April 22, 2014

We began our operations leadership meeting this morning with music. Our special guest, Tom, a retired computer programmer also spent years as a rock-n-roll band leader. Now he volunteers at one of our largest hospitals. He journeys the halls and sings and plays his guitar for patients in Hospice, Palliative Care, and Oncology.

Between songs he shared stories of some of the patients he spent time with. One was an early stage Baby Boomer now in the latest stages of cancer. She was actively dying. Within days or even hours of completing her time in this space. Tom wasn’t aware.

He sang for her. She smiled and said, “How about Knockin’ on Heaven’s Door?” He appreciated her spirited sense of humor and gladly played for her. She thanked him and said, “Play another.” Tom played and they chatted for a moment more. As he packed up his weathered acoustic, he said…

“Ill see you Monday.”

“No, Tom, you won’t. I’ve been told I probably won’t make it through the weekend. Will you consider singing at my funeral?”

Tom replied, “I’ll do anything for you.”

She died that Saturday. He sang the following Tuesday.

From our earliest moments with lullaby’s from a mother, to our final hours with hymns or favorites at the graveside, and all the times in-between, music is such a critical connecting element.

I will think of Tom and his gift to our patients as I sing tonight. I will thank my fellow troubadours at Open Mic for how they each add to the joy of this life. I’m going to call Mom and thank her for encouraging me to listen to whatever I liked growing up. I will call my sister and thank her for playing guitar and for being the first to get me interested in one of my own. I’m going to take the long drive home today to my North Carolina home and turn up the volume along the way.

As I study and attempt to apply the whole idea of presence and mindfulness–a full time quest–to my personal and professional life, I find so many treasures of connection. For many years, rounds were more of an inquisition or an interview. A series of questions, all good ones, but almost teaching patients to our test.

Now, I just greet and listen to their story. Whatever story it is, their stay with us, their life in or out of our care, whatever is on their mind.

Eunice is a soft-spoken, petite, perfectly mannered, self-educated, adorable lady who has spent 91 years on this planet. She sat in her chair, a blanket wrapped around her waist. She was just finishing her lunch. He hair wrapped in a knitted cap from her daughter. She proudly pointed it out to me as she turned and smiled at her daughter sitting on the couch by the bed.

With almost a century of story with her, she has seen a lot. We spoke briefly of her experience through the hardest times. Physical trials through times of extreme poverty. Emotionally through the toxin of racism. And now, spiritually as she confidently and peacefully addresses her mortality. Yes, all of that in about 30 minutes.

I asked, “What have we done right for you? What can you tell me that will help us improve?”

She touched the napkin to her lips. Eunice cleared her throat and said, “Excuse me,” as she shifted to sit up a little straighter in her chair.

Her voiced raised a bit as she said, “It’s been wonderful!” She turned her view to the nurse assistant and the nurse who joined us in the room, pointed her finger at them both and said, “Because they make me feel loved.”

The room was silent. Smiles beamed from ear to ear on the faces of our beautiful caregivers.

There was a little more chat and we offered our best and thanked Eunice for her time. I leaned in and we exchanged a hug.

I shared this story in a meeting the following day. There was clearly a mix of positive energy and some tension in the room. I opened up the dialogue. One colleague asked, “Don’t you think ‘love’ is a little much?” The question opened and thoughtful conversation about the nature of compassion, empathy, and yes…love as an expression of our care. We landed in a soft place of openness to the possibilities, the responsibilities, the burdens we share for our patients, and the privilege of caring. 

I can’t say whether our two nursing staff loved Eunice or not. That is theirs to offer. But Eunice felt loved. Love transcends customer service; it offers a degree of commitment and trust; it is an unexplainable connection at the level of the heart. Who is to say what rules or boundaries there are to love? There isn’t a protocol or a clinical pathway. No service standard or guiding principle. It is something in me offered to you. Something in them offered to her and in return.

I would hope that true empathy, the kind that comes from a compassionate spirit goes so far as to make those suffering feel…loved.

Eunice, may you continue to bring the joy you do through your smile and words and gentle presence both here and in the next places. Thank you for spending time with me and our team. To Kristen and Charise, thank you for doing what so many of our amazing people do…lead with the heart and heal so beautifully.

Sean

I love making administrative rounds. These few hours ground me and remind me of the burden and privilege we carry. Greetings, welcomes, thanks, small talk, serious talk. The visits are never ordinary as each patient has this journey…this unique experience…this story that is there staring at me and waiting to be heard.

“Alex” offered a half smile as we entered his room. I introduced myself and inquired about his stay. I scanned the white board on the wall and remarked on some of his goals and offered accolades for his general surgeon. It seemed a pleasant and uneventful encounter. Then he stared at me with a look that was saying, “You really have no idea, do you?”

I pulled up the stool that was tucked under the counter. I asked if I could sit. I asked about his home: he had none. Family: none. Friends: none. He rescued me from empty chase for filler in his story.

“Where does the name ‘Keyser’ come from?” he asked. I told him what I knew of its goat path to Ellis Island. “As romantic as it sounds, I have no idea of its true history.” He smiled.

“Does a name make you someone?” he asked me. Curious, I thought for a moment and replied….”I guess it gives us context for an image of who we are.”

A bigger smile crossed his face and he said, “I like you, man.” Then, his eyes changed and softened, his smile relaxed. “I don’t know if my name is necessary for anything other than to paint that board up there.”

His eyes never left mine. Mine never left his. I sensed he wasn’t finished with his thought.

“I am walking anonymity, Mr. Keyser.”

I sat quietly, never asking him to elaborate. I didn’t offer a retort or an encouraging word. It wasn’t time.

“But for this pain inside, you would have never known me. Just a straw in the bail…not even a needle to be found.” This rugged poet of a man shook me with his words.

He wasn’t cynical or bitter–just sort of resigned. “It’s really not so bad, I don’t have to worry anyone or make them afraid.”

My chest tightened and I fought back a tear. I leaned in and said, “No one should be anonymous. You are with us now. For this time you are…Alex.”

We sat silently for a moment more. His nurse assistant knocked and entered, asking permission to take care of some things. Alex smiled and said, “Sure, Dear. I’m just chatting with my new friend.” I stood and said I would like to come back and visit more. He politely nodded in agreement, sensing it was unlikely, but considerate.

I stepped out of the room and took a deep breath. My body felt a rush of cold. Mildly choking from the lump in my throat.

It snowed the next day. I worked from the comfort of my home. I talked to my daughter and my mom and my friends and others I love. I ate and played my guitar by the fireplace. I don’t think often about what it would be like without all of this. I am grateful for every person and every thing and every moment, but there are times when life crowds the gratefulness. Alex brought me back.

I returned to the hospital Friday. I didn’t check the patient list, I just walked to his room. Another patient occupied the space previously his. I remembered our few moments with a stool next to a bed in a quiet room of contemplation.

Alex, you are not a straw in the bail. I hope our time offered your body a chance to heal. I hope our time offered your spirit some comfort. I hope you find a home, friendship, and a family beyond the new one you have in us.

A walking paradox. I treasure the time in the gatherings of many. Though my time alone becomes increasingly critical to my health…emotional, physical, spiritual. My growing distaste of small talk and materiality is at a tipping point. So much of it serves to veil the deep passions and the trials of those around me. I avoid the very places I used to love for an absolute fear of the same introductions followed by the same topics and the same questions and the same looks that bounce around a room with kinetic–or should I say pathetic–energy.

They…we… mean well. Its manners, I guess. But, I find myself shying away. And I’m not shy. I find myself more in retreat. I typically swan dive into life. Is this a primer for a life of a recluse? A proverbial Howard Hughes.

I don’t think so.

A signal adjustment is in order. I feel restored when I stand before a piece of art; when I listen to a song with story layered on thoughtful melody; when I notice the tone and inflection in another’s voice in conversation…and the meaning in their eyes; when words of poetry have so much life I might as well be reading in brail and feeling each word; when I am on a bike in the woods hearing the crackling mulch under the wheels or on my kayak in the marsh; when I sit quietly and scratch the bridge between my loyal pup’s nose and forehead (R.I.P. Tybee).

I am going to the beach soon.

No computer. No phones. No “i” anything. Some hardbacks, my first guitar, a bike, a boat, and this old body carrying a mind too full and a spirit needing to be filled.

Not seeking an epiphany. Not expecting an Oprah moment of discovery or Maslow’s self-actualization. Just peace of mind. I expect to run and purge. I expect to rid myself of any demons of cynicism that try to create a beachhead against my joy. This is a life of joy.

Ride. Dive. Swim. Sing. Be quiet and let it in.

December 2013

I opened the door and swept my shoes over the mat and shook the drops of rain off of my coat. She was sitting in a chair in my den, the television on, the screen blue and blank. Mom was clutching the remote in her hands. Looking at it as if it was going to wake and speak to her. Her face showing a mix of frustration, confusion and sadness.

I said, “Hi” and asked what she was up to. She mustered a token smile and replied, “Oh, nothing much.” I asked if she was having trouble and she nodded her head. Mom had been sitting there for the better part of an hour or so, hoping that pressing a combination of buttons might miraculously mix and find a channel, any channel interesting enough to stay with. She was afraid to mess with this device for fear of pushing the wrong button and losing connection. It had happened before. It had happened again.

The look on her face told a story. Her eyes spoke volumes of her current lot. In these later years she has less independence and more challenge. More fears and less possibilities. Ironically, she is one of the most positive people I have ever known. Optimism’s reality can be squelched or at least derailed for a time by the body and the mind’s loss.

And here am I…frustrated from time to time at her inability to get past it, or get over it, or make a different choice. Who the hell am I to dare get mad or frustrated at her for those things that swell and choke out so much of what was.

We children can sometimes deny time’s affect. Life is this majestic sea that, with all of it’s mystery and beauty, also erodes the land’s edges.

I am a student of empathy and wonder if I am the least empathetic with those I love the most. I chase possibilities and hope while cursing mortality’s riddle.

Within the last two years she has lost the privilege of driving, had a knee replaced, suffered from arthritis in her back, has seen the pressure of her blood rise and fall like tides, has struggled with deteriorating vision, and has had memories leave and return almost at their own will.

With all that, still smiling. Asking about MY life and work and love. Grateful for most every moment. Nostalgic but still speaking of dreams for the future. How would I be in the same circumstances? How will I be in those circumstances?

I watch silently from a hallway on this Christmas Eve morning. She sits and stares at her crossword puzzle book or at the paper or the television. Turner Classic Movies or The Weather Channel or Joyce Meyer. Some curious mix of living in the past and anticipating the days ahead.

I have so much control over what, when, how, and where I do things. My choices remain seemingly infinite at this decimal of life. I have health and good work and means. My challenges are significant, but I am able to fight them…or negotiate them. What if I couldn’t? I don’t know the feeling that surrounds trying to force a body or a mind to do what it wont.

Tony Robbins can’t motivate you to remember what happened only moments ago when it chooses to leave. Charles Stanley can’t pray you through a body that won’t run with you again. There is only so much a jungle fruit or herb remedy can do to reverse the outer layer’s signs.

Life changes. We adapt. We focus on less, but with more intent. We make choices…a proverbial fight or flight. Some are good fighters and good flyers at heart, their wings clipped, if you will.

Not her.

Determined that she will fly again. She might need help getting altitude and then be more of a glider than a jet. Now leaving this metaphorical jaunt to say this… I love you. I am grateful for having the privilege of spending all these years with you on the same planet. I wish proximity had been more kind. Sis and I will tow you to a higher place and be a part of your gliding for years to come. We begin, again, now.

Sean

It’s about this time of year that on a rainy day, like today, I dig through the closets and the drawers and through the unpacked boxes and purge of those things that need a home away from here.

I took on the boxes of clothes that somehow made their way to the attic in my town home. They were all from those days before I decided to be better to my body…eat smarter…try and live longer and with more joy.

I unfolded and re-folded and counted. 14 pair of slacks, 2 pair of jeans, 11 dress shirts, 9 polos, 4 belts, and a pair of cargo shorts (what the hell?). I threw it all in a couple of lawn bags and headed down the road to Goodwill. There was a huge line for the unloading dock. That’s a good thing. A virtual two-fer. The passing of good things for those looking to get bargains or simply get warm this season.

I decided to park and carry it in. The rain was light and the place was packed. I popped the trunk and grabbed the bags. A few pair of slacks fell out and I was picking them up to stuff ’em back. A woman and her teenage son were walking by. She saw the stack in my hands and commented, “Those look really nice.” I turned and smiled and said, “They actually are really good clothes. Most of them new when I started losing a lot of weight.” She asked if I was taking them into the store and I said I was. “I wish my husband was your size…he needs good pants for when we go to church and to my momma’s.” I laughed and said, “What size is he?” She told me and I said, “That’s about the same as I was when I was wearing this stuff.” When she told me he is about my height, I said, “Where’s your car?” Puzzled, she said, “Right over there.” She pointed to an old brown Buick with a cracked windshield and one window duct taped to hold it in place.

“Well, if you don’t want to shop for him this year…they’re all yours,” I said.

“Really…you’re not serious…really?”

“It’s up to you,” I said. Her face lit up like the Christmas tree in the window of the store. Her son ran and opened the trunk. He moved the spare tire to the side, moved some bags over and ran back to me to take the bags.

“Merry Christmas,” I said. You just saved me some time and your husband got a new wardrobe.”

She laughed like a little kid and exclaimed, “I can’t wait to wrap these up and have them under the tree.” We exchanged a hug and I wished them all the best.

As I started my car and cranked the volume of Vertical Horizon, I couldn’t help but think–as I always do during these handoffs at the Goodwill–of just how much I have been blessed with in this life. Relationships, work that means something, and yes…stuff. With each passing year the material things mean less and less to me. Giving them over or throwing them away becomes less of a conflict. I knew someone out there would benefit from this small wardrobe given to this great organization. It was a pleasure to be there for a first-hand exchange.

Merry Christmas, Joan, Andy, and Andy Jr. Thank you for letting my blessings now be yours. Joy.

Terry Moran described the celebration and this good man with those words. It was a cold, pouring rain in and around the packed stadium this day. Rain is a sign of blessing and joy during a memorial in Africa.

There is nothing I can say about the man that hasn’t been said by those galactically more eloquent that I. This simply offers my penned tribute and gratitude.

My library contains three books by and/or about the great Nelson Mandella. My favorite, In His Own Words, offers personal reflections of a life of oppression and freedom; of courage and vulnerability.

On the night of his passing I walked down and pulled the works from their place on the shelf–or from their place in a stack on the floor. My hand shook a little as I pulled Long Walk to Freedom from my autobiography section. I realized the subject of these thousands of pages had now left us. I paused and offered a wish for peace and said “thank you” as I stood in the small room filled with books and bottles of wine and music of all kinds. I realized I was surrounded by the things that feed my soul, and how such a soulful man, chief among them, was now gone. This book sat next to Make Gentle the Life of This World: The Vision of Robert F. Kennedy. An ironic and sweet proximity.

I experienced racial prejudice for the first time after moving to Panama City, Florida at the end of my 7th grade year. I was motioned to a seat in class next to Angela Woods, a beautiful, kind, and edgy girl. She smiled and offered a muted, “Hi, new kid.” Oh, by the way, she was–and remains–black. Later that same day, I found her in the cafeteria during lunch. Not knowing any better (or worse, in this case), I sat down next to her and enjoyed chicken chunks of some variety and peanut butter balls lightly covered with powdered sugar. After lunch I went to my new locker and was immediately surrounded by four or five guys, all wearing baseball caps (what is it about race hate and baseball caps with select logos?) who wanted to let me know, through a series of pushes and shoves, that we didn’t need any more “nigger lovers” at Rosenwald. That was the beginning of an orientation to a disgusting and continuing chapter in this “Land of the free.”

Things eased a little over the years. People found their uncomfortable “place” in this still-struggling society. Some of us use the discomfort for advocacy. Others rely on the discomfort to remain hunkered down in their ignorance. Keep the fight.

Mr. Mandella fought…in the best way. Through his words and actions. He moved millions from a cell in a horrible prison while serving a life sentence for his struggle against the abomination of apartheid. As history has proven, truth and justice have their way over evil, ultimately. As providence would have it, the planet was exposed for a time to a man, like others in history, who was willing to pay with his life for a cause of freedom.

My friend, Basil, once said to me, “The only time in my life I have felt pride in being a South African was in February of 1990, when this good fighter was released from the hell of injustice.” My friend was a 25 year-old at the time. A student and a protester against apartheid. I’m sure he is sad this week, but also smiling on a life devoted to defeating ignorance. Smiling on a life dedicated to speaking for and standing for what is right, regardless of our fucking’ placement on the color wheel. I’m sure Basil raises his face to the cold rain and smiles.

It is raining in my Carolina this morning. I will walk outside to do just the same.

Peace, Madiba. Thank you.

Sitting comfortably in my First Class seat from Charlotte, NC on my my way to Lawton, Oklahoma via Dallas, Texas. Comfortable, but anxious, like the kind before going on stage or on a first date or racing toward an unknown trail. Mind and heart racing and wishing I could add thrust power to this Boeing 757. High above the clouds that canopy a huge Winter storm sweeping the midwest and waltzing her way toward my Carolina. I gaze from my window seat across the sun-drenched sky around me. I look down at the clouds below, knowing that the earth underneath is gray and cold and wet. Above the storm and hoping she is kind as we soon descend through her on our way to the place I belong over these days of giving thanks.

He was the greatest little boy. Logan Ted Keyser. Born on the fourteenth day of April, one day after my own. God’s additional reminder of the beauty of life’s circle.

Chelsea was born only days after Dad’s passing. He held her in his arms before leaving us too soon. Her birth brought joy where sadness was so overwhelming. To this very day she represents what is possible, not what is lost. Then, two years later this little guy would add his own serendipity.

My birthday was destined to be melancholy. Dad died on April 12. With my birthday on the 13th of the same month, how could it not be a sad time? Well, there was a plan…Logan arrived on the 14th. Again, where there is loss, there is joy. A yearly reminder of life’s precious cadence.

My little man graduates from Basic Training tomorrow morning. His own destiny revealed. He grew up a cheerful spirit. A peacemaker of the most extraordinary kind. Playful and curious. His hope for reconciliation in a broken home was always trumped by his love for us individually. Always the one to want the best for us–whatever that meant. Always the most encouraging and affirming.

His dad, an athlete and a bit of an artist. Logan sought his own way through the things he wanted and the things we wanted for him. Good at everything…great at few (according to him, at the time–I happened to think he was perfect). Then, as he moved into high school he found his own groove. Wrestling and guitar and theater. His curiosity turned to passion. He took a stage, never seeking applause, but hoping to express and share his gifts. Teachable. Inventive. Authentic. Loving.

Five years ago, on a visit to Charlotte he said, “Dad, I think I’m interested in medicine and nursing.” Well, he was in the right place to find out. I put him on a three-day scavenger hunt with physician and nursing leaders in one of my hospitals. They took him in and offered their guidance. He saw what happens in these places of healing. The mix of science and art. From invasive surgery with instruments and gasses and protocols to the compassionate enveloping hands around a little life born too early in the NICU. He came home day 3 and said, “That’s what I wanna do.”

He did. A graduate of Belmont University’s nursing program–one of the most respected in the land. It was all a part of his master plan.

He would not only use his unique mix of compassion and precision in medicine, but serve us all as a soldier. He raced to his dual calling with determination that inspires me to this moment.

As I watched the van drive from the parking lot of his swearing-in ceremony, September 17th, I cried and cheered at the same time. He waved through the window and nodded at me as if to say, “It’s okay, Dad…I’ll make you proud.” He already knew that from the moment I brushed my hand across his little newborn bald head that I was the proudest man alive…its never changed.

In a matter of hours I will see him in his Army uniform. Prepared and fresh. Proud and strong. A natural leader of men and all people. A servant for a country and to anyone in need. In a matter of hours we will hear his stories of Basic and meet his new family of “battle buddies.” We will relish every moment as they will be fewer and fewer from this day. I will give thanks on Thursday for so much, but especially for the gifts of Logan and Chelsea and for the rich life they bring to this planet.

Logan didn’t get to meet my dad, but their soldier connection is something they will both smile on. I know Dad will fly air cover for his grandson for the years to come.

Now, as we descend through this storm and head for earth, I pray for his safety, for the ability to stay above the storms, and also for a soft landing from those he must go through.

You are my hero, Logan.

Love,

Dad.

No matter how many times I experience a museum of art, in today’s case, The Mint in Charlotte, I find a whole new range of sensory response.

Emotive.

The permanent exhibits speak differently as if to say, “I’ll bet you didn’t catch this before…” This hue, this movement, this texture.

The uptown jaunt was to witness the early exhibit construction by artist, Motoi Yamamoto. The exhibit is one of his “Returned to Sea” projects. His medium is salt. Just salt. Motoi works with surgical precision and a painter’s flow to produce an evocotive floor of beauty.

We stood silently watching as he sat quietly on a mat and delicately and rhythmically moved as salt flowed from a plastic funnel, like those used by bakers applying icing to a wedding cake. The room was silent but for the sound of grains as they spilled onto the surface. Motoi would turn his head here and there and move his mat back a few inches, adjust his position and pour over the next waiting area. The organic beauty and the silence and the craftsmanship in the moment were enough to fill a day. Once, just for a moment, he looked up and offered a smile and got one in return. Mutual gratitude.

Then, strolling through from room to room, the voices spoke from the canvas, the metal, the wood, the glass, the clay, the fabric, and all other manner of vessel for expression. They did what they do. Some whispered. Other pieces screamed out as if an anxious child demanding attention. Others, still, as if coyly inviting my interpretation. Peace.

Exiting the place of art brought an entirely new and unexpected joy. Snow. It fell from the sky in waves and quickly covered the cars and the benches and the streets of uptown. It blanketed the floor outside. It’s product equally beautiful and strikingly similar to the salt covering the floor only a few feet away inside.

The drive home was quiet and appreciative. Taking in the art of this soulful man from Ishikawa and the art of nature as she poured onto her canvas.

It was a good day.