Confessions of a Male Nurse. Michael Alexander
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how much. Maybe it was his background that made me reluctant, or maybe it was because I was giving him more each time, which meant his heart was getting worse.
‘Thirty milligrams,’ I reluctantly replied, avoiding his gaze.
‘Hell, I’ve never had that much in one go.’
Mr Holdsworth didn’t sound upset, more intrigued, as if curious about how much his body could take. You see, Mr Holdsworth used to be an intravenous drug user. Over the years that he had injected morphine into his veins, he had built up a resistance to the drug. This was also how he damaged his heart. Most of the damage occurred on the occasions he took so much that his breathing stopped (one of the primary risks of morphine). Once his breathing stopped, it wasn’t long before his heart stopped. Fortunately paramedics were able to revive him. Each time, he survived, but the damage to his heart was permanent.
‘Not a good sign is it?’ he added.
Sometimes it pays to tell the truth, even when it can hurt, but it’s still hard. Should I tell him that I’ve never given such a high dose of morphine in one push, or given it as frequently to one patient, in my entire career? Should I tell him that I’m even a little nervous giving 20 to 30 milligrams pushes of morphine every half an hour? He probably already knows this, especially given his background. He probably already knows that for most people one to two milligrams is a sufficient amount.
‘You’re probably just having a bad day,’ I replied with false bravado and an equally false smile.
‘Now I know you’re trying to be nice, but stop the bullshit. You know as well as I that I probably won’t make it to Christmas.’
Mr Holdsworth tried to say this as casually as if he was talking about the weather, but I could tell his efforts were as forced as mine.
‘You’re still young, there is a chance. Something could happen any day.’
Unfortunately, Mr Holdsworth had had his first heart attack at the relatively young age of 36. It had been his first wake-up call, but now after four heart attacks, and four subsequent areas of dead, scarred heart muscle, there was very little that either drugs or a healthy lifestyle could do to help him. Christmas was one month away and unless a miracle happened Mr Holdsworth was probably not going to see it.
Still, we had to hope, sometimes it’s all that keeps us going, and there was one chance, one possibility, that we could help Mr Holdsworth. At the age of 47, the only thing that could save him was a new heart, but after five years on the waiting list already, it seemed a very small chance indeed.
With Mr Holdsworth’s rapidly declining health, the topic of conversation was often how much longer he would last, and whether a miracle would happen.
‘I feel sorry for him . . . sometimes,’ Jenny said to all the other nurses in the office, ‘but at other times, I think he doesn’t deserve our compassion, or a new heart.’
‘I know we’re supposed to be caring, but we’re only human,’ I said to Jenny. ‘Today I felt sorry for the poor guy, but I’m like you. I don’t always have much sympathy for him.’
As I looked around at the other nurses in the office I could tell, by the nodding heads, that we all seemed to have similarly mixed feelings. ‘I guess it doesn’t really matter what we think now,’ Jenny continued, ‘he’s paying for his mistakes.’
Four weeks passed. It was now only a few days until Christmas Day. The girls had been busy decorating the ward, and I nearly broke my neck balancing precariously on a patient’s bedside cabinet to put the finishing touches to the tree. I love this time of year – everyone is in such great spirits – even the patients don’t seem so sick.
With half the ward empty we had time to sit around gossiping and reminiscing about who was the drunkest at the Christmas party – until it came time for me to check on Mr Holdsworth.
‘How much that time?’ he asked.
‘Forty milligrams,’ I replied. ‘Is it enough?’ I added.
He had stopped clutching his chest but his face was still creased with pain.
‘Could you try a little more, just another ten? That should do the trick.’
The instructions given to us by the consultant were to give Mr Holdsworth whatever it took to keep him comfortable, so I administered a further ten. With the additional dosage the last vestiges of pain left his face.
‘You’ve been good to an old fool like me,’ Mr Holdsworth said.
‘We all make mistakes,’ I replied.
‘It won’t be long now and I’ll pay the ultimate price.’
My mind was blank. There was no suitable response. I chose that moment to leave the room, my Christmas spirit well and truly dampened.
The next morning something strange happened; as I headed towards the nurses’ station I found myself taking a detour until I was standing outside Mr Holdsworth’s room. The first thing I noticed was that his name had been removed from the door; the second was the deathly silence in the room.
I felt strangely depleted. I think that deep down, I had been believing that a Christmas miracle might happen. I quietly opened the door and there, staring me in the face, was an empty room. I headed to the office, where the nurses seemed to have gone mad.
Jenny greeted me with a big smile. ‘Have you heard the news?’
I didn’t know what news she was thinking. I know we all had mixed feelings about Mr Holdsworth, but it didn’t seem quite right to be so damn happy first thing in the morning when a patient has just passed away.
‘It’s Mr Holdsworth,’ she was almost exuberant. ‘They came for him last night. They found a donor. He’s getting a new heart.’
Everyone in the office was so genuinely happy that he was going to have a chance at life – regardless of whatever past mistakes he had made. Without a doubt that had to be the best Christmas present ever.
Mr Holdsworth’s transplant operation had taken place far away in a big city hospital, so Jenny had to phone the hospital every few days to get an update on how our patient was doing.
‘He could be discharged soon,’ Jenny informed us, three weeks after he had been taken away. ‘The doctors say he is doing really well. No sign of rejection.’
Three months later and Mr Holdsworth was back at home and living a normal life – although, we assumed, a much more careful, healthy life. It makes sense that a near death experience makes a person wiser.
During the two and a half years I had spent with patients in the medical/surgical ward, I thought I’d seen it all. I had seen how high the human spirit can soar, and then how low and selfish humanity can be. But then, along would come someone new, who would set up new boundaries, whether high or low.
One April morning I was greeted by Jenny, who had news to share: ‘Mr Holdsworth is in the emergency room.’
‘Organ rejection,’ I blurted out.
‘Oh no, it’s much worse than that’ – What could be worse than your body rejecting your new heart? – ‘He’s back to his old habits. He’s overdosed on morphine.’
Jenny didn’t attempt to hide the scorn in her voice.
‘But that’s not even the worst part. When he gets out of here, he’s got an interview with the police. It seems he’s been selling it as well.’
I guess not everyone learns from their mistakes. As I look back at some of the ambivalent feelings I had had while looking after Mr Holdsworth, I wonder if deep down I doubted that he really had changed. That heart could have gone to someone else less likely to waste it. I try not to judge, but the fact is we’re all human and we do have opinions. I just hope that as a nurse, I can always accept people for who they are and give them the best care that I can.