Nursing Notes

Medical writing

Year’s End

/ aggiemurch / 8 Comments
Recorded by WSM Knit together by MAM
From Thanksgiving to Twelfth Night the farm is lit with forty plus year old lights. Wecloming you home and into the New Year. Photo by WSM.

Year’s end.
November rolled like storm-tossed tumbleweed into December and the nights slid earlier into darkness each evening. Now December is ending and even through the storms covering America the light is beginning to return.
It was already night-time when we landed back from Poland and the Heathrow train stopped at Paddington. The station was closing down for those midnight to five a.m hours. Only the Sainsbury Local stayed lit for the late-night travelers and I dipped in to pick up the milk and bread to be turned to tea and toast in the morning. Outside the vast hollow waiting area which feeds onto the platforms there was no cute, lost Paddington Bear with a suitcase, instead there were a dozen or more old men settling in on the benches – separately – but close enough that each could watch out for another as they came in off of their street-corners to a place of warmth. A plastic shopping bag or a shopping cart contained their travel baggage. I wonder what it is that remains precious to these homeless gentlemen. They each had a blanket that they wrapped around their legs and even their shoulders, if it was big enough. There must be regulars who show up at Paddington, Victoria and Waterloo train stations each night – until they don’t. Do the staff who clean and monitor the stations sweep round the huddled bodies and shopping carts. Is ‘keeping yourself tidy’ a prerequisite to keeping your patch and even bench? What time do you have to ‘move along’ and face the world in the morning? There is a rhythm to this unseen pedalling-in-place, train stations hold these men who watch leavings and loneliness travel alongside of expectation and desire.

Paddington at Paddington

In November Mehram Nasseri died. Nasseri had lived on a bench at the Charles de Gaulle Airport for 18 years and was the inspiration of Steven Spielberg’s film ‘The Terminal.’ Stranded and stateless he perhaps brought a focus to the question of what or where is home. He found a community, and a sense of belonging.

Mehran Karimi Nasseri, or ‘Sir Alfred’, on his home bench at Charles de Gaulle airport. Photograph: Eric Fougere/Corbis/Getty Images

Under Rishi Sunak, the Conservative Government continues with its agenda – to avoid paying Universal European taxes – thank goodness for Brexit – but with no taxes paid by those who could – there is less in the coffers for The National Health Service, the state schools and other community-run organizations. It is now becoming obvious, though it was before if we looked, that the goal is to cripple and disband the NHS, take it away from those who need it most – and the best way to do that is to lock the pay scale of the workers. When I graduated in 1963, satirist Michael Frayn wrote in the Guardian Newspaper: he was looking at reports on wages on what they called ‘the devotional fields’, then primarily nurses. Saying the general principle was to hold the wages as low as possible to keep out ‘undesirable elements wanting to make a fast buck.’ Well they certainly did that, kept the wages as low as possible. Nursing is a devotional field and the wages remain among the lowest of professional workers to this day. On graduation we were encouraged to join the Royal College of Nursing and almost everybody did. But in my youthful idealism I couldn’t ever envision following an order – to go on strike. Now, for the first time nurses are being called on to do that. But they won’t. Instead the ambulance drivers and paramedics will be at the forefront of this battle with the government, and once again the government will win, grudgingly giving out pennies rather than pounds. Nurses will continue to use food banks and be at the mercy of the transport unions who can strike and get the money they are asking for. The Army will get to practice some drills while substituting for the paramedics. And people will die because of it.
From one family to another, we came back home – unsure where that is. We are old nomads – and with a little more infirmity we would be outcasts from the herd but for the moment we are lucky and received by our families wherever we land.
And we landed at the bar in town. With the nudge of a full bladder at 6.30 in the morning we bundled up, and scraping the frosty car windows, to drive downtown and to Smiley’s to watch the World Cup soccer final. The bar was open at 7 in the morning serving its customers what they wanted – a big screen and sports special. And free maté – with honey. It was as fun watching us as it was watching the football, two teams at the very top of their game, with grace, skill and respect as more than once a player in azure blue and white helped another in navy to his feet after a fast clash.
From Sunday to Sunday, turning from the big screen at Smiley’s to the computer screen in the Hayloft and finding the King at Windsor Castle. From here it felt like opening an old blue aerogram letter, with news of home and I watched as keenly as any other ex-pat around the world. There was a light snow on the grounds of Windsor Castle and young girls in the soprano Choristers at the Christmas Carol service in St. Georges Chapel.

The King spoke with no photographs around him to point emotion one way or another. His notes were handy to glance at, maybe showing that the teleprompter was not for him. He spoke in empathy for those families who have lost loved ones this year, of the importance of her faith for his mother – our late Queen, and for him too, and of all faiths. He gave thanks to the hundreds of people who help those in need through the hardships of these times, and very carefully showed those of his family who, by their presence, gratitude and acknowledgment of the work of others, help to sustain us all.


This has been A Letter from A. Broad
written and read for you by Muriel Murch




Tripping About the Countryside

/ aggiemurch / 5 Comments
Recorded and Knit together by WSM

They took to the stage on all three major television channels; the BBC, ITV, and Sky. Rishi Sunak trots eagerly up to the podium in his Gucci loafers, though sometimes jacket-less, unsuccessfully portraying a working man. Liz Truss walks carefully in her heels with a smug smile and discreet earrings – one day saying one thing and the next day saying another. She is changing statements, but maybe not her mind which appears to be missing in action at the moment. These are the Conservative leadership rivals to be the next Prime Minister clashing on how they will address: high inflation, the rising cost of living, gas prices, Ukraine’s war with Russia, while sidestepping how both of them are looking to kill the National Health Service. But then the broadcasts stop, the candidates and their lies are just too transparent and boring. Now each gets a news moment as Liz changes her earrings to gold stirrups visiting a farm, and Rishi puts his jacket back on to speak at the Royal St. George’s Golf Club.

Those rural earrings

Like the story of the frog in the hot-tub, the National Health Service is coming to a slow boil. The news has me hold my head with the charts of the numbers of medical staff, doctors, and nurses that have left the Health Service. There are two main reasons for this. Since Brexit, European nurses and doctors are better off regarding pay, hours, and family situations returning home. English-trained nurses and doctors are fleeing abroad to countries that pay more. England is reaching out to poorer countries and importing staff from those that pay even less than England. This migration has gone on since we English, Irish and European nurses flew to America, Canada, and Australia for better living and pay. But nobody talks about Brexit being the cause for this new low, the ridiculous staff-patient ratios, and the non-pay of nurses and doctors. The government counts on the moral inability of nurses and doctors to abandon their patients, and laugh all the way to the locked coffers.

The sky is cloudy and dull, pouting at being left behind in grey England while these two politicians vie for the Conservative leadership. The chambers of the House of Commons sit empty as ministers flee the city, following the example of their old boss Boris Johnson, who took his family off to Greece for the holiday month of August. 

There is no rain. The streets are sticky with the detritus of human and animal food ingested and eliminated. Leaves are falling from trees a month ahead of Autumn. They are dry, crisp, and crackle when kicked about on the pavements. There are no conkers on the chestnut trees in the park and those not-so-old trees are dying.

The second heat wave was well underway, and the scheduled train strikes still a day off when I traveled from Waterloo to Hampshire. The South West trains are all new and all air-conditioned which bought a welcome relief from the rising heat. I am meeting three old friends for lunch at the North Hants Golf Club. The youngest of us is only 75 years old. The tables and umbrellas are set out on the veranda overlooking the first and last holes of the course. Though it is hot we can safely gather in the shade. We sort of look great – in our elderly way. We were children together, almost sisters, and though our paths diverged our roots were seeded in the same soil. My friends stayed close to their rootstock and settled deep in rural Hampshire and Wiltshire, each raising champion horses, sheep, and cattle.

Four for Lunch, Sue, Susan, Ann, and Susette

The North Hants Club is well over 100 years old but was still young when we were. Within that world, there is the sweetnesses to be found in any close-knit organization that becomes a family. Jackie has been a part of the kitchen staff for 43 years and we have known each other with mutual respect and admiration through all that time. The kitchen, where deep frying remains a specialty, is stellar and provided us four Caesar salads that were not on the menu along with teasers from their small tapas plates. It was grand to be together and share our autumnal news. We spoke of our lives, of families, and thought of old friends, remembering that though now we are four, we used to be six. The relentlessness of life continuing after another’s death has a bite to it that is hard to define.

Susan getting Settled

Returning to London the train stops at Weybridge and ‘all change’ is called out – to anyone who can understand the voice through the microphone. There are no leaves on the line, these tracks have not buckled from the heat but there is a fault with the train and so we are directed to a local one waiting on a side platform. ‘Change at Staines for the fast train to Waterloo.’ But I don’t. I stay seeing the names Virginia Water, Staines, Barnes, East and West, Putney, and Chiswick before Clapham and Vauxhall. I realize this so slow train travels alongside the western A30 road laid down over the old Roman Road and follows the historic London to Land’s End coaching route – a popular place for highwaymen. William Davies, known as the Golden Farmer and robber of coaches traveled across Bagshot Heath and was hanged in 1689 at a gallows at the local gibbet hill between Bagshot and Camberley. The Jolly Farmer pub built close by was in remembrance of him.

Sculpture to honour the Windrush Generation of Immigration at Waterloo

The train pulled into Waterloo and the platform exit is beside the newly erected statue tribute to The Windrush Generation immigrants who came from Jamaica and the Caribbean to help England after the Second World War. It is a fine statue, showing hopeful and proud parents and their young daughter. She would grow up to become one among us in nursing school, another sister from another time. Tourists from Africa and America proudly stand beside the statue for their photograph moment.

I was not alone in going out today with a cardigan and umbrella though neither was needed. We, and the earth, are crying for rain – or would be if we could cry. All we can do now is sweat, copiously, as we wait for the bus. An Asian gentleman of about my age is also waiting for the number 274. When it arrives he graciously extends an ‘after you’ gesture to let me board before him. We sit on opposite sides of the bus in the reserved for old people seats. The bus driver is not yet exhausted and the bus almost empty. It is August. Hot, dry, there is no school, and whoever can be – is on holiday. I find myself imagining the cold rainy days of autumn, wishing for them, and having a hard time believing the evidence before me that we are seriously damaging our planet. ‘First, do no Harm’ is the Hippocratic oath and here we are committing murder. The bus goes quickly along its route carrying its few passengers. My gentleman friend gets off at Prince Albert Road. He smiles at me and I at him. It is a moment of grateful recognition but I’m not sure what of.

Now there are hosepipe bans imposed by most of the Water districts, whose own leaks are responsible for almost 30 % of water loss around the country. Then quickly news comes of the other leaks, of sewage from more faulty treatment plants into the local rivers and streams, or to the sea for those low-lying coastal areas. It is too much for the cartoonists who show pictures of Boris Johnson, remember him? the still – but on holiday – Prime Minister, entering the sea somewhere in Greece. Sewage flowing outwards but not yet gone.

This has been a Letter from A. Broad. Written and Read for you by Muriel Murch

Female Complaints

/ aggiemurch / 2 Comments
Recorded and Knit together by WSM

September mornings, and the sun is finally shining in London. The first flurry of falling leaves are swept up and the pavements look just a little bit fresher, gardens are tidied for winter and their last autumnal blooms wave at us before the summer light fades. Children are back to school and there is a bustle of work, increased traffic on public transport and Boris had some questions to answer in Parliament on Monday afternoon. Which he did, with his hair combed softly – he knew it would be a difficult day – and a promise to fulfill one election pledge by breaking another. Taxes in one form or another must to go up, to pay for the increased health care needs of the country. It is not all the fault of the elderly for living longer – though that could be where to focus some attention. But after the afternoon session in parliament, it is onto the ‘Let’s all have a drink together and get along’ cocktail party hosted by Johnson, and paid for by us, as he tries to keep his friends close and his enemies closer. The Right Honorable Jacob Rees Mogg gave a weak smile before turning his back on the reporters and, with double-vented jacket not showing him to advantage, entering number 10 Downing Street. The Right Honorable Michael Gove may still be in Aberdeen. Luckily Domonic Raab is nowhere to be seen having slipped off to Pakistan trying to find safe passage for those afghans left behind after the British evacuation of Afghanistan. There is no certainty that Raab can return with the needed free pass tickets on his shopping list.

The Right Honorable Jacob Rees Mogg on the bench

We hear less from Afghanistan, but the news stories that do come through are of cruelty and despair, such as the pregnant police woman, Banu Negar, killed in front of her family. There will be no ‘good news’ coming from Kabul until the Taliban control the media outlets and feed news to the Western world. How it is that Secunder Kermani and Lyse Doucet can continue to report for the BBC from Kabul and other parts of Afghanistan is hard to fathom. With a new government not yet formed, and young men on the streets all eager to do something, the Taliban’s promise of ‘No grudges, no revenge’ is proving messy to follow. We hear little of how other countries faired getting their personal out during the Taliban take over and may hear even less about how they might return.

But the Taliban and the new Afghanistan leadership need money. Europe recognizes this and Germany appears to be leading by a nose, sniffing out what opportunities there are still in this land-locked country. Where can a foothold be found that will ensure a western presence to plug the hole of a ship-side leak open to the seas of Russian and Chinese advances?

The Taliban say that women and girls will have full rights ‘under Islamic law’ but Islamic law, like any other law, is subject to interpretation and already new rules about dress and education leave many women and their families fearful. Such strict laws preclude many women from the problems that beset women from other countries and, as has been recently seen – states such as Texas.

The new laws in Texas, banning abortion for whatever reason beyond 6 weeks of gestation, brings fear to this generation of fecund women and some hash memories back to those way past their prime. Seeing the protests in Texas of young women dressed in the red cloak of Margaret Atwood’s “The Handmaid’s Tale” was as chilling as anything we have seen in America since the beginning of this year. Margaret Atwood says of her 1985 novel “I didn’t put in anything that we haven’t already done, we’re not already doing, we’re seriously trying to do, coupled with trends that are already in progress… So all of these things are real, and therefore the amount of pure invention is close to nil.” It is as if the men of Texas and beyond have said to themselves, ‘Yeah. This is how it should be.’ 

Women in Texas

And that can be the burping misfiring of art, rather like ‘Apocalypse Now’ conceived as the ultimate antiwar film only ofttimes used as a training tool to those young men and women heading out to the deserts and beyond.   

“I tried gin, hot baths, the lot” said my mother recounting her reaction when learning she was pregnant – with me. Not necessarily how one wants to feel welcomed into the world, but no less true because of it. Documented in the Egyptian Ebers Papyrus 1850 BC, ways to prevent an unwanted pregnancy have been sought out and used to various degrees of dissatisfaction, despair, disease and death. Fighting for legal methods of birth control have consumed women, and some men, during the past two centuries, and remains contentious to this day. Those of us who ‘came of age’, in the mid-1960’s still remember the fear of unwanted pregnancies.

A little box of little pills. From the Welcome Trust Museum.

For nurses there were various paths open within hospital systems: volunteering to take patients to the X-ray department, before the mandatory introduction of lead aprons was one; a somewhat-drunken date with a maintenance supervisor who was as handy as any Vera Drake in his day another. And then there were Widow Welch’s Pills. Containing high doses of iron, pennyroyal and juniper and advertised as being very effective in curing ‘Female Obstruction’ they were freely obtainable from Boots the Chemists.

And if prayer, that first and last resort, was also tried and failed, there may be a rushed marriage and definitely expulsion from nursing school. For pregnancy and even marriage made one unsuitable for the profession. Meanwhile those impregnating young doctors graduated into their lives carrying only their memories that faded over time.

This has been A letter from A. Broad

Written and read for you by Muriel Murch

First Aired on Swimming Upstream KWMR.org

Web support by murchstudio.com

1 Percent

/ aggiemurch / 1 Comment
Recorded and Knit together by WSM

“In 1961, twenty-four young women came together in a classroom at The Royal Surrey Country Hospital in Guildford, Surrey. We were entering our three-month period of preliminary nurse training. With its completion, we could begin our official journey to become State Registered Nurses. But first, we had to pass through Sister Cartwright’s schoolroom, her capable hands, and caring heart. Only twenty students emerged from her classroom and by the end of our three years, we were a graduating class of sixteen.” So I wrote for ‘Learning to Heal’ published by Kent State University Press in 2018.

Of those sixteen nurses who graduated in 1964, eight left England searching for working opportunities in other countries.  We loved nursing and yet knew that it would be near impossible to afford a life much beyond the student style we already lived. My three cottage mates and I left for Australia, Africa, America, and Canada. 

In this last year of the COVID-19 pandemic, we have seen nurses in England, and all over the world, work harder and longer than ever before. They, along with medical consultants to cleaners, have been tireless in their dedicated care of their patients. They have given their best to bus drivers and to Boris, and so it seems something of a wet fish in the face to hear this year’s budget distributions to the National Health System – while understanding that education, business, and all endeavors need financial aid at this time. Many public sector workers had a pay freeze, and the NHS staff account for half of that budget.  People cost money. Last year this very government promised an over 2% pay increase. Nada. And yet, tucked away in the LBC, a little radio program, comes the news of the HMRC, short for the tax collector, garnering a total 13% pay rise. They may deserve it, but it brings back the wet fish feeling. 

Before Brexit and COVID, nurses were moving across Europe and other countries, as we had done before them. In accepting the Tillie Olsen Award for ‘Learning to Heal’ I spoke of that too: “Oft times we choose nursing as a pathway from one social environment to another, usually empowerment and/or of a social context.”  After Brexit many European nurses returned to their home countries, leaving England once again – the poorer. 

In this Government Budget, Rishi Sunak is not looking so Dishy with a 1% pay raise for the NHS nurses, with other public-sector workers’ pay is frozen. “A row has erupted,” says one headline, “Unions warn,” says another. And I think how when I graduated in 1964 I made the conscious decision not to join the Royal College of Nursing because in their mandate was a clause whereby nurses could strike. I couldn’t believe that action would ever be needed or used. But today it is not a stretch to see how it can be discussed. We understand that equipment and machinery are expensive. But we remember the incredible spending blotches of this government: the huge Nightingale hospitals, erected with fanfare and speed, stand empty – and are soon to be dismantled. Nobody had thought of the staff needed to run them. Meanwhile, old brick-and-mortar hospitals remain hugely overcrowded, and last spring some even came close to running out of oxygen. Then there are the containers of PPE ordered from Turkey last May at a cost of millions of pounds. The shipments were delayed and then found to be below standard and useless on arrival. All this while firms in England were converting factories into making the equipment needed. I could go on, but you get the picture.

You would have thought Boris Johnson, with his own hospitalization and desperate need for nursing care, would have learned something. But as profuse as his thanks were at the moment, he thought no more of the nurses than of a maid who has ironed his shirt, nicely. 

Boris has other things to think about. This week schools reopen across England. There will be protocols of swab testing and masks in place, but not yet the sensible vaccination of all teaching staff. While fact-checking this I found an on-line petition to bring this item forward for Parliament. And signed it.

Boris Johnson in School

As we look up from Little England, which looks smaller by the day, there is a place to be grateful for a moment, for our smallness brings the ability of the mass vaccination program being rolled out across the country. The fact that we have a higher ratio of deaths per capita than almost every other country in the world is put to one side for the moment and hopefully will be dealt with later.

But we do lookout, even knowing that what we are seeing is often curated for our viewing: not much from Belarus or Moscow but still horror from Myanmar where, according to Reuters, close-by residents were warned not to enter the cemetery on Friday. The police and military were digging up the body of 19-year-old Kyal Sin in an effort to prove that the bullet that killed her could not have been theirs. They couldn’t prove it and so the protests continue to grow. A small change has happened that the military is mostly now using rubber bullets rather than live ammunition – mostly.

Meanwhile, The Pontiff, Pope Francis, traveled on a commercial plane on a pilgrimage to Iraq. He met with Iraq’s most revered Shiite cleric, Grand Ayatollah Ali al-Sistani, and other religious leaders and visited churches and communities bombed by ISIS in northern Iraq. 

Shiite cleric, Grand Ayatollah Ali al-Sistani with His Holiness, Pope Francis

Many years ago, when Pope Francis was still the archbishop of Buenos Aires, California’s Bishop Bill Swing, (Also known to KWMR golfing listeners as a fine golfer and supporter of KWMR) was visiting that city. They talked of Bishop Swing’s dream of a United Religions Initiative and together gave the first interdenominational service at the Cathedral. Now, as Pope Francis, he carried that message of inclusiveness deep into the Muslim world at Ur, the birthplace of the prophet Abraham. 

Timing and Dosage and the Saga of the Sussexes. I think back to our beloved Sister Cartwright and wonder that there was not a similar helping hand to light a lamp and show the way forward on the new path and calling for the young family. I hope that wherever their journey takes them they find such a person, who, like a nurse, will hold their hand in the darkest of times.

This has been a Letter from A. Broad. 

Written and read for you by Muriel Murch 

First aired on Swimming Upstream – KWMR.org. 

Web support by murchstudio.com

An Intersting weekend

/ aggiemurch / 3 Comments
Recorded and Knit together by WSM.
(Photo by FAYEZ NURELDINE/AFP via Getty Images)

Saudi Arabia’s Crown Prince Salman bin Abdulaziz gave the welcoming address as all the members of the G 20 summit were made visible on the big Zoom Screen. The summit was hosted by Saudi Arabia but without the lush, welcome goody bags that must have been missed. Here were twenty nations coming together, to talk, or in this instance, to listen, trying to come up with a positive action in this COVID year that has affected every nation. President Putin looked suitably serious, President Merkel was as clear and concise as ever. Prime Minister Johnson huffed and puffed his way forward, while ‘you know who’ got up after the first photo shoot and went golfing. The consensus that emerged was that COVID-19 vaccines should be made available world-wide, and equally accessible to poorer countries.

There were no cozy tete-a-tete in the tea rooms or bars of the hotels where so much, for better or worse, can be discussed, suggested or mooted. So it was no surprise that the U.S. Secretary of State, Michael Pompeo, slipped off touring the Arab states and ‘had a word’ with the Israeli Prime Minister Netanyahu and Crown Prince Mohammed Bin Salman, M.B.S. undoubtedly picking scabs in Irainian politics with Pompeo saying “It’ll be our policy until our time is complete.” One wonders what the ‘it’ is, beyond giving President-elect Joe Biden a headache on entering the White House in January.

In England, beyond Brexit, beyond COVID, beyond a Prime Minister in isolation again, the UK government has another little problem. Sir Alex Allan, as adviser on ministerial standards, clearly decided that the Home Secretary, Priti Patel, had breached the ministerial code through yelling profanities and bullying. For whatever reasons Johnson sat on the report for months, though now it is clear that Patel’s role as dark haired handmaiden to the blond bumble may be in jeopardy. While Sir Alex Allan resigned, a few ministers came forward uttering variations of:

“I’ve never seen her behave badly,” The business has left another bad taste in the mouth of the public that is barely being rinsed away by the news of COVID Vaccines soon becoming available, or the promise of the national lock-down being lifted and Christmas having some element of normality.

European and international news is buried deep in back page paragraphs. In Belarus the 16 weeks of protest continue though the weekends arrests were down to 200. Three young Hong Kong activists including Joshua Wong, have been charged with activism and each face three years imprisonment. Exhaustion and the COVID Virus have caused many demonstrations to fade, though the women of Poland are still visible, struggling for the last vestiges of control of their bodies.

Seeing all this harsh political power-playing behavior, being isolated in COVID quarantine, and feeling powerless has been countered by the human kindness we met this week.

By Friday night, after a little biopsy on Thursday, my body had taken offense and raised my blood pressure to the extent it needed to let off steam, or blood, and, as there already was a wound available, it did. After doing all the right things it became clear this wasn’t going to stop without help. We had been instructed, “Dial 111 if you bleed for longer that fifteen minutes.” And I felt nothing but relief when two slender men in green uniforms strode into our cottage and joined me, sitting, and dripping, in the bathroom. Mike and John had been a paramedic team for over 20 years. Though both were now retired they had responded to this spring’s outreach call and came back into part time service for COVID.

After a bathroom sit and a chat it was clear that it was time to return to University College Hospital where a hand-off, such as I recognized, took place. Two young nurses tucked me up, watched my not good blood pressure and gently cleaned what they could of the continual stream of blood that was flowing into unmentionable creases. We were well connected before a very jolly God’s-gift-to-whoever doctor bounced in.

“We’re giving you some medicine for your blood pressure and now if you just hold this here with a little more pressure. And why did you have a biopsy?”

“Well it wasn’t for fun.” brought laughter to the little cubicle in which he had the grace to join in. I was wheeled off to a holding pen ward to wait, while continuing to drip, for the facial surgeon.

“And you are?”

“The Doctor.” A beloved young Asian Muslim knelt by my bed to talk at my level. I held out my hand and he took it, receiving me into his care. His soft brown eyes held my old bloodshot ones as he gently explained what he was going to do. He had done the first healing with acceptance and tenderness and now with his skill and experience he cleaned up the mess. I was beyond grateful.

While he went off to write up his notes, completing this minor event for him, I wondered if he realized that his healing had begun when he knelt by my side to look me in the eye. At one time he too must have had to overcome the fear of ‘the first time’ that was still carried by the young doctor who had performed the first, maybe her first, biopsy. We have all been there, learning the procedures, by the time honoured, “see one, do one”, been an assistant who lets their hand be squeezed so tightly as to bruise, before becoming the experienced practitioner who has the assurance to heal.

This has been A Letter from A. Broad.
Written and read for you by Muriel Murch. First aired on Swimming Upstream – KWMR.org. Web support by murchstudio.com

Following Florence

/ aggiemurch / 1 Comment
Recorded and knit together by WSM
First aired on KWMR.org May 13 2020

In this new reality, a phrase that crosses my lips at least once a week is “Incandescent with Rage.” Usually by the time I come to write I have calmed down. But the feeling bubbles up and like waves rolling into the shore, heralds a possible storm at sea. This week it began – again – at Matt Hancock. A concise question from the Labour MP for Tooting, DR. Rosena Allin-Khan, about the continuing shortage of Personal Protective Equipment that was supposedly shipping from Turkey led him to respond that she should “Mind her Tone”.

And so it is UK people and businesses who step forward. On Princess Street there is a small sewing shop now closed. Walking past in the mid-afternoons we could see young children enjoying their after-school sewing programs. But the owner, Roz Davies, has gathered her staff together and, with a small army of off-site volunteers, been busy making gowns, scrubs and bags for the staff of The Royal Free Hospital. Nurses can put their scrubs in the bags for laundry and thus not contaminate their homes. This enterprising spirit has been repeated up and down the country by such shops as ‘Sew Much Fun’ and larger companies like Burberry. But wait a minute! This is the National Health Service. National, as in: owned and paid for by the UK government with our taxes. Would that not presume that the government would pay for and provide all the Personal Protective Equipment that the staff need? Ah well you see – that brings up an incandescent moment.

The testing for ‘essential workers’ has been abysmal failure. To find out if you are considered essential and how to get tested – you need a computer – where you can try to access a self-referral portal and fill out the 35 page form. Alternatively, try to book an appointment at one of the supposedly 50 testing sites open throughout the country. The nearest can be several miles away. And who is running them?

God Bless the Army. Newsreel footage now shows young soldiers with flapping blue plastic aprons over their army fatigues, standing, masked and gloved while waving cars forward. Then, while clutching papers and test tubes, they lean into car windows and poke swabs into open breathing mouths. No figures have yet been published as to how many of these young, partially trained, men and women have succumbed to the virus.

Throughout the week it was announced that The Prime Minister would outline his road map for going forward on Sunday evening. (Thereby cleverly missing a dissection by Andrew Marr on his Sunday Morning political broadcast.) We turned on the Television at 7 p.m. to see Boris in Blue. A navy suit, pale blue shirt and discrete tie. His hair, for those who like to note such things, was combed into a semblance of flattened style. Sitting at an old-fashioned desk with the door open behind him so we could see the elegant chairs and chandler in the room beyond. Did he give the broadcast live on Sunday? No he did not. It was prerecorded. Why was that? I still don’t know. And what did he say? Well a lot of us still don’t know that either. The three other United Kingdom Countries, Scotland, Wales, and Northern Ireland all rejected his new message of ‘Stay Alert’ and are continuing with ‘Stay Home and Save Lives’. This could be a moment to reflect that: “When Three Russians tell you that you’re drunk, you might want to lie down.”

But the general message seemed to be, “You‘ve all done a good job and now it is time to go back to work tomorrow. (Later that was corrected to Wednesday as tomorrow was Monday, a bank holiday.) If you can work from home, keep doing that. But if you do have to travel, try not to take public transport but “get on yer bike”.

And there must be a way to keep the natives happy and the country divided. (I’m sorry to sound so politically incorrect but here it is). Essential workers, and some businesses were to reopen, such as – wait for it – garden centers. How does that work? By keeping the home counties happy. They can shop for and work in their gardens and feel that Boris is taking care of them – as they will for him come election time. He must be careful as the warmth of the fire’s dampened faggots are beginning to smolder underneath him.

May 12th is Florence Nightingale’s 200th birthday. A day celebrated throughout the world with maybe even with a Google Doodle. This spring five Nightingale hospitals were built in London, Birmingham, Manchester, Harrogate and Bristol. Similar facilities have been set up in Cardiff, Glasgow and Belfast.

Frequent hand washing by nurses was an early directive of Nightingale’s and remains one of the most important health messages in this coronavirus pandemic. The new hospitals share many similarities to those that Florence Nightingale designed after returning to England from the Crimean war in 1856. But the main component was nurses. And the lack of nurses, as well as the situation just staying manageable, is what has kept these new pop-up hospitals almost empty. Nightingale also understood “politicians have short attention spans”. She was a quiet woman who would never have shown my emotion. I can’t but feel she might have given me a tight lipped smile of understanding.

This has been a Letter from A. Broad.
Written and read for you by Muriel Murch

From the Florence Nightingale Museum

Grateful in Week Seven

/ aggiemurch / 1 Comment
Recorded and knit together by WSM
Photograph by WSM

Week seven of Shelter in Place or Lockdown in London. Whatever we call it, this means remaining vigilant and at home. There is a new sense of ‘wait a minute’ … a new dawning of how life is really changing. Workers on building projects have had enough time off and money is running out. White vans are again parked on the roadside and masked laborers trudge in and out of the buildings. With luck, money will slip into empty pockets by the day’s end.

Meanwhile not only are all retail shops shut but so are most of the services that we have come to rely on. Hair is an optional accessory: some of us have it and some of us don’t, and blessed are those with a hairstylist in the family. Here in Camden, Ossie’s and the younger hip barber shops are all closed. So too are the ladies’ salons. Stylists have all gone home. The phrase ‘Shut up Shop’ has taken on a new meaning. As middle-age recedes, giving way to our senior years, we face the decisions we have made. Some of us have gone silver and others golden. Yet most of us try to do so something. Maintenance has become an almost full-time occupation while ‘You are looking very neat’ could be accepted as a compliment in these times. No longer able to enter the high street chemist’s I turn to the internet and find there is a run on ‘Age Perfect’ from L’Oreal and that Amazon is only allowing one package out with each order. But one is enough for the moment and will take me behind the closed bathroom door for a morning. Soon it maybe time for a pony tail clip.

But others are not so fortunate. The nurses, doctors and auxiliary personal on the front lines of the medical care of the COVID-19 epidemic can give no time to such personal considerations. Showers and laundry are all they can manage, meals are often gifted from the communities they serve. Some staff have even been camped in hotels, isolating themselves away from their families for weeks on end.

As we enter May, and come into Nurses’ week, celebrated around the world for the birthday of Florence Nightingale, I think of us nurses particularly. There are stories, penned in hours of exhausted lonely frustration, by Intensive Care Nurses working on the front lines from London, New York, Europe and throughout the world. These are heart’s weepings at the incredible loss of life they see and the family sorrow they bear witness and give comfort to. It is in writing themselves to sleep they join in comradeship with each other.

When patients are admitted to hospital with a clinical or tested diagnosis of COVID-19, this may be the last time they see their families. The death rate of those admitted to Intensive Care still remains at 50%. So many relatives have no time or way to say goodbye to their dying family members. It is the nurses who try to bridge that gap, calling families, holding mobile phones, and then holding hands with their dying patients. Nurses take their place at the bedside with both physical patient management and emotional support. If the nurses are lucky and gowned into proper protection, it is only their eyes that the patient can see, their voice the patient hears, and the warmth or a gloved hand that they feel. These can be enough. It is what nurses do.
The hold that the National Health Service has on the UK psyche is deep. It was conceived and brought into being in 1948 by Labour’s health minister, Aneurin Bevan. Subsequent governments have all taken turns nipping away at the NHS funding, mostly with cutting the salaries of nurses and doctors alike. This virus could be the a moment that the people say: Enough. Pay our staff.

Every European country with a socialized medical system sings its own praises. “Italy has the best Health Care System in the world.” says my Florentine friend Idanna. In less serious times I would banter with her that ours is better. But Italy, like all of the socialized systems has been sorely let down by their own government at this time. Italy went into lock down on February 23rd. Other European countries quickly followed with their own forms of isolation. It was not until March 23rd that the UK government asked this country to Shelter in Place. Italy quickly turned to music for community comfort. People came together across balconies and plazas to sing in praise and gratitude to their medical teams. Spain, Germany, France, England, China and America even, began their rituals of standing on doorsteps, singing, clapping and banging on whatever they can find to say thank you.

At 8:00 PM every Thursday, as night gives way to spring-time dusk, people around this country, on doorsteps, outside of hospitals, fire departments, and public services come out to clap, smile and wave at each other and for a moment not feel so alone.

This has been A Letter from A. Broad. written and read for you by Muriel Murch.

Keeping Calm in London Town

/ aggiemurch

“You ol’ rite?”
“Yes, thank you.”
“Not coughin’?”
“No Maddy, not coughing.”
And Maddy gives me a thumbs-up sign before she scurries away to catch an overland train to Battersea and visit her ailing mother.

Thank you Zine

“Do you need anything? Can I shop for you?”
“Thank you Sinder. We are ok at the moment.”
A note is slipped through the letterbox from Zine our neighbor at # 37. “… I would be most happy to help”.
“Aggie, Aggie.” Mr. Habto has returned from his early morning taxi run and is standing by his cab. 

“Anything we can do to help. Please let us know. Knock on the door or leave a note.”
Maddy is probably London born and bred, Sinder is Hindu, Zine is from Eastern Europe, and Mr. Habto a Coptic Christian from Africa. This is the mix of the little community at the bottom of our street. They all have families to care for and yet are finding moments to be watchful over us. We have become the “old folks” on the street. Thus neighbour cares for neighbour in our little corner of London. And we are grateful.

It is Sunday afternoon. The sun will not come out again today. The wind is blowing and the raindrops seem hesitant and unsure where to fall. Families are walking home from their ‘fresh air and exercise’ moment in the park. Football games are still scrubbing along in the mud. White shorts are streaked with brown, hair is windblown and there is quiet laughter coming across the pitches from the players. Out there – the city, London, – is very quiet.

Boris Johnson and his lieutenants appear very old school serious as they stride to the podiums set up in the State dining room at Number 10 Downing Street, while trying to cover up the fact that Number 19 Coronavirus may be beyond their abilities. This may be the first time in his life that Johnson gets really serious, and not everyone is convinced he knows how to do that. We can only hope that he might in fact be growing into the role of Prime Minister and treating this with all with the gravitas it deserves. One does suspect that upsetting the populace is as an important part of the equation as is protecting the insurance companies. Another supposition is that this is seen, by Johnson at least, as his Churchill moment. One can be grateful though that he has these two lieutenants: England’s Chief Scientific Advisor, Sir Patrick Vallance, and the chief medical officer, Professor Chris Whitty by his side. Whitty, or is it Vallance, produced graphs on a large board and pointed away so that the journalists in the room, sitting as close together as ever, could understand what was trying to be accomplished and then relay that information to us, the presumably less well-educated public. Vallance and Whitty are both, in their English way, considerably more competent than the school-yard gang that surrounds Donald across the water.

Daily updates from the government will now come from Number 10 Downing Street as the situation changes every twelve hours with more confirmed cases and deaths. Johnson and his team are putting some guidelines in place while they wait to come down with a heavy hand. It’s a gamble for sure. Health Secretary, Matthew Hancock, sputtered and muttered on the Andrew Marr Sunday morning show about ‘Doing everything we can and self-isolation’. Manufacturers have an opportunity to make millions of Pounds Stirling and ventilators. “Other countries in the world will be needing them too.” Mostly though it is businesses, sports centers, and banks (!) that are leading the way, encouraging working from home, canceling big matches (though not the Cheltenham Race meet last week), and encouraging self-isolation.

And now, on Monday morning, there are more shutters coming down. Museums have already closed, special openings have been postponed, and the British Film Institute team all work from home, strategizing what this means for the film industry in England. We withdraw too, canceling lunch dates with friends and family. Being well over a certain age, 70, we are all ‘vulnerable.’ and many of us have at least one strike hitting our general health. We are being encouraged to self-isolate. What will happen then to the organizations run primarily by older volunteers who serve their communities? As I write an email comes through from one such trusted leader: ‘The Library is closed for the foreseeable future’. What will happen to those books? Sitting on their shelves so lonely and unread. Theatres, cinemas, concert halls, hotels, and restaurants are all growing dark as their lights dim. Today all religious leaders united in asking their followers to pray at home.

Hand sanitizers are out and visible – where they are available. Otherwise, it is serious and constant hand washing – by those who do that sort of thing. Shop-keepers and checkout folks wear rubber gloves to handle the £ coming in. And £s are rolling into supermarkets as folks panic buy and buy. That may have begun to calm down now with ‘assurances’ that the stores have enough of what we need stock-piled somewhere. This morning the pharmacy was full even as folks tried to stay apart from each other. The doctor’s office is closed with a notice on the door saying that appointments will be by phone for the near future! The local Deli and other coffee shops on the street are almost empty. Can they hold on for those over-70s for whom a little sandwich at the coffee shop is their main meal?

Daffodils from Taghi A’s Morning walk

We are grateful for the Hill and Regent’s Park where we can walk in isolation. Wild primroses rise from the soil to shine close to the ground. The daffodils are reaching their peak, staying upright through the foul weather of the last weeks. But the plum and pear trees lining the street are beginning to loosen their soft blooms and whisper in the breeze for us to keep heart. Our Robin Red Breast hops down to check my worm count as I work in the little garden. She too tells me to let the warming soil soothe my soul.

Primrose in St. Mark’s Church garden Wall. Photo WSM

‘Our’ Robin checking my work

Minding the Gap

/ aggiemurch / 11 Comments

Learning to Heal recipient of the Tillie Olsen Award for Creative Writing; Working Class Studies 2019

“Mind the Gap,” says the voice over the loud speaker and as I sit on the bench at the platform edge waiting for the train to unload the commuters coming into the city I think of ‘The Gap’. The book in my bag carries writing that looks back across the gap in time, from the days when we were nursing students to now. Each nurse author has written of where they have come from, and the events that bound them to their calling. Often it was touch, and the humble bed bath that was the sacrament that enfolded and claimed us as nurses.

Learning to Heal

Nurse Slater. The end of first year, receiving ‘Medicine in its Human Setting’

Sitting on that railway station bench, holding my bag and coffee (and croissant) I watched as the passengers got off the train, and walked quickly towards the exit, making their way down the escalator into their days in the city. It was a very definite ‘Miss Pym’s Day Out’  moment of watching: the dogged determination of the young man with his folding bike, the resignation of an older middle aged man, the nervous excitement of a young girl maybe hurrying to a new job. Then there was a very slim woman wearing a pencil pleated yellow skirt and pink blouse. She was determined not to let summer go – just yet.

The passengers are all off and the train is cleaned and ready for the few of us to board. It is a fast train from St. Pancras in London to Canterbury in Kent and I will take in a day at the ‘Working Class Studies Conference’ before the evening event at the University of Kent in Canterbury.

A knowing Taxi driver takes me to the campus and Keynes College, dropping me off exactly where I need to be. How many young students has he driven to their first day of college?

First there was Registration before going upstairs to the reception and classrooms. There were two book stalls, and on one, our book, propped up comfortably among communist manifestos and the rights of workers and all else.

Learning to Heal at the book stand

Looking through the program I circled three seminars to attend. What I heard time and again, is that when industry that has been built up is then taken away, closing factories but without providing alternative jobs or industry, it is the community that dies.

The evening light was soft and autumnal as I walked with a fellow participant from Nova Scotia University to the Darwin College Conference hall. The tables were prepared, and the buffet pans were being set up for the food that would follow. Terry Easton from the University of North Georgia introduced me to the other Tillie Olsen award winner, Ted Van Alst Jr. author of Sacred Smokes. We exchanged books and as I peeked inside his collection of stories I raised my glass of cider to his seeing. We sat together with his lovely wife Amie. My ‘End of Empire’ friends also came to the dinner offering moral support and a bed for the night.

Terry introduced us with these words:

“Judges named two winners in this year’s Tillie Olsen Award for Creative Writing. The interlocking stories in Theodore C. Van Alst Jr.’s Sacred Smokes provide “an authentic representation of working-class urban life in the 1970s,” one judge wrote, adding that ‘[t]he collection’s tone-perfect survival humor helps create verisimilitude and keeps readers engaged . . . despite its often-dark themes.’ The collection is ‘one of the few fictions about urban working-class Natives,’ and it reveals ‘the deep truths of growing up working class in 1970s America.’ Another noted ‘Van Alst’s ability to put the reader inside the head of the protagonist’ to reveal ‘the humanity and texture of life among those in the poverty/working class who actually enjoy being there, despite the many drawbacks and dangers.’

“The award is shared by Jeanne Bryner and Cortney Davis, editors of Learning to Heal: Reflections on Nursing School in Poetry and Prose. The collection illuminates worker-voices, and a judge noted, ‘the writing is emotionally strong, creatively composed, and an important addition to the literature of ‘what work is.’ Learning to Heal should be required reading in all nursing schools.’ Another praised ‘[t]he quality and ambition of the poetry.’ A third described Learning to Heal as ‘the best kind of writing working-class studies has to offer: actual workers telling their real-life stories with poetic, authentic, and instructional voices.’”

Ted went first and then I followed.

And this is what I said, for you all:

Thank you very much. It is a privilege to be honoured by ‘The Working Class Study’s Association’ and to share the 2019 ‘Tillie Olsen award for Creative Writing with Ted Van Alst Jr. and his book ‘Sacred Smokes’.

Thank you for including and acknowledging the work of nurses among all of you who are building appreciation of the role of work and exploring working class life and cultures.

Tillie Olsen is particularly close to my heart. Many years ago she penned me a personal thank you letter for my reading of Babette’s Feast on KPFA Pacifica radio. She was always listening to, and for, story and literature.
And Thank You for hosting this 15th Conference at Kent University in Canterbury. Canterbury was my father’s childhood home and where many, many years ago he was caned after being caught playing pop tunes on the Cathedral Organ.

Timing and dosage are everything in medicine and also in life and so I feel particularly fortunate to be able to represent the nurses whose work is included in “Learning to Heal, Reflections in Poetry and Prose,” and edited by Jeanne Bryner and Cortney Davis and Published by Kent State University, (The other Kent,) with a forward by beloved Judy Schaefer, all who have been writing of nursing in poetry and prose for over 30 years “Learning to Heal,” is a jewel and an important piece of nursing and cultural History.

Oft times we choose nursing as a pathway from one social environment to another, usually empowerment and – or – of a social context. But in the course of our training and then our work we are blessed with another kind of change. A movement of the heart and – for in the acts of caring and healing – we are given the opportunity of growing and healing ourselves.

In the forward Judy Schaefer quotes Sister Frances’s phrase from ‘The Silent Treatment,’ “Silence, once learned, is the tabula rasa upon which the art of Nursing thrives; Silence is a language spoken by all. It is the music that goes before every note of love that a nurse’s hands can offer.”

Those of us who are lucky enough to write of our work in this reflective anthology are blessed to give you our gifts again. The 51 nurses I represent tonight have been able to share their stories, their history, and interestingly, they have shared their fears and failures more than their glowing successes. Nurses and writers know how much we learn and grow through our mistakes and humilities. We write to share those stories and give courage and comfort to the nurses to whom we pass the lamp. Though our kind of student life was hard none of us would give up a moment of it.
Particularly there is Minnie Brown Carter’s story of being a ‘coloured’ nurse training and graduation in 1947. It is of particular relevance, a reminder to us all that this fight, in America and through out the world, is not over yet. Minnie, on the other side of 90, is still a voice calling for recognition of fair treatment for all.

There is Judy Schaefer’s delicate voice … from Pennsylvania

I’ve singing lessons

“So let me out of class
Early please
It is time to go
No calculus
Anatomy

Throw a syringe like a dart
Remain alert to peristalsis after breakfast, lunch and dinner
Smile when you enter a room
See one, do one, teach one ….”

Cortney Davis’s soft New England tones purr like a crouching cat,

“I learned how cells collide then melt and peel into spheres,
multisided like soccer balls or Rubik’s Cubes.
I stabbed oranges until my hands ran with Juice, then patients
until my hands ran with grace.
I learned the quick save: airway entered upside down and turned into breath.
I learned to kiss death.”

While Jeanne Bryner sings out of her Appalachian heritage in Ohio remembering …

“I have rainbow pills, water from a jug, syringes, needles
kept in shallow drawers. I am here to help the heart’s fist
squeeze and twist its red mop. Pain is a forest. My Hands?
Both ends of a two-man saw, my will, its blade.”

At some point in your lives you may be touched by a nurse’s hand. However much pain you are in, however weary we are, whatever passes between us – it will have been our privilege to care for you.

Thank you very much.

For Cortney and Jeanne, From WCSA and us all

1967

/ aggiemurch / 10 Comments

Sometimes when I get mad or sad beyond the normal ups and downs of day to day living, I recover by writing poetry which – naturally – makes much of the work unpublishable.

But the political arena of the last weeks in the USA has led me to more sorrow and anger than I have felt for a long time. It is deeply profound with a collective grief that has become personal. Private and public in the same way the wars, famine, floods, fires, shootings and political shenanigans are to any of us thinking and feeling in the world today. Maybe it is that I not only feel these assaults on women as a woman but also as a nurse. Assuredly an old one, but still active in heart and mind and even on occasion in the physical world.

Heartbeat bills in the USA as of May 2019

The governmental legislation occurring in Alabama, Georgia, Ohio, Mississippi, and beyond, leaning hard to the political far right, and the gamesmanship of these politicians, is chilling and terrifying, and reminiscent of a time when …

In 1967 I was working the afternoon 3-11 p.m. shifts in a major Hollywood hospital in Los Angeles County, California. One busy afternoon, shortly after we had come on duty, after the day nurses had left, we were making rounds and checking on our medical patients and the post-surgical patients returning from the recovery room when a phone call came to the nurses’ station. We were to take an emergency admission who would be scheduled for surgery later that evening. Hardly had I put the phone down when a gurney, carrying a young woman, came out of the lift and was hurriedly pushed onto our floor. The orderlies wheeled the gurney into a double room close to the nurses’ station and tipped the patient onto the empty bed. A clipboard with doctor’s order lay over her body.

“Start IV of Dextrose and Saline and insert a nasogastric tube STAT.” was scrawled on it, with a signature. I hardly looked to whom her admitting doctor was, just focused on the fact that she came from the Emergency Unit. Once unstrapped from the gurney and on the bed, she (I want to call her Helen) began thrashing, screaming, and writhing with abdominal pain, while gagging, trying to release whatever was inside her. Doris, my aide, hurried to get the nasogastric set-up and we called for the IV nurse to come to the floor, Stat.

The other team, of one nurse and an aide, were caught up caring for the remaining patients on the floor and there was no-one else around. Helen was beyond hearing me as I tried to explain what I had to do, for and with, her. She was obviously terrified and aside from her not able to hear me she continued to thrash in the bed. We could not hold her steady. So I slapped her. Not hard but I did slap her and I remember it to my shame to this day. But, still terrified, Helen focused on me for the first time, and our eyes remained locked together from then on.

“I need your help. You have to stay with me and let me do this for you.” Having a nasogastric tube inserted is always unpleasant and there are risks attached to the procedure, making sure the tube enters the esophagus and not the trachea and goes to the stomach and not the lungs. As Doris stood by her (and my) side she stroked Helen’s arm giving her calm comfort. I managed to insert her tube correctly and immediately a torrent of brown fluid came up. The IV nurse arrived and started the intravenous fluids into Helen’s veins.

Soon Dr. L., a gynecologist, arrived. He was quick and brisk but also quiet and reassuring as he spoke. Helen was prepped and soon taken to surgery. Later that evening she returned to us. Dr. L. was tight lipped when he too came back to the floor to write up his notes.

We didn’t talk much at the nurses’ station. I was young and naive enough to only begin to understand what had happened to Helen. Who was with her? She had come to us alone but someone, a friend or family member, had got her to Dr. L. and he had managed to save her life if not her uterus. It was clear this was not the first time he had taken such care of a women. His tired face showed that he feared that it would not be the last. Helen recovered, walking the hall carrying her IV pole, catheter and shame. She discarded the IV and the catheter over the next few days, but maybe she took the shame with her when she was finally discharged.

That was 1967, within so many of our life times. Those of us fortunate enough to have lived within relative control of our bodies need to remember to be grateful. Women around the world today still carry unwelcome and dangerous pregnancies. The thought that so many young people within once enlightened societies could again face such a situation is beyond chilling and beyond poetry.