A Nurse Considers Suffering

I'm sick. I'm so sick I haven't gone to work at the women's clinic, where I'm a nurse practitioner, for days. Staying home is something I rarely do. Usually I manage to drag myself in, in spite of a runny nose, headache, back pain.

Not this time.

I'm so sick I'm in bed in my pajamas and fuzzy robe for the entire three days. So sick I haven't made it downstairs to turn on my computer and must instead write in my scribbly hand on a yellow legal pad and hope that, later, when I'm able, I can decipher the scratchings and type them into words.

Because I'm a nurse, illness is part of my life, my daily bread, my soul-work. For more years than I care to remember I have cared for others tenderly and passionately. But now, I am the one suffering.

Usually, I try not to get carried away at the onset of a personal illness. Instead, treating myself as if I were my own patient, I take a history and then a body inventory. When did this illness first begin? What, exactly, are my symptoms? I'm on the alert for the big symptoms, the ones that almost shout emergency room, things like shortness of breath, chest pain, fever over 102, unrelenting abdominal pain and the like. For the past three days, I've been compulsively and anxiously taking my history and body inventory.

Headache? At first, it was mild but persisted in spite of Advil. Sinuses? Not a touch of congestion. Throat? For the first several days I felt as if ground glass had been mashed into the tissues of my upper pharynx. When I looked with a flashlight, saying ahhhh like I ask patients to say, I could see that my throat was beefy red. My throat, as patients say, was killing me.

Deep slow breath with mouth open. Lungs fully expanding? Well, almost. The virus had insinuated itself from throat to lungs, creeping down my main stem bronchus and spreading itself over the surface mucosa of my bronchial tree just like fine beach sand sticks to moist skin. The tissues scritched and scraped with my every breath. Whenever I took a breath, I felt as if I were a hundred feet underwater.

Within days, my symptoms crescendoed, yet still I functioned, as we women do, watering plants, grocery shopping, making lunches, and going to work in the clinic as I have for the past 14 years. Then, at work on day four of the still-on-my-feet part of this illness, I was suddenly struck with that peculiar and horrible feeling that can only be described as someone pulling a plug in your ankles so that all your energy runs out. One minute I was smiling and talking to a patient. The next moment my energy was gone, streaming out from my ankle bones in twin rivulets and soaking into the already stained clinic carpeting. I felt myself deflating, becoming pale. My heart raced. There was a high-pitched buzzing in my ears. What was wrong with me? As soon as I'd thought that thought, I began coughing, a spasm so intense, so prolonged I couldn't catch my breath or talk. While horrified hospital employees stood by, helpless, I waved my hand to signal I'm okay. When I finally mouthed the word water, three people scurried as one to fetch me a Styrofoam cup of warm hospital tap water. Tiny sips seemed to calm things down.

Then I felt faint; I flushed steamy hot and bright red, partly from embarrassment and partly from fear. I felt really, really sick. "I have to go home," I said. It was barely an hour and a half into my shift, but everyone nodded, happy to have whatever germ I was harboring go home with me.

Once in the parking garage, key in the ignition, I wasn't sure I could drive home. My vision seemed to brighten and pale, alternatively, and my legs were shaking. I kept coughing, on the brink of another spasm, which frightened me. What if I coughed so hard I ran off the road or caused an accident? What if I managed to pull over, but couldn't stop coughing? What if I passed out in my car? Stuck between here in the parking garage and there at home, there seemed a better place to be, and so I decided to chance it. When I at last pulled into my garage, all in once piece and with no dents in the car, I felt wildly grateful. I walked straight into the bedroom, stepped out of my clothes and into my pajamas and robe and, folding back the covers, got in and collapsed against my two propped pillows.

I was sure that there was something terribly wrong. If only I could figure out what it was then I could understand it, know it, cure it – control it. My body was light, as if it was trying to levitate from the bed. I was dizzy and yet my vision was clear, extra sharp. My steady pulse didn't speak of anxiety or an impending swoon. Instead, I felt something like a shift in the core of my being. It was this something else – a feeling familiar to patients and yet not documented in any of the anatomy and physiology books – that made me think, as I sat there in bed staring at the blank reflective face of the TV across the room, that I might actually be dying.

When we're young and sick we rarely think we might be dying. In our thirties and forties, a brief virus or bacterial illness might perplex and frighten us, but still we hardly ever think that this could be it, the fatal blow. When we humans cross the line into our fifties and sixties, however, illness takes on a different shape, a different beat. Even a simple virus might be, our shadow half reminds us, the beginning of the end. Maybe, we think, we don't have a virus but avian flu. Maybe the cough isn't just bronchitis or even a simple pneumonia, but that unusual and fatal pulmonary condition discussed on TV last night. Maybe the stomach bug is really a blocked and non-functioning bowel, soon to gangrene. Maybe the pain in the breast is the warning of the lump that will be the cancer that will bring, sooner or later, the inevitable end.

I have, I think, a solid intellectual understanding of mortality. I see the seasons slide by, and I have sat with enough dying patients to understand that death comes to us all – leafy tree or human being. I believe too that I've always been aware of the state of being we call suffering, and how suffering can exist separate from or conjoined with illness and death. I have suffered myself, physically, and I have, as we all have, suffered emotionally. I have held sobbing parents whose children are ill and I have comforted patients suffering with other losses – blindness, amputation, paralysis. I have had my own serious illnesses and my own losses and so have contemplated, often, the ways in which we will all eventually lose everything that we are, everything that is ours upon this earth. Like everyone, I have cried at the thought of, someday, leaving family and friends and this beautifully complex world behind.

But during this particular illness, one that persists as I am writing – I have learned something else about suffering. Not with my mind but with my body and, dare I say it in our secular age, most of all with my soul. During these past days in bed, laid low, I've come to understand that illness is, in its own annoying way, a gift. This happened one afternoon when, alone, exhausted and frightened, I stopped listing and evaluating my symptoms and simply sank down into the reality of sickness. I gave in to suffering, especially to the horrible something that came in waves, sweeping over me: the odd lightness of the body, an alternating illumination and dimming of my vision, a high-pitched hum in my ears, as if my soul was trying to drag itself from my flesh, stretched out by some invisible hand, pulled taut like taffy is pulled by women in the kitchen, laughing and talking, making candy.

As soon as I let go of being the nurse, of believing that I might be always in control, I recalled something I'd read many, many years ago. The words, clipped out of an article about Cardinal Cooke's illness and death had been forgotten, but now they came back to me entire:

"He wants this to be purposeful. He wants his suffering to be a beautiful gift for others. Catholics believe that suffering can be dedicated to a purpose, including the salvation of the souls of others."

Reading this, years ago, I'd understood with my mind but not with my flesh. Maybe I hadn't been a nurse long enough. Maybe I hadn't yet seen so many others suffer or suffered enough myself. But now, during this brief illness, I incorporated the truth of those words. Their import struck me like lightning. Of course, I said, and then simply opened the door for whatever it was, this suffering. I beckoned it in, I claimed it, and then I gave it away.

I let my body lie back, sinking into the pillows. I closed my eyes and offered my suffering, this frightening about-to-die feeling, for the good of another, in order that another person's suffering might be lessened. Because this is not fiction, but truth, I will not name the person. But I will tell you that this small act, this tiny gift, accomplished something astounding. I may never know if the person I named has suffered less because of my offering. I do know that my suffering assumed new shape, new import. The sicker I felt, the more I suffered, the more I had to give away, as if each symptom, each moment of discomfort or fear was a gold coin. Instead of being anxious about my inability to feel better, I accepted my situation as a gift and then passed that gift along, currency to reduce another's debt. In bed, unable to read or think or watch television, I thought of all the other times when my suffering had been greater. What a shame I had wasted those moments by hoarding them to myself, by cataloging and trying to beat them away! What a shame that, once, I had mentally chided a patient for "giving in" to illness when I wanted him to fight. Now I understood that one does fight, does cling to life precisely by accepting suffering and actively, consciously, using it.

All this time, standing beside suffering patients, perhaps helping them endure, perhaps not, I had never acknowledged suffering as instructive, as malleable, as useful – other than giving a nod to that old saw that says suffering makes our moments of joy more potent, which is true enough but not the whole truth. This particular illness, a very minor one, nevertheless brought me up short. For the space of a few days, I entered a realm I hadn't truly entered before, even when my physical suffering had been much greater.

Was the noise in my head and the sudden recognition of suffering as opportunity the voice of my soul? Or was that rushing wind simply a physical symptom that might be explained away rationally as the sound of blood pumped by the beating heart, the effects of fever or the machinations of anxiety? Good nurse that I am, I know that it was not.

So ended my essay, originally, and so, two weeks later, ended my illness. But something happened more recently that seems a part of this and so must be added on. I have gone to the local post office to get my mail. Walking in, feeling better but still weak, I see a man I know. He looks awful. There is an off cast to his skin, and the blue circles beneath his eyes tell me he has not been sleeping. Still, he greets me with a big smile and a hug. Are you all right? I query. I'm fine, he says, healthy myself, but I have two friends for whom I am suffering. What else is the human heart for?

Indeed. Now I know exactly what he means.

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