]]> http://theharperstudio.com/2009/10/chicken-soup-and-humble-pie/feed/ 1 http://theharperstudio.com/2009/10/whose-death-is-it-anyway/ http://theharperstudio.com/2009/10/whose-death-is-it-anyway/#comments Fri, 16 Oct 2009 14:59:27 +0000 Steffen http://theharperstudio.com/?p=4833 Nurse Theresa Brown wrote another post for The New York Times’ Well blog, looking at a patient’s decision to refuse cancer treatment against the doctor’s advice. It’s a thought-provoking piece, bringing another question to the health care table: Whose death is it anyway?

We’re also excited to learn that Theresa’s writing has been included in two anthologies: The Best American Science Writing, 2009, and The Best American Medical Writing, 2009. Additionally, she was recently featured in the American Nurses Association‘s daily newsletter as their top story. For those that would like to read Theresa’s essays in another context, here are a few more options!

It was a year ago in the hospital, sometime during the week between Rosh Hashanah and Yom Kippur, when another nurse and I heard one of the more disturbing sounds we’d ever heard in the hospital coming from a patient’s room. It was like a strangled, low-pitched moaning, and we both went on instant and frightened alert.

On my floor all the rooms have glass windows set into the doors and we began cautiously peering into them as the haunted sound continued. The patient we saw through the first window was sitting comfortably in bed watching television. The second patient was clearly asleep and breathing normally. We moved to the third window in the row, expecting to see something unimaginably horrific and terrible—for what, short of a huge blood clot stuck in someone’s larynx, could cause such an inhuman sound?

We looked into the room together, and saw not a blue-faced patient struggling to breathe, but three men with big beards wearing white shirts, black hats and black suits. One of them was blowing on what looked like a ram’s horn. Quickly we realized that the ram’s horn was the source of the surprising sound.

To us, expecting to see an oxygen-starved patient possibly spitting blood (because that’s what my imagination conjured) and to see instead these three men, embracing the dress and customs of their century-old ancestors, was too much of a contrast. We both burst out laughing, and then hustled away as quickly as we could, hoping the Orthodox Jews who had come to share part of Rosh Hashanah with a hospitalized patient would not hear us.

There’s a large community of Orthodox Jews near where I live, and if you have cancer, we’re the hospital a lot of people come to. We’re close enough that Orthodox friends and family can walk to and from the hospital. It’s a long walk, but it means that Sabbath visits are possible for observant Jews who won’t drive on the day of rest.

Still, the ram’s horn that had caused the other nurse and I so much worry: what was that, I wondered. My husband is Jewish, but a self-described “Hebrew-school dropout;” he wouldn’t know from ram’s horns. So I asked another friend, one who’d served in the Israeli army.

“Oh, that’s a shofar,” he said, his tone implying “Everybody knows that.”

And it turns out the shofar isn’t that exotic, but in the context of the hospital, where anomalous sounds are always worrisome, the tones of this simple instrument, meant to herald the new year, were ominous.

The other nurse and I argued afterwards about what we thought the shofar had sounded like. She heard the moans of a sick cow, whereas I thought it sounded more like a cat stuck in the heating duct. It’s the nature of our work that odd sounds typically signal distress. When I told her later, “That ram’s horn is called a shofar,” she insisted that visitors should warn someone at the nurse’s station before playing such an unusual instrument.

This led to several jokes about hospitals needing to be shofar-free zones. However, knowing a little bit about Rosh Hashanah, what could be more appropriate than blowing a shofar on a cancer floor?

My understanding is that hearing the shofar wakes people up to the idea of judgment and to God’s sovereignty and power. According to tradition, Rosh Hashanah is the time when God decides which names will be written in the book of life for another year—who will live and who will die. Our patients are acutely aware that their fate is out of their hands, that they need all the help they can get to make it into that book. We offer them the most cutting-edge treatment available. But some patients will also find comfort in rams’ horns and their own time-worn traditions of religious community.

I think back on my surprise when I saw those three bearded black-hatted men trying to bring a little piece of their faith to our sterile hospital environment. I was so happy to see them, rather than a patient going through a physical ordeal horrible enough to make him produce such a sound.

Probably for the patient in the room, the shofar, an ancient instrument with years of accumulated cultural and spiritual meaning, sounded like hope. But there’s little space in the modern hospital for displays of faith. When one occurs so dramatically, and so audibly, the effect can be unnerving.

So when the other nurse and I laughed, we were expressing relief. We thought we’d look in the room and see a patient retching blood, but “Gottze dank, just three Mensches playing the Shofar,” transmitting a message we can all find meaningful. Here’s wishing all our patients another year in the Book of Life.

Now, amid all the chatter and the noise on radio and TV, with all the falsehoods that are promoted by not just talk show hosts but sometimes prominent politicians, sometimes it can be easy to lose sight of what the debate over reform is all about. It’s about stories like the one told by an oncology nurse named Theresa Brown. A few weeks ago, Theresa wrote a blog post about a patient of hers. He was in his 60s, a recent grandfather, a Steelers fan — (applause) — spent the last three months of his life worrying about mounting medical bills.

And she wrote: “My patient thought he had planned well for his health care needs. He just never thought he would wake up one day with a diagnosis of leukemia. But which of us does?” she asked. And then she wrote: “That’s why we need health care reform.”

Nurses, that’s why we need health care reform. I am absolutely confident that if you continue to do your part — nurses, you guys have a lot of credibility; you touch a lot of people’s lives; people trust you — if you’re out there saying it’s time for us to act, we need to go ahead and make a change — if all of us do our parts, not just here in Washington but all across the country, then we will bid farewell to the days when our health care system was a source of worry to families and a drag on our economy, and America will finally join the ranks of every other advanced nation by providing quality, affordable health insurance to all of its citizens. That’s our goal. We are going to meet it this year with your help. Thank you very much, everybody. God bless you. (Applause.)

We’re publishing Theresa’s extraordinary book, Critical Care: A Nurse’s First Year, next June. (We’ll make sure to send President Obama an early copy!)

Click through to view the video and advance to the 12 minute mark to catch the exciting clip!

]]> http://theharperstudio.com/2009/09/maybe-we-should-ask-the-nurses/feed/ 0 http://theharperstudio.com/2009/08/house-rules/ http://theharperstudio.com/2009/08/house-rules/#comments Fri, 21 Aug 2009 12:35:31 +0000 Steffen http://theharperstudio.com/?p=4348

Since photos of Michelle Obama in sleeveless J. Crew started popping up, women across America have been doing bicep curls at their desks.  And let’s be honest…how many of you seriously considered starting a vegetable garden when Mrs. Obama dug her own at the White House?  Mrs. Obama has made some clear, strong statements that have resonated across the nation, becoming the perfect spokeswoman for a better America.  But Amanda Hesser thinks something is missing.  Check out her op-ed from the New York Times, and see what she has to say to “The Commander in Chef.”

I compare his choice with deciding whether to jump from a burning building. Staying in the building means certain death. But if you jump, you might break both legs and take months to heal or sustain injuries serious enough that the complications eventually kill you. But you would be alive when you hit the ground. Maybe it will only buy you a few more rough years. But you might just walk away and live.

When it comes down to cancer patients making the choice, a few decide to stay in the building. They opt for the quicker, surer death of cancer. Others, for different reasons, don’t have the option of a transplant. But even knowing the risks, I’m pretty sure I would make the leap, endure the free-fall, feel the impact, and hope to be one of the lucky ones who survives to walk back into the life that is waiting for me.

This week, Theresa’s post on The New York Times Well blog is a touching tribute to a man who took that jump.

Desperate parents of organizationally challenged children will find relief with Marcella Moran's great tips.

As the mother of a highly (HIGHLY!) disorganized child, this book is near and dear to my heart. We’re hoping to get it out before school starts next year.

Marcella’s a study coach (not to be confused with a tutor). She teaches organizational skills. I say she’s like a “Child Whisperer.” (Full disclosure: Dr. Kutscher is my son’s doctor and he recommended Marcella to me. My son would not have survived the last school year without them.)

Here’s a sample tip:

Get rid of the mountains of papers from the backpack with a portable open top file container from Staples. Ask your child what color they see each subject. If math is red, take 2 red file folders and a hanging folder and label them: one for tests and quizzes and the other for homework/class notes. Store them in the open top file container and you’ll never have to wonder where that old test is, especially during midterms and finals.

We’re going to start a blog for Marcella and Dr. Kutscher soon so they can give tips as the school year goes along and answer questions.

To be continued…..

If that phrase catches your attention, you’ll understand why I read Theresa Brown’s article "Perhaps Death Is Proud: More Reason to Savor Life" in last Tuesday’s Science Times section of the New York Times.  "At my job, people die" is the first line in Brown’s essay about her first "Condition A" as a new nurse…"Condition A" as in "cardiac arrest"…as in watching someone die.  I was in Brown’s thrall from that first line to her last ("The antidote to death is life"), so wrote to her on the Times website asking if she might want to write a book about her experiences.  Happily, the answer was "yes," and yesterday afternoon Brown’s agent Lynn Johnston, who had approached Theresa for the same reason I had, and I shook hands verbally on a deal.  Brown writes so well that I can’t wait to read the whole book, let alone publish it.

Bob