My grandma is hurting again. Last Sunday, she leaned over in her recliner to rearrange some books and she slid out of the chair onto the floor. And her hip broke.

This is the latest and maybe the gravest incident in a string that started about a year and a half ago, and I gotta be real about it — it’s been a tough time. Ma has had a heart attack, a MRSA infection, dizzy spells, multiple skin tears, limited mobility, and varying levels of lucidity. There have been dozens of visits to the doctor and to the ER, dozens of nights in the hospital, and two nursing home stays totalling up to more than seven months. There have also been countless hours on the phone and mountains of paperwork to fill out so that she can have medical benefits and at-home care and prescription coverage and everything else she needs. It’s a real project management situation.

On top of all that is the way she feels about what’s happening to her. My grandma has always been a quick and bubbly and memorably warm person, and she still is. She is a little forgetful, sure, and sometimes confused and anxious, but essentially, she is still herself. Unlike a lot of old folks.

And that is an enormous blessing, but also somewhat of a curse, because she understands what’s happening to her. She clearly sees that her capabilities are diminishing, and it sometimes brings her way, way down. So, on top of all the logistical and bureaucratic and medical stuff, my brother and I have also been trying to keep her spirits up, too. We know it could be a lot worse, but it still has not been easy.

Part of the difficulty is that the situation just fucking sucks. People say taking care of an old person is like taking care of a child, and I guess there are some similarities, but I think the comparison breaks down for one simple reason: children grow. They develop and change and great new things keep happening with them all the time. But with an aging person, it’s the exact opposite. With every incident, new levels of horror are revealed, and even the strongest souls can falter a bit in the face of it, I think.

But the other part of the difficulty is on me, because I have to admit that I am kind of selfish prick. I don’t want to get into my whole life story — at least not right now — but suffice it to say that my childhood was bananas, and I spent most of it trying to grow up quickly so that I would no longer be subject to the weakness and poor decision-making ability of the adults around me. That is way harsh, I know, but it’s the way I grew up thinking about things.

So, now, yay, I am a grown-up, and all I want is freedom, and I can’t have it. I can’t spend my day doing what I’d like to do because I have five phone calls to make, and I have to stop at my grandma’s apartment and pick up some clothes for her to wear when they transfer her from the hospital to the rehab place, and I need to take them to the hospital and talk to her and try to explain what’s going on and see the wildness in her eyes that means she is terrified. And I have to go to work and try not to lose it even though my heart is breaking. And then I have to drive out to rehab to bring her suitcase and make sure she’s settled in and comfortable. And by the time all that is over, I will be exhausted and it will be time to go to bed.

Sometimes I feel like Louis CK in this bit of stand-up — “Now I have an old lady.”

And sometimes I rage against it. Sometimes I cry my eyes out and drive around screaming at a God I don’t really even believe in that this isn’t fair, and what has she ever done to deserve such misery besides be a beautiful loving person? And what have I ever done? I’m a freaking orphan, shouldn’t I somehow be excused?

In short, I turn into the worst person ever — resentful towards everyone, entitled and selfish, full of anger and despair.

This is a pattern I found myself playing out a lot last year. I can’t call it a rabbit-hole, because it’s bigger and more menacing than that. I guess it feels more like a road with well-worn ruts that I sometimes just find myself on without even realizing it. Something goes wrong with my grandma’s health, or someone drops the ball on her care, or I hit my daily limit on dealing with bureaucratic bullshit, and suddenly I am the freaking Hulk. Impatient and surly and, eventually, ashamed.

I know there’s no point to it. It brings me no relief, no catharsis. It’s just an emotional reflex, a pattern of adolescent rage against reality itself, and it does nothing but sap me of my strength. I’m not, like, satisfyingly cried out after one of these rages. I’m red and raw. I’m spoiling for a fight.

Going away for a month gave me a lot of perspective on the situation, and since then, the raging hasn’t been as much of a problem. And I guess I was foolish enough to think I had magically conquered it through the power of, I dunno, travel-related attitude change or something.

But the other night, after a long day of work and a long emotional visit with Ma, I found myself driving home from the hospital scream-crying at no one. Knee deep in craziness, before I even knew what was happening. Again.

When I got home I sat on the edge of the bed in the dark and cried and ranted and felt wretched for a while. But then something new happened … a wisp of a thought drifted through my brain. What are you doing, honey? Haven’t you spent enough time playing this terrible loop? Isn’t there something else you’d rather do? Something useful, or at least not destructive?

And suddenly I was looking at myself. I was looking at the tornado of emotions rising up out of my chest, and I was breathing. And that gave me the blessed grace of space — space I needed to stop, to step back, to pop myself out of the swirling part of my mind.

From there, I was able to talk myself down, to be as reasonable and reassuring to my own self as I try to be to the people I love. I was able to say very accurate, rational, and kind things like Oh, my sweet Madge, anyone in this position would feel awful. But do you want your whole life to be about this? Isn’t there another way you can go about it? Can you acknowledge that this blows and let yourself feel sad without allowing it to turn into a fiery rage that burns up the rest of your life?

And then, having received a perfect dose of logic and sweetness courtesy of my brain’s sanest part, I felt myself open up. I felt the knots inside me untwist, and I felt the emotions flowing through me. And I remembered that taking good care of my grandma is not a burden that’s been thrust upon poor put-upon me — it’s a choice I have made. It’s something I can and should feel good about. It’s an important commitment, and I am fulfilling it the best I can.

But as much as I want to help, I simply don’t have the power to set my grandma’s world right. All I can do is take care of the logistics, love on her as much as possible, and let the rest of it go.

Because the reality is that she is almost 90. Shit is probably going to suck from now until the end of her life. But there will be moments of grace, too, as long as I can accept what is instead of raging against it.

You’ve heard me talk about the process of side-stepping craziness before — notice what’s going on, breathe, reason with yourself in a kind way, and turn your attention elsewhere. It ain’t easy, but the cool thing is that it seems to work the same for all kinds of irrational, unpleasant, hard-to-corral feelings, even existential rage at the impersonal cruelty of aging. Once you get good at noticing what’s going on in your brain, you almost can’t help but get a little saner.

It’s not magic … you have to keep trying as hard as you can and sometimes even harder than that … but it does work.

And as it turns out, I don’t have to look very far to find a role model — Ma herself is a master. (I don’t think a person can make it to 89 otherwise.) Time and time again I have witnessed the way she gets through hard stuff. She holds tight to her friends and family. She appreciates how good she’s got it and focuses on what’s possible rather than what’s not.

Most of all, she never gives up. Even when she’s worn out from surgery and can’t keep her eyes open, she keeps trying to connect, to soothe, to give and receive love. She has the heart of a warrior, my sweet ancient grandma. And I do, too, as long as I keep my craziness in check. Thankfully, I am learning how.