Brie Gowen

Savor the Essence of Life

PTSD in Nursing

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Last night my family and I drove to pickup dinner. I had asked my husband if he still felt uncomfortable taking our young daughters into a public restaurant, and he had been quick to say, “yeah, I don’t want to do that.”

The numbers had gone down, but that did little to change the routine we had carried since April. I’m very honest with my spouse about my work, and as such, he suffered from the same problem I did. We knew too much. There was no way in hell we could be blissfully ignorant, and I don’t mean that offensively. I truly wish I could forget this year.

As we pulled up to the restaurant to get our curbside pickup I noticed the large group of people sitting outdoors. The tables weren’t spaced like they had been just a month prior, and people milled about inches from other groups, laughing, smiling, not a mask in sight.

“That doesn’t look like continued social distancing to me,” I said to my spouse, pointing towards the outdoor dining.

The thing was, I didn’t want to be the social distancing police! I didn’t want to see pictures of church gatherings on Facebook and wonder why no one wore a mask. I didn’t want to cringe at friends starting to gather again, throw parties, and enjoy life. I didn’t want to be wary of strangers. I didn’t want to worry about my daughters drifting over to play with some new kids at the pool. I wanted everything the way it used to be, but I couldn’t for the life of me forget the past four months. I just couldn’t.

For nurses and other healthcare professionals who have been in hotspot areas of the COVID-19 pandemic, I think we’ve received injuries that are invisible. We’re nursing wounds no one can see, and the scars we carry are still raised and angry. So while a large part of society has basically forgotten a pandemic was here, nurses are still trying to catch their breath.

I think of a skittish cat, jumping with shackles raised at every tiny sound. I think of someone who has been abused, how they’re always suspicious for when the next hand will be raised to harm them. It wasn’t fear that griped me, but rather an awareness of what the virus could do. For so many people COVID-19 was like a really bad cold, or maybe the flu, but for the hundreds of patients I had seen in an inpatient, critical care setting, it was a death sentence. All that people with no hands-on experience could say about the virus was that its mortality rate wasn’t that high, but you know who I never heard say that? Those of us at the bedside the past four months, sweating profusely in our respirators, while we pumped aggressively on someone’s chest to help their heart restart. The reason you didn’t hear that from us? Because 90% (or more) of those patients did not live. Last I knew, our hospital had tried to save over 200 people, without success. We did everything humanly possible. The virus is that bad. For the families of those two hundred and something lost, statistics for survival rate meant very little. For those of us who had cared for them, it meant even less.

So, here we are with case numbers declining, but I still don’t feel comfortable allowing my children to go to a restaurant or play with other kids in the neighborhood. To me, it’s life and death, and until someone can tell me what makes one person just get a scratchy throat, and the next guy (with similar age and health) be unable to survive, I must remain the way I am. I cannot help it. My poor husband, who has seen my defeat amidst so much death, he cannot help it either. We’re still over here self-isolating, wearing masks in public, and social distancing when we do get out.

Today my husband said, “I hope they’re wrong. I mean, it doesn’t have to get bad again, right?!”

You see, the healthcare field, based on their knowledge and models, has their own predictions for the next few months. Those of us knee-deep in the muck of this novel virus are like the skittish cat I mentioned. We’re waiting for flu season 2020. It will be like the two tropical storms converging, but when COVID couples with flu, it will be a level 5 we fear. I don’t want to listen to projections, but I try to be realistic.

Y’all, I don’t know if it will ever be the same. I don’t know if I will ever be the same. I’m so aware of germ transmission at this point, I’m surprised the skin on my hands isn’t falling off from hand sanitizer and washing them. Today I let my daughters play with two little girls at the public pool. Then I spent the next twenty minutes praying silently for God’s hedge of protection around them, worried I had made the wrong decision. I don’t want to be that mom, but I’m that nurse. I just can’t seem to be any other way.

I’m not alone, y’all. I cannot unsee the frightened look in a patient’s eyes before we stuck a breathing tube down his throat. I cannot forget the fact that although I wanted him to live, he didn’t. I can’t erase the images of the handful of critical care patients who did leave my floor alive, but did so forty pounds lighter, unable to do the things they had done prior to being a COVID survivor, some with holes in their neck to keep breathing. I think back to when I was active duty military after 9/11. At some point, as we continued to receive soldiers from The War on Terror, I grew so very tired of seeing young men (boys, really) with only one limb remaining, or their face mangled. I just wanted the war to end. I think your civilian healthcare workers of 2020 are feeling much the same. We’re tired, we’re anxious, and we’re depressed. We’re overly protective of our families, but we’re also happy to be alive. We’re in need of a break, and even though the case numbers are on the downtrend for now, we don’t really believe the end is even close. We can’t catch a break, and our patients can’t catch their breath. It’s an ugly scene for bedside nursing, and so many of us will never be the same.

When you say your prayers tonight, try and remember your frontline workers. We feel like we’ve been forgotten. And although we’d keep doing what we do even without accolades or good vibes, I personally covet your prayers for my team. This year has been traumatic, and I don’t think it’s something we can ever forget.

Is There a Thorn in Your Flesh?

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I’m going to be very transparent here. Naturally, that’s the only way I know to be. See, the past couple of months have been, not that great. In fact, at moments over the past month, they’ve been just plain awful. So many people look upon the things I write and perhaps assume my life is a Mary Poppins, practically perfect journey, but they would be mistaken. Even joy-filled women, victorious in Christ, suffer. I have been in a time of suffering, in the valley of the shadow of death, in a season of mourning. The worst part? I couldn’t pinpoint the reason for my grief.

Over the past couple of months I’ve found my mood declining, and the reason not easily discovered. I blamed some of it on the dreaded hormones. Since turning forty my body had begun a cruel roller coaster ride of emotional surges, and despite a couple of different medicines prescribed by my doctor to try and level things out, it had continued its ups and downs. Forgive the TMI, but I had actually been on my menstral cycle for five weeks straight recently. It was at that point I felt like I hit a rock bottom of my emotional well.

I know the mental and emotional discomfort I have been under has been the same for many people. Isolation, financial loss, and sickness have spanned the globe. As a nurse I’ve experienced the harsh work of dealing with a pandemic and the pain of being helpless to save the many lives we’ve lost. As a mother I’ve experienced the challenges of keeping children at home for extended periods, and as a working mom I’ve tried to maneuver through my daughters’ worry over me working in such close proximity to a sometimes deadly virus. I guess I say all that to get across that a downtrodden mood isn’t exactly unexpected, but that somehow doesn’t make it feel any better.

As a Christian I know I’m not immune to anxiety and depression, but I’d be lying if I said it didn’t bother me that it’s hit me so hard lately. You see, I know that this world is not my home. I understand that Jesus is in me, and I am in Him, and we are seated with the Father in Heavenly places. Just recently as I prayed for His help I saw a vision of Jesus and me walking together in a field of grain. There was such peace in that moment. And I suppose knowing that this world is temporal and finite still couldn’t seem to remove me from the grip of hopelessness that tried to take me. That bothered me.

I was praying about it one day and Paul came to my mind.

1 Corinthians 12:7-10 Therefore, in order to keep me from becoming conceited, I was given a thorn in my flesh, a messenger of Satan, to torment me. 8 Three times I pleaded with the Lord to take it away from me. 9 But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me. 10 That is why, for Christ’s sake, I delight in weaknesses, in insults, in hardships, in persecutions, in difficulties. For when I am weak, then I am strong.

I didn’t know if depression was Paul’s thorn, but it certainly seemed to be mine. I know that many mornings recently I would wake up feeling so sad. My life is amazing, my family is wonderful, and on an off day of relaxing I certainly had no reason for a feeling of hopelessness. All I knew was that in those feelings I had to be extremely intentional to remove myself from them. Or rather, I knew I couldn’t extract myself, but I knew who could. And in those feelings of melancholy I would seek the Lord in earnest. In fact, I have never sought Him so hard as I have since April. I have never experienced the Holy Spirit so strongly as I have this year. So while 2020 has been terrible, it’s also been a blessing. In the mess I’ve discovered Jesus more deeply. In feelings of helplessness I’ve found my hope can only be in Him. I mean, this world sure ain’t helping.

The Lord has been speaking so much to us personally, and we are on the edge of a major stepping out. As we prepare to move forward in what God has for us, we have felt the resistance from the enemy. My husband, a man who has never been prone to depression, has also recently experienced the downtrodden mood that has no physical cause. We’ve been partaking in communion in our home, and that helped tremendously. The girls have been experiencing headaches, tummy aches, and trouble falling asleep the past few weeks, and this too isn’t normal. We recognize the attacks we are under, and again it has us clinging all the more closely to Jesus. But please, if you think of it, cover us with prayer frequently.

I don’t know what the future holds, but I do know who holds it. I do know who holds me, who holds my family. I do know that when feelings of hopelessness come, they are a lie, and I know where my hope is found. I suppose the past few months have been an exercise in this battle for truth, and thankfully I do not fight this battle alone. For now, my thorn remains, but like Paul, I can delight in a weakness that causes me to more desperately draw from His strength.

A Window Into COVID Critical Care

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My eyes ached. You know that gritty, raw feeling, like you’ve been crying razor blades or something? That’s what it felt like. I made an extra effort to focus on the freeway lines that zoomed by as I drove towards my safe place. Home. That’s where I could forget my day, where I could escape, leaving the sadness and stress sitting in the seat of my car, ready to be picked up again in the morning.

I had told my coworker that afternoon that it felt like 10 pm. My eyes had been hurting then, at what surprisingly was only four o’clock. I had assumed it was because of the tears. Now that I think about it, though, it was probably just the weariness of what I had seen. Not just that day, but every day for months. It was like being witness to a horrible car crash, and being unable to extract the victims. Except the wreck never ended. You relived it every day. I realized my eyes hurt from watching that repeated carnage. I wasn’t sure I’d be able to unsee it.

There is a weight sitting heavy on the heart of healthcare right now. From a critical care point of view, it feels like the dreaded elephant on your chest. It’s this heaviness brought on by unspent grief, coupled with a frantic frustration over the things we cannot change. You see, COVID-19 has brought us something we’re not used to or comfortable with. Defeat. It’s beating us, pretty much every time.

The world, and certainly the United States, has experienced the unparalleled effects of this novel virus. We’ve all experienced the shutdown, the isolation, and the economic loss. What a large percentage of people, outside of the healthcare system, are not seeing is the wicked behavior of this disease. They don’t see the cruel nature by which it attacks, making certain that stories of survival are few and far between for those poor people who happen to fall into respiratory distress under its grip. Y’all, it just won’t let the people go.

Here it is in a nutshell. Because we’ve shut the hospital doors and won’t allow you in. Here is a window into COVID Critical Care.

Death. Over and over. It does not matter what we do, or what we don’t do. It doesn’t matter if we follow every recommendation, give every medicine, and check every single box. Nine times out of ten, if you end up on a ventilator with COVID-19, you are not coming off until your heart stops. That is why my eyes hurt.

You can see your patient turn the corner, start looking better, wean down the oxygen from 100%, finally. You can say to the spouse something you try not to say lately, like, “I’m hopeful. Things are looking better. I’m very optimistic about this.”

You can say those things one week, a few weeks into the particular ordeal, and you can want to believe it in your heart so desperately, but then you can have your hand on that same spouse the following week, praying for comfort while they cry, holding them while they weep in grief because your hope just didn’t pan out. That is why our eyes ache. You cannot unsee some things. Some pain etches itself into your retinas.

Listen, we knew what we were getting into with nursing and medicine. We knew that death and dying occur. We’ve dealt with this our entire careers, some of us for twenty or thirty years. What we were not prepared for was constant death. See, in nursing you win some and you lose some. But you win some! Do you see where I’m going? We’re used to having some good news to throw into the mix, but this pandemic hasn’t been playing by the usual rules. It has its own book, and sadly that manual is still being written. As it stands now, and since this began, the odds are not in our favor. The real Hunger Games are worse than you ever saw on TV.

We are fighting, y’all. We are doing all the things we do so well. There are many times over the years that I’ve been part in successfully reviving and continuing the life of someone who probably should have been allowed to pass on to the hereafter. In those moments I have said, “we are too good at what we do.” Well, this year has upended that statement. This year, we can’t seem to be good enough. We can fight, and we can do all the great things we normally do, but nothing can seem to alter the poor outcomes of critically ill COVID-19 patients. It. Is. Killing. Us. All of us. It is breaking our hearts, but it hasn’t stopped, so we just keep fighting.

You can watch a patient you’ve personally fought for, die every shift, every day, and it’s draining. Sometimes it’s more, sometimes it’s less. I don’t know the numbers, but I know how it feels. It sucks. Where’s some good news?!

I can count the success stories, on one hand, and I’m so very grateful for them. But they’re not enough. The bad is still outweighing the good in intensive care. Even when you do have someone get wheeled out the door, they’re not the same. The effects of this continue, and we don’t even know to what extent yet. I’m not a negative or fearful person, but gosh, that’s scary. The significant and lasting damage to lung tissue is real, and it’s crazy. We won’t even talk about the other physical and emotional tolls.

Our eyes hurt from the things we cannot unsee, from the tears we sometimes cannot stop. Our hearts hurt for the grieving families, for the pain of our patients and their loved ones. Our brains ache from trying to understand the vast variations of presentation and progression of this virus, and our minds are blown by the damage it can do. This virus is cruel, it’s uncertain, and it’s unlike anything we have seen. We have worked beyond what we believed we were capable of doing. We have carried ourselves to physical points we have never experienced before, but also emotional roller coaster rides we never anticipated. So, while the Nation at large is angry to watch football and not be made to wear masks, we’re just over here trying to survive. We’re just over here trying to make our patients survive, even as we know that statistically they will not.

The Side Effects Nurses Are Having From COVID-19

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I fell asleep the other night feeling so beaten down and defeated. I had tried to scroll mindlessly through my Facebook newsfeed before bed as I used to do to decompress after a long, thirteen hour shift at the critical care bedside, but it had only succeeded in making me more upset. I wasn’t even mad about the ridiculous post I had seen shared by a friend claiming coronavirus was a “Democratic hoax.” It would have made me mad back in April, when I knew this thing I fought was really real, but at this point, as numbers climbed even faster than I had imagined they would, I was just tired. I had erased the very true comments I had written on the aforementioned post, and I had fallen asleep knowing that was just one more thing I had no control over.

I had zero control over the public’s perception of this virus, and even though I had intimate details of what Covid was really like, it didn’t matter. I could change opinions about this about as much as I could about mushrooms being gross. The fact was a lot of people really liked mushrooms, and I had zero chance of making any of those folks agree with me that they were slippery and weird. Touché. I guess what ground my gears was having an appetite for fungi was a matter of preference, but in my book COVID-19 was as sure as the button nose on my masked face. For me, standing in the muck of this mess, it was not debatable.

And so I drifted asleep feeling bummed that public perception was just one more thing I couldn’t control. This concern toppled over the crown of a hundred other uncontrollable factors I held as a nurse during a pandemic. My healthcare peers and I faced a novel virus, new to us all, and we swam through the treacherous waters together. Initially, much fanfare and support had followed the medical community as we stood bravely against this foe. But now? Not so much. Nurses were no longer the darlings of the working world. We were lumped in with all the other exaggerators, seemingly wringing our hands for a bug that experts on social media described as “basically the flu.” I mean, you can’t applaud someone who combats a fake virus.

The thing was/is, I didn’t need applause. But I did desire someone to take our words for it. Instead it seemed a large part of public opinion favored the advice of YouTubers or folks with one-lettered names like ‘Q.’ I couldn’t tell if people were so scared they convinced themselves it was fake, so distracted by the conspiracy theories that they truly believed it was all a political ploy, or so dense that they didn’t care. After all, I had even seen some people in nonclinical healthcare suggest we all go out and catch it.

Just the day prior I had heard such an idea of herd immunity, and while I understood the general premise and points, I could only reply, “I still can’t figure out what makes you the type of person who this affects like a mild case of the flu versus the people whose lungs are attacked and die. Until they figure that out, I don’t want to roll the dice with my family.”

See, that’s the burden bedside nursing carries. The physicians, respiratory therapists, and nurse aids in the trenches too. We all see what it can and does do to a person. Young, old, healthy, sick. Doesn’t matter. It will kill anybody it so desires. We wish we could end this crap already too, but we’re too personally involved with corona to play roulette.

I see people protesting being required to wear a mask in public places. Meanwhile, I’m triple checking the seal on my respirator to make sure I don’t take this virus home to my family. I see people griping about wearing it for a thirty minute shopping trip. Meanwhile I fall asleep with my nose still feeling numb from the pressure of a mask for thirteen hours straight.

The next morning when I arrived at work, all prayed up, and mostly rested up, almost immediately someone asked me what was wrong. You see, I’m the singing nurse, the smiling nurse, the uplifting one who always lightens dark moods. So when I’m not exuding those things, it’s noticeable. After a second person asked, I realized I was suffering from the side effects of a pandemic. No, I wasn’t sick with a virus, but I was sick with the emotional, physical, and mental toil of the virus. You can only exist in so much uncertainty, sickness, and sadness before you succumb.

I thought of the patient who breathlessly called family to say quickly, “well, they’re putting me to sleep for a while. Talk to you soon.”

The memory left my heart hurting, and I recalled how at the time my eyes had met those of a coworker, both of us hoping that was true, but knowing that statistically and according to gut feeling, the patient likely would not wake up again. And that’s the biggest battle we face. That was what kept us awake at night. That’s what might create future PTSD for many, and it’s what made my spirit feel so heavy since this had begun. The rising case numbers, incidents, and COVID admissions only worsened an already aching heart. It was the thing we wanted to control the most, but the one thing that sadly we could not. No matter how hard we tried. People were dying, a lot of them, and for those accustomed to healing, this bitter pill was especially hard to swallow.

The side effects to COVID-19 on healthcare workers are multifaceted. They’re not just placing their physical bodies at risk, or even that of their families. They are also investing their hearts. The emotional and mental toil cannot be imagined unless you have faced it head on personally. I am a veteran, and I don’t use this term loosely, but I do consider this a battlefield of sorts. Nursing is fighting a war, one they feel they are losing, both at the bedside and in the court of public opinion. We’ve got battle scars already. I can’t imagine how it will feel down the road.

So, if you see a nurse, please cut them some slack. If they’re sharing about the benefits of social distancing, hand hygiene, or wearing a mask, realize it’s because they care. They’re not pushing any hidden agenda, playing politics, or even in on the “government hoax.” The fact is, we’ve seen far too much death already, we anticipate to see much more, and we want to prevent that if at all possible. There’s so much with this pandemic we cannot control, but maybe we can help save a life.

And for goodness sake, stop trying to convince us it’s not a big deal or as bad as the media says! I don’t even watch the news. But I do believe what my eyes tell me. And right now, sometimes through tears, they tell me we have to work together to stop this thing. Please.

If My Mother Was Still Alive

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If my mother was still alive she’d be turning sixty-five years old today. As a middle aged woman of forty-two, myself, that seems so young. Since I’ve started living an RV lifestyle I am surrounded by men and women decades older, who are full of life and vigor. It doesn’t seem fair sometimes that a woman who loved life so much is gone. It doesn’t seem right that a lady who desired grandchildren so intensely passed away before she met even one of (now) seven grandkids. Most of the time, I just try not to think about it.

Have you ever had someone in your life become someone else? What I mean is, they change. One day you’re close, the next day, not so much. It’s usually some huge event that fosters change, but sometimes, I guess, people just evolve. They become someone new, and that someone doesn’t fit into your life anymore. It’s almost like they died, like they dropped off the face of the earth. Or even if you do speak, it seems like such a foreign conversation.

You ask yourself, who is this person?!

It’s happened to me before. Someone I love dearly moves on to a new life, with new friends, new hobbies, new interests, and it feels like the person I once held so dear is no more. Except for the moments.

I’ve discovered, in my own personal experience that you are sometimes given glimpses, or precious moments of time where the old personality of your friend or loved one emerges, even if just briefly. Just such a moment occurred for me recently, and afterwards I joyfully shared it with my spouse.

“Do you know what I wouldn’t give to have a moment like that with Mom?” I asked my husband.

As we spoke I explained to my husband that while it could make me sad to lose a relationship through distance or time, that when it was reunited it was even sweeter than before. Though the relationship I had once known was gone, those spectacular glimpses into our prior connection were a treasure. And though they were far and few in-between, they still were wonderful. Like a breath of a sweet fragrance your memory had locked away for safe keeping.

If my mother was still alive today I would cherish each second with her for the fleeting time it was. Because now I realize that even one, five minute, phone conversation would be like Christmas morning. Even one hug, one glimpse of her smile, one sound of her raucous laughter, that would be the biggest thing for me. One small encounter would mean the world. One smell of her perfume, one minute of advice, one session with her gentle, listening ear. What I wouldn’t do for that one moment of time!

I wish I could buy her a birthday card today, but even more, that I could watch her read it. I would scour the card aisle, reading every one, and even then I know it wouldn’t get close to conveying how much I loved her, missed her, needed to see her face. But I sure would love the opportunity to try and see.

I wish she could meet the girls. I would let them visit whenever she asked, and I wouldn’t complain when she spoiled them! I’d laugh about how ridiculous they acted when they came back home hopped up on sugar and leniency. I promise I would.

I would listen to her say, “you did that exact thing when you were little!”

In fact, I yearn to hear her say that. After all, she was the only one who knew those things.

Did I learn to crawl first or cruise?

Was I easy to potty train?

Surely I wasn’t as persistent as my second child is, or as independent as the third!

What do you think, Mom?

I think that if my Mom was still alive I could finally pick up the phone and tell her what’s on my mind, instead of intending to call for a split second, before sadly remembering I cannot.

I would ask her advice. I would share how wonderful life has gotten over the last ten years, even though she hasn’t been a part of it, and I’d let her know that’s the only piece missing. Her.

As it stands, I long for forever, to not have to wish for mere moments, but to enjoy timeless togetherness. For that will be a fine day indeed. But until that day I’ll enjoy every morsel of each one that exists for me here on earth. I’ll savor the moments that pass too quickly and fade into memories before your very eyes. I’ll enjoy every smile, every laugh, each and every one. I’ll cherish my relationships, my family, and all the in between.

I Cried About a Patient Today

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The day was over. A long shift had finally ended and I gathered together my belongings for the brief trip back home to sleep before returning tomorrow. I smiled at thoughts of my children. My six year old daughter had learned to ride her bicycle without training wheels, and though I had missed the momentous event in person, my spouse had been good enough to capture video evidence for me. I looked forward to dinner together, even though I knew I’d be exhausted and ready for bed. The idea of a hot supper and quick sitcom before snoozing made me smile again, but then I didn’t. Because I thought about my day. I don’t guess I had really thought about it. I hadn’t allowed such a thing. You couldn’t.

As I stood behind closed doors, the bathroom door and break room between me and the patient care world, tears began to well in my eyes.

The horror of it.

I swallowed hard trying to dislodge the lump of emotion that had taken up residence in my throat, but that exercise was as futile as trying to will the tears not to flow down my cheeks. The emotional heaviness of such a horrible happening for my patient had left me deflated. I hadn’t realized it before. I couldn’t.

And as the empathetic emotions reared their ugly head, the raw tears streaked my face in frustration. I couldn’t change my patient’s circumstances anymore than I could have prevented the befalling of such tragedy, for the patient and their family. I wiped a stray tear away. It had snuck up on me, this emotional outpouring. I hadn’t felt it all day while I was in the thick of the awful. I hadn’t. I couldn’t. That’s not how it worked.

Nurses see a lot of pain, their beyond, fair share of heartache, but also occurrences so terrible that words can’t even begin to describe. You wouldn’t know it by their face, though. In death, work continues. In patients’ and families’ grief, condolences and support are given, but efficiently. To some it might even appear aloof. It’s not that.

We feel pain. We know pain. We know it so intimately that we wish we didn’t. We have held hands, heard prayers, and passed out Kleenex more than you can imagine. We’ve held shaking daughters who never got to tell mom goodbye, and we’ve picked up inconsolable mothers off the floor when their only son passes suddenly. We know pain.

We’ve stood there silently, back against the wall, hands wringing behind us, silently praying while the physician delivers the news no parent of a toddler wants to hear. Cancer. We’ve made the long walk down the hall to the waiting room. The one where the family all look up at the sound of the door, like a group of deer caught in the headlights. We hope our face doesn’t betray the sentence the surgeon is going to have to say.

Your dad didn’t make it out of surgery.

We watch your pain, we see your tears, we hold you up so you don’t hit the floor. But our tears seldom fall. They don’t. They can’t.

Not yet.

As I stood in the private bathroom I allowed my tears to fall, tears that had been there for thirteen hours, tears that I had hidden so well, they were hidden even from myself. I let them fall, I felt the pain of the horrible things my patient had experienced, and my heart broke for my patient. I suppose it had been breaking all day; I had just been to busy to allow it to surface.

It wasn’t that we didn’t feel. It wasn’t that we didn’t care. I think, in my own personal experience, it’s that we care so much. We care so much that we keep our own emotions in check. We do this so that our patient can have all of our effectiveness and thorough care. Yes, we empathize. And yes, we support their turmoil. Our turmoil, though, it stays below the surface. The thing is, we’ve seen so much pain, year after year, that if we let in the fullness of the whole lot, we’d crumble. It’s not just understaffing or overworking that leads to burnout. Sometimes you can only hold so much pain before you must step aside. With this in mind, we have a bit of a fence in place.

We joke, some often times inappropriately. We laugh, we sing, maybe we seem distracted or detached. But maybe that’s just how we cope. It’s how we cope with the pain, the grief, the patients who cause their own demise. It’s how we hold all the awful within without toppling over. Although, sometimes we spill over. We spill over the hot tears behind closed doors. You can only hold so much behind a fence, even if it’s built for your own protection.

I cried about a patient today. I know I will cry again. Maybe not tomorrow, the next day, or even the following week. But I will. I’ll cry, and I’ll probably do it when they can’t see me. You see, when they’re looking at me, I’m too busy looking at them, ready to help with their tears. That’s just how it is, and how it has to be.

What You Can’t Anticipate About Nursing

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I enlisted in the military a year before 9/11, and after that day that I watched the second plane crash into the South WTC Tower things changed. It didn’t take long for our country to spring into action, and before I knew it my base was announcing a deployment to Iraq. I wasn’t naive, exactly. I knew when I joined the military that war could happen, but I suppose I just wasn’t ready for it when it came around. I mean, I was proud to serve my country, and I had every intention of doing whatever my service required, but I was scared.

I remember calling my mom and dad on the phone and crying, “I don’t want to die.”

Some things you’re just not ready for, I guess. You can train, prepare, psych yourself, get motivated, or whatever. You can listen to the stories of those who have gone before you, hear the concerns of well-meaning family and friends, and be certain that you are prepared for the worst that can be thrown your way, but then when your number gets called, you’re stunned. When the crap hits the fan, you’re shocked. When the hard job becomes trying and more difficult than you ever imagined, you’re thrown off balance.

After I had cried to my parents, I dried my cheeks. I puffed out my chest, and I stood tall. I was still afraid, but my pride for country, dedication to duty, and commitment to my job helped me tell my folks it would be alright. Then I hung up the phone to go about my day. What I’m saying is, I was thrown off balance bad, but I stood back up and kept walking. It’s no wonder I became a nurse.

My mother was a nurse, and I still remember her saying, “are you sure?”

She wanted to ensure a career in nursing was really something I wanted for my life. She knew the difficulties I would face. At the time, I thought she meant long hours or working holidays and weekends. I had grown up seeing her do those things. I had heard her complain to my dad about documentation and staffing shortages, but I figured I could handle that too. I still remember the strange look on her face after I told her I was going into nursing, and before she asked if that’s what I really wanted. Her eyes had shown a mixture of pride, amusement over my ignorant excitement, and a concern for her child thrown into the mix. I realize now that she knew. She knew I’d be thrown off balance, but she didn’t know how it would go after that.

I still remember my first Code Blue. I was a new graduate, mid-twenties, on orientation, and green as spring grass. I was on night shift when we ran quickly to the ER as part of our Code Response Team. I was excited, scared, adrenaline pumping, hands shaking. It was just like all the medical shows I had watched with my mom, but better. We were saving lives, man! It was awesome!

But then it wasn’t. I felt the tone of the room change. I watched in shock as the man’s slack skin jiggled back and forth while a nurse violently pushed up and down on his chest. His flaccid body jerked up and down on the cold, narrow gurney. He face looked contorted from the large tube coming out of his open, drooling mouth. It was terrible. It was nothing like TV. This man was dead.

“Push another Epi,” the ER doc commanded!

The drawer I had been pulling from was depleted. Someone pushed new medicine cartridges into my hand, and with frantic fingers I assembled the syringe.

I could feel it in the air, though. This round wasn’t going to work either. The look on everyone’s face told me it was so.

“Hs and T’s, guys,” the doctor asked. “Anyone have any ideas?”

It was that last ditch effort, a collaborative meeting of the minds to try and think of something we could reverse to magically restore this man to life. Everyone stared ahead, silent, searching the database of their knowledge, but coming up with nothing.

“If no one objects,” the MD announced flatly, “we’ll call it. Time of death, 2357.”

And just like that it was over. The floor lay littered like a battlefield, the trash, drops of spilt blood, and empty syringes a reminder of the fight we had lost. Our prisoner of war still lay on the hard stretcher, a victim to the iron grip of death, despite our valiant efforts. I stood slack-jawed, surprised that we had stopped, and that the patient was really gone. In the back of my mind, as if through a cheesecloth, I heard the doctor say something about going to speak with the wife. It wasn’t supposed to go this way at all.

“Come on,” my preceptor called cheerfully. “We got a lot of charting to catch up on!”

That was fifteen years ago, but still fresh in my mind. I think, though, the one that shook me the most was an unnumbered Code. It wasn’t my first, nor my second, and not even the third. I had gone through dozens of codes by the time this one occurred, and as I assembled a medication syringe from the crash cart, my fingers moved at lightening speed. Like a liquid team, my SICU coworkers and I ran the event. We followed the steps smoothly, we did everything right, yet it ended the same way as my first code. It wasn’t as if death was a new thing for me. In fact, I had even done a stint as a Hospice Nurse. Death was a part of life. It was what happened to everyone. Yes, it was never “good,” per se, but it was inevitable. It was out of my control, in the end. So, I did not feel guilt. I didn’t feel overly traumatized by the event. It felt like any other work day, and maybe that’s why what happened next happened. Maybe God was trying to shake me up, make sure I could still feel.

You see, in nursing, after seeing death day in and day out, you build up a certain barrier. It’s not that you don’t care. It’s kinda hard to explain to the layman, but it’s like you stop making tears about the sad stuff, because you know that if you ever started crying, you may never stop. That’s the part you don’t anticipate in nursing. How the loss will affect you, how it will rock you, shake your foundation, threaten your faith, or harden your heart. You don’t realize how all the pain, death and dying, grief, and overwhelming helplessness will affect you. You don’t understand the pain of a hopeless situation or the trauma of being unable to change the downward spiral. You don’t understand it until you live it, and even then it changes.

This day, the day of an ordinary, unsuccessful code, I broke. Y’all, I fell apart, and I didn’t even see it coming. After this old woman died we called the family back to the room. It had been so unexpected. They didn’t even realize we were coding her until after she was already gone.

I stood in the room, readying the body before calling back the son. And at that moment, as I looked at the woman’s face, I saw her son kissing her cheek. Less than half an hour ago he had swept his lips across her cheek, telling her bye before she wheeled away for a simple procedure.

“See you in a minute, Momma,” he had said.

And that’s what I thought of as I straightened the sheet across her chest. He had no idea that would be the last time he saw her alive, and the thought of it made me bawl like a baby. Right there at a stranger’s bedside. My mother had passed away in much the same manner, and I never knew that particular kiss of mine on her cheek and “see ya later” would be our last. I also never knew when I became a nurse that the pain of others could become like my own, that I would build stoic fences to keep me strong, but let them be torn down just as easily to keep me empathically tender. Nursing hurts. I think that’s what that particular look in my mother’s eyes some twenty years ago was trying to say.

Not long ago my husband and I were watching Grey’s Anatomy. One of the surgeons was tore up by the loss of their patient. They were really having a hard time, and I told my husband, “I totally get it.”

I explained to him how after my last code and patient death I had trouble getting it out of my head. I had three days off after it happened, and I needed every one of them. And even after that, it was still hard to return to work. You see, I questioned myself. I didn’t do anything wrong. There was nothing I could have done to prevent his death, nor anything I could have done differently that would have been better. I knew this to be true, but it didn’t change the fact that I still asked myself those questions. When you hold life and death so closely, it’s hard not to take it personally, to feel responsible, to feel the pain, to feel grief, to feel defeat in some sort of strange way. I couldn’t stop my feelings of responsibility anymore than I could stop breathing. It came just as naturally. I don’t think I ever anticipated it would be this way.

It’s like that, you know? You stand straight, firm, tall, proud. You laugh so you don’t cry. You feign indifference even. You break down, you piece it back together. You march on, battle after battle, a soldier for good, an angel of health, moving forward in the calling you wear so mightily. Broad shoulders, air of confidence, liquid efficiency, like a well-oiled machine. You fall, you get back up. You cry sad, salty tears. You dry your eyes, you smile again, you laugh. Sometimes you do all these things in a single afternoon. You keep going. The pride, courage, and commitment continue. It hurts, it makes you happy. It breaks your heart, it repairs your confidence in mankind. It is Nursing, and I never anticipated it would be this way.

Why Do Bad Things Happen to Good People?

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I suppose we have all wondered at one time or another. When a child dies in a freak accident, we question life. When a new mom passes away in childbirth, we throw up our hands, demanding answers, letting them fall back down limply in grief. When a family slips away from this earth as they sleep, a shocked community, and even the world wonder why them. We all want to know why only the good die young, or why in the world wonderful, kind people find themselves in tragedy, while the rotten, selfish folks continue on their merry way, skipping and whistling through their seemingly perfect life. I mean, seriously, why do bad things happen to good people?!

This is especially a difficult question for believers, and by that I mean people like myself, Christians, followers of Christ. We believe in a sovereign God who holds the world in the palm of His hand. We believe He controls our lives, controls the very ocean waves and violently strong wind when it blows. Why do people who love the Lord have their house burn down, lose a child, have to say goodbye to their marriage, suffer through sickness, or get laid off from work?

Why do bad things happen to good people?!

I think the first thing we have to do in these questioning moments is remember that questions are good. They’re not bad in themselves. I think God, especially as a Father, understands children who desire answers. So we shouldn’t feel guilt for angry, sorrowful questions thrown emotionally into the air, but we should also be open to the answers that will come. The thing about answers is they don’t always come until much later. So, we have to hold on to what we know.

I believe the first thing to keep in mind when bad things happen is God’s character. He is good. And since He’s good, bad doesn’t flow from Him. God doesn’t make bad things happen to us. He’s not mad at us. He doesn’t want to teach us a lesson like a stern school master, or purposefully injure us like a cruel kid pulling the wings off a fly. God is good. God is Love. Therefore, He wants love and good for His children.

His Word states He works all things for the good of those who love Him. That means that even the bad can be worked for our good.

We do live in a sin-filled world, a world ruled by sin, a world where sin creates bad things. God doesn’t create the bad, but He does work the bad for our eventual good. It’s hard to see that good in the thick of the bad, but as Christians who know God’s character, we can hold fast to that truth.

I can remember years ago, when my daughters were babies, continuously praying for their health. Sick babies are so scary. If you’ve ever held a tiny infant’s chest in your hand and felt their tiny ribcage rattle with the rough movement of mucous, you know what I mean. I can recall during one prayerful morning the Lord speaking something to me about their health. I had been praying for zero sickness. Perfect health, if you will. And the Lord reminded me of reality. They had to get sick!

As a nurse I knew the importance of them getting those little viruses. They needed to build their weak, immature immune systems. If they didn’t get a little sick with some common sniffles every once and a while then they wouldn’t be able to handle a bigger virus if it ever came. Sometimes you needed a little sickness to make you stronger.

I know you’ve heard people say jokingly, “let them play in the dirt. It builds their immunity.”

Well, sometimes life gets dirty to build us stronger.

Even as my children are young now, when they fall I know it’s for a reason. They’d never learn to be careful if they didn’t trip and fall first. They’d never understand accidents hurt if they never felt pain.

It’s the pain that matures us.

It’s the sickness that builds us.

It’s the fire that refines us.

It’s the hurt that teaches us.

It’s the tests that create our testimony.

I don’t always know why bad things happen to good people! But I do know this. I know God works the bad for our good.

I know that through the struggle we grow closer to Him.

I know that in transversing through pain we become stronger.

I realize that in the bad we become better.

I get that in the fire I don’t walk alone.

He is with me.

I can see that even in the bad, He is good, and His purposes always prevail.

But sometimes you can’t see. You can’t see Him. You can’t see how all the bad can ever be good! You can’t see the purpose in the pain! You can’t see why bad things happen to good people. You can’t see.

You can’t see the steps that lie ahead for you. You’re too afraid to walk further. You can’t even see behind you, to remind you of His past provision. But do you know what?

He sees.

He sees you.

He knows your pain. And He knows the way past it. He knows the steps you take, and He knows how to lead you to higher ground. He sees. Even when we are blinded by the bad, He sees good.

I don’t always understand why bad things happen to good people, but I do understand this. I understand that nothing we have been through or are going through now, in fact, no trial we face in this world can compare to the glory that awaits us. We face a tough world in the current, but the current problems of this world are like a passing mist compared to an eternity with Jesus. If we can only put on Kingdom Eyes we can see! We can see that the bad we face here is nothing. Our victory is in Christ. Our victory brings only good things ahead.

So, come on, sickness, debt, disaster, and such. We can count it all as joy for it is building us stronger, wiser, more mature, and closer to Him.

Why do bad things happen to good people? So we can become good like Him, better than we are. So He can show His love and power to us by lifting us higher. So He can take us beyond the passing bad to a constant good. A forever good. That is a future I can handle.

Appreciate Your Mother While You Still Can

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“I woke up this morning and all that kept going through my head was ‘everywhere I go, I love you so,’ and I knew I had to call you,” my aunt gleefully relayed with a giggle.

I laughed too as I thought about my debut album from over thirty-five years ago. She was referring to a song I had written when I was five years old. My mom had recorded it on a cassette tape and given a copy to her only sister to enjoy. It was that stellar performance that came into her head that morning, and we both laughed at the sweet remembrance.

“You know, I guess you’re the only one…” as my voice cracked with emotion my sentence broke off abruptly.

I collected myself and tried again.

“You’re the only one still alive who remembers me at that age,” I finally managed to get out.

We ended up talking on the phone for another 45 minutes. We didn’t have anything in particular to discuss, nothing exciting or worth writing home about, so to speak, but our conversation lingered along as we discussed mundane details, wall border, and other uninspiring topics. Yet it was wonderful. When I hung up the phone I smiled with contentment for the privilege of relationship with someone I held so dear. Life had dealt me the kind of hand where I understood loss. It had caused me to appreciate more those who remained on this earth with me.

As I got to work this morning and looked at the date on the computer it hit me that today was my mother’s birthday. I realized quickly that had she still been alive she would be 64 years old today. And then it hit me that she had been gone for ten years.

Ten years!

The weight of time took my breath away. The gap between the age of her death and my own current age were not that far apart. The thought crossed my mind that if I were to die as young as my mother, I would only have thirteen more years left on this earth. When I thought of all the things that remained that I still wanted to see, do, experience, and impact, that seemed like a terribly short amount of years. Imagine if you only had a little over a decade left of life? How would that change how you loved each day?

It’s an easy answer. You would cherish each moment and not take a single experience or relationship for granted.

I think the saddest thing we can go through is not the death of a loved one, but the thought of not fully enjoying the time you had with them. Hindsight is a cruel thing sometimes. I try to not have regret in life, because what good does that do? But if I’m honest I have to admit that so many times when I think of my mother I wish I could have loved her harder. I wish I could have forgiven her quicker. In my teens and early twenties I wasted so much time harboring anger towards her over minuscule matters that mean not a thing to me now. If I could take back that selfish, missed time over the years I would pack it all together and take us on a trip to the beach. I would hold her hand as we walked along the seashore. I would laugh deeply at her crass jokes, I would soak up her smile even as she shyly tried to cover her mouth with her hand like she tended to do. I would say, “I love you, Momma,” cause I’ve decided you can’t say that enough.

There’s not many days that go by that I don’t look at my beautiful daughters and wish she could be a part of their lives.

There’s not many weeks that go by that I don’t have something terrible, wonderful, or all of the above happen, and wish that I could pick up the phone and share it with her.

There’s many moments where I look at my purple stethoscope, purple water cup, or purple earrings and know that my favorite color was her favorite color too, and that’s just one of the many similarities we share.

Talking to my aunt reminded me that when my mom passed away there was a lot that passed away with her. For the first seven years of my life it was just us. Many times I see my young girls do something in particular and I wonder, did I do that as a baby? But there’s no one who can answer that question for me. It’s a small thing, in the grand scheme, but also another reminder of how precious knowledge and memories are.

As a woman who has lost her mother, and has her own moments where she wishes she could turn back time, I would say, appreciate your mother while you still can. Don’t wait until they’re gone to realize how precious the moments you shared together were. I look back on simple moments just sitting together in the living room, curled under a blanket, watching a movie. What I wouldn’t give to have half an hour of that. I would take in her every feature and commit it to memory. I would say the things I never had the humility to utter. I would simply soak in our togetherness, something I took for granted. Perhaps I would ask the questions that I never thought I’d need to know until it was too late. I would certainly appreciate the time I had with her, that I can’t get back now.

Don’t wait until Mother’s Day to send your mom a card. Call her now, go by for an impromptu visit, and tell her how much you love her while you still can.

I Can Still Praise God Through Tears

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I recently stood in the congregation of my small church with racking sobs pouring out of me. My hands covered my face as I wailed, and although I felt awful, it also felt good to let it all out. It was like the small, spring shower that had started at the beginning of the week had just continued to pour, and by Sunday I was swept away in the torrent that flooded my soul. And although I held tightly to my faith through the storm, the pelting rain still caused me pain. That pain emitted from me in the way of hot tears coursing down my cheeks and falling on my chest. 

It wasn’t any single issue on its own, but rather the conglomeration of so many small hits that tried to take me over. Health scares, financial worries, job scares, and seeing things you had put so much work into be ripped right out from underneath you. So something as seemingly simple as a Facebook hacker stealing my account could actually equate to years of investing into my writing and garnering blog followers across the world being gone in an instant. Tons of invested time in my Rodan + Fields business forever erased. Customers lost, readers gone, and friends leery to reconnect with me. I felt silly about being upset over a social media account, even if it did provide financially for my family, but I also realized that this was just the final straw that was breaking the camel’s back. So I wept. 

There’s no way I could contain in one blog post all the many things God has spoken to my heart in the past four or five days. It would likely be a jumbled mess if I tried. But I do know that through all my grief over my recent trials I have held close to Him. I do know that Satan desires to separate us from relationship with the Lord, and that has been something I have not let him do. I have held fast to my faith even when I don’t understand, and I have thanked Him for the many things He is teaching me through it all. I’ve held tightly to the promises written in His word, and accepted the things I cannot change. 

I’ve professed that if it’s not from God then I don’t want it, and that I desire to be humble and a servant of my King no matter what. I’ve rested in the fact that He cares for me, and that even when I cannot see the end of my trials or a solution to my problems that He is faithful to walk me through it. So although tears may fall from my face, my heart rejoices for the one who counts every single one. 

His promises are true.


My issues are small when compared to that of others, and the very big things God has taken care of for us. Yet that doesn’t always make you feel better in the midst of an issue. I would imagine, though, if it’s important to me then it’s important to God. He’s that kind of Father, and He doesn’t go around grading who needs His help and comfort the most. I’m grateful for a big God who can handle the most difficult of needs and find solutions when there is no way in the natural, but also that He is personal enough to see the most tiny, insignificant parts of me. 

The best part, I suppose, is that I know I’m good regardless. No matter what the outcome, if a solution comes, or even if one does not, I know that God has His hand on it. What the devil means for harm my God works for good, and He is a God of ultimate restoration. I’m resting in that. I may still grieve some circumstances, and I may fall to moments of anxiety or worry, but I never doubt that He is in control through it all.