In Memory of Madeline Spenrath, R.N.

I just found out on Thursday, April 25, 2013 that one of my favorite nursing supervisors had died.  I’d talked to her several times over the last few years when we were both going through various cancer diagnoses, but hadn’t talked to her in a while.  She had been through breast cancer, and thought she was doing well when she discovered she had bone cancer in her thigh and had to have an amputation at the hip (around 2010).  She went through that with a great deal of grace and dignity.  I’m told that she had recurrence of cancer in her lung and spine.  I can’t imagine what that was like for her. Getting used to her leg prosthesis and wheel chair were hard enough; the leg prosthesis drove her nuts.  She was incredibly independent, and needing help didn’t make her smile.  I can just hear her saying “when I go, just toss me out into the pasture with the horses”.  Down to earth, no frills, and knew SO much about nursing.  I will always have a great deal of respect for her.

Madeline  was a no- nonsense supervisor, but also had a heart of gold. I first met her in in  1991, and while there are many people who knew her much better than I did, she left a definite impact on me, for the better.  I worked at Sid Peterson Memorial Hospital in Kerrville, TX on and off for over 10 years.  Madeline had been there much, much longer, and was a ‘staple’ supervisor on the night shift.   She had her own way of getting report on every patient in the hospital for the next shift’s supervisor (or ‘Number 9’, as they were called at Sid Pete, at least at that time). Some supervisors wanted report from each nurse- Madeline wanted the charge nurse to give the run-down.  SO, I talked to her a lot.  She wanted ‘just the facts’, but also had a really good sense of humor, and if a patient needed something, and she could do it, she’d give it her all.

Madeline could get IVs in just about anybody.  Generally, if someone needed an IV started or restarted, the direct care nurse or charge nurses would get them in.  If that didn’t work- or if someone’s veins were just too puny to go poking around when it didn’t make sense, the charge nurses would call Madeline (or whoever was the supervisor that night).  Madeline could get an IV in the butt vein of a grasshopper. In motion.  She was just that experienced and had all of the tricks down pat.

Madeline used to have incredible BBQs for the night shift staff. They were annual and legendary.  I got to go to one in 1991. She had them in the summer, and would have one of her horses saddled up for anybody who wanted to go for a ride around the farm in Comfort.  I still have a photo of me on one of her palomino horses, in my tennis shoes and t-shirt…. I looked SO not ‘Texas’.  But it was fun 🙂

When Coca-Cola changed their formula back in the 80s, Madeline rode her horse to the town store, and brought home as much of the original formula as she could secure to that horse!  I never heard that she ever smoked or had other vices- but don’t mess with her classic Coke !! 🙂

One night, Madeline called me about a predicament with staffing on the telemetry floor.  Uh oh.  Madeline could get me to agree to a lot of things that I’d normally freak out about (like charging two floors on nights when there were simply no other nurses to cover one of the floors- they were back to back units – 4A and 4B- so I just ran between the two that night; one was my usual floor, and I knew the other staff well enough).  The regular charge nurse on the telly floor had some emergent health situation happen, and they really needed a charge nurse.  I really didn’t read telemetry strips !  I knew ‘OK, looks survivable’ and ‘uh oh’. She reassured me that the monitor techs knew the rhythms and there were standing medication orders that the nurses knew about- I’d be fine. They just needed an RN body to check off orders and be physically present.  Scared the snot out of me, but I went.  Everybody survived the shift 🙂

She hated taking bodies to the morgue in the basement of the old hospital. Madeline would do anything she could for anybody in the hospital, but once she was notified of a death, she’d show up like the wind and drop off the keys to the morgue.  She wasn’t a fearful person but that morgue gave her the willies. I have to admit, it was creepy- it was a ‘one occupant’ room, with shelves along all available wall space that had the specimens from various surgeries… there were gallbladders, appendixes, lungs, and just about anything that could be removed from a body bobbing along in preservative liquid in semi-opaque plastic buckets. You could still tell they were guts.  Named, dated, and labelled.  The first time I went down there, I was very distraught.  I was still shaking the next day, and actually had to leave when I got to work (major chicken-poo reaction). Madeline was on that night, and while she wasn’t amused at me falling apart, she never made me feel ashamed of my reaction. Once I knew what I’d be seeing, I was able to go if I had to help take a body there.

When I was diagnosed with diabetes in 1995, I had just started working at SPMH again (and was diagnosed with diabetes through general pre-employment screenings)… one night I said I felt a little funny, and Madeline went bounding off to the cafeteria to get me a pimento cheese sandwich, in case my blood sugar was getting too low; I was still very early on in being treated, and could sometimes have symptoms even when numbers were decent- my body was just used to having much higher blood sugars.  Being diabetic wasn’t seen as a liability, and I had a great deal of support from Madeline and others there at SPMH.

When Madeline brought a meal for a patient admitted later in the evening or night, she’d bring back  a tray full of food fit for a football player…. her theory- never trust a skinny chef, and make sure they get enough food if they’re hungry.  Never knew when someone sick would either lose their appetite, or have the need for some energy stores.

Madeline loved her horses and cats.  She retired from nursing several years ago, and while she was dealing with a lot of health issues, she always talked about how she was doing with taking care of the horses and cats on her farm. She was deeply saddened when that palomino died… it was one of her favorite horses.  She also volunteered at the local VA hospital, and loved going out there.  She had passion about many things, and when Madeline took to something, she did it with a great deal of satisfaction- and she was good at it.

Madeline was a ‘giver’. I never heard her ask for anything for herself, even when she was going through so many life changes with her health.  When she’d call me, she’d sound upbeat- and she had so many reasons to be bummed.  She’d send funny e-mails, and periodic notes- and never complained.

When Madeline would hear of something just not sounding fair in regards to how someone was being treated after some management changes at the hospital, she felt so badly for them.  Madeline believed in people being accountable- but she also knew that sometimes people got a really raw deal… and it hurt her when they hurt.  One other supervisor comes to mind in regards to that.  We both deeply respected that other person.  Madeline didn’t always wear her emotions on her sleeve, but she was an incredibly caring person who wanted the best for those around her.   Sometimes there might be someone (usually someone who didn’t last long) who drove her a little nuts- but she was always fair if anything came up that involved her input with that person.

I’ve worked with some great people in the years I worked as an RN.  Madeline Spenrath is someone who I will never forget, and am forever grateful for things she taught me.  I became a better nurse and person for having known her.

For those who knew Madeline, and would like to leave a comment about your memories of her, please feel free to do so, and I’ll get them added to the comment section 🙂

Mom’s Final Days…Please Excuse Me While I Bawl My Eyes Out

This is still rough.  And yes, it’s long.

Mom had been through so much, and survived.  She had been through breast cancer, pre-cancerous tumors in the other breast (so bilateral mastectomies when all was said and done), reconstruction, metastasis to her right lung (so part of her lung removed), and then metastasis to her brain (so removal of a right frontal brain tumor, roughly the size of a golf ball). In the mix, she’d also had a hysterectomy, gallbladder removal,  and ankle surgery (she fell and broke it in the bathroom).   There were countless hospitalizations, radiation, chemotherapy, rehab, and progressive decline.

By March 2003, mom had been cancer free for 17 years.  Considering the number of sites  where she’d had it , that’s pretty amazing.  But the radiation for the brain cancer had left her with dementia.  Bottom line- she was goofy. Her memory was horrible.  She could still answer simple questions, and liked going out on rides in the car. She still had some things she enjoyed (if it came in the form of a candy bar, so much the better).  The day before she ended up in the emergency room in Sun City West, AZ, she had been to an art opening and visited with friends.  She may have had no memory of it later that day, but for the moment, she was happy.

Dad called me one afternoon to tell me something was wrong. She just wasn’t  right. Something had ‘dulled’.  I told him she may have had a seizure and to keep an eye on her. If he saw a seizure, dial 911.  I got a call not long after that from him; they were in the ER at Sun City West Hospital.  She’d had a seizure, vomited, and then been out cold when 911 got there.  He sounded scared, and he never sounded scared with all she’d been through before this.  I told him to call me with any updates.  I was near Chicago, so really depending on his reports.  I felt helpless.  I’m an RN.  I want to help ‘fix’ things when family and friends are sick.

He called me  a while later saying that they couldn’t get blood from her to do tests. Huh? This made no sense; they’d gotten an IV in her and had fluids going. Her urine test showed an infection. With the change in her normal behavior and the positive urine test, that told me she was septic. That is basic, BASIC knowledge in the medical field, especially with older patients.  I told him to tell them that they needed to restrain her, and get the blood. They refused to use restraints even briefly- so did an incomplete workup for their convenience.   We exchanged a few more phone calls (me getting more and more angry), and the bottom line was they were sending her HOME with him on oral antibiotics (well, their rental home).  A partially conscious woman with a urinary tract infection bad enough to make her lose consciousness and seize, and she was being sent home.  I was beyond livid.  Dad was terrified.  It took three people to get her into the car (a clue?), and he had to get help from friends on the other end to get her to bed.  Somewhere along the line, they got the antibiotic pills.

I’ll never believe that the ER people did what they needed to do because mom had dementia and was a ‘no-code’ (but she wasn’t actively dying yet; the no-code was not in effect).  And the hospital was full (like they couldn’t move her to another hospital; she NEEDED IV antibiotics and fluids).  The doctor signed off that she was safe to fly later on… that’s nuts, but she’d be out of his hair.  I’ll never know if it would have made a difference.  I just wanted her to have a chance. As it ended up, dad and I have to look at the one positive: she didn’t end up curled up in a nursing home, not knowing anybody or anything.

Over the next few days, dad came up with various ideas on how to get her home. She was taking the crushed pills in applesauce, and when I’d talked to her, she sounded exhausted but was answering the usual basic questions. She was doing better- but not great.  I didn’t know exactly how badly her body was doing, but I knew I supported dad’s plan to get her home.  Except the plan to drive her home.  I had visions of her dying en route, him being arrested for transporting a body, and mom left in the car in some car impound area…. sometimes an imagination is a bad thing.  I made him  promise me NO DRIVING HOME. He promised.  The final option was for her to fly to O’Hare where a friend of dad’s would drive me in with his van so we could let mom lie down in the back while he drove us back home. Dad would then drive on his own, and be back in about three days.  When I talked to her, I was satisfied that she was ‘back’ enough to be near her baseline.

Well, part of that worked out.  Dad got to Sky Harbor Airport in Phoenix, and the folks at American Airlines said she could fly, but only if he was with her.  He left everything but what he was wearing and got on the plane with her.  A few hours later, they were in Chicago.  I was allowed past the security gates to help get her off of the plane. The folks at American Airlines were wonderful. Her wheelchair was waiting (as were a few others- must have been handicapped day for flying), and the flight attendants said “Oh, you must be J”…. Uh, yeah?  Mom  smiled when she saw me, and we got her into her chair, and headed for the van.

When we got to the van, it’s like mom knew she was near home, and partially collapsed. She didn’t have to fight. I was getting nervous that we wouldn’t make it back home to the hospital where her doctor practiced. (why do they call it ‘practice’?  Shouldn’t they ‘know’ at that point?) I’d brought a blanket to use as a sling to ‘arrange her’ in the back of the van- which dad’s friend helped me do while dad put the wheelchair in the way back part of the van.  Dad was muttering about getting her home to bed, and after a good night’s sleep, she’d be fine.  I looked at dad’s friend, and shook my head no.  We weren’t going home. We were going to the ER.  If I had to get out at some toll booth area, and do some psycho dance, we were NOT going home.

Mom moaned most of the way back to our home town. Somewhere along the way, dad knew that we needed to go to the ER (thank God).  We got her there, moved to a stretcher from the parking lot, and thus began the end.  The ER people knew by looking at her that she was going to be admitted, and when they started an IV, they got blood.  Hear that, Sun City West ‘Hospital’???  It was BAD.  She was septic (duh) and her kidneys were failing. She also had a high blood sugar (she wasn’t diabetic and not on steroids).  She did know the name of her doctor when he came in to see her.  Dad and I stepped out into the hall with him and one of his first questions was about resuscitation measures that we wanted.   We’d discussed this before. If it got to this point, comfort was the primary issue.  It was fine to do fluids and antibiotics in this situation since she was in and out of lucidity, and she theoretically could get better…but her kidneys had never looked this cruddy. She was dying. The blood sugar issue wasn’t helping anything. Her white blood count wasn’t good.  We decided to get her admitted, see her through that and then go home to bed since she was relatively stable.

I’ve seen so many people die I’ve lost count.  That sounds rather cold, but as an RN of 18 years at that point, it just wasn’t possible to remember them all.  I knew the signs. I was seeing some of them, but I was still in and out of denial.  I felt OK going home that night though.  Dad and I told the nurses to call us if anything changed; we lived about 5 minutes away. We went home. She was awake, and tired, but looked ‘settled’.

The next morning, mom was getting the last part of her bath when we first got there, so we waited in the hall for a few minutes.  When we went in, she was awake, and recognized us. She was even drinking some nutritional juice-type drink (not the milky based stuff). She’d had a seizure during the night, and got some IV medication for that, but was doing a bit better. The nurses were wonderful about letting me see her lab work, and her white count was down, mostly from being diluted somewhat from the IV fluids. It was still in the septic range, and her kidney function was still in the ‘not-going-to-get-better’ range.  But she looked a bit perkier.  That was nice for the moment.

At lunch, dad’s friend (who did the van driving the day before) had offered to fly to Phoenix, and get the stuff from the rental house. He then offered to drive the car back to the Chicago area.  Wow.  We all went to the hospital cafeteria to talk about the plans.

We got back to mom’s room about an hour after we’d gone to the cafeteria, and there had been a huge change.  She was beginning to mottle, and was groggy. I’d seen that  mottling SO many times, and that is one of the things that people don’t come back from.  It’s when the circulation starts to shut down, and blotchy dark purplish-blue areas are visible.  Hers had reached her knees.  I ‘knew’.  I told dad that if he wanted to tell her anything he needed to get after it; she was dying. He figured she’d be fine (after all, she always got better, right?), but must have sensed something about my reaction. He asked me to step out for a few minutes. I did.   She was quickly going into a coma, and even at that point, I’m not sure how much she was hearing.  But it wasn’t just for her. I wanted HIM to have closure.  Then I took my turn.

During that afternoon, she went deeper into the coma, and I’d let her nearby brother know earlier that if he wanted to come, it was probably better to do so sooner rather than later; he and my aunt and cousin came.  I was also in contact with mom’s other brother, and only sister.  Mom’s mother was on her way back from  the winter in Florida and with the brother in Tennessee.  They were making plans to drive up here (near Grandma’s home also).  Her sister was looking for a flight ASAP.  A very few family friends also came; we didn’t make it broadly known what was going on.

Mom never regained consciousness, and I decided to spend the night at the hospital. She couldn’t tell anybody what was going on, and I wanted to keep track of how hard her breathing was (or wasn’t), and if she showed any signs of pain.  It was a long night. She did start having some respiratory patterns and sounds that indicated she was having a bit of trouble. I asked for some medication to be ordered, and the nurses were great about contacting the doctor (at about 3:00 a.m.) and getting her something. That helped her breathing ease up.

That was the same night Elizabeth Smart was found alive in Utah.  I’ll never forget that. One family was welcoming someone back home, and I was watching someone leave this earth.  I still remember that so clearly. CNN was all over it.  Mom would moan occasionally, so I’d move the chair closer to the bed and hold her hand and talk to her. I also let her know (whatever she could hear and  understand) that dad and I would be OK. If she wanted to keep fighting and come home, that was great!  We wanted her with us- but if she was just so tired of fighting all of the medical stuff she’d had go on over 20+ years, it was OK to stop, and  let go.  I also let her know that whatever had gone on in our relationship, everything was OK.  We were good.  It’s important to let folks know that the living will be OK, and give them ‘permission’ to be free.

She made it through the night, and remained in a coma.  Dad came back up in the morning, and we both stayed during the day.  Another couple of friends came by, but mostly we answered the phone calls, and just talked to each other.  Mom would only respond to discomfort, so we let her be.  I did agree to the air mattress the night before to make her skin less likely to break down- nobody knew how long this was going to go on (though the mottling is not generally something that happens until near the very end).  By that morning, her blood pressure was so low they needed an ultrasound gizmo to check it- so we didn’t bother with that other than once a shift.  The blood sugar wasn’t going to get fixed- so no point in making her wince and groan with each fingerstick and insulin shot; they weren’t doing much good anyway.  Had she shown signs that she was going to get better, I would have agreed to those things. At that point, it was just pain. She had no periods of even being remotely awake, and the mottling was getting darker.  She needed peace and comfort.

Dad’s friend had made it to Phoenix, and found the obituary mom had written for herself many years earlier, and left in her address book. He faxed it to his wife, who brought it to the hospital for us to have handy.  That was a huge help.

I was so torn about what to do that night. I didn’t want her to be alone, and dad wasn’t up for pulling an all-nighter (understandably at age 70).  I needed to get some rest if I was going to work the next night at 7 p.m.  But I really didn’t want her to be alone. The nurses were great, but it’s not the same as having someone next to the bed, watching.  I finally had to make the decision that I’d have to go home that night so I’d be OK to work the following night.  I hated that.  Dad knew I was struggling with that, but we knew that we could both be at her bedside within 10 minutes of getting a call from her nurse.  And we told the nurses to call for anything.  Anything.

Around 8:30 p.m. or so, her breathing got funky.  Like ‘here it comes’ kind of funky, but also somewhat labored, so I asked for the medication for her breathing to be more comfortable.  The nurse gave it, and it did help. Her breathing became less gravelly. (She didn’t have the ‘rattle’; it was different). At about 8:55 p.m., her breathing became sporadic, and I told dad this was the last pattern I usually saw ‘at the end’.  He was still hanging on to the idea that his partner of 46 years was just going through a rough patch and would recover.     I told him no. This was it.  And it was fast. Really fast when it finally happened.

At 9:00 p.m. my mom took her last breath. She was gone.  Dad and I were on either side of the bed, holding her hands. She wasn’t alone. She didn’t have any more pain or confinement to a body and mind that had been ravaged by disease and the effects of radiation.  She was free.  There was a brief moment a couple of seconds after she died when she looked like she had 30 years earlier.  I don’t know if my fatigue was making my vision wacky, or what- but I saw my mom. The one I’d known before anything was medically wrong with her.  She was at peace. I’d like to think that’s when she saw Heaven, and the Lord she loved so much.  She finally got to see the two baby boys that had each died soon after being born, that she’d never seen in life.  She wasn’t held back by anything.

On March 13, 2003, she was healed.

The Power of Decency

January 10, 1987…the date that altered my life forever. I was 23 years old,  had been raped, beaten, and had things done to me that I’d never heard of before.  I’d never had ‘normal’ sex before… After six hours of this torture (as it was termed by the newspaper writer at the trial) I finally was able to escape when the man who did those things to me passed out in my bed.  Before then, he was within inches of me along with one of my large kitchen knives.  I had to wait until it was safe to make the attempt to get away. Even when he had to use the bathroom, he had me get down on my hands and knees, and traced the knife along my spine with one hand until he was done.

I’d pounded on the downstairs neighbors’ door wearing a bath towel.  I had met them the day before (having moved to that complex 10 days earlier).  It was January in central Texas, and I was barefoot in a bath towel.  My face was swelling from being beaten in the head, my lip was bleeding where my teeth had gone through it, and I was bleeding from the force of the wine cooler bottle that he also used to repeatedly rape me (with it’s torn foil label on the neck of the bottle).  And unseen trauma from the force of ‘him’.  I was terrified he was going to catch me before the neighbor answered the door, and hadn’t even thought that they might not be home.  Fortunately, late on that particular Saturday morning,  Mrs. Neighbor was baking muffins. She answered the door with a muffin tin fresh out of the oven, an oven mitt on her hand.  She just sort of looked at me for a second, as if to try and make sense of why this 23-year old was standing in front of her in a towel.  I tried to be calm as I said “I was just raped. He’s still upstairs. Can I use your phone to call 911?”.

She got rid of the muffins, and grabbed me- pulling me into the apartment and closing the door. Mr. Neighbor then came out of the spare room, and saw me.  They both got me to the phone, and stood by as I called 911, and told the 911 operator the situation.  Mrs. Neighbor then went and got me a pair of underwear (she was about 5-foot nothin’, and much smaller than I was, but she wanted to give me some modesty), one of her robes that was quite small, and some slippers…she was also a mom, and treated me as a mom would.  The ensemble was complete; I was in a small robe that required the bath towel to fill in the gaping front, small undies, and slippers about two sizes smaller than I wore. I was so thankful to be covered.  Mrs. Neighbor told the police ,when they told her those items had just become evidence, that she wasn’t worried about her stuff. She wanted me to have something to help cover me up after what had happened.  That proper Jewish mama wasn’t sending anybody out naked.  *Thank you, Mrs. Neighbor, wherever you are*

The first police officer arrived fairly quickly and went up to my apartment. I’d left the door unlocked when I escaped, so he just walked inside.  What he hadn’t expected was to be beaten up by the rapist as he tried to handcuff him in my bed before he fully awakened.  The sound of his body being slammed around my apartment as I listened from downstairs was disturbing. One bookshelf was knocked over, and various items were crashing to the floor. Finally, the front door slammed, and he hollered down to Mr. Neighbor (who was listening from the doorway of his apartment- where I was) to call for backup.  Poor cop was a rookie, not expecting to get pummeled.  He ended up sitting on the pavement in front of the stairs leading to my apartment. He ended up with some minor injuries, and a major lesson.

Mrs. Neighbor called 911 again, and explained the situation. There were more officers en route, but they were having trouble finding the exact apartment on the large complex grounds.  Shortly, however, there were officers and police cars all over the parking lot.  Soon after that media trucks arrived, including all network TV stations. They made short work of setting up their cameras.

The backup officers went upstairs, and began the process of apprehending the man who violated me. There were more sounds of struggling, and officers in front of my apartment had their guns drawn, aimed at the balcony. Neighbors had started gathering to check out the commotion. At that time, I’d begun ‘shutting down’.  I had been in survival mode for so many hours, and hadn’t been able to let my guard down at all. When I finally could, shock set in fairly quickly, and while I was still aware of my surroundings and what was going on, I was more into my thoughts than what was going on around me. I was sitting in a rocking chair in the Neighbor’s living room, somewhat oblivious to anything but my thoughts, and the occasional glimpse out the window at the gathering crowd.  I never heard the gunshots upstairs, though Mr. Neighbor did.

By then, an ambulance had arrived for me, and the EMTs had started checking my vital signs, and assessing the busted lip and visible bruise that was blooming on my jaw. The other injuries would have to wait for a physician at the ER.  I had torn uterine ligaments, and various abrasions and lacerations from the foil on the wine cooler bottle.  A hospital helicopter was landing to take the rapist to the hospital. He had been shot in the groin, and was losing a fair amount of blood. From what I later heard, he was moving towards the officer, and not a ‘still target’; the officer that shot him later apologized profusely for not killing him.  I was kept inside the Neighbor’s apartment until ‘he’ was loaded into the helicopter,  and gone from the premises.

The EMTs were going to bring a stretcher in to take me to the ambulance, but I asked them to let me walk.  There had been enough drama, and the TV stations were still filming.  I was assured that they wouldn’t film me (rules about ‘victims’).  I still wanted to walk out, and not be buried under blankets on a stretcher. For some reason, I had to prove I wasn’t completely damaged, filming or not.  I didn’t want to look like I’d been destroyed.  I had to show I was stronger than what he had done to me. Those weren’t conscious thoughts at the time, but I knew I didn’t want to look ‘that bad’.

On the way out, cameras were still mounted on tripods, or in the hands of those filming, aimed in the general direction of the sidewalk. I walked past all of them, and looked at them. One relatively young female photographer made direct eye contact, and then did something that made a huge difference on that horrible day.  She aimed her camera at the ground, and bowed her head as I walked by that group of cameras.  She was offering me a sign of respect after I’d been completely dismantled in regards to dignity and simple human decency.   I wish I knew what TV station she was from so I could thank her (I’ve tried writing to all of them over the years), and let her know that that gesture was something I’ve never forgotten. That act of decency was, and is, greatly appreciated. It took her 2 seconds to do, but it’s lasted a lifetime for me.  That act of decency is one of the most healing things I’ve ever experienced.  It was the beginning of becoming a survivor, and not staying a victim.  While I had my ups and downs as I worked through what happened during the rape, that reporter/photographer was the beginning of shedding the ‘victim’ label. There aren’t enough thanks for something that powerful.

Nobody ‘Deserves’ AIDS…

I was a young nurse in the late 80’s when AIDS was really exploding.  I’d hear some really snarky comments about ‘well, those guys deserve it’.  Really?  Looking back, with more years of experience and observation under my belt, I’ve got some questions about other people who may have deserved their ‘end’.

Look at the number of celebrities who have died from drug and alcohol abuse/addiction.  They must have ‘deserved’ it, eh?  John Kennedy, Jr.- risky flying conditions, he must have deserved to go down, too.  The guy who came up with the Atkins diet- he slipped on ice, fell and cracked his head a good one, and died as a result.  Must have deserved that.  You think they have nothing in common? Well, consider this:  all high risk actions have high risk consequences. Period. 

I grew up in an evangelical church, and know the stand on homosexuality from that arena.  There was no looking at the person aside from the actions that caused some to contract AIDS.  I got to know some of the AIDS victims (and yes- they were victims of a disease that is incredibly cruel).  Not everyone who got AIDS back then (and certainly not now) was gay. And even the gay guys deserved some compassion.  Hey, church- love others, right? Or just ‘some’ others?

I’ll never forget one guy; he’d been with us for several weeks, and was deteriorating.  The family wanted him to be ‘comfort care’, no heroics; the doctor wouldn’t write the order.  Now this guy was lucky to have anybody around at all. Most of them were alone after all of their ‘friends’ and ‘family’ bailed out on them after their diagnosis. The nurses were their only contact with other humans.  Anyway, one night this guy stroked.  It was bad. The doctor still wouldn’t write the ‘Do Not Resuscitate’ order, so if he had started going south (even more) we would have had to ‘code’ him.  I talked to the doctor, who was great with AIDS patients, and normally very realistic with prognoses. He still thought this guy would pull through, at least this time. The nurses knew he hadn’t had a seizure as the doc thought; the period of symptoms after the ‘seizure’ had lasted too long.  The night after the stroke, this patient started to look worse (hard to do).  His nurse that night was doing all she could to keep the guy from trying to take his last breath. There’s not much to do, really , but hope- and try nudging the bed now and then trying to stimulate a breath.  The family was pleading for us not to do anything, and the charge nurse was on the phone to the doc, letting him know that we were going to have to proceed with a code very shortly if he didn’t give us the order to let him go in peace.  Well, it got worse, and his nurse was to the point of putting a back board behind him (a hard, thick plastic board that provides a surface that allows chest compressions to ‘work’), and I was grabbing an oral airway (to keep his windpipe open until the code team got there and put a tube into his lungs)…we were literally seconds from starting a ‘Code Blue’.   As his nurse and I exchanged helpless glances, the charge nurse came in and said “We’re done.”, waving the written telephone order in one hand.   Everybody in the room exhaled a huge sigh of relief.  The patient was pronounced dead within a minute or two. And the family was the one around him instead of ‘strangers’ pounding on him when he took his last breath.  I still have a basket that the family had left full of candy…reminds me of him. That night was one that haunted me for a long time. I was 24 years old, and learning some really intense lessons.

Then there was the heterosexual guy who was in bad shape with AIDS.  He wasn’t going to live (as was the case with virtually %100 of AIDS patients in the early days).  His wife had contracted AIDS  from a blood transfusion after giving birth to their baby.  The wife and baby were already dead.  Blood supplies are tested now; they weren’t back then.  Her high risk behavior was to give birth. His high risk behavior was to love his wife in a faithful relationship.

The guy who was transferred up from ICU was really sad.  I was helping his nurse get him settled in the room. We were adjusting blankets, the TV, and making sure he had the urinal nearby. He couldn’t speak well, but nodded when he understood what we were saying.  Very pleasant guy, with considerable AIDS related brain damage.  Anyway, his nurse and I had finished getting him settled, and left the room. We had gotten about six feet down the hallway when we heard him cry out “Oh, no. Oh, no.”, so we immediately u-turned and went back in to the room.  The patient had wet the bed. He didn’t have the ability to react to the need to urinate and reach for the urinal anymore. When we got him up to the chair by the bed, so we could change the linen, he kept saying “I’m so bad. I’m so bad.”  It was heartbreaking.  He was so ashamed.

People can be all judgmental all over the place.  But be sure to include everyone on that list. Don’t just isolate one sin, and ignore the rest in your wrath and condescension.  We all needed Jesus to keep us from eternal damnation.  I don’t see anybody around me now who even comes close to having the right to damn someone for their actions.  If you do, there’s a preacher in Kansas you might enjoy.  He’s at a church with ‘Westboro’ in the name.  You know- the bunch that pickets military funerals?  For my fellow Christians, I’m not asking anybody to put blinders on and ignore the Bible. In fact, I’m asking you to live it.  Hate is a choice.  But so is love.  If Christians won’t step up and help those who really need the love of Christ, who will?  Nobody deserves to suffer, and everybody can be saved.  If the first thing you think of when you are reminded of a particular group of people is ‘sin’ and some form of judgement, then love isn’t the first thing on your heart.  I’ll pray for you.

It Was A Privilege, Sweet Lady, It Was A Privilege…

Before ending up on disability eight years ago, I was a full-time registered nurse for nineteen years.  I graduated in 1985,  back when hands on nursing was how nurses were taught, and if any of us hadn’t planned on getting our hands dirty, we were told on the first day of nursing school to leave and not come back.  Because of that way of teaching and thinking, I was prepared to really get in the middle of things even when I’d become a charge nurse  or shift supervisor (and many RNs in the region elevated themselves above actually touching a patient- Lord knows nobody else did!).

I remember many patients fondly  in the countless patients I saw over the nineteen years I worked.  Some of the names may have been lost to time and a memory full of patients, but I remember many  of their situations and some events/characteristics quite specifically. There are a few select patients that were a gift to know.  They weren’t  technically VIPs as the world sees people, but my life was better for having known them. I’m very thankful for each of them.

One of my favorites (and yes, I know I was  supposed to be impartial, but I’m human!) was a wonderful woman who was in and out of the hospital as she battled terminal cancer. She was an immigrant from Germany, and still had a delightful accent in her flawless English.  Even with the torment her body was going through, she had a wicked sense of humor, and if someone got to know her ‘well enough’, she could come up with some silly comments that totally masked her life as it was then.  She used to tell me I was like a bat. On the surface that doesn’t sound so sweet, but she’d have a sideways grin, explaining “You are up all night, and in the morning you want blood.”  She had a point !   I love bats now; they remind me of her in a fond way.

She was in her 70’s I think, and aside from the cancer that was killing her, was fit and mentally sharp. She also was from a generation that still believed in some modesty in personal matters, and was very unsettled when she had difficulty with control of  some bodily functions.  While I was in charge and didn’t have a direct care patient load, I would often answer her call light because she had expressed some mild uneasiness at the youthful  unawareness of some of the younger nurses who would help her get cleaned up. She was ashamed, and embarrassed.  The younger nurses didn’t mean anything by their quickness, though a few would come back to the nurses’ station stating that the odors were offensive to them (which was the place to express those things- we all did).  I told this patient that if she wanted me to come and help her, she could just tell her nurse that she wanted to talk to me, no reason need be given, and the nurse would not be in trouble. (They were all very sweet, and did a good job as young nurses, but the were young, and just didn’t have the experience to look at things as the patient might be seeing them- or how they would feel in the same situation).  She thanked me, and did call for me periodically.

This woman was no stranger to suffering, and yet she remained upbeat and pleasant. The ‘worst’ I ever saw from her was when she’d get a bit quiet. I’m sure she had to be exhausted. There was nothing left to do with the cancer except for comfort care.  Her husband would come to the hospital every day. I rarely saw him, since he’d go home before dark, and I worked the 7 p.m. – 7 a.m. shift.  But he was consistent, and her main support system.  What I heard about him from the day shift told me he adored her.

What really left an impression about this sweet lady was the tattoo on the inside of her left forearm. She was a concentration camp survivor. She had seen- and lived through– the absolute worst that humanity has seen (and done) and she hadn’t let that determine how she interacted with the world around her. It would have been so easy for her to be hostile, untrusting, and resentful, but she was the exact opposite. She was a true survivor, shedding the ‘victim’ label and mentality when it would have been more than understandable to let it define her.  She and I never discussed that tattoo, but she knew I’d seen it (she didn’t attempt to hide it, nor did she ‘show it off’- it just was). Maybe my  eye contact after first seeing it let her know that I acknowledged the indescribable hell she’d survived. I don’t know.  We talked about general things, and she seemed to feel comfortable with me, so I believe if she had wanted to discuss it, she would have. It wasn’t something I felt I had the right to bring up.  I had no frame of reference for the horrors she’d witnessed and lived through, and while I would have gladly listened to her, I didn’t want to seem intrusive into something that so few truly understand.

I was amazed by this sweet lady. I felt honored to have known her, even during a part of her life that was unpleasant and sometimes messy.  She embodied life even though she was dying.  She showed me what the human spirit is capable of, if chosen.  When I heard that she had died at home (with hospice care) I was sad, though also relieved that  she didn’t have to endure any more of the nastiness that cancer brings.  I knew she’d never leave my memories of nursing. She’d always be someone I thought of when anyone said ‘survivor’, even though she’d died.  She had enriched my life, though I was supposed to be the one making hers a little better.  She was a privilege to have known.