THE DASHING YOUNG MAN ON THE FLYING TRAPEZE

     One evening I arrived at work, walked onto the ward, and was greeted by the sight of Mr. Sims swinging himself by both arms while hanging from the trapeze bar over his bed. I looked towards the nurse's station and saw that the RN, Mrs. Brown, was on the phone. I hoped she was calling the doctor to help Mr. Sims.

     Mr. Sims was a tanned, wiry little man who lived in the Imperial Valley in California, close to the Mexican border. He was a farmer and grew alfalfa, barley and cotton on his acres. He'd been involved in an accident with farm equipment and lost both of his legs just above the knees. He was admitted to our unit to be fitted with artificial legs, rehabilitated, and ultimately sent back home to his farm. Mr. Sims was a humble man, quiet, and very polite. What we didn't know about him was he was also a closet alcoholic. He'd kept that little tidbit of information from us during his admission interview. Him swinging naked from the trapeze was our first clue he might be having DT's.

     Mrs. Brown called his family in Brawley and they confirmed that Mr. Sims was indeed a drinker and had been without alcohol since coming to our hospital three days earlier. Perfect timing for withdrawal. Mrs. Brown then called the doctor on call and received orders to give the patient Paraldehyde injections. Now there are much better medications, but in 1968, this was all we had. Paraldehyde was a thick, viscous solution, that smelled to high heaven of a strong chemical with a little vinegar mixed in. The odor is very distinctive and can be smelled on the breath of anyone who takes it. It had to be drawn out of the vial using large bore needles, and then injected slowly into a large muscle. Guess who got that job?

     I drew the medication dose up in two syringes, enlisted the help of several nurse aides, and went to Mr. Sims bedside. There was no reasoning with Mr. Sims, so we had to pry his hands free from the trapeze bar and get him back onto the mattress. This was no small feat. Mr. Sims was little, but he was powerful from all his years of farm work. We finally got him down and turned onto his stomach so I could inject each syringe fully into the large muscle on his backside. He screamed like a banshee throughout the whole procedure, but eventually settled down and went to sleep. Within a couple of days he was back to being his normal, polite and kind self. We couldn't resist teasing him a bit about his flying trapeze act, though. He did recover, get two new prosthetics for legs, and went back to Brawley to his farm. I hope he didn't start drinking again, but life experience tells me he most likely did.

APPALACHIA IN ORANGE COUNTY

In my part-time work as a hospice nurse I’m often sent to see patients I know little about. I view it as an adventure and also as an opportunity to put the pieces of a puzzle together. One day in early summer, I was sent to see an elderly lady in Orange County, California, who was dying of end stage dementia. The only information I was given was her name, address, and telephone number. I looked it up on my street map since it was in the days prior to GPS, and made my way there. I turned into an ordinary working class neighborhood of one story ranch style California homes, located the street and found the house number on the mail box at the curb.


This particular house sat at the end of a long driveway and was obscured from view by many fruit trees and tall weeds in the front yard. I retrieved my medical bag and notebook and started down the drive. Lined along one side were several junk cars that seemed to be slowly rusting into the ground. The house came into view and seated in a rocking chair on the front porch was a very fat, old, toothless man smoking a pipe. He smiled at me as I walked up and told me to “just go right on in the house”.

I opened the door and stepped inside. I’d only taken a couple of steps when I had to stop, not sure whether what I was seeing was real or a hallucination. The house was dark, dirty, and dreary. What were formerly drapes now hung at the windows in shreds that resembled ropes. To block out the light, someone had taped big pieces of cardboard to the windows, and old sofas lined the walls of the living room. Once my eyes adjusted to the dim light, I realized there were bodies covered with blankets lying on the sofas. Various bodily noises were frequently being emitted from these lumps under the covers, the odor in the house attested to the origin of the noises.

Trash, newspapers, and junk were piled everywhere. I wondered where I would find my patient in all of this, then finally located her lying in a hospital bed in what would have been the dining room of the home. She was clean and her clothing and bed linens were clean as well, much to my surprise and relief. I took a disposable plastic barrier from my bag and placed it on top of a stack of newspapers so I had a sanitary place to put my bag and notebook. I was getting ready to examine the patient when I heard footsteps coming down the hall. Expecting to greet the patient’s son, I was dismayed to find myself face to face with a man wearing only a towel. He’d apparently just come from the shower. When I inquired if he was the son, he said no, and shouted out the son’s name.

Soon, Billy appeared. He was a younger version of the elderly man on the porch. Billy wore overalls that were filthy, and he didn’t have a shirt, so I was treated to the sight of major chest hair and pretty foul body odor.

Billy greeted me with great enthusiasm and said he was just about to get his mom up to the commode by her bed and then I could do my exam. He lifted the lid of the commode, and I was again dismayed to see it was filled almost to the brim with bodily waste. Apparently it was the real source of the odor in the house. Billy explained without apology that the toilet wasn’t working so he couldn’t empty the contents of the commode. I didn’t bother to ask what the rest of the residents of the house did when they needed to use the toilet.

I finished my exam, checked the patient’s medications, and gave him some more supplies to help him care for his mother. I stood up to write my nursing notes as I balanced them on the patient’s chart, as there wasn’t a clean place to sit. I exited the house as soon as I could.

Billy met me outside with a paper bag. He thanked me for the visit and told me there were homegrown tomatoes in the bag. I thanked him for the gift and said homegrown tomatoes were one of my very favorite things, and I took them to my car. Once home I scrubbed them with soap and water and laid them on paper towels in the kitchen to dry. That’s where they stayed until my husband decided to eat them, telling me I was being silly not wanting to touch them. I couldn’t bring myself to take even one bite, and still wonder what kind of fertilizer grew such beautiful tomatoes.

NO WINING...Nurse Story

THE LIONESS HAS NOTHING TO DO WITH THE STORY, BUT SHE SURE IS BEAUTIFUL EVEN AFTER HAVING JUST EATEN A WART HOG. I TOOK THE PICTURE!

Millie was ninety-five years old and on Hospice for end stage cardiac disease. She and her daughter, Dena, lived together in Millie’s home. Millie was weak and fatigued, but didn’t require a lot of care when she first came on service. She was mentally very alert and I enjoyed my visits with her immensely.

We’d discussed her smoking when she’d first been admitted to the hospice program. She’d tried to quit over the years and she and her doctor had agreed that there wasn’t much point in quitting now when she was at the end of her life. My opinion was the same, and I let her know that. Dena didn’t want her to smoke in the house, so she’d made a little area in the garage for Millie to go to when she wanted to smoke. Millie went out a few times in the day and evening to have a cigarette.

One day, shortly after I’d arrived for the visit, Dena walked in from the garage carrying a wine glass. She said, “Mother, how many times do I have to ask you to bring your wine glasses back into the house?”

At this, Millie’s head whipped around and she looked guiltily at me. “I like to have a glass or two of wine in the evening, is that all right?” she asked.

I smiled and patted her hand. “I like a glass of wine in the evening, too. If it’s okay with your doctor, it’s okay with me.”

Millie breathed a sigh of relief. “Oh, I’m so glad you don’t think badly of me. What kind of wine do you like?”

“Oh, my favorite is chardonnay.”

“That’s my favorite, too!” she said, beaming. “Would you like a glass?”

I chuckled at this and said, “Not right now, Millie. I’m working and can’t drink on the job. Thank you for offering, though.”

She smiled, too, and said, “Oh good, because I would have been really worried if you’d said yes.”

Life Lessons

When I was now in the third grade, my new best friend, Karla Porter, happened to live in a nursing home. Her mother, Catherine, owned a big, two story house on the edge of town. The family lived in the upper story, and Catherine housed elderly patients on the first floor. Since I lived just a block away, Karla and I were in and out of the house every day. We’d wander through the hospital beds on the first floor, looking for Catherine or for something to do to keep us out of the trouble we invariably got ourselves into.


Sometimes Catherine would assign us small chores. One of those was to retrieve the eating utensils that Daisy had hidden away in her room. Daisy was an elderly woman with some kind of mental illness. She seemed to have multiple personalities, and spent most of the day carrying on conversations with these different personalities. She lived in a small bedroom that had to be kept locked to keep her from wandering off. When the utensil supply ran low, one of us girls would stand outside Daisy’s big bay window and distract her while the other one ran in the room and quickly grabbed the silverware from Daisy’s many hiding places. The one that was in charge of distracting Daisy had a big responsibility since she’d become very angry at the girl that was stealing the silver, and smack her over the head. I was usually in charge of distracting her since Karla was much faster at swiping the utensils.

Karla’s mom, Catherine, and my mom, Kathryn, were our Camp Fire Girl’s den leaders. The meetings were always held in the nursing home so Catherine wouldn’t be too far away from her charges. We spent much of our grade school years playing in the nursing home and my mom worked there occasionally when we needed some extra money. I wasn’t really surprised when years later my mom decided to become a nurse, and then Karla and I chose nursing, too.

Catherine Porter thought it was important for us to learn about all aspects of life. Later on in my life I grew to questions some of her ideas, but as children, we went along with the ride. One of those rides took Catherine, Karla, and my mother and I to the Clarinda, Iowa mental hospital grounds. It was an all day trip and I remember we didn’t even get out of the car. We parked in a parking lot and a few of the residents of the hospital who were allowed to roam the grounds, peered in the car windows at the four of us. To this day, I don’t know what the purpose of that particular field trip was, but I’m sure Catherine thought she was teaching us something important.

My family attended the First Baptist Church in Indianola, Iowa when I was a child. Church services were conservative and dignified, and our preachers were not of the evangelical type. Catherine seemed to think I was missing out on something, so when the tent preachers came to town, she would take Karla and I with her to the revivals. I guess she thought we would benefit from being saved, but no matter how many times we “went forward”, we never became “one with the spirit”.

The summer of 1962, my family moved to southern California. Later that year, Catherine sold her nursing home and moved her family to southern California, too. Catherine’s had a husband, Russell, who was more than twenty years older than her. She was the one who supported the family and made all the decisions and when she decided to move to California, they moved. Though we attended different high schools, this move made it possible for Karla and me to remain best friends and for Catherine to continue trying to give us life lessons.

She made one more attempt at “saving” us after moving to California. They lived in Artesia and Catherine found an evangelical church there and started attending regularly. One weekend when I’d slept over Saturday night, she woke us up on Sunday morning to get ready for church. We tried to protest but to no avail. We were sent to Sunday School class before the church services, and that went well. But then we were ushered over to the church and the fun began. This particular church encouraged participation by all members, and it heated up into a frenzy pretty quickly. When a very pregnant woman started speaking in tongues and fell to the floor in a quivering heap, it was too much for us. Karla and I started giggling and soon were doubled over with laughter, tears streaming down our faces. An embarrassed Catherine ushered us out as quickly as she could, and never forced us to attend church with her again.

I loved to do hair when I was in high school and soon became the hair expert. I was often called on to help my friends tease and pouf their hair into the elaborate styles of the early sixties. My friend’s mothers would also pay me to comb out their hair, tease it, and restyle it between their weekend hair appointments. By this time, Catherine had found work in a nursing home in Whittier, California. They were having a hard time finding a hairdresser to come in and do the patients hair, so she hired me. For one whole summer I posed as a hairdresser, cutting, shampooing and styling all the little gray heads in the nursing home. Now that I’m older and wiser, I realize how illegal it was, but at the time it was just a lot of fun and the little old ladies loved me.

Catherine wasn’t the only source of my introduction to nursing. In high school, I became a candy striper and worked at Whittier Presbyterian Hospital. I started out working in the central supply area, putting together admission kits for patients. The other candy stripers and I would fill plastic bags with wash basins, emesis basins, tissue boxes, Cepacol mouthwash and body lotion. The work was boring but you had to start there and prove yourself or you’d never be allowed out on the floors with actual patients. After awhile, I earned my way onto the floors. I filled water pitchers, delivered dinner trays, changed the water in flower arrangements, and had plenty of opportunities to interact with patients. I loved the atmosphere of the hospital and couldn’t wait to become a nurse.

The summer following my high school graduation was precious to me as it was the last months of my childhood. In order to enter the Registered Nursing program in September of that year, I would have to take chemistry during the summer and I preferred going to the beach and lying in the sun. My mom had gone through the Licensed Vocational Nursing program during my senior year in high school, so I decided that would be good for me, too. Karla and I applied to and were accepted into the Licensed Vocational Nursing program instead of RN training.

I was eighteen and Karla seventeen when we started our LVN training program. We dressed in our white starched blouses, yellow starched pinafores, white nurse’s cap, and white stockings and shoes and were on our way.

I’m amazed now that we were mature enough to make it through the program. Sometimes it didn’t seem that way. We were always professional and worked hard when we were out on the floor with patients, but we were in trouble a lot during our classroom hours. We found it extremely difficult to be quiet and pay attention, and did a lot of giggling and talking in class. Fortunately, each of us was the favorite of one of the instructors. The head of the program liked me, but didn’t like Karla, and one of the other instructors liked Karla, but not me. We were always being protected by someone. It also helped that we were both excellent students and quick learners and the patients we were assigned liked us, too.

One incident could have gotten both of us in really big trouble if we’d been found out. We were practicing injections in class one day. We were using large needles to draw up sterile water out of a vial and inject it into oranges in order to practice our technique. Some of the others weren’t catching on as fast as Karla and I, and we got bored pretty fast. I don’t know who started it, but we started squirting each other with the water in the syringes. I was spraying Karla and she tried to hit me. The needle jabbed into her arm and I was still pushing the plunger of the syringe. It squirted enough sterile water into her arm to raise a lump the size of a golf ball. When we realized what had happened, we looked around quickly to see if anyone noticed, then turned our attention back to the oranges.

Twelve months passed by and we graduated, took our nursing exams, and got jobs. I was nineteen and Karla eighteen then. She took a job in a nursing home and I went to work at a one thousand bed rehabilitation hospital operated by Los Angeles County. My education really began there.

North From Alaska

I'm writing a book of stories based on my nursing career. I've decided to share them on my blog. Here's the first:

June, a 67 year old woman on our hospice program for lung cancer that had metastasized to her bones, was in tremendous pain, both physical and spiritual. The physical pain was due to the cancer, the spiritual pain due to the hole in her soul. She’d had several failed marriages and her three children hadn’t grown to be the successful individuals she’d hoped for. Her oldest daughter, Julie, wasn’t allowed inside her home because she would steal anything she could, including money and the drugs we prescribed for her mother. June had custody of Julie’s three year old son due to Julie being confined in prison for drug abuse and grand theft. Now she was out but apparently hadn't been rehabilitated.


June’s second daughter, Betty, lived with her, along with Betty’s two young sons. Betty also had a criminal record and was on house arrest for one month during the year I was seeing June. Her arrest was for forging checks. The Judge decided on house arrest so she could supervise her two sons and care for her mom. Betty was a pleasant though ineffective caregiver. She probably had attention deficit disorder and didn’t understand the instructions I gave her on how to care for her mom. When Betty’s charming and handsome husband, Eric, was released from prison after his most recent stay, he also moved into the house. Betty’s attention then turned to keeping Eric happy, and she did little to care for her mom.

After much prodding from me and the hospice social worker, the family contacted their brother, Mark, who lived in Alaska. Mark arrived along with his girlfriend, Debbie, and moved into the house with all the rest of the family.

I arranged a meeting with Mark for the day after his arrival. When the door opened, I was greeted by a bear of a man with the most beautiful blue eyes I’d ever seen. They didn’t look like they belonged on this man, but if the eyes are the windows to the soul; I was soon to learn this man’s soul was as beautiful as his eyes. His gray hair was long and stringy, rather thin on top, and a huge gray beard that hung halfway down his chest. It stopped at his enormous belly that looked as if he had a full term baby inside. He was fond of going without a shirt and the sight of his huge stomach and tattooed arms took a bit of getting used to.

However, Mark was a natural caregiver. He cooked for his mom, fed her when she couldn’t eat, took her to the bathroom, bathed and kept her in clean clothing and bed linens. He monitored her medications carefully and kept them under lock and key. Though he had spent time in prison on drug charges and was currently on parole, there were never any drugs missing once Mark took over his mom’s care.

Many times I would arrive to find Mark grieving over the impending loss of his mom and the many regrets over the choices he’d made in life. On those days, tears would fill his blue eyes and pour down his cheeks once they’d dropped off his long, curly black eyelashes. All I saw when I looked at him were his eyes and what lay behind them. I knew the rest of the world would probably never get to know what a tender, loving man he really was.

One day I arrived for my visit and Mark answered the door wearing sunglasses. After a few minutes, he asked me to take a look at his eye, saying it was bothering him. When he took the glasses off, I gasped at the sight of his formerly blue left eye that was now completely black. On closer inspection, I found that his pupil was completely dilated. He denied injuring it and when I pressed, he finally confessed he’d put his mother’s “eye drops” in his eye since it was irritating him. Puzzled, I asked him to show me the eye drops. He came back with the bottle of Atropine eye drops, clearly labeled with his mother’s name and the directions for her to take the drops orally for congestion, which is standard practice for hospice patients. Atropine is normally used to dilate the eye for eye exams, but we use it to dry up excessive secretions when people are dying. Knowing that there wouldn’t be any permanent damage to Mark’s eye, I burst out laughing before I gave him the lecture about never using someone else’s medications. I then went on to explain that his pupil would eventually go back to the normal size but it would probably take several days and he’d need to wear the sunglasses until then. Relieved, he finally smiled a sheepish grin. When I visited the next week, his pupil had indeed returned to normal size.

Several times during the months Mark cared for his mom, I wrote letters to the Judge in Alaska to whom he was supposed to report during his parole, telling him about what a good job Mark was doing and how much he was needed in California. I never heard back from the Judge, but he didn’t order Mark back to Alaska, so apparently my letters worked. I wonder now where Mark is and how his life is going. He was truly a special person hidden behind a burly, and pretty intimidating façade. This big grizzly bear man was really a teddy bear underneath.