Upside Down and Backwards

Each year as the anniversary of my husband Fred’s death approaches, I am preparing to teach Vacation Bible School.  I taught the art at VBS for many years before Fred’s death and now for years after.  It always is an honor.  The hardest year I taught was when we had just buried Fred.  It was a few days after seeing Fred die, that I stood before a room of bright faces and taught them about the love of God. 

Sometimes the lessons are hard ones. 

Sometimes the lessons I teach do not mesh well with a young child’s concept of what is fair.  I know the parable of the last minute laborers in the vineyard was a hard one for a lot of my students.  Do you know that tale?  Jesus spoke of a landowner at harvest who hired some laborers at the beginning of a day and they toiled all morning.  The job was large, so at midday the landowner hired more, and then again at mid-afternoon.  Finally when the day’s work was almost over, he hired any laborers yet remaining to work within his field.  At the end of the day he paid all the same coin: the accepted amount for a day’s labor.  Some of the morning crew grumbled that it wasn’t fair, they had worked longer had should be paid more.  To this complaint the landowner responded he had paid the agreed upon wage to all.  Jesus concluded the parable with a powerful phrase,  “The last shall be first, and the first shall be last.”

That is a good phrase to keep in mind when we consider The Walking Gallery.  I do not paint the jackets in the order in which they arrive.  I paint them in the order that they should be painted.  I do not own the gallery; it owns me.  Sometimes I see with crystal vision the image that should be painted upon a jacket that just arrived that day, while other worthy jackets linger in the queue.  No, it is not fair. 

I guess by that standard an ER is not fair.  Patients are not processed in a straight chronological order, they are triaged.  Sometimes the last shall be first, and the first shall be last.

This is Michelle Litchman’s Jacket: “Upside Down and Backwards.” It arrived express mail and left via express mail and should arrive in time for Michelle to speak in at the American Academy of Nurse Practitioners Conference. 

In this painting we see a cheery gingham tablecloth.  Upon that cloth is a spoon.  Within the concave depths of the spoon, we see a reflected face.  This is Michelle’s mother who is an immigrant Vietnam.  She lost her hearing at the age of two.  Each time she goes to the doctor she needs a sign interpreter to fully understand.  Often she has been left without an interpreter as facilities say it is not feasible and is a financial burden to provide this needed accommodation.  Often staff will try to letter sign alone.  Can you imagine as a hearing individual the cognitive processing frustration of someone speaking letters to you one letter at a time during a medical encounter?  A system of care must first and foremost communicate well with patients, anything less than that is antithetical to good care design.  It is upside down and backwards.

But Michelle's frustration does not solely revolve around her mother’s care.  Michelle is a nurse practitioner who specializes in diabetes care.  She has heard far too many patients vent their frustrations at a system that left them with no preparation on how to live with diabetes.  Diabetes is far more than just “watch your sugar.”  Diabetes is a complex disease and all of the elements of care cannot be discussed in a fifteen-minute appointment. 

So within Michelle’s jacket glittering sugar is spilt upon the tabletop. It is literally glittering, as I added glitter to the white paint on this painting.  I bet some folks will stare mesmerized by the sparkle as Michelle stands before them.  They will stare and they will wonder.  What does this painting mean?  What is it trying to say? 

I wonder if they will get a chance to ask her, or like so many patients with diabetes or like Michelle’s mother, will they leave with their questions unanswered? Left filled with a nagging frustration and wishing that had been able to learn more.