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A recent blog reader commented on my pandemic lessons post with the comment "we are not all scared and trying to stay alive." I have had to sit with that for a few days. I am not scared of death... for many reasons... but a lot of it does have to do with my blood, sweat, and tears I have poured into countless patients for decades now... as well as my faith, but the two seem very intertwined when I think of my own mortality. I think another reason is that I have a chronic illness and I know end-stage pulmonary fibrosis (how my disease usually pans out) is not a cake walk, so if God calls me home at another time for another reason, I am okay with that. But, I think it's her last little bit of commentary that hasn't settled well in my soul. "We are not all trying to stay alive." We are not all trying to stay alive. 🤔 🤷♀️ 🧐 But aren't we, though? Isn't that why all of these scenarios insight fear, panic, palpitations, stomach-drops, sweaty palms, and often tears?
This post is not meant to be a Debbie Downer. It's meant to be a reality check for myself, and perhaps for you too. Every SINGLE day in my work, I encounter people I hold dear now after all these years that are FIGHTING to stay alive. Whether it is cancer, chronic disease, renal failure requiring dialysis, congenital or acquired physical disability (think MS, cerebral palsy, and paraplegia to name a few), OR they are in an unsafe home environment OR they are mentally on the brink of self-harm. they are each FIGHTING to stay alive. The following examples have all taken place in the past 2 years along with countless other patient deaths (some covid, some not), but these have rocked me. I lost my first patient to suicide this year and I am not the same. I always worried about him. I would leave our visits thinking about him. Did I do enough? I lost a close friend my age, someone I admired- so many admired- this past year to a 6-year battle with colon cancer, and I have tried to help my friend of 27 years keep herself and her children together during and after that loss. I am still learning - we all are. This is new territory for us. I lost a patient my age that was so much like me health-wise and personality-wise that it was like looking in the mirror every time we had our visits. We just happened to have different colored skin, but our hearts, fears, loves, and passions were so aligned. I was the one her son called while the nurses were "pounding on mama's chest" and I was the one weeping in my parents' backyard looking to the heavens begging God "please don't take her, she's not ready. Please don't take her, she's not ready. Please, please, please Lord don't take her yet." As I attended her funeral, it was like I was attending my own. I still think of her so very often. So yes, dear reader, I can agree that most of the time I choose not to live in fear. I have a "crappy" (it's my blog and I will almost-cuss if I want to) autoimmune disease that makes me feel lousy some days and fine other days. I take mouthfuls of medicine twice a day and my Humira costs could house a small family (thank you Aetna for your coverage). Occasionally, I "fear" not ever seeing my 2 youngest sons graduate high school or college. I "fear" never meeting my grandchildren, and sometimes I "fear" my precious boys having to take care of dear old Mom. I'm afraid I won't get to tell them everything I want them to know about me, about love, about God, about marriage, about friendship, about what truly matters, and about how to navigate the good days and the bad days. How to forgive, how to keep moving forward, and how to love themselves. Honestly, I think it is part of why I felt this huge push to write. They don't read my words now, but they might one day. But as for not trying to stay alive? I will disagree with every hair on my head, bone in my body, and adjective in my razor-sharp vocabulary on that friend. I AM TRYING EVERY SECOND OF EVERY DAY TO STAY ALIVE. And I stand witness and hold space for every other person I have cared for during my career in nursing and medicine who were all and are all still trying to do the same. I learned a new term today during a visit to Little Havana in Miami. It was made for the patriots who were anti-Castro who often became political prisoners. They were named "Plantados" - they stood planted, strong, unmoving, unwilling to step down. I am a Plantado for life, sister who made that comment. I shall never budge on that. I am here, showing up, every single day- trying to stay alive. I welcome my fellow Lifers. Let us make this world a little better each day. 🌎 Please help support my fellow Hope*Writers
by reading their work 🥰 Does Fear Have a Place in the Life of a Christian? By Regina Marcazzo-Skarka https://reginamarcazzoskarka.wordpress.com/?p=90 Living Fearless By Sharla Hallett www.sharlahallett.com/living-fearless/ I ain't afraid: Reflections on turning 50 By Jessica Weaver www.rootedunrooted.com/blog/i-aint-afraid When Hidden Fear Creeps Out By Dianne Vielhuber https://simplewordsoffaith.com/2021/10/31/when-hidden-fear-creeps-out/ How to Help Kids with Anxiety and Fear By Ashley Olivine https://louvaria.com/how-to-help-kids-with-anxiety-and-fear/
Before deciding if you love me or hate me, let's look at each of these in a little more detail. If you are reading this and you don't work in healthcare, I encourage you to close your eyes. Imagine driving to work where patients are very sick and you are responsible for their health. Imagine being extremely exhausted - mentally, physically, and emotionally. Imagine having the same conversations day in and day out. Imagine wearing a mask and face shield all day every day AND if you work in certain healthcare settings, full plastic gowns (sweaty and HOT) with even more restrictive masks (n95). Think about having heart-wrenching conversations about death and dying with families and patients that you have come to love over many years. Consider praying on your drive in and your drive home because you've worked in healthcare since you were 19 years old, but you've never seen anything as dark and dangerous, cold and pointless, savage and destructive as THIS. Imagine that you, like everyone else, have also been unable to see loved ones, travel, send your kids to school without a mask, and that you- like everyone else- have your own political and religious beliefs but you cannot mention those since ALL eyes and ears are on you. Now imagine doing that every single day for 20 months in a row.
I usually wrap up my posts with some heart-swelling, tear-jerking, or funny concluding thoughts. I try to connect us as humans, mothers, fathers, daughters, sons, sisters, brothers, neighbors, and friends. I find a way to touch you, soften you, move you even if it’s only for a moment. I don’t know how to do that with this post. I’m tired. I’m sad. I’m frustrated. I’m still hopeful. I still believe. I guess I will end by asking all of us to consider the division we have all felt over the past 2 years. Consider the lost lives and energy we have all spent to prove we are right. And hug your family. Hug your loved ones. And look your “enemy” in the eye before you judge their choices. We really are all the same. Imperfect. Scared. And trying to stay alive. 🌎 I do want you to listen to the podcast, because I think there are some big pearls in this interview, but here are a few highlights:
Find out who is in your circle:
Plan as much as you can ahead of time:
Final pro tips: -Keep a medical binder of all your paperwork -Have a designated inbox for all incoming papers (follow The Planning Woman for more on this) -Apply for intermittent FMLA with your employer -My personal pro tip: PET THERAPY! 🐶🐱 Charlie the Dachshund makes everything better!
State Prints from Jane- White on White Frames from Amazon These are the 4 states in which I've lived!
LUG Switch crossbody bag - came with free phone holder that you can touch through (though I haven't tried it) and it has that RFID technology that keeps people from scanning your card #s. Ya'll, this was my first ever QVC purchase and I am 45 years old. I love, love, love the bag though for shopping as it's the perfect size for my small LUG Splits Wallet (got it from amazon- will link on my tools page), my phone, keys, lipstick, coupons, mask, and hand sanitizer. I think the QVC chic showed it worn as a fanny pack also, but I haven't been to Disney since I got it. :-). I know I paid under $50, but I would have to look back at the exact price. I can't find the exact one on Amazon but I linked one very similar in my "tools" page. This bag is still available on the QVC site but the colors are very limited. 👀
When a patient presents with hair loss, I obtain a thorough history:
I then perform a thorough physical exam and order the following tests:
That may not “answer” your question but I hope it helps you know what a clinician will be looking for with this presentation of hair loss. 🩺👩⚕️ Personally, I have dealt with hair loss from taking Methotrexate for my sarcoidosis.
It started coming out in clumps in the shower and then in my brush. I soon had very patchy areas of hair loss all over my scalp. My hairdresser advised me to stop applying heat to my hair when possible, to wash my hair less frequently, to avoid ponytail holders when possible, and to avoid any hair color or harsh chemicals. I usually got some blonde highlights in the spring put in my naturally red hair, but I went without those for 4 years while I was on Methotrexate. My rheumatologist increased my Folic Acid dose from 1 mg to 2 mg daily, and I ordered Biotin off Amazon Subscribe and Save. I took the Biotin daily to help with hair growth. I am finally off Methotrexate and on Humira and am seeing hair growth again. Losing my hair was very emotional for me. My bright red hair has defined me for so long. I now knew what all of my patients struggling with hair loss from chemo or other medical reasons were feeling, and boy was it a wake up call. My heart goes out to anyone struggling with hair loss. Much love to you and I hope this helps. I was surprised 🧐 when the vaccine came out for frontline HCW (healthcare workers) in December 2020 and the general public started claiming it caused sterility. Let’s use common sense. 🧠 It takes 1–24 months 📆 to conceive before most providers start to investigate infertility. It takes 40 weeks to carry a baby 🍼 to term. Let’s average conception time to 12 months and add the gestation time of 9 months🤰 to = 21 months. Covid REALLY started to hit the US hard about 18–19 months ago. The vaccine was available to some of us 9–10 months ago but MOST of the women of childbearing age could not receive it until 5 months ago. How can anyone claim infertility at this point in time? 🤔 I never say never because I am constantly learning in medicine. Every day I see something I never thought I would witness. I have had pregnant women🤰contract Covid and pregnant women🤰receive the Covid vaccine. I have also seen pregnant unvaccinated women with Covid whose babies had to be delivered while mom was on the ventilator. My community just lost a 28 year-old mother of 3 who never got to know her newborn. 🥲 The American College of Obstetrics & Gynecology and the Society for Maternal Fetal Medicine issued a joint statement encouraging the vaccine for all pregnant women🤰 in July 2021. I recognize that I have the benefit of being "done" having my babies as I navigate this pandemic. That fact is NOT lost on me. I know young adults are faced with a very hard decision with such a new vaccine and their entire lives in front of them. Early in the pandemic, I even advised some of my young, healthy patients to wait until we had more long-term data... that I saw no serious health risk if they were to contract covid. 2021 changed that. I have had YOUNG, healthy patients on the ventilator and near death. I still believe it is a personal decision, but please be sure you are getting your information from reputable sources and people you trust. Much love...
Those are the 3 phrases that come to mind when I think of intention. And boy do I try to live intentionally. I even chose a name for my blog / business/ alter ego etc with the word INTENT. So why do I feel ill-equipped to write about intention?!? I have all the planners, techniques, vision, and skills to live a life well-planned. I have mastered and honed the Home CEO, Working Mom, and Grown Adult roles so much so that I even write blog posts dedicated to living with intention, being more productive, and living your best life. And then I consider the best days and moments I have experienced. They weren’t planned or perfect. Most of them were a result of unforeseen circumstance. I’m living in a state that never crossed my mind prior to my dad losing his job in 1994 when I was a freshman in college. I’m a mother to a child I never knew existed until he was six. I have AMAZING friends, patients, and coworkers I never would have met had my first marriage not ended. And I’m married to a man who gave me 2 gorgeous, smart, funny, loving boys that never would have known my name if all my plans had worked out. Those that know us would agree we would probably have never been in the same room if it weren’t for someone somewhere creating the internet. So I will continue to plan, manifest, set goals, and make to-do lists. It makes me happy and I like to think I’m in control. Then I will watch some of it unfold, unravel, get messy, hurt, and burn - I will be better, wiser, and more compassionate in the aftermath of my intention. ❤️ As I sit outside to write, I hear birds around me, the gentle breeze in the trees, and squirrels rustling through the leaves. It is a gorgeous late summer afternoon, and I can feel the energy of fall from my toes up through my body and into my smile. Fall is my absolute favorite time of year, only one tiny degree above Christmas. I see a blue-tailed lizard shuffle along my patio and I notice a few dry leaves dancing from the treetops to the creek bed.
God didn't make me to live inside. He didn't make me to sit still or stay in one place either. I have lived in 4 states, multiple homes, and I think I'm on my third lifetime (or so it feels most days). Sometimes, when I'm quiet... when IT is quiet.. I reflect on all I have seen, witnessed, felt, loved, lost, and won. Certain flashes in time come to me, waves of emotions, smells, sounds, and FEELINGS. When I'm quiet. When my day is quiet. When I'm not moving or doing or thinking...
Reflection is a beautiful thing. It is often overlooked, but when we slow down and DO IT, we can learn and grow. Now that I'm in my forties, I sometimes look back at times in my teens and twenties and try to "hold on" to that feeling. We really can't do that, though, can we? Frequent reflection allows us to "hold on" right now. To really "feel it" right now... before it passes. Reflection gives us room to take note, consider future improvements, and relish in current joy. I'm hoping to start reflecting every quarter here. A public diary entry of sorts. A record of the good and the bad. A glimpse in time.
This is what I'm learning right now, September 2021:
Bonus question: what can I do to help? I feel so helpless!
***as always, consult your PCP for your healthcare. I’m trying to raise awareness. Let’s not bicker and judge over vaccine status. Let’s educate ourselves and let’s come together to get out of this public health crisis!!!***
When to test after known exposure (kid, adult, masked, unmasked, vax, unvax, PLEASE READ):
⁃ are the CDC recs confusing? Yes ⁃ Is your school or work throwing out different recs? Yes ⁃ I say this is when our common sense 🧠 MUST play a role ⁃ This is Sally 🙋🏼♀️ and she was around 🤒Bobby who tested + for 🦠Covid ⁃ I don’t care about Bobby’s 🤒 vax status but I do want to know Sally’s 🙋🏼♀️ ⁃ I want to know if 🙋🏼♀️ & 🤒 were unmasked and close to each other for longer than 15 minutes or if something “crazy” happened like 🤒 sneezed or they 🤝 or they were 🍷🍽 together. Maybe they LOL’d next to each other or hugged. How close were they? Maybe they cried together at a funeral? ⁃ Next I want to know if 🙋🏼♀️ has any fever, cough, chills, body aches, sinus congestion, sore throat, loss of taste or smell, joint or muscle aches, diarrhea, nausea, abdominal pain, headache, shortness of breath, wheezing, chest tightness, confusion, or dizziness when standing and if/when she does, I’m testing her regardless of vax status. If neg, I’m testing her again in 2 days. Meanwhile I’m keeping her home because she is symptomatic. ⁃ The only reason I’m testing 🙋🏼♀️ if she never shows symptoms would be: ⁃ the exposure was risky based on above mentioned factors, or 🙋🏼♀️ has someone who is immunocompromised, elderly, young, or unhealthy that she sees regularly ⁃ Work / school requires it ⁃ Peace of mind ⁃ I would test at day 3 or 5 or both ⁃ I’m seeing exposed folks (symptomatic and asymptomatic) test too soon. Then test + a few days later. This burdens the testing sites. So wait until day 3-5 if you can! ***as always, consult your PCP for your healthcare. I’m trying to raise awareness. Let’s not bicker and judge over vaccine status. Let’s educate ourselves and let’s come together to get out of this public health crisis!!!*** What can I do at home for Covid? 1. Zoom with your provider 2. Walk around as much as you can- covid causes blood clots 3. Lay on your belly when you’re resting, not necessarily when asleep. We are proning Covid patients (placing them on their belly) even when they are on the ventilator to help move mucus / fluid and drain the lungs. 4. Hot steamy showers. Even if you don’t feel good enough to shower, sit in your smallest bathroom with the steam running to help open up the lungs. If you feel lightheaded though, stop. 5. Hydrate hydrate hydrate - covid is an inflammatory virus and hydration is key! 6. Monitor your pulse and oxygen levels as I mentioned yesterday. 7. What has fallen out of favor / lacked statistical backup and/or caused harm: ivermectin, oral steroids prior to hospitalization, hydroxychloroquine (Plaquenil), unnecessary antibiotics 8. Mucinex, zinc, Vit C, Vit D, Singulair (it’s Rx though) are all in the grey zone- I don’t think they’ll hurt you but they may not keep you out of the hospital. 9. Finish out your quarantine please and thank you. 10. Chest percussion- look it up on YouTube How do I know if it’s Delta? 1. Big testing centers are batch testing swabs for variants and extrapolating that data to identify geographic variant trends. Your local urgentcare is not. 2. Whatever the variant, we treat based on symptom severity and delta may look good on you and horrible on Sally. Alpha (the original variant) may have put me in the hospital but barely slowed Steve down. 3. I equate it to flu A and B which are always swabbed and tested together each year. Every year I hear “oh Flu B is way worse than A. I’m so sorry you have B.” Etc etc etc when patients’ flu courses can vary regardless of the strain. 4. Anecdotally, my zoom covid visits with this wave seem different than in 2020. Less fevers. Less complaints of crippling headaches. Less loss of taste and smell. More dizziness & confusion (likely from low oxygen levels). Similar diarrhea complaints. Worse shortness of breath and chest tightness. Way more trips to the hospital and ICU. . My only vent-survivor told me all of a sudden they just Could Not Breathe. I should add this person is under 40 years old and is (or was) healthy. 5. Speaking of strains, did you know the Gardasil vaccine protects against 9 strains of HPV? Did you know Prevnar13 protects against (you guessed it) 13 strains of pneumonia? Strains have been around forever as have vaccines yet sudden interest persists. Just educating- no judgment on vaccine choices. I’m too tired. How many times can a child under age 12 have Covid? Will they develop immunity? Great question. I’ve seen twice so far and I expect more. Their bodies should be developing antibodies but no children have volunteered for my quantitative antibody study yet. Stay tuned. How soon should I get my vaccine after I have Covid? I’m recommending one month not 90 days IF you’re truly feeling better. Ask your PCP as they know your health situation. If I’m + today, symptoms resolve in 2 weeks, and then I’m + in 4 weeks, is it a reinfection or residual positive from original infection? I would ask if you ever had a negative test. If you did, maybe it is a re-infection but if you did not, I know we saw some folks stay + for 6 weeks or more in 2020. ***as always, consult your PCP for your healthcare. I’m trying to raise awareness. Let’s not bicker and judge over vaccine status. Let’s educate ourselves and let’s come together to get out of this public health crisis!!!***
Taking multiple medications multiple times per day can be overwhelming at best. Remembering to take them, remembering to refill them with the pharmacy, remembering to contact the provider if you run low, and remembering to purchase or pick them up can be stressful, time-consuming, and somewhat depressing. I hate filling my 2 pill boxes each month (one for morning, one for evening). It is a reminder that I am living with a chronic illness and that my body has "failed me." My rheumatologist told me 5 years ago at the onset of my sarcoidosis diagnosis, "Amy, my goal is for us to get your treatment regimen in line to the point that you only think about having an illness when you see me every few months and when you take your medication. Otherwise, I want you to feel so good that you don't even think about it." I did not know then how important those words would be to me five years later. I have FINALLY recruited my husband to help me fill these PITA boxes (they are- I spill meds every month and lose count without fail). Now we turn on Ted Lasso or Bloodline and he fills one while I fill the other. It is depressing to accept that my body depends on the very THING I shell out every single day in my profession. I can truly empathize with my patients who say "but I don't want to be reliant on a pill." A few times I have shown them a picture of my med boxes, and sometimes it has provided comfort. One patient asked "oh my goodness- what is wrong with you?" so I decided I might share a little less. Vulnerability is hard. My best advice is to have a system for managing your medications if you have a chronic illness.
I just had a funny thought as I sipped my coffee. I wish I had read this article 19 years ago in my first few weeks of NP school. I wonder if I would have kept going to class? Probably... knowing me. I'm always trying to prove somebody wrong. Alright, alright, I'm about to let you all in on a BIG secret! Those who love me, and especially those who live with me know all of these truths, but I bet many of you are about to lose all your enamor for your health care provider. I am going to tell you about the daily life of a family nurse practitioner working in primary care. In essence, my day can be broken down into a few "sessions" or time periods.
Let me laugh with another sip of coffee real quick before I proceed.
Going back to my original "dreams" of working as an NP, did any of it come true?
Check out these posts from my fellow Hope*Writers for our monthly writing challenge. This month's theme was "daily": Oh, I Try by Jessica Weaver www.rootedunrooted.com/blog/oh-i-try Kids Sleep Meditation: 6 Daily Practice Dos and Don’ts by Ashley Olivine louvaria.com/kids-sleep-meditation/ Lessons from Daily Bread by Dianne Vielhuber simplewordsoffaith.com/2021/09/01/lessons-from-daily-bread/ Daily Conversations with God by Sharla Hallett www.sharlahallett.com/daily-conversations-with-god/ As a family nurse practitioner, I see moms, dads, grandparents, and kids every day in my office. One of the most common questions I encounter with my pediatric patients comes from frustrated, defeated parents or grandparents. HOW CAN I GET MY CHILD TO EAT VEGETABLES? Here is the tried-and-true method I've used with my own children to get them to eat vegetables (and other healthy foods):
Let's discuss each tip in more detail. There are some things you need to know before you begin.
If you are reading this article thinking that I am judging you, I am not by any means. I think all mothers and fathers are doing the best they can when they can where they are in life. You decided that you want to work on Johnny's diet, and you looked for help. I decided I could not lie to you and give you what you wanted to read. You need the truth! These tips have worked in my house and in HUNDREDS of homes of my patients throughout my career. Good luck Mom or Dad! You can do this!!! I am cheering for you! I'm waving broccoli and carrots at you from Georgia!
Throughout my career, I have had to deliver hard news to my patients. I have had to deliver even worse news to their families. It is the LEAST favorite part of my job, but I have found some comfort knowing I am delivering the news with compassion and empathy. I usually know the patient and family very well, and I think that means a lot. These suggestions may be helpful when faced with a difficult diagnosis.
Let's look at each suggestion in detail:
I am in a unique position in that I have both delivered and received hard news. At the age of 40, when my youngest son was 4, I was told I probably have lymphoma AND multiple sclerosis over the phone by a nurse. I was told to get an appointment with an oncologist and a neurologist as soon as possible. Many blood tests, imaging tests, and biopsies later, I was finally told that "you don't have cancer! And I don't think you have MS but I'm not sure. What you do have is a lifelong incurable autoimmune disease that can attack any organ and can be difficult to treat. And by the way, nobody has really heard of it and even us doctors have to google it when we see it on a chart."
So maybe those weren't his exact words, but it was close. And there will be a lot more to that story to come in my posts. I wish someone had used tip #3 with me when delivering my news. Pros:
Cons:
I have worked as a family nurse practitioner since 2004. As with any career in medicine, I have had peaks and valleys. Burnout and frustration countered by personal reward and gratitude. Humility for sure. In nursing school, I liked every rotation. I wanted to do "all of it." My faculty advised me to go into med-surg. I guess my love for "all of it" carried into my choice to primarily stay in family practice. I have done some moonlighting in GI and Pediatrics. GI was interesting, a challenge, and a break from a full family practice panel of patients. Pediatrics was fun, repetitive, and just a different pace. I think any career in medicine comes down to a few things:
In the words of Thoreau "It's not what you look at that matters. It's what you see."
Here are 10 easy ways to support someone with a chronic illness:
I have been living with a chronic illness for 5 years now. My family and friends have been a huge source of support. Even as they've tried to love me, I've witnessed their looks of "what can I do?" or "what should I say?". Most chronic illnesses are unique and involve multiple appointments with various specialists, countless medications, and years of simply managing one's health. These concrete examples can really help your loved one and make them feel important.
Top 10 ways to make your commute more productive:
I have been commuting for 11 years. Commuting WITH children was horrible, and I do not want to discuss it. However, if you have the luxury of commuting solo (if you have to commute, I think solo is probably the most enjoyable unless you have a great commuter group or partner), then the above tips can really help make your commute more productive.
How to have an effective office visit with your provider: There are some tried and true ways to have a productive, meaningful visit with your medical provider. As a patient with a chronic illness AND a family nurse practitioner, I have the inside track.
If you need more frequent office visits, ask for them. Your provider is PAID to see you. Your insurance is billed for those visits where as most providers do not bill for phone calls or portal messages. If you end up needing them before your designated 3 or 6 month follow-up and you have more than 1-2 simple questions, PLEASE schedule an office visit. As a provider with complicated patients of my own, I would much rather have that patient in the office with me to have a discussion than to do multiple back-and-forths over the portal. It’s better patient care. AND my time is used wisely in my employer’s mindset. Medicine is a business. Although so many of us really do care!!! Healing people is wonderful. It’s challenging and rewarding and exhausting and sad and scary and exciting and mundane. It’s refills and phone calls and charts and labs. It’s insurance authorizations and having the same conversations with the same patients over and over and over again.
But it’s also seeing progress and growth and determination. It’s witnessing families come together and sometimes fall apart. It’s being a steady presence in the lives of what starts as strangers and ends as friends. Can we be friends? Am I your friend? I like you. I’m cheering for you. I want you to do well! I think of you and I pray for you. I laugh and I cry with you. I love seeing your pictures of your babies and your successes. My heart hurts when you hurt. Where are the boundaries? I don’t want you to have my cell number, but I want you to tell me when you need me. How does that work? What are the rules and who makes them? I don’t want to think of you as just a name or a number. I am invested in you and you in me. Working in a small town feels like home. It’s likely that I know your mom, your neighbor, your hairdresser, and your child’s teacher. I wouldn’t want it any other way. At the end of our time together, I want you to smile when you think of me. I will always smile when I think of you. Even if you didn’t heed my advice. Even if you missed too many appointments. Especially then, because you made me work harder. I want you to know I looked forward to walking in your room and seeing you just as you are, whatever you were going through. I am thankful you put your trust in me. I know you made me laugh at least once. I saw you, all of you. I think you saw me too and I’m okay with that. |