September 20, 2008

Christine Wideman, R.N.

HOWLIN’ MOON

must be a howling full moon tonight because everybody is streaming through my hospital and just howling crazy after 15 years in this job there isn’t much that surprises me anymore lets face it being sick brings out the very best and absolute worst in patients and their families and it all comes to a head in intensive care.

take poor grandma here in bed-one with a little bit of dementia at home but she’s mostly functional in her own normal environment but two days in the hospital with a heart attack have taken their toll and knocked her for a loop so i find her standing stark naked at the side of her bed with a river of poop yup poop that’s what we call it running down her leg she is holding the end of her iv tube in her mouth with one hand and staring at the trickle of blood from the bleeding iv insert site on the other hand i’m going home she says this hose isn’t putting out enough water for my flowers she holds the iv tube out to me it’s flooding onto the floor here she smiles you take it oh my God honey what in the world are you doing did you have to go to the bathroom here let me help you are you ok are you in any pain are you in any pain oh no dear she answers there hasn’t been any rain oh damn i think and glance at her ears empty God only knows what she did with her hearing aids now she’s totally confused sun downing and stone deaf too great don the nursing assistant comes to my rescue and 20 minutes later she is cleaned up and put back together we are both hoarse from screaming at her she still wants to know when she can leave her sister’s basement and go home.

i walk by my friend pat’s room to see if she needs help with her patient it’s a man who for all the world looks like a werewolf his face is a bushy mass of black hair and beard he is flushed and sweating and absolutely stinks of sweat and vomit he is tethered to the bed like an animal because that is exactly what he is right now he snorts and grunts like a pig then opens his eyes and yells mary mary you bitch i’ll kill you mary he grinds his teeth and pulls at the leather restraints and rattles the siderails and then bangs his head against the back of the bed next to the bed is mary complete with a black eye and bruised arms blossoming like purple orchids and she is angry at nurse-pat telling her this can’t be from his drinking he doesn’t drink that much she says she’s a little woozy herself with a cloud of eau du vin the doctors just don’t understand him she says there must be something else wrong pat listens and glances at me in the doorway our eyes meet and we know silently that d’nial still ain’t no river in egypt he drank two pints and a six-pack every day every day for the last 20 years but he’s been in the hospital for about two days and without a drink dry as a bone he’s in dts suffering from what we technically call sympathetic nervous system overload of alcohol withdrawal all the hallucinations tactile insects and spiders crawling on his skin visual snakes and monsters on the walls auditory hearing mary mary and another man?

pat keeps one eye on the telemetry monitor watching the blood pressure sky-rocket along with his heart rate which the ivs will bring down and she’ll give him sedatives to keep him calm and alive until his withdrawal is complete then he’ll go into rehab for about a day until he checks himself out and grabs two pints and another six-pack.

i finally make it to my other patient a man with a massive heart attack he is sick sick sickee-bug sick bad sick someone who truly has one foot on a banana peel he’s hooked up to every piece of hardware we have the room is full of machinery blinking colorful lights banging bonging clicking and whooshing sounds and alarms a ventilator an inter-aortic balloon pump multiple iv drips to regulate heartrate and blood pressure invasive arterial lines a swan-ganz pa catheter our best technology to try an save a weak 90 year old heart with a little old man attached to it i look at him and i get that bad feeling that bad feeling that every nurse knows call it foreboding or instinct it’s just an icy little trickle that drips down your spine and makes you a little apprehensive a heightened awareness i tell the other nurses keep an eye out there’s definitely potential in this room tonight he’s shocky already i can see that i’m going to be chasing the blood pressure in here all shift putting out fires and trying to comfort his poor terrified little wife she is huddled on a chair next to the bed looking for all the world like she’s ready to jump out of her skin she’s got to be 80 herself if she’s a day.

i come into the room and talk softly to her and a good thing too ’cos i’ll have to return to bed-one in a bit and shriek at my deaf grandma to help her order dinner i try to explain as simply as i can the intricate technological workings of all the machinery what the funny waves on the tv-screen mean and how her husband of 60 years is doing how’s he doing how is he doing hmmmmm well that is a truly loaded question and unfortunately we need to have the talk that dreaded talk holy mary mother of God help me again think of something really good to say i think being raised a catholic i can usually invoke mary or a saint that i like but i am happy to accept help from any positive power in the cosmos i pray for help when i have to find some way a right way to tell someone that a person they love is dying many times i am amazed stunned baffled at what comes out of my mouth so much so i think that couldn’t have come from just-me i really think there are times some higher power comes along positions me into certain situations and puts the right words into my head so that i can fulfill one of my purposes here so i tell her as gently as i can that her husband is terribly ill and that it is possible that he could die even with all the things we are doing to help him her eyes fill with tears is he suffering she asks i tell her i will give him a little morphine even if he cannot tell me he’s in pain we both can see the pain her tears spill over and my eyes fill a little bit too even after these oh so many years and oh so many deaths i am glad there is still something inside me that is not depleted yet so that i still have a few tears to spare for someone else that i do not even know as she decides to make her husband a no-code so that i will not have to jump on his frail chest or shock him if his heart makes that final run her daughters come to pick her up and take her home she tells me i will sleep better knowing you are here she hugs me goodnight before she leaves lucky her back at bed-one the nursing supervisor calls me to say that grandma who is still deaf has been phoning the police to say she has been kidnapped check in her room she is naked again and packing her bag to go home so i spend the rest of my shift running between my two rooms keeping one patient dressed and the other one alive.

all in all not a bad night nobody died on me or had a major calamity i couldn’t say it was routine ’cos no nurse’s day is ever routine it’s never predictable never boring but always spent with people i like most people the other stories i could tell you would curl your hair flat and i’ll tell ya fiction’s great but nothing beats the reality of people doing what they really do howling streaming through my hospital.

from Rattle #28, Winter 2007

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