Margaret vs. Pauline

Two patients, both with problems.

One is on Medicaid. She was hit a couple of years ago by a drunk driver in a big SUV; her youngest child died. The older two survived. She was paralyzed from the belly down. She has Brown-Sequard Syndrome, which means her touch sensitivity and her movement ability are both completely out of whack and she has constant pain, even from gentle stimulus. She had to come back for a revision after surgery to repair a bone-deep bedsore didn't work out well.

The other is a privately-insured patient with money to burn. After years of plastic surgery and expensive beauty treatments, she decided to get her lower back pain fixed with a lumbar laminectomy. She has an inch-long incision in her back, private duty nurses around the clock, a Dilaudid pain pump with a basal rate, and a husband who waits on her hand and foot.

Guess which patient was more willing to get out of bed this morning? Guess which one cried and moaned and complained about having to have physical therapy today? Guess which patient refused to walk in the hall, while the patient next door would've given her eyeteeth for the chance?

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You're the one that I still miss

She has vascular dementia and doesn't remember that her husband died three years ago. Her kids kept reminding her of that until I told them to stop it, that making her go through that grief again and again was cruel and unhelpful. She still asks where John is, though.

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Can't give up actin' tough; it's all that I'm made of

One of the new nurses asked me tonight how I managed not to burst into tears every time something sad or pathetic happened. I replied, half-joking, that it's because I'm cynical and bitter. Looking back, that answer made more sense than I realized at the time.

It's not that certain things don't break my heart; they do. It's just that you learn a certain distance over time that allows you to keep working, to keep doing unpleasant things to pleasant people and not obsess about it later.

I used to obsess all the time. Occasionally I still do. Mostly, though, it's out of anger at a person's situation rather than from grief.

I told the chaplain once that nurses believe in God primarily so that they'll have somebody to blame. This is still true.