A Nurse Remembers

The large man's chest rose and fell with each breath, virtually the only movement I saw as I entered his room on the cardiac unit. Only half way through my nursing courses and two days into my first position as a nurse extern on a hospital floor, I was as enthusiastic as I was green.

I filled a wash basin with water, wondering who he was and what he had been like before his stroke. I approached him cautiously, determined to hide my insecurity.

"Mr. Smith*," I said, "My name is Suzanne. I am a nurse extern, and I'm here to give you your bath." He did not answer. I had not expected him too. Aphasia, a complication of his cerebral vascular accident, had silenced him.

I pulled the curtain around his bed and set about my task. At 46, he was younger than most of the patients on the unit. Thick, dark hair framed strong Mediterranean features. A pool of saliva glistened on his ruddy left cheek.

"Don't be surprised, Mr. Smith," I told him, "I'm about to wash your face." The rhythm of his breathing never changed. Did he hear me or even feel the washcloth as I wiped his stubbled chin? I washed his arms and legs, mesmerized by his deep tan. Only days before, he had been awake and dynamic, pursuing an active life in the Florida sun.

When I had done all I could do alone, I called another nurse for assistance, and we completed his bath. We talked. Mr. Smith only occasionally mumbled.

"You know, it was early when I left the house today, but it sure looked like a beautiful day," I told him and opened the blinds before leaving.

That night, I reviewed what I had been taught about the acute care of the stroke patient, both the medical science and the human art. The instructor had emphasized the responsibility of respecting and preserving human dignity, and the importance of communicating with patients, even with those who could not speak.

In the five days I cared for Mr. Smith, I worked to implement those lessons. I talked to him. I listened as his beautiful blonde wife and daughter spoke of his strength, his love of sailing, and what a wonderful husband and father he had been.

Then one day, a porter came in, impatient to get Mr. Smith to radiology. I helped transfer him onto a gurney and roll him into the hall, announcing every move. As she started to move on, I stopped her to place a blanket over my patient, noticing that his dark tan had only just begun to fade. "You'll need this, Mr. Smith," I said, ignoring the porter's scowl. "It's cold down there in X-ray.

"Hurry up," the porter barked, "You're wasting my time. It's not as if he can hear you."

It took all the courage I could muster to speak up. "Every human being is worthy of respect," I said, echoing my instructors. Despite his stillness, I told her, Mr. Smith might indeed be hearing every word we were saying. Inside the motionless body was a man still very much alive, infinitely in need of human contact. The porter did not reply.

Soon after, Mr. Smith was transferred to a rehabilitation center in a nearby city. I continued on the cardiac floor.

As I delivered meal trays less than a year later, I noticed a large man with a cane exit the elevator and walk slowly toward me.

"Are you Suzanne?" he asked, his speech halting and slurred. I nodded noting that the left side of his face hung slackly. Although it took quite some time for him to complete his thoughts, I listened.

"I want to thank you," Mr. Smith said. "You talked to me when almost no one else would. You reminded me I was still alive." A tear rolled down his cheek, and I felt the moisture well up in my eyes. "I heard what you said to the girl in the hall that day, and I wanted to stand up and cheer, but I could not. You said everything that I could not say."

I hugged him, wishing to stand in that spot a little longer, but knowing I had to move on. Other patients waited.

Now, six years later, I vividly recall the man and his mission. I have one regret though: I let Mr. Smith leave without telling him how much he would guide me in my nursing career and how he gave flesh to the lessons my instructors had taught. Because of him, I would never forget that inside every body, even those that are broken, aged, or nearly motionless, is a soul, the heart of a woman or a man, wanting to reach out, to be spoken to, and to be touched.

Aphasia disconnects stroke patients Aphasia (either expressive or receptive) is the term for communication difficulties that can result from stroke, head injuries, or other neurological disorders. Aphasia challenges the stroke patient's recovery by erecting a barrier between the individual and his or her environment. Often, it leads to depression, which can further hamper progress. Fortunately, resources are available to family members and caregivers. Coping with Aphasia by JG Lyon (San Diego: Singular Publishing, 1998) provides a comprehensive guide. The United States has a National Aphasia Foundation that provides information, links, and referrals to support groups. It can be accessed via the internet or by calling 1-800-922-4622. At this time in Canada, there is no national aphasia organization. Across the country, various institutes and centers provide treatment and resources for aphasia patients and their families, and, in Ontario, there is a self-help group for patients and families. The group, the York-Durham Aphasia Centre, can be contacted at 905-642-2053. For membership information, e-mail ydac@ydac.on.ca or contact the group's main office at 12184 Ninth Line Stouffville, Ontario, Canada L4A 3N6.

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