fan mail

"I've been through it all, baby. I'm mother courage."
Elizabeth Taylor

"Full code? Really? Are you fucking kidding me?!?"
Jimmy

Dear Ms. Taylor:

I've been following, with some interest, the news of your recent hospitalization. First and foremost, let me wish you the speediest of recoveries, assuming you survive this admission.

Forgive me for being so blunt---this is my first letter to a celebrity, after all, and I have the social grace of roadkill. However, I think it's time that someone from the unwashed masses shares a fact as sure as tax collection: your CHF is going to kill you. If not now, within the next two years. (That is an optimistic number that I've pulled out of, as you Brits say, my arse.) I hear of your 'second month in hospital', and I picture others of your cohort, struggling to breathe, praying to make it to their granddaughter's wedding in June, or their 53rd anniversary next week, or to Christmas, or to tomorrow.

I think of a BiPAP mask cutting the skin across the bridge of your nose, and your thoughts every moment of ripping it off. I consider the pulmonary congestion, the daily chest x-rays, the barely concealed horror of every nurse that sees your ankles for the first time. I wonder how tired you are of every nurse, every shift, checking your butt for pressure ulcers. I frown at the idea of Cleopatra on a bedside commode with maximum assist back to bed.

I picture your violet eyes crossing when the BiPAP comes off and you get a little hypoxic.

And, since we're being honest here, I'm going to tell you: if you have any personality "quirks", well, it's being shared over report. Repeatedly. Someone who sees you naked daily probably speaks with at least momentary irritation about you and your hatred of oral care/ability to get out restraints/self-extubation/specific odor of your bowel movements/obsession with Pepsi products.

Ms. Taylor---Elizabeth, if I may be so familiar---Elizabeth, let's cut the crap. The ICU is no place to die. My own grandmother is dying of CHF. She was an ICU nurse, she knows she's dying, and yet she still practically told my mother to fuck off when Mom suggested she go to an assisted living facility. Grandma told her that she wanted to die in her home, in front of the TV. Get out of that shiny, decontaminated, tastefully decorated, well-staffed hellhole, Elizabeth. Die surrounded by the things that remind you of your admittedly kick-ass life; your family and friends. Hell, if it's all you have, your cat, sofa and TV. Put on National Velvet, hire some cute boy to rub your feet (tip him well; let's admit, CHF-affected feet are not "dainty"), drunk dial your exes that are still alive, and have a hospice or home health nurse come visit you. He or she will manage your air hunger, your diet, any wounds you might have, and possibly keep you company when you're feeling low. They'll help you make the most of it. Jesus, they don't even let you have a decent drink and cigarette in the ICU. Something about a "fire hazard" and "not good for you".

Go home, Elizabeth. Live in peace, like I wish the rest of my patients would do.

Your adoring admirer,
Kilgore

that book was a hoax anyway

Patient arrived in the mid-afternoon on a stretcher. Not because she couldn't walk, but rather because she was in four-point restraints, and probably would have kicked the still-beating heart out of any staff member in her way if she hadn't been. I looked directly in her eyes, and saw Jodie the Pig Demon from The Amityville Horror.

"YOU FUCKING STUPID-ASSES! WHY THE FUCK AM I FUCKING TIED DOWN, YOU FUCKS??"
Yes, really.
"LET ME THE FUCK GO, I GOT FUCKING FIVE FUCKING KIDS AND YOU HAVE NO FUCKING RIGHT TO DO THIS! FUCKING ASSHOLES!"

And so on. She wasn't even creative about the way she was shrieking at us, but she was persistent. It was old before we ever parked her in her room. She was Mother Superior's patient; I offered to help tuck her in.

Mother Superior is one of the best nurses I know. She is the supervisor for my shift, the leader of our posse. Soft-spoken, thoughtful, reserved and brilliant, she makes The Job look effortless. I have never seen her run, rush, or become flustered. Sometimes, she'll shuffle a little faster, but that's about it. She is the nurse that I endeavor to be. She was the perfect person to take on Satanette. I watched her talk to the patient in that soothing, maternal way that she has, and wondered where someone finds that kind of restraint. I certainly don't have it. That's why I chose to keep my mouth shut that afternoon.

Mother Superior and I worked together to attach Satanette to her EKG leads.
"I'M FUCKING ALLERGIC TO TAPE, FUCKHEADS!"
I asked Mother Superior if she thought she would need any labs.
"YOU BETTER NOT FUCKING TRY, YOU STUPID BITCH! I'LL TAKE THAT FUCKING NEEDLE AND STAB YOU WITH IT, CUNT!"
Mother demurred on the labs.
What about a glucose check?
"LEAVE ME THE FUCK ALONE, THEY ALREADY CHECKED MY GODDAMN SUGAR! DON'T YOU FUCKING PEOPLE TALK TO EACH OTHER?"
She was diabetic as well as apeshit crazy nuts. Mother Superior stuck Satanette's finger for the requisite drop of blood. She was rewarded with a soul-curdling howl and a 352mg/dL.

I pulled back the sheet to assess Satanette and realized, with horror, that the ER staff had left her partially dressed.
That underwear was gonna have to come off.
Both Mother Superior and I sighed.
"Well," Mother said, "I guess we're going to have to just cut them off. I always feel badly about cutting people's clothes off, though. It's all she's got with her."
Satanette's eyes glowed red, but before she could string together a new, ear-wilting string of FUCKs, Mother and I had each whipped out our scissors and sheared up either hip seam.

"YOU STUPID CUUUUUUNTS! IIIIIIIII'M... OOOON... MYYYYY... FUUUUCKING.... PERIOOOOD!"
"I noticed," I muttered, as the offending pad came into view. "See, I'm a nurse. I know stuff. We'll get you a fresh pad."
"FUCKING BITCHES! I CAN'T FUCKING BELIEVE YOU CUT MY FUCKING UNDERWEAR OFF WHILE I'M FUCKING BLEEDING! YOU'RE SO FUCKING STUPID, BITCH!"

Then it happened.
Mother Superior jumped the gun.

She walked up to the head of the bed.
She bent over Satanette.
She took up the edges of the blanket, as if to tuck Satanette in, all snug and comfy. I marveled again at Mother's eternally composed state. I thought of incorruptibles, the scent of lilies.

She wrapped the corner of the blanket around two of her fingers, and started to stuff them in Satanette's mouth.

She whispered. "I...am tired...of your...filthy...mouth."
And kept stuffing.

Satanette was quiet now; not by choice. Her eyes were bulging with fear, and I began to worry. "Uh, Mother? I can't believe I'm saying this, but it might be time to take it down a notch." I gently touched Mother Superior on the arm. No sudden moves here. She was still armed with the blanket.

Mother Superior never broke eye contact with the Pig Demon. She looked over her narrow granny glasses, and slowly withdrew her fingers and the slightly soggy blanket from Satanette's mouth. "You need to be quiet now," she said with deadly calm. Satanette obeyed. The demon had been cast out, for now.

No lillies.