Exhausted Nurse Quotes

Be not defeated by the rain, Nor let the wind prove your better. Succumb not to the snows of winter. Nor be bested by the heat of summer. Be strong in body. Unfettered by desire. Not enticed to anger. Cultivate a quiet joy. Count yourself last in everything. Put others before you. Watch well and listen closely. Hold the learned lessons dear. A thatch-roof house, in a meadow, nestled in a pine grove's shade. A handful of rice, some miso, and a few vegetables to suffice for the day. If, to the East, a child lies sick: Go forth and nurse him to health. If, to the West, an old lady stands exhausted: Go forth, and relieve her of burden. If, to the South, a man lies dying: Go forth with words of courage to dispel his fear. If, to the North, an argument or fight ensues: Go forth and beg them stop such a waste of effort and of spirit. In times of drought, shed tears of sympathy. In summers cold, walk in concern and empathy. Stand aloof of the unknowing masses: Better dismissed as useless than flattered as a "Great Man". This is my goal, the person I strive to become.

Incidentally her head ached and her shoulders ached and her lungs ached and the ankle-bones of both feet ached quite excruciatingly. But nothing of her felt permanently incapacitated except her noble expression. Like a strip of lip-colored lead suspended from her poor little nose by two tugging wire-gray wrinkles her persistently conscientious sickroom smile seemed to be whanging aimlessly against her front teeth. The sensation certainly was very unpleasant.

The labor of love begins, then, in the home. We are still told that the work of cleaning and cooking, of nursing wounds, of teaching children to walk and talk and read and reason, of soothing hurt feelings and smoothing over little crises, comes naturally to women. These things are assumed not to be skills, not to be learned, as other skills are, through practice. And this assumption has crept from the home into the workplaces of millions of people—not all of them women—and has left them underpaid, overstretched, and devalued. Our willingness to accede that women’s work is love, and that love is its own reward, not to be sullied with money, creates profits for capital.

The Everlasting Staircase" Jeffrey McDaniel When the call came, saying twenty-four hours to live, my first thought was: can't she postpone her exit from this planet for a week? I've got places to do, people to be. Then grief hit between the ribs, said disappear or reappear more fully. so I boarded a red eyeball and shot across America, hoping the nurses had enough quarters to keep the jukebox of Grandma's heart playing. She grew up poor in Appalachia. And while world war II functioned like Prozac for the Great Depression, she believed poverty was a double feature, that the comfort of her adult years was merely an intermission, that hunger would hobble back, hurl its prosthetic leg through her window, so she clipped, clipped, clipped -- became the Jacques Cousteau of the bargain bin, her wetsuit stuffed with coupons. And now --pupils fixed, chin dangling like the boots of a hanged man -- I press my ear to her lampshade-thin chest and listen to that little soldier march toward whatever plateau, or simply exhaust his arsenal of beats. I hate when people ask if she even knew I was there. The point is I knew, holding the one-sided conversation of her hand. Once I believed the heart was like a bar of soap -- the more you use it, the smaller it gets; care too much and it'll snap off in your grasp. But when Grandma's last breath waltzed from that room, my heart opened wide like a parachute, and I realized she didn't die. She simply found a silence she could call her own.

Most changes in perception are gradual: we grow to hate or love an idea, a person, or a place over a period of time. I had certainly nursed a hatred of Nora Jansen over many years, placing much of the blame for my situation on her. This was not one of those instances. Sometimes, rarely, the way we see something is subject to alchemy. My emotions changed so rapidly, and I felt so strongly all the things I had in common with these two women, there was no way not to take immediate notice and stock of what was happening. Our troubled history was suddenly matched by our more immediate shared experience as prisoners on an exhausting journey. We huddled together

An exhausted parent can’t provide the best care, although occasionally, we have all had to do so.

river in northern France?” She mumbled something and slouched away. What had they taught her in nursing school? he wondered. AFTER LUNCH THE TAXI driver safely returned them home and Zod, exhausted from the outing, dozed on the couch, snoring

... Before your horror can be sweet. Or proper. Before your grief is other than discreet. The intellectual damn Will nurse your half-hurt. Quickly you are well. But weary. How you yawn, have yet to see Why nothing exhausts you like this sympathy

When live entertainment was not available, women delivered the film and ran the projectors for the hundreds of movies that were shown to the soldiers. Frances witnessed the popularity of movies time after time; they were shown in warehouses, airplane hangars, on battered portable screens, or projected against the wall of a building in the village square where townsfolk crammed in around the soldiers. “Charlie and Doug” were the two favorites, but anything showing familiar sights from home—the Statue of Liberty, a Chicago department store, or San Francisco’s Golden Gate—created a sensation and bolstered morale. Toward the end of the war German propaganda films left behind by the retreating army became a prime attraction.30 Frances traveled to and from Paris for a few days at a time, usually arriving on or near the front after a battle to witness doctors and nurses doing what they could for the injured in the shattered villages and burying the dead. She was struck by how thoroughly exhausted the Europeans were after four devastating years of war.

It was getting late, but sleep was the furthest thing from my racing mind. Apparently that was not the case for Mr. Sugar Buns. He lay back, closed his eyes, and threw an arm over his forehead, his favorite sleeping position. I could hardly have that. So, I crawled on top of him and started chest compressions. It seemed like the right thing to do. "What are you doing?" he asked without removing his arm. "Giving you CPR." I pressed into his chest, trying not to lose count. Wearing a red-and-black football jersey and boxers that read, DRIVERS WANTED. SEE INSIDE FOR DETAILS, I'd straddled him and now worked furiously to save his life, my focus like that of a seasoned trauma nurse. Or a seasoned pot roast. It was hard to say. "I'm not sure I'm in the market," he said, his voice smooth and filled with a humor I found appalling. He clearly didn't appreciate my dedication. "Damn it, man! I'm trying to save your life! Don't interrupt." A sensuous grin slid across his face. He tucked his arms behind his head while I worked. I finished my count, leaned down, put my lips on his, and blew. He laughed softly, the sound rumbling from his chest, deep and sexy, as he took my breath into his lungs. That part down, I went back to counting chest compressions. "Don't you die on me!" And praying. After another round, he asked, "Am I going to make it?" "It's touch-and-go. I'm going to have to bring out the defibrillator." "We have a defibrillator?" he asked, quirking a brow, clearly impressed. I reached for my phone. "I have an app. Hold on." As I punched buttons, I realized a major flaw in my plan. I needed a second phone. I could hardly shock him with only one paddle. I reached over and grabbed his phone as well. Started punching buttons. Rolled my eyes. "You don't have the app," I said from between clenched teeth. "I had no idea smartphones were so versatile." "I'll just have to download it. It'll just take a sec." "Do I have that long?" Humor sparkled in his eyes as he waited for me to find the app. I'd forgotten the name of it, so I had to go back to my phone, then back to his, then do a search, then download, then install it, all while my patient lay dying. Did no one understand that seconds counted? "Got it!" I said at last. I pressed one phone to his chest and one to the side of his rib cage like they did in the movies, and yelled, "Clear!" Granted, I didn't get off him or anything as the electrical charge riddled his body, slammed his heart into action, and probably scorched his skin. Or that was my hope, anyway. He handled it well. One corner of his mouth twitched, but that was about it. He was such a trouper. After two more jolts of electricity--it had to be done--I leaned forward and pressed my fingertips to his throat. "Well?" he asked after a tense moment. I released a ragged sigh of relief,and my shoulders fell forward in exhaustion. "You're going to be okay, Mr. Farrow." Without warning, my patient pulled me into his arms and rolled me over, pinning me to the bed with his considerable weight and burying his face in my hair. It was a miracle!

During her time at Miss Porter’s School in Farmington she had often become depressed and was hobbled by fatigue. In 1887, when she was twenty, she wrote in her diary, “Tears come without any provocation. Headache all day.” The school’s headmistress and founder, Sarah Porter, offered therapeutic counsel. “Cheer up,” she told Theodate. “Always be happy.” It did not work. The next year, in March 1888, her parents sent her to Philadelphia, to be examined and cared for by Dr. Silas Weir Mitchell, a physician famous for treating patients, mainly women, suffering from neurasthenia, or nervous exhaustion. Mitchell’s solution for Theodate was his then-famous “Rest Cure,” a period of forced inactivity lasting up to two months. “At first, and in some cases for four or five weeks, I do not permit the patient to sit up or to sew or write or read,” Mitchell wrote, in his book Fat and Blood. “The only action allowed is that needed to clean the teeth.” He forbade some patients from rolling over on their own, insisting they do so only with the help of a nurse. “In such cases I arrange to have the bowels and water passed while lying down, and the patient is lifted on to a lounge at bedtime and sponged, and then lifted back again into the newly-made bed.” For stubborn cases, he reserved mild electrical shock, delivered while the patient was in a filled bathtub. His method reflected his own dim view of women. In his book Wear and Tear; or, Hints for the Overworked, he wrote that women “would do far better if the brain were very lightly tasked.

Usha is Kavita’s choice alone, a secret name for her secret daughter. The thought brings a smile to her face. That one day she spent with her daughter was precious. Though she was exhausted, she would not sleep. She didn’t want to miss a single moment. Kavita held her baby close, watched her small body rise and fall with breath, traced her delicate eyebrows and the folds of her tender skin. She nursed her when she cried, and in those few moments when Usha was awake, Kavita saw herself unmistakably in the distinctive gold-flecked eyes, more beautiful on her child than on herself. She could hardly believe this lovely creature was hers. She didn’t allow herself to think beyond that day.At least this baby girl will be allowed to live—a chance to grow up, go to school, maybe even marry and have children. Kavita knows, along with her daughter, she is forsaking any hope of helping her along the path of life. Usha will never know her parents, but she has a chance at life, and that will have to be enough. Kavita slides one of the two thin silver bangles she always wears from her own frail wrist and slips it onto Usha’s ankle. “I’m sorry I cannot give you more, beti,” she whispers into her downy head.

In short, while I certainly don’t have all the answers, when I look at the brokenness of this world: it is not God’s fingerprints that I find on the smoking gun at the scene of the crime. You know where I do see His fingerprints? On the torturous crossbeam that Jesus held onto tightly, as He carried my cross through the streets and up to Calvary. I see them on the nails he gripped while hanging there to die my death for me. I see His fingerprints all over the places where Christ stood in my place, and where he took me by the hand to lead me into the eternal glory of new life in Him. I find the fingerprints everywhere that my Father, in His relentless love, searched for me in the night of my own darkness. Or I find them wrapped around me, in the places my Father held me in His loving embrace, and on His best robes He threw around me to clothe me, after I came home exhausted from a long journey of running away (Luke 15:20). I see the hand of God where the Holy Spirit worked His wonders and miracles, and cast out the darkness with His invincible light. Surely this was the “finger of God” (Luke 11:20). I see God in the hands of the nurses and doctors who cared for our son, and the friends and family who reached out with compassion and grace to lift us when we were down. Everywhere I find pure light, life and love: those are the places I find God in the story.

The next year, in March 1888, her parents sent her to Philadelphia, to be examined and cared for by Dr. Silas Weir Mitchell, a physician famous for treating patients, mainly women, suffering from neurasthenia, or nervous exhaustion. Mitchell’s solution for Theodate was his then-famous “Rest Cure,” a period of forced inactivity lasting up to two months. “At first, and in some cases for four or five weeks, I do not permit the patient to sit up or to sew or write or read,” Mitchell wrote, in his book Fat and Blood. “The only action allowed is that needed to clean the teeth.” He forbade some patients from rolling over on their own, insisting they do so only with the help of a nurse. “In such cases I arrange to have the bowels and water passed while lying down, and the patient is lifted on to a lounge at bedtime and sponged, and then lifted back again into the newly-made bed.” For stubborn cases, he reserved mild electrical shock, delivered while the patient was in a filled bathtub. His method reflected his own dim view of women. In his book Wear and Tear; or, Hints for the Overworked, he wrote that women “would do far better if the brain were very lightly tasked.

If she had to choose which aspect of the suite she despised most, it would have been a hard call between the lock and the garden, though these days she nursed a particular grudge against the curtains. She hid behind them to watch Arin leave the house, and return--very often on her horse. Despite the way he had looked after the battle, his injuries weren’t serious. His limp lessened, the bandage on his neck disappeared, and the raging bruises muted into ugly greens and violets. Several days passed without any words between him and her, and that set Kestrel on edge. It was hard to rub out the memory of his smile--exhausted, sweet. And then that waterfall of relief. Kestrel sent him a letter. Jess was likely to recover, she wrote. She asked to visit Ronan, who was being held in the city prison. Arin’s reply was a curt note: No. She decided not to press the issue. Her request had been due to a sense of obligation. She dreaded seeing Ronan--even if he agreed to speak with her. Even if he did not loathe her now. Kestrel knew that to look upon Ronan would be to come face-to-face with her failure. She had done everything wrong…including not being able to love him. She folded the one-word letter and set it aside.

Diamond Jubilee with him for extra contrition. Her father was clearly exhausted, sleeping almost all the time now, like an aged dog. Why didn’t he just go? Was he hanging on for a hundred? Two more years of this? It was mere existence—an amoeba had more life. “The triumph of the human spirit,” the new nursing sister said, new enough to talk about “positive outcomes” and “enhancement programmes”—emollient management-speak, meaningless to most of the residents of Poplar Hill, who were either dying or demented or both. It was called a “care home” but there was precious little of either to be had when you were run by a profit-based health-care provider employing

Some might regard such a circumstance as a suffering of a punishment. But the one who dares to live with suffering through to its completion will discover that it is actually a great gift. Some people are difficult to live with, difficult to love. Sometimes the old or the new or the genetically defective can be a trial. But instead of routinely putting them in nursing homes or institutions - or killing them before they can be born - what if we were to live with them? What if, when our love is exhausted, we were to ask God to give us His love for them? Eventually we will discover the blessing they can be. And who knows, perhaps in the process we will become more what He intended us to be - which may have been part of His purpose.

One nurse at Great Lakes would later be haunted by nightmares. The wards had forty-two beds; boys lying on the floor on stretchers waited for the boy on the bed to die. Every morning the ambulances arrived and stretcher bearers carried sick sailors in and bodies out. She remembered that at the peak of the epidemic the nurses wrapped more than one living patient in winding sheets and put toe tags on the boys’ left big toe. It saved time, and the nurses were utterly exhausted. The toe tags were shipping tags, listing the sailor’s name, rank, and hometown. She remembered bodies “stacked in the morgue from floor to ceiling like cord wood.” In her nightmares she wondered “what it would feel like to be that boy who was at the bottom of the cord wood in the morgue.

Classical Sanskrit prose writers made very long sentences like this: "Lost in the forest and in thought, bent upon death and at the root of a tree, fallen upon calamity and her nurse's bosom, parted from her husband and happiness, burnt with the fierce sunshine and the woes of widowhood, her mouth closed with silence as well as by her hand, held fast by her companions as well as by grief, I saw her with her kindred and her graces all gone, her ears and her soul left bare, her ornaments and her aims abandoned, her bracelets and her hopes broken, her companions and the needle-like grass-spears clinging round her feet, her eyes and her beloved fixed within her bosom, her sighs and her hair long, her limbs and her merits exhausted, her aged attendants and her streams of tears falling down at her feet...." and it goes on.

The schedule took a toll. As residents, we were working as much as one hundred hours a week; though regulations officially capped our hours at eighty-eight, there was always more work to be done. My eyes watered, my head throbbed, I downed energy drinks at two A.M. At work, I could keep it together, but as soon as I walked out of the hospital, the exhaustion would hit me. I staggered through the parking lot, often napping in my car before driving the fifteen minutes home to bed. Not all residents could stand the pressure. One was simply unable to accept blame or responsibility. He was a talented surgeon, but he could not admit when he’d made a mistake. I sat with him one day in the lounge as he begged me to help him save his career. “All you have to do,” I said, “is look me in the eye and say, ‘I’m sorry. What happened was my fault, and I won’t let it happen again.’ ” “But it was the nurse who—” “No. You have to be able to say it and mean it. Try again.” “But—” “No. Say it.” This went on for an hour before I knew he was doomed.

Last night I decided that it is totally nuts to believe in Christ, that it is every bit as crazy as being a Scientologist or a Jehovah’s Witness. But a priest friend said solemnly, “Scientologists and Mormons and Jehovah’s Witnesses are crazier than they have to be.” Then something truly amazing happened. A man from church showed up at our front door, smiling and waving to me and Sam, and I went to let him in. He is a white man named Gordon, fiftyish, married to our associate pastor, and after exchanging pleasantries he said, “Margaret and I wanted to do something for you and the baby. So what I want to ask is, What if a fairy appeared on your doorstep and said that he or she would do any favor for you at all, anything you wanted around the house that you felt too exhausted to do by yourself and too ashamed to ask anyone else to help you with?” “I can’t even say,” I said. “It’s too horrible.” But he finally convinced me to tell him, and I said it would be to clean the bathroom, and he ended up spending an hour scrubbing the bathtub and toilet and sink with Ajax and lots of hot water. I sat on the couch while he worked, watching TV, feeling vaguely guilty and nursing Sam to sleep. But it made me feel sure of Christ again, of that kind of love. This, a man scrubbing a new mother’s bathtub, is what Jesus means to me. As Bill Rankin, my priest friend, once said, spare me the earnest Christians.

In March 2002, the National Academy of Sciences, a private, nonprofit society of scholars, released a high-profile report documenting the unequivocal existence of racial bias in medical care, which many thought would mark a real turning point. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care was so brutal and damning that it would seem impossible to turn away. The report, authored by a committee of mostly white medical educators, nurses, behavioral scientists, economists, health lawyers, sociologists, and policy experts, took an exhaustive plunge into more than 480 previous studies. Because of the knee-jerk tendency to assume that health disparities were the end result of differences in class, not race, they were careful to compare subjects with similar income and insurance coverage. The report found rampant, widespread racial bias, including that people of color were less likely to be given appropriate heart medications or to undergo bypass surgery or receive kidney dialysis or transplants. Several studies revealed significant racial differences in who receives appropriate cancer diagnostic tests and treatments, and people of color were also less likely to receive the most sophisticated treatments for HIV/AIDS. These inequities, the report concluded, contribute to higher death rates overall for Black people and other people of color and lower survival rates compared with whites suffering from comparable illnesses of similar severity.

I picked her up and carried her down the hall to the bathroom, just a pitiful skeleton with skin stretched over the top and a great red scar across her chest. She sank onto the plastic seat we had got from the hospital and closed her eyes as I washed her, leaning her poor bald head back exhaustedly against the back of the shower cubicle. "I'll just change the sheets," I said, "I won't be a minute - would you rather sit under the water, or shall I turn it off and wrap you up in a towel ?" "Under the water," she whispered. I had to strip the bed entirely, and two of the pillows were saturated. I replaced them with pillows from my bed, and while I was at it my duvet as well. Then I propped the poor woman up against the bathroom sink to dry and dress her, picked her up and carried her back to bed. Never have I been so grateful to be, after all, a strapping wench rather than a delicate wisp of a girl. As I pulled the covers up under her chin she opened her eyes, looked at me sternly and said with nearly her old decision, "This is not the way I wish to be remembered, Josephine." "I know," I whispered, the tears spilling unchecked down my cheeks. Nurses are supposed to be bright and matter-of-fact about these things: my bracing professional manner left a lot to be desired. "I'll get you some dinner." "No," she said. "Just my pills, love." Back in the kitchen I stood for a moment in a trance of indecision, wondering where the hell to start. It didn't really matter - when you're overcome with lethargy you just have to do something. And then the next thing, and then the next, and eventually, although you'd have sworn you were far too tired and depressed to accomplish anything, you're finished. I turned on the tap about the big concrete sink by the back door and began to scrub sheets and blankets.

Undoubtedly, my dear Dick. Just note the progress of events: consider the migrations of races, and you will arrive at the same conclusion assuredly. Asia was the first nurse of the world, was she not? For about four thousand years she travailed, she grew pregnant, she produced, and then, when stones began to cover the soil where the golden harvests sung by Homer had flourished, her children abandoned her exhausted and barren bosom. You next see them precipitating themselves upon young and vigorous Europe, which has nourished them for the last two thousand years. But already her fertility is beginning to die out; her productive powers are diminishing every day. Those new diseases that annually attack the products of the soil, those defective crops, those insufficient resources, are all signs of a vitality that is rapidly wearing out and of an approaching exhaustion. Thus, we already see the millions rushing to the luxuriant bosom of America, as a source of help, not inexhaustible indeed, but not yet exhausted. In its turn, that new continent will grow old; its virgin forests will fall before the axe of industry, and its soil will become weak through having too fully produced what had been demanded of it. Where two harvests bloomed every year, hardly one will be gathered from a soil completely drained of its strength. Then, Africa will be there to offer to new races the treasures that for centuries have been accumulating in her breast. Those climates now so fatal to strangers will be purified by cultivation and by drainage of the soil, and those scattered water supplies will be gathered into one common bed to form an artery of navigation. Then this country over which we are now passing, more fertile, richer, and fuller of vitality than the rest, will become some grand realm where more astonishing discoveries than steam and electricity will be brought to light.

One day, however, they had an experience that revealed just how fragile their life had become. Bella developed a cold, causing fluid to accumulate in her ears. An eardrum ruptured. And with that she became totally deaf. That was all it took to sever the thread between them. With her blindness and memory problems, the hearing loss made it impossible for Felix to achieve any kind of communication with her. He tried drawing out letters on the palm of her hand but she couldn’t make them out. Even the simplest matters—getting her dressed, for instance—became a nightmare of confusion for her. Without sensory grounding, she lost track of time of day. She grew severely confused, at times delusional and agitated. He couldn’t take care of her. He became exhausted from stress and lack of sleep. He didn’t know what to do, but there was a system for such situations. The people at the residence proposed transferring her to a skilled nursing unit—a nursing home floor. He couldn’t bear the thought of it. No, he said. She needed to stay at home with him. Before the issue was forced, they got a reprieve. Two and a half weeks into the ordeal, Bella’s right eardrum mended and, although the hearing in her left ear was lost permanently, the hearing in her right ear came back. “Our communication is more difficult,” Felix said. “But at least it is possible.

I lay there, depleted and relieved that whatever used to be in my body was now out. Marlboro Man, on the other hand, was stunned. Patting me affectionately, he stared at our newborn baby girl with a shocked expression he couldn’t have hidden if he’d tried. “Congratulations,” Dr. Oliver had said moments before. “You have a daughter.” You have a daughter. In the previous several months of gestation, I’d been so indoctrinated with the notion that we were having a boy, it hadn’t even occurred to me that things might go the other way. I couldn’t even imagine Marlboro man’s surprise. “Good job, Mama,” he said, leaning down and kissing my forehead. The nurses immediately wrapped our little one in a white blanket and set her on my chest. Plop. There she was. Lying on top of me. Writhing and looking pink and pitiful and about as precious as anything I'd ever seen. Marlboro Man grasped my hand, squeezing it softly. “Wow,” he said, almost in a whisper. He stared and stared. We were totally quiet. We could hardly move. My throat began to tighten as I realized what had just happened. The being that had been growing inside of my abdomen, that had tapped and kicked and pummeled me in the ribs and bladder during those final weeks, that had brought me heartburn and exhaustion and weeks of debilitating nausea, was now lying on my chest, looking around this strange new world in which she found herself. It was the most surreal moment of my life--more surreal than any moment of surprise during my courtship with Marlboro Man, the father of this new human that had just arrived on the scene and changed absolutely everything. She had arms and legs and a nose and a tongue, which she slowly thrust in and out of her tiny mouth in an effort to familiarize herself with the sensation of air. She was a person--alive and moving around in a real world. I realized that tears were rolling down my face. I hadn’t even noticed I was crying.

Late that evening, I begged Marlboro Man to go back to the ranch to sleep. We’d had visits from my dad, our grandmothers, my best friend, Becky, and Mike. My mom had even peeked her head in once she’d determined the coast was clear, and I’d been poked and prodded and checked by nurses all day long. I felt tired and gross, not having been given permission to shower yet, and I didn’t want him to sleep on a hard cot in the room. Plus, I couldn’t risk being asked about my bodily functions in his presence again. “Go home and get some sleep,” I said. “I’ll still be here in the morning.” He didn’t put up much of a fight. He was exhausted; I could tell. I was exhausted, too--but I was supposed to be. I needed Marlboro Man to stay strong. “Good night, Mama,” he said, kissing my head. I loved this new “Mama” thing. He kissed our baby on the cheek.

Dependence can make people hate those they depend upon. It could be a complex and exhausting relationship. Often it was better to be nursed by someone whose opinion does not matter to you.

As my daughter nursed, I ran my hands over her tiny legs and silken cheeks, marveling at the mystery of such a small creature, the fact that inside her head, a world was awakening. Looking at her blue-green eyes and fuzz-dusting of blond hair was like waiting for a picture to come more fully into focus. So far, little had been imprinted on her but each moment, even right now, was shaping who she would become. It felt too late for me, but was I going to offer her words that would stick in my mouth as I tried to say them? Orthodoxy, or at least our small corner of it, had continued to evolve, changes forged by women I admired. Maybe my daughter wouldn't have to feel the inequalities and the constraints as viscerally as I did. But even then, would I have to teach her the tactics I used to remain inside? Don't say what you really think. Don't name what you really feel. It's not what it sounds like. It's not what it really means. I didn't want her to feel that she had to tuck away any dissenting part of herself. I didn't want her to feel that the only choice was to live with an endless sense of obligation and contradiction. Try not to be bothered by things that make you seethe. Try not to feel exhausted from walking against an ever-present tide, the current pulling your body, the sand slipping away beneath your feet.

And now that mulch of dead imaginings beneath the feet of Temperance ladies, union-affiliated Vaudevillians and maimed men home from Europe has contaminated the groundwater of the upstart country's nightmares. Immigrants in their illimitable difference come to seem a separate species, taciturn and fish-eyed as though risen from the ocean waves that bore them in their transport, monstrous in their self-contained communities with bitter scents and indecipherable ululations, names, unsettlingly unpronounceable ensconced at isolated farms where beaten track is naught save idle rumour stagnant families nurse grievance, dreadful secrets and deformity in solitude; pools of declined humanity entirely unconnected to society by any tributary where ancestral prejudice or misconception may become the plaint of generations. Fabled and forbidden works of Arab alchemy are handed down across years cruel and volatile, trafficked between austere and colonial homes by charitable fellowships with ancient affectations or conveyed by fevered sea-captains, fugitive Huguenots or elderly hysterics formally accused of witchcraft. Young America, a sapling power grown suddenly so tall upon its diet of nickelodeons and motorcars, has sunk unwitting roots into an underworld of grotesque notions and archaic creeds, their feaful pull discernible below the weed-cracked sidewalk. Buried and forgotten, ominous philosophies await their day with hideous patience. Well! I think that's pretty darned good for a first attempt. A little over-wrought, perhaps, and I'm not sure about the style - I can't decide if its too modern of it's too old fashioned, but perhaps that's a good sign. Of course, I guess I'll have to introduce a plot and characters at some point, but I'll wrestle with that minor nuisance when I get to it. Perhaps I could contrive to have some hobo, maybe literally a hoe-boy or travelling itinerant farm labourer who's wandering from place to place around New England in the search for work; somebody who might reasonably become involved with all the various characters I'm hoping to investigate. Being a labourer, while it would lend a feasibility to any action or exertion that I wanted in the story, wouldn't mean that my protagonist was lacking in intelligence of education: this is often economically a far from certain country for a lot of people, and there's plenty of smart fellows - maybe even an aspiring writer like myself - who've found themselves leaving their homes and families to mooch around from farm to farm in hope of some hay-baling or fruit-picking that's unlikely to materialise. Perhaps a character like that, a rugged man who is sufficiently well read to justifiably allow me a few literary flourishes (and I can't help thinking that I'll probably end up casting some imagined variant of Tom Malone) would be the kind of of sympathetic hero and the kind of voice I'm looking for. Meanwhile I yawned a moment or two back, and while I'm not yet quite exhausted to the point where I can guarantee a deep and dreamless sleep, perhaps another six or seven vague ideas for stories might just do the soporific job.

A solution to many of the issues in this book, and one that would go a long way toward fixing American healthcare, is relatively clear: Treasure nurses. Hire more. Nurses are perennially the number-one most trusted profession in America, according to an annual Gallup poll rating honesty and ethical standards. They are called to an exhausting commitment in which mortals must sustain an unwavering grace at the edge of life and death, almost divinely slowing heartbeats, hurrying them along, or pounding them back into existence. Nurses are exceptional. So why aren’t they treated accordingly?

Finally, on Wednesday, they began to lower the sedation again, and immediately he reached for the ventilator tube and tried to pull it out. “Don’t fight it,” I told him again and again, trying to explain what was happening. I held his hand. The nurse came in and told me they were going to try to take the ventilator out. “Do you want me to stay, or leave you?” I asked him. His eyes were closed, but he put his hand out and rubbed my back. Just for a moment. He’s there! I wanted to shout. Everything’s going to be okay. The antibiotics must be working! I wanted to sing and shout and dance. After the ventilator was out, he began opening his eyes just a crack when someone came in to say hello. And things got even better--he was calm although he was still tied down, and when a friend and Willie came in to say hello, Jep said, “What’s up?” I wanted to laugh and cry at the same time. Those were the first words I’d heard him say since he’d gone deer hunting. I questioned him a little, wanting to know what he remembered, but he couldn’t talk much and still seemed very sleepy, dozing off every few minutes. Thursday morning was one of the best days of my life because Jep woke up bright-eyed. “Why am I in here? What happened?” he asked. He didn’t remember anything. He looked awake and alert and rested. But I was exhausted, having gotten very little sleep or food and not knowing if Jep would live or die, while he’d been taking the longest nap of his life. We held hands, and though I was exhausted, I was happy. Thursday afternoon he talked a little more and ate a cracker. He was back. Slowly but surely, he was coming back. He knew who I was, so I believed he would know who the kids were. And he started talking more and more. Thank you, Lord, for bringing Jep back to me.

Come on, Melinda. You can’t avoid it forever. We both know you’re pregnant.” “Ugh,” she said, accepting the cool, wet cloth. She pressed it to her face, her brow, her neck. She didn’t have any more to say. But Jack knew. There had been tears, exhaustion, nausea. She turned watering eyes up to him. He shrugged and said, “You eased up on the breast-feeding, popped an egg and I nailed it.” Her eyes narrowed as if to say she did not appreciate the explanation. He held out a hand to bring her to her feet. “You have to wean David,” he said. “Your body can’t completely nourish two children. You’ll get weak. You’re already exhausted.” “I don’t want to be pregnant right now,” she said. “I’m barely over being pregnant.” “I understand.” “No, you don’t. Because you haven’t ever been pregnant.” He thought this would probably be a bad time to tell her that he did so understand, since he had lived with a pregnant person and listened very attentively to every complaint. “We should go see John right away, so you can find out how pregnant.” “How long have you suspected?” she asked him. “I don’t know. A few weeks. It was a little tougher this time….” “Oh, yeah?” “Well, yeah. Since you haven’t had a period since the first time I laid a hand on you. God, for a supposedly sterile woman, you certainly are fertile.” Then he grinned, fully aware it would have got him smacked if he hadn’t been holding the baby. She whirled away from him and went to sit on their bed. She put her face in her hands and began to cry. Well, he’d been expecting exactly this. There’d been a lot of crying lately and he knew she was going to be mighty pissed off. He sat down beside her, put an arm around her and pulled her close. David patted her head. “It’s going to be okay,” he said. “I’m not delivering this one. I want that understood.” “Try not to be cute,” she said through her tears. “I think my back already hurts.” “Can I get you something? Soda? Crackers? Arsenic?” “Very funny.” She turned her head to look at him. “Are you upset?” He shook his head. “I’m sorry it happened so soon. Sorry for you. I know there are times you get damned uncomfortable and I wanted you to get a break.” “I should never have gone away with you.” “Nah. You were already pregnant. Wanna bet?” “You knew before that?” “I wondered why you were so emotional, and that was a possible reason. I never bought your whole sterile thing. But I don’t have a problem with it. I wanted more kids. I like the idea of a larger family than the three of us. I come from a big family.” “There will not be five, I can guarantee you that,” she said. Then she bored a hole through him with her eyes. “Snip, snip.” “You’re not going to blame this on me, Mel. I suggested birth control. A couple of times, as a matter of fact. You were the one said it could never happen twice. And then explained that whole business about not ovulating while you’re nursing. How’s that working for you so far? Hmm?” “Screw you,” she said, not sweetly. “Well, obviously…” “I’d like you to understand I wasn’t relying on that breast-feeding thing. I’m a midwife—I know that’s not foolproof. I really didn’t think it possible that… Shit,” she said. She sighed deeply. “I just barely got back into my jeans….” “Yeah, those jeans. Whoa, damn. Those jeans really do it to me. No one wears a pair of jeans like you do.” “Aren’t you getting a little sick of having a fat wife?” “You’re not fat. You’re perfect. I love your body, pregnant and unpregnant. I know you’re trying to get me all worked up, but I’m not going there. You can try to pick a fight with me all day and I just won’t play. It wouldn’t be a fair fight—you’re out to get me and we both know it. Do you have appointments this morning?” “Why?” “Because I want to go to Grace Valley for an ultrasound. I want to know when I have to have the house done.” *

They stopped in front of a doorway. Myron looked inside. Win’s mother lay in bed. Exhaustion emanated from her. Her head was back on the pillow as though it were too heavy to lift. An IV bag was attached to her arm. She looked at Myron and mustered a gentle smile. Myron smiled back. With his peripheral vision, he saw Victoria signal to the nurse. The nurse stood and moved past him. Myron stepped inside. The door closed behind him. Myron

Luke made fast work of his first drink and was nursing his second, through many jokes and soft, respectful laughter, when Mike came into the great room holding a very small bundle wrapped in a pink receiving blanket. Mike went to the women first—Paige and Vanni. While they were murmuring, smiling, beaming, the men moved in a crowd out of the kitchen to have a look at what Mike had for himself. The look on Mike’s face was a combination of exhaustion and exhilaration—just what would happen to a guy who’d just helped and worried his way through labor with his wife while she produced this, his first child. His smile was huge; his eyes were bright inside and weary on the outside. And that’s when

Luke made fast work of his first drink and was nursing his second, through many jokes and soft, respectful laughter, when Mike came into the great room holding a very small bundle wrapped in a pink receiving blanket. Mike went to the women first—Paige and Vanni. While they were murmuring, smiling, beaming, the men moved in a crowd out of the kitchen to have a look at what Mike had for himself. The look on Mike’s face was a combination of exhaustion and exhilaration—just what would happen to a guy who’d just helped and worried his way through labor with his wife while she produced this, his first child. His smile was huge; his eyes were bright inside and weary on the outside. And

That gave me an obvious next step: move from this room. Find a weapon somewhere. Kill with impunity. As a plan, it lacked detail. I was exhausted, running on empty and nursing the worst hangover I’d ever had. I was in no shape to take on anything, but fuck it. I’d be nothing but a victim if I stayed here, and I didn’t do victim.

Shura, I did quit. I want you to quit, too.” He sat and considered her. His brow was furled. “You’re working too hard,” she said. “Since when?” “Look at you. All day in the dank basement, working in cellars... what for?” “I don’t understand the question. I have to work somewhere. We have to eat.” Chewing her lip, Tatiana shook her head. “We still have money— some of it left over from your mother, some of it from nursing, and in Coconut Grove you made us thousands carousing with your boat women.” “Mommy, what’s carousing?” said Anthony, looking up from his coloring. “Yes, Mommy, what’s carousing?” said Alexander, smiling. “My point is,” Tatiana went on, poker-faced, “that we don’t need you to break your back as if you’re in a Soviet labor camp.” “Yes, and what about your dream of a winery in the valley? You don’t think that’s back-breaking work?” “Yes . . .” she trailed off. What to say? It was just last week in Carmel that they’d had that wistful conversation. “Perhaps it’s too soon for that dream.” She looked deeply down into her plate. “I thought you wanted to settle here?” Alexander said in confusion. “As it turns out, less than I thought.” She coughed, stretching out her hand. He took it. “You’re away from us for twelve hours a day and when you come back you’re exhausted. I want you to play with Anthony.” “I do play with him.” She lowered her voice. “I want you to play with me, too.” “Babe, if I play with you any more, my sword will fall off.” “What sword, Dad?” “Anthony, shh. Alexander, shh. Look, I don’t want you to fall asleep at nine in the evening. I want you to smoke and drink. I want you to read all the books and magazines you haven’t read, and listen to the radio, and play baseball and basketball and football. I want you to teach Anthony how to fish as you tell him your war stories.” “Won’t be telling those any time soon.” “I’ll cook for you. I’ll play dominoes with you.” “Definitely no dominoes.” “I’ll let you figure out how I always win.” A Sarah Bernhardt-worthy performance. Shaking his head, he said slowly, “Maybe poker.” “Absolutely. Cheating poker then.” Rueful Russian Lazarevo smiles passed their faces. “I’ll take care of you,” she whispered, the hand he wasn’t holding shaking under the table. “For God’s sake, Tania... I’m a man. I can’t not work.” “You’ve never stopped your whole life. Come on. Stop running with me.” The irony in that made her tremble and she hoped he wouldn’t notice. “Let me take care of you,” Tatiana said hoarsely, “like you know I ache to. Let me do for you. Like I’m your nurse at the Morozovo critical care ward. Please.” Tears came to her eyes. She said quickly, “When there’s no more money, you can work again. But for now... let’s leave here. I know just the place.” Her smile was so pathetic. “Out of my stony griefs, Bethel I’ll raise,” she whispered. Alexander was silently contemplating her, puzzled again, troubled again. “I honestly don’t understand,” he said. “I thought you liked it here.” “I like you more.

Nice familiar weight at the foot of the bed, the sort of fever guest weight, aunt or mother, nurse, or the after-fuck check-up, to tuck me in, still a little whiff of hurt in the room, of procedures. Rather wonderful actually, to be reminded of childhood sickness and post- coital exhaustion in the same second. Rather comforting. Close.

She was exhausted. Her body felt soft and alien, yet she was required to lift and carry and nurse. Her skin felt raw, and yet there was always someone touching her. There was no silence and no uninterrupted length of time in which to read a book. It was a state of being fraught with anxiety and self-doubt.

And now that mulch of dead imaginings beneath the feet of Temperance ladies, union-affiliated Vaudevillians and maimed men home from Europe has contaminated the groundwater of the upstart country's nightmares. Immigrants in their illimitable difference come to seem a separate species, taciturn and fish-eyed as though risen from the ocean waves that bore them in their transport, monstrous in their self-contained communities with bitter scents and indecipherable ululations, names, unsettlingly unpronounceable ensconced at isolated farms where beaten track is naught save idle rumour stagnant families nurse grievance, dreadful secrets and deformity in solitude; pools of declined humanity entirely unconnected to society by any tributary where ancestral prejudice or misconception may become the plaint of generations. Fabled and forbidden works of Arab alchemy are handed down across years cruel and volatile, trafficked between austere and colonial homes by charitable fellowships with ancient affectations or conveyed by fevered sea-captains, fugitive Huguenots or elderly hysterics formally accused of witchcraft. Young America, a sapling power grown suddenly so tall upon its diet of nickelodeons and motorcars, has sunk unwitting roots into an underworld of grotesque notions and archaic creeds, their feaful pull discernible below the weed-cracked sidewalk. Buried and forgotten, ominous philosophies await their day with hideous patience. Well! I think that's pretty darned good for a first attempt. A little over-wrought, perhaps, and I'm not sure about the style - I can't decide if its too modern of it's too old-fashioned, but perhaps that's a good sign. Of course, I guess I'll have to introduce a plot and characters at some point, but I'll wrestle with that minor nuisance when I get to it. Perhaps I could contrive to have some hobo, maybe literally a hoe-boy or travelling itinerant farm labourer who's wandering from place to place around New England in the search for work; somebody who might reasonably become involved with all the various characters I'm hoping to investigate. Being a labourer, while it would lend a feasibility to any action or exertion that I wanted in the story, wouldn't mean that my protagonist was lacking in intelligence or education: this is often economically a far from certain country for a lot of people, and there's plenty of smart fellows - maybe even an aspiring writer like myself - who've found themselves leaving their homes and families to mooch around from farm to farm in hope of some hay-baling or fruit-picking that's unlikely to materialise. Perhaps a character like that, a rugged man who is sufficiently well read to justifiably allow me a few literary flourishes (and I can't help thinking that I'll probably end up casting some imagined variant of Tom Malone) would be the kind of of sympathetic hero and the kind of voice I'm looking for. Meanwhile I yawned a moment or two back, and while I'm not yet quite exhausted to the point where I can guarantee a deep and dreamless sleep, perhaps another six or seven vague ideas for stories might just do the soporific job.

When we homeschool, we take on the role of full-time (as in most-waking-hours full-time) parent, teacher, tutor, nurse, and counselor. It feels exhausting because it is likely more responsibility than we’ve ever had to shoulder before, and we’re probably not prepared or equipped for it. The amount of responsibility isn’t a problem; it’s our calling. When God calls us to educate our children at home, He also equips us to do so.

Thus husbands and wives were together only once every eight or ten months and when they met they were so exhausted and depressed on both sides . . . they ceased to procreate. As for the newly born, they died early because their mothers, overworked and famished, had no milk to nurse them, and for this reason, while I was in Cuba, 7000 children died in three months. Some mothers even drowned their babies from sheer desperation. . . . In this way, husbands died in the mines, wives died at work, and children died from lack of milk . . . and in a short time this land which was so great, so powerful and fertile . . . was depopulated. . . . My eyes have seen these acts so foreign to human nature, and now I tremble as I write. . . .

I take three Advils, and also zinc because the child next to me on the plane had a runny nose. My cheeks are flushed despite the A/C cooling the room. I wash my face and administer various toners and moisturizers and antiwrinkle creams. I do the facial yoga exercises I looked up after leaving the nursing facility that day. Do I really look like I could be Mom’s sister? I look exhausted. But who wouldn’t after a long flight?

The tea was brought. Mumbling her thanks, she took the cup in her hands, not bothering with the saucer. She drank it all without tasting it. “What are you using to dress the wound?” West asked, looking over the collection of bottles on the table. “Glycerin and disinfecting drops, and a layer of oiled muslin.” “And you’re keeping him packed with ice.” “Yes, and trying to make him take a sip of water at least once every hour. But he won’t . . .” Garrett paused as a swoosh went through her head. She closed her eyes—a mistake—the entire room seemed to tilt. “What is it?” she heard West ask. His voice seemed to come from very far away. “Dizzy,” she mumbled. “Need more tea, or . . .” Her lashes fluttered upward, and she had to fight to keep her eyes open. West was in front of her, easing the china cup from her lax fingers before it could drop. His assessing gaze ran over her, and it was then that she realized what he’d done. “What was in my tea?” she asked in a panic, trying to rise from her chair. “What did you put in it?” The room revolved. She felt his arms close around her. “Nothing but a pinch of valerian,” West said calmly. “Which wouldn’t have had nearly this much of an effect if you weren’t ready to drop from exhaustion.” “I’m going to kill you,” she cried. “Yes, but to do that you’ll have to have a nice little rest first, won’t you?” Garrett tried to strike him with her fist, but he ducked easily beneath her flailing arm, and picked her up as her knees buckled. “Let go! I have to take care of him—he needs me—” “I can manage the basics of nursing him while you sleep.” “No, you can’t,” Garrett said weakly, and was horrified to hear a sob breaking from her throat. “Your patients all have four legs. H-he only has two.” “Which means he’ll be half the trouble,” West said reasonably. Garrett writhed with helpless rage. Ethan was on his deathbed, and this man was making light of the situation. He contained her struggles with maddening ease. As West carried her along the hallway, Garrett desperately tried to stop crying. Her eyes were on fire. Her head throbbed and ached, and it had become so heavy that she had to rest it on his shoulder. “There, now,” she heard him murmur. “It’s only for a few hours. When you awaken, you’ll have any revenge you want.” “Going to dissect you,” she sobbed, “into a million pieces—” “Yes,” West soothed, “just think about which instrument you’ll start with. Perhaps that two-sided scalpel with the funny handle.” He brought her into a pretty bedroom with flowered paper on the walls. “Martha,” he called. “Both of you. Come see to Dr. Gibson.

This morning, I went past the Mons Palatinus,” said Karl one evening as they sat together over bread, olives, and cheese. “There, some commoners still pray to Romulus and Remus.” He shook his head. “Allegedly, there are remains of a cave where the two brothers were nursed by a she-wolf. What a ridiculous notion!” “Really?” Johann smiled. “Weren’t those brothers abandoned as infants and washed ashore in a willow basket on the banks of the Tiber? And didn’t Romulus kill his brother later on before founding Rome?” “Yes, I think that’s how the story goes.” Karl frowned. “Why?” “Well, Moses was also abandoned in a willow basket on a river, and Cain killed his brother, Abel. So, the one story is a ridiculous notion while the other is true belief? Where is the difference?” “Debating with you is probably more exhausting than debating that Luther.” “I’m not debating, merely posing questions,” replied Johann. “Just like the Greek philosopher Socrates used to do. Questions bring light to the darkness of the world.

Getting the design right means exhaustively investigating the product's functional requirements and the users' needs and preferences. Today, products such as programmable infusion pumps may have a host of users, including physicians, nurses, technicians, and patients.

Journal Entry – April 17, 2013/May 10, 2013 Hollow. Numb. Empty. Nothingness. Are these feelings? Or are they just words in the English language? I ask these questions, because these words best describe how I feel right now as I sit here in my hospital room. The waiting game. My mind and thoughts swishing around my head, and my eyes burn feeling as if I am going to cry at any moment. Breakfast has come and gone. Vitals have been taken. And the five to ten minute check in with my assigned morning nurse has occurred. It has been three hours since I woke up, and I have twelve to thirteen hours to survive before I can go to sleep for the night. My day will be made up of one education group, lunch, dinner, and the remainder of the day and evening doing nothing but laying on the bed curled up in a ball depressed waiting for the time to pass looking at the clock hanging on the wall periodically wishing the time would move faster… on the flip side…a few days later…Writing in an attempt to keep my mind and head out of the skies. My heart feels as though it will beat outside of my chest, and my brain is on its own axis within my skull. I feel like I am on top of the world. I feel like I could do anything. I feel like I could write forever. I feel like my mind is on the spin cycle of a washing machine. Or, like I am hooked onto a pair of windshield wipers stuck on a speed mode. Although, my brain has spun faster than this and I feel that the meds are keeping the jerks at bay, I still feel that all too familiar whirling feeling. It is indescribable. It is hard to pinpoint. Some of it must be anxiety. Some of it must be that I am locked up like a caged animal ready to pounce. Then again, some of it must be nature. My brain misfiring and backfiring and causing itself to spin in every which direction at all sorts of speeds none of which are consistent or in the same direction. Inconsistency. Slow, fast, in between. A complete blur. I have trouble tracking. I have trouble focusing. I have trouble remembering…My mind is obsessing. I try to stop my mind from racing. I try to stop my eyes from darting across the page. I try to stop my legs from jittering. To no avail. It all starts again. My internal engine drives the show. It is as if I have a compulsion to move and dart and jerk. It is uncomfortable. My thoughts are scattered. My thoughts do not make sense. I find I have to edit my own thoughts or at least dig through the mess. I must navigate the thoughts to find the ones that fit together all in time before the memory loses focus and the tracking loses hold and “poof” the statement or thought is gone forever. Frustrating. I am intelligent. I feel stupid. My mind is in 5th gear and climbing at an unprecedented rate of speed. It is magical and amazing, but terrifying and exhausting. How to remain “normal” – is it possible? Is there a possibility of the insanity to stop? Is it possible for the cycle of speed to come to an end? I like the productivity, but the wreckage is too much to take. I just want a break. I want to be normal. I don’t want to be manic.