The Search For Ceremony

It is interesting how, as humans, we need ceremony to accompany our major life transitions.  Weddings, baptisms, Christmas dinners and funerals…there is comfort in procedure.  There is support in the families and friends who gather.  There is probably also a part of us that feels something has been processed by the ritual of formal recognition…

I realized today why my job seems so lonely sometimes.  I build these intense relationships with families and patients that all eventually come to an abrupt ending.  For me, there is no ceremony.

This weekend, amid the busyness of life as a mom and a friend and a wife, one of my very favourite patients died.

Bert (**name has been changed for confidentiality**) came to me 10 years ago.  I scooped him up from a walk in clinic where he was being seen for the 5^th time for his bad knee.  I suggested to him that he might need a family doc – after all, he was in his late 80s – and I always had a soft spot for feisty older men.  They remind me of my dad.  I can relate.  I admire them.  I know how to talk to them.  They come with their own set of challenges I willingly accept.

Bert and I have been through a lot since then.  Bert survived repeated visits to our ICU; dopamine drips and last rites –he always managed to pull through. Our relationship survived my gentle nudging to retire his skis, my taking away his driver's licence and final my insistence that he move to a supported living facility.  We had our tiffs.  At time he came right out and told me he was angry with me.  I sometimes had to do the same to him.  But we always reconciled our differences and moved forward together in the quest to find the right balance of safety and autonomy that would allow Bert to truly live (in his own terms) the final years of his life. 

A month ago I admitted him to our hospital for what felt like the 50^th time.  (I know his 6-digit hospital dictation code off by heart…) He lamented to me that his good friends hadn’t been around to bring him in this time, because they had “all gone off to Mexico”. I tried to brighten his spirits by joking about Mexican drug cartels and the dangers of sunburns and he laughed before clarifying for me that fact that he didn’t actually WANT to be in Mexico right now.   “Nah,” he said, “I don’t think I’d feel safe being that far away from you.”

I should have known that he was nearing the end.  His fight was flickering as he allowed tears to enter our conversations and sometimes insisted on holding my hand during some of the more difficult chats.  He had about him this lovely gratitude I had never really seen before.  I should have known and warned him then that we were at the end.  I suspect he knew.  He probably assumed I did, too.

Today I unceremoniously had the task of dropping off his death certificate to the funeral home.  No one expects this to be the ceremonial event of this ending.  It became sandwiched in my to do list somewhere between taking Mia to a birthday party and getting groceries for the week.  I called first to see if someone could be there when I dropped it off.  That was an impossibility and the owner grew frustrated by my insistence on coming when someone was there. “Just put it in an envelope” he said, “And slide it through the mail slot.”   I explained that I didn’t want to fold the death certificate and he scoffed, “They get folded all the time, ma’am”

As I drove to the funeral home I took the long route.  I drove around the block once before I had time to process what my odd behaviour was all about.  For me, this was my ceremony. This was my goodbye.  People cry all the time at funerals, but no one cries when they drop mail through the mail slot of a funeral home.

I slid my final duty as Bert’s doctor through that door today and wished I could have had a moment to sit on the steps and weep.  For the relationship we had built.  For all of the conversations we’d had.  For all of the many times he had needed me and I had come.  For the many life stories he had shared. For his final words he had whispered to me just the day before, “Thank you.  Thank you.  Thank you.”

It’s impossible to invest fully in a relationship without becoming emotionally attached. And yet we are often not granted permission to grieve and celebrate the life we too have lost in the usual traditional ways.  Sometimes we have to make do with simple ceremonies we create for ourselves.

I paused in my car before driving away from the funeral home that day and said out loud right back at him, “Thank you. Thank you.  Thank you.”

Zack's Final Lesson

I see a lot of loss in my line of work and I felt like I had a good concept of how it manifests and is appreciated by families.  But enduring the loss of Zack I have explored it all to a different extent and in a way than I hadn't appreciated before.  I hadn’t thought much in depth about the different kinds of losses and the poignancy of day-to-day loss and the slow petering out of a life after death.

Full disclosure: I would not have predicted myself to grieve deeply over Zack’s passing.  I was quite open about the fact that we had adopted him when the kids were both at too young of an age.  I was balancing my own return to work with my new job of being a mother of 2; Toby was just 3 and Mia only 5 months old when Rob decided that our family needed a dog.  To the kids he was their 3^rd sibling.  To Rob, his parental leave and lakeside companion.  To me, Zack was always a dependent that I never had enough time or energy for.  He challenged my beliefs on a dog's role in the family and I often looked at him with a sense of guilt.  I wish now I could have realized what a good life he had with us as opposed to always resenting what I wasn’t providing him with.

And so my first observation about sudden grief is the pedestal.  We all immortalize the dead and speak only of their good qualities and so are true about dogs – even the goofy, loud barking ones you never feel like walking.  I am struggling to remember what was so annoying about this now.  Gone are the daily frustrations that he gave me, replaced instead by the quiet emptiness of the spot where his smelly mat should be lying with his water bowls, waiting to be tripped over.

It’s hard to pace your grief when you lose one of your day-to-day fixtures.  The reminders are everywhere – previously banal, commonplace things now carry a weight of loss and sadness that is unavoidable.  Some seem impossible.  How is it that he was just eating breakfast out of this bowl?  Others just serve as unexpected reminders.  Oh right, I don’t need to hang his leash back up…  

I felt this way the day he died.  As I struggled to figure out which order to do things in and how quickly to do it all in order to make this process easier for the kids I fear I might have rushed some steps. That first night I washed and put away his dog bowls and beds.  The next day while the kids were at school we packaged up his food, treats and dog brushes to distribute among our dog owner friends and I spent an hour in the mudroom trying to rearrange the mats in their to make it look like there shouldn’t be a dog bed at the end of it.

I didn’t feel overly emotional about the big things –it was the little unexpected things that crept up.  When I nonchalantly vacuumed the main floor on Sunday afternoon I realized that this would be the last time I’d be vacuuming up his hair.  (Turns out it wasn’t – I’m clearly not a very good vacuumed…).  When I washed the back door window I gasped as I realized I had just wiped off his nose print from where he used to sit.  And today, as a balmy day in February brought with it a giant thaw, I watched as his footprints disappeared from our once snow covered backyard.

It’s amazingly sad to watch someone peter out of your life.

I know what will come next.  One day I will be able to leave for work without purposely shutting the mudroom door so the dog doesn’t get out.  I will return home from work and not hesitate before putting the groceries on the floor and I will not cringe and wait for the loud barking to start when I see someone with a dog walk by on the back trails.

These steps and remembrances are unavoidable.  Like everything in life, you realize that grief, too, is a process.  Though I see it every day, I don’t actually know anymore how people cope when it’s their daily life companion that they lose.

Before any more of Zack peters out I want to end with one final voice over.  I would always vocalize Zack’s inner voice for the kids when he would rush out after animals in the back yard or do something particularly goofy and Zack-like.  His final voice over tells of his final run down to the fence where we found him lying in quiet stillness just 10 minutes later…

It reads in a deep, slow, earnest voice,

“What a lovely morning, sitting here with the family – WOAH - WOOOAHHH!!!

There’s something walking by out back!!! WOAH…wait there’s a TRAIL in our BACKYARD?!? WHOOOOGOES THERE!!! WHOOOOO GOES THERE!!!!

LET ME OUT LET ME OUT LET ME OUT LET ME OUT!!!!”

(The door to the backyard opens)

“OMG IT’S A PERSON! AND A DOG!  MY FAVOURITE COMBINATION!!! AND THEY ARE WALKING TOWARDS ME!!! HELLLOOOO!!!! HELLLO!!!! HELLOOOOOO!!!!

OOOF.

Woah.  There’s a fence.

OMG IT’S A DOG! IT’S A DOG! IT’S A...oh she smells so good…OMG It’s TILLY!!!

TILLY!  TILLLY!! TILLY!!! I haven’t seen you in SOOOO LONG! 

OMG you smell SOO Good I almost forgot what you smelled like!

Hey!  Where are you going? TILLY!!! TILLY why are you walking away?! 

Don’t leave me!!  OH NO TILLLLY!!

Now I’m standing her all alone in a …oh wait…there’s my house… and my people…

My People!  Toby! Mia!  What am I doing out here when you’re all in there?  Oh my goodness you must be missing me….don’t worry…I’m coming….”

We do miss you, Zack.  Every day.  Though the little details and habits of having you around will continue to fade with time, the missing and loving of you will forever stay with our family.  You were our first dog and our kids 2^nd sibling.   Our lakeside companion and our day-to-day constant.  And ironically for me, in the end you were a great lesson on grief and love and focusing less on the details, but noticing instead what’s lying right in front of you the whole time….

Perhaps the greatest treat of his life - Mia's ice cream cone remnants.
He never did figure out that he was actually able to eat it...

Our very last picture of Zack  - taken after laughing at how he insisted on digging his nose into the snow

Toby Hits Double Digits!

And we have reached DOUBLE DIGITS!!!!!

It is hard to know where to start, Toby, to explain to the world what a wonderful, thoughtful, sweet and funny boy you are.  Many times a week I find myself explaining to someone that you are “a 40 year old stuck in a 9 year old’s body…” As we both pass our milestone birthdays together this year, I feel like I might have to adjust my saying…perhaps a 60 year old trapped in a 10 year old sounds more fitting? …

I feel like I could take you anywhere, anytime to share any handful of worldly experience with and you would be a great companion.  Last weekend Grandma Lynda had her birthday and we decided that you were old enough to come out for an adult dinner with us.  You did have a short last minute panic that you had made the wrong decision and were missing out on the opportunity to stay home with a babysitter and the Emoji movie but it turns out you were just hungry.   As soon as you had INHALED your ceaser salad, you brought out your favourite dinner game ‘The Conversation Piece: and regaled us with interesting questions to keep our minds and the conversation going, proving that you are indeed, the PERFECT dinner companion.

I hope it is not an insult to be called an “Old soul” by your Old mother.  I mean it in the very best of ways: you are wise beyond your years.  You think before acting and have such great control of your emotions.  You are kind and thoughtful.  And you come up with the most insightful perspectives on the world.

When Zack died a few weeks ago it hit you hard.  There was no sheltering your innocence from this huge loss as it happened so suddenly and right in front of your eyes.  Even then, in the midst of great sadness, you taught me a thing or two about grief. (Which, I hate to say it, is kind of supposed to be my area of expertise…)  You grieved openly and loudly and you knew exactly what you wanted.  Though it was painful for me to watch helplessly as you cried and cried and cried in my arms, you allowed yourself the unabashed experiencing of your feelings.  And when you were done crying you knew that you just needed to see Holden.

I was a WEE bit worried that poor Holden might not know how to handle such an openly grieving Toby but you two dove right into a game of mini sticks and chatted earnestly about loss and Zack and even had a debate about the average life expectancy of dogs and whether or not he SHOULD have lived until 12 just because he average age of a dog his size is 12.  (You have always been a man of numbers and accuracy…)

Later, you eloquently pointed out to me that Zack’s death had left a hole in your stomach that was filled with butterflies.  And when you were playing hockey or hanging out with your friends the butterflies subsided but you still knew, and always would know, that this pit was there.  You didn’t think it would ever close up.  I know one day it will, Toby.  But I also know that you meant what you said – you will forever hold a deep, deep love for Zack that is as infinite as that hole you so clearly feel.

My favourite picture of you and Zack

One of the things I am most proud of happened a few weeks ago when you put a dent in our neighbour’s car.

That’s a strange sentence- I get it – and it’s not the fact that you didn’t realize that you shouldn’t shoot a puck right at the side door of his Audi  (still shaking my head on that one…) but what you did afterwards that impressed us.  The dent happened before school, and even though I drove you to school that day you didn’t say anything to me about it.  Clearly, your poor little brain worried about this all day, but you came up with the Right thing to Do and immediately after getting off the bus, you went next door , bravely knocked on the door, confessed to having made the dent, apologized, and then offered to pay for the damage.

I don’t know HOW, with your allowance of $10 a month (that I only sometimes remember to give you) you intended to pay for this repair, but it was the fact that you had thought it through and determined what the RIGHT thing to do was and then executed it despite your nerves that was so noble.

Your eternal quest, Toby, is to do right thing in every situation.  It is admirable and wonderful and perhaps one of the greatest traits you can ask for in a kid.

I want to end with a quick selfish note.  This year marks the year that you started playing hockey WITH me.  As you know, we come from a lineage of hockey greatness.  Well, not ME perse but your Grandpa Boyd was an incredible hockey player, NHL scout and the coach of the first women’s hockey team at UofT.  I didn’t start playing hockey until I was in grade 10 and I was terrible.  But I persevered and kept playing and now I play with a few different groups of ladies and I absolutely LOVE It.  You, as well, have played hockey for a few years now, but until this year it never really clicked for you.  This year, for some reason, it did.  You are one of 2 centers on your team and many times you are the best player on the ice.  I can’t tell you how proud it makes me.  You have gotten so good at hockey, in fact, that a few weeks ago when the Thornbury Sunday morning ladies were short a few players I brought you with me.  Normally we don’t let kids under 10 play but I assured them that you were mature for your age and could keep up.  (I believe I might have even dropped the “old soul” line…!)

I don’t think I have ever been happier, playing hockey with you that Sunday morning.  You kicked ass.  You rose to the occasion, challenged people, skated your heart out and played with passion and respect and a keen knowledge of the game.  In the dressing room afterwards the ladies commented on how mature you seemed. They have asked me every week since if I’d please please please bring you.

Though my dad  came dutifully to many of my games, even as an adult, he never knew that any of his children or grandchildren had inherited his trait.  I feel that the immense pride I have taken in your hockey abilities is in part on behalf of Papa.  Even though he is now beyond able to come and see you play, I tell him every time I see him about how good you are and how passionate you are about the game and about what a beautiful skater you are.  Just like him.  I couldn’t be prouder.  And even though I know Papa will never see me skate to my full abilities, I know that you and I have many, many more ice times to come.

As we got off the ice last Sunday you were red faced and out of breath, but you took the time to bang the back of my stick with yours and said with your usual earnest conviction “You’re really good, Mom.  Good game!”

I will never hear those words from my own dad, but it doesn’t matter any more, now that I’ve heard them from you, my Old Soul.  Happy Birthday.
Love,
Mom xoxo

Harry Potter : You read yourself the entire series in a matter of months.

At the Arena, Cheering your Old Mom on...

You and Everst at Cross Country-  you made the finals for Chess AND Cross Country with this friend :)

Mature, And a Little Weird, too...

Loved being on the bench with you and your crazy team this year.  Go Hawks!

You also learned to snowboard this year

Happy 7th Birthday to my Eternal Optimist

I haven’t been able to step into a toy store or our local Walmart for over a week now.  With Miss Mia’s birthday on the horizon everything I see is something she would LOVE and my mom brain immediately reaches to buy it for her.  I had the same problem at Christmas – I had to stop my Christmas shopping by mid November because I seemed to just keep buying things for HER.

Mia, my conclusion might simply be that you are easy to buy for.  But I think it stretches beyond that.  You exude joy and love and wonder.   I see your zest for life in everything that surrounds me.  In even the most ordinary of stores I find treasures that I know will light up your face.

Sometimes your joy and zest for life is under appreciated.  You have the unfortunate position in our family as being a morning person.  So does your dad.  Unfortunately, though, dad leaves the house at 7am, leaving you and your joy to contend with the likes of Toby and me who are NOT morning people.  It’s a daily struggle for you to keep your positive nature unscathed. Sometimes, while Toby tries his best to swallow yoghurt through his scowl, you sing boisterously and bounce on your stool beside him.  This doesn’t go over well.  Other times, you enthusiastically ask me questions, questions and more questions from the side of my bed as I beg my eyes to open.  This also, is often not met by the response you so desire.

                                             

We have yet to tame the enthusiastic joy of Morning Mia.

Other mornings you bounce downstairs and surprise me by making lunches for yourself and Toby.  Granted, a wee bit of correcting must then take place (your ideal lunch would consist of fruit, fruit roll ups, cookies and a chocolate) but it’s the enthusiasm that counts.

You approach almost everything in life with the same enthusiasm: a majestic grin fast paced determination and eternal optimism.   I say ALMOST everything because we have discovered a few things that do not evoke this predictable behaviour: being asked to come home from Jack’s house, being denied a play date because of Toby’s hockey schedule, and Friday night Clippers.

I get it.  You’re tired on Friday.  The last thing that I would want to do on Friday after a long week of being an eternal hardworking optimist is to change into a bathing suit and go swimming.  You fight us on this EVERY week.  Unless jack is going and then, of course, you go joyfully and without discussion.

  The other Friday, Daddy put his foot down and you got the lecture on Commitment and Following Through With Things and Being Part of a Team blah blah blah...  Though this often works on Toby, you were having NONE of it.  You grumbled ALL the WAY to the pool, which was a full 3 minutes of my life I will never get back.   It was just SO not you that I was actually concerned and felt immensely guilty. An hour later when I was back to pick you up the old Mia was back.  After your shower (you very independently dress, undress and shower yourself – something your brother could have NEVER done at your age!) you BOUNCED into the car full of vim and vigour.  “WOW, Mommy that was the BEST SWIMMING LESSON EVER!  We went into the warm pool and played GAMES!  It was SO FUN it was the BEST NIGHT of my LIFE.”

Clearly, though you are old enough to know how to wash your own hair, you haven’t quite caught on to the art of subtlety.  You then went on to tell me that I had had the right thoughts in my head and that you hadn’t.  You had had “WRONG THOUGHTS about swimming” and then you thanked me for making you go.

Wow.  I have a feeling that things aren’t going to go this smoothly when you’re a teenager. 

The other night at dinner Toby made us play a game where we all picked a “Theme song” for our life.  Toby picked “Fight song”.  He finds it relates to what he thinks in his head when he plays hockey.  (Obviously.)  Daddy picked “Seasons of Love” from the musical Rent because it reminds him to make the most of every moment.   I chose “Love is Louder” by Craig Cardiff because its message is that at the end of the day the only thing that matters is love.   And finally it was your turn.  You chose the opening instrumental piece from the movie Inside Out.  You said it was from the part in the film when Joy was born and you feel like you can relate to Joy because you are happy.  We sat there, all 4 of us in silence as we listened to this wonderful piece of music.  It was beautiful and soft, and hopeful, and joyful.  It was you in a piece of music.  What a clever girl you are, to have picked something so uniquely perfect as your theme song. 

I hope for you, sweet girl, that this will always be the music that you hear in your soul.  I hope the world gives back to you the joy you so eagerly give to it.

When Daddy and I got married many people gave speeches.   They told stories that were long and funny and filled with anecdotes about us.  All except for Grandpa Boyd.  A man of literature and infinite wisdom, Grandpa Boyd skipped the verbosity and said only one sentence – a quotation from his favourite author William Blake.

“Exuberance is beauty.”

It is one of the greatest gratitudes of my life to know that I have a daughter that can live up to his prophecy.   Happy 7^th Birthday, Miss Mia.

You and Papa enjoying a game of Chocolate Tic Tac Toe at the Teddington last Weekend

Your 7th Birthday Party at The Paint Bar