The Making of a Nurse (43 page)

I went back into his room and pulled up a chair and sat down beside him.

“What’s your name?” I asked. “I mean how do you pronounce it?”

“Whaddya need to know for?” His voice was hoarse from the tube.

“What should I call you?”

“Nothing.”

“Who are you?”

“Nobody.”

I waited.

“Okay. Call me Joe.” He picked his nose.

“How are you feeling?” I waited. “Joe?”

“How the hell do you think?” His skinny legs were splayed open and he scratched at them.

“Your legs must be itchy,” I said, and he grunted. “I’ll get you some cream for those bites.”

“I’m thirsty. I could use a drink.”

“How about some juice?”

“Got a beer?”

I handed him a cup of orange juice. He took it, looked at it, and hesitated.

“What’s wrong?”

He turned meek, unsure. “Do you have apple instead?”

I stopped in my tracks. He’d found my soft spot. I preferred apple, too. We weren’t apples and oranges. We were both apples.

“God, I need a fucking drink in the afternoon. I mean a real one.”

“I know how you feel.” I craved something in the afternoon, too. For me it was coffee or chocolate, or both, but wasn’t it the same thing as booze or drugs? Both were cravings to fill the same emptiness. We each had our own drugs of choice.

“I’d like a smoke, too.”

“Can’t help you there. I’m sorry.”

Perhaps this was compassion. It wasn’t being upset with someone else and it wasn’t fixing people’s problems. It wasn’t feeling what they were feeling. It was simply bearing witness to another person’s predicament. For years I hadn’t known how to give and always either gave too much and felt overwhelmed, or else gave too little and felt inadequate. So often, I turned away in the face of things that shamed or disgusted me, things that scared or saddened or enraged me. To be the kind of nurse I wanted to be I had to get beyond these barriers. This way of compassion empowered me. It felt healthy and helpful. For years I had been a caretaker and now I was a caregiver. Caring was no longer a burden. It was my life’s work, the work I was meant to do. My emotions no longer felt like a liability. I was able to do this work
because
I care as much as I do, not in spite of it.

Joe and I sat together. There were questions I wanted to ask, advice I thought of offering, maybe even a pep talk. Instead, I sat quietly, giving him the space to speak if he wanted to, hoping my presence was some comfort. I wanted to tell him I had once been just as lost, but had found my way back. Should I have told him? Probably not. There was no need to say or do anything.

My shift was almost over. I asked someone to cover for me and raced to the bank machine and withdrew five twenty-dollar bills. As I slipped them into his worn, empty wallet, I knew my small gesture was a token, more for me than him. I said goodbye and went out to hand him back over to George, who arrived back for night shift. He would likely be transferred to the floor the next
morning and eventually discharged back onto the streets to a men’s shelter or detox centre. Like so many of our patients, once they go out the door we lose contact. Maybe he will get a dog or find someone to love. Love can bring about miraculous cures. I know this from personal experience.

“I
s it true?” Laura asked. “I heard you left the
ICU
. Have you finally come to your senses?”

“No, I didn’t leave. I merely took some time off,” I said, a touch defensively.

“After all these years, it’s getting to you, isn’t it? Face it, Tilda, it’s time to make a change. Even Tracy’s had enough. She left.”

It was true. After completing her degree in nursing, working full-time in the
ICU
, and being a full-time hockey mom, Tracy resigned from the
ICU
and took a position as a public health nurse. I’ve been encouraging her to go on and do a Master’s or become a Nurse Practitioner,
*
but she looks at me like I’m crazy. She’s got a student loan to pay off, a mortgage, and kids going off to university next year. Her career has taken a different course. She’s teaching mothers how to breastfeed and care for their babies and told me she’s enjoying the new challenges.

Every few months Laura’s Line gets together. If more time goes by, I pine for them. I need to see them, be near them, and hear the interplay of their voices. Recently, one Saturday evening, we were sitting outside on a restaurant patio sipping drinks. We meet on weekends now that all of them, except me, work weekdays, nine to five. I asked Tracy about her new job.

“It feels strange going into people’s homes. It’s their territory. The other day I asked a mother how her baby was doing and she told me he’d gained two pounds since my visit the week before. I took one look at the baby and I was horrified. He had a bony, triangular face. I picked him up. There was no way that baby had gained weight! What could I say to the mother that wouldn’t freak her out or make her lose trust in me? I asked her if I could watch him feed. I wanted to see the baby latch onto her breast and how he sucked. How many poos, pees, I asked her? She said she’d just fed him and she was putting him to sleep. But I had a terrible feeling. Something was wrong. Your baby needs to be weighed, I told her. I made her promise she would get him weighed that day. She said she would, but I worried. I called her on my day off. She ended up taking the baby to emerge and he had to be hospitalized. He had lost nearly three pounds, and finally she saw how serious it was.”

We sat taking that in. Only then did we realize what this meant. Tracy saved that baby’s life.

“A new nurse wouldn’t know that,” said Frances finally. “It takes experience and intuition.”

Or a good teacher to guide her
, I thought, looking across the table at Frances.

I’d been teaching, too. Back in the icu, I had taken Sandy under my wing. (Her real name is Sankofa, she told me.) She’s from Eritrea and has big blue eyes, mocha skin, frizzy hair framing her face, and a huge, beautiful smile. She is new to Canada, but is an experienced nurse who has worked in many countries – it seems that highly skilled nurses are in demand all over the world. She was paired with me in the
ICU
for a day and we were caring for a liver transplant patient, four days post-op. The new liver was not yet working optimally and there were complications. The patient’s husband stayed by her side all day and the children were in the
waiting room. Sandy and I ran the entire day, giving her blood transfusions, platelets, plasma, and medications. Later, her blood pressure dropped and her blood-clotting factors were so depleted that she started vomiting blood. Still, there was reason to believe her liver would recover with the whopping doses of steroids we were giving her. In short, it was an ordinary day in the icu.

It was even becoming ordinary for her husband. “I’ve finally realized that every day is a completely different day here. It’s a strange state of mind you have to wrap your head around,” he said, nodding, “hoping and praying she’s going to get better and preparing myself for the worst.”

Yes, that about sums it up
, I thought, looking at him. Sandy and I were on opposite sides of the bed. We lifted the patient up to place the X-ray plate behind her back and found a large pool of blood seeping out underneath her. We cleaned her up as best we could and I glanced over at the husband. He seemed to be coping, but Sandy looked horrified. It clearly wasn’t an ordinary day for her.

“I could never work here,” she said later, on a coffee break. “It’s a scary place.”

“You’re right,” I agreed.

“How do you cope with this work?”

“There is so much you can do to help people.”

“Have you worked in the
ICU
long?”

“Twenty years.”

“Wow,” she said, looking at me. “You don’t look that old.”

“I don’t feel old, but I started in my twenties and now I’m in my forties. Believe me, it happens fast.”

The prospect scared her. I’ve seen this same surprised look in the eyes of younger nurses when they consider the possibility that such a thing might happen to them, too.

“Your real name, Sankofa,” I asked, “I mean your African name. What does it mean?”

She smiled shyly. “It is difficult to explain. It may sound strange to you, but it means one who reclaims the past in order to move forward.”

THE OTHER DAY
I was about to get onto the elevator and I almost bumped into a very energetic elderly woman from Volunteer Services who was getting off. She was pushing a rickety cart out in front of her and it was the exact same size and shape as the one I used to fill with books and take all over the hospital. Near the bottom, underneath the patina of the thick, cream-coloured coat of shiny paint, there was a scratch and I could see a chip of the old bright blue paint. It was the same cart I used to push all around the hospital, thirty years ago! Now, it was loaded with Italian, Korean, and Chinese newspapers. No one in hospitals these days is well enough to read novels. If they’re there, it’s because they are sick and if you happen to catch one reading a book, it’s time to send them home!

SOMETIMES MORE THAN
a few months slip by between get-togethers with my gang, but we keep tabs on one another by phone and e-mail. Everyone’s well, taking good care of themselves, despite a few aches and pains that have started creeping in. Last year, Tracy’s mother died suddenly and she worries about her father now, left on his own. Frances took care of her older sister, who was ill for many years until she died a few months ago. As usual, we talk about work, the good old days, and new topics such as varicose veins, menopause, and kids.

“What did we used to talk about?” I lamented.

“Boys!” we laughed.

Frances and Laura never married and seem perfectly happy on their own. Laura did date a few guys, but stopped because, as she said, “They’re all either looking for a purse or a nurse!” Life is good for all of us, but back then we had some of the best times of our lives. To be sure, we saw the worst things, but also the best. We helped people return to their lives, mothers to their children, husbands to their wives. We delivered good news with jubilation or bad news with gentleness. We used morphine to relieve pain and later discovered how we could bring about comfort with our touch, our words, and our presence. We saw things so raw and real we could speak about them only to one another. We exchanged wisdom, some of it
practical and basic, some of it instinctive and complicated, some of it modern and sophisticated, and some of it timeless and ancient.

Tracy and I used to laugh about a plan we had, to cause a scene at a dinner party in which we would reveal the truth about our work. Everyone would stop mid-chew. They’d put their forks down as I would cheerfully tell them about the litre of pus we drained out of one guy’s chest cavity. They’d weep as I would tell them about the tiny smile the semi-comatose man gave when his wife bent down to tell him she loved him. Their jaws would drop after I would tell them about a young man, a ward clerk, who was hit by a car while running out at lunch to register for university courses. In the afternoon he was declared brain-dead and became an organ donor and by that evening, another man dropped down to his knees in gratitude to that unknown donor and to God. Of course we never went through with our devilish plan, but I realized that when you put some things into words, they gain a weight and a power that they hadn’t had when left unspoken or unrecorded.

“I hope you never do that.” Frances was aghast. “It would be too unsettling for people.”

“Hey, Frances,” Laura interjected, never at a loss for a jibe at her. “Did you hear they removed the word
gullible
from the dictionary?”

“Did they really?” Frances asked. “Now, why would they do that?”

“Because it means the same thing as the word
Frances.”

“You’re mean.” She stuck her tongue out at her. “All I’m saying is there are some things you shouldn’t tell people. It’s too shocking. It scares them. Besides, they’d never believe you.”

“You
should
tell people,” Justine insisted. “The public needs a dose of reality.”

“It’s good Tilda’s out there telling people about nursing,” said Tracy. “Many people don’t know what nurses do. They still think it’s bedpans and helping the doctors.”

“Yes, it should be Tilda, after all, she’s still embedded with the troops, down in the trenches.”

“So, Tilda, what else have you been up to lately?” Justine wanted to know.

I told them that I’d started working on my Master’s degree and about the travelling I’d been doing across the country, meeting with nurses and speaking with them about our work and our stories.

“I hope you’re telling them about all the exciting developments,” said Frances, “like Nurse Practitioners, and clinical nurse specialists. Nurses are now First Assistants in the operating room.”

“What about film studio nurse?” Justine said. “They need nurses on movie sets. I did that once and gave a Tylenol to Denzel Washington. I would have liked to have given him a lot more! Once, I got to airlift a patient to Anchorage, Alaska. What a blast! Oh, and make sure you tell them about the army. The army needs nurses. There are lots of wounded soldiers these days.”

“I met a nurse who runs a sexual assault clinic, collects forensic evidence, and counsels victims,” Tracy said.

“Remember those old Cherry Ames books, Tilda?” Laura was a big second-hand bookstore browser and had recently bought me two, in mint condition:
Cherry Ames, Jungle Nurse
and
Cherry Ames, Army Nurse
. “Even Ol’ Cherry Ames would be shocked at what nurses are doing now!”

“What
do
you tell the student nurses you meet on your travels?” Frances asked.

“I start off by asking them why they chose nursing.”

“I tell you what I’d say,” Laura interjected. “The only choices open to me were teacher, secretary, or nurse. So I ended up being all three.”

“Well, these nursing students say they’ve heard you make a decent salary and that there are good dental and drug benefits and lots of opportunities for advancement. I ask them how many plan to work in patient care when they graduate and they all raise their hands. Then I ask, what about five years from now, how many of you plan to still be at the bedside? You know what?” I took a breath for the clincher, “None raise their hands. They all want to be managers or researchers. Patient care is a stepping stone, an apprenticeship at best.”