The Story Behind the Message

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Rearranging my bookcase, I came across a book with the following inscription:

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To Marianna–No, it’s not easy! But you can do it. All the best, Molly

This is the story behind the message:

I had been writing for as long as I can remember. I saved many of my stories in longhand on scraps of paper, on faded yellow legal pads, and typed up on an old manual typewriter with multiple errors (I flunked typing in high-school). All were unedited and unfinished.

In the early 90s when I lived in the Washington DC area, I started to take writing more seriously by attending classes and conferences. One of the workshops was sponsored by the Smithsonian. I can’t remember for the life of me the woman who conducted the class. What I do remember was the cross section of adults who sat on folded chairs in the cramped room three stories below ground level at the Dillon Ripley Center. At one session, the instructor had invited her friend who was visiting from out of state, the author Molly Giles.

Molly looked to be about my age. She had reddish blond hair and a warm, earthy persona. I immediately wanted to be her best friend. She described the office she rented so she could write undisturbed.

After the class, I stood along side of the table where Molly was autographing her latest book: Creek Walk and Other Stories (still in print). creek-walk-by-molly-gilesShe was poised with pen in hand ready to inscribe the book to me as I chatted on about how much I enjoyed her talk and how I thought writing was fun. She cocked an eyebrow at me as if I had just told her I still believed in the tooth fairy. Gently, she told me that writing could be difficult.

Now, over 20 years later, I have written many words, finished and published some stories. I completed a memoir and am investigating self-publishing venues. For me, writing is more arduous than exhilarating. My greatest strength is persistence.

How I wish I could meet with Molly over a mocha latte at some cozy coffee house. I know what she was trying to tell me so long ago. She was right.

Dad and the Bride Doll

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My father, a complicated man, was the oldest son of 10 children. His parents came to America from Naples, Italy via Ellis Island at the turn of the century, and settled down in Jersey City, New Jersey.

He left school in the sixth grade to pick up bits of coal from the railroad tracks, placing them in a wagon, to later sell to buy food for the family.

Brookyn Navy Yard

Brookyn Navy Yard

My father was a tight package of a man. Dark and solid with biceps of steel and large hands heavily calloused. He worked on the docks of the Brooklyn Navy Yard during World War II and then in construction. When we visited Grandma for Sunday dinners, he would flex his muscles and I, and another cousin or two, would hang on his arm as our legs swung above the floor.

A hard drinking man, he was the black sheep of the family but my grandmother’s favorite. She would cook the foods he loved and he would sing and dance her around the kitchen, dodging the hot wood stove and the table that could expand to serve her large family. He never failed to make her laugh, she who took to her bed with headaches; dour and sad, more days than not.

I was his only child. I knew he would have preferred a son who he would teach to box, throw a ball and take to the Yankee games. To please him, I learned to swing a bat, hit a fastball and bob and weave as I sparred with an imaginary opponent. He took me out of school to see the 7th game of the World Series when the Yankees beat the Dodgers in 1952.

One Christmas when I was about eight or nine, I wanted a bride doll. I knew it cost a lot of money and money was always tight. My father shook his head indicating I would not get my wish.

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Close to Christmas, when my father went into his bedroom and pulled the door behind him—not quite closing it—I crept up to watch through the slit. He opened the closet and reached on the top shelf and took down a box. Opening it, he removed a beautiful blond doll with a white gown and stroked her veil with his heavy hands. I guess I faked my shocked reaction when I opened the present on Christmas day. I don’t remember if I wished at the time I hadn’t peeked into the bedroom, since it diminished my surprise. However now as I look back I treasure the sight of my father gently smoothing out the doll’s veil and knowing he was making his little girl happy on Christmas.

 

Merry Christmas and a Happy and Healthy New Year.

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Cardiac Advances Versus Patient Benefit: A Moral Dilemma

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My story, Closing the Door, recently published in Stories That Need to be Told: A Tulip Tree Anthology, tells of the emergence some fifty years ago of cardiac catheterization, artificial heart valves and cardiopulmonary resuscitation and how I, as a young nurse, had to make sense of the advancement of technology versus patient benefit.

This story is especially significant to me because just six months ago my husband had open-heart surgery replacing two valves with biological valves. I witnessed, first hand, the tremendous advances in cardiac surgery and treatment.

 

CLOSING THE DOOR

I gagged on the alcohol fumes as I carefully measured out sixty milliliters of Black and White Scotch into a medicine glass. Balancing the small plastic tray with a pack of Lucky Strikes and the Scotch on one hand, I locked the door to the tiny medication room with the other. Then I went in search of Charlie Hobbs.

A plume of tobacco smoke drifted from the patients’ lounge. A ripped vinyl sofa and two orange bucket-like chairs lined the walls. The sole occupant was a middle-aged man hunched over a jigsaw puzzle on the card table. Charlie Hobbs had been admitted to the research unit on the third floor of the city hospital with just the clothes on his back. Every day he wore the hospital issued striped robe and pajamas. One of other staff nurses had donated slippers.

I gazed down at the top of Charlie’s wild red hair. He shuffled jigsaw pieces by day and watched television by night, all a maneuver, I thought, to keep human interaction at bay. No one ever visited him. Did he even have a home to go back to?

“I got to get me another puzzle,” he said without looking up. “This here one is almost done.”

At twenty-three, and a nurse for just two years, I vacillated between professionalism and irreverence. At times, I imagined myself the airline stewardess I had always wanted to be. Coffee, tea, or me? This day I was a Playboy Bunny as I bent at the knees, stretching to place the drink in front of Charlie, while his blue eyes riveted on my imagined cleavage. But Charlie’s eyes fixed solely on the amber liquid. Not once in the past four weeks had he acknowledged me, the young nurse in a starched white uniform with thick support hose, and practical shoes. An unlikely dispenser of booze and butts.

Charlie snuffed out the remnant of his cigarette into an overflowing ashtray and reached for the drink.

Harold Clark’s research money supported Charlie’s hospital stay. Dr. Clark needed recruits who would agree to have a cardiac catheterization in order to see the effects, if any, that alcohol had on their hearts. Cardiac catheterization was the latest tool of the sixties to measure heart function. This new procedure carried a high risk of injury, and even death.

Dr. Clark had scoured the downtown bars searching for men who drank excessively. On a warm autumn night he had gotten lucky. Charlie seized the carrot: a roof over his head, three squares a day plus free liquor and cigarettes. He agreed to live on the research unit for a month, and then undergo a cardiac catheterization.

I carried the empty medicine glass and the tray back to the nursing station. How could Charlie drink alcohol at nine in the morning? Or all day long, for that matter? What would make a man so desperate that he would consent to undergo a procedure that might kill him?

Even though I didn’t particularly like Charlie, there were times when I placed the Scotch in front of him that I wanted to nudge him, and jerk my head towards the exit sign at the end of the hallway. Get out, Charlie. The catheterization isn’t worth all the free alcohol and cigarettes. But I didn’t have the audacity to undermine Dr. Clark’s research, no matter how conflicted I felt.

In the small sink in the medicine room, I rinsed out the glass and turned it upside down to dry on a paper towel that rested on the narrow windowsill. Still thinking of Charlie Hobbs, I started down the hall to check on my other patients.

Nellie Mineo waved to me from the doorway of her husband’s room. She looked like the Italian housewife that she was: salt and pepper hair piled in a bun on the top of her head. A well-worn cardigan sweater covered her simple cotton dress. When I walked toward her, she grabbed my hand. Behind her I could just make out her husband’s outline under the starched white sheets.

“He seems worse,” she said, rubbing my hand in absent-minded distraction. “Promise me you’ll stop in before you go off duty today.”

The Mineos had known the chances weren’t in their favor when they first met with Dr. Clark to discuss replacing Joe’s diseased heart valve with an artificial one. He was so short of breath that he could hardly talk, much less continue working in the family grocery store.

In the operating room, Dr. Clark had removed the incompetent valve, and slipped the artificial one, a silastic ball encased in metal cage, into the excavated space. The ball-valve clicked audibly. Not a pleasant side effect.starr-edwards-mitral-valve

After my regular tour of duty, I rode the elevator to the fifteenth floor, the surgical unit, and worked overtime as Joe’s private nurse. He reminded me of my Uncle Tony with olive skin, dark eyes, and soft smile. At first things looked great, but soon Joe developed a cough and a fever. His legs swelled. He had difficulty breathing. Diuretics worked for a while. Antibiotics failed to prevent an infection. His once muscular body had shriveled into sagging skin covering a bony frame. Although the valve was being rejected, it continued to click on.

“Stop and see me before you go off duty,” Nellie repeated. I nodded. Only then did she loosen her grip on my hand.

At the end of the day, as I flung my coat over my arm, I heard a racket from the patients’ lounge. Charlie stomped past me, head down, and fists clenched. “I’m outta here.”

“What happened?” I asked the nurse who jogged after Charlie.

“Charlie kicked over the card table. For no reason I could see.” She shrugged her shoulders, and continued on.

Nellie watched the commotion from the other side of the hall. The Mineo’s large, gregarious family resembled my own extended Italian family. Visitors came and went at all hours, but that day only Nellie stood guard. When I approached, she pulled me into her husband’s room, grabbed my coat and purse, and clutched them against her body. From behind her I could hear Joe’s wet bubbly breaths, which barely muffled the click of the valve. Even in my short stint as a nurse I recognized the rancid smell of impending death. I wanted to escape the hopelessness of Joe’s futile struggle, but Nellie moved her face closer to mine.

“He’s dying,” she whispered.

She swallowed hard as if to stop herself from crying. “I don’t want him resuscitated. Please stay with us. Don’t let them resuscitate him.”

Nellie had witnessed plenty of resuscitation attempts as she lingered outside her husband’s hospital room day after day. Cardiopulmonary resuscitation was so new that all patients were candidates. At the first moment a patient stopped breathing, we leapt into action. We flung him to the floor and straddled him. We thumped the sternum with the side of our fist, then breathed frantically into his mouth. Pumped on his chest. We worked until we were exhausted. In most cases the patient died anyway with fractured ribs, and a lacerated liver.

Nellie kept her gaze on me; her dark eyes pleading. What would I want for Uncle Tony? A quiet death, or zealots in white coats beating on his chest? What should I do?

Charlie’s voice boomed from down the hall spewing curses. Perfect timing. Charlie would leave the hospital AMA—against medical advice—right before his scheduled catheterization. He wasn’t as clueless as I had thought.

Hopefully, Charlie would distract the staff long enough for Joe to die. My heartbeats kicked up a notch. How could I ignore Nelly’s plea? I reached over and slowly shut the door.

Nellie’s hold on my coat and purse relaxed, and they slid to the floor. Wordlessly, she settled in the chair next to Joe’s bed, lifted his limp hand onto her lap. I commandeered the chair by the door: the sentry blocking the enemy from entering.

I had seen dead people before but never lingered for that final breath. The valve and the minutes clicked on. The lapses between Joe’s gasps for air stretched farther apart. Just when I thought he had quit breathing, he gulped for air. I silently cheered him on. Die Joe. Come on, get it over with.

I sat knotted tight. How would I explain the closed door to a co-worker who decided to check on Joe? Or the fact I was still there after my shift had ended?

Finally, Joe’s noisy breathing ceased. Then the mechanical valve stopped clicking. The silence sounded thunderous as I grappled with the fact Joe had actually died. I walked to the bed to see his torturous face frozen, his dark hair matted with sweat, his mouth agape. His open eyes stared at nothing. I placed my hand over Joe’s clammy hospital gown. No movement in his chest. No heart thumping against my palm. As I smoothed down his lids, Nellie gripped her husband’s hand to her breast and sobbed softly.

While I felt relief that Joe had died with his wife by his side, each footstep by the door made my heart flip.

“I really need to leave, Nellie.”

Tears trickled down her cheeks. She placed Joe’s hand over his chest before she rose from the chair to embrace me.

“Thank you,” she said, her voice cracking. She cried on my shoulder as my own tears fell. Then she pulled away, and sat back down next to Joe, taking his hand again.

Grabbing my coat and purse from the floor, I wiped the moisture off my face with the coat sleeve. I cracked open the door, and glanced up and down the empty hallway. I forced myself to walk leisurely toward the exit.

Nellie waited for the evening nurse to discover Joe dead in the bed.

The floor was unusually quiet. The medication door stood ajar in the nursing station. I had no intention of poking my head inside, and saying so long to the evening nurse. Just a few more steps and I would be in the clear.

I turned the corner of the white tiled hallway, my thoughts back in the room with Nellie and Joe. My body jerked as Charlie Hobbs blocked my way.

“Hi,” he said as if we were old friends. “I’m leaving.”

He sported a bright green jacket that covered the rumpled clothes he had worn when first admitted. “Borrowed this from the guy in the next room,” he said, noticing my eyes on the jacket. “I’ll return it.” I nodded even though I knew the coat would never make it back to its owner.

“I ain’t got no money on me. Can ya spare a buck? I’ll pay ya back.” He shifted his feet nervously waiting for my answer. For a fleeting moment, I thought to try to persuade him to stay. But that would have been hypocritical. I reached into my purse knowing he would head for the nearest tavern, and never give a second thought to repaying me.

“Thanks,” Charlie mumbled, shoving the dollar bill into the pocket of the purloined jacket. He turned abruptly, and disappeared though the doorway under the exit sign.

While I jogged down the three flights of stairs following behind Charlie’s footfalls, I attempted to justify my behavior. Frightening to me was how quickly I intervened for my patients without foresight into the repercussions.

However, I felt positive that Charlie had planned all along to leave the hospital before the catheterization. Not giving him the dollar wouldn’t have made a difference. And who would question that my closing the door to Joe’s room to allow him to die naturally had violated any ethical rule? Even if I didn’t intervene, the chances that anyone would get past Nellie Mineo to resuscitate Joe seemed unlikely.

How could I have realized that over the years I would continue to struggle with knowing when to step back, and when to dig deeper into my patients’ psyche. How to be empathic and not sympathetic? How to balance cool detachment with overbearing involvement? It was just the beginning. There would be many choices throughout my long nursing career that would test my allegiance, and strain my conscience.

Before I reached the last flight of stairs, Charlie had flung open the door to the street, and let it crash behind him.

Happy Lasagna Day

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My husband and I are spending Thanksgiving alone—by choice. We had been invited out but graciously declined.

After having three sets of houseguests in six weeks, we are happy to be alone. By the way, the house has never been cleaner.

And we broke from the traditional Thanksgiving dinner—we are having lasagna.

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I love leftover lasagna as much or more than leftover turkey, stuffing and gravy.

 

Over the years lasagna has become the ubiquitous casserole. You can find it premade in deli departments and frozen food cases in grocery stores. It’s the go-to meal neighbors bring over to neighbors on happy occasions (childbirth) and solemn occasions (sickness or death in the family).

My love of lasagna goes back to my childhood when we visited Grandma in Jersey City. She lived in a second floor walk-up two blocks from my house. Who remembers what time she got up in the morning to begin cooking the lasagna and the rest of the meal, including homemade bread and a roasted chicken? As for the lasagna, she made the pasta from scratch. The tomato sauce (we called this gravy) simmered for hours on the stove. She used whole-milk ricotta and mozzarella cheeses that were made fresh at the Italian store down the block.

Being the oldest granddaughter, I sometimes helped by assembling the multiple layers of the dish. First the sauce, the pasta in one layer, a few spoonfuls of cheese mixture (ricotta, parmesan, eggs, oregano and parsley), sliced mozzarella, more sauce/gravy and then I started over again finishing with the mozzarella on top.

If the family ever had turkey for Thanksgiving, I don’t remember.

In Grandma’ s cramped kitchen the men ate first—Grandma’s three sons, her five sons-in law and Grandpa. My cousins and I sat at the “children’s table” that was cobbled together with end tables and folding chairs. The women served and cleared and eventually sat down to dinner with the windows open to let out the steam from the kitchen along with the delicious aromas of the Italian Thanksgiving feast.

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So this Thanksgiving I am thankful for the usual, although not insignificant blessings, such as health, family, friends, but also for the memories that warm me and bring me back to Grandma’s table laden with her gifts and in the company of my extended family—some long gone but not forgotten.

Wishing you a very Happy Thanksgiving and joyful memories.

80 year-old male model

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As a retired gerontological nurse practitioner and a woman dealing with my own aging, I am always happy to read about successful aging. This one comes all the way from China. I hope you enjoy 80 year-old Wang Deshun’s story as much as I did.

 

An 80-Year-Old Model Reshapes China’s Views on Aging

 

Sinosphere

By DIDI KIRSTEN TATLOW NOV. 3, 2016

 

Wang Deshun, who turned 80 this fall, at the China Fashion Week in Beijing last year. Credit Quan Yajun

Wang Deshun, who turned 80 this fall, at the China Fashion Week in Beijing last year.
Credit
Quan Yajun

BEIJING — Before cranking up the techno music at his 80th birthday party, the man known as “China’s hottest grandpa” paused from his D.J. duties to poke fun at the country’s staid traditional celebrations for the elderly.

“I should wear a long robe, with the word ‘longevity’ embroidered on the front,” the birthday boy, Wang Deshun, said at his party in September.

Far from looking frail, the silver-haired actor, model and artist wore a crisp white shirt and black jeans, his back straight and his eyes glittering with humor.

“Two young maidens should help me into an old-style wooden chair,” he added, pretending to hobble.

Determined to avoid mental and physical stagnation, Mr. Wang has explored new skills and ideas while devoting ample time to daily exercise. Last year, he walked the runway for the first time, his physique causing a national sensation. He takes obvious joy in subverting China’s image of what it means to be old.

Wang Deshun explains how he became a runway model last year. Video by Redstart Media

And old age in China begins relatively early. The legal retirement age for women is 50 for workers and 55 for civil servants, and 60 for most men.

Being older in China typically means being respected, but also, often, sentimentalized. Someone as young as 50 may be addressed as “yeye” or “nainai” — grandpa or grandma — regardless of whether they have offspring.

Mr. Wang is having none of that.

“One way to tell if you’re old or not is to ask yourself, ‘Do you dare try something you’ve never done before?’ ” he said in a recent interview at a hotel in Beijing.

“Nature determines age, but you determine your state of mind,” he said.

Mr. Wang has not escaped being called grandpa — he has two children and a 2-year-old granddaughter — but the honorific is accompanied by accolades for his vigor and his embrace of the new.

“Grandpa, you’re my idol!” one admirer wrote on Mr. Wang’s Weibo social media account, one of thousands of similar comments.

Sex appeal is part of the mix.

“Grandpa, your stomach is so gorgeous! Incredibly handsome!” another person wrote next to a photo of Mr. Wang, topless in a gym, his skin smooth and pectorals buff.

Mr. Wang said he was always athletic. An avid swimmer as a child, he still swims more than half a mile each day. “Morning is my learning time,” he said. “I read books and news. From 3 to 6 p.m. is my exercise time, in a gym near my home.”

He also drinks less alcohol now, he said, but that is about as far as his dietary restrictions go. “I am not picky at all about what I eat. I eat whatever I want.”

Mr. Wang was born in the northeastern city of Shenyang in 1936, one of nine children of a cook and a stay-at-home mother. At 14, a year after the Communist Party came to power in 1949, he began working as a streetcar conductor.

Mr. Wang blowing out the candles on his 80th birthday cake in Beijing on Sept. 20. Credit Shen Qi

 

“I liked acting, singing, dancing, playing musical instruments so much that I joined my work unit’s band,” he said. At the Workers’ Cultural Palace in Shenyang, he took free lessons in singing, acting and dancing. He later took a job at a military factory and joined its art troupe. Sometimes they entertained soldiers.

“Even if there was just one sentry, say, at the top of a hill, like once in Dalian, we’d surround him and perform,” Mr. Wang said.

Later he worked in radio, film and theater. In the early 1980s, Mr. Wang, who would teach runway modeling at a Beijing fashion school, staged what he believes was the first modeling show in the northeastern city of Changchun.

“In 1982, the clothes Chinese wore were so out of date,” he said. “I went to the city’s biggest department store and told the sales clerks, ‘Give me your nicest clothes, and I’ll organize a show.’ They agreed. The best clothes they had were fur coats, and for men, woolen Sun Yat-sen suits” — also known as Mao suits.

Back then, he said, “Chinese had no sense of color or style. People wore black, white, gray or blue. Some people wore army uniforms. I wanted to start a sense for fashion among ordinary people. We did a swimming-suit show. The girls refused at first, thinking it was indecent. But I insisted.”

By 49, Mr. Wang was eager to move to Beijing, China’s cultural capital. He wanted to be a “living sculpture.” He also needed money.

He began working out, determined to have a lithe body that would allow him to interact, almost naked and covered in metallic paint, with copies of Auguste Rodin’s and Camille Claudel’s sculptures of women. The idea, he said, came from his wife of 48 years, Zhao Aijuan.

After the first show in Beijing, in 1993, the authorities, disturbed by its sensuality, barred Mr. Wang from performing in public. He continued to perform privately.

“I really admire him very much,” said Xiao Lu, 54, a performance artist. “I do body art, and you know, after a certain age. a person’s abilities decline. But he has this amazing sculpted body and spirit. Such power for life really comes from the inside. He makes the feeling that’s in the Rodin sculptures come alive.”

Last year, he appeared bare-chested in a fashion show in Beijing’s 798 arts district, featuring designs by Hu Sheguang.

His appearance on the runway earned him a cultlike following. Some fans call him laoxianrou, or “old fresh meat,” making a play on the word for teen idol: xiaoxianrou, or “young fresh meat.’’

So has old fresh meat replaced young fresh meat?

Perhaps not. But Mr. Wang’s physicality, notable in a society where men rarely highlight their attractiveness, also sets an example in a nation that is growing older fast.

“People can change their life as many times as they wish,” he said. Having a goal is important, he said.

“Being mentally healthy means you know what you’re going to do,” he said. “For example, a vegetable vendor, when he wakes up, he has a goal, he works hard. And when he finishes, he feels fulfilled.”

For Mr. Wang, fulfillment comes in many forms: acting, modeling, exercising and creating art.

And one day soon, he said, parachuting. That is the plan.

 

 

 

 

TRICK OR TREAT AT THE FRONT DOOR; HEARSE AT THE BACK

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Reblogged from September 20, 2012. Happy Halloween.

Marianna Crane: nursing stories

I have been pestering my classmates from nursing school (we are about to celebrate our fiftieth anniversary next month) to write their stories so I can post them on my blog. Maybe pestering is too mild a word. Regardless, I have succeeded. Two women have sent me stories.

The first comes from Joan Moore. 

This is her story when she worked for a Hospice in Central New Jersey in the late 1990’s.

THOUGHTFULNESS IN THE FACE OF GRIEF

Written by Joan Moore

One of the most important aspects of hospice nursing is that a nurse is available 24/7 for the patients. This means every nurse on the team is required to take a turn being “on call”.

I’d like to share one of my many on call experiences.

My weekend started quietly. It was a Saturday in October. Halloween. In that neighborhood when Halloween falls on a weekend, the kids…

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The Gray Area of Nursing: Being Uncertain of One’s “Moral Role.”

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Here’s a great example how one nurse saved a patient’s life.

American Journal of Nursing

American Journal of Nursing

Speaking Up to Save a Life

by

Diane Szulecki, Associate Editor

American Journal of Nursing

October 2016 – Volume 116 – Issue 10 – p 68–69

 

 

Abstract

 

A nurse’s advocacy alters the path of a patient with locked-in syndrome.

On a winter day several years ago, critical care nurse Katie L. George began her first of four day shifts in a row. Among her tasks was taking over the care of Ms. A., a young woman who had a traumatic head injury after being involved in a car accident. Ms. A. had been sedated for several days to allow for intracranial pressure monitoring; her fiancé had stayed in the room with her the entire time.

Katie L. George

Katie L. George

At the start of George’s shift, Ms. A.’s physician decided to stop her sedation so she could undergo a neurologic exam. Within an hour, Ms. A. opened her eyes and her fiancé jumped up, grabbed her hand, and began talking to her. But the initial assessment George conducted yielded troubling findings: Ms. A. had no spontaneous movement and her heart rate didn’t elevate in response to noxious stimuli. She appeared, however, to be looking around the room and tracking George and her fiancé.

Ms. A.’s physicians repeated the assessment and arrived at the same conclusion. Magnetic resonance imaging revealed that she had sustained a severe C2 fracture in the car accident and that her spinal cord was nearly severed.

Ms. A.’s parents, who lived abroad, were en route to the hospital but wouldn’t arrive for another day. In the meantime, Ms. A.’s fiancé stayed by her side and quickly established a way to communicate with her. He would read her the title of an article from her favorite magazine, then tell her to blink once if she wanted him to read it to her or twice if she wasn’t interested.

“Throughout the day it became clear to us that she absolutely could understand what we were saying,” said George. Ms. A. was suffering from locked-in syndrome—a condition in which the patient is conscious and certain eye movements remain functional despite full body paralysis. When her parents finally made it to her bedside the following morning, they faced devastating news. The attending physician informed them that because of the severity of Ms. A.’s injuries, she was unlikely to regain movement of her extremities. She would always be dependent on a ventilator and she had a high risk of dying within a year from complications of immobility such as pneumonia.

Ms. A.’s parents were advised to take some time to think about how to move forward. The next day, they decided to have their daughter withdrawn from life support. Despite Ms. A.’s apparent cognizance, George said, “I think her family was trying to do what they thought was best. In their minds—and understandably so—they didn’t want to put her through this.”

But, according to George, Ms. A’s fiancé pushed back on his future in-laws’ decision. “This isn’t right—I think she’s in there, and this should be her call to make,” he said to George. George agreed, and scrambled for a solution: Ms. A. was due to be removed from life support that afternoon.

First, George discussed her concerns with the attending physician. He agreed with her, but emphasized that since there was no way to determine Ms. A.’s mental capacity from a legal standpoint, the decision of whether to continue life support remained with her family.

Despite the physician’s response, George was determined to find a way to help give Ms. A. a voice in deciding her own fate. So she reached out to a colleague in palliative care, who referred her to a speech pathologist. Over the phone, the pathologist confirmed that Ms. A.’s capacity could, in fact, be legally validated through the blinking of her eyes.

“At that point I went to the attending and the resident and said, ‘Here are the calls I’ve made; we can prove her capacity by doing this,’” said George. “They weren’t happy that I had persisted after they’d said no, but they were receptive.”

A plan was made for Ms. A.’s parents and fiancé to gather in her room along with her physicians, a chaplain, and George, her nurse. Once assembled, they explained her condition and prognosis to her, and reassured her that she wouldn’t be in any pain if she chose to discontinue life support. She was instructed to blink once if she wanted to continue life support and twice if she preferred not to. Everyone in the room let out a collective gasp at Ms. A.’s response: “She blinked once and opened her eyes so wide—it was very clear what she was telling us,” recalled George.

After that, the situation resolved uneventfully. Ms. A.’s parents supported her choice, and the decision to continue care was formally made. Eventually, she was transferred to a rehab facility in another state. It was the last George would see of her patient for a long time.

A few years later, George was at work when one of the attending physicians who had cared for Ms. A. called her over. The physician had come across a recent video of their former patient.

George watched the footage, in shock. Ms. A. had made enormous progress in her recovery: she was now able to move most of her extremities and no longer required a ventilator or a feeding tube. The footage showed her dressing herself, using various tools to help her perform basic tasks, and getting around in a motorized wheelchair. Her mental capacity was fine, and her fiancé was still by her side, now as her husband. “You did this,” the physician told George. “She’s alive because of you.”

Looking back on the situation, George said she never doubted that getting involved on behalf of her patient was the right thing to do, despite facing pushback from some of her colleagues. “This was something that was way too wrong not to stand up for. I was sick knowing what would take place that afternoon. It really made me feel like, ‘OK, this is what we have to do.’” Taking a stand was intimidating, she said, but her instinct reassured her. The experience exemplified what she called the gray area of nursing: being uncertain of one’s “moral role,” and wanting to tread carefully.

George says the experience of advocating for her patient and witnessing the rewarding results has kept her driven, both personally and professionally. “It’s given me the motivation to keep challenging things even when they’re tough, and in my day-to-day patient care, not to sit back if I feel something is truly wrong,” she said. “You can’t pick every battle, but you need to pick the ones that matter and stand up for what’s right.

The Compliment

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Two weeks ago I flew to Sioux Falls to visit my good friend, Lois, in her new home. She and her husband left a Chicago condo off Michigan Avenue facing the lake to settle in a small town with less excitement than a big city. That weekend we attended the South Dakota Annual Festival of Books, a free conference that would be rare in a big city like Chicago. There are pluses for small towns. And I might add, anyplace that is home to one’s grandchildren holds excitement.

Back to the weekend and the Festival of Books. The keynote attraction on Saturday was Jane Smiley on the main stage in conversation with a local radio personality. Smiley came across as a composed, self-assured woman, emitting an occasional monosyllabic answer to the delight of the audience. She was comfortable in the spotlight and seemed to harbor no insecurities. Of course, why not, since she has won a Pulitzer Prize, studied in Iceland as a Fulbright Scholar, and written many books—the most recent a trilogy covering 100 years.  screen-shot-2016-10-07-at-4-18-29-pm

Earlier that day, Lois and I had spotted a solitary tall blond with a bright red jacket, jeans, and matching red running shoes striding briskly toward the Larson Memorial Concert Hall where the festival was held. A few minutes into Smiley and the radio personality’s conversation, Lois nudged me. The lone walker had been Jane Smiley. Lois recognized the red shoes.

On Sunday we had a difficult time choosing which of the various breakout sessions to go to, except for Robert Olen Butler’s discussion of his new novel, Perfume River: A Novel. I like his writing. In fact one of his small pieces, Nostalgia, was in Self in 1994. That piece impressed me so much so I cut it out and saved it all these years, and even included it into a post: So What’s Nostalgizing, that I wrote on February 2, 2015.

Once when a writing instructor asked us to bring a copy of what we considered a good piece of writing, I brought Nostalgia. Others brought longer, more nuanced examples but Nostalgia, to me, was perfect. And it spoke right to my heart. It was like a painting or photograph or snippet of music that trips open a trap door to expose a forgotten memory—soft and misty—unclear to the brain but familiar to the heart.

img_2967Butler sat in a folding chair facing his audience and directly in front of Lois and me in the first row. He and I were eyeball to eyeball. If he moved up a foot our knees would touch. There was the man who wrote words that always caused my breath to catch in my throat whenever I read them. I needed to tell him. I got up and leaned down to speak into his left ear.

“I just want to tell you I Iove your writing,” I said. He smiled. Then I added, “There is something you wrote in the 90s, a short piece about nostalgia. I have read it over and over again for years. It is so well written. Not an unnecessary word. I have carried it around with me all this time.”

He looked pensive. “I don’t remember it.”

I gave him a synopsis as he stared at the floor. He nodded.

Maybe he didn’t remember after all. But, back in my seat, I felt content in finally telling Robert Olen Butler how much his writing has meant to me. And maybe, just maybe, some day someone will give me the same compliment.

I can only hope.

 

Addendum:

I am delighted that my story, Baby in the Closet, has been reprinted in Hospital Drive: A literature and humanities journal of the UVA School of Medicine. “This anthology is our editors’ choice of work published since the first edition of Hospital Drive in 2007.” It is the first print edition.hospitaldrive-1024x717

Unsolved Mystery?

Visiting my good friend, Lois Roelofs, in her new home in Sioux Falls. Hope you enjoy this post from the past.
Check out Lois’ blog, https://loisroelofs.com/2016/09/05/cartwheels-in-my-living-room/

Marianna Crane: nursing stories

This happened long ago. I worked for a hospital-based home care program. We, nurse practitioners, received referrals from physicians who had exhausted all options to prolong the patients’ life. We visited the patient in his home and helped the family care for him until death. Traditional hospice services were not an option as yet.

My patient was in his 60’s or 70’s and had a ditzy wife. Just like Edith Bunker on the old All in the Family T.V. show. She looked like Edith with dark hair, a whiney voice and hands that kept flying in the air as she talked. Edith and I sat in the corner of the living room with its high ceilings, dark woodwork and antiquated furnishings talking about her husband. I think he had lung cancer. I can see him wandering around in the turn-of-the-century apartment, seemingly unaware of his wife and me. While Edith…

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WHAT DOES AGE HAVE TO DO WITH IT?

I thought it was time to revisit the positive aspects of aging. I wrote this post in October, 2013.

Marianna Crane: nursing stories

I made an ageist comment. It didn’t seem ageist at the time. I was sitting in the second row of a packed room at Flyleaf Bookstore in Chapel Hill as Pat Schneider finished reading from her new book, How The Light Gets I9780199933983_p0_v2_s260x420n.

I came to hear Pat for two reasons. One, I wanted to see the woman who developed the Amherst Writers and Artist (AWA) writing method. And, second, I wanted to see a fellow writer that was still prolific going into her ninth decade and had the stamina to go on a book-tour at six sites across North Carolina in seven days.

Maybe it was the interview I had heard a few years ago, which had taken residence in my memory that influenced my comment. A local author discussed her new book on a radio talk show. When asked her age, she said she never tells…

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