Palliative Care in the ED

http://vimeo.com/59785062

"The Call to Forgiveness at the End of the Day", Kathleen Dean Moore, May 25, 2025

All those years, the Swainson’s thrushes were the first to call in the mornings. Their songs spiraled like mist from the swale to the pink sky. That’s when I would take a cup of tea and walk into the meadow. Swallows sat on the highest perches, whispering as they waited for light to stream onto the pond. Then they sailed through the midges, scattering motes of wing-light. Chipping sparrows buzzed like sewing machines as soon as the sun lit the Douglas firs. If I kissed the knuckle of my thumb, they came closer and trilled again.

For years there were flocks of goldfinches. After my husband and I poisoned the bull thistles on the far side of the pond, the goldfinches perched in the willows. When they landed there, dew shook from the branches into the pond, throwing light into new leaves where chickadees chirped. The garbage truck backed down the lane, beeping its backup call, making the frogs sing, even in the day.

Oh, there was music in the mornings, all those years. In the overture to the day, each bird added its call until the morning was an ecstasy of music that faded only when the diesel pumps kicked on to pull water from the stream to the neighbor’s Bing cherry trees.

Evenings were glorious too. Just as the sun set, little brown bats began to fly. If a bat swooped close, I heard its tiny sonar chirps, just at the highest reach of my hearing. Each downward flitter of its wings squeezed its lungs and pumped out another chirp, the way a pump organ exhales Bach. Frogs sang and sang, but not like bats or birds. Like violins, violin strings just touched by the bow, the bow touching and withdrawing. They sang all evening, thousands of violins, and into the night. They sang while crows flew into the oaks and settled their wings, while garter snakes, their stomachs extended with frogs, crawled finally under the fallen bark of the oaks and stretched their lengths against cold ground.

I don’t know how many frogs there were in the pond then. Thousands. Tens of thousands. Clumps of eggs like eyeballs in aspic. Neighborhood children poked them with sticks to watch their jelly shake. When the eggs hatched, there were tadpoles. I have seen the shallow edge of the pond black with wiggling tadpoles. There were that many, each with a song growing inside it and tiny black legs poking out behind. Just at dusk, a hooded Merganser would sweep over the water, or a pair of geese, silencing the frogs. Then it was the violins again, and geese muttering.

In the years when the frog choruses began to fade, scientists said it was a fungus, or maybe bullfrogs were eating the tadpoles. No one knew what to do about the fungus, but people tried to stop the bullfrogs. Standing on the dike, my neighbor shot frogs with a pellet gun, embedding silver BBs in their heads, a dozen holes, until she said How many holes can I make in a frog’s face before it dies? Give me something more powerful. So she took a shotgun and filled the bullfrogs with buckshot until, legs snapped, faces caved in, they slowly sank away. Ravens belled from the top of the oak. When the bats stopped coming, they said that was a fungus too. When the goldfinches came in pairs, not flocks, we told each other the flocks must be feeding in a neighbor’s field. No one could guess where the thrushes had gone.

Two springs later, there were drifts of tiny white skins scattered in the shallows like dust rags in the dusk. I scooped one up with a stick. It was a frog skin, a perfect empty sack, white, intact, but with no frog inside – cleaned, I supposed, by snails or winter – and not just one. Empty frogs scattered on the muddy bottom of the pond. They were as empty as the perfect emptiness of a bell, the perfectly shaped absence ringing the angelus, the evening song, the call for forgiveness at the end of the day.

As it happened, that was the spring when our granddaughter was born. I brought her to the pond so she could feel the comfort I had known there for so many years. Killdeer waddled in the mud by the shore, but even then, not so many as before. By then, the pond had sunk into its warm, weedy places, leaving an expanse of cracked earth. Ahead of the coming heat, butterflies fed in the mud between the cracks, unrolling their tongues to touch salty soil. I held my granddaughter in my arms and sang to her then, an old lullaby that made her soften like wax in a flame, molding her little body to my bones. Hush-a-bye, don’t you cry. Go to sleep, you little baby. Birds and the butterflies, fly through the land. I held her close, weighing the chances of the birds and the butterflies. She fell asleep in my arms, unafraid.

I will tell you, I was so afraid. Poets warned us, writing of the heartbreaking beauty that will remain when there is no heart to break for it. But what if it is worse than that? What if it’s the heartbroken children who remain in a world without beauty? How will they find solace in a world without wild music? How will they thrive without green hills edged with oaks? How will they forgive us for letting frog-song slip away? When my granddaughter looks back at me, I will be on my knees, begging her to say I did all I could.

I didn't do all I could have done. It isn't enough to love a child and wish her well. It isn't enough to open my heart to a bird-graced morning. Can I claim to love a morning if I don’t protect what creates its beauty? Can I claim to love a child if I don’t use all the power of my beating heart to preserve a world that nourishes children’s’ joy?

Loving is not a kind of la-de-da. Loving is a sacred trust. To love is to affirm the absolute worth of what you love and to pledge your life to its thriving—to protect it fiercely and faithfully, for all time. My husband and I were there when the last salmon died in the stream. When we came upon her in the creek, her flank was torn and moldy. She had already poured the rich, red life from her muscles into her hopeless eggs. She floated downstream with the current twitching when I pushed her with a stick to turn her upstream again. Sometimes her jaws gaped, still trying to move water over her gills. Sometimes she tried to swim. But she bumped against rocks, spilling eggs onto the stones. Without reason, she pushed her head into the air and gasped. We waded beside her until she died. When she was dead, she floated with her tail just above the surface, washing downstream until she lodged on a gravel bar. The music she made was the riffle of rib-bones raking water, then no sound at all as her body settled to the bottom of the pool.

I buried my face in my hands, even as I stood in the water with the current shining against my shins. Oh, we had known the music of salmon moving upstream. When the streams were full of salmon, crows called again and again, and seagulls coughed on the gravel bars. Orioles sang, their heads thrown back with singing. Eagles clattered. Wading upstream, we walked through waves of carrion flies that lifted off the carcasses to swarm in our faces, buzzing like electrical current. Water lifted and splashed, swept by strong gray tails, and pebbles rolled downstream. It was a crashing coda, the slam and the buzz and the gull-scream.

Ring the angelus for the salmon and the swallows. Ring the bells for frogs floating in bent reeds. Ring the bells for all of us who did not save the songs. Holy Mary mother of god, ring the bells for every sacred emptiness. Let them echo in the silence at the end of the day.

Forgiveness is too much to ask. I would pray for only this: that our granddaughter would hear again the little lick of music, that grace note toward the end of a meadowlark’s song.

Meadowlarks. There were meadowlarks. They sang like angels in the morning.

Mr. Wright

Jeffrey Wright is well known around his high school in Louisville, Ky., for his antics as a physics teacher, which include exploding pumpkins, hovercraft and a scary experiment that involves a bed of nails, a cinder block and a sledgehammer.

But it is a simple lecture — one without props or fireballs — that leaves the greatest impression on his students each year. The talk is about Mr. Wright’s son and the meaning of life, love and family.

It has become an annual event at Louisville Male Traditional High School (now coed, despite its name), and it has been captured in a short documentary, “Wright’s Law,” which recently won a gold medal in multimedia in the national College Photographer of the Year competition, run by the University of Missouri.

The filmmaker, Zack Conkle, 22, a photojournalism graduate of Western Kentucky University and a former student of Mr. Wright’s, said he made the film because he would get frustrated trying to describe Mr. Wright’s teaching style. “I wanted to show people this guy is crazy and really amazing,” Mr. Conkle said in an interview.

The beginning of the film shows Mr. Wright, now 45, at his wackiest. A veteran of 23 years teaching, he does odd experiments involving air pressure and fiery chemicals — and one in which he lies on a bed of nails with a cinder block on his chest. A student takes a sledgehammer and swings, shattering the block and teaching a physics lesson about force and energy.

But each year, Mr. Wright gives a lecture on his experiences as a parent of a child with special needs. His son, Adam, now 12, has a rare disorder called Joubert syndrome, in which the part of the brain related to balance and movement fails to develop properly. Visually impaired and unable to control his movements, Adam breathes rapidly and doesn’t speak.

Mr. Wright said he decided to share his son’s story when his physics lessons led students to start asking him “the big questions.”

“When you start talking about physics, you start to wonder, ‘What is the purpose of it all?’ ” he said in an interview. “Kids started coming to me and asking me those ultimate questions. I wanted them to look at their life in a little different way — as opposed to just through the laws of physics — and give themselves more purpose in life.”

Mr. Wright starts his lecture by talking about the hopes and dreams he had for Adam and his daughter, Abbie, now 15. He recalls the day Adam was born, and the sadness he felt when he learned of his condition.

“All those dreams about ever watching my son knock a home run over the fence went away,” he tells the class. “The whole thing about where the universe came from? I didn’t care. … I started asking myself, what was the point of it?”

All that changed one day when Mr. Wright saw Abbie, about 4 at the time, playing with dolls on the floor next to Adam. At that moment he realized that his son could see and play — that the little boy had an inner life. He and his wife, Nancy, began teaching Adam simple sign language. One day, his son signed “I love you.”

In the lecture, Mr. Wright signs it for the class: “Daddy, I love you.” “There is nothing more incredible than the day you see this,” he says, and continues: “There is something a lot greater than energy. There’s something a lot greater than entropy. What’s the greatest thing?”

“Love,” his students whisper.

“That’s what makes the why of what we exist,” Mr. Wright tells the spellbound students. “In this great big universe, we have all those stars. Who cares? Well, somebody cares. Somebody cares about you a lot. As long as we care about each other, that’s where we go from here.”

As the students file out of class, some wipe away tears and hug their teacher.

Mr. Wright says it can be emotionally draining to share his story with his class. But that is part of his role as a physics teacher.

“When you look at physics, it’s all about laws and how the world works,” he told me. “But if you don’t tie those laws into a much bigger purpose, the purpose in your heart, then they are going to sit there and ask the question ‘Who cares?’

“Kids are very spiritual — they want a bigger purpose. I think that’s where this story gives them something to think about.”

Mr. Wright says the lecture has one other purpose: to inspire students to pursue careers in science and genetic research.

“That’s where I find hope in my students,” he said. “Maybe if I can instill a little inspiration to my students to go into these fields, who knows? We might be able to come up with something we can use to help Adam out one day.”

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Reflections from the Past re the 2011 NDAA

There was a time in my life that I was an M1 tank platoon sergeant(19K40) in the National Guard. Typical tank company organization then (and probably now) was made up of three tank platoons; each platoon having four M1 tanks. Normally an officer would lead the platoon, but in the absence of the lieutenant, the platoon sergeant was in charge. Since officers were usually in short supply then, the "plat-daddies" were in charge.

On the long nights of overwatch, waiting on firing lines, etc, the three platoon sergeants often discussed what we would do if the federal gov't asked us to take arms agains the civilian population of the U.S. Back then, there were rumors the Marines were conducting civilian crowd control. So we talked about it.

It was an unambiguous declaration between the platoon sergeants: the citizens would immediately have at their disposal 12 M1 tanks and crews. It was utterly unthinkable that we would use our training and equipment against the very civilians we pledged an oath to protect. We considered such an order, if it were to be issued, totally unlawful.

Passage of the 2011 NDAA bill, recalls those discussions and commitments. I sincerely hope there are still enough of those in uniform who will not allow themselves to be used as an illegitimate force against those to whom they've pledged to support and protect.