One Wednesday afternoon, I got to the unit to select our patients for the next two days. One of the nurses commented that they had just admitted a 100-year-old woman for a total hip replacement. I went in to meet Sadie and asked her permission for a student to participate in her care the next two days.
Then I had to ask, “Why at 100 would you elect to have this surgery?”
Without a moment’s hesitation, she answered, “I’m having trouble getting on and off of my motorcycle.”
“What?” I asked, thinking she was joking. But she wasn’t.
“I live alone and ride my motorcycle every day to visit my little sisters. They’re ninety-nine and ninety-seven.”
Kathleen D. Pagana
Reprinted by permission of Mark Parisi and Off the Mark. © 2000 Mark Parisi.
This Is the Way We Brush Our Teeth
She had an unequalled gift . . . of squeezing big mistakes into small opportunities.
Henry James
Long, long ago, as first-year students, we were on the floor for a short time each day. Our duties were limited to refilling water pitchers, changing flower water, dusting the room, and taking vital signs.
On one of my early mornings on the ward I was asked to clean the dentures of all the patients before breakfast. Delighted with the important assignment, I went to each room with a tray, gathered the denture cups on the nightstands of the sleeping residents, and proceeded to the workroom to fulfill my duty. I diligently cleaned the teeth under clean running water with a special brush and denture cleaner, then placed them all on the counter in a neat row. As I started to put the dentures back into each cup I suddenly froze. Although I had done a superb job of cleaning them, I now saw a dilemma, which held me suddenly suspended. I didn’t know to whom the dentures belonged!
Nervously, I went to the charge nurse and confessed my problem. After she wiped tears from her eyes from her laughter, she helped me sort some that she recognized, then we set about the arduous task of fitting the remaining dentures to the appropriate residents.
Room by room, we fit and refit teeth until, hours later, each resident was smiling a gleaming smile and anticipating chomping down on breakfast.
The next day when I returned to the floor, the charge nurse began laughing again as soon as she saw me.
“Mrs. Smith’s son came in last night wondering who was responsible for his mother’s new teeth!”
My heart stopped. Expulsion from nursing school whirled in my mind.
“He said, ‘They fit for the first time in fifteen years! We cannot thank you enough!’”
Beverly Houseman
An Alien Named Maria
If you want others to be happy, practice compassion. If you want to be happy, practice compassion.
The Dalai Lama
It was indeed a dark, stormy night, much like a classic horror film, when I met Maria. Tropical storms often flooded our department with water and excess patients.
“Alien at the door! Alien at the door!” the hospital overhead paging system announced.
UFOs hadn’t landed. “Alien at the door” was the code used to announce the imminent arrival of an illegal alien to our OB department. Our visitor would probably be in very active labor and unable to speak English.
I worked as a nurse-midwife in a large inner-city hospital, which served primarily the poor and indigent. Most of our patients were young, poor, and frightened . . . especially of being deported.
To remain anonymous, the illegal immigrants developed a strange policy of literally dropping off their laboring family member at the emergency room entrance of the hospital. When a woman was in labor, someone borrowed the only working car in a neighborhood, then drove around the hospital perimeter in the junker car, trying to time the patient’s arrival to within minutes of the new baby’s delivery. Squealing around the circular drive to drop off their precious cargo, they hoped their timing was such that they were not caught—and the baby was.
I heard the overhead page again. “Alien at the door!”
Tonight was my turn, so I quickly donned the requisite blue gloves and ran for the elevator, expecting I would be delivering the baby, or at least the placenta,with in minutes.
The elevator door opened. I saw her eyes first: wide and dilated in pain and terror. These huge chocolate-colored orbs beckoned me to help. Long black hair glistened with raindrops and perspiration as she writhed on the hospital stretcher.
Clenched fists were rigid at her sides. I tried in my limited Spanish to ask her to relax her arm. Hospital policy required an IV before delivery, if possible. But she would not, or could not, relax. As I looked at her arm, I saw she clutched something in her left hand. It appeared metallic. I wondered if it were drugs or a weapon.
I stepped back to try a different approach.
“Mucho dolor?” I asked her. (Much pain?)
“Sí, sí!” she cried.
“Lo siento, Senora.” (I am sorry, ma’am.) “Agua?” I asked her. (Water?)
“Por favor.”
I handed her a small paper cup with cold water in it, but as she reached to accept it, a deep guttural sound escaped her lips.
I dropped the cup, but managed to catch a beautiful screaming baby girl. The universal journey of a life began for this new little one. I gently handed the baby to the now sobbing mother.
“Felicidades,” (Congratulations) I told her.
I patted the Cuban Madonna’s cheek and watched the awesome miracle again, as if for the first time.
All too quickly I heard the persistent overhead page and ran to the next emergent delivery.
The next day, I visited Maria’s room and learned more of her story. She had been born in Cuba, one of eleven children. Her family had saved money for almost ten years to send one of their members to Florida. When it came time to take the dangerous trip, they chose her because they wanted her unborn baby to be born in America. The handlers in Cuba charged $8,000 to ride on a makeshift raft made of Styrofoam and inner tubes. I could not imagine being pregnant and riding for three long nights on the open ocean with twenty other people on a 10x15-foot raft.
What in life is so desperate that one must escape at all costs? What hope lies within a woman who will do anything to provide a better life for her unborn child?
Instead of feeling angry or disgusted, I felt admiration for her bravery and dedication when she told me stories of persecution, confiscation, and even torture of her family members.
Sorrowfully, Maria related how badly Americans had treated her, criticizing her for laziness, or accusing her of trying to take advantage of American tax dollars. Maria was not lazy or selfish, but courageous, motivated, and self-sacrificing. Maria wanted what every mother wants: a safe and better life for her baby As I entered the hospital the next day, Maria was being wheeled out to the same circular driveway on which she’d been thrown out of a car only forty-eight hours earlier.
“Buena suerte,” I said. (Good luck.)
“Señora Doctor,” she called out to me. I was not a doctor, but she did not understand the difference between a midwife and a doctor. “Para usted,” she said (for you).
She reached inside the baby’s blanket and brought out a beautiful silver, fan-shaped brooch. I realized that it was the same metal object she had been clenching in her hand upon her arrival at the hospital.
In Spanish, Mana told me that her favorite aunt had given it to her. “I want you to have it,” she went on in Spanish.
“No!” I protested. “I cannot accept this.”
I could see in her eyes that it meant everything to her that I receive this gift.
She tried to explain her feelings to me. In English, it went something like this, “You were the first American to treat me with respect since I have been here. Wear it and do not forget. There are many other women like me. It is the hope of all women, not poor or rich, but all women, to sacrifice for their children. Do not despise the steps they take to move beyond their difficult circumstances. Tell th
em my story.”
And I have.
Cheryl Herndon
Two Choices
The strongest principle of growth lies in the human choice.
George Eliot
I enjoy working on the oncology floor, although a lot of my colleagues find it depressing. Sure, it can be sad at times, but I don’t look at it as seeing people waiting to die, as much as seeing people who need others to see them as still living.
For several days I’d been assigned to give Bob his breathing treatments. We’d never met before but I was instantly impressed with his wit, however old his jokes might be.
Bob was what most people would call “a character.” He always had a risqué joke that made his wife groan, laugh, and punch him in the arm. Like, “Have you heard the one about the guy who says that every year for the last three years when he goes on vacation his wife gets pregnant? Yeah, so this year he’s taking her with him.” Ba-dum-bum.
He asked everyone who entered the room, “How are you today?” or, “What’s new with you?”—and then he waited for their answer. He’d never met a stranger, as my mother used to say. He was completely open about his life, showing everyone who came in the room photos of his kids and grandkids, and telling us about their latest winning game, great test score, or band concert.
He was just as open about his diagnosis. Bob had six months to live and when he informed me of this fact, he looked me right in the eye and the smile didn’t leave his face. He shrugged and said, “I’d really like to make it through Christmas. I sure like all the food the Missus cooks and having all the kids around the house.”
I couldn’t help myself; I had to ask.
“Bob, how can you be so happy all the time? I don’t mean to insult you in any way. I love it when I come in to work and see your name on my list of patients, but with your diagnosis, how do you manage to stay so positive?”
He grinned his Bob grin. “Well, it’s like this. Pretty simple. I figure I have the same two choices every single day, no matter if I’m sick or well, no matter if the doctor says I’m dying or not. I can be happy or I can be bitter, and I’m the only one who controls that.
“I also figure that, since the doctor has told me I’m dying, I still have two choices. I can either make them miss me when I’m gone, or I can make sure they’re relieved that I’m finally out of their lives. I’m still the only one who controls that too. Personally, I’d like them to miss me.”
“You’re right,” I said.
“Not only that,” he said, pointing a finger at me. “It’s not just me. You have the same two choices every day, too. You can be happy or you can be bitter. Many people think they have no control over their lives. Sure, there are many things that happen that we wish could pass us by, but we can always choose whether we’re going to be happy or bitter, and if we’re going to make our family and friends glad they know us or not. It’s simple.”
He was right about both of those things. It is that simple and we do always have those two choices.
I choose to be happy and I miss Bob.
Glenna Anderson Muse
8
DIVINE INTERVENTION
Man’s ultimate destiny is to become one with the Divine Power which governs and sustains the creation and its creatures.
Alfred A. Montapert
Do You Hear the Bells?
Where words fail, music speaks.
Hans Christian Andersen
It was a cold December night. I was working the 3–11 shift and we only had five patients on the pediatric ward.
As I took report, I learned that Kelly was back. Kelly, a beautiful five-year-old with leukemia and sparkling blue eyes, lost her blond ringlets after her last round of chemo. But tonight the sparkle was gone as she struggled to deal with the pain of the disease.
I volunteered to care for her. She and I were good friends and had a special relationship. When her mom was at work, I often read to her or played games when the evenings grew long and lonely.
But tonight her mom was with her too, and we both knew she was failing fast.
As I entered the room, her mother was singing softly, “Away in a Manger,” and rocking Kelly. Kelly looked up, smiled weakly, and leaned into her mother’s chest.
I spoke softly. “How are you feeling?”
“I’m really tired . . . but I’m waiting for Christmas,” she answered just as softly.
“For Christmas?”
“Yes, I want to put the bells on the tree.”
Her mother explained as she rocked, “Her uncle sent a set of bells all the way from Bethlehem and Kelly is so excited to have a gift from the birthplace of Jesus.”
“Well, we will have to get you feeling better so you can get home for Christmas,” I replied. I left the room quietly and went to the desk.
Kelly’s chart was opened with a note from the doctor. “Pain meds per protocol for comfort. No code.”
I sighed as the realization hit me that Kelly would not see Christmas.
I held back the tears as her call light came on. I entered the room to check on her and she looked at me and said, “Do you hear that noise?”
Her mother shook her head no and asked for pain medicine.
I returned quickly to the med room to draw up the dose of morphine. When I returned, Kelly was sitting up with her finger on her pursed lips.
“Shhhhhh. Do you hear the bells? It’s the bells my uncle Ben sent me. Do you hear them?”
I nodded my head as I pushed the pain med. She settled back again to snuggle against her mother’s chest.
“What do I do?” her mother asked.
I just shook my head, and whispered a prayer with her. As I left, Kelly was resting quietly.
When I returned later, Kelly was awake and smiled as I entered the room.
“The bells are calling me,” she said. “I’m going . . . I’m going to be with Jesus’s, bells.” With that, she took a deep breath—and was gone.
Her mother and I were crying softly together when suddenly, out of the dark night, the sound of tiny bells pierced the silence.
“She did hear the bells,” her mother sighed, “and she’s home for Christmas.”
Judy Whorton
“I would have been here sooner,
if not for a wonderful caring nurse in the hospital.”
Reprinted by permission of Aaron Bacall. © 2007 Aaron Bacall.
A Mysterious Intervention
Those who learn to know death, rather than to fear and fight it, become our teachers about life.
Elisabeth Kübler-Ross
Nancy had a heart for those facing death. As a hospice nurse, she journeyed with them right up to their point of departure and saw glimpses into the unknown that most people never see. Nancy loved her work. “I wouldn’t have any other job,” she said.
That was her sentiment before she encountered David.
A young man, David lay in his hospice bed facing the wall. Angry and frightened, he didn’t speak to the staff or to his wife, Julia. He had undergone painful, radical neck surgery, radiation, and chemotherapy, hoping for a chance at life, hoping to continue his good job and happy marriage. But the cancer returned with a vengeance. Disfigured and with no hope left, he felt his feelings were justified.
“How do we deal with this unfortunate man?” Nancy asked. The nursing staff tried many approaches: counseling, medications, conversations, invitations, anything to try and gain his participation in his own care and reduce his suffering. But these interventions all failed. He responded to their efforts with no eye contact, no verbal interaction, and a rigid body position that faced the wall.
Nancy had joined hospice because of the special, caring relationship opportunities it presented. Day after day, she took time with each patient. The philosophy at hospice was clear: “We are all in this together and we will help each other get through it.”
But there was no possibility of such teamwork with David. The palpable gloom in his room made Nancy’s former nursing
duties look vastly preferable. She would have welcomed the chance to be overloaded with hospital tasks, or be undone by a complicated baby delivery, or buried in bandages in the burn unit. Even the nursing home patient who called her “nefarious” would be a welcome change from David’s silent despair.
For the first time in her hospice career, Nancy felt eager and relieved to go off duty.
The next day she returned to find that David had lapsed into unconsciousness. Cold and clammy, his color was gray, pulse and respirations very slow. Thinking perhaps he had slipped into a diabeticlike coma, a blood sugar test was taken but found normal. He did not respond to the lancet sticking his finger or to Julia calling his name. The nurses were sure the end must be near.
About an hour went by and much to their surprise, he woke up. He seemed dazed but he immediately turned his body position away from the wall and toward the door. Most amazing of all, he smiled and made conversation.
“Where were you this past hour?” Julia asked. “You seemed so far away. What happened?”
Very calmly, he replied, “I have been somewhere else.” Then with a peaceful expression, he refused to say any more about it. He spent the rest of the day quietly talking with his wife and interacting with the hospice staff.
That evening, Nancy answered his light and assisted him to the bathroom. “I appreciate your help,” he said. “Thank you for everything.”
“You are most welcome. How is your pain tonight?” she asked.