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Simple Acts

Dianne Avey ~

One night on my nursing shift in the cardiac intensive-care unit, I received a new patient from the operating room: an eighty-eight-year-old woman who had suffered a major heart attack and had just undergone emergency coronary-artery bypass surgery.

Her bed was wheeled into the room along with the usual accoutrements: six different IV drips, a ventilator, an aortic balloon pump and various other lines and monitoring devices. Her name, I saw on the chart, was Mrs. Green.

The young surgeon took me aside.

“I don’t care what it takes, just keep her alive for twenty-four hours,” he told me, clearly more worried about his surgical-outcome stats than he was about Mrs. Green’s welfare. The hospital and insurers kept data on these procedures; it didn’t look well for a surgeon to have too many patients die during or right after surgery.

“No problem,” I replied confidently and went right to work, adjusting drips to maintain her blood pressure, cardiac output and heart rhythm.

Despite my efforts, Mrs. Green’s health status remained very unstable. Her heart was extremely weak, and she showed signs of brain damage.

We seasoned nurses had a term for patients like her: “electric corpse.” We’d been around long enough to predict who would survive and who wouldn’t. I guess it was a protective mechanism–a macabre way of distancing ourselves from the harsh realities of the ICU. In the face of her fragile condition, I did what I was trained to do: scientific medicine.

Until a nursing assistant wheeled in Mrs. Green’s husband.

A tiny man with a white shock of uncombed hair, he was clad in a tweed suit coat and dark grey trousers, neatly ironed. I’ll never forget the look on his face.

He’d been waiting for more than ten hours to see his wife. She was pale, lifeless and hugely bloated. A line or tube emerged from every body orifice, real or created.

Although her appearance must have shocked him, he didn’t show it. Seemingly oblivious to the cacophony of computers and equipment, he maneuvered his wheelchair up to the bedside, focusing intently on her all the while.

Gently, he brushed aside the IV lines and took her puffy, bruised hand, cradling it as if it were the most exquisite thing in the world. He gazed into her pale, swollen face, then the corners of his eyes creased deeply into a warm smile that spread across his face.

Although he must have known how gravely ill she was, it didn’t seem to matter. I could tell that he’d thought he might never see her again, and that, even in this terrible state, she was his angel. They’d clearly been together for a very long time, and I knew I was witnessing something special: a complete devotion that had spanned their whole lives.

Something deep inside of me cracked–something that had been waiting for this moment to emerge. My confident, efficient, competent self gave way before it.

I started crying in great, heaving sobs. Tears ran down my cheeks and neck, along my stethoscope, down the front of my blue scrubs. I couldn’t stop them.

I’m a professional! I’m not supposed to lose it like this! I scolded myself. I’ve seen hundreds of patients die; I can handle one more.

Nothing, absolutely nothing worked. The tears just kept streaming out of me.

I realize, now, that it was the pent-up stress of years of being “professional”–not letting myself feel the sadness, rage and bitterness that were an inevitable part of my work–that literally brought me to my knees that morning in the cardiac ICU.

Mr. Green turned to me. “Are you okay?’ he asked.

“I’ll be okay,” I assured him. “I just need a minute.”

I struggled to my feet. Glimpsing my tear-stained reflection in the mirror across the room, I knew that it was time to do something different with my life. While I’d been recovering “hearts,” as we called these patients, I’d been ignoring my own.

Finally, I pulled myself together, made my way over to Mr. Green, knelt down beside his chair and took his hand.

“Can you please tell me about your wife?” I asked.

“Mary and I have been married for sixty-two years,” he said, then told me the rest of their story–six decades of love and dedication. They’d weathered many storms, including losing a son in Vietnam. They’d been true companions; best friends.

When he’d finished, I took him down to the end of the bed, by Mary’s feet–the only part of her body that was free of tubing and lines.

I handed him a warm washcloth. Tenderly, he scrubbed her feet clean of the yellow antiseptic, then rubbed thick white lotion over them and between her toes. Finally, I helped him to cover her feet with a warm blanket. He seemed pleased; I knew it would be his last act of service to his wife.

A few months later, I left critical care and began working with terminally ill patients in their homes.

For three years I worked as a hospice nurse, continuing part-time while I attended graduate school to become a nurse practitioner.

I’ve never forgotten the lessons I learned in the ICU that night.

I know now that seeing people only as patients, or as data sets to be manipulated, is a way of warding off the human intimacy that true healing demands.

I realize that acknowledging another person’s humanity also means admitting my own fragility and mortality.

And I look for ways to practice small acts of kindness that can bridge the divide between my patients and myself–knowing that these acts can be as simple, and vital, as holding a hand or washing a loved one’s feet.

About the author:

For more than twenty years Dianne Avey has worked as a family nurse practitioner, caring for people and families across their lifespans–something she still considers a privilege. Her poems have appeared in Pulse and elsewhere; a recently finished poetry chapbook, Impossible Ledges, chronicles the love and loss of her first husband, who died of leukemia in 2006. Currently she is crafting a memoir about having a near-death event and, as a scientist, trying to come to terms with this deeply spiritual experience. She is a fifth-generation resident of Anderson Island, Puget Sound’s southernmost island, where she runs an annual writing retreat and lives with her second husband, a teenage son and one very lazy dog.

Story editor:

Diane Guernsey


14 thoughts on “Simple Acts”

  1. Nurses suffer Compassion burn-out in dealing with
    the results of Scientific technological medicine that extends
    a patient’s existence but not realizing the suffering this
    will have for the patient. The POLST (Physician Orders
    for Life-Sustaining Treatment) form was created so the
    patient has some legal right to refuse heroic efforts to
    further sustain life beyond a certain point.

  2. Elaine Whitman

    I read Pulse every week, but rarely have I read a story as compelling as yours. I was crying along with you, while the patient’s husband gently washed the feet of his beloved wife.

    I completely understand why this powerful encounter changed the direction of your professional life. Thank you for sharing your story with Pulse readers.

  3. Marianne Lonsdale

    Thank you for writing and sharing this story – it is difficult to convey what being with someone at end of life is like and what it wakes up in us – you did this well and loved learning you went on to work in hospice.

  4. Dear Dianne,

    Beautiful story beautiful told.

    When I read “I handed him a warm washcloth. Tenderly, he scrubbed her feet clean of the yellow antiseptic,……” I began to cry, as did (probably) many others. Very touching.

    Your life and calling have been a blessing to so many others.

    You are an angel, a teacher from the Compassionate, Healing, Creative Force.

  5. michael mcleod,m.d.

    A beautiful story and so illustrative of how we are taught to hide our hearts and our emotional lives in our culture and especially in medicine. We can hide behind the data, facts and avoid our human vulnerability, denying a part of who we are.

  6. Lynn Assimacopoulos

    For many years, I also worked in an surgical ICU taking care of hundreds of very critical patients. I loved every minute of it even though so many patients succumbed to their illness; however, many also lived on to continue in a better life because of their treatment. Nurses then too were not expected to break down, cry and become disheartened but we could not help it and we did the best we could in each situation. I have never regretted any day I had to go to work in the ICU—and I still have so many memories of patients that I cared for. Your story is moving and so true!

    1. Peter Barnett, MD

      I love the washing of feet, and the broad inquiry: tell me about.his wife/life/etc…Wonderful. Thank you. Touch, listen, and touch again, and…listen….and, touch…

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