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Who takes care of the caregiver?

From the Spring 2013 issue of Scrubs

I decide I can’t go with Brian and the kids to his secretary’s party. I feel too anxious, too much in my own head, to be able to make small talk with people I don’t know. As soon as they’re out of the door, I have second thoughts.

Maybe I should force myself to socialize.

Will Brian be able to handle all three kids at the same time?

It’s drizzling outside and the streets are slick. When was the last time I had the brakes checked? I think about the father and his two sons who were killed by a drunk driver on their way back from a ski trip last year. The mother and daughter had stayed home. What if…

Stop! You have precious time alone. Uninterruptible time, reading time, singing time, gardening time.

I stand immobile in front of the window. The house itself seems to be in a state of shock. What, no clamoring? No whining? No crying? In the silence, my heart pounds.

Do something! Clean the kitchen. Turn on the music.

While I wail with Chaka Khan, I fill the dishwasher, scrub the counters, and put away toys. I make beds and throw in a load of laundry. After that, I clean the kitchen floor sticky with juice and spilled pancake syrup. When Chaka has sung herself out, I vocalize with Dusty Springfield singing about “a little lovin’ early in the morning.”

Clearly, Dusty didn’t have young kids.

Singing has always been a tonic for me, a way of releasing my feelings. Suddenly, I’m aware of how much I’ve missed it.

Maybe I should join a church with black gospel singers. I’d love to let loose like that every week.

The church ladies stood in a circle around Linda St. John, a twenty-nine-year-old woman who sustained a broken femur and multiple contusions when she was hit by a truck that jumped the curb where she was waiting for the bus with her seven-year-old daughter. The little girl was thrown into the air. She died in the ambulance.

The church ladies’ hands were clasped together; their eyes were closed; their soft voices melded into a lullaby.

What a friend we have in Jesus
All our sins and grief to bear
What a privilege to carry
Everything to God in prayer.

My baby, she said, my baby’s been taken from me. Why did God take my baby from me?

How will Linda get through the day? How would I get through the day if it were my daughter?

I understand nothing about losing a child.

“We were just standing on the corner waiting for the bus. She was telling me about a boy in her class who could wiggle his ears. I said, ‘I bet you could wiggle your ears if you really put your mind to it’ and she shut her eyes to concentrate when all of a sudden I see a truck jump the sidewalk in front of us. Oh my Lord Jesus, he’s hit my baby! My baby. Help me, Jesus. But I know she’s gone. I know my baby girl is dead.”

I do not want to cry in front of a patient.

Sometimes I can distract myself but in front of Linda St. James tears stream down my face like Yosemite Falls in spring. It’s so sad I almost can’t bear it until I realize that she must bear it, not I. She must endure this sorrow while I get to go home and hear my children’s laughter and feel their kisses and hugs. Life is not fair.

Don’t go there. How about the garden? Weren’t you going to dig out that plum shrub?

I pull on my jeans and boots and walk into the drizzle.

Nasty barbed whips grow from each branch. I begin to slice the earth around the roots with my shovel. Not so much as a rootlet snaps. When a barb hooks my forearm skin, I curse and change tactics. Gripping my pruner, I begin to sever the five to six-foot whips on each branch, removing most of them by the time the drizzle turns to rain. I bundle and tie the whips with jute rope. When I stand up my head spins. Kneeling, I wait for the feeling to pass.

After a shower, while waiting for my tea water to boil, my head starts to spin again. I forego the tea and drift off on the couch with a wool blanket stretched over me.

When I awaken, it’s dark outside. Where’s Brian? It would be like Brian not to call. During the workweek, he rarely calls during the day. He is so focused the thought just doesn’t occur to him, even when the kids are sick. I make a cup of tea and carry it over to the piano where I play one of the few songs I know from memory, “Like a Lover,” barely hitting the high E flats I used to make with ease.

Rummaging through my Laura Nyro songbook, I turn to “Billy’s Blues.” When I sing, “Billy’s down, he was born, he was bound to lose,” Will Avery’s face appears in my mind’s eye. Will, who told me he had killed two women by the time he was four—his mother in childbirth and his aunt in a car accident he had inadvertently caused—spent his entire life avoiding people. After barely surviving six weeks in the ICU with necrotizing pancreatitis and with $1500 to his name, no one who cared, and no hope for a job, he turned his face to the wall and died. Before I finish the last note, emotion rises up in my throat. This time I give in. No one’s here. No one to upset but myself.

Oh, Will. If only someone had told you that four-year-old children cannot be held responsible for killing people, you might have forgiven yourself and found some happiness.

I am full out crying now, so this must be the mother lode. I mix myself a vodka tonic and take two ibuprofens for my throbbing head.

It’s after six. They left before ten this morning. Why aren’t they home?

By seven o’clock, I’m pacing and wondering if I should call the emergency rooms.

Maybe another drink will help me not bite Brian’s head off when he walks in. But the alcohol has already unleashed my worst thoughts.

I didn’t tell them that I loved them this morning when they left. What was the last thing they heard me say? “Mommy needs some time to herself.” When did I start putting my needs above my family?

Then, another dizzy spell sends me to bed.

“Mommy! Mommy!”

Lights snap on.

The boys jump on the bed. “Let us in!”

I groan, “Mommy is sleepy. Where’s Daddy?”

“Hey, Laur. It’s only eight o’clock. What’s up?” Brian drops his backpack and takes off his leather jacket.

“I’m just beat. Could you pop the kids in the tub and put them to bed?”

I hear exasperation — he’s been watching the kids all day — but I can’t force myself out of bed.

“Mommy, where’s the gold marker?” demands Corianne. “I NEED it for my Victorian house project.”

I try to answer but something triggers a coughing fit. She stares at me as if I were withholding vital information from her.

“In the telephone drawer,” I sputter.

I kill the lights and slide back under the covers, coughing through the early morning hours before finally falling into a dead sleep.

Brian’s heels click on the hardwood floor.

“Bye, Honey,” he says, “I’ve got to get in early for a conference call. See you tonight.” Heels click down the stairs.

Wait a minute!

The door opens, then closes.

I will myself up, roust the kids, make breakfast, pack lunches, drop the kids off, and collapse back into bed.

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Laurie Barkin, RN, MS

Laurie Barkin, RN, MS, is a psychiatric nurse consultant to the University of California, San Francisco. She is the author of "The Comfort Garden: Tales from the Trauma Unit."

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