Chicken Soup for the Nurse's Soul: Second Dose

  I told Carolyn about the school support program. We marked her calendar with a schedule for my visits. Occasionally I paused to smile at Michele who watched from her chair a few feet away. I gave Carolyn a book with signs and went over a few sample lessons. I expressed the importance of her husband learning to sign with her and suggested they practice together.

  I answered Carolyn’s last question and turned to Michele. I gazed at her puzzled expression, wondering what she was thinking. A blue barrette barely hung on to her short black hair. Slowly, I signed . . . “My name is Peg. I’m your new friend. I’m going to help your mother and father learn sign language.”

  Michele raised her slender arms, bent her small fingers, and signed, “My name . . .” she made an M and touched the dimple in her right cheek. But her dimple disappeared when she made the sign for mother.

  Before I left, I helped Carolyn sign her first sentences to Michele. “You were a good girl while I talked with Peg. Thank you.”

  Then to Michele I signed, “Have fun at school. I’ll see you when you come home for Christmas.”

  She smiled and waved good-bye.

  All that fall, I met with Carolyn twice a week. Whenever I asked about her husband joining our signing lessons, the reply was the same. “He’s too busy.”

  “Tell your husband that children look to Dad as well as Mom for answers to their questions and support for their fears. ‘Where do the sun and moon come from? What are stars? Why do others make fun of me? I’m scared in the dark.’ Explain to him that when a parent ignores their child’s questions, their thought is, ‘Why doesn’t Daddy love me?’”

  At my next visit Carolyn said, “My husband told me waving his hands makes him feel silly. He talks to her by pointing to things.”

  “Everyone feels a little awkward at the beginning,” I said. “Pointing is a fun game for children. But ask him how will he feel when Michele is older and ignores his pointing when she signs?”

  At our next lesson, Michele’s father sat at the kitchen table. He listened intently and began to slowly repeat simple signs. During my weekly visits, I watched as this family’s emotional scars began to heal.

  When Michele was home for Christmas vacation, I was invited for coffee one afternoon. When I stepped into the house, pine scent mingled with the aroma of perking coffee. Michele took my hand and led me to the Christmas tree decorated with tinsel, colored glass balls, wooden beads, and small blinking lights. She pointed to a paper angel on the top of the tree. “I made for Mother and Dad,” she signed.

  “It’s beautiful, Michele.”

  Her dimple appeared with a wide grin.

  “Ask Peg if she wants a cookie,” Carolyn signed.

  “Mom is learning to sign with me,” Michele signed and beamed a smile. “Sometimes Dad tries and my little brother knows some words with his hands.” She giggled. “When his fingers look funny, I help him.”

  “I’m happy for all of you,” I signed.

  When I left that day, mother and daughter held hands while waving good-bye.

  A year later, my program with Michele’s parents was finished. I planned my last visit to say good-bye when Michele was home at Thanksgiving.

  “Mom and Dad’s signing lessons with me are all done,” I signed. “I won’t be coming anymore . . . ”

  “But you’re my friend. Who will help Mother and Dad?” Michele signed. Tears welled in her beautiful brown eyes.

  “You can be their teacher now.”

  Carolyn signed. “Yes, we need your help.”

  Michele smiled and hugged her mother.

  “I’ll come by to see you when you are home at Christmastime.”

  “I love you,” she signed.

  “I love you too,” I signed.

  As I opened the door to leave, snowflakes drifted, leaving a dusting of snow over the stately pine trees grouped in their front yard. I thanked Michelle again for the plate of Christmas cookies she and her mother made for me and her dimple deepened. I looked back at their room dressed for the Christmas season. This year, I thought, Carolyn and her husband opened the best present of all. Speech.

  A loving bridge to their daughter’s silent world.

  Margaret Hevel

  The Survivor

  Be kind, for everyone you meet is fighting a hard battle.

  Plato

  It had always been difficult for me to watch old men cry. Helpless and unsure, I couldn’t imagine the hardships they endured in life . . . the want of the Depression to the horrors of world wars. When they cried, they wept for their parents trying to put food on the table, for friends lost, for themselves.

  About eleven years ago I cared for a gentleman who had had a severe stroke, and it was hard to understand him when he talked. But he couldn’t talk anyway because he just kept crying.

  “Are you having a lot of pain?” I’d ask. He always shook his head no.

  “What can I do for you?”

  “Nothing,” he would answer. Then he’d look at me as his eyes filled with tears.

  I offered, “Let me know if there’s anything I can do for you.”

  The old man would nod his head, then tears spilled down his face until both cheeks were drenched. Since he couldn’t wipe his own eyes, I would dab a tissue on his sodden cheeks, then leave, wondering what was really hurting him.

  One day, the oldman’s son came to visit. He approached me and asked how his father was doing. I told him that I didn’t know if his father was sad because of his stroke or if something else was bothering him.

  “Let me see if I can figure it out,” the son said. “I’ve got a good idea of what it is.”

  About a half hour later, he came to me. “My dad was a survivor of the USS Indianapolis. They were on a secret mission at the end of World War II. They were struck by torpedoes and sunk. No one knew they were there because they had no radio contact. For five days they were in the water while sharks circled around them and picked off people one by one.”

  “How horrible!”

  “It was. My dad has never cried about it. He said that since he’s been lying in bed, that’s all he can think about.”

  With this information, I knew what I had to do to care for him. I pulled up a chair when he started talking and just let him talk. I learned to accustom my ear to the old man’s speech pattern and he told me the whole incredible story. He spoke of the sounds in the water when the sharks came and the screams as hundreds of men were yanked under. He spoke of the frigid water on his body and the darkness at night.

  “It was so dark you couldn’t see the person next to you,” he wept. “We kept talking at night so we wouldn’t feel so alone. We were all afraid to go to sleep. But the worst part was the never-ending thirst.”

  I choked back tears. “I’m always amazed at what people can endure.”

  He smiled in that gentle way of his. “I wonder if the reason I keep thinking about it is to give me the strength to come back from my stroke.” He paused for a few seconds. “Because this is the hardest battle I’ve ever fought. But if I made it through the Indianapolis, I can make it through this too.”

  And he did.

  From that day on he worked diligently at his physical therapy and became . . . again . . . a survivor.

  Mary Clare Lockman

  This Is Bill

  How far you go in life depends on your being tender with the young, compassionate with the aged, sympathetic with the striving, and tolerant of the weak and the strong—because someday you will have been all of these.

  George Washington Carver

  It was one of those days in the nursing profession that you just have to get through. The workload was heavy, the pace frenetic. Everybody wanted something from me, and they all seemed to want it at the same time. As I hurriedly finished my lunch, in my mind I organized the tasks I needed to complete that afternoon. It was going to be a tight fit, but I thought I could get everything done.

  But as soon as I returned to the floor, things began to unravel
.

  I got a report on an unexpected admission from one of my coworkers: “They brought some old guy up from the unit to die.” Without waiting for further explanation, I headed toward what had been my only empty bed. It was now occupied by an elderly gentleman, and as I entered the room I knew that he had already done what he had been sent there to do. Without fanfare, without attendance, without anyone even knowing it, this person had left the world.

  I was filled with righteous indignation, as I made my way back to the nurses’ station to start the long and time-consuming process that surrounds a death in the hospital. For me it had always been important to see that someone was with my patients as they died. As a matter of principle, I felt that we had failed this man. How could the nurses from the ICU let his family go home when his death was so imminent? Why had he been dropped on my doorstep in the last few minutes of his life? And where was his family, anyway? As the questions whirred through my mind, anger rose in me like bitter bile. I was mad at everybody, including the poor old man who had died so unceremoniously on my watch.

  Unable to reach anyone at the phone number listed under next of kin, I called the designated funeral home and went back to his room to try to garner some information from his meager personal effects.

  Stacked in the corner in standard-issue hospital plastic bags were his belongings: a worn pair of work boots, a cap embroidered with a local feed company’s logo, a faded pair of bib overalls. In one of the pockets I found a wallet but no driver’s license or other identification. My frustration mounted. As I started to stuff it back into the pocket I saw a piece of yellow paper peeking out from one of the sections. I opened it and began to read. It was written with big block letters and had the telltale look of a palsied hand.

  “Well, honey,” it said, “if you are reading this, it probably means that things didn’t go so good for me this time. I know you did everything you could.” It went on for a while, sharing some memories. At the end it was signed simply “Love, Bill.” Tears of shame and sorrow filled my eyes as I realized that this letter was to me and my coworkers. Indeed, I had just lost an old friend.

  Bill was everybody’s friend. He had no real family, just one cousin in a distant state. He had outlived the rest of his family and his contemporaries. For the past several years he had been fighting the demons of old age. Repeated hospital visits brought him to the floor where I worked. He always came with a crooked smile and a kind word. He came with big floppy old ears that were interested in all that was going on in the world and in others’ lives. He came with a simple wisdom and a gentle nature toward his fellow man.

  “Did you find out who this guy belongs to?” asked one of my coworkers as he shot past the room to keep pace with his own schedule. When I didn’t answer he backtracked and peeked into the room. I stood crying silently and contemplating the face of a man that I knew so well, yet hadn’t recognized at all. Swelling, illness, and death had transformed him. The love that he radiated in life had left along with his soul.

  “Don’t you know who this is?” I asked sadly. “He belongs to us. This is Bill.”

  He left in silence to spread the word. Soon there was a small army of nurses at the door.

  Gently my coworkers helped me with the postmortem cares. We talked about Bill and all that he had meant to us. We remembered the time that he brought us homemade bread. Since he could no longer drive, he carefully coordinated the timing of his baking with the bus schedule so that the bread would arrive still warm. We recalled the time that he brought trinkets to everyone at Christmas, making two trips on the bus in the bitter cold so he could deliver his gifts to each of the shifts personally.

  In due time the funeral home attendant arrived and Bill was transported to the elevator with an honor guard of sorts. Every nurse on duty stopped what they were doing and came to escort our old friend off the floor for the last time.

  Soon enough we were all back to the tasks at hand. Our patients were concerned with their own problems. Few were aware that a death had occurred on the unit that day. But on that day Bill taught me something profound and lasting that has guided me throughout my nursing career, and that something is this . . . that everyone is someone’s Bill.

  In nursing school they taught me about psychology. They taught me about the fight or flight response and about Maslow’s hierarchy of needs. They taught me about the different ways people tend to respond to the stress of hospitalization. But nothing in a book or from Freud or Maslow could teach me what Bill did.

  There are days in nursing when things don’t go well. Sometimes patients don’t act in ways that you might expect, and sometimes they don’t even act in ways that make much sense. Pain and fear and frustration have chipped away at the core of the person until you can’t recognize who they really are. These are the days that I make myself stop and ask a simple question: “Don’t you know who this is?” And the answer comes. This is someone who has a life that you don’t even know about. This is someone who has hopes and dreams and fears. This is someone who is loved and cherished by people that you haven’t even met.

  This is Bill.

  Susan Stava

  The Value of Time

  We must use time wisely and forever realize that the time is always ripe to do right.

  Nelson Mandela

  As a nurse, I knew the battle of the nursing shortage and our inability to spend individual time with our patients. When I flipped to the other side of the bed rail and became a mastectomy patient, I wanted to be as little fuss for the nursing staff as possible.

  I arrived on the post-op ward at 3:00 PM with nausea and vomiting. Instead of putting on my call bell, I recruited my family to help measure my emesis. The nursing unit was short-staffed that evening, something I deciphered from hearing nurses talking outside my door. It was cracked open only six inches—but sound travels more than we realize. One nurse had called in sick with no one to cover for her. There were two Whipple (pancreatic surgery) patients who were fresh post-ops. Another patient had crumped (coded) and was taken to the SICU. It was organized chaos.

  Myckie, my evening shift nurse, came in every ninety minutes or so to empty my hemovacs, check my I&O, and ask me how I was feeling. I had declined pain medication due to the nausea problem. Each time Myckie prepared to leave my room she would say, “How are you doing?”

  I answered, as if rehearsed, “I’m fine.” That was the extent of our conversations.

  My husband left at 10:00 PM to go home to our child and I was alone for the first time to reflect on what had happened, and to deal with the reality of a cancer diagnosis with still unknown pathology. That would determine the rest of my treatment and potentially my fate.

  At 10:50 PM, Myckie reentered my room to empty my drains one more time and record the amount remaining in my IV bag. She again asked, “How are you doing?”

  I again responded, “I’m fine.”

  She paused, put my side rail down, and sat beside me.

  We made eye contact for the first time. She stared right at me and said, “How are you doing?”

  I started to cry. “I don’t know how I got on the other side of this side rail but it is really scary over here.” I told her my worries about my future, about my child, in the event I lost my life to this disease. I rambled for twenty minutes. She didn’t utter a word, but held my hand, focusing her eyes on mine and nodding that she was listening intently. It was now 11:10 PM. A unit clerk came to the door and sternly said, “Myckie, you are late for report.”

  Myckie didn’t turn around but kept her focus on me. “Tell them to wait. I’m taking care of a patient.”

  Myckie gave me that night what she had the least to give . . . her time. I didn’t need special sophisticated machines or interpretation of test results. I needed to express myself and know I wasn’t alone.

  I’ve read before that we know the value of time when we measure it in ways of what we lost as a result of not having enough of it. A student learns the value of a year when he is hel
d back in grade eight. A mother knows the value of a month when she gives birth to a premature baby. The grandmother, late for a plane for her daughter’s wedding, knows the value of an hour.

  We nurses know the value of the few moments we are privileged to have being present to our patients.

  Lillie D. Shockney

  “We should talk about how time constraints prevent us from dealing with the emotional needs of patients, but I have to run.”

  Reprinted by permission of Aaron Bacall. © 2006 Aaron Bacall.

  7

  MATTER OF PERSPECTIVE

  We ourselves feel that what we are doing is just a drop in the ocean. But the ocean would be less because of that missing drop.

  Mother Teresa

  Fifty-Fifty

  There are truths that are not for all men, nor for all occasions.

  Voltaire

  As nurses we know that third-degree burns are generally pain free because nerve endings have been destroyed. At the same time, the burned patient is usually alert and conscious, unless they have also sustained a brain injury.

  When the rescue crew loaded Mr. E. into the helicopter, he asked what his chances were. The nurse knew he was in serious shape, but not wanting to destroy his hope, he hedged, “I think you have a fifty-fifty chance, my friend.”

  When Mr. E. arrived at the regional burn center, he was stabilized in the emergency room and the burn surgeon came down to review the resuscitation efforts. The surgeon was a straight-shooting, mustached professional who looked like he could have been a marshal in Dodge City during the days of cowboys and gunfights.