Review: Critical Care by Theresa Brown

Dear Lit Loves,

While I'm patiently waiting to hear from literary agents and publishers, I'm continuing to read widely in my preferred genre of memoir.  Last week I read Critical Care:  A New Nurse Faces Death, Life, and Everything in Between by Theresa Brown.  I really like to read about all things medical as I've had a vast amount of experience with the medical industry over the course of not only my life, but the lives of my immediate family.  This book was a very fine read about a woman who was once an English professor at Tufts University when one day she decided she wasn't doing what she wanted to do with her life.  Happens to quite a few of us.  She decided to return to school to become a nurse and this book chronicles her first year of nursing on an oncology ward. 

One of the first nurse responsibilities Ms. Brown chronicled was when to call a "Condition A".  A "Condition A" means a patient has crashed or arrested.  I had always assumed it was the physician that made this call, but no, nurses make the call especially if you are in house at the hospital and not arriving via ambulance.  When a nurse makes this kind of call, it basically means all hands on deck; we've got a patient in serious distress and on the verge of death.  In this particular case Ms. Brown encounters a woman who had been admitted after a CT scan showed profuse amounts of lung disease and the patient was having trouble breathing.  When her heart rate went to 160 beats per minute the all hands on deck mode went into effect whereby adenosine, a medication to regulate heart arrhythmias, was administered.  This caused the patient to experience a kind of shock, but it also stabilized and returned to a regular heart rate.  Two weeks later Nurse Brown returns to see this patient once again on her rotation, but the woman is near death.  Her body remains, but she is unaware.  She was having such a difficult time breathing that she was experiencing air hunger where the patient is grasping physically for air.  The family of the patient asks Nurse Brown to assemble a priest to administer last rites.  Later, after family members have expresses a desire for the patient to no longer suffer, Nurse Brown removes the breathing mask and gives the patient morphine.  The patient passes.  This is Nurse Brown's first experience with patient death and she learns that she must call the funeral home and the funeral home prefers to pick up patients with no family members present. 

It was also interesting to me to read about a nurse's first year experience on an oncology ward for cancer patients as I've spent much time on one.  My dad has anaplastic large cell lymphoma that has relapsed twice and he's also had a stem cell transplant.  Additionally, my mom has endured breast cancer.  And my dad and I have both been treated for skin cancer.  An oncology floor is challenging, but it's not without its victories as when Nurse Brown stands up to a pre-op nurse in order to make sure one of her sickest cancer patients gets his Hickman catheter so he can begin receiving his chemo treatment.  Cancer doesn't take a vacation and the longer a patient has to wait for catheters to be embedded in the body, the more time the cancer has to spread.  Nurse Brown thinks like this and she wasn't scared to stand her ground against another more experienced nurse in another busy department of her hospital. 

And nurses are also the folks who have to deliver news of death to a family member.  This happens when a patient assigned to Nurse Brown is sent down to the basement area of the hospital for a radiation treatment.  His wife chose that time to go to lunch or run an errand.  Later, Nurse Brown receives a call from radiation informing her that her patient down in radiation has coded and since he has no "do not resuscitate" papers, the medical team is continually trying to revive him.  Nurse Brown has to be the one to give this news to the patient's wife upon her return, but the wife must go down to radiation and give the crash team permission to stop trying to revive her husband.  And only then can the medical team pronounce the patient dead.  My advice:  Have the living will done, get the healthcare power of attorney form completed and signed by a notary, and don't make your family have to make these kind of awful decisions when something dire happens to you.

And who even knew that bullying exists even among the nurses at a hospital.  Sure enough, Nurse Brown experiences brushes with nurses who critique her patient notes and those that just plain want to point out her shortcomings in front of all the people on the oncology floor.  This made me furious because honestly, there's no time for this type of juvenile behavior on an oncology ward.  So I was glad to learn that Nurse Brown moved to an adjacent oncology floor where stem cell transplants and bone marrow transplants take place.  There's no shouting at staff, no staff belittling one another, and  better still, the oncology staff works as a team and takes up for one another.  This is as it should be.

I thoroughly enjoyed this book, learned quite a few things in the process, and overall felt satisfied I had come away from the book knowing more than when I first read the back copy.  It's excellent and you should read it.  Until next time,
Grace

Happy National Lilly Pulitzer Day!

Did You Find Your Lilly For This Summer?!  I've Got Mine!
Lemonade, Sea Shells, and Sunshine.......Summer Spells Lilly Time!

Love,
Grace

Ladies! You Must Know How To Cope With The Unimaginable

Dear Lit Loves,

It's been a trying week in my efforts to inject myself into the publishing community.  Most everyone who knows me can tell you that I write about facing down unimaginable health issues:  chronic, rare and perplexing disorders and diseases.  I've been doing this since I was age three and contracted a form of bacterial meningitis from a preschool classmate and wound up surviving.  Why is that so unusual you ask?  Because the year was 1972 and no one survived it back then without suffering major bodily damage like going cross-eyed or not being able to walk.  I then was diagnosed with Meniere's disease at age eighteen.  You know, the inner ear disorder where fluid builds up inside the cochlea and vertigo ensues.  Eventually, you lose your balance, hearing, and oftentimes your dignity.  Yes, I've dealt with that since 1988, age eighteen.  Then in my late twenties, I developed the chronic form of an eye condition called Uveitis which inflames the eye and causes vision loss.  And obviously, this led to Uveitic Glaucoma for which I've had five surgeries to implant a shunt to drain my inner eye fluid and save my vision.  Plus, I was also found to have an underlying autoimmune disorder called Cogan's syndrome which causes my immune system to attack my own organs and damage them.  I regularly take chemo to keep that from happening.

And heaven knows I've dealt with facing the grim reaper when it comes to my family.  My dad has had quintuple bypass surgery along with two bouts of Anaplastic Large Cell Lymphoma along with one stem cell transplant.  My mom has endured breast cancer and I just recently watched a fellow teaching colleague battle a recurrence of neuroendocrine colon cancer which by the time it was found, had spread to her brain and liver.  No one avoids the unimaginable or the grim reaper so if you think you will, you are sadly mistaken. 

It came as a bit offensive to me this past week when a literary agent who had requested an adventurous, inspiring memoir rejected my book proposal and manuscript "because it didn't quite pique her interest enough".  Short of jumping on a broom and flying to New York to stand in my Tory Burch heels to whack my broom on her desk while yelling "What the hell is your problem?!  I wrote this for women who need to know how to deal with the healthcare system!  I wrote this because I'm a firm believer in being your own patient advocate!  I write to enable women to come to grips with the reality that you can't run from adversity sister; you can live in denial all you want, but everybody faces the pied piper one day or another!  So you've got to put on your big girl Spanx and understand that in this healthcare system we have today, whether it's you, your dad, or your best friend, you better know how to deal with discrimination, sexism, negligence, asinine surgeons, cash-strapped insurance companies, and how to research and receive the best care possible or you are quite simply Up A Freaking Creek!  Do you understand me?!"  Cause what I'm saying sister is that this material may not pique your interest today for whatever reason, but one day, when you're the one receiving the grim diagnosis or waiting in the pre-op holding area for that life-saving surgery, you're gonna think back and go, "Damn, wonder what that gal who wrote about all this really had to say; what had she learned that might have helped me now?"  So even if I don't pique your interest right this second darling, one day you will think back and remember that I truly had the valuable insight to share; I have the experiences and an up close and personal relationship with the ugly, badass diseases and disorders that will one day invade your life; well, damn, you'll think, "she knew how to cope and deal and resolve, but it didn't pique my interest then, but it does now because the unimaginable drop-kicked down my front door and decided to set up its next residence in my living room."   And you know what I'm going to say sister, "I tried to tell you; I tried to help you; I tried to enlighten you. BUT it didn't pique your interest, till now." 

Grace