Over the past 8 years, I’ve left or lost several jobs. Some I’ve left because I couldn’t connect with the person(s) running the show (love the work, hate the job, ya’ know?). And some I’ve been asked (told, directed, shown the door, ya’ know?) to leave. And I’ve had a hard time finding work, partly because of the economy, partly because of my age (ya’ know?). Sadly, I’ve lost these jobs in a field I’ve trained extensively for and loved—end of life care. I find that I am most useful in places where suffering is at hand, honesty is valued, and a cure unlikely.
I’m also trained in women’s health care, and have been able to pick up per diem work with Planned Parenthood over the past 2 years, a gift that in a real way has kept me un-homeless. My experience in women’s health dates back to the 70’s when the women’s health movement was vibrant and able to re-frame critical issues such as body ownership and reproductive choice. I brought some of those ideals and practices to my work in HIV/AIDS care for a decade in the 80s-90s, which then lead to a fund of hard-earned skill and knowledge in care for the dying, and the privilege of participating in AIDS activism with ACT UP NY, which led to other hard-earned gains, particularly in the areas of patient empowerment and participation in health care decision-making.
In terms of women’s health care, I’ve been (and continue to be) grateful for the work (income) these past 2 years, but I feel like I’ve aged out of this field. Reproductive issues just aren’t my issues any more. But I do miss end-of-life care, a field that brought me into close proximity, even comfort, with my own mortality. I fulfill this need now by volunteering with Compassion and Choices, which is part of yet another political movement, this one geared towards choice in death. I help clients die well. Nothing could be more satisfying.
So now, to earn my keep, I’ve entered a new field, one that does use my skills and training. It’s not surprisingly located in another crack in the healthcare system (a place where I feel most welcome and most at home)—chronic pain management. I now have work in two clinics, providing medical management for people with chronic pain—that segment of the pain population (after all, who doesn’t have pain?) that relies on opiates to get by. It’s challenging for many reasons, and since I like challenge, it seems to be working out OK. The newer job is taking me to Sequim on the Olympic Peninsula, which is an amazing setting (mountains, water everywhere). On the other hand, it’s one of the most worrisome counties in Washington state for its prevalence of prescription drug abuse.
All of which brings me to another hard-earned lesson about suffering. I want to help my patients who think they need opiates to survive (and some of them are able to work and have creative lives due to appropriate opiate use). BUT, I’m certainly seeing the down side. The side of dependence, addiction, diversion, unintentional deaths. These things are quite real. People who have chronic pain often get caught in one or more of these cycles and don’t find their way out.
But also what I’m learning, regarding my own pain issues, and in general, is that fear of pain is sometimes worse than the pain itself. Having “pain meds” on hand is a buffer against that fear. Learning to live with pain is not an easy task. I don’t have the answers. But learning to accept pain, to release the fear of it, might be a place to start.