January 31, 2012

the nurse and the locksmith

I've been out in the country for my outpatient rotation, which involved seeing patients whose families had been in the area for hundreds of years, lots of procedures, views of the innerworkings of a small hospital, some dangerous drives in the snow on unplowed, unsalted roads, and staying with an older couple who opened their house to me.

The best part was that I got to remember why medicine is like story telling because the easier pace of the outpatient setting and the incredible stories people would share with me.  In fact, my last week one of my attendings handed me a copy of the Boston Globe, an article called Charting the Human Condition, which says that the taking and recording of a patient's history (what we do all day) is "a way for doctors to internalize the patient's experience, to fully understand it, to feel it".  Interestingly, I listened to a radiolab podcast the other day that talked all about how when you are truly empathizing with another person, your brain actually starts to sync with theirs, so that if you are put in a PET scan, you can see the same parts of your brain light up.  Crazy, right? Anyways, in this post, I want to tell the story of the couple with whom I stayed, who were not my patients at all, but whose experience I wanted to fully understand:

They met when they were in their twenties on a blind date.  
He was back from a tour in Vietnam and she was about to start nursing school in the big city.  
He fell for her immediately.  
She was interested but knew he was going back to Vietnam.  
So without deciding to actually date, they decided to write letters.  
Every day.  For three years.  
By the end of that time they were dating and he was hoping to marry her when he got back stateside.  But she would not hear of it until she finished nursing school.  
(She says now this is because she knew that they would need the flexibility in their lives provided by two incomes at least some of the time, and nurses can work anywhere!)  
So he started working with  her father at a nearby elite boarding school, doing all sorts of maintenance and construction work.  
Then her parents decided to move up to the country. 
He went along to keep working with her father.  
She finally finished her nursing program, had her nursing degree.  
They were married in her parents house the next day with 5 witnesses.  
They could not have been happier.  They moved up to the country with her parents and opened a general store.  He built them a huge beautiful house.  When I asked about their big beautiful bay window, he said: "she wanted a bay window, so I built her THE bay window".  
She became pregnant with a baby girl, and it seemed like their life was finally settling into what they had both envisioned.  Then seven months later (8 weeks early) they had their first baby and found out that she had an incompetent cervix all at once.  
Their daughter survived thanks to the NICU, but she would not be able to have any more children.  Since she was clearly programmed to be an incredible mother, when a friend asked if she would consider foster care.  
She talked it over with him.  They decided to go for it.  
And 200 foster children and 5 adopted children later, it is clear to me 
they are also programmed to be grandparents.  

I got to talk with their biological daughter about her experience as the only biologic child of parents who had raised, in part at least, over 200 foster children.  She said that her parents did a great thing from the very beginning: they would only take foster children who were younger than she was.  That way she always stayed the oldest child.  But all in all, she loved it and saw it as completely natural for her parents to be foster parents.  She had five children of her own and when I watched her interacting with them, it was clear that she had inherited and learned the skills of being an incredible parent.

Ah, I'd love to wear a rainbow every day/and tell the world that everything's ok/but i'll try to carry off a little/darkness on my back/til things are brighter/I'm the man in black
-Johnny Cash

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