Becoming Real


"What?" I mouthed to my husband through the car window, pointing to the phone still up to my ear. I'd been holding for 30 minutes and cut off twice -- I wasn't hanging up without good cause. We had stopped for gas after our son's occupational therapy. I didn't even notice my husband had wandered inside until I saw him walking quickly back toward the car with a strange look on his face and a lottery ticket in his hand. As I am finally patched through to the nurse reviewing my long-term disability claim, he's feverishly tapping on the closed window, "An elderly woman tripped over a speed bump and hit her head. She's saying she doesn't need an ambulance."

As he disappears back inside, it clicks through to voicemail. I leave a discombobulated message for the nurse and sit momentarily disoriented wondering what to do. Emergencies are not my forte and I'm out of practice, dull, medicated. I haven't been able to work as a nurse in four years.

I ransack the glove compartment for anything absorbent and find nothing useful save a nearly empty pack of travel tissues and an unopened bottle of water. My head launches without pause into a rapid-fire assessment of my usefulness in this particular situation: I can't leave the children in the car by themselves. Surely they called an ambulance already. I'm not even a legit nurse anymore. My nursing license lists my status as inactive. Tissues? These are going to stick in the wound. Diapers. Don't panic. I need diapers.

One day when I was still a practicing RN, we were leaving the supermarket when an older disabled man was struck by a car crossing the street. He was still lying in the crosswalk next to his overturned scooter as we were pulling out of the parking lot -- someone had called 911 but they hadn't arrived yet and his head wound was gushing. All I had was a stash of diapers which sufficed until the paramedics arrived moments later. Despite working in the Neonatal ICU for seven years, emergency situations were out of my comfort zone. Emergencies in the ICU were usually controlled, predictable. Someone who knew exactly what the hell to do was always right there. That wasn't me. I brought Huggies to the scene of the accident. Today I didn't even have those. I took my pocket tissues and my water, and got out of the car.

That morning I had prayed for reassurance that I still had something useful to offer and here I didn't even have a first aid kit. Make it clear, God, I had prayed. I'm thick sometimes. Lately I had felt useful to no one, least of all myself. All the nonsense with having to keep proving my disability to the insurance company despite my doctors repeated documentation of three unsuccessful surgeries had me feeling cynical about my chances against corporate bullies and the general goodness of humankind.

I was certain I had found my true calling in nursing and I counted on doing it until I couldn't do it anymore. I would feel better for a while and would work as much as I was able in between surgeries, but after several months the pain always returned. Still, I held onto to my plans, clung to them really, while I tried to heal my back until my spine was finally fused. Inactive, they call it. That's what they put on your license when you aren't practicing anymore. Status: INACTIVE.

Inactive: adjective, not working; inoperative. Synonyms: idle, lifeless, inert, motionless.

That's exactly what it feels like when you lose something you love, that somehow you aren't quite real anymore. That you are inert, lifeless.

"If you could just drive me down the street to see if my friend is home," she kept saying with her legs dangling sidesaddle out the driver's side door next to the diesel pumps. The blood around her head wound was already coagulating but a steady stream was dripping off her brow onto her cheek, and running down her neck. She lived alone and had no family nearby, she told us. Her friend might be home though, she kept insisting, she just couldn't remember the address. I told her I was a nurse and that an ambulance was on it's way. She made it clear she didn't want all this commotion when she heard the sirens approaching

"I don't need an ambulance," she kept repeating. The assistant manager was hovering nearby, completely beside himself, trying to make himself useful. It occurred to me later I should have sent him to look for a first aid kit, but he was as clueless and unprepared as I was. Before we pulled up he was about to drive her off the premises and down the street to look for her friend's house. Even in her fragile state, she nearly had him convinced that she didn't need medical care. He thanked us profusely for making him call an ambulance. This was his first week at this new job and he didn't really know what to do, he explained.

I poured the water onto my pocket tissues and wiped some of the blood from her face and where it had collected in the hollow of her neck. I looked down at her arm -- both the bones were snapped in two the same way mine was the day I fell off the monkey bars in the 3rd grade. The only thing I knew to do was comfort her and it was only a few moments, because thank God the paramedics showed up and saved us all in what felt like seconds. I took a deep breath and gratefully stepped out of the way while they opened their emergency gear around the car and tended to her. I whispered a prayer for them all as I walked back to the car and gave thanks for a day of saves. We had saved the assistant managers job. The paramedics had saved the injured woman. The injured woman had saved me.

For those moments, while I was wiping blood from a stranger's face, I forgot all about the insurance company bullshit. Serving others has that effect because sometimes it means showing up with a mostly-empty pack of pocket tissues. Sometimes it's just holding someone's hand or wiping blood from their face. Sometimes it's not knowing what to do and showing up anyway.

And unfortunately my past good deeds do not protect me in any way. There are no minutes to roll over, or special passes to cash in for public service. I've learned bad shit still happens and the good guys don't always win. Despite providing the insurance company again and again with what seems to me sufficient documentation, a year ago they dropped my claim. I've been fighting them ever since.

They don't know every time they suggest that I would choose to not return if I were able, it's a knife in my heart. They don't know I had counted on nursing carrying me through the rest of my working years. They don't consider that it not only sustained my family financially, it sustained my well-being. So I have had to seek other means in search of the wellness that comes with doing what you love. I have found writing to be one of the only things that has helped me work through such abrupt changes in my perfect plans. And for now, as long as I'm breathing, I'm going to keep doing it. It has kept me alive.

As for the insurance company, they want nothing more than to dump a drain like me. Losing one's livelihood is hard enough and then you lose the insurance that you get in case you can't do your job. These things did not factor in to my precious plans. And my story isn't special, it's one of millions. My research has revealed a treasure trove of patient stories on the internet; horror stories of big-corporate insurance companies screwing over the little guy. I'm now well versed in what happens to you when have an injury that doesn't get better. They get tired of paying you whether you have a legitimate claim or not. They will wiggle and worm their way around every law. They will lie, cheat, trick, stalk and surveille you -- anything to get out of making good on your policy, all while using Snoopy as a mascot.

They operate on the premise that I like collecting less than half my salary and assume I would pretend to be hurt while I rot away into nothingness and get paid for it. As much as I know that it isn't personal. It is. It's calling me a liar, a fake. It's saying, "There's nothing wrong with you," when something clearly is.

That day I fell off the monkey bars in the 3rd grade and snapped both bones clean in two, I had gone to the school nurse. It's probably just sprained, she said sending me back to class after first recess at 10 am. I went all day guarding my arm close to me and that afternoon I took the long bus ride home. We lived in the sticks and often didn't get home until 4:30 or later. There was an older boy, Kevin, who always sat in the back. He taunted me as I got up to get off the bus when it finally stopped in front of my house. "There's nothing wrong with you," he said as he shoved my arm into my abdomen. I got off the bus and walked through the dirty gravel up the driveway.

When she saw my arm, we did not pass go or collect two hundred dollars -- my mom took the ten-mile drive back into town straight to the emergency room. My hand was hanging at the wrist, a near-greenstick fracture where the bone comes through the skin. I hadn't complained all day at school. I trusted that a nurse would know better than I did until it was clear she didn't. I was eight then, but the fact is, I'm still figuring out how to be heard at forty-one. It has taken me all the time in between to figure out that some of us just speak more clearly in the written word.

Who knows if the insurance company has a chance at redemption, or if the nurse I was on hold with that day will have mercy on me; they are, after all corporate machines. I was not silent this time, I appealed their decision. I didn't let them push me and tell me I wasn't hurt. And Kevin? Sometimes I think about him and hope he got his redemption via a nurse-given enema. No, not really. Ok, maybe a little bit. But more than that, I pray he grew up and learned how to treat a human being. He taught me what it felt like to not be seen or heard and I carried it through my nursing career and carry it still today. It made me a better person, a better nurse, so thanks, Kevin, and by the way, I forgive you. Everyone is an asshole sometimes.

I still feel like a nurse as I keep learning to be a writer. It's not something that leaves you. It's a difficult transition and at times I am utterly lacking confidence in my ability or potential with a pen. In order to do it well, you have to make yourself vulnerable, and maybe being hurt has provided me that vulnerability. But the solace offered me by writing has also kept me isolated and inside my head, which has made me slow, off my game. That was clear to me when the only thing I could offer the poor lady at the gas station was comfort and an almost empty pack of pocket tissues. But what she gave me was priceless. I need blatant reminders despite my purest intentions. Nursing kept me grounded, reminded me that being alive means that you bleed. It's why I miss it like a lost limb. To see the truth about what it is to be born, to live, to get sick, hurt, to die -- those experiences keep us honest, humble, real.

And being real means my joints are loose and shabby and yes sometimes (almost always) it hurts. It means changes happen midstream and there is not a damn thing you can do about it. Being real means losing your job and being on hold for 30 minutes with insurance company. And sometimes, being real means bleeding from the head at the gas station. I know that being alive means it can be no other way. For me, it has meant getting down to the truth of things, even when it isn't pretty. Writing has served me well to sift through the insecurities and fears I mistakenly thought were behind me. Getting it out on paper has been a safe-haven while I have mourned the loss of my best-laid plans and tried to forge new ones.

I've long since lost my sharp edge, dulled by unrelenting pain and mind-numbing medications. I had no supplies at the gas station and had forgotten all the things you do in emergencies because writers aren't required to know these things. Lucky for me they don't need strong backs and quick feet are not a prerequisite. Writing has expanded my awareness in ways that otherwise might have escaped me, but it also comes with a heaping dose of self-doubt. For me, sacred as it is, holding a pen is not the same as holding someone's hand. I'm still learning how words can save us. I'm still learning how to let them.

This morning as I sit at the kitchen counter while my coffee drips and try to make heads or tails of this essay, my phone rings. It's 5:30 a.m. I haven't been up this early in a while, but pain woke me and it's my favorite time to write. It's staffing on the phone. My number is still in the system. They need nurses to work 0700-1900. And though I know I can't, somehow that comforts me -- to know I'm still needed. It tells me, just keep going. It says, this is where you are right now. It gives me just enough to endure when I want to give up.

So I will keep writing about this journey, unexpected as it is. I know it doesn't happen all at once; that becoming Real takes a long time. And even though I can't do what I once could, the important stuff I learned not from a science degree or nursing school or even writing. The really good stuff I learned from a beloved children's book because the stories we're told when we're kids are the ones we never forget:

"Real isn't how you are made,' said the Skin Horse. 'It's a thing that happens to you.'

'Does it hurt?' asked the Rabbit.

'Sometimes,' said the Skin Horse, for he was always truthful. 'When you are Real you don't mind being hurt.'

'Does it happen all at once, like being wound up,' he asked, 'or bit by bit?'

'It doesn't happen all at once,' said the Skin Horse. 'You become. It takes a long time. That's why it doesn't happen often to people who break easily, or have sharp edges, or who have to be carefully kept. Generally, by the time you are Real, most of your hair has been loved off, and your eyes drop out and you get loose in the joints and very shabby. But these things don't matter at all, because once you are Real you can't be ugly, except to people who don't understand..."

Margery Willliams,
The Velveteen Rabbit