I Care About People
By Elias Orrego
Paulo clenched his eyes shut. They felt dry and strained from staring at a white screen for too long. He closed his laptop, and slid it off his knees onto his bed. With a headrush from standing too fast, he shuffled across his bachelor suite, to the screaming kettle. It was time for his sleepytime tea.
Third year nursing was no cakewalk, and late-nights on a laptop often caused him to ask the question, “Why do I want to be a nurse?,” which also happened to be the topic of the paper he hadn’t begun.
The tea was too hot to drink, as he sat on the recliner, so he settled for smelling it. The chamomile aroma filled his nostrils and the steam rising from the mug moistened his unshaved face. He breathed in. His elbows were resting on his thighs, and the mug sat on his knees that were up by his chest. The blanket over his legs and feet was thick enough to block the heat from the mug and soft enough for him to slide it back and forth over each knee, letting his mind wander.
Breathing deeply always reminded him of his grandfather. He was diagnosed with stage four cancer when Paulo was eight. Paulo began sipping his tea slowly. He remembered Nonno’s thick Italian accent and the contagious enthusiasm he had, as he talked about coming out of that first surgery--the removal of three tumors: in his brain, his liver and his left lung.
“You don’t have a lot of control in that situation,” Nonno had said, “You can’t lift a finger to buzz the nurse. You can’t move.”
The tea was getting cooler now. Paulo took a deeper mouthful. He grinned and gently closed his eyes as the gulp warmed and soothed his swallowing throat. He breathed out and then in, deeply, and paused before letting it out again--eyes still shut in stillness and respect for Nonno.
“And then you realize…” Nonno began, “you realize you are breathing. I could control one thing at that moment! My breath was gurgly and halting but I focused, and I could push through. ‘I can control my breath.’ I told myself. That was enough to keep me fighting. And then, my thoughts.… What else can I control? Later, my food, my sleep, my exercise...”
For four amazing years, Nonno bombarded Paulo with enough alternative medicine and meditation-healing talk to drive any “actual professional” mad. He lived an extra three years and eight months.
“What does DNR mean, Papà?” Paulo asked, when the doctor went out of the room, in the palliative unit of the Brandon Hospital. The nurse was dabbing Nonno’s dry lips with a wet cloth. Nonno’s eyes were closed, and his breathing was crackly and coarse.
“It means Do Not Resuscitate.” Papà explained, “So, sometimes when a person has been through a lot, and their body is weak, and they are close to passing on...they request a DNR. They do not want to be resuscitated in the case of a heart attack or something. They do not want CPR.”
“Is Nonno drowning?” when his father returned to the waiting room. The cold Manitoba winter wind was howling on the other side of the big, dark window beside them.
“His lungs are full of blood, yes. But, he is ready to go. He has fought well, figlio mio.” Papà hung his head as he patted Paulo’s shoulder.
Paulo swallowed his last bit of tea and marveled at the light dancing off the empty mug as he moved it around.
“Paulo wants to be a nurse! Allora!” Zia Gina announced at a family dinner one Sunday, when Paulo was fifteen. She kissed him on the forehead. Paulo chuckled to himself, thinking about his zia’s wet kisses--he always had to wipe them off. The family toasted and cheered, clinking their glasses. “Why not a doctor?” Zio Bruno asked. Zia Gina shoved her elbow at him with a shush: “Because Doctors don’t care.”
“No,” Paulo laughed. “Too much school...”
Having spent enough time in hospital rotations to know what his zia meant about doctors, Paulo pondered the stereotypes. His mug was empty, and he took it over to the sink. He would do dishes in the morning--maybe.
“What makes you a good nurse?” Paulo remembered a guest speaker asking the nursing class, earlier that semester.
His hand was picked. “I care about people,” he said. It felt right. A little bold and a little simple, but right.
“What more could you ask for?” His instructor remarked, with her hands in the air. Heads were nodding.
Paulo turned on the shower and thought of his childhood next-door neighbor, John. John was a friendly man with a sad, hard life and a rather lonely existence. Paulo undressed and held a hand under the running water as it warmed. As a kid, Paulo would gawk at this smiling, quiet, six-foot-five man that would walk up and down the street throughout the day. He would stand and watch the kids briefly as they played hockey, before continuing on his straight-back march.
“Did you know John used to play hockey, down in the states?” Paulo remembered his mother asking him one morning at breakfast. She must have noticed him staring out the window at the man. It was awkward how big he was. Awkward when he spoke, when he walked, when he didn’t speak. He was a mystery.
“Like, professional?” Paulo asked.
“Semi-pro, in Florida.”
Paulo couldn’t wait to ask him about it. It took a few days before he built up the courage.
“Hey!” He remembered crying out one evening, as John walked home. The curiosity bubbled out of him. “You played hockey?”
Paulo stepped into the shower and smiled, thinking of John’s hockey tales. He laughed as he pictured again, “The Mighty Duck,” as they apparently called him--heads and shoulders above the other players--bashing and smashing and knocking over his opponents as he awkwardly skated down the ice. Paulo loved the stories.
“I wasn’t the best skater,” John told him one day, as they sat on his porch and drank sugar free lemonade. “I never set out to play at that level, but it was fun. I needed money, and a guy as tall as me was a real crowd pleaser in the rink. Got into a lot of fights.” John would chuckle and grin proudly, as he spoke of his glory days on ice.
“Why did you stop?” Paulo asked, in sad confusion.
“Had to,” John remarked. “I didn’t know it, but they were using me. You get beat up that bad, every game--guy as big as me--you don’t last long. My back couldn’t take it. They spat me out fast.”
“How long did you play?”
“Only about a year and half before it got real bad, but I kept on and off for another three-and-a-half years before my back couldn’t take it anymore.” John’s speech fell heavy.
Paulo shut off the shower and dried himself off with a towel as he stepped out. He thought about John pushing through all that pain. “Lace up and skate on,” John would say, as he spoke of his injuries. It was probably a line from an overbearing coach, Paulo thought.
The team wouldn’t cover any medical expenses once John could no longer play, so he came back to Canada. No more hockey, but John built up the strength to work again. He became an orderly at the same hospital in Winnipeg that Paulo now trained at. Paulo laughed as he wondered how many times John talked about being an ‘orderly’ before actually asking John what it meant. It just sounded made up--John might as well have told him he was a wizard.
That was years before Paulo thought of becoming a nurse. The decision was made in the summer before grade ten, at the cottage with his grandmother.
“Nonna?” he asked in disbelief at what he saw, and with even more fear. She was stomping and pounding the counter. She made horrific sounds with her throat--she couldn’t breathe. Paulo jumped from his stool and flew across the room to her side. He put his hand on her back; she was moving uncontrollably. She pounded the counter. “Will I watch Nonna die tonight?” he thought, “is this it?” But, he cried in desperation, begging inside, for a miracle, “What can I do?” he asked her.
She gestured. “The heimlich,” she said, barely understandable; but it was impossible to misunderstand. This was it. A defining moment in a boy’s life. He suddenly remembered the first aid class he took for his Chief’s Scout Award. He hugged her from behind, thrusted her stomach with his fists, and cried out, “Am I hurting you?” It felt wrong to be putting so much force on anyone, let alone his Nonna. Was he breaking a rib?
“Harder!” She somehow could say. So he did.
Her hands flew up. She could breathe. His cousins were screaming; his father ran in from outside. It was like a scene from a Tarantino film, but he lived it. They embraced.
“I want to be a nurse,” he said to Zia Gina, the next day over the phone. They had talked quite a bit about the incident. She was a nurse--she was thrilled at his decision.
Paulo sat cross-legged on his bed in his underwear and brushed his teeth. He thought more about John.
“What’s it like to have chronic pain?” He asked one day as he helped John weed his garden.
John was standing up straight, with a hand on his back. As he was taking a break, his face was tense. “Well...you know what it’s like to feel pain, don’t you?”
“Let’s start there. What’s the worst pain you can recall?” John challenged.
He thought of an ear-ache. Those were pretty bad. Then, he remembered his bike accident at age twelve. That was probably the worst time. He told John.
“Okay,” John responded, “so describe it to me. What’s it like to crash your bike that bad?” John walked over to the porch and sat down, as Paulo went on:
“Bones achy, like you have when you get a fever. Blaring flashes of pain like an ambulance siren. Pulsing pain. Areas of raw skin, scraped off, exposed. It felt like I was on fire.”
“Fire?” John asked, “Pain is a tricky thing like that. You feel scrapes and jabs and bangs, and bruises, but when you feel fire, your nerves are so messed up with the pain, they don’t know what they’re feeling. Just, pain. Imagine that blaring sensation, flaring up for five minutes or so. One hundred times a day…”
Paulo rinsed out the toothpaste from his mouth. There was a dull, warm sensation on his gums from the mint. It made them sensitive to the cold water. He spat it out. Turning the light off, he walked over to his bed, put his laptop on the ground and hopped in under the covers. Staring up at the ceiling, he thought of the other things John had told him about pain.
“You sit up out of bed...there it is--” Paulo remembered John telling him. Then he remembered his laundry was still in the washing machine. He thought of John’s words as he got out of bed, “--you turn wrong, and there it is. You get a cup from the cupboard, you pick up the cat’s food-dish, you look at the squirrel in the window as you sit at the computer, there it is. There it is. There it is! THERE IT IS AGAIN! PAIN. In your back. You can’t enjoy the time you don’t feel it, ‘cause you’re bracing for the time you will—unless you forget, and it comes back twice as strong.”
“But the pills help?” Paulo remembered asking one day, in faint hope. He moved his clothes from the washing machine, into the dryer.
“Even if they didn’t, and someone told me they were supposed to, I would still take them. Not in the states, maybe, but Manitoba healthcare covers them for me, here. The pills break up my day. They give me purpose--a reason to go on with the pain--and yes, they do ease the sensation a little. Mostly, though, they just distract my mind, with fuzziness, fogginess, and crazy dreams at night. But, the effects of withdrawals are worse than the pain--almost--so I trek on. Walking the streets, feeding my cat. Doing what I can to live. ‘Cause if you’re not living, you’re dead.”
Paulo turned on the dryer and welcomed the white noise, as he thought of John’s depressing perseverance. He recalled the time they talked about God.
“Do you pray?” Paulo asked one Sunday afternoon as they chatted, the summer before he left for university. Paulo was still wearing his tie from church service.
“I do, yes. I don’t know if He’ll hear me,” John said, looking down. He offered Paulo more tea.
Paulo was shocked at the idea of John praying--willing to go out on a limb and act and live as if there’s a God--and yet not believing that that God would be interested in his life, in his pain. What of Jesus? What of His suffering? His pain? Paulo wanted John to have some relief. Some comfort. Anything. “What do you mean?” he asked.
Paulo thought about John’s answer as he turned off the light again, and crawled back into bed. He felt dark inside, as he remembered it.
“My father...well, I never knew my father. My stepdad raised me. And he drank. He didn’t spoil me--didn’t ‘spare the rod’, either--if you know what I mean. I could take it just fine, but when he did it to my mother, I stood up. It only made things worse. I ran away at fifteen. Worked different jobs. Ended up in Florida--had to get as far away from him as I could.”
“That’s where you started playing hockey?”
“Well, I played as a kid, you know, Manitoba winters, just like you guys. But yes, after a few years in Florida, they discovered I was a star on the ice, so long as I had a stick, and the other fellas had pads.”
“Or diapers,” Paulo said, trying to lighten the mood.
“Yes,” John laughed. Then his lips tightened, and his brow lowered. “You know about my back pain,” he continued, “So I’m back in Manitoba, and I have my dream job as an orderly. My own pain is manageable, at that point, but these are my people, you know. They are broken, I feel sorry for them. Every day someone new, or some new pain. I know pain. And these are my moments, you know, life or death, emergency--it gets my blood going. Anyway, one day an old man comes into the hospital, in a bed, you know, had a stroke or something, in pretty bad shape. I have compassion like always. Anyway, I don’t know it at first, but this old, flimsy, helpless man in critical shape is my stepdad.”
Paulo lay in bed and remembered the confused, cold look in John’s eyes as he described the events that followed. He felt a chill, and hugged himself, under the blankets.
“I’m not scared of this man anymore, but I’m still terrified inside. I’m big, and he’s helpless and old and dying. We recognize each other at about the same time. He’s in shock. I see weakness, just weakness. In his eyes. He needs my help, and it’s my job to save him.”
Paulo held his breath.
“I let him…” John continued, “I just froze.” He was halting, and the blood was rushing to his head as he related the events. “I just let him die on the bed there!” He blurted out, finally, “I just let him die. Right in front of me. My job: to save him. I couldn’t.” John looked down. “His eyes,” he whispered, “I’ll never forget his eyes as he recognized me. He knew. Then, he was gone--lifeless. I couldn’t...”
Paulo felt like his body was covered in ice. He had goosies and his hairs stood on end. “No, you did not…” he thought, wishing it were not true. “Did you get caught? Did you tell anyone?” he asked, desperate for some kind of resolution.
“The nurses came in, and one asked, ‘How did you know?’ How did I know ‘what?’ She held up a clipboard,” John gestured and pointed. “Right there, DNR.”