The Caregiver’s Space: Thoughts on John Jacobson’s Essay “Now and Then” by Simona Carini

Simona Carini, who was born in Perugia, Italy, is a graduate of the Catholic University of the Sacred Heart in Milan, Italy and Mills College. Carini writes nonfiction and poetry and has been published in various print and online venues. She lives in Northern California with her husband and works as an academic researcher in Medical Information Science. Her poem      Diagnosis      appears in Poetry in the Spring 2019 Intima: A Journal of Narrative Medicine. Find more of her work at simonacarini.com.

Simona Carini, who was born in Perugia, Italy, is a graduate of the Catholic University of the Sacred Heart in Milan, Italy and Mills College. Carini writes nonfiction and poetry and has been published in various print and online venues. She lives in Northern California with her husband and works as an academic researcher in Medical Information Science. Her poem Diagnosis appears in Poetry in the Spring 2019 Intima: A Journal of Narrative Medicine. Find more of her work at simonacarini.com.

Events like a disabling illness or accident, or a terminal diagnosis bisect life into the time before and the time after for the person directly affected and her/his family. We adjust to the new situation, but there remains a memory of the carefree past.

Though I have not been a caregiver in such an intense situation as that John Jacobson describes in his essay “Now and Then” ( Intima, Fall 2018) understand his struggle with accepting the present.

Jacobson touches upon the constant requirements of his wife’s health situation, the energy (both physical and emotional) involved. Caregivers don’t cease to have feelings, thoughts, or hopes just because caring for another person has become central to their life.

When you are thrust into the role of caregiver, there begins a struggle to maintain a balance and to keep a private space, where you can be with yourself and do something not related to providing care. Both Jacobson and I talk about a natural setting acting as that space:

Darkness seems to seep out of the woods as if exhaled by tree roots. Gray poplars at the edge of dark pines look nearly white. Beavers have taken some down leaving pointed stumps. Three ghostly white poplars felled recently lie across the path. I climb over them and walk on toward the pond.

Nature tells us of impermanence, encourages us to believe our grief will evolve too.

I want our good times back. It can’t be changed though. It’s a want I have to let go of. I wonder if then I can begin to find acceptance. I try to imagine what acceptance might feel like.

Where do we begin to find acceptance? Rowing in silence in the early morning hours played an important role in my case:

I balance on the water seeking grace

to breathe and draw a trace that leaves no trace.

Jacobson writes: I think I will know acceptance when I count my successes even when they are much smaller than I hoped for… I imagine feeling anticipation of what comes next instead of dread.

He can imagine a future.

When I rise again, an owl flutters out from branches and flies on silent wings over white ice on the pond.


Simona Carini, who was born in Perugia, Italy, is a graduate of the Catholic University of the Sacred Heart in Milan, Italy and Mills College. Carini writes nonfiction and poetry and has been published in various print and online venues. She lives in Northern California with her husband and works as an academic researcher in Medical Information Science. Her poem Diagnosis appears in Poetry in the Spring 2019 Intima: A Journal of Narrative Medicine. Find more of her work at simonacarini.com.

©2019 Intima: A Journal of Narrative Medicine