Put Your Mind Where Your Mouth Is, And Other Short Directives from the Holiday Buzz

He sat at the edge of holiday chat, bent forward as if he wanted to catch the drift, but talking more with his face than his voice. When the subject turned to health, he revealed that he was a nurse. We asked, “What have you noticed from your years of nursing?”

“Want to know the two hardest things?” he answered. We did. “Weight’s the first. Every medical condition, every medical emergency is complicated by excessive weight. Everywhere I look, on the street, in hospitals, in fast-food parlors, there’s obesity.” We nodded in agreement and concern.

“The second,” he went on, “is the teaching of nursing. When I was training, first as a nurse, then a nurse anesthetist, 80% of our training was clinical. Nurses learned on the floor to give sponge baths, to administer medication taking care not to over or under dose. We looked at patients’ skin, pulled down their eyelids, inspected the inside of their mouths, even casually tested their reflexes as we made them comfortable.” We nodded approvingly, remembering how frequently it was the nurses who soothed a fever, popped hemorrhoids back inside the rectum, kept up the regular supply of fluids–either intravenously or by mouth. Doctors would speed in and out, barely noticing the body in the bed, but the nurses felt around.

“Now, too much of nurses’ training is by the book. Ph.D’s have taken over the training. Too much is in the classroom, as memorization. Even at best, this is insufficiently applied in clinical situations, and once a nurse is actually working, the stuff that was crammed in the head gets confused or fuzzy.”

Listening, we quietly determined never to be sick, though lately it seems we’re surrounded by seriously ill friends or relatives. Breast cancer here, internal bleeding there, bone deterioration. So far, no mental breakdowns, but wait, yes there are. We tell ourselves it’s normal aging, except that normal has such disturbingly individual shapes. Each sufferer tugs at our heart strings and makes our stomachs tighten with anxiety.

After some cogitation, these bits of holiday buzz coalesced toward several simple conclusions: FIRST: smaller and shorter are better. Smaller portions. My mother changed the size of her dinner plates when she and my father began to put on weight. “If you see a full plate, you think you’re getting enough,” she commented. She out-foxed the belly with the brain.

Add to smaller, shorter. Shorter stays with extended family (especially kids made wild by excitement–it’s wearing!) Shorter WALKING distances between home and grocery store, library, work place. Smaller care facilities–as long as certain minimum standards of cleanliness, nutrition and medication monitoring are in place, the essence of good care is regular, hands-on loving kindness. That’s easier to deliver in a small facility.

Of course, there are wide exceptions–friends going to the Mayo Clinic for tests, etc., report being amazed at the clinic’s intelligent, careful assessment and treatment. I’d add that hospitals in the Twin Cities can also perform daily miracles of teamwork and yes, astonishingly competent nursing. Emergency Room nurses being at the top of the list.

SECOND holiday message: Training that’s hands-on and personal. First-hand experience of illness for nurses and doctors. Bring back the clinical model. BUT ALSO FOR TEACHERS, since health care and education belong in one over-lapping category. If White teachers in training are truly going to understand what it means to be African-American in Minnesota, they need to work with classrooms of African-Americans. And they need to be guided by teachers who themselves have learned to walk in the shoes of this least understood community of color. Least understood in this land of the “white” meal, White Christmas and White opportunity. I tried it recently: imagined myself an aging Black woman walking down Grand Avenue, with a limited income, and grandkids to feed. All the treats had a Nordic or Gaelic flavor. Every face I passed was white. I was miles away from family in Mississippi or South Carolina. After years of living in cold country, I still pined for warm Christmases where tinsel was draped over live oaks and palmettos. Where some Santas have brown faces, and chittlins and collard greens are served at, yes, white folks’ restaurants. I decided that, next year, even if I had to take the bus, I’ll get myself home, really home for Christmas.

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