Tale of an Unsterile Instrument

After we had finished our first of the three years in nursing school in a hospital-based diploma program, we could work on our days off and be paid.  On these occasions we had to wear a different uniform than the student uniform, and we were referred to as nursing technicians.  Many of us made use of this way of starting to put money away for college.  My father had told me that after nursing school, I was on my own, so I knew I needed to start earning and saving as soon as I could.

At the beginning of the day, we would go to the office of the nursing supervisor and find out where we were needed.  We would, of course, not be sent to a place where we had not already had experience, so usually we ended up on a medical/surgical unit.  Once in awhile, the operating room would be short staffed.  I was one of the only students who would agree to go there.  I had enjoyed the time I spent there as a student and didn’t mind going back. 

Except….on one such occasion, I was asked to be the scrub nurse for Dr. H who had a reputation for hating students.  Once outfitted in a scrub dress, cap, mask and gloves, I would look like any other nurse, so there was reason to think he might not know I was a student.  But, he had a reputation for being very precise and difficult.  We were all terrified of him, because we knew he had no patience with students.  If I made a mistake of any kind, he would guess and be furious.

 When I was assigned to scrub with him, I protested.  The RN who was to be the circulating nurse in the room said I shouldn’t worry.  She knew exactly how he liked things.  She wrote his preferences on a piece of paper and taped it to the wall right behind my back table.  When one scrubs for surgery (or at least it was true 60 years ago) there are two sterile tables to be concerned with.  There is a tray that goes right over the patient, adjacent to the area being operated on.  It is from this table the scrub nurse passes the instruments to the doctor.  The back table contains other instruments and supplies that might be needed to restock the tray one is working from.  There was plenty of opportunity for me to go to the back table and check the list the RN had taped to the wall.  I fooled him all morning.

I knew he had not figured out my lowly student status, because after lunch he asked me where I had been at lunch time.  He had wanted to buy my lunch.  If he had any idea I was a student, he would have know that I got my lunch for free, and that I sat in an area of the cafeteria designated for students.

The afternoon did not go as well as the morning…that is an understatement.  One of the last cases of the day was an intestinal resection necessitated by a cancerous tumor.  All went well until I handed him the clamp to close off the intestine so he could cut it without intestinal contents getting into the abdominal cavity.

“This is not my clamp!” he roared.

The tray of instruments had been prepared and sterilized the prior afternoon by someone who was supposed to know his preferences.  I certainly did not know he had his own special clamp for this part of the procedure, so I had handed him the standard issue used by most surgeons.  I frantically looked through the tray on the back table…no luck.  The circulating nurse came and looked without touching anything…no luck.

She told Dr. H she would go and find his clamp.  She came back in the room quite quickly and informed him she had found the clamp, but it had not been sterilized.  She would put it in the high pressure autoclave and it would be ready in…I think she said…three minutes.

He shouted that he wasn’t waiting three minutes.  I don’t remember if I had to say to him that I would not hand it to him or if he figured this out on his own.  He directed the circulating nurse to put the clamp in the basin of sterile water which was adjacent to the OR table.  She protested.  He insisted.

She put the non-sterile clamp in the basin, and told him she would have to record on the surgical record that he had used a non-sterile instrument. 

Dr. H said, he didn’t care what she said on the record.  He directed her to bring him some antibiotic crystals to place in the abdomen in hopes of preventing an infection.  Then he said, “It doesn’t matter.  The guy is full of cancer anyway.”

I could hardly wait to be done and get out of there.  As the scrub nurse, I had not participated in his breech of protocol and had no responsibility.  It was the circulating nurse’s job to report this.  I was sickened by what I had seen and heard.  Dr. H was renowned throughout the Midwest as a top surgeon.  People came from great distances to have him operate on them.

I, of course, also wondered, if I wasn’t a student would I have known that his special clamp was missing from the tray?

I never knew what happened to the patient following surgery.  I’m pretty sure neither he nor his family were told what happened in the OR.  I would not be telling this story, except that I'm pretty sure both the patient and Dr. H are long dead.

Premature Self-Congratulation

The king and Haman sat down to drink, but the city of Susa was bewildered.  Esther 3:15

I don’t know exactly why this struck me as funny.  Maybe because we are presently in a state where much of the populace is bewildered.

This verse is set in the time when Xerxes was king over 127 provinces stretching from India to Cush (the upper Nile region in Africa).  He had become disenchanted with his queen (Vashti), who had openly defied him, so he had disposed of her, and replaced her with the winner of a beauty contest.  The woman who he made the new queen was Esther, who was a Jew. 

Haman was one of Xerxes’ chief officials.  He disliked the Jews in general and Mordecai, who was Esther’s uncle, in particular.  Without being specific as to the fact he was describing the Jews, he told Xerxes that there was a troublesome group of people who should be annihilated.  Xerxes went along with this not knowing he was condemning Esther and her people.

After agreeing on the plot to wipe out the offending group, Xerxes and Haman sat down for a self-congratulatory drink.  The people of the capital city of Susa were left in bewilderment.  They probably knew that Haman had it in for the Jews, and that Esther was one of them.  This was something Xerxes had not yet figured out.

Long story short, Esther intercedes for her people.  Xerxes is enraged with Haman, and it doesn’t end well for Haman.  The Jews are allowed to defend themselves and are saved.

I’m just thinking that sometimes our political leaders sit down to drink with each other either literally or figuratively.  They believe they have solved some knotty problem and deserve a reward.  The rest of us are left scratching our heads.  What are they thinking?  How is this a resolution of the real problem?  Do they not understand the far-reaching practical implications? 

At least Xerxes was approachable and able to see that he had been hoodwinked.  He listened to reason.  He could not reverse his previous decree, but he gave his permission for a new one to be written that provided a way out.

We need an Esther and officials who will listen to her.

Uncertain Times

In this time of pandemic, Pfizer is running an ad which has a hopeful and uplifting message.  So much so, that it could easily slip past the listener that it says:

“When things are uncertain, we turn to the most certain thing there is…science.”

Uncharacteristically, my husband picked up on this first.  He often pays no attention to ads and uses ad time to flip from one channel to another.  But he caught it and drew my attention to it.

Science is the most certain thing there is?

I suppose we would like to think that, because we would like to believe that science, including medicine and technology, have all the answers and have the potential to solve all problems.  We want to believe that it is only a matter of time before the current crisis fades away as a treatment or prevention are discovered by hard working scientists.

Don’t get me wrong.  I love science.  I remember during college days butting heads with a friend over whether science or the humanities were more important areas of study and bodies of knowledge.  But, I do recognize the short comings of science.

Over the years, multiple theories have been put forth with a high degree of certainty and later discovered to be off the mark.  Perhaps they had an element of truth or pointed the researchers in the next direction to be explored, but they weren’t “certain.”  If science is the most certain thing there is, we are in a lot of trouble.

A few years ago, I remember reading that our DNA contained a lot of “junk.”  There were areas that did not code for essential proteins and had no reason to be there.  It was cited as proof of evolution over creation.  Certainly no creator would have left this useless stuff in the code.  That was science.  More recently it has been determined that the areas that don’t actually code for the proteins are the “operating system.”  The areas previously understood are the “software.”  Both are essential. 

Ideas regarding the origin of the universe and its age change on a regular basis.  How the current novel virus came about is still being debated.  Science hasn’t yet figured out whether certain medications are actually helpful in the battle with the virus.  Will science figure this out?  Perhaps eventually, but in the process, there will be false ideas coming out of the scientific community.  What is said with certainty today, may not be so certain next year.

Science is wonderful.  It has allowed us to make phenomenal discoveries.  But, it is not infallible and it is not CERTAIN.

I chose to believe in an omniscient God who actually has all the answers, and who also sees into the future.  He is the only certain thing in uncertain times.

Isaiah 44:28 Do not tremble, do not be afraid. Did I not proclaim this and foretell it long ago?  You are my witnesses.  Is there any God besides me?  No, there is no other Rock; I know not one.

God’s sovereignty is our only security.

I plan to stand on the Rock.

Seventy-Five Years....summing it up.

Seventy-five Years

How is that possible?

I haven’t yet achieved greatness!

I haven’t written a best seller or won a Grammy or been awarded the Nobel Prize.  I have somehow slipped through the cracks of childhood, youth, and middle age and landed in senior land.    The likelihood of distinguishing myself from this vantage point seems slim.

So how have I filled up the time in the past 75 years?

Hmmm….if I start to recount the activities of those decades, it is going to sound something like an obituary.  I’m not sure I want to write that yet!

But…by the grace of God…

*I survived some serious illness as a small child.  I had pneumonia twice and a kidney infection before the age of 4 at a time when an array of antibiotics was not available.

*I enjoyed my years in school and was an excellent student, but I had little self-confidence.  I was not popular in high school, although I had a small circle of close friends.

*I had an innate love of music and found it to be a wonderful source of expressing the thoughts of my mind and feelings of my heart.  I had some amazing opportunities to use that gift from childhood and into my 50s.

*I became a nurse.  It is difficult to begin to explain to someone who has not shared those experiences what it does to a person to see life and death in such an intimate way.

*I paid my own way through college.  What a lot of hard work that was!

*I met the love of my life and have spent the last 52 years building that relationship.

*I became a teacher…in high school, junior college, community and church.  Eventually I got a Masters degree in adult education.

*We raised 4 children.   All of them had some portion of their education in home-schooling.  I had a total of 16 years experience as a home-schooling parent.

*I was involved in some community activities, but primarily my volunteer activities were church related.  Over the years, I served on and chaired multiple committees….nursery, hospitality, music, nominating, Christian education, Sunday School.  I served on the Governing Board at one church and was Church Clerk at another.

*After the children were raised, I worked as an outreach coordinator for a small rural hospital.  It was a job with lots of variety.  Retiring from that, I did outreach for the local Cancer Service Program.

*After retiring from retirement, I tutored high school subjects both privately and for the local city school district.

* I have had poetry published.  I have written and performed my own music…none of it published, however.

* I have knit more sweaters and sewn more clothes than I can count…or remember.  I have also enjoyed crocheting and embroidering.  I have made several quilts.

*I have never been an athlete, but I have at various times enjoyed bowling, cross-country skiing, swimming and ice-skating.  I still enjoying swimming and ice-skating and have done both in the past 3 months.

*I have done quite a bit of home maintenance in the form of painting and wall-papering, both of which I genuinely enjoy.  I have also refinished several pieces of furniture.  I am delighted when I see the beauty in the grain of the wood.

*Gardening has been fun for me.  My husband has done the hard work of tilling and weeding.  I get to do the fun part of planting and harvesting.

*Cooking and baking have been great activities.  I dislike the clean-up afterward, but that’s part of the game.

*I have traveled more than I imagined I would when I was a young person.  I have been to all but 7 of the 50 states and have been on four continents.

*I have a great love of books and reading.  I read mainly periodicals and non-fiction, but I do enjoy novels by John Grisham and Randy Singer.

*I am quite addicted to crossword puzzles (especially New York Times puzzles) and Sudoku (but only the very difficult ones).  I have played around with creating decoding puzzles for kids.

*I was an early user of computers.  I learned to program Fortran in the 60s.  I still frequently use Word, Publisher and Powerpoint.

*The unifying thread of my life has been my relationship with Jesus as my Savior and Sustainer.  I rarely miss reading the Bible on a daily basis.  I have lost track of how many times I have read it cover to cover.  I pray throughout the day looking for guidance, for wisdom, for help in setting priorities. 

There is a part of me that wishes I had done something truly spectacular in the past 75 years, but there is another part of me that realizes that I have tried every day to do what I believed God planned for me for that day, so I need to be content with the sum of those days, and the point at which I find myself.

And there is also this….earlier this week, I did a video chat with my grandchildren in California.  The 5 and 3 year olds were showing me how they have learned to make their beds.  As they spread the quilts I had made for them over the top of their beds, the 5 year old said, “The quilts you made for us make us feel special.”  If I have done something to make each of my eleven grandchildren feel special, I am satisfied with my life.

Kitchen or Chemistry Lab--Details Matter!

Today I am working on a Boston Cream Pie for my husband’s birthday.  It is his favorite.  I made the filling from scratch.  One of the steps is adding a mixture which has been boiled for one minute into a slightly beaten egg yolk.  Then putting that mixture back in the pan and boiling it for another minute.  If you don’t understand the reasoning behind this, you might think “that’s silly!”  I’ll just add the egg yolk right into the boiling mixture….why be dumping things back and forth?”  If you were to do that, you would not end up with a nice rich sauce.  You would end up with a milky sauce with chunks of cooked egg floating around.  Direction of addition matters.

It made me think about my days in college as a chemistry major.  The second semester of organic chemistry most students could take a regular lab session, but majors had to do something called “Special Preps.”  We would go to the professor’s office and be given an index card with the name of the compound we were supposed to create.  This might also include the reagents available to us.  We would then have to research in the chemistry library and determine how this substance had been previously made, check out with the professor if we were on the right track, and then hit the lab to create the compound.

On one of these occasions, I researched the substance I was assigned, and discovered the only place in the literature where it was recorded was in a Russian journal.  I do not speak Russian.  I went to see my professor.  He knew that is what I would discover, but he wanted me to go through the process.  He then handed me another index card on which he had written the translation from the Russian journal.

I assembled my equipment and followed the directions carefully.  This involved carrying out the procedure in “the hood” where I was shielded, and any resulting gases would be safely exhausted.  The main flask in which the reaction would occur was packed in ice, so obviously I was supposed to expect an exothermic reaction.  I was not expecting an explosion, but that is what I got.  The reaction was so violent that it blew the glass stoppers out of the equipment.  What was left in the flask was a stringy mess of a polymer.  I knew I was not supposed to get a polymer.  A liquid was expected, and I knew at what approximate temperature it should come off and condense.

Thinking maybe I had inadvertently added too much, I ran the reaction a second time.  This time I was careful to add only one drop of the reagent to the one in the main flask.  The result was similar.  I now suspected that the direction of addition should be reversed.  Instead of adding Reagent B to Reagent A, I should be added A to B.  But, the professor’s translation said B to A.  Did I really want to confront the professor with the notion, he had translated incorrectly?  I tried a third time with the same results.

I took a deep breath and went to the professor’s office.  I told him I was getting polymer, and as diplomatically as possible, I asked if perhaps the direction of addition was reversed in the translation.  He readily agreed that was probably the case.

I returned to the lab and tried the fourth time.  This time adding A to B.  Much to my delight, I did not get a polymer, but a liquid which boiled off and condensed at the predicted temperature.  The professor was delighted with my results, and I learned something important.

Transferred to the kitchen, it means do not add egg to a hot liquid.  Add small amounts of the hot liquid to the egg, so that the egg doesn’t cook and is heated up gradually.  We haven’t eaten the Boston Cream Pie yet, but I licked the spoon after making the filling, and it is yummy!  I definitely never licked anything in the chemistry lab!

Finally Giving It Up

My license as a registered nurse expires this month, and I have decided not to renew it.  I took the licensing exam in Illinois in the fall of 1965.  The next year, I was licensed in New York by reciprocity.  Early in my career, I put myself through college.  I worked in 4 different hospitals and in a doctors’ office during the first 5 years after graduating from nursing school.  In 1969, after teaching high school biology for a year, I began teaching nursing at a junior college and also became a guest lecturer in an EMT program.  I eventually gave those lectures in 3 different counties and my notes were used by someone else in a 4^th county.

In 1972, we adopted our first child and a year later had our first biological child. I decided to “retire” for awhile.  I pictured this as being until children were in school.  I diligently renewed my license and kept up with all the required continuing education.  About the time when a return to work should have happened, I got a call from a local director of nursing.  She said she had three key job openings, and any one I wanted was mine for the taking.  However, one of our daughters had significant behavioral problems.  I didn’t feel comfortable leaving her with a babysitter.  There was too much possibility of things getting out of control.

In 1983, we adopted another daughter who had a physical disability.  There were several issues that had not been dealt with while she was in foster care, and I knew that adopting her was a commitment on my part to continue at home.

As the girls got into their teenage years, I thought the possibility of reentering a career might be on the horizon.  I decided to work on a master’s degree in adult education.  The courses were being taught right in our small city as an extension from Syracuse University in a weekend scholar format.  This seemed quite doable.  I could see multiple ways that adult education interfaced with my previous experience as a nurse and as a teacher.

Then in 1986, my husband and I had a major surprise.  I became pregnant.  I thought that was fine, because I could complete the master’s program, and the expected child would go to kindergarten about the time our daughters left the nest.  I could go back to work then!

Well…another surprise.  The son we had was unusual.  We could not see any way he was going to fit with the school system.  He began playing Monopoly at the age of 3 years and 9 months and taught himself to read, because it was necessary to read the cards in order to play the game.  He also insisted on being the banker and had no difficulty in making change.  I thought at first, we might be able to send him to school, but when he did 1/3 of the years work in a kindergarten math book in one sitting, I could see my thinking was faulty.  I figured I was stuck for 13 years until I homeschooled him through high school.  I did, however, hold out enough hope, that I continued to renew my license and keep up with continuing education.

When our son was 13, he informed us he wanted to start taking college courses.  When he was 14, he made it clear, he intended to go full-time.  Ha!  I still had a few good years left in me.  The time had finally come!

Because I was by this time in my mid 50s and age discrimination is real, it took me awhile to find a job.  If my clinical skills had been current, I’m sure I could have found a job more easily.  But, although I had maintained my license, I knew I would be totally unfamiliar with equipment and procedures in the clinical area.  I eventually found a job at a small rural hospital that required background health care knowledge, but nothing more clinical than taking blood pressures.  By this time, I had also developed essential tremor which is inherited from my mother’s family, and I could not consider doing anything with needles.  

The job I ended up with was ideal.  I began by coordinating the hospital’s participation in a prostate cancer research program which was NCI funded.  After the initial phase of that program, I had time to do other things, and I began coordinating all of the hospital’s outreach programming.  It was a wonderful job with lots of variety.

When I became 65, I decided to “retire.”  We were downsizing and I needed time to organize and clean out for the move.  After that was accomplished, I worked for awhile part-time doing outreach for the NYS Cancer Service Program in our county.

When I stopped doing that, I became a part-time tutor of high school subjects.  That obviously didn’t require a nursing license, but I still maintained it…because you just never know.

So, I will be 75 this month.  Although the current Covid-19 pandemic and crisis caused me to get 3 emails from Governor Cuomo requesting that I inform him whether I am available to return to work, I don’t see that happening.  I am living in Florida, have had a respiratory illness myself recently, and that annoying hand tremor is popping up in all sorts of unsettling ways.

So…I’ve made this difficult decision.  I am not going to renew my license.  It was earned with sweat and tears and hard work.  It provided me with employment when I needed it most.  But, it isn’t just the license that makes one a nurse.  That is a part of me that is integral to who I am as a person. 

Life Changing Choice

I have been thinking recently how one decision I made when I was only seven years old has changed the whole course of my life.  I asked Jesus to be my Savior in a very personal way on November 2, 1952.  Years later my mother told me that there was a definite change in my life from that time on.  As I grew older and began making decisions about education and career path and marriage partner, my commitment to look for and follow God’s guidance was the defining factor in my life.

If I had not accepted Jesus into my heart and life, I quite probably would have chosen a different career.  I would have had no reason to consider the nursing school affiliated with a Christian college.  I probably would have attended a school in New York State as multiple scholarships were available to me if I stayed in New York.  Would I have become a nurse, or would I have pursued some other interest?  I was interested in most everything other than law and politics.  My guidance counselor had told me, given his awareness of my aptitude testing and grades, he could recommend me to any school in the country to study any subject I pleased.  He had also encouraged me to apply for a scholarship available at our high school for someone intending to be a medical doctor.  What would I have done?

In any event, I would have probably already had a bachelor’s degree by 1966, so I would have been out on my own.  I would not have moved to Watertown with my parents between college years in the summer of ’66.  I certainly would not have gone to church with them there, so I would not have met my husband.  If I had met him, nothing would have come of it.  He never dated anyone who did not at least profess to be a Christian.  He certainly would not have married someone in whom that faith was not genuine.

So…our biological children would not exist.  Our adopted children would exist somewhere in the world probably.  The child we adopted as an infant has said that her biological mother might have killed her, but perhaps someone else would have adopted her, and she would be somewhere.  The daughter we adopted at age 11 might or might not have survived.  Her case worker told me that without us, she would have eventually been placed in an institution.  If they had both lived and grown up elsewhere, none of our grandchildren would exist.  Our daughters would not have grown up in Watertown, made the decisions they made, and had the children they have had.  Of our eleven grandchildren, the only one who would be in the world is the one who is actually a step-grandchild, although we think of him as fully ours.  The lives of our son-in-law and daughter-in-law would have played out differently.  In fact, many lives would have been different.

I cannot begin to imagine how many lives have been impacted by a choice I made at the age of 7.  I stand in awe of a God who can speak so directly to the heart and mind of a child.  I don’t know quite how he brought me at such a young age to a deep understanding that I was powerless to change things in my life on my own, but I am grateful.  I really don’t want to imagine where I would be without Him.  I do know that during at least three time periods in my life, I could have easily succumbed to despair.  I clung to Jesus to give meaning to my life.  I have no desire to live outside of His loving guidance.  To whom would I go?

John 6: 66-69  …many of his disciples turned back and no longer followed him.  “You do not want to leave too, do you?” Jesus asked the Twelve.  Simon Peter answered him, “Lord, to whom shall we go?  You have the words of eternal life.  We have come to believe and to know that you are the Holy One of God.”