The Murder Building

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Originally posted on February 19, 2012 

 

When I visited a patient in my caseload that lived in an “unsafe” part of the city, I went in the morning. Right after the pimps and drug dealers had called it a night and before the shop keepers pulled up the bars over the store windows and the women came out to sweep the sidewalk litter into the streets.

One day Pearl, the social worker, asked to come with me to see a patient. She had a meeting in the morning so we left after lunch against my better judgment. If I were going to go to an iffy part of the city, this was the last place I would want to visit. The Chicago Tribune ran a story a few weeks previously about the “Murder Building.” I knew by the address it was next door to my patient’s apartment.

Everyone knows it simply as “the murder building.“

“They call it `the murder building` because people have been known to go into that building and not come out,“ said one young man standing on a nearby street. “You got to stay away from that place. Things go on in them halls you don`t want to see.“

What does that say about the neighborhood we drove through and the scattering of young men gathered on the stoops, some leaning against the parked cars, all seeming to be without a sense of purpose? I felt their eyes following us.

My patient lived on the second floor of a three story apartment building with his common law wife and various other relatives. The front door was locked and since there wasn’t a bell, I had to stand under the window and yell the patient’s name. The patient’s wife would come to the window before she sent one of the grandchildren down to let me in. This was before cell phones.

I dreaded leaving the safety of the car. Did any of the men think we carried drugs? I scooted out and quickly grabbed my nursing bag from the trunk along with a white bathroom scale. The patient was on tube feedings. It remained unclear if his wife was able to manage the procedure and give the feedings on schedule. I was monitoring his weight as evidence of success.

When Pearl and I completed our visit, we took quick, long steps to the car, avoiding eye contact with anyone near-by. As I stuffed my bag and scale into the trunk, I felt someone tap me on the shoulder. I waited for the command to hand over my nursing bag. Instead a soft voice asked, “Before you put that scale away, would you weigh me?”

I turned to see an older man with short gray whiskers on his chin and a pleasant smile. He moved aside as I slammed the trunk closed and carried the scale to the sidewalk. He took his shoes off and stepped on the scale. “I can’t see the numbers,” he said. I read them off to him, he stepped down, retrieved his shoes and said, “thank you.” Behind him stood a young man with dreadlocks. “Can I get weighed too?” He slipped out of his high tops. I called out his weight and he left with a “thank you.”

Behind him a line of men snaked along the sidewalk. Pearl emerged from the car and began joking with the men, young and old, as they waited their turn at the scale.

Back in the car, the scale packed away in the trunk, Pearl and I drove to the corner. As we pasted the Murder Building, ominous and frightening with smashed windows and debris scattered around its foundation, I realized a building doesn’t define a neighborhood.

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A Story You Won’t Soon Forget

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For the past ten years, I wrote my book in isolation. Long hours in front of my computer at my home, or a coffee shop, library and on Amtrak traveling between our home in North Carolina to Washington DC or New York City, and in other spaces I can’t remember. Wherever the location, I rarely chatted with others.

Now I am sharing my thoughts about my book and publishing issues with other authors. A whole new network of fellow writers has opened up to me. I no longer struggle alone but can discuss my experiences with those that have walked along the same path.

I spotlighted Nightingale Tales: Stories from My Life as a Nurse, by Lynn Dow in November. The book described Lynn’s nursing education and early hospital experience that was very much like my own. I spoke with Lynn three weeks ago and more recently with another author, Antoinette Truglio Martin. Both women freely shared their experience in their journey to publication, which publicist they choose, and how they promoted their books. I’m looking forward to contacting more authors as I travel this road.

Getting back to Antoinette Truglio Martin. She wrote Hug Everyone You Know: A Year of Community, Courage, and Cancer. Yes, it’s about cancer but it is not a depressing book. In fact, the Antoinette’s story is a thoroughly enjoyable read about her life as a wife, mother, speech therapist and special education teacher. Cancer is a tangential occurrence in her busy, happy life. She writes:

“. . . The less attention and verbiage I gave this cancer, the less real it was in my day. This cancer is nothing more than a detour—not a chronic condition or terminal illness. Audible words, long dialogues, and ownership would provide it with an embodiment. I tried to keep that to a minimum. The treatment I was willingly putting myself through was aimed to kill any trace of cancer that might have been left behind from surgery (lumpectomy). I believed it was completely gone, and the chemo and radiation therapies served as insurance against a recurrence. This cancer did not deserve an audience and would never be referred to with the personal pronoun ‘my.’”

Antoinette balances her story between her encounters with oncologists, chemo and radiation treatments, and stories of her extended Italian family, living in Long Island near the Great South Bay, and being supported by a group of caring family and friends. Coincidentally, four of her friends were also undergoing treatment for breast cancer.

I happily followed as Antoinette, a self described “overly squeamish, wimpy crybaby” who passed out during a blood draw, as she took charge of her treatments and confronted rude, uncaring and unprofessional medical staff.

One does not have to be faced with a cancer diagnosis to enjoy this book. Hug Everyone You Know opens a window on what it is like to navigate the health care system with a frightening illness. Antoinette educates us with a tender, engaging story that we will not soon forget.

 

 

 

 

A Broken Man Who is Hard to Forget

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Richey rolled himself in a manual wheelchair into the exam room of the spinal cord clinic for the first time on a warm spring day in April. He managed to lift his quivering right arm to shake my hand. I was the new nurse practitioner in charge of his care. He had some ability to walk but he used the wheelchair to maneuver the halls of the VA. Luckily, he could schedule a hospital van to drive him back and forth to appointments. Having a spinal cord injury proved to be an advantage in the system.

Richey’s dirty blond hair stood in tuffs on his head. Dressed in jeans and a T-shirt, he could have passed for eighteen but in reality he just turned thirty, had an ex-wife, two preteen girls, and a few years of homelessness under his belt.

“What are all these scars on your abdomen?” I had asked.

“All the fights I had growing up,” he said. “Always in fights.”

When I met him he was living with his brother, his brother’s wife, and their young daughter. His brother was planning to leave for Iraq and his wife would move in with her family, so Richey decided to move back with his mother.

“Don’t do that, you’re crazy,” Richey’s brother told him. But Richey figured that his mother tried her best when they were growing up. He would give her a second chance. Plus, he said he would be near his ex-wife. He wanted to reunite with his girls.

Richey couldn’t get out of his own way to avoid trouble. He had a long history of drug abuse and alcoholism. He saw evil intent in everyone he dealt with. He could worm his way into a confrontation by just looking at a person. No one respected him. Not one person was supportive.

Richey hated our physician but he seemed to tolerate me. Most of the spinal cord patients flattered me because I had the prescription pad. They had pain and needed medication. Like all my patients, Richey signed a contact to submit to random urine testing. The first sample tested positive for marijuana along with cocaine.

“Knock off the cocaine,” I told him and added that I would look the other way with weed. Most of the spinal cord patients liked marijuana because it helped with spasms and improved their appetites.

Richey wasn’t too different than the spinal cord guys I cared for—“broken men” I called them. They had no incentive to look back and try to figure out what happened to turn them into the non-functioning adults they had become. They had no insight, no imagination, and no drive to make changes.

Most of Richey’s problems revolved around his perception of not getting any respect. The receptionist in the x-ray department didn’t respect him so he didn’t get the x-ray I had ordered. The night nurse didn’t respect him so he left the rehab center I had worked so hard to get him into. Maybe she was mad that he broke the rules by wandering outside after hours, peeing in the bushes, falling down afterwards, and unable to get himself up until he was found in the morning. His mother didn’t respect him so he left her and went to Florida to live with an estranged sister who didn’t respect him so he went back to live with his mother who I found out used drugs and let him drive her car that he was physically challenged to drive in the first place. I suspect that if a policeman had stopped him, that policeman wouldn’t respect him for driving without a license.

His ex-wife didn’t respect him for having an affair. Nor did she respect him when he drove home with his ladylove in the front seat on the day she, his wife, was in the hospital giving birth to their first daughter. During that drive Richey flipped the truck over, his girlfriend was fine but he fractured his spine.

I have long forgiven myself for not being able to help Richey recognize that his actions caused most of his problems but I still think about him after all these years.

Dream Deferred 

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Dream Deferred 

by Langston Hughes

 

What happens to a dream deferred?

Does it dry up
Like a raisin in the sun?

Or fester like a sore–
And then run?

Does it stink like rotten meat?
Or crust and sugar over–
like a syrupy sweet?

Maybe it just sags
like a heavy load.

Or does it explode?

 

I read this poem in Roger Cohen’s essay The Year Not to Defer Dreams, New York Times, December 27, 2017. He looks out of his window in Brooklyn Heights at the Staten Island Ferry, which he has never taken, as it is “crisscrossing the water.” He cautions us to wander aimlessly, pay attention to detail, and re-examine the familiar.

At the end of his essay, Cohen finally “boarded the ferry, not to go anywhere, just to be transported.”

In closing, he writes, “In 2018, take the time, dear reader, to gaze at the familiar, board the ferry to nowhere—and do not, at risk of an explosion, defer your dreams.

Don’t defer your dreams seem an admonishment to those of us who are growing older. I hadn’t thought that many, regardless of age, might not acknowledge dreams we harbor silently in our hearts.

I wrote in my last post that I had never planned to write a book. Say what? Why did I take classes, attend seminars, write about my patients, and focus most of all on the stories surrounding a single experience of becoming a coordinator of a new clinic in Chicago in the 80s? Not write a book?

 

My friend, Helen (not her real name), called me a few weeks ago. Without salutation she said, “I am in love.” I knew she was taking about Tom, a friend of more than 30 years.

Helen and her husband, and Tom and his wife, were friends back in California. After Helen and her husband moved to North Carolina, both couples began sending Christmas letters over the years. Tom and Helen were the scribes. Helen called to give her condolences after Tom’s Christmas letter noted the tragic loss of his beloved wife after a brutal battle against Alzheimer’s. Soon the two were reconnecting and updating their lives. They found they had much in common. “I’m going to tell him that I am not interested in a relationship,” she had told me. And then her phone call.

Their frequent phone calls and messages erupted into deep emotions. Tom flew from California to North Carolina for Christmas, leaving two days after the New Year. He stayed with Helen in her one-bedroom apartment. They laughed constantly. Sang familiar songs. Finished each other’s sentences. Fell into a routine as if they had co-habited for years!

And the sex was great!

Helen will visit Tom the end of this month. Both in their seventies, they are investigating on which coast they will live—together.

From my vantage point of Tom and Helen’s relationship—I am more observer than an intimate—I wonder if each had had the dream of finding a kindred spirit. Tom having a wife who was becoming more of a stranger to him probably left him grieving more than thinking of a new wife to replace her. Helen, who often spoke of her deceased husband as the “love of my life,” was not planning to get remarried. Yet when they met each other and felt the warmth of this new love and recognized the potential of a happy life together, the dream was born. And I believe that both Helen and Tom will not defer their dream now that it has materialized.

I wish them happiness.

Letting Go of the Life We Plan

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“We must be willing to let go of the life we planned so as to have the life that is waiting for us.”
― Joseph Campbell

I didn’t plan to write a book but that’s what happened. I had always wanted to be a writer and, even as I worked as a Nurse Practitioner, I took writing classes, went to workshops and kept a journal documenting patient stories that one day I would expand and publish. But writing a book was never on my agenda.

I like to think I followed Joseph Campbell’s advice and stayed open to the many possibilities that came my way. And I may have, but not intentionally.

I am pleasantly surprised to find myself a soon-to-be published author.

With the New Year almost here, I reflect on the serendipitous events that supported my literary efforts, including meeting other writers that inspired and encouraged me, finding supporting mentors and willing beta readers.

Somehow what I needed at the time found me.

In 2018, as I journey along the publishing road, I plan to stay open to all the new adventures awaiting me.

Thanks to all of you who follow my Blog.

I wish you happiness, health and contentment in the New Year.

 

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Excerpts From My Book

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My book will be published on November 6, 2018 by She Writes Press.

I have changed the title over the course of writing the book so many times that I can’t give you a count.

The latest one, and I do hope the final one, is Stories from the Tenth-Floor Clinic: A Nurse Practitioner Remembers.

She Writes Press asked me to select three of what I felt to be the most powerful excerpts from my book (75-150 words each).

I thought I would share them with you:

When Margaret saw me, she ran to unlock the inner door before I got a chance to grab the key from my purse. Had she been waiting for me? My neck muscles tightened.

“Top of the morning to you,” Margaret sang out in her Irish brogue, exposing black, broken teeth, and a wooden expression in spite of her hearty words.

I looked for the ice pick Margaret reportedly always carried. She was empty-handed, and the pockets of her cardigan sweater weren’t bulging. Sometimes, it was said, she stashed the ice pick under Josie’s lap blanket.

*********************************************************************

“I’m going to do the dishes,” she said.

“No, you won’t. Ernie and I will do the dishes after our company leaves,” I repeated.

Annie wandered in and stopped by the stove, eyeing Mom and me with nervous concern. I wished she wasn’t present to witness our confrontation. But I was determined not to let Mom wash the dishes. The sound of water and the rattle of pans would be heard in the living room, not conducive to an after-dinner conversation with our guests. They might presume we wanted them to leave.

Mom stood facing me with one sleeve rolled up to her elbow. I held my stance.

From my peripheral vision, I watched Annie shudder, her feet rooted to the floor.

Then I peered into Mom’s angry eyes. Where did this rancor come from?

*********************************************************************

(After I told Grandma I was going to nursing school)

“Hey, whana you do? You cleana da bedpans? Huh?” She came close. Garlic breath warming my face as her waving hand grazed my ear. “Thata no gooda work. No gooda.” Her braided bun loosely fastened by hairpins wobbled as she shook her head.

Her feet, with stockings rolled down around her ankles, planted themselves firmly by my chair. The pizza she made just for me, her first granddaughter, lay warm and fragrant on the Blue Willow plate in her hand. She slid the plate in front of me.

Grandma knew as well as I that in the ’50s there were few job choices, much less careers for a woman. Those in her Italian neighborhood lived in multifamily clapboard houses. They cooked the meals, raised the children, and played a supporting role to their husbands.

Grandma expected me to get married after I graduated from high school and start making babies.

There Are Some Patients We Never Forget

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This was first published on January 29, 2012.

 

When you have been a nurse as long as I have there are patients who take residence in your memories and resurface frequently. They could almost be family except they have a short history in your life. What they were like before or after you knew them usually remains a mystery.

Mr. G was a cantankerous, legally blind, brittle diabetic I had taken care of in the late 80’s. His house was the worst on the block: paint peeling off the frame, rickety wooden stairs and overgrown weeds. Thankfully he lived close to the  police station because I had to drive there one day when Mr. G didn’t answer the door. He was convulsing on the floor as I peered through the window. I had to beg the police to break down the basement door to enter because Mr. G often complained to me how many times they had axed into the front door and how expensive it was to repair. He frequently had hypoglycemic reactions.

Mr. G. gave himself insulin injections using low vision equipment to measure out the dose. His much younger wife worked full time, leaving him lunch, usually a sandwich, piece of fruit and a drink on the dining room table. He had confided in me that he thought she was having an affair with her boss. Having an active imagination (I’m a writer aren’t I?), I wondered if his wife was trying to kill him. Maybe the house, inside and out, was in deliberate disarray leading to a potential life-threatening accident. I don’t remember the other scenarios I entertained as I drove to and from his home.

When I left my job to move to another state, my friend, co-worker and fellow nurse practitioner, Jane Van De Velde, took over his care. He died on her watch. She recently emailed me with remembrances about him.

“But I really remember his memorial service. It was so touching, all the people who attended and spoke so highly of him. I was literally brought to tears. I got up and spoke about how wonderful it was to see another side of someone–the strong, healthy, community-involved and well-respected side. We saw him at end of life when he was so very ill and depressed and visually impaired.”

Jane adds, “There are some patients we never forget.”

Amen

Nightingale Tales

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My new project involves interviewing my classmates from nursing school. We “older nurses” are dying off. Who will be around to tell our stories?

As I gear up to start this project, I’m educating myself in the art of interviewing. In the meantime, a serendipitous thing happened. Lynn Dow, RN, wrote about her long career in nursing in a new book: Nightingale Tales: Stories from My Life as a Nurse.

Lynn Dow entered nursing school in 1956, three years before I did. She attended the diploma program at the University of Rochester, which like my diploma program at Saint Peter’s School of Nursing in New Brunswick, New Jersey was three years long without any summer vacation breaks. The stories she shares of her nursing school days entertained me the most since my experiences so mirrored hers.

In her book, she reminded me that after a patient went home we had to strip the bed and then wash it. Yes, the plastic coated mattress and exposed metal coil springs were washed by hand. When the bed dried, we made it up for the next patient. There were no housekeepers at this time. Two cranks at the foot of the bed were used to raise up the head or to “gatch” the knees so the patient wouldn’t slide down. Later, a third crank was added that raised or lowered the bed. I remember having black and blue marks on my shins from hitting the cranks that were left on the bed instead of taken off and stored somewhere, like on a window sill.

Lynn recalls when cardio-pulmonary resuscitation was still in its infancy, a surgeon might bypass this effort and “crack the chest.” This rarely was successful. Once when I worked in the recovery room my patient went into cardiac arrest. Her surgeon dragged her off the stretcher to the floor, cut her open and pumped her heart with his bare hands. She was an old woman and I felt at the time he did this for the experience rather than to revive her.

Commonly, student nurses staffed the hospitals because there was a shortage of registered nurses, and students were a cheap substitute. In the third year of school, students were put in charge of a ward on the evening or night shifts. Lynn reminds the reader that the student nurses were “teenagers, too green to realize the extent of our responsibilities.” Sometimes the students worked a “split shift,” covering baths and meds in the a.m. and returning to help with dinner trays and get the patients ready for bed in the evening. Before I graduated from nursing school this “abuse” of student nurses was no longer allowed.

Nightingale Tales goes on to cover Lynn’s long nursing career and is filled with educational information and surprising vignettes. While I am especially glad she shows us nursing in the “olden days,” her book also depicts the advancements in current nursing practice. But she feels that possibly “the nurturing aspect of nursing has given way to technology.”

Read her book and decide for yourself.

Twenty Years After the Cancer Diagnosis.

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Next Sunday, November 5th, will be the 20th anniversary of my mastectomy. Afterward, my surgeon draped her arm over my shoulders and said I was “cured” as she escorted me out of her office on Connecticut Avenue in Washington, D.C.

Each November 5th , I would make a big deal of the anniversary date of my surgery, or my second birthday, as I called it. I went someplace special. Like a superstitious baseball player, I ran through the same ritual when I came to bat. I wrote down what I was grateful for in my journal, contacted friends and family, telling them how much I appreciated their concern and attention when I was in the throes of cancer crazy and then scheduled something I would do all alone.

The first year, I took Amtrak from Union Station in Washington, D.C. to New York City and ambled up Fifth Avenue on a glorious fall day. In Central Park, I ate a hot dog with mustard and sauerkraut and listened to a skinny old guy dressed in a bright blue suit with a vest and spats, who sat on a bench across from me, playing a ukulele and singing songs my mother and I had listened to on the small radio on top of the refrigerator when I was a kid and she cooked supper. Wait till the Sun Shines, Nelly. Over There. Don’t Sit Under the Apple Tree with Anyone Else but Me. Filled with nostalgia of my childhood and gratitude for my life, I licked the mustard off my fingers and walked back down Fifth Avenue to Penn Station and back home. I repeated some version of this for the next nine years.

However, when my ten-year anniversary rolled around, I decided I would no longer engage in this superstitious ritual. I no longer needed to hang on to the label of cancer survivor, or replay each detail of the cancer journey as a holy event.

On another glorious fall day, I traveled from my new home in Chapel Hill, North Carolina back to DC for what I called the last celebration. First, I had lunch with Cathy, a nurse who was diagnosed with breast cancer around the same time as I. While I had stage 0—no infiltration, she has stage III. She sat across from me in McCormick & Schmick’s front dinning room, a seafood taco salad front of her. She had lost 30 pounds, intentionally, and looked professional with her soft beige jacket, long green velveteen skirt and government ID hanging around her neck. During radiation treatments she had worn a strawberry blond wig. Rather wild for a woman in a religious order.

“Well, I believe that if I didn’t get breast cancer, I would be still be living in the religious community. It was having cancer that lead me to evaluate where I was and why. It took two years from the first questioning to finally leaving,” Cathy said as she snapped off a piece of the taco shell, and scooped up some beans and fish into her mouth. I wasn’t surprised she left—she always struck me as an independent person—more of a free spirit than a follower who vowed obedience to an organized religion.

“Remember when we talked about whether or not cancer had changed us? You said you were still the same, right?”

“Yeah,” I said, “ I wished I would have become a better person, more caring and polite. But I am the same big mouth from Jersey City. Clumsy and rude.”

Cathy laughed even though she had heard this before.

“Are you happy?” I didn’t know why I asked her—she looked content.

Her eyes widened. “I thought I was going to die.”

Maybe a cancer diagnosis does change you. Not overtly. Some foreign emotion tugs at your gut: an awareness that only rises when it’s important. I didn’t do anything great. I just lived more honestly. Taking responsibility for my own thoughts and actions, I needed less approval from others.

After lunch Cathy went back to work and I headed to the National Cathedral on Wisconsin Avenue.

While my “lesions” were investigated and various treatments were discussed, I frequently made a detour on my way home after work to the Chapel of the Good Shepherd. Small, with seating for seven worshipers, the chapel was tucked away off the courtyard on the crypt level of the cathedral. There I would sit with my fears, always alone. The cool concrete walls, dim lightening, and silence calmed me. I focused on the stature of Christ, a lamb cradled in his arms, his hand burnished smooth by the touch of visitors seeking miracles. I always left infused with strength to face whatever was coming.

This time, when I entered the chapel, I wasn’t alone. To my left, a young woman with long dark hair silently sat with her legs drawn up and her bare feet on the bench, her shoes placed neatly on the floor in front of her. Her dress didn’t classify her as homeless. Her brow was knotted in worry and her cheeks were wet with tears. She didn’t acknowledge me but kept her eyes fixed on the statue of the Good Shepherd. My own mission seemed insignificant in the presence of her agony.

After a few minutes I left. But not before patting the Good Shepherd’s hand. “Thanks for being there when I needed you,” I whispered.

Now approaching my 20th anniversary I know that a “cancer” diagnosis has forced me to appreciate that there are no guarantees in life. I need to take chances. I don’t see any choice but to dive into my dreams.

As I look back on my life that has been rich and challenging, I remember that young woman and wonder what was so awful in her life at that moment. I hope, like me, she went back to the tiny Chapel of the Good Shepherd, her problems resolved. And before she left, she touched the back of Christ’s hand thanking him for being there when she needed comfort and then got on with her life.

Nurse at the Switchboard

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Ten of us from a class of 44 traveled to Cape May, New Jersey to attend our 55th nursing reunion. We first met as young Catholic teens in the late ’50s enrolled in the diploma program at Saint Peter’s School of Nursing in New Brunswick, New Jersey. Hard to believe we are now in our mid-70s.

At our luncheon at the Inn of Cape May on a glorious sunny day this past September, we laughed and reminisced about the three years we lived together, when Connie mentioned that she had to man the switchboard at night during the psych rotation at a private psychiatric facility in a Maryland suburb.

Never heard of this we said. But one of us (can’t remember exactly who that was) chimed in to say she remembered at the time how glad she was that she never had to do this. So there was validation that Connie’s memory was intact. Imagine having to work at a telephone switchboard! What does this have to do with learning about psychiatric patients?

lady at switchboard

I found a picture of a telephone switchboard for you too young to remember this contraption that connected folks to each other via telephone lines. Or you could just watch the old movie: Bells Are Ringing with Judy Holiday and Dean Martin.

 

 

 

After hearing about the switchboard, we began outdoing each other with anecdotes about our early nursing days.

I wanted to take notes to capture these unique tales but decided I would rather just enjoy the fellowship. Later, I asked my classmates if I could call them, one by one, and document what they would want to share with current nurses about life in the “olden days.” They all consented.

So now I have a new project. I had been thinking about surveying my classmates about their nursing lives for quite a while. Since our 55th celebration is over, I realize it is now or never. We are dying off. Sad to say but true. Who will remember us? Or what nursing was like years ago? Who would believe that as part of the educational program to learn to be a psych nurse you had to know how to work a telephone switchboard?

You’ll be hearing more about my classmates.