WriteRN Ramblings

I was a first year nursing student.

It was my initial week of clinicals – the first week of hands on, with patients, putting into practice what we had spent a semester learning time, in an actual hospital.

Like most things, the lessons to be learned that day could not be found in a book.

The hospital was old. The urinals, bedpans, and emesis basins were all metal, and had to be rinsed out before going down to soiled utility.

Our instructor gave us our assignments. We eagerly walked toward our patient rooms, ready to be the nurse, fresh white scrubs clean and pure against the dingy hospital walls.

As soon as I walked in my patients room, I immediately knew she was dying.

There is an intrinsic “knowing” that can’t be explained. We had not studied death and dying yet, and I had never been around anyone who was dying.

Yet I knew as I walked into that semi-darkened room, I knew that my assignment for the day had nothing to do with assessing vital signs, and everything to do with assisting a soul.

I greeted her warmly by name, telling her my name, and that I was going to take care of her today.

She looked at me with huge, pleading eyes. She could not speak – she already was past that point.

My mind scrambled, trying to process in my head the thoughts that were behind my kind smile and murmuring words.

In report, I had learned that her husband had just left to go get a haircut. I remember being told he had stood by her side since her recent admission, and was finally taking a break.

I knew she was going to take this time to spare him having to see her transfer her citizenship from earth.

I looked over at the closed curtains, and briskly strode to them, snatching them open, leaving the sheers to filter in the bright morning sun.

Turning back to my patient, I did my head to toe assessment efficiently, noting she was quickly becoming soaked with the intense sweating called diaphoresis that comes before the final breath is drawn.

I clasped her hand, and she looked at me with an intensity that shot to my core. “Ma’am” I said gently, “let me go get you some clean bedding. Let’s get you dry and comfortable! I’ll be right back!”

I swiftly dashed out the door, around to cleaned utility room, and grabbed fresh sheets, towels, and a gown.

I wasn’t going to let her die in a puddle of her own sweat.

I returned to the room, and set the bedding down. “Let me get you dry and comfy” I said, as I placed a draw sheet over her, and began to unbutton her gown.

Slowly, but with absolute purpose, she brought her right arm up, laying her bruised and pale hand over the place where her right breast used to be. I stared into her eyes and nodded. “Don’t worry” I reassured – “I’ll keep you covered.”

I methodically went about changing her soaked gown under the draw sheet, ministering to her dampened body with warm, dry linens. I had a fellow student help me change the bedding, gently rolling her to and fro as we went through the basic bed making lessons we had learned. My helper left the room, and I turned my attention back to those pleading eyes.

I held her hand in mine. “Look what a beautiful day it is!” I smiled gently into her now terror filled expression. “It’s going to be okay – look at that sun shining in here!” I leaned in closer, whispering now in her ear. “It’s okay – if you want to go, you can, you know!”

It was like a switch turned. Her hand fell limp, and I tucked it under the crisp sheet. Her head moved just enough for her eyes to look toward the window, and immediately I saw the beginning of the change in her, one that would lead to the final outcome.

My heart raced, and I had a moment of panic. I cracked the door and called for a couple fellow nursing students, intensely whispering to them that I needed to step out for a second and get a drink of water, and they silently came in, standing on either side of her, murmuring words of comfort as they clasped her hands.

I made a bee line for the water fountain, gulping in water, and taking a couple of deep breaths. Had I done enough for her? Was I prepared for this?

My instructor appeared suddenly. “Get back to your patient” she snapped militantly.

“I didn’t leave her alone. I just needed a moment”. As I looked into her face, I knew she had given me this assignment today, knowing full well the probably outcome.

Resolute, I stood tall and walked past her, back into my patient’s room.

Now my patient was transformed, her breathing haggard and irregular, in the Cheyne-Stokes pattern that comes shortly before the final breath. My eyes darted back to the door frequently, looking for the return of her husband, lest he come in without knowing what what happening. I held her hand in mine, silently praying.

Then she was still.

I put the stethoscope that was stiffly hanging around my neck into my ears, and confirmed what I knew. I stepped out and asked the charge nurse to get the doctor.

He came and listed to her chest as he felt her wrist, and pronounced her deceased.

My fellow students and I straightened her hair, placed her arms gently at her sides, smoothed the blanket, and exited the room.

I positioned myself outside the room, perched on the edge of a chair, and waited for her husband.

Within minutes he came striding up the hall, eyes on her door.

I stood up and walked to him before he could get to the door – “Sir, the doctor needs to speak to you!”

And we stood in silence while the charge nurse got the doctor.

I don’t remember what happened next, because my caregiving for this situation had come to an end, as we were leaving our clinical assignment for the day.

As we walked out of the hospital to go to our cars, arms laden with notebooks and flash cards, I reflected on the day.

Her last purposeful movement was to bring her right hand up and lay it over the place where her right breast used to be.

This one, slow movement taught me more about breast cancer and it’s effect on the psyche of a woman’s heart, mind, and soul than any textbook ever would.

Or could.

I’m on a roller coaster and I want to get off.

My Diabetes has not been fun today.

I’ve had two hypos. (Diabetes slang for hypoglycemic incidences. )

Between hormones and the stress of knowing that I have cancer now, my blood sugars are all over the place today.

Strangely, I have not had enough carbohydrates and calories today. I’ve had three meals and three snacks! But somehow it’s not been enough.

The fun thing about Diabetes, sarcasm, is that you can do it all right and still have it come out all wrong.

Just knowing that the stress and hormones are messing with my diabetes, makes me wonder what’s coming up next going to do to my faulty pancreas. And me.

There is so much to think about.

I don’t want to think about it.

I have to deal with this urgent low sugar.

I don’t have a choice.

I’m not enjoying this.

Breast cancer.

These are the words I did NOT want to hear today.

I had a good day at work, and was only overcome by nerves at the thought of my upcoming appointment one time. These intrusive thoughts were quickly squashed by the hugs and support of my fellow nurses, and I left for my appointment at 1430, my mind a blank slate.

My appointment was at 1500, but I was taken back at 1530. I was placed in a small room with a door, and immediately I was apprehensive.

I know what they do with these small rooms.

I focused on my surroundings, specifically the two disturbing abstract paintings hanging above our heads. Square and white, with some faded blue green in the background, they were overlaid with cuts and smears of red.

They did not spark joy.

In short order, the beautiful young radiologist who had done my needle biopsy came in. She was as kind and as friendly as she was to me 48 hours ago, introducing herself to my husband, who was beside me with his arm around me.

Then she got down to business.

“I’m sorry…you have cancer”.

I made a concentrated effort to hear the rest.

She was so glad I got regular mammograms. This was a very tiny spot. More positive calming words.

Another woman had a folder, full of information for me to read.

In one pocket , the copy of my diagnostic imaging.

In the other, loads of information about my status as a breast cancer patient, and the potential paths ahead of me.

I had my information. Now I wanted to leave.

I walked quickly out, and my husband grabbed my hand in an attempt to stop and embrace me. I said no let’s go – I was shaking and feared I would completely fall apart.

I got outside into the bright sunny day and pulled my cell phone out. Between tears and shakes and nerves, I had a hard time dialing the number of the surgeon I wanted to do my next surgery on my breast.

Her office was kind and sympathetic, hearing the tears in my voice, and the fear that hovered over and around my words. They scheduled me for an appointment, even before any data had been transmitted, and I was strangely comforted. I was doing SOMETHING about this damn diagnosis.

We walked to our separate cars, and I doubted my ability to drive. After a few minutes of sitting in his car, I got into mine, and began following him home.

I don’t remember the drive.

I made the calls to my mom. My children. My best friends.

I was reassured. I reassured. I cried.

I cried some more.

Then I came home and decorated the Christmas tree with my husband and son.

Last week I had a series of medical tests.

Tomorrow, hopefully, I’ll get a definitive answer.

In the mean time, I’ve been in the in between.

In between hope and fear.

In between past and future.

It’s uncomfortable.

As I drove to work today, my biopsy site throbbing with pain, I counted my blessings.

I also fought off doubts.

I realized that we are all in the in between.

We start when we are born, and when we die, we go to our permanent rest.

As a born again believer, I know I’m going on to eternal life in heaven. No more pain, tears, or illness.

In this great in between that is life, this is just a footnote.

When I expand my microscope to a telescope, I take my eyes off a biopsy, and look to the heavens instead.

It’s where my help comes from – my help comes from the Lord, maker of heaven and earth.

Until tomorrow, I remain in the dark.

It’s been a rough week.

I’m still waiting for a needle biopsy after a suspicious mammogram.

Work has been…well, let’s just say dynamic.

My asthma is flaring.

It’s been torrentially raining all day, and it’s a weekend day.

Etc.

For the past few weeks, I’ve been doing a Bible study about joy.

Before my mammogram, the study was a challenge that I have read with interest and insight.

Now I’m trying not to read too much into it.

The author was a recent breast cancer survivor as she was writing the book.

I was putting up my Christmas mantle ornaments tonight, and the “joy” decoration fell down and broke in two.

Yes, my joy is broken.

I’m struggling.

It’s amazing how quickly everything could change.

I’m still praying that it won’t. That it’s nothing.

In the mean time, I’ll keep decorating my house for Christmas and listening to classic songs of the season.

As to joy…well, we shall see.

I’m here again.

In the waiting room at the breast center, called back for a suspicious finding.

It’s been three years since my last call back – but it isn’t any easier.

Tinned 70’s music is playing out of the ceiling. The clay colored decor is broken up only by magenta half gowns on a table, and a five foot tall Christmas tree, decorated in sparkly pink and gold ornaments, and topped with a bow to match.

I’ve had my screening mammogram, and I’m back to repeat.

I know the next words coming will bring exceeding relief, or fear. Maybe even terror.

Working as an RN, I know so many stories. I’ve seen them, from the best case scenarios to the worst.

I just want to have an “everything is okay, thanks for coming back”.

I wait. Play sudoku. My phone is on “do not disturb”.

I’m disturbed.

I’m escorted back for a more intense mammogram. I hope this will be the test that reveals I’m fine.

It’s not.

The tech comes out and tells me in a hushed voice that the radiologist “wants to see an ultrasound”.

My heart is racing.

I update my people.

I’m called back for the ultrasound.

I’m trying not to read too much into the sonographer’s mannerisms. She’s nice – but not too nice. Kind, but is it in a pitying way?

I lay on the sheet draped table, my feet and ankles awkwardly hanging over the end. I bend my knees and draw them in.

I close my eyes and sing a hymn in my mind. I don’t dare look, because I know too much…and I don’t know enough.

I’m asked to put my arm over my head, and I’m a ballerina again, reminded of my childhood, and 14 years of ballet lessons. I imagine myself at the barre instead of here.

Anywhere but here.

She spends a lot more time taking pictures.

She’s scanning my sentinel node area.

Lord, let this please just be her bring thorough.

All the types of the C word I know are running through my mind.

Please, God, no.

She tells me to sit and cover myself back up.

This is the ultimate in agonizing waiting.

She’s at the computer, typing in data. I know my images are probably on the screen, and I refuse to look. I’m thinking of my favorite surgeon, and hoping I don’t have to call her soon.

The tech answers a call from the radiologist, who’s high, disembodied voice goes on and on, directing her.

I keep my eyes closed.

I tell her that it’s moments like this that I wish I wasn’t a nurse. We make small talk about my job, and then she lets it slip that “it’s 3mm so it’s hard to find just the right spot to image”.

Now I know.

Now I want it absolutely identified – so it can be eradicated

Another ultrasound. More pictures. I imagine myself floating.

Then the next call confirms what I already know – I’ve “bought myself a biopsy”.

We schedule it. She explains the outpatient needle biopsy procedure.

My husband is on his feet before I hit the waiting room. We embrace for a long time, then walk out, hand in hand

And now we wait.

My Mama is a very good cook.

She has no classical training.

She was born in the South, raised in the South, and cooks Southern.

She’s cooked everything from scratch my whole life…with the exception of when my dad was on temporary duty in the military. Then it was pizza, hotdogs, and rarely, fast food!

Her crowning glory is Thanksgiving dinner! Her side dishes steal the show. Cornbread dressing made from scratch from dried bread and fresh corn bread,, white gravy with egg, fresh cranberry relish,snapped green beans cooked with fat back, and pumpkin pie. Alternately, we’d also have pecan pie, too.

For many years, she made very good sweet potatoes.

As soon as I could reach the stove, my mother started teaching me how to cook. Inevitably, I learned how to make the Southern treasured recipes that she passed down to me.

I’ve held fast and true to the methods and recipes that are ingrained in my soul, but not written down anywhere else.

A couple of decades ago, I decided to change the way I made the sweet potatoes.

Instead of cooking the sweet potatoes in a sauce, I started drizzling a sauce over the top of the sweet potatoes.

The sauce itself has changed and morphed into something really quite spectacular. So much so, my mother has stopped making sweet potatoes and I have taken over.

Every year I think I could do it a little bit better. This year, I browned the butter first.

I finally may have reached the pinnacle.

We shall see tomorrow!

I came home from a busy day working as an RN, and was turning on the oven to preheat even as I was putting away my nursing bag and taking off my shoes.

I grabbed the first thing a saw – a bunch of quickly deteriorating bananas. I methodically made 2 loaves of banana bread.

My husbands said we’ve got to eat dinner, why are you doing this now?

At the moment, I honestly didn’t have an answer that made sense. I said the bananas were overripe.

They’d be that way for hours. Another day, even.

I needed to comfort myself, though. Even though I knew I wasn’t going to eat but a small test slice, I was preparing this gift of sweet breads for my family and coworkers.

As I took a breath when the loaves went into the oven, I began to tell my husband about the call I had been on right before I got home.

Barb had a heart attack that morning.

In a panic, I had called her son – one of my oldest best friends – as soon as I got the word.

When I as 14, I met Barb – and she was an extra mother in my life for decades now.

Hysterically funny, she and I laughed and laughed over the years with her son.

As I grew into adulthood, she became even more important to me – she became a mentor, someone who gave me advice, and eventually someone to commiserate with about being a grandmother. She has quite literally walked with me from being a teenager to being a grandmother.

My frantic rush to bake yesterday was a coping mechanism.

I needed to make something and share it.

I didn’t realize how badly I was affected by the news until the loaves hit the oven.

As soon as they did, I was sobbing like a baby.

It never crossed my mind that I could lose her. We live on separate coasts and don’t talk as frequently, but I love her fiercely. She’s knit into the fabric of my life like very few people are.

As I smeared the tears over my face and sobbed out the story to my husband, it hit me that I was stress baking.

Banning the ability to go to her, I was baking for others.

As I write this, the report so far has been good.

In the mean time, I added a browned sugar glaze to the top of the loaves at 10pm last night.

I’m still unsettled.

I was on the beach, on one of the most beautiful islands in the Caribbean.

We were there to relax under an umbrella, rising to snorkel, swimming lazily, gliding over rocks, coral, and the occasional sea turtle.

The tide proved to be strong this day. Despite wearing flippers on my feet, my arms and legs could not keep up with the force of the ocean.

Exhausted, I fought my way back to the shore, and flopped back down on my chair.

Not for long. It was hot, and I was restless.

Rising, I walked along the shoreline. Many people were looking for shells, but I spotted a cool green shadow among the pebbles that rolled with the tide.

Sea glass.

I picked it up, amazed to have found it for the first time in the wild.

As I ran my fingers over and over the surface, I was amazed at how smooth it was.

It had started whole.

Formerly trash, it had been smashed into countless small pieces, tumbled and formed by the sea, sand, and rocks.

It had been battered.

It had been cast aside.

Now, in the palm of my hand, it felt warm, soft, and comforting.

The clear, colored shards were now opaque and smooth, hiding the story that got them there.

There were many more outcasts littering the beach that day, and I took a few to remind me of this tropical beach.

The rough tide.

Most of all, to remind me of what happens when we let go and let what happens…happen.

Beauty from glasses.

I’m working on a new book – it’s called “Hand to Dog”, is a humorous, non-fiction account of our relationship to our dogs over the years.

I’ll have sneak preview once I’ve gotten further in – I’m just putting my title out there!