I finished my Bachelor of Science in Nursing a couple of weeks ago. It felt like a personal triumph, given how hard I fought every step of that process. I was my own worst enemy, building up dread, creating internal chaos, fostering procrastination that ultimately lead to the worst kind of motivation - panic. But it is done now. In a sense I have arrived. A four year degree was never, ever in the realm of my consideration. I had told myself long ago I was not of the caliber of person who earns such a thing. I was wrong. Not the first time.
As I work at my job, doing what some might consider demeaning labor but which, on the better days, I find to be a personal joy, I consider how far I have come. Nursing is dirty work. We smell, touch, feel, clean, treat the most basic and degraded of human conditions. We see people at their lowest and most vulnerable points. Eyes look to me daily, watching for a twitch of my brow, a purse of my lips, a wrinkle of nose...anything that might indicate to them any information. Am I disgusted? Do I mind? Is this normal? Are they going to be okay? Have I seen this before? One of the greatest privileges is handing people back their dignity, providing as much independence as possible, celebrating as things we all take for granted every day when we are healthy slowly become reacquired through the journey to wellness. It almost always is truly two steps forward, one step back. It is that step back where I am needed the most.
I get so much more than I give, on my better days. It can, at times, be hard to keep perspective. So much more goes into nursing than simply providing comfort and concern. It is a scientific profession with a unique, holistic basis. Family drama and intense anxiety go hand in hand with the hospital experience. I deplore conflict, yet witness a great deal of it in my profession. Doling out hope versus reality versus probability versus acceptance is a tricky dance. I have learned not everybody wants the truth. Not everybody wants comforting. I suspect at times the act of comforting can imply in and of itself the presence of illness and the potential for death, triggering hostility in some patients toward the medical staff. Not everyone reacts with grace or gratitude to pillow fluffing, endless questions, invasion of their space, their privacy and their sense of control. My experiences with Joseph have left me with unique insight, insight so deep that I sometimes get baffled at death denial in our society. It is painful to me. It is something I have learned to recognize in myself and draw back from, to let the patient lead the way. Not everyone wants the truth. That is hard, as a nurse, to be part of. I am a "value truth, give them choices" kind of person. But to accept choices requires one to recognize there are decisions to be made. My saddest days on the floor are the days when a family cannot face where life has brought their loved one. We all die, but so many never, ever consider this fact. As a culture our uniform coping with life's end is deny, deny, deny. Then when it happens, shock. Anger. Blame. Reproach. Fear.
I'd love to change the language of death in our society. I'd love to help people have more days at home, fewer days in the hospital. I'd love to be a voice of change, not just for my patients here, but for the population. That is what gets my juices flowing. Joseph didn't die the way that he wanted to, nor did he die how we would have chosen had choices been presented to us. Perhaps that could have been different, perhaps not. I do not reproach myself and I do not reproach his medical team. I just wish it could have been different. Better.
I am thankful to Joseph for sharing the experience of dying with me. I am thankful to him for burning out of me very distinct parts of my personality and thought processes that made me not a very good person, that his death was the launching pad for a person I actually like and who continues to grow, change and alter herself. I am grateful to him. He may have been quite helpless in his illness and his death, but somehow his very presence seized a power that is more than anything I ever created within myself. This power created something new and different within me. I feel a deep and humble responsibility - to Joseph, to my patients and to myself.