THE ARRIVAL...

WE'VE ALL BEEN THERE WHEN THE SIMPLE THINGS JUST PLAIN REFUSE TO GO THE EASY WAY. TOO MANY YELLOW TRAFFIC LIGHTS, TAKING A NAP AND FORGETTING TO TURN OFF THE PHONE, AND GETTING JUST PAST THE HALF WAY MARK ON MY WAY TO WORK WHEN THE FRONT TIRE BLOWS ON MY BIKE...WHAT WAS I SUPPOSED TO DO? RIDE THE SHORTER DISTANCE TO THE HOSPITAL AND DEAL WITH IT IN THE MORNING AFTER A LONG NIGHT SHIFT? OR RIDE THE LONGER DISTANCE HOME, RISK COMPLETELY DESTROYING MY TIRE, RAPIDLY CHANGE CLOTHES, DRIVE LIKE HELL BACK TO THE HOSPITAL HOPEFULLY MAKING IT ON TIME? I CHOSE THE LATTER. ONLY TO FIND ON MY ARRIVAL TO THE UNIT, BREATHLESS, SWEATY AND PITTED OUT, THAT FOR THE FIRST TIME, A NEW 70% BURN WAS ON ITS WAY UP FROM THE E.D. AND HE WAS GOING TO BE MINE THROUGH THE NIGHT...

ON MY FIRST DAY OF NURSING SCHOOL THE DEAN LEFT US WITH THIS MESSAGE:
OUR LIVES CONTAIN PERIODIC "RED LETTER DAYS" THAT SIGNIFY MEMORABLE MARKERS. THIS SIGNIFIES ONE STEP IN THE FULFILLMENT OF YOUR DREAM TO BECOME A NURSE, AND I CELEBRATE THAT WITH YOU. I CONGRATULATE YOU ON THE HARD WORK AND ACCOMPLISHMENTS THAT GOT YOU HERE; WELCOME ABOARD!

AS THE TAIL LIGHTS FADE ON MY FIRST YEAR AS A PROFESSIONAL ICU NURSE I HAVE FOUND MYSELF REFLECTING ON THE VARIOUS RED LETTER MOMENTS THAT HAVE BEEN ETCHED IN THE VERY STEEP LEARNING CURVE, THAT THROUGH 148 TWELVE HOUR SHIFTS, HAVE COME TO DEFINE THE BURN NURSE THAT I AM:

THE FIRST BURN DRESSING, LOOKING INTO "MR'S" EYES OF PAIN, WITNESSING HIS GHOSTLY AND SILENT SCREAMS...FEELING HIS ROUGH UNEVEN GRAFTED SKIN.

WATCHING AN UNSUSPECTING FAMILY COME TO THE DECISION THEY THOUGHT THEY WOULD NOT BE MAKING THE DAY THAT IT WAS REQUIRED OF THEM TO MAKE IT; WITHDRAWING LIFE SUPPORT ON A FATHER AND HUSBAND, AND THROUGH THEIR TEARS, WATCH HIS LAST BREATHS.

FEELING ETHICALLY STRAINED AS EXTENDED MEASURES AND CARE WERE LAID DOWN UPON PATIENTS WHOSE VOICES WERE MUFFLED BY THE NOISE OF RELIGIOUS RESTRAINT AND FAMILIAL INDECISION.

THOSE IN MY FOXHOLE, TRUSTED MENTORS AND LEADERS, THE ICU CREW, THE "TOP 3", & B.F.F

THE SMELLS.

THE DISFIGUREMENT.

THE POWER OF DEPRESSION, GRIEF AND UNHAPPINESS LEADING SOMEONE TO FEEL THAT THE ONLY WAY OUT IS TO LIGHT THEMSELVES ON FIRE AND BURN AWAY THEIR PAIN...AND LIFE.

HEARING THE LAST TENDER SWEET WHISPERINGS BETWEEN HUSBAND AND WIFE AS THE VESTIGE OF MORTALITY CLAIMS IT'S FINAL VICTORY.

THESE EXPERIENCES AND MANY MORE HAVE LEAD ME A STEP CLOSER TO BECOMING THE QUINTESSENTIAL PROFESSIONAL I ENVISIONED IN THOSE FIRST HOURS ON THE BURN/TRAUMA ICU.

...12 HOURS LATER, WITH GREASY MATTED HAIR AND SEVERAL FLUID POUNDS LIGHTER, WEARING A GRIN. I STOOD IN THE SHOWER WASHING AWAY THE SWEAT AND STINK, FEELING THE "RED LETTER" ACCOMPLISHMENT OF HAVING MADE IT THROUGH MY FIRST MAJOR BURN ADMISSION. AS MY HEAD HIT THE PILLOW IN PREPARATION FOR THE TWELVE MORE HOURS AHEAD, A FLEETING THOUGHT AND BURGEONING CONFIDENCE PASSED THROUGH MY MIND WRAPPED IN THE FEELING THAT I HAD ARRIVED...

#1

ON ANY GIVEN DAY, WE WAKE WITH A CERTAIN CONFIDENCE AND APPRECIATION FOR THE MUNDANE REQUIREMENTS AND TASKS THAT LIE SAFELY AHEAD. A SORT OF NEVER ENDING LIST OF "TO-DO'S" THAT WE ATTACK AND MINIMIZE DAILY. WE HAVE OUR JOBS, OUR KIDS, OUR WORRIES AND CONCERNS. WE DRIVE THE SAME ROUTES, WE FREQUENT THE SAME STORES, AND CONTINUALLY ANALYZE OUR LIVES SEARCHING FOR THAT SOMETHING TO MAKE US FEEL MORE ALIVE AND BUMP OUR ROUTINE OUT OF THE RUT OF NORMALCY. THOUGH IT IS CERTAINLY ACKNOWLEDGED THAT ANY NUMBER OF EVENTS MIGHT TAKE CONTROL AND SHAKE OUR DAILY "TO-DO'S", SURELY CHANGING THE COURSE OF OUR LIFE, WE STUBBORNLY INSIST THAT THOSE EVENTS ARE SOMEWHERE UP THE ROAD, AND THAT "TODAY" WILL JUST BE ANOTHER REGULAR DAY.

#1'S HEALTH HAD BEEN AILING IN THE PAST MONTHS, AND A UNFORTUNATE OVERUSE OF AN ANALGESIC HEAT RUB (BENGAY) CAUSED A CHEMICAL BURN AND BROUGHT HIM TO OUR FLOOR. #1 BEGAN TO LOOSE CIRCULATION TO HIS EXTREMITIES LEADING TO FULL BLOWN SEPSIS AND A NEED TO AMPUTATE. DAYS PASSED, AND MACHINES WERE ADDED. I WATCHED A CONFLICTED WIFE BEING PULLED BETWEEN HER OWN HOPE AND HIS WISHES. THOUGH A DECISION TO GIVE TREATMENT THROUGH THE WEEKEND WAS REACHED WITH THE BURN TEAM, THIS YIELDED NO FREEDOM TO HER QUIET STRUGGLE. 12 HOURS LATER AND 72 SHORT OF THE AGREED PLAN, HER ANGUISH FOR HIS SUFFERING SURPASSED HER OWN HOPE. SHE KNEW BETTER THAN ANYONE THAT THE MAN SHE WOKE UP TO EACH MORNING FOR 63 YEARS WOULD NOT HAVE ANY OF THIS, AND THEREFORE THE DECISION WAS ALREADY MADE...IT WAS TIME. THE MACHINES WERE REMOVED, PAIN WAS TREATED, AND PRIVACY GRANTED. AS I WATCHED #1'S FAMILY CIRCLE HIS BED TO SHARE HIS LAST MOMENTS I COULDN'T HELP BUT THINK THAT THIS DAY WOULD FOREVER MARK A CHANGE IN ALL OF THEIR LIVES, EACH DAY AFTER WOULD BE DIFFERENT FOR TODAY WAS GOING TO BE THE DAY THAT THEIR FATHER AND HUSBAND WOULD DIE.

LATER, AS I PULLED THE TUBES AND IVS FROM HIS BODY, TAGGED HIS TOE AND ZIPPED UP HIS BODY BAG, I REFLECTED ON HOW ORDINARILY MY DAY HAD BEGUN, LIKE MANY OTHERS...WITH THE DREAD OF AN EARLY ALARM WAKING ME TO THE REDUNDANCY OF LIFE...OR SO I WOULD THINK...

...RIP #1...