Category Archives: Blog

Life Unexpected: Losing my Mom

 

My mom was one month short of her 91st birthday when she passed on.  Mom knew how to live life fully. Swimming daily well into her 90th year, attending study groups and concerts, even dancing at weddings, Mom was famous for her granola and cinnamon yeast rolls. She had such a zest for life that it was hard for her to let go – and even harder for her to talk about death.

As a trauma psychologist who has studied and dealt intimately with death and dying for the better part of four decades, here was my opportunity to finally talk about death – in real time – with my own mother. But, she didn’t want to talk.  As I lay in the bed next to her, holding her hand, on one of the last Saturday mornings of her life, I told her what a wonderful mother she had always been, something I didn’t say often enough during these past 62 years.  Then I added, “Mom, now is the time to tell me all the things you never told me.” A deafening silence met my words.  I looked over to see if she had fallen asleep, and though her eyes were closed, I could tell that she was listening.  She was just silent.

And so, she chose to meet death in her own way, and what an amazing way that was.  She stopped eating a few days before Sunday, the day her newest great grandson – my son’s son – was born. Sitting in her armchair for – unbeknownst to us – the last time, she smiled and said “Mazal tov!” when she heard the good news.  By then, she had begun subsisting on liquid nourishment with a special penchant for the Ben and Jerry’s chocolate milkshakes I made for her. We focused, with the support of the wonderful home hospice team, on making her last days comfortable without unnecessary medical intervention.  We understood where we were headed, and heroic efforts were out of the question.

On Wednesday morning, she stopped drinking and did not get out of bed. She became less and less communicative, and the home hospice team made it clear that her hours were numbered. We watched as she continued to breathe, her chest rising and falling, and we stayed close by, singing her favorite songs, talking to her, and praying for an easy passage.

The hours passed. Sunrise, sunset. Thursday. Friday. Saturday. Each day, each hour, seemed that it would be her last. Against all odds, she was hanging on and didn’t seem ready to die. By Sunday morning, her breathing was quite slow, each breath punctuated with a long pause.

Meanwhile, my new grandson’s bris or circumcision, the milestone ceremony performed on the eighth day after birth, was scheduled for 10AM in a neighboring town.  My sister-in-law volunteered to stay with Mom so that the rest of us could attend this joyous occasion at such a bittersweet moment.  The baby was given his name: Zohar Chai. Chai, meaning “life”, was in honor of my mother, whose name was Chaya.  My father called my sister- in-law to check in with her, and told her the baby’s name.  My sister-in law bent down to whisper the name in Mom’s ear. My mother took one more breath. And then her soul departed.

Mom and Dad

 

Allowing my mother the dignity to die at home in her own bed, surrounded in her last days by all four of her children and her husband of 67 years was a blessing.  The support of a caring and experienced home hospice team enabled us to avoid the prevalent reaction to hang on at all costs. So often, our loved ones go through terrible trials and tribulations before dying in the impersonal, clinical surroundings of a modern day hospital. We made sure that Mom was comfortable, in her own bed, in her home that she loved so much.

We came back immediately after the bris, and gathered around Mom as a family to say a final goodbye. In keeping with Jewish tradition, we laid her to rest that same day, in the late afternoon at the nearby cemetery, in a spot shaded by a pine tree with a view to the hills.  My mother couldn’t have chosen a better final resting place, nor a better hour to depart this world.  How amazing that our mother chose the precise moment for her departure from this world. I am humbled by the inner wisdom that we human beings possess.  If we can pause to listen, we will be so much wiser.

 

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Resilience Building in Nepal: Musings on the Second Anniversary of the Nepal Earthquake – April 25, 2017

Marking the second anniversary of the Nepal earthquake, on April 25, 2017, is a time to stop and take stock of all that has happened since that terrible day and to underscore the humanitarian aid that flowed freely from Israel xxx kilometers away.

April 25,2015 dawned bright and clear with no sign of what lay ahead for this landlocked country of 27 million inhabitants.  At 11:56 AM on that fateful Saturday morning, the earth began to rumble and rock leaving in its wake death and destruction.  Measuring 7.8 on the Richter scale, the earthquake killed more than 8500 people and destroyed more than 750,000 homes. A second major quake struck on May 12, 2015, causing further damage and death.

Destroyed village houses Ramichap, Nepal

Destroyed village houses Ramichap, Nepal

Bordered by two gigantic countries, China from the North, and India to the South East and West, Nepal is ranked among the weakest countries economically, and close to half the population is unemployed. On the measure of disposable income, Nepal ranks 173 out of 175 countries, with an average monthly income of $63.00. Poverty is rampant, literacy rates are low and hunger is prevalent.  Add to that a natural disaster and the catastrophe is overwhelming.

330 humanitarian aid agencies responded to the Nepalese government call for help.  Aid ranged from responding to immediate medical needs, safe housing, sanitation and food, and continued with psychological first aid. Israel was almost first on the scene to offer aid with the IDF field hospital up and functioning within 48 hours of the quake.

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Nyayik Sansar, a Nepalese NGO that partners with Tevel B’Tzedek, an Israeli based NGO responded immediately as well. In normal times these two organizations work collaboratively on integrated community development programs in rural Nepal in the fields of education, health and sanitation and, youth and women’s empowerment. Recognizing the importance of both physical assistance and psycho-social support during this time, together these two organizations led the way in harnessing their existing infrastructure to implement a variety of programs including a resilience building program to address the psychosocial needs of those hardest hit by the earthquake in urban and rural settings. I was privileged to help develop and implement this program.

Hearing about the terrible devastation in Nepal I.  reached out to the offices of Tevel Be’Tzedek in Jerusalem, offering my services.  According to reports filtering into the Jerusalem offices, at least fifty Nepalese staff members and an equal number of Israeli volunteers and staffers were streaming into Kathmandu from destroyed villages in the field.  They were scared.  They had lost their footing in both a real sense and the proverbial sense.  Tevel B’Tzedek was eager to send over a team to help staff cope and invited me to take the lead.

As a long time trauma psychologist, and previous director of the Resilience Unit at Metiv-Israel Center for the Treatment of Psychotrauma I was a veteran of previous natural disasters such as Hurricane Katrina in Mississippi, USA, and the 2010 earthquake in Haiti.  Building on the expertise that we had developed in Israel dealing with the psychological and social effects of terror and war, I eagerly volunteered my services, and within days was on a plane headed for Kathmandu.

Arriving in Kathmandu, the only visible signs of the earthquake were several cracks in the floor of the airport. Driving through the city things looked deceptively normal, until we turned a corner and saw the golden roof of a temple hanging askew at an awkward angle.  Nearby the side of a building looked like it had been shaved off and half rooms lay exposed to the heavens. I learned that seventy people lost their lives in this building.  Onlookers were gathered watching the rubble being sifted in the hope of finding victims.

Arriving at the offices of Nyayik Sansar/Tevel, I was met by weary looking staffers who eagerly shared their stories, and their sense of responsibility for their workers, reaching out for much needed support.  Luckily, I was joined by Nili Lavi, a volunteer psychologist from Metiv, and together we rolled up our sleeves and began to work.  First order of business was working with the staff of Nyayik Sansar and Tevel.

Staff training

Staff training in Kathmandu – Learning about resilience building

In post disaster environments the needs of helpers are often overlooked, as they work around the clock helping others.  Looking after their needs both physical and psychological was a priority for us.  Teaching the staffers and volunteers about trauma, and how it affects the body and the mind was a first step in helping them to understand what they had experienced. This laid the cornerstone for work that they would eventually do in the field.  Allowing for staff and volunteers to share their experiences with each other, and appreciating the necessity of social support for healing was not only emphasized but also experienced.

Workshop sessions including drawings, story telling, dancing and relaxation, using a variety of techniques so that each person could find their own unique way to share their story.  At the conclusion of the workshop participants shared their sense of relief.  One senior staffer said,”Wow-it’s great to listen to other people and see that I am not the only one who feels shaken up.” Another shared, “It’s good to learn that what I am experiencing is normal. I was worried that I was going crazy.”

Building resilience in the village

Building resilience in the village

After completing the first round of workshops with staffers focusing on both psychoeducation and sharing of feelings including sadness, fear and hope, we joined with the directors at Nyayik Sansar/Tevel to develop a yearlong program in building resilience, beginning with training field staff who could then adapt the program and  bring psycho-social support and resilience building to the villagers.  Encouraging Nepalese staff to take ownership of this Israeli based resilience program, mold it to their needs and their culture proved the key to successful implementation.

The model we used, the BRI (Building Resilience Intervention) is a flexible model that provides a framework for considering basic building blocks of resilience. It includes units on self-awareness and self-regulation, understanding feelings, expanding coping repertories, and finding hope and meaning in difficult situations.  Staffers first experienced firsthand the resilience building workshops and then worked hard at translating and adapting the materials to the culture as well as to meet the challenges and needs of the people they were working with in rural Nepal.

BRI in Action

BRI in Action -Exploring Feelings

There were many challenges in developing a yearlong program from both the physical and psychological distance of Israel, yet we were able to successfully able to bridge the miles.  In addition to three onsite visits for training and supervision, a key part of the program was providing ongoing support via Skype over the course of the entire year.  As the year drew to a close and we celebrated the first anniversary of the earthquake a feeling of excitement was in the air, optimism and hope flourished, and participants in the resilience building program were feeling a sense of productivity and mastery.

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Talking about the after effects of the earthquake in rural Nepal

Today, as we reach the second anniversary of the earthquake on April 25, 2017, we can report with a real sense of satisfaction that staff of Nyayik Sansar/Tevel B’Tzedek successfully implemented the BRI – Building Resilience Intervention in 66 groups of primarily women, with 959 participants.  Each group reported on more than ten resilience building activities that were done as part of the group meetings.  A semi-structured evaluation yielded important data showing which areas were most powerful for participants (importance of sharing and self-care), and where there was room for improvement.

The Nepalese earthquake provided an opportunity to bring much needed mental health services to rural Nepal.  I was grateful that I as an Israeli professional had the privilege to bring the knowledge and expertise developed in the wake of terror attacks and war in Israel, to the Nepalese people during their hour of need.

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Stumbling on the Holocaust:  Surprising Stolpersteins

45 Michelangelostrasse, Amsterdam

A recent trip to Amsterdam offered the opportunity for a visit to the home of my namesake, Elinor Chava Oettinger, and her parents and brother. 45 Michelangelostraat  was our destination and on a cloudy afternoon in late March, after a lunchtime concert at the nearby Concert Gebouw, my husband and I mapped out our trail, and pedaled our borrowed bikes along the well-marked bike lanes easily finding our destination.

The Oettinger family, Herbert, Betti, Elinor and Ralph, my great uncle, his wife and two children were four of the more than 107,000 Jews deported from Amsterdam  in late 1943 and killed by the Nazis,  along with more than 90% of Dutch Jewry. My middle name Chava, was Elinor’s Hebrew name, and as the years pass, I often think about her, particularly on Yom Hashoa.  I wonder what she was like, and whom she would have become had her life not been so tragically cut short.  Like millions of others killed by the Nazis, there is no memorial, no gravestone, for her or her family, and there are no living descendants from this branch of our family.

Elinor Chava Oettinger

Gunter Demnig, a German artist created the first stolpersteins in the last decade of the twentieth century. Stolpersteins, literally “stumbling stones”, are small brass squares placed in front of houses of the victims of the Nazis during World War II, never to return.  These memorials, engraved with names along with date of birth and death, as well as place of death, are the only memorials for many who perished at the hands of the Nazis, including the millions of Jews.  These stones bear silent testimony to lives cut short and families stunted.  According to the artist Deming, a stolperstein would symbolically return the victim to their neighborhood so many years after being so cruelly deported and killed.  The stolpersteins are a sobering witness to once thriving communities, uprooted, displaced and destroyed. Over 50,000 have been placed in eighteen countries throughout Europe and after recently reading about this project, I was eager to pursue the placement of such stones in front of Elinor’s house to commemorate her parents, brother, and herself. I planned to photograph the house and send it out to my relatives to interest them in the project.

As we pulled up in front of Number 45, I felt my heart beating faster. Was it fear, excitement, or merely the exertion of the bike ride?  I looked at the number, to make sure we had arrived.    Stone row houses, typical of Amsterdam, faced each other on the quiet tree lined the street.  I pictured my family, the family I never knew opening the door and treading over the threshold with the black and white stone entrance hall.  There was a slot with the word “Post” etched above it into the greying stone just to the right of the front door, and I could imagine young Elinor collecting the daily mail.

Then I looked down.  There they were, winking back at me in the weak March sunlight. Engraved brass stones with the names: Herbert Noa Oettinger, born, murdered, Auschwitz, Betti Oettinger- Ettinghausen, born, murdered, Auschwitz, Ralph Jozef Oettinger, born, murdered, Auschwitz, and Elinor.  There was Elinor.  Born 1929. Murdered 18/10/1944. Auschwitz. My eyes teared. The cousin I never knew. A life cut asunder. Fifteen years old.

I sat on the stone stoop, and communed with the souls of my relatives who had met their death in such a violent and tragic way. Sending a prayer for their souls. Sending a prayer for ours. Sending a prayer for the people who now live in this house. My husband decided to say Mincha, the afternoon service, at the doorstep, deeming this an appropriate place to talk with God.

As I continued my reverie, I noticed a young man pushing a baby carriage, slowing down as he arrived at the stoop where I was sitting. He looked at us quizzically, and I explained that we had come to pay homage to relatives who had lived here, pointing to the stolpersteins.  “But how did you know that they lived here?” he said, barely able to stutter the words.  I explained that my father had visited here as a youngster, and remembered well both the house and its inhabitants.  I asked if he knew about these stolpersteins – when they had been installed, and who had initiated and paid for them.  He told me that his parents, the owners of the house, had arranged for the memorial stones, and that they were placed in the pavement just a few months prior.

There was an awkward moment between us – the relatives of people wronged in this very spot, and the unrelated individuals who recognized the tragedy, taking of their own time and money to make sure that the injustice was acknowledged. It is hard to say who was more surprised by this chance meeting – him or us.

We exchanged e-mails, and asked him to thank his mother for her generous and heart-warming gesture. Interestingly, his beautiful baby is named Rafael, a name close in sound to Ralph, the cousin I never knew, who had also lived here. I wondered about little Rafael’s grandmother, a woman I had never met, a woman totally unconnected to our family who decided to place these stones.

Herbert Noah Oettinger and his wife Betti

Thinking of this righteous woman reminded me of the hundreds of years where Jews found safe haven in Holland, a place where they could pray freely, be proud Jews and find good fellowship with their neighbours. My uncle, Herbert Noa, had moved from Germany to Holland in 1922 for that very reason, to escape the rampant anti-semitism he had experienced in Germany. For most of the more than twenty years he called Amsterdam home it was a welcoming one.

We pedalled away, with hearts filled with sadness and pain, anger and gratitude. Sadness over the loss of relatives we never knew, pain remembering the Holocaust and the 6,000,000 who lost their lives because they were Jews/ Anger at what the Nazis had wrought. And gratitude to the righteous stranger who cared, who made the effort to place these stones, the only physical memorial for my four dear departed relatives, people I have never met, but whom I know, deep deep inside.

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Life Unexpected: Stuck in the Mud

There we were, a combined 153 years between the two of us, in a white 2007 Mazda, spinning our wheels. Not proverbially, but actually. We were thoroughly and completely stuck in the mud, and not just any mud, but thick, brown, oozing, sticky mud. Now, if you have to be stuck in the mud (and that indeed is a philosophical question of epic proportions, which we will leave for discussion to a later date) try to choose a sunny day, world ­class scenery and a good friend. I did.

The fishponds

To round out a lovely visit with my dear friend Anina, a longtime resident of a kibbutz in the Bet Shean Valley, we decided to drive out to the nearby fishponds to see what birds we might spot, and to enjoy the flowering bounty of spring. Thanks to abundant rainfall the valley was lush and green, and we spotted many varieties of birds enjoying the sunshine and water.  Anina suggested that we continue driving in search of the black stork, a very rare variety of stork that had recently been spotted in the vicinity. She pointed out the way to a nearby fishpond and after slipping and sliding cautiously on the narrow ring road, our wheels began to spin and soon we were utterly marooned.  The Gilboa Mountains climbing off to the west, and the even taller Gilad Mountains soaring off to the east formed the backdrop. Right next to us, thousands upon thousands of birds were circling overhead, swooping down and occasionally coming to rest a stone’s throw away at the edge of the fishpond. There were enormous birds of all sorts: ­ pelicans, seagulls, kingfishers, and yes, the black stork too!

The black stork

There was absolutely nothing we could do to extricate ourselves, except for what we had already done, which was to phone for help. Enjoying the minutes as they slowly ticked away, my 93 year old friend Anina assured me that this was not the first time this had happened to her, and she had thus far always gotten out. I decided not to worry. With a sparkle in her eye, she told me that she had actually arranged for this to happen so that she would remain unforgettable. Dare I say she succeeded?

To my mind, slow travel focuses on savoring the experience, the people, the culture of new places and foreign countries, in contrast to ticking off sites one has to see. Writing a blog about slow travel for the last few years, I thought I had come to understand just what slow travel meant. However, being stuck in the mud puts a very different spin on that concept. Just how slow is slow? When you are stuck, as we were, and all you can do is wait for someone to come and pull you out, you have time to look around, savor the view, laugh with your friend, and enjoy the sun.

Our saviors on the way

The first truck arrived to extricate us but was unable to make it up the slippery slope. Calling for reinforcements, a tractor with my friend’s son riding shotgun arrived. After failing to find a place to connect my car to the tractor from the front, the tractor backtracked through the muck and in order to make the long and muddy approach from behind. The tractor was slipping and sliding in the mud and I wondered whether this time they would succeed. After attaching the cable, my friend’s son slipped into the driver seat as I gratefully buckled myself into the back. Getting pulled out along the narrow, muddy path, with the fish pond plunging down to the left, and an equally deep gully on the right, all I could do was screw my eyes shut and pray. I could feel the car slithering over the mud, as the seconds crawled by. We held our collective breaths in silence.

A few minutes later as we drove to the garage to spray down the car and do a damage assessment, the magic of that half hour at the fishpond receded.  We were  thrust  into real time and the pull of everyday events.  Gone were those magical moments when there was nothing at all we could do, so all we did was wait, look at the birds, the scenery and each other. Gone but not forgotten.

In memoriam of my dear friend Anina Korati who passed away peacefully, aged 95, in her own home almost two years after that eventful day. 

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Resilience amid the Rubble: Notes from Nepal

Memories of Nepal, that earthquake ravaged sliver of a country, lying between the two behemoths of India and China, are beginning to fade.  Returning home just two weeks ago, I shake off the dust of the journey, and examine where I have been and what I have done, trying to make some sense of it all.

During the three days before my hurried departure, I worried whether I had something of value to offer the people of Nepal.  I wondered whether my knowledge and skills would be of use in a country that is different in so many ways from the Western traditions that nurtured me and taught me everything I know about people and trauma.  Upon landing in Nepal, I reminded myself of “beginner’s mind,” that Buddhist concept that directs one to have an attitude of openness and lack of preconceptions.  Don’t assume that you know anything about these people and what will help them.  Listen, observe, tread lightly, offer tentatively, respect.  These words repeated themselves like a mantra as the battered white taxi that had met me at the airport rattled through the unpaved, rubble strewn streets and alleyways of Kathmandu. It was difficult for me to determine whether the rubble was recent, or of earlier vintage.

Street Rubble - Kathmandu

Street Rubble – Kathmandu

Arriving at the doorstep of the offices of Tevel Betzedek, located in the Swayambhu neighborhood,  famous for the nearby Monkey Temple. I saw the temple located on top of a nearby mountain,  but did not realize that it was missing one of its iconic stupas.  The stupa is a semi-spherical memorial found in Buddhist temples. Many stupas toppled during the recent earthquake and for the people of Kathmandu, and of the Swayambhu neighborhood in particular, the missing stupa of the Monkey Temple was like the post 9/11 New York City horizon without the World Trade Center, only I, as a newcomer, was clueless.

I went to work almost immediately, meeting first with Tevel’s Nepali staff, many of whom had lost their homes. Thankfully, none had lost immediate family members, although most knew of people who had died, and some were grieving for uncles, cousins, and friends.  We sat on the floor in a circle, a room filled with approximately twenty-five young men and women, all eyes trained on me.  How to begin?

I could feel my heart beating.  This was the moment of truth.  In a briefing about Nepal, I had learned that the Nepali people do not readily share feelings, and participation in a group activity is often difficult. I looked at their expectant faces, notebooks opened, pens poised. I needed to stop for a moment, get my bearings, and breathe.

I opened the session with a minute of mindful breathing, explaining to the participants as much as to myself, that by focusing on our breathing we could let go of some of the tension in our bodies.  They readily closed their eyes, placed the hands palm up on their folded knees and breathed.  I peeked through half closed eyelids and noted that there was 100% participation.   This was culturally appropriate,  for sure.  I closed my eyes again.  We all breathed deeply.

After explaining how stress affects not only our minds and hearts but also our bodies, the next step was clear to me.  I directed  participants to choose one person with whom to share their earthquake story.  Immediately, the room filled with the sounds of animated conversation in Nepalese.  After several minutes, I asked them to share their feelings with their partner, and then several minutes after that had them focus on how they were doing right now.   I looked around the room.  Couples were engrossed, looking into each other’s eyes, communicating, listening, sharing.  By encouraging them to talk in their native tongue, with only one other person, the barriers to sharing dissolved, and conversations flowed.

Talking about the Earthquake

Talking about the Earthquake

 

Going around the circle at the close of this activity, staff members shared, in English, what the process had been like for them.  What was it like to talk to somebody about the earthquake?  What was it like to listen?  When they compared how they were feeling now to how they had felt in the days following the quake, what did they notice?  As we went around the room, familiar themes appeared.

It was good to talk to somebody and tell my partner the story from beginning to end. 

This was the first time I talked about how I was feeling, and it feels great. 

I am happy to see that I am not the only one who feels the way I do.

I was surprised that the person I spoke to was experiencing similar things to what I have been feeling. 

This short exercise had given the group members an opportunity to organize their experiences, examine their feelings, share worries, symptoms, and thoughts, and note that they were not in the same place today, as they had been a week ago.  They could see improvement and change, and could expect more in the future.

This, then, is the cornerstones of resilience, that term we mental health professionals have borrowed from the more exact sciences and made our own.  Resilience, the ability to experience loss, trauma, pain, and fear, and to recover, is in fact, ordinary magic.  “Magic” by virtue of the fact that it is indeed magical that people who have lost so much can return to the tasks of daily living and get on with their lives, picking up the pieces one by one, and “ordinary” because most folks do bounce back..  Making sure to allow enough time and space to experience the pain, to understand that people heal at different rates, and that there is not one correct path to coping, was an essential part of what I could offer.

House in Rubble Mahadev Besi

House in Rubble
Mahadev Besi

After working with Nepali, Israeli and American staff and volunteers in Kathmandu, we took this exercise into the countryside to a village where all eighty mud and stone houses had been destroyed.  We visited the makeshift tents that families had erected near their emerald green rice fields and talked with them about sanitation and fears.  Later, a group of women assembled in the concrete and cinder block community center, the only building still standing.

Breathing Exercise Mahadev Besi

Breathing Exercise
Mahadev Besi

The forty brightly dressed women, with gold rings in their noses and ears, ranging in age from twenty to seventy sat quietly on the dirt ground in the small, unlit room.   Rashamita and Gita, the young Nepali women who a mere two days earlier had participated in that first session in Kathmandu, confidently directed the women in breathing and in the storytelling exercise. There was a palpable excitement in the air as the women eagerly paired off and spoke to each other from their hearts.  They laughed, they cried, and later sang and danced.  We ended the session standing in a circle holding hands, sending energy and blessings around the circle.

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Faces of Resilience

Resilience appears to have universal appeal and value.  Each time I come to a new country, an unknown culture, and hear a language that I do not understand, I am careful and move slowly. I do not assume that I know what is best.   Each time, I am delighted to find, once again, that we human beings have so much in common.  Whether it is a terrorist attack, war, hurricane, typhoon or earthquake, human beings grieve their losses, lick the wounds of their shattered assumptions about the world and their lives, and go on to cope, heal, and eventually thrive.

Resilience crosses cultures, bringing the promise of hope and healing.   This common core reaches far beyond geography, language and culture.  We are after all,  children of the universe.

The writer, along with a colleague from the Israel Center for the Treatment of Psychotrauma,  worked with Tevel B’Tzedek, an Israeli NGO that has been in Nepal for the last eight years working to improve living conditions and wellbeing.

 

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Sharing the News: Telling People You have Cancer

One of the issues that anybody with cancer has to confront early in the game is how and with whom to share this news.  While there is no one correct response as every person with cancer is unique, several parameters of this decision are worth considering.

  • Decide with whom to share your news

The first question to think about, is how open or private you wish to be.  Do you want to keep the diagnosis a secret?  Do you want only family members to know?  Do you want to post it on Facebook and start a blog?  It is your choice.

I can make a good case that life is much easier if you let go of secrecy, and share the news freely with family and friends, but this may not suit you, your life style, or your work circumstance.  For me, sharing the news, and dissolving the secrecy was both liberating, and created around me a tremendous outpouring of support and love.  This aided my healing process immeasurably, and when I made the decision to share the news soon after diagnosis, I felt a burden I didn’t even know was there, being lifted from my shoulders.

I shared the news first with my immediate family, my children, parents, siblings, and then with my closest friends and colleagues.  I stressed to all of them that this was not a secret, and I urged my children to talk with each other so that they could be supportive of each other in a way that I, as their sick parent, could not be.  I left the work of spreading the news farther, to the natural grapevine. Unless you swear people to secrecy (and even then there are no guarantees) you can expect your news to travel.bad news

  • Do it in person

Do not underestimate the importance of sharing your news in person, particularly with people who are closest to you.  If there is one mistake I made in this process, it was taking the short cut of telling a family member that I had cancer, over the phone.  The reason to tell them in person, is because despite all the advances in technology, there is nothing like face to face communication.  When you talk to someone face to face, they can see that you are still the same person, you can gauge their reactions, and clear up uncertainties. Often, at the time of diagnosis, you will still look like you always have, and that can be reassuring as well, particularly to children.

  • Prepare a short script

This is not going to be an easy conversation, particularly the first several times you do it.  You can be sure that the person you are sharing the news with will be more surprised than you are and will find it difficult as well.  Preparing several opening sentences can ease the way for you into this conversation.  Often, the direct approach is best.

I started with something like this:

” I have some news to share with you that isn’t so good. (this gives your friend or family member a half a second to prepare themselves)  I was diagnosed with……”

Additional parts to the conversation might include what the doctors have told you, what your  next steps are, what kind of help you may need or expect from them.

  • You choose how much to share

While I am a strong proponent of unlocking the secrecy surrounding cancer, and I shared my news freely with family and friends, I found that I didn’t feel like sharing all of the details with everybody.  You did not choose to have cancer, but you can choose whom you share your story and how much you tell.  If people ask questions that you prefer not to answer, do not feel forced to reveal everything.  This is your choice and you are in control of the information.

For many people, short disclosure and a few pertinent details are enough.  It is up to you to set the tone as to how much you want to share.  Practice saying, “I’d prefer not to discuss that.”  The person you are talking to will usually take heed, but if they persist  you can explain that while it is important for you to let them know that you have cancer, you prefer to keep the details of the extent of the cancer and the kind of treatment you will be receiving, to yourself.  It is certainly your prerogative.  This is one small way for you to take back some element of control into your life.

 

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Life Unexpected: Lost Luggage

On a recent trip to Malta I experienced something new. At age 59 that doesn’t happen every day so I stopped and took notice.  My luggage was lost.

This event was even more startling, as my husband’s bright red suitcase was the very first one to arrive off the airplane. That too was a new experience. As the baggage carousel circled round and round, and the number of unclaimed bags decreased, my level of anxiety rose exponentially.  I craned my neck watching the bags as they made their entry into the crowded hall as if that would encourage my small, burgundy duffel to be the next one out. Finally, the carousel shuddered to a halt, and with it all hope that my bag would arrive.

With a sinking feeling in my stomach, I went over to the Baggage Claim desk and pulled out my passport where the luggage tags had been affixed just a few hours earlier in Tel Aviv. I was horrified to find that there was now only one luggage tag, where previously there had been two, and that one remaining tag was, of course, my husband’s.  Not only did I not have my bag, but I also did not have the tag to prove that I had sent it.

The clerk frowned and clicked his tongue, succeeding in making me feel like an irresponsible toddler. He assured me that while he would try, he could promise nothing, since I did not even have a tag to show that I really did check in a bag.  My eyes teared, and my lower lip trembled. When he asked whether I had baggage insurance I recalled to my dismay how I had refused it just a few hours ago, in order to save a few shekel.  The clerk rolled his eyes and sighed.  To note that he offered no compensation along with his lack of sympathy would be redundant.

We ran to catch the bus that had two remaining seats for us, to take us to our hotel. An internal dialogue started up that went something like this:

Get a grip.

Get a hold of yourself.

It’s just a bag.

Do you want to ruin your vacation?

This is your chance to show the stuff you are really made of.

This is adversity, and here is your chance to be resilient. Life unexpected?  See what you can make of it.

Need I mention that I have headed up the Resilience Unit at the Israel Center for the Treatment of Psychotrauma for the past 12 years, and recently published a book called, “Life Unexpected”?

During the 30-minute ride to the hotel, I began an inventory of what was in my lost bag, having decided that I would never see it again.  I decided that taking an accounting, noticing what I was missing, feeling sorry, and then moving on would be the way to salvage the vacation.  All in the space of 30 minutes.  By the time I got off the bus, I have to admit that I was feeling much better, albeit a little shaky.

Since I am of the belief that things happen in this world for a reason, trying to figure out what I was to learn from this turn of events was uppermost in my mind as  I went out to shop for a very few essentials. Bathing suit, underwear, hat and suntan lotion, an extra shirt and pair of shorts were quickly purchased, and then I settled in to enjoy a wonderful five-day vacation.  Occasionally I would have a stray thought about what was in my lost bag, and a twinge of regret that it wasn’t with me but for the most part I let those feelings go and focused on fun.

On my last day in Malta I sat down to write the lessons learned.  Here goes:

  1. Notice how attached you are to stuff. Then, notice how well you can get along with so much less than you thought.  Next time I travel, I am convinced that no matter how long the trip, I will go with one piece of hand luggage consisting of three pair of underwear, one change of clothes, a good book, and a very small toilet kit.  Ok. Maybe I’ll pack a bathing suit too!
  2. Figure out what are the real essentials in life. What do you need to have a good time? Does your luggage provide any of that?  Probably not.  On my list of essentials for a fabulous vacation are: a good frame of mind, a wonderful travelling partner, and a sense of adventure.  You do not need an extra bathing suit, a beautiful dress, or even a spare pair of earrings.
  3. Control. The issue is control. Losing luggage reminds you of how little you control in life.  This is a lesson I should have gotten the first time around with breast cancer. It is amazing how quickly one forgets.  Okay, I get it now.  I am not in the driver’s seat.  I am not in control.
  4. Living in that nether land of “what ifs” is actually the hardest place to be. My thinking went something like this: What if my luggage comes?  Then I will be sorry about all the money I put out to replace my stuff.  What happens if it never comes?  What if they don’t compensate me?  What if they do?  I decided to live life as if that bag would never show up.  Kiss it goodbye.  Lead my life as if it is gone forever.  So much so, that I gave up on calling Air Malta after the first day, after several frustrating and unsuccessful attempts.

When my bag finally appeared 12 hours before departure, I was almost sorry to see it.  Almost, but not quite!

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How to be A Friend to Someone with Cancer

Life is truly unexpected. Who expects their friend or close family member to be diagnosed with cancer. It usually comes at us out of the blue, often when we least expect it. So, what can we do? How can we be a good friend, neighbour or relative to someone with cancer?

So often, because of our own fear or discomfort with this disease, we back off, and stay away, leaving the person with cancer not only to deal with the difficult treatment, but also reeling from the effects of being abandoned by family and friends. Most people who have had cancer will tell you stories about friends that stopped calling, or family members that made themselves scarce.

When cancer hits, what a person really needs is a support network that can help them out both physically and emotionally. You do not have to shoulder the entire burden here by yourself, but you certainly can decide what part you wish to play.

If the person who has cancer is someone you have been close with, and shared “heart to hearts” with, try to continue to be there for them emotionally. That means, inquiring gently, and letting them talk as much or as little as they want. Some people who have cancer like to talk about it and others do not. There is no one right or wrong way to go about this and it is important as a good friend, to respect the person who has cancer. Let them call the shots. Remember: this is about them, not about you!

If your relationship is more casual, or you are uncomfortable with hearing about the cancer and providing the emotional support, think of what you might do to help the person physically. This may mean doing the grocery shopping, preparing a meal, babysitting, helping with errands, or sending over a cake or casserole. So often people say, “If there is anything I can do, let me know.” They mean well, but this does get tiresome. Far better is to suggest the things you are available for, and have the person choose what suits them. Is it an afternoon outing, a meal, a drive to the doctor, or something else entirely? Not all people with cancer are comfortable asking directly for help, and sometimes we just need to figure it out as best we can.

The most important piece of advice here is to SHOW UP. In other words, be there for your friend or relative with cancer. Don’t wimp out because you are afraid, or think you can’t handle it. Ask yourself what you can do to help out your friend or relative, and do it. Show in both words and actions that you care. You have no idea how healing this can be.

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Life Unexpected: The Aborted Ride

The last day of the old year is an auspicious time to start a blog.  I have called my blog, “Life Unexpected,” and hope to share with you the vagaries of life and reflections of a personal nature, as well as thoughts and musings about the goings on of life in Israel.  I am a psychologist specializing in trauma and resilience, and as such will inevitably focus on these topics as they play out here in Israel.

How did I come up with the title “Life Unexpected”?  For a start, this is the title of my newly published book about my journey through breast cancer.  This title represents for me one of the big takeaways from that experience, namely, that much as we would like to think that we are in control and in the driver’s seat, that is simply an illusion.  Secondly, life in Israel is always unexpected, sometimes for the good, and sometimes for what seems to be, the bad.  And lastly, the title “Life Unexpected” allows me the latitude to take this blog into directions as yet unknown.  I, for one, am looking forward to the ride.

Speaking of rides, today I woke up bright and early to begin my training for the Alyn Bike Ride – Wheels of Love, to which I signed up last week.  I set out for my first training ride leaving the house when it was still dark.  As I drove the winding roads down to Emek Haela from my home in Gush Etzion, I marveled at how lucky I was to live in such a beautiful country.  The mountains, the valley, the vineyards, the sun rising over my shoulder to the last day of this year, gave me pause, and a moment to give thanks for being here in this complicated land.

I parked my car, put on my helmet and gloves, took the front wheel out of my trunk and went around to the passenger door to pull out my bike.  Lo and behold, there was no bike!  Life unexpected, indeed!  I quickly realized that my son, who had borrowed the car last night, had probably taken the bike out and put it in the storeroom, to make room for his friends.  He had neglected to return it to the car, and I had simply not noticed as I climbed into my car in the pre-dawn dusk.

As I drove back up the mountain feeling the anger and disappointment coursing through my veins, I picked up a hitchhiker, a women about my age (59), dressed in ultra-orthodox garb.  She entered my car and immediately struck up a conversation.  Within minutes, she was giving me advice about how to control my feelings, and how to look at this as an opportunity to learn about how to deal with anger.  This is not untypical of Israelis who often like to share their advice freely, whether solicited or as in this case, not.  I held my tongue as I answered her point for point in my head.  By the time she got out of my car, I had calmed down significantly but was still not convinced that her advice was sound.  After all, I am a psychologist.  I should know a little bit about childrearing, strong emotions, etc.  I drove into my parking spot, as I finally reached my son on the phone, and told him to bring my bike down immediately so that I could still squeeze in a ride. As he put the bike in my car, I uncharacteristically held my tongue and quietly said that we would talk later.

I quickly pulled out trying to make up for the lost time, and took a quick look at the clock in my car.  It read 7:02 AM.  I was puzzled as by my calculations it should have been at least 7:30.  It took a moment before I realized that my reliable car clock had stopped the minute the hitchhiker had entered my car.  I considered what supernatural forces were at play here.  What did this mean?  Was this a sign from the great beyond to listen to the wise words of this messenger?  Who knows? Who will ever know?  Meanwhile, the clock started moving.  As of the time of this writing, the clock is still 20 minutes slow.  I suppose that soon enough I will advance it to the correct time, but meanwhile I am considering the advice I got this morning and the lessons learned from this (mis)adventure.

In Israel, the start of a new year is a time for reflection, for looking back, examining our behavior, what we have done, and what we have omitted.  It is a wonderful opportunity for living the examined life on both a personal and national scale.  My aborted early morning ride contributed to that “heshbon nefesh” (literally, the calculations of the soul), and surely put me on the track for Rosh Hashana.

With best wishes for a wonderful new year, in which the mysteries of life continue to intrigue us, and may we be blessed with ongoing learning in this life, unexpected.

 

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