Richard

I've been a caregiver for the guy in the photo above, the love of my life, sculptor Richard Cabe, since he began seeing bird hallucinations at the end of August, 2008. I didn't think of myself as a caregiver then. He spent a week in the hospital that September after the birds came and went, and it was a shock to see my strong and rudely healthy husband sitting cross-legged on the bed in a hospital gown, day after day. We both figured whatever was wrong in his brain was an aberration, and he'd recover quickly.

I still didn't think of myself as a caregiver even when I learned how to administer his thrice-daily infusions of IV antiviral drugs, or after his brain surgery that October to remove the first brain tumor, or after his subsequent diagnosis with brain cancer. Not even when we moved to a suburb of Denver for six weeks that winter for his radiation. Or during the six months of his intensive chemotherapy late that winter and spring. Not during brain surgery number two, when his neurosurgery team removed much of his right temporal lobe. Not even when the pathology report came back with the worst news, "grade IV, glioblastoma."

Somehow I avoided thinking of myself as a caregiver through two succeeding brain surgeries, and the trips back and forth to the hospital for various crises…

It really only hit me that I had become a caregiver when brain swelling degraded his vision so he could no longer drive, or bake his widely admired whole wheat sourdough boule (loaves as sculptural as anything he ever created with stone and steel and wood). Or pay the bills, or, on some days, button his shirts. (He can still split firewood though, hence the photo at the beginning of the post!)

Passages

That unanticipated, unrealized slide into caregiving is why renowned literary journalist Gail Sheehy wrote Passages in Caregiving: Turning Chaos into Confidence. The role takes over our lives insidiously, usually with no warning, much less time to think. Not only do we not consciously sign up, we often don't even realize we've become caregivers until it's almost too late to figure out how to not hurt ourselves–or others–in the doing.

If you're female, you'll need this book someday: "Today's average caregiver," Sheehy writes, "is a 48-year-old woman who holds down a paid job (more than half work full-time) and spends twenty hours a week providing for an adult who used to be independent… And this role lasts an average of five years."

Sheehy walks readers through the journey in chapters shaped by walking a labyrinth from the start through the many turns, arriving at the center and finally, back out again. Each chapter includes some of Sheehy's own journey in caring for her husband, the legendary editor Clay Felker, through 17 years with cancer, plus facts and stories from other caregivers, research related to caregiving, and an extensive sidebar detailing resources for caregivers at each step along the way.

Caregiving can be a grueling journey. But as Sheehy writes in this illuminating, informative and inspiring book, if we allow ourselves to be thoughtful and prepared, to ask for help and call on the resources available, caregiving can rise above the pain and terror and panic and exhaustion into an exercise in "practical spirituality," a walk that can transform our lives, families, loves, and selves.

(Read my full review of Passages in Caregiving at Story Circle Book Reviews, the largest review site for books by and for women. Thanks to Denese for sending me the book!)

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As for my beloved: We're home for another week before traveling to Denver again for his first infusion of Avastin, which we hope will starve his growing tumor by cutting off its vascular network. His energy and some of his brain functions–especially vision–have definitely been impaired by the tumor activity in his right brain.

But we still find grace notes in every day, like the wonderfully sky-blue blizzard of mountain bluebirds that fell on our yard yesterday after the weekend's spring snow.

Twobluebirds

And he is still determined to greet each day with "an attitude of celebration and gratitude." That's inspiring.

Richard was sprung from the hospital at about one this afternoon. We walked out of the ward, turned the corner and headed down four flights of stairs to the pharmacy, picked up his prescriptions, headed down a hall and then down another flight of stairs and out to the parking garage. He led the way confidently through the rabbit-warren of corridors.

His ability to guide us through the hospital correctly is an example of what's exciting about the results of this last brain surgery. Navigation was one of the skills that dwindled as the processing power of his right brain faded.

Another endangered skill was fine motor ability (a skill crucial to sculpting), and as you can see in the photo below, that's back too. He's cutting his hospital ID band into tiny pieces. His tools? My grandfather's old penknife and a small pad of motel notepaper, which he drafted as a straightedge and vise. His ability to figure out creative solutions for design problems has clearly returned too…

Rhands

Watching him relearn the world after a brain re-shaping procedure that seems to have rescued his right brain and its ability to process information is at once comforting and exciting.

What's most exhilarating though is watching him see again. As we drove out of the parking garage into a sparkling-bright and balmy spring day, I warned Richard that the sunlight might be intense: "You should just close your eyes if they get tired."

Instead, he drank in everything we passed as if thirsting for it all: the grove of crabapple trees with clouds of pink buds ready to burst into bloom. The black trunks of the old elm trees lining the street and their new seeds, startlingly chartreuse against a Rocky-Mountain-blue sky. The worn red brick of the old hospital buildings, the gray concrete, the tulips thrusting up scarlet buds. The rock pigeons wheeling overhead, the squirrels scampering across new grass, the myriad cars going past…

"Wow!" he said after a few minutes.

"Wow, as in the world is richer and more detailed than before?"

"Yes," he said.

That's his beleaguered right temporal lobe coming back online (what's left of it after last August's surgery to remove his brain tumors). Before these last two months of repeated right-brain compression crises, I hadn't grasped how much the right brain–especially the right temporal lobe–is involved in processing visual information. Then Richard's view of the world shrink as if he was wearing blinders, and I came to realize that as the pressure on his right brain increased, his brain essentially triaged tasks, allocating what functioning it still had to what was critical, and slowing or eliminating everything else.

He never actually lost visual field–we did all sorts of tests to determine that his field of view was intact. But he couldn't perceive the whole as well as before. Processing each thing he looked at took a while, and when he moved on to something else, the first thing was often lost, so it was difficult put together a complete picture of the world around him.

Now he can.

And it's a mite overwhelming. After a few minutes of taking in the array of visual details that we all get used to seeing (and ignoring) every day, he shut his eyes and rested. Then he opened them again and gazed around, his face enraptured. 

This evening, when I drove into the parking lot of our motel, he was quiet, looking at this oh-so-familiar place through what amounts to new eyes but is really a newly revived right brain.

"Wow!" he said again.

"It's all new, isn't it?" I said.

He nodded.

"Isn't it wonderful that it's spring and a new moon, and here you are seeing the world anew?"

"Yes," he said. "Yes it is. I am a very fortunate guy."

Honestly, I think I'm the fortunate one, watching Richard rediscover this ordinary old world, perceiving it afresh with the processing magic of his revived right brain. It's all wonderful to him, and some of that rubs off on me.

It's spring. The moon is new. My love's brain is working again. No matter what happens tomorrow, I won't forget today's gift of wonder.

Rstaples