Elbow Shemelbow

Now this blog has a huge WTF!? factor…just so you know. I went to fetch my wife…sound southern, don’t I? I fetched her from yonder Colorado. (Of course, people in Florida don’t have southern accents.) Anyway, I drove out to Colorado for two weeks to visit my kids and grandkids and to bring my wife home. When we left Colorado, we drove to Texas to see my wife’s family. Fortunately, we did not get hit by a tornado, but it was close.

The evening we arrived, I noticed my arm was red. Specifically my left, elbow replacement arm, was red around my elbow. I didn’t think too much of it until the redness spread on Sunday. That’s when I showed my wife and became terrified that I might have an infection in my elbow. Apparently, I was told, you can get an infection in a joint replacement up to a year after the surgery. From reading I’ve done it can be many years after surgery. That’s scary.

So, on Memorial Day I called to talk to the on-call doctor back in Florida. He prescribed me some antibiotics and said I needed to be seen when I got home, and I needed to call if anything got worse. Cellulitis is what he called it. It’s a bacterial infection that is usually caused by a cut or some other opening in your skin…well, I don’t have any cuts, so I thought it didn’t sound so bad. Then I started reading about it in connection to joint replacements. Thank you very much google. According to the Mayo Clinic, Cleveland Clinic, and John’s Hopkins this type of infection almost always requires surgery to get the infection out and remove the infected joint. WTF!?

Now I’ve had a lot of surgeries in my life…approximately 45 on various joints. 13 on my elbow. I’m not so afraid of surgery. I’m afraid of what it would mean if I did need surgery. If my elbow replacement needs to be removed, besides the months of IV antibiotics, I won’t have an arm anymore. Nothing will replace the replacement. I’ll have an arm with no elbow so my arm will just be decorative…because it won’t work. I’ll wear a brace and have minimal use of my hand.

When I had the surgery for my broken arm and dislocated elbow replacement last November, I was told that if this replacement failed, as others have, the only option left would be to remove it and not replace it anymore. At that time, I appreciated knowing that if that happened, at least I wouldn’t be in pain anymore. That sounded good. Until now. Now it sounds horrible. If this infection is in my joint, I’m going to lose my arm. Its not going to be amputated but it will only be for show…a useless appendage hanging from my shoulder. I feel overwhelmed and terrified. It’s one thing to hear about a possible thing that might happen in the far away future and being punched in the stomach by an inevitability staring you in the face.

Maybe it’s not inevitable. The redness is mostly gone…it’s still swollen, hot, and stiff. I see the doctor Friday. So, WTF!? I don’t know what the fuck. My work this week is sitting with not knowing…and not freaking out. I’m not inappropriately freaked out…only about a 5. That seems reasonable…given the circumstances. I did stop googling. My mind is very distracted this week on its own…I don’t need to encourage it by being sucked down the google black hole.

I need extra awareness this week. Awareness of my interactions with myself and with others. Awareness of my anxiety. Awareness of my capacity and willingness to love. Awareness of kindness I can offer to myself and others. I didn’t do anything to make this happen so being angry at myself seems unhelpful. Because in the end all that matters is how we love people…and that includes me.

In the Event of My Death

We have lived in Florida now for about 15 months and 12 of those months my father has been on hospice. Last week my family met with my dad’s hospice nurse and his status was changed to “imminent” as in dying any day now. When did it get so close? Since that meeting I shut my world down. Now I sit with my dad and wait for death…wait for death to take my dad away from me…imminently.

It’s a weird thing to wait for someone to die. It’s uncomfortable and peaceful at the same time. I am a person with strong propensities and under stress they pop up…or pop out. I’ve been breaking out all my coping mechanisms. Comfort food and wine were first. And always I turn to reading. Books allow me to explore and question what’s happening around me and to open up to the present moment. One of the best things reading does for me is move me out of denial in a way that I am amenable to…sometimes I don’t even know what’s happening until I realize I am actually feeling my feelings.

“Bardo” is a Buddhist term for in-between time. After death and before rebirth. A transitional time…the gap or space between what ended and what is yet to come. My teacher, Dzogchen Ponlop Rinpoche, says, “This experience of the present moment is known as bardo in Tibetan Buddhism. Bardo in a literal sense means ‘interval’; it can also be translated as an ‘intermediate’ or ‘in-between’ state. Thus, we can say that whenever we are in between two moments, we are in a bardo state. The past moment has ceased; the future moment has not yet arisen. There is a gap, a sense of newness, of pure openness, before the appearance of the next thing, whether it is our next thought or our next lifetime” (Mind Beyond Death, p. 10). So, the essence of bardo is found in the experience of nowness, the gap between the end of one moment and the arising of the next one. 

Why is death so scary for us when we experience it all day every day? Something ends and something else begins, over and over again. The reality is that death and birth happen continuously. Every day is filled with small deaths. We are continually faced with endings…transitions between the end and the beginning. Our fear comes from our desire for things to be permanent and solid. We don’t like impermanence. We like sameness. We like the predictable, consistent, and comfortable. Our desire for comfort keeps us butting our heads into reality…get a helmet.

Pema Chodron, in her book How We Live Is How We Die, says, “What everyone can agree on, however, is that during our present lifetime, thing’s definitely keep going. And as they keep going, they continually change. Things are constantly coming to an end, and things are constantly coming into being.” Change never stops. The way to live with the fear of death is to embrace it. What we resist becomes stronger. I must open myself to the inevitability of death, and the fear that arises, and live in its presence.  Live with death in mind because how we live is how we die. Death doesn’t just happen at the end of our life; it happens in every moment. Impermanence. Reality will take place whether I like it or not. My dad is going to die. Everyone will die, including me. We can be open to everything whether we like it or not, because it’s going to happen, and then it’ll change. We are always in a bardo because impermanence never takes a break. There is never a moment that we are not in transition.

It’s strange knowing death is imminent. Of course, we’ll all die but we don’t usually know when that will happen. I think I prefer the mystery. As for him, I’m not sure what he knows. His whole life has been reduced to our family room. The family room is where everything happens for him…makes it an aptly named room. He gets a bath, nurses and aides come to check on him and up until a week ago he used to eat in this room. He isn’t eating or drinking anything now. He has to be changed every day and that has been the hardest thing for him, because sometimes that responsibility is mine. One day he told me that he used to change my diapers and now I change his, and he paused a minute and said, “That’s just not right.” But in a circle of life kind of way it is right…it’s exactly right. We need to take care of each other.

It’s a strange time when someone’s death is imminent…waiting for death…waiting for the transition. I wonder if he feels like he’s waiting? Or getting ready for a big change? He sleeps most of the time but sometimes while he’s sleeping his mouth will move like he’s having a conversation with someone but there is no sound to his words. I wonder if he’s talking to his mom and dad…getting ready to see them after 55 years. I don’t know who else he might be looking to see on the other side but he’s got something going on. 

At this point the only thing I can think to do is tell him that I wouldn’t have traded a single day of this past year being with him and my mom. There have been some challenges, but I wouldn’t change anything. I hope that helps him and eases his worries. He has told me more than once this past year that this is not what I signed up for, and I tell him it’s exactly what I signed up for. I hope he believes me.

Let’s be real…when we reach the time of our death, that’s not the time to try something new, something we always thought we’d try but never did, like meditation, or prayer, or who knows what. All we have at the end of our lives is what we had a second before the end. We aren’t suddenly a spiritual guru, if we have never cared about developing our own spirituality. We won’t suddenly be relaxed if we’re always anxious, or loving if we’re cruel. We won’t be able to be present in that moment if we routinely live in the past or the future. All we have is who we are, our habits of who we are and how we think. Our propensities. We’ve had a lifetime of building our propensities, the habits of our minds.

The only way to become comfortable with death is to develop our ability to remain in the present moment. Stay present with the little deaths that happen all day every day. Learn to live in the in-between state. Become comfortable with groundlessness, the uneasy footing of continual change. Facing these fears day after day is how we become comfortable with death, and with life. After all, living a life we aren’t present for isn’t really living at all. Let’s love ourselves enough to be present and love others enough to give them the gift of our presence. Never forget love. Love always wins.

“When the appearances of this life dissolve,

May I, with ease and great happiness,

Let go of all attachments to this life

As a son or daughter returning home.”

Dzigar Kongtrul Rinpoche