QUO VADIS?

"Come now, you who say, "Today or tomorrow we will go into such and such a town and spend a year there and trade and make a profit"-- yet you do not know what tomorrow will bring."

                                                                   James 4:13-14

"...and he was asking him, "What is your name?" He replied, "My name is Legion, for we are many."                                                                                          Mark 5:9

"..for glory means good report with God, acceptance by God, response, acknowledgement, and welcome into the heart of things. The door on which we have been knocking all our lives will open at last..." 

                                                   C.S. Lewis, Weight of Glory 

"What do I do next?", Karen asks. I have picked her up from her current place of residence, a memory care center in west Phoenix; our goal is to retrieve the mail, drop by our daughter's home to see the grandkids, and grab something for dinner (yes, shrimp; not only her forever favorite meal, but easier to eat; the disease has caused her to have difficulty knowing when, and how, to use utensils). While we have discussed the plan multiple times, memory for the itinerary is lost; she will ask "what next" several times over the next few minutes. (I can recall my mother's similar behaviors over the final several years of her struggle with Alzheimers, asking "What am I supposed to do now?" every minute whenever we would visit her.) I don't believe this is just that someone with dementia is curious about upcoming events; I know that Karen wants to know what is coming next because her greatest fear is that she will look, or act, differently if she finds herself in an unfamiliar setting. When her memory retention was longer than the now-15 to 30 second duration, as we would be en route to visit friends or church group she would want me to rehearse all the names and relationships with her so that she would not appear to have forgotten who people were. 

"What do I do next?", I ask. My work at the prison which had been so personally rewarding over the past two years suddenly came to an end in early February, an unexpected decision by a new medical management company to reduce clinical staff in a poorly-designed cost containment maneuver. I will miss the people I worked with, and the witness opportunities; something about dealing with people in prison provides fertile ground to talk about how to find true freedom. But more urgently, there is the issue of my meeting the financial cost of Karen's living circumstance. I have to work, but I don't want to work full time (I need time to be with her, as well as time to honor some of the volunteer commitments I have made) and I don't want to to have to travel. But no opportunities meeting my criteria arise during the 4 weeks I have to find new work. Well, there is one offer: an inpatient psychiatrist position in Flagstaff, a 2 hour drive north of our home, too far to commute but perhaps close enough to get home at least on weekends. But I keep telling God that this isn't the answer to the prayer I had expected, nor desired; He keeps showing me as the clock ticks on that there is no other offer. Finally, I have no choice; I drive to Flagstaff in a snow storm to start my new job.

Buddha, the director of the CIA, and an undercover FBI agent: on one particular day in my new position as the psychiatrist on this closed unit providing acute psychiatric care to the underserved (homeless, drug abusers, chronically and severely mentally ill, and developmentally disabled) I am faced with three patients who simultaneously have these three delusional identities. It has been a long time since I have worked with patients this ill. They, too, are unsure about not just what they are to do next, they are unclear as to who they really are; their name is Legion. They suffer a different form of imprisonment, and my ability to care, communicate and witness is much more limited in this setting.

Perhaps God did have purpose in my being in Flagstaff after all; over the past two weeks in this new position I have received an offer from the prison to not just return to my old position but also to become the director of psychiatric services; and even though nothing had been available elsewhere in Phoenix three weeks ago, a position as psychiatrist at an outpatient mental health clinic has become available, this one located about 20 minutes from our condo and only 5 minutes from where Karen is staying. 

So, what do I do next? One thing that I have found that I had not expected: even though Karen cannot retrieve a memory of what we have done, and cannot remember what we plan to do for more than a few seconds, I absolutely miss being able to see her regularly. The thought of being able to drop over and see her after I get off work is powerfully driving this decision, accentuated by my at-this-moment-five -days/week-two-hours-away forced separation. I will finish this contract and be working in the new position at the mental health clinic by April. 

Karen has never asked to come home; she never complains when the answer to her query "what do we do next" is that we are going back to the memory care center. The only time she expresses disappointment is when I leave; her question then: "I won't see you anymore tonight?"  Dementia, you have taken away so much, but you haven't stolen this from us: Karen still misses me. And I still miss her.

I know that these next changes will only lead to others, and that I will be asking "what do I do next?" again, and again. But there is comfort in knowing that for now, God has rather clearly answered me, by taking me places I did not want to go, showing me that my discomfort about unclear direction pales in comparison to those whose very ability to comprehend any path at all is impaired by illness, and reminding me that there is a part of me that wants reunion, and home, more than I had ever sensed. 

In the long run, we really do know what will happen next...and that is a very good thing.

Heading home 'fore long, 

Barney, for Karen too.

Stay in touch with us: barneydavis@gmail.com or on FB