Pam and Sybil
It’s always hard when friends become patients. this time it was two of our very good friends, both women who worked in the hospital. Pam was an administrator downstairs, she had worked as a head nurse on the wards; she liked to poke her nose into everything. She had lots of suggestions for doing things better, and was usually right, even though Patty hated to admit it. Sybil Crowe was another head nurse; she was interested in local Native American culture and medicine, and had written books on Apache and Comanche women.
They were both in their mid-fifties, full of energy and life. They had been our supervisors and our co-workers for years, and now they were our patients, and we would take care of them as best we could, as much as they would allow. They were used to taking care of everyone else, and didn’t know much about asking for help and needing care for themselves. Marie had worked with them, and remembered how they were, and put herself in their shoes. Her care was in the background, unobtrusive.
Sybil was admitted first that day, businesslike and efficient. .
“I already did the pre-admission three days ago,” she said, handing Patty the paperwork. “Here’s the lot, and I had blood drawn, too, yesterday, along with the chest x-ray. No point in waiting.” .
She tossed her little suitcase on the bed and turned to me with a glare.
“I guess I’ll have to wear that silly nightgown after surgery, but not now, right? I have my own gown, Marie.” She pulled out a long flannel plaid nightie, with long sleeves. I sighed.
“Sybil, you know that won’t work with the IV. There’s a reason that ‘silly little gown’ is made like it is, you know that.”
“I’ll freeze my butt in that thing.” She pointed to the little gown, so I went and got a pair of pants to go with it, that we usually gave to the gentlemen. She sniffed and looked at the bed next to hers, and glared at me again. “When is Pam coming in? I figured we could get some work done this afternoon before.....” she stopped and looked down at her hands, folding her sweater. “Before, you know.”
I nodded. Before surgery, before anesthesia, while they were still alert.
“She’ll be here soon, they called from downstairs.”
Sybil nodded, figuring that Pam would work up until the last minute, like she did. I heard she had gone in at 3AM this morning to help with a difficult patient. There’s no patient like an old head nurse, I thought. She and Pam would be doing chart audits next, at the nurse’s station in their bathrobes. Patty was in charge, and she was going to have her hands full.
“No calls to that room,” she was telling the ward clerk. “No calls except Pam’s husband or Sybil’s sister. I won’t have them trying to run their offices from that room.” She shook her head and looked at me. “I told Pam and Sybil that, and they had a fit. Had to pull rank. They’re patients now, not head nurses.”
“No, Patty,” I said. “They’re still head nurses. That’s the problem.”
She nodded, and pulled a face. “I’ll send students in to keep them busy answering questions.”
Both nurses had found a lump in their breast, both biopsies had been positive for breast cancer, both nurses were going to surgery early in the morning. Both would have a breast removed, and both had been counseled and all options discussed. They were both going to have chemotherapy and radiation next month, so Peg would have her hands full down in the Therapy Suite. Both nurses knew that their lives and that of their families would change, that never again would they look at a hospital floor or a hospital gown or a patient with an IV pole the same way again. Pam’s husband and Sybil’s sister were the finest support systems around, and they would be sorely tried in the next few months. These two would have to learn to be patients, to let us take care of them. What happened was, they ended up taking care of each other.
“You’re only a few hours post op, let me do that.”
Sybil was up to the bathroom, helping Pam with the little basin we used to count their intake and output, what they took in and what was voided. Pam growled at her.
“So are you, dear. And you’re losing your gown.” So they helped each other, teeth gritted, and walked together slowly down the hall, each one holding on to her IV pole, keeping a sharp eye on the patients in the hall out of habit.
“That guy is doing better; last time I saw him walk he was all bent over.”
“Like us, you mean? There’s a dirty laundry cart out in the hall, remind me to tell Patty.”
“Race you to the window.”
“In a pig’s eye.”
“Call downstairs and get us a steak, or at least a hamburger. I’m sick of Jell-O.”
“You’re the administrator, you do it.”
Nora, the woman from Reach for Recovery came, with a woman called Ruth (Change this) who was doing training with her. They spent a long time in the room, and came out smiling. They had both been patients here several years ago, and knew us all well.
“They’re friends, aren’t they, sort of?” She noted on the chart how long each one had done her exercises, while Ruth looked over her shoulder and wrote it down in a little blue notebook.
“Sort of. They’re both head nurse types.” Patty sniffed. She glared at me, daring me to say something. I didn’t. I knew that there were really three head nurses on the floor now, and I would do well to keep my mouth shut and watch.
“They’ll do OK, they really are trying.” Ruth smiled. “Do they help you change the bandages?”
“Of course, and they make broth and tea in the middle of the night for the lady across the hall, and get the old man in 504 up and walking.”
Ruth nodded. “I remember when I was here,” she looked down the hall towards the big windows. “Just getting up was an effort, but Nora and her friends were a big help. Nights were the worst.” She smiled again, and gave Nora a hug. “It’s been nearly a year…..” she looked away down the hall, at all the bustle on the floor, and turned to Nora.
“I’ll meet you downstairs, I have another friend to visit on the third floor.” She turned quickly and went out the big double doors, with a smile and a wave. Nora watched her go, and sighed.
“She’s doing so much better; this is hard, but good for her.” She turned to me and put the chart in the rack. “Hard for all of us, right?”
“But good, thanks to you.” Patty gave her a hug and we watched her go, tall and straight and hopeful.
I went in the next day to check the IV’s and chart medications for Sybil and Pam before I went off shift, and ran slap into a philosophy discussion.
“Marie, you know about cancer patients, don’t you?” Sybil was sitting straight up in bed, with a flannel shirt on for a bed jacket. Her short gray hair stuck up all over her head, she had been raking her hands through it like she did when she was upset or asking questions she couldn’t find answers to.
“I guess. I’ve been working this floor for fifteen years, that’s a lot of cancer patients.” I went on with my work, figuring she was just wanting to talk.
“They’re nice people, aren’t they? You know, no trouble, no ringing the bell until it falls off, no hollering about bad food, or not wanting to get up and have a bath at six in the morning. They’re really cooperative, right?”
“You got that right. Nicest patients in the world, scared some, but nice.” I knew that, and every other nurse knows that.
“Then what the hell are we doing with cancer? We’re not nice, we’re head nurses. Carolyn’s a writer, she’s not nice, she follows people and writes down everything they say, private or not. “ Henrietta was indignant, that’s what she was. Indignant that this bunch of cells had gone off and done something she couldn’t control. I had to walk carefully here, so I didn’t say anything, just emptied the catheter bag and took my sweet time measuring it.
“Well,” I said, carefully, “I guess life just hands us cards and that’s it, there’s no real personality where cancer cells are concerned. It just happened, that’s all.” I turned to look at them, both sitting up in bed, one with the flannel shirt bed jacket and the other with a sweatshirt with the hospital’s logo all over it. Both tough, both smart, both scared. I didn’t want to think about it being me in that bed, asking someone why they had cancer. “No figuring it out, you’ll wear yourselves to a nub trying. Just get on with it. You know how to do that, get on with it?” I looked at both of them, me being about their age, just about as bossy.
They were quiet fort a minute, fiddling with the controls on the TV and rustling papers. These were two for papers, I can tell you. Looked like they had a desk right there on the bed. We didn’t say anything, and I finished my work and charted the intake and output on the door chart, and stood there for a minute, watching the sun set way off.
“Look out the window, you two. I need to change your beds. Look at the day end.” They got up and walked a little stiffly to the window, while I changed the sheets. The staff had tried to change the sheets on the day shift but Pam and Sybil were sleeping and the day charge just gave up. She was young and didn’t know much about taking care of bossy old head nurses, and besides, these two scared her. They would have scared me, too, twenty years ago.
The day dimmed outside, and we could see the lights of the airport, and watched the city’s lights come on, slowly, to meet the dark. The mountains were like black cut-outs against the dark velvety blue sky. There were people on the freeway going past the hospital, automobile lights on in the deepening dark, on their way home from work.
I left them then, I’m not too good at philosophy, just nursing. But before I left I plumped the pillows up good, and turned the blankets down. Even scared bossy old head nurses need their beds turned down.
They had visitors, Pam’s husband came after his work, looking drawn. He sat on the chair by the bed and held Pam’s hand, and Sybil bustled out the door, claiming to have pressing business at the nurses’ station. She got lots of visitors from the third floor, plus students from all over the hospital.
“Grand Central Station,” muttered Patty, “that’s what this floor is. I’ll be glad when those two are discharged and we can get back to normal.” But she always wandered down to their room when she had a few minutes to sit and talk about old patients and scheduling and all the years of experience. She always came back to the station shaking her head, claiming that between the three of them they could run the world. She was probably right.
It was the day before they were to be discharged, they were both healing well, range of motion good, but restless as cats. I was giving them their medications, and I had a student with me. We kept sending nursing students in to their room, figuring with about sixty seven years of experience between them, just listening to them tell war stories would be good instruction. Most of the nursing students stuck around, some got intimidated and those were the ones who wouldn’t last anyway.
“They’ll get run off and end up working in a bank in six months.” Patty had seen it, and she laughed. “The ones that stick around will have some stories they can use in a book someday.”
“There’s an IV needs restarting, Patty.” Pam came out of someone’s room, wiping her hands.
“Well, why don’t you just take over the floor, I’ll go home....” Patty got sarcastic when her turf was invaded.
Pam looked at her mildly and raised her eyebrows, and looked at me.
“Got her dander up, has she? Go check that IV, girl.”
I was older than Pam but she called every female over age three ‘girl’ so I didn’t mind. The IV did need changing, so I did it while Patty walked Pam back to her room.
“You’d be all over me like white on rice if I came on your floor and told you how to run it, ‘girl’!” Patty walked with her hands in her lab coat pockets and a frown on her face.
Pam looked straight ahead and didn’t smile. “I don’t know what to do with myself, and wandering into patient’s rooms is all I know. “ She turned and looked at Patty with a little grin. “If it makes you mad, tough.”
Patty laughed and gave her a hug. “You are a royal pain, you know that. I’ll come down to Mahogany Row someday and tell you about the carpet that needs cleaning and the secretary who does her nails all day and is nasty to nurses.”
Pam spun around and looked alarmed. “I know about the carpet, but which secretary....”
Patty leaned against the wall, laughing, and Pam looked put out.
“Don’t do that, girl. I know what’s going on in my office....”
“...and the sixth floor, and the seventh floor, and the Operating Room, and Recovery.....”
I heard them laughing, and the patient whose IV I changed watched them go by.
“Is one of them a patient, or what?” he asked. I wrapped up the old IV tubing and shook my head.
“Who knows? They’re both running the floor, that’s for sure.”
Pam went back into her room, and she and Sybil sat and watched TV for a while. I was in and out, finishing the late medications. The television program was old, one of those hospital soap operas with nurses whose uniforms were cut nearly to the navel and doctors had wandering hands and dimples in their chins. Sybil hooted.
“Who has the damn time to play games like that? Look at that poor patient on the stretcher, lying there hurting and confused while they’re making eyes at each other.”
Pam looked at her watch. “Nearly time for dinner. Should we help pass trays? Patty and Marie here would have our hides, but they could use the help.”
Sybil nodded. “You go bother them, I’ll go back and wait for Jane ??’s call. She calls every night about this time, and I need to hear her voice.” XXX was Sybil’s sister, ten years older, sometimes mother as well as sister. Their parents had died when Sybil was a teenager, and she was very close to XXX. the support of XXX was going to be very important to her healing, giving her a big strong staff to lean on.
“When the hell does Dr. Whatsis do his rounds and sign discharge papers, anyway?”
“What does he think, we’ve got all day to sit around waiting for him?”
They were waiting for their doctor to make rounds and let them go home. Their suitcases were packed, everything was ready to go. We had all our paperwork done, so it was a question of one last examination, follow-up appointments for the chemotherapy clinic, and then home and some time off for more healing. It was about 3PM, our shift had just come on and I was doing rounds with Patty. We walked into their room and heard them discussing the future.
“What are you going to do when you get home?” Pam was putting a zillion papers in her briefcase.
“Get a job.” Sybil saw my face and added, “.....just kidding. No, what I’ll do is go see the medicine man.”
Around four in the afternoon Pam’s husband came to the nursing station. We were used to seeing him every day, around this time, just before dinner. He never said much, seemed shy. He was a tall thin man, we didn’t know him well but he was always kind and calm. He didn’t look well tonight, I thought. He stood there, stooped more than usual, brown eyes troubled, glancing back and forth around the floor as if he wanted to run.
“Things getting you down? The doc should be here soon, for the discharge, and then you can take her home and help her heal.” I looked at him, and saw deep lines in his face that I hadn’t noticed before. He looked at me with a long, hurtful look. I watched his face and got a cold little feeling in my gut.
“What’s the matter, Pete?” I asked, watching his face.
“I need to talk to Pam, right now. I thought it could wait, but....”
He had had a skin cancer a few years ago that was taken out and healed. There was nothing much in the way of therapy for this cancer, so he took vitamins and exercised and worked and life went on. When Pam felt the lump in her breast, he forgot about a lump of his own, in his groin. During her surgery he remembered it, and went to see his own doctor.
It was back, the skin cancer had come back, and lodged in the lymph nodes, and now he and Pam had to deal with two serious problems. We left them alone to talk, and Sybil came out and sat at the nurses’ station with her chin in her hands. Her eyes were red, and she talked quietly, through her teeth.
“Damn bad luck, that’s what it is. Just damn bad luck. Why now? Why them?”
“That’s a dumb question and you know it.” Patty was checking charts for surgery in the morning. “You’ll go nuts trying to answer that question.” She sounded calm, but her hand was shaking.
We helped them clear out of the room, in silence. Sybil kept hugging Pam and Pete and bustling around. Patty had a new admission down the hall, and things were getting busy. I watched them leave the floor, holding hands, and helped Sybil and her brother with the plants and the suitcases. I stood at the big double doors and watched them all into the elevator, quiet and still. They looked numb, their faces looked scraped in the harsh light in the hallway. There didn’t seem to be anything to say, so no one was talking. I walked back on the floor and went into the lounge for a cup of coffee. I felt a little numb, myself.
“Life’s a real bitch, right, Marie?” Patty drank coffee and frowned bleakly into the darkness out the window in the nurse’s lounge. “And then you die.” She turned to me, and I saw tears in her eyes. “Are you going to tell Carolyn, so she can put this in a book?”
I poured a cup of coffee and said, “Sure. It needs to be told. All of it.” I took a deep breath, and drank my coffee. “You need to check the IV in room 612.”
Patty stared at me for a long minute, put her coffee down, and nodded. “Back to work. We all need work, even those two old war-horses who just walked out of here.” She put her coffee cup down, and turned to me with some fire in her eyes.
“Tell her to write it down, all of it. No one’s going to believe it, no one will. They’ll think we made it up. Things like this happen all the time, but no one wants to hear it. So go and tell it.” She stopped for a minute and turned so I couldn’t see the tears. “And you better be right about the IV in 612.” Patty stomped off, hurting. I waited for a minute, for the perspective to settle, and then I followed her out on the floor, and sure enough, the IV in 612 did need tending to. So did about twenty other things, so we got the work we needed.
Those two old war-horses did well, and healed, and went down to Peg in the chemo room for their treatments, but that’s another story. Pam’s husband is stable, and everyone seems optimistic. The hospital filled up with new patients just as fast we send the old ones home, and we all had work to do. Sometimes we had more work than we could handle, but we were all still on duty, just the same.