I don’t really know Michael. I know he lives in Connecticut. I know he’s a nurse. I only know that much because he was my nurse for 12 hours from a late Sunday to early Monday.
But for those 12 hours or so he knew me better than anyone because I was almost nothing but pain and he was my companion.
Hospitals are often settings for TV shows. They are a natural for the quick and well-defined drama. I’ve lived that reality having been treated for a variety of health problems from the dire to the urgent. I recently had another of these unwanted experiences, and Michael appeared in a leading role.
Medical stories are often told with the doctor as hero. There is nothing wrong in that view; it’s just incomplete. Medical care is a complex process. There are many contributing factors and making it all work together is, despite the critical views, a technical marvel. To make it work, many procedures and guidelines are put into place. Even within all those constraints, the individual actors like Michael have lots of agency. I believe that how they use that agency is the difference between a medical system being OK and great.
Michael made crucial choices for me during his shift, and it is hard for me to adequately express my gratitude.
I am a longtime kidney stone sufferer. For those of you unfamiliar with kidney stones, they are nightmares. The pain of kidney stones beggars the imagination. There is a pain so intense that it affects one’s psychology in a very profound way — pain at some point becomes context. It’s pain without any purpose, suffering distilled, without anything redemptive or meaningful. My kidney stones were assaulting me and I wanted the pain gone. Sometimes pain is more tolerable if it is at least moving in the right direction. Mine was not, and so I could feel myself starting to get a little desperate.
On that Sunday, the pain became completely unmanageable. I had been urged to drink lots of fluid, take pain killers. But I was sliding down the mountain fast, and I was doubled over — literally, not figuratively.
My wife decided (the odd part about extended pain states is a mental paralysis that impedes making any decision) that we were going to take my MD brother’s advice and go to the Yale New Haven emergency room.
It was a quick sort to the decision that I was going into surgery. I would have to wait though to get a slot, which meant parking myself in the hospital for the evening.
That’s when I met Mike, who was going to be my pain doula.
I was in slightly better shape, since the hospital had already given me some of the industrial-strength narcotics. A little breathing space appeared.
This was short lived, as their effects wore off. My pain was going to hit me like an unending sequence of increasingly bigger waves.
I went from needing a certain dose of the controlled substances to actual continuous pain management. The medicine would work for a bit but not for very long and soon I was flailing and gasping for relief. I had shifted from needing an intervention to requiring continuous pain management.
This is often hard for medicine. For good reasons and some bad, medicine wants to react to problems with solutions.
Management of the chronic and complex is hard. The problem sometimes starts at the level of diagnosis. I know this firsthand, having lived through an extended previous struggle in getting a cancer diagnosis.
That Sunday night I needed more than a nurse making sure that my requests were fulfilled. I needed a partner whom I could trust.
Michael went beyond his basic job description and became that partner.
Not only did that save me from an awful evening but it delivered a much better, more relaxed patient to the OR. I was stressed but not in a panic. It was in other words, better medicine.
As my pain doula, Michael began to learn my patterns. He used that informal knowledge to make decisions about what to do next.
He learned how to manage me, speaking to me in an informal, joking style, but with earnest directness.
By the time I showed up at his doorstep, I had not eaten for a long time. While the hunger was a bit bludgeoned by the pain, I was nonetheless hungry and maybe even most acutely aware of a need for some bit of pleasure.
By the time food arrived, though, Michael had concluded that the activation of my system would likely trigger some new wave of unpleasantness.
“I think it’s a good idea to stay off the food.” he said, guiding me but leaving me with agency. He left the food outside of my door in case I changed my mind. I didn’t, because I trusted him and knew he was right.
The food example is but one of several dozen similar interventions, pain treatments, keeping me informed, and just being there.
Michael quickly started using buddy language. His demeanor contributed to my actual and psychological relief.
Michael was not just doing his job. He was doing the best version of his job with strong purpose — getting me through the night (and it was all night). He operates with great constraints but worked within those to take acceptable care into superb.
After I left the hospital, I got back in touch with Michael. I learned that he has worked for Yale New Haven Health for eight years, close to seven as a nurse. A Southern Connecticut State University graduate, he’s finishing up a master’s program in nursing as a family nurse practitioner at Quinnipiac. (He asked not to have his last name used in this article.)
“Nursing and providing care for human beings is the only thing I have ever known in my professional career,” Michael told me. “I think those who can stay in the profession their whole lives have a calling and I am blessed to be surrounded by some of the world’s best physicians, surgeons and nursing staff.”
I am also lucky to have had care from two other nurses, Jeff and Andrew. They had shorter terms of responsibility for me but displayed similar results with similar bonhomie.
It’s easy to look at Yale Medicine and be impressed by the rankings of the departments. I am a direct beneficiary of great medicine. Medical care, though, lies a lot in the hands of people like Michael, Jeff and Andrew. It’s good and proper that we recognize and value this.
Nurse are often those that have the most contact with us and see as a human beings and not just as bodies when we have to be in a hospital. They are the backbone of the medical system, and often the living angels that we depend on when we need medical care and compassion. There is tremendous burnout and often a lack of respect for the difficult work that they do compared to how doctors are seen, but without the nurses, we wouldn’t have most of the care we receive in a hospital.