“Most nurses carry invisible wounds.” An interview with Patricia McCarthy

Posted on May 14, 2012 by

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Patricia McCarthy is a registered nurse who resides with her husband and children in Chicago, Illinois.  In “Do You Remember?”—her first publication— McCarthy addresses the dying patients she consoled, entertained, and helplessly watched over, as well as those who suffered in spite of the overworked hospital staff’s best efforts. “I often cannot remember faces and names,” she writes to her innumerable former patients and their loved ones, “[b]ut I remember their skin or their hands, their eyes, the fragility of their bodies.” Interview conducted by Chad Vogler.

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This is your first published work. Can you say a little about how this essay came to be?

I wrote this essay for a 300-level writing course I was taking at Northeastern Illinois University. We had been studying the different genres in essay writing, and our major assignment was to produce a piece inspired by our readings. I had just read Gloria Anzaldúa’s “Borderlands/La Frontera,” and I was planning to write something about religious symbolism and the mystification of women. It brought to mind the expectation, which I think still exists, of nurses as nuns in white: that is, self-sacrificing handmaidens to the doctors. But real nurses and real nursing are so far from that. It kept bothering me, so I thought, “I’ll write it all down and go back to the other piece.” This essay was actually one part of a three-part essay on the subject.

You have years of nursing experience and thousands of patients to draw from; why did you choose to write about the particular moments you capture in your essay?

They are the moments that have stayed with me all these years, and because they are so painful, they are also very precious to me.

Were there memories that you’d have liked to include, but had to omit?

There were many more memories included in the first drafts. There was one particular memory that I had a very hard time deciding whether or not to include. There was a patient, a man, in room 23. It was a quiet day, and I was able to really pay attention to him. I was washing his back, and we were talking and laughing, and it was really lovely. I turned around to do something, and when I turned again he was gasping and literally died right in front of me. I slammed the emergency call button and called out, “23 is dead” or something like that. I remember cringing that the man I had just been caring for in such an intimate way, and laughing with, had suddenly become “23.” I had reduced him to a number so that I could care for him without letting emotions take over.

But it has an effect on you. When I was deciding whether or not to include the story, I decided against it, telling myself it was redundant. Now, I think the thing still comes a bit too near, and that was why I didn’t include it.

At the opening and closing of your essay, you address the many people who have asked you, over the years, whether you remember them or their loved ones. What is the relationship between receding memory and emotional distance, and how did it affect your writing?

Most nurses carry invisible wounds, but they are wounds that they will not acknowledge if they want to continue to provide patient care. You can’t stop to ponder and weigh what it all means while you are still in the thick of it. Many of the first readers of this essay were fellow nurses, and every last one of them returned the essay to me with a queer, sick expression and each of them said something like, “That was just too close.” Most of them were still doing or thinking of returning to patient care. Not me. I will not be returning to bedside care, ever. Knowing this gave me the ability to remember it all and to feel it all. I’m in a safer place now.

Why did you decide to write in the 2nd person?

I’m speaking to the patients. I’m apologizing and making a plea for understanding.

There’s a striking moment when you are playing with a very ill child: “[…] I ran my toy car over your head, softly, of course, especially over your shunt.” How did you select images and details for this piece?

When I write, I know how I want a piece to feel, but I have trouble articulating that feeling. It is only after a work is done that I recognize what I was going for. In this essay, I selected images and details to convey that sense of a very vivid dream.

In the last two stories of your essay, your voice becomes increasingly overworked, frustrated and regretful. Why did you end the essay with uncertain and troubling memories?

It was how I left nursing. I just couldn’t stand that terror that nurses sometimes feel when they are forced to care for their patients in very dangerous situations because of staffing. You have to acknowledge that you have much of the responsibility and very little of the power. The guilt is terrible, too—the guilt of not being able to do enough for those who can benefit, and of doing too much for those who cannot.

Hospital bureaucracy also makes an appearance; how did you decide that this criticism would be productive?

People need to know that Grandma’s medical care is directly affected by decisions made in the offices of administrators and executives and government officials. If a government program covers fewer people or pays fewer cents on the health care dollar already spent, the budget has to be cut somewhere. There will be fewer housekeepers, or secretaries, or nurses’ aids, or transporters. The amount of work doesn’t diminish; the patients still come for care, but there are fewer people to give it. Less time is spent caring for Grandma. And there wasn’t a lot of time for Grandma to begin with.

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Chad Vogler is an editorial assistant at Creative Nonfiction and a graduate of the University of Pittsburgh’s MFA program in poetry.

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