Birds and the mountains calling

I’ve written before about how when we’re lying in bed we can see the bird feeder right outside the back window and 7 feet past that, the bird bath and behind/beside the bird bath is a big bush that's undistinguished in terms of flowers, but is a major bird bush. Actually our entire yard, front and back, is a bird sanctuary. With all the bird-watching, squirrel studies (all squirrels are named Chubby), lizard updates (all named Mr. Green), various roses and other flowers coming into or going out of bloom, so on and so forth, it’s as if our lives inside our house extend to outside. Photo: Junior wren on the front porch - first day of flying

So many wonderful things …

The adolescent jay dive-bombing the feeder to bother the other birds.

Mr. and Mrs. C (the cardinals) are always first to the feeder, just as the sky begins to lighten.

The year before last a wren couple made their nest in our mailbox, so we closed the porch off. One day we found a tiny baby wren (no feathers, big head, totally helpless on the porch and put it back in the nest – which we confirmed later really is the best thing to do). When the junior wrens were ready to fly, they spent a few hours clinging to the brick, flying from wall to wall and away they flew. Photo: Junior wren on Phyllis' house - first day of flying

Now there’s another wren nest in the ivy growing all around and on the front bathroom window overlooking the driveway. When a parent is on the way with food she or he calls in a kind of descending trill and the babies respond with the faintest of peeps that Leslie can hear, but I cannot. After the babies get their food there is complete quiet. I walked up on the porch a few days ago and there were two junior wrens on the porch. I got the camera and went to the driveway, where the juniors were practicing flying back and forth between Phyllis’ house and ours. A few juniors were around the next morning and by afternoon they were all gone. Photo: Junior wren on the feeder on the front room aircon - first day of flying

The “homeless birds” (drab-appearing cowbirds and grackles) are the most spectacular bathers, using their wings and tails to splash water everywhere. They crowd up – 6-8 of them on and in the birdbath.

Doves are a poor symbol of peace – they’re aggressive with other birds and among themselves. They lift their wings and spread their tails to appear bigger and run toward others. What goofy birds they are. The sparrows pay them no mind, crowding around like they do. Photo: Chubby in the roses at a living room window

The sparrows are always around, crowds of them, hopping and flying around, happy as larks. They seem to have no conflicts with anyone, including among themselves. They’ll take a piece of the bread and kind of hop off the edge of the feeder to the ground where if they drop the bread often another sparrow grabs the bread and hops away. When the young ones are able to fly to the feeder they hop after adults, shivering and cheeping for food.

For awhile we had what we called sparrots – parrots that flocked with sparrows. They actually live closer to the lake and after a month or so, found their way home.

Once Leslie called me to the back of the house and there on the bird bath was a hawk – a force to be reckoned with.

We have blackbirds (all named Quoth the Raven [said in a husky deep voice]) who prefer the bread. When one of them lands on the feeder it pretty much clears the deck, except for Chubby. They take a piece of bread and fly back to the birdbath to soak it for 15-20 seconds, the scoff it down and back to the feeder. Back and forth, back and forth. Photo: Robin red breast and cedar wax wings in back. The cedar wax wings are around for one, sometimes two days/year - just passing through

Leslie rescued a baby jay from Judo’s formidable jaws. She fed it little pieces soaked dog food on a toothpick for a few days and then found a rescue place (ABC Vets) that took it.

We are on the 35th day of >100F. We’re filling the birdbath several times/day and I’ve begun spraying the leaves of the pecan tree and the bush by the birdbath, thinking that that might improve things for the birds. Yesterday, when Leslie was lying down to take a nap (actually it’s mostly lying down for her daily back, hip, and leg-rub – same as mine, earlier in the day) I saw a hummingbird hovering by the bush by the birdbath. There are no flowers – what is that little guy doing – Oh, right, having a drink, taking a break from the usual fare of Phyllis’ Turk’s caps. Photo: Quoth the Raven



This morning, before daylight we saw an owl on the birdbath.

In a few days I’m headed to Wyoming to do a similar trek to my epic (it was epic for me, anyway) hike into the Wind River wilderness in 2009. https://picasaweb.google.com/chaskemp/WindRivers2009North.

As is increasingly so, I’m uneasy about being away from Leslie, especially going into a wilderness area. But I have my SPOT (satellite beacon to check in okay or to send distress signal) and an ever increasing sense of my limitations. And this time I’m uneasy about leaving home in all this heat – Yikes! And I go with a tremendous sense of appreciation for a wife who is so supportive of this. Leslie is a rare one – in quite a few ways, actually. For all our life, all our love, all our work together, all our travel, our wonderful son, our dreams, all these days, and so much more: I love you. Photo: Looking back on the mountains I came over in 2009.

From Dallas I35 north through OK City, Wichita, go west on I70 to Denver, north on 25 a few miles, cut off to Ft. Collins, then north on 287 to Laramie, west on I80 to Rock Springs and 191 to Pinedale. Here is an exact route that will be abundantly clear to anyone around Pinedale. I’m planning on starting at Elkhart Park outside of Pinedale, through Miller Park (“Parks” are huge meadows.), past Photographer’s Point past Hobb’s Lake, Seneca Lake, Little Seneca and then if everything is real good (I’ll let you know by sending three consecutive I’m okay messages) north on the Highline Trail past Lower and Upper Jean Lakes, on to Shannon Pass Trail to Cube Rock Pass around the south side of Peak Lake up through Peak Basin and up between Split Mountain and G-4 to overlook Mammoth Glacier, then traverse around to Knapsack Col and down into Titcomb Basin to Island lake and on out. If it’s going just okay, i.e., I’m too slow or too much knee pain or whatever, I won’t send 3 consecutive okays and will go past the Highline Trail cut-off to Island Lake and from there into Indian Basin and either up Freemont Peak or just mill around in Indian or Titcomb Basins for a few days and then out.

And here's a song for you, sweet Leslie: http://www.youtube.com/watch?v=3j4cu-MuLgc

Starting Hospice

Here is how hospice started in Texas in 1978-79.

I was interested in dying and death before I got into nursing – what with all the gunfights, mines, morters, and so on. And the healing path after the war also brought life and death into sharper focus. Dorothy Pettigrew, one of my teachers at Baylor told us about Kubler-Ross’ stages and I sought out more information and the opportunity to work with people at the end of life. John Reed was very helpful in this process and I owe a lot to him.

When I graduated I went to work at the VNA and again sought those opportunities. I decided I needed to get better at communicating with patients, so went to UT Austin to work on a master’s in psychiatric nursing (I had a fellowship and veteran’s bennies). It was an intense year in school and another good year with Leslie.

There were few jobs and little apparent opportunity in those jobs in Austin and so Leslie stayed and I went to Dallas. It was in no way a separation, but it was a commuter marriage. Leslie stayed at Carol Nunley’s and flew in every Friday afternoon and left Sunday afternoon. I had an apartment in an old sixplex on Prescott in Oak Lawn – every weekend, what a great time we had there.

At the end of our time together in Austin I spent a week at a “Transitions Workshop” with Elisabeth Kubler-Ross, Stephen Levine, and about 75 people who more or less fit into one of three categories: some had life-threatening illness, some had lost a loved one, and some were working in terminal care in some way or another. This thing happened at a Catholic retreat center in San Antonio. The sessions went from ~8am until 1 or 2am. On the first morning we were all in a large room, going through us all, with people sharing why they were there. We learned later that this was called bullshit time, because so many people would be saying they were there to learn about dying and death. In our time, however, we went from a person who was dying to someone who was afraid to a man who said he was there because he was always judging other people, and somehow these people freed things so that other people began saying why they were really there: because of our pain. Photos by Debora Hunter

Most of the rest of the time was spent in a process called externalizing, in which people would express pain, anger, grief and say what they had to say to those who had been a part of whatever it was that was happening (God, an abusive parent, self, spouse, the usual line-up). Part of that was that nobody was comforted. People, myself included, expressed the pain, then deeper, and deeper into it, until (often with groaning, sobbing, and so on) the pain really was out, not sanitized for public consumption, but agonized, snot-running, sweaty, and raw. People were realizing they could survive these terrible feelings. Though toward the end there was comforting, and greatest in the comfort was that we were all doing this thing. One thing I shared was how Donohue was killed. It was the first time I said this aloud, though I was running the video in my mind every bleeding day of my life for 10 years. I later told Jeff and I wrote it here: http://sites.google.com/site/chaskemp/personal2

In Dallas I went to work at the VNA. When I graduated from the master’s program I was thinking I should have a certain level of job, certainly “higher” than staff, but after the Transitions Workshop, I realized all I ever wanted to do was to help others and the best way I could think of to do that was to work with patients (I still believe that). So I went to work as a staff nurse providing care in people’s homes. Within a few months some other people (Ruby Carter, Tim Brown, Johnnie Turner) and I were meeting to talk about what we could do to do a better job caring for people with terminal disease. There were no pagers at the time, so we all carried note cards with all our names and phone numbers and we’d give one to each patient who was dying – the idea being that surely, one of us was bound to be available no matter what time of the day or night the call came.

Not too long after we got this going, the VNA Executive Director, Elsie Griffith called me to her office and told me she wanted me to “work on something for people with terminal illness.” I came out of the field and went to work on program planning and on how to get leadership to buy into what I was planning. Early in the process someone asked me to look in on Jan, a young woman with metastatic breast disease. Incredibly she lived about a mile from my apartment and I began helping her mother, Jean, an amazing woman. I think it was about three months before Jan died. She had an incredible journey, with many long nights at the edge.

Meanwhile, back at the VNA we brought in Al Shapero, one of my professors (design and management) at UT, to help with the planning and bringing the organization’s leadership along. It all came together and was kept real, at least in part through my nightly encounters with Jan’s journey toward death. Somewhere along the way I spent a week at Hospice of Marin, where I learned more about program details and met some of the other people who were making hospice happen in the U.S.

VNA had Dallas divided into three districts and we started the program, (initially the VNA Terminal Care Program – creative, ain’t I – and later called the VNA Home Hospice), in the East District. It was a very lean program, basically a team of nurses, medical director, social worker, chaplain, home health aides, lay volunteers – each team integrated into their district organizational structure. Three months later we started in the West District and three months after that the third district and Dallas was covered.

Each time we started up, we had a training program that lasted about a week if memory serves me. We covered hospice principles, symptom management, communications, spiritual care, etc., and we also had some powerful exercises and meditations. One of the people who helped with training was Herman Cook, who had worked with Kubler-Ross at the University of Chicago and was now (at the time of the training) a chaplain at Parkland, Dallas’ county hospital.

One very nice outcome to the care we were providing was that the percentage of VNA patients with advanced cancer who died at home went from ~32% to >66%. On any given day we were taking care of more patients than any hospice in the U.S. It was working.

In keeping with my outlook on things, I didn’t have an office for quite awhile. Still focused on patients. Then I had an office and a secretary, Virginia, who did wonderful work. I told everyone who worked in hospice, including administrative, that we would all always be working with at least one patient. Virginia worked with this woman, whose life was truly tragic.

At this time there were a few hospice programs on the east and the west coasts, and of course in the U.K. In Texas, there were a few people talking about it, but we were the first people in Texas to actually provide hospice care.

There was a spirit alive in those days – one which is still alive in many hospices! It was a spirit of hope for our patients, of faith in our potential and the potential of our patients, of pushing the limits of symptom management, of dedication to this better way of living in the context of dying. Those were epic days of legendary efforts in mercy. People like Cathy Little, Laura Neal-McCollum, Major Thomas, and Jimmy Boyd were spending day after day in the presence of suffering, fear, despair, and pain. By their faithfulness, skill, and love they showed that hope was real and healing possible.

How can there be healing in dying? When my teacher, Stephen Levine said,

We’re born to be healed

He wasn’t talking about healing the flesh. It’s the healing of the spirit, the person, the family, the past, the present, the future. We worked so hard to ease the body and thus open things up for communication, growth, and healing.

Reach out your hand
if your cup is empty
If your cup is full
may it be again

Let it be known
there is a fountain
that was not made
by the hand of man
A year or so into the whole thing I went to work on a proposal to the U.S. Department of Health & Human Services for our program to become one of the national hospice demonstration projects. Several other people were also involved in the writing and together we produced a proposal that was awarded (our functional and successful program had everything to do with the award). We became a national demonstration project and the program began going through a lot of changes. I did as I intended all along and became a hospice clinical specialist (training, consulting, difficult patients and families). I was betting that VNA would hire someone good to take my place and then the most awful thing happened. The program went under an administrator who didn’t get it except as a career thing and she hired a guy who was just a terrible choice in so many ways. That was a very difficult time for me.

I worked in hospice for about two years. They were extraordinarily intense years of pushing the limits of care, grand innovation, hard work, and the realization of dreams beyond dreams.

Fifteen years later I wrote Terminal Illness: A Guide to Nursing Care. When the book was finished, the editor asked me to write an epilogue and though tired of writing, reluctantly I did. In the first sentence I wrote that the purpose of all this was for the patient and family “to have the opportunity for reconciliation with God, self, and others.” It blew my mind that I wrote that. It was as if, oh, right, there’s the purpose of life: reconciliation with God, self, and others. My life, your life, all our lives. Some of us have farther to go than others, but there it is.

Goodby to all that - Hello!

I had planned on retiring about three weeks from now, but things changed and I resigned from Agape. For the longest time I thought I would never want to retire, but I am truly ready. I’ve had a good career. There have been probably about 40,000 patients (hospice, refugees, immigrants, psychiatric ER and state hospital, in the community); several thousand students; working with Leslie to manifest hope, love, faithfulness; countless hours in inner-city apartments; three books, many articles, etc.; writing grants and raising some millions of dollars – and never losing track of who I was serving. The hardest parts of leaving are leaving people like Nora and walking away from something I was good at, that mattered. I wrote a 3 part account of all this when I left Baylor several years ago at following link. http://ckjournal.blogspot.com/2008/03/im-retiring.html/03/im-retiring.html. Photo: Megan, me, Joe - two people I'm sad to leave. Plans:

Leslie and I will be together differently in some ways. For one thing there’ll be no work worries/stresses to get in the way of things. We’ll see how all this goes – changes and stuff to work out, no doubt. I’m looking forward to it. Photo: Leslie on the bus leaving Rangoon for Moulmein ~2007 and Leslie waiting for the bus in Kathmandu ~1978.

I’ll be gardening, baking, cooking, working in/on the house and yard, working out, meeting friends, riding my bike and Leslie will be keeping our business act together, doing all her correspondences, exercising, going out with friends, doing house, food, etc. things and who could guess what all else.

We’ll travel – more or less continuing our current patterns of west coast 3-4 times/year to be with David and Asia once a year – maybe get to Boston area, other places.

I’ll backpack as long as I’m able – this could come to an end at any point as it’s pretty hard on the body. Next up is ~10 day trek in the Wind Rivers in August. Photo: High up in the Wind Rivers - rock, ice, snow, air, the wind, a little lichen. It took me 6 days to get to there.

Volunteer-wise, I’ll be helping with some psytrance camping gatherings. This is a new direction for me and I’m really excited. I like the people I’ve been meeting at these gatherings and I like the music. Next up is Soul Rise in September near Austin. See photo below from Deep in the Heart of Trances.

Hopefully I’ll spend more time with Jeff.

What else? I don’t know.

My mate, Jeff said this: "How cool is it to have someone to testify that it all even happened." He was talking about the gunfights, the blood and iron of Vietnam, and how 30-something of us (of the >180 who started out together) came home on-time. All the others were dead, too badly wounded to keep going, and of course the lucky ones with malaria or 3 non-crippling wounds. He was talking about the years after, when we really did dance beneath the diamond sky, filled with wonder and sparkling beauty, the years of healing, returning to the heart. Photo: At Con Thien

Then take me disappearin’ through the smoke rings of my mind
Down the foggy ruins of time, far past the frozen leaves
The haunted, frightened trees, out to the windy beach
Far from the twisted reach of crazy sorrow
Yes, to dance beneath the diamond sky with one hand waving free
Silhouetted by the sea, circled by the circus sands
With all memory and fate driven deep beneath the waves
Let me forget about today until tomorrow

Jeff was talking about how we both, in different ways, have been/are with people at the end of life, manifesting faithfulness and truth in those difficult times. He was talking about NOW, as we again dance beneath the diamond sky with one hand waving free, silhouetted by the trees, circled by the circus lights … again filled with wonder and sparkling beauty … and now there are all these other people dancing too! Photo: The dance floor at Deep in the Heart of Trances - just wait until the night!

51 is the number of push-ups in one set I did this week, on my way to doing more push-ups than my age. Haha, I’m not sure I can get to my age before I’m another year older. So it’s either 16 or 17 to go. (At least I’m not going on about health problems, much.) I decided to stress my knee to see if I’m able to backpack after arthroscopy earlier this year, so this week I hiked for an hour up hill and down dale with a 35-40 pound pack. More laughter: my knee is fine, but my back hurts. But I’m good to go.

I saw a woman last week who asked if she could bring her daughter to the clinic for significant interrelated psychiatric problems. Sure. The mother and daughter came in today. The young woman’s problems are extraordinarily difficult and they have high mortality and morbidity rates. Serious morbidity has already occurred. We made some progress, I felt mostly as stop-gap measures, but, you do what you can and you take what you can get. Afterward I was telling Leslie about this and later she came back with a brilliant intervention and suddenly there’s light and a way. Wow! Photo: Leslie in her natural habitat (scan from a magazine article)

You (actually I mean they) say stop
I say go
You say why
I say I don’t know
Oh-Oh, Oh no
You say goodbye
And I say hello
Hello hello
I don’t know why you say goodbye
I say hello-o-o-o-o helloo

Spring 2011 photos

Spring 2011 photos are here: https://picasaweb.google.com/chaskemp/Spring2011# (click slideshow)

Spring 2011

We were at a wedding and someone was asking me about retirement, what I planned to do and I answered garden, bake, backpack, festivals, travel. Leslie mentioned that I was starting a 10 day backpacking trip next week (and that she was going to Cali). I thought, though the moment had passed, that a major part of my plan for retirement is just being with Leslie more. Photo: From the small balcony upstairs at the house where we stayed in Berkeley.

And I was thinking about this and that, like the bride’s parents and their journey from war and Vietnam and what Leslie and I have done so far this year. I’m working out and Leslie’s walking. I work two part days/week and was doing some serious gardening until it got so bleeding hot and Leslie does everything that keeps us going (considerably more than two part days/week!). We’ve been having lunch together almost every day, going on weekend “field trips” to Saigon Mall and Super H, and random things like Half-Price Books. As much as possible, we’ve had some long easy days, like on Fridays. Photo: Where Telegraph meets UC Berkeley at Sproul Plaza, where the free speech movement started. Pretty good little band.

January (the trip started 11/2010 and ended 1/2011) – we traveled for about 8 weeks in Cali and SE Asia.
February – Arthroscopy knee
March – Cali (Oakland & SF) – some major good times
April – I went to Oklahoma for a couple of days – a great trip
May – Berkeley for David’s graduation – talk about a family trip!!!
June – Deep in the Heart of Trances, which was wonderful and Sonic Bloom which wasn’t; Leslie to San Francisco – San Francisco!
July – Rest
August - ?
Photo: David moments after graduation from Berkeley Law! Good work! WooHoo!

My teacher, Dan was talking earlier about Nietzsche’s idea that the “death of God” results in "weightlessness.” I was thinking about that in relation to faith and works – I was thinking that often, without works (doing good, being in the flow, practicing mercy, etc.) there is a lack of weight and substance in life.

For me, the faith vs. works question is false. The way I see it is the reason to do works is not for some future reward, but because it’s just what a person does, maybe cannot not do. We’ll find out whatever in the sweet by and by. Photo: Speaking of substance ... country French sourdough loaves, several with cheese.

In June Jeff and I went to Deep in the Heart of Trances. It was basically a perfect party. There was music from Friday evening to well into Sunday morning. Here is an example of the sort of music we listened and danced to (click start on the third piece, Summerlands - whew!): http://soundcloud.com/search?q%5Bfulltext%5D=aes+dana5Bfulltext%5D=aes+dana

Photo: Sunday morning at Deep in the Heart

A Victory for Veterans

New York Times, May 18, 2011

The United States Court of Appeals for the Ninth Circuit ordered an overhaul of mental health care for veterans, who are killing themselves by the thousands each year because of what the court called the “unchecked incompetence” of the Department of Veterans Affairs.

In a scathing 2-to-1 ruling on May 10, the judges said delays in treating post-traumatic stress disorder and other combat-related mental injuries violated veterans’ constitutional rights. The delays are getting worse as more troops return from Afghanistan and Iraq, the judges said. About 18 veterans commit suicide on an average day.

The government’s obligations are clear. Veterans are entitled by law to be treated for injuries and illnesses. Benefits claims are supposed to be dealt with in days or weeks, but it takes an average of more than four years to fully adjudicate a mental health claim. When a veteran appeals a disability rating, the process bogs down drastically. The problem is an overwhelmed bureaucracy and a chronic inadequacy of resources and planning.

The judges said the system for screening suicidal patients was ineffective, and cited a 2007 inspector general’s conclusion that suicide-prevention measures were mostly absent. The same report found that the veterans department’s regional medical centers have suicide-prevention experts, but its 800 community-based outpatient clinics — which veterans most often use — do not. This crisis plagues active-duty soldiers, too, and the Pentagon has lagged in responding effectively. The government has long known what it was up against with P.T.S.D. and brain injuries — the signature afflictions of current wars.

This new ruling came two years after the appeal was filed, during which lawyers for the government and the nonprofit advocacy organizations that sued, Veterans for Common Sense and Veterans United for Truth, were trying to negotiate a plan for fixing the system. Those negotiations did not succeed, so the judges have remanded the case to the district court to order one.

The government can keep appealing, but it should work with the advocates and enact a plan to fulfill the promise of the veterans affairs secretary, Eric Shinseki, to do better. For 25 million veterans, including 1.6 million who served in Afghanistan and Iraq, the choice is clear.


http://www.nytimes.com/2011/05/19/opinion/19thu2.html?_r=1&nl=todaysheadlines&emc=tha211

After All This Time

Heading out of town and want to leave this with you, Dear Leslie (Listen to the words here):

There were trains And we out-run 'em There were songs And we out-sung 'em There were brighter days never ending There was time And we were burnin' There were rhymes And we were learnin' There was all the love two hearts could hold

And after all this time You're always on my mind Hey I could never let it end 'Cause my heart takes so long to mend The dream that keeps your hopes alive The lonely nights you hold inside And after all this time You're always on my mind I still want you

There was rain That we outlasted There was pain But we got past it There were last goodbyes still left unspoken There were ways I should have thrilled you There were days I could have killed you You're the only love my life has known

And after all this time You're always on my mind Hey I could never let you go A broken heart that heals so slow Could never beat for someone new While you're alive and I am too And after all this time You're always on my mind I still love you

And I could never let it in 'Cause my heart takes so long to mend The dream that keeps your hopes alive The lonely nights you hold inside And after all this time You're always on my mind I still want you Hey after all this time You're always on my mind I still love you