Posts Tagged ‘patients I make up because of HIPAA laws’

Dear Charlotte,

This letter won’t get to you directly, because I don’t know your last name.  I don’t even know if you live in Tuscon anymore.  I was nominated for this nursing award thing, and then I wasn’t.  But when I was still nominated for it, I was thinking about you.  And I wrote this.  You were a nurse living in Tuscon, Arizona ten years ago.  I’m sure you won’t remember me, or my grandfather, Jim.  Ten years ago, he died.  You were there.

Ten years ago in April I was a self-employed geek, commuting every other week to Tijuana, Mexico.  My client were some vile people who now run a very large and profitable organization in Mexico that buys incredibly cheap junk made by children in China and sells it to the Mexican middle class for pesos.  Horrible people.  The company owners, not middle class Mexicans or poor Chinese children.  I worked, sixty to eighty hours a week, moving data from one computer to another.

Yes, there are computers in Tijuana…everybody asks that.  No, I didn’t see any shows, to answer the other question.

Jim was a man’s man.  He grew up a stinky cowboy in Medicine Bow, Wyoming.  (He was always very careful to emphasize in great detail how stinky he was.)  He was eighteen years old when the Japanese Empire bombed Pearl Harbor, and he ran out with the others and joined the navy and became a machinist on an aircraft carrier.  He told me once that “World War II was a lot of fun, except for when the Japs were shooting at us”.  That’s all he would tell me about that subject.

He and my grandmother jitterugged through the 50s, raised two sons, had a wonderfully boring life speckled with dog shows, favorite cars, and picking wild blackberries for ice cream with their two grandkids….my cousin Michael and me.  My grandmother’s spirit died with a stroke and her body persisted for five more years.  We all learned to hate modern medicine and everybody in it in those five years.  So when my grandfather was diagnosed with lung cancer on top of his prostate cancer, he said the H E double hockey sticks with ALL of you, took his whippersnapper seventysomething wife to Tuscon in their fancy RV and made jewelry.  And chose hospice.

We hung out all week, me, Grandpa, Linda, Dad and my Uncle Joe.  Linda made brownies.  Dad read the paper and picked at his fingernails.  Joe wandered around doing whatever it is that younger brothers do in a family crisis.  I walked the dog, trimmed her toenails, read a book I don’t remember.  I sat with him on the bed, and when he woke up, I’d lean over him and ask, “Miss me?”  On one of those days he gave me his favorite black Stetson hat, onto which he had hand-tooled a silver setting with chrysolite stones.  I love that hat.

You came every day, Charlotte.  I have no idea how many times you told us how to give the morphine, and we listened very carefully, honest, because this is MEDICINE and it’s a NARCOTIC and we don’t know how to DO this stuff.  And it was REALLY REALLY important that we do it right because we’re horrified if we give to much and equally horrified if we give too little.  I think you had to repeat yourself a lot.  But every time you said it, you were patient with us.  He told Linda that you were the only medical person he could stand.  I know it’s gruff and rude, but that’s a Daisy Award from my grandfather. You have no idea the power of your kindness has been to me, to my family, the peace of mind we have had because of your gentleness.

 There I was, living the well-paid geek life and you did things for my grandfather that were…well, gross.  I had no idea people did gross things for other people.  I had no idea how grateful I would feel for your willingness to do these things for my grandfather to make him comfortable.  I didn’t know about that.  I didn’t know how grateful I’d be for that.  My family is dorky, we don’t know how to do this stuff.  I mean, we love each other, but we certainly don’t TALK about feelings or anything.  We are proper Midwesterners, for gods’ (God’s) sake.  Our streets are set to 90 degree squares.  People go to their respective houses of worship on weekends.  You eat meat, with potatoes, and a vegetable.  You’re either Packers or Bears half the year, then Cubbies or Sox the other half, and we just don’t talk about any of that other stuff.

On Thursday, we just sort of didn’t leave the fancy RV…we, me, Dad and Joe all sort of fell asleep in the recliner chairs and the ledge thing.  I gave Grandpa a dose of morphine in his iv at 1:15 in the morning.  And at 3, Linda screamed for my father.

And it was okay, I want you to know that…It was really okay.  Actually.  It was very….quiet after that initial bit.

I was at a board meeting in Tijuana the day they buried my grandfather in Green River, IL, next to my grandmother.  But I made it okay.  The Americans running the Mexican company got me to that meeting by using phrases like, “It’s only your grandfather.”  But I made that okay, too, because the Mexicans working for the Americans running the Mexican company approached me, one by one, with hugs and genuine sympathy.  Because every Mexican citizen I’ve ever met gets that whole ‘family’ concept.  They were the reason I finished the production phase of the work.  It was so okay that once we finished the data production phase, I fired my client to great satisfaction.  (My satisfaction, that is.)

I took three months off.  I went to Italy.  I read books.  I bought an $800 purple couch.

I started prerequisites for nursing school the following January and took an 83% pay cut to become an uncertified nurse aide at a hospital.

I don’t have any idea how many souls I have met in the past few years.  Being a geek at heart, I actually did the math.  As a floor nurse and uncertified CNA, I took care of roughly 700 patients per year.  As an ICU and dialysis nurse, that number is about 250.  I have probably taken care of about 3,750 people so far….I’m fudging for the variables of admissions, discharges and low census.

I do not remember all three thousand of those people.  And Charlotte, Jim is probably one of those faded faces in the thousands of people, maybe tens of thousands of people, that you have helped in your career.

They told me in nursing school that some patients would always “live” with you.

Some people in my almost four thousand people live still with me.  Reuben.  He is always first on that list.  The mother from India who we pulled back from HELLP syndrome to her healthy twins.  Sweet Jane with lungs full of PEs.  Chanel.  The WWII vet with bladder cancer, who hit my soft spot for that generation perfectly.  Kurt. That flinty COPDer I dialyzed over at Rose ICU whose prodigious bark hid just a sharp kitten love bite underneath.  Melissa, who taught me to hate “code white”s. The first woman whose ribs I cracked doing CPR and whose name I never knew.  Michael (who still cracks me up just thinking of him).  The nurse whose failed suicide attempt led to a day of her telling me her wonderful stories…and possibly, maybe, showed her that there was still one person, namely me, who wanted to listen, and maybe that was of value.  Miss Kitty, the refined 89 year old woman who named herself from her heroine from Gunsmoke until it became the only thing you COULD call her.  Crash, who offered to stick a snow shovel to his power chair when the blizzard of ’03 happened, so that we could get out after pulling three 16 hour days in a row with 12 to 14 patients each.  The family of Bob, who joined hands and sang Amazing Grace over his bed.  Powerful song, Amazing Grace.

These people are my secret jewels and most of them won’t ever know that.   Many of them have died.

You’ve had years of more patients behind you since even your probably forgettable encounters with us…just some practical, sensible stiff-upper-lippy-and-all-thumbs-and-elbows Midwestern family, utterly lost in the desert.

I want you to know what you’ve done.  I want you to know, somehow…I don’t know how…the power of your silly little kindness to my silly little awkward family.  The kindness that you probably do. Not. Even. Remember.

Sometimes I’m a cranky nurse.  ‘Cranky’ is probably a polite term for it, too.  I mean, come on, there are legions of nurses that are just plain nicer people than I am.  If I have less than 150cc of coffee before someone speaks to me, it just doesn’t go well.  I’m really blunt.  I am the granddaughter of Jim, and though I am more attentive to my hygiene, I have his rough edges that are sometimes resistant to polite managerial suggestion… in multiple annual reviews from multiple employers.  I’m mellowing.  Slowly.  I work at it.  I forget to chart things and sometimes those things are really important, and that lands me into a lot of trouble.  I should have more grace in my dealings with others.  I really, really, need more grace in dealing with others.  And some days I would really rather be at home, even if it’s just getting my laundry done, just so I don’t have to talk to people.  I mean, I just don’t know that I’m cut out for this some days.  Part of me is still geek, and grace isn’t easy for a geek.  I have entirely too many elbows and sometimes I really fuck up.  That’s how I get un-nominated for things.

I don’t know how you did it….especially to raw (emphasis on raw) material like me.  But there are days I pull really.  Really.  Hard.  For complete strangers because I am really offended by suffering.  I think it’s stupid.  Suffering, I mean, is stupid.  And I don’t like it and some days I really fight it hard.  And Reuben, Kurt, Miss Kitty and the rest got the benefit of that.

But you should really get some credit for that.  I have no idea how you did that.  Because I do not even know your full name.  You didn’t ever talk me in to anything.  Ever.  Until I can give you credit where it is due, I have to pay forward.

So, as self-consciously as I’m writing this….because somebody really kind nominated me for this cool award and this cool award won’t happen to me…I thought of you a lot.  I really do want to thank you.  I don’t know if the universe hears me.  Maybe there is a giant ear that hears these things.  The gravitational patterns suggest not, but science always tells us new weird things every year.

Thank you, Charlotte.  If I could pay you back with a million sunflowers pointing your direction in a gorgeous Tuscan July afternoon, I would do it.  If I could pay you back with the hazy rainbow morning light effects over the canyons in Utah and the ravens soaring above it, I would do it.  I would pay you with puppy breath from a hundred happy laborador retrievers if I could.

I got Reuben.  Kurt.  Bob.  Crash.  Miss Kitty.  I hope that’s a start.