"To glory over slain men is no piety.
Destiny and the gods' will vanquished these..."

"The Odyssey," Fitzgerald Translation. Book 22, Lines 442-443.
Used without permission.
 

AND NOW, A WORD FROM OUR NURSES...

GIZZIE:

What a night. I was supposed to be off shift two hours ago. However, three people coded within five minutes, and we're short of hands here.

We got lucky. Brought them back from the brink.

In a way, I'm grateful for this delay. I have something to give a dear friend of mine. And it's not something I want anyone to see when I do it. Hell, I don't want her to see it. I don't have a choice, though.

I watch Martha, day in and day out, as she grows wearier and more anguished. Daniel continues a slow, horrible walk towards death. His pain is constant. All the Dilaudid in the world will afford him no relief. And as a result, she will have no peace. Not until he finds it.

I have a confession to make. I never liked Daniel. Okay, I didn't meet him until after he got sick. And being sick, as I am well aware, does not bring out the best in people. I just felt that...oh, hell, I don't know. It's none of my damn business anyway.

Martha married him young, right out of high school. She set her life path on course at a time when I was out drinking, carousing, and dabbling in all kinds of better living through chemistry. While I was reveling in my youth, she was packing her husband off on missions that she knew nothing about, waiting to see if he would return alive, dead, or at all. He was in Special Forces, a weapons specialist, just like her daddy. The daddy that was furious at her decision to marry at 18 and make her life with a military man.

I've met her daddy. To meet him, now retired, you'd never know this man was a trained killer. He's the most mellow guy I've ever met. His passion is the cooking shows, and watching his Emeril imitation is a howl. He loves his dogs, his food, his wife, and his garden. Not necessarily in that order.

Martha's mother is from Japan. Her daddy met her while he was stationed in Osaka. Martha was born there, but moved to the states shortly after her birth. She spent her young years in Beaufort, South Carolina, and Camp Jejeune, North Carolina. A southern girl with an Oriental twist. I would have thought that she would have faced a great deal of discrimination-to see her, it's immediately obvious that she is of mixed heritage-but she says that on the military bases where she was raised, this wasn't uncommon.

I think she had a happy childhood, in spite of her daddy being gone so much. She said she was never aware when she was little of how dangerous his work was. That part was kept from her. She grew up attending school, playing jump rope and hopscotch with her pals, arguing with her sisters, and learning how to shoot. Daddy may not have confided his missions to her, but he did teach her a great deal about weaponry.

I think getting married was a cold shock. All of a sudden, she had to live with this kind of uncertainty, day in, day out. And on a military man's salary.

I think for Martha, it was either find something to do or go insane. She'd been a good student in high school, and after about two years of marriage and living this kind of life, she applied to North Carolina State's nursing program and was accepted. She was a good student there, too. Worked hard, good grades. And unlike me, she probably didn't stay up half the night partying her brains out. She worked at Duke University Hospital for a number of years. Then they were moved up to Virginia, where she served in the VA hospitals for a time, moved on to George Washington University Medical Center, and finally, we were lucky enough to recruit her to the competition over here at Georgetown. That was five years ago. I interviewed her.

Best damn decision I ever made. Not only is she an outstanding nurse-the two of us have been accused of being able to raise the dead-but she's a dear, wonderful friend. A total sweetheart. The patients-well, at least those who are cognizant enough-love her. Those who are unaware, well, if they knew, they'd love her, too. She gets a lot of thank you cards from patients after they leave.

I do, too, actually, which never ceases to amaze me. I'm something of a taskmaster around here. I don't have time for bullshit and I let everybody know it. When you've got somebody seriously circling the drain, it's not the time for sweet talk and gentle manners. You better move your ass, and move it in a hurry.

And Martha moves hers, and never loses the sweet talk and gentle manners. She's one of the few of us that can do this. I'm not sure how. This job is stress cubed. I used to thrive on this kind of adrenaline rush, but I'm not as young as I used to be, and sometimes it gets to me. Fortunately, I drink, and that seems to be restorative. Better living through chemistry has always been my motto.

And I'm lucky enough to have a healthy, terrific husband who is supportive and funny in his quiet way. And my dogs and my birds. It's hard to feel depressed for long when your dogs need you. Having a bad day? Walk your dog. I think everyone should get a dog. In my mind, a house is not a home unless it's covered in dog hair.

Martha has a cat. Hey, I like cats. They're soft and silky and quiet and they, too, can be healing. But if you ask me, nothing does it like a dog. Cats come when THEY feel like coming to you. Dogs are always anxious to please you and make you happy.

Martha needs someone to please her and make her happy.

And I think she found him.

We ended up drinking one night a few weeks back. She needed someone to talk to-I think she needs someone to talk to more than she says, but she really needed to unload this time-and we headed out for our favorite watering hole, and we talked. And got drunk. And talked more. And got drunker.

And finally it came out.

She's met someone. Someone she can't stop thinking about. And not being able to stop thinking about him, coupled with the fact that she still loves her husband dearly, is making her glide slowly but surely over the edge. How it hasn't happened yet is beyond me.

She knows it's wrong, she says, but she can't help it. She thinks about him night and day. She thinks about him when she's caring for Daniel.

About how much she loves Daniel, and how she knows there is no future for them, and how she feels as if she can't keep putting her life on hold. She is torn into a million pieces, constantly, all of them running into each other, melding over into each other, creating a messy canvas of clashing color in her life.

Martha is a person who craves order and routine. Needs it to function effectively.

So far, her work performance has held to standard. She hasn't compromised patient care. I am grateful for this. Because I know if it does happen, I will have to be the one to confront her with it.

But she is an emotional time bomb, a walking disaster area inside her guts. Something will make her pop one day.

I don't want to see that happen.

Daniel continues his downward spiral. He can no longer talk. He does not recognize his wife, or anyone, for that matter. The only indication that there is still life and breath in him are his moans and shrieks of pain.

He doesn't deserve this. And neither does she. Fact is, whatever I might think of her life with him, he served his country well. And this is how they treat him in return. That pisses me off. To say the least.

She's researched every avenue she can to help him. Here at Georgetown, we have access to some of the best specialists in the world. And for him, she capitalized on every contact she had. She's read every paper on the subject of Gulf War Syndrome, raided every medical journal printed for some sort of help and guidance, sought the help of herbologists and acupuncturists and God knows what else. There is nothing she hasn't tried.

I think she's tried long enough. I need to help her.

And I did what I could. After about a month of furtive efforts, not to mention some very illegal and unethical doctoring of records, I have what I need to give her.

It's pinned inside my scrub shirt. I don't even trust it in my purse.

Tonight, we'll head for the ladies' room, and I will pass it under a stall to her in the next one. I won't say anything. She won't, either.

She doesn't have to use it.

But I'd like to give her the choice.

Seems a strange thing to do for a friend, doesn't it? Hand over the drugs that can kill her husband.

Here in the world of nursing, though, this is not a shocking thing. Dr. Kevorkian is nothing but a publicity seeker. What he does, we've all been doing for years. We're just a lot quieter about it. And if you don't think these sorts of decisions are made every day, guess again. You've got a surprise coming. I've had a number of families, when there has been no chance for survival and a useful life, only a prolonged, horrible death, come to me and ask me to be merciful. I know what that means. We all do. And it's not just the nurses. The doctors frequently initiate this. Nobody is forward about it, and we don't discuss it among ourselves. But we all know we've been a party to it.

Particularly in this age of managed care, when insurance companies are robbing us of our ability to make the best possible patient care decisions. Used to be, your doctor and the nurse in charge of your case would decide what would be most beneficial to you. Now some seven-dollar-an-hour clerk who can barely string a sentence together makes these decisions. And they're rarely in the best interest of the patient.

The press and the politicians make a big deal about the sanctity of life, about how euthanasia is a sin, a slide down that slippery slope to debasement of human nature.

Ha. Let them spend a day here in ICU. Let them work a quarantine ward. Let them watch people suffer and the families around them go through gut-twisting agony as they watch them suffer. And if they're so fucking concerned about the sanctity of life, how come the money runs out so fast?

I never worried about budgets and shit when I first went into practice. You worried about making the patient well. About relieving pain and suffering. You could give the patient the medications and treatments best suited to them and their conditions, not what the insurance companies mandate as a reasonable and proper (read: cheap) approach.

Now we all have to worry about it. What's it going to cost has replaced, what will best benefit the patient?

This isn't medicine. This is social Darwinism at its worst. Those who can afford, get what they need. Everyone else takes what the seven-buck-an-hour clerks say they can have.

Sometimes I think about getting out of day to day practice. I have my PhD in nursing. Took me ten years to get it, but I did. I could teach nursing. I wonder how I'd like it. I'd really like to teach medical ethics...

Yeah, and get my ass fired the very first day.

No, I'm trying to practice medical ethics, which is a lot harder than it looks. And when you tighten down the rules, it makes it all the harder.

I know what I'm doing isn't legal. I don't even know if it's ethical. Martha hasn't asked. She never would.

I want my friend to live. And right now, I'm afraid the only way to help her to live, is to let her husband die.

There is a certain brutality in this line of work you never get used to, but you can skate around it, go home, pretend it doesn't exist. Martha long ago ceased to have that option.

I'll at least give her the choice.
 

MARTHA:

Finally it quiets down. It's hard when you come in, like you always do, an hour before shift, so that you can read the notes from the day shift and assess the patients, only to be called to a code before you've even got your hair up.

It's after 9:00. Giz is still here. She's just finishing up her paperwork. I start on mine.

"Martha." She gets out from behind the desk, waves her hand towards herself in a 'come with me' gesture.

We head for our office-the ladies' room. It's the only place I know of where you can get any privacy here. Hospitals are extremely public. Everything in ICU is on videocam, and you don't want to say anything you don't want repeated in the nurses' lounge. That place is about as non-private as it gets.

This is something of a ritual with us. We always head for the ladies' room, one of us to put our hair up, the other one down, and to talk about what's REALLY happening. The things you don't say where anyone can hear you.

Some of it's clinical conversation-a lot of it is, in fact. But clinical conversation that steps into areas that we don't dare broach in a public setting.

Many times, we just need to blow off steam. Some patients are hell on wheels. And you still have to be polite to them. At least I do. It's the way I was raised. I can't get past that. We come in here to make fun of the doctors, gossip about our fellow nurses, and bitch about the patients and their families. Call it Lifetime Cable Network female bonding. It gets us through the day, or night, if that happens to be your shift.

There are only two stalls in this staff ladies' room. And you can lock it. Which we do. We're serious about not having intrusions.

I take one, Giz takes the other. A few moments later, a small plastic Ziploc makes its way to my side.

I recognize the contents. I feel my eyes fill with tears.

I can't tell you how many times I thought about doing this. But I'm fundamentally chicken. The risks are high.

Gizzie could lose her job, not to mention her license, over this.

Yet she probably shorted patients on medication, hid this in her clothes, altered documents. For me.

She has always been a good friend. I never knew how good, until this moment.

There will be no discussion about this. It will never be mentioned again.

We are too conscious of the legality (or shall we say, illegality, in this case) of our actions. We don't admit to things like this. We're conscious of them, but we keep our thoughts to ourselves.

Maybe some people confess to their priests. I don't. I haven't been to confession since before I was married. As to whether or not Giz goes-well, I don't find her to be religious, but you never know.

No, this will be a secret that Giz and I will keep forever and never share verbally, even among ourselves.

The question is, will I have the nerve to do this?

I honestly don't know.

I have loved Daniel with all my heart. Through the good times and bad times, I have always stood by him. I have honored my vows as best I know how.

I still love him.

What is the most loving thing to do for him?

Perhaps to an outsider, it would seem obvious. My husband is dying the most hideous of deaths. I have made every attempt, legitimate and otherwise, to palliate his suffering. I have stretched my goodwill and reputation in efforts to find what is wrong with him, what can be done about it.

All to no avail.

What is the hardest thing to live with? Is it the certainty that he will die, yet the uncertainty of when? Is it watching him writhe in pain, gasping for breath, unable to communicate or even recognize me anymore? Is that the hardest part?

Is it the anger? The fury I feel at a government I feel-hell, I know-has betrayed him? He, who served faithfully, has been turned away at the door of every institution, military and civilian. Knowing that there is no one I can turn and point to, no one individual, no one organization, that I can aim and shoot at?

My father taught me to shoot when I was four. I could barely hold a pistol then. But he persisted, and so did I. By the time I was eight, I was an accurate shot.

Nobody knows this about me, except for Gizzie. Daniel knows, of course, but he cannot communicate that knowledge, probably not even to himself. I seem to find release by visiting the firing range whenever possible.

I tell myself it's simply to keep myself in practice.

In practice for what?

It would be so easy if I could simply aim and fire, eliminating that which has terrorized both Daniel and myself.

It's never that easy.

Such as the decision I will have to make regarding Daniel. It only looks simple to one standing near the perimeter. Step into the center, and it becomes horribly, painfully complicated. There are no clear signs pointing me to what should be done. Or not done.

And it isn't simply the issue of Daniel's suffering anymore. It's become my own.

God forgive me, but I have fallen in love with another man.

Do I think this would have happened had Daniel not become ill?

No, I don't. I know it wouldn't have. Because if Daniel had not become afflicted, then I would not have had to fight tooth and nail to get him decent care...I would not have had to exhaust all of our resources...I would not have had to take a second job...

I would not have been part of a police bust.

I would never have met Melvin Frohike.

I cannot get him out of my thoughts. He is with me, almost a sort of body consciousness, all day, all night, every waking and sleeping moment. I sometimes reach out in whatever it is that passes for sleep for me and imagine that I am running my thumb over the unshaven cheek, and he will turn to me, and I can feel the warmth of his breath on my skin.

I imagine that with him near me, I will finally have a full night of decent sleep. That he will take me in his arms and tell me everything is all right, that nothing I did was wrong. It's been so long since the urges in my body have been satisfied. But I need more. I need my conscience assuaged.

I think this is a man who would understand. And who could comfort me, not in a shallow way, but sincerely reach into my soul and bring me peace of mind.

Maybe it's those eyes. Green. A beautiful shade of sea green, warm and sweet and deep. It reminds me of the waters near the shores of the Carolinas where I grew up. I'd watch the waters for hours when I was a girl, and felt an incredible calm wash over me.

That same feeling returns when I see his eyes.

I barely know this man...yet he did not know me from Adam (all right, Eve) when he bailed me out of jail that night. And he felt, simply because he was my client at the time of the raid, that he was responsible to me. There is something so delightfully old-fashioned and chivalrous, if a touch chauvinistic, in this man that makes me shiver when I think about it. I've had to be terribly self-sufficient all my adult life. I could count on my husband to love me, but not to be able to physically or emotionally take care of me, due to the nature of his work.

It dawns on me. I have no idea what he does for a living. He said something about computers, but did not elaborate.
 
I'd love to contemplate him more, to imagine what it would be like to be with him, to live in his universe, but I've got a floor full of patients and a long night ahead of me.

Not to mention a decision to make.

I could simply flush away all of Gizzie's hard-won booty. She would not grudge me doing so.

Even if I do keep it, I don't know that I will have the nerve to pursue it.

The green eyes come back to me.

I pin the Ziploc to the inside of my scrub shirt.

END OF PART 8