On a Wing and a Prayer

I live in a conservation community near the Savannah River. Since moving here,  I have walked out my back door and seen many things that nature has on offer. A sleek black snake draped from a tall plant over the edge of a wooden boardwalk, luxuriously sunning himself and oblivious to me. A Cooper’s hawk, silently settling into the tree in front of my kitchen window, then picking off an unsuspecting baby mockingbird with deadly accuracy, snuffing out its life with a powerful clawed foot, then soaring away with him as I watched agape. A fat beaver, lazily sloshing about in the shallow water of a creek tributary, looking up at me, inquisitive, then swimming slowly off toward the creek, broad leathery tail rippling the water behind him.

I saw a beautiful sight early one morning on the way to work. It is one that always makes me smile.

There they were, two beautiful creatures with compact heads, long, straight, thin necks, plump bodies and powerful wings. They flew side by side, wings almost touching, like the pairs of Marine Corps fighter jets I’m used to seeing rocket by overhead when I’m at the beach on the coast of South Carolina. Less than thirty seconds later the main body, the vee formation we’re used to seeing at change of seasons, chased the pair and no doubt were trying to get the whole group back together.

Geese fly in this characteristic formation for very specific reasons. Among them: the ability for all of the geese in the formation to see each other, to watch each others’ backs, as it were; the need for only one member to bear the brunt of flying point, against the most wind resistance, at a time, allowing others in the party to expend less effort; to provide for an easier “middle ground”, the center of each arm of the vee, where members can expend the least energy and rest a bit; and the ability to rotate from one of these positions to the other and round again, working hard at your turn but then regaining strength and preparing oneself for the next round of effort.

This flying formation, copied by squadrons of fighter jets, allows these beautiful birds to fly for hundreds or even thousands of miles, helping each other along the way, attaining a common goal. Now, what happens if a bird gets sick or injured, such as by a hunter who wings it? That poor fellow must sometimes turn away from the formation, banking and descending and heading for the ground to a safe haven, where he will either get well and rejoin his fellows, or where he will die. Does he do this alone? Of course not. One or two of his fellows follows him down, never leaving him. They are there for him to help him rejoin the group at full steam, or they are there to help ease him out of the world. If the latter occurs, they rise back up and catch up to their kin, ready take their places back in the formation and keep flying. Even when one is lost, the group sustains itself, and life goes on.

I know that many of you who read Musings are hurting today. Some of you have seen friends and family leave the safety of formation, follow their loved ones, only to deal with the awfulness of death. You may be trying to help them rejoin the group and fly again. Some of you have been that injured member who must stay behind. Some of you have been shot out of the sky by life’s cruelties, grounded for good and dealing with pain and suffering. You are hurt, angry and wondering why. Some of you are crippled in mind, some in body, some in spirit.

The things we can learn from nature in these times of trial are elegantly simple and profound. We can learn to take our turn at being the one who must face the gale force winds head on, cutting the sting of the rain and making it just a little more bearable for the ones who follow behind us. We can learn that there is a time to let go of the control and drop back to the safety of the bosom of the formation, letting the ones who fly point and the ones who bring up the rear do most of the hard work, while we regain our strength in the center. We can allow ourselves to heal. We can learn that there is a time to be close and to support a fallen comrade, but that there is also a time to say goodbye and to let go. It is after that goodbye, in its hushed quiet or in its regal and terrible pomp and circumstance, that we must decide to once again spread our own wings, rejoin the group that still labors, and fly on. We cannot stay on the ground. That is not our nature. We are built to soar. We are built for community.

It is programmed deep within these beautiful birds to cut drag and resistance to a minimum, and to experience life to the maximum.

In their misty morning flight they silently teach us, if we will only listen.

The End

My cousin’s fifteen-year-old son committed suicide.

Caught up in activities with school friends that got out of hand, he had made a promise to do some things that did not go the way he planned. Sick and afraid, at church with his family, he had his mother take him home. She put him to bed, then went downstairs to get him some water. A single shot rang out. He had been so afraid of disappointing his parents, getting into trouble with them, that he made a decision to take his life rather than to face what seemed like insurmountable troubles. His devastated parents, who were so proud of him and loved him unconditionally, would never have the chance to explain to him that a parent’s love is not predicated on perfection, but on a bond so strong that even death could never break it.

Halfway through the year in Aiken County, we had already had twenty-one suicides. Twenty-one people who decided for myriad reasons that life was unbearable, that there was something better, that they were too ashamed to go on, that the hurts were too harsh or the damage too deep. Some probably left notes. Some probably left clues pointing to what was about to happen. Some probably made the decision, told no one and carried out a plan that they saw as redemption. I don’t know the stories behind the decision to end each one of these lives, but I’m sure there were stories to share.

Who were they? Nineteen of them were males and two were females. Their ages ranged from sixteen to ninety-five years old. Nineteen were white, one was black, and one was Hispanic. Eleven of them had alcohol or other drugs on board at the time of death. Overwhelmingly, they killed themselves with guns. Fifteen males decided to end their lives using guns.

Do these numbers, our numbers, mirror the national ones? According to an article in the Wall Street Journal, “To Lower Suicides, Methods Matter”, by Jo Craven McGinty, 47,173 people killed themselves in 2017. This was up from 29,350 people in the year 2000, according to the American Foundation for Suicide Prevention and the Centers for Disease Control. Suicide is the tenth leading cause of death, according to the CDC. Those at greatest risk are white males, middle aged white males. People like me, and probably like a few of you reading this column, folks. In 2017, white males like me accounted for seventy per cent of all suicides. White women accounted for nineteen per cent. Men of color made up eight per cent, and women of color only two and a half per cent.

Firearms are the most common method of suicide used by men. In 2017, fifty-six per cent of males who committed suicide killed themselves with a firearm. Do our Aiken County numbers mirror the national ones? I think that is easy to see.

One thing that I found fascinating about the Wall Street Journal article was that whether someone acts on the urge to commit suicide may hinge on having access to their preferred method in a moment of crisis. Because of the percentage of suicides involving guns, wrote Ms. McGinty, the American Foundation for Suicide Prevention and the National Shooting Sports Foundation are working together to encourage the safe storage of firearms. I am not personally against guns by any means (I do not own guns at this time, but I have a younger brother who has been an avid hunter all his life), but the bleak statistics involving firearms and deaths by suicide are simply too awful to ignore. If someone is struggling and has access to an unsecured and loaded gun at the time of their most severe crisis, tragedy is simply too often the result. Blocking access to this most lethal of methods may indeed save lives.

In the world of mental health treatment, we already do a fairly good job of screening for issues including suicidality and plans to harm oneself. However, given the statistics above, we must do better. Eighty three percent of those who die by suicide have seen a health care provider in the year before their death. Aiken-Barnwell Mental Health is using the Zero Suicide initiative (www.zerosuicide.com) to address this terrible problem. This system uses evidence-based tools, systematic practices, and embedded workflows to strive for continuous quality improvement in the assessment, screening and addressing of suicidal ideation in everyone who walks through our doors. It involves systematic changes and improvement in training, identifying those at risk, engaging in a meaningful way, treating suicidal thoughts and behaviors, and making good transitions to ongoing care and follow-up once the acute crisis has passed.

What can you do?

Remember this number for the National Suicide Prevention Lifeline: 1-800-273-TALK.

Secure your guns if you own them.

Listen. Ask questions. Respond. Act.

Consider participating in the Out of Darkness Walk on November 10th at 2 PM at the H. Odell Weeks Activity Center in Aiken.

I have lost patients, family members, neighbors, and coworkers to suicide. I wager that many of you reading my column this week have had similar experiences and losses. It will take all of us working together to bring about meaningful change that leads to the end of suicide.

A Very Busy Day

I am up early on this day that is to be another scorcher. They say it will not quite reach ninety today, which is good. A heat index of one hundred is not my friend. I don’t tolerate the biological steam, outside and in. I grow weak and faint sometimes. I get angry. My temper gets short. Things irritate me. It happens.

Breakfast would be nice. It may be the most important meal of the day, but for me it’s the hardest to come by. The kitchens and churches are not open yet. Lunch, ah, yes, lunch will be no problem if my feet don’t fail me. If I can make it down the hill-wheeeeeee-pushing the cart that contains everything tangible, touchable in my life, I’ll get lunch. A hot lunch on a hotter day in a numbingly cold room. Why do churches think common areas have to be so freaking cold? Am I complaining? No, not really. It’s a mini-respite from the baking air. Sit in the corner, back to the wall, always know my exit. Keeping my ear to the ground, scouting out dinner. Always looking for the next meal. It’s part of the job.

I see the same cars come down this hill every day. Same cars. Some shiny and new. Some old and battered. Some middle-aged, slow and barely functional, like me. I wonder if they see me, those cars and their people. I stand right here, like I do every morning, one hand on the cart to balance me, stretching, stretching up to the lightening sky, stretching out the kinks that come from a night on the ground. The other hand clutching the tattered cardboard sign, my calling card, my resumé as I apply for one more day of life on the street. It’s getting warmer already. Calisthenics make me hungry.

My appointment book is full today. Social services, paperwork to fill out, deadlines to meet. Church, via the back door of course, never the front door, oh, no, never the front door. Discretionary funds can be lifesaving. I wonder if they are ever afraid of me, these pious friends and benefactors of mine. I read the papers. You’re surprised at that, aren’t you?  I know about shootings at mosques and churches. I carry an old backpack everywhere I go. Do they look at me and wonder? Do they see Jesus in me, or do they see Dylann Roof? Do they cringe when I open it? Do they expect a gun? A bomb? A half rotten banana peel all mottled brown and musty smelling?

Soup at the kitchen for lunch, but I’ve already told you about that. Sorry. I like the soup and the company. The cooks see me and talk to me. My downtown stroll in the afternoon. The air is cooler by the river some days. The river is always peaceful. The shade under the old bridges is nice too. The stench not quite so. But the shade. In the heat of the day, the shade is cool gray friendship in a bright world of hurt. Mental health before closing time at five if I can get a ride there. Two strikes and I’m out. Can’t afford to miss this appointment. No show, no meds. They have their rules, I know. I like my counselor. My doc is all right. The one who knows the most about me at the mental health center? I’ll let you figure that one out.

I’ll have a dinner date on the square tonight. She’s usually there, and she shares. Oh, mind you, it’s just platonic. What? Are you surprised that I know that word? Via Latin from the Greek, I think. I’m not so different from you, in that way. My mind works just fine most days, if I take my meds. It’s just my community that fails me sometimes. You know.

It will be a very busy day. You’re surprised again, aren’t you?

Ah, my friend, don’t lose a minute’s sleep over it.

I’m not homeless, really.

Like my blue mental health center sticker says, I’m just a Visitor here. A wanderer. A wayfarer.

We’re not so different, you and I.

 

Grief

I had a brief, quiet, intense conversation with a friend today. She had just lost another friend, a close one, to a sudden and tragic accident.

“How are you doing?” I asked.

“Okay,” she replied, as she turned to go up the hallway. In a second, I knew better. “No, not okay.”

Her usually bright smile was strained, her voice soft, her features drawn.

That brief exchange, the sharing of feelings about trauma to mind, body, and soul, did what those exchanges almost always do to many of us. It triggered, instantly, my feelings and memories of the death of my father twenty four years ago.

As I have written elsewhere recently, I can’t help but wonder how dozens if not hundreds or even thousands of people are dealing with these kinds of reactions and feelings as we have been assaulted on every level by hate, destruction, and death. This on top of expected deaths from old age, deaths from illnesses that are not expected but are accepted, and accidents that leave us jarred, numb and questioning everything we’ve always held dear.

“Your father has collapsed.”

The call came at the worst time possible. We were moving into a new house, we needed to pack, and someone needed to watch the kids.

“I don’t know. Your mother is with him. They’re taking him to the hospital now. I don’t know.”

I am in the car in what feels like minutes. I don’t think I even take a toothbrush, although I really don’t remember.

“Call and let me know as soon as you find out something. We’ll be fine heel. Go.”

“Take all the time you need. We’ll cover things here. Don’t worry. You need to be with your mother. Go.”

Racing down the interstate in slow motion. Time flying by as it stands stock still. Tears and prayers and more prayers and more tears and time flying by with the miles.

“Don’t you die on me. Don’t you die before I get there. Hang on until I get there.”

There are still so many things unsaid. The scenery blurs, clears, blurs, clears, blurs, clears. My eyelids are the windshield wipers for my soul. Is it raining outside? No, it is raining inside. Come in out of the rain. I can’t. I’m getting soaked.

“Don’t you dare die on me.”

The time in the hospital is a blur. The waiting room. The ICU. The doctor. The staff with their kind eyes and kinder manner. My mother is broken, silent in the corner. I have the knowledge but not the will. There are decisions to make.

“We can make him better. We can rebuild him.” A part of my brain laughs hysterically at the thought of the old television reference, so stark against the sunshiny darkness of his bed. Beep, beep, beep. We can never rebuild him. I have seen the scans. They show me because I am a doctor. I see the vast whiteness in his brain. Clean, pure, permanent. I know what this means. I do not want to be a doctor. Oh, God, not now.

I try to support my mother as we walk up the aisle in the church. I see little. I remember little. His mother, my grandmother.

“Oh, parents are not supposed to outlive their children. Oh, ohhhhhh.”

We travel. We talk and eat and visit with folks who have known me since birth.

“Oh, how your children have grown and I remember when your Daddy…”

They put him in the ground. It is hot. Why do people die in the summer, that hysterical part of my brain laughs, way off in the distance. It laughs and laughs so that it will not cry. They put him in the ground. My little sister is there, off to his side. Others are already there waiting for him. Waiting for all of us, I think. It is so hot and the hole in my chest is so huge that I cannot get enough air. I am drowning in the middle Georgia sunshine.

Six days later I am working in an air conditioned emotional bubble. I do what I know how to do the best I know how to do it.

Six months later, I open my closet door and see the stack of papers there on the floor beside the filing cabinet. Odd, I think. That’s not like me. I sit down and go through them, filing and getting things back in order. I feel like I have just awakened from a half year’s dream. No. A nightmare.

Twenty four years later, I think about him every day. Every. Single. Day. It is not unpleasant. It is not painful. The scar over the huge chest wound is thin and tenuous, but it holds.

When change jingles in my pocket, or when someone mispronounces a word the way he did, I smile. When I hold my grandchildren in my arms, the way he held his the day he died, I feel proud. He is here with me. He will always be with me.

As my mother once described it, I am not happy with what happened, but I am content.

This is grief.

This is life.

The Will to Live

The parents, Jordan and Andre Anchondo, had just dropped off their five year old daughter for cheerleading practice. They drove to the Walmart in El Paso with plans to buy school and party supplies, as that same daughter was turning six and had a party coming up that afternoon. They had just celebrated their one year anniversary on July 30, 2019. They had just built a new home together. To hear their extended family members talk about them, they were happy people, loving parents and had every reason to think that the start of school, birthday parties and cheer practice heralded the beginning of a wonderful academic year.

They parked with dozens of other families with similar purposes in mind, got baby Paul, age two months, out of the car, and went inside to start their shopping.

Soon, shots rang out. One, two, three, then groups of shots. Rapid fire. Pop, pop, pop, pop-pop-pop-pop. Instinctively, for how else could it have happened, Jordan enfolded and protected and shielded her tiny child from the rain of bullets. In that desperate moment, she must have known that her entire reason for being, her entire driving force as a human mother of this fragile, helpless infant was to keep him alive. She must have had little if any time to think about herself, her own wellbeing, her own life. She had one purpose. She rose to it with infinite love as only a mother can. She cradled Paul.

Her husband Andre, whose life had been immeasurably blessed by his time with this woman, by her love for him and their love for their newborn and the rest of their family, heard and saw what was happening. We can only imagine that, like Jordan, he had precious few seconds to ponder the situation he found himself and his family in. He had little time to weigh his prospects, craft a plan. He could not afford the time it would take to decide. He acted, jumping in front of his wife and only son, shielding them from the murderous hate that came for them in a stream of deadly projectiles.

Andre died.

Jordan, blood flowing, succumbed to the onslaught of bullets and fell to the floor, never failing to protect her son. When the moments of terror ceased, little Paul was pulled from under his dying mother’s body. He suffered broken fingers, but he was alive. His mother, Jordan Anchondo, would never hold him again.

The will to live is a psychological force to fight for self-preservation at virtually any cost. There is an element of conscious and unconscious reasoning behind it. Wikipedia tells us that German philosopher Arthur Schopenhauer first named this force that keeps us alive. There are other drives, as you are well aware, including the drive to find food and shelter, to find a suitable mate, to reproduce, to maintain dominance over others, and to connect with others of our own kind. Psychologists agree that all of these biological drives are important. Paramount, however, is the drive to exist, to live, to continue our lives. We, as biological beings, must ensure the preservation of the species. Absent this, of course, literally nothing else matters.

We do what we do, in all sorts of conditions and circumstances and situations, to stay alive as long as we possibly can. We survive abuse. We live through terrible wars. We battle cancer. We seek treatment for addiction to alcohol and drugs. We even cradle our tiny, helpless children in our arms, shielding them from almost certain death, even as we are willing to lose our own lives to save theirs, to make sure that life goes on.

We will push for survival at all costs, even at the brink of sure and certain death.

Self-preservation has two components, pain and fear. In the El Paso shooting, we must believe that the fear component lead to safety seeking, a rush of adrenaline, increased physical strength in the moment, and markedly heightened senses of sight, hearing and smell. Jordan and Andre knew, consciously and most likely unconsciously, that they were in a fight for survival, and they acted accordingly with little hesitation.

An article in Stanford Medicine teaches us one more very important aspect of this drive and its interaction with the possibility of imminent death.

The will to live involves hope.

Hope is manifested by a positive attitude, a view toward the future and one’s place in it.

Hope, almost paradoxically, also involves acceptance of one’s fate in life, even when faced with a hailstorm of bullets.

Live your every day with gusto. Have hope for the future. Mourn the loss of precious life, but embrace the tenacious will to go on that allowed two courageous parents in El Paso, Texas to pass along the gift of life to their two month old son.

About Face

FaceApp is the newest craze.

Make yourself younger.

Make yourself older.

See how ___________ (fill in the blank: much younger, much older, gorgeous, handsome, ugly, wrinkled, terrible!) you will look in five years, ten years, twenty years.

We are preoccupied with our looks, for good or ill. Selfies give us instant feedback. Tagged posts keep us honest. (I really do look like that?) We watch ourselves age, day by day, on social media.

Look, we are where we are. In life, in our careers, in school, in our family position, in our climb up the corporate ladder, in our steady, inevitable march toward the end of our lives.

The future will get here soon enough. Why push it, for goodness sake?

Do you want to enjoy the journey, feeling things, noticing things, accepting changes in your mind and body as you age? Do you really want to catapult yourself photographically or otherwise (Back to the Future movies notwithstanding) to age ninety, just to see how may wrinkles and chins you’ll have?

I am changing physically, and some of it I DO NOT LIKE. My stamina is not as good as it once was. I am not as physically strong. My body shape and composition are changing. My clothes don’t fit the same. None of these things keeps me from being as active as I can be mentally and physically. I try things. I push myself.

Try something. Turn your attention inward this week. Forget about your changing face, just for a week. Lines mean character. Gray means experience. Aches and pains mean you’re up and moving. “Only physically active people get these kinds of injuries,” I was once told in the ER after breaking my leg on sliding a bit too aggressively trying to stretch a single into a double.

LIVE YOUR LIFE. Don’t just document the hell out of it.

LIVE IT.

You will age, most assuredly, in good time, whether you use the newest app or not.

I can guarantee it.