Ticking Clocks
Ignoring the alarm won't prevent it from winding down.
As promised… a story to fill in the blanks.
I also promise this story concludes with the next chapter in Heart Sounds.1
First, we must begin at the beginning of the pause.
Many have asked about my TED talk: “How was it?” and “What was it like?” or “How do you feel?”
My reply is unwavering: it was the hardest thing I have ever done, and not for the reasons you think.
The gift of hindsight allows perspective that was unknowable, unseeable, unreadable or writable until now.
I could have titled this post: 9 months gestation: Giving birth to a TED talk and how birth plans only take you so far.
Consider that the subtext. A reading between the lines.
I often say the Universe loves to eavesdrop.
Ticking Clocks is the context. Listening for Time is the conundrum. For when we are present in Time, we are paying attention to all that is contained within the Time without any regard to the Time.
Time stands still.
Time disappears.
Choose your cliché.
They are all true.
I had not realized the pacing of preparing for delivering a TED talk, my TED talk, was mapped to the gestation of giving birth to a human child.
9 months nearly to the day (which is also the same for my 3 children).
Sometimes, we can choose to practice in preparation for things to be hard…in anticipation of things being hard. We can imagine what may make something hard and we rehearse with the intention of making things easier when the hardness arises.
Practice with pregnancy makes approaching a task — in this case, birth— in some sense, familiar. The scenery and signposts along the way become recognizable. (Though ease is a bit of a stretch—-pun intended) becoming adept at adapting to what is happening may be the more accurate outcome.
While every moment in Time is unique, similarities persist. Making the acquisition of skill through practice a thing that happens with Time.
What the experience of TEDbirth2 has begun to illuminate is that a practiced skill lends itself to enhanced ease of adaptation. This is not to be confused with ease, in and of itself.
And perhaps that is what practice and birth plans are all about: making us as agile as possible so we can adapt as easily as possible to the unique, unforeseeable, unrehearsable, realities that occur in Real Time.
To be clear, I had no idea at the Time that TEDbirth was a thing. I had never considered giving a talk a “birthing” process. I had no reason to consider that my 3 prior and wholly, holy unique experiences with CHILDbirth had any practiced skills to offer in the arena of TEDbirth.
Now postpartum from birthing Ask. The time is Now. 3 9 months of CHILDbirth x3 broken into trimesters offers subtext to the text that was written between the lines. First, a review of CHILDBIRTH with 3x practice:
First trimester
first child: shocked and excited, clueless, tired with a bit of nausea and lots of amorphous anticipation. Blocking calendars and letting a short list of people know to block their calendars, too.
second child: shocked and excited, extremely tired, disabling amount of nausea and lots of specific logistical planning. Shoring up support plans for our daughter. Blocking calendars and letting a short list of people know to block their calendars, too.
third child: shocked and excited, support already in place with calendars synchronized. Routine routine.4
Second trimester
first child: anticipating starting to show. Nesting begins. No pressure, all fun. First time looking for pregnancy clothes, hand-painted baby furniture, and reformatting the “office” to a “baby” room. First sharing with a wider circle. First deliberations with names.
second child: starting to show. Nausea intensifies. Adding to the nest. Pragmatic furniture shopping (now we know what a changing table needs to do). Unpack the pregnancy clothes. Reformat the guest room into a baby room.
third child: pre-loved is the best kind of love (except when it comes to names). Unpack storage and hand-me-downs for pregnancy clothes and furniture. Recycling names is not an option.
Third trimester
first child: denial is real. What am I supposed to pack? Candles? Playing cards? A cozy robe and nightgown? Who is that round person passing by the window? My shoes don’t fit! I cannot reach my toes to feed my feet into the pantyhose for a final fancy night out before becoming parents! How is this birth going to happen? (aka that baby is too big to fit my anatomy’s exit strategy!) Taking a birth class. Practicing breathing with a coach is not intuitive. At least one thing seems clear: we have agreed upon names!
second child: Bag has a robe that can be thrown out. No nightgown or candles. Kept the cards. Nausea has abated. Feeling great. I know birth hurt. I just don’t remember exactly what it feels like. Maybe it’s not so bad the second time. Often goes faster, they say. This one is bigger, they say, though not so big. Everything is in place. No need for pantyhose. No need for a birth class. (Breathing with a coach didn’t help. The epidural did). We agreed upon names from the first time around!
third child: Bag ready. Skipped birth class. Practiced mindfulness approach to pain while holding ice cubes. New hospital tour highlight: “catered” post-partum dinner for two! Can’t agree on names. OB is stressed and wants to schedule a c-section. I still can’t remember what birth felt like.
Birth
first child: false alarm. Sent home. Real labor was unmistakable. One thing for certain: whoever designed a hospital’s labor and delivery unit on the 13th floor without an express elevator was never in labor. Epidural relief. 6lb 4oz. She fit.
second child: Real labor was unmistakable. Called family down the street mid-contraction for first-baby hand-off on the way to the hospital. 8lb 13oz. (He was way bigger). He did not fit. C-section.
third child: Real labor was unmistakable. Drove kids 1 and 2 to nanny and put dogs in the yard. Sat in a warm bath instead of holding ice cubes. Water broke. Drove to the hospital. 7lb 4oz. Vbac.5
Post-partum
first child: “What have we done?” we wonder in amazement at the tiny life now being placed in our arms. We stay overnight in a shared room with another set of new parents. (The design of the environment was, without question, created for people lacking the descriptors “new parents”). We go home the next day. Learned after the fact we never discussed spelling of the agreed upon names….
second child: my arms are restrained, tethered to boards to protect the IVs. I can’t hold him. Touch him. I only can see him from afar as the doctors sew me back together. I get a private room. We hear him from down the hall. A bellow of a newborn cry. Our daughter visits and wonders when we will come home.
third child: he falls asleep nursing. The nurse comes to give routine eye drops. He’s not asleep. He’s blue. He’s not breathing. The button on the wall you never want pushed is slammed like a life depends upon it. Room fills. He’s out of my arms. Being bagged6 in the corner. Too many people. I can no longer see. All I want to hear is him cry. The room empties with an explosion of silence, leaving wreckage and worry indistinguishable from a tornado’s wake. A nurse comes to check on me. “Oh dear.” Not what you ever want to hear. A second nurse arrives. “Oh no.” Still not what you ever want to hear. Then a doctor, “You’re still bleeding.” Elbow deep, my doctor squeezes my uterus. Andy sways trying to decide where to be. With me. With him. With family waiting. Wondering. I pray for any version of a cry.
Re-living these moments, it is clear that practice supported adaptation. Which is not synonymous with ease. Practice enabled retained presence, even…especially, when things got hard.
Which brings me to this reflection on 9 months of TEDbirth broken into trimesters.
First trimester: excitement, fear, a bit of nausea and lots of amorphous anticipation. Blocking calendars and letting people that need to be present know to block their calendar, too.
Second trimester: nesting begins. The talk must be written. No matter how conversational and spontaneous they may appear, TED talks are scripted. Every letter approved.
Third trimester: a wardrobe that supports the rotund. A big red dot in this case. On the surface, that seems like it ought to be fun. Exciting! Until it gets closer. Making sure things fit, can get on, will stay on. Practicing breathing with a coach.
As with the practice of childbirth, I knew what I needed in order to deliver. My bag was packed three days before I was to deliver. I knew what would help me concentrate. Focus. Soothe in the absence of an epidural. I had more of a birth plan than any of my prior births because I had had years of practice. Who would be at my side was a given. How he would be, where he would hold me until he couldn’t, apply pressure to keep me present, hold other’s at bay to protect my space, support my concentration, my ability to focus. This was all clear because we’d done this together— before.
Before—.
Like with the birth of our second child and then again with our third, what we’d planned bore little resemblance to what we bared.
Two weeks before TEDbirth’s due date I met with someone I will now call a TEDbirth doula.7 Ava Roy, of the We Players, is a master director, performer and creator of authentic presence in unexpected spaces. After two hours of rehearsal, Ava prescribed me a practice, a daily routine that would take me straight through delivery.
I was ready.
For the next 10 days, I did exactly what Ava instructed. Warming up my body. My voice. Stretching. Humming. Breathing. Speaking my lines in full voice while walking two times in a row. Speaking my lines in full voice while driving at least three times a day. Picking up the talk in different points. Listening to my talk. Speaking my lines in soft voice while relaxing — in a bath, in bed before falling asleep, as I fall asleep, upon waking before getting out of bed. The words filled my head. Became the automatic meditation. My lullaby.
Dress rehearsal was on Friday afternoon.
Due date was on Saturday.
Thursday, the unexpected happened.
No rehearsal could pick up where I left off. Could pick me up where I last stood.
I was on all fours.
I never saw the tornado coming.
I got the call at 4p.
The person who was woven into the fabric of my talk, who lived and breathed every word of its message, more sister than friend, who would never let on how sick she was, would never dare distract, died.
Every pore wretched. Every cell wailed.
I could not speak.
I could only sob.
I sent an SOS to Ava Friday morning.
“Of course you cannot speak. Not today. Of course the warm-up and rehearsing doesn’t fit. Not today. Your body is hyper alert. Vibrating. You don’t need any help waking up. If I could I’d tell you to curl up and stay in bed. And, I know you have rehearsal.”
Ava’s voice was radiant clear, like the lifeline offering of a lighthouse in the most impenetrable of fogs.
“Tech rehearsals come in a variety of flavors. This one is not meant for you. It is for sound and lighting. You need to mark your words and your place on the dot. Nothing more. You don’t owe them anything. Just say the words. Then leave. And trust that you have done the work. You have been a good student. You have been practicing. You will deliver. Tomorrow.”
These words offered stability. Reorientation. Permission to grieve AND trust the practice.
I know about grief.
This, I have also practiced.
I know how to recognize what I need. And I knew I needed to see my friend, now widow, before I went to rehearsal.
My husband encouraged me to reconsider.
Halfway across the Golden Gate Bridge, I say outloud with complete calm, “I’ve left my bags at home.”
Andy prepared to turn around.
“No,” I said with the focus of a sailor attuned to the lighthouse beacon, “I need to see him. Family can bring my bags in the morning.”
We arrived unannounced.
We were shown into their Livingroom. Its name seared.
We hugged. We sat. And then he collapsed. Like a phoenix daring to show his lethal wound, screeching, gulping air, quivering, gravity stronger than his wings can bear.
“How does anyone survive this?” he pleaded.
“We do. You will. Of this I am certain. She worked so hard to make sure you would.”
He nodded, whispering, “I know. It’s true. She did.”
“I don’t have time to explain it all right now. I have to go… I have to give this talk that she knows all about. That she is a part of.…”
He walks us to our car. Each footstep is a soulquake of grief.
We continue our drive north.
“You were right,” my husband says wiping streaks from his cheeks. “I thought you were crazy, but you were right. It couldn’t wait.”
We practice breathing the remainder of the drive. Ice cubes were not necessary to help us localize the pain. It was everywhere.
Arriving at the theatre, my internal instructions were running hot. Just speak the words. You don’t owe them anything. Just speak the words. Not full voice. Then leave. You don’t owe them anything.
Sunglasses. Headphones. Music. Staring at a wall until it was my turn to be mic’d I made no small talk.
I had no playlist. Every song streaming through my headphones was random. Expect they couldn’t be. Every single note, lyric, title was her speaking directly to me. When “Remember” from The Lion King soundtrack hit its apex, I moved outside and blended with the rain.
Called to the “runway”, I ignored the instruction to walk onto the stage with “energy.”
I reached the center of the red dot.
I took a deep breath.
I allowed myself to speak an unscripted line to open.
“This talk is dedicated to Francesca and Max.”
I spoke the rest of the words without change…until the end.
I realized as I began the line, it was no longer true.
The original script: “Talking about these things may not save your life…”
What I said instead was/is true: “Talking about these things won’t save your life…”
I left the dot. Returned the mic. Received one note from the stage director: Can you wear your hair pulled back? The camera cannot see your whole face.
(Intentional today, I thought to myself). “Of course. Tomorrow I will wear my hair pulled back,” I say to the director.
We left. Checked into our hotel. Curled into each others arms. The searing reality sufficient for us to succomb to the silence of sleep.
We awoke with little time to get ready for the mandatory dinner. Gracious hosts welcoming all the speakers, sponsors and guests to convene, celebrate and network.
Under the best of circumstances a difficult setting for an introvert.
Under these circumstances….
“You just tell me when you want to leave and we are outta there,” Andy says as we attempt to ready ourselves.
“I have nothing to wear but what I am wearing.” My forgotten suitcase had my clothes for tonight and tomorrow.
“It’s fine,” Andy says with all sincerity. “Here. I will change to match you.” He slips into jeans and a t-shirt.
The rain feels like a sacred bow. A knowing surrendered. Externalized.
GPS shows a 6 minute drive to dinner.
3 minutes to go I get a text message from a friend: Brenda is taking her last breaths.
What?!
Andy feels my reaction.
“You know the person in my talk….my friend’s wife, who I helped go to Provence…? She is dying. Right now.”
I lose sensation in my fingers as I type my reply:
You. Keep. Breathing. With me…
I know an Angel waiting to meet her. Arms open.
Like mine are for you
We arrive at the dinner.
I feel.
My breath catches on itself.
The rain seems to know and keeps falling. Gently. Steady in the invitation to join.
Andy is the embodiment of Shield. Graceful. Unyielding. Discerning where to position. How to offer to answer for me when a person asks, “How are you feeling about your talk tomorrow?”
When we realize the host intends to call on every speaker, randomly, to share their “5 minute ‘Why’” Andy catches my fall as I excuse myself from the table.
I squat in the rain. Read a text: Our Beloved Brenda flew to the Spirit World...
When I return to the table, Andy slides his phone to me. It is open to a notes page. It has 3 lines typed, beginning with: You could just say this…
He had written me a script. It created the opening for me to speak the truth.
…I am hurting.
It created space. Now everyone knew. And those fluent in grief could come toward me. And those not, could knowingly stay away.
I could go to sleep. I could wake up. I could ready myself how I’d practiced.
I delivered.
When I left the stage and returned to the green room one person asked how I felt now? I paused for a long time. Searching for the word(s) to name what I was feeling. Such a mix of emotions. Grief. Love.
My reply: Gratitude.
It is a rare thing to get to speak what matters most to a room filled with 700 people listening with generous intention, hungry to receive whatever comes out of your mouth. So many people came in person to support me because I asked. So many people came in spirit because that was what their bodies allowed. It was impossible to be afraid, nervous or worried. I was never alone in the red dot. I was present. And Time, while being clocked to the second, vanished.
Now you know.
Photo by Asa Mathat taken a few minutes after my talk.8
(This is your moment to pause or resume whenever you wish).
Ticking Clocks
When a physician is directly asked, "How much time do I have, doc?" the almost cliché answer has become, "Well, I don't have a crystal ball ... but ..." followed by an answer that has historically been shown to overestimate reality. You'd probably be better off placing bets in Vegas than blindly trusting the prognosis of physicians. We fear telling "the truth" when it is a truth no one wants to hear. We assume we will destroy hope and trust. That we will be seen as a failure. We are also, simply put, distractible, which may make us unintentionally ignore what our patients are trying to tell us.
****
I intended my last patient visit of the day to be brief. I had a 45-minute drive ahead of me to pick up my daughter and two of her classmates from camp before needing to dash home to meet my mother. This was a very understandable, familiar, human mistake. My focus was not on my patient. My attention was on the clock. My ability to be fully present for this man and his long-time girlfriend was compromised from the get-go.
****
Harvey Leister is lying in his bed. His snowy white hair looks like a marshmallow cap atop his head, transforming him into an immediately loveable character from one of my toddler’s bedtime stories. He is surprisingly stout, and aside from the color of his hair does not have an appearance that matches his age, which is greater than 80. He is one of 13 siblings and the only remaining. Betty, his girlfriend of over 30 years, is stroking his right arm the entire visit. She looks even younger.
“Who are you and why are you here?” Harvey’s tone is very matter of fact, unafraid and unassuming.
Slightly put off by this, I’m not sure how to make my visit worthwhile, particularly since I already have one foot out the door.
Before I can make any significant inroads, Harvey stops me and says, “Look, we both know what’s coming. I’m just waiting here for it to happen. Do whatever you want to make yourself happy.”
I am beside myself with this remark. Make myself happy?
I muddle through with some euphemisms on how I am here to bring quality to each of his days. When I ask what I can get for him, Harvey calmly raises his left hand, points his index finger to his head and pulls an invisible trigger.
Betty’s eyes begin to turn red as tears well in them, “Oh, you don’t mean that, Harvey.”
I struggle to put two intelligible words together, but in truth it all feels hollow. In hindsight, I see that the only person dealing with a full deck in this conversation is Harvey, and he’s the one with an invisible gun to his head. I am simply not available to be with him and his very real and appropriate anticipatory grief.
Even still, he attempts to save me.
Harvey suddenly reaches his left arm out straight toward my neck and takes my small circular pendant in his hand. He then asks, “What is this?”
The look in his eye tells me he really wants to know, but my mind is unable to comply.
“It is a drawing from the book, The Little Prince,” I hastily reply.
He is staring straight into my heart as he holds my pendant. It is my talisman, my mantra, my essence in an image. And no one has ever asked me about it until Mr. Leister.
“That’s all you’re going to say?”
The clock is ticking, (only I am sadly mistaken about which one), so I dismissively tell him I will read the story to him on my next visit.
He then tries one last time to wake me up.
“What does your ID badge say?” I read him my full name. He reaches for it deliberately so he can turn it over and read the back. It features a list of our hospice team's values.
“Patients and families come first,” I say.
As I look back on this moment, a scene from the Stephen Sondheim musical, Sunday in the Park with George, painfully blares through my brain. Georges Seurat is feverishly focused on completing his massive painting, Sunday Afternoon on the Island of La Grande Jatte, while his lover is desperately trying to get his attention:
“Hello George.
Where did you go, George? I know you're near, George.
I caught your eyes, George.
I want your ear, George.”
Well, I certainly am not near; nor do I have an ear Harvey can bend in this moment. In my own mind, I am clear that I will make it all up to him on my next visit. He will have my full and undivided attention then. But now, I have to go.
Anyway, I think reassuringly to myself, Betty seems to appreciate my smile and laughter and attempts to address Harvey's pain and shortness of breath and offers to make these symptoms better by adjusting some of his medications, so that's good, right?
“Suit yourself.” This is Harvey's final remark to me. Not bitter or contemptuous, just once again, matter of fact.
After successfully navigating the roads to camp and toll crossings back to the city, I quickly shower and kiss my children and race to meet my mother.
Rather unexpectedly, I find myself sharing my unsettling visit with Mr. Leister with her. I tell her of my struggle to find meaningful words, given his plain awareness of his life and its end quickly approaching. As she listens, I feel a mounting ache in my chest that seems to grow as the lights in the opera house fade. The music and voices take over our conversation for the next several hours. It isn't until the character, Brunnhilde, flies onto the stage in Act II of Wagner's opera, Die Walküre, that I begin to understand the source of my ache.
The super titles translate the German libretto as Brunnhilde, the leader of the Valkyries, explains her purpose to one of the opera's heroes, Siegmund:
Siegmund asks, “Who are you and why are you here?”
I stiffen as I realize I heard these words only hours earlier.
Her reply, “You only see me before death approaches. Whoever looks upon me must leave life and the light.”
My breath catches.
Could it be? I silently gasp. Did Harvey see me as I have never seen myself: a Valkyrie coming for him? Shudders go through me as I try to own this possible role. It strikes me throughout the rest of the opera that each of the Valkyries sing and laugh and delight in their task, while each of the fallen heroes trudge solemnly and silently behind, never once exuding the joy of their guides.
The following day, I learn that Harvey has died. No hint that anything was coming other than his saying so, should anyone have been listening.
His hospice aid, Veronique, was changing his sheets in the skilled way that does not require a person to get out of bed. Veronique helped Harvey roll to his right side. He did so without distress. When Harvey returned to his back, he reached toward the pendant on Veronique’s necklace.
"What is this?" he asked.
Veronique replied, “It is a cross. My most treasured gift from my husband.”
He smiled and said, “It is beautiful.”
Then he gave a shudder.
He looked at Veronique, smiled and said, “I’ll be fine.”
Veronique had him roll to his left. When he returned to his back he smiled, took a deep breath and died.
Feel free to pause between stories. Or, if you prefer to skip the pause and skip ahead to the story from Heart Sounds that is titled, Ticking Clocks, it begins after the portrait photo.
Just made that word up.
While I had a say in choosing the names of my 3 human babies, the same cannot be said for the naming my TEDbaby.
That routine repetition is for my brother (and anyone else who knows the film, Champions: A Love Story).
Vaginal birth after c-section. Some OB’s don’t like them because of risk of uterine rupture.
The term used when an Ambu bag is squeezed to help force oxygen into a person’s lungs during CPR.
A birth doula is a person who has been trained to provide physical and emotional support before, during and after giving birth. They compliment rather than replace the role of a physician or midwife. A TEDbirth doula (another term I am just now birthing), is a person trained in the art and delivery of authentic presence in performance. I knew the moment I was told I was pregnant with TED (i.e. invited to give a talk), I wanted/needed a particular kind of support in addition to the support that was provided by the organizers. I am forever grateful my TEDbirth doula agreed.
In addition to taking candid photos throughout the day, Asa gifted his photography talent and offered to take “headshots” of all the speakers once they returned to the green room after delivering their talk. He was specific in his invitation. This photo, the last in the series, was taken after he instructed me to look over his shoulder toward the door across the room and picture the people I love who are no longer walking on the Earth to be coming through the door to hug me… yeah, I wasn’t imagining…