Tuesday, November 23, 2010

The Definition of Nursing

I remember sitting in the first class of the first course in Nursing School…It was taught by an imposing woman who to this day makes me just a little bit nervous when I see her. The first assignment sounded simple. Write a definition of nursing. I shrugged…thinking ”how hard can this be?”  Let’s just say it was probably the longest time I ever stared at a blank piece of notebook paper in my entire 40 years of life. After about an hour I realized that I had no idea what nursing was. I spent the rest of the time looking up definitions and concocting a statement that she really liked, but did not show it outwardly past the mark she put on my paper. I was happy to have that good grade on my homework, however I knew I was in trouble because I still really had no idea what nursing really was. I certainly had no idea what nursing was going to end up meaning for me. There was a split second where I nearly turned tail and ran, this would not be a surprise to many, but that one little bit of self rose up and kept me on the course laid out before me.

I did a lot of challenging and difficult things and learned a lot of skills over the next year, none of which brought me any closer to really knowing the answer. I knew what dressings were, I knew what tube feeds and IV lines were, I knew what catheters and rectal bags and enemas were. I transfused blood and I assisted new babies into the world. I knew how to write great care plans, how to document in a chart and I knew how to talk to physicians. What I did not know was, my definition of nursing. I just was not feeling it.  I do remember fretting about this with some instructors who had a reputation for being a bit more kind and indulgent than the first. One in particular told me that what I was feeling was not uncommon, and that sooner or later I would get my hands on something that would change everything for me and make the definition of nursing a reality for me. I hoped it would happen sooner or later because I found it hard to have a heart for something that I could not define or relate to.

On September 11, 2001 I got up early just like any other clinical day, and drove across Fairfax County, VA into Arlington on Route 50.   I was listening to the radio and not paying attention. It was 8:45 am and I was late. I also missed my turn for Columbia Pike. I ended up turning around just in front of the parking lot for the Pentagon, and arrived at the clinic I was working in just minutes later. It was a clinic set up for refugees. Out of the corner of my eye I saw two kids sitting in the same wheelchair together. I remember shrugging thinking I wanted to get out of seeing patients that day. It was minutes later when all hell broke loose in the world. I had taken a quick walk up to 7-11 to buy soft drinks for a few of us still in shock over what I was hearing on the radio about the collapse of the World Trade Center buildings. I was standing outside avoiding the opportunity to see the two kids in the wheelchair when the jet that crashed into the Pentagon that morning came screaming down through the sky just over my head! What I will never forget was the look of a jet from the underside, heading at top speed for earth with no landing gear down.  It was no more than some seconds after the aircraft disappeared behind the tree line that I heard the muffled impact and saw the black smoke pouring up into the sky. Seconds later the sirens were blaring and we were all instructed to close the clinic and evacuate.

I was running for what could have meant my life and I remember feeling relieved that I did not have to see the two kids in the wheelchair. Looking back that fear makes me shake my own head, but that is because I know myself now. I went home and waited with the rest of the world to see what had just happened to our country.  I went back to school two days later and was called into the assistant dean’s office. She told me that someone needed to go back down to ground zero and assist the physician for two school physicals. She said that she did not feel right asking any of the other students to go back down there so soon. I remember looking at her while she told me they were the two disabled kids in the shared wheelchair. I am positive I made a face.  I went anyway though. It changed my life forever.

She was a 14 year old Syrian girl, extremely small for her age, yet strikingly beautiful. She lay quietly on the exam table where her father had gently laid her.  I have the privilege of also being a Syrian girl so maybe that is why once I was closer to her I felt a sort of familiarity with her. I assisted the physician as the physical was performed and she and I discussed her cervical spinal cord injury.  I was studying spinal cord injury in the neuroscience course at school but this was the first time I had ever encountered  a person who actually had one. I was fascinated by the way she managed to move, and how she managed to be expressive when not moving. Her father explained the cause of her injury through an interpreter. It was horrific. It happened in Iraq. The whole event took about 15 minutes and after she was safely back in her chair with her brother, who was also disabled, her father asked me in very broken English if there was a doctor in the United States that could help his daughter walk again.  I never felt so helpless in all my life. I did not  know any kind of answer to give him except some gibberish about finding someone in the Children’s Hospital network.  Her father was very appreciative for our time and was then on his way with his children.  I drove home asking myself the same question I did after every clinical experience. “What is the definition of Nursing?”  I was halfway through my schooling and I still felt like I had no idea, and I felt like I let that father down.  I did know one thing. I was going to go home, and figure out how to find a better answer. 

When I got home that afternoon, I was hanging out with my next door neighbor, Ruthe. Ruthe handed me a newsletter and said it was written by a friend of her brother’s from high school named Steve and she thought I might find it interesting. He had a horrible accident in a swimming pool and broke his neck. The newsletter was about his experiences with his spinal cord injury. The timing could not have been better. I noted that he wrote about his feelings about American nurses, and called them “insensitive bitches”. Of course, I took issue with his generalization. Of course, I opted to send the total stranger an e-mail.   That e-mail led to more e-mails, and over time I found I had made a friend in Steve Crowder, aka Nick Danger. I was blown away by the magnitude of troubles that are created by spinal cord injury. I really had no idea what people had to go through every day with paralysis.  I was immediately interested in the acute injury, the nursing care, and the treatment algorithms.  I had so many questions that Steve pointed me in the direction of Paul, another person with a spinal cord injury in California. For a variety of reasons I can say that, Paul Nussbaum had a hand in saving my life.  I challenged Paul to remember his prior profession in counseling, because at that time it also came out that I was hurting, from events in my personal life. I found him kind, gentle and reasonable to talk to. He taught me about what it was like to live with a chronic spinal cord injury. He taught me more than I could ever thank him for. It was Paul who told me about Care Cure and Dr. Wise Young.

Mary_Wise Young                                                                      

It was Paul who led me to Debbie Kelsoe, and another great California paralyzed man who goes by the screen name, vgrafen.  When I looked up the first posting written by vgrafen, he characterized American nurses as, you guessed it!  “Insensitive bitches.”


I had no idea what clicking on the link for Care Cure was going to mean for my life. I had no idea that by reading the words written in the forums there, and the networking that came as a result of those postings, that I would finally find the answer to the burning question, “what is the definition of nursing?”  The new question became, “could I live alongside the answer?”

       Working 2 Walk 2007

Saturday, November 20, 2010

A Boy After My Own Heart - A Man After My Own Heart

                                                                      best day1
In the wee small hours of the morning, 20 years ago today, I lay happy and peaceful in my own home, having run the most challenging physical gauntlet of my life to that date, and in my arms I held the prize. In those moments, my heart was changed forever. Never again could I be selfish, could I be seeking my own. This was true treasure in my arms.  I knew him before he was born, how he kicked and rolled, and those martial arts are no surprise to me. I knew him then as he is now, He is the same person. That little happy baby that I could pass around at parties, has never really changed..except….he pulled a fast one and grew up!   Something told me the day that boy was born that each day was just a little bit closer to the day he would say goodbye and strike out on his own. Younger than most, he is independence minded and I suffer with the pride I have in him.  There is no end to our memories, no end to our appreciations.  There is no greater pleasure I have than watching him grow from a distance, always being ready to still be Mom.  He made me smile so much this week. I carry what he says around in my brain and pull it out when I need a reminder and a laugh.  It is an honor to be his mother.  No one is prouder. No one more thankful.
Happy Birthday!!

CoolJohn  John The Star                              cake 

Lesson From Londo



Autumn 2010

I look back fondly at a time not that long ago when I was greatly satisfied and happy with the man I had chosen for a partner. We spent our quiet moments doing many things, and one of the best for me was watching our way through the entire series of Babylon 5 on DVD. What I remember most was looking forward to going upstairs together and watching an episode in bed before we slept. I remember the warm feeling I would get each time I crawled into bed beside him and how it felt back then to be together enjoying that time together. I remember it being peaceful, I thought it was honest and I believed it to be complete.  

Sometimes when I see something on TV or in a movie, it resonates with me and I never seem to be able to forget it.  It happened in the 16th episode of the 3rd season. One of my favorite characters was an ambassador named Londo Mollari.  Londo was a colorful fellow, sometimes hot and sometimes cold, bred to be unscrupulous but with a sense of justice. Londo was obnoxious and while it was always veiled in deep sadness he also had a great capacity to love.  I loved watching Londo grow and change, and sometimes retreat into past bad behavior. He was always forgiven. I always believed Londo would eventually do the right thing.   

In this particular scene,  Londo was telling Captain Sheridan who had travelled 17 years forward in time how the capital city of his planet, Centauri Prime came to be in ruins, and while it was a short statement it stayed with me ever since I heard it for the first time. 

 "During your little war, you drove away the shadows. Oh yes. But you did not think to clean up your mess! If a few of their minions, their dark servants, came to Centauri Prime, well. Where is the harm in that? Yes?" Londo Mollari

Recently I found myself spinning in all directions as my newlywed husband, that same loving partner, checked out of my life first emotionally, then mentally, then physically. Each step he chose felt as though I was being thrown into a shredder, and nothing that came out the other side even remotely resembled the me that was there when he threw me in. At that time I had come to the conclusion that I had no choice but to lay it all out in front of him and hope he would come to a place where he could see what our lives had become. It was my hope that he would consider the truth and seek to save us but instead  I was blindsided by things that later I realized I should have seen coming.  There was one huge outburst of anger from him, that frightened me terribly.  I really had no idea that our relationship was so fragile on his side that one burst of anger would end it all for us.  For many months I processed this but could never remotely understand what had happened. He announced that he was going to "own" the fact that he was a horrible husband.   He said it was nothing I had done. He said it was all him. He said there was no one else. He said and did a lot of things, none of which I have bothered to believe or accept and none that to this day come close to paying for the overall damage I have been abandoned to repair.  All that mattered was that for whatever reason he chose to seek his own, and that meant I had to do the same.

A number of years ago a friend of mine sat me down and gave me a direct and brutal awakening.  I was fighting for my life on so many levels that I could no longer keep up or keep track. I was living and going through the motions trying to avoid a head on collision but the daily damage control was about all I could do to keep my head above water. The lecture my friend gave me boiled down to this: The only way through a difficult time is through it. You cannot go around it, or over or under it, you have to go through it.  The path is rarely left clear in times such as these, there has usually been a war filled with bloody battles and there is always destruction, there is always rubble. It makes a mess of people, it makes a mess of their lives.

It helped me quite a bit when I recently realized that what was required of me was that I have the courage to follow the steps that were laid out in front of me logistically so that I could pass through. I did not have to "live up " to him or anyone else or anything. I did not have to remain attached, despite his financial obligation to me.   It also helped me to realize that I was no one special in this equation, I was just like the others, passed through, used up and finally thrown away. I am certain I will not be the last.  When I finally got it in my head that he was nothing special either, it all became easier to negotiate. I had to move on.  I had to stop thinking of myself as anything to him.  The truth is that in order for any of us to truly "own" a problem or situation, we have to take responsibility for what we have done.  We have to accept our part in things and act accordingly.  The forms have to be filed, the debts have to be to be paid, and the innocent one's have to be healed.  We have to take the time and be careful to clean up our mess before we dare to drag it all behind us into the next inevitable relationship.  I knew he would have one before me. I knew what he would do before  he did it because he had done it all before, and never, ever, bothered to clean up his mess.

Recently a respected new friend taught me that going forward and really living demands focus and attention towards the direction I intend to go. He told me that I had to keep my mind on the things important and work on them one at a time until I get to where I need to be to be truly free. There is really no other way to be ready for the next chapter of my life.  I had to take the time to clean up the mess. This is real wisdom for reality, not playtime games in fantasyland.  My life is at stake, and I intend to prevail.  I appreciate this man, this protector, this willing friend and guide.  It has been a long time since anyone made this much sense to me, and with such good feeling. 

Yes, there was someone who was applauded in a certain realm for battling his demons which he laid out upon the table for all to see, and yes he fought his little war, not bothering to close the door when he fled and not bothering to clean up his mess.  Will I be like Londo Mollari, living out my existance with a Keeper around my neck choking me into submission in hopes of saving my world? I don't think so.  It is a better choice to take the time to clean up my mess, take stock of all I truly own, and close that door behind me.

Thank you Londo Mollari..for the reminder.  


Friday, November 12, 2010


Winter 2005

I am told that during that time I was a bit of a zombie. I was using a medication created for people who have seizures for the management of the neuropathic pain that was de-railing my life. It was an uncomfortable feeling knowing that I could not just stop taking it. While I was assured that it was a physiological addiction and not a psychological addiction, it seemed to not make much difference to me since I had no control over how I was able to stop taking it.

I made the effort to do some reading and I found a message board that included people sharing their experiences with taking this certain medication. I did find one person's posting about his adverse reaction to the same medication that I was struggling with.  I was gratified to find that I was not the only person in the world who experienced these difficulties with this drug. When I read what the people were writing about what had happened to them it made me feel validated. When I read the horrible experiences people were reporting, all things they chose to attribute to changes in them as a result of the drug, I began to see that I was falling into similar patterns of behavior and that it would only be a matter of time before my choices could potentially become my undoing. I had no choice, I had to figure a way to get off this medicine.

As it has come to be the way with me, traditional pathways of seeking care seemed to never work well. I found myself talking to my dear friend, a doctor who suffered the hard way on a path to discovering a new focus of practice for people with addictions, about my situation. I found it amazing that in order for someone practicing medicine to actually pay attention to my pleas for help with my problem, I had to gather information from a doctor who currently could not practice medicine, learn all I could from him, and change a doctor's mind before anyone would hear what I wanted to propose in order to withdraw from the drug. I was finally hopeful when I found a new doctor and she began to write prescriptions that made sense for a more subtle tapering. I can remember taking smaller doses over the weeks while I had no choice but to endure detox. My body held on to this drug as a toxin and while I was tapering down with doses delivered by an eyedropper onto my tongue all I could think of was being free from it.  I tried hard to keep this end in mind while I suffered through the weeks of low level neurological torture. I had issues with memory, cognition and word finding. I had issues with reasoning and logic and decision-making. I was feeling relentless low-level electro-neurological torture as my entire body tingled, buzzed and crackled with no relief or end in sight. The pain was unreal. The confusion was worse.

I admit this was a shaky time for me. I clung to my Dr. Steve who never once took his mind or attention off of me. I remember now asking him when all of this was going to stop. He said. "When it does". My body burned for weeks after my last dose of the medication. Finally, one morning I noticed a calm in my body that I did not recognize. I had finally done it.  The experience had taken its toll though, and I would not realize for years just how difficult the rebuilding was going to be. I met my second former husband while I was taking  then detoxing from that drug. Looking back I think that may truly explain how the whole thing worked out.

Looking back I realized that I had no idea anymore who I really was because I could not remember anything of my self from my past.  Getting rid of that toxin was only the first step.  I was an exhausted, defeated woman in pain. I chose that time in life to begin a serious relationship with a man. That turned out to be the third biggest mistake I ever made.