In Praise Of Nurses: Learning At The Knee (And Heart And Mind) Of Bobbie

Know When to Push

Though it took a strangely long time, when the chemo finally hit Gracie’s system, she was in pain.  A lot of pain. When Bobbie saw how bad things had gotten, she asked me into the hallway for a chat. She knew it was time to administer morphine, which I was resisting. I was afraid to acknowledge that Gracie was in pain so severe only opiates could extinguish it.  And more pressingly, more rationally, I had been warned by other parents about morphine’s many complications and side effects. After morphine, I was afraid, a child could be patched together but never made whole. I told Bobbie the truth — that Gracie was insisting, every time I asked, that she was not in pain, even as she writhed around in her sheets.

Both Bobbie and I knew Gracie was engaged in magical thinking. Either she was trying to be superhumanly stoic, or more likely, she hoped that denying the pain could make it disappear. But Bobbie knew what suffering looked like–she’d witnessed people suffer on at least three continents. She would not collude in my denial, or in Gracie’s.

“Listen, just try it,” Bobbie said. “If she responds well then you’ll know you did the right thing.” While she waited for my answer, she held my gaze, held her head and body very still.

After I agreed and Bobbie worked her magic once again, Gracie slept. A true, sound sleep. She didn’t make a sound or motion for five full hours. When she woke up she was not only refreshed but vaguely excited. She motored both the foot and head of her bed all the way up, to make a small valley in the middle. She climbed up and slid down, over and over.

When Bobbie came in the next day, Gracie slid from the bed’s peak into the valley and said: “Bobbie, look what I made!”  Bobbie clapped in amazement and looked at me with delight, not an ounce of I told you so.

Bring Your Whole Self to Your Job, Even or Especially, to the Small Stuff

Eventually, we got a glimpse of who Bobbie was outside of the hospital—we learned that she worked with refugees all around the world, that she was married to an Irish doctor, that they had four sons together. We’d learn she was someone who did not give ground when ground had to be held. We’d know that her oldest son was a gifted musician and her youngest a natural comedian. The first, terrible time a child on our transplant ward died I asked Bobbie if she had known him and she nodded and welled up. Many of the nurses responded to the loss with an understandable steeliness. Bobbie, by contrast, transmuted her grief into a reservoir of caring. I got the sense that even when she was at home, mothering her four sons, she was thinking of her patients.

Occasionally, she called the ward on her days off to see how Gracie was doing, how the other kids were. Instead of being inured to the suffering of the children under her care, she was wholly present. For them. With them. Into every mundane interaction, she brought to bear all her skill, all her experience, all her heart. Whether she was changing a bandage or titrating a dose of pain medication, she gave that action the full light of her attention. It made me wonder what our world would look like if everyone approached their job in this way. It made me want to do better, to be better, and more present for, all the little toss away actions of my own life. Most of all, it made me admire Bobbie in a way that will last a lifetime.

Show Up & Care (Then Care Some More)

Forty-four days after being admitted, we were told Gracie could go home from the transplant unit. On the day of her discharge the first thing she said was, “Is Bobbie gonna be at my goodbye?”

I understood her wish to have Bobbie there; leaving Bobbie was the only awful thing about leaving the hospital. Bobbie kept her safe. Bobbie knew how to handle things. Bobbie had bubbles, and juice, and secret ways to make the pain stop.

When Bobbie arrived with her air of mischief, her cats’-eye glasses, her calm, her humor, I wondered how on earth we would we keep recovering without her.

“OK, Gracie girl, get ready to say goodbye to Tough Guy,” Bobbie said.

Gracie shot us a smile, “Bobbie came.”

“Of course I came,” Bobbie says. “I have to make sure you don’t try to steal my machines!”

“Gracie, this is gonna be the last time I unhook you from Tough Guy. After this, you’ll be off leash forever. Are you ready?”

Gracie gave a solemn nod.

Bobbie unscrewed the plastic IV tubes that lead from Tough Guy to Gracie’s chest catheter. She rubbed down the catheter plugs with alcohol, flushed the lines with saline and heparin and recapped them.

Gracie looked up at Bobbie. “Good job,” she said, and this phrase seemed to encompass everything Bobbie had done for her over the last 43 days. The gum she made appear out of thin air, the bubbly apple juice and plastic champagne flutes on New Year’s Eve, the morphine drip with its magic red button, the softening heart lights she’d strung around Gracie’s room, when Gracie grew light sensitive. Bobbie, the mother of four sons, has made Gracie feel like the most important young person in her life.

Bobbie wheeled Tough Guy, now an independent operator, to the door. Before she pushed him outside, she paused and asked, “Gracie, do you have any last words for your friend?”

Gracie looked Tough Guy up and down. “Be good to the next girl,” she said.

If Bobbie, at four years old, had herself been a transplant patient in this very bed (and thank God she had not) this is just the kind of thing she might have said. That empathetic leap to considering the next girl who would arrive in this room, dropped alone into hospital life. The next girl who would be riding beside Tough Guy for months. Bobbie’s natural empathy had rubbed off; it was, it is, her parting gift.

-Heather Harpham

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