Open Mic: A Nursing Student's Letter to an Overdose Patient

Mar 16, 2016

A Violet Battle Flag: Somehow, I found myself genuinely, internally distressed about color choices I was debating between painting a room in the upstairs of my new house. Pressuring myself to make a selection in my mind, I was increasingly full of doubt regarding selecting either hue. Would this one complement existing colors? Would that one go well with the furnishings?

I was actually, seriously concerned, bouncing back and forth between a final, concrete choice of nimbus cloud versus what could possibly be just settling for chromium gray. This was before I met you.

You are preceded on the Intensive Care Unit by a respiratory therapist setting up your ventilator machine. Once securely attached to your ET tube, air forced into your lungs will ventilate you, perfusing you, sustaining your life, for at least a time. There are bursts of activity all over your soon to be room. Your assigned nurse ensures the placement of items she foresees needing to quickly, steadily care for you amid rising instability. The nurse tech readies the cardiac monitor for application to your chest. This will continually survey and record any sways in your existence and blast noxious alarms when you start to stray away from us.

Your wife is arriving now from the emergency department. She is escorted to the waiting area just beyond the bed awaiting you. She won't stay in the waiting room long. Once you've arrived and we've ensured your stability, properly attaching you to your breathing machine and a host of other electronic devices, she will come to you and will remain at your bedside, refusing to leave you for even a moment. She’ll rub your hand, speak softly into your ear, sometimes she’ll just sit quietly next to you, matching her breaths to the robotic in and out overly audible inspirations and exhalations emanating from the giant foreign box behind your bed. As the hours she spends next to you culminate into days we will worry about her wellbeing, perhaps sometimes, even more than we will worry about yours.

She is obviously in emotional shock. She is visibly present but she is not really here. Even the simplest questions we ask her are met with responses of requests for repeating the asked question at least once but occasionally multiple times. When she finally has a thorough understanding of what information is sought, the responses she offers begin with repetitive, bewildered stuttering as she struggles to formulate a coherent string of words from a disarray of thoughts. She stares into an unseen dimension built into the stark tile of your floor, a collapse of space and time leading straight into the bathroom in the home that you two share. This is where she found you, face down this afternoon. Blood from your nose scantly pooling underneath your face, a color she couldn't even identify unforgivingly taking over your skin.

Stunned, amid the deafening shatter of future dreams with you and reeling from the blare of the prospect of a life without you, she manages to begin the actions that will summon paramedics who then will begin this war to save you from yourself. This is the war that we join here, now, as this battlefield expands from your bathroom into your new hospital room. Narcan has been administered to reverse anything still reversible, you’ve been intubated, you’re receiving vasopressors to keep your blood pressure up. The paramedics said they didn’t know how long you were “down.” Your assigned nurse whispers to me that means that we don't know how much “brain you have left.”

Amid gentle questioning, your wife softly, haltingly responds that she knew that you had used drugs before but she knew that you would never, ever use heroin. That just wouldn’t be like you, it isn’t something you would do. This must be the very first time you’ve ever used it. One of the friends she’s been urging you to distance yourself from must've given it to you, encouraging, ultimately manipulating you into giving it a try. You have been having a hard few weeks, after a kind of crummy last year, but this isn’t how you would deal with it yourself. In a few weeks she will start to feel naively stupid for not seeing or recognizing the warning signs you exhibited emanating from the initial stagnation of overwhelming addiction. Once or twice she’ll secretly admit to herself that maybe she had some denial about your true condition. Maybe she just misinterpreted a few subtle changes but… Eventually, she will crush herself with the unrelenting weight of her own guilt compounded by regret for allowing herself to get slowly blinded by the fog of lies your addiction spread to survive. She will spend years dissecting the events leading to today, trying to pinpoint things she missed slowly realizing they were just things disguised, camouflaged by her own immense desperation into things she couldn't actually even see. This past will occupy her, shielding her from the soul shattering currentness of this trauma, the trauma you initiated in your bathroom today, the trauma that she won't be able to actually face again for over a decade of lost years.

She’s hugging herself with one arm underneath her wonderfully violet purple North Face jacket while sitting in the chair directly at your bedside. She’s a rare splash of rare virile color in this monotonous wasteland of hospital taupes and beiges. A stare glazed with intent, she peers through the wormhole in the floor while caressingly grasping and holding on to your left hand. She is undisturbed by us finagling our way around to get to you. A short time later she hesitantly rouses out of her daze as our pace and intensity increases around you and as our numbers mount. She grasps your hand tightly through alarms that start to wail, relaxing her grip only when the alarms briefly, intermittently subside.

We brought our artillery into our battle for you, combating your systemic acidosis, hypoxia, respiratory failure, and hypotension. Sometimes, we briefly won. But, your pulmonary edema is worsening. Your assigned nurse, after spending years in this ICU, is a veteran at clinically managing patients with severe issues related to opiate overdoses. She is fundamentally undeterred by the complications you silently aim in her direction as rhythmic counterattacks to any positive progress she makes in this losing fight for your life.

Eventually, our resources taxed and our surrender forced, our battle to save you from yourself ends. As we face our final task, packaging you up for delivery downstairs as another vital health statistic, your veteran assigned nurse cries real tears, for the first time in years. The majority of your body has succumbed to the spreading gray of cold in death but a contrast to the unsettling settling chill, your left hand, just minutes ago released from a strenuously loving grasp is still warm. A small piece of her heat, broken away, lingers with you despite your unwavering insistence of cold.

As a nursing student, participating in and being a witness to the war waged for you against your own suicide has left me with a tiredness that I cannot adequately describe. Somehow, I open my eyes and I find myself at home, with a pan, a roller, and a gallon of wonderfully potent, violet purple paint. Now, facing a large blank wall my story as a nurse truly begins, with you and your wife at the heart of the tale.

This room, once finally transformed into an office, will house nursing diplomas, certificates and

certifications fixed high to the bright walls. This will be where I will sit and think of you, wondering how your wife is doing, if she adjusted to the new loneliness she quietly faced in your hospital room, if she is still able to adequately breathe despite the immense heaviness of her unwarranted guilt. Eventually, in this room, I will initiate my campaign of rewriting suicide notes into stories of lives well lived via an ink unadulterated by the toxins of addiction. Until that day, this is the room where I will reconfirm my position in war on the opiate epidemic as an inner city, ICU staff nurse. In this room I will commit myself to returning to school, to better serve people like you and like your wife that I may meet in the future and to increase the productiveness of my opposition to this increasingly common, tragedy of an incidence and affliction. Never will I forget my days as a nursing student. Never will I forget the day that I met you. Never will I ever doubt, wherever it is that you find yourself now, that your left hand is still anything but wonderfully warm.