Lisa Rich

Lisa Rich attended the University of New Mexico and the University of Maryland where she received her bachelor’s social sciences. She is a Tillman Military Scholar and, prior to coming to Yale, worked with military families and homeless pregnant women. She is wife to a retired U.S. Marine and mother of four children, all of whom not only moved to Connecticut so she could follow her dream of becoming a certified nurse midwife, but also allow her to practice her physical exam techniques on them. She is forever grateful for their support. She will graduate from Yale School of Nursing in May 2018.

The Colon is Easier

“I held someone’s colon in a bucket today,” I tell my husband as we sit down to dinner. “I think the attending thought it would be funny to try and freak out the student nurse, so he asks me to stand there and hold a bucket. I had no idea what it was for until he starts yanking this guy’s colon out of a little hole in his abdomen and loading it in the bucket.”

“Did you freak out?” he asks.

“A little, but I didn’t show it,” I admit. We laugh. I don’t elaborate. This was my day. I held a colon in a bucket.

It is the easiest thing I can tell him. The most quantifiable. It was heavier than I thought it would be. I can’t really describe that I thought the color was the most beautiful shade of coral I had ever seen, glistening in the bright lights of the OR. That before this morning, the only time I had seen a colon was the dark, dead tissue of cadaver lab, which did no justice to this organ. This organ had been living, until seconds before, somewhat unhappily in the body of the man laying on the table, asleep and trusting virtual strangers to deliver him safely back to his life.

I realize I am omitting the larger part of my day, something I am doing with increasing frequency lately. I have been choosing one or two anecdotes to share—things that are safe and somewhat amusing in an attempt to keep these two worlds separate. I have one world, where the most important question is whether I will finally allow my tween daughter to dye the tips of her hair pink (“You can just cut them off if you hate them. I don’t see why it’s such a big deal!”). And then I have a second world where I see pressure ulcers and people with schizophrenia and broken legs who think I have kidnapped them so I can torture them. I haven’t figured out how to meld these two worlds together, or if I even want to. It doesn’t do to tell my three year old that I don’t feel like reading Where the Wild Things Are tonight because I can still smell my dying patient in my hair. It is easier to talk about a colon in a bucket and move on to pink hair dye than talk about the patients that come home with me. I don’t know if I could even tell my family that sometimes I lay awake at night and wonder if my patient is also laying awake in the hospital. I wonder if they’re hurting. If they’ve fallen. If they’re even still alive. I wonder how to learn to let go of these things. If there will come a time when this isn’t so new and I don’t even think about it anymore. I wonder if that ever happens if it will be a good thing.

Today I am talking about the bucket, but what I am really thinking about is the patient with liver cancer that has metastasized to the brain and lungs. How I came upstairs to find him restrained to his bed, naked and raving. The flash of annoyance at the wife of his roommate, sitting in a chair reading Oprah magazine and ignoring him. I schooled my face, but inside I wonder how she could just sit there and not call someone? I know this isn’t her job but I wonder how one human being can ignore another. The frail man I see before me is unclothed and spilling out of his bed. He is only saved from falling by the bands around his wrists which have been secured to the bed—there to keep him from pulling the tube out of his nose in his delirium. I don’t know how he’s managed it, but his gown is held on by the last closed snap and his arms are extended like some terrible, naked flightless bird. I already know his real nurse has four other patients and likely hasn’t had a chance to so much as pee since she came on shift, but I feel a stark sense of shame that he has been left like this.

I tell him who I am and pull him back up in the bed, trying to ease his breathing. I cover his genitals and start snapping his Johnny coat back up, talking all the time. I want him to know he isn’t alone. He grabs my hand. I look at him and say his name. He tells me, “Get me the fuck out of here.” It is the first lucid thing he has said in the ten minutes I have been in the room.

He kicks his covering off.

I put it back on.

He kicks it off. I sigh and pull his curtain. At least the hall doesn’t have to see his penis.

“Tell me about the boat,” he tells me.

“I don’t have a boat,” I say. I cover him again. He kicks it off.

“It’s blue, Sylvia. You love that boat.” He is crying.

“I’m not Sylvia,” I say. I wipe his face with a damp washcloth, getting the dried bits of mucus that have gathered at the edges of his mouth. I wipe away his tears. “I’m a student nurse.”

He grabs my hand again. “Get me the fuck out of here, Sylvie. We can go on the boat.”

I keep his hand in mine. “It’s a beautiful blue, that boat,” I say, sitting down. I stroke his hand with my thumb.

“Yes.” He says, relaxing. He’s closing his eyes, going to sleep. I cover him again. I see the outline of the roommate’s wife, still reading her magazine, and I can feel the tears pricking at the corners of my eyes. Frustrated with myself, I sit and wait, holding his hand. It isn’t long until the real Sylvie comes.

By dinner that night, I can’t talk about the blue boat. The colon is easier.