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Heroic Measures

I'm reading The Geography of Bliss, a nonfiction account of a curious and somewhat discontented journalist who decides to hunt out who the most happy people are and why. On his search, he visits Bhutan and meets a man who runs the country's think tank, appropriately named Karma. Karma advises the author, "You need to think about death for five minutes every day. It will cure you, sanitize you....It is this thing, this fear of death, this fear of dying before we have accomplished what we want or seen our children grow. This is what is troubling you....Rich people in the West, they have not touched dead bodies, fresh wounds, rotten things. This is a problem. This is the human condition. We have to be ready for the moment we cease to exist."

But I touch dead bodies, handle fresh wounds (both physical and mental), and rotten things. I, and my fellow emergency department coworkers bear the brunt and weight of the rancid realities of life and death and what happens in between. I'm not sure that it's made me happier.

It makes me want to tell someone that the next time they find themselves in an ER with their 86 year old grandpa saying, "Do whatever it takes to save him," don't think you're a hero. "Heroic measures" mostly mean the opposite--fear-driven, ignorant, selfish, torturous measures. It often takes more courage to decide to let someone die than to tell those of us to be the "heroes" who pound on a chest, hear and feel the sharp yet dull crunch of ribs under our hands, smell and clean the bloody stool, watch and suction as a physician moves a cold metal blade down an airway, insert large tubes to drain urine, gastric contents, or infuse medications. We feel like torturers, roped by your cowardice or inability to face reality into tormenting a person to whom we wish we could give morphine and a less painful, less violent death.

This exposure and participation in the most intimate, gritty, traumatic moments of life and death is a rare thing. A gift? A calling? An identity?

Even at my sister's house, if a nephew gets sick, it's me that is comfortable standing with him over the toilet. Someone on a plane or bus that needs help? I move forward. A little dog, having a seizure? I hold her, stroke her fur, murmur comforting words. I love doing it. I'm glad I've turned into a nurse.

I remember when I was a nurse at the beginning, but was too shy, intimidated, insecure, to say or do what I wanted when someone was dying. Now, almost nine years later, I fight a different set of demons. The demons of anger, apathy, resentment, bitterness, judgment.

Will moving out of the ER fix this burn-out? I don't know. But I'm tired of being an anti-hero. I'd like to be a nurse again.


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I waited for a second, then looked at his wife and smiled, and she smiled back. I asked, "Did you just say you were wearing panties?"

He said, "Um, yeah." We all started laughing.

A few hours later, when I was discharging him, he asked, "You're not going to tell anyone that I called my underwear 'panties,' are you?"

I replied, "Oh, you bet I'm going to tell people!"

Good Question

The other day, a patient asked me, "Do you have any pets?" Immediately, I pictured Spike and his cute little mustached face and hilarious personality. I replied, "Yes, a little Cairn Terrier. How about you?"

She told me about her three Italian Greyhounds, and showed me pictures on her phone.

It struck me suddenly that this is a fabulous question to ask people. It's not invasive, it won't make the childless people hurt, and there may be some fascinating stories behind the answers.

Usually, patients and other strangers ask me if I have children. I say, "No, not yet" and leave it at that, quickly getting back into my therapeutic nursing communication mode to get the focus off me and back onto the patient. But I always feel the ache of having to say "No, not yet" over and over again. It just felt so good to be able to say, "Yes!" to the pet question.