I lay and think about how robust one must be to surround themselves with sick people. Daily, I am immersed in an environment that harbors illness. How I haven't keeled over from pneumonia is shocking. How I haven't been attacked and knocked out by a psychopath is even more surprising. I once thought that I was tough enough to withstand anything and everything. As I grip my chest in pain like an obese smoking coke addict, I realize that even super-humans have their limits.
My thoughts start to wander from my own aches to chest pain patients I see at the hospital. Span three weeks ago, I had two of the more impressionable.
Days after his 18th birthday, a 6"8' freshman basketball player for a local university took a hardy spill onto his face in the mayhem of Haight street. He claims he was standing on the corner, by a curbside and obligatory garbage can, chatting with a few ladies, totally sober and drug free. The next thing he knows, he is riding code 3 into the trauma bay on hard backboard with a stiff collar around his neck, startled with his broken face. And how.
The brand new adult had several broken teeth, gashes galore along his chin and cheeks and it was evident by just looking at him that his jaw was crooked. Blood oozed from his ear. He couldn't range his shoulder. He started crying.
Him: My face is so broken! (cry cry cry)
Me: I know it hurts, but I promise, it is not as bad as you may think.
Him: Really?
Me: Yeah, your entire top row of teeth are still there. (I just couldn't bare to speak of his lower row...) And your nose looks totally straight.
Him: What's wrong with my jaw? My ear hurts.
(since his jaw was totally jacked it sounded more like "Whuts wong with muh juh? Muh err hewrts.)
Me: Well, it looks like your jaw might be broken.
Him: CRY CRY CRY
Me: But you know what, we are going to fix it. And this cut on your chin, we are going to have the plastic surgeon sew it. Which is great.
Him: I have a cut on muh Chinn? CRY CRY CRY
Me: Is there anyone you want me to call? Any family in the area? Mom? Dad?
Him: Don cull muh mom. Don cull muh mom.
Me: Ok, we won't call your mom....yet. Do you have any friends who would like a call?
Him: Yuh, I wa with two girls. I thin they came to the hospital.
Me: What are their names?
Him: .........I dun know............I met em a few days ago.
Me:........
Him: They arr pwetty
I take a stroll though our waiting room. I see a drunk passed out in his wheelchair. An adorable mexican family with 5 children...runny noses attached to all. An older lady who had just been discharged trying to extract coins from the vending machines. And as if they were two fish out of water, I see normal looking college kids. Ahhh.
Me: Are you guys with Joe? (not his name but lets just call him that)
Them: Yes! Oh my god...Oh my god! Is he okay? Oh my god! Is he going to be okay?
Me: oh yeah, he will be just fine. He broke his jaw and has a lot of cuts and bruises but he will survive to show the battle marks. What are your names?
Girl 1: Olivia
Girl 2: Olivia
Me: You are both named Olivia?
Girl 1: Yep
Girl 2: uh huh.
Me: Ah yes, Olivia...and Olivia.
I smile and walk away after telling them that I will come and extract them from such a scary waiting room as soon as Joe is back from his cat scan. They thank me profusely then turn to take their seats next to a smelly, shoeless man licking the inside of a Dorito bag.
Joe was where I left him, in the trauma room getting a few Xrays. I report back that the fine ladies who have come to his rescue, and what seems his new and best friends, are named Olivia and that they are indeed pretty. He is crying even harder.
Me: ohh, does it hurt? Do you want more pain medicine?
Him: My gurlfrien bwoke up with muh yestaday. CRY CRY CRY
What?! So this kid just moved to San Francisco for college, recently turns his childhood into manhood, gets dumped then falls 7 feet to a crashing demise. Un Fun.
Me: She did? Where does she live? And how long did you date?
Him: LA...fwee years. (thats 3 in broken jaw talk)
Me: Look Joe, your face is going to be fine. You are a strapping young man and at the peak of your youth. You just moved to an amazing city where the girl to guy ratio is like 7 to 1. You know, we call you a tall glass of water around these parts. Do you realize how much you can capitalize on that? See, the Olivias are subjecting themselves to the grossest situation I am sure they have ever been in by just stepping foot in this hospital...because they want to make sure you will be alright.
For a moment his crying had calmed. He took a deep breath and started to relax.
Me: I am going to put you on this portable monitor and you are going to be taken over to the CT scanner. When you come back, I will clean off your face, okay?
Him: Are you coming with me?
Me: No another nurse will take you...
Him.....CRY CRY CRY
Me: Joe, do you want me to come with you?
Him: I know this sounds werd...buh will you come with muh? I don't wan yuh ta leave...
It was the first time in a long time where I felt so appreciated. I am so used to demands and orders and screams that I was completely taken off guard that a completely rational and scared 18 year old needed me. I told him I wouldn't leave him. I was his shield from the reality of bad health, hurt wounds, gross ER's.
When we were reassured that his brain wasn't bleeding and his stitches were meticulously placed, I allowed the Olivias to come in. Their excitement exploded with energy that is reserved for underwater volcanoes in the pacific. It was as if they were long lost siblings who had been taken away to monstering foster families at the ripe age of 9. They threw themselves onto the gurney in unison, delicately trying not to aggravate his ailing body. He matched their enthusiasm with an equally baffling charge. He instantly turned from the scared had-been adolescent, to a courageous, unfathomed man. His voice instantly got deeper as he joked about the silly IV in his forearm and the unnecessary pillows propping his right, intensely swollen elbow. When they were getting ready to go home, they asked me for a note to excuse them from class in the morning as it was already 4 am and the two of them had been up all night. I immediately felt old. Anything for Joe.
So what does Joe and the Olivias have to do with my razor fierce chest pain? We had done an EKG on the young chap, testing the electrical rhythm of his blood pumper. Low and behold, it was abnormal. Meaning that all the electrical connectors in his heart cells weren't adding 2 and 2 to make 4. His ventricles were enlarged and causing a disruptive pathway to safely and effectively pump blood to the hot spots, mainly his brain. This causes a dizzy spell then a blackout phase...in laymen terms. Joe had denied anything like this ever happening to him before. Who just passes out and wipes the cement with their face? But as I dug deeper into Joe's high school relationship and as I mothered him in Trauma 3, he divulged to me that indeed this had happened before. When he was 16. The picture is now clearly being painted on an enlarged canvas in my head. Joe has a heart condition :(
Back to me.
I get ready for work trying to ignore the fact that standing up straight is nearly impossible. I pop some ibprofen and gear up for a twelve hour rendezvous with San Francisco's finest ER regulars. I power through it, because I don't know what else to do. By 6 am, I can't support myself without the help of a table or countertop. Praise the fine workings of baby jesus that I am completely trapped by medical professionals that convince me to "rule things out". I settle into Zone 3, and cry as I get my very own EKG.
Which turns out to be abnormal. Say what? You mean, I am not the healthiest human on earth? You mean, this chest pain could very well be something serious? AM I HAVING A HEART ATTACK? Blood is drawn, sent to the lab and also slightly abnormal. My head was starting to spin. I lay in a gown, under a sheet which I am sure has once covered a dead body and gaze at the cardiac monitor. My pulse is all over the place. 72. 83. 76, 98, 75, 86. When I sat up...it jumped 20 more points.
The short of the long is that I wasn't having a heart attack (phewsh). I wasn't even having a Pulmonary Embolus (double phewsh phewsh). Pericarditis they thought? Maybe. GERD...reflux....? Perhaps the murmur that I was diagnosed with at 21 was causing it? Doubtful. My millions of doctors weren't quite sure but it was wasn't a cardiac emergency so I was safe to go home.
It looks like Joe and I were surfing somewhat of the same wave. A silent abnormality with our number one ticker. Scary. I wonder when he decided to call his mom.
Joe is the sentimental patient. I felt bad that he would most likely be spending the first few weeks of his college experience with his jaw wired shut and his wounds slowly healing, all while watching his fellow basketball players from the bench. It made me appreciate that my work in the ER isn't all for nothing.
But then I get a patient like Mr. "Saps" (not his real name because I am not looking to get sued here.)
Mr. Saps is one of the regulars who presents with "unbearable chest pain" at least once a week.
I. Am. So. Sure.
The man sits in the hallway, refuses to take his t-shirt off so we can evaluate him and demands hot tea while people are dying, quite literally, right next to him. He certainly chose the wrong night to play chest pain while conveniently was assigned the worst nurse ever (me). It was busy. There were a million traumas. And Mr. Saps was complaining that he hadn't eaten since 10 pm....only 3 hours prior. He would stand up, disconnect his own IV and wander the hallway. No matter how many times I asked him not to. He looked me in the eye, stood up and started walking outside so that he could smoke a cigarette and phone his daughter in London. Not even my sweetest of sweet talking could convince him to sit his fat ass down.
And then it started. I became angry. I raised my voice.
Me: Mr. Saps, you need to sit down....or else I will have to restrain you. (eww)
Him: (in some eastern european accent) I need hot tea. I am hungry and haven't eaten in hours.
Me: No, you do not need food. You need to lay back and take deep breaths because your heart isn't working right!! YOU KNOW THIS ROUTINE! We are not a cafeteria. Did you come into the ER at midnight so that you could ask us for food? Worst idea ever. Sit down, stop getting up and quit asking for something to eat and drink.
Him: My wife is prettier than you.
Me: Yeah right.
And it was loud. He stared me down and told all the doctors that he wanted a new nurse. (I guess there really is a first for everything) He pointed at me and screamed my disgrace. Mind you, this is all occurring while my own heart is fighting for normality. I sat down and retraced my verbage. I was fighting with a patient and couldn't believe it. With all the chaos I deal with on a regular basis, I had finally reached a tipping point with an old chubby Russian.
When it was time to take him upstairs to his room on the 5th floor, I couldn't get moving fast enough. In the middle of bike crashes and stabbings, I threw his chart on his bed and started pushing him as fast as my sickly body could go. Our conversation in the elevator was sweet.
Him: You are a snob.
Me: Oh really? Well you are our least favorite patient ever. Did you know that? There is no one else we dislike more.
Him: You hate your job. I need a nurse who likes their job.
When others entered the elevator, I bit my tongue. The whole ride up I imagined pushing his gurney off a towering cliff that hovered over jagged rocks...
We stroll onto the 5th floor. He makes eye contact with a few of the nurses and they high five him.
"Ahhh welcome back Mr. Saps! How you feeling buddy? You're looking good. Ahh man, I can't believe you're back. How is the misses? Good to see you!"
Him: See, some people like me.
Me: Good for you...
I dumped him like a sack of molding compost and rolled my eyes at the lame nurse who praised his presence. I couldn't believe that he was someone that people actually looked forward to being around. I have since doubted all 5th floor nurses and their judgment in all things great.
I needed a serious reality check. What am I doing? I am working in the highest stress environment, at the most unhealthy time of day (nights), dealing with the most unmanageable people, while living with a flailing heart. And I chose it. It is not in my character to fight with people. I hate it. I hate being and feeling grumpy. I am a smiler. And a laugher. And a 'hey lets be good friends'er. I felt like I was being taken over by a negative nancy.
So, what do I do when I don't know what to do? Yoga.
I feel suspended in air as I rest on my back in a puddle of my sweat. Nothing seems to wring out my soul like a hot hour and a half of twisting, bending and breathing. Inhaling the good, exhaling the bad. In with the Joe's, out with the Mr. Saps. It always tends to ease my emotions, knowing that no matter how far away I may feel from sanity, that I can always turn to a practice that brings both calm and serenity. My left hand rests on my chest, my right hand on my belly and I envision a large, red, pulsating heart. I see the vessels that extend and vary in each direction. I see the flow of my blood run like a river. It is encased in a white bubble sealing it from distress, from anger, from unhealthy sentiment.
I remind myself that even those who power their bodies with goji berries, bee pollen and various other superfoods, can have trouble arise. Was I cheating myself all those times I opted white instead of red wine? Damn the Sauvignon Blanc. Was it all that running? Tread lightly. Quit my job? There are Joes and Mr. Saps in every aspect of life. Runaway to a far off destination? Tempting.
At the end of class, we chant the obligatory OM, and the teacher closes with one statement...
"Beautiful life, Healthy body"
This is what it must mean to take the good with all the heartache. How appropriate as I sip a malbec.
