Hey there,

I was just thinking about Dear Abby. When she took the day off, she always printed something for her readers. I am writing a book and I thought some of you might want to read the first chapter so I am putting it here for you. Let me know what you think and if you like it, I will post other chapters as time and writer's block allow.

Have a great day!

Meg

By the way, it never comes out with the paragraphs indented so I apologize if it isn't as easy to read.

I SEE THE MOON...........Chapter One

To say Colleen was an open book was an understatement. The window to her soul was her not her eyes, but her mouth instead. If you asked her a question, she would answer from the heart. If she had a feeling, she would share it with you. Positive or negative, she spoke it, and then she let it go. She wasn’t exactly naive, but she assumed everybody else was just as honest with her. Dishonesty was not in her emotional vocabulary so she didn‘t see it in others. On the rare occasion that deceit had been proven, she was deeply wounded by it. But, she was also quick to forgive. She was what they call an “old soul”. She had been around forever and she tended to choose her battles most prudently.
When in her presence, you are almost immediately struck by her sense of unaffected sincerity. It actually draws you to open up to her.
“Hmm, Damndist thing.”
Anyway, traffic is light this morning, I will arrive at work a bit early. “Alright,” I said out loud as I entered the grounds of Maplelawn Gardens, “at least I can make some fine nurse coffee.” Nurse coffee is what you brew at 11 P.M. for the express purpose of consuming sometime around 4 A.M.. I don’t care how many years you have on the night shift, you are going to get tired sometime around 4 A.M.. You can’t fight that circadian rhythm. That stuff will wake up the drowsiest of nurses. I believe it is bionic.
When I went on the floor that night, I worked my fingers to the bone from 11 to 3. All in a failed attempt to avoid paperwork. Most of the routine paperwork falls on the night shift. I don’t mind, although my shift can have it’s moments, ordinarily you wouldn’t have trouble out of, say, 5 residents at one time, and that’s stretching it. Rarely do they revolt. I love these guys, I really do. Oh, the stories I could tell.
I had to get firm with myself. “Self,” I said, “You’d better get at those monthly summaries.” So I sat myself down and began to do just that.
Ordinarily, I hate monthly summaries. It can be rather depressing to track the monthly decline of the residents I care for. Most of the regular paperwork is left to the night shift. So here I am, at 4 O’clock on a Sunday morning, contemplating the monthly summary of Colleen Broderick. Her summary will be different than most because she is getting better. In 1975, Colleen and two friends were coming home from a high school basketball game when they crossed over Highway 83 at 3rd Avenue. The car they were in was t-boned by a truck. It will always be known as the crash that finally put a stoplight up at the intersection of Highway 83 and 3rd Avenue.
The driver was in a coma for a week but he did not suffer any long term effects, physically. Emotionally, Dan has never gotten over the wreck and the fact that he survived. I’ve seen the guilt in his eyes over the years as he visited Colleen every Wednesday evening. Jimmy, riding shot gun that Friday night, wasn’t so lucky. He died two days after the accident without ever having regained consciousness. A lovely young man, he was headed for great things. Anyone who met Jimmy was impressed by him and his kindness. In his case, the good truly did die young.
Colleen on the other hand, was in the hospital for a week before the decision to remove her ventilator had to be made. The doctor said she had suffered irreversible brain damage and that the injury was so severe that she would never so much as breathe on her own, much less think. He told her parents that the daughter they knew was gone, and she would not be coming back. Yet, here I am, 28 years later, writing the monthly summary of a breathing, thinking woman that has doctors using the word “miracle”.
Resident is 45 year old white female with history of closed head injury in 1975 MVA, compression fractures of T-4 through T-11, hypertension, S/P gall bladder removal, S/P total abdominal hysterectomy with oopherectomy, pressure sores. VS: B/P 150/94, T-97.8 P-84 R-20. Had been in “persistent vegetative state” for 28 years and began showing signs of cerebral activity beginning this past May. Neuro status has been slowly improving over the past 3 months. Current neuro status, alert and oriented to person, place and time. Pupils equal and reactive to light, hand grasps strong. Answers questions appropriately, emotional reactions appropriate, pleasant resident. Diet: g-tube feedings currently ordered to be given as bolus only if resident does not eat at least 50% of her meals. Resident almost always finishes 100% of her mechanical soft diet but is adamant that she is ready for “normal food”. Speech therapist recommends thickened liquids but resident refuses to allow staff to thicken her liquids. Resident signed release, states understanding of choking risk. When staff checked g-tube for placement, resident stated, “I am going to pull that out so don‘t bother”. An hour later, resident removed her g-tube by cutting the tube with scissors and allowing the balloon to deflate. (See nurses note dated August 5th, 11 A.M. entry.) Rehab: resident currently receiving intensive physical therapy 5 days a week to regain ability to ambulate w/o assist. See physical therapy notes for further information. Integument: large stage four decub on right hip healing well. As of last weekly skin check, width is at 2.8 inches by 3 inches, depth is at one inch. Continue treatment with enzymatic debrider covered by moistened 4 x 4’s once a day. Small red area still remains on left hip area, size of a quarter, blanches sluggishly. Sacral decub is healed as of August 12th. Social: resident has many visitors, family highly involved, many friends visit, resident seems to enjoy all visits. When she has no visitors, she gets around in her motorized wheelchair and attends many activities. Gets along well with other residents, most of whom are decades older than she. Generally cooperative but obviously in a hurry to get out of this facility. See Plan of Care for further details. Also, see Medical notes for more detailed history.


Short and sweet but good enough for now as the residents are beginning to wake up and the call lights are flashing all the way down the hall. The CNA’s are scrambling to get the lights to stop blinking and dinging. It isn’t quite time to get residents up but most are wet and need attending. Colleen’s light is flashing but I know she isn’t wet, she regained control of her bladder within a month after we removed her catheter. I flipped on the room light and said, “Knock Knock” as I walked into her room.
“Oh, Barb, next time warn me.” Colleen whined as she pulled the covers over her eyes.
“Sorry about that, what can I do you for Miss Colleen?”
“Would you mind getting me a pain pill? My back seems pretty acrimonious at me this morning.”
“Acrimonious?“ I repeated. Colleen managed a little smile and pointed to the dictionary at the foot of her bed. “I’ve been teaching myself new words. Acrimonious was my word for yesterday, it means extraordinarily angry.”
Colleen was usually pretty stoic about her pain but every so often, you could tell it was getting the best of her. She could have used percocet or something in that arena but all the doctor ordered was vicodin...and only one of them every six hours. I had just enough time to get Colleen her vicodin, and an acetaminophen for good measure, before I had to start pushing the med cart down the hall for my last round of the day. Add the 6 A.M. meds to the blood sugar checks ordered for the diabetics, the tube feedings I have to fill, and the dressing changes I have to do and I’ll be lucky to finish by the time the day nurse comes on duty. After an hour of charting on my residents, I will be off the clock and free to go.
Ever since Colleen came out of her coma, there really isn’t anyone who hasn’t at least introduced themselves to Colleen. Everyone from the administrator to the drink machine vendor found at least one “valid” reason or another to approach her. The doctors flocked in, all intrigued by her medical history and then charmed by her ability to make you feel as though you were her closest friend. And, to top it off, she cleaned up brilliantly. It was amazing how good she looked after what she had been through. And, like the teenager that she was when the accident happened, she played with her make-up everyday. Her primping alone would be more than enough physical therapy for many. She was lovely, well mannered, and possessed a very impressive way with words. One night she told me that her father had once told her to “be very economical with your words”. She had tried to do so ever since. But you simply cannot teach the way she used her words. One must be born with that kind of talent. She always knew the absolute correct thing to say and she was a very quick wit. I have only heard her use this aptitude to express disapproval a few times and let me tell you, she did it well. But 96.2% of the time, she was captivating. When I come on duty at 11 P.M., Colleen’s father is with her. He stays with her until she falls asleep. So, I don’t really get to see her unless she needs something from me and that is rare. We have spoken a few times, but I haven’t actually sat down with her and chatted like most of the day and evening nurses have.
After I finished my paperwork, I returned to Colleen’s room to see if the pain pill worked. As I “knock-knocked” my way in, I found her attempting to dress herself. I had never seen a resident try so hard to do everything by themselves. Colleen is a determined woman, but she has not yet regained the full use of her muscles that have atrophied over the years. It truly hurt me to see this lady struggling to complete the tiniest tasks. It’s difficult to know whether you will be insulting someone by offering to help but she was so wrapped up in that shirt I had to take a chance.
“Here, Colleen, let me help you.” We put her shirt on first, then I helped her to sit on the side of the bed to get her pants to her knees. She could actually stand for the 3 seconds it took me to pull the pants up. It may not sound like much, but it’s amazing to those of us who saw the hideous condition she was in only 3 short months ago. She doesn’t weigh much so I was able to sit her in her wheelchair by myself.
She pointed to a basket on the windowsill. “Would you mind bringing that to me, please?”
“Not at all.”
The basket contained just about every different hair product or implement you could think of. I watched as she struggled to brush her long red hair. I told her how beautiful her hair was and as I asked her how her back pain was she suddenly stopped brushing her hair and looked right at me.
“Barb, you know, I just recognized your voice.”
“What do you mean Miss Colleen?”
“I can’t believe I didn’t notice it before. Did you ever sing hymns in my room? Amazing Grace, In the Garden? Was that you?”
A chill went up and down my spine. I do sing hymns late at night while I care for my residents who can’t speak to me for one reason or another. “Yes Miss Colleen, I do sing songs as I work.”
“I thought so.” Colleen said with a smile.
“So tell me Miss Colleen, what was it like?” That was out of my mouth before I could stop it.
Colleen just chuckled and said, “Oh, what was it like you ask? Let me see if I can explain it any better to you than I did to the doctors. Sometimes it was like sleeping. Sometimes it was like being awake but not able to do a thing to get anyone’s attention. Sometimes I sort of knew what my situation was because I could hear people speaking but other times I knew it was all a dream. I mean in my mind I just knew it was a dream. And sometimes I would think that a long time had passed and then I would think it was all one long nights’ sleep. Sometimes I couldn’t see, I don’t know if my eyes were even open but I couldn’t see a thing. I would hear though. And I heard you singing. I have fuzzy memories of someone talking to me as though they knew I could hear them. I’m pretty sure it was you. That person, you, I think, always spoke to me as though they were speaking to a friend. As a matter of fact, after a while, I knew that voice and knew it was my friend. There were actually times I remember wondering where it was.”
She looked at me and smiled. This was just the type of moment that makes me swell up with pride as a nurse. It was a short-lived moment because Colleen was abruptly struck by a spasm in her back that left her motionless.
After catching her breathe and regaining her composure, she smiled at me and said, “I really wanted to thank you for those hymns. They were my mother’s favorites and you know, she died a few years back.” She smiled right at me, the prettiest smile. And then she said, “Well, anyway, I just wanted to thank you ma'am.”
I smiled back at her. “My pleasure Miss Colleen, my pleasure.”
Lifting her arms to do her hair was a struggle and every time she did so, she winced with pain. I thought about how much more range of motion she could achieve with less pain. I asked Colleen to excuse me for a moment. I went down the hall to the nurses station and sent a fax off to Dr. D’Marco’s office requesting stronger pain relief for Colleen.
Before I left for the day, I went back to Colleen’s room to say good-bye and to let her know how good she had made me feel. When I went back, I found Colleen staring at the television with her eyes wide open and her jaw dropped.
“What is it?” I asked.
“You won’t believe it, I was watching the news and a commercial came on for a T.V. show and they used the word “b-i-t-c-h” in the commercial!” She was stunned. It took me a minute to see the problem but then I thought how strange it must be for her. In 1975, you didn’t hear such language outside of an R-rated movie.
“Well, Miss Colleen, you might as well get used to it, things have changed quite a bit.” There is no way to prepare a person for a foreign world.
She looked at me, eyes still wide, and said, “But you don’t understand. I remember doing the dishes for my grandmother and listening to the radio. The song they were playing was that one that goes ‘he can’t even run his own life I’ll be damned if he runs mine...Sunshine...’, do you remember it?
I told her I did.
“Well,” she continued, “My grandmother walked in and heard that line and pulled the plug out of the wall and punished me for listening to it. That doesn‘t seem so long ago to me. It seems as though I went from rarely hearing words like that to hearing them all day long, every day. It doesn‘t matter what time of day it is, the television has swearing, the radio has it, the staff use it as easily as though they were saying hello.”
“I know, honey, I know.” I thought about how much more different the world would become as she progressed and was exposed to more of it.
We said our good-byes for the day. I told her I would be back and I headed for my car.
I couldn’t get her out of my mind during my drive home. Her reaction to vulgar language surprised me in a way. From what her friends and family had told me over the years, she was quite a handful as a teenager. Apparently, she was a typical hippie, she smoked marijuana, stayed out all night on occasion and rarely did as she was told. Her mother once told me that Colleen had led a sit down protest at her high school to criticize the school’s non-smoking policy for 18 year olds. She didn’t even smoke cigarettes. She just thought it was unfair to ban smoking for 18 year olds while you couldn’t pass the teacher’s lounge without being hit by a cloud of smoke. Her mother said it led to quite a battle. Colleen’s father was on the school board and he supported his daughter’s stand. He told the school board that they had two options, either give the 18 year olds an area to smoke or extend the no-smoking policy to include the teachers. Afraid of the teacher’s union, the school board took an empty storage room and made it a smoking room for the students who were legally old enough to smoke. Her mother also told me Colleen was disappointed by the board’s decision. What she had really wanted was to have the smoking banned altogether but she was too young and naive to understand the influence of a teacher’s union. Her mother also told me that one year, Colleen saved all the money she earned working part-time at a fast food restaurant after school and used it to travel. Her mother didn’t really like the idea but Colleen’s father thought it would be good for her. So, she did. She left Chicago in her 73 Volkswagen beetle and headed down what had been the famous Route 66. She drove all the way to Los Angeles, with a few detours along the way. Then she headed north to San Francisco. San Francisco had been her destination from the beginning. She returned home on Interstate 80, all the way back to Chicago. She arrived home about a week before school began. I am 45 years old now and I don’t have the nerve to do something like that. Colleen was 16 when she embarked on her trip and 17 when she returned. That was her last summer vacation, she truly made the most of it. I’ve heard that she kept a journal during her trip. Her father promised to bring it in if he ever came across it.
I had been intrigued by the stories I’d heard about Colleen even before she “woke up”. I never imagined I would have the chance to get to know her. I thought about what she said about my voice being her “friend” and I decided right then that I would go out of my way to live up to that word. The few encounters I had already had with her, though short, have always made some kind of impact on me.
One morning I was in her room for one thing or another when she asked why I wasn’t wearing white. I explained that very few nurses wear white anymore.
Colleen replied, “That’s too bad, since I was little I’ve had this amazing picture in my mind of a very wise and kind person dressed in white. The image of that person always was a safe and warm one. How do the children know who the nurses are now? Oh, or the old people, I bet they are confused enough without have to wonder who all the different people are, they would remember a nurse in white as much as I do.” She was right, I smiled and told her so, “Why, Miss Colleen, I believe you are right. Well, about the older people anyway. I believe I am going out tonight and get myself some white uniforms.”
I did. And I’ve been wearing them ever since. I can’t tell you how many times I’ve calmed an anxious resident simply by showing them my white uniform and asking, “Now, who wears white uniforms?” The most confused person knows that doctors and nurses wear white. And they also know that doctors and nurses are there to take care of them. They always answer correctly, “Doctors and nurses.” I tell them, “Yes, and I am a nurse and I am here to take care of you.” Oh, the stories I could tell.
Colleen was right. She changed me a tiny bit with her observation. That change affects people that Colleen will never meet. I need to learn more from her.

Copyrighted 2/2005 All rights reserved.