In the Waiting Room

I was in the airport in Seattle, waiting for a flight to arrive to take me to Chicago and thence home to Madison, Wisconsin.  The flight was coming in from across the Pacific Ocean.

As I sat there by myself, reading and watching the airport activity around me, I became aware of a group of people nearby — probably 6 or 8 of them — who were obviously together and waiting in excited anticipation for someone or something that was arriving on the incoming flight.  After overhearing much of their conversation during the next 15 minutes, it became clear what was happening; they were there to meet another member of the family who was coming home with a newly-adopted child from the other side of the ocean.

By the time the flight arrived, I think most people in the waiting area had become aware of the unfolding narrative, and we were quietly but intensely focusing in on the expected arrival.  And then it happened.  The new mother came out of the jetway holding the hand of a small boy. They entered the circle of family who were there to greet them.  Huge smiles all around, hugs, but also care taken not to overwhelm the little boy with too much emotion. The family members wiped away their tears and the rest of us did likewise.  I felt like we other travelers had been given a gift to witness a singular and fiercely private event in another family’s life.  The memory still warms my heart.

During our lives, we spend a lot of time in waiting rooms.  Waiting areas are ‘coming and going’ places where time is in suspension.  In one of her poems, my sister referred to the time spent in airports as “thick” time.  So too is time spent in other waiting rooms: before medical appointments, haircuts, bus boarding, restaurant seating or while the car is getting an oil change and its tires rotated (an experience unto itself that probably deserves its own posting). Sometimes, the waiting is one of happy anticipation.  Sometimes, it is full of apprehension or even fear.   And sometimes, the waiting is just that — simply waiting.

For children, waiting is often a basically difficult task.  I remember one time, when our son was probably about two years old, he and I had arrived at the clinic for an appointment with his pediatrician. We were in the corner of the waiting room taking off his snowsuit.  Once out of his snowsuit, John took off across the waiting room and, without any hesitation, climbed up into the lap of an elderly man — a total stranger.  He was a lovely man, a grandpa-type; he simply smiled down at John and patted him on the back.  Apparently, this was John’s way of handling the waiting room scene.

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When I was an undergraduate student here at the University of Wisconsin, I took the passenger train to Chicago one weekend to visit my sister.  The train arrived in the ‘windy city’ and I got off and went into the enormous Chicago Union Station to meet Eleanor.  As I looked and looked for her among all the milling people, I slowly began to realize that she wasn’t there.  This was my first solo venture to Chicago, and a sense of fear and not knowing what to do welled up in me. Ultimately, I found a pay telephone, we got things sorted out and I took a taxi to her apartment.  When she opened the door to welcome me, I burst into tears.  I had definitely been scared and challenged in a way that neither of us anticipated.  When the waiting and watching have no known resolution, the experience can be full of anxiety and worry.

My mother was more brave.  After Ed and I moved into our present house, about 25 years ago, my mother agreed to take the Greyhound bus to Madison to visit and see our new home.  This would have been in 1988 when she was 88 years old.  At that point in her life she had significant macular degeneration and hearing loss.  One of her friends would take her to the bus station in Baraboo and I would meet her on her arrival at the bus station in Madison.  The day of her visit came, and when I got to the bus station, a little ahead of the posted arrival time, the waiting area was full of people and commotion.  I made inquiries at the ticket desk and, sure enough, the bus had come in early and all the passengers had de-boarded.    images (4)As I scanned the lobby, a woman came up to me and said, “Are you looking for your mother?”  Yes!  “She’s right over there.”  How did you know?!?  “You look so much like her.”  When I reached my mother, I apologized for not being there sooner, and she simply stated that she wasn’t worried — “I knew you would come.”  In retrospect, I think my sociable mother had made some friends on the bus and they knew she was to be met by her daughter and the woman who approached me had just put two and two together.  But I loved the fact that I looked “so much like her;” Sort of a built-in assurance that we would always be recognized as mother and daughter.

A less recognized waiting room exists in the context of hospice care.  One of my doctoral students did her dissertation on the meanings of occupation in a residential hospice.  In her analysis of the narrative data generated during six months of participant-observation, “Waiting” was a primary theme of meaning.  In effect, the resident’s room became a waiting room.  As Noralyn stated, “Residents waited, family and friends waited, staff waited.”  In the hospice study, one of the patients, who was struggling through the final week of her life, said at one point, “It takes so long to die.”  My mother, during the final night of her life, had said almost the exact same thing to my brother:  “Why does it take so long?” Waiting has been referred to in the literature as a “liminal experience;” perhaps the waiting during dying and death is the quintessential example of that liminal experience.

Meanwhile, the newly adopted little boy, who arrived those many years ago to meet his new family at the Seattle airport, must be a young adult by now. I hope that the loving welcome he received at the airport from his waiting family was a sign of what the years since then have held for him.  Surely this experience of waiting was, for the family, one of happy anticipation, and for the little boy, one of sweet resolution and promise.

Cohn, E.S. (2001).  From waiting to relating:  Parents’ experiences in the waiting room of an occupational therapy clinic.  American Journal of Occupational Therapy, 55, 167-174.

Gasparini, G. (1995).  On waiting.  Time and Society, 4, 29-45.

Hasselkus, B.R. (1993).  Death in very old age.  A personal journey of caregiving.  American Journal of Occupational Therapy, 47, 717-723.

Jacques, N.D., & Hasselkus, B.R. (2004).  The nature of occupation surrounding dying and death.  OTJR:  Occupation, Participation and Health24, 44-53.

Trigger Trouble

I woke up one morning this past December and noticed an odd sensation in my left hand. The 4th finger — the ring finger — hurt a little, plus, when I tried to flex my hand or make a fist, that finger had a sort of “catch” to it, as if it was coming up to a gate that it had to push open in order to get through.  Yup, I recognized the symptoms of a trigger finger.

What were fairly mild symptoms that first morning proceeded to get gradually more severe in the days and weeks that followed.  And, of course, I increasingly had difficulty carrying out my usual everyday occupationsgripping the steering wheel in the car, opening jars, wringing out the dish cloth, pulling up the quilt that had slipped in the night, tearing open the sealed bag inside the cereal box.  Eventually, even the light typing on the computer keypad was uncomfortable.

All this time, I felt relieved that the finger problem did not seem to interfere significantly with my piano playing.  But the possibility of having to cut back on my time at the piano every day, perhaps permanently, was definitely a worry.

After about a month, I finally gave up on the hope that the problem would just go away and I arranged for an appointment with an orthopedic surgeon.

My first visit to the orthopedic clinic was interesting and a little puzzling.  I did indeed have a trigger finger.  A handout with an anatomical diagram of the finger including the muscles, tendons, and pulleys was used to help me visualize what was going on. Two possible procedures were explained to me, i.e. injection and surgery.  The upshot of the conversation was that it was up to me — totally, as far as I could tell — to decide which I wanted to have done.

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I have long supported the concept of client-centered care, or, the term I like even better, family-centered care.  Yet I found myself wanting to at least get a recommendation regarding the options that were described.  But no specific recommendations one way or the other were forthcoming.  Up to me.

At about midpoint in the office visit, the surgeon asked me if I was able to remove my rings from the trigger finger.  “No.”  I had not been able to remove them for years and years.  He replied that I would need to have the rings cut off before he could go forward with either procedure.  He also wrote out a prescription for an oral steroid 6-day “pak” to take in the meantime while we sorted things out.

I left that first visit mulling over what I had learned about treatment for a trigger finger, and I started to swing into action.  I went downtown to a trusty jeweler and had my engagement and wedding rings cut off (the jeweler used an impressive little tool that he slipped under the rings and then cut upward, away from the finger). Next, I picked up the oral steroid “pak.”  The pharmacist told me the steroid would “mess up” my sleep and have me talking “a mile a minute” — in other words, I would be totally revved up. Not good, as I had a big weekend coming up with our daughter and son-in-law arriving to celebrate my 75th birthday.  So — I made the decision not to take the steroid yet — maybe after the weekend — or maybe not.  “Maybe not” won out.

Coincidentally, I discovered that two of my friends had histories of trigger fingers.  I listened to their stories and comments about injection/surgery options and success or lack of success.  Even though these women were not totally in agreement with each other, their ideas helped me to keep thinking things through and to appreciate that the choices I had been given were not so easy to deal with.

Back to the orthopedic surgeon two weeks later for follow-up and a decision. This time I was assigned to a physician assistant.  I reported that I had not taken the oral steroid and was still on the fence about which way to proceed.  He repeated the options and shared his own past experience with a trigger finger, i.e. two trials with injections brought no improvement and he ultimately had surgery, which was 100% successful.  Me:  “Okay, I’ll have the surgery.”  PA:  “Okay,we’ll set that up.  Let us know if you change your mind.” Holy cow!  This thing really was totally up to me!

Surgery was scheduled.

In the days that followed this decision, doubts about the wisdom of going ahead with surgery persisted.  And then I began to wonder why I could not come to terms with this situation. Good grief!  Why was I so undecided?  Ed finally chimed in with what suddenly seemed like good advice.  Why not start with the prednisone pak, then, if no relief, move on to the injections, and leave the surgery option for last?  Aha!  I finally felt like the eagle had landed.

So, I called the clinic to cancel the surgery.  I would take the oral steroid.  Another appointment was set up for three weeks hence, when I would report on the results.  As it turned out, the prednisone did not interfere with my sleep, I did not talk a mile a minute.  However, I also did not experience any improvement in my trigger finger.  None.

At the next clinic appointment, we went ahead with the injection. By the following day, my trigger finger had improved immensely.  It has continued to get better and better, and I am now, five weeks later, virtually symptom-free.

So that is the mini-saga of my trigger finger.  Along the way, after my rings had been cut off, I was surprised to find that I apparently had a habit of sort of “fiddling” with the rings on and off all day long.  I kept reaching for the rings, only to find the empty space where the rings had been.  I had been totally unaware that such a habit existed throughout my daily occupations.  Also, I realize now that family, friends and health professionals all contributed to my thinking in an ultimately helpful way.  It really does “take a village” to care for ourselves and to get through daily life.

Can You Stand Another Spring?

As you may know, my sister Eleanor was a published poet.  Every year, about this time, one of her poems comes vividly to mind.  It’s one of those frustratingly “Untitled” poems, but the first lines are these:

Can you stand another Spring?
Rhubarb nubbing pale fuschia
out of worm-moist earth
unwrapping yellowy leaves
with the sound of
an old accordion unpleating.

Last week, I looked out the breakfast room window and there it was:  Rhubarb nubbing pale fuschia out of worm-moist earth!  In our household, this annual “nubbing” of the rhubarb in our kitchen garden ranks right up there with the return of the turkey vultures as a most welcome sign of Spring.  Taste buds perk up in anticipation of the first slice of warm rhubarb pie topped with a scoop of vanilla ice cream.

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What are the harbingers of Spring for all of you bloggers from around the world?

Here, in Wisconsin, our four seasons have very distinct personalities.  First of all, we do definitely have four seasons — Spring, Summer, Fall and Winter. Depending on how you are bringing up this blog, you may see the cover of my book with its photograph of the spectacular fall color in our University Arboretum.  As we near the end of one season, we look for the first signs of transition into what is next.  But it’s the first hints of Spring that carry the most emotional currency for many of us.

The turkey vultures and the rhubarb are very early signs, and we greet and celebrate their appearances.  Next will arrive the robins and hummingbirds, and the tulips, daffodils, lilacs and crabapples will come into bloom. We begin to put winter coats and woolen turtleneck sweaters back up in the attic for storage, and snow boots are put away in the basement cupboard.  At the same time, we enjoy the gradual lengthening of daylight hours as we switch from standard to daylight saving time. We open up the sunroom, which has been closed off and unheated all winter and is now flooded with warmth and bright sun. Off goes the extra blanket on the bed, and the debate begins; “Do you think we can open the bedroom window a bit tonight to get some fresh air?” Outside, we rake off the leaves that fell in the Fall, and that have provided the garden with a layer of protection from the winter’s cold and snow.  We inspect the plantings for winter damage and worry about those that seem to have extensive winter “burn.”

I grew up here in this state and all my life I have lived with the four seasons.  I would miss the changing seasons if I were to move south.  Many people, especially those who are retired, go away to Florida or Arizona for part or all of the winter. Some people are drawn to warmer climes in middle-age, enticed by the promise of never having to chip ice or shovel snow.  One friend moved with her family to Phoenix many years ago — thinking the move would be temporary and would be followed by a return back to living in Wisconsin. She ultimately changed her mind and is staying on in Arizona.  She said to me one time, “You don’t appreciate how hard it is to deal with winter until you’ve been able to live without it.”  And I’m sure that is absolutely true.  And yet . . .

I look back on our winters over the years with a sort of perverted pleasure.  In their own way, the snow storms we have are beautiful to behold.  And a sense of being freed from the rest of the world and all its responsibilities comes with not being able to go anywhere, with spending a day at home waiting until the plows can get through.  These are what we call “snow days;”  the weather channel sends out a “snow advisory,” schools are closed, and people are advised to stay home.  Then comes the crisp sunny day after a snowstorm, with its unbelievably blue, blue sky against the white, white landscape — the outside world is just plain gorgeous.  And we know that the plows will come, and we know that the day at home is over, and we know that it’s time to go back to school and work. But, in its own way, the snow day has been an unexpected respite, a chance to rest and get re-energized for the return to the everyday routines and tasks of life.

This year we are coming out of a particularly harsh winter.  Lots of snow and subzero temperatures. The coldest day this year was January 6 — 18 degrees below zero (F).   Hence, we are reveling with more than usual enthusiasm in these first signs of Spring, knowing we will soon be enjoying lovely warm days and glorious color in the garden.

But, hold on.  We are understandably excited to see the rhubarb coming up in the “worm-moist earth” outside the breakfast window.  But we groan out loud as we read the weather forecast for tomorrow in this morning’s newspaper — high of 42 degrees, partly sunny and chance of snow (!).