People are at their most vulnerable when they are in the hospital. As ICU nurse, mother, and blogger Brie Gowen writes, "I can promise you that you do not want to be a patient in my unit. If you are then that means you're really sick. But I can also promise you that if you end up here you will get stellar care by a team of the best health care providers available." Health care providers have different ways of coping with the stress and high stakes. For Gowen, it involves singing Rodgers and Hammerstein.
Gowen published an open letter on her blog to tell her patients' families that her cheerfulness should not be interpreted as nonchalant, but the opposite. Gowen sings to balance out the inherent sadness that's a part of her every day, so she can keep her cool and perform her duties:
Dear Disenchanted Family Member of My ICU Patient,
So you walked in to me singing a song out loud as I hung that IV medicine, huh? You were a little bewildered, and thought, "Is that from the Sound of Music? Why is she so inappropriately jolly considering my dad has a tube down his throat?!"
First off, it is the Sound of Music. After all, these are a few of my favorite things.
But seriously, I'm not singing for my own satisfaction. What you don't realize is I'm singing to calm my nerves, to keep myself relaxed. Your dad almost died before I let you back. I'm concerned for him, but I don't want you to see that on my face. I don't want you to worry about him. That's my job. I just want you to love him.
I know you just heard us laughing and cracking a joke in the hall. I get it. You don't see anything funny with your mom being confined to that bed, attached to all those monitors.
I understand. I do. I hope you can understand that while you were waiting outside unaware we saved the young woman next door. She couldn't breathe. Now she can. We didn't think we'd get the breathing tube down in time...
We also restarted the heart of the man across the hall. We shocked him so many times, and I actually broke his ribs. Just when we were afraid it wouldn't restart, it did.
The patient next door to him wasn't so lucky. We tried. I begged God, but she went anyway. I held her daughter and let her cry in my hair for twenty minutes.
Some times we have to laugh. It's the only thing we know to do. We're afraid if we cry, we won't be able to stop.
I'm really sorry if I seemed short with you when you came in to visit. I know you thought I was being rude, and I know that once outside again you complained about me, saying "she must have wanted a break instead of taking time to talk to me!"
No. I won't get a break today. I wasn't trying to be rude. I was focused on the change I just noticed on your dad's EKG. I was wondering what I could try next when his blood pressure plummets again. You see, I'm giving the maximum amount of all those drugs you see hanging. I know you're not ready to say goodbye. I'm not ready to give up. That distracts me sometimes and makes me a less than perfect conversationalist.
I want you to know that when I see your mom in this condition I feel your pain. I think of my own mom who has passed away. When their conditions mirror each other, so similar in presentation, it's like peeling the scab off my grief. I don't let you see that, but I choke back my own tears while you cry.
Oh dear mom, as you try to maintain your composure while your child remains unresponsive, I have to fight to keep from sobbing all over your shirt while I hug you. Your plight is a very real confrontation of the frailty of our children. I don't like it as a mother. I will sweat blood to fight for your baby's life, no matter the age. I know it could be mine just as easy.
My dear sir, as you cry over your ailing spouse, I'm sorry that I have to walk away. I'm sorry I can't be stronger for you. For a moment I place myself in your shoes. I imagine my spouse laying there, and I grieve with you. Then I get back on the horse and I fight for your bride. I just wanted you to know that.
My singing, dancing, laughing behavior might make you think I'm indifferent. Or my distraction and firmly set expression might make you think I don't care.
But I do.
What you don't see is when I pull into my driveway at the end of the night after my long shift has ended. Often times I put my car into park and I cry. All the stress of fighting for them, all the grief pushed away, all the emotions finally have time and catch up to me. I don't sing or laugh. I weep.
Then I wipe my eyes and go inside. I hug my babies a little tighter. I hold my spouse a little closer. Then I go to bed early so I can come back in the morning and fight another day.
I just wanted you to know.
Your ICU Nurse