Camp Nurse (30 page)

“Oh, you’re all against us, too, I can tell,” Jasmine chimed in. She was on the verge of tears. “This whole thing has been blown out of proportion. Are you going to call our parents?”

Louise spoke first. “You were asking for trouble. You put yourselves at risk by going into the boys’ cabin by yourselves, and besides, it’s against camp rules.” She launched into the results of a study published in a medical journal that stated that 62 per cent of fourteen-year-old girls said they wished they’d waited until they were older to have sex.

“But we didn’t do anything!” Lee wailed.

Louise switched gears and lightened up. “Did you ever stop and think maybe you were getting into more than you bargained for by going into the boys’ cabin?”

Or, maybe exactly what we bargained for
, their smiles at one another seemed to say. On the one hand they’d enjoyed themselves, but now they weren’t so sure about this new bad-girl rep they were developing.
How confusing it is to be a young woman today with so many mixed messages out there!

Next, Alice spoke. “You may be causing things to happen sooner than you are ready,” she cautioned in her gentle way. “You have to know if you’re ready for this.” She spoke about her own daughters and her wishes for them to respect themselves and to wait until they were ready for intimate relations with the right person at the right time.

It was my turn and I wanted to contribute something useful. Louise had been the authoritative professional and Alice, the protective, concerned parent. Then there was me, who remembered all too well what it was like to feel those desires. It didn’t seem so long ago that I’d done some pretty wild things myself, so it felt hypocritical to come down on them. Besides, I wanted to be the kind of grown-up who didn’t stand in judgment, and who could help them sort out these complicated matters, but I wasn’t sure how to do that. I’d read enough of those how-to-communicate-with-your-teenager books to know that offering advice was the worse thing. It only made them shut down, lose trust, and worse of all, it cut off the lines of communication. As a nurse, I’ve always been taught not to offer my personal opinion. We’re supposed to merely echo back, in a neutral way, our patients’ points of view and not influence them with our own values. However, here at camp, where I was both a parent figure and their nurse, that approach felt counter-intuitive. No, they didn’t need judgment or information – “411” as they called it – but I wasn’t sure what they
did
need.

“We’re here, if you need to talk,” was all I offered in the end.

After they left, we congratulated ourselves.

“They really listened to us,” Louise said.

“We kept the lines of communication open,” Alice murmured.

“I guess we did a pretty good job,” I said.

But later, as we walked to the dining hall for dinner, we happened to fall in behind Jasmine and Lee and overheard them talking to their friends.

“So, we had this major sex convo with the doctor and the nurses,” Lee was saying to her friends, “and it was
soooo
ridonkulous!”

“
Soooo
lame,” Jasmine squealed.

But how bad could it have been? The very next day they came back. I was working by myself when the two of them showed up. Jasmine was still pouting but Lee came at me in her assertive way. “We want to know what you really think. I mean, like, so what if we were making out with them? Is that so bad?”

If I said the wrong thing, they’d blow me off and I’d lose them altogether.
What to say? What to say?
I looked at their low-cut jeans and bare midriffs, their breasts spilling out of their skinny tank tops.
Okay, here goes
. “You both are very attractive –” I started.

“Are you saying we brought it on ourselves?” Lee snapped. “We have the right to dress however we like. It’s a free country. This isn’t Iraq, you know. We’re not sluts.”

“We didn’t do anything wrong,” Jasmine said, looking tearful.

“I didn’t say you did,” I countered.

“So, I take it you’re saying, we should wait, before, ahh, doing anything more?”

“You’re not ready for more,” I said firmly. “Why not wait until you are?” I said the thing I’d want another parent to say to my own kids in this situation.

“I knew you’d say that,” Lee folded her arms across her chest. “Talking to you is like talking to my mother. She always freaks out, too. C’mon, Jaz, we’re done here.”

I’d said nothing, but already I could feel those precious lines of communication shutting down.

“I sound like a seal,” I heard a girl say.

I was in the midst of giving out the evening meds when I heard a strange sound. It was coming from Naomi, an always-smiling, very popular fourteen-year-old who’d never come to the Health Centre for anything before but was now sitting in the waiting room, surrounded by a group of friends while she had fits of coughing. In between bouts of a high-pitched, insistent, squeaky coughing spell, she joked around and giggled. If this had been the
ICU
and a patient suddenly started coughing like that, I would have placed an oximeter on her finger (an instrument we used to measure a patient’s oxygen concentration). Had she been a patient in the
ICU
, the sudden onset of a harsh cough like this would have garnered her a stat chest x-ray and maybe even a bronchoscopy, which involved a tube placed down into her trachea and lungs, but here, that wasn’t necessary – at least not yet. Even without an oximeter, just looking at Naomi’s rosy complexion and relaxed manner, I was fairly certain her oxygenation was normal.

I went out into the waiting room. Her friends were joking around with her, making her laugh. “This is not a party,” I said, ushering them out.

“I can’t breathe!” Naomi said, waving goodbye to her friends. I brought her into the examining room and listened to her chest and heard adequate and equal air entry on both sides, but she was breathing rapidly. “I can’t swallow and my chest hurts.” Her hands shook. “Is this a heart attack?” Off and on she gave that strange-sounding cough.

“No,” I reassured her. “Probably your chest is sore from coughing so much.”

Louise examined her thoroughly and then we went aside to speak privately. “I think it’s a panic attack,” she said. “You were right to throw out the friends. We want to make sure there’s no acting up for an audience’s attention. For now, let’s try giving her a small dose of sedation.”

I gave Naomi a tiny pill under her tongue and let that take effect. After about twenty minutes, we checked on her. She’d fallen asleep, and while she slept there was no cough, shakiness, or fast breathing. She must have sensed we were standing at the foot of her bed because she startled awake. As soon as she did, the cough and rapid breathing started up again. “I feel like I’m going to pass out,” she yelled. I stopped in my tracks.
Someone about to pass out does not have the strength to yell. Someone about to lose consciousness is too weak to speak
.

“My heart is racing,” she said, trembling. “It’s flip-flopping all around!” Her hands shook violently. She clutched at her chest and took big gulps of air. “I can’t breathe.”

Her strange cough seemed to be gone but her pulse was racing at 120 beats
^*
per minute and her respiratory rate was also fast at forty-five breaths a minute. I gave her a paper bag to breathe into, to try to retain the carbon dioxide she was losing by hyperventilating.

“My chest hurts,” she cried. “I’m going to pass out.” Before we could deal with one problem, Naomi had moved on to the next. “The room is spinning. I’m going to faint!” she shouted. I took her blood pressure and it was a robust and normal 132 over 80.

Someone about to faint would have low blood pressure
, I thought.

“I feel like I’m losing control of myself,” Naomi said. But her words sounded false like she was repeating lines she’d learned.

“I’m sure it must feel that way,” I said quietly. I felt sympathy for her because I could see she genuinely felt upset.

“My feet are numb! They’re tingling. I can’t feel my feet. They’re paralyzed.” She suddenly closed her eyes and lay there motionless.

“Naomi? Look at me! Open your eyes,” I told her, feeling slightly alarmed.

“I think I just blacked out there for a moment,” she said weakly.

But she hadn’t lost consciousness. She had been awake and, I was fairly confident, completely aware of everything she was doing. None of this was adding up. I found myself in the situation I’ve always hated: suspecting a patient was “faking it.” It was an especially uncomfortable feeling to doubt a child. I knew Louise was also looking for something deeper by her line of questioning.

“Is something bothering you, Naomi? Are you homesick?”

Naomi looked at her fiercely. “I love camp. I’ve never been homesick, not even for a minute.”

“Because, if you are,” Louise continued, “that can bring on these kinds of feelings and they can be really scary when you’re away from home and missing your family.”

“I live for camp.” She turned away from us.

Louise and I spoke privately. “I can’t find anything wrong,” Louise said. “I think it’s pure anxiety and nothing physically abnormal, especially since her memory is intact and she can describe her symptoms perfectly …” Louise’s voice trailed off and I caught her drift: after a true faint, a patient can’t recall events immediately prior to losing consciousness. “Let’s give her another dose of sedation and watch her closely. If she worsens we’ll take her to the hospital,” she said, and went to call Naomi’s parents.

Just then, Naomi’s brother Lorne, an older camper, arrived. He rushed over to her, sat at the edge of her bed, scooped her up into his arms and held her tight. As she clung to him, their two heads of dark, curly hair mixed together like a huge, luxurious wig. He soon left to let her sleep. Naomi would stay overnight in the Health Centre. Alice was on call so I said good night.

The next morning, Alice told me it had been a quiet night. Naomi had slept and was now smiling and making light of what had happened, even apologizing for worrying us. She was dressed and eager to return to her cabin. Louise examined her and cleared her to return to her cabin. We wrote it off as a weird, inexplicable one-off episode and since she was now well and happy again, we didn’t give it another thought.

I always looked forward to Saturday lunch because it was family day and I could sit with my kids.

“Where’s Max?” Harry asked as he joined me. He wasn’t too happy about it but grudgingly agreed to this one meal a week with me and his brother. Max soon appeared, triumphantly bearing a dripping, overflowing bowl of Greek salad he’d scored for me, because he knew I didn’t have the patience to stand in the long line for this popular item, even though it’s one of my favourite foods.

My kids were growing up. Their maturity brought many such delightful acts of independent thoughtfulness but it also meant they were pulling away from me and each one becoming his own person.
They grow up so fast
, I thought, and camp makes it seem even faster. It was exactly what was supposed to happen, but it was bittersweet, just the same. It was a reminder that I was getting older, too, and that they needed me less, or perhaps in a different way. Harry, especially, guarded his privacy, and now shared so little with me. Impulsively one day, I’d pumped his
counsellor, prying for some insider details. He was reluctant to be an informant but eventually caved and dished.

“Harry is quite an instigator,” his counsellor said with obvious pride. “He led a raid on a girls’ cabin last night but took his punishment like a man.”

“I guess he’s coming out of his shell.”

“What shell? He’s the noisiest kid in the cabin. Oh, and by the way, he’s quite the chick magnet. A few of the girls are majorly crushing on him.”

Whoa, back off
, I told myself, now uncomfortable knowing information I’d asked to know. Harry would definitely not want me hearing this. I was beginning to see why it might not be such a wonderful thing to have your mom at camp.

Late one evening a few days later, I was sitting in my room reading, when a buzz and crackle came over the walkie. “Is the nurse there?” a counsellor’s voice cried out. “Someone’s having a seizure!”

As I ran to the cabin, I remembered Amanda and that terrifying trip to the hospital in the thunderstorm with Wheels a few summers ago. She’d had a cerebral bleed – a mild stroke – and I prayed this wasn’t going to be anything serious like that. When I got there I found Naomi, lying stiffly on the floor beside her bed, her friends and counsellors around her. I knelt down beside her. “Where are you?” I asked. Her eyes were open and I could tell she saw me but she didn’t answer. This wasn’t a seizure, but something was definitely wrong. “What’s your name?” I asked her.

“It’s Naomi,” someone said. I explained I needed Naomi to answer for herself, because I was testing her level of consciousness, to see how her brain was working.

“What made you think she was having a seizure?” I asked the counsellor.

“That’s what Naomi told me.”

But from what the counsellor described of what she herself had witnessed, Naomi hadn’t had convulsions. She was not now in a typical post-seizure state. We brought her to the Health Centre where she immediately began to flail about and breathe rapidly. Again, I gave her a paper bag to breathe into and coached her to slow down. I worried that her hyperventilation could cause her to pass out and might lead to a drop in her carbon dioxide levels so severe that it would disrupt the acid-base balance, or the “Ph,” of her blood chemistry. Calcium levels would then be affected, leading to tremors and spasms, a state called tetany. I had seen the condition of “metabolic alkalosis” in my critically ill patients but never in a healthy person.

Again, Lorne, her brother, rushed in. “Naomi! Are you okay?” She stared at him blankly. “Naomi, you’re going to be okay,” he told her. He turned to Louise. “Is my sister okay?”

“My neck hurts,” Naomi mumbled. Louise and I looked at each other grimly. Sudden neck pain was a classic indicator of meningitis, a highly infectious, deadly disease.