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.

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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 bear 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.

Spotlight: Marianna Crane

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This appeared in the September 2017 Erie Family Health Center Donor Newsletter

 

Anniversary Spotlight: Marianna Crane

 

Over thirty years ago Dr. Sally Lundeen, a nurse and Erie Family Health Center’s first Executive Director, spearheaded a project that would provide care for the underserved elderly right where they lived. The Senior Clinic* opened on the 10th floor of an apartment building on 838 N. Noble, then managed by the Chicago Housing Authority specifically for low-income elderly residents. Marianna Crane was one of the first nurses to join Dr. Lundeen in this endeavor. She had recently left the VA Hospital, disappointed that, due to a lack of funding, she wasn’t able to provide the specialty care she knew that the elderly there needed.

Crane was at the forefront of a shift in health care, one of the first gerontological nurse practitioners at a time when geriatrics was barely beginning to be considered a specialty. The idea that older people required a different approach to care wasn’t yet mainstream, and many doctors weren’t interested. But Crane had grown up with older family members whom she cherished – her own grandmother lived to be 104 years old – and she believed that a change in approach to elder care was long overdue. “During school, I had two classes in geriatrics,” recalled Crane. “Chronic Disease I and Chronic Disease II. It was the older people on the job that taught me what was really important about nursing.”

At Erie, Crane, along with her collaborating physician, Dr. Olga Haring, cared for patients in the clinic while staff members visited isolated lonely seniors, monitored people’s medication, and even arranged breakfasts and luncheons for those who couldn’t afford food. Crane quickly realized that meeting the physical needs of the elderly was only one aspect of care. She witnessed older people being emotionally or physically abused by their family members, and older people with depression or other mental health issues who needed someone to talk to. When she would make home visits, she was often unsure what she would find on the other side of the apartment door. She waded her way through hoarders’ stuffed living spaces, nursed sick alcoholics, and worked closely with an ambulance service to ensure critically ill patients were delivered to the right hospital. But she felt that this was the care she needed to provide. “It was such a unique model of nursing, and the job was so different from anything I had done before,” she said. “Our community nurse would give exercise classes including swimming lessons at Eckhart Park. We brought in a podiatrist, negotiated reduced fees with a local ophthalmologist. We’d host free breakfasts every single Friday. It was just so unique.”

Crane was with Erie for five years before moving on to provide home care at the VA Hospital in Durham, North Carolina. She is now retired and is an active volunteer at a local hospital, where she serves as co-chair of the Patient Advisory Council, recommending ways to keep patient care running smoothly and efficiently.

Crane is also a writer (check out her nursing blog at nursingstories.org) and is working on her first book, a memoir about her experience at Erie Senior Clinic. The book will be published by She Writes Press at the end of August 2018, and Crane has generously pledged that a portion of the proceeds from the book go towards patient operations at Erie Family Health Center.

 

*While the Erie Senior Clinic has closed its doors, Erie remains committed to serving elderly patients and connecting them with the resources and referrals they need for a healthy, comfortable life.

 

 

 

Nurses Save Lives

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What a pleasant surprise to read that nurses save lives (italics mine) in a news article yesterday, September 21. Unfortunately, the story was not a happy one. The Raleigh, NC News & Observer detailed the memorial service for the crew of a Duke Life Flight Air Ambulance that crashed on September 8 killing all aboard: pilot, patient and two flight nurses.

“Like all medical personnel at Duke, Life Flight’s Crew ‘have a strong desire to save lives (italics mine),’” said Irene Borghese, program director. She goes on to say “what sets this group apart is their desire to do so (save lives) while putting themselves in harm’s way and without the safety net of an entire health care team . . . They simply depend on each other.”

What she is saying is that the nurses can rely on their own knowledge and expertise when they deal with difficult patient problems on a flight mission and not have to follow doctor’s orders, although there probably are protocols when needed.

The nurses who died, Crystal Sollinger and Kris Harrison, had worked together on a flight “that wound up saving the life (italics mine) of an infant . . .that baby is now 3 years old, and her family brought her to” the service.

We all know that in most instance nurses are not recognized for the intelligent, caring and competent health care providers that they are.

In a post I wrote in February 2013, Businessweek reporters gave doctors credit for caring for Hillary Clinton while she was admitted to the hospital when she had a blood clot. Nurses were never mentioned. I can’t imagine a doctor was around to do vital signs on the night shift.

Thank you to Ray Gronberg and Tammy Grubb, the authors of N & O piece, for giving credit to Crystal and Kris for doing what they really do: save lives.

 

 

 

 

 

 

 

 

Laughter: the measure of a friendship

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I believe the better the friendship the more raucous the laugher—the real belly laughs that make you think you are going to die of asphyxiation. I have a number of friends that are enjoyable to be with but I have just two or three that make me really laugh.

Donna and I worked in home care at a Chicago area VA in the late ’80s. Our caseload mostly included veterans who were elderly with chronic disease or dying of cancer. Both NP’s, we worked four-ten hour days a week, each covering for the other on the day we had off. Jane, a third NP who worked with us, had young children and requested to work a regular schedule.

Many times after work, Donna and I lingered in the large 4-bed room on a deserted patient unit that served as an office for us three NPs. Each of our desks was centered against a wall. No other furniture filled cavernous room. Donna and I would take turns rolling our chairs next to the other’s desk. We discussed our patients before we wandered off into the personal and humorous. Our laughter ricocheted off the walls. If we became raucous, we didn’t care since there was no one nearby to complain.

After my husband and I had moved to the DC area, Donna came to visit. At one of my favorite art museums—The Phillips Gallery, Donna and I burst into unrestrained laughter. I can’t remember the trigger. What could be so funny in an art gallery? The other patrons gave us wide berth while we two middle-aged women tried to control ourselves. The more we worked to settle down, the harder we laughed. That was the last time Donna and I were together.

In 2000, Donna moved to southern Illinois and I to North Carolina. We emailed and occasionally spoke on the phone. In 2013, Donna was diagnosed with lymphoma.

During one of her remissions she reviewed my manuscript checking for any inaccuracies in my descriptions of NP practice in the 80’s. I sent her a thank you bouquet of flowers.

Now as I ready my book for publication, I am composing the Acknowledgements. The realization that Donna won’t see a formal appreciation saddens me. She died on July 9th.

I will miss her laughter.