Wednesday, February 23, 2011

"Where's my CAP, Millie." or Lorane, RN (Part I)



I received another reminder email from the coordinator of our 45th "GUNS '66 (Georgetown University School of Nursing, Class of 1966) Reunion". Joan was recalling that while we were doing our psychiatric rotation at Walter Reed Hospital -where they treated our military's sickest of the sick - I had suggested she audition for the University's annual musical production. She did, got a part and met her husband of 44 years - also a member of the cast. I was ruminating about my first job after graduation - back home in NYC.

I peeled my nurses' cap off the refrigerator door. It was the first step in what had become a ritual of preparation and, that day, prelude to the commencement of a career. In 2 hours I would report for duty as a registered nurse. The cap had been scrubbed then soaked in a starch solution and finally spread carefully onto the door - all wrinkles kneaded into disappearance - to dry and stiffen overnight. It felt good - hard and stiff, ready to take on its winged shape. It was five A.M and the night still had a tentative grasp on the apartment. Only the fluorescent beam from the oven door shot through the shadowy room to where my hands worked deftly, creasing, folding and securing the fabric with relentless little studs. I placed a rolled sock into each of the wings to discipline curves into submission.. Then, for the first time, I affixed the narrow blue-over-gray grosgrain ribbon which sliced the white span horizontally announcing its wearer was a graduate. I slipped the cap into its plastic bag and shuddered. "What if I can't handle it?"

An hour later I was walking quickly to the subway (there is only ONE pace in 'the city' - "quick") bound for Queens and one of the city's largest city-owned hospitals, Elmhurst General. The "zoo", her former roommate, Connie had called it. Trundling under the East River, I thought of my interview. I'd been appalled by the woman's appearance. Miss Mulvehill was a cartoon of all of the short, plump supervisors I'd ever met. Her yellowed, long-sleeved uniform seemed to strain at the task of containing the abundance of lipoid tissue, which, if ever freed, would roll back and down, slamming her dyed-red curls into the wall behind her chair. Leaning forward on ink and grease-stained elbows, her mass was firmly anchored by the voluminous, pendulous breasts which gripped the blotter upon which my application risked envelopment.

"Interested in Critical Care.," she asked impassively. My trim figure was so tensed I hardly needed the chair from which I leaned forward in confrontation.

"Coronary Care, actually. We had a very progressive program at Georgetown, as you may know, and I . . . "

Ms. Mulvehill thrust her meaty lower lip out and down and slowly slid her finger across its moist surface. Hesitating just a second - to focus on her target - the wet nub then impressed itself on the application, an assist to the movement that would flip the pages to where my assignment would be scratched. Exhaling her interruption, I heard,

"What makes you think you'd like critical care?" I smiled: enthusiasm conquers annoyance.

"Oh Ms. Mulvehill. It's such a CHALLENGE. Those patients are SO fragile, vulnerable and frightened by their illness. And the MACHINES. We forget how threatened they are by the machines. There's such a . . .a RISK of depersonalization. We, I mean the NURSE must keep the patient's individuality in the forefront. (I know. I'd like to slap me shut, too. We were just sooo programmed.) Of course the doctors are SO busy. And the families - loved ones are too often shut out." (BRAIN: SHUT UP!) She had allowed her squeezed eyes to study me during this diatribe. They reported thick, chocolate hair, eased back into a bun at the crown, high cheekbones, walnut eyes framed by thick brows, glazed lips, barely tinted coral and even, 'Chicelet' teeth. She thought, "She's got a ball on the tip of her nose, and on HER it's cute." Reaching for her pen, she scribbled in a manner that precluded recourse. Noticing the definitive move, I heard my voice grow thin as I concluded. Then, speaking as she wrote,

"There are no openings in Critical Care at the moment. You'll be working on N-6. Report is at 7. I think you'll find the experience invaluable." My train of thought completely de-railed, I fought for the presence to ask a pertinent question. "At the moment?" What does that mean. Would there be an opening in a few weeks? By Christmas" Next summer? When? Mulvehill was not inclined toward elaboration. I thought, "She's right. I need a job - now. And the experience."

"N-6. Is that a Med-Surg Floor?" She glanced up and beyond at the wall clock, then rested her gluttonous gaze on a rusted lunch pail which dominated her cluttered desk.

"N-6 is Neurology-Neurosurgery. Call me if you're having any problems."

The train screamed to a halt and I bolted for the doors, aware I'd almost missed my stop. Tried to calm myself as I walked (quickly). "The first day of ANY job is always rough. I'd be even more of a mess if I were starting in Critical Care. Mulvehill did me a favor. I need time to get used to their routines. But Neuro! The damage is so OFTEN irreversible. It's so. . . long-TERM. But now I'm a graduate. More time to REACH people, coax them out of their oblivion. Time. We'd had too many conferences, interruptions. But NOW."

"Did you want six?" snapped a stranger in scrubs. "Six? Six what? . . .Oh, sorry, half asleep," as I backed out of the elevator. Squinting, I approached a deserted Nurses' Station. Noting the disarray of metal charts, lab slips and medication cards, I proceeded to a door marked "Lounge". Must have had a busy night. Maybe an arrest. I hung my coat in a tall, narrow metal locker. The room was "done" in late dirty, torn, unkempt distress-type decor topped with some variety of eating, drinking and smoking debris. Having secured my ("the") cap, I blessed myself and marched out to the patient area. Closing the door behind me, I was staring into a pair of dull, brown eyes about four inches from my own. "I'm Brite. You must be Clarke. C'mon, I'll show you the floor."

I followed the chubby, shuffling frame, fascinated by the black woman's shoes. They plopped. The backs of the laced, white oxfords were pressed in and flat, the feet resting on a now-opened surface, like a bedroom slipper. The brief spell was broken when I started choking on the air. The combo of Pine-Sol and urine stung the sinuses, watered the eyes. (Have not used Pine-Sol to THIS VERY DAY) Steeling myself, I asked the back of Brite's head,

"How many beds on this ward?"

"We got forty beds on this ward. This here is the treatment room," as she kept plopping. Stopping, I pushed the door open a bit. Then. I gasped and smacked my hand so hard against my mouth, my lips were already puffing out.

"Ms. Brite," spoken deliberately and to no one, "this man is dead." The corpse - no covering or ID tag - had been parked for a while, so hard and set were the open eyes and mouth. Closing the door, I caught up with Brite.

"Ms. Brite, you DO realize. . . "

"Jack, here, is the night orderly. Clara's the night charge. We'll make rounds with them and get report." Jack chewed a toothpick, Clara a donut and I my now-swollen lip as we walked to the end of the ward. From the faded-green, rusted, metal beds, the glassy, glazed, confused, unfocused eyes of some twenty-odd human beings stared. Most were diapered, drooling and disoriented.

"What's the current census, Brite?" I was hoarse, stunned by this suffering montage.

"Don't know."

"Jack?"

"ROUND . . .uh . . .thirty-five."

My thoughts sizzled. Around? Well I guess it would vary. We'd just passed two unmade, vacant beds. Their occupants. . . . down in x-ray? Out for breakfast? In the closet? And what about that guy in the treatment room? Isn't anybody going to SAY anything?

"Excuse me, Clara." She stopped, head down, tapping a bed footrail with her pen.

"What happened to the patient in the treatment room?"

"Spired."

Bristling, "I can SEE that he's expired, Clara. Was it during the night? What happened. . ."

"Don't know. He 'spired on evenings and they put him in there. We didn't have time to take him to the morgue."

My thoughts continued their hot race. Don't KNOW? Dear GOD! Poor man probably couldn't take it any more, stole down there - easily un-noticed - and, after clumsily hoisting himself onto the stretcher, blissfully dropped dead. A zoo.

We'd reached the Nurses' Station again. I was making some mental care plans when Brite said, "You'll be in here."

"In here" was a room contiguous with the nurses' station. I'd noticed it in passing. The door had been closed. Thought it was a conference or med room. Brite was gone and Clara lounged on the door jamb for,

"This is Neuro's 'tensive care'," the way a centurion might tell a Christian, "These are cats."

Don't know about y'all, but I'm thinking (I lied. Actually, I've made a decision.) that the COMPLETE title of this post was left off - inadvertently, to be sure. Following "RN" I neglected to type: "Part I ". And I know you'll enjoy "Part II" - hard to imagine, but there's some funny (tho at the time 'black funny') stuff to come that you'll not want to miss. (Of course there have been times I've wished I HAD; just a very few, TEENY times) So then, Later, L. . . .

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