I bit my lip and told her I certainly hoped not, and then gently reminded her she was still in the hospital. We both laughed until we cried. And laughter was just the medicine Sadie needed that morning to regain her dignity.
Andrea Watson
Lucky
The only good luck many great men ever had was being born with ability and determination to overcome bad luck.
Channing Pollock
The truth is, we were whining about being tired, and it was cold and dark as we ran to the helicopter at 0400 that morning. We had no clue this would be one of those flights we’d never forget.
After liftoff, dispatch told us to rendezvous with local EMS at the scene “of a gunshot wound to the neck.” Thoughts of being cold and tired were replaced by waving red flags. First, our EMS is a skilled and sophisticated service that only requests our presence at unusual events. Second is the consideration of the structures of the neck. A bullet in the cervical spine is frightening; a bullet through the trachea more frightening; a bullet through the carotid artery or jugular vein most frightening. Is the patient paralyzed? In need of a surgical airway? Spurting arterial blood? Is there an internal bleed occluding the airway? And where is the weapon? More importantly, who has that weapon?
We landed in the street of a neighborhood made up of small older homes. After egress from the aircraft, we approached the scene, noticing it did not have the feel of a catastrophic event. Law officers had the weapon secured. Our patient was under a huge tree on a front lawn. EMS had fully immobilized him and established two large-bore IVs. The heart monitor showed a normal sinus rhythm, and EMS reported stable vital signs. The victim was talking a mile a minute, which afforded us instantaneous information regarding level of consciousness and integrity of the airway. Assessment by flashlight revealed no paralysis. In fact, he was gesturing wildly to the extent that someone is able to do when he or she is fully immobilized. Cajoling him to stop talking long enough to peer into his oral cavity was the most difficult part of the assessment. There was no bleeding in his mouth. It was noted his top dentures were missing, which was his only complaint.
Overall, Lucky, as we came to call him, appeared to be quite healthy and spry for a gentleman eighty-nine years of age. He had no allergies, took no medications, and hadn’t the foggiest idea when he had his last tetanus booster. As we prepared to transport him, he pleaded with the EMS and law enforcement personnel to search for the missing dentures because the “gol-dang uppers had cost him an arm and a leg.”
During the ten-minute flight to the trauma center, Lucky remained in a sinus rhythm with stable vital signs. No symptoms were manifest and certainly shortness of breath was not an issue, as he animatedly relayed his story. A strange noise awoke him while his dog slept next to his bed. “The gol-dang dog never woke up and barked like a watchdog should.” Lucky grabbed the .22-caliber pistol he kept on his nightstand and charged into the night. Running out the front door, across the porch, and into the yard, he tripped over an exposed tree root. As he fell, the pistol fired, striking him in the neck. During the melee, he lost his uppers. The gol-dang uppers had cost him an arm and a leg—which remained his chief complaint.
In the emergency department, examination under bright lights revealed an entrance wound in the neck, an abrasion to the hard palate, and a small laceration without active bleeding at the base of the tongue. To everyone’s amazement, X rays of the head and neck showed no bullet fragments.
News of such a mysterious event always travels fast. There was already a crowd of “night people” forming in the emergency department when EMS and law officers from the scene arrived, bearing the missing uppers. There was complete silence as the multitude gaped at the sight of the dentures with the .22-caliber slug imbedded into the hard palate portion.
After completing our paperwork, we usually say goodbye and good luck to our patients before departing for base. It seemed prudent to dispense with the good luck part of our salutation to Lucky. Our last impression of him was of a little old man under a heap of blankets with a shock of unintentionally spiked hair (hence the term, hair-raising experience!) sticking from the top of the blankets. Sticking out the other end were his little house slippers that appeared to be older than he was.
As we left the department we could hear Lucky telling no one in particular, those gol-dang uppers had cost him an arm and a leg—the best investment Lucky ever made!
Charlene Vance
Cast-Cutter
Invention is the talent of youth as judgment is of age.
Jonathan Swift
After years of hospital nursing, I loved my new job in a busy family-practice office, performing a wide variety of duties—phlebotomy, spirometries, EKGs. I accepted each as a new challenge and mastered all of them with confidence.
Well, almost all of them.
I was still nervous whenever I cut off a cast. To prove to the patients (and to me!) that the motorized saw wouldn’t cut their flesh, I always put my fingertip next to the spinning circular blade. I then explained how the cotton padding underneath the cast snagged the blade and stopped it before it reached the skin. But, in spite of my own reassurances, cutting casts still made me a bit nervous— especially when the patient was a squirming four-year-old boy.
Danny had broken his arm in a playground accident a few weeks earlier, and I had assisted the doctor in applying his cast. When I rewarded his bravery with double trinkets from the toy chest, Danny and I became buddies. He had complete confidence in my ability to remove his cast.
That made one of us.
With a reassuring smile I fired up the cast-cutter and started cutting the cast, hoping he’d think the trembling was from the vibration of the saw, not my hands.
The motor buzzed and bits of plaster flew as I methodically pressed the whirling blade back and forth along the length of the cast. Danny started to fidget in the chair, and his face flushed.
“Doing okay, Danny?” I asked.
“I’m okay.” He smiled meekly. “It don’t hurt.” But his facial expression and wiggling told me something was making him uncomfortable.
Thankfully, just then, the final part of the cast was cut. I carefully pried it apart with the cast spreader. After showing him the blunt-ended scissors and promising him they couldn’t cut his skin either, I began cutting the cotton padding and underlying stockinet. Danny wiggled some more and even winced a bit when I spread the cast further and gently lifted his arm out of the cast.
I gasped to see a long purple streak on his inner arm! My mind raced for a diagnosis. Phlebitis? Necrosis? Had I cut him? There was no blood!
There, inside the opened cast, embedded in the padding, was wedged a purple crayon.
Bewildered, I looked at Danny.
He said, sheepishly, “It itched!”
LeAnn Thieman
“If you get an itch, just turn whichever one of these cranks is closest to it.”
CLOSE TO HOME © John McPherson. Reprinted with permission of UNIVERSAL PRESS SYNDICATE. All rights reserved.
The Race
I am only one; but still I am one. I cannot do everything; but still I can do something. And because I cannot do everything, I will not refuse to do the something that I can do.
E. E. Hale
He’d come for minor surgery, a simple patch-up job. A piece of cake, really, unless you have a history of hemophilia and HIV, a legacy of contaminated blood. What started as “routine” spiraled into complications—needles, tubes, a ventilator—trying to sustain a body that would no longer sustain itself.
He came to us for end-of-life care—pale, hunched over, breathing hard, a feeding tube hanging uselessly from his nose. Fifty years of life condensed into a slim chart of medical relevance: an admitting sheet, history and physical, progress notes. Bare facts: prognosis poor. Running out of options. Running out of time.
His family came to him and knelt at the bedside, their faces wet with knowing. Touching. Talking. They wrapped their arms and voices around him
in a passionate effort to keep him connected to this world.
“I want to go home,” he said. “I want to go home to die.”
Health-care professionals often toss around phrases like “comfort care,” “supportive intervention” and “the patient’s right to self-determination.” We say them as if we know what they mean. But what did they mean to this man and this family?
“I want to go home. I want to go home to die.”
His family came to us for help in achieving that wish. They knew it would not be easy, as did we. They knew there were no home-care arrangements in place. They knew his blood pressure was fifty-four over zero. They knew home was an hour away; not a vast distance by most standards, but a tremendous journey under these circumstances. They knew, too, that there was a strong possibility he could die in the ambulance.
“It doesn’t matter,” his family said. “He will know he is on his way.” In that knowing, perhaps, lies the ultimate “comfort care.”
And so, we, his medical team of nurses, doctors, social workers and more, blended our planning efforts. We were all participants in this last leg of the race. There were discharge orders to be obtained: morphine, oxygen, a home hospice nurse visit. There was urgency, pressure and determination. Voices were raised and minor misunderstandings occurred, but despite the glitches, a major victory was achieved.
Two hours and forty minutes after we began our efforts, the ambulance arrived. Making an exception to policy, they allowed two family members to ride along, in case death came too soon.
Our patient made it home by two o’clock that afternoon. Four hours later, he died a peaceful death in his own house, in his own bed, with his family present and his dog curled up at his feet.
Martin Gray once said: “We never believe enough in ourselves. We are forever ignorant of the resources of life. But life is to dare to break through the walls that we erect before ourselves. To transcend the limits we impose on ourselves. Life is always to go beyond.”
I believe each of us in health care has the opportunity to assist people in how they want to live, and sometimes, in how they wish to die. All of us have a stake in that process. When we bring our gifts to the race, when we combine our gifts with those of others, we are choosing “to go beyond.” The results can be powerful, extraordinary— even transforming—for ourselves as well as the people we serve.
Anne Riffenburgh
He Conquered It
The conditions of conquest are these: We have but to toil a while, endure a while, believe always and never turn back.
William Gilmore Simms
There are angels on this Earth and they come in subtle forms, and I decided LaTrice Haney was one of them. Outwardly, she looked like just another efficient, clipboard-and-syringe-wielding nurse in a starched outfit. She worked extremely long days and nights, and on her off-hours she went home to her husband Randy—a truck driver—and their two children—Taylor, aged seven, and Morgan, four. But if she was tired, she never showed it. She struck me as a woman utterly lacking in ordinary resentments, sure of her responsibilities and blessings, and unwavering in her administering of care. If that wasn’t angelic behavior, I didn’t know what was.
Often, I’d be alone in the late afternoons and evenings except for LaTrice, and if I had the strength, we’d talk seriously. With most people I was shy and terse, but I found myself talking to LaTrice, maybe because she was so gentle-spoken and expressive. LaTrice was only in her late twenties, a pretty young woman with a coffee-and-cream complexion, but she had self-possession and perception beyond her years. While other people our age were out nightclubbing, she was already the head nurse for the oncology research unit. I wondered why she did it.
“My satisfaction is to make it a little easier for people,” she said.
She asked me about cycling, and I found myself telling her about my bike with a sense of pleasure I hadn’t realized I possessed. “How did you start riding?” she asked me. I told her about my first bikes, and the early sense of liberation, and that cycling was all I had done since I was sixteen. I talked about my various teammates over the years, about their humor and selflessness, and I talked about my mother, and what she had meant to me.
I told her what cycling had given me—the tours of Europe, the extraordinary education and the wealth. I showed her a picture of my house, with pride, and invited her to come visit, and I showed her snapshots of my cycling career. She leafed through images of me racing across the backdrops of France, Italy and Spain, and she’d point to a picture and ask, “Where are you here?”
I confided that I was worried about my sponsor, Cofidis, and explained the difficulty I was having with them. I told her I felt pressured. “I need to stay in shape. I need to stay in shape,” I said over and over again.
“Lance, listen to your body,” she said gently. “I know your mind wants to run away. I know it’s saying to you, ‘Hey, let’s go ride.’ But listen to your body. Let it rest.”
When I had nothing left to tell LaTrice about the bike, I told her about the wind. I described how it felt in my face and in my hair. I told her about being in the open air, with the views of soaring Alps and the glimmer of valley lakes in the distance. Sometimes, the wind blew as if it were my personal friend, sometimes as if it were my bitter enemy, sometimes as if it were the hand of God pushing me along. I described the full sail of a mountain descent, gliding on two wheels only an inch wide.
“You’re just out there, free,” I said.
“You love it,” she said.
“Yeah,” I said.
“Oh, I see it in your eyes,” she said.
I understood that LaTrice was an angel one evening late in my last cycle of chemo. I lay on my side, dozing on and off, watching the steady, clear drip-drip of the chemo as it slid into my veins. LaTrice sat with me, keeping me company, even though I was barely able to talk.
“What do you think, LaTrice?” I asked, whispering. “Am I going to pull through this?”
“Yeah,” she said. “Yeah, you are.”
“I hope you’re right,” I said, and closed my eyes again.
LaTrice leaned over to me. “Lance,” she said, softly, “I hope someday to be just a figment of your imagination. I’m not here to be in your life for the rest of your life. After you leave here, I hope I never see you ever again. When you’re cured, hey, let me see you in the papers, on TV, but not back here. I hope to help you at the time you need me, and then I hope I’ll be gone. You’ll say, ‘Who was that nurse back in Indiana? Did I dream her?’”
It is one of the single loveliest things anyone has ever said to me. And I will always remember every blessed word.
Three years later, with a climb into Siestriere, I led the Tour de France by six minutes and three seconds. In Indianapolis, LaTrice Haney, the staff of the medical center and all of the patients on the ward stopped what they were doing to watch the taped coverage. As I mounted the hill, increasing my lead, they stared at the televisions. “He did it!” LaTrice said. “He conquered it. He conquered it.”
Lance Armstrong
Mr. Jackson and the Angel Pin
The cure for all ills and wrongs, the cares, the sorrows and crimes of humanity, all live in the one word “love.” It is the divine vitality that everywhere produces and restores life.
Lydia Maria Child
Mr. Jackson wanted to die. He missed his wife who had passed away five months earlier. They had been married sixty-three years and were blessed with five children— children who were busy with their own lives. In his loneliness, he lost the will to live. He shut himself off from the world, quit eating, closed his eyes and waited to die.
Several weeks later, he was admitted to the hospital. “Malnourished,” the diagnosis reported. During the shift change, the evening nurse hastily explained the case to the morning nurse, Freddie.
“He hasn’t eaten in the two days he’s been here,” she said softly. “Hasn’t said a word either. He just looks away and stares off at who knows wha
t. The doc is going to put a feeding tube in his stomach if he doesn’t start eating. Good luck, Freddie.” With that, the evening nurse hurried out.
Freddie looked at the frail form in the bed. The room was dark except for the soft morning light peeping through the semi-drawn curtains. The white sheets accentuated the outline of his body, which appeared to be nothing more than a skeleton draped with skin. The patient turned his head away and stared at the wall, his eyes void of hope, void of life itself.
Freddie could always find a way into the patient’s heart. Somehow, she would find the key to unlock his. Gently picking up his delicate hand, she held it in hers. “Mr. Jackson? How about some lotion on your hands, wouldn’t that feel good?”
No response. She walked around to the other side of the bed, leaned over and whispered, “Mr. Jackson?”
His eyes widened as he fixed his gaze on the pin she wore—a gold and silver angel given to her for Christmas. Impulsively he reached out to touch it, but drew his hand back. His eyes began to mist and he spoke his first words since being there. “If I had my pants with me, I would give you all the money I have just to touch that pin.”