writing – The Best Third

Adventures in Maine

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One of my favorite things about traveling to Maine to work as a CRNA was the opportunity to experience a new place. I had never visited Maine before in any capacity, and living there for ten months while I worked out my contract was a way to immerse myself in different regional culture in the United States. It made me realize how blessed we are to live in such an expansive country with diverse populations and regional geography.

It was a season of personal firsts. The first time that I had ever rented a car by myself, and the first time that I was away from my husband and home for an extended period of time. The first thing I noticed when I arrived in early August was how late the sun set and how the beautiful pinks and blues reflected off of the high cirrus clouds for what seemed like forever until they melted into the blue hour of twilight. I could understand why there is such an outdoor aesthetic in the state known as Vacationland.

There were some interesting differences that I noticed right away that went beyond stretching myself personally. Maine is a state that is surrounded by Canada, specifically the Province of Quebec. I learned that it was common for people to speak both French and English fluently. The Quebecois migrated down to work in the factories in Lewiston and the surrounding areas when there were operational factories and before the decline in manufacturing in general across the United States. It was common to hear French being spoken in the hospital where I worked, or the grocery store. Our chief anesthetist’s first language was French. She learned English at the age of nine. Many directional signs are printed in both English and French. I noticed this when I took a walk on the Riverwalk Trail next to the Androscoggin River which connects Lewiston and Auburn. Two separate cities connected by the trail that I heard locals refer to as the LA of the East.

I learned that Irish last names were usually connected to factory bosses and that French last names were the progeny of the “immigrant labor”. I never got the hang of pronouncing the French last names. If I tried to pronounce it the French way, I was inevitably corrected to an Anglo pronunciation. If I tried the Anglo, it was French. As a nurse in Pittsburgh, I can pronounce Eastern European names, which are short of vowels and heavy on consonants, with no problem at all, but throw a French sounding name at me, and I would butcher it nine out of ten times.

There are several ways I would describe Mainers: independent, resourceful, and stoic. Being from Pittsburgh, I am used to smiling at people I pass on the street or in the hallways of a hospital and most times having that smile returned. In Maine, that gets you treated with suspicion. I had the impression that they thought there was something wrong with me. The proper way to greet someone was with a cordial “good morning”, smile optional. This will earn you a “good morning” back, a cordial nod of the head, and a modicum of respect. The smile has to be earned.

While I was there, my husband came up to visit and we headed to Quebec City. I was told where to stay – The Fairmont Le Château Frontenac – with a warning to start the trip with a full tank of gas. That area of Maine is a wild place. Literally. There are moose crossing signs on the winding two lane roads and very few towns or people along the way. The trees changing color under the fall sunshine and reflecting off of the clear, calm lakes in mid-October was breathtaking. It was almost enough to make you forget that if something like an accident with the above-mentioned moose or a flat tire, it may be hours before help comes along.

I live in western Pennsylvania.The area in the commonwealth between Pittsburgh and Philadelphia is very rural, and there are some wonderful natural places to explore, but the Pennsylvania turnpike, Route 80 and close proximity to other states makes it easy to find a gas station. I have never felt more isolated than I did on that trip in the Eastern United States. It was awe-inspiring.

After crossing the Canadian border in a small, rural border crossing, we adjusted to highways marked in kilometers and road signs in French and English and made our way to the first town with a gas station, Saint Georges, Quebec. This was three and a half hours into our drive, making me very grateful that we listened to everyone who told us to make sure we had a full tank of gas.

We arrived in Quebec City after a five hour drive. It was enchanting. I felt like I was dropped in the midst of a fairy tale. We spent the weekend exploring one of the last walled cities left in the world, giving it the feel of a medieval European city, eating at French restaurants and walking along the cobbled streets. It is indeed the closest to feeling like you are visiting Europe while remaining in North America.

After a magical weekend, it was time to head back to Lewiston. Crossing back into the United States was not as easy as crossing into Canada. The US Customs officer at the border was very nice, but extremely thorough. We were driving a rental car, and I had to show the rental agreement, which was not in the glove compartment, but was sitting on the kitchen table in the apartment I was staying in back in Lewiston. I could feel my anxiety creeping in, but before it was able to paralyze all of my muscles and brain cells, the gentleman said. “Check your email for the rental agreement, as long as you have already opened it. There is no cell service here.” I fortunately did have it on my phone and after he examined it, we were able to proceed.

We again went through Saint Georges, Quebec, stopped for gas and made what I thought would be a quick stop at a McDonalds. This is where things get interesting. The McDonalds was located in a French speaking city and not a tourist town where most people are bilingual and speak English to accommodate American tourists. This McDonalds experience was eye-opening.

As an American, I have ordered from McDonalds for as long as I can remember. As a special treat when I was growing up, my dad would go through the drive through and order a dozen cheeseburgers on a weekend to share with all six of us children. It was a hangout in high school in my local community, a place where I took my children to celebrate birthdays and play in the ball pit when they were little. In other words, a place with which I was very familiar.

We walked in to order, and the menus were in French. I have been trying to learn French, but Duolingo does not have a lesson about ordering fast food. My husband was with me, but his knowledge of the French language doesn’t go past polite greetings. Everyone around us was French speaking, they were yelling order numbers in French. People were greeting each other and having conversations in their native language, as they should, but I felt out of place and intimidated. Thank goodness there are picture menus at a kiosk, and I didn’t have to embarrass myself at the counter trying to order in person. Understanding a language doesn’t necessarily mean you can speak it in any meaningful way, and I am still at the state where I have to translate in my head.This also makes it difficult. As I am translating the first few words in my head, the rest of what is being said has timed out of my short-term memory. Thankfully, at the very bottom of the touchscreen menu was a button that said, English. Relief washed over me, and I set the menu to English and ordered our meals. I probably could have ordered it by picture in the French menu, but being the “other,” the one that didn’t fit in, was so anxiety-provoking that I didn’t even feel comfortable trying. We placed our order in English without incident. I had time to translate our order number in French and was able to recognize it when it was called, pick it up at the counter with a quick merci, and quickly head back to the car.

My point is not that the rest of the world should speak English to accommodate me. My point was that if you come to the United States and don’t know the language, you should be given respect. Ordering from a McDonalds during a quick drive through of an unfamiliar town in a foreign country was intimidating and anxiety-producing. People who come here who learn the language, go to school at any level, and find jobs should be celebrated and treated with dignity and compassion.

After leaving that McDonalds, I vowed that I would stop and help any visitor who was in this country and needed help navigating someplace when a language barrier existed. I remember once when I was in Key West, and I saw a French couple attempting to use an ATM in the lobby of the hotel where we were staying. There was only an English and Spanish option. They were struggling, and I almost stopped and helped, but at the time, I was only armed with two years of high school French. I guess I thought they would make fun of me, or resent my intrusion. Looking back now, I regret that. I realize now that I didn’t have to have the perfect accent or all of the correct words. All I needed was a sincere desire to help someone who was struggling and we probably would have muddled through. It is a mistake I will never make again, and I hope that if I am traveling and find myself in a situation where everything is unintelligible to me, that someone will stop and help me.

That is why we are here, isn’t it? To recognize the humanity in each person, and respond to that, not our own egos, preconceived notions or doubts. We are here to respond to each other’s humanity and lift each other up. Yet another personal lesson I learned while on a travel assignment in Maine.

Act Three, Scene One

My first step in my journey toward building my best self in this transitional time of life, the post time (post-menopause, post-children, post-pandemic, and post-retirement) was to address my mental health. This was a very difficult step for me. There is such a stigma around mental health, and I was guilty of falling into this trap of minimizing its importance as well. I was always one to tell others, “You don’t need therapy or medication! Change your diet, exercise, get a good night’s sleep and you’ll feel better!” I am sorry to all of the people, including my children, who heard that speech. This “pull yourself up by the bootstraps” mentality only works to a certain point, and not at all for some people. I found out I was one of the people who needed more than good vibes and terrible advice.

Before I resigned from work, I started by exercising and putting time into myself by journaling and doing some self-care activities. I joined a gym, I scheduled a facial, scheduled a manicure, and bought a brand new notebook. These things helped. The gym that I joined, the day spa I went to for my facial, and the nail salon were all female-owned businesses. They were also all places where I could go and learn what this new me was going to look like. I could look like a fool trying a new exercise at the gym, and Avery, the owner, who was the same age as my youngest daughter, would tell me to give myself grace. This was something I needed to hear and apply to many aspects of my life. The first time I went into the day spa for a facial, I thought, “I am not worthy of this luxury. People like me don’t do this.” Brynn, the owner, sensed my nervousness and said, “This is a safe space. I am here to make you feel comfortable.” I relaxed immediately and got rid of some unwanted chin hair in the process. Clara at the nail salon listened to me tell the same stories over and over and just listened, judgment free. They all made me feel empowered, and they all became my friends as people in other aspects of my life were falling away.

All of those things helped, but I still had my own voice on a loop inside my head that said the most unsupportive things to me. Things like, you are broken, and no one cares about you, and damaged goods. Sometimes, in my mind, I was fighting the notion that I was depressed and anxious. I was doing everything I needed to do. I wasn’t missing a step. So what if I wasn’t enjoying any of them? Everyone has down times, after all. Life isn’t all unicorns and roses. My cup was absolutely empty, but that is what is expected of women, right? Give until it hurts. Do for others, wait for the crumbs from the table, and make sure you make those crumbs last. Even with the support of these new people in my life, I was struggling, but powering through.

Then, one day, I was yelled at in a parking lot. A middle-aged man walked in front of my car. I was annoyed by this and I didn’t stop or make much of an effort to slow down. He made it across safely and I parked my car. When I got out, an older woman was standing next to this man and was yelling at me, “You almost hit him!” This was not true, but I definitely was thinking about what an idiot he was for crossing in front of me without looking. Instead of stopping while he crossed, which I absolutely should have done, ignoring this outburst, or even apologizing, I chose to yell back, “He should have learned in Kindergarten that pedestrians have an obligation to look before they cross the road!” I proceeded to walk away, very thankful that there were no cell phone cameras in the vicinity. This was it for me. I was shaking with anger, rage, and shame, and I asked myself, “is this the person I want to be?” The answer was a resounding no. What was I doing? Whatever it was obviously wasn’t enough. Being yelled at in a parking lot and yelling back was the sign I needed to make changes. I made a therapy appointment that afternoon.

For the next year, I went to therapy. I learned about myself, and I learned what boundaries were. I tried things that I had been too afraid to try. I learned to respond, not react—in other words, how to not yell at strangers in parking lots. I was doing work like journaling that would help me heal, but still berating myself daily and not getting much joy out of anything, even things I used to enjoy, like cooking. I found myself doom-scrolling, although in my defense, there was plenty to doom-scroll about. I was self-medicating without even realizing it. I seemed to need a glass or two of wine at night to help myself unwind and relax.

I white-knuckled it until my next physical, where I admitted to my PCP, “I think I’m depressed.” She proceeded to screen me. I answered honestly. On the Patient Health Questionnaire (PHQ-9), I scored an 11, indicating moderate depression. No surprise there. On the General Anxiety Disorder (GAD-7), I scored a 17, indicating severe anxiety. This did surprise me.

It really shouldn’t have. From the time I was in elementary school, if I heard police sirens, I believed that someone in my family was hurt or dead, and that was what the sirens were about. I would go home and be so relieved that my mom was alive and well. I saw a Godzilla movie when I was a kid and spent the next two weeks looking out the back door to make sure Godzilla wasn’t terrorizing my neighborhood. I spent the summer between third and fourth grade agonizing over the possibility of not being able to remember my multiplication tables and how I would probably end up being held back a grade. When I tried to tell my mom about how worried I was about this, she laughed and said, “Wait until you are an adult and have to face real problems.” I learned to keep these worries to myself. I knew that Godzilla was probably not going to step on my house, but the chance of me failing out of fourth grade was not zero. There were signs that anxiety was a problem.

There were also physical indicators that showed up in my adult life. I had constant stomach aches, heart palpitations, and cracked teeth from clenching at night. I was irritable, which I thought was a normal response to life. Also, I couldn’t hold still. When I was sitting, I was constantly biting my lips and moving my feet. I didn’t realize I was doing this until my grandsons saw me moving my feet and starting playing with my toes and laughing. They thought I was playing a game with them. I had no idea these were indicators because they had always been a part of me. Hyper-vigilance made me a very good CRNA, so why would I want to change something on which my livelihood was dependent? It’s generally a good thing that the person taking over your vital functions in the operating room is vigilant.

I am pretty sure there was also a hereditary element. My mother struggled with anxiety. She bit her cuticles until they bled, she was a foot fidgeter, and she also ruminated. She would come home after meeting a neighbor in the grocery story and spend the next few hours dissecting the conversation. She pulled apart what she said, what the person she was talking to said, their intonations, and their body language. I remember trying to reassure her that I’m sure they weren’t being critical or judgmental, but she was sure there was more to the story. I would try to convince her not to read too much into it. As an adult, I found myself doing the very same thing. Once again, I thought it was normal.

My PCP started me on a low dose of an anti-depressant after screening me, and I am not exaggerating that it changed my life. The recording in my head that told me I wasn’t good enough was silenced. I started to enjoy things like cooking again. I still have all of the normal human emotions, but they are in check now. I am comfortable responding instead of being reactive. No more yelling at strangers in parking lots. I feel happiness, joy, and gratitude every day now. I thought those emotions were lost to me and it was a normal part of aging, but they are back.

I asked my PCP about weaning off of the medication at my recent physical. She did the screening again. My score came back as a 4 on both the PHQ-9 and the GAD-7. Both scores were in the normal range. “Why do you want to stop taking them?” she asked.

I answered, “I feel really good, I’m not sure that I need them anymore.”

“You are on a low dose, and you feel good. If you want to try to wean off, I have no objections, but be aware that your symptoms may come back.”

That’s all I had to hear. I decided, after consulting with my physician, that I am much happier now and to stay the course. If I was treating high blood pressure, I wouldn’t think twice about taking medication. I decided this was no different. I will be on this medication as long as it works. It was the next step in getting my life back. The medication and therapy together have helped bring enjoyment back to my life. Every time I hear someone like the HHS secretary say that anti-depressants aren’t necessary and they shouldn’t be so easy to get, I think, “You’ll get mine when you pry them out of my cold, dead hands.” I’m not going back. I will take the advice of my trained physician and therapist. The HHS secretary holds neither of those credentials.

I met with my therapist the other day. She told me of how far I’ve come and how proud she is of me. For the first time in a long time, I was able to look back over the last several years and actually see the progress I have made, and I was able to say, “I am proud of myself, too.” I am now ready to embrace what comes next with a healthier and happier outlook on life.