Reading Lips

Most of my patients can't talk. Some of them can mouth words. They talk to me and talk to me and I can't understand what they're saying. The worst are the people that die. People often wake up right before they die. They catch your hand, look at you for the first time and say something. Their mouths move, but there's no sound. And they need to say it, whatever it is is probably the most important thing they've ever said (Tell Myra I always loved her, even though I married Nancy. All my gold is buried under the McBain Oak, and it's yours, dear Nurse. Who knows?) and it's so absurd. Luck of the draw. They get me. Who can't read lips.
"What?"
"One word at a time. Let me get the word board! Can you point? Hang on! Oh. Oops. Bye."
What an idiot, they probably think, as they lapse back into darkness. Of all the people to get stuck with. And I'm not even going to get to live to fill out the Press Ganey on that one! Darn. Oh, there's the light!
No, I don't know what they think or say, and it's just awful. We are in such isolation, so dependent on externals. Wiz, of course, can always understand what they're saying. In detail. "No, I don't think Oprah's on right now. It's a Sunday. You've been unconscious for about 2 days. " he'll reply. "Your elbow itches? I'll get that for you. Your cast is twisted."
But yesterday, I was taking care of this woman I'd taken care of several months before. She was in a car wreck, then sent to a rehab facility, then returned to us septic, in terrible condition. Her hair matted and dirty--with mold in it, her trach ties reeking and green, yeast under her breasts, pressure ulcers under her braces, starving. Terrible. We were horrified. We had gotten her in such good shape--what had they done? I felt I'd been punched in the stomach when she came in. I took everything off, drenched it in hydrogen peroxide (hydrogen peroxide can solve almost everything--and it's only 80 cents!) She's doing better now, after a week. Most of her hair has fallen out, but we combed it and cut it and put it in little braids on top of her head. Lavished her with care. Sometimes, putting someone right is so satisfying. She wasn't septic, just neglected and starving. Wiz taught me that. I came in to nursing contemptuous of the little things. I liked things that made me think--I liked out diagnosing the doctors. I still like that, but the other stuff is just as important. Maybe more so. People give Wiz a lot of crap. I remember my preceptor saying, after Wiz had made a comment about our patient's fingernails, still dirty after a week in the unit, that if he liked all that nurse tech stuff, he could just do that--save the hassle of being a clinical supervisor. As if it was beneath us.
So anyways, I'm fussing over my patient. She was having a lot of gas. We'd had one ostomy bag explode, and I was burping her new one. She mouths something, and--it was the strangest feeling--I heard her words in my tummy--silent but there--like my own thoughts, but located in a different place in my body--she says, I don't think I can take this any more. And without thinking, I respond. "This is all part of the process, Gretel. You've been starving. Your gut is waking up."
They were so mean to me there. Will I have to go back?
"No. You don't have to go back."
It was the strangest thing.
I remember when Spanish finally clicked for me. I had really been trying to learn Spanish, since everyone speaks it in Miami, with very little success. I listened to Spanish radio all the time and I was driving home from work, listening to Radio Ritmo! and an advertisement came on. I never understood the ads, but all the sudden, I found myself musing "That's a really good price on pillows! And we need new towels." It was an ad for Bed, Bath & Beyond and I'd understood it without even realizing it. Language is only one part of communication, I think. Listening is getting your ego, your overactive "I'll figure this out!" part of you out the way and being present with where you are. Letting go of your own story.
It's a zen task, I think. You have to give over to the other person to really understand what they're saying.
Life can be full of awakenings, can't it?
That's my 1/2 hour.

How Not to Eat Dinner

I have more than a cold. I have pneumonia.

It finally sort of let up yesterday, but I still have a fever. I've been out of commission for a good six days at least. Amazing. I haven't been this sick in years.

I feel a little better today, but still as if I've been hit by the truck. My breath has this dry raspy feeling, this heaviness. I can't taste anything very well or smell, either. I keep forgetting things.

I've spent the whole week with doctors.

Lilly's doctor on Monday. She lost weight. I argued with the doctor about it. The number she had was different than the number on the scale. I didn't want to get the nurse in trouble, but it had been written down wrong. Still and all, even though the number was wrong, Lilly had still lost weight.

I don't like Lilly's doctor.

In the office, Lilly confessed that she'd been lying to me, and she hadn't been eating what she said she had. I felt stomped. So much for the Gilmore girls.

I feel like these people are trying to drive a wedge between Lilly and me.

"Have you been eating?" They ask her.

"Not always." Lilly tells her, not looking at me.

I'm exhausted. The pneumonia, school, the job, Lilly, the boyfriend, Nick into college. He got into the state university, not a sure thing, given his GPA. He's not really excited about staying in town, but, oh, well!

Lilly and I met with the therapist that afternoon.

"Have you been fighting about food?" She asked us.

We've only had one fight about food, but it was a doozy. "No," Lilly and I start to say, then "well..."

Tell me about it, the therapist says in her gentle voice.

Lilly begins: "Well, I was making myself dinner, because Mom was sick, and I was taking too long, so Mom thought I wasn't doing it and she got mad. But I wasn't trying to keep from eating dinner."

"So your mom misunderstood?"

"Yeah."

"Is that what happened, Mom?" the therapist asks me.

Here's what happened.

At 6 pm, I was flat on the couch. Fever, coughing up a lung, etc. "You need to get yourself dinner," I told Lilly.

The refrigerator is full of food. It was Thanksgiving, after all. We have 1/2 a turkey, ham, sweet potatoes, mashed potatoes, vegetables, squash soup...dinner is not an issue. Cooked. Ready to heat up and go.

"I don't want any of this,"Lilly declares. "I want to have that egg and tuna salad Amanda makes." She calls Amanda. Amanda isn't there, so she leaves a message.

"Amanda, I'm getting ready to eat dinner and I want to make your egg and tuna salad. Could you call me back with the recipe, please?"

1/2 hour later. The phone rings. It's Amanda. They talk for awhile. Around 7, Lilly calls out, "Mom, do we have relish?" A list of other ingredients follows. Tartar sauce. Mustard powder.
"Look in the fridge," I tell her. I highly doubt we have tartar sauce.
"Mom, are you too sick to go to the grocery store."
Is she kidding? I'm too sick to walk to the bathroom. She asks her brother.
"No," Nick says, not taking his eyes off his video game. "I'm not taking you to the store for relish."
"But the dinner won't be any good without relish."
She decides she can do it without relish. I hear the sound of water being brought to a boil.
She keeps taking to Amanda. An hour goes by.
"Lilly," I shout out hoarsely, "have you made your sandwich?"
I get up and stagger in to the kitchen. "What's this, Lilly? Why is the egg still boiling?"
She puts her hand over the mouthpiece of the phone. "The other egg wasn't the right consistency. I had to do it again."
"How long has this egg been boiling?" I croak.
"Not long enough. Mom, I'm on the phone."
Another 15 minutes goes by. The egg is still boiling merrily.
"Lilly, you need to make yourself dinner."
"I am, Mom," she snarls.
"Ok. Tone. Off the phone."
"You've got to be kidding."
"Now.'
She rolls her eyes. "Sorry, Amanda. My mom wants me to get off the phone."
2 hours and 37 minutes after I first told Lilly to get herself something to eat, Lilly has finally managed to prepare herself an egg and tuna salad sandwich. Then I have to nag her about the fruit.
"I don't have to eat a piece of fruit at dinner!" she tells me. We've had the same diet for 2 weeks.
Mental illness is so fucking fun.
"You're the mom," the therapist says. "You can tell her when she needs to eat."
"I was going to eat." Lilly says, sulkily.
"I know that." I say.
Duh. 2 and a half hours of Lilly not eating.
Her father is this way, too. "I'm doing it, " he'll maintain--whatever it is you ask him to do. And then he'll delay and delay and delay--creating more and more and more rules about how to do it and when to do it. Preparing to prepare to prepare. It's psychotic. "Well, for organizational purposes, I want all the checks I write for the kids to end in '2', so I couldn't send the orthodontist money until the new checks arrived--and we'd switched banks." That sort of thing. The way to avoid having mentallly ill children is not to marry anyone mentally ill, I've decided. But the mentally ill are usually so charming and good in bed! So what do you do?
Oh, well. Too late now. I guess I'm stuck with her.
That's my 1/2 hour.