I received my memoir manuscript from my editor this past week. Thankfully, she hadn’t any issues with structure. (I’m not counting the many grammatical errors she found that I thought I had addressed but still missed).

Since the last version of my book, I have changed the title, dropped five chapters, deepened some others, and added more about gerontological nursing.

Here is chapter 10 that I dumped. It repeats a lot of what is in the first chapter of the book.

I am writing about a time in the early 80s when I worked as a nurse practitioner in charge of a recently opened geriatric clinic housed in a one-bedroom apartment on the 10th floor of a senior high-rise on the Westside of Chicago. I am new to the role and stumble with the unexpected. Mrs. R is an 80-year-old volunteer that serves as the clinic receptionist. Luther is the building custodian.




I heard heavy footfalls shuffle into the waiting room and Mrs. R’s shrill voice ask, “Why, whatever is wrong, Luther?”

I ran out of the exam room just in time to watch Luther, grimacing in pain, flop down in the chair next to Mrs. R’s desk. Sweat beaded on his nutmeg complexion. His overalls were dotted with blood. He gripped a towel that was wrapped around his upper arm.

“I was fixing a window. The glass cracked.” Luther’s words came in breathy bits. “Cut me.”

He was one of the custodians in the building, a short, sinewy man with a generous smile and warm personality.

I moved on heavy legs toward Luther as if wading across a pool: slow and deliberate. Standing in front of him, I could smell his sweat mixed with the musty, sweet odor of blood. I hated the stench of blood. Trying to suppress my gag reflex, I grabbed his wrist and held his arm up over his head hoping that gravity would slow the bleeding.

“Where did you get cut?” I asked.

Luther pointed to the underside of his arm still covered with the towel. With my free hand I applied pressure. Soon I felt the wet, stickiness of his blood steep into my palm. Acquired Immune Deficiency Syndrome hadn’t yet walked into my medical world, but the thought of what might be under the towel made me want to vomit.

No one else was in the office but Mrs. R and me. I didn’t want to tell her to dial 911 until I knew what I was dealing with. Still nauseated, I forced myself to concentrate on Luther’s injury.

“Do you think there are any pieces of glass in your arm?”

“The window didn’t shatter.” Luther’s voice was tense.

He was still sweating and breathing rapidly. His eyes darted around the room as if looking for a quick way out.

Maybe my own nervousness showed.

“Luther, concentrate on breathing more slowly. In. Out. In. Out.” I breathed along with him. “Good. That’s it.”

After a few minutes Luther stopped sweating and my nausea dissipated, but my arm trembled with fatigue holding Luther’s arm upward. The blood from the towel began to congeal. The bleeding probably stopped but I still needed to see the wound. Not something I was anxious to do.

“Okay, let’s put your arm down.”

Luther rested his arm in his lap. I put Luther’s other hand where mine had been.

“Press,” I instructed, “while I get some supplies to clean you up.”

I kept half an eye on Luther while I scrubbed his blood from my hands in the sink across from the waiting room. While his breathing had returned to normal, his eyes still darted about the room as if watching for some unexpected calamity.

I laid the supplies—a bottle each of iodine solution and sterile water, tape and several sterile gauze pads to replace the towel—on the edge of the Mrs. R’s desk and went back to snatch a tourniquet, quickly slipping it into my lab coat pocket, praying I didn’t need to use it.

Snapping on a pair of disposable gloves, I braced myself for the worst.

“Let me see what this cut looks like.”

With shaking hands, I slowly peeled the towel from his skin with my right hand. My other hand clutched two thick gauze pads that I would slap on the wound if it were still bleeding. Trickles of sweat from my brow dripped down my face and over my eyes blurring my vision. My imagination slowed me down. What was under the towel? Muscle and bone? Shards of glass? A gaping wound spewing blood? If that happened, I would need to apply the tourniquet and tell Mrs. R to call 911. I decided against alerting her ahead of time. Luther might pass out from the expectation.

Caked blood covered the wound. No fresh bleeding was evident. The muscles in the back of my neck softened.

“I cut an artery, right Miz Crane?” His eyes large with worry.

I tossed the bloody towel into the wastebasket by the desk and wiped my eyes with the back of my hand before I answered.

“I need to wash your arm so I can see better, but I don’t think you cut an artery.”

Luther exhaled slowly and his shoulders relaxed.

The laceration was about three inches long with even edges and deep enough to need stitches. I told Luther my assessment.

Mrs. R had fixed her gaze on Luther from the moment he arrived. I raised my voice to get her attention.

“Mrs. R, call Sam Levy and tell him to come up here right away. Thanks.”

Her body jerked as she snapped out of her trance.

“Why Sam?” Luther asked.

“Sam’s your boss. Your injury’s workman’s comp. He can drive you or pay for a cab to get you to the ER for stitches. And probably get a tetanus shot. Do you remember when you had one last?”


While Luther and I waited for Sam, I reached over and poured some of the iodine solution onto the gauze squares and slapped it on the wound.

“Ow! Ow!” yelled Luther.

Blinking back tears, he searched the floor as if he were embarrassed to have yelled so loud. How dumb of me, I shouldn’t have used full strength iodine on the wound.

All I could say was “Sorry, Luther.”

After Luther and Sam left, I thought how easy it was for anyone to walk into the clinic and expect immediate service. Rather than acknowledge my own inadequacies, I blamed Karen Cranston who hired me. She should’ve told me I would be running an emergency room. I didn’t have the supplies or equipment to handle unexpected events. I didn’t acknowledge that even she couldn’t have predicted how the clinic would operate.

I was flying blind.

While Mrs. R looked on, I dragged the mop and bucket from the closet and washed the blood from the floor.



By Marianna Crane

After a long career in nursing--I was one of the first certified gerontological nurse practitioners--I am now a writer. My writings center around patients I have had over the years that continue to haunt my memory unless I record their stories. In addition, I write about growing older, confronting ageism, creativity and food. My memoir, "Stories from the Tenth Floor Clinic: A Nurse Practitioner Remembers" is available where ever books are sold.


  1. “Luther”. An honest reflection of reaching for your skills in an emergency situation, when the job description didn’t meet the demands. Liked the comments about the human side of nurses dealing with our own “triggers”, like nausea with the smell of blood. Mine is lung secretions. Yuck.
    Looking forward to reading your book-


  2. Oh, if mops and floors could talk–what nursing-related stories they could tell. Gripping! And informative about how nurses learn and become aware of the larger circumstances guiding their practice.


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