The halls of my unit are a gallery - a gallery of remembered faces and stories on parade each day I spend at work. 35 beds, 35 patients, 35 lives interrupted by surgery. As quickly a as a person is discharged to home, the fax machine whirs with report of another groggy patient in the Recovery Room ready to occupy the vacancy. The rooms are constant-- scuffed laminate floor, bedside table (prone to sudden spills and tipping), recliner chair, temperamental thermostat. But the scenes that play out within those walls are diverse. Sometimes, unexpectedly, a moment or a conversation settles into the back of my mind and engraves itself into memory. These are my ghosts at work.
* * *
09
It was a rare day- meds were passed, patients were comfortable, care was charted. I dropped by to see if my patient in room 09 needed anything and found him sitting up in his recliner. Two pillows propped between his ankles preserved the precautions necessary after hip replacement surgery. Arms crossed, chin in one hand, he studied the news broadcaster as she delivered a report on a recent shooting. I watched silently with him for a moment and then shook my head.
"It seems like every time I walk by a TV, they're talking about something terrible that's happened. It never ends."
He considered for a moment. "You know, I used to get discouraged about it. I worked as a Chicago cop for years- I thought I wanted to be that guy busting down doors, breaking up fights. But I kind of got burnt out on it. Then one day I found I had a soft spot for the kids in school who go home to these messed up families, who live surrounded by drugs and shootings and broken relationships. I started going to schools just to build trust and be a safe person for them to talk to. It was amazing: these kids would open up to me- a stranger- and talk about things they hadn't told their parents." He looked over at me. "And that's when I realized that you can't worry about everything bad that happens in the world. You just focus on what's in front of you, help the people you can, and don't worry about the rest of it. There are other people working on those other issues.
"Like you, for example," he went on. "You're here every day. Think about how many people you come in contact with. That's your margin of impact. I worked with the kids; someone else is working somewhere else. It all adds up." He waved dismissively at the TV. "You can't let yourself worry about all the things out of your control."
* * *
04
The smell of alcohol hit me like a wall when I opened her door. She startled at the sound and turned from anxiously pulling apart the surgical dressing on her hand: eyes puffy, face streaked, hair straggling down her green hospital gown. Tufts of surgical dressing lay scattered on the floor where she had thrown them. "Degloving," the PACU report stated. She'd had her hand outside the passenger-seat window of the car as it sped down the highway, she and her boyfriend both drunk: all the skin below her wrist had been stripped away as the car rolled down a bank. Now, on the flip side of the O.R., she was detoxing from multiple addictive substances... in strictly medical terminology, she was a hot mess.
She sobbed into her free hand as I picked up a discarded ACE wrap off the floor. "It's so hard, everything is awful, I don't want to talk about it anymore," she wailed. Her boyfriend's lean frame stooped unsteadily with one arm tucked into a sling.
"I know it's not your thing, and that's cool, but at least you could try to support me! I mean, come ON man, we've talked about this! You know it's always been my dream, you've never even cared that it's important to me, all you would have to do is come with us and help out with some stuff, it wouldn't be for long." There was crazy in his eyes and his gait was anything but steady.
"No, NO!" my patient yelled. "Stop asking me! I don't want to talk about it! I've told you a hundred times, I don't WANT TO! Your band is STUPID!" Her sobs got louder. I surveyed the picture. This was not the first time I had broken up this fruitless discussion tonight. Even after I'd given my patient multiple doses of IV Ativan, the boyfriend still managed to work her into a sobbing frenzy. Frustration made me braver than usual.
"ALRIGHT, guys." I declared, cutting them both off but directing my attention to the boyfriend. "I have to say again that you need to stop discussing this with [my patient]. You're obviously upsetting her, and right now, she needs to calm down and focus on recovering. She just had surgery. She's in pain. Neither of you are thinking straight and now is not the time to deal with this. I know this has been a difficult night but I am going to have to ask you to leave until you both calm down. There is a family waiting room down the hall where you can go. NOW, please." I pointed to the door. The boyfriend wilted into a tearful mess as he staggered towards the door. "I know, I'm sorry, it's just not fair, I'll leave now, you guys have to do your job, I'm sorry, this is all awful."
I fully agreed.
It took twenty more minutes to calm down my crying patient and patch together her surgical dressing. By the end of the night, I was hopelessly behind with my other patients, and my charge nurse alone kept me from drowning. Days later, I learned that the boyfriend smuggled a bottle of vodka onto the unit, spiked hospital-standard juice cartons for himself and his girlfriend, and ultimately the happy couple signed out AMA.
Some days, you just can't win.
* * *
13
His little frame was tucked neatly into bed-- the sheets arrayed to perfection. His face crinkled into a mischievous smile as I pushed my computer into the room.
"Ahh, Kris-tina!" He always used the Italian version (the "right" version, he insisted) of my name. "Did you discover the answer to my riddle yet?" I laughed.
"No, I'm afraid I haven't. I wracked my brain but I still have no idea." He chuckled gleefully.
"Ah, well, keep working on it, in the meantime I will go to I-taly and find you nice Italian boyfriend. Perhaps you would not mind if he has one leg and is 40 years old?" He tilted his head up at me, and I waited expectantly for the punchline.
"...because if you double that, it's ME!" He broke into giggles again, and I couldn't help laughing over how pleased he looked. His chuckles died away into high-pitched wheezes, and suddenly he looked old, frail. He swallowed his pills submissively and settled back into the pillows.
"I think maybe I will take a nap now."
I turned toward the door, smiling, and began throwing away my isolation gear.
"Sleep well, my friend."
* * *
21
The squeaky wheel of a bed rolling down the hallway told me that my patient had returned from surgery. I hopped up and around the nurses' station and met him by the door to room 21. This was my patient's second surgery since admission, and nearly my second week of caring for him. I was relieved to skip the "hi-my-name-is-Kristen-and-I'll-be-your-nurse" speech. I leaned against the bed and evaluated my patient's tight-lipped, pain-drawn face.
"Welcome back, stranger. I hope you didn't have too much fun without us downstairs."
My patient's eyes stayed shut against the light, but he turned slightly in the direction of my voice. "Oh, absolutely. We had quite a party, they have all the pain med candy. You quite missed out. Speaking of which..." he squinted one eye open. "Where is my Puff the Magic Dragon?"
I placed his PCA pain button back into his hand. "Same deal as before. Dilaudid. You can push your button and get a dose every 6 minutes if you need to. Let's get you settled and we'll go over Dr O's orders, okay?"
He nodded. The PCT and I helped the transporter maneuver the bed back into the room.
"One more day in paradise," I grinned. My patient made a face and pressed his pain button.
* * *
