Writing as patient care

I remember a rough day, one of my last days in the hospital. I had a patient immobilized from the waist down and fresh out of surgery who could. Not. Stop. Peeing. In her amnesiac withdrawal from anesthesia, she was rapidly cycling through refusing to use a bedpan and demanding a bedpan. It was madness. An hour of back-wrenching linen changes and getting yelled at.

I can not tell you now how much I miss even those days. As a complete digression, I am made crazy by the challenges faced by nurses (and all clinicians) on the hospital floor, how it is everything but the patients that drives us mad. How many of us are forced to choose between the career we worked to hard for, our calling, and our own health and family. The American Journal of Nursing addresses the concern.

But hospital or no, I observe and I care and I’ll never not be a nurse.

Today I spent a minute in the Sylvia Plath exhibit at the National Portrait Gallery. Visiting with my son for a family event I just happened to pass the small room of framed letters and photos. I dragged him in, promised a treat if he’d chill for just 5 minutes, and let him tap sounds out of the installation of bell jars while I read.

In her letter, pinned just below a smiling photograph of Plath taken 6 months prior with her two very young children, I saw the lines that made it clear why a week from that day she would be dead by suicide.

She was getting over a terrible flu. After much distress, she had left her husband with babies in tow. Fled the comfort of their country home to a flat in London. It was the first week of godforsaken February. The longest, darkest, depressionest month.

February 4, 1963
“Everything has blown and bubbled and warped and split—accentuated by the light and heat suddenly going off for hours at unannounced intervals, frozen pipes, people getting drinking water in buckets and such stuff–that I am in a limbo between the old world and the very uncertain and rather grim new.”

So here is where writing can be patient care. Always be assessing, always be educating. You can do it with a dead mid-century poet if it makes a piece of writing.

Plath is in a volatile state, the responsibilities of motherhood on her shoulders, just separated from the comfort and support of friends and familiar places. The pipe freezing signals her loss of control. Her limbo between old and uncertain and grim? An expression of hopelessness.

It’s no revelation that Sylvia Plath was depressed a few days before her suicide. But by seeing her as not an hysterical artist inclined to shuffle off this mortal coil at a moment’s notice, and instead as a person, mother, a sufferer of a common condition, she is a

I recognize her words as if they were my own read back to me. Because they were my own, not long ago. The remark “I long to have somebody really play with and love the babies…They are so beautiful and dear and will in effect have no father.” This kind of loneliness, where you seek for someone to share love for your precious child, is crushing. And in the worst of depression: losing the ability to play with you babies, lacking energy, lacking interest. Having failed to mother, life’s most important task, why keep fighting? For me, someone noticed. And they got me help.

Hearing words like those of Sylvia Plath in her last days come from the mouths of friends and family should spur action. Recognize a mental health crisis. Help us take care of each other better. Be there at the bedside.

And as a writer, considering anyone who reads this my beloved patient, now you know. I’ve told a story that educates you. Listen for that tenor of in the speech of the people you care about. And to recognize it in yourself. Like a good nurse, assess, then act.

Also, why isn’t February Mental Health Awareness month? It is rough out there, folks. Take care of each other.

Public overdoses and my friend is a lifesaving superhero at a all-day-breakfast restaurant.

What were you up to at 3AM? Oh, just looking for an article about the increase in public overdoses of opioids and what that says about the power of addiction, the danger of the fentanyl-laced drug, and the will of people to, despite their dire state, be saved.

I couldn’t find the specific article, but I promise it exists and this is not an academic publication so sue me. The NYT article below about availability of Narcan as a health and safety measure like CPR training and AEDs in public places is good, too. I’m for it because I’m for life saving.

I’m going to tell someone else’s story; I’ve asked permission. This happened recently. Of the six of you who read this five probably know her. To know her is to love her, get ready to love this too, especially if you’re nursey and can do that thing we do where we care about people to a degree that we dedicate our lives to them but at our core lies a daaaark and morbid sense of humor.

So our friend is a recent PhD in nursing. A person who commiserated with me in when I was walking in the valley of clinical care is scary gross by saying “I knew it wasn’t for me the first time I emptied a peritoneal dialysis bag.” She’s an empath to the nth degree. Terrifically gifted in the field of psychology. Destined to be great to innumerable patients and, if there is justice, the wider field of psych/nursing/medicine. She is however not into emergency or critical care.

She’s in a medium sized city in the south, enjoying her favorite breakfast-all-day chain restaurant with her man, just having given their orders to their waiter who looks exactly like you would expect a breakfast-all-day chain restaurant waiter to look. The youngish ones. In the kitchen there is a commotion being made. Staff is peeling away from the dining room, forming a crowd. SOMEBODY DO SOMETHING is hollered. Our friend, the gifted psych nurse, is getting a look from her man (also a doctor of not medicine).



She’s getting the go get ‘em tiger from her fella. She rises, whispers to the backs of the crowd “I’m a nurse.”

SHE’S A NURSE” Hollers her dude with the authoritative bass of a public lecturer. The sea of people parts.

It’s their waiter, passed out on the floor of the breakfast-all-day restaurant kitchen. She is hella smart, so clinical person or not she can handle an OD. She activates that emergency response system (call 911, damn it), asks for an AED (there is none–what?!), checks that carotid pulse for not more than ten seconds (absent), and starts high quality chest compressions times thirty at a rate of not less than one hundred per minute with two rescue breaths between cycles.

Woman saved a life, people. SHE SAVED A LIFE.

EMS comes in narcannons blazing and brings the victim back. Poof. Death-be-gone.

Sigh. So that is our girl. My girl. My nurse friend and mentor. It feels good to know someone this gangster.

In summation: the opioid crisis is real, everyone must learn CPR, Narcan should be in first aid kits, and let’s address institutional cycle of poverty creating helplessness and hopelessness in economically depressed areas such as the stripped-bare resource colonies of the southeast leading to physical manifestations of what might be at the root existential disability and the introduction of opioids.