Thursday, October 5, 2017

toward the mess

ICU nurses are often counseled to “detach” from what’s going on around us, because no one – and I mean no one – should see what we see. The realities are too dark, and so we throw up the wall around ourselves as protection from the all of the too-real-things. But not long ago I decided to stop throwing up the wall. I’m ashamed to say that it’s almost 17 years into my career, but it’s my new therapy – for myself, for those who learn from me, and for my patients and their families.
This idea came out of an experience I had with a patient…I couldn’t keep my heart from venturing in deep, and so mid-way through this person’s ICU stay I just committed to running toward their mess. I asked questions about how they really felt, I asked their family what this experience was like and how they were doing, I visited briefly on days that this person wasn’t my patient. I worried about them when I wasn’t working. I advocated for them as I would for anyone, but behind that there was an urgency – because I cared so much.
I was there for times when they could have died, when they were afraid because they knew how grave things were. I was there for moments of relief, when time was bought. I was there for THE moment of triumph, when the knight on a white horse arrived to save the day – and I saw cups of joy overflow. I was there to see them leave intensive care…I saw the exhausted but content eyes of someone who had made it, and the pride of their family who made it too.
In practice this is probably the scariest thing I’ve ever done at work. To allow my heart to get involved means that I risk grief over and over again, and that there will most definitely be hurt and worry and emotional fatigue. But on the flip side of that possibility is also depth of relationship that could never happen if I wasn’t vulnerable and open to the possibility of loss. True empathy comes with an insane amount of risk, and people respond to those who will take it. In an instant, vulnerability can create a new trust and openness that would never happen through professionalism.
I am afraid if I continue running toward messes at work that I will suffer loss. It is a certainty – probably more often than not. But instead of the wall, instead of pretending away the too-real-things, I am willing to stay connected so that someone else can know they aren’t alone. I will ask questions about the elephants in the room…about death and dying and fear and loss. I will ask people how they are really doing inside themselves, and listen to the answer. I will wholeheartedly celebrate the wins.
I think of this now when I'm out and about. I find myself asking people more and more if they're ok, or if they need help...I find myself looking more people in the eye as if to say "I see you" - because they are someone who needs to be seen. We all long to be known and to have our needs met - and one way that we can meet the needs of others, and even to stop this vicious cultural disease we are seeing, is to run toward messes instead of throwing up the wall.
"To love at all is to be vulnerable. Love anything and your heart will be wrung and possibly broken. If you want to make sure of keeping it intact you must give it to no one, not even an animal. Wrap it carefully round with hobbies and little luxuries; avoid all entanglements. Lock it up safe in the casket or coffin of your selfishness. But in that casket, safe, dark, motionless, airless, it will change. It will not be broken; it will become unbreakable, impenetrable, irredeemable. To love is to be vulnerable.”
― C.S. Lewis

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