Confessions of a School Nurse

by Michael Alexander

  Some students thought Bryce had ‘crossed a line’ because bare buttocks were involved – others thought it genius. Regardless, everyone felt Adam had been ‘owned’ and the score settled.

  None of the faculty would have found out about the latest video had it not been for a careless slip of the tongue. There’s always one student who can’t keep their mouth shut and ‘accidentally’ says too much to a teacher, and that was how Mr Driscoll became involved. But it was to no avail. Adam and Bryce kept their traps shut and denied any such feud, while Adam’s eyes continued to weep. It took a visit to an ophthalmologist and a third course of medication to clear it.

  Surprisingly, the boys claimed they didn’t hate each other throughout any of this. Bryce even said as much to me, with a shrug: ‘It just got a bit out of hand.’ One thing is for sure … this wasn’t the last time a bit of fun went bad …

  When the fun goes bad

  Part one

  Most of the pranks I witness at school are harmless. Even Bryce and Adam’s brief feud didn’t cause any real damage. But you can never tell what will happen when boys will be boys …

  It began with a sausage. Not a banger or hotdog – a twelve-inch-thick, meaty sausage. The sausage that started the whole mess belonged to Pablo.

  ‘Come and try zee sore-sage. Vee know vous want ze taste.’ There are some things that most guys will always laugh at; farting, and walking around with a sausage hanging out your trousers. I shouldn’t join in the laughter at Pablo’s antics, but in a school full of kids, I’m still the biggest kid I know.

  ‘Give it a rest, Pablo. I’m sure you’ve got some homework to do,’ I said, trying to be the mature grown-up. ‘We’ve had some fun, but it’s study hall and I’ve got patients to see.’

  Pablo returned to his room, sausage safely tucked away. I headed towards Room 45 to see Max, a boy who had been complaining of stomach cramps and nausea. It’s always helpful to see someone looking miserable, not because I like to see people suffer, but because it brings out my better side. It brings out the nurse in me; the parent in me. Max was curled up in a ball on his bed, hands clutching his mid-section, and his face pale.

  Medicine is rarely exact and it took me ten minutes to diagnose a probable viral gastroenteritis. He had no fever and no signs of appendicitis (although that could change at any time), and the onset of diarrhoea was oddly reassuring. Max would be OK with rest. Mere moments after I left his room I heard a blood-curdling scream echoing down the corridor. I ran towards it.

  Pablo was kneeling on the hallway floor, clutching his face, blood steadily seeping through his fingers. His shirt was already soaked. Standing over him, armed with a broom handle, was Azamat. At sixteen years of age, Azamat was small by Kazak standards, but even small guys can be pushed too far.

  ‘So … so … so … sorry … so sorry,’ Azamat squeaked. The makeshift weapon fell from his fingers. ‘I didn’t mean to.’ Two teachers had arrived. I asked one to take Azamat away and the other to keep the rest of the kids in their rooms.

  Pablo was a head taller than Azamat, but like David slaying Goliath, it looked like the smaller man had broken Pablo’s nose with one hit. A bloody, broken nose will nearly always knock your opponent down.

  I took Pablo straight to Dr Fritz while Pablo was being x-rayed to confirm the break, I was able to ascertain the full story.

  Pablo had been playing with his sausage again and chased Azamat down the corridor with it hanging out of his trousers. Azamat had told him to ‘fuck off’, but Pablo had not let up. He caught Azamat off-guard as he pretended to ram him from behind and had told him to ‘bend over, and take ze sausage like a good little boy!’ whereupon Azamat snapped and lashed out.

  Rarely is an assault a simple matter. It would always be much easier if there were a designated asshole who deserved it, but Pablo wasn’t a bad guy. He was just a kid who took a prank too far with the wrong person. That seems to be the way most problems get out of hand.

  Azamat felt awful.

  ‘I didn’t mean to. I’m sorry. It’s all my fault …’ Azamat had retreated to his room. When I returned I found him sitting cross-legged on his couch, rocking back and forth. ‘It’s my fault, all my fault.’

  He not only accepted full responsibility, he didn’t even try to defend his actions. There was no ‘he started it’ or ‘he made me angry’.

  Naturally, this matter was a huge deal, but after many discussions both families agreed that Azamat could stay at the school on the condition that he have anger management counselling.

  I was pleased that he would be staying because we all make mistakes. The most important thing is to learn from them, and Azamat was genuinely remorseful and willing to learn to deal with his anger, although it was a calculated gamble, because anything can happen when you can’t control your anger.

  Part two

  Even before the sausage incident, Azamat had been the sort of boy who kept to himself. He wasn’t a loner, he just liked staying inside.

  When others went biking or played sport, he could be found sitting at his desk in symbiosis with his computer. When he needed a break, he migrated to his couch and fired up the Xbox, his eyes glued to the 36-inch flat screen he’d brought with him.

  Most of his social interaction at school happened when others came and joined him on the couch, or when someone had a problem only he had the skills to fix.

  Everyone knew him as the ‘quiet’ guy who was good at gaming.

  Only a handful of people noticed as he quietly disappeared off everyone’s radar altogether.

  ‘He hasn’t played in two weeks,’ said Yang, Azamat’s roommate.

  Alongside Cathy the counsellor, the dorm staff and nurses, Yang was keeping an unofficial eye on his roommate. Yang was as addicted to the virtual world as Azamat, and they usually played together in team events or solo, where they’d hunt each other down.

  I made a note to tell Cathy this latest piece of news. She was already seeing him two times a week, but every bit of information always helped.

  Another week passed and things seemed a bit better. A group of boys had spent Friday night playing with Azamat on his Xbox and Yang even said that things seemed more normal.

  ‘He seemed pretty happy,’ Yang said, referring to Friday night. ‘It’s been a long time since I saw him like that.’

  Cathy’s sessions with Azamat were going well. ‘He’s starting to open up,’ she said, ‘although he does feel a lot of shame.’ Some shame seems natural, even healthy, but in some cultures shame is more powerful or harmful than others. I asked Cathy if he’d said anything about his family, and she shook her head.

  ‘We haven’t got that far yet, and his parents haven’t responded to my emails.’ It’s often hard dealing with some parents, especially when they come from backgrounds like Azamat’s. Often Kazak families are traditional, patriarchal, as in the man is the head of the household, and he needs to look and be strong. Children must show respect for their elders, and must avoid bringing dishonour to the family. Family is everything in Kazak society.

  ‘Did he give you any idea how angry they are, or if he was punished?’ Not every family treats their child the same when problems arise, and some punishments that are illegal here, are normal elsewhere. Again Cathy admitted to drawing a blank.

  One month later I received the most disturbing phone call I’ve had yet.

  At 8.15 on Saturday night Azamat tried to kill himself.

  Yang had left the room he shared with Azamat to go into town but before leaving the building he had realised he’d forgotten his wallet and returned a few minutes later to find Azamat with an open bottle of pills and a bottle of vodka. He had seen the bottle before, sitting harmlessly on the desk, a bottle of ibuprofen which he thought had been at least half full.

  ‘If I hadn’t forgotten my wallet, he’d be dead.’ Yang would need serious help to get over this experience; he would go on to spend a lot of time with Cathy. There was at least one dorm parent who would require cou
nselling as well.

  After the incident, Cathy kept berating herself. ‘I should have known. I could have done something.’

  Fortunately, Azamat had no lasting physical damage from his suicide attempt, and his parents came and took him home. I never heard from Azamat again. No one did.

  Any suicide attempt is awful, but there’s something especially chilling about teenage suicide. In my ten years as a school nurse, I’ve seen four other ‘attempts’, although Azamat’s was by far the most serious. The others have been cries for help, students who had overdosed on a handful of paracetamol (because they thought it harmless) then called the nurse. This is not including those who self-harm, of which, sadly, there are too many to mention in this book. Since Azamat’s suicide attempt, I’ve often found myself lying in bed at night mulling over what drives a young person, with the whole world in front of them, to take their life. As a school nurse, and when you experience these types of situations so close up, so real, you spend too many nights awake. It’s part of the job.

  Chapter Four

  The Internet

  Swine flu

  Part one

  It all began over Christmas break. Reports about and the subsequent panic over the swine flu outbreak started to take hold.

  ‘Thank goodness it’s in Mexico,’ Justine remarked as we sat watching the evening news, but any sense of relief evaporated when I reminded her that we had twenty Mexican students returning to school after the break. ‘Oh shit, what are we going to do?’

  ‘Maybe their parents will keep them at home, keep them isolated,’ I suggested. It sounded a reasonable and sensible suggestion.

  Even if there were no students returning from that part of the world, these things invariably spread. Everyone gets ill to some degree or another over the winter, and with 400 children, plus nearly 100 adults living, working and breathing the same moist, stagnant dorm air, it was only a matter of time before swine flu panic reared its porcine head.

  What were we going to do? Firstly, I wasn’t going to tell Justine about the horrific YouTube clip I had just watched, and the next thing was to stay calm.

  ‘Half of those infected are dying!’ Justine wasn’t doing the best job of staying calm. ‘Healthy young people are dropping all over the place.’ She had determined that the school needed to close and began warning the rest of the faculty just how fatal this new virus was.

  As a result, no one was willing to look after anyone with swine flu, and that was before the students even came back from the holidays.

  ‘You’re the nurse, it’s your job to look after them,’ explained Mr Green, the head of the social studies department. He was a methodical, concise speaker who managed to sound reasonable no matter how unreasonable his request, and as such was the natural spokesman for the rest of the faculty. ‘I don’t get paid enough for this sort of stuff, and neither do any of the staff here. We’re not having anything to do with swine flu.’

  I don’t get paid enough for this sort of stress either, but I wasn’t worried about myself getting sick. I was worried about my family getting sick. I’m terrified of bringing home a bug and infecting them.

  If there was a major outbreak, there was no way three nurses could handle it. I tried reassuring the staff that they were over-reacting and that the most likely thing to happen would be a few extra cases of flu.

  ‘But you don’t know for sure.’ I was becoming irritated because Mr Green wanted definite answers, when there weren’t even any confirmed cases in Europe yet.

  I’d had enough. ‘You’re right, I don’t know for sure. For all we know, everyone could die.’ Oddly, he didn’t feel reassured.

  About the same time the students were returning from break, the first cases of swine flu outside of Mexico were confirmed.

  Justine wondered if any of the Mexican students would be coming back. Indeed, they all returned, plus some more. Twenty Mexican students had gone away for break, and twenty-two Mexican students had come back. Two students had been enrolled over the holidays because their parents wanted their children as far from the centre of the outbreak as possible. With such logic, it was no wonder that swine flu became a worldwide event.

  Meanwhile, the scare-mongering was only getting worse, not just amongst the faculty, but the students …

  Part two

  I couldn’t tell if the boys were serious, or just pulling a fast one on me.

  ‘There’s a video on YouTube. You have to see it,’ Ryan, the loudest of the group, was insisting. I refused to look at any video claiming that vaccinations, especially flu vaccines, were not just potentially harmful, but fatal.

  ‘You can’t believe anything you see online,’ I protested. ‘Do some real research and find out the facts.’ Such fighting talk got the reaction it deserved.

  ‘You’re not injecting me with poison,’ insisted Ryan; the rest were in absolute agreement. There was no way they were going to get the swine flu vaccination, even if their parents insisted. ‘You can’t make me take it. I know my rights.’

  No one can force anyone to take a vaccination, but we’d been in daily contact with Dr Fritz for guidance on how to deal with the problem, and he was getting his recommendations from the health authorities. Because of the school environment, we were instructed to vaccinate everyone, both low and high risk, although we’d need parental consent.

  After reassuring the students that no one would be forced to do anything – and that no one should believe what they read on the internet – I did my own ‘in-depth’ research, and asked Google. I couldn’t get a straight answer. The news filtering through was that swine flu wasn’t particularly serious for healthy people, but to the old, young, frail and those with chronic diseases, it was deadly.

  When the vaccine finally arrived at school, a record 90 per cent of parents requested their child be vaccinated, but only half of the students wanted it.

  ‘You didn’t watch the video, did you?’ accused Ryan. ‘You wouldn’t be making us do this if you had.’

  We had set up a vaccination booth in the boys’ dorm, and things weren’t going well. Ryan had become the unofficial anti-vaccine spokesman, and he had made life difficult because he’d posted a link of the YouTube video on Facebook and to the whole school, via the online student conference. I finally agreed to look at the damned thing.

  How can something be convincing and unbelievable at the same time? I wished I hadn’t looked at the clip, but at least I knew what we were up against. ‘She can only walk backwards.’ Ryan was kindly acting as narrator for me. ‘She had the vaccine, and now she’s a freak.’

  The clip portrayed a healthy young woman’s reaction to a flu vaccine and how it had destroyed her life. She could no longer walk in a straight line, and couldn’t speak properly either. The news reporter said the scientists thought she had a rare form of dystonia. It had to be a lie, or a one-in-a-million freak reaction, but it didn’t matter because the damage was done.

  Ryan didn’t get a swine flu shot, or any other shot for that matter. In fact, only half the students finally got the vaccine; it didn’t matter that there was no objective data, or that the government health authorities had given their approval for it as well as guidelines for coping with any confirmed cases.

  That winter saw no deaths at the school, although we did see a slightly higher number of coughs, colds and fever. Thankfully no one began walking backwards.

  We did get one confirmed case – Ryan. He suffered from asthma, and regularly used his inhalers, especially when he had a cold, and as an ‘at-risk’ patient, the health guidelines insisted he be tested. After an unpleasant few days, he made a full recovery.

  How did Ryan catch the virus? We had no idea, but there were probably plenty of others that got swine flu. In fact, there were more cases of flu than normal, but they weren’t tested as they did not have an underlying illness. The reality was that flu season was pretty much like every other winter.

  As for the backward-walking woman, there was another YouTube c
lip of her, with the same reporters reporting in the same authoritative tone that she was completely normal. She was either a convincing actor, or had a psychological disorder as opposed to a neurological disorder. They should have just said it like it was; she was probably crazy.

  YouTube had, in my eyes anyway, made this complex situation even harder to understand. But the internet isn’t all bad. There’s always Google, after all …

  Google

  Google is a mixed blessing. With my modest medical knowledge I feel reasonably capable of filtering out the junk, false hopes, propaganda and outright lies that pervade the internet. But you really have to delve deep to dig out the precious gems of knowledge, and that’s why I rarely trust any medical website the students insist I visit.

  But Roman insisted I look at the site he had discovered.

  ‘They guarantee a cure,’ he said, the excitement in his voice making my gut clench. He leapt into the seat opposite me, and opened his laptop.

  You’ve met Roman before. Earlier that year we diagnosed him with Type I diabetes. He hadn’t been coping well.

  He placed his laptop on my desk. ‘Look, they’ve got real doctors telling us how it worked for them.’ I glanced at some of the endorsements and for a second even I began to hope. There were over thirty testimonials from doctors and other medical types praising the product and claiming they were reducing and even cutting out their insulin altogether, even for Type I diabetics. Without giving the ‘secret’ away (that would cost a couple of hundred bucks) the testimonials hinted that the special diet and ‘approach’ to health was revolutionary and life changing.

  But I was unconvinced. How could I tell Roman there is no cure for Type I diabetes? But to say nothing would cost him $200, and that’s not including the devastation and potential harm these fake cures offer.