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.


                                                                      

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?”

      

An Unreasonable Fear

     I was never very interested in math. I am educated, but willing to admit I have never seen the inside of a physics book. My unreasonable fear of statistics has stalled my two graduate degrees in midstream and soon I know I will have to do something about that. I am relying on my brainy 17 year old daughter to partner with me and save the day, in order to ensure my future. It is always a little amusing to me that as my mother made a satisfying lifetime career out of math, teaching countless young people algebra, geometry and trigonometry, in the same junior high and high schools that I attended, that I, quite intentionally, made an equally satisfying effort to avoid it.  I could not get very far into this discussion without admitting that as I grew older, regardless of my lack of interest in anything labeled "math", that my rabid and voracious interest in chemistry and medicine created a conflict.  Annoying as it is to admit, chemistry and medicine, appears to be related to, and rely quite heavily on math.  At 23 years old, with my first bachelors degree under my belt, I had to wake up and realize that in order to gather the education and knowledge and experience that I needed to become the healer that I knew I already was, that I had to gather up my fortitude, all of my emotional strength, suck it up and open the black algebra book lying around my parent's house and uh...attempt to learn it.  


     When my mother observed this, her first thoughts may have been something like these: " How come she did not open that book in the 9th grade when she was supposed to?" or " Better late than never " or "Maybe she should think about taking a remedial class".  A few years later I did take that "13th grade" math class at Columbus State Community College, mostly to prove to myself that I could do well in math, and partially to prove that regardless of how good I had become in chemistry, anatomy and physiology and despite my natural medical aptitude, math could still be excruciatingly uninteresting and remain imprinted upon my entire psyche as the irrational fear that I still hold tightly to today.  I am 50 years old, I am a healer, and I do not "heart" math!  Not "hearting" math leads me to also not "heart" physics and alongside that, not "hearting" statistics.  Unfortunately this also leads me to a daunting brick wall in front of my current vocational goals and calling, so I have become irritated.  


     Before  I go on whining about "not being good at" math, I should document here that I am in fact very good at a whole bunch of other things.  I have actually heard my mother point this out on many occasions so I know it must be true. One very cool thing about my mom and I is that we are both strong-minded women and neither of us really have any trouble pointing out the talents and shortfalls of the other.  My mom says she is envious of my creative artistic talents especially in the area of the home arts. Honestly I think she says that to be "motherly" but I think that she feels the same way about all of those disciplines as I do about math, physics and statistics.  I know my mom works just as hard to avoid a sewing needle or a complicated recipe, as I do algebra and geometry.  This kind of relationship is not easy to have.  Having to co-exist in the mother-daughter relationship for the first part of my life being cared for, and now seeing the scale about to tip in the other direction where I see it inevitable that I will take care of her, I have to admit that this was not ever a perfect or easy relational road.  I think my mother and I have gone through life believing that the other never listens or understands, and that each of us thinks that the other is somehow not as good as we might want the other to be.  Looking at my relationship to my mom realistically helps me face what I know is going to happen as time goes forward.  This is not a novel scenario, all of my peers are facing it now and all of hers are too.  Fortunately for me, at just some bit of time before age 80, my mom still "hearts" math, and fortunately for me, I do not.  I think this knowledge creates a parallel resonance for us. It simply works best. We both make faces at each other when we ask each other to make up the shortfall.  That is a bit silly since we both know we really have no choice but to apply our natural gifts and talents to whatever challenges come our way, after all we are both strong, intelligent women, and if we were each asked we would both say that successful life and family relies on achieving a "power factor of unity".  Each should act according to their own talents and a house divided falls. I believe that this is why my parents remain married and happy with one another after 50 plus years. I also know that my house has divided and fallen and at this tender moment my compass is pointing toward north and I am going home.

   



     For me this one thing is true: Living life successfully with the corner of my foundation missing is exhausting me. Being afraid to face the math is nowhere near as daunting as admitting that I was foolish for avoiding it in the first place. To go forward in my life, and to redesign and rebuild what I allowed to be invaded by a rover, a plunderer... (thank you Henry Miller, T of C for those original words) who built a fortress of dry sticks and a thatched hay roof around my carefully preserved homelife and laid waste to all but some smoldering embers with the cavalier toss of a single torch he carried, will require a whole new architectural plan.  This new building will be set on a solid foundation, with all four cornerstones firmly rooted and set in place.  


It is time I embraced and did the math.