it's, like, meta-homework.

mental health lectures always make me squirm a little.

it is said that in the grieving process, the number and nature of past grief experiences, the importance of the lost object or idea, the perceived number and nature of existing relationships, the degree of ambivalence toward the loss, the degree of preparation for the loss, and the age of the lost person all play a role in just how complicated the grieving process may be.

in my case, I had lost two mother figures in six years -- and in so doing, I lost two extended families, lost the father I knew to unsavory habits -- the nature of which I would later find out, gained the thought that I would lose two little brothers in the divorce, transferred schools, moved out of the first home in which we had settled for more than three months since my mother's sudden, premature passing... I felt like the world-rug was being pulled out from underneath me. Complicating matters, my father's second marriage was far from a happy and healthy and safe one. We all hadn't slept for years, and the suspicion was slowly encroaching upon our happiness. So both grief and elation washed over me, accompanied with guilt for feeling elation during a traumatic life-event.

Moving into the new house and hitting a plateau of relative peace for the first time, I finally had time to move from preservation-mode to grief mode. and it hit me in the form of a major depressive episode. it was tenth grade. I missed three months of school, in segments. I experienced what I now understand is somatoform pain, that pain which is real and terrifying to the affected; but baffling to a healthcare provider because there is no clinical reasoning for it. mine manifested itself in my head and neck, so I tried multiple migraine medications. I used the very real pain as an excuse to hide from school and other forms of reality in the darkness of pulled shades for weeks at a time. My parkinsonian father had to drag me out of bed and into doctor's offices. luckily for him, I've never been fat.

finally, my primary care provider suggested that I try taking antidepressants and seek out a therapist to work through my emotional turmoil. I also juggled a few depression medication regimens and talked to two different child psychiatrists. I didn't feel like myself when I took the medication, so I stopped taking them and stopped filling prescriptions. My dad didn't push me. Day by day, I decided that I would not be consumed by my dark cloud any more. And more than any other factor, my unfairly placed hate for my advisor pushed me to complete my coursework on time. I returned to school my junior year, invigorated and encouraged, ready to kill it. And for whatever reason, I was triggered again. after about a week, I retreated to my room, wedged myself between my bookcase and chest of drawers, and cried all afternoon. I did not leave that spot for an entire week.

Exasperated, my dad sought out my aunt for help. I needed a shock to the system. I pleaded not to be sent away -- the stigma of my inability to cope already weighing heavily on my heart. the solution? a return to the tiny school at which I had started my academic career, Cheswick Christian Academy. I sat my four best friends down at dinner after my week-long absence from school and explained my situation as best I could. In the middle of a busy Max and Erma's, we cried and laughed and shared. only half of them even knew what I had been struggling with, and even without my extensive explanation, they supported my decision to transfer schools and promised unconditional long-distance love. I knew then that I had been foolish to think I was alone. sometimes the best family is the family you choose, not the family awarded to you at birth.

At CCA, I felt I could make a relatively fresh start, revealing myself to only a select few. I remained largely misunderstood, but at least I was renewed and forgiven. and the benefit of a new venue was that I could talk about my struggle in the past tense. I used to be this way. I used to think that. it was freeing, but at the same time, I didn't really deal with it in a healthy way. I just pushed it away from who I felt I was in the present -- Caitlyn the Survivor.

I was accepted to Allegheny College with a sizable scholarship and began what proved to be the best and worst year of my life. I experienced another major depressive episode, during which I purposefully sabotaged relationships; so I could remain in my "safe" haven. I kept my friends abreast of the day-to-day triggers, but not about how it was affecting me. I attended only the classes I shared with them and cried every moment they weren't around. I had to be reminded to eat, to leave my bed in the morning.

the dangerous thing about depression is that it's easy to confuse with laziness and self-absorption if you're good at hiding it. the behaviors that perpetuate the problem are insurmountably simpler to carry out than attacking your problem head-on. it's easy to ignore a phone call. it's easy to close the drapes. it's easy to just say nothing about how your heart is breaking. it's easy to lash out at people who care for you to keep from confronting what is really going on. it's easy to assume that other's actions are steeped in contempt for you, when all you can do is imagine how much contempt you have for yourself. it's easy to attribute a headache or neck ache with a problematic pillow. it is not easy to admit to yourself or others that you are experiencing a major depressive episode, and all that which you thought you had overcome has come back to eat you alive.

it took another large shock to my pattern and lots of lying on the floor, crying, but I eventually was able to work through pieces of my grief with my aunt's help. I have made some great friends up here. I have begun on a path that will facilitate my transition to functional adult life. but I never forget who I was. and sometimes, I hurt people unintentionally because I am afraid of who that person is and her potential return. and sometimes, I throw myself into projects or relationships that cannot fulfill me because I have a need to make up for "lost time." and then I quit them because it would be easier than hurting others with my darker self.

I like to think that as I age with grace, my shame slowly dissipates, and my self-worth returns. I know what I want. I know what I need. I know who I can trust with these concerns. and sure, maybe I don't have everything I ever wanted at my age, but shit. who does?

I have my health. I have a family, both adopted and hereditary, whom I love dearly. I have a career path. I have a bright future. I have self-capabilities the likes of which astonish me. I have a very forgiving metabolism. I have lovely teeth -- and a reason or seven to smile. I have seen the monster in the shadow and shined a light in its face. But I do not forget.

HOW DID I FORGET NO-PANTS LANCE?

Thursday was an odd day, to be sure. But I forgot the most glaring example of how bizarre it was. Ambition is a lovely thing in nursing school. I firmly believe that you get every bit out of it as you put in, and if you ask, you shall receive. However, ambition isn't always practical with us newbs. Newbs are slow; newbs are crazy thorough. Newbs are a bag of nerves. And this particular newb is way smarter after ten am.

Ambition is pushing eight o'clock meds with three different newbs. I admire my professor for her patience and steadfastness. I, however, don't always exude the same qualities. whilst waiting on another classmate's more extensive med list, the third woman and I chatted in the hallway. But again, it was before ten am, so my creativity came to a standstill. so we just kept silent company while we waited. My eyes began to glaze over when a white blur passed through my field of vision.

I snapped out of my partially conscious state. A man in a white lab coat and bare legs turned the corner and out of sight. I consulted my classmate's eyes for confirmation that I did indeed just see what I thought I saw. Our eyes met, and the giggles began. Like the professionals we are, we ducked into the resource room to dull the sound of laughter. Another classmate was using the resource room for its expressed purpose, researching a client's condition, so we shared with her why we were laughing.

The classmate laughed and told us it must be the same man who arrived in man-leggings. He must have ditched them sometime between the then and now. He walked past the resource room just when we had gotten ourselves together. On further inspection, he was wearing an ID signifying that he is an MD... and it appeared as though he was wearing no shorts or undergarments, as white cotton is hardly a forgiving or opaque fabric choice. That was the final straw! He was a doctor!

Imagine yourself in the hospital, desperately ill, when a man wearing no pants waltzes into your room to evaluate you! I would question my sanity. I would wonder what medication was causing me to experience psychotropic side effects.

P.S. Rudy told me today that I look like one of the residents, a man-resident. why? because we're both slender redheads. I'm telling you, I will be on the lookout for this guy. If he doesn't have blue and golden brown eyes, crazy long eyelashes, a straight nose, a girly waist, and shoulder-length hair, Rudy will be on the receiving end of a vicious punch to the arm. I guarantee it.

let's just say I did that on purpose.

... so if this whole nursing thing doesn't work out, I have a fine career of stand up comedy to fall back on. I told two jokes that made a room full of hospice personnel snort with laughter. The morning began with a bang -- not a fall, though. thank goodness! a client tore out an IV and made for the exit. And the demand never let up. each Tuesday morning, the hospice team gathers in the staff room for a powwow called "Team Meeting." Healthcare personnel are generally conservative folk. My nurse and I had performed targeted assessments on four clients, acclimated a new client to the environment, dispensed medication, and intervened in two near-disasters in the first hour alone.

Team meeting time began with a time for remembrance, the chaplain read a poem written by St. Francis and said a few kind words of each soul lost in the last week. After acknowledging each life, a single seashell was dropped into a tall vase sitting in the middle of the table and a moment of silence observed. The ceremony left me with goosebumps. Next, each case was discussed in terms of each facet of life each member of the team addressed: spiritual needs, psychosocial needs, physical needs, pain management needs, etc. The holistic look at each client was inspiring. The sort of care provided in this facility is that which you strive to accomplish in any setting. See the whole person as they are -- suspending judgment -- and attack the problems, as a team and in conjunction with the client.

But as often as "continuity of care" is drilled into our heads, it is easy as a nursing student to roll your eyes. I mean, two major nursing roles are communicator and teacher to our peers and to our patients. Why wouldn't we talk to each other? derr. But it inexplicably doesn't happen... ALL THE TIME. [insert signature Maura WHAT here] alright, prof, I will listen to common sense lectures with less cynicism. you were right. I was wrong. don't get used to it. it doesn't happen often.

My head was filled with end-of-life concepts I never before experienced. When my grandmother passed, I was too young to understand what was going on and was often shielded from her suffering. My mother died so quickly, I didn't have the chance to visit her post-op. palliative sedation? mottling? terminal agitation? shwat?

I read many a pamphlet on these topics and more, preparing for a more informed team meeting to discuss an incoming client. Before it began, my stomach rumbled audibly. Everyone turned around to stare at me. Breakfast had been nothing but a cup of coffee. ha-ha, that awkward moment when you've consumed more milligrams of caffeine in a day than you have calories. My colleagues urged me that if I think I should eat, I should eat. I asked if anyone had a nut allergy. The ladies looked at me quizzically. "Well, better to check beforehand and look like a doofus than send someone into anaphylactic shock. Yeah, that Caitlyn girl? She should never come back!" The room erupted with laughter, taking me completely aback. It was nice to hear a little laughter. It was nicer to know I elicited it.

Running, running, running -- documentation? not yet! My long-suffering nurse apologized to me for the hectic nature of the day, as if it was a bad thing and presented me with the option of staying or going at one o'clock. I said that I would love to stay, but I have an ultrasound scheduled at 1:30 in Hyannis. [if you're a little lost, take a look here] My nurse squeezed my forearm, a goofy smile spread across her face. "GOOD ULTRASOUND!?" I looked her in the eye and said, "Given my relationship status, there is no such thing." killed it!

I thanked everyone and dashed over to Hyannis for my ultrasound. I was greeted with, "Oh, good. You're wearing a perfectly low cut shirt." That's a weird way to greet someone, but yes, I dressed appropriately. I was ushered into a room not unlike a massage parlor and laid down on the examination table. I cursed myself for wearing my glasses to clinical because I couldn't directly visualize the screen. Yeah, I planned this. Therefore, I cannot see the screen and freak out about shit I don't understand. The report should be in by the end of the week from a radiologist in Boston. we shall see. we shall see.

until such time, I'm hittin' the salad -- hard.