Monday, March 24, 2008

I'm retiring

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Well, I did it – I sent the letter and will retire at the end of spring 2008. Less than 2 months and one more clinical group to go. It’s time. My work has been a huge and fulfilling part of my life these past 30+ years. I’ve accomplished more than what I set out to do – hospice, refugee work, teaching, community clinics, 3 books and >100 articles and chapters, 1000+ students, and many 1000s of patients. For more than 30 years I’ve put others first much of the time – not now and then or philosophically or whatever, but in hard reality. My goals for the coming years can be summarized in the words of John Muir: “The mountains are calling and I must go.” Now, at least for the next ~9 months, I am laying it down. Glacier, the Wind Rivers, and Southeast Asia are next. Then the John Muir Trail. Below is a summary of my career. It’s long, so you might just want to let it go with this first paragraph above. Photo: At the DMZ - it was about to get a lot worse

Career, part 1

5-6 years after Vietnam I had a store on Sears Street off lower Greenville. It was called the New Store and I and my partners David N. and Jeff W. made and sold waterbed frames, shelves, walls, tables and the like. One day a customer who looked familiar and I were talking and we realized we knew one another in high school. She had dated one of the Catholic guys I hung out with (and who later was badly wounded in Vietnam). She had become a nurse and as we talked I realized that working as a nurse was something I could do that for me would not be a waste of time. (After Vietnam I was completely committed to never wasting the time of my life.)

To get into nursing school I had to take about a year of prerequisites such as organic and inorganic chemistry, anatomy, physiology, micro, and so on. To pull up my abysmal GPA I had to make close to all As. Taking these course was the first time in my life I applied myself in school. I made all As and was admitted to Baylor School of Nursing. The next two years was good. The courses and clinicals were mostly good and to my surprise, my fellow students were among the first people I could relate to after my 13 months of combat in Vietnam. The young evangelical Baptists and the old profane Marine found common ground. Except for the religion course (from the Baptist perspective), I made all As – I mean, what chance did have in that company – I was probably lucky to make a B in that course. I graduated magna cum laude in 1975.

I’ll stop here and express my deep appreciation to Leslie – I’d be so much less without her. Leslie’s love and loyalty have sustained me though some tough times and it’s not been easy for her. She’s stood tall beside me for many years through the good times and the bad. This sounds almost flat – for once I don’t have the words to express all that she has done and my love and gratitude to this woman who changed my life – all for the better. More later.

After I graduated, I worked at the VNA for a year — first as staff, then supervisor. In 1976 we went to Austin for me to go to graduate school. Leslie got a good job in the DHS state office – good in the sense of not having to contend with destructive politics or personalities. I got a M.S. in psychiatric nursing. There were some interesting times working in Austin State Hospital with people who were chronically mentally ill. We lived on 43rd Street and were very happy there. As I think about it, we’ve been happy just about everywhere we’ve ever been.

We wanted to go back to Dallas, but I was having difficulty finding a job in Dallas that I felt was appropriate for my master’s degree status. Then I went to a Transitions Retreat held by Elisabeth Kübler-Ross in San Antonio. The way these retreats worked was they had about 75 people (1/3 terminally ill, 1/3 bereaved, and 1/3 caregivers like myself) in a room to share our lives and selves with the others. We cut quickly through the crap – like, “I’m here because I want to learn how to take better care of people who are dying” – when someone said, “I’m here because I have the problem of judging people.” It turned out that we were all there because of our pain, aloneness, judgments, and so on – we were all there to be healed. Except for meals and bathroom we were in that room from 8 am until 1 or 2 am the next morning. Truth was told and I was humbled. I went back to work as a staff nurse at the VNA because, of course, all I ever really wanted to do was take care of patients. Photo: Tillie, a hospice patient

In early 1978, some friends (Ruby Carter, Tim White, and Johnnie Turner) and I came up with a plan to make note cards with all our names and phone numbers on the cards. We gave the cards to our patients who were dying so that they would always have someone to call when things went bad (no pagers or cell phones in those days). We also started a study group to look at what other people were doing in caring for people with terminal illness. In April the executive director of the VNA called me out of the field to begin planning a program for people with terminal disease.

At the same time I began planning, Jean Saunders asked me to see a friend of hers who was dying. The woman was Jan Viola and for the next several months, along with her amazing mother, Jean Mitchell, I took care of her. Jan had breast cancer with widespread metastases (brain, spine, and eventually lungs and liver). Before I met her she developed spinal cord compression and lost the function of her legs, bowel, and bladder. Her Mom and I went all the way through the journey with Jan and we were with her when she died. Jan was a tough customer and it was a great privilege to care for her.

Meanwhile the program grew from the VNA Terminal Care Program and before I left, it became the VNA Home Hospice Program. During this time it became the largest and one of the best hospice programs in the United States. With two other people I wrote a grant proposal which resulted in the program becoming one of 26 hospice demonstration sites across the U.S. The start-up was a consuming two years. We were blazing a trail and it was a good trail that many followed. Then I resigned as director to work as a hospice clinical specialist. My replacement as director was intolerable to me, so I left. The creation of this hospice – the service given to patients and the influence on the care of patients of other agencies and hospitals – is something I am very proud of.

I went to work teaching community health at TWU. Shortly after I started there (1981) Leslie and I got involved in refugee work. We had contacted some agencies in prior years, but nobody wanted individual volunteers. One day I got a call from Kevin M., an infectious diseases specialist at UTSW. He wanted to know if I wanted to go to a house in Old East Dallas and put in some PPDs for some newly arrived Cambodians. Leslie came too, and we were quickly caught up with Cambodians. It’s difficult to describe what we’ve done. People tend to seize on the most concrete thing, such as a clinic. But it was much more than that. We gave a lot of help to a lot of different people: individuals, families, and community. It was incredible working like this with Leslie – she is a great person in the same sense as Dan F. (all about mercy). We consciously tried to embody welcome to as many people in as many ways as possible. Photo: Francine, a hospice patient

The following was written during that time and I’m leaving it as it was written: For us personally it’s the first time we’ve worked together like this. For the first time in all that I’ve written, I am at a loss for words. It’s been about three years of very intense work; long hours and life and death; steady. Then for about two years, less of the personal work and more organizing, meetings, and politics, at which I am not very good. Leslie and I worked together very well and very productively. The Khmer have been amazing. In some ways they are like people anywhere, and in other ways there is nobody like them.

What stands out for me is their tremendous strength along with their grace and beauty. One thing that sets Cambodians apart is their having been through a holocaust (which of course is far more than just the killing). We learned a lot and for both of us I think it’s the most we’ve ever done or experienced. We’ve spent a lot of time in the apartments on Carroll, San Jacinto, Fitzhugh, Bryan, Annex, Sycamore and Live Oak working it out, figuring it out and filling it out (a million government, etc. forms). We also spent time at Parkland, Children’s and various clinics wheeling and dealing, operating at top speed in some very intense relationships. In 1982/83 we visited refugee camps at Khao-I-Dang on the Thai-Cambodian border, and Aranyaprathet, which is closer to Bangkok.

Community development wise, we were directly responsible for the East Dallas Health Coalition, involvement of the Dallas Police with refugees, the NCJW Khmer Community Development Project, the TWU Project, raising a fair amount of money and providing most of the community education, and so on. As I write this I am aware of how much was done and how lucky we are. But it was what we did in the apartments with individuals and families that will live on in us.

Teaching at TWU was good, in part because I met my mentors, Bets A. and Judy M. there and partly because I was doing the refugee work. I was able to put the teaching and refugee work together and thus amplified both.

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