My patients teach me, guide me, and remind me that I am here


It’s an odd thing doing what I do sometimes.  Dichotomies of highs and lows, life and death, joy and sorrow.  In the past 15 years that I have been in health care — a nurse’s assistant, to registered nurse, to now pediatric nurse practitioner — I have had the strange experience of all this emotion.  It wasn’t until recently, maybe because I have a family of my own now, that the experiences I have at work followed me home.  That’s not to say I didn’t feel all I did leading up to this moment of realization.  I did.  I remember the first death I saw. And since then, every loss has piled on like layers of clothing that slowly add to the weight until you can no longer place one foot in front of the next without feeling the lead in your shoes.

The pressure of an intensive care unit becomes routine.  But you know a mistake won’t be making the wrong latte, but perhaps the cause of death.  That your words to a family may be the slap that they knew was coming. That one subtle change may have been the only hint at decline.  There is no luxury of making a new latte, only the truth of being knocked down by humility that medicine so often brings.  It can be a lonely place here. No one wants to hear about children suffering and dying.  Why would they?  It’s not supposed to happen.  That’s not the natural order.

I have always believed that, in this role, the honor is mine to walk a family through horrific experiences, the worst days of their lives.  To be the voice that comforts, and the knowledge they seek, the reassurance they need. But how do you wipe the slate, so you are not paralyzed when the next family needs you? How do you get back up, add another layer to your outfit, and keep walking forward?

The truth is, I can’t answer any of this. I just go on. I cry sometimes. Sometimes I have nightmares. I often berate myself and question my decisions. Other times I simply move forward.  But every day, when the double doors click open and the fluorescent lights shine down, the names of my patients follow me.  I catch glimpses of their faces. I remember her blue eyes, or his crazy hair, the toy llama he slept with, or her tiny striped socks. They teach me, guide me, remind me, that I am here. I am in this place because I belong here. Because I am meant to be right where I am right now.

Karley Mariano is a nurse practitioner.

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