I couldn’t help but gag at the stench in the room. Mr. B greeted me with a smile.
“Pretty disgusting isn’t it. Rotting flesh. The smell. Nothing like it. Your mask won’t help you much.” He gave a loud chortle as though he had told the funniest joke ever.
The year was 1965. I was a student nurse. This was my first encounter with gangrene.
Not many people can say they are comforted by the smell of jet fuel. But I can.
I was working as a new medical scribe in the emergency department when a crew of flight nurses rushed in with a trauma patient. As they passed by me, in uniforms I recognized, the scent of jet fuel whisked me back to some of my most cherished childhood memories.
When I was growing up, my dad was a flight nurse. My mom sometimes brought us kids to the base during his 24-hour shifts so we could eat lunch with him. If we were lucky, and maybe when others weren’t, while we were there he’d get a call to fly out to rescue someone in need.
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.
