Big Nurse

by Dennis Green

I’m just an old sack of flour. Throw me in the car and drive me to my next appointments… But watch out, I still bite!

WellPoint Clinic, in Emeryville. Peritoneal Dialysis. Luxurious reception room, offices and exam rooms, where, two years ago, I endured six months of dialysis training and prep.

Big Nurse. Blonde and buxom, in her fifties. Emma. “I’ve been doing this for 30 years!” she announces, “and I’ve never heard of adding supplement to the fluid to be any help!” Very assertive.

Oh, yeah? I think, just like I did when I was five years old, and first talked back to my mother.

“Well, listen to me!” I tell her. “I’ve been doing this for 63 years, passed my first kidney stone at six. And I will respect your expertise, but you will NOT be the boss of my life. I am the boss of my life, and my health and I will be in control of everything that goes on here.”

I’ve learned over the years that even a sack of flour has to be in control of his own healthcare. With Kaiser Permanente coverage, I’m facing a lot of choices and a lot of latitude regarding my care. And this Big Nurse is very capable, but needs to understand that I am not a passive “patient.”

Diane and the coordinator both smile. Big Nurse nods in agreement, and I tell her about my resigning from Children’s Hospital rather than agreeing to lie to the press during the nursing strike there in 1989. I wouldn’t betray all my friends, and I want her to understand that she can be one of those persons.

The rest of the exam goes reasonably well, until we get to the catheter in my belly. When Big Nurse, Emma, tries to flush it out, nothing works. No fluid will go inside the peritoneal cavity. She tries again, and gets a little fluid to go in. But then, she has trouble draining it back out. She asks me to stand, and I do.

Still no draining. This is what happened in the hospital, after the peritoneal catheter was first installed by the surgeon. We speculate that it might be blocked by my internal organs, or that the tip is bent. She gets on the phone and calls one of the team of nephrologists who is attending my case, Dr. Chien.

He advises me to take a medication I have at home, and to come in for x-rays of the area. Emma cleans the catheter and re-tapes it against my belly. I stand up again and make my way slowly back to the front office. Diane is right behind me and we get to the car and she drives us home through rush hour five o’clock traffic.

I come away somewhat encouraged. WellPoint is a much nicer setting than the Piedmont hemodialysis clinic in Oakland. Big Nurse, once she understood my nature, impressed me as a very capable source of comfort and support. But I’m still a sack of flour.

When you’re sick, and in some process of treatment, it’s a choice. You can sink into yourself and let the world of care come to you, attend you, push you around, and run your life. Or you can be assertive. There’s a sensitive line between doing that and becoming merely a bitchy pain in the ass, and I trust that I’ve not crossed over.

©2010 Dennis Green