This Brief, Beautiful Moment

Your fingers were laced so tightly around your cane that your knuckles turned as white as the hair on your head. You, and I assume your son, also with streaks of white in his hair, waited in the hallway, just outside the door of the room your husband was in. Your husband was just brought back from a cardiac cath procedure and was surrounded by nurses hooking him up to the monitor. I stood at the door, trying to observe as much as I could without getting in the way and offered you a small smile, as a way to reassure you that everything was alright. You could go inside if you liked, I said.

Your son put his arm around your shoulder and gently steered you inside as I stepped out of the way. I left to grab some extra blankets and when I returned I found you sitting in a chair at his bedside, talking to him in hushed tones. He was awake, yet groggy from the sedation. His face was etched in as many lines as yours, his hair the same color of snow. And for a brief moment I wondered if you two had been together your entire lives.

As I laid the extra blanket on top of him, tucking the sheets under his feet, the exchange that occurred between the two of you just then was something I’ll remember forever.

“Did you remember to pack my clothes?”

“Not yet,” you replied. “The doctor wants to keep you overnight.”

“Then you should go home, get some rest.”

You placed your hand on his cheek. “I’m not going anywhere.”

He then took your hand and gently brought your fingers to his lips and kissed them tenderly.

That moment felt too beautifully intimate for my eyes and with my heart full I quickly looked away. I quietly stepped outside into the empty hallway and hastily wiped away at tears that were threatening to fall.

How lucky am I? To be in a profession that allows me to witness people at their most vulnerable, their souls stripped down to its rawest state… and every now and then I get to see something as beautiful and intimate as this. I get to witness love in one of its truest forms.

L’appel du Vide

The following deals with suicidal ideation. If you find talks of suicide or self-harm triggering, I urge you to please not continue.

Back when I was 14 I went on a road trip one summer with my aunt and a few of her friends and their kids from Karachi, Sindh to Quetta, Balochistan. If I could sum up Quetta in a few words, they’d be intense dry heat and steep, rocky mountains. We stopped near the edge of a cliff to stretch our legs and get a view of the mountains before us. I remember walking to the edge and, while staring hundreds of feet down to the ground below, having a thought that shocked me before it had fully formed in my head.

What if, right this minute… I jump off this cliff?

My heart skipped a beat and I quickly stepped back, pushing that thought out of my head. I didn’t tell anyone about my thoughts, afraid I’d be called crazy. I was horrified with myself for even thinking about doing it. Life was perfect. I was happy, made the honor depressroll, was experiencing my first silly teenage crush and the feeling was mutual at the other end. At the time, my entire world was colored in different shades of rose. So it didn’t make sense for me to have thoughts of putting myself in possibly fatal danger. Yet, it wasn’t the last time I did.

A few years later, I came across the French phrase “L’appel du vide“.  Translated, it means “Call of the void.” Basically, it’s that little nagging voice  in the back of your head that tells you to swerve your car suddenly into oncoming traffic. Or  jump off a cliff. But the fact that there was an actual word for it and the fact that many people in the world experience it made me feel some relief that I wasn’t the only one with thoughts of doing something crazy like that. The point is, these thoughts are not necessarily associated with depression and suicide and are often fleeting and not connected to any emotion.

But the problem wasn’t that those thoughts hadn’t stopped. The problem was that up until recently, every time I had those thoughts, I’d be filled with a sense of peace. Relief.

During my ER rotation in nursing school, I followed a nurse whose patient included one who tried to commit suicide by overdosing  and was found and rushed to the ER to have his stomach pumped. A cop sat outside his room, nursing a cup of coffee and a paperback. After we left the room, the nurse sighed impatiently and muttered, “Waste of space.”

Surprised, I turned to look at her. Noticing my disapproval she quickly added, “In the ER we save lives for people who want to live. If he doesn’t want to live, that’s his problem but he shouldn’t be wasting resources or my time. Or the doctor’s time. Or this police officer’s time.” Being a lowly student and hence, at the bottom of the food chain, I couldn’t risk answering back and getting kicked off the floor, so I stayed silent. She glanced back at his room. “Psych will be here soon to take him. Do me a favor and remove his IV, will you? Thanks.” And she walked away.

I turned on the light in his room, introduced myself, told him what I was about to do. He stared at the wall ahead and didn’t acknowledge me. Taking his silence for consent, I approached his side and quietly took his hand. As I gently lifted the tape securing his IV, I stole quick glances at his face. From his chart I knew he was in his mid-thirties but he looked so much older. His gaunt face remained expressionless but those clear blue eyes held so much grief. I slowly removed the catheter from his vein and said, “I hope I’m not hurting you.”

He still didn’t say anything but turned to stare at me. As I bandaged his hand, I smiled at him and said, “Thank you for being so patient with me. It’s my first time doing this.” It wasn’t.

He gave me the slightest of nods.

I didn’t know the circumstances that lead to him downing those pills. But I understood the drive that made him do it.

The thing about harboring suicidal thoughts is that you can’t really bring yourself to tell most people because they might react in one of two ways. They might treat you with over-exaggerated care, afraid to talk to you or joke with you, walk on eggshells around you… as if you’re something fragile and you’re going to fall apart. Or at the other end of the spectrum, you’ll have people who, like the nurse, are going to think of you as a total waste of space because the fire inside you has been extinguished for some reason, your will to live, much less thrive, has been stolen from you. Either way, their image of you will forever change. You’ll no longer be the quiet girl with  surprisingly a lot to say, who loves to laugh and joke around and tease people. You’ll just be looked at cautiously as a mentally unstable suicide risk, which you’re really not.

Before I continue, I want to stress that I won’t kill myself. There’s nothing brave or cowardly about my decision. I was raised by people who sacrificed so much for me. To end my own life with my own hands is to throw away a gift they’ve given me so selflessly. It’s a slap in their faces. Their love for me, even though both of them have passed on, makes me both grateful and resentful for keeping myself tethered to this world. There’s no question about it. For their sake and their memory, I’ll never do it.

Depression isn’t always feeling sad. It’s not always crying all the time. There are moments where you feel so incredibly numb and your heart so hollow. You lay in bed at night, staring off into darkness, wishing for the sweet oblivion of sleep to embrace you and it doesn’t. It’s like you’re living your life and you see people and stuff around you but all the images have blurred into unidentifiable shapes and all the colors are a now murky gray. You wish you could feel something, anything. Even pain. And that’s when your thoughts turn to self-harm.

I could never bring myself to cut and it’s not because I’m afraid of the pain. I needed pain, to remind myself that I could still feel. But at that point I also realized that I was heading down a very slippery slope. And I recognized that I had a serious problem. So I started to look into why it was that people cut beyond experiencing the distraction offered by pain. Endorphins. And if there are two things depressed people lack it’s endorphins and serotonin.

I started running a few weeks ago. Actually, I use the word “running” very loosely as I’m, as the saying goes, “slower than a herd of turtles stampeding through peanut butter”. Yet, I still run. And each day I run a little faster, a little longer. I run when the sun is shining to get my fill of serotonin. And though I feel so sore after a run, being outside in the fresh air, surrounded by nature, and that high I feel after a run is completely worth it. And more importantly, each day I’m finding reasons to smile again.

Becoming a runner has become my salvation. It’s that thing I need when ‘L’appel du vide’ rears its ugly head back at me because I now know what to do with those thoughts. My world, while not completely in bright jewel tones, is now in different hues of pastels and the shapes from before are a little more recognizable.

Take My Hand

Getty Images. Selina Joiner.

I have this problem.

Last semester I finished my pediatric rotation in nursing school. I was lucky enough to spend two weeks in the pediatric ICU. The first week I cared for an eleven year old boy. From his chart I found out that before being admitted, he was suffering from dizziness and headaches. One day, he collapsed onto the ground during soccer practice. He was rushed to the ER. There was a tumor in his brain and so the doctors operated to remove it. Big success. The kid was on his way to recovery.

About a day after the surgery, he suddenly went into respiratory arrest. He had to be intubated. He became unresponsive to any stimuli. Unable to move. Unable to speak. Unable to breathe on his own. Unable to blink at will. As it turned out, he had cerebral edema so they inserted a shunt in his head to remove the excess fluid. And this was all done two weeks before I saw him. There had been no change in that entire time.

I half listened to the nurse as she talked about CPAPs and flow rates, the intravenous meds infusing through his veins, the shunt in his brain, the wound vacs… and all I could see was a broken child with so many tubes snaking in and out of his body at multiple points. I helped the nurse as she gently repositioned him to avoid pressure ulcers. As she continued talking and fiddling with the machines, I stood silently to his other side. His head was repositioned so that he was looking at me. And it almost looked like he was staring at my face, but there was no way to know if he was able to process what he was seeing. A lump formed in my throat. I did the only thing I could think of… I reached over and held his hand.

In that moment, all I wanted him to know was that he wasn’t alone. That he could feel my touch and know that someone was there. That there were people who still cared. Hell, if he was still in the “I-hate-girls” stage, I wanted him to feel that embarrassment of holding a girl’s hand, too. I wanted him to feel like a normal eleven year old boy, if only for just a few minutes. The nurse finished talking, turned around to see me holding his hand and smiled softly. She told me to find her outside when I was ready and left the room. I stayed a little while longer and told him my name, that I liked the stuffed teddy bear the nurse had placed under his arm, my favorite Spongebob episode from ten years ago, since that’s what was on TV at the moment.

As I said, I kind of have a problem. I get too emotionally involved. No matter who it is, a stranger or a friend, someone who ignores me or has hurt me… if they are suffering in any way, the neurons in my brain that control empathy go into overdrive, short-circuit, and stay stuck on ‘Max’. I suffer from a case of the feels, big time. I asked my nurse how I could provide compassionate care while still remaining somewhat emotionally detached. She smiled and said I was asking the wrong person. She had worked in both adult ICU and PICU for a total of 6 years and still couldn’t fully compartmentalize her feelings and emotions.

A week later, I was on the same PICU floor but was assigned to a different patient. As I passed his room, I couldn’t keep myself from peeking into the glass door. A doctor was with him and his family. Later, I looked up his chart. He could now blink on command… but also had an endotracheal intubation. One step forward but two steps back.

This was almost three months ago. I still think about him every now and then.

Surviving L&D in Nursing School

As I stood next to the nurse, holding onto one of the patient’s feet and helping her bring her leg closer to her body, facilitating her to push, I looked everywhere but the actual point of interest.

This was not what I had expected.

Back in high school I watched a lot of episodes from A Baby Story on TLC and it was always such an amazingly emotional experience. The mom cried, the dad cried, the grandparents cried (for the record, I don’t think I’d be okay with my in-laws watching me try to push a creature out of my hoo-ha), the jaded doctors and nurses shed the occasional tear, and by the end of the episode the bowl in my hand was a soggy combination of frosted flakes and tears.

Going into nursing school, L&D was always a specialty I was interested in. What could be more beautiful and magical than bringing a new life into the world, right? And who doesn’t love babies? I’ve had a couple of rotations that I’ve loved such as the ER and the OR so far. Although, I wonder if the ER is really for me. If restraining a mentally unstable patient who is flailing his arms and legs wildly, trying to connect a wayward fist with your face in an effort to knock you out makes you feel alive, then maybe you should step back and reevaluate a few things in your life. Or you could just be a closet adrenaline junkie.

And it’s not like I haven’t seen blood and guts (literally) before. In the OR, I watched as the surgeon cut open a patient’s abdomen and removed a section of the patient’s intestines. I watched in fascination as another surgeon performed a bunionectomy, and carved off a portion of a patient’s foot like carving a turkey, tiny pieces of bone flying off in every direction, and I never even flinched. So I thought I could handle something as natural as childbirth.

“Push.” The nurse counted to ten and then told the patient to relax for a bit. She turned to me. “The baby is crowning. Would you like to see?”

Nope, nope, nope, nope, nope, nope, nope, nope…

“Sure…” Except I didn’t really want to. This was not like A Baby Story at all. This was frightening. The patient, a teenager herself, had already had her epidural, so it wasn’t like she was screaming bloody murder. At least not like the lady in the next room, who had decided to forgo the epidural and whose screams were scaring the shit out of me.

And there it was. The baby’s head. Hair covered in tons of mucus and blood. I felt the bile rise up in my throat and for an irrational moment I thought that if I looked too long I might go blind, kind of like how staring at Medusa’s head turned you into stone.

“Wow,” I began feebly. “That’s…” I couldn’t finish.

At that point, the nurse called the doctor, the first assist, and another nurse for the delivery. I watched as the first assist set up all the tools needed and I cringed when I saw the forceps.

“Can you take a picture of all of us?”

I turned around to see the father giving me his phone. Up until this point, he was sitting in a corner playing on his Nintendo DS. I could breeze through a few hours of Super Mario Bros on my siblings’ DS, no problem. But if I was going to have a baby in the next hour, I’d leave the DS at home. This kind of gives you an idea about how young this couple really was.

“Sure. After the baby is born, right?”

“No, I mean right now. while she’s trying to deliver.”

“Oh. Sure.”

As I fiddled around with the zoom feature on the phone, I had a monologue going on in my head.

Am I supposed to take the picture with her cookie all exposed and a living creature tearing her apart? Should I even keep that in the picture? Do they even WANT me to keep it in there? Do they want me to focus on it? Screw it, I’ll just take it and then they can crop it out later if they want.

So I took some pictures, trying to keep out of the way of the doctor and nurses, feeling like a pervert for some reason while I clicked away.

The doctor told her to put more effort into her push. I stood there with my back against the wall. The nurse told me later that I was standing with my ankles crossed, like I had to pee. And that all the color had drained from my face. I distinctly remember the doctor briefly glancing back toward me and asking me if I was okay or if I was going to pass out. To my credit, I didn’t feel faint or woozy. Just totally shocked.

Childbirth was not pretty. I was not ready for that amount of blood and… other stuff. Our instructor recommended that we wear goggles but I stifled a snort and thought there was no way, I’d be laughed out of the room by everyone. Might as well bring a raincoat while I’m at it. Besides, I didn’t think there’d be any splashing… until the doctor turned around and the front of his gown was covered with blood.

Push-Push

But as horrified as I felt, all of that melted in an instant when I heard the baby cry for the first time. I was rooted to the spot, completely mesmerized by this bundle of miracles, so fragile and so resilient at the same time. I think at that point I became painfully aware of my own biological clock and the need to pass on my DNA, which is funny because I don’t really have a particularly strong desire to have children. I think my ovaries may have started to hurt a little, too…

“Where the fuck is my Sprite and fruit cup? I told you to have it ready after the baby’s here! Why can’t you do anything right?”

Aaaaaaaaaand just like that, the magical moment was over. The guy scrambled out of the room to fetch his girlfriend her victuals. And I excused myself to get back to my instructor.

I’m not ruling out L&D as my go-to specialty, I still think it’s pretty awesome. And I’m sure I could eventually get over women howling in pain and my surroundings looking like a recent crime scene.

I think.