** Below is a brief excerpt from a book of health care stories I’m working on. Having spent around 24 years wrapped up in that first career of mine, I have some pretty gruesome stories to tell. But this one is mild in some respects, from the early days, but it starts to set the mood.
The old stand-up scales squealed and rattled as I rolled it down the hall on the two wheels soldered on the bottom, below the weighing platform. I wondered what the patients thought hearing this beast as we approached the rooms for daily weights. The patient weights were all supposed to be taken roughly at the same time of day to duplicate the patients’ conditions. So, we performed this routine in pairs, moving down the hallway from one room to the next. Filling in the appropriate box on the flow sheet hanging at the foot of each bed. More numbers to the list that defined who was in the bed. Numbers not names.
I remember the way she looked when we entered the room. I was helping one of the RNs weigh this thirty-three-year-old woman dying of cervical cancer. Her eyes sunken. Her hollow face, which became taunt with pain as we stood her up to the scales. The nurse I was with impatiently yanked her to get her out of bed and inflicted a little more pain than was necessary. RNs are in a hurry. Other patients and duties were waiting.
Moving a patient is a chance to assess them. If you’re observant. Strength, flexibility, balance, body temperature, skin color for oxygenation, skin turgor for hydration, abrasions, bruising, breathing – relaxed or labored, diaphoresis, the color of the sclera of the eyes, and their facial expressions and what they reveal. It’s all there, if you look.
I can see her arms and legs, only 3 centimeters (1.2 inches) in diameter. I can feel her weakness, the muscle mass wasting away, the fragility of her bones. If I squeezed too hard her arms would break. She had poor balance and could barely stand. She sweated profusely with the effort. Her skin, cold and clammy, tinge of blue beneath the fingernails. Poor oxygenation. Breathing as though a boulder was on her chest. Heart pounding. I can feel my own gut tighten as I help her to use the emesis basin, barely having enough strength to bring her stomach contents up the length of her esophagus. The acrid smell of her vomitus blending with the smell of antiseptics.
I still see, hear, smell, and feel this scene. It’s burned into my brain.
I look around the four-bed room on the surgical floor. Three other women, each with a different cancer, look away from us, and from each other. They all lay on their sides, facing the bleached-out, green tile walls. Their backs in alignment with each other. Maybe, if they look away, their cancers will not get ideas about devouring them. Denial is powerful medicine.
I stand confused, for I am only a nursing assistant. I have no formal training, yet. No one has taught me how to build barriers to human suffering and emotions, yet. I don’t think that I will ever become a RN, but eventually I will. I stand outside the door and cry. No one notices.
The next evening, when it’s time for her weight, I insert myself between her and the RN. I gently cradle her in my arms, placing her arms around my neck. I lift her out of bed and her face remains relaxed — still hollow. Her breathing is effortless. Her skin dry. Her stomach calm. I stand on the scales and the RN weighs us together. I gently lay her down in her bed and say, “I’m sorry.” She barely whispers back, “Thank you.” I weigh myself and subtract the two weights – 38.6 kilograms or 85 pounds. Down again. The cancer and the chemotherapy continue to consume her.
I promise myself that I will always feel the pain and never lose my compassion.
In the old days, before electronic scales, they looked like this. They weighed a ton and their color even matched the walls and the floors – all uniformly designed.
Photos: I found these pictures on the Internet in the public domain. I could find no further attribution for them.