Unmasked: Voices from Healthcare

This is a new section featuring the various voices in healthcare: from nurses to social workers to chaplains to respiratory therapists and other medical professionals who care for us. 

Erika Shimahara is an education specialist with the Department of Otolaryngology/Head & Neck Surgery at the Stanford University School of Medicine.

May 10, 2022

Caring for my aging mother has helped me live in the present

By Erika Shimahara

When I heard the crickets chirping, my heart clenched. It was the sound I have assigned to my 85-year-old mother’s calls. Had she fallen? Had my father, whom she looks after, taken a turn for the worse? Or was she calling to say, for the third time, that she’s almost out of toothpaste?

Even though I was busy in the middle of a workday, I answered: “Hi, Ma.”

“How do you turn off the TV?”

This would be quick. I swiped my phone for the photo of her remote. “See the button with the gold star sticker?” I said, in broken Japanese.

“Star sticker?”

“Yeah, I put a sticker on the button, remember? Press that button.”

Silence.

“Ma?” My eyes toggled back to the work email that I’d abandoned, mid-sentence, while three new messages populated my inbox. I searched for something I could hurl against the wall.

“Just press it!” I flared. “Any button! See what happens!”

In the background, I could hear the tinny voices from the TV and the pounding of my heart. But nothing from her. I slammed my phone down on the kitchen table.

“I am sorry,” she said, her voice breaking, “that I am so stupid.”

“Ma, you’re not stupid.”

She is the person I love most in the world.

When I see her slumped on her bed, forlorn as she often is these days, I daydream about the smiling, dimpled mom of my childhood years who once made a cover for my flute case with my name, Erika, embroidered in cursive, dotting the “i” with an exquisite heart. I reminisce about the messages she included in the bagged school lunches she made for my brother and me: on the paper napkin, Have a nice day!, her beautiful handwriting beside a drawing of a smiling cat or, if it was October, a pumpkin. Now, when I cut up apple slices for her, I recall that when she did the same for me, she made bunny ears with the skins.

She regularly baked coffee cakes for her friends, wrapping them like presents. Shuttling daily to and from her office in Manhattan from Princeton on standing-room-only Amtrak trains, she was always moving, up before anyone and last to bed, but she didn’t race through things just to get them done. When she got home, she never threw her purse on the floor as I do, but systematically parked it in a corner of the closet where it couldn’t get stepped on or lost. Hardly the type to be resentful or hold grudges, she was unfailingly pleasant and respectful with others, never trivializing her interactions with them, even if the content of the exchanges was trivial.

These days my mom can’t remember where her purse is and forgets that she wears the key to her door around her neck. Her most common refrains, often mumbled through tears: “I am useless!” “I am an idiot” and “Stop wasting your time on me.” Though I vehemently protest, it has little impact.

I am haunted by regret that I was not more helpful to her growing up. In the fourth grade, I should have humiliated the kids at the pool who called her “fat Chinese.” As a teen, I should have taken the dog out more or assisted with dishes and laundry so she didn’t have to stay up so late. And in my early 20s, when we commuted to New York together, I should have berated the men in suits on the crowded trains for not giving up their seats for her.

I can’t change the past, but I can make up for it in the present, partly by being available to her now.

In real life, outside of yoga or meditation classes where we’re encouraged to be “in the moment,” few things get our undivided attention. Increasingly, we are emboldened to multitask. Colleagues attend Zoom meetings from their cars; some even while driving. Others turn off cameras, attending only as names on the screen. Are they really there? During phone calls, I hear the rustling of packaging as someone opens a delivery, a faucet running, the clanging of cookware. Parents stare at their mobiles while their children long for attention. At Trader Joe’s, shoppers throw items in the cart while carrying on an animated conversation with someone invisible to the rest of us.

I am no different, my attention inevitably divided. But this is not how my mother approaches life.

To connect with her in the most meaningful way, “in the moment” is where I need to be.

This is evident when I am not in a hurry or juggling work emails and Slack messages while tending to her. By listening carefully to the timbre of her voice, or observing the look on her face, I can often tell whether she needs to be disarmed or calmed, reassured or directed. She imparts the virtues of patience and compassion, and the value of a single focus by requiring it of me. I can then appreciate something else: how my fading mother has unknowingly become my teacher.

Even something as simple as turning off the TV should be carried out with purpose and without undue haste. She helps me remember to walk her through tasks as if she is experiencing them for the first time, because according to her memory, she is. If she does not know which button to press, even though she has pressed it a hundred times, I must reassure her that she is not dumb, that the remote control’s assemblage, with all its buttons, arrows and numbers, is absurdly confusing — to anyone.

It helps if I slow down my pace to half or quarter time. Instead of snapping at her, I can say: “Tell me what you see,” and then wait, thereby meeting her where she is. I can remind her that it’s okay if she forgets and remind myself that the work email isn’t all that crucial either. I can put my work on pause. This is mindfulness in practice, is it not?

The reward when I’m patient: She smiles and says, “I did it!” Rather than feeling inept, she feels successful. And I feel a gust of pleasure.

Toggling between her slower world and my other one, of do-everything-as-fast-as-you-can, I slip all the time. But some small adjustments have helped. If I have only a minute before a video call, or I’m in the middle of a complicated spreadsheet, or I’m starving, it’s not the right time to take a call from her. If my mom can’t figure out how to change the TV channel, it’s not a crisis. And if I take better care of myself — put on my own oxygen mask first — it’s easier to be kind.

The extent of my mother’s multitasking was listening to Peabo Bryson while she cooked or folded laundry. If we’d had today’s technology back when she was at her fullest self, would she have shouted commands at Alexa, texted, made phone calls and read her email all at the same time, as I do? Of course, I will never know. But given her nature, I doubt it.

Visiting her now, I notice how irritated her skin is. Normally, I’d view this as yet another thing I must take care of for her, and so I would briskly slather her hands and arms with lotion, wanting to get it over with. But lately I go slowly, turning it into a mini-massage. First, I tell her to sit in her comfy chair and prop her feet up on the ottoman. Then I roll up her shirt sleeves to her biceps and tell her that I am going to apply a cooling lotion that will soothe her itch. “You don’t have to do that,” she says, helping me lift her sleeves as high as they go. I work her soft, fleshy arms with gentle pressure, smoothing the lotion into her skin, and she says “Kimochii!” (“Feels good!”) These are the hands that held mine as a child; these are the forearms that accomplished everything. By taking my time, she relaxes into the exchange. But still, she playfully protests — that unworthy thing again.

“I am not a king!” she says.

Oh but you are, I want to say. A king and a queen and so much more.

 

This essay was originally published by The Washington Post, May 6 2022.

Suzanne Tay-Kelley, NP, is one of many Stanford Neurosurgery Advanced Practice Providers (APPs) supporting Covid surge coverage.

February 10, 2021

DRIVE-THROUGH on NEW YEAR’s EVE

By Suzanne Tay-Kelley, NP

sliders, cappuccino, dang even pot, why not?
a fresh stash apropos a dire year
an exit comfortably numb
swing on by for a Brain Tickle in your car
and coming soon, vaccines!

welcome to our drive-through testing lanes
swiftest swabbers in the West
need an oropharynx sample? deft swish in ‘n out
nasopharyngeal? drop a dart
nose-to-ear & you’re all set

traveler nurses wielding specimen vials
retirees recalled to cope with The Surge
bio-suited, trailing respirators, double-masked
scrappy crew of extra shifters
poised kitted out – at your service

no worries granny is manic; gimme 3 minutes, tops!
just cut your engine sir
& grab her wrists please
mid-turbinate swirl-twirl, see? done in a blink
and she only swatted me once

teen abruptly sorry post-Christmas revelry; glistening eyes
a fear-laced maelstrom of chagrined bravado
gaunt chemo patient, wig askew, proffers sweets and thanks
frenetic pace gentles in swath of grace
stay safe ma’am; best luck finding those fireworks

Rabbi Chaya Gusfield, Spiritual Director, Board Certified Chaplain, and Teacher, was ordained as a rabbi in 2006 through the Aleph Rabbinic Program. She currently serves as a Palliative Care chaplain at Kaiser Richmond and Oakland. Rabbi Gusfield works closely with Buddhist teacher Eve Decker offering healing services and workshops. You can find Rabbi Gusfield’s writings on her blog at chayasgarden.wordpress.com. 

May 27, 2020

In response to the writing prompt, “What do you do?”

By Chaya Gusfield 

I am a spiritual midwife: I listen to your words and your body. I ask God to bring me images, sounds, smells and memories of what you are experiencing beyond your spoken words.

I listen even more deeply for the responses that would be most helpful, most healing in the moment. I trust my intuition and the messages I hear. I honor what comes to me and consider it carefully. It might be a deep sacred silence, a touch, looking away, inviting prayer, breathing with, singing a song, offering a blessing, inquiring for more, writing your experience as I hear it as your poem/prayer, listening for or inviting an image from the mundane to the divine, or asking for more information…There is no formula.

I am a spiritual midwife. We co-create rituals that help you deepen and honor the turning moments in your life. We explore together where you are turning towards that which opens you to something new, or away from something that you no longer need. Whether it be a child, animal, house, body, moment, or whether it be a separation, a death, a transformation. We honor, celebrate, grieve, deepen. 

I am a spiritual midwife, I help you remember your own wisdom, traditions, music. I help you remember your own poetry, your own words, your own hope. Your breath. I help you remember when remembering feels impossible.

I am a spiritual midwife. We do this all in the name of Healing. Thank you for allowing me to join you during this precious time.

Suzanne Tay-Kelley is a nurse practitioner with Stanford Medicine’s Department of Neurosurgery, working especially with oncology patients. Her passion is Palliative Care.

May 20, 2020

In response to the writing prompt, write a prescription for this time.

By Suzanne Tay-Kelley

Prescription: Treat yourself to a quiet 10 minutes, when you can tear yourself from your laptop or clinic or quivering patient. Hold your heart in your hand and caress it. When your boiling mind is finally still, blow a kiss to salve the hurt around you. Warning: this bit might take a while. Repeat every couple hours while awake. Refills PRN but recommend ad infinitum.

Cheryl Ann Passanisi, native Californian, grew up in Monterey, went to school at California State University, Long Beach, and University of California, San Francisco where she earned a master’s degree in Nursing. She lives on the San Francisco peninsula and works at a Stanford hospital as a nurse practitioner. She is active in local community theatre and opera chorus. This poem is featured in her book, Geraniums from the Little Sophias of Unruly Wisdom www.finishinglinepress.com

May 6, 2020

This body broken for you
(reports from the ICU)
By Cheryl Passanisi

We who have the power to hurt
stand poised
with needle, tourniquet.

This one turns into a crane
folded origami arms bent into her side,
face hidden under gauze,
her wings cover the holy.

Out of another's mouth protrudes
feathers and tubes as if he swallowed a hook and lure,
tagged catch.
This one mutates, loses a liver or toe.
This one we keep bringing back to life,
bringing back to life.
Another lives just short of poisoning.

They are not afraid
even as I, with pilot goggles and gloves,
navigate an opened vein.
 

 

Healthcare professionals interested in submitting a story for consideration for Unmasked: Voices from Healthcare can send their story to jmgeno@stanford.edu

Stanford’s Unmasked: Voices from Healthcare is committed to protecting a patient's right to privacy and identities have been protected by altering identifying characteristics.