A Month in Lockdown London

A month in Lockdown London

Early morning walkers are wrapped up warmly against the nipping wind that dances below the sun and tosses infrequent April showers across the country. The warm winter has brought green aphids out to suck on my roses. Every morning I brush them off and say thank you to the ants who are trying to devour them as quickly as they appear.

Walking past our local supermarket, the wind added to the chill of watching the long line of one-person one-cart each distanced apart, shuffling along the wall around to the waiting guard at the store’s entrance. It still feels too dangerous to shop there and not all right to ask someone to go for us. So we stay close to home shopping in the village and getting used to doing without the simplest things. It has been two weeks since I saw Philadelphia creme cheese in the dairy cooler. This week there is no mayonnaise and I pluck the last bag of risotto rice from the shelf.

Listening to the daily news bulletins from the government it is clear that they are not ‘telling the truth, the whole truth and nothing but the truth.’

Health care workers, transport, postal, delivery and essential service personnel are becoming increasingly distrustful of, and frustrated by, the government. There are no state governors here to overturn and bring clarity to the federal shambles. The major of London, Sadiq Khan, the son of a bus driver, needs union pressure to catch up, trying to make all transport workers safer and promote the use of face masks for public places where the correct social distancing cannot be kept. His frustration is palpable on the news clips where he is seen. Since before the weekend a shipment from Turkey of Personal Protection Equipment for medical personnel had been promised. Today we learn that it was only officially asked for on Sunday! and is now due (again) to arrive today. Turkey – the country once demonized to help win the Brexit vote.

Beech Tree in the Wilderness of Regent’s Park

This is week four of our London shelter in place and the government has decreed at least three more weeks. But over this weekend with the Spring sun shining and the air warm, there was a casual feeling from people that this will not affect them. We walked through a wilderness area of Regent’s Park, where couples and families were picnicking under the trees, hanging out where old London tramps like to make their camps. Impromptu soccer games were played, though the goal posts and nets are all put to one side of the pitches. Hardly anyone was wearing masks but we were. The last of our table napkins have been turned into masks. A bag on the front door holds more fresh napkins from friends. They are waiting, cocooned like caterpillars to metamorphose into white butterfly masks.

From Table napkins to Face masks Photo by WSM

Mr Habtu works for Addison Lee the car hire firm. His hours are rough and spontaneous and he is still working. Who are the people who need his services? He has a wife and three growing boys to support. Every time I see him drive away I worry more than a little and yet am grateful for him that he has a job, is able to work and provide for his family.

This morning another book arrived through the letter box. ‘The Great Influenza’. Written by John M. Barry published in 2004 and picked up as one of the three books by G.W. Bush as a vacation read in 2005.

On opening it up I am immediately caught and it looks like Thomas Cromwell’s death in ‘The Mirror and the Light’ may have to wait a little longer. Glancing through The Great Influenza I am stopped by the end. Though one is not supposed to quote from books the two concluding paragraphs bear repeating at this moment in time.

“Those in Authority must retain the public’s trust. The way to do that is to distort nothing, to put the best face on nothing, to try to manipulate no one. Lincoln said that first and best. A leader must make whatever horror exists concrete. Only then will people be able to break it apart.”

And there is hope in the world as we read of Jacinda Ardern, the Prime Minister of New Zealand managing her country through this crisis followed by the delicious news that the governments of Poland and Denmark are refusing to give financial aid to companies that are registered off shore.

Primrose Hill is embraced on three sides by The Regent’s Park, the Canal and then the railway heading away from the city center. Walking home through the park we paused on the bridge over the canal. In these last few weeks the canal water has become so clear that the shallow bottom was visible. The sunlight was strong and sparkled through the trees while the ducks flew in pairs along its path. Such is the stillness of the air that for the first time in twenty years we can hear the trains clatter quietly by – leaving us all behind.

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

Easter Weekend 2020

Easter Weekend in London brings news and time for reflection.

Some days swirl by in a non-specific haze, leading to a confusion of thought, and a seeming inability to get anything done, so that the by day’s end one wonders what did actually happen. Like older relatives and parents who cut out articles from the newspapers and mailed them to us, we now swap internet links and stories. “I thought you might be interested in …” and we often are.

Thomas arrived for my birthday. He had been hinted at, noted, ordered from our local book shop and was wrapped up to serve beside a pot of coffee for breakfast.

Thomas at Breakfast

Hilary Mantel’s “The Mirror and the Light” brings Thomas Cromwell’s life to an end. For three days and nights I managed to resist him, continuing to read an evening chapter from “Jock of the Bushveld” an old favorite book of my mother’s.

But before even a week was over, I had picked up the hefty tome of 880 pages. I said (to myself) “I’ll just take a peek”, as if “I’ll just go for a drink with him. It’s nothing. I can get up and leave whenever I want.” But now Jock is laid aside, and Thomas has my heart and mind. I love him, more than a little bit, and am infinitely in awe of and grateful to Hilary Mantel. I am not alone. Others I know read him in this gifted time of solitude. We will go with him to his end and close the book with sadness.

When Susan Sontag published ‘The Volcano Lover’ in 1992, she went on her book tour. I was fascinated with the history and had lots of questions prepared for speaking with her at KPFA, Pacifica. But as the conversation relaxed and drew to a close, I asked about living alone in New York City. “Are you ever lonely?” “How could I be,” she responded. “I have two thousand years of history in my library.”

Here in London we both have small libraries crammed full of books that we cherish. We are both re-readers, I returning to history while he explores science. Though I’m a one-at-a-time gal there are at least seven books piled behind “The Mirror and the Light”.

My father would have been in his 70’s when I was first old enough to become conscious of his reading habit. And for him, too, this age was a time of re-reading books that he welcomed back into his life as long lost friends.

Saturday morning began in the new quiet, but by noon a helicopter began to circle overhead. There is no Prince traveling from one palace to another, and the air ambulance is hardly needed now that the London streets are almost empty of traffic. This is the police, boys with their toys, circling Primrose Hill and Regent’s Park looking for those, oh no, sunbathers and loiterers. Later, when we take our walk a police patrol car is cruising The Broad Walk. They are not walking to give a face to their presence, nor even on horseback when I might get lucky with a bag full of droppings for the compost pile.

The evening news program brings the government representatives out to the podiums with their daily bulletins. Mathew Hancock, Minister for Health, speaks his coverup nonsense “Maybe the NHS are hoarding gowns and masks which is why there is a shortage.” Priti Patel, the Home Secretary says, as one does when knowing there is a need for an apology but not ready to give ground, “I’m sorry the situation makes you feel that way.” As of this writing 8 national health doctors – all of them UK immigrants – have died. The number of nurses to have died is unknown. Today at over 11,000 deaths, England is set to overtake Italy in the number of Covid-19 deaths.

On Easter Sunday morning, the Prime Minister Boris Johnson was discharged from St. Thomas’s Hospital and driven to Chequers, the country seat of the current Prime Minister. Whatever one feels about this Prime Minister we are grateful that one more life has been saved. And so is he, giving public thanks to the nurses who cared for him; particularly Ward Sister Jenny McGee, from New Zealand and Staff Nurse Luis Pitarma from Portugal – again – immigrants.

Easter Sunday is when some look for a miracle. Not necessarily the one of a life returned, but possibly of the recognition in this moment of gratitude by the Prime Minister, for the nurses, doctors and all staff working in the health service. Doctors may cure but it is the nurses and hospital staff that keep us alive.

Old into New – again

A strange part of all of this is trying to accept that my job is to be out of the way, not on the ‘front line’ – not helping. But what to do? what is next? The table napkins are next, the first one already torn and sewn to make a face mask. I take up a needle and mother’s cotton threads while listening to history unfold itself again.

I bow my head over the work as a gentlewoman would in the Tudor time of King Henry and his Lord Privy Seal, Sir Thomas Cromwell.

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

Keeping Calm in London Town

“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 to 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, cancelling 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

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

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.

Colleague or Patient

Lilacs in bloom in Regent's park. Photo by WSM

Lilacs in bloom in Regent’s park. Photo by WSM

On a beautiful spring morning my husband and I walked hand in hand through Regent’s Park.

Crossing the Marylebone Road we turned onto Harley Street to be met by our memories.

Could this be the same building that we entered over fifty years ago? Though many times repainted and re-carpeted and now with a lift beside the stairs and we felt a shivering echo of remembrance.

Harley Street W1

Student Nurse Slater 1962

In the mid 1960’s, contraception was not readily available to young unmarried nursing students. Those who became pregnant had to choose between pregnancy, possible marriage and leaving nursing school or terminating the pregnancy to continue training. At our hospital the choices were stark; a tryst with Reg the long-fingered maintenance super, several patient escorts to the Radiology lab or a visit to a discrete gynecologist on Harley Street. I remember a smooth, urbane, gentle young man who was used to caring for the young nurses who had fallen too quickly into the arms of his lustful colleagues. I only saw him one time and had no need to go further into his suite.

Today we took the lift to the third floor and entered a compact, neat office to wait at the reception desk – for the receptionist.

Another young man is pacing. He is shyly courteous and assures me someone will be with me shortly. He is, again, urbane, handsome and impeccably dressed but in this space he seems caged and nervous. The receptionist arrives and I fill in identical forms to those I filled out ten days ago at the doctor’s office. I return the forms to her and handed over a credit card, keeping my fingers crossed that our U.S. health insurance will kick in and help us out.

The young man is still pacing. Trying to put him at his ease I turn and ask: “And what do you do here young man?” Maybe this was not the most comforting of questions but it was the best I could come up with, for, I too, was nervous this morning.
“I’m a plastic surgeon. Are you a colleague or a patient?” He bats the question back at me in defense of himself. He is taken aback by my question, and I by his reply, so we laugh together as I gather my answer.
“I’m both. A nurse and, today, a patient.” I make a quick prayer that he is not on standby for my procedure. We laugh again as I gently ask, “Do you still get nervous?”
“Yes. Always, but I try not to show it.” He knows this is the answer I want to hear. Now our conversation is over and we part, I to sit down and wait, he to pace where he cannot be seen.

Brenda, the nurse who welcomes me, is Irish, old school and cheerful. I expect she greets all her patients as sweetly as she does me. She settles me into a waiting -recovery room and I gown-up with added pale blue socks before Dr Dobbs strides in.

He is a big man, tall and more than a touch over-weight. After a long weekend his nose is sunburnt and his cheeks are ruddy. This is not a man who follows his own doctoral advice. He introduces me to the histology pathologist who will be checking over my bits after they are dug out.

He applies a little light numbing to my lip before I am led into the OR suite. Two more nurses, one from Slovenia, the other from Romania are waiting. Between them they settle me onto the table. The room is air-conditioned cold which is great for them but I need a blanket.

The local anesthetic is given and soon it is: lights, camera and action as Dr. Dobbs begins. I am aware of blood being swabbed from my face and, from time to time, the smell of burning flesh as he cauterizes bleeding vessels. Brenda has a hand on my thigh, softly stroking me as if calming a stalled horse. When she moves around the table she constantly reaches and touches me. She is steady. My eyes are closed as I ponder the difference between numbness and pain.

Dr Dobbs is focused and I can feel when the work is easy and when it is hard. He has entered the sea surrounding the tip of an iceberg, the only visibility sign for two and a half months that something was wrong. This is a tricky, not so little, intrusion in my body and I can feel he is straining hard to get underneath it all. His stomach leans up agains my side and presses into me. His belly is as comforting as Brenda’s touch. I am reassured by his efforts and silence when working and his good manners to his nurses when he calls them.

Stage one is done. I return with my blanket and socks to the waiting – recovery room. Dr. Dobbs takes my bits to the lab while I’m surprised at how shaken I feel. Brenda sits with me a while, popping in and out to give me sips of water from a paper cup.

The pause is over and it is back to surgery for another round. Dr. Dobbs repeats his scraping, as if cleaning all the fruit-flesh from a melon skin, until he is satisfied he has enough and it is time for final closure. Luckily there is no sign of the young plastic surgeon and Dr. Dobbs is relaxing as we come down this home stretch together.
Eight sutures later, a dental pad dressing and I return to recovery.

“You’ll have a sort of hockey-stick scar. It will do very nicely in the skin crease in your face.” He kindly refrains from saying “wrinkle” but I am grateful to have aged in my own skin.

“How long do you want to keep her?” Brenda asks. I want to go home and let my husband get back to work so post-operative instructions and prescriptions are given before Dr. Dobbs sums up this morning, as if to himself, “You were good to be so relaxed. It makes a big difference.” And it felt so, a team effort between doctor, nurses and patient. It was collegial. I hugged each of the nurses as we said good-bye.

Taxis turn onto Harley Street

A black cab turned onto Harley Street as we came out of the building. We climbed in and the taxi driver took us quickly home.

I was laid out and down to begin a week of advanced Sofa-thenics while the next member of the team, my husband as colleague, bent down to caress and take care of me.

Advanced sofa- thenics

Nurse’s Day 2017

Today is May 6th, the beginning of Nurses Week in North America which ends on May 12th, the birthday of Florence Nightingale, and, since 1974, is celebrated as International Nurses Day.

1963 Prize giving @ Royal Surrey County Hospital, Guildford

Though I will not be buying any Hallmark cards for my nursing chums, I am thinking of my comrades and sisters who are my fellow nurses. Those friends we made, bonded in student years with the sharing of patients as we changed ward rotations; the remembrance of patients who were dear, beloved, or cantankerous, those we recall as much by attitude and character as by disease, those births celebrated and deaths honored. Then there were the working years before reentry to university bringing new adult companions, both student and teacher. Now, in this final quarter of life, I have found a sisterhood of nurse writers and poets. Some still work at the bedside of, or in the clinics with, patients – others teach, and all of us remain nurses within our communities and families. We write of the past, distant and immediate, bringing disease and care into the present.

Nurse Poets reading in Charleston 2016, Veneta Mason, Cortney Davis, Muriel Murch and Jeanne Bryner

 

We are lucky to have found each other and are grateful for the collectors among us: Cortney, Judy and now Jeanne who gather up our words, harvest them to reseed the bare virgin soil of tender young hearts. We write from different geographies of the Americans and the world. Jeannie Bryner from Ohio, Cortney Davis from Connecticut, Venenta Masson from Washington DC, Judy Schaefer from Pensilvania, Madeleine Mysko from Maryland, Patsy Harman from West Virginia.

Before I left California, I took from my bookcase the written work of my nursing friends. It is an impressive display of non-academic writing from professional women and men, and grows each year.

Within my bookcase

In 2018 Kent State University will publish another anthology of nurse writing, ‘This Blessed Field.’ Within this anthology are stories from young nurses, our stories, sharing our innocence with the new nurses of today helping to guide and comfort those following in our footsteps with the light we shine for them.

Each year on May 12th a church service is held in Westminster Abbey in London and at St. Margaret’s Church at East Willow in Hampshire. Wikipedia tells me that during the service, a symbolic lamp is taken from the Nurses’ Chapel in the Abbey and handed from one nurse to another, thence to the Dean, who places it on the High Altar to signifies the passing of knowledge from one nurse to another.
I will be in London that day and will go to the Abbey.

Norfolk bound

Thanks to Nikki Morris, director of Norfolk’s Big C Cancer Charity, The Bell Lap and I are heading to Norfolk this week. It will be wonderful to be speaking to nurses, carers and other health care providers in the afternoon and then reading and in discussion at Kett’s books in the evening.

Events
2016

Muriel Murch High Res 4

Muriel Murch photo by Beatrice Murch

Muriel Murch, Author of The Bell Lap
Wednesday 7 September 5:00 pm

 

 

All of us age and change – and we all watch while those we care about go through their own life changes.

Muriel Murch’s new book The Bell Lap (Taylor and Francis) shares human stories of caring and being cared for that will ring true for all of us – and the bigger medical issues such as living longer vs ending well are timely debate for those in the medical profession.

Tickets £3, refundable against the purchase of any book.

Kett’s Books is delighted to be donating profits from the sale of this book to the Big C, Norfolk’s Cancer Charity.

BELL LAP

The Bell Lap Stories for Compassionate Nursing Care

Permission to Touch: ¿Permiso?

We laugh when AARP first shows up in our mail box on our fiftieth birthday. But over the years we come to read more articles until devouring the magazine from cover to cover. This April’s bulletin issue features Jessica Migala’s article High-Tech Ways to Stay Healthy which looks at the new world of medical app options for both patients and doctors.

In Stuck in the Past: Why are Doctors still using the Stethoscope and Manila Folder? Michael R. Splinter, Executive Chairman, Applied Materials, Inc., asks ‘Why Physicians haven’t adopted more modern Technology?’ He suggests that physicians should get rid of the Stethoscope and the Manila Folder. But I would ask him, along with Medscape Editor, Dr. Eric Topol and others, in the interest of good physicianship, for want of a better word, to hold steady and reconsider, first the sturdy stethoscope with all its uses and then, memory.

Mike Newall’s 2007 film Love in the Time of Cholera opens in the year 1880. Early in the film, Fermine Urbino, having rejected her suitor Florentino Ariza, suddenly, mysteriously falls sick. Her anguished father calls for the young doctor, Juvenal Urbino, who hurries to the bedside of his friend’s daughter. A lady’s maid hovers nervously in the background. Approaching the bed Dr. Urbino takes in Fermine’s glistening, feverish forehead. His hand reaches down to check her pulse. Then, bending low over the bed, and in haste for a rapid diagnosis (and screen drama), rips open Ferimine’s bodice to reveal her breasts, which rise, quivering under such an assault. Putting his ear close to her heart he leans low to hear its rapid, beating pulse while struggling to contain his emotions. But we all know what is going on and – because the film is a little slow and predictable, and most viewers have read the book – what will happen.

We may miss these dramatic bodice ripping moments but it is an undeniable fact that the invention of the stethoscope in the early 1800s made diagnosis of certain illnesses better, and faster.

In 1816, while studying medicine in Paris under Dupuytren and Jean-Nicholas Corvisart-Desmarets, René Laennec began to experiment with ways in which to hear the body better. His first instrument was a plain wooden monaural tube.

This early stethoscope belonged to Laennec (Science Museum, London).

This early stethoscope belonged to Laennec (Science Museum, London).

By 1851 it had evolved to a binaural instrument with flexible tubing. He named his instrument the stethoscope from the Greek words Stethos (chest) and Skopos (examination). Laennecs’ new invention was far more accurate in hearing heart and lung sounds than the old method demonstrated in Love in the Time of Cholera. But it had its detractors. Christopher McManus writes in his Right Hand, Left Hand, that Thomas Watson MD, was known for not only using his new stethoscope but sitting and watching the patient and saying he found the stethoscope ‘more of a hindrance than a help and that although he could not do without it, he did without it as much as he could.’

A young Scottish physician, John Forbes, moved to London in 1840 while his old friend James Clark was the young Queen Victoria’s physician. Queen Victoria loved all things Scottish and was fascinated with modern medicine. So it was not surprising that in 1841 she chose this studious doctor for her family and the Royal Household. Scottish physician or not, Forbes brought with him the new French instrument, the stethoscope.

Not until almost a hundred years later, in the 1940s, did Rappaport and Spraugue design the stethoscope with two sides, one for the respiratory system and the other for the cardiovascular system which remains the basic design used today.

The most basic work horse stethoscope used today.

The most basic work horse stethoscope used today.

What the Stethoscope does now, beyond listening to the regular or irregular trills and lub-dubs of the heart, and searching through the dull silence or fretful peristalsis of the abdomen for the calm gurglings of a bubbling stream, is to permit the physician to bend low, in homage to the body. His other hand may search to feel for a pulse away from the apex beat, ‘the Watson Pulse,’ of the heart’s aortic pounding, catching the dance of the two partnered beats. Maybe his fingers brush the abdomen before he takes courage and palpates the flesh, quadrant by quadrant.

In Argentina it is customary to ask permission, ¿Permiso? before crossing the threshold and entering a home. Today the physician needs an excuse to touch the body and the stethoscope gives that permission and allows the patient to accept this touch. Then he can slip the scope into his pocket and bending closer again percuss the lungs, tapping and listening over and around each lobe that embraces the heart.

As nurses we have permission to touch the patient, and time to be intimate. Washing, turning and tending the body are among our arts. They hold their place as skills alongside checking monitors and charting observations. Touch can comfort and bring safety, relaxation, even healing, and healing can pave the way to curing. Maybe nurses used touch more when we moved from bed to bed in the large open wards of long ago where patients saw and connected with the suffering of one another and were helped by that sharing. In our efforts to incorporate ‘individuality’ and privatization into every aspect of our lives, illness has become shuttered away in lonely single and semi-private rooms, where patients lie secreted and alone.

In Buenos Aires, I have had occasion to see a few physicians over the years I have visited. Nothing big, just mindful checking in and up. The office of Doctor Garavaglia, the General Practitioner, is typical of them all. His big desk faces out from the back wall and the two chairs sitting comfortably in front of it are inviting rather than intimidating. There are two bookcases holding literature as well as medical texts and a screen in the corner to give privacy for undressing and the examination couch if the patient should need it.

In each office, the visits begin with conversation, discussion about our mutual families, for that is but courtesy. Before Doctor Garavaglia asks what brought me to him, what he can do for me, he pulls out a card – no bigger than the old Kardex cards we once used. My name is written on the top, my passport and phone numbers also. And there, in cryptic hand, go a few notes. But then he puts down his pen, and listens as I talk, occasionally nudging me this way or that. For as he listens and watches me, how I talk is as meaningful to him as what I say. I speak of our daughter and he reaches into a drawer, pulls out her card and glances at it. In a moment he has her relevant history in his recall, which he – naturally – shares with me. When, a year later, I return he pulls my card from the same drawer. ‘Ah yes, I remember’ updates are made on the card, then it is put aside. ‘¿Cómo estás? Estas bien, verdad?’ He means it. It is good to see you. And we talk once more.

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