Bertram's Blog

Making End of Life Decisions

March 3, 2013 — Pat Bertram

Some of the hardest decisions to make when taking care of a person who is nearing the end of life are not dire life/death decisions, such as taking him off a respirator, but simple decisions that continue to haunt you long after the person is gone.

The hardest decision I had to make when it came to the end days of my life mate/soul mate was whether to take him to the hospice care center. The nurse suggested the move to give me time to rest (he had what is called “terminal restlessness” and kept getting out of bed; considering how unsteady he was on his feet, I had to get up with him.) He wasn’t ready to go, wasn’t ready to face the ending of his life, and yet knowing the truth of the matter — that he wouldn’t be coming home again — he still agreed to go. I, on the other hand, believed the nurse when she said he would be away just a few days to give me time to rest, but still, I felt horrible about agreeing to take him. Afterward, that decision haunted me. I wished I’d let him stay home one more day, especially since I didn’t sleep anyway.

The decision I face now in taking care of my father is even less dire, but infinitely more complicated. Until about a week ago, my father still answered the phone, eager to talk to anyone who called, but now we’ve unplugged the phone in his room because he doesn’t like to be awakened.

He spends most of his time sleeping, getting up a few times a day to eat something — an egg or a bit of jello or a few canned peach slices. He is willing to talk to his children during those times, so that’s not a problem, but he doesn’t want to see anyone. He is very fragile, and so I have been honoring his wishes. However, some of my siblings want to make sure they see him one last time, and this is where the decision lies.

When is the cut-off point where his wishes become secondary and the wishes of his children come first? When it’s close to the end, I suppose, and I don’t think he’s there quite yet. Although he doesn’t eat much and has developed an aversion to most of his favorite foods, he does still have an interest in eating, which is a good sign. He’s also alert when he’s awake, so he hasn’t quite begun removing himself from life. (He has no interest in reading the newspaper anymore, but I don’t consider the newspaper “life”.)

I hope I’m doing the right thing by continuing to honor my father’s wishes, and that the decision to do so won’t come back to haunt me. I hope, if I make the wrong decision (or make a wrong assessment about how much time my father has left), my siblings will forgive me.

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Pat Bertram is the author of the suspense novels Light Bringer, More Deaths Than One, A Spark of Heavenly Fire, and Daughter Am I. Bertram is also the author of Grief: The Great Yearning, “an exquisite book, wrenching to read, and at the same time full of profound truths.” Connect with Pat on Google+

Posted in culture, life, relationships. Tags: end of life, end of life decisions, final visitations, honoring my father’s wishes, hospice care center, life/death decisions. 7 Comments »

Rubicon Ranch ~~ Prepare for Mayhem!

March 2, 2013 — Pat Bertram

I enjoy finding out how other writers approach their craft, and especially how they develop their characters. J J Dare, author of False Positive and False World, delights in creating evil characters. As a fellow collaborator in the Second Wind serialization, Rubicon Ranch, J J Dare created the monstrous victim in Rubicon Ranch: Necropieces, the second book of the series, along with a couple of his offspring. In her blog post Bad Wasps, J J Dare said of her two POV characters:

They’re bad. Bad to the bone. Bad in ninety-five percent of their molecular makeup. If an ice-cream flavor was named after them, it would be “Vinegar and Vinegar” and it would taste just as sour as it sounds.

They are evil, narcissistic, self-centered, selfish and plain mean. Both characters think nothing of climbing over the living and dying bodies of anyone in their way. They are Bad Wasps.

So, why did I write them this way? It’s not a reflection of me. I’m fairly mild, with only a bit of flair once in a while. And I’ve never wanted to murder my parents.

I’m glad she added those last two sentences. Someday J J and I will meet, and I’d hate to have to go to the meeting prepared for mayhem.

Seeing how much fun J J Dare has with her evil characters, I’d considered exchanging my character for a bad wasp (or perhaps revealing a waspish side, which I might someday do), but my character, Melanie Gray still has so much work to do that I can’t just dump the poor woman. She needs to find out who killed her husband and why, and she needs to resolve her feelings for the misogynist sheriff.

J J’s characters might not reflect her, but Melanie Gray is a lot like me. She’s a writer dealing with grief, she wanders in the desert, she’s fairly calm and passive though she can be riled. Even though she started as an alter ego (but younger) she turned out to be a world traveler, which I am not, and she has a penchant for finding dead bodies, which I don’t. Thank heavens for that! Being some sort of human cadaver dog has never been an aspiration of mine.

If you have not yet checked out Rubicon Ranch, now would be a good time. You can download the first book free in the ebook format of your choice here: Rubicon Ranch: Riley’s Story and you can follow the second book as we finish writing it here: Rubicon Ranch: Necropieces. And you will have to prepare for mayhem!

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Posted in books, writing. Tags: collaboration, J J Dare, Melanie Gray, Rubicon Ranch, Second Wind Publishing, victim, villain, writing evil characters. Leave a Comment »

Insurance Hell . . . As if Being Sick Isn’t Bad Enough

March 1, 2013 — Pat Bertram

I’m not one to air my feelings about government intervention (except in my novels, of course) but this whole thing about forcing United States citizens to buy health insurance is about as insane an idea as . . . well, as aspartame, and that got shoved down our throats, too.

The main problem with our health care system is the insurance racket, and the government wants to reward them for stupidity with our money? Sheesh. Case in point:

I am taking care of my 96-year-old father, and he’s recently taken a turn for the worse. He was in the hospital for pneumonia and various tests for about a week. Got out about eight days ago. The doctor prescribed a breathing treatment, but when I went to pick up the drugs at the pharmacy that night, they weren’t ready. Somehow, the doctor had forgotten to send in the prescriptions. Several calls and one personal visit to the doctor’s office later, the prescriptions were called in, and that’s when the fun really started.

The insurance refused to pay for the breathing treatment, so the doctor changed to a different one — one, moreover that the insurance company said was covered. I went to pick up the prescription and again, it wasn’t ready. Turns out this particular drug needed a doctor’s authorization. Say, what? Isn’t a prescription an authorization? Apparently not. Apparently, the insurance company wanted the specific reason why the doctor had prescribed that particular treatment. So I started making calls again, to the doctor’s office, trying to get them to do the authorization; to the pharmacy, trying to get them to do their part. Finally, the authorization was sent. But . . .

The insurance company told the pharmacy to bill Medicare, that they don’t handle any aerosol treatments. Huh? So what was the whole thing about changing medications to one that the insurance company does cover? Anyway, Medicare agreed to pay for the drug but . . .

Yep, another but. As of this year, Medicare has a $148 dollar per year deductable, which means my father ended up paying the whole bill of $119.00 out of pocket. He pays a fortune in insurance, a fortune in co-pays though his insurance policy, and yet because the insurance company refused to honor the prescription, he ended up bearing the full cost. A refill, of course, will be only thirty dollars or so, but the problem is that this replacement drug needs to be taken four times a day, every six hours, instead of two like the originally prescribed drug. It will be hard getting my father to do the treatment even once, so we will have a year’s supply of the drug, which means that any refills will also be at full cost.

So, if he has to pay the entire cost of the drug out of his own pocket, why weren’t we told this upfront so we could have just gotten the original prescription and been done with it?

This sort of situation is becoming way too common. I have a friend who suffers from advanced rheumatoid arthritis. One particular very expensive injection is keeping the disease at bay, allowing her to continue living without too much debilitation, and yet her insurance company refuses to pay for the shots any longer. The drug company ended up finding a sponsor for her. So what’s the point of having insurance if you have to beg someone to pay for a drug you need to survive?

And this is the insurance hell that everyone is going to be forced to endure. Cripes. As if being sick isn’t bad enough.

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Posted in culture, life. Tags: breathing treatment, co-pays, insurance companies, insurance racket, medicare, prescriptions. 10 Comments »

Striving For Clarity in Writing

February 28, 2013 — Pat Bertram

stage There seem to be two vociferous groups of writers nowadays:

1. Self-published writers who insist that they can do everything their way without regard to grammar rules, publishing conventions, and even readers.

2. Writers who want to be published by the major publishing houses, and who scrupulously follow every dictate in the hopes it will bring them the acclaim they strive for.

The first group of writers often strive for originality at the expense of readability. They take the easy way out by choosing limp words that demand to be propped up with adverbs and adjectives. Or they throw out grammar rules, which comes across not so much as being creative but as being too lazy to learn the right way. Grammar is not a straightjacket but a garment that flows softly around readers, keeping their attention on the story rather than the structure. If readers have to read and reread a paragraph to try to make sense of it, then the author has not done her job.

Some of these authors believe that readers should have to work to make sense of their story, that it’s okay if readers are pulled out of the story to look up an unfamiliar word, or to admire a particularly well-turned phrase, but readers for the most part want to be immersed in a story. If you’re watching a play, you want to see the characters, the action, the set. You do not want to be shown the backstage bickering or the ugly scaffolding. You simply want to be immersed in the play. (Unless, of course, the play is Noises Off, in which case all the bickering and scaffolding are part of the story.) And the same goes for books.

The second group of writers strives for perfection at the cost of originality, especially originality of style or voice. These writers are often too assiduous in their dislike of “was”, “it”, “ly” adverbs, adjectives, or any number of words that make our writing seem amateurish. Yes, an abundance of such words does make our writing seem amateurish and even hard to read, but removing every single was or it or modifier makes for a stilted style.

The truth of good writing lies somewhere in the middle of those two groups.

As I read in an old book called The Practical Stylist by Sheridan Baker: “Clarity is the first aim; economy the second; grace the third; dignity the fourth. Our writing should be a little strange, a little out of the ordinary, a little beautiful with words and phrases not met everyday, but seeming as right and natural as grass.”

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Posted in books, How to, writing. Tags: clarity in writing, readability, self-published writers, traditionally published writers, truth of good writing, what is good writing, writing style. 7 Comments »

Grief at Thirty-Five Months

February 27, 2013 — Pat Bertram

Today marks the thirty-fifth month since the death of my life mate/soul mate, yet today is a day like any other. There is no particular upsurge in grief, no particular focus on his death or my loss (two separate things).

This “acceptance” of the day is not a positive step forward so much as the combination of a couple of non-related factors. For one, I’m dealing with a major sinus infection, and upsurges in grief and upsurges in ill health don’t seem to happen at the same time, probably because both take an enormous toll on the body so one gives way to the other.

Even old grief, grief that is past the first year of raw pain, is stressful because you walk an unsteady path in an alien world, and you have to make mental compensations to travel that path, the same way you have to make physical compensations if your ankle is broken. During that first year, a person who has lost a spouse has 25% higher death rate from all causes than those who are not grieving, and even beyond that first year, the bereft seem to have a higher rate of illness since the stress of grief affects the immune system. (Sometimes it even seems as if there could be a bit of body/mind interaction, where the mind gets tired of grieving, and so allows the body to become sick, though that isn’t what happened in my case since I haven’t had a major upsurge of grief in a while, just upswings of sadness.)

The other factor involved in making this day less emotional than expected is that I’m looking after my aged father, who has taken a turn for the worse, and I find myself falling into the same mindset I had when I watched my life mate/soul mate die. In such a case, you take a step back from your emotions, wait to see what happens, do the best you can in any crisis, and bear the burden of helplessness as lightly as possible.

Seeing myself getting into this mental state again makes me realize that I did the best I could three years ago, that so much I regretted or felt guilty about was beyond my control. I’d worked past those concerns, so they haven’t been haunting me lately, but now I have a graphic illustration of truth. I did the best I could for him, just as I will do the best for my father.

The thing I regretted most about my mate’s death is that I took it for granted. He was ill for a long time, and after a while, his dying became a way of life. I see that happening again, that my father’s aging and inevitable dying is becoming a way of life. My life.

The odd thing for me is that I’ve spent the last three years trying to embrace life again, to get away from the stasis of dying and grief, but now, willy nilly, I am back in neutral. Not looking forward. Not looking back. Just taking life each day as it comes, even if the day marks the thirty-fifth month of my grief.

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Posted in culture, grief, life. Tags: grief and death, grief and illness, grief and stress, new grief, old grief, taking dying for granted, thrity-five months of grief. 6 Comments »

It Takes Courage to Grieve

February 26, 2013 — Pat Bertram

People have often mentioned how courageous I’ve been by writing about my grief, but the truth is, for the most part, it didn’t take any courage. At the beginning, I was in such incredible pain and bewildered by all I was feeling, that I tried to make sense of all the emotions and physical symptoms the only way I knew how — by writing.

There were two times, though, where it did take courage. The first time was when my grief continued far beyond what I had expected, and I was afraid people would think I was weak or self-pitying or self-indulgent, unable to move beyond the tragedy. I am moving, but at my own pace.

The truth is, when you lose your mate, you lose not only the person who meant more to you than any other, the person who connected you to the world, you also lose your best friend, your confidante, your support, your sense of self, your hopes and dreams, your shared world, your faith in a universe that makes sense. The changes are so vast and so sudden, it can take years to process them all.

I’d been honest about everything I’d been feeling, so I continued telling the truth about my grief even when I thought it made me seem pathetic. No one wants to show a weak side to the world, but someone has to explain how grief works, to show the ramifications of a certain type of loss. We are steeped in a culture of couplehood. Many songs and movies extol the joys of meeting the one person who makes life worth living, yet when you lose that person, you are expected to continue as if it didn’t matter. Well, it does matter. And it matters more when you lose that person to death. It’s almost impossible to fathom the absence of a person who once breathed the same air you did, who was there through every crisis and triumph, and who now is simply . . . gone. (Well, if I’m going to tell the truth, then I should tell the truth. It’s not almost impossible. It’s totally impossible.)

I’m past worrying about how people see me and my grief, so I’m back to not needing courage to write about how I am doing. I’m just continuing to chronicle the journey of a woman who is trying to rebuild her life after an immeasurable loss, both the steps forward into hope and the steps backward into sorrow and tears.

The second time I needed courage was when I published Grief: The Great Yearning, the story of my first year of grief. It’s one thing to write about grief in the backwaters of the blogosphere, and a completely different thing to put my grief out there for the whole world to read. Well, the whole world isn’t reading the book, so that’s not an issue, but more importantly, those who do read my story find they are reading their own story. Although grief is unique to each person, the pain and angst and bitter losses are the same. And so is the way we make this unwanted and terrible journey . . . one step at a time.

And that takes courage.

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Posted in culture, grief, life, writing. Tags: grief and courage, grief and loss, Grief: The Great Yearning, loss of a soul mate, loss of a spouse, writing about grief. 4 Comments »

Are Book Trailers a Good Idea?

February 25, 2013 — Pat Bertram

rainbow Someone asked me for advice on how to get people to see his book trailer and then called me negative when I explained how difficult it would be. I admit I’m burned out when it comes to promotion. I’ve spent the past five years researching book promotion in all its many facets, tried hundreds of different things, and I still don’t know how to turn a sleepy seller into a best seller, though I know a lot about what doesn’t work, or at least what doesn’t work for me. Other people do the same sorts of things I’ve been doing and find a pot of gold at the end of the promotion rainbow, but I’m still searching for the rainbow.

Book promotion is a lot like the house that Jack built. You have a book you want to sell, so you create a video trailer to promote it. Then you have to promote the video that promotes the book you want to sell. Then, you join Facebook to get more viewers for your video, so now you have to promote your FB page that promotes the video that promotes the book you want to sell. And on and on and on.

Some people can just throw a book out there and make a fortune on Amazon, but the rest of us have to promote. Have to find a way to get people interested in us and then in our books. As I said in What Works When It Comes to Book Promotion?, the first authors to blog or use the various social networking sites to promote their books found a strong readership, but now all of those means of promotion are so common that they are simply an expected part of being an author.

It’s the same with book trailers. The first people who created book trailers to promote their books did well, but now video promos are just an expected part of being an author. Even if the video is great, the problem is getting people to see the video.

Sometimes people will stumble across a book trailer when they are surfing Utube, but it’s not as if people by the thousands will be searching for his book trailer. I wanted to hear Madonna’s “Playground” the other day, so I used the search function to find it since I knew what I wanted to listen to, but what if I didn’t know there was a song out there I’d like to hear? How do I find it?

The problem is, you have to promote the book trailer as assiduously as you promote the book. If I knew how to get people to see his trailers, I’d be good enough at promotion that I’d be selling millions of books.

Still, book trailers are a good idea, and the better they are made, the better they will do. I don’t want to discourage him from making his video because . . . who knows? His might catch people’s attention and go viral. At the very least, it will give him something other than the book itself to promote.

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Posted in blogging, books, writing. Tags: book promotion, book trailer, the house that Jack built, video book promos. 8 Comments »

Excerpt from LIGHT BRINGER by Pat Bertram

February 24, 2013 — Pat Bertram

Description of Light Bringer:

Becka Johnson had been abandoned on the doorstep of a remote cabin in Chalcedony, Colorado when she was a baby. Now, thirty-seven years later, she has returned to Chalcedony to discover her identity, but she only finds more questions. Who has been looking for her all those years? Why are those same people interested in fellow newcomer Philip Hansen? Who is Philip, and why does her body sing in harmony with his? And what do either of them have to do with a shadow corporation that once operated a secret underground installation in the area?

Excerpt from Light Bringer:

Where am I? A new foster home?

Philip supported his throbbing head in his hands and wondered if he’d live to adulthood.

Tamping down the pang of self-pity, he raised his head, and everything came clear. Or almost everything.

He knew who he was: the thirty-eight-year-old Philip, dressed in yesterday’s clothes. He knew where he was: the foldout bed in Emery Hill’s den. But he didn’t know how he got there. He remembered being in the car with the creature, flinging himself against the door—no wonder he felt so bruised—and the icy touch on his neck. Had it brought him back here?

He stood, rocking until he caught his balance, then staggered off in search of the coffee he could smell brewing.

When he entered the kitchen, Emery started and dropped the mug he had been removing from a cabinet. It came to rest at Philip’s feet. Wincing, Philip bent to pick it up.

“Jeeminy Christmas!” Emery exclaimed. “You about scared the intellect out of me. What are you doing here? I thought you went back to Denver. See what you’ve done? I’m already turning into a blithering idiot.”

Philip laughed, then cut it off and clutched his head.

“What’s wrong? Hangover?”

“Feels like it, but I haven’t been drinking.” Getting a mug for himself and pouring a cup of coffee, he wondered if he’d been drugged. He took a sip of the brew, which seemed strong enough to soften a stone, and barely refrained from spitting it out. “Tomorrow I make the coffee.”

“Fine,” Emery said absently, regarding Philip with narrowed eyes. “I always know when one of my students is in trouble. It’s time you told me what’s going on.”

“I was never one of your students.”

Emery waved away the remark. “Between the two of us we should be able to solve your predicament.”

“I’m not sure there is a solution. Right before I came here, two NSA agents came to my apartment.”

Emery shook his head as if to clear it. “I must have misunderstood. I thought I heard you say NSA agents.”

***

Where to buy Light Bringer:

Second Wind Publishing

Amazon

Barnes & Noble Nook

iStore (on iTunes)

Palm Doc (PDB) (for Palm reading devices)

Epub (Apple iPad/iBooks, Nook, Sony Reader, Kobo)

Posted in books, fiction, writing. Tags: Colorado, fiction, Light Bringer, mystery, novel, search for identity, Second Wind Publishing. Leave a Comment »

Grief Is Unique to Each Person

February 23, 2013 — Pat Bertram

My mother, far right, on her 60th wedding anniversary

Today is my mother’s birthday. She would have been 91 if she had lived. Her life wasn’t cut short, nor was her death a tragedy — she’d lived a long life, and for the most part, her death wasn’t particularly horrendous. And even at the end of her life, she managed to get one last wish — to reach her 60th wedding anniversary.

One of the things so confusing about grief is the various lengths of lives and loves. Do you feel more grief if you’d been together for 60 years as my parents were? Do you feel less grief if you’d been together a matter of months?

I was with my soul mate for thirty-four years before death took him. After he died, I’d look at couples like my parents, and I’d envy them their long togetherness, but then I’d look at couples who had been torn apart before they ever had a chance to settle into their lives, and I would be grateful for the years I had with him.

Despite my envy/gratitude, I’ve concluded that when it comes to the loss of a mate, the length of time you were together isn’t a factor in your grief because you always grieve the entire life — everything you had and everything you didn’t have. If you’ve been together for most of your life, there is more of the past to grieve. If you had little time together, you grieve for all you never had. And in my case, I grieved for both the past and the future.

Many other factors are more important than the length of time you had together when it comes to grief. The depth of the connection matters, as does the interdependency of your lives. If you count on two paychecks to pay the bills, for example, and one of those paychecks evaporates, financial fear adds to one’s grief. If you are each other’s support group, providing a sounding board or hugs when necessary, then the loss of that support when you need it most adds to grief. Complications in the relationship can add to grief because you lose any chance of ever smoothing things out. Quick deaths add to grief because of the horrendous shock, and long dyings add to grief because of all the guilt and regrets that built up. And if you lose your mate when you’re relatively young, then you face many years without him, which adds to your grief.

All of these things combine to make grief unique to each person, but what isn’t unique is the sense of loss, the yearning, the hanging on the best we can until life opens up to us once again or until we find peace at the end.

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Posted in culture, grief, life. Tags: 60th wedding anniversary, adding to grief, complications of grief, depth of grief, envy/gratitude, grief and loss, interdependency. 4 Comments »

A Sweet Tale or a Horror Story?

February 22, 2013 — Pat Bertram

bread On Valentine’s Day, a Facebook friend posted an anecdote that I can’t get out of my mind: A man made his wife toast on their anniversary, and she got upset. “For 50 years,” she said, “you have given me the end pieces and I am sick of it. I hate the end piece!” The man was stunned by her outburst and quietly responded, “But that is my favorite piece.”

Everyone who commented on the anecdote thought it was a sweet story, but all I could see was the horror of fifty years of misunderstanding. In fifty years, she never once told him she hated the end piece? Never once, when she got upset at him for some other hurt, did she bring up the matter of the toast? Never once did he bother to find out what she liked? Never once did he watch her make toast and see that she didn’t fix the end piece for herself?

This anecdote does not portray a loving relationship. She is long-suffering and uncommunicative, unable to find a way to express her wants until the frustration overwhelms her and she bursts out in anger. It’s even possible the problem isn’t the end piece at all — if the only thing he does for their anniversary is make her toast, then maybe she is upset at the lack of flowers or gifts or a meal in a nice restaurant, and mentioning the toast was simply a way of letting him know she wasn’t happy. He, on the other hand, is self-absorbed and arrogant, assuming that just because he likes something, so does she. He also seems smug in his belief that by giving her his favorite piece he is doing something loving, when in fact he is disregarding her by not considering her wishes.

Somewhere along the line, every new couple runs into such a situation, where one repeatedly does something the other doesn’t like, and so they compare notes about likes and dislikes and the expectations each has of the other. Something as simple as toast preferences should have been mentioned long before it became an emotional issue. If a couple can’t find a way around this sort of misunderstanding in the first few years of being together, then their problems run much deeper than who likes what piece of toast.

Love is seeing the truth of each other. Love is witnessing each other’s lives. Love is being present to each other. If after fifty years he did not know what she wanted, it shows how little he saw of her. If after fifty years, she did not know why he gave her the end piece, it shows how little she saw of him. It seems like a cold relationship at best.

On the other hand, loving or not, apparently they deserve each other, and maybe that’s what kept them together all those years.

This anecdote illustrates one other thing — the value of showing rather than telling. If this anecdote were developed into a scene as part of a story, it would be a great way of showing the problems of the couple’s relationship rather than simply saying that they misunderstood each other. Or it could be an example of how much he loved her, as the anecdote was meant to be. That’s the beauty of showing — the writer merely presents the story. Readers interpret it through their own experiences, deciding whether it is a horror story or a sweet tale, and hence make the story their own.

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