Winter and "Call the Midwife"

Aleathia says:

In winter I feel the roots of my heritage take hold. Polish, Yugoslavia, Russian....possible Romanian. Throw in French Canadian and you have a recipe for hibernation. We are a somewhat contemplative, stoic bunch around strangers; full of vibrant life around those we trust and love. when ice and snow take over the land it begins a time of inner discovery.

Personally, I love the snow and quite enjoy a brisk walk in the winter sun. From my warm couch I can see the skeletal remains of trees on the hills, the ground blanketed in snow, the palest of blue skies, and ice flowing down the river. I sit here a lot and do nothing but think.

Winter is also the time when I binge watch television at night when my bones are aching and cold and the only comfort from pain I get is the distraction of needlework and television. There are some shows I put on for noise to ease the winter loneliness. The sound of conversations I don't have to engage in are a pleasure and the cadence of them makes the crocheting go faster. But once in a while I find a show that pierces the heart of me.

This week I wanted a break from my usual British crime series, so I stuck with the British theme and dove into "Call the Midwife". I have anxiety for when the series will be done. I have consumed 4 seasons already. I have cried nearly every episode.  It is not often that this happens. I admit to being an old softie, but this show has struck something deeper for me.



I am a nurse, so the show is relative to me in this sense. When I was first in nursing school I wanted to work in OB and help deliver babies. I had this unrealistic dream of how I would feel about such a thing. I felt my sensitive nature would make me perfect for the job. One evening during clinical I was able to witness the births of two babies. I am not sure I ever cried so much in my life. The screaming, the blood, the first sound of a baby crying, the look on the mother's face when she first sees her baby...these things are devastatingly beautiful. I decided that night that I could never do the job. I would need to be stronger if things went wrong and I wasn't sure that I wouldn't cry every time a baby was born. I went into the cut and dry of surgical floor nursing and then to emergency medicine where I have spent more than a decade.

"Call the Midwife" is more than strong women in the poor conditions of London's East End in the 50's and 60's. It is about finding faith in  your work, about friendship and love; losses suffered on a personal nature and ones suffered because you are in the same room. It is about standing up for patient's rights, for women having a voice in a time when they weren't supposed to, and about building your own identity from the ground up.

I had a conversation with my teenage daughter after she mentioned how much the show makes me cry. She said "maybe you get so emotional since you had a c-section instead of giving birth?" She sent this in a text from her room and I was glad of it, because I sat there crying again. Yes, maybe it was that. My body robbed me of that moment to see her after all the hard work I had done. 20 hours of labor, 6 hours of pushing, a failed epidural when it was time for surgery and having to have general anesthetic which left me unconscious for over 8 hours. Everyone in the family and all the staff had seen my baby before me. It is truly the only regretted moment of my life. The rest I chalk up to experience, but I missed the one perfect moment in life a mother can be given.

"You have to be brave to be in love, don't you? Knowing your heart will get broken at sometime."

This was a line from the show and it struck me so terribly hard. I sat there nodding, because it is one of the truest things I have ever heard. My heart has been broken so many times. My poor heart spent so much time on my sleeve where people could abuse it and do with it what they wanted. This last year has been sad and somewhat loveless for me. The bond with my daughter the only thing that got stronger besides the will to find myself again. Life is about the chances you take, about dealing with the consequences of your choices, and learning from the mistakes as much as the triumphs.

Never be afraid to dream big and fall short. Get back up again and do it all over. Cherish those small, perfect moments in life...never take them for granted. Don't let the world distract you from the daily wins and the opportunity to open new doors.

Thanks for reading
Aleathia

OM-11/23/2014 Being Truthful in Healthcare

Aleathia says:

Last week, while shaving my legs, I listened to a Ted Talk by Leana Wen who is a medical doctor here in America.  The video was about transparency between a doctor and their patient and how by doing this a true trustful relationship could begin to form.

She made valid points about patients having to hand over their most personal information, their lifestyle, their body to a person with a degree whom they know nothing about.  Patient's don't know where their doctor's stand in the community, with their beliefs, or their conflicts of interest.  It is like a one-sided conversation.

Leana Wen put forth this idea to a wave of hatred by physicians across the country.  She got death threats and bomb threats and was asked to "move back to her country" despite living in the US since she was 8 years old.

I am not a doctor and the nursing model of care is much different than the physician's.  Nurses are a bit more able to look at the bigger picture and take into consideration all of the peripheral reasons why a person might be sick or act the way they do.  We are also more honest and upfront, because maybe, we have less to lose.  We aren't going to get sued for our opinions like a provider might.

Yesterday I had a patient who had pretty severe cancer and was being seen at a prestigious cancer center that is nationally known.  They told him he had lung and kidney cancer and he was young and was undergoing chemotherapy.  When he came to us he had been coughing up blood which is never good.  When all was said and done, his exam revealed a worsened cancer in the last month and cancer in places that our facility had seen in August that were never mentioned to them by their cancer center.

The patient's wife was furious and in tears, because there at 3 am they were both realizing the severity of the situation.  She looked at me and asked my why won't any provider tell them the truth without sugar coating the outcome.  I told her that I could not answer that question as I am not a doctor, but I looked her in the eye and explained slowly and carefully the true possible outcomes of her husband's disease process as it stood right then.  She cried some more.  He cried some more.  I stood there and cried with them.

I understood first hand the power of cancer's grip to steal those that you love right from under you.  It is so silent at first, so evil in the end.  The wife thanked me for my honesty and my compassion.  We were going to transfer him to a higher level of care and after I finished the paperwork I thought about Leana Wen and I too was angry for this family.  Why don't doctors tell you how it is really going to be?  Sometimes it is because they want you to move forward with their plan of care.  Sometimes people don't want the truth.  Sometimes I think they forget what it is like to be on the other end of the spectrum.

I went into work last night and was told that as my patient was being put into the ambulance for transfer, he died.  His cancer swallowed him whole, so to speak, and he was gone.  I knew the ending to his story, but some part of me had a glimmer of hope that maybe I was being a fatalist or being too severe.  I know now that I was able to give them both a realistic picture as sad as it was.

A nurse's job is very hard.  We have to learn so much about a patient in a short amount of time.  We have to juggle 4-5 lives at a time while making everyone happy.  We get to save lives and watch them slip away. Each one chipping a layer away silently.  Each one embedding themselves in your collective personal graveyard.  Try to remember as patients that we are limited to what the doctor says we can do for you, that though we may seemed rushed, or busy, we really do care about making you better.  We wouldn't put ourselves through this daily torture if we weren't compassionate and loving at the core.

Today, I am looking for meaning in the face of untimely deaths, and I am not sure I find any good reasons.  Love your life while you have it.  Tell people how wonderful they are, don't forget to smile and laugh, and take all the hugs you can get.

Peace.