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Kristen Nace

You will never see my face or know my name. You probably won't give much thought to what happens to your blood after your doctor says, "I think we need to run some tests," and the phlebotomist draws it into the tubes with their colored tops. I know I never did, until I became a medical laboratory technologist.

Over the course of a normal day at the hospital lab, my coworkers and I process hundreds of patient specimens--everything from blood to bone, from sputum to spinal fluid. Twenty-four hours a day, 365 days a year, the specimens come to us from the hospital's ER and ICU, from doctor's offices and nursing homes, from the inpatients on the floors above us and from outpatients who walk in through the hospital's doors.

Our work is essential to the practice of modern medicine: it gives today's doctors a wonderful ability to know in minute detail, as their predecessors couldn't, what is happening within your body.

Your doctor has ordered a complete blood count, or CBC. One of the most frequently ordered tests, it provides a wealth of information. It tells the number of white blood cells circulating in your blood, and what type of white cells they are. It tells your hemoglobin levels, the shape and size of your red blood cells and the number of your platelets.

The first time I become aware of you, it's because of your white-cell count.

My analyzer flags your specimen: the number of white cells is far higher than normal. A pair of human eyes must confirm the finding, so I inspect a drop of your blood on a microscope slide, smeared and stained to reveal your white cells.

There they are, forever frozen in time, their pretty (I think) purple-pink hue standing out clearly against a backdrop of red cells.

This is how I know, before anyone else, what your doctor only suspects: you have a left shift. This means one of three things: one, that your bone marrow is pushing out lots of new white cells in an effort to fight off an infection; two, that you have atypical lymphocytes, white cells whose contorted, scallop-edged shape suggests they are reacting to a viral infection; three, that you have something else that the pathologist will say needs follow-up testing when I send him the slide for review.

At some point, months down the road, your name becomes familiar to me. I know, even before I make a slide and look at it, that I can expect to have difficulty finding and counting your white cells. There will be only a few, and those few will look abnormal, because of your chemo treatments.

And even further on, when you are being admitted to the hospital often, my coworkers and I compare your lab values.

"Do you think this is right? Her hemoglobin has really dropped---how are the chemistries? What does the potassium look like? Should we get a redraw?"

Finally, your platelets fall to critical levels. There are none to count on my slide. I issue some red blood cells and platelets to a nurse, who transfuses you.

Later the nurse says, "She's looking much perkier now." This makes me happy; you'll get to go home.

And then, one day, still in my pj's, coffee in hand, I open the paper and check the obits (which is morbid, my husband reminds me).

I see your name and, finally, your face. And I learn details that I didn't know before and that, because of HIPAA laws, I really couldn't have known. (HIPAA stands for the Health Insurance Portability and Accountability Act, which requires, among other things, the confidential handling of personal health information.)

I have known you on the deepest and most intimate level--have known the minutest details of your cells. Now I also know that you served in the Marine Corps, that you were a Girl Scout leader, a softball coach, a mother and a devoted grandparent to many.

"Ohhhh," I say out loud. I say your name.

At work, I say your name again.

"Did you see in the paper? Mrs. So-and-So passed away. You remember, with all the platelet orders?"

"Oh yes, I remember. I thought she was doing better."

And then we stop for a minute, thinking about you.

Eventually we'll go back to our microscopes and beeping electronic instruments. And my analyzer will flag someone else.

I will answer an ER doctor's call: "Hey, I'm looking for CBC results on Mr. Such-and-Such...You got a white count for me?"

"Yes, I'm looking at the slide now."

You may never think about me as I work in the lab. But I think of you, and wish you well....

About the author:

After obtaining a BFA from Colorado State and living the life of a military spouse and stay-at-home mom, Kristen Nace returned to school to get an associates' degree in medical laboratory technology. For the past seven years, she has worked as an MLT in a hospital setting. "I like having a job where I can be of help to people, even though I'm behind the scenes and rarely see a patient's face." She has recently started writing for therapy and stress relief and, like millions of other people, has a blog--Love~K--on WordPress. This is her first piece of published writing.

Story editor:

Diane Guernsey


# Margie Gottlieb 2014-04-04 10:33
Kristen, you have subtly and with simple beauty revealed a tale of hidden intimacy that's a pleasure to read. Well done!
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# Barbara Young 2014-03-02 15:02
Kristen Nace, I think "Secret Admirer" is a poem in disguise! I love it, either as story or poem. You are a writer in addition to being someone who processes specimens, and I hope somehow you can find time to write.

The world needs more Kristen Naces!

Best regards from Barbara Young, poet and new Pulse reader.
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# victorsousa 2014-02-28 16:40
Well done! Let's see more!
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# erlina hassen 2014-02-22 14:15
Thanking you for writing about the very reason why I love laboratory work.
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# Terry 2014-02-17 17:12
Silent and behind the scenes are what make the rest of us work. Health Care is so broad but still a body and without the rest of our entities where would we be. Behind the scene workers don't see patients just as numbers they create a personal relationship in their own ways which makes each and every one someone. Awesome piece, just one of many touching and inspiring peace's. God Bless.
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# Michelle 2014-02-17 09:36
This was really a great read. Thanks for taking the time.
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# Joanne 2014-02-17 09:07
This really touched me because I work around all of the people that do the same job and know that they dont get to see the people that some of us draw blood on and to know who they are. I love working with and around people because they can make the worst day the best day. Loved this essay.
will share it with others becasue its a beautifully said.
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# Carol Hayes 2014-02-16 16:23
Kristen is one of the sweetest people you could ever be lucky enough to know. I ment her while visiting my daughter So glad she is writing for others to see.
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# Jennifer 2014-02-16 10:13
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# joseph fennelly 2014-02-15 15:06
the person cannot be fractionationed like blood. the person is a holograph. one small wedge, piece, represents the whole. we physicians do not own the market on the soul of the person- the lens through which we see the other is from an open and compassionate heart. no man is an island. thank you for your deep caring. it makes you a better team member.
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# Karen Donley-Hayes 2014-02-15 14:05
Beautifully written, and I especially appreciate how, after all the "techno-talk," the author begins inserting the person behind it, the discussions among the lab workers, and finally, seeing the patient's name in the obituaries. This is just beautifully done. It may be Ms. Nace's first published writing, but I doubt very much it will be her last. Thank you for sharing!
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# Yehuditrose 2014-02-15 12:44
What a lovely story! It sheds light on a little known aspect of modern medical care, and expresses feelings that many health care workers feel about patients, those whose disease and progress we know intimately, and whose personal lives are complete unknowns. Unknown that is, until the day we open the newspaper and see their names listed with the time of their funeral.
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# Karen 2014-02-15 11:25
Oh! I really liked this - I shared her sense of wonder when I read this essay and felt her ultimate human connection upon its conclusion. Graceful and full of grace. Please continue to write. You have a light within you.
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# Wendy S. Harpham MD 2014-02-15 09:47
Meaningful, moving essay from an often invisible yet vital member of the healthcare team.

Thank you for sharing your heart.
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# dr.s.c. sundriyal 2014-02-15 08:31
Beautifully written & yet simple. It touches the heart.I ve been an ophthalmologist for long than I remember, but never thought of the path guys.KEEP IT UP
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# Janet Maiocco 2014-02-15 07:54
The most lovely piece of writing I have read on this sight so far...intriguin g...as a nurse practitioner I "see and know" the face of those blood results -what a different perspective you give. BRAVO!
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# ellen diamond 2014-02-15 00:43
I'd like to take a moment to say thank you. As someone with CLL for 16 years, I 'm very aware of the lab technicians
and have seen the consistency of their expertise year after year. I'm also grateful for the speed with which the CBC results come to my doctor these days, so I'm not kept in suspense for very long. Thank you for this piece and for your wonderful work.
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# Kristen Nace 2014-02-15 14:19
Thank YOU so much for your kind words.
I can well imagine as someone living with CLL, you are no stranger to the world of the medical lab. I am happy to know you have good experiences. I hope that continues and I wish you the best of health and success on your life journey!
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# June Rose Dowis 2014-02-14 22:52
a wonderful piece
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# Muriel Murch 2014-02-14 22:30
Congratulations Kristen,
This is a lovely piece of writing and takes us to a place we don't get to go very often. (Though I do remember Sue to drew my mothers' blood for months)
Keep going with the watching and the writing.
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# Carol 2014-02-14 22:29
Wow, I love the staccato tempo of your writing, reflecting the tender staccato of those lab specimens as they arrive for analysis. Thank you for a great piece of thought, thoughtfulness, and writing skill.
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# Jolanta Davis 2014-02-14 20:34
This is really beautiful! A bit scary, but beautiful. Thank you for writing it, and for helping us realize how many people it takes to care for a person with cancer or any other illness, really.

I hope you're working on more stories!
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# Karen Greenbaum-Maya 2014-02-14 19:59
This is moving and tremendously comforting. I am one of those who provided you with CBCs and slides of bone marrow aspirations, who required bags of platelets, and who came out the other side. Now you've got nothing more troubling from me than lipid panels (legacy of years of prednisone). Thank you so much for putting a human voice and human eyes on all those tubes.
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# janice mancuso 2014-02-14 19:53
Kristen, I seriously just thought about "you" the other day. I wondered if "you" would take good care when my daughter-in-law 's blood reaches you. She has Type 1 diabetes and is expecting my first grandchild. I thought about my friend and also a doctor-blogger I read who are both enduring chemo treatments. I remember asking myself about "you" and if "you" think about the stories of those whose tubes you touch. You eloquently answered the questions and have offer quiet, yet real, comfort. Thank you. Keep writing!
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# Pris Campbell 2014-02-14 19:33
Beautiful, heartfelt article. I'm forwarding this to a friend who was a lab technician.
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# Brenda Shorkend 2014-02-14 19:26
A beautiful, moving piece. Thank you!
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# Linda Lee 2014-02-14 19:13
Absolutely beautiful and so well written!
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# Cortney davis 2014-02-14 19:03
First published piece, and a very compelling one, fascinating and beautifully written. Congratulations !
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