by Tilda Shalof
Sydney beefed up the activities for Nursing Week. She helped make it more than just a roving cart of coffee and doughnuts for all staff. She made it more than just a free visit to the stethoscope clinic to get your instrument cleaned and oiled. She brought in guest speakers and provided workshops on stress management and career counselling, and offered gift certificates for massages for all the nurses.
But there were a few things she did that irked us. For one, she disbanded the lines that we had worked in for so many years.
“Nurses are not factory workers on an assembly line, punching in a time clock. You are professionals who can determine how and when you work. You have power over your work life, within the union agreement, of course,” she added with a nod to Morty.
She instituted flexible scheduling to enable nurses to go back to school, to take courses, to arrange their schedules to accommodate child care needs.
Another thing she did that felt strange to us was to put price tags on the equipment. Barrier cream to prevent pressure sores, $12 a tube. Ceftazidime, $88 a vial. Chest tube suction bottle, $23 each.
“Think twice before opening that pulmonary artery catheter tubing,” she wrote in the communication book. “Make sure you understand the rationale for its use and remember that each one costs $75!”
She wanted us to fight for frugality with the supplies, help rein in any profligate use of hospital resources, and eliminate wastefulness. She tracked everything carefully so she could report the extent of the money she had saved the unit after six months.
“Maybe Sydney could get a good deal for medical supplies on the Shopping Channel,” said Laura.
We eventually got used to Sydney’s ways and learned to respect her, but it was also around that time that a number of other disturbing things happened.
One evening at home I got a telephone call and I could hear only sobbing at the other end.
“Tilda, it’s me. Father Szigetti. Vince Szigetti.”
“What’s wrong?” We were friendly at work – he was with everyone – but he’d never called me at home before.
“They’ve fired me, my dear.”
“Why you? Surely you don’t cost the hospital any money!”
“I’ve been called before the parish and they’ve taken away my hospital duties. They’ve sent me on a silent meditation retreat for penitence. They say I’ve been too familiar with the nurses. They say I hug the nurses too much and touch them inappropriately.”
“I can’t … I can’t believe it.” Some things made me speechless.
“That’s not all, my dear. They’ve accused me of telling homophobic jokes. I’ve always known there’s a Lavender Mafia out there and it’s been going on for years. Some of us call it ‘Notre Flame.’ I may have told a joke or two, in fun of course, but no harm was ever intended.”
“You know how sensitive people are these days, Father. One has to be so politically correct.”
I couldn’t help but remember the joke he’d told in the med room one day about the gay church where only half the congregation was kneeling. Didn’t we all laugh at that one?
“But I’ve always said that homosexuals can make good priests. Of course they can. As long as they remain celibate. The teachings of the Bible must be upheld. We need to bring more discipline back in the church. And there’s another crime I’m wanted for, my dear. They accuse me of proselytizing. They say I’ve been putting graffiti around the hospital, just to offer a bit of inspiration to the nurses and the patients.”
“But is it true, Father? Was it you who did that?”
Was I taking confession from a priest?
“It’s perfectly harmless. In these trying times, my dear, all the more is the need for people to hear the word of God. A man is a priest forever, either to his greater glory in Heaven or to his damnation in hell. Please write a letter on my behalf to vouch for my character.”
“Of course I will,” I said.
“I will need your prayers, my dear, to get me through this crisis.”
I assured him that he had them and vowed to start praying.
But another call I received a few days later informed me that even more urgent prayers were needed.
“Tilda, it’s Tracy.”
“Hey, Trace, how are you feeling?” She was ten weeks pregnant with their second child – Jake was already three years old – and was having a rough first trimester.
“I was feeling better until I heard this news. I’ve got bad news and bad news. Which do you want to hear first?”
“Let’s go with the badder one.”
“The first one is badder for me and the second one is badder for you.”
“Okay, shoot.” I was feeling great. We had just bought a house. I was pregnant too, feeling fine. Nothing could bother me.
“You remember that patient I took care of a week ago? He was a travelling businessman who had gone to Singapore and has had a respiratory infection ever since he returned? Well, he’s really sick and the test results just came back showing that he’s got tuberculosis! I took care of him and that exposed me to an active case of TB. They want me to have a chest X-ray and are recommending I take a course of rifampin and isoniazid and all those other TB drugs.”
“Did you tell them you’re pregnant?”
“They say it’s safe to take the drugs during pregnancy. I don’t know whether to believe them or not. What choice do I have? They say my risk of getting tuberculosis is greater than the risk of the drugs harming the baby. Now, are you ready for your bad news? I’m sure Sydney will call you later, but a bunch of us at work just discovered that pink slips really are pink. Five hundred nurses have been laid off at the hospital, twenty of them from our ICU, and I’m sorry to tell you, Tilda, but you’re one of them.”
11
TRANSFIGURED WORDS
As it turned out, I didn’t have to mourn the loss of my job for very long. Two weeks after we received our layoff notices, the hospital was scrambling for nurses. The human resources department invited all the laid-off nurses to submit applications to be re-hired at the hospital. Only now they were offering us part-time or casual positions.
“What’s this all about?” I called Morty at home to ask.
“Union-busting. They wanted to get rid of as many of us as they could. The hospital is under pressure from the provincial government to cut costs. They figure they can save on us by having a flexible, transient workforce of nurses and bolster it with agency nurses if they have to. This way also, they don’t have to guarantee you any shifts or pay you sick time or benefits.”
Sydney Hamilton called us individually at home to encourage us to re-apply for our jobs. But many nurses were fed up and had already left or were planning to leave – either the profession of nursing altogether, or else the province of Ontario – to seek employment elsewhere. Many nurses started going to the job fairs that were being held to recruit nurses to work in the United States. Indeed, many were lured away by offers of relocation bonuses, education opportunities that included tuition reimbursement, a significant night shift and weekend differential, and a range of career choices in every specialty of the hospital.
“I’m thinking of taking a job in Florida,” said Suman, a nurse originally from Iran who had worked in the ICU with me. “I know I’ll love the weather, but I really don’t want to go.”
We met over coffee to commiserate with each other.
“In Tallahassee they’re offering me free housing and full-time hours, but I don’t want to leave my family and my fiancé. We just got engaged. So I’m taking a casual position here.”
“Back in the ICU?”
“No, I got bumped out. They offered me a job on one of the medical floors, but I’m not getting enough hours. Last paycheque, I only clocked four hours of work in one pay period. I’ll manage somehow, but if I wasn’t living at home I wouldn’t be able to stay here. I’d be forced to go to the States.”
I knew of many nurses who did leave.
I returned to t
he ICU, on a part-time basis. I was lucky because I was pregnant and would soon be off on maternity leave, anyway. In the meanwhile, following in Rosemary’s tradition, Sydney did everything she could to help us further our nursing education. She sponsored me to attend a critical care conference and there I made a new friend.
It was in the Delta Chelsea Inn, amid a throng of critical care specialists from Washington, Paris, and Helsinki, that a strong hand reached out to grip mine and shake it warmly. It was connected to a tall elegant man with a shaved head and an earring. It was Darryl Price, who had done a fellowship in our unit in critical care. He had recently joined the staff of the ICU as an intensivist. I had always admired the way he talked to patients and I wanted to learn from him. Besides, there was something about him that made me think he would make a good friend.
“I’ve noticed you at work, Tilda, and you’re a very good nurse.”
His voice was soft so I had to move closer to hear him better. He sounded just like the voice I heard in my imagination while I was reading Angela’s Ashes, the book I was obsessed with at the time.
“Have you read Angela’s Ashes?” I asked.
“I can’t bear to read that book,” he said with a sigh. “I knew too many families back home who lived like that in such wretched poverty.”
One morning, a few weeks after that encounter, I was kneeling on the floor emptying my patient’s urine bag when I heard Nicole speaking to someone.
“You want to hear the nurse’s head-to-toe assessment? Tilda is the nurse taking care of this patient. I guess she must have just stepped out for a moment.”
They couldn’t see me, but I could see she was talking to Dr. Darryl Price, who had just entered the room. The entire entourage of ICU residents and the rest of the team were converging en masse around him. I stayed down there beside the bags of urine and stool and thought of hiding out for a while, not coming up until after rounds. Would they miss me? I was holding a graduated cylinder, a large metal calibrated cup that we used to measure urine.
“Do you know Tilda? She’s going to be a famous writer one day,” I heard Nicole say. I cringed.
“So you’re a writer too, as well as a nurse, are you?” asked Darryl, coming around to my side of the bed and peering down at me. I looked up from where I was kneeling on the floor, holding my jug of urine under the steady stream of fluid. I almost made a joke about the pint of ale I had on tap, but stopped myself in time.
“Yes, she is. She’s the editor of the hospital’s nursing newsletter,” said Nicole on my behalf. “It’s called Vital Link.”
“Yes, but we all call it Vital Stink,” said Morty in her booming voice. “Or sometimes Vicious Link.”
Nicole glared at her and pulled me up off the floor.
The pitcher of urine was full to the brim and I couldn’t just leave it there on the floor. I bent down to retrieve it as gracefully as I could and carried it carefully to the bathroom, where I dumped it into the toilet.
“And that’s one of the more glamorous parts of our job,” I said as I emerged from the bathroom, grateful for the laughter of the assembled team.
As the resident launched into my patient’s past medical history, his referring complaint, and a complete review of the biochemistry and microbiology workups, Darryl leaned toward me and whispered, “If I was that bloke in the bed with a bag of urine, I would want a nurse as intelligent and respectful as you to wipe my ass.”
I blushed. I kept my head down and pretended to be Princess Diana, once a commoner, but singled out of the crowd by royalty.
Then it was my turn. I proceeded to give my detailed assessment of the patient’s condition, while everyone listened intently. Darryl made sure of that by commanding silence and attention. The resident continued his report, and Darryl interrupted him frequently to make a correction or to challenge him, or to refer to a new research finding.
“It’s incorrect to say that multifocal atrial tachycardia is always indicative of an underlying respiratory –” Darryl broke off suddenly, lifting his head as if he had heard a far-off cry or as if he were a bloodhound, sniffing a scent. In a few quick leaps, he dashed across the room to Nicole’s patient, a young man who was suddenly gasping and struggling to breathe. His oxygen saturation was dropping, 90 … 84 … 79 … 71 …
How had Darryl sensed this even before the alarm sounded?
Nicole raced to her patient’s side and quickly turned up the oxygen concentration on the ventilator so that it would deliver 100 per cent and then drew up a syringe of emergency medication.
Darryl took the young man’s hand and said, “Lad, you’re just fine. We’re going to fix you up right away.” He cleared the patient’s airway, the passageway into his lungs, then adjusted the breathing tube, and in a few minutes, colour returned to the young man’s face.
All the time he was doing these things, it seemed as if Darryl kept holding on to the patient’s hand, but I couldn’t figure out how he could manage that. I had seen all these actions and interventions many times before, but the way Darryl did them made the machines, equipment, and medicines he was using seem incidental, almost imperceptible. Darryl’s focus was solely on rescuing the patient and reassuring that frightened person in the bed.
Later, when everything settled down, Darryl came back to my room to speak with me about my writing aspirations, about music, and about the literature we both loved.
“Are you nuts about the Irish writers? Seems like everyone else is these days.”
“I’m just discovering them,” I admitted. “I’ve tried to read Ulysses, and The Dubliners, but it’s difficult. I love William Trevor’s short stories. Roddy Doyle is funny, but there’s a lot of jargon that I don’t get.”
“About Joyce,” he said. “Forget about everything else but Portrait of an Artist. That’s brilliant. The rest is rubbish.”
“Oh, and I like Edna O’Brien a lot.”
“She’s rather … earthy, isn’t she?”
“Very sensual. She writes a lot of sex scenes.”
“Oh, you always gotta have that, don’t you?”
“Absolutely.”
“The book you’re writing, does it have sex scenes in it?”
“Lots,” I said, and silently vowed when I went home that evening to write some.
“IT’S A GOOD thing Darryl Price isn’t from India. You’d be reeking of curry,” Morty said to me at one of our monthly nights out. “You’d be making us meditate and listen to whining sitar concerts.”
This time we were at The Rebel House, on Yonge Street, an Irish pub where they played Celtic music. We had just seen the movie The Commitments in a review theatre and were having drinks and were trying, as usual unsuccessfully, not to talk about anything related to work.
They had taken notice that I was deep into Leon Uris’s Trinity and had developed a sudden collection of Chieftains’ CD s. I guess the tipoff was when I kept asking them to join me to see Riverdance. There was no point trying to keep anything from my friends.
“Does your husband know about your infatuation?” they asked.
“I’m going to call Ivan and tell him,” threatened Morty.
“There’s nothing to tell. I like Darryl as a friend, and because there’s something I want to learn from him.”
“What about Daniel Huizinga? David Bristol? Jessica Leung – she’s probably going to be staff soon. They’re no slouches.”
“They’re superb doctors. All I’m saying is that there’s something different about the way Darryl talks to families and patients and I want to learn more about it. I like the words he uses.”
“Why do you like him so much?” Tracy asked, joining us late. She was feeling better after that terrible TB scare, and as far as we knew, her pregnancy was progressing normally.
“Have you ever heard how he talks to patients? Have you ever been in a family meeting with him?” I asked.
“He has a great accent,” said Nicole. “It reminds me of that soap commercial for Irish Spring: �
�Manly, yes, boot aye loik it too!’”
“So, what’s so great about the Bald Leprechaun, anyway?” Morty asked. “He’s a control freak, don’t you think? He came down hard that time when I turned off the alarms on the cardiac monitor. They were going off all the time because the patient was moving around in the bed and creating artifact. I told him I couldn’t hear the hockey game on the radio with the alarms going off all the time, but he didn’t look too impressed with that. Let’s face it, the guy has no sense of humour.” She grinned to show that at least she did.
“He’s no better than any of the jerks,” said Laura. “I tell them what needs to be done for the patient, they argue with me, and when I come in the next day, what do I see? They’ve gone ahead and done exactly what I told them to do in the first place. Anyway, he’s an anesthesiologist, as well as an intensivist, isn’t he? I can’t stand anesthesiologists. Of all the specialists, they’re the worst.” Laura was off on one of her favourite rants. “All they care about is money, money, money and doing procedures, everything is just another billable procedure to them. All they do is give a few drugs, put the patient to sleep, and then monitor them. They’re no better than a nurse. They’re the most boring of all the specialists.”
“I disagree,” I said. “Anesthesia is the one specialty concerned with the whole body. They’re not like cardiologists, just focused on one organ and forget about the rest of the body. They’re the doctors who really understand pain and how it works and care about how to relieve it. You’ll sure want an anesthesiologist pretty fast if you’re delivering a baby. Do you know how important it is to patients to feel confident in their anesthesiologist? For many people that’s the scariest part of an operation, going to sleep, worrying that they might not ever wake up. What about that phenomenon of being awake under anesthetic?”
“What’s that?” asked Nicole.
“I’ve been reading about it. Some post-op patients have reported that they were actually awake during their surgery. They remembered everything, felt everything, and could even recall accurately what the surgeons and nurses said during their operation. It’s very rare and can usually be detected, but it’s a scary thought for people undergoing surgery. That’s why I’m telling Laura that anesthesiologists are underappreciated. Besides,” I turned to her as she was draining the last drop of beer from her glass, “is there anyone you actually do like? Do you have a good word to say about anyone?”