self inflicted or accidental? N’s records were conflicting. the doctors cannot agree on the cause.

she had that superficial wound, approximately 2 inches wide, on her abdomen. the day nurse said he honestly didn’t have time to ask her what the real story was, but it was passed on that she was stabbed by a knife, by herself, while feeding her cats.

of course she was referred for psych consult.

she woke up with an excruciating headache at 1 o’clock. i bargained with the doctor to give her more pain medicine, but he wouldn’t budge. he was concerned that she was extremely drowsy the whole day, and 2 mg of Dilaudid per hour is more than enough. i went back to her room and saw her standing. her hands on her head, her head on the table, crying. i helped her back to bed and apologized that i can’t give her anything for her pain. she mumbled that she understood.

having no further options, i decided to do what i thought was best, given the situation.

diversion.

“do you remember what happened to you?”

“yeah. i was having this really bad headache the whole day, but i needed to feed my cats. i was cooking. i was slicing something, then i tripped over one of the cats and i don’t know how the knife ended on my stomach, but the next thing i knew, blood was dripping from it.”

“did you lose consciousness?”

“i don’t think so, because i was able to drive myself to the hospital. it was stupid, but that’s me, always trying to be independent, so what if i dripped blood on my car on the way to the ER? i wasn’t scared because i knew it was not that bad, but i had to pull over a few times because of my headache.”

it was working. it could have been the dilaudid, it could have been the diversion. it didn’t matter. at least she appeared a little bit relieved.

although very slowly, she kept on talking.

she just got back from Iraq about 10 months ago. she worked there as an army nurse. she was with two other nurses, a doctor, and a driver when the humvee they were on, passed by an abandoned, wrecked car with an IED (improvised explosive device). three died and she was one of the two who survived. she was brought to germany and was in an ICU for a while, for anoxic brain injury among other things. her left side paralyzed, she was told that she will never be able to walk normally again. she had a metal plate on the right side of her forehead that she guided my palm to feel. she told me that the terrible pain did not really go away after the surgery, but some days were better than others.

her husband of five years, a navy, went to see her in germany while she was still in the ICU. everything was a blur, but she vividly remembers him with his arms accross his chest, looking at her unemotinally, saying “i will not stay married to a cripple.” this statement must have been in her ears and heart all this time, because she said it a number of times, with such raw, gnawing sense of pain, that i can almost touch.

that was the last time she saw him. the papers are being finalized. it pains her that he did not take the “till death do us part” portion of the vow seriously, because she did not believe in divorce, but she can’t force him to stay if he doesn’t want her. “a door was closed but a window will open”, she said.

“i know part of it was because we were always apart, but i do not regret anything i have done. i will do it all over again. i will do it all over again. i have been walking five months now, and once i regain my normal strength in my left hand, i will go back. it is hard, but i will do it again. it is not political for me, the war. it is because i know i can make a difference out there. no matter how small.”

“you know what the hardest part is? the kids. you see them dying on the street and that is the hardest part. you want to scoop them in your arms and make everything better, but you can’t. you can’t take all of them. you just can’t. that’s the hardest part. it’s not the fear of getting killed, it’s those kids. they tear your heart apart. that’s the hardest part.”

i was overcome by silence. i was in the presence of greatness, and there was nothing relevant to say.

she went on to tell me the other places she’s been assigned. korea. australia. papua new guinea. she reminisced how she met her husband. she told me she started in the army when she was 21. it has been over 16 years. she remembered her mom and dad, she told me how she can never have children. she told me how her three cats are her babies. she told me how she used to work in a boys’ town kind of facility in hawaii. she told me how four teenagers she connected with still call her up once in a while. she asked about me and my life. she told me that just like her, i am “making a difference”. she told me i should not be like the others, who treated her “like a number, maybe because they didn’t know i am a nurse, or maybe because they were too tired.”

we were both quiet for a while. i was thinking about the “making a difference” part of what she said. thinking about how i do not really live up to my self proclaimed goal of doing that, much more to the idea that just like her, i was making that much of a difference. she was quiet too, she seemed very far away.

i knew i was standing there listening to her for almost an hour, but i did not know how to stop listening. i finally said “thank you for sharing your stories, your life.” she became very quiet, and appeared to be in really deep thought, so i stepped back to leave.

she motioned to hug me, and i hugged her back. it was the least i can do to let her know i appreciate the work she did, and all those who risk their lives for others. i was silent, because no words were necessary.

my personal opinion is that she is a human being hurt by her past, painful, personal and work experiences. i don’t think the wound was self inflicted. but that is not an expert’s opinion, i am not a doctor. the psychiatry resident will come up with the professional decision. if he/she thinks N is suicidal, it won’t really be a shocker. war does that to human beings. life either becomes so precious and fragile you go crazy trying to save everyone. or it becomes so senseless, your own has no value. needless to say, war is ugly, and it does cruel things to people.

i finished the remaining hours of my shift with a diefferent perspective. the things i complain about are nothing, absolutely nothing compared to what other nurses are forced to deal with in a war. my so called commitment to make a difference pales in significance to what other nurses have suffered, in the name of commitment.

one has to make big sacrifices to make a small difference. it is no accident that there are people like N, who are willing to make that sacrifice.