Some young girls grow up with visions of becoming the next Florence Nightingale but you had an actual vision of Florence Nightingale that prompted you to go into nursing. Tell me about that.
I was just 21,with two little kids and a husband with a drinking problem. We had just moved to Pennsylvania and he took off with the car that had the diapers and food in it. I didn’t even have a telephone. That’s the night I saw the vision of Florence Nightingale—which of course I didn’t know was a vision.
And you didn’t know it was Florence Nightingale, either?
No clue at all. There was this woman with ringlets, her hair pulled up on her head, she had a ratty cape on and she was holding this strange lamp, checking out the baseboard and I kept saying, “excuse me ma’am, excuse me,” then I poked myself to see if I was awake. The next morning, I found a phone and I called my father and said, “I want to come home I’ve decided I want to be nurse.”
You’ve written a lot about heeding your intuition, has yours always been strong?
From the time I was a little kid I always had this voice that would help me through the really tough times. So many of the things that were my greatest satisfaction, the biggest moments in my life were things that I had to go on intuition with, I had to trust myself that it was the truth. I’m sure every one of us has those voices that sound like whispers, those little tugs, I just learned to trust them.
I know your grandmother was a nurse and midwife, do you think her career influenced yours?
You know it’s really hard to tell, but she was my favorite person in the whole world because she was so authentic. We lived with her until I was seven years old and I remember from the time I was a little bitty kid she would tell me all these stories. She drove a car, carried a gun, was divorced, she was a midwife, she spoke different languages and she was so real and she allowed me to be so real. I think she was buried in my subconscious for a long, long time.
You’ve said that she helped shape your fascination with death, why is that?
At that time they didn’t let you see anybody who had died, and she just disappeared. But before she went into the hospital she called me into her room and I remember her rolling up those silly stockings and she had this pink satin slip on and she said, “I have to go away, I have to have an operation.” She took my hand and put it on her breast and she said. “I have a lump and I won’t be able to come back. But I want you to remember that I love you and I want you to be kind to everyone you can, but enjoy your life and have a good time. Don’t hurt others unnecessarily but don’t hurt yourself either.” She never came home from the hospital, she hemorrhaged on the table. But boy was I mad. She died and she died on me. I think I didn’t realize any of this until after I got married and divorced and I suffered my next big loss.
And nursing helped you handle that loss?
I felt like such a terrible failure when my marriage ended. I don’t think Italians know what a drinking problem is, either because it isn’t prevalent or because they drink and fall asleep or they eat so much that they never get that wacky. So I didn’t have a clue. Nursing saved me. You can’t think badly of yourself if so many people are telling you how special you are to them. Healing others can help heal yourself.
In Then An Angel Came, you wrote movingly about the impact of losing your grandchild to Sudden Infant Death Syndrome. How were you able to get through that?
Nursing is boot camp for life. I always said anyone of my patients could have been my mother, my father, my children, or me, so when my grandson died the feeling of grief was familiar and I thought, oh my God I really was legit, my patients meant an awful lot to me. Of course, when I said that to my daughter she said, “Mom don’t you think you should be telling that to someone other than me?” What can I tell ya, I’m a flawed human being.
You seem to be a blend of traditional Italian with a strong streak of the unconventional. How does that work?
One time I told a therapist that I felt like I walk around in one body but I’m Siamese twins. I’m traditional, but at the same time, like Mario said, “you’ve got some crazy beliefs but you’re the most the competent person I know.” I said, “Competent, that’s suppose to be sexy?” And he said, “You have no clue how sexy competent is for a man.”
Mario, of course is Mario Puzo, the author of the Godfather, who also co-wrote the movies (and won a couple of Academy Awards for the screenplays). You met him through nursing too, didn’t you?
I had taken care of his wife, Erika, while she was dying—very cliché, I know. She really was a wonderful, wonderful woman and they are a wonderful family. After she died, I showed Mario some of my writing and he said, you really should write a book, people should know how important nurses are to families, and how much more important they are to help families get through this kind of stuff than doctors.
So, you had a pretty good mentor for your writing career, what was that like?
It was like being an apprentice to one of the great masters.
How did the trajectory of your life change after you met Mario?
My external life was completely different. I got to see the beauty the world has to offer which was really nice. With Mario we would eat in the finest restaurants and stay in 5-star hotels around the world. But it’s funny, we could be in Malibu or Cannes, meeting directors or actors and he’d always introduce me by saying, “This is my girlfriend Carol, she’s a nurse.”
You spent 20 years with Mario Puzo, why didn’t you ever marry?
The only time I wanted to get married was when he was sick so I could make decisions if he went to the hospital. Mario used to say, “I’ll marry you when I want to get rid of you because you always leave your husbands.” My two marriages and the other relationships I had—all those years added up didn’t last as long as the time I spent with Mario. As you so adeptly picked up, there’s a part of me that’s very, very traditional, and we could relate on that level and at the same time he would always encourage me to make decisions that were good for me.
How was it finishing The Family, the book about the Borgias that Mario had worked on—but hadn’t completed—before he died?
It was lovely. When he was researching his books, we traveled to the Catacombs, the Vatican I got history in living color. For 15 years or 20 years we talked about the damn Borgias, so when I was finishing what we had talked about so often, it gave me an extra year to hang out with him and that was a lovely thing.
What effect did being a nurse have on your writing—besides providing good material?
I think I’m a better writer because of the nursing. To diagnose you have to be able to observe and put things together. All the subtle things you have to look at as a nurse helps you describe characters in writing. Writing is truly intimate and so is nursing.
Do you think if you hadn’t been a nurse you would have been a writer or do you think you can’t separate the two?
I think my primary vocation or calling is to help to heal. I think I did writing as a way to help heal. I had done home care for a while, and when I left nursing. It was after a period of time when 5 or 6 of my patients died—notice I said, my patients died on me—and I can look at that girl very fondly now and see the things that might have helped her deal with it more easily, but it allowed me the kind of satisfaction that I’ve not found in a much easier life afterward.
I know you are a critic of our current healthcare system, what do you think needs to change?
We have to have universal health care, we really do. We’re I think, 44 of 46 on the list of the best health care in western culture. As a civilized nation, we should have it and it’s also a good business model. Otherwise [the uninsured] will just go to the emergency room. I don’t know whether its either greed or just dumbness that keeps politicians from seeing that. Maybe they just don’t know.
What is different about nursing since you first entered the field?
Before it was a medical machine and you had to fight with the doctors, but now it’s a business model, where all the things that made the difference in your pay, the intimacy you were allowed with patients, the time you were allowed to spend, the hands-on care you were allowed to give—all feed some part of that calling in you, and now they’ve limited all of that by the understaffing. So that they may give you more money but there’s less satisfaction, more frustration. I think we’ve devalued nurturing and caretaking in our reverence for the rational. Unless we start to value those nurses at the bedside what we wind up with is a lot of infighting because any oppressed group oppresses.
What can nurses do to change the system?
What we can do is be can be kind to each other, whether each other is a nurse or a patient. We can remember that a lot of healing happens in areas that we don’t understand. We know that children die of morasis if they don’t have nurturing, and I believe strongly that there is an inherent healing power in caretaking and nurturing, if you bring with it real caring that you feel for a person. Nursing is a hero’s journey. If we believe in ourselves, we can then make new models of nursing that will move us forward into the place of healers.
Finally, how did nursing shape your life?
I guess I lived my life fully because of nursing. I forgave myself lot of the things other people judge themselves for. It was harder to beat me down because I saw what other people went through. You see the best and the worst and you’re introduced to the whole spectrum of human existence. I saw an awful whole lot of heroism whether it was vulnerable patients or nurses who went above and beyond, doctors who wanted desperately to help. It’s the one passion that I haven’t been able to beat.