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.

Excerpting some knowledge

Y’all notice there is a biannual rhythm to me getting super poetic? The specter of cancer reappears in the form of 6 month surveillance scans. I get real weird. I imagine for some people its prayer, and sure I go there too, but for the most part my appeal to a higher power is poetry. Poetry and a few totally wrecked looking novels.

This scan around I’ve got some questionable results. So as saddle up for another ride in the wild world of oncology I have the voice of my favorite author ringing in my ear. He’s saying:

“Make sure,” “be prepared,” plan out every endeavor.
Like a scout on the stupidest camping trip ever.

If New York City is in the east, David Rakoff was the sun. When he died I mourned selfishly. Who will take this world full of sads and uglies and make it beautiful for me? Great writers are all guilty of this, I know, but I felt like David was mine. He took my tangle of fears and loves and laid them out in all of their transcendent beauty and absurd anxieties. God damn I miss him.

Here’s the excerpt I’ve memorized from the his final novel “Love, Dishonor, Marry, Die, Cherish, Perish: A Novel (by David Rakoff) written in the last year of his life and recorded in the last month. If your tear ducts need flushing and you could use a belly laugh, consider listening to him read it. It’s entirely in AABB verse. Anyway, superlative, superlative, superlative. This section is about the character Cliff who is now dying of AIDS. It’s beautiful, it’s sad, it’s darkly hilarious, it’s exactly what David was to me.

It was sadness that gripped him, far more than the fear
That, if facing the truth, he had maybe a year.
When poetic phrases like “eyes, look your last”
Become true, all you want is to stay, to hold fast.
A new, fierce attachment to all of this world
Now pierced him, it stabbed like a deity-hurled
Lightning bolt lancing him, sent from above,
Left him giddy and tearful. It felt like young love.
He’d thought of himself as uniquely proficient
At seeing, but now that sense felt insufficient.
He wanted to grab, to possess, to devour
To eat with his eyes, how he needed that power.

But, just like a child whose big gun is a stick,
Cliff was now harmless, he’d gotten too sick
To take any action beyond rudimentary
Routines that had shrunk to the most elementary:
Which pill to take now, and where is your sweater?
Did the Immodium make you feel better?
Study your shit to make sure you’d not bled,
Make sure the Kleenex is next to the bed.
“Make sure,” “be prepared,” plan out every endeavor
Like a scout on the stupidest camping trip ever.
The facts were now harder, reality colder
His parasol no match for that falling boulder.
And so the concern with the trivial issues:
Slippers nearby and the proximate tissues
He thought of those two things in life that don’t vary
(Well, thought only glancingly; more was too scary)
Inevitable, why even bother to test it,
He’d paid all his taxes, so that left… you guessed it.

Thank you for marching. Love, Me.

I knew by last Wednesday I wouldn’t make it to the march. My six-year-old had had a fever for 3 days, I was calling out of work and trying to get him to the doctor, and my nursing work schedule included non-negotiable 12 hour shifts on Friday and Sunday.

I was desperately sad when I woke up on Saturday and, like every normal human, pulled my phone from under my pillow and started scrolling twitter. All these beautiful women I love and admire, my friends! Together on The National Mall with their children. Arms linked, posters cutting, experiencing history’s counterpoint to Friday’s stiff and depressing presidential inauguration. And here I was in my PJs. A bad mom for not bringing my son to the momentous even, a bad woman for skipping the rising up of the sisterhood.

But wait, forget that guilt. You marched for me. I’m a single parent of a young child. I struggle with being a mom without a partner or adequate child support, a professional with no job flexibility to accommodate my role as parent, and due to the unaffordable nature of childcare lean on the support of my own mother to help raise my child. Also, I’m a cancer survivor and the ACA keeps me covered with health insurance and free from the fear of medical bankruptcy. Last, I am fortunate in this time of health professional shortages to work with a diversity of talented professionals from all over the world. I worry that through fear mongering or bad policy I will lose these irreplaceable nurse, tech, and doctor colleagues caring for our sick and elderly.

So to everyone who marched–I couldn’t be there on Saturday to show my support. I am forever grateful to you for marching.

Warming the engine/Thank god for Oliver Sacks

For a while now I’ve been scribbling notes and spending long hours before sleep and short minutes before getting out of bed figuring on how I will tell the story of my absence. Where I’ve been (literal and figurative).

I’m not consuming much fiction these days, but can slide through clinical tales like a hot knife through butter. So to warm me up a bit, and to remind you that I still think and breathe, I’ll share a passage from the late Oliver Sacks’ book The Man Who Mistook His Wife for a Hat (from the introduction, Losses):

…But it must be said from the outset that a disease is never a mere loss or excess–that there is always a reaction, on the part of the affected organism or individual, to restore, to replace, to compensate for and to preserve its identity, however strange the means may be: and to study or influence these means, no less than the primary insult to the nervous system, is an essential part of our role as physicians.

This is a perfect prologue. You know I had cancer. And that is the least interesting part of the story I wish to tell. The compensating, the strange and destructive means by which I strive and fail to preserve my identity is where the drama lies. And that, my friends, was completely overlooked by both me (RN) and all of my care providers.

Where is Oliver Sacks when you need him? In print I suppose. Thank god.