I first posted “The Story Behind the Message” in 2017 before my memoir was published. Now as I work on my second book, this post remains as relevant to me as ever.
Writing for me doesn’t get easier, Molly.
Rearranging my bookcase, I came across a book with the following inscription:
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). She 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.
Last Friday I discussed my book, Stories from the Tenth-Floor Clinic: A Nurse Practitioner Remembers at the Wonderland Book Club, which was held at a local independent bookstore. The audience was quite engaged and we shared discussions not only of my book but of the status of nurses, problems within the health care industry in general and in North Carolina in particular.
Here are some of the questions/comments:
- How do you deal with the stress of caring for patients? Do you take these problems home with you?
Me: I have always taken home patient problems as evidenced by what I wrote in my journals. Journaling was a way I dealt with problems at work. The more difficult the patient issues, the more time I spent writing in my journal. A lot of the stories from the book have been documented in my journal. In fact, the last chapter, Playing Sheriff, was written before I found the journal from that time period. I was surprised to find the story closely paralleled the journal entry.
- How brave you were to write about your mother. (I’ve had this comment before. The first time, I really didn’t understand what the person was talking about)
Me: It was difficult to write about my mother. We didn’t get along. It was especially disturbing that I was a gerontological specialist and couldn’t get along with my own elderly mother. But it was truth and I felt it was part of my story. (At another reading, I was asked what happened to my mother when she had a place of her own. I told how my mother found a boyfriend. Wish I had thought to add that to my response.)
- How do you deal with writing about yourself? (Asked by someone who doesn’t write non-fiction)
Me: I look at this book as a story about someone I know. I tried to dissociate from myself so it was easier to be honest about my actions.
- Who was your most memorable patient?
Me: Helen Stoltz. She lived in the apartment next door to the clinic. When I wasn’t busy, she would drop-in and sit a few minutes beside my desk and teach me about aging. Of course, she didn’t know that what’s she was doing. She talked about getting older and eventually dying, which showed me that older folks aren’t afraid of talking about death. She was ready to die. However, she was cheerful and upbeat and accepting of her life until her time came.
- What was the most memorable line your wrote in your book?
Me: I didn’t write it but it came verbatim from my notes at the time. The funeral director told me how to go about purchasing a grave site for the Pigeon Lady: The Greeks are tight but the Catholics will give you a break. (page 96). I’m thankful that I wrote down what he said. He was such a character—embodied with Chicago smarts and a big heart.
What I didn’t say was that “I killed all my darlings.” Therefore, there are no “precious” sentences that have survived my editing, thank goodness.
Besides the Q & A, I was happy to be able to drop some facts about nursing, such as nurses have been voted the most respected of professions for the past 18 years. And that the World Health Organization designated 2020 the Year of the nurse and midwife.
I was grateful for such an enthusiastic and supportive turnout.
Reflections in the December issue of the American Journal of Nursing had an essay by Mark Darby RN, ARNP: The Way of Johnson Tower. Johnson Tower, a public housing building, sounded very much like the Senior Clinic I worked in and wrote about in my book: Stories from the Tenth-Floor Clinic: A Nurse Practitioner Remembers. Seems that the only difference between the residents of the buildings was that Mark’s building housed adults, mine was limited to residents over 60. Otherwise, both sets of folks who sought care from either of us nurse practitioners were mostly marginalized, underserviced, and poor—and gutsy.
Mark didn’t identify the location of his public housing building but I can surmise that it was in an unsafe part of town, on the first floor and, like my clinic, had been a converted one-bedroom apartment. He says the clinic has . . . “one exam room” and is “below the building laundry. If more than four people use the washing machine, water will drip into the centrifuge.”
Mark describes four of his patients, each with their own challenges but each reaching out to help others. Getting to know patients as intimately as Mark does is facilitated by caring for the patients on their own turf. Mark and I get to know first-hand what challenges our patients face and we know the strengths they gather up to face them.
I bet Mark’s clinic, like the Senior Clinic, promoted low tech/high touch. Here is a copy of the brochure from the Senior Clinic that a friend who had worked with me sent recently. He had been sorting through “memorabilia” from over 30 years ago!
A murder due to a drug deal gone bad occurred just outside Mark’s clinic. Those who planned my Senior Clinic decided to place the clinic on the tenth floor to avoid any drug seekers trashing our clinic looking for narcotics. Neither clinic would attract patients with medical insurance who had a choice of health care facilities.
I especially liked Mark’s answer when asked how he could work in such a setting. He said, “One thing I learned in NP school is that I am a nurse first and an advanced practitioner second. Nurses are supposed to look at the whole person—mind, body, and spirit—as well as the environment. I have found that the residents of Johnson Tower teach me more about being a nurse and a human being than you would imagine.” Amen I say to that.
I’m not exactly sure when my clinic closed. When I went back to Chicago in 2007 the building was no longer a public housing building but was run by the Hispanic Housing Development Corporation. It looked well cared for. I called their office soon after that visit and was told there was no longer a clinic there.
I attended the North Carolina Writers Network Fall Conference in Asheville this past weekend.
The Keynote Speaker was Charles Frazier (Cold Mountain)
Frazier spoke of how he came to be published. His wife’s good friend was an agent. How lucky can you get?
Sessions I attended:
I. Screenplay: Fake vs Fiction with Maryedith Burrell
To Do: Adapt my book to a screenplay-optional.
2. Power Up the Truth You Tell with Christine Hale
To Do: Create a compelling protagonist for my next book.
3. The Limits of Perception with Tessa Fontaine
To Do: Try this prompt at home– and others.
4. The Ins & Outs of Small Press Publishing with Luke Hankins
To Do: Appreciate the fact I worked with She Writes Press.
5. Creative Ways to Promote Your Book (& Yourself) with Anne Fitten Glenn
To Do: Pat myself on the back for doing lots that Anne suggested. Plus look into Audio Books and begin to use Instagram.
* * *
Brothers Like These is a program at the local VA hospital to help veterans from the Vietnam War who suffer with PTSD heal through writing. Moving. Good thing I had tissues in my tote.
I sold 4 out of the 5 books we authors were allowed to place on the conference sales table. Last year I sold only one book. Did the award stickers make a difference or the discussions of my book with other attendees?
To Do: Read. Enjoy. Write a comment on Amazon.
Saturday, June 1, 2019
I am scheduling this post to publish on Wednesday, June 5, 2019. That day, I will be in Chicago talking about my book to the Advanced Practice Nurses at Rush University. I have three other venues scheduled before I head home on Monday. In between events, I will spend time with old friends. I’m having lunch with one woman that I haven’t seen in over 20 years!
On Sunday, I will be reading at the Oak Park Library, Oak Park, Illinois. My daughter and 15-year-old grandson will have flown from Raleigh to join me. Afterwards, my daughter will show her son where she grew up. Maybe we’ll visit the Frank Lloyd Wright Home and Studio where, to get a change from nursing, I volunteered in the gift shop. I learned so much about Frank in particular and architecture in general. I always wondered if my involvement with the FLW Foundation had any influence on my daughter’s choice of a career—architecture.
So, think of me in the Windy City as you read this.
I flew into cold, snowy Chicago last week to discuss my book at the main facility of Erie Family Health Centers. This felt like a dream as I stood behind the lectern gazing at the audience that, believe it or not, included a few familiar faces from some thirty years ago. I had been invited to read from my book: Stories from the Tenth-Floor Clinic: A Nurse Practitioner Remembers.I was discussing EFHC’s humble beginnings to this group of employees seated in the conference room on the third floor of an impressively designed modern building.
The main clinic that I remember was housed in a community center. Children’s laughter in the after-school program and the sound of the ball dribbling on an indoor basketball court easily penetrated the partitioned walls of the exam rooms. The dedicated staff experienced delayed pay days when revenue came up short. The clinic where I worked, a short walk from the main center, had mismatched chairs in the waiting area, second hand medical equipment, and roaches in the cabinets. In spite of the physical shortcomings, EFHC cared about the patients, the community, and its staff.
EFHC not only survived its humble roots but thrived and expanded. The non-profit organization now has 14 health centers, and more Advanced Practice Nurses (nurse practitioners and midwives) than doctors and is recognized as providing the highest quality of care by the US Department of Health and Human Services. The Chicago Tribune named EFHC as one of the top workplaces in 2018.
I am honored to be part of EFHC’s history.
I look back on 2018 with wonder and gratitude. My book is finally published. I feel such a sense of accomplishment. I don’t credit this achievement to talent, genius or education as you can see from my most favorite quote below:
Nothing in this world can take the place of persistence. Talent will not: nothing is more common than unsuccessful men with talent. Genius will not; unrewarded genius is almost a proverb. Education will not; the world is full of educated derelicts. Persistence and determination alone are omnipotent.
Up until the of the end of November, I worked with Caitlin Hamilton, my publicist, who promoted my book through book signings, guest posts on writers’ blogs, testimonials, interviews by correspondents of newspapers, etc. Now the job of gaining visibility for my book is up to me.
In 2019, as I learn more about marketing a book than I care to know, I will also begin writing my next book about my nursing experiences.
I wish you a happy, healthy and peaceful New Year and the persistence and determination to reach your goals.
I have three readings scheduled at local books stores in the next few weeks. I will send out an e-vite tomorrow. It’s both a stressful and exciting time. I have to remind myself to “have fun.”
The latest review of my book: Chicago Writers Association, Windy City Reviews:
Stories From The Tenth Floor Clinic. Marianna Crane. Berkeley, CA: She Writes Press, November 6, 2018, Trade Paperback and E-book, 212 pages.
Reviewed by Deb Lecos.
Marianna Crane has written an important memoir detailing the complex needs of an aging population and how a humane society should shift its thinking about what is “conscious-care” when people reach a certain level of fragility. The reader journeys along with Marianna while her beliefs change as a nurse practitioner, running a senior clinic within a Chicago-based, subsidized-housing building.
As a nurse practitioner specializing in gerontology at the Veteran’s Administration, Marianna is governed by strict parameters. When a job change takes her to a senior clinic within a CHA building, she faces an environment quite different from where she trained, and is forced to adapt so she can help those under her care. Many of her patients are alone, disconnected from family, and easy prey for those intent on stealing their meager incomes. Continuing to live independently can be difficult when a patient’s health moves swiftly downhill and there are no friends or relatives to assist in decision-making. Residents of the building have come to rely on the clinic and its support staff to ensure they have social interaction, food in the refrigerator, and a fan when the heat becomes dangerously high.
After work, Marianna’s home life is fraught with similar issues, as a complicated relationship with her mother has reached an unsustainable level of dysfunction. Her mother has become increasingly combative, and her disinclination to engage therapeutically requires Marianna to devise a solution that is respectful to her husband and two teenage children, while ensuring her mother has a safe place to land. Utilizing the new approach that she’s been reluctantly taking with her patients affords Marianna necessary skills to handle this emotionally-challenging situation.
With chapters unfolding in story form, the reader glimpses the lives of vulnerable people. We learn what happens when the frail are shuttled into the corners of society without enough support. Filling that gap in care are Mattie and Mary, who work under the direction of Ms. Crane and are devoted to building humane over-sight relationships with the residents. Mattie and Mary compel Marianna to redefine her role in the clinic community by introducing her to Angelika, a woman choosing to die in her apartment instead of going to a hospital. Angelika has refused a diagnosis of the ailment ending her life. After losing the battle of Angelika’s resistance to leave her home, Marianna allows herself to adjust to the
needs of those she is intent on helping. She comes to understand that sometimes care means respecting the wishes of a dying woman and not requiring her to take a final breath in the hospital, even if doing so breaks a dozen rules in the process.
The stories Ms. Crane starkly and, at times, graphically illustrates occurred in the 1980’s. Similar events are continuing to unfold today in subsidized housing and homes all across the country. Difficulties the aging and poor experience in navigating ill-health and death within a system built for the well-off and healthy have worsened in the time since the author encountered these experiences. The VA, health clinics, and senior care programs are still underfunded and mismanaged, exacerbating the condition of buildings and staffing needs.
There are no concrete solutions to the problems we face in determining how to care for a growing low-income, aging population. It is my fervent wish as a reader of this memoir that we do so with an ability to change our thinking, much as Marianna Crane convinced herself to do. Convenient, easily-enacted answers to the complex struggles of the elderly, many of whom are not connected to functional families, will not be successful. As Marianna came to her own epiphanies on how to be of assistance, so must our national community. This is a relational issue and it deserves a relationally-creative response, one that is centered on humane and caring treatment for all ill, infirmed, and end-stage-aged people.