The Life and Times of Florence Knitingale

Tuesday, December 05, 2006

Why I Want to Be a Nurse, part II

I met her for the first time when I was a brand new medical assistant. Green, you might say. She had come into our clinic with a deep cut which clearly needed stitches, and she clutched soaking gauze to it as she stared at me. She was intimidating, this woman. She appeared angry, defiant. She spoke very little. When I asked her how she had gotten cut, she glared at me and said “I did it to myself.” And she waited. Right away, I knew a few things. I knew she expected me to judge her. It was in her eyes. I knew she figured I’d be shocked, uncomfortable, disgusted. Or worse—that I might pity her. I knew that even a delay in answering would be catalogued, tucked away, and I’d be found wanting. I also knew that I would likely see her again, and that whatever I said or did next was my only chance to get through the outermost layer of her anger and fear. If I did it wrong, I’d never get another chance. I scarcely dared to breathe, so fragile and fraught was the moment. I nodded, met her eyes, and replied as calmly and matter-of-factly as if she’d said the carving knife had slipped “Okay. When was this? About an hour or two ago?” She blinked. She cocked her head to one side. Clearly, she had not expected this. We sat and looked at one another for what seemed like years. Finally, she allowed as to how it had probably been an hour or so. I nodded, handed her fresh gauze. I told her I was glad she’d come in, and I left to get the doctor.

I was right that I would see her again. She came in often, almost always for the same thing. For the first few times, we did the same dance over and over. She would challenge me, wait for the judgment that did not come. Slowly, painfully, she began to trust me. She began to look for me when she came in, and we started to connect. I liked her, if the truth be told. She was so much more than her pain, and the things she did to herself, while disturbing, were far from the most important thing about her. She turned out to be shockingly intelligent, and possessed of a sharp and dry wit that often caught me off guard because of her perfect, deadpan delivery.

There were rules. I tend to touch my patients—a hand on a shoulder, a pat on the arm—if they are willing. She was never, ever willing. I never got the sense that she disliked touch but rather, that she was denying herself even this small comfort. Her self-harming shamed her and her self-loathing ran deep. Another rule was that I could not be sympathetic in any way. I learned to never ask her if the wounds hurt, or to murmur words of support when she got the painful injections of anesthetic so she could be stitched up. I could ask her about her pets (whom she loved) or I could tell her something funny. I could stand nearby where she could see me, but even the simple kindness of a pillow under her head was often too much.

If this was a movie of the week, it would end with her getting the necessary help and slowly stopping the behavior, and my presence in her life would be a catalyst for change. If you work in the medical profession, you know better. “Helping people”, a fine ambition, is nevertheless a phrase that requires redefinition over and over again when you care for people in this way. It was beyond my ability to help her with the soul-deep wounds that had brought her to this place. But I could and did create a place of comparative safety, and one without the judgment that she feared. When I left that clinic, she was still suffering although she had started to see a professional. It wasn’t the first time. I hope fervently that it was the last, that it did the trick, but I know the odds aren’t good.

Thing is, my co-workers (who were mostly sweet young things) were baffled and would say things like “You’re amazing with her”. As if she were a dog to be trained. I hated those remarks. I wasn’t amazing with her—I was amazed by her. I was amazed by her strength, her courage. You’re probably thinking that it doesn’t sound very strong to keep hurting oneself over and over, but who knows what dealt the vicious blow that led her to that place? For her, survival of any sort was probably a triumph.

It’s like when you walk on an icy sidewalk in slippery shoes. You flail, right? You wave your arms around and bend and twist and grab pointlessly at whatever’s nearby, just to keep from falling on your ass. And it makes perfect sense—to you. But to the person across the street who doesn’t see the ice, you look like a freak. Your behavior is crazy, inexplicable. It’s like that with people who have been so badly hurt. I couldn’t see this lady’s personal sidewalk, and nor could anyone else. She was trying with all of her being to stay upright, though, and I admired the hell out of her for that.

I’ll tell you the absolute truth: if I helped her, if I held a fraction of her pain from time to time, if I made her a safe place for brief periods, then I’m glad. But knowing her was a gift. She taught me volumes about life and about pain and about caring. About the breathtaking indomitability of the human spirit. She taught me that you can touch without your hands and you can comfort with laughter and help doesn’t always look the same. Everything she gave me was precious and rare.

She’s why I want to be a nurse. But not just her—all of them. Every last person who comes for help and still graciously offers lesson after lesson while asking little or nothing in return. They’re gifts that take my breath away over and over again. I can’t believe I get to be there for that…..but I know I don’t want to stop.


  • At 4:43 PM, Blogger Marianne said…

    Somehow...there's got to be a way..for you to get your nursing degree and practise the art of nursing...and to practise your art of writing...because I swear, more people given half the chance would read your words...over and over...seriously.
    You are an angel.

  • At 7:01 PM, Blogger Peg said…

    So beautifully written, Ms. K. I never celebrate Christmas without thinking of the 'repeat' patients who just could not face Christmas at home, but would end up in hospital and curl up in the bed like a small child. What hurt brought them there. I don't know, but I hope, like you, that I helped somehow!

  • At 11:42 PM, Anonymous angie cox said…

    You would be such an amzing nurse Florence.I feel deeply patronised when I have a very severe panic attack .My G.Ps just don't know how to deal with the state I am in , I know you would. I must admit that tears are rolling down my face . So many of our Doctors see their careers as status symbols , empathy with patients is rare. It should be a vocation not a job.

  • At 5:04 AM, Blogger Ms. Knitingale said…

    Angie, now I'm crying, too. I hate the thought of anyone patronizing you or making you feel badly for having panic attacks--which are so terrifying and so real. The last thing you need is someone to make you feel worse. I used to keep a sign above my desk that said "Whatever the patient is complaining of may not be the worst thing you've seen all day--but it's almost certainly the worst thing the patient has seen all day." I wish to heaven that all doctors would remember that. Just know that you're not alone. Whomever is taking care of you next time may not be giving you warmth and support--but over here, in my heart, I am.

  • At 9:12 AM, Anonymous marti said…

    ms. k, you are truly amazing woman! i am thankful for your gifts of writing, nurturing and just being you.

  • At 10:22 AM, Anonymous angie cox said…

    Thank-you Florence'll understand this .My Panic attacks are visual to me as a huge Tiger that I am fighting .I can feel his breathe and weight .The Doctor stared at me , the counseller straed at me only the psychologist listened .Sadly on the N.H.S you get three sessions and then they suggest you spend all day in a care centre.I only have very severe ones about twice a year so I am not ready for that . I do have medication but sometimes I can feel it is being over-ridden .Our Doctors are high class Hindus and the staff there told me they treat most people like that .They should work in the private sector ,as it is they do both . big hugs.

  • At 10:56 AM, Blogger Charity said…

    Very well said, Ms. K. What a beautiful gift you have, to look into a person, past their pain, or "issue". I hope you are an example to those around you, that you are able to share this gift with your fellow students, as well as your patients.

  • At 11:38 AM, Blogger Kit Is Knitting said…

    I think the other students were amazed because it takes such a high level of sensitivity to have found an appropriate way to relate to this patient of yours.

    And I'm impressed at the way you approach nursing. I feel similarly and yet haven't found very many nurses who are open like that.

    Thanks for the connection.

  • At 2:59 PM, Anonymous Doris said…

    What a beautiful post. I have a son with Bipolar Disorder and pray that whenever he seeks help there is always someone like you there. I know that that won't be the case, but it sure would be nice if it was.


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