Breaking Elizabeth: Background

Love

When we were 16 years old I’d told him I thought I was in love with him at a high school dance. His face had shown the shock, and it made me giggle inside. I hadn’t really cared at that point if he said he wasn’t interested, but he was interested and we started dating. I swelled with excitement, happiness and contentment when I saw him. Our first kiss is still vivid in my mind, laying on the grass in the sun at sixteen, with the world seeming so solid, open, and bright. my lips tingled and the sensation spread to my toes. I remember falling in love with him. About 6 months into dating we were talking on the phone and he started talking about physics, astronomy, Einstein, newton, and I was hooked.  Not only was he cute, sweet, and caring, but he had a brain underneath that surfer-dude haircut. I loved how much he loved his family and how other men looked to him for advice and to share confidences.

He went from my “practice boyfriend” to my everything. I would have died for him, but that’s not saying much. To die is so easy. One split second decision to jump in front of a bullet perhaps. I’d die for any of my friends or family. It’s more to say that I lived for him, that I chose everyday to choose him, and try to put him/us first. I considered him in everything, my choices and decisions were all filtered through him and what would be best for us.  I lived for us.

A year after we started dating, he started struggling with the overwhelming feeling that God didn’t want us to be together and he broke up with me. I was devastated in the way you are when your first love leaves.

A few months later I was in a car accident. T-boned by a truck running a red light. I broke the window with my head and had a pretty severe concussion. We hadn’t spoken in a few months, but I had called him the night before because we had run into each other. He was the last person I’d spoken to on my cell phone, and the person who ran up to see if I was okay just called my most recent contact. He notified my family and came to the hospital. I don’t remember that day, but he was wiping blood off my face and taking care of me. We started hanging out and got back together by the end of my senior year. He was still my everything.

We did long distance for a few years. I went to Africa and worked in a school/orphanage before I started college and he went off to a bible college to become a pastor. I was looking for direction, I wanted to help people, but I didn’t know how. The nurse on the compound made such a difference for the community and it seemed like the perfect fit for me. I came home with my purpose and powered my way through school, getting my bachelors in nursing in 3 1/2 years.

Our protestant christian religion was everything to us back then and we did everything we could to “walk with God.” We were heavily involved in our church, lead bible studies, ran sound for the services, went to workshops, fed the homeless. We debated theological principles and learned a lot about the inner workings of religious explanations. God was our focus and we pursued our faith with happy hearts.

We spent our time talking and connecting. We talked easily, and for hours about anything and everything; pondering morality, meaning, purpose, etc.  He was my best friend, and I loved him more then anything. With every anniversary, I was surprised by how happy I still was. I was happiest with him, being around him, cuddling with him, talking to him. I was proud to be his woman, and felt like I was the luckiest girl in the world.

I was caught off guard often throughout our relationship by how much he loved me. He genuinely thought my eccentricities were adorable. He encouraged all of my quirks and truly enjoyed all the parts that made me. A gentle giant with seemingly endless patience. I found so much joy in pushing his buttons, which he somehow thought was cute. I was his little woman. I knew he loved me. I could always see it plainly in the smile in his eyes when he looked at me. I saw that look all the way up until the month before he left.

 

Career

Austin never quite had the focus I did in the career arena. He changed his career path and degree plan multiple times a year. Pastor, Theologian Author, astronomer, mechanical engineer, car mechanic, biologist, chemist, philosopher….. the list goes on. He had a hard time settling, but I figured he would get there someday and I just had to be patient.

We planned to marry after I graduated nursing school, and my first hesitance came in premarital counseling. After he asked me to marry him, he was supposed to get a job and start saving for our life together. We were down to a month before the wedding  and there had been excuse after excuse for him not to get a job and just keep doing an occasional odd job for his parents. I became very concerned when he said, “I just don’t see why I need a job for us to get married!” I had been working since I was fifteen, and although my parents paid for my college, they instilled in me the need for good work ethic and the need to sometimes make sacrifices to live.

Austin’s parents had seemingly never instilled these values. He had always just quit anything he didn’t feel like doing anymore, and his family would blindly believe that there was no reason for him to continue whatever it was. His boss was a jerk and he shouldn’t have to put up with that type of treatment, his teacher wasn’t a christian and was persecuting him by giving him a bad grade on a test or paper, that martial arts instructor was weird and he deserved better. What was the point in him working? He should be focused on school anyway. When he dropped out or took a semester off it was completely acceptable to live at home, play video games, read philosophy books and get paid $20-$40 an hour to do chores around the house. To his family, Austin was a genius child who would do great things. There was no reason he should take a job that would make him work undesirable hours, or miss out on things he wanted to do. Austin felt the same way.

There was a serious disconnect in the way he thought about work and being an adult, and when that realization hit me, I considered calling off the wedding. Austin is a very genuine person, and he has this talent for making you see things the way that he does. I loved him, and I wanted to be with him forever so I listened to him when he said that he would work hard for us. I just had to trust his character, and I did. He is to this day, a very sweet genuine person.

We were married, and it was the happiest day of my life. There were the normal wedding hang-ups, but everything felt perfect and I was so happy. We were together for 6 years before we got married and hadn’t had sex until our wedding night. Looking back I think it’s a terrible idea to be abstinent until marriage. It caused a lot of dysfunction and guilt association with sex. We figured our way through it and got pretty good in the bedroom, but I think it would have been healthier if we had been able to follow a more natural progression of our physical relationship.

Religion

About 6 months after we were married, Austin started looking into Catholicism.  I was shocked, because it seemed crazy to me. He didn’t like the way the leadership at our church was treating him. They were very focused on the man being the head of the household and the woman submitting to her husband. The church leadership didn’t like him, partly because of me working to support us while he popped in and out of school, and partly because he wasn’t blindly following some of their strictly Calvinist theology. He was looking for there to be more God and less man in the decisions of the church and he thought Catholicism held the answers.

I watched and suspected that a big part of this transition had to do with the fact that he didn’t like that the leadership of our church didn’t recognize his, mostly subconsciously, self-assumed, unproven genius and promote him to the top right away. He hated the idea of having to work his way up. I, of course, knew he was incredibly smart, and that they should value his opinion. He is incredibly intelligent and made some very good points about the holes in their philosophy, which they were less than happy to hear. I was however unable to understand his aversion to working his way up from the bottom. I just didn’t realize at that point the level of entitlement I was up against. I didn’t realize that his feelings of entitlement were going to be a big problem.

Austin decided he wanted to finish his bible college degree, which he had dropped out of a few years earlier, and maybe be a pastor. We picked up and moved to Portland, but the day before we left he said he wasn’t even sure that he believed in God anymore. I was shocked. I didn’t understand the catholic stage, though I had tried to see his perspective, and I couldn’t fathom how he thought God might not exist. I thought it was just another phase. He would go through it and we would come out the other side. I knew for absolute certain that God existed and would lead us through this.

Three months later, Austin became an atheist and I was terrified. We had been married for a year and a half and I could never have imagined that the man I married could make such an extreme transition. I was afraid of losing him. I was afraid of what it would mean for our children to grow up with Mom telling them about God and Dad saying he didn’t exist.  I had grown up with a christian father and an agnostic mother, it was not something I wanted for my own children.

I was starting to stress about when we would have kids and the fact that we had been married for two years and Austin still hadn’t had a job. Yes, he was in school, but he was only taking a few very expensive classes and I was struggling to support us. my job was incredibly stressful and I was picking up a bunch of overtime. I was a nursing supervisor of a 77 bed long term acute care hospital. I was good at it, but I was stressed by the amount of responsibility I had and was throwing up nearly every morning before work. Add to that, my husband was studying to become a christian pastor and had decided he was an atheist. He wanted to drop out and take some time off to “find himself.” I stood my ground and told him he had to complete the last semester to get his bachelor’s. He could get jobs with a bachelors degree, even if it was in Theology.

During this time I remember telling him that I was feeling a lot of pressure trying to support us and asked him to get a part time job. He was in his last semester and had lots of free time, but there was always an excuse and I would buy it. He didn’t want to work on campus because he didn’t want to have the other students see him working, he didn’t want to work at a bank because it would be boring, he didn’t want to work for minimum wage because he was worth more then that.

Over Christmas I told my mom about what was going on and how stressed I was. She assumed I was going to leave him, and I was shocked. I had never considered leaving him, we were married and we would fight through it, right? He still loved me, he still packed me lunch, he was still my best friend. I just had to adjust my perspective of what I thought our life would be, and so I did. I didn’t want to have kids if we weren’t on the same page about religion and if he wasn’t able to get or hold a job. My situation wasn’t what I had thought it would be when I got married, but people said it would be hard. I had proven that I was willing to put in the work and I was never going to give up on him no matter what. I liked my job and career, we talked about him being a stay of home dad, but that wasn’t something he wanted. I decided to take kids out of the equation. I only wanted them because that’s what you were supposed to do, and as soon as I took reproducing off the table I felt a huge weight lifted. There was no more hurry to get things figured out so I could get down to baby making before 30.

I made a deal with Austin, he could watch his spending, cook, clean, and grocery shop instead of work and he liked that idea. Things settled down a bit and I started trying to research reasons for believing there was a god. I researched miracles and reached out in prayer for help, for the words to say for the reasons to believe. I thought that if I looked the reasons would be there. After about 6 months, I came to the conclusion that I believed in God because the people I trusted believed in God and I had always believed he was there because I wanted to believe he was there. My religion was slipping away, my God was dead. I was lost and depressed for a couple months after that. I had never lost anyone close to me and this was the closest thing to a death I had experience. I struggled to readjust, but Austin was there. He was with me and we could make it through this together.

We had to redefine our reality. I was afraid that since he didn’t believe in God he wouldn’t believe in marriage, because those were so linked for us. He said that marriage would mean what we made it mean. He loved me and we would make it work.

Changes

We told very few people that we were no longer Christians. We moved back home and just didn’t go to church. We had been involved in youth groups and bible studies and didn’t want to shake anyone’s faith by leaving the religion, didn’t want to field the attempts of people trying to bring us back to Christianity, and didn’t want our families to worry about us going to hell. There was still the chance that we could change our minds and there was no point worrying everyone. I’d never had to hide something like that before, and I found it incredibly stressful.

The filter we viewed the world through had been changed and the scenery was incredibly different. We could laugh at dirty jokes, say naughty words, watch stand-up comedians and not feel guilty. The sadness at the loss of religion was wearing off and the new possibilities were presenting themselves. I didn’t have to worry about my mom’s or anyone else’s souls if they weren’t Christians, I didn’t have to try to weasel God into all of my conversations with  non-believers, I didn’t have to speak in the christian lingo or worry about other Christians judging my actions and whether they lined up with all the beliefs all the time. It was a weight lifted.

Austin still wanted to take time off of school and work and do some soul searching while I provided for us, but I told him the deal was that he was either in school or had a job, he could soul search in his free time. He decided to continue his education. Honestly, looking at all the changes, he seemed to be finding himself just fine. I was  along for the ride and learning to roll with the punches. I’d come to terms with the fact that Austin probably wouldn’t ever settle in one place for long, but I loved him and it was more than worth it to me to deal with the constant change and discomfort. As long as I had him, that was all that mattered. If things settled down for too long, he would feel like he was stagnating and feel the need to change. I started understanding the cycle and could recognize the signs of impending newness.

Breaking Elizabeth: Part 2

Breathe with me

They had left her on the ventilator overnight after her third surgery and it was time to take the breathing tube out. She was doing well for while and I had left to get a snack in the cafeteria. My brother called me as I was paying and said that mom was having a hard time breathing and should get back up there. I got there as fast as I could and as I was buzzed into the ICU I could sense that something was really wrong. I opened the curtain and saw Mom breathing fast and hard with her eyes wide. I could see she was well on her way to respiratory distress. The doctor thought she might just be anxious and that she would ease into breathing without the tube with some intravenous anti-anxiety medication.

After 20 minutes she was breathing harder and her oxygen sats were dropping. My gut had been right and she was going into respiratory failure. They decided to put her on the bipap machine, which is a mask that fits over your face, is strapped tightly to your head and blows air against your nose and mouth. It made her feel even more out of breath and I could see the anxiety on her face, brows furrowed, eyes tight shut as she gripped the bedrails and her knuckles turned white. I was standing at her side, putting on my calm nurse face, trying and failing to sooth her. I was trying to keep her, my family, and myself calm, but I was scared. This wasn’t normal and we couldn’t figure out why she wasn’t breathing.  

She was “air-hungry,” anxious, terrified, but still trusted me. I could see it. She wanted to rip that mask off of her face and tried multiple times. I could see the desperation to breath in her eyes I could see her Sats dropping lower as they prepared to reinsert the breathing tube. It felt like years, though I’m sure it was only moments. Her eyes looked up at me pleading as she started feeling even more desperate for air and reached up for the mask, again trying to rip it off, her oxygen hungry body believing that the mask was keeping her from breathing.  I had to hold her hands down as I continued trying to sooth her. I knew as I looked into those desperate eyes, that even if she lived through this, these moments would haunt me.

My face was close to hers as we waited. There was increasing desperation in her eyes, frustration and terror, but even worse there was trust. She trusted me, she was trying so hard to listen to me. Trying so hard not to fight my grip on her wrists. Fighting that instinct a drowning person has to attack the person trying to save them. She was fighting the urge to fight me. I saw the conflict and the pain and would have done anything to make it stop. Those moments lasted an eternity and are forever burned into my mind. That wide eyed look of terror, half-crazed mixed with the trust of her daughter the nurse. They came in to intubate her and sedated her so they could do it.

When she was unconscious, I walked out passed the curtain because I couldn’t watch anymore. I had seen hundreds of intubations, had kept patients from pulling tubes and removing masks before, but this was different, this was my mother. One of the closest people in my life. I had kept my cool, remained calm, and held her down but then I went to the bathroom and sobbed. I will never forget that. Those were some of the hardest moments of my life and some of the few conscious moments she had left. It turned out that a cyst had swollen up on her vocal chord, which had been irritated when the breathing tube was removed. I had spent 20 minutes explaining to my mother that it was just anxiety, that she really could breathe as we waited for the anti-anxiety meds to kick in, as the cyst swelled and made it harder and harder for her to breathe. I was wrong, she trusted me, and I was wrong.

Breaking Elizabeth: Part 1

Death as a Nurse

I have seen many people die in the hospital. It is a safe, controlled environment. People pass with little fanfare, sometimes with family, sometimes alone. We nurses follow our process, console the family if we can, ship the remains off to the morgue and refocus on the living. As a nurse, it becomes almost second nature to be unaffected by death. I remember the transition, from being heartbroken for my patients to focusing on the process and maintaining efficiency.

I learned to deal with horrible, gut-wrenchingly painful situations on a daily basis. I became invulnerable to the pain of my patients. Plenty of sympathy, and focus on doing the best I could, but keeping the empathy in check. I was able to leave the pain at the door when I left and found humor in morbid situations to process them. Too much, empathy is simply unsustainable in the hospital environment.

As a nurse, there is a wall you create to keep distance from your patients. Patients aren’t people, not really. We care for them, but keep our emotional distance so that if things go badly we can easily walk away unscathed. Certain situations can and will hit you unexpectedly, you will connect with a patient or a family member and experience that loss and pain as a regular person might, but it is rare. It should be rare, because those walls are built for your protection and are required to maintain your sanity. Wall maintenance is a constant, mostly unconscious effort. Sometimes your wall is too much of a barrier and has to be opened up, other times it isn’t built high enough and you sustain damage. It’s a delicate balance, that you must attain for sanity to be maintained.

Trying to meld the experience of the death of my mother with the previous closed off experiences of my patient’s deaths has been very difficult. I tried desperately to balance the concept of my mother as a patient, with the reality of my mother being my mother, and I failed miserably. I knew all too well, the dangers of the hospital, things get missed and people slip through the cracks. I was on guard as a nurse and a daughter. So afraid as a daughter, but seeing things from a removed nurses perspective and trying not to be too paranoid because of the extreme cases I’d seen. Visions of all the possible bad outcomes danced in my head and I did my best to balance that knowledge with the very real likelihood that the treatment would work fine and she would recover. It was a simple diverticulitis rupture in my relatively healthy 60 year old mother. There was no reason it should not have been a successful recovery. It’s a fairly standard treatment of surgery and antibiotics. We just had the worst possible luck and every time she should have recovered she didn’t. Abdominal infection that would not respond to treatment, cultures weren’t growing the bacteria we were fighting, her organs started shutting down one by one. Five weeks of hell for my mother, my family and myself before her body was giving out and we decided to take her off the life support and let her pass.

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The process left me broken in ways I didn’t think I could break.  I maintained so well while at the hospital, while fighting, planning and leading my family through the process. Recognizing when the time had come to stop fighting, and assuring that her death was as comfortable as possible.  But, watching her die, dealing with the loss and guilt that I felt was so painful. I was in over my head. I failed her, and it broke me. Broke my faith in medicine, my confidence in my abilities as a nurse, my confidence in my own strength. I had this perception of how I would handle the loss of someone I loved, I thought I would be strong and valiantly move forward, instead I was broken and weak and grieving. Obsessively reviewing the situation, staying awake at night cycling the lab values through my head, frantically trying to solve the situation, trying to find answers that would make no difference but unable to let it drop. I would see patients in situations similar to my mother’s and have momentary visual and audio flashbacks. I saw a patient with dusky skin, and flashed back to her face as it grayed, her lips and tongue as they turned black, heard her rasping, gasping, final breaths. I held myself together and didn’t let my coworkers see how bad it was. Even though I was having multiple flashbacks a day, I was seen as strong and doing well and didn’t want to lose that perception. Wouldn’t let people see my weakness.

Her death, my failure, tore my carefully maintained walls down, turned them into rubble. Working as a nurse became a daily onslaught of pain and suffering that I couldn’t seem to block out. I still had to do my job, but my soul was so vulnerable. I had to rebuild my walls from scratch, and over a year later, they are stronger but still vulnerable.

I’ve thought often over the last year over what it takes to break a person. I assume that anyone can be broken given the right set of events. Abdominal Sepsis was high on my list of ways I didn’t want to see someone I loved pass. It is a truly horrific way to go, and the pain and guilt I felt were tremendous and overwhelming for a while. This horrible experience broke pieces of me and affected my nurse side in ways I didn’t anticipate, but didn’t quite break me. I had my husband, family and friends for support… or so I thought.