How Do You Solve a Problem Like Maria?


One month ago today on Friday the 13th, I flew into San Juan, Puerto Rico.  I volunteered to serve as part of the VA Disaster Employee Medical Personnel System (DEMPS) to assist with disaster relief efforts after Hurricane Maria touched down on 9/20.  I fully intended to write a journal entry every day, just to capture the memories that can be so fleeting in the moment.  I wrote one short blog post on the bus ride to the temporary Federal Medical Station at the Acrópolis de Manatí that I never published, then never wrote another word until now.

Though people have asked me over and over about the experience, though I dream nightly of being there still, and though I know I am forever changed by the patients I cared for and the friendships I made in Puerto Rico, I have been unable to find the words to express what I feel and think about it without feeling completely inadequate to the task, the weight of the experience anchoring my tongue and laying heavy on my mind.

“How do you solve a problem like Maria?
How do you catch a cloud and pin it down?
How do you find a word that means Maria?”

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These lyrics from one of my favorite movies are on rewind in my head, the incongruent cheerful riff at odds with the churning emotions inside.  I am in contact still with some of the incredible people I met and worked side-by-side with in Puerto Rico.  I’ve shared some of their eloquence to give friends and family who ask a small glimmer of what it was like, but it feels a little like borrowed elegance, a little like cowardice to hold back what I’ve turned over and over in my mind like a many-faceted gem, and a whole lot like the type of pressure I feel always to paint the picture right the first time. I kept biding my time, waiting for the perfect words to come.

Then recently while at dinner in Phoenix, I had a sudden sharp pain in my L eye.  It felt like a torn contact lens, the sharp edges drawing across my sclera. I thought nothing of it, and driving to dinner with another friend, I noted a larger than usual amount of blood in the centrolateral aspect of my L eye from a subconjunctival hemorrhage.  Confirming this with my fellow PAs (really what better place for a curbside consult than at a leadership conference for PAs?), I knew it required no specific medical care.  On my 7 hour drive home from the conference, I mentioned that this had been the 4th one in less than a year or perhaps 6 months to my good friend, who happens to be an acupuncturist.  She gently reminded me that after travelling to Columbus for the National Girl Scout convention with Daughter #2, two weeks working nearly nonstop in Manatí, a short week home, then another nearly week-long conference in Phoenix, I might consider that I need rest.  Apparently the sclerology chart she sent to me indicates that the area of my eye affected points to a possible problem of the heart.

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As a former cardiology PA, I know there is nothing wrong with my heart. I also know that when I think about Puerto Rico, I feel a pressure in my chest that has nothing to do with a myocardial infarction, and everything to do with another type of blockage, the kind that comes from feeling something so strongly, and being unable to talk about it in any kind of coherent way. I get updates from DEMPS personnel who replaced us there about patients I took care of, and it makes me wonder.  How is it possible to love being home with my family and wanting so badly to be back in Manatí, in a place where I don’t speak the language, but where I understand perfectly what my purpose is?  How can it be that everything here goes on as normal, commuters driving badly to work, kids struggling with slope and y-intercept homework, and at the FMS Manatí, patients whom I cared for still have no home to go to and still have no power for basic needs? How can it be that my patients are dying, and I can’t do anymore about it now then I could then?

I struggled with these thoughts, overthinking perhaps that by talking about it, I might be exploiting the prurient aspects of seeing a disaster up-close versus the need to show people what it is really like there in this era of “fake news.” And then today, a NY Times article about the mental health crisis affecting Puerto Rico was featured, and the trolls online could not type fast enough about how we are wasting money on an island that isn’t even a real part of the US, and I told myself it was time to tell the story. The 2 questions I’ve been asked most frequently: “Is it really as bad over there as they say it is?” and “What was it really like over there?” The short answers: Yes, and terrible, but wonderful.

The long answer, well, that’s harder. That’s going to take more than 1 blog post to answer.  And I promise you, it will not be any semblance of a perfectly presented answer to the question of how to solve the problem of Maria and it’s effect on the people of Puerto Rico.  It will be my truth about the privilege of being a PA serving as one small part of the federal medical response to Hurricane Maria with fellow VA employees in the DEMPS program, DMAT, DoD, USPHS, ICE, and volunteers from New York Presbyterian Hospital.  Stay tuned–there won’t be any nuns breaking into song, but there will be cake, clowns, and cops with rhythm.  There will also be stories about patients that will make you rethink what you know about love and devotion. It was my privilege to witness all of it.

Special thanks to my husband, my mother, and my friends who took over mom duties at home so that I could go and serve. I could not have done this without their support.  I love all of you more than I can say.

If you’d like to help the people of Puerto Rico:  https://www.fema.gov/news-release/2017/09/22/how-help-after-hurricane-maria

This is the main page for up-to-date resources and information on the federal response to Hurricane Maria:  https://www.fema.gov/hurricane-maria

This link will take you directly to the statistics for Puerto Rico: https://www.fema.gov/disaster/4339

The NY Times article about the mental health crisis in Puerto Rico that finally broke the dam holding in the words:

 

 

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Hello September


via Daily Prompt: Critical

“Mama, I’m so sad for her.”  My sensitive daughter, as awkward socially as I was at her age, has a big heart.  She has had friends battling big demons, problems that I hope my children and your children will never have to deal with, and comes to me with questions on how to help them.  She wants to know why her friends who are so sad, can’t see that she wants to help them, to be a shoulder to cry on, and a listening ear, and can’t understand why that is not enough to fix their problems.  These friends thankfully have loving parents who are getting them the help they need. My children have been lucky enough to grow up with plenty, a mother and father who love them and each other fiercely, a family bonded across miles by real affection and goofy humor with both sets of grandparents, aunts, uncles and innumerable cousins, friends who are steady and enough of a tribe to create a blanket of security. But even having all of the above doesn’t make you immune to trouble.  Having to confront the turmoil of the teenage years so early definitely feels like summer is over.

September

It’s September, which for most people bring to mind crisp, cool evenings and pumpkin-flavored everything (to my husband’s chagrin).  Fall is my favorite time of year and the smell of school supplies makes my nerd-heart want to dance.  But September also stands for something very real and very critical.

September 1 kicks off National Suicide Prevention Month.  I remember the first (and unfortunately, not the last) time suicide touched my life. I was 13, the same age as my daughter now, and a boy from my school whom I did not know had taken his life over the weekend.  I saw girls crying in the hallways.  Many of them talked about the last time they had seen him, their last words with him, or memories they had shared.    The question overwhelmingly asked is the same question my daughter asks me now. Why?

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For those who have never felt this way, it can seem incomprehensible.  Many of my veterans struggle with this, as well as many first-responders, but we can’t forget that even kids can feel this way, and don’t have the maturity to think through the very real consequences to actions that can be heart-breaking.

I tried to explain to my daughter what I think it is like when you are so depressed and full of despair that you think life cannot get better.  I told her that even though her friends know that she cares deeply for them, it is like being at the bottom of a hole so deep and so dark, that even though you know the way out is up there, it feels so far away that you cannot even see the light, or if you do, you’re not sure if it’s just your eyes playing tricks on you.  And you feel so tired that trying to get to that light is hard, and curling up in yourself feels so much easier.

She said hopefully, “I could climb down in the hole and pull her out. I’m pretty strong, even though everyone calls me skinny.”

Man, I love this kid so much.  So I hugged her, even though at 13, she’s not always into hugs no matter how much I tell her everyone needs a minimum number of hugs a day to stay healthy. https://www.scientificamerican.com/article/a-hug-a-day-keeps-the-doctor-away/

And I told her that being a kid, it would be too hard to climb down in that hole, because it’s her friend’s pit, and even adults sometimes can’t climb down there, but that she could keep trying to extend a hand to her friend by being the best friend to her she can be and telling her that she cares about her so she knows which direction is out, but that no matter how far down she reaches into that deep, dark hole, her friend has to climb up far enough to grab on, because no one else can climb those walls but the person who is at the bottom of the hole.  And hopefully with help, they can do that, but it takes work and time, and never giving up. And being with someone who is trying to do that can make you feel helpless.

We aren’t helpless though.  What we can do is to recognize that those we love may be at the bottom of that pit of despair even if it doesn’t seem like it to everyone else.  We can shine a light to show the way out, share words of encouragement and provide nourishment for the soul with kind words for the hard journey, but no one can travel that road for them, though we can walk with them.  It is a hard thing to say to a child of 13, and a harder one for an adult who sees others suffering to know, but the hardest task is figuring out who is in need and trying to help them before it is too late.

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My attempt to capture the eclipse

I’m sharing this because you can never know what lies in the heart of another.  Please be kind to one another. Be that light for someone. We never know what demons others are battling, with bright smiles and shining eyes, Facebook posts filled with kids starting school and Labor Day plans.  It starts with awareness.  And a good heart, whether you are a confused 13-year-old with skinny arms or a mom who wishes she were better at these kinds of talks.

Imagine


I grew up in a town where being an artist was not valued in the same way as other more practical jobs. No one in that small town in which I grew up in ever introduced him or herself as an artist.  But in the days following terrorist attacks in Paris, Beirut, Syria, Russian jets being shot down over the Sinai peninsula, and countless other senseless killings, artists are the ones who are showing others the way through the tragedy and heartbreak.

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Through artwork, poetry, photography, and music, artists are showing the world how to mourn, drawing all of us together in community, and demonstrating solidarity in support of peace without the boundaries of language or religion or politics.  Art can cut through all the rhetoric of spin, fanaticism, and shouting, to show us the humanity that links us, and by doing so, reminds us again of what makes us more than the base creatures who perpetrated all of these crimes, which are crimes against not one people, not one country, but against all of humanity.

This musician is a perfect example of an artist who felt so moved to share in a perfect setting a song that draws us all together to mourn and to imagine a better world. If we can imagine it, we can make it a reality, and for this reason, I am proud to call myself an artist, too.

ImagineTellitSlantMama