Book Club: Critical Care: A New Nurse Faces Death, Life, and Everything in Between

If you read the MidlevelU December Newsletter, you were probably anticipating the book review this month to feature I Am Malala.  Early in December, I imagined I would pick up I Am Malala while sitting by the fire with a cup of cocoa over Christmas break.  I had the book downloaded onto my Kindle and ready to go.  But then, reality set in and I found myself making trips to Target, playing with my nephew and chatting up my in-laws.  My vacation days passed me by book unopened.

Thankfully, much more motivated Melanie Chen, MidlevelU intern extraordinaire, stepped up and actually read a book this month.  Melanie has raved about Theresa Brown's Critical Care to me in the past and has graciously agreed to share her opinions on the read with us today.

Critical Care: A New Nurse Faces Death, Life, and Everything in Between

By Melanie Chen

When novice floor nurse Theresa Brown tells others she used to be an English professor, she gets some raised eyebrows in response, especially from other nurses.  Her colleagues at the hospital question why she would trade in the comfort of the "ivory tower" of academia for the emotional and physical stress of caring for patients on a daily basis.

"You left teaching English for this?" is the first sentence of Critical Care, a book that documents Brown's sink-or-swim first year job experiences as a floor nurse.  But Brown says that nursing ignites in her a passion and urgency that teaching never did, and from the first page I could feel that earnestness.  While reading this book I felt like a nurse working alongside Brown on the medical oncology floor of her hospital.  I marked up the charts and fumbled with IV drip bags with her.  She and I encountered together our first death, first crash cart code, and first Condition A (a sudden cardiac death due to cardiac arrest).  As readers, we learn, just as she did, that what lies behind the scenes of health care is often an unspoken set of well-understood hierarchical rules.  We witness the ways in which people respond to loved ones losing control of their failing bodies.  We see that nursing is just as much about time-management and multi-tasking as it is about medicine.

Through each one of her patient's stories, Brown explores communication.  She attempts to dissolve the barriers between doctor and nurse, nurse and patient, and writer and reader.  Brown writes that people often hold the stereotype that nurses are saints- they always have a smile ready when they see a patient, ask you nicely how your day was, and walk quickly out of the room after doing whatever they needed to do.  Brown writes that she was taught in nursing school to come and go without revealing anything personal, but now she rejects that.  Instead, she chats with her patients about her life to make them feel human. 

"If I'm a saint and they're the sickly person, then we're unequal," she says.  Sometimes, patients want to be the ones asking "How are you?" instead of the ones always being asked that question.  Along the way, Brown's thoughts on the fragility of life and her own mortality are accompanied by lines of poetry from her past life as an English professor.  She sums up why she loves being a nurse by quoting "Catullus: Odi et Amo", a two-line poem by Frank Bidart:

     I hate and love.  Ignorant fish, who even

     wants the fish while writhing.

Brown recognizes this duality as an essential part of her job.  She cares deeply for her patients while hating the diseases that take them.  She does her job with sure hands and expert knowledge of the procedures even when she doesn't know exactly what is wrong with them.  That's what nursing is like for Theresa: she loves it even when she hates it.  She says that she wouldn't trade that feeling for the world.

Ultimately, Theresa Brown's message to all her readers, especially if they work in healthcare, is that sometimes the best way to treat someone is to just talk to them as one human being to another.  As a pharmacy student, I know my training will focus on drug-drug interactions and drug information, which means that I'll probably interact with patients less directly than do nurses.  Perhaps I'm at a heightened risk for seeing patients as an amalgamation of signs, symptoms, and medications than as actual human beings.  In that case, it is even more important for someone like me to remember Mrs. Brown's words.