Here, There and Everywhere

Posts tagged ‘doctor’

Yadda Yadda Yadda

Just Sit: A meditation guide for people who know they should but don’t. By Sukey Novogratz and Elizabeth Novogratz. Illustrations by Niege Borges. Reviewed by Gabriel Constans.

412a0ezS86L._SX373_BO1,204,203,200_If the writers of Just Sit could do so, they would reach out from the page (or screen) grab you by the throat, wrestle you to the ground, and hold you there until you started meditating – metaphorically speaking. That is what it seems to take for us to stop with all of our excuses (real and imagined) and actually do it. The Novogratz’s do everything in their power to convince us – joke, explain the benefits, teach us the fundamentals, and answer every possible question. “10 million Americans meditate, 6 million of them because their doctor told them to.” Let’s just pretend our doctor told us to and start doing it.

Whether you are just beginning, or are the oldest living meditator on the planet, the insights and instructions within make a lot of sense. It includes steps for how to meditate, questions that arise once we’ve started, and why we are reluctant to begin in the first place. “Meditation is a way of training your mind to slow down, to be responsive, not reactive, to bring you into your life and out of the constant chatter that’s going on in your head.” It is often this chatter, and mind-fuck, that keeps us from paying attention to our selves, or side-tracts us once we’ve begun. One of the most practical, and enlightening aspects of this book, is how to work with such thoughts, feelings, and actions. How to “observe” our experiences without believing we “are” our momentary experience.

Here are some of the questions people ask. If some of these sound familiar, join the crowd.  “I feel like a fool. How do I get past it?” “How does just sitting there help me train my mind?” “My mind is sharp already. So why would it need training?” “Can anyone meditate?” “What can I or should I expect?” “I understand prayer, but meditation seems a little out there for me.” “Can I do meditating wrong?” Here’s the crazy part. The answer to most of these questions is, “For meditation to work, you actually have to do it.” Go figure. What a wild idea. “The biggest secret to meditation is all you need to do is show up.” Like exercising the rest of the body, the mind needs attention. It doesn’t happen overnight, and it takes practice.

The introduction says, “Meditation Is Not for Sissies”, which reminds me of another book “Growing Old Is Not For Sissies”. In other words, it’s not always a bed of roses (though that could be quite thorny). One of the reasons people avoid meditation is because we begin to see what’s going on, and what we are telling ourselves about what’s going on (with our body, emotions, and thoughts). It isn’t always pleasant, but it is what it is. Sukey and Elizabeth Novogratz invite readers to watch whatever arises. “In order to deal with your shit and have a way better life, you’ve got to be willing to show up and sit in the much.”

So, there you have it. Grab yourself by the scruff of the neck (gently), get a copy of this book and Just Sit. “Yeah, yeah, yeah. It’s hard. It’s difficult. I don’t have time. It doesn’t work for me. I don’t know what to do.” Yadda yadda yadda. Stop believing you are what you think (or feel), and take a chance. What have you got to lose? As the author’s state so simply, and brilliantly, with one of the headings, “WARNING: Conditioning impairs freedom.”

P.S. The illustrations, and layout, match the words, and greatly enrich Just Sit with clarity, wit, and wisdom.

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Down to Earth

41QaxKjEXjLFruits for Life by Dr. Amrita Basu
Reviewed by Gabriel Constans

Dr. Basu takes us on a journey, from A to Z, through the health benefits of fruit. “A guide to knowing what to put inside your body for a healthy you.” This ear, nose and throat MD, and medical college professor, provides just the right amount of information, without going overboard with complex descriptions and scientific jargon. It is also understood that she is only sharing information on what has been backed up by research, and clinical experience.

Fruits for Life is based primarily on foods available in India, and many are labeled in Bengali, and Hindi, as well as being written in English. Most of the primary fruits described however are accessible throughout the world in some form or fashion. Chapters include: Banana: Goodness in fruit, flower and stemFigs the miracle fruit: Younger youMango Malda and MeNuts About Nuts: To have or notEggplant and Allergy: Fruits you should knowIndian Gooseberry;  and Watermelon Wellness.

Regarding apples, “Packed full of fibers and micronutrients that keep your skin, teeth, heart, lungs healthy.” Speaking of figs, “What’s not to like about a fruit which prevents aging, keeps your rain, heart and bowels healthy?” Referring to figs, “Very high in vitamins C, E. K, foliates, carotenoids, potassium, fibre and antioxidants.” The benefits of citrus skins are highlighted, “Peels are storehouses of phytochemical, which can decrease blood pressure and prevent cancer, if research is to be believed.”

One of the benefits of Fruits for Life is the down to earth, next door neighbor, feel it has to it. Even though Dr. Basu doesn’t sound preachy, or snobish. It’s more like you’re sitting down for tea and you happen to ask her a question about apples, guava, or mangoes. She provides suggestions for how much fruit to eat, and how often, as well as some personal stories about her home village, husband, daughter Rai, and family. If you have any curiosity about the health benefits of fruit, this book will quench your thirst, and fill your belly, with mouth-watering morsels of information and knowledge.

Free Love & Free Clinics

Excerpt from biography of Dr. Arnold Leff.
Paging Dr. Leff: Pride, Patriotism & Protest.

Free Love & Free Clinics

By the time Captain Leff arrived at Wright Patterson Air Base for his last year of military service, he was a changed man. He didn’t continue fighting city hall on base, but slowly worked his way into creating an alternative city hall in the way medicine was provided in the public sector. In addition to working in the outpatient clinic from 8 to 5 at Wright Patterson, he also jumped in feet first with the fledgling Cincinnati Free Clinic in the evening. That involvement turned him around to wearing longer hair and becoming more enmeshed in the counterculture of the time.

The Cincinnati Free Clinic provided a 24 hour suicide prevention line and support for people dealing with issues of drug abuse, V.D., and birth control. It ws based on the Haight Ashbury Free Clinic in San Francisco that had been started by Dr. Dave Smith.

The Cincinnati clinic was instrumental in changing the laws concerning parental consent so that young people could get the confidential treatment and health education they needed. All the docs working at the free clinics were volunteers. They provided countless hours to public health services that most communities now take for granted with their county hospitals and clinics.

Dr. Leff lived in a commune on McCormick Place in Cincinnati and commuted to the base to work during the day. He grew long hair and a beard and hung out with all his old friends to listen to music at the Family Owl. He was welcomed back into the fold, a composite of musicians, hippies and anti-war activists. Few of them realized the risks he had taken to stop the illegal bombing in Laos and his battles within the military for truth and accountability.

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Rahula, Savarna & Bodhi

Excerpt from the novel Buddha’s Wife.

Historically, Rahula was Yasodhara and Siddhartha’s son. Siddhartha was later known as “The Buddha” or “The Tathagata”.

Chapter Thirteen

“Run! Run!” shouted Rahula, as he picked Bodhi up under his arms and headed towards an impression in the hill. Savarna was close behind. He turned and yelled at Savarna again. “Hurry; they’re getting closer!”

She hitched up her sari and ran alongside her husband and son. The sound was like thunder. Their feet slid and bounced on the ground as it heaved. They plastered themselves against the shallow crevice just as the stampeding elephants ran by, their eyes wild with fright.

They had avoided bandits by following Rampal and Moksa’s advice. They had traveled in numbers and kept to the center of the plains. Now, just as they were about to traverse their last major obstacle, the Aravalli Mountains, some idiot had tried to catch a baby elephant. His attempt had angered the herd. People scattered to safety, but Rahula and his family had found themselves caught in the gigantic mammals’ path with nowhere to turn.

As the last tusked male lumbered by, blowing his trunk, Bodhi coughed violently from the wave of dust. It was so thick they could barely see one another.

“Bodhi.” Savarna covered his mouth and eyes with her sleeve, hoping that would alleviate the irritation. His coughing continued and they tried to comfort him, to no avail. His cough had worsened over the last several days and this was not helping. It was deepening and dangerously persistent.

“What happened?” Rahula exclaimed, after the last elephant had passed.

“We’re lucky,” Savarna reasoned, as her breath returned. “I didn’t think we would make it, did you?”

“I wasn’t sure,” Rahula panted, gasping for air.

They all rubbed their eyes, blinking to wash away the dust and dirt.

“We’ve got to find him a doctor,” Savarna insisted. “It’s getting worse.”

“Yes, I know,” Rahula agreed. “Let’s go back to Kanpur.”

“That’s a two-day journey,” Savarna exclaimed. “We can’t wait that long.”

“I doubt if there’s an herbalist int he village we passed this morning,” Rahula reasoned, “but we can try.”

Carrying his coughing son on his back, Rahula and Savarna backtracked and asked everyone they met if they knew of a healer in the vicinity. Late in the afternoon they came upon a woman washing clothes at the river. Her children were close by. They expected her to reply like all the others, that there was no help in the area.

“Yes,” she said, as she rung out a shirt on the rocks and yelled at one of her kids to stay away from the river’s edge. “Let me finish and I’ll take you to her.”

Rahula and Savarna shared a hopeful glance.

“Here,” Savarna said, “let me help.” She got down on her hands and knees, took a wet sari out of the basket and pushed, twisted and shook it in the wind, then folded it neatly and placed it on top of the other clean clothes in the adjoining basket. The women smiled and quickly completed their task.

“I am Henna,” the woman said, as she picked up her basket and called to her children. “Come. I will take you to my mother.” She looked at Bodhi, who was clinging to his father’s back and coughing. “She can cure anything.” They followed Henna towards the small village.

“Your mother?” Rahula asked.

“Yes,” Henna replied, “my mother.”

“I am Rahula and this is Savarna,” Rahula said. “This bag of rice on my back is our son Bodhi.”

Heena stopped short, as one of her youngest bumped into the back of her legs. “Did you say ‘Bodhi,’ like the tree?”

“Yes,” replied Rahula, “like the tree, strong and wise.”

“The Bodhi tree is the same one under which our Lord Buddha of Gotama awoke to his true nature,” Henna said.

“Yes,” Rahula said sharply, then saw the admonishing look from Savarna. “Yes, so we discovered.”

“Are you followers of the Tathagata?” Henna inquired, as she lifted the basket onto her head.

“No,” Savarna answered, before Rahula said something to offend their guide. “But we have hard of his great deeds and compassionate heart.” Rahula looked away as Savarna came alongside Henna. “Are you a follower of the Tathagata?”

“Yes,” she smiled. “We became disciples after hearing him speak. I was just a little girl, but my mother remembers him well.”

They walked the rest of the way in silence. Rahula wanted to find a remedy for Bodhi’s cough but hated the fact that it might come from a disciple of his father.

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His Mother’s Arms – Part 2

Hist Mother’s Arms – Excerpt from Children’s short story collection Solar Girl and Lunar Boy.

Hist Mother’s Arms – Part 2

The nurse, Bea, washed Jon’s forehead with yellowish-brown betadine that ran behind his ear. Bea’s brown face was surrounded by straight, thick black hair. The rest of her body was covered in white. She kept smiling and repeating, “That’s a good boy.” Her soothing voice put him into a matriarchal trance, as name-calling, rocks and falling took an afternoon nap.

Grace stood close by, rocking Mary side to side, like mothers’ of young children do. She was trying to put on a good face and comfort Jon, but he could sense her aversion to looking at his wound.

A tall mustached man, in a hospital coat, suddenly loomed over Jon.

“This is Doctor Patrick,” voiced the nurse, in a hasty introduction.

“What have we here?” he questioned, without expecting anyone to answer. He took the pad off of Jon’s eyebrow.

“Don’t touch it!” Jon screamed with fright.

The doctor ignored his outburst and stated matter-of-factly, “Pretty good one there buddy.” Turning towards the nurse he said, “I’ll need a butterfly suture set.” The nurse already had it ready and placed it in his hand.

Jon eyed the doctor with the hair on his lip, as he opened the suture kit and seeming to speak to the plastic tray said, “Son, I’m going to give you a little poke. It will sting.” Nurse Bea handed Doctor Patrick a small syringe. “Then I’ll stitch you up so good you’ll never know what happened.”

Doctor Patrick moved closer. Jon could feel his height. He looked at the doctor’s black belt and buckle, when his white coat fell open, then felt a sharp sting. He started to cry.

“The next part won’t hurt,” the physician’s monologue continued.

“It’ll just feel like someone tugging on your eyebrow a bit.”

“Son,” Jon repeated to himself. It sounded like his father’s voice. He knew his dad would want him to “be tough” so he bit his lip, counted backwards and closed his eyes. He longed for his mother’s arms and cried out “Mama!”

“All done,” chuckled the tall, black-belted, mustached man. “You can open your eyes now.” As he put the tweezers back in the tray, Dr. Patrick turned to Grace, who had just opened her eyes and said, “You have a brave little guy here.” Jon wiped away the tears with his dirty sleeve.

Before Grace or Jon could say a word, the self-absorbed doctor had gone to the next bed and disappeared behind a sliding beige curtain. Bea looked at Grace. “He’ll need to come back in a few weeks to get those removed.” She gestured towards Jon’s forehead and smiled her bewitching smile.

“I’ll tell his mother,” Grace replied, then helped Jon off the gurney and held his trembling hand out to the car.

CONCLUSION TOMORROW

His Mother’s Arms – Part 1

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Neighbor to Neighbor

If there hadn’t been a gigantic sign on the street saying “C.E.L.P.A.R. Polyclinique”, the house within which it resides would have been indistinguishable from the other small dwellings crammed side by side along the road in East Kigali, the capital of Rwanda. We had only driven for about 15 minutes from central Kigali and it was like night and day. The French spelling for the center is a result of the association Rwanda had with Belgian after they were colonized in the last century and the close connection they maintained with France, until the last decade. They are now focusing on English as their second language of choice and teaching it in place of French in the schools.

There was a crowd of people waiting for us on the street and others quickly joined, as they saw a mini-bus of muzungas (white people) stepping foot in their neighborhood, an area of town seldom visited by foreigners or aid agencies. It took us several minutes to say our hellos, take the obligatory photos of children and show them their image in the camera (to their unquenchable delight) and head towards the sounds of music we were hearing from somewhere in the near distance. Someone standing next to me said she was hearing the sound of angels and kept looking up, even though she wasn’t religious in the least. We soon discovered where the heavenly music was coming from.

The clinic’s doctor, Fred Ndatimana, led us over the ditch on a slanted path up to the entrance where we were warmly greeted by the director, Abel Sekabarati, his assistant, Fabien Musabyinana, the nurse, Ndayifluga Bizinana and a choir of patients (men, women and children) singing their hearts out. Some of them were sitting (too tired or sick to stand) and the rest were swaying side to side clapping their hands and looking upward as they harmonized. There was one older woman with a baby in her arms that immediately caught my attention. They looked like an African version of a cover from The Saturday Evening Post and had that Norman Rockwell vibe, even though their reality was far from idealistic or serene.

In the last ten years, Rwanda got a jump start on HIV education and treatment with a comprehensive array of support from the President’s wife, Mrs. Jeannette Kagame, multiple governmental organizations and national health plans, as well as funding from numerous international aid agencies and foundations. Mrs. Kagame has gone beyond the efforts of most governments in other countries to address the AIDS pandemic, let alone as First Lady. In 2001, she hosted the African First Ladies at the Kigali Summit on Children and HIV/AIDS Prevention gathering, which was the first of its kind. This meeting provided recommendations and suggestions that each First Lady in attendance would implement in their own region and country. Mrs. Kagame developed a national plan of action for Rwanda, which catalyzed the creation of PACFA, which means Protection and Care of Families against HIV/AIDS. Another program that has been somewhat successful is called Unite for Children, Unite Against Aids. The health department has this campaign in all the provinces. Its priority is making treatment and testing available to all children, as young as possible.

My friend Wendy Leonard, who is the director of an AIDS education and health treatment organization in Rwanda, called The Ihangane Project, was in a small town (Ruli) in the northern part of Rwanda four years ago, working as a physician with a program connected to the Clinton Foundation. She discovered that one of the most challenging issues was making sure everyone was getting the same information and protocols from the various government offices, committees, NGO’s and countrywide initiatives. She also found that the best way to connect with adults was to first focus on and get treatment for their children, thus the importance of programs like Unite for Children, Unite Against Aids. She concurs that there has been a lot of progress, but that much remains to be accomplished.

Though these programs and policies have made great strides, they have not completely reached small community clinics such as C.E.L.P.A.R.’s Polyclinique, which is overseen by a local church organization and gets by on pins and needles, literally. There supplies are minimal, medical staff scarce and funding almost non-existent. In spite of these realities they have hope, education and community support beyond the expected.

As the singing and dancing continued, we were led by Dr. Ndatimana through the facility, which consisted of a small room containing the lab equipment (a few items for testing blood, including an old hand crank egg beater turned upside down (which was used as a centrifuge), two brightly painted “sick rooms”, a toilet closet and the front living room, from which we had entered. Their medicine cabinet, in the same room as the “lab”, contained about 30 medications (antibiotics, Tylenol and a few antiviral meds). That was the extent of their high technology laboratory and pharmacy; a far cry from the equipment at the hospital. There are 2 hospitals in Kigali. One is public and the other private. There are also numerous health clinics run by government and religious organizations and departments.

Dr. Ndatimana filled us in on the details. “We have two doctors. One is here and the other is in school in Belgium.” There is only one medical school in Rwanda, which is of course a very expensive expenditure. “We see many people that are HIV positive and others with AIDS,” the doctor continued. “The government helps a lot, but it can take a long time to see a doctor or get treatment at the hospital. We help them here through the church. The medicine is from the government, who pays for the drugs. If people have good support they can live for 15 years or longer, if not, they usually die within 2 years. This is an outpatient clinic, but sometimes if they are real sick they stay overnight in 1 of our 2 beds.” The doctor couldn’t recall exactly how many people had died from AIDS over the years and didn’t want to guess. He said, “It is sad, but it is part of my job. I’m a doctor”.

Even with the help of the clinic, fellow patients, the church and the government, it is unlikely that many people have the “good support” which Dr. Ndatimana speaks of as a necessity of living longer, since the country (and surviving family members) is still struggling to regroup after the shattering 1994 genocide. Many families were decimated, leaving few relatives or next of kin, let alone the financial or material whereabouts to recover. Top that off with the thousands upon thousands of orphaned children and you have an overwhelming, though not insurmountable, landscape of suffering and struggle.

When asked about the attitude of Rwandans’ towards those with HIV and AIDS, Dr. Ndatimana said, “Many organizations have worked on educating people about the disease. Now they are treated just like friends, like any other sickness. They are not stigmatized as they once were. Now they know we care. We have a team of counselors that help talk with people and teach them to not be afraid.” Mr. Sekabarati (the director) added, “We help them here through the church. “These people are our neighbors and from different churches. We want to help them, not condemn them.”

People were not always so understanding in the 80’s and 90’s. A lot of misinformation, fear and ignorance surrounded the disease and those that had it. Like most places in the world (West and East), it has taken an armada of consistent and persistent educational, governmental, health care and religious leaders to get the truth out about HIV and transform the cultures attitude from judgment to concern and support.

The fight is far from over. After another “awareness campaign” to reduce the spread of HIV, it was reported that there is still a low rate of condom use in remote areas of the country. They believe this is due to remaining stigma and lack of access to supplies. Rwanda imports about 14 million condoms per year, but that supply doesn’t meet the demand, especially in small villages outside the capital. These realities have driven the National HIV/AIDS Control Commission to increase imports for the demand and continue the Witegereza campaign, whose message is “Teach Me How To Use a Condom”. This campaign combines radio ads and over 200 billboards throughout the country. It is targeted at young people and adults.

The staff at C.E.L.P.A.R.S. Polyclinique state that all of the government programs, such as United for Children, Unite Against Aids, PACFA and Teach Me How, have made a difference, but it is neighbor to neighbor that works best. “When someone you know and have known for years, is sick, you want to help, says Mr. Sekabarati. “As Christians we are taught to love our neighbor as ourselves. It is the right thing to do. We are not here to judge others. Anyone can get sick; it doesn’t make you a bad person.” C.E.L.P.A.R.S. has been educating people door to door, during sermons, at social events and from the example of their pastors and church elders, who not only support the clinic, but helped set it up in the first place, when they saw that not everyone’s needs were getting met.

Before leaving the clinic I spoke through a translator with one of the women singing. She said, in her birth language of Kinyarwanda, “We all support each other and are starting to understand.” She stated that patients help each other and check in on one another’s families throughout the week. They’ve developed a support system of those that are HIV positive and are not shunned, as they were in the past. Her words reminded me of one of the teachers at the ROP Center for Street Children, the orphanage in which we had been working for a number of weeks.

The teacher that came to mind was a woman who is Hutu, but is now teaching children who come from predominantly Tutsi backgrounds. Her husband is in jail for committing atrocities during the genocide (perhaps even against some of the parents of the orphans his wife now teaches). The teacher is HIV positive, as a result of transmission by her husband, as is their child. She continues to teach and love the children at ROP, while also visiting her husband in prison. In the past, she would have been ostracized and shunned for her illness or tribal affiliation, but now she is accepted and speaks of it freely. Her life embodies the contradictions, traumas, circumstances, transformations and ever-present hope, mixed with realistic and pragmatic solutions, which encompass the lives of most Rwandans.

After our tour was ended, we sat on a wooden bench or leaned against the wall and listened to some more songs. I don’t know how many people were not feeling well that day or had been sick for some time or how many folks in that small room had already lost family members, relatives and friends to AIDS, but the energy that radiated from their hearts and voices, seemed to transcend their circumstances. It was as if they were telling illness and death that they had no hold on them and were powerless in their presence. Children were laughing and playing outside the door, peering in, giggling and smiling before dashing off to play hide and seek. Adults entered and left quietly or stayed and joined in the singing. Dr. Ndatimana translated a verse from the last song. “We might have AIDS,” they sang, “but no matter how sick we are, it doesn’t matter. By the time we get to heaven we won’t be sick any more.” They weren’t being fatalistic. It didn’t mean they would stop taking medicine, educating others or desiring to live into old age. They were at peace with what was and what would be. Although I doubt they have ever heard of Alcoholics Anonymous or 12-step programs, they seemed to have down the serenity prayer by heart and not just in their heads. The prayer says, “God grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference.”

As we made our way back to the ROP Center for Street Children, we discussed the clinic and the experience. We tried to make sure that we cut short our tendencies to compare health care and HIV prevention and treatment in Rwanda with our experience back home in The States or Europe, but couldn’t resist. Some of us on the team, who had come to work at the orphanage, have also worked in the fight against HIV/AIDS in the West and dealt with the bureaucracy, setbacks, prejudice and fear that held sway in the early days of the pandemic and continue, to some degree, into the present. We were saddened by the lack of material provisions at the clinic, but also gratified by the community understanding and support. What impressed us most was the incredible dedication and lack of self-righteousness by the church, especially since it was a fundamentally conservative evangelical organization. They were actually matching their religious rhetoric with their actions. They were giving time, money and most importantly, a human touch to their faith. It was such a divergence from what we were used to with similar “Christian” bodies in the west. We were intimately familiar with people professing to be Christians, but whose rhetoric was hateful and only caused separation and pain and fanned the armies of ignorance. It was so refreshing to speak with the pastors and board of C.E.L.P.A.R.S. Some of us even began reconsidering our own faith or lack there of.

If there was no sign in front of the clinic and we’d been taken there under a different pretext, we would have thought we were simply going to meet someone’s family in a small apparently insignificant home on the outskirts of Kigali. The clinic was so inauspicious and unassuming. Some of us had expected to see a large building with modern conveniences, staff in white coats and long lines of patients sitting quietly in waiting rooms, awaiting their name to be called. As it turns out, size really doesn’t matter, it’s the quality of the place and the connection of the people that make something special. The people in this East side community of Kigali are connecting. Members from the local churches are connecting. The families in the area are communicating, educating and connecting by knocking on doors, speaking in the alleyways and markets and embracing their neighbors, one precious soul at a time.

Health Care’s Invisible Glue

I once had the opportunity of developing intimate relationships with people of all ages and from all walks of life. They and their loved ones often shared deep secrets and lifetime memories. Challenges arose daily, imploring me to make an individual more comfortable or free of pain or to help someone deal with an emotional crisis. As the years progressed, I found that a simple touch, deed or word could profoundly affect the people I cared for.

You may be thinking, “You must be a nurse, right?” No. “Oh, then you’re obviously a doctor or an intern?” No, but close.

I’m talking about life as a nursing assistant, better known by the pseudonym “aide,” “orderly” or “attendant.” Their work with elders in convalescent homes is legendary. Legendary because they continue to work in such facilities with little pay, dangerous under staffing and terrible supply shortages. Conditions are frequently better in acute-care hospitals, but even there they are often seen as appendages to doctors and nurses. Rare is the individual or organization that grasps the importance and necessity of their involvement in the health care system. They are the “meat and potatoes” of hands-on medical care in this country, the glue that holds it together.

Nursing assistants make a crucial difference in peoples’ lives. Frequently, they spend more time with patients than nurses and doctors combined. For some, their presence means the difference between fear and loneliness and even life and death. They are there when we hurt, sweat, laugh and cry.

Some individuals (health care professionals and the public) act superior or snobbish to aides, treating them as if they are lacking in brains or have no motivation to “move up” the social ladder of medicine. It’s not overt or cruel prejudice, it is a basic disregard for the job, the training required and the workers involved.

Let me take you inside the world of a nursing assistant for just one 8 ½ hour shift, when I used to work the swing shift on the cancer unit of a local hospital. This is the real stuff, the nuts and bolts of health care and healing. It’s what nurses used to do before they become inundated with paper work, passing medications and running madly to finish all necessary procedures and treatments and to fulfill all the other responsibilities demanded of them.

After receiving my list of assigned patients and finding out which nurse I’m working with, I begin obtaining patients’ vital signs and get an overall picture of how they’re doing.

The gentleman I encounter in the first room needs his oxygen adjusted and some fresh water and towels.

The next patient, Alice, needs an entire bed change. A 73-year old woman with breast cancer, she has become incontinent and soiled her gown and linens. She is embarrassed and painfully apologetic. As I cleaned her up she spoke of her fear that she was beginning to lose control of her life. When I left, Alice said she felt “clean, fresh and renewed.”

The third person I contacted that evening was Charles, a 60-year old man with leukemia. As we conversed, he asked if I was in training to be a nurse. When he found out I wasn’t, he said, “Oh well, this is a good job for you to start out with for your future.” Just then the charge nurse came in with a frantic look on her face and asked if I could get another patient on a gurney to go downstairs for x-rays.

After I located a gurney on another unit and got the patient ready, another nurse requested that I make a trip to the blood bank to pick up some packed cells (blood). When I returned from the lab, I found my team leader (nurse) at the medicine cart.

We sat down and looked over the “care” charts to decipher what protocol was desired for each patient. Some vital signs needed to be taken and some patients needed to walk, be turned, bathed or catheterized (a tube put in the urethra to empty the bladder). Others had doctors’ “orders” that entailed checking blood sugar levels or collecting sputum, urine or stool samples for lab tests. During report, the nurse suddenly stopped, turned excitedly toward me and said, “When are you going to nursing school? You would make a great nurse.” She looked downhearted when I explained that I had no desire to be a registered nurse or to go back to school. She said, “But you’re so intelligent!” I grimaced and said, “Thanks”. Was she implying that that nursing assistant’s are stupid?

When report was over, I finished the remaining vital signs, lifted one patient up in bed, helped another to use the bedpan and took Alice for a walk down the hall. While shuffling along we pretended we were dancing to, “Tea For Two.” Her eyes sparkled when she told me that she and her deceased husband had been prize-winning dancers in the 1940s.

I informed the nurse that a patient’s IV (intravenous bag) was almost dry and that a number of people had requested pain relief and various other medications. The dinner trays arrived and after checking to make sure they all matched each patient’s diet, we passed them out. One of my folks needed help eating (as a result of an old stroke), so I sat by her bed and slowly gave her a few mushy bits of her soft diet, so she wouldn’t choke. Meanwhile, a patient undergoing chemotherapy was throwing up just two doors down the hall. After emptying his emesis basin (vomit container), I went to supper. Believe it or not, I was famished. It had been only two and a half-hours since my shift had started, but it felt like two and a half days!

On the way to dinner, I picked up a magazine which had a feature story entitled, “What Do Nurses Want?” I got my hot, soggy food, set my tray on the table and turned on the television. The channel I selected dramatized the story of a big-city hospital. As usual, the only characters given any airtime were, you guessed it, doctors and an occasional nurse. Everyone else in the show (housekeepers, technicians, secretaries and nurses aides) were shown as auxiliary personnel who did nothing but get in the way of the featured players.

After devouring my food in the allotted half-hour supper break, I returned to the unit and picked up the patients’ dinner trays. As I walked by Room 264, I saw Sam (a patient with advanced renal failure) falling headlong towards the floor. I leaped through the door and grabbed him just in the nick of time. Sometimes I felt like I was in one of those old commercials were people dove to catch a spill before it hit the carpet. Sam was getting more confused and said he had to go get things ready for the rabbit cage. I maneuvered him back to bed and eventually convinced him to stay in his room for the rest of the night. It took another hour before he realized he was in the hospital, after frequent reminders of who, what and where we were.

Then Michael put on his call light and literally screamed for help! Michael was a young man with AIDS who was in the hospital for treatment of a lung infection. Upon entering his room I found him tense, angry and perspiring profusely. He asked various questions about medications, IVs and food. Everything was worrying him. Was this working right? Was that being done on time? Was he getting the proper nourishment? After sitting and listening a few minutes, it was apparent that he was concerned about something other than mere food. At first, I answered his questions, then I asked him if he could tell me what he was really afraid of? He began to cry. He said he was overcome with feelings of abandonment from a dear friend and the emotional loss of some of his family members as a result of his illness. Fifteen minutes later Michael and I were laughing about the absurdity of life and the beauty of loving and sincere friendships. He only rang for assistance one other time that evening, to have someone turn out his light and say goodnight.

I left Michael’s room, made a fresh pot of coffee for family members and staff, fixed someone’s bed and TV and then took Jackie her evening snack of fruit and juice. Jackie and I had known each other for a few years, as she’d had frequent admissions for chemotherapy, such as her present three-day stretch. She always called it her “dose of poison” for the month and described her hospital visits as, “A working, masochistic vacation!” We spoke of her family, hopes for a cure and her latest garden project. Then she asked about my children and work. After a pause, the familiar questions began. “When are you going to go study medicine?” “Isn’t this just a job you’re doing to get through medical school?” Patiently, I said, “No, I’m not going to school right now.” It seemed futile to explain once again that this was my profession.

The remainder of the evening involved collecting and measuring fluid totals from each patient and spending time with the family members of a man who died at 9:00 p.m. His death was not unexpected, but the grief his family experienced was far greater than they had anticipated (as is often the case). We called the doctor, minister and mortuary. I got his body ready by taking out the IVs, putting in his teeth and folding his hands on his chest with as much dignity as possible. I finished charting on all the patients around 11:30 p.m., said goodnight to my co-workers and friends and called it a night.

Another “routine” shift had passed. As I drove home in the darkness, I thought about the perceptions people have of nursing assistants. Our society says it cares about the young and old, yet it places little value on those who care for the sick and aged or teach our children. Such failure to match words with deeds is, at the least, hypocritical. Why don’t people respect and reward those providing the hands-on care of their father or mother as much as they value the doctor who diagnosis the illness or the nurse that starts the IV or hands out the pills? If appreciation for the work nursing assistants’ do is ever acknowledged by good pay, healthy and safe staff to patient ratios and mutual respect, I think I’ll pass out from the shock.

Doctors and nurses are prime assets in delivering good quality health care. Without them, many would flounder and perish. I’ve seen them work long hours with great heart and dedication. But they are not the sole providers of care, nor do they have an exclusive patent on providing expert and passionate service. They do not work in a vacuum devoid of others’ energy and skills. Without secretaries, housekeepers, laundry workers, department managers, volunteers and countless other technicians, assistants and personnel, the health care system would find it impossible to function, let alone provide adequate or quality care.

Life tends to go in circles. Who will be there when you are feeling sick and miserable or someone in your family is? A nurse, maybe. A doctor, perhaps. Most likely, it will be one of my colleagues, a nursing assistant.

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