also know that I will be okay, because my very existence was manifested by acts of revolutionary and unconditional love going back hundreds of years, through countless generations, which eventually lead me to this very point in time, and that because of our collective memory the loss of Fran’s memories are not the end of hers, but rather, now the responsibility of ours to keep.

This is what it means to be a Jew…we pick up the shards of our broken glass and turn them into mosaics. I will not eulogize my mother now, but I will mourn and grieve the mom that I have lost. I will also wait with excitement, and joy, and awe to meet and become friends with Fran, the new woman that she is becoming.

בָּרוּךְ אַתָּה, יְיָ אֱלֹהֵינוּ, מֶלֶךְ הָעוֹלָם, שֶׁהֶחֱיָנוּ וְקִיְּמָנוּ וְהִגִּיעָנוּ לַזְּמַן הַזֶּה

moocowinthecity 2021-11-23 No Comments

Jumping Down The Waterfall

When I was emigrating from the United States to Israel I remember the feeling of jumping from a waterfall. I could provide the inertia and forward movement, but the laws of the universe (physics, God, your preferred higher power) would guide me down safely. I had to have faith, courage, and trust.

It led me on an incredible adventure. I saw joy and sorrow, had a few near death experiences. Made family. And learned a lot about leaning into my fears and growing as a person.

I am once again at a major waterfall in life. I have those same fears and concerns I had in my chest when I boarded my plane to what was then my unknown. I once again feel God’s presence holding me, saying “you got this.”

Once again I am being asked to take a leap of faith. Once again I am jumping down the waterfall. Once again into the unknown with only the knowledge that no matter what it will work out.

moocowinthecity 2021-11-12 No Comments

Can’t do. Can do.

Yesterday on the treadmill for my stress test I initially had some very negative thoughts. It was Veterans Day. While I’m not a veteran of the US, I was an NCO in the IDF.

I, in my younger years, have hiked the highest mountains in the Negev Desert, mountains in Northern Israel. I completed basic training and the NCO course. I loved hiking and backpacking and travel.

My nickname in almost any job has always been the Energizer Bunny. Though, since I woke up nearly fully paralyzed a few years ago, I feel like the Energizer Bunny who’s had the battery removed from his back.

So I was on the treadmill, out of breath, and in pain having little to do with my heart and mostly having to do with my Rheumatoid Arthritis and my Myositis.

It took five years to get those diagnoses down. Two misdiagnoses (one in Buffalo, and another at the illustrious Mayo Clinic until blood test would reveal what was going on.

And as my back was in pain and my arms were hurting and my joints were screaming from something I used to be able to do with a 60+lb trekker pack – well before my army days – I felt awful and like a failure.

That is until the social worker voice in my head said “you aren’t a failure. You don’t have to meet any physical expectations. You are Disabled. It’s okay to lose old skills and learn new ones. No, you couldn’t do what you used to, but your old you couldn’t do what you do now.”

I felt a wave of gratitude come over me as my heart continued to beat through my chest and the EKG machine attached to me continued to print…and I realized that the sum of my experiences is who I am now, and I would be a whole new person tomorrow, adding in todays experiences.

So often we let that negative voice of what we can no longer do through. Instead, before me opened a path of all the things I can do now that I couldn’t do then. From homeless to homeowner. From drifting to vocation and calling. From confused to having an identity.

Friends, normalize and validate these thoughts. Breathe. And then look ahead of you, because tomorrow you’re going to be able to do things you weren’t able to do today. You might not be able to do things you did yesterday. That’s the adventure. That’s the journey.