Friday, 29 May 2009

Eye Lash

I was waiting at the bus stop this morning as usual. The bus service not seemingly beholden to reduce waiting times unlike the targets we toil under. It being Summer, my cardy was a touch excess to requirements, so I took it off. No matter the temperature, I always don it to leave the house. The pockets are invaluable, since I don’t carry a bag. That’s just common sense, given the amount of things which go walkabout in a hospital. From drugs, through unattached prosthetic limbs, to administrators trying to look purposeful.

Laying eyes on the uniform beneath, the expressions of my fellow commuters gathered under the shelter, instantly soften. A young woman, (a model ?), smiled at me (there for but the grace ...?) A teenaged boy stopped scowling in my direction and busied himself experimenting with the acuteness of angle with which he could tilt his tip-up seat, without it unsaddling him. A besuited executive nodded sharply in my direction, before twisting his wrist to consult his watch and then contorting his head to adapt to the now crazy splay of his tabloided ex-broadsheet newspaper. A wrinkled lady clasped my wrist with both of her gnarled hands and genuflected our trinity over her heart. As she thanked me profusely for some procedural care my peers had bestowed upon someone late of hers.

I have, on more than one occasion, been cooed at. In the chaste way one might delight at stranger’s a baby. In fact, I’m intrigued as to the possible outcome of a full bus stop beauty pageant. Me and a mother with her wisp of a cherub and let’s see which angel rings up more of the public’s appreciative sighs. But I don’t want you to think I’m blowing my own trumpet. There has to date been no such convergence, not without a stiff breeze or slanting rain, that for all the overhang of the bus shelter, has witnessed me vain enough to peel off for the full effect of the uniform fob watch and all.

I know I can veer towards the cynical side. And a touch hard-hearted to boot. Indeed that is part and parcel of the job, as we cannot afford to get too close to the patients. Yet I have to concede that my spirit skips when I induce such reactions. This is who I am and this is what I do. I help people. I am an angel, in a modest ministering way. It is still the most virtuous of callings.

But on setting one foot across the threshold into work, all that goodwill and approbation evaporates. Unfailingly my wings are stripped from me. Presumably impaled on Nicks’ pronged gate. Certainly checked in at the door and no reclaim ticket ever proffered in return. Instead I am supposed to sprout multi-armed limbs akin to a Hindu deity. Juggling innumerable tasks, while navigating a razor thin high wire of courtesy. Within these walls, an improbable re-enactment of Florence Nightingale’s Crimean battlefields, somehow, I am expected to demonstrate an adept femaleness. Professional in the honed performance of my tasks, feminine in my demeanour as I execute them. A dispassionate compassion if you could possibly conceive of such a thing. Oozing care and concern from my manner and detachment from every pore stopped up behind my uniformed body. It never used to present a problem straddling two such carriages.

However, in this day and age, folk are fully acquainted with what hospitals are for. No more are they foreboding places in which to creep off, in order quietly to die. To cordon off the sick from the sight of the robustly healthy. (Though MRSA and the other superbugs are pulling out all the stops to return them to their former infamy). Broadly though, the wonders of science and modern technology mean that the overarching expectation, is to be healed. Set upright once again and delivered back into life for a longer haul. Our mortal lodgers are all fully aware that there is no afterlife, but are confident in medicine’s magical ability to postpone termination til the absolute end of the line. Failure isn’t permissable. Human error can only ever be extrinsic. Budget shortcomings do not add up. Increasingly adaptive immunity of the viral foe are aberrations. Bureaucratic and therefore actionable slips ups.

None of this blind trust meshes with the intial experience of admission into a ward. The infected, the sallow, the unsound and the valetudinarians, each enter hospital alone with their pain. A pain emanating from some nether place. An intimation of their enduring fragility, whatever the textbook prognosis for their present condition. I am the first intercessor between them and this pain. Before the doctors even. I take their temperature, blood pressure, sequester urine from them. I grip their wrists for a pulse, rather than hold their hand as their eyes beseech me. More than likely I will draw blood and insert a cannula under their skin. Even with their implicit consent, I cannot deny that these procedures constitute an inundation upon them. Already lying prone, subject to the dreads working away at them, now their integral boundaries are being breached. Though this is hardly a rupture of professional etiquette. Nor could it remotely be construed as an assault.

Yet for some, they choose to avenge this perceived violation and wrest a modicum of control back for themselves. They try to draw off their pain and smear me with it. As the looming soft target of the regime that confines them. They perceive pain to be catchable. They are after spreading the contagion, so that they do not have to suffer alone. That they may diffuse it among other hosts. They grab my wrist and not to gauge my pulse either. That slap or pinch was no somatic reflex, since I wasn’t engaged in any manner of procedural contact with them at that point. They seize any forcible means, by which they can attach a fleshy trocar from them to me. It ought to be a question of open trust. I assume I will be permitted to carry out my duties and consequently they can rely on receiving consummate care. Any breach of this trust, always arises through some action from just the one side of our compact.

If that wasn’t bad enough, for some malignant bodies, our initial binding develops further into a rather more internecine linkage. Doctors are the true omnipotent beings, attired head to toe in numinous white. Bringing forth their clipboard tablets of judgement over life and death (which we’ve partly inscribed I hasten to add). The supplicants cannot lash out at them, since they represent their sole opportunity of being healed. They have to stay on the right side of them. That leaves open their sinister side, where we angels can be found hovering. Enlisted to your cause to conduct your soul with dignity through its physical tribulations. A messenger to lift your spirits and to help you emerge the other side of your agonies. But to you the unbeliever, the doubting Thomas, we are the fair sex game. You destroy any divine powers of mercy with your apostasy. In doing so, you reduce us to brute matter messengers. Well then I have to tell you the message borne by me, is that there’s scarce any dignity concerning the human body. It is rotten and corrupt. A capital betrayer and that’s what my weak servility seems to reacquaint you with. Consequently in my presence, they resist allowing themselves to succumb to their attenuated condition. Disdain displaying their vulnerability. So they may smite me a second time. As a marker of their impregnability. I am present to assist in preserving life within their miserable, flawed frame. Yet they recoil and try to snuff it out in me. To devivify me. To douse my spark.

I will not stand for such evisceration. I won’t turn the other cheek as I lean in close to swab them or take their temperature. There are none I can appeal to for protection, no matter how black and blue in the face. The managers are too squeamish about their litigious customers to risk inflaming them. The Sisters are straight off the Crimean battleground and hold that we must demonstrate the same unflinching military discipline and not break rank. As for my Union, that upholder of all things enshrined as inalienable, unfortunately I appear also to have blotted my copybook with them. I insisted they fight my corner on the right to continue to wear long-sleeved blouses, rather than the tunic and trouser ensemble the management were after making mandatory. I constructed what I considered to be an unimpeachable counter argument. How they ought to be agitating for the new clothes budget to be spent on extra dresses, so that we weren’t all rendered Typhoid Marys for the want of spare uniforms to change into. Or alternatively, to provide a decent staff laundry service. But that was just too ward floor for them to dirty their hands with. C’est très difficile, cette C difficile. My persistence saw me triumph personally through a grant of special exemption. But they weren’t terribly forgiving, when I queried whether the rest of them were content to resemble dental technicians.

So, I steadfastly refuse to become a bruised-kidney receptacle for patients’ drained pus. A disposable punchbag for their septic workouts. Your body has let you down, but not half as badly as your self-restraint. You labour after seeing authenticated empathy writ large across my face, but you’re going diametrically the wrong way about attaining it. You might look to displace your suffering on to me. But that only makes me care so much less for yours. As actually might seek to increase it.

I am a mere nurse rather than a physician. Yet when you profane my body, then I am empowered to make a diagnosis of your moral degeneracy. I will prick any swollen pride and homeopathically medicate you back to where you ought to be. Flat on your backs, spreadeagled before the altar of affliction. I proscribe you a dose of realism, wielding my syringe like a surgeon wields his scalpel. No, make that his endoscope. As I redraw your focus back to the case in hand, your failing self. Honour our mutual contract of nurse and patient, then I will be present, available, attentive and focused on you. Rather than skulk behind the technology that ordinarily keeps you at arm’s length and out of the picture. You intrude upon that gap however and I will use that technology to reinstate the chasm. Professional and feminine. Eat your heart out Florence ! This endeavour you’ve charged me with, has wholly consumed mine.

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