Mike’s Farewell to Teaching Silver Lake June 1989-
(minus the very important Far Side Cartoons)
Dear Silver Lake Colleague and Friend,
Teaching and healing have always seemed to me the most noble endeavors. During my past six years at Silver Lake I have happily done my best to combine both. With your support and great administrative leadership I/we have been addressing critical adolescent health issues – drinking and driving , drug abuse, suicide, sexuality, AIDS , etc. The many assembly/seminar programs offered to our students complement the excellent Grade 9 health course, other oferings in Science ,Sociology, Psychology, Child Development and the extra efforts of individual teachers and taken together demonstrate a strong commitment to health. So much more needs to be done on these and other issues –domestic and social violence, inter-personal communications,relationships. More later* Over the past year I have been involved in an independent nursing study program. (Yes, as I explained my goal to my students “real men” care, help and become nurses too, and no I am not about to enter that field , as one uncomprehending stud suggested to “pick up chicks”.) I have just recently come to the conclusion that I must combine more structured study with actual clinical/hospital training. I am optimistically looking forward to both in September at Quincy Junior College. This will mean two years of hard study and financial sacrifice /juggling, but the “lifestyle”rewards should be wonderful in many ways. As with teaching I will be fortunate enough to earn a livng helping others. Most important are the benefits for my marriage and home life. So often as teachers we find ourselves in difficulty balancing our energy between our first loves – marriage and family/home and our second,kids/school/profession. You know the scenarios…getting home too late, too tired, with too much left to do or undone for tomorrow or Monday…the frustrations,unintended impatience…My wife Cyndy and I have enjoyed many extended holidays and summer vacations amidst part-time work with our now 19 (!) year old college Sophomore son Joe,but as we grow (change,age) we crave more shared daily living. Nearing twenty years of marriage my wife Cyndy (Nurse Practitioner Extr’ordinaire) and I are looking happily forward to an even happier future, possibly working together , definitely sharing more home and travel time- “the amazing flying RNs”?
Leaving teaching has been a difficult decision for me emotionally. Teaching has been my way of life ages 22-39. I have truly loved the best of being an educator (despite the infrequent student thank-yous…I won’t miss the typical teen rejoinders ,”This is stupid” or the ever popular,”This is boring.” ) or the heads down on the desk because of too much work out of school ,usually for cars and clothes. I welcome constructive criticism to my carefully orchestrated classess and lift those tired heads with a gentle pat on the back and a joke for “kids will be” just like adults. Society must in deed support schools before kids will …more later*. As I wrote to my students in this year’s “diplomento” part diploma and part momento, given as a last lesson to each with a sincere handshake-
“Several very special teachers helped and inspired me about twenty years ago in high school. This is why I have been a(n English) teacher –to help people develop their powers of communication as thinkers,speakers, readers and writers, to increase awareness of the problems ,choices and solutions that we face in our personal lives and the life of our country and our world…Teenagers inherit a world from adults …”The best of times and the worst of times “… a world of goodnessand beauty, a world also in crisis from war, violence,social injustice , pollution,drug abuse, disease, etc. The challenge is to care more about yourself , your family/friends and your world than about mere money,material possessions ,cars, looks or artificial values and highs.Believe in humanitarian values, have hope ,keep your sense of humor, and be courageous enough to choose a postive ,intelligent, peaceful and loving way to live a healthy and happy life.”
Of course, as a student, or teacher- human being it’s a struggle to aspire to such ideals in daily reality ,but this is a the essential and noble struggle. As educators we yearly face increased societal demands and decreased support and involvement. * This is the later part … I do believe that “Education is a race between civilization and catastrophe .” In reality public education desperately needs a fundamental reorganization in response to the radical societal/instutional/environmental /health changes of the past twenty years and the corresponding crises of the present and future. I propose (though no one has asked ) that beyond the basic skills of reading,writing, reasoning of the first three elementary grades we must implement a curriclulum of personl /social survival and growth. How long will it be before we as professionals and as a nation provide an education for the prevention of problems,focusing specifically on positive self-image and growth, inter-personal communications and relationships,personal problem- solving,peaceful conflict resolution ,human (e) sexuality ,marriage, family parenting ,dealing with death and grief - think of all the essential areas of living we leave to the trial and error method which should complete this curriculum/agenda…not to overlook basic first aid,CPR, emergency skills, vocational knowledge for every day life for everybody = basic carpentry,electricity, plumbing ,automotive maintenance and repair,typing, computer usage, etc. Is all of this any more far-fetched or less necessary than the ideal of public education itself? I firmly believe that this is the reformation that education must take or face increasing irrelevancy and failure. As any idealist comes to realize, this realignment is painfully and frustratingly slow. The need is present; we certainly have more ,more needy young people than ever before. The technology and accelerating teaching/learning methods are available ( and working amazingly well for business) and within reach. Will we do what must be done?
I look at Silver Lake as a school which (within the limits of community support) aspires to the best that a public school can be. Thanks especailly to the leadership of John McEwan and Charlie Thibodeau and the daily work of our dedicated faculty SLRHS is evolving as a truly great school emphasizing care,compassion and competence through an array of special offerings,event and activities for our students. It has been a privilege and source of great pride and satisfaction to me to have been a part of it all these past six years. My deepest respect and best wishes to you as you continue the “race.”
I hope that one or several of you will be willing to continue and improve the SADD/Health programs I have been organizing with a great group of kids, health agencies,community groups,police ,etc. If you would like to do this necessary and rewarding extra work , please contact me at home during the summer-471-4663. I can provide a simple guide to the programs ,materials and contacts.
Finally, I hope that some or all of this unusually punctuated,perhaps radical conceptualizing makes an understandable valediction. I am 90% sure I will be attending nursing school and doing clinical work in September. I am used to getting what I want and plan , but if the ideal is postponed a year and I am back in K-216, I’d be happy with a curtain call. Several of the many mottos which deck the doors and walls of “my room” seem the best notes on which to conclude:
“The greatest gifts we can give our children are roots and wings.”
“If you think education is expensive, try ignorance.”
“Caution –human beings; handle with care!”
and a “whale” of a commitment- “Save the humans!”
Sincerely,
Mike Cotter …Teacher/Friend
Thursday, February 10, 2011
Monday, January 31, 2011
The USS Indianapolis - War and Peace and Pat...
The USS Indianapolis Survivor’s Fund
C/o The Grand Traverse Regional Community Foundation
Suite 300
250 East Front St.
Traverse City, MI 49684
To the Friends of the USS Indianapolis -
I have just finished reading “In Harm’s Way” by Doug Stanton and was so moved and enlightened by this powerful and detailed retelling of the tragedy of the Indianapolis. This is definitely a chapter of WWII, of individual sacrifice and governmental failure/betrayal , that should be in the reading and realization of every American ( as addendum to the “People’s History of the US”, perhaps.) If only our leaders ,military and political , were so much more careful about putting the lives of Americans “in harm’s way” and in accepting responsibility when tragic mistakes are made! I will surely pass along the story of the Captain and crew to all I can. My Dad, Pat, who passed away in 2002 ,was a young artilleryman in the Pacific poised for the invasion of Japan. He likely would not have survived if the atomic bombs had not forced the Japanese government to surrender and I would not be alive to write this. He never spoke much about his experiences in the War, but when I asked how the people of Japan reacted to him and his fellow soldiers during the occupation he said that like himself they were just relieved that the long and horrible war was over and wanted to reclaim their lives with their families...I have been so fortunate to be his son and to live in peace- while many in my generation have not. All of us are ever at the mercy of our leaders in all lands and at all times : perhaps in the future they may truly be wiser and more compassionate. I have the greatest respect and gratitude for, and wish peace to the survivors and families of the Indianapolis. Please accept this small donation in memory of my beloved Dad and WWII veteran, Pat Cotter.
Sincerely,
Mike Cotter, RN
5 Post Island Road
Quincy, Ma. 02169
April 14,2005
C/o The Grand Traverse Regional Community Foundation
Suite 300
250 East Front St.
Traverse City, MI 49684
To the Friends of the USS Indianapolis -
I have just finished reading “In Harm’s Way” by Doug Stanton and was so moved and enlightened by this powerful and detailed retelling of the tragedy of the Indianapolis. This is definitely a chapter of WWII, of individual sacrifice and governmental failure/betrayal , that should be in the reading and realization of every American ( as addendum to the “People’s History of the US”, perhaps.) If only our leaders ,military and political , were so much more careful about putting the lives of Americans “in harm’s way” and in accepting responsibility when tragic mistakes are made! I will surely pass along the story of the Captain and crew to all I can. My Dad, Pat, who passed away in 2002 ,was a young artilleryman in the Pacific poised for the invasion of Japan. He likely would not have survived if the atomic bombs had not forced the Japanese government to surrender and I would not be alive to write this. He never spoke much about his experiences in the War, but when I asked how the people of Japan reacted to him and his fellow soldiers during the occupation he said that like himself they were just relieved that the long and horrible war was over and wanted to reclaim their lives with their families...I have been so fortunate to be his son and to live in peace- while many in my generation have not. All of us are ever at the mercy of our leaders in all lands and at all times : perhaps in the future they may truly be wiser and more compassionate. I have the greatest respect and gratitude for, and wish peace to the survivors and families of the Indianapolis. Please accept this small donation in memory of my beloved Dad and WWII veteran, Pat Cotter.
Sincerely,
Mike Cotter, RN
5 Post Island Road
Quincy, Ma. 02169
April 14,2005
Open Letter to the Catholic Church- a while ago
An Open Letter to the Church I Grew Up In-
With all due respect, humility and hope for healing...
Undeniably, not just for decades, but rather for centuries, and not only in America, but also worldwide, the Catholic Church has hidden the sin and the shame of sexual abuse/pedophilia by a significant number of its priests. The pain and suffering caused to vulnerable children is hellish and inexcusable. The legal and financial repercussions have been and will continue to be staggering, but ever more so will be the moral/morale consequences dependent upon the official Church leadership’s response. Perhaps as the truth is exposed there can be a kind of redemption, if the leaders of the Church accept responsibility and commit to prevention of further abuse. The sad “his”tory of the Church reflects that of “man”kind- men in pain maladaptively inflicting pain on women and children. This will not change significantly until the Church (and society in general) addresses this fact and dedicates itself to truly “humane” values and living for all men, women and children. I believe that there are essential flaws in the customary “recruitment“ to and function of the priesthood. Fundamental changes in the nature of the priesthood must take place to make this a vocation that allows a life of human fulfillment and service. Many" traditionalists” may react negatively, but the very life of the Church and its clergy depends upon a revolution in thinking and practice. The Catholic Church needs to join most other major religions and allow both men and woman to be ordained," allow” priests whether male or female, heterosexual or homosexual to marry and parent as they freely choose. Celibacy likewise must be a choice,not a “commandment”. Before any person is considered for training for the priesthood, the individual must be screened thoroughly as is routinely done with professionals in other “vocations” to disqualify potential likely abusers of any type. Clearly the training of all priests must focus on education to prevent the abuse that is coming to light so alarmingly now. Historically priests who abused children were transferred to other assignments with no official intervention, treatment or reparation and the abuse continued. From now onward all allegations must be investigated by the Church and simultaneously by the police and courts; the protections and due process for all “accused” and “accusers/victims ” must be respected under canon and civil law. Where there is innocence there will be vindication and where there has been abuse appropriate punishment and “restitution”. The magnitude of the crime and the pain of the victims demands this and nothing less!
In the specific case of the Boston’s Cardinal Law, he must more than publicly admit sorrow and regret...his knowledge of abuse cases, reassignment of offending priests and the consequent continued child victimization makes him an accomplice in these crimes, for he had the knowledge and power to stop them and he did not. This is not to undo the goodness he has done in many other areas or to destroy the man, but as an example of true contrition and repentance, a beginning of truth and healing and future trust, he must step down! (He could assume an appropriate role perhaps in conjunction with his successor to organize a clergy-laity task force to begin the preventative and therapeutic work that needs to be done desperately and immediately.)
For the autobiographical record I am very happily married, a father, a former public school teacher and a practicing Registered Nurse. I was baptized and raised in the Catholic Church, was an “altar boy” for many years, attended parochial schools from the 2nd-12th grades and was extremely devout, even considering the priesthood until the age of 16...I was inspired (and sometimes confused or baffled) by priests and nuns who varied from excellent to eccentric in their intellectual and emotional search for God and service to man and woman. I was never abused by any person of the clergy- perhaps I could have benefited from a gentle “reality check “ to bring my heartfelt mysticism back down to earth. I am no longer a “practicing Catholic”- I think I have my spirituality and “humanism” about right in my life. I do share in the Church baptisms, weddings and funerals of family and friends with the utmost respect for their faith, for the dedication of the majority of the clergy, and for the tremendous power “religion” of every denomination has in the lives of the sick I serve as a Nurse. If the aforementioned changes to end child/sexual abuse in the Church were to take place would I return? No- that was and ever will be the faith of my childhood, so always a part of me, and I have made my personal peace with whatever Good/God there may be.
The Catholic Church can continue to be a tremendous source of inspiration and a powerful force for good for its members - and for all the people of this needy, hurting world. If only it will answer this current crisis and other fundamental human concerns (sexuality, reproduction, divorce, ecumenism, poverty, racism, violence ...) with truth and compassion. The alternative is a more sorrowful future of dwindling, disheartened priests and parishioners, of religious faith and human spirit broken.
Let us pray (and work) that it is not so.
Sincerely,
Mike Cotter,RN
5 Post Island Road
Quincy,Ma. 02169
617-471-4663
February 26,2002
cc: His Holiness, Pope John Paul II
Cardinal Bernard Law
The Boston Globe
The Quincy Patriot Ledger
The Pilot
With all due respect, humility and hope for healing...
Undeniably, not just for decades, but rather for centuries, and not only in America, but also worldwide, the Catholic Church has hidden the sin and the shame of sexual abuse/pedophilia by a significant number of its priests. The pain and suffering caused to vulnerable children is hellish and inexcusable. The legal and financial repercussions have been and will continue to be staggering, but ever more so will be the moral/morale consequences dependent upon the official Church leadership’s response. Perhaps as the truth is exposed there can be a kind of redemption, if the leaders of the Church accept responsibility and commit to prevention of further abuse. The sad “his”tory of the Church reflects that of “man”kind- men in pain maladaptively inflicting pain on women and children. This will not change significantly until the Church (and society in general) addresses this fact and dedicates itself to truly “humane” values and living for all men, women and children. I believe that there are essential flaws in the customary “recruitment“ to and function of the priesthood. Fundamental changes in the nature of the priesthood must take place to make this a vocation that allows a life of human fulfillment and service. Many" traditionalists” may react negatively, but the very life of the Church and its clergy depends upon a revolution in thinking and practice. The Catholic Church needs to join most other major religions and allow both men and woman to be ordained," allow” priests whether male or female, heterosexual or homosexual to marry and parent as they freely choose. Celibacy likewise must be a choice,not a “commandment”. Before any person is considered for training for the priesthood, the individual must be screened thoroughly as is routinely done with professionals in other “vocations” to disqualify potential likely abusers of any type. Clearly the training of all priests must focus on education to prevent the abuse that is coming to light so alarmingly now. Historically priests who abused children were transferred to other assignments with no official intervention, treatment or reparation and the abuse continued. From now onward all allegations must be investigated by the Church and simultaneously by the police and courts; the protections and due process for all “accused” and “accusers/victims ” must be respected under canon and civil law. Where there is innocence there will be vindication and where there has been abuse appropriate punishment and “restitution”. The magnitude of the crime and the pain of the victims demands this and nothing less!
In the specific case of the Boston’s Cardinal Law, he must more than publicly admit sorrow and regret...his knowledge of abuse cases, reassignment of offending priests and the consequent continued child victimization makes him an accomplice in these crimes, for he had the knowledge and power to stop them and he did not. This is not to undo the goodness he has done in many other areas or to destroy the man, but as an example of true contrition and repentance, a beginning of truth and healing and future trust, he must step down! (He could assume an appropriate role perhaps in conjunction with his successor to organize a clergy-laity task force to begin the preventative and therapeutic work that needs to be done desperately and immediately.)
For the autobiographical record I am very happily married, a father, a former public school teacher and a practicing Registered Nurse. I was baptized and raised in the Catholic Church, was an “altar boy” for many years, attended parochial schools from the 2nd-12th grades and was extremely devout, even considering the priesthood until the age of 16...I was inspired (and sometimes confused or baffled) by priests and nuns who varied from excellent to eccentric in their intellectual and emotional search for God and service to man and woman. I was never abused by any person of the clergy- perhaps I could have benefited from a gentle “reality check “ to bring my heartfelt mysticism back down to earth. I am no longer a “practicing Catholic”- I think I have my spirituality and “humanism” about right in my life. I do share in the Church baptisms, weddings and funerals of family and friends with the utmost respect for their faith, for the dedication of the majority of the clergy, and for the tremendous power “religion” of every denomination has in the lives of the sick I serve as a Nurse. If the aforementioned changes to end child/sexual abuse in the Church were to take place would I return? No- that was and ever will be the faith of my childhood, so always a part of me, and I have made my personal peace with whatever Good/God there may be.
The Catholic Church can continue to be a tremendous source of inspiration and a powerful force for good for its members - and for all the people of this needy, hurting world. If only it will answer this current crisis and other fundamental human concerns (sexuality, reproduction, divorce, ecumenism, poverty, racism, violence ...) with truth and compassion. The alternative is a more sorrowful future of dwindling, disheartened priests and parishioners, of religious faith and human spirit broken.
Let us pray (and work) that it is not so.
Sincerely,
Mike Cotter,RN
5 Post Island Road
Quincy,Ma. 02169
617-471-4663
February 26,2002
cc: His Holiness, Pope John Paul II
Cardinal Bernard Law
The Boston Globe
The Quincy Patriot Ledger
The Pilot
Saturday, January 15, 2011
"Joe Cool's" Fishing Adventure
Joe Cool’s Fishing Adventure
-an exciting and valuable true story for boys and girls ages 6-12. Joe learns to keep “cool” and cope with an emergency when the family fishing boat capsizes…
(illlustrations in progress)
My name is Joe. Some people call me “Joe Cool”.
Early one Sunday morning in August when I was eight, my Grampy called on the phone and asked,”Joe, would you like to go fishing today?”
I always had a great time fishing out on Quincy Bay, with my Grampy, Nana and Uncle Robbie, so I said, “Sure!” after my Mom and Dad said I could go. Grampy said they would pick me up in an hour.
Robbie had dug the worms for bait. Nana and Grampy packed the fishing gear and a lunch to eat aboard the boat.
In about an hour they picked me up with my fishing pole and we drove to the dock where their boat was moored. It was a 16 foot white and blue fiberglass hull with a 35 horsepower outboard motor,a windshield, steering wheel, seats for four passengers and a canopy for shade from the sun.
Grampy checked the life preservers,oars ,anchor, lines, motor and gas to make sure we were safely prepared.
When everything was ready, Grampy , “the Commodore” gave the order to “cast off all lines!” and we were underway. We passed the yacht clubs with the large sailboats and cabin cruisers and the shipyard with the enormous oil tankers and reached the open channel. Grampy let me steer for a while following the marker buoys.
We cruised by the Nut Island sewerage pumping station and headed out near the Boston Harbor Islands. In fifteen more minutes we were at the “Glory Hole” , the spot where we always had our best fishing during the summer. Grampy turned off the motor and Robbie threw the anchor overboard.
It was a beautiful warm day with bright sunny skies and light winds. Our boat bobbed up and down gently with the small swells. There were boats of all kinds and sizes around us –sailboats, fishing boats,big cabin cruisers and large ships on their way out to sea.
We fished for several hours passing the time in between bites by talking, telling stories, eating lunch and watching the other boats. Each of us won prizes for the fish we caught: I got the first; Grampy got the most, Nana landed the largest and Robbie reeled in the strongest. After a while it got a little windier and cooler . Robbie and I pulled up the anchor;Grampy started the motor and we headed back in .
Everything went smoothly as usual until we hit a rough spot between two islands called “the gut” and water became very choppy. This had happened before so it did not bother us.Suddenly a very big wave from a large boat that came too close washed over the bow and filled the inside of our boat.! We were all surprised, but Grampy acted quickly.He tried the hand pump but it could not handle the water that rushed in. Nana grabbed a life preserver and and buckled it around me in a flash and held on to me. The boat quickly filled completely up with water, sank from under us and tipped over! Out floated our gas tank, fishing rods, cooler with the fish we caught, everything – and us!
The shore was only about 100 yards away ,but we remembered –“always stay with the boat…don’t try to swim to shore, wait for help”. The water was cold and it had all happened so fast, but Nana held on to me tightly and I wasn’t afraid. I knew we would be OK. Grampy and Robbie yelled to nearby boats for help.
It seemed like a very long time ,but in about 5 minutes a big cabin cruiser pulled up beside us and a kind man and woman helped us climg aboard. We were soaked and cold ,but happy to be afloat again. The friendly couple gave us towels to dry off. Grampy attached a line to our swamped boat to tow it into the Coast Guard pier at a nearby island. The nice couple then brought us back into the Bay and to our home dock and car.
When we pulled into Nana and Grampy’s driveway my Mother and Father came running out of the house and threw their arms around us, especially me. They had been called by the Coast Guard and told that our sunken boat was at their pier ,but not that we had been saved. A search had been started for us and they had been so worried- but now they were so happy!
To celebrate our “rescue” we all went out to a Chinese restaurant for a delicious meal. My fortune cookie said,” you will learn much from a great adventure that ends happily”. We all laughed because it was true. I had learned to be “cool” in an emergency ,not to panic and everything had turned out fine. We had helped each other and kind people had helped us.
In a few weeks Grampy had the boat fixed. One Sunday morning he called to ask if I’d like to go fishing again . I said, “Sure!” and he said, “OK, I’ll pick you up in an hour –Joe Cool!”
-an exciting and valuable true story for boys and girls ages 6-12. Joe learns to keep “cool” and cope with an emergency when the family fishing boat capsizes…
(illlustrations in progress)
My name is Joe. Some people call me “Joe Cool”.
Early one Sunday morning in August when I was eight, my Grampy called on the phone and asked,”Joe, would you like to go fishing today?”
I always had a great time fishing out on Quincy Bay, with my Grampy, Nana and Uncle Robbie, so I said, “Sure!” after my Mom and Dad said I could go. Grampy said they would pick me up in an hour.
Robbie had dug the worms for bait. Nana and Grampy packed the fishing gear and a lunch to eat aboard the boat.
In about an hour they picked me up with my fishing pole and we drove to the dock where their boat was moored. It was a 16 foot white and blue fiberglass hull with a 35 horsepower outboard motor,a windshield, steering wheel, seats for four passengers and a canopy for shade from the sun.
Grampy checked the life preservers,oars ,anchor, lines, motor and gas to make sure we were safely prepared.
When everything was ready, Grampy , “the Commodore” gave the order to “cast off all lines!” and we were underway. We passed the yacht clubs with the large sailboats and cabin cruisers and the shipyard with the enormous oil tankers and reached the open channel. Grampy let me steer for a while following the marker buoys.
We cruised by the Nut Island sewerage pumping station and headed out near the Boston Harbor Islands. In fifteen more minutes we were at the “Glory Hole” , the spot where we always had our best fishing during the summer. Grampy turned off the motor and Robbie threw the anchor overboard.
It was a beautiful warm day with bright sunny skies and light winds. Our boat bobbed up and down gently with the small swells. There were boats of all kinds and sizes around us –sailboats, fishing boats,big cabin cruisers and large ships on their way out to sea.
We fished for several hours passing the time in between bites by talking, telling stories, eating lunch and watching the other boats. Each of us won prizes for the fish we caught: I got the first; Grampy got the most, Nana landed the largest and Robbie reeled in the strongest. After a while it got a little windier and cooler . Robbie and I pulled up the anchor;Grampy started the motor and we headed back in .
Everything went smoothly as usual until we hit a rough spot between two islands called “the gut” and water became very choppy. This had happened before so it did not bother us.Suddenly a very big wave from a large boat that came too close washed over the bow and filled the inside of our boat.! We were all surprised, but Grampy acted quickly.He tried the hand pump but it could not handle the water that rushed in. Nana grabbed a life preserver and and buckled it around me in a flash and held on to me. The boat quickly filled completely up with water, sank from under us and tipped over! Out floated our gas tank, fishing rods, cooler with the fish we caught, everything – and us!
The shore was only about 100 yards away ,but we remembered –“always stay with the boat…don’t try to swim to shore, wait for help”. The water was cold and it had all happened so fast, but Nana held on to me tightly and I wasn’t afraid. I knew we would be OK. Grampy and Robbie yelled to nearby boats for help.
It seemed like a very long time ,but in about 5 minutes a big cabin cruiser pulled up beside us and a kind man and woman helped us climg aboard. We were soaked and cold ,but happy to be afloat again. The friendly couple gave us towels to dry off. Grampy attached a line to our swamped boat to tow it into the Coast Guard pier at a nearby island. The nice couple then brought us back into the Bay and to our home dock and car.
When we pulled into Nana and Grampy’s driveway my Mother and Father came running out of the house and threw their arms around us, especially me. They had been called by the Coast Guard and told that our sunken boat was at their pier ,but not that we had been saved. A search had been started for us and they had been so worried- but now they were so happy!
To celebrate our “rescue” we all went out to a Chinese restaurant for a delicious meal. My fortune cookie said,” you will learn much from a great adventure that ends happily”. We all laughed because it was true. I had learned to be “cool” in an emergency ,not to panic and everything had turned out fine. We had helped each other and kind people had helped us.
In a few weeks Grampy had the boat fixed. One Sunday morning he called to ask if I’d like to go fishing again . I said, “Sure!” and he said, “OK, I’ll pick you up in an hour –Joe Cool!”
Mike's Last Day At VNAB -Labor Day 9/1/08
Mike’ Last Day at the VNA- Labor Day 09/01/08
(
9 RVs no Admits or s/p’s)
After nearly 15 years ,of amazing encounters and very hard physical and mental work (see my resignation letter) it comes down to this last day and as I traveled down so many streets, past so many apartment buildings of all kinds, group homes and private residences remembering so many patients and families I had encountered I just want to record these last patient visits each special and representative .
Molly ,age 91, in a rather posh assisted living facility, former math teacher in NYC, had been married 65 years ,her “Red” had died … yesterday waiting for the25 minute saline soak integral to her special dressing change she had said to do some computer work if I wanted while waiting but instead I took the time and she shared her life story …and how she slept in a single bed in this room while her husband was in a hospital bed beside her while he was sick until he died and as she said this her voice started to tremble and she cried slightly and so did I just imagining and I reached out to touch her shoulder…and there was a bond there of shared humanity and, the realization that we are here together with our beloveds for a time then so painfully separated and perhaps reunited… she was ready after a very good life when the time comes
…
Kathy- I had also seen the day before, when I had set up a time she agreed to for her injection then had to change it when I received a call in the field for another time sensitive visit…I had apologized for the change and she had let loose with all the frustration she felt at being hobbled by her hip repair and being sick of these Lovenox injections etc., that she was tired of waiting past noon ,had been up since early and just wanted to take a nap…as I was suggesting I could come later she just hung up on me- the first patient who had ever done that in 15 years. (Literally a handful of patients over the years had declined a visit from a man/male nurse- “You sound nice and all ,but your nurse wide isn’t comong with you –so I’ll wait until tomorrow ) So I tried again in the evening on the way back to the office and she kind of grudgingly agreed during the 10 minute visit I just validated her frustration, that’s mostly what she or anyone needs and she was fine and thankful to have me come back this morning and give her the last “thankchrist “ shot …
Sammie C- a VNAB legend, seen for so many years by so many nurses , often bid to keep his sugar in line and him out of the ER…he was one of Sandy Grant’s special people and Dennis Cunningham’s , and mine- having seen him in 3 different apartments , a gentle soul living for years with AIDS due to the Anti-retro virals…had been a hairdresser for a time, owned 2 houses, had 3 kids and some scattered grandchildren , my same age ,things fell apart when he started doing drugs and hence his immune status- his Alzheimer afflicted Mom reputedly a onetime big drug dealer …he did his best to mind her when she rambled and wandered at night – there has been a stream of pretty affable yet clearly dysfunctional “family and friends” floating in and out at times in various states of pharmacologic consciousness –Sandy had been there once during a police raid. There was the odd seizure here and there , a few episodes when he was “pimped up” uncharacteristically doing some Super Fly imitation, many times Sammie was lethargic or obviously on something or just holed up in the house sleeping his way through but through it all Sammie was Sammie …sincerely liked hearing of my life …as we sat around his kitchen table , so often so damn hot with a pot of some kind of gizzards boiling away on the greasy stove , I’d share some details of current event s ,the basic wonders of computers and the internet or some personal experience thoughtful or funny and he’d be genuinely interested –the content might have been world’s away from his or very close to home – but he always really appreciated that any nurse did not just run in and out for the usually very basic diabetic check but instead made it a personal meeting. Sammie said he’s miss me as we shook hands and I will definitely always remember him…
Kim- as happened often this was a one time encounter- I’d do the basic research to find out pt’s age (confirm the sex because as with a Kim it could be either) nurse ,MD, dx, wound care ,etc. Lisa McNeil –over my 15 years probably the best nurse overall professionally and personally and bi-lingual to boot ,did her usual for her but actually rare for other equally time-pressed nurses great work of specifying on the weekend list exactly what wound care and evaluations and tasks to be done…Kim needed an abd wound dressing changed ,I really did not have time to check the reason for the surgery – but could give my basic teaching on wound precx, s sx inf, pain meds ,timing , Tylenol adjunct and preventing nausea and constipation (rarely taught in the hospital discharge) It was a relatively quick visit for this 58 year old white male stranger nurse caring for a 35 year old black female in her 2nd floor apartment with a number of cute kids all around …and as always I hope I made her more comfortable ,got her to laugh a little, did not talk too much and left with us both a little better for the encounter .
Herb – as I start to write this as often happens since we moved to the laptops I can’t remember initially who Herb was,where he lived or what he needed…there is something about this kind of “data entry “ documentation that “goes in but does not stick or come readily out”…He lived on Dunreath St off Warren past McDonalds ( bathroom OK , but service and food terrible – I so much preferred the Burger King in Grove Hall next to Uncle Neil’s fire station,near where I parked opposite Ma Dixon’s restaurant hoping for a day’s work with Dooley Bros. trash…the BK where I ate most Sundays for the almost 4 years St Clair and I worked together early on and where Cyndy and I would infrequently meet for lunch) anyway Herb was a youngish 80, had a memory problem, not sure what kind of work he had done ,but for sure one daughter and family lived on the first floor and another on the 3rd and it was mostly good . All he needed from me was basic bilateral LE minor woundcare- done with empathy and friendliness. It was so good as I left to have his teenage grandson come through the door , calling Hi Boppa, how are you and see them exchange hugs…family sysems and support or dysfunction = such an integral part of health for each and every one …and over these years I have seen every degree from near isolation and abandonment to heroic care for a parent,grandparent, sibling , spouse or friend.
Ana P- living on Annunciation Road ( “Assassination Road” per the cabbies for the NU Professor kidnapped and thrown off one of the roofs – but also site of one of the best Visiting Nurses sing-alongs when we did a rave up version of “Hey Jude” for Betty and her grown son Treyan …see VMA for a very special part of my VNA years and PS –Screw HIPPA! ) only 44, a little less English than my Spanish (after so many courses ,3 times to Guatemala…I can just basically get by but have such regard for those who come here and become so fluent in English while speaking 2-3 other languages …we will press on to keep our braincells from atrophying ) so many digressions but there really were so many aspects to this “job”…well Ana at only 44 had a physical struggle = very obese , a temporary ileostomy, one of the largest abdominal incisions I had ever seen, confusing orders on the weekend ,unclear whether to be once or twice daily – that first weekend it was definitely twice as I explained to the MD on-call the set-up for a recurrence of infection ,what you would want in care for your family member or I for mine – I never really did anything heroic with the care just be kind and competent and provide the follow through for the poor weekday case-managing primary nurse …this had been a “General Dynamics” dressing change a la Richard Allen, hot and noisy in the apartment ,sometimes the dtr helpful with translation or explanation,sometimes Ana was alone , but on this last vist the wound was so much smaller, the skin around the ostomy no inflamed, the hemorrhoid pain bearable with a doctor’s visit coming the next day . As always as I left she was a little closer to healing and as usual not needing or able to communicate the significance of this last day for me I gave a tender hand on the shoulder and Buenos dias ,amiga….
Rose ….I decided not to make this my last visit of the day, just too final and emotional after seeing her for somewhere around 10 years , the patient I had cared for the longest and knew best … from that first visit back then she was a bit wary of the “guy nurse” ,but we gradually found common ground and I learned of her life of struggle = born with Spina Bifida about 1955 , never able to walk, always “wheelchair fast”, had been a “victim” up to her teens of what she felt amounted to “medical experimentation and humiliation ,complete with those photos where they have a little black rectangle over your face” to just barely disguise your identity and humanity, this had been very painful and scarring for her…she had been married for a time, had been part owner of a stock car/always loved the thrill of racing, had moved to Boston from Conn after her divorce ,worked in her PCP’s office for a time,had been very mobile,had some abusive relaitonships ,but over time became more and more disabled with respiratory and chronic wound and pain complications and housebound ,even when the recurrent mechanical problems with her electric wheelchair were resolved (unconscionable rigamaroll many times for a part or repair = this chair was her essential mobility from bed,around her cramped apartment…crowded with stuff from “home shopping network” that commercial club for shut-ins, with her 4 beloved cat companions …live in PCAs either took advantage by stealing or not really living up to their part of the deal…Rose was generous to a fault,so good hearted ,was fascinated by her TV lifeline animal/racing/shopping/surgery –medial oddity and Lifetime melodramas and the creepy films where an innocent female was stalked in her home by some violent madman. The VMA had visited at least twice at Christmas, the last several years she had not been up to it. I had once visited Rose in he hospital when at death’s door she had called 911 and been admitted to BMC and was there for most of the summer and I could see that for her to be in the hospital was to utterly give up all her autonomy ,to be bed bound and at the mercy of whatever nursing care was available ,to have to explain her story again and again, to plead to be listened to ,to be so often frustrated and at times ironically isolated . Rose appreciated the fact that I listened, that I knew her that we could laugh together and discuss common/shared or different interests as distractions to the needed nursing care for her chronic skin problems and pain….usually 10/10 because to be hospitalized for a pain evaluation and pehaps better pain regime would mean that loss of autonomy and she would rather suffer and be in control. Speaking of suffering I have detailed the most neeedlessly painful (for myself and a patient) experience I have encountered in 17 years of nursing due to a conflict with MV my manager over finshing in 12 hours = if you can’t some one else would see have to see Rose ( who would reject anyone who did not know her because of the aggravation – reply “that’s her choice” ) Briefly after caring for her for about 9 years I did not see her for about 6 months …other very caring and competent nurses took by place –Katie W helped with my prep notes, but it was just so personally punitive , to be “yanked off the case” instead of the promised alternating… it finally ended up in an ethics conference discussing boundaries , and my special violations of sending vacation post-cards and singing at Christmas…this did definitely cross a line for me – the causing of totally unnecessary and truly unethical emotional pain for poor Rose…it was just a power struggle over hours paid and “patient demands” vs VNAB control…in the discussion I had with the Veep of Ethics she commented how infrequently an MD contacted the VNAB and how Rose’s PCP had requested to have me put back on the case…and finally I was ,seeing Rose frequently and this was our last visit …we really had an unusal “therapeutic “/friendly nurse –pt relationship – I have such respect for her bravery and empathy for her suffering …we parted with a hug and some tears from both… and an intention to keep in touch and revisit at Christmas…
Daisy G- a one time encounter, lived in the revitalized Orchard Park where I had picked up trash so many years ago when it was so delapidated , but still a high concentration of ailing individuals and families…Daisy was bed bound,somewhat demented but pleasant and well cared for by her grand-daughters –reminder with the confusing orders and primary caregiver not at home ,go with the flow listen respectfully and with good humor to the patient and family , stick with the care basics,document well and leave a voice mail as needed for good communication and continuity –later of course for me as I jot down notes in the home, finding the computer a barrier there ,just a reference ,and much more effective when I can recollect my thoughts quielty later= works for me.
Aida – my very last patient ,had not answered when I called earlier ,but I tried again (persistance) and she did. I had admitted her a week or so before for a rather large arm abscess due to IV drug use…she was in her 40’s, good pesonality,bilingual, married, adult child and had said the abscess happended from a fall…I had not pursued the IVDA at the time feeling it was not useful…just tried to be a good ,supportive nurse ,make the dressing change easy, pain managemment effective , and complications less likely. I was surprised when she told me that she had gone back to a program, had had a hard time for the past 6 months ,relapsed,but was back doing what she needed to. We talked about that , her plans - I briefly told her that her about our plan and that she was indeed my last VNAB patient. She gave me a sincere hug and thank you as I left for the cab-that’s it the last patient, probably my last caregiving in an inner city home after 15 years …
the last cab ride to the Braintree office another unique aspect of this nursing experience – I had worked in the Harbor and Hyde Park offices each such odd space ( with “Reactonary/Recovering Rich” BC High 1955, wife a former nun , Principal of Cathedral, basically a good hearted if slightly odd felllow a devotee of politics local and national,smart but rather acidic…so many drivers over the years St Clair my street pal, Benny with the bootlegged videos in the front seat, Dick who had headed the MBTA Police and suffered a major political appointment upset and downturn in fortune rna for kKingston selectman and I wrote his main pitch letter, Steve of the horrible breath night and color blindness and awful reflexes but also in recovery and recovering from the loss of his wife, Al so eccentric and happy go lucky, with a gallon jug of urine in the front seat because he would not stop for a bathroom break , who conducted his passenger surveys and driving so slowly would proclaim “every time they honk it’s a victory for our side “ and sincerely that “the city is ours”, Cavenack a gentleman and entreperner from Haiti who had imported cars and busses to sell for cash on the Port au Prince dock, whom I had to lift the cab off when it slipped off the jack in the Burger King parking lot – “I planned it that way” , and a host of others so often leasing for up to $100 daily plus gas other expenses before a dime for themselves and driving for 12 hours a day for weeks on end here from Sudan because there was better opportunity here than as a doctor or dentist there…)
An on this last day Cyndy and I had checked in with each other as we usually did and unusually we were able to rendez-vous back at the office; I cleaned out my stuff and we were able to adjourn to Bertuccis for a celebratory early supper= we made it safely! I finished the laptop documentation by 10:30 (never a 12 or 7.5 hour day for me- as I joked I never got the keys to the time machine at orientation ) or so at home and “transferred” in and that was the end of the last day.
We had told our colleagues that we did not want any gifts or to go out and that we would bring a light breakfast in the RV the next Sunday 9/7 (fortunatley a hurricane side swiped us and aftrer some wild wind and rain blsted through and the sun was out in the AM. We turned in our laptops,some required items and adjourned to the parking lot - had left the driver’s door open for the first time and there was a great sign= “Just Retired”…and we munched ,opened funny and thoughtful gifts and very generous giftcards from Jayne,Maura,Rhonda (discharge orders) Diane ,Val,Anne and sister Joan came in on crutches, Dennis-writer/actor /film-maker /bi-lingual nurse who had recently returned from a year in South Africa with his wife ,and Rachel who had cared for our unforgetable patient Jim Tyree years ago …it was a lovely send off …and Cyndy and I skipped out the door hand in hand, so very fortunate and grateful for the work we had done, the folks met and cared for and learned from and with such a wonderful road ahead!!!
Addendum – because it summarizes as well as I can the 15 years ,the longest and most intensely,most challenging and most meaningfully I have worked in my life…
Dear Maura Vitello, Managers and Colleagues:
cc- Joanne Handy, Keren Diamond…
As I stated verbally in March of this year after almost 15 years at VNAB I will be resigning as of Labor Day, Monday, September 1,2008.
I attached this comment to my last evaluation: “ I will continue each day to take the 2/4-6 or equivalent assignment I am given, help as requested, and give the most efficient and compassionate care to each patient I can.” I sincerely believe that I have done just that.
Of course, not being the “shy and retiring type”, I would like to share briefly some reflections and perspectives.
After 14 years as a High School English Teacher (in Randolph and Silver Lake –Kingston) with an involvement in health education programs for the Silver Lake School District, I was inspired (and still am) to be a nurse by my Family Nurse Practitioner wife Cyndy. After graduating from Quincy College School of Nursing in 1991, I ‘had my baptism by fire” in Med/ Surg at Cambridge Hospital, then moved on to a long established weekend program at Spaulding Rehab which was eliminated just 7 months later. Having been The Quincy Visiting Nurses’ first male home health aide (with Carol Morris as my manager and supporter- small world!) during my nursing school training, I was drawn to community health and had two immediate opportuities - weekend positions at Quincy Visiting Nurses or VNA of Boston.
I chose VNAB for the opportunity to serve the inner-city community, where my parents and in-laws had grown up. The experience has been truly extraordinary in so many ways over these years! It has been both such a tremendous gift and challenge to be a VNAB nurse- first of course (as we all do) to try always to be a “healing force” to the degree possible in the lives, families and homes of the thousands of patients I’ve encountered. I could write volumes (and maybe I will, anonymously of course per HIPPA) about these profound, unique, unusual, delightful, depressing, somewhat “dangerous”(as in the time I had arranged to visit calling at 9AM,confirmed with pt and no answer to door at 10AM, pt had been murdered within that hour...what if?), but ultimately inspiring and life enriching experiences. So many times I have been amazed by the strength, resiliency and spirit of patients who are disabled, infirm or elderly as they cope with seemingly insurmountable health and environmental challenges, even being part of some stirring “home-going” ceremonies along with family and friends when death inevitably came, but faith and hope and love remained.
It has been a real challenge to give the care- the weather, home conditions (from the most impoverished apartment /rooming house/shelter, even a few fields and cars to a wealthy architect’s penthouse), through community parades and festivals and the truly daunting documentation – from the hand charting in the Harbor Office in the extremely wearying wee hours- that 24 hour position = mostly 34 hours, up to 37 hours from Saturday AM through Monday AM, to the current “fujitsu laptop data headlock”. Always it has been the dedicated and donated efforts of the nurses keeping the Agency afloat in the tempest of today’s healthcare- For my own part I calculated several years ago that I had donated at least 4000 hours of “free time”- but that’s another story. It has been such a privilege to work with and learn from so many talented and dedicated nurses, therapists, staff and managers-especially my remarkable team-mates on the Southwest Weekend Team.
Most special, indeed unique, is that Cyndy and I have shared this chapter of our lives as nurses at VNAB, she on the MCH team and I on the Adult. In addition to serving as MNA representatives, and sharing the general Agency “trials and triumphs”, we have had shared patient encounters. On a few occasions I have seen a patient for a C-Section dressing change and Cyndy arrived to care for her newborn, or I could alert the new Mom “when your baby comes home, your nurse on the weekend might be my wife”, or Cyndy might do a BP check in the AM and I would do the PM follow up. What other couple is so fortunate to have this commonality?
Of course both being nurses, I for 17 years and Cyndy for 33 years, 26 of them as a Family Nurse Practitioner, we have every nurse’s sense of how precious,
Fragile and finite life is. For that reason and because and while circumstances allow, we have decided to ‘retire early’ and it’s more of a renewal, really, to have as much time together as possible. For the next 5 years, at least, we plan to travel the eight winter months around North America in our ‘eco’ motor home with four summer months at home by Quincy Bay. We intend to write, stay environmentally active and do some nursing work and volunteering.
All my best to each of you and yours personally and professionally. Continue to take the best care possible of yourselves and your patients.
Gratefully,
Mike Cotter, RN
5 Post Island Road Quincy, MA 02169
postisland@verizon.net
(In memoriam – St Clair Brathwaite- my cabdriver and friend on the streets, August 1997, Age 49 and Sandy Grant-wonderful teammate, human being and superb Nurse, April 2006, age 37 – both of you are remembered always...)
(
9 RVs no Admits or s/p’s)
After nearly 15 years ,of amazing encounters and very hard physical and mental work (see my resignation letter) it comes down to this last day and as I traveled down so many streets, past so many apartment buildings of all kinds, group homes and private residences remembering so many patients and families I had encountered I just want to record these last patient visits each special and representative .
Molly ,age 91, in a rather posh assisted living facility, former math teacher in NYC, had been married 65 years ,her “Red” had died … yesterday waiting for the25 minute saline soak integral to her special dressing change she had said to do some computer work if I wanted while waiting but instead I took the time and she shared her life story …and how she slept in a single bed in this room while her husband was in a hospital bed beside her while he was sick until he died and as she said this her voice started to tremble and she cried slightly and so did I just imagining and I reached out to touch her shoulder…and there was a bond there of shared humanity and, the realization that we are here together with our beloveds for a time then so painfully separated and perhaps reunited… she was ready after a very good life when the time comes
…
Kathy- I had also seen the day before, when I had set up a time she agreed to for her injection then had to change it when I received a call in the field for another time sensitive visit…I had apologized for the change and she had let loose with all the frustration she felt at being hobbled by her hip repair and being sick of these Lovenox injections etc., that she was tired of waiting past noon ,had been up since early and just wanted to take a nap…as I was suggesting I could come later she just hung up on me- the first patient who had ever done that in 15 years. (Literally a handful of patients over the years had declined a visit from a man/male nurse- “You sound nice and all ,but your nurse wide isn’t comong with you –so I’ll wait until tomorrow ) So I tried again in the evening on the way back to the office and she kind of grudgingly agreed during the 10 minute visit I just validated her frustration, that’s mostly what she or anyone needs and she was fine and thankful to have me come back this morning and give her the last “thankchrist “ shot …
Sammie C- a VNAB legend, seen for so many years by so many nurses , often bid to keep his sugar in line and him out of the ER…he was one of Sandy Grant’s special people and Dennis Cunningham’s , and mine- having seen him in 3 different apartments , a gentle soul living for years with AIDS due to the Anti-retro virals…had been a hairdresser for a time, owned 2 houses, had 3 kids and some scattered grandchildren , my same age ,things fell apart when he started doing drugs and hence his immune status- his Alzheimer afflicted Mom reputedly a onetime big drug dealer …he did his best to mind her when she rambled and wandered at night – there has been a stream of pretty affable yet clearly dysfunctional “family and friends” floating in and out at times in various states of pharmacologic consciousness –Sandy had been there once during a police raid. There was the odd seizure here and there , a few episodes when he was “pimped up” uncharacteristically doing some Super Fly imitation, many times Sammie was lethargic or obviously on something or just holed up in the house sleeping his way through but through it all Sammie was Sammie …sincerely liked hearing of my life …as we sat around his kitchen table , so often so damn hot with a pot of some kind of gizzards boiling away on the greasy stove , I’d share some details of current event s ,the basic wonders of computers and the internet or some personal experience thoughtful or funny and he’d be genuinely interested –the content might have been world’s away from his or very close to home – but he always really appreciated that any nurse did not just run in and out for the usually very basic diabetic check but instead made it a personal meeting. Sammie said he’s miss me as we shook hands and I will definitely always remember him…
Kim- as happened often this was a one time encounter- I’d do the basic research to find out pt’s age (confirm the sex because as with a Kim it could be either) nurse ,MD, dx, wound care ,etc. Lisa McNeil –over my 15 years probably the best nurse overall professionally and personally and bi-lingual to boot ,did her usual for her but actually rare for other equally time-pressed nurses great work of specifying on the weekend list exactly what wound care and evaluations and tasks to be done…Kim needed an abd wound dressing changed ,I really did not have time to check the reason for the surgery – but could give my basic teaching on wound precx, s sx inf, pain meds ,timing , Tylenol adjunct and preventing nausea and constipation (rarely taught in the hospital discharge) It was a relatively quick visit for this 58 year old white male stranger nurse caring for a 35 year old black female in her 2nd floor apartment with a number of cute kids all around …and as always I hope I made her more comfortable ,got her to laugh a little, did not talk too much and left with us both a little better for the encounter .
Herb – as I start to write this as often happens since we moved to the laptops I can’t remember initially who Herb was,where he lived or what he needed…there is something about this kind of “data entry “ documentation that “goes in but does not stick or come readily out”…He lived on Dunreath St off Warren past McDonalds ( bathroom OK , but service and food terrible – I so much preferred the Burger King in Grove Hall next to Uncle Neil’s fire station,near where I parked opposite Ma Dixon’s restaurant hoping for a day’s work with Dooley Bros. trash…the BK where I ate most Sundays for the almost 4 years St Clair and I worked together early on and where Cyndy and I would infrequently meet for lunch) anyway Herb was a youngish 80, had a memory problem, not sure what kind of work he had done ,but for sure one daughter and family lived on the first floor and another on the 3rd and it was mostly good . All he needed from me was basic bilateral LE minor woundcare- done with empathy and friendliness. It was so good as I left to have his teenage grandson come through the door , calling Hi Boppa, how are you and see them exchange hugs…family sysems and support or dysfunction = such an integral part of health for each and every one …and over these years I have seen every degree from near isolation and abandonment to heroic care for a parent,grandparent, sibling , spouse or friend.
Ana P- living on Annunciation Road ( “Assassination Road” per the cabbies for the NU Professor kidnapped and thrown off one of the roofs – but also site of one of the best Visiting Nurses sing-alongs when we did a rave up version of “Hey Jude” for Betty and her grown son Treyan …see VMA for a very special part of my VNA years and PS –Screw HIPPA! ) only 44, a little less English than my Spanish (after so many courses ,3 times to Guatemala…I can just basically get by but have such regard for those who come here and become so fluent in English while speaking 2-3 other languages …we will press on to keep our braincells from atrophying ) so many digressions but there really were so many aspects to this “job”…well Ana at only 44 had a physical struggle = very obese , a temporary ileostomy, one of the largest abdominal incisions I had ever seen, confusing orders on the weekend ,unclear whether to be once or twice daily – that first weekend it was definitely twice as I explained to the MD on-call the set-up for a recurrence of infection ,what you would want in care for your family member or I for mine – I never really did anything heroic with the care just be kind and competent and provide the follow through for the poor weekday case-managing primary nurse …this had been a “General Dynamics” dressing change a la Richard Allen, hot and noisy in the apartment ,sometimes the dtr helpful with translation or explanation,sometimes Ana was alone , but on this last vist the wound was so much smaller, the skin around the ostomy no inflamed, the hemorrhoid pain bearable with a doctor’s visit coming the next day . As always as I left she was a little closer to healing and as usual not needing or able to communicate the significance of this last day for me I gave a tender hand on the shoulder and Buenos dias ,amiga….
Rose ….I decided not to make this my last visit of the day, just too final and emotional after seeing her for somewhere around 10 years , the patient I had cared for the longest and knew best … from that first visit back then she was a bit wary of the “guy nurse” ,but we gradually found common ground and I learned of her life of struggle = born with Spina Bifida about 1955 , never able to walk, always “wheelchair fast”, had been a “victim” up to her teens of what she felt amounted to “medical experimentation and humiliation ,complete with those photos where they have a little black rectangle over your face” to just barely disguise your identity and humanity, this had been very painful and scarring for her…she had been married for a time, had been part owner of a stock car/always loved the thrill of racing, had moved to Boston from Conn after her divorce ,worked in her PCP’s office for a time,had been very mobile,had some abusive relaitonships ,but over time became more and more disabled with respiratory and chronic wound and pain complications and housebound ,even when the recurrent mechanical problems with her electric wheelchair were resolved (unconscionable rigamaroll many times for a part or repair = this chair was her essential mobility from bed,around her cramped apartment…crowded with stuff from “home shopping network” that commercial club for shut-ins, with her 4 beloved cat companions …live in PCAs either took advantage by stealing or not really living up to their part of the deal…Rose was generous to a fault,so good hearted ,was fascinated by her TV lifeline animal/racing/shopping/surgery –medial oddity and Lifetime melodramas and the creepy films where an innocent female was stalked in her home by some violent madman. The VMA had visited at least twice at Christmas, the last several years she had not been up to it. I had once visited Rose in he hospital when at death’s door she had called 911 and been admitted to BMC and was there for most of the summer and I could see that for her to be in the hospital was to utterly give up all her autonomy ,to be bed bound and at the mercy of whatever nursing care was available ,to have to explain her story again and again, to plead to be listened to ,to be so often frustrated and at times ironically isolated . Rose appreciated the fact that I listened, that I knew her that we could laugh together and discuss common/shared or different interests as distractions to the needed nursing care for her chronic skin problems and pain….usually 10/10 because to be hospitalized for a pain evaluation and pehaps better pain regime would mean that loss of autonomy and she would rather suffer and be in control. Speaking of suffering I have detailed the most neeedlessly painful (for myself and a patient) experience I have encountered in 17 years of nursing due to a conflict with MV my manager over finshing in 12 hours = if you can’t some one else would see have to see Rose ( who would reject anyone who did not know her because of the aggravation – reply “that’s her choice” ) Briefly after caring for her for about 9 years I did not see her for about 6 months …other very caring and competent nurses took by place –Katie W helped with my prep notes, but it was just so personally punitive , to be “yanked off the case” instead of the promised alternating… it finally ended up in an ethics conference discussing boundaries , and my special violations of sending vacation post-cards and singing at Christmas…this did definitely cross a line for me – the causing of totally unnecessary and truly unethical emotional pain for poor Rose…it was just a power struggle over hours paid and “patient demands” vs VNAB control…in the discussion I had with the Veep of Ethics she commented how infrequently an MD contacted the VNAB and how Rose’s PCP had requested to have me put back on the case…and finally I was ,seeing Rose frequently and this was our last visit …we really had an unusal “therapeutic “/friendly nurse –pt relationship – I have such respect for her bravery and empathy for her suffering …we parted with a hug and some tears from both… and an intention to keep in touch and revisit at Christmas…
Daisy G- a one time encounter, lived in the revitalized Orchard Park where I had picked up trash so many years ago when it was so delapidated , but still a high concentration of ailing individuals and families…Daisy was bed bound,somewhat demented but pleasant and well cared for by her grand-daughters –reminder with the confusing orders and primary caregiver not at home ,go with the flow listen respectfully and with good humor to the patient and family , stick with the care basics,document well and leave a voice mail as needed for good communication and continuity –later of course for me as I jot down notes in the home, finding the computer a barrier there ,just a reference ,and much more effective when I can recollect my thoughts quielty later= works for me.
Aida – my very last patient ,had not answered when I called earlier ,but I tried again (persistance) and she did. I had admitted her a week or so before for a rather large arm abscess due to IV drug use…she was in her 40’s, good pesonality,bilingual, married, adult child and had said the abscess happended from a fall…I had not pursued the IVDA at the time feeling it was not useful…just tried to be a good ,supportive nurse ,make the dressing change easy, pain managemment effective , and complications less likely. I was surprised when she told me that she had gone back to a program, had had a hard time for the past 6 months ,relapsed,but was back doing what she needed to. We talked about that , her plans - I briefly told her that her about our plan and that she was indeed my last VNAB patient. She gave me a sincere hug and thank you as I left for the cab-that’s it the last patient, probably my last caregiving in an inner city home after 15 years …
the last cab ride to the Braintree office another unique aspect of this nursing experience – I had worked in the Harbor and Hyde Park offices each such odd space ( with “Reactonary/Recovering Rich” BC High 1955, wife a former nun , Principal of Cathedral, basically a good hearted if slightly odd felllow a devotee of politics local and national,smart but rather acidic…so many drivers over the years St Clair my street pal, Benny with the bootlegged videos in the front seat, Dick who had headed the MBTA Police and suffered a major political appointment upset and downturn in fortune rna for kKingston selectman and I wrote his main pitch letter, Steve of the horrible breath night and color blindness and awful reflexes but also in recovery and recovering from the loss of his wife, Al so eccentric and happy go lucky, with a gallon jug of urine in the front seat because he would not stop for a bathroom break , who conducted his passenger surveys and driving so slowly would proclaim “every time they honk it’s a victory for our side “ and sincerely that “the city is ours”, Cavenack a gentleman and entreperner from Haiti who had imported cars and busses to sell for cash on the Port au Prince dock, whom I had to lift the cab off when it slipped off the jack in the Burger King parking lot – “I planned it that way” , and a host of others so often leasing for up to $100 daily plus gas other expenses before a dime for themselves and driving for 12 hours a day for weeks on end here from Sudan because there was better opportunity here than as a doctor or dentist there…)
An on this last day Cyndy and I had checked in with each other as we usually did and unusually we were able to rendez-vous back at the office; I cleaned out my stuff and we were able to adjourn to Bertuccis for a celebratory early supper= we made it safely! I finished the laptop documentation by 10:30 (never a 12 or 7.5 hour day for me- as I joked I never got the keys to the time machine at orientation ) or so at home and “transferred” in and that was the end of the last day.
We had told our colleagues that we did not want any gifts or to go out and that we would bring a light breakfast in the RV the next Sunday 9/7 (fortunatley a hurricane side swiped us and aftrer some wild wind and rain blsted through and the sun was out in the AM. We turned in our laptops,some required items and adjourned to the parking lot - had left the driver’s door open for the first time and there was a great sign= “Just Retired”…and we munched ,opened funny and thoughtful gifts and very generous giftcards from Jayne,Maura,Rhonda (discharge orders) Diane ,Val,Anne and sister Joan came in on crutches, Dennis-writer/actor /film-maker /bi-lingual nurse who had recently returned from a year in South Africa with his wife ,and Rachel who had cared for our unforgetable patient Jim Tyree years ago …it was a lovely send off …and Cyndy and I skipped out the door hand in hand, so very fortunate and grateful for the work we had done, the folks met and cared for and learned from and with such a wonderful road ahead!!!
Addendum – because it summarizes as well as I can the 15 years ,the longest and most intensely,most challenging and most meaningfully I have worked in my life…
Dear Maura Vitello, Managers and Colleagues:
cc- Joanne Handy, Keren Diamond…
As I stated verbally in March of this year after almost 15 years at VNAB I will be resigning as of Labor Day, Monday, September 1,2008.
I attached this comment to my last evaluation: “ I will continue each day to take the 2/4-6 or equivalent assignment I am given, help as requested, and give the most efficient and compassionate care to each patient I can.” I sincerely believe that I have done just that.
Of course, not being the “shy and retiring type”, I would like to share briefly some reflections and perspectives.
After 14 years as a High School English Teacher (in Randolph and Silver Lake –Kingston) with an involvement in health education programs for the Silver Lake School District, I was inspired (and still am) to be a nurse by my Family Nurse Practitioner wife Cyndy. After graduating from Quincy College School of Nursing in 1991, I ‘had my baptism by fire” in Med/ Surg at Cambridge Hospital, then moved on to a long established weekend program at Spaulding Rehab which was eliminated just 7 months later. Having been The Quincy Visiting Nurses’ first male home health aide (with Carol Morris as my manager and supporter- small world!) during my nursing school training, I was drawn to community health and had two immediate opportuities - weekend positions at Quincy Visiting Nurses or VNA of Boston.
I chose VNAB for the opportunity to serve the inner-city community, where my parents and in-laws had grown up. The experience has been truly extraordinary in so many ways over these years! It has been both such a tremendous gift and challenge to be a VNAB nurse- first of course (as we all do) to try always to be a “healing force” to the degree possible in the lives, families and homes of the thousands of patients I’ve encountered. I could write volumes (and maybe I will, anonymously of course per HIPPA) about these profound, unique, unusual, delightful, depressing, somewhat “dangerous”(as in the time I had arranged to visit calling at 9AM,confirmed with pt and no answer to door at 10AM, pt had been murdered within that hour...what if?), but ultimately inspiring and life enriching experiences. So many times I have been amazed by the strength, resiliency and spirit of patients who are disabled, infirm or elderly as they cope with seemingly insurmountable health and environmental challenges, even being part of some stirring “home-going” ceremonies along with family and friends when death inevitably came, but faith and hope and love remained.
It has been a real challenge to give the care- the weather, home conditions (from the most impoverished apartment /rooming house/shelter, even a few fields and cars to a wealthy architect’s penthouse), through community parades and festivals and the truly daunting documentation – from the hand charting in the Harbor Office in the extremely wearying wee hours- that 24 hour position = mostly 34 hours, up to 37 hours from Saturday AM through Monday AM, to the current “fujitsu laptop data headlock”. Always it has been the dedicated and donated efforts of the nurses keeping the Agency afloat in the tempest of today’s healthcare- For my own part I calculated several years ago that I had donated at least 4000 hours of “free time”- but that’s another story. It has been such a privilege to work with and learn from so many talented and dedicated nurses, therapists, staff and managers-especially my remarkable team-mates on the Southwest Weekend Team.
Most special, indeed unique, is that Cyndy and I have shared this chapter of our lives as nurses at VNAB, she on the MCH team and I on the Adult. In addition to serving as MNA representatives, and sharing the general Agency “trials and triumphs”, we have had shared patient encounters. On a few occasions I have seen a patient for a C-Section dressing change and Cyndy arrived to care for her newborn, or I could alert the new Mom “when your baby comes home, your nurse on the weekend might be my wife”, or Cyndy might do a BP check in the AM and I would do the PM follow up. What other couple is so fortunate to have this commonality?
Of course both being nurses, I for 17 years and Cyndy for 33 years, 26 of them as a Family Nurse Practitioner, we have every nurse’s sense of how precious,
Fragile and finite life is. For that reason and because and while circumstances allow, we have decided to ‘retire early’ and it’s more of a renewal, really, to have as much time together as possible. For the next 5 years, at least, we plan to travel the eight winter months around North America in our ‘eco’ motor home with four summer months at home by Quincy Bay. We intend to write, stay environmentally active and do some nursing work and volunteering.
All my best to each of you and yours personally and professionally. Continue to take the best care possible of yourselves and your patients.
Gratefully,
Mike Cotter, RN
5 Post Island Road Quincy, MA 02169
postisland@verizon.net
(In memoriam – St Clair Brathwaite- my cabdriver and friend on the streets, August 1997, Age 49 and Sandy Grant-wonderful teammate, human being and superb Nurse, April 2006, age 37 – both of you are remembered always...)
Wednesday, January 12, 2011
Richard Nixon and Toilet Training Negativity
Richard Milhouse Nixon and a Toileting Travesty
A Freudian Foible)
In 1972 our son Joe was two and we were twenty-two. I remember well what the Republicans called “the clearest choice of the century” Nixon vs. McGovern. It was indeed “the clearest choice” for my wife Cyndy and me and it stirred us to some at least token political activism distributing pamphlets for the Democrat McGovern and the platform for social change, equality and peace. WE were tearful and down-trodden as we watched the election results, a Nixon landslide with Massachusetts the only state which gave McGovern a majority. Later I would proudly drive around with my “Don’t Blame Me; I’m from Massachusetts” bumper sticker as it became “perfectly clear” what the national majority had chosen. Yes indeed, you can fool almost all the people some of the time. We even drove south,stayed ironically at Fort McHenry of Star Spangled Banner fame (we knew a kindred spirited National Park Service Ranger stationed there) and we attended the “Counter-Inaugural” protest organized by the loyal dissenters. We came face to face with some frightening police (state) crowd control tactics in response to what we considered totally acceptable free assembly and expression. The “Tricky One” even crossed our path in his motorcade and I swear he seemed to glow/gloat with a very strange aura as he was surrounded in all directions by motor cycle police, rooftop snipers,troops and choppers in the air. Returning to Boston with our civics lesson set firmly, we were delighted to open the weekly alternative Phoenix front page which carried a picture of President Nixon with the jagged teeth of “Jaws” ,the movie non-hero of the time superimposed on RMN’s mouth. As an expression of domestic political protest I cut the photo out and taped it irreverently to the inside cover of our toilet seat so that in effect we could “dump” on Nixon even as he “dumped “ on us. I thought no more of it and the photo disappeared sometime during the next months – or the next thousands flushes.
Not too long after this we commenced our first toilet training experiences with Joe a la Dr. Spock- gentle encouragement ,praise ,reward ,etc. ,but Joe was very reluctant. In fact, over the ensuing months he was fretful and even fearful in response to our regular BM training attempts. He would hold in for long periods and finally go in his underpants to his discomfort and our frustration. (One time he refused to admit that he had gone in his pants ,insisting that “the dog did it!} Despite our cajoling, story telling ,playing etc he would have no part of the toilet and our training was becoming a rather traumatic ordeal. We became involved in some therapeutic “anal”ysis and as Joe did his “clay play” it was obvious that he was fixated on the toilet as a painful ,”biting “ experience…Oh,oh! To be honest I think at first I repressed the truth of the Nixon/Jaws connection probably out of guilt that my act of political potty protest had had such an adverse effect/association for my beloved son. Oh the guilts! How could I have been so insensitive? But , I had a brainstorm in response. Batman (the original television parody ,not the subsequent dark,pop culture hyped item) was omni-present in ads and related toys. I cut out a picture of Batman ,taped it to the underside of the toilet seat where the offensive Nixon/Jaws parody had been and as the “official prosecutor is my witness", Joe did his first self-gratifying bowel movement on the toilet that very afternoon! Was this a clear case of psychic image replacement? From that time Joe demonstrated no toilet trauma, but a distinctively retentive personality.
It was a different type of sinister plumbing (Watergate) which led to Milhouse's evacuation from the White House not much later. I celebrated as the President who had had such a negative impact on us chose his infamous position in the “annals “ of the Republic!
For Human Growth and Development ,QJC 9/25/89
A Freudian Foible)
In 1972 our son Joe was two and we were twenty-two. I remember well what the Republicans called “the clearest choice of the century” Nixon vs. McGovern. It was indeed “the clearest choice” for my wife Cyndy and me and it stirred us to some at least token political activism distributing pamphlets for the Democrat McGovern and the platform for social change, equality and peace. WE were tearful and down-trodden as we watched the election results, a Nixon landslide with Massachusetts the only state which gave McGovern a majority. Later I would proudly drive around with my “Don’t Blame Me; I’m from Massachusetts” bumper sticker as it became “perfectly clear” what the national majority had chosen. Yes indeed, you can fool almost all the people some of the time. We even drove south,stayed ironically at Fort McHenry of Star Spangled Banner fame (we knew a kindred spirited National Park Service Ranger stationed there) and we attended the “Counter-Inaugural” protest organized by the loyal dissenters. We came face to face with some frightening police (state) crowd control tactics in response to what we considered totally acceptable free assembly and expression. The “Tricky One” even crossed our path in his motorcade and I swear he seemed to glow/gloat with a very strange aura as he was surrounded in all directions by motor cycle police, rooftop snipers,troops and choppers in the air. Returning to Boston with our civics lesson set firmly, we were delighted to open the weekly alternative Phoenix front page which carried a picture of President Nixon with the jagged teeth of “Jaws” ,the movie non-hero of the time superimposed on RMN’s mouth. As an expression of domestic political protest I cut the photo out and taped it irreverently to the inside cover of our toilet seat so that in effect we could “dump” on Nixon even as he “dumped “ on us. I thought no more of it and the photo disappeared sometime during the next months – or the next thousands flushes.
Not too long after this we commenced our first toilet training experiences with Joe a la Dr. Spock- gentle encouragement ,praise ,reward ,etc. ,but Joe was very reluctant. In fact, over the ensuing months he was fretful and even fearful in response to our regular BM training attempts. He would hold in for long periods and finally go in his underpants to his discomfort and our frustration. (One time he refused to admit that he had gone in his pants ,insisting that “the dog did it!} Despite our cajoling, story telling ,playing etc he would have no part of the toilet and our training was becoming a rather traumatic ordeal. We became involved in some therapeutic “anal”ysis and as Joe did his “clay play” it was obvious that he was fixated on the toilet as a painful ,”biting “ experience…Oh,oh! To be honest I think at first I repressed the truth of the Nixon/Jaws connection probably out of guilt that my act of political potty protest had had such an adverse effect/association for my beloved son. Oh the guilts! How could I have been so insensitive? But , I had a brainstorm in response. Batman (the original television parody ,not the subsequent dark,pop culture hyped item) was omni-present in ads and related toys. I cut out a picture of Batman ,taped it to the underside of the toilet seat where the offensive Nixon/Jaws parody had been and as the “official prosecutor is my witness", Joe did his first self-gratifying bowel movement on the toilet that very afternoon! Was this a clear case of psychic image replacement? From that time Joe demonstrated no toilet trauma, but a distinctively retentive personality.
It was a different type of sinister plumbing (Watergate) which led to Milhouse's evacuation from the White House not much later. I celebrated as the President who had had such a negative impact on us chose his infamous position in the “annals “ of the Republic!
For Human Growth and Development ,QJC 9/25/89
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