Monday, May 4, 2009

Being Seen

I have had the most interesting weekend at work.

For the first two shifts of the weekend I had the ER, along with some general med-surg floors. I had to confront death head-on for a couple of patients. I lost one battle and am still in the process of losing another.

A 75-year-old man comes in as a full cardiopulmonary arrest. We are doing CPR, and they let the family back. I hate that. Hate it. I have to remain detached and professional to do my job effectively. But this little old lady comes limping back with her family, as we are doing CPR on her husband of over 50 years. They have had this life together, and I feel like we are taking that away from her when there is nothing we can do to save the man. As I watch her cry, I am finding it hard not to cry. The doctor calls time of death and I help her limp to the bedside, where she gives him a kiss on the cheek and crumbles with grief.

The next night, another full arrest comes in. That is what these patient's are to us. The full arrest in bed 18 or 8 or wherever they land. Not a name. She comes in already intubated, so the task of ventilating her falls to me. I am tweaking the vent to find a way to ventilate her that works best with her natural patterns of ventilation. I have my back turned to the door, turning knobs on the vent. I turn around for some unknown reason and see this sweet guy from housekeeping there behind me. In that instant I assume he is at work until my eyes take in his street clothes. He looks at me with these wide eyes, and I just know. I ask him if it is his mom, and he just nods. He stays in the room while we do all sorts of medical procedures to the woman. She is nude from the waist up for an EKG, and all I could think of was my relationship with my son, so I reach over and cover her breasts with a sheet. Later I go down to the smoking area for a much needed break for coffee and a Marlboro Light. He is down there smoking too. Before this, he and I would joke about college football. He would tease me about my hatred of Florida. He was always quick to offer a smile. Before that, I don't think either of us were very aware of what the other does in the hospital, other than these huge badges that go along with our picture badge that is designed to quickly reveal to patients just who we are. Mine says "Respiratory Therapist" in bright green. His says "housekeeping" in pale blue. But that night, in his grief, he saw firsthand what it is that I do. Never again in his eyes will I be the joking girl who loves Buckeye football.
We are sitting there talking. Once again, we are just two people down in the smoking area. There is no whoosh of a ventilator in the background or a beep of a monitor. He looks at me and gulps down tears as he thanks me for all of the hard work I do, not only for his mom, but for all of the other patients I see on a nightly basis. I get choked up by that. Because every night, I whisk in the room in response to a call that someone somewhere in the hospital has stopped breathing. I do my job and slip quietly away unnoticed by the patients' loved ones. I stay under the radar. They will never remember my name like they will the nurse who takes care of their loved ones. Or the doctor charged with their care. They don't know that I am the girl who stands over their family member, with my back breaking and the hot exam lights forming beads of sweat on my brow, breathing for them when they cannot. I am fine with that. I know what I do, and somewhere inside of me, despite self-criticism, I know I am good at my job. That has always been enough for me. It is okay to be the unseen. But that night, I was seen. And the reality of what it is that I do for a living settled with a big thunk somewhere inside of my soul. I see hundreds of patients nightly. I never remember names-- only faces. In that instant, a myriad of faces come back to me. I worry myself daily if I have been a success at the tasks I have undertaken. Did I do well on Exam X at school? Will I get into medical school? Does my time away from home to pursue these goals I have set for myself do harm to my husband and son? Am I truly making a contribution to this world in which we live? In that instant, the housekeeper from the hospital gave me my self-worth on a silver platter, showing me that this is who I am. That I have touched lives, even when I didn't realize I was doing anything more than earning money to support my family. And for some reason, at that point in time, my thoughts went to my mother. Is she watching me now? Does she see the hard work I do? Is she proud? What is this work I do really about? My confrontation with the housekeeper had such an impact on me. I am still the nineteen year old girl who lost her mom too soon to lung disease. And I have been battling lung disease ever since. It will not win. I am too tough to allow that to happen. It is like the housekeeper took a large mirror and held it to my face for me to see, saying "Here. Look at her. This woman, who works hard to fight for the lives of others. This woman who is capable and tough and smart, who can do whatever she deems fit in life, who will reach the dream she has set for herself, who is Pauline's daughter and John's wife and Evan's mom. She is you." I need to be thanking him.

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