Camp Nurse

by Tilda Shalof

  “Because, if you are,” Louise continued, “that can bring on these kinds of feelings and they can be really scary when you’re away from home and missing your family.”

  “I live for camp.” She turned away from us.

  Louise and I spoke privately. “I can’t find anything wrong,” Louise said. “I think it’s pure anxiety and nothing physically abnormal, especially since her memory is intact and she can describe her symptoms perfectly …” Louise’s voice trailed off and I caught her drift: after a true faint, a patient can’t recall events immediately prior to losing consciousness. “Let’s give her another dose of sedation and watch her closely. If she worsens we’ll take her to the hospital,” she said, and went to call Naomi’s parents.

  Just then, Naomi’s brother Lorne, an older camper, arrived. He rushed over to her, sat at the edge of her bed, scooped her up into his arms and held her tight. As she clung to him, their two heads of dark, curly hair mixed together like a huge, luxurious wig. He soon left to let her sleep. Naomi would stay overnight in the Health Centre. Alice was on call so I said good night.

  The next morning, Alice told me it had been a quiet night. Naomi had slept and was now smiling and making light of what had happened, even apologizing for worrying us. She was dressed and eager to return to her cabin. Louise examined her and cleared her to return to her cabin. We wrote it off as a weird, inexplicable one-off episode and since she was now well and happy again, we didn’t give it another thought.

  I always looked forward to Saturday lunch because it was family day and I could sit with my kids.

  “Where’s Max?” Harry asked as he joined me. He wasn’t too happy about it but grudgingly agreed to this one meal a week with me and his brother. Max soon appeared, triumphantly bearing a dripping, overflowing bowl of Greek salad he’d scored for me, because he knew I didn’t have the patience to stand in the long line for this popular item, even though it’s one of my favourite foods.

  My kids were growing up. Their maturity brought many such delightful acts of independent thoughtfulness but it also meant they were pulling away from me and each one becoming his own person. They grow up so fast, I thought, and camp makes it seem even faster. It was exactly what was supposed to happen, but it was bittersweet, just the same. It was a reminder that I was getting older, too, and that they needed me less, or perhaps in a different way. Harry, especially, guarded his privacy, and now shared so little with me. Impulsively one day, I’d pumped his counsellor, prying for some insider details. He was reluctant to be an informant but eventually caved and dished.

  “Harry is quite an instigator,” his counsellor said with obvious pride. “He led a raid on a girls’ cabin last night but took his punishment like a man.”

  “I guess he’s coming out of his shell.”

  “What shell? He’s the noisiest kid in the cabin. Oh, and by the way, he’s quite the chick magnet. A few of the girls are majorly crushing on him.”

  Whoa, back off, I told myself, now uncomfortable knowing information I’d asked to know. Harry would definitely not want me hearing this. I was beginning to see why it might not be such a wonderful thing to have your mom at camp.

  Late one evening a few days later, I was sitting in my room reading, when a buzz and crackle came over the walkie. “Is the nurse there?” a counsellor’s voice cried out. “Someone’s having a seizure!”

  As I ran to the cabin, I remembered Amanda and that terrifying trip to the hospital in the thunderstorm with Wheels a few summers ago. She’d had a cerebral bleed – a mild stroke – and I prayed this wasn’t going to be anything serious like that. When I got there I found Naomi, lying stiffly on the floor beside her bed, her friends and counsellors around her. I knelt down beside her. “Where are you?” I asked. Her eyes were open and I could tell she saw me but she didn’t answer. This wasn’t a seizure, but something was definitely wrong. “What’s your name?” I asked her.

  “It’s Naomi,” someone said. I explained I needed Naomi to answer for herself, because I was testing her level of consciousness, to see how her brain was working.

  “What made you think she was having a seizure?” I asked the counsellor.

  “That’s what Naomi told me.”

  But from what the counsellor described of what she herself had witnessed, Naomi hadn’t had convulsions. She was not now in a typical post-seizure state. We brought her to the Health Centre where she immediately began to flail about and breathe rapidly. Again, I gave her a paper bag to breathe into and coached her to slow down. I worried that her hyperventilation could cause her to pass out and might lead to a drop in her carbon dioxide levels so severe that it would disrupt the acid-base balance, or the “Ph,” of her blood chemistry. Calcium levels would then be affected, leading to tremors and spasms, a state called tetany. I had seen the condition of “metabolic alkalosis” in my critically ill patients but never in a healthy person.

  Again, Lorne, her brother, rushed in. “Naomi! Are you okay?” She stared at him blankly. “Naomi, you’re going to be okay,” he told her. He turned to Louise. “Is my sister okay?”

  “My neck hurts,” Naomi mumbled. Louise and I looked at each other grimly. Sudden neck pain was a classic indicator of meningitis, a highly infectious, deadly disease.

  “Naomi, touch your chin to your chest,” Louise asked her. She couldn’t. It was highly unlikely she had meningitis – there were no other signs and she’d probably received the vaccine – but just in case, we closed all the doors and put on masks and gloves to protect ourselves. If it did turn out to be bacterial, or meningococcal, meningitis, it would be life-threatening for her and dangerous for us, as well as everyone at camp who’d come anywhere near her. Anyone exposed to her would have to go on antibiotics.

  Naomi’s counsellor went with her in the ambulance and I followed in my car. In the er Naomi had a ct scan to examine her brain and a lumbar puncture, which involved putting a needle into her spinal column, to obtain fluid to test for meningitis. When these tests were done I went in to visit her. She was now fully conscious, sitting up, giggling, and playing a finger game called Chopsticks with her counsellor. It was as if nothing had happened. Again, she apologized for causing us worry.

  I knew all the dire things that still had to be ruled out: seizure, a cerebral bleed, a serious disease, or a tumour. The er doctor decided to keep her overnight for close monitoring and more tests. Her counsellor slept beside her in a chair, her head resting on the bed, while I headed back to camp. I had to get some sleep or I’d be utterly useless to anyone, much less myself.

  * A normal, resting pulse is 60 to 80 beats per minute.

  13

  SABBATH CHAOS

  By the time I got back to camp from the hospital, it was morning. I could see Xiu-Ling, Frankie, and Nathan, along with the rest of the kids, making their way down from the cabins for pill call. One girl had beat them to it and was already there, anxiously waiting. I knew her name was Sarah but she didn’t take meds and wasn’t one of our “regulars.” When she saw me, she ran over. “I have to talk to you!” I unlocked the door and she followed in, close on my heels. “I just got my period. What a nightmare! I can’t believe this is happening. My mother said I probably wouldn’t get it until I turned thirteen but I’m twelve so I didn’t bring anything with me.”

  “Congratulations!” I gave a big, cheery smile to offer a warm welcome to womanhood.

  “I’m so not ready for this,” she moaned. “Why couldn’t I just have pneumonia?”

  I gave her some supplies in a brown paper bag. She waited while I finished pill call then walked with me to the dining hall for breakfast. “Do you think anyone can tell?” she asked, looking around self-consciously. “I never thought I would get it before my bat mitzvah. When does menopause start?” she asked wearily before joining up with her cabin.

  After breakfast, Alice let her call her parents to tell them the news. Her cabin was planning a party complete with a red cake, and Rabbi Emily offered to take her for some
private time, just the two of them, together. Sarah was very pleased with all the attention, and was it my imagination or did she now carry herself a bit more confidently?

  Alice and I sat for a few minutes over coffee before starting the morning clinic. “You should have woken me,” she said when I told her about the emergency with Naomi and my long night with her in the hospital. “I could have helped you. I can’t believe I didn’t even hear the ambulance. I slept right through it.”

  “That’s nurse sleep for you,” I said and we shared a laugh about that. I’ve slept through a lot of things, myself. After most night shifts working in the ICU, my entire next day would be lost to sleep. There have been days when sunlight streamed through my bedroom window, the TV blared, and my kids played game after game of mini-sticks hockey right there on the floor beside me, but I slept through it all. (Once, Ivan ran the vacuum cleaner around the bed. I only knew by the carpet marks.) Yet, when I was on call at camp, even a soft tap on the door would wake me up and I’d spring into action. As for nights when I wasn’t on call, I slept soundly, just as Alice had done.

  Problem was, we were both getting tired. It was only the first week of camp, which was usually quiet, but already there had been Mitchell’s injury, his high-maintenance convalescence, and Naomi’s baffling emergency – not to mention the late-night after-hour schmooze sessions with the counsellors, which were way too much fun to turn away – and it was all taking its toll on both of us. Now, it was Friday and things would slow down and hopefully we’d get a breather. (Mostly, I didn’t even notice what day of the week it was until Friday night arrived and the Sabbath celebrations began. It gave shape to the week and reminded us of time itself. Oh, for sure, pills had to be given at certain times and clinic hours were set by the clock, but at camp, I was aware not just of clock time, but of natural time, too. I’d seen the sun rise and the sun set. I noticed the phases of the moon. In the city, I rarely paid attention to such things.)

  The next morning I couldn’t come up with a single compelling excuse to not go to services, so I went. It was a hot day. The lake was still and only a gentle breeze rustled the leaves in the trees. There had been no further sightings of Yogi Bear but I stayed off to the side, on guard duty – and also so I could sneak away if I wanted to. By eleven o’clock, sitting in the outdoor chapel in our good clothes, we were sweating. I’m sure everyone wanted to jump in the lake to cool off. I tried to hang in there because, eventually, there’d be cake. After the closing song, they passed around slices of delicious yellow pound cake, which I’d only heard about but hadn’t actually tasted because I’d never stayed to the end. I sat for a few more minutes and then slipped off, anticipating a mid-morning snooze. But as I neared my cabin, I saw a swarm of people gathered outside on the lawn of the Health Centre.

  “It’s closed!” I yelled out to them. “You guys are supposed to be in services!” I said as I arrived upon a scene of utter bedlam. (Luckily, no one turned the tables on me to say, What about you?) Three girls were stretched out, writhing on the grass, clutching at their chests, spluttering, coughing, and gagging. A friend told me what happened.

  “Tammy was sitting in services, minding her own business, and she swallowed a feather that fell off a bird! Zoe thinks she might have inhaled one, too, and just the thought of it is making Paige freak out – and can you check me, too?”

  A few other “emergencies” had gathered. A little girl waved a splinter-ravaged thumb at me, begging for immediate attention. A pale, skinny girl stood patiently, but with a desperate look on her face. She gave a little wave and mouthed the words, “I don’t feel well.” There was Dylan, pacing around as usual, but this time not running off when he saw me. “I need to talk to you,” he said urgently. Sarah, the girl who’d gotten her period, pulled me aside to whisper frantically, “I can’t get the tampon out! It’s stuck in there!”

  I unlocked the Health Centre and they followed me in.

  “I’m seeing double,” cried Tammy, the feather-traumatized girl, spluttering and coughing. She and her friends were also coughing and very flushed. It was a hot day. Could it be sun stroke? But all three of them at the same time made that iffy. I was pretty sure this gaggle of gagging girls was okay, but they were adding to the overall chaos so I sent them off to lie down and told them I’d be with them shortly.

  Just then, Daniel sauntered in. His insulin needle had fallen out of his abdomen and he had to re-insert it into his arm, but his hands were dirty and he refused to wash them. He was rude to Seth who came in to help. Was this ordinary teenage crankiness or a sign of a dip in his blood sugar? In Daniel’s case, even slight hypoglycemia could quickly lead to a medical emergency. “Please check your blood sugar,” I told him.

  “Yeah, yeah, I’ll get to it,” he snapped at me.

  “I need to know the results,” I said when I saw he wasn’t doing as I asked.

  “Daniel, just do it,” Seth said, wearily.

  Alice and Louise were still at services and hadn’t taken their walkies so I couldn’t call them, but I knew they’d come afterward. You can handle this, I told myself. Out of the corner of my eye, I noticed a boy standing off to the side who had a stream of bright red blood shooting out of his nose. Now, this is an emergency! I ran for an ice pack, slapped it in place, and applied pressure. As the flow settled to a steady drip on the floor, I took a few minutes to assess the situation. There was a lot of commotion but nothing I couldn’t handle on my own – for now. As usual, the urgent and the trivial were all mixed up. But since there wasn’t anything truly serious, a part of me just wanted to gather up all their achy, needy selves into my arms, then go and put on the kettle for a cup of tea for me and a round of instant noodle soup for them. I sat there, looking at their miserable faces, taking comfort in the old ICU nurse dictum: If the patient is breathing, the rest is gravy. I took a deep breath and thought it through: Bleeding took priority over anxiety, but anxiety trumped a splinter and also a tampon lost in outer (inner?) space. As for the skinny, distraught girl, the sad little boy, and all the others vying for my attention, I would get to them as soon as possible. “Sit down,” I told the boy with the nosebleed.

  “It tastes gross.”

  “Lean your head forward so the blood won’t drip down the back of your throat,” I told him. “I wish I had some cocaine,” I muttered to myself.

  That got his attention. “Cocaine?” he asked. “No shit! Are you a user?”

  There was no time to explain that in the hospital er they kept a small vial of cocaine that was used to constrict the tiny arteries deep inside the nasal passages. “You’ll have to go to the hospital if we can’t get the bleeding under control.”

  “Can I have the cocaine instead?”

  I went to check on the three feather girls. They were stretched out on the beds, out cold. Once again, the magic sleep treatment cures all.

  Someone tapped me on the shoulder. I twirled around. It was the pale, worried girl. “What’s wrong?” I asked, immediately regretting my abruptness. She had been waiting so patiently. It’s easy to overlook a quiet one!

  “I don’t feel well.”

  I put my hand on her forehead. She had a fever and it was a high one. I had even more reason to apologize for my irritability when I realized who she was. It was Sophie. Catheterizing herself made her prone to urinary tract infections and fever was a sure sign of one. “I’m sorry. You are sick.” I showed her to a bed and covered her with blankets because she was now shivering with chills.

  Back in the waiting room, I was given a note from the little boy who was sitting curled up on one of the easy chairs, his legs slung over the arm, his nose deep into a comic book. It had been passed hand to hand around the crowded room, until this message in teeny-tiny letters reached me:

  I’m depressed. I want to go home.

  This needed time and attention, but just then Xiu-Ling and Frankie arrived, which made me glance at my watch. I thought it must be lunchtime pill call, but it was too early for that. X
iu-Ling was ticcing furiously. Her eyes were blinking, she was stamping her feet, clearing her throat, spitting on the ground, and shouting swear words. Frankie stood staring at her, stunned at this shocking scene, her eyes wide behind her large glasses. “Why is she doing that?” she asked, but there was no time to explain. I handed Xiu-Ling a package of chewing gum she’d told me helped when this happened. I had talked to her parents and they’d told me just to wait it out, it would run its course.

  In the midst of all this chaos, Alice and Louise arrived, saw what was happening, and got straight to work. Alice obtained a urine specimen from Sophie to send to the lab and Louise started her on antibiotics “empirically,” meaning without proof of infection, but knowing the high probability in her case. Next, Alice peeked in on the three copycat girls, still sleeping off their feather trauma. Louise took the sad boy into her office to talk to him. Alice checked on Daniel, whose blood sugar was normal and who had rejigged his insulin device, while I finished up removing the splinter and then returned to the nosebleeder. “Stop checking to see if it’s still bleeding,” I said. “No! Not you, Sarah!” I said, seeing her shocked face. “I didn’t mean you!” Alice took Sarah into the bathroom to help with the retrieval of the lost tampon. Just then Amy appeared and said in her stiff and stilted way, “I can’t stop thinking about my vulva.”

  “Your what?”

  She leaned toward me and stared at my hair. “I’m thinking about my, you know, my va-jay-jay. I’m having … sensations … down there.”

  No, not now! No sensations now! It was likely sexual feelings that were unfamiliar to her and that she didn’t understand, but this was not the time for conversation about such delicate things.

  “My vagina is talking to me.”

  I desperately wanted to know what it could possibly be saying, but I held back from asking just to satisfy my curiosity. Luckily, I recalled that her mother told me that if she got “sensations,” we should offer her Vaseline. “Tell her it’s medicine,” the mother had advised. I’ve never liked the ruse of a placebo but I was under pressure. “Here’s your medicine, Amy,” I told her uneasily. “Put it on, say, three times a day?”