Don't Curse the Nurse!

Sharing support with stories & humor

A Very Good Read

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I don’t look for these books, they find me, Death Be Not Proud, Before I Go, Being Mortal, and now When Breath Becomes Air — stories that don’t glorify death, only bring to light the questions intersecting life, death, and meaning.

When Breath Becomes Air crossed my daughter’s path (a lover of Hiaasen and Palahniuk), not mine, she mentioned it to me in the same easygoing manner she would share her yoga schedule. Little did she know how much of an impact reading this book who have on me.

Atul Gawande and Carol Cassella are the only other physician/ writers of who’s work I’ve read; Gawande —philosophical and earnest in taking his own experiences and finding the common threads we can all relate to; Cassella , in my opinion, a master of upmarket fiction  who creates stories with characters and themes that jump off the page and hold you captive.

Kalinithe’s memoir, completed by his wife when cancer took him, is a lyrical retelling of his entrance into residency, the day he learned of his diagnosis, and how the blending of his calling and his cancer gave him a perspective he was driven to share until the very end. Kalinithe explained early on that he chose neurosurgery because “the brain is the crucible of our identity and medicates our experiences of the world.” Little did he know that lung cancer would spread to his brain and be one of his last teachers.

I don’t have a fondness for stories about people dying. I am a hopeless romantic who could watch Rob Reiner movies all day. It could be the “doctor becomes patient” thing I find intriguing. William Hurt did this well in a 1991 movie, but, it was fiction. While reading When Breath Becomes Air there is no getting up and categorizing the plot as a well-crafted or full of witty dialogue you want to share with friends.

I feel blessed to have gotten to read this book. Right after “courageous” the word “generous” comes to mind, courageous not because Mr. Kalanithe pushed hard to keep working, keep helping people, courageous because he was willing to put his fears and insecurities on paper and leave them for all to read.

And generous, that’s self-explanatory once you read the book.

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Someone Else’s Bucket List

ImageI met a patient this last weekend whose history and physical read like a dictionary for Oncology terms. She’d survived one type cancer five years ago, was diagnosed with breast cancer prior to her hospital stay, AND she couldn’t start treatment because she had an infected wound, symptoms suspicious of a spreading cancer to her lungs, and a low blood count.

Here’s the amaaaazing thing about her: she had the most genuine smile on her face, a “Let’s make the best of today” kind of look, and a light in her eyes that I have to get fourteen hours of sleep to obtain. Her frame was slight but her presence filled the room.

We( the other nurse in the room and I) were discrete with our assessment — asked no dumb questions about her cancer — focused on explaining what we were going to do in our department.  She must have noticed us trying too hard because she brought up her complicated history without prompting.

“You know what I’m going to do when I get out of here?” She said in a matter-of –fact way.

“What’s that?” I was done preparing the equipment and stood at her stretcher.

“I want to go to Disney World.” Her smile got bigger.

Now, all I was thinking about was the heat, the heat and the crowd. She shut down my ever too pragmatic attitude with her next comment.

“I’ve never been.”

I heard the regret in her voice and didn’t know what to say. She went on.

“I think I need to get there. Soon.”

I just shook my head in agreement.

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I was angry…

For the first time, I was angry that I was “just a nurse”. Ooh… yes… I said it, the same thing that makes me want to reach out my right hand and lightly tap the offending mouth from which that comment occasionally comes.

Here’s a little back story to help explain:

It was my day to assist with checking in and recovering outpatients.  Joe, I’ll call him Joe, was the second person to arrive.   His wife and college-age daughter came along to drive him home after his procedure. Joe had the laid back attitude of someone enjoying life and all it has to offer. It was a pleasure to check him in.

An hour later, Joe came out from his procedure, a little groggy, but awake enough to tell me how he, like most, enjoyed the effectiveness of the anesthesia. I poked my head around the corner to wave his wife and daughter over, and turned to the nurse who’d brought him out. She turned toward me, and with her back to the family, mouthed the words “found a mass”.  I gave the family the standard “Dr.____________ will be out soon to tell you how he did.”  His wife and daughter were surprised when I went on to explain how quickly the medicine would wear off and how soon he’d be able to dress and leave. Then I opened the chart.

Orders for a CEA level, CBC, CMP, a CT of the abdomen, and a referral to a surgeon were written in scratch on the discharge order sheet. Like the muscle memory you get from learning to bike ride, I entered the order quickly and the tech came sooner than usual to draw the blood. Joe’s daughter spoke first. “What’s this for?”

I coughed out a response about the doctor ordering some labs that would add more value to the completed procedure. It felt like crap saying something so vague, not having the infinite wisdom and letters behind my name to explain just why the test were ordered and reassure the family.

Over my shoulder to the left, I saw Dr._____________ at the end of the hallway walking back into the procedure room, gown on, hands gloved. He was doing his next procedure before coming out to see my patient!  I hated him for that second.

 I stepped to the next bay to help check in a patient and returned to Joe and his family ten minutes later. He was wide awake, looking at the almost empty IV bag, and joking with his family about where he wanted to eat lunch. After I’d taken his IV out, and just before he was about to change, Dr. _____________ came walking down the hall. When he stepped in close to Joe’s stretcher, I partially drew the curtain and stood behind the wall mounted computer screen. I felt five years old again, drowning in guilt over my lie of omission. When Dr. ____________ left, I pushed the curtain back and knelt down between the sitting family members.

I was embarrassed about the tears that came as soon as Joe grabbed my hand. I know that cancers caught early increase survival rate, and the family, they were more composed than me. They reassured me that they understood, they knew that kind of information has to come from the doctor. Joe left with a prescription for his CT scan and an appointment with a surgeon.

No other “masses” or as we call them sometimes, “lesions” were found that day.  And I realize now, I wasn’t angry at that doctor, he’s a great doctor. I was just angry.

 

Check this story out: http://www.huffingtonpost.com/mike-spohr/nicu-nurses-on-the-wings-of-a-nightingale_b_3353060.html?utm_hp_ref=parents&ir=Parents?utm_hp_ref=parents&ir=Parents&icid=maing-grid7%7Cmain5%7Cdl9%7Csec1_lnk3%26pLid%3D324771

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