2026

Knock-knock. The thumps sounded like someone from beyond this world knocking on his chest.

I thought of Bob Dylan’s Knockin’ on Heaven’s Door.

As I pumped the heels of my hands into my patient’s gaunt chest, I hummed Stayin’ Alive to keep the rhythm of my strokes consistent.

Before I was a nursing student, I didn’t know CPR was so violent. So the first time I cracked someone’s chest in the ICU when I was a new graduate nurse, I almost stopped for a moment, surprised by the way my arms had plunged into the man’s body.

Her right hand trembled over the bedside phone. In her left hand was a laminated menu, worn at the corners, like her weathered hands. The cardiac acute care room was dimly lit, with sunlight peeking through the blinds.

I knocked softly on the doorframe. “I’m Akash,” I said, “a volunteer. May I take a seat?”

“My name is Kate,” she said, as her eyebrows drew together. She then turned back to the phone, as if she were waiting for the numbers to rearrange themselves into a pattern she recognized.

“May I help you order?” I asked.

The ICU nurse doesn’t look at the chart when she talks. “GCS four. Intubated, on propofol and fentanyl. No seizure activity overnight. Pupils sluggish but equal. Pressors stable.”

I glance back at the screen. “Oh,” I say, pointing. “And today’s her birthday, right?”

The nurse smiles. “Honey,” she says gently, “that’s what we put in the system for crash patients who come in alone. Until we know who they are, today has to be enough.”

What’s he wearing? An odd thing to ask about a dead man.

Nurses hear everything. I think I’ve heard it all, but I haven’t, even after more than two decades at the bedside.

Ash was sixty-nine years old. His mother, Ashley, who was named for her father (Ash’s grandfather), is eighty-six. She was working when Ash died, braiding hair at the mall, a temporary job to cover his deductible. She called to check in mid-shift, whimpered softly when we told her, then asked about his clothes.

I jumped when a woman cried out, “Albert! Albert! Someone help!” I rushed over to their table; told her I was a nurse. His head slumped next to the bill he had just paid. My fingers moved on their own to find his thready pulse. “Call 911,” I told the waiter. Albert was soaking wet with shock and sweat. His hand covered mine on the hospital white tablecloth. I bent close to his ear; told him I would stay until help arrived. He squeezed my hand in reply. We stayed tethered this way for nine long minutes. I had to kneel to keep my head level with him to whisper assurance, ask if he took any medicine for his heart.

My seventh-grade social studies teacher posed a question: “Which professions are the most important?” We know-it-all adolescents shouted “Doctor!” “Lawyer!” “Accountant!” My teacher’s answer is seared into my memory: “Farmers, parents, teachers, nurses.” I was dumbfounded; my world paradigm shifted.

Hardly anyone forgets a first.

As a medical student, the first nurse I worked with on a pediatric ward was the formidable Ms. Shanta, who left a lasting impression. She wasted no time correcting a few cocky students, efficiently and without ceremony. “An old nurse is any day better than a new doctor,” she would say. And she was right.

In June 2013, my life was upended by a psychotic break after several months of chaotic and progressively disabling thoughts and behaviors. Then, on Father’s Day in the early morning, I became acutely manic, convinced I was going to solve the problem of the exorbitant cost of undergraduate education. Instead of sleeping, I wrote frantically in a notebook, filling the pages with my thoughts and plans for saving humanity. Meanwhile, I also became convinced that my upcoming presentation for my Master’s in Health Professions Education should be the first and in fact only presentation at that day’s Convocation Seminar. At 3 a.m., I called my eighty-year-old parents and insisted that they come right away–a one-hour-plus drive–to watch my extraordinary presentation.

I started my nursing career in 1977 after graduating from an excellent NYU nursing program. I moved upstate to work in a community hospital’s Cardiac Care Unit.

It was wonderful to care for a manageable number of patients who were afflicted with a variety of cardiac conditions. At that time, nurses were allowed to insert IVs and NG tubes, manage various medicated drips, and follow standing orders in emergent situations. Every patient was visited by their own family doctor who was committed and passionate about their patient’s care.

My wife was a nurse. She trained at LA County USC Medical Center, the same place where I began my internship as a physician. Because of her career, I was always respectful of nurses but not fully aware of how valuable they really are.

When I completed high school in 1965, three career options awaited me: secretary, nurse, teacher. I had the skills for the first, having spent the summer I turned twelve taking typing and shorthand at a business school, but I lacked interest in the job. My fear of blood and needles eliminated nursing from my future. Thus, I became a teacher—a profession that fulfilled me for more than four decades.

Dear readers,

When I was thirty years old and in my first year of medical school, I came down with symptoms–extreme thirst and frequent urination–that turned out to be type 1 diabetes, formerly known as juvenile onset. My body wasn’t producing any insulin, and I was hospitalized.

During my five-day stay, I had to make some adjustments and learn a few things. The biggest adjustment was this: I had to accept that without insulin injections, I would die and that unless I controlled my blood sugar well, I could suffer all kinds of serious complications from diabetes–and then die.

The people who eased my way into this new life were nurses.