A poem I share with the bereaved.

I Am Fishing for God

I am fishing for God,
using my heart as bait.
It is just before dawn,
the slightest hint of
pink bleeds into the
night sky.

I use my pen knife to cut the
hole in my chest,
reaching behind the
pocket of my shirt.

What a tough muscle
to pull the hook through.

The heart is astonished
to be in this other world
and trembles and shivers like
a moth discovered in daylight.

I try to calm it by stroking it,
by telling it that it will all be ok,
but what do I know.

The breeze picks up and
chills the cavern
in my chest.
It feels good to
be empty at last.

I cast my heart
across the water.

I cast it again
and again.

Sometimes it floats on
the surface,
other times it sinks
below.

Something will strike at it
that I can't see. I pray
I am using the right bait.

The tough outer layers
soften in the water.
The heart grows
smaller, more pliant.

It has become a beautiful
blue jewel. I begin
not to recognize it.

Was this me?
It waits. I wait.
The boat rocks
slightly in the breeze
lifted and lowered
by the tide.


Copyright © 2004 Stuart Kestenbaum

Life isn't that short.

For a long time it had seemed to me that life was about to begin - real life. But there was always some obstacle in the way. Something to be got through first, some unfinished business, time still to be served, a debt to be paid. Then life would begin. At last it dawned on me that these obstacles were my life.
~Fr. Alfred D'Souza

I don't want to get to the end of my life and find that I lived just the length of it. I want to have lived the width of it as well.
~Diane Ackerman



No, life is not always short. It only seems that way when it is ending.

Life can feel really long to some people. Days, hours, months can seem to simply drag by, and some see only more empty time in the future. And it doesn't just feel this way to depressed people or old people in a nursing home. It can feel this way to each and every one of us occasionally. And sometimes more often.

Only when we know the expiration date in life or get sick or know someone who has died suddenly do we feel like our life is short.

Most of us trod along each day pretty certain that there will be a tomorrow. We plan for future events. We save money for our retirements. We think about our home and plans to downsize in the future when our kids are safely tucked away at college or beyond.

And most of us get there. We grow old. We have grandchildren. We do indeed retire. We stay healthy and vibrant for many years. It is good.

Some don't make it, I know. I am reminded of that each time I work. So I try to make the best of the time I know I have, like today and perhaps tomorrow. But I still think about the future. We can't always just live in the present, we must plan for our future whether we get there or not.

I think the problem arises when we think too much about the future and let today pass by, thinking that there will always be more time. So we let really important things wait.

Like telling someone we love them. Or reaching out to an old friend. Or going to see that movie we keep promising our children. Or that trip. Or that scrapbook.

We will get to it "when we have more time." That is what we say. And we fill our days with a lot of meaningless tasks that sit in front of us day in and day out taunting us. We feel somehow we must conquer the mundane first before can get to the meat of our lives.

And that is a mistake. A big, huge mistake.

So, life may be long. But don't fill those seemingly empty days with nothing. At least take time to do some really fun things and sprinkle them into the everyday upkeep of life.

Put down the laundry and take your kids to the movie. Let the dishes sit while you play a game with your family. Call an old friend even if you don't have time. Start that scrapbook, just do a few pages. Sort though old photos with your kids and tell them stories. Go for that walk. See that sunset. Pop over and visit that friend or relative you have been meaning to see. Put that picture in a frame so you can enjoy it. Finally get that dog you promised the kids.

Yes, there may be many more days to do these things. But we never know. And what we fill our lives with now will be the memories that future generations have of us. Do we really want them to think of us, even if we live to be 90, as the pragmatic soul who mindlessly watched TV or did dishes and laundry all of the time? Or do you want them to remember us as folks who ventured out of our pragmatism to do spontaneous acts of fun and good will? They are a much more powerful memory. And a much better example to follow for a meaningful happy life.

So, look ahead. Look towards the future. It is there most likely. But take a really hard look at your journey so far and then plan ahead and fill the rest of it, no matter how long, with some fun and laughter along the way.

A boring journey is just that, boring. So, save for the future. It is a must. And plan ahead. It is not only okay to be practical and prudent, it is imperative. But don't forget about the here and now. Cut loose frequently. Be spontaneous. Give out little gifts of yourself along the way to everyone that you know. Don't just pass them along after you are dead. A shared memory is the gift that keeps on giving. Giving your time while alive is much more precious than anything material you could possibly pass on after you are dead or disabled.

The journey is the best part of our lives. Don't squander it.

Spend the afternoon. You can't take it with you. ~Annie Dillard

“Life is not a journey to the grave with intentions of arriving safely in a pretty well-preserved body, but rather to skid in broadside, thoroughly used up, totally worn out and loudly proclaiming ... WOW! What a ride!”

Life is not lost by dying; life is lost minute by minute, day by dragging day, in all the thousand small uncaring ways. ~Stephen Vincent Benét

To change one's life: Start immediately. Do it flamboyantly. No exceptions. ~William James

“I haven't a clue as to how my story will end. But that's all right. When you set out on a journey and night covers the road, you don't conclude the road has vanished. And how else could we discover the stars?”

When we don't feel like being thankful.

Soon it will be Thanksgiving. Most people like Thanksgiving because a.) it revolves around food and b.) you don't have to buy gifts. I guess I should also add that it is a day for family and football as well. So all around, a fun holiday.

But some people are just not in the mood to feel "thankful." They may have lost a loved one, or have been laid off of work, or have a sick child. They may have memories of lovely family holidays in the past that no longer exist. They may hate being forced to be around people they just simply do not like. The list goes on and on.

So, what do we do when we feel this way? Certainly all of my patients and their families and friends do not feel so thankful right now. And platitudes and cheery greetings do not help at all.

So what does?

Really, there is nothing. Nothing can make the pain go away. But the problem is, most people turn inward towards the holidays. They steel themselves against any happiness creeping in. It is as though they won't allow themselves to feel anything but miserable. They sneer at the "lucky" people who seem happy and content. They simmer in their own regrets and misery. It can be a very lonely place indeed.

Well, I have to tell you something. We all feel like that on many days, particularly during the holiday season. Even the smiling, seemingly happy people. If you can remember that and remember that you are certainly not alone in your despair, it could help you to feel more connected.

And a connection to anything is something to be thankful for.

So, you may have a load of misery that feels especially compounded at the holidays. How to get through it? Connect.

You can connect in many ways. It is okay to reminisce about the old days. You are connected to them. It is okay to remember those we lost and pine for them. We are still connected even though they are not here in person. You perhaps had something great. And although it is gone now, you can be thankful for the wonderful memory, even through tears.

Now, the ones that are still here who drive us nuts are another issue. But we can be thankful we have to only see them occasionally. And leave it at that.

The bottom line is, you don't have to be thankful or cheery. You can feel sad at holiday time. But don't take it out on yourself. Do something nice for yourself. Connect with yourself if need be. And find ways to be thankful in small ways. Reach out to others instead of always drawing in and admit that the holidays can be tough and limit yourself to a few activities that make you, if not happy, at least content. And don't be alone. Connect to something, anything.

The holidays are hard. Life is hard. But we are really not alone on this. We are all connected to each other in so many ways.

And that is something to be thankful for.


A positive attitude may not solve all your problems, but it will annoy enough people to make it worth the effort. ~Herm Albright

If you don't get everything you want, think of the things you don't get that you don't want. ~Oscar Wilde

Oh, my friend, it's not what they take away from you that counts. It's what you do with what you have left. ~Hubert Humphrey

So often time it happens, we all live our life in chains, and we never even know we have the key. ~The Eagles, "Already Gone"

Sadness envelops the day.

Stop all the clocks, cut off the telephone,
Prevent the dog from barking with a juicy bone,
Silence the pianos and with muffled drum
Bring out the coffin, let the mourners come.

People ask me all the time how I can be a hospice nurse. I tell them I don't know. And I really don't. But I do it and it usually makes me feel good that I am actually helping someone.

But yesterday, a very young patient died and now I am engulfed with sadness. She was a lovely young woman with much to live for, struck down by a cancer so devastating that I am not sure how she pushed forward for the 6 years since her diagnosis.

The treatments alone would have done me in. But she not only survived those treatments, she went back to school and received her Master's degree plus opened a restaurant. She was brave right to her very last breath. So brave. So very lovely. It was truly amazing.

I usually keep myself a healthy distance from becoming too involved with my patients. I have to. But I really liked her and her family. They were so genuinely kind and generous. And so I am devastated by this loss. The world is a sadder place for having lost her. And her family will move on but with a huge hole that will never really fill. My heart goes out to them.

So, how do we deal with this sadness? I am not always sure. I guess we just leave it alone and allow it to envelop us for a a while until we can come out of it to the other side.

There are no words that can make it better. No cheery platitude. No drug even. Not really. And there is no such thing as closure. We can put it away in our hearts, but the wound never really closes. We always remember.

So today I am allowing myself to feel sad. Death is sad, it really is. There is no denying that. And I see my fair share of it and have experienced it in my own life as well. I still to this day have very sad moments about the loss of my parents even though it has been many years.

They say that every death that touches us reminds us of all the deaths that we have experienced. I am not sure that that is actually true. I just think each death or loss is simply sad on its own accord. There seems to be no reason to complicate it any further. It is what it is. Sad.

Very, very sad, indeed.

So, anyway, I started this with a poem about death that is my all time favorite, if you can even have a favorite poem about something as awful as death, but here it is and I will end with the remainder of that poem.

(In honor of all of my patients, but especially for H.Y. and her family.)

Let aeroplanes circle moaning overhead
Scribbling on the sky the message He Is Dead,
Put crepe bows round the white necks of the public doves,
Let the traffic policemen wear black cotton gloves.

He was my North, my South, my East and West,
My working week and my Sunday rest,
My noon, my midnight, my talk, my song;
I thought that love would last for ever: I was wrong.

The stars are not wanted now: put out every one;
Pack up the moon and dismantle the sun;
Pour away the ocean and sweep up the wood.
For nothing now can ever come to any good.
W. H. Auden

And if you would like to see a reading of this poem, which is from the movie "Four Weddings and a Funeral" but read well anyway, go to http://www.youtube.com/watch?v=b_a-eXIoyYA

Waiting for death to come.

Currently, I have several young patients that I am case managing. They are in the age range of 9 (yes, 9) to 53. All have been dealt a nasty hand with a nasty cancer. All are very sick with disease, but still quite functional.

All are waiting to die.

All have been given a time frame. And all have seen that time frame come and go.

I hate time frames. They are always wrong. Always.

The problem with time frames is that people start counting down the days. And they stop living. They just stop.

And they say goodbye and hug their friends and have tearful, heartrending talks and meet with their priests and some even pick out the music for their funeral. And then? They sit and wait.

And they waste a lot of precious living time.

It is a shame really. They just don't know what to do if they keep on living. And neither do their friends or loved ones.

So, they ask me. How much longer do I have? Why didn't I die yet? What is going on?

And I have little to say other than I just don't know and they are just going to have to keep living and so we move forward. Many times, reluctantly.

I wish MDs did not give patients a time frame. Some nurses do it as well and they are often wrong, too. I only can tell by my physical exam, but that is not to say that something catastrophic won't happen that causes sudden death. Like a clot or a hemorrhage or something else.

But I could say that about everyone I know.

So the point is to just keep living. Regardless of the hand you are dealt. And tell people every day that you love them and would miss them if they were not near you. Get that out of the way so that if you ever do get a bad diagnosis or are struck down while seemingly healthy, you will have no regrets. And the people in your life will be free from wondering how you really felt. It is a gift to them.

So give it often and freely.

My patients that have already said good-bye at what they interpreted as the end have many regrets. They regret doing it too soon and treating it like it was the last thing to say to friends and loved ones. Because now that are still alive, they don't know what to talk about anymore. So they avoid their friends and family. And they feel alone.

"So what do we do now? Do we just go back to the trivial," asked the wife of one of my patients.

Well, most times the trivial is the mainstay our lives. Laughing at a funny show, talking about work or school, asking what to have for dinner, picking out new furniture, watching sports. These trivial things are our lives. The "profound" really does not matter so much after all. We think it does, but a hug and a smile and a squeeze of the hand pretty much can sum it all up. And we can do that every day, even during commercial breaks while doing something as trivial as watching Dancing with the Stars.

So, just keep living. Don't worry so much about death or the end. It will come. It will. But life, life is all we know. And all that trivial nonsense we thought was a waste of time? It is as profound as anything else we could ever say or do.

So, my advice to my patients and their families is this; don't ever stop living. Keep doing what you love for as long as you can. Enjoy any moments that seem normal. Try not to look too often over your shoulder for the bad, it will come when it is ready. Laugh if you can. It is really okay. There will be many bad moments, but grasp any good ones that come along.

Feel free to be angry. Get really mad. You don't have to be strong.

This is hard.

Lean on friends for support. Allow them to help you. Call the nurse if you need help. We want to help, we do. You are not bothering us. Give us the burden of care so you can just be the wife, the husband, the sister, the brother, the child.

It is hard to wait for death. It is much harder than the fight to survive, even with the horrible treatments and side effects. At least you were moving forward. Death has its own time frame and follows no rules. The hardest part isn't letting go or fighting to live. The hardest part is waiting to die.

So, don't do it. Just keep living. Don't stop and wait for the end to come. Just try to keep moving forward. Listen to no one except the promptings of your own heart. It is the best and only reliable guide we have.

Sometimes even to live is an act of courage. ~Lucius Annaeus Seneca, Letters to Lucilius

Rejoice in the things that are present; all else is beyond thee. ~Montaigne

It is only possible to live happily-ever-after on a day-to-day basis. ~Margaret Bonnano

Yesterday is history. Tomorrow is a mystery. And today? Today is a gift. That's why we call it the present. ~Babatunde Olatunji

Don't believe the hype.

Every day, I receive an email from various health and beauty web sites I have signed up for that talk about health, diet, fitness and general grooming, such as skin care. And every day I read about the newest, the latest, the greatest. And you know what? It is all just hype.

There really is not too much that is so new as to be earth shattering. They have simply taken the old ways of doing things and repackaged them to make them look new.

Like skin care for example. There are hundreds of skin care lines. Walk through any Sephora and you will find a special cream or lotion for just about any body part. They have special creams for kids and men as well.

And guess what? You don't need any of it. Not really. All you really need to do is to cleanse your face at night, moisturize to prevent it from looking like old, dried out leather and occasionally you need to exfoliate.

And that is it.

The trick, and there is a trick, is to do it routinely, every single day and night. And that is where so many fail.

It is not necessarily the product that is helping you. It simply that you are taking better care of your skin.

And you don't need to spend a fortune to do it. Personally, I use a cleanser from Walgreens that dermatologists love. It is called CeraVe and it is an inexpensive, awesome cleaner. You don't need a fancy, expensive cleanser. You just need to clean your face.

I have an elderly patient who has great skin who uses Dove soap. And Vaseline. For about the past 60 years. And very few wrinkles at all. (she recently signed off of hospice---she got better and she's 88)

Now, that said, I must confess I use an expensive face cream. It is called SK-II. It is remarkable, in my opinion. But I use it as a day and a night cream. And I use it under my eyes as well. Along with using a vitamin E stick that I purchase for about three dollars. And I exfoliate with a scrub from Target 3 or 4 times a week, from Boots. That is it. And my skin looks pretty good for being 50. Not perfect, but okay. But I never go to bed without washing and moisturizing. I do it religiously.

And that is the trick. Doing it consistently.

Consistency is the name of the game.

Now, if I could only apply that same logic to exercise....but I digress.

The next big hype is diet. I read every single day about a new food that will cure whatever, a new supplement that we all should be taking or a new diet book that promises you can eat all you want and still have a flat stomach.

But they are selling nothing new. Blueberries have always been good for us. As a matter of fact, eating fruit has always been a great idea. And veggies, too. Do I really need to spend time reading about this? No. I know what to do. And so do you. There are no secrets out there to learn.

Eat real food in smaller portions. Don't eat food your grandmother would not recognize. Don't eat food that has a list of ingredients you cannot pronounce. Eat whole foods.

And if you want to drop weight, eat less and walk more.

(That will be $29.99. Thank you.)

But they are still selling these books and exercise videos and special eye creams and neck creams and, well, I could go on and on.

And we are all still buying them.

Go figure.

Anyway, I am not buying into the hype anymore. If you want to lose weight, you have to eat less. If you want to stay healthy, you should walk more and not smoke or drink to excess. You shouldn't drink 7 Diet Coke's every day, drink water. You should get out in the sun to get vitamin D. But just not too long unless you put on sunscreen. You should learn to relax more, have fun friends to hang with, get a good night's sleep and worry less. A baby aspirin a day is a proven winner. So is a regular multivitamin. And a glass, one, of red wine cannot hurt. Cutting back on sugary foods is also important. Excess sugar and sodium causes our body to have an inflammatory response. And inflammation causes problems like cardiac disease and cancers. That is a proven, scientific fact.

Anyway, I am not saying that any of this is easy. I struggle with it too. But we all know the things we need to do.

The hard part is doing them.

And not buying into all the hype.

Life expectancy would grow by leaps and bounds if green vegetables smelled as good as bacon. ~Doug Larson

A good laugh and a long sleep are the best cures in the doctor's book. ~Irish Proverb

To avoid sickness eat less; to prolong life worry less. ~Chu Hui Weng

Those obsessed with health are not healthy; the first requisite of good health is a certain calculated carelessness about oneself. ~Sydney J. Harris

Didn't he see the warning signs?

I am often asked about how people die. Not specifically how their actual death occurred, but what lead up to it. What the warning signs were. And why they were missed.

Most people ask me this because they want to make sure that they do not have the same issues.

For example, if a young patient has melanoma, people will ask me, did they sit in the sun a lot, did they have a lot of moles, did they have a family history, did they wear sunscreen?

Or a stroke victim. Did they have high blood pressure, was there a congenital anomaly, did they suffer from headaches?

Most of us do this. It is how we justify death. When someone who ate and drank everything they wanted to dies, we often shake our heads and think, well, they just didn't take good care of themselves. That won't happen to me.

But I see a lot of people who die and they seemingly did everything right. Exercised, went to the MD yearly for a check-up, ate healthy food, had parents who lived to be 90, put on sunscreen, kept their weight normal.

But they developed cancer or heart disease and they died. Usually way too young. And it is these types of deaths that give us a chill. Especially as we enter middle age.

So, what can we do? Are there warning signs that they missed?

My answer to that would be a yes. They did. And we all do as well.

So, what warning signs can we look for. What can we do to protect ourselves?

We can start by paying attention to the warning signals in our car and remember to always wear a seatbelt. Many healthy people die this way, in stupid accidents. We don't often think about it, but most motor vehicle deaths are totally preventable. We drive after a couple glasses of wine. We don't always pay attention and become distracted by cellphones and kids. We text. We don't always wear a seatbelt. And we place ourselves in peril. Sometimes daily.

Stop it. Be more aware of the risks here.

We also need to understand that our body talks to us. It is quite wise. It tells us when we need to slow down, take a rest, get more sleep. But we hardly ever really listen to it until we are ill. We just stop at Starbucks for another jolt of caffeine to get us through the day. But we need to rest. We need to sleep. These are preventative measures we should all be taking. But don't.

And pain. We often dismiss it. But it tells a story as well. Don't ignore it.

There are other things that happen to our bodies as we age and they are silent. High blood pressure being one of them. We need to have it checked and keep it around or below 120/80. High blood pressure leads to a myriad of problems if left unchecked.

And our weight. I am not saying we all need to be thin. On the contrary, there are many studies that suggest a little bit of fat can be protective. But we still have to keep it in check. We need to stay away from excess sodium and sugar. We need to walk more. Drink more water.

Many cancers are not related to any one cause. We would like to think they are, but they are seemingly random. And that is simply the truth.

Our bodies have to be equipped to fight aberrant cells. The best way to do that is to listen to our body and take good care of it. From the inside out.

That means we should take a vitamin pill, take an aspirin every day to alleviate inflammation in our body (which is deadly), not feed it too much junk and processed foods, not overwhelm it with too many chemicals and pharmaceuticals. We need to balance things better. Mom was right; everything in moderation.

You have to watch out for the warning signs yourself. Your MD may say that things look great, but only you know yourself. Only you can really judge.

I don't know everything for sure, but I do know one thing; we will all die. I see it all of the time. But we can prevent an early, premature, needless death if we take certain precautions. We can.

So, start to tune into your own warning system. It may in fact save your life.


First we make our habits, then our habits make us.
~~~Charles C. Noble

Nobody ever did, or ever will, escape the consequences of his choices.
~~~Alfred A. Montapert

The name of the game is taking care of yourself, because you're going to
live long enough to wish you had.
~~~Grace Mirabella

Medical professionals who are anything but.

We have all met them. Or worked with them. Or have heard stories about them. Bad medical professionals. Be it nurses, MDs, dentists, physical therapists. You name it. They are out there. Everywhere.

And just because someone has MD after their name, or RN, it simply does not make them a compassionate, caring person. No. Not by a long shot.

Nor does it mean they are necessarily competent. No matter how impressive their credentials are.

I could tell you stories, scary stories that would make you sad. And afraid. But I won't.

I would have to say that most medical professionals are good people. They know their limits and ask for help when necessary. But there are a few out there with an ego as big as Sputnik, and those are the ones that give all the rest of us a black eye.

Nurses know what I am talking about. The arrogant resident, for example, who thinks he knows it all. But he is merely book smart with a fancy degree from a Ivy league school who could not cut his own toenails well, let alone know what to do for a patient in crisis. But he refuses to listen to an RN because, well, we are just beneath him. We could not possibly know anything. And he is dangerous. 007's we call them. Licensed to kill.

Or the RN who gets the best accolades from management because she never calls in sick and works extra shifts and always charts perfectly. Unfortunately, she is awful with any practical patient care and actually puts patients in harm's way. But you cannot say anything, no one is listening. So you just clean up after her as much as you can and hope for the best.

It is maddening. It is what stresses out nurses and MDs and others more than anything else. I always say that it is not the job I hate at times, just the people I am forced to work with that make the job hard.

That is not to say I think myself perfect or that I have never made a mistake. I have. But I try to learn from any mistake I make. I also ask for help when needed. And I always, always, put the patent's needs first.

And that is what you should look for when you are looking at care providers. Putting your needs first. Treating you as a person. Not a diagnosis, not a 4:00pm appointment, not a simple home visit.

They should greet you warmly and look at you. In the eyes. They should listen to you without interrupting or putting words into your mouth. They should explain things thoroughly and not look at their watch every time you ask another question. That is simply rude.

Most people know when something seems not quite right. They realize their concerns are simply being dismissed. They may have a gut feeling that someone is doing something wrong. But most are too intimidated to say anything.

But I will tell you this; be the squeaky wheel. Complain. Put complaints in writing. And repeat as necessary.

The one thing that I can say for sure after being a nurse for 30 years is this; medical professionals do not police their own. We see it all. We know who is bad. We have all witnessed things that we have found to be quite incredulous. But many of us have not said a word. Or we have said something, only to be shot down. They kill the messenger. See if we do that again. It is frustrating, but true.

So, beware. Don't assume that because you are going to a well respected institution for care that everyone there is top drawer. They aren't. Ask around. Get referrals from friends or people with the same medical issues. Go online and search.

I know people who ask for more information about a veterinarian for their dog or a hairdresser for their hair. And I have seen people change their hairdresser after a bad cut, but not too many who will change their MD after a bad diagnosis. It is crazy. It really is.

There are many good, hardworking, excellent medical people out there. Start with the MD and the hospital of course. You cannot always choose your nurse, but you can unchoose her by stating your concerns. Trust your gut. Follow your own thinking.

It could save your life.


All men make mistakes, but only wise men learn from their mistakes.
~~~Winston Churchill

Guard against the prestige of great names; see that your judgments are your own; and do not shrink from disagreement; no trusting without testing.
~~~John Emerich Edward Dalberg Acton

You gotta know when to hold 'em, know when to fold 'em, know when to walk away, know when to run
~~~Kenny Rogers

Deciding to be happy.

I was driving to a patient's home the other day and was behind a car with a bumper sticker that said, "Life sucks, be happy anyway." Truer words have never been spoken, or written.

Life indeed can and does suck. You do not have to be a hospice nurse to understand that. I see a lot of misery. I see a lot pf pain. But I also see something else; happiness despite all of it.

Anti-depressants are the number one prescribed medication in the world. I am sure that self-medicating with alcohol or street drugs trump those numbers 2:1. And why shouldn't people be unhappy. After all, life is hard. People disappoint us, money is tight, people get sick, the news is always bad, work is awful, things never seem to live up to the hype. Some days it seems that we need to just stay in bed with the covers over our heads and hide from the world.

But no one said life would be easy. No one said that we have a right to happiness. So, we should just grab happiness anywhere we find it. We can and must choose to be happy.

I was at the home of an 8 year old patient the other day. It is a sad scene. Here is a beautiful 8 year old with an inoperable brain tumor that will kill her in a few short months. It came on suddenly, and will kill her suddenly. She is still attending school. She has all of her hair. She does not look sick at all.

I look at her young mom. She is devastated. So is the dad. But in that house also lives a 12 year old sister. One with a full life ahead of her. So, do they succumb to doom and gloom? No. They grab any moment of happiness and go with it despite the pain they are feeling.

They choose to be happy.

Happiness is not something that we can feel all the time. But when we feel it, we should immerse ourselves in it. Really feel it. Ask yourself, when was the last time you felt pure happiness?

Many of us do not allow ourselves to be happy. Many wallow in misery and look for others to share their misery with. They are the Debbie and Donald Downers, and they are everywhere. They are hard to avoid. And they usually find a reason to be unhappy about any circumstance. I try to avoid them whenever possible.

Abraham Lincoln once famously said, "Most folks are about as happy as they make up their minds to be." And he was surely right about that. But he also said something better, that is not often quoted. He said, "I want it said of me by those who knew me best, that I always plucked a thistle and planted a flower where I thought a flower would grow."

So, look at happy thoughts as a way of planting a few flowers in a yard full of weeds. Sometimes that is the best we can do. Life will always be hard. Bad things do indeed happen. Misery abounds.

But happiness is there, too. We just have to look for it and embrace it when ever we can.


My advice to you is not to inquire why or whither, but just enjoy your ice cream while it's on your plate. ~Thornton Wilder

The best vitamin to be a happy person is B1. ~Author Unknown

Jumping for joy is good exercise. ~Author Unknown

Happiness always looks small while you hold it in your hands, but let it go, and you learn at once how big and precious it is. ~Maxim Gorky

Let us be grateful to people who make us happy, they are the charming gardeners who make our souls blossom. ~Marcel Proust

When the patient is a child.

I can think of nothing worse than a child on hospice care. The family sitting there, day in and day out, hope gone. Feeling horrible because they cannot kiss it and make it all better. Sitting there feeling angry and sad, feeling like they cannot cope another day, another hour, another minute. Just pure agony.

We don't get too many referrals for pediatric hospice care. Most parents are reluctant to even think about it and fight to the last breath, many children dying in the hospital. I cannot blame them. I would most likely do the same.

But some MDs want the patient to be able to be managed at home. To die at home. To have their last days in a comfortable place. A place that feels safe to them.

And the parents who chose this option are so brave. So very, very brave.

I remember my first pediatric hospice patient. His name was Brian. He was 12. He was the bravest kid I had ever met. I have trouble even thinking about him, let alone writing about him. He remains in my heart always.

Kids have a way of doing that. Being special by just being.

Many kids who are not sick are very special as well. Actually, all kids are special. They just don't get to hear it as often. Many healthy siblings of sick kids are often jealous of all the attention their brother or sister are getting. They feel left out, isolated. They cannot talk about these feelings because it feels so wrong. They think, how can someone be jealous of a loved one who is sick? Something must be wrong with me to feel that way. But nothing is wrong with them. It is completely normal. We see it often. Sometimes in adults as well.

When I go to see a sick child, I also try to visit with the siblings. I bring them gifts. I give them small tasks so that they feel they are helping me with the care of their brother or sister. They want to help and feel a part of it all. As scared as they are, and they are, it helps them to cope. It makes them feel special, too. And they are special. And very brave.

I look at my own daughter. She is very healthy. I am very blessed. But I tell her all the time how special she is. Because things can change in a moment's notice.

People worry about spoiling their children. They worry that if they give them too much they will expect more and never be satisfied. But I say bunk to all of that. Make a wish wishes should not be granted only for the very ill or dying. They should be granted for the living as well.

Many people turn away or refuse to think about the unthinkable. But it happens to all types of families every single day. It humbles me to meet these wonderful families, the ones that have been through so much and still are able to laugh and smile and just simple carry on.

If they have one message it is this; love your child. Love them as much as you can and be grateful for them in your lives, even when they make you crazy. Indulge their whims. Do something unexpected for them on occasion. Hug them more. Tell them how much you love them.

And then tell them again and again and again and again.


While we try to teach our children all about life, our children teach us what life is all about.
~~~Anonymous

Death leaves a heartache no one can heal, love leaves a memory no one can steal. ~~~From a headstone in Ireland

Where you used to be, there is a hole in the world, which I find myself constantly walking around in the daytime, and falling in at night. I miss you like hell. ~~~Edna St Vincent Millay