Broken

I had a co worker ask me the other day about my statement on this blog that I've lost faith in humanity. It took him by surprise because I seem like a cheerful person, and that sounds like such a sad thing to say. So I feel like maybe clarifying, expounding, philosophizing a bit, if you will... to explain why I would say that I've lost faith in humanity.

There are basically two general opinions of the human condition out there. That human beings are basically good though we make some mistakes and that human beings are basically corrupt, though we do some good. The yin and the yang so to speak. I've even heard that this is the basic premise that divides our political parties. I'm no politician, so I can't say for sure.

The Christian worldview (which is my worldview, if you haven't picked that up yet) is that humans were made to be good, but we got this idea in our head that we could do things better our own way and went into rebellion against God. Since that time, we hold the memory of goodness, but no matter how hard we try, our best acts have a bend. I only have my own head to live in, so I can't say what goes on in yours with any authority, but in mine I find that my motives aren't often what I would like to believe they are. There's a saying that there are two reasons a person does anything - the real one, and the one he likes to believe.

I used to think I wasn't very selfish. Maybe a little, but certainly not very. Then I got married, and my husband hadn't gotten the memo that the world was supposed to revolve around me, my needs, and my emotional inclination of that particular day, and I found out, oh... I'm a little more selfish than I thought. And then.... I had kids. Two beautiful, precious, wonderful babies that could care less about my need for sleep, quiet time, order, sanity, etc etc, and I discovered.... wow. I'm actually very selfish.

My nursing career has been the outspoken child for the emperor's new clothes of my self perceived goodness. I thought I was fairly empathetic and compassionate. Enter unkempt, inconsiderate, dishonest, addicted, sometimes ridiculous clientele of the world, and oh. I can actually be pretty cold, cynical and judgmental.

So, losing faith in humanity for me is a striping of unrealistic expectations. I don't expect me or the people around me to meet a certain standard, because well - we can't. But it's also a bit of a paradox. Because as I've said, I haven't lost faith in the God who has promised to heal humanity. And if God is in the process of healing us; restoring our goodness by His own Sacrifice of love... then I'm very hopeful indeed. Because that means that the most broken of people has hope. And as a broken person, I find that very reassuring.

The Escape

She wore a patterned red sundress with a red zip up sweater and red flip flops. Her hair was combed straight back into a ponytail and then carefully braided down her back. Her eyes were an unusually light blue and contrasted exotically with her dark hair.

When I called her name from the triage room she stood and made a slow and seemingly painful journey to the room. Her mouth was tight around the edges and as she slowly lowered herself into the chair by my vital sign machine, I could see the signs of stress on her face.

"What are we seeing you for today?" I asked.

"I have sores on both of my thighs and my right hip," she replied stiffly.

I reached up to the glove box and slipped on a pair of white gloves. "Do you mind if I take a look?"

She shook her head slowly and eased painfully out of the chair. She lifted up the bottom of her dress to reveal swollen, painful, and infected looking abscesses, one making her right buttock look almost double its normal size. Seeing her up close, I also saw all over her legs the tell tale scars of a long time heroin or meth user. The infected boils on her legs were most likely from places she'd been trying to shoot up. It isn't an uncommon problem for users.

I asked her if she had been running a fever, and she stated that she thought she had. The fever could mean the infection was becoming more severe than just a skin infection and those sores had the potential to make her very sick. This was a day, unfortunately, that the gates of Hades had unloaded its hordes through our ER doors, and I knew I wouldn't be able to take her to see a doctor right away. I would've liked to do blood work while see was waiting to get an idea of the severity of the infection, but seeing the same scars all over her arms as I had her legs, I knew that she probably had little to no veins that could be accessed in the confined space of my triage room. All the same, I tied the tourniquet around her arm. Feeling the hardness of her scared veins I felt even less hopeful.

"They have a hard time starting IVs on you?" I asked her. She nodded yes. Her lips became tighter and frustrated tears began pouring down her cheeks. The redness in her eyes made her light blue eyes even more brilliant. The lines on her face and the suppressed anger and frustration around her mouth told of the vicious and possibly endless cycle of trouble her addiction had bound her to. The addiction that had probably seemed to offer the only escape and solace from who knows what else life had offered her.

I felt something like sorrow for her as I watched her limp back to the waiting room. Sick patients kept pouring through our doors, and two hours later when her name was finally called to see a doctor I couldn't find her.

I couldn't help but wonder what would become of her. Her abscesses needed treatment and I hoped she found it at another hospital. But more than that she needed freedom. Freedom from the Escape that turned out to be just another prison. As I laid in bed that night, I said a prayer for the girl in the red dress with the sad blue eyes.

Tears

Any of my childhood friends could tell you that me and emotional expression are awkward bedfellows. There was a time when I could count on one hand the number of times I had cried in several years. Then of course I got married, and I don't know what it is about testosterone that can make me a blubbering idiot, but in my normal life I still find strong emotions a little ill-fitting.

It's not that I don't care when people are sad. I do. Very much. But for some reason, tears make me as uncomfortable as any man. I'm suddenly too aware of my facial expressions, they feel forcefully sincere... and my arms have no good place to go... and I can hear all my words twice as though there's an annoying echo, just in case I didn't hear how flat they fell the first time around. And it doesn't matter who is crying. It could be a family member, a college roommate, or a patient. (My kids are fine, but that's probably because with that much repetition it can't possibly feel awkward).

In my line of work, you just can't avoid it. At some point, someone is going to cry. Sometimes it catches me off guard. I'll be happily adjusting monitors and cables, humming the latest Sesame Street song that I have stuck in my head under my breath (I have a 2 year old, ok?) and I turn around, and bam! Someone is looking down with tears running down their face, or giving that tell tale sniffle. My gut reaction is to act like I didn't notice and take the quickest exit. Sadly, I'd be lying if I said I've never done it.

But usually I have no choice but to look the scary Tears Monster in the face, and say something like "do you need to talk?" while all the one liners from my nursing school course on "therapeutic communication" start jumbling around my brain. Occasionally I've slipped an arm that suddenly seems to weigh twice as much as it used to around someones shoulder and given the awkward pat. I think of some of my dearest friends, so blessedly endowed with sweet grace that seems to multiply tenfold at the very hint of a tear, and wonder why I have to be so stunted.

Yet as in all things, I can only trust that in my weakness, God is strong. That He'll redeem my painful interaction with emotions, and somehow communicate the compassion and grace that I'd like to give. I just have to give what I can, and try to avoid the temptation to hide from people's tears.

The Fight

It just felt like we should have saved him.

Most of our patients that come in full cardiac arrest look like they've had it coming for a while. Either they are elderly, obese, or have the signs of a hard life or long term illness all over them. But not this guy. He was young as far as these things go, maybe fifties, regular build, and looked like he could have been out fishing yesterday, or playing with his grandkids, or enjoying a normal, fairly healthy life.

We worked hard, doing all the cycles of all the things we're taught to do to save someone, but none of them were working. We would get his pulse back, start to transition from resuscitation mode to sustaining mode, and all of a sudden his pulse would be gone again and we'd be back at square one, doing more CPR and pushing more drugs. Finally after losing his pulse again, the doctor made the normal decision to call an end to our efforts. I held the doppler to his femoral artery and listened to the silence where the 'woosh woosh" of a pulse should have been.

The doctor stepped out to speak with the family as we began unhooking the cardiac monitor with its dismal flat line and turning off the breathing machine. I stood and stared at my patient. I just didn't feel like he was done. Watching him for a few moments I saw his body's final agonal gasps for air. But then.... it seemed like more than that.

"It really looks like he's trying to breath." I said looking up at the Respiratory Therapist. He eyed the patient uncertainly as I stepped a little closer. "He looks like he's still alive to me."

I grabbed the doppler again and held it to his femoral artery. And there it was. "Woosh, woosh, woosh."

"Get the doctor back in here!" I yelled to one of our ER techs. The Respiratory Therapist started hooking the breathing machine back to the tube in his windpipe and another nurse started clipping the heart monitor leads back on.

Moments later the doctor stepped back in the room and looked up at the monitor. "You're kidding me!" He exclaimed and stood looking at the monitor for a moment. "Well, alright!" he said finally. "Get a dopamine drip started and.... I think I need to go have another talk with the family..."

We had a pulse and a fairly reasonable blood pressure. I found myself having trouble moving from my post with the doppler, listening to the reassuring sound of his pulse, afraid that if I moved it would disappear again. And sure enough, not 20 minutes later, it was gone.

"Come on, buddy!" I found myself saying, as though I could will his heart back to motion. We started CPR again, and someone poked their head out of the room to yell for the doctor yet again. It was like dejavu in the worst sense. We did more rounds of chest compressions and medication and IV fluid, but we couldn't get his pulse back. For the second time, the doctor called an end to our efforts, the doppler silent and the heart monitor line depressingly flat. I knew it was time to call it, but I didn't want to. It felt like he had been fighting to live, and I wanted to keep fighting for him.

I knew that his heart had probably been too damaged by the heart attack that most likely proceeded his cardiac arrest for it to ever be strong enough to sustain his life. And I knew that in the grand scheme, someone's life never really rests in our hands. But sometimes it doesn't seem to matter what you know. It still felt like we should have saved him.

Suffering and Hope

Sometimes I feel floored by the amount of suffering around me. It's like walking through a meteor shower watching people all around me getting hit, wondering when my turn will come. Families falling apart, parents becoming disabled, babies with incurable terminal illnesses, untimely, tragic death. And these are just my personal acquaintances.

To see the scope of human suffering that walks through the door at work is enough to give anyone a case of mild anxiety. A diving accident that robs a young man of any movement, the drowning accident that takes a family's young child, the driving accident that takes a brother, the incurable, degenerative illness that ensures a young woman a future of doctor's appointments, hospitalizations, and pain. The woman who "fell down the stairs" but you're 99% sure her husband hit her. The woman who wakes up on a cold porch after being date raped. I've seen so many suicide attempts I've lost count.

I look around sometimes and think, what a sad, broken world.

And I wonder... what do people do without hope? If your best consolation is the journey into oblivion offered by death - how do you possibly cope? If people really grasped that, I'd think many more would be understandably crippled by panic attacks.

I have hope that God will set everything right. That all the pain and sorrow of this present world will be only a speck in the grand scheme of God's eternal plan. I know many people think that is naive and fantastical. I disagree. And I wonder how they get out of bed in the morning without hope.