Wednesday, November 20, 2013

An open letter to all Nursing Professionals



November 20, 2013


An open letter to all Nursing Professionals:

      WHITE TRAUMA MALE” was my designation upon arrival. I have often shared my story of appreciation with nurses. Based on their reaction I sense that they are very rarely, if ever, thanked for what they do. Please take a quiet moment to contemplate and understand this: You are appreciated and honored by me, and I represent all you have served, are serving and will serve throughout your noble career. Thank you for serving with your heart, which communicates serenity, hope and encouraging direction to patients under your care. Your healing touch, smile and kind regard offers strength that lasts forever.

      “At 0814, January 14th, 2001 with the sun low on the horizon, a citizen First Responder is reacting to the immediate medical needs of an accident victim in the center of a seven lane eastbound major metropolitan freeway. As the Emergency Medical Team approached the scene, they saw the First Responder react helplessly to the swerving vehicle which, at 60 miles per hour, caught him dead center, launching him fifty feet and six inches forward, before he hit the asphalt.”

      “The EMT’s called for assistance and began to provide emergency aid. As reported, they approached the presumably lifeless First Responder who proceeded to open his eyes and provided them with the data needed in a ‘patient transfer’. He also provided the EMTs with formal trauma-suit instructions, though he had never seen such a medical device. With that completed, he closed his eyes, went into a comma, was placed in the ambulance and transported to the local hospital. The ‘patient’ that the First Responder had been attending to, was treated and released the same day.” 

      “The Chief Radiologist did not recognize the patient, with whom he had been water skiing with several weeks prior. He was amazed that the injuries, though extensive, were local to both humeral bones and both legs below the knees, with a basilar skull fracture. Word got out and his wife arrived, followed by several members of his church. No surgery could be done as he remained in a comma. His wife asked the elders to provide a blessing. The doctors and nursing staff retired from the immediate area with little hope.”

      “As seen in the New Testament, the patient was anointed and bless; during which the humble yet confidant voice was heard to pronounce “… a full and complete recovery…”  He immediately regained consciousness and was transported into the waiting operating room. A nine hour surgery ensued, followed by several days in an ICU and a move into a private room… with legs and arms in casts, a cranial pressure gauge, life support tubes and monitors keeping vigilant watch over this father of seven little ones. Members of his church stood watch over him 24/7 and congregations, friends and associates around the globe fasted and prayed for his survival and eventual recovery although the prognosis was not favorable.”

     

        Several weeks later, I find that I am awake, although I cannot remember anything that has happened in the past days… or years. I am looking into a mirror and recognize myself… being shaved… by my wife… in a hospital room. It seems a little odd, but I go along with it. During the next several days, I regain more ability to recognize people, and eventually recognize a regular routine which starts at 5 am with a wakeup instruction of “roll on your side, your medicine is here”, and ends with, “OK, let’s go down the hall for a shower”. Moving my fingers is beginning to be easier, so I use them as a tractor-walker against my abdomen to pull my right arm several inches.

      Although my grasp of events was not steady, I remember the deep concern and the encouraging smiles of the entire nursing staff. I was moved to the in-patient rehab center and met what I call “the ice women”.             The twice-daily physical therapy session would always end with a smiling nurse placing a huge bag of ice on each leg and my right shoulder. Two hours of sleep provided the necessary rest between the exhausting ‘workouts’ consisting of ever-so-slight movements of each plaster-encased limb. Eventually one day, the rehab nurse looked me in the eye and said “Tomorrow, you will stand up” I did not know what stand up meant, but was willing to try.

      The rotating table I was strapped-to brought my head to a frightening height I had ‘never’ experienced. As the straps were loosened, my feet touched the floor and as they settled into a a foreign stance, the pain was excruciating. I was relieved to be lowered back to the stability of ‘horizontality’. The same drill was repeated the next day, and the next, until I could stand without pain. The term ‘walk’ was then introduced, and I now had something specific to focus on, since I vaguely understood what it meant. Along with my ever-present sweetheart wife and seven young children, the nursing staff was my biggest cheering section.

      They say that recovery from a brain injury is sometimes tenuous, and begins at the infant stage, circling through stages of growth until it rests at a maximum potential. The spiral of my cognitive recovery began with constant coaching; learning to take food, chew and swallow it. I progressed from learning not to spit food up as an infant, to the advanced ability to drink using a straw. During each rapidly-progressing stage, I would have conversations appropriate to the ages I was traveling through; often repeating actual real-life conversations I had had with my parents and family members during my youth.

      As my ‘life reenactment’ passed through my teenage years, I would concoct elaborate hospital escape plans involving my asking the nurse for ice cream to distract the nurse, my brother arranging the ‘escape vehicle’, and making a mad dash out. Needless to say, I was still the center of a complex set of hooks, pulleys and cables which presented a challenge I had not considered. When I was finally successfully at negotiating the twenty-yard trip to the elevator and back, my wife was trained how to handle ‘full-lift’ protocol and I left the hospital.

      Still in a wheelchair most of the time, I practiced walking to the front door and back twice a day. I then tried to get to the end of the porch, then the neighbor’s mailbox, and so forth. Eventually, I was allowed to have my first few hours alone and ‘on my own’. I was sure I’d be ok and wondered why my wife was so worried and overly protective, did she not know that I could walk almost a half-mile and back without getting lost?

      Lunch time arrived on my first ‘solo’ day and I was so excited to make it. I had thought how good a peanut-butter-and-jelly sandwich was going to taste. I had even worked out what I needed to build it and so I set to work. I rolled the wheelchair into the kitchen (not an easy task, as my left arm was still un-repaired and still in a sling). I gathered the necessary materials and tools for a world-class PBJ.

      Once I had them all on the counter I re-verified they were all there; bread, butter, strawberry preserves, peanut butter, spoon, knife… check! I stood there looking at my perfect collection of everything needed, and stood there, and stood there. Somehow, I had never considered how to actually build the masterpiece. I only knew what was included in the process. When I realized that I had no clue what to do first, and had no idea how to get what was inside the jars where it was supposed to be…. which knowledge was also elusive. I began to laugh out loud. I had ‘never’ seen a PBJ, and had no idea what one would look like and did not know how to make one. The discovery of this absurd circumstance was hilarious. 

      I continued to practice walking and after a full year of recovery, returned to work. I gained strength and stamina and after eighteen months, was able to complete a walking half-marathon along with several of my ever-supportive children. During the next several years I was able to walk great distances, walking the equivalent of five marathons in one week. About seven years ago, I began using a small backpack, adding books for weight which led to using my 1978 Gregory internal-frame backpack filled with forty pounds of camping gear to hike twelve to fifteen miles each Saturday for the past three years. In my travels, I would often see runners and think “oh, I wish I could run again”, I thought “If I can hike well, I certainly should be able to run”. The results were immediate.

      October of last year…pain lit like fire with each step down the stairway. My knees did…not…like…running, so I began to research; certainly they have come up with a running process which is not painful. I found and read two books which, for me, changed my world and opened the door to continued progress; Slow Burn, by Stu Mittleman and Katherine Callan and Born To Run by Christopher McDougall. With these new tools in hand, I started to teach my legs altogether something new… no pain before, during or after (slow) running.

      March 18th, 2013… competing (participating) in my first 5k Trail Race I had successfully managed to not die and was coming down the last root-infested hill approaching that last aid station. As suggested by Danny Dreyer in his book Chi Running, I was thinking about how best to express my gratitude to the two volunteers on the far side of the oncoming foot bridge straddling a gully. One of the volunteers moved away from their position and this little movement distracted me and the next thing I knew my face planted directly on the bridge. The sensation of pain told me I had teeth protruding through my upper lip.

      I decided to move something, thankful I had not gone over the edge. A brief self-survey indicated that there was no significant damage, I could get up, walk, say thanks to the shocked volunteers and continue the race. I was, for sure, the only runner left on the course and my goal was to finish the race, and to cross the finish line before they took the bagels away. I received stunned looks and assistance was kindly provided by my fellow runners while the last several awards were announced.

      I run Trail Races because old people are afraid of them. You have a better chance of winning something” the first place in-my-age-category jokingly quipped. As I was absorbing his amusing self-observation, I was stunned when my name was called to receive second place in the sixty-plus age group. With new wind in my sails, I determined to participate in the following trail race of the series… a 10k at the National Olympic White Water Training Center. I was a full 20 minutes behind all other runners and finished in time to get a bagel…and since I was the only person in my age group, won first place. Although I am terribly slow, I have since participated in a 15k Trail Run, and managed to complete two non-event-associated half marathons.

      My left arm was repaired a full 18 months after the accident. I have been working for twenty years to re-build a small-but appreciated set of deltoid muscles. I have progressed to complete several pushups at a forty-degree angle. Last week I met with a physiologist who agreed to help me regain some range-of-motion, and perhaps, teach the surrounding muscles to properly compensate for the loss of function. I look forward to meeting the challenge.     

      Nursing Professionals… the details of the life-cost of your compassionate service cannot be enumerated here, but please know that I am aware of the weight you have taken on in dedicating yourself to professional nursing as your life’s mission. Please know that even after more than 22 years, your valiant efforts in my behalf continue to have a positive, strengthening effect on me and my family. Because of you, I have achieved a “Full and complete recovery” and will be forever grateful. Others you have, do, or will care for are also grateful…and will each, one day, thank you personally.

Warm regards to each one of you,

Dennis McKaskey