On nursing

The night of November 30th, 2004 found me crowded onto the back of a flatbed truck in rural Mozambique, cramped and uncomfortable but alive in my own skin, bumping over the long road between Marrupa and Lichinga en route back to the modern world after 5 days inadvertently spent walking from village to highland village in a world with no electricity, no motorized vehicles, no English speakers, and no tourists of any kind, one of the highlights of the 15 months that I spent traveling the world without flying in my younger days. The truck ride would turn out to be an 18-hour travel day by the time all was said and done, and before it ended it would plant a thought in my mind that I would wrestle with over the course of the next 8 ½ years—up until two weeks ago, to be precise.

At this point I’d been “out”, in backpacker parlance, for about 11 months, traveling mostly in New Zealand, Australia, and the global round-the-world sailing community, but I’d spent the last month or so in South Africa and Mozambique, and being in Mozambique especially reminded me in a lot of ways of the study abroad semester that I’d spent traveling across Asia the first semester of my senior year, specifically my guilt at traveling through truly impoverished areas solely for my own pleasure. Part of the rationale for the trip, at least in theory, was to figure out what it was I wanted to do with my life, and something I’d realized very clearly, especially in the last week, was that I had no meaningful way to be able to contribute to the lives of the people through whose communities I was traveling aside from the disparity in purchasing power that came with the winning lottery ticket of my birth in America. Money was a negative thing to me, though, something that separated me from others rather than bringing us closer together. I wanted to be able to give something positive back to the world, and I wanted it to be something that would have value no matter where I found myself.

A few days ago I finished re-reading Lord Jim for the first time in 7 or 8 years, a book whose protagonist I identified with heavily in my traveling days, and thinking back on it I realize that what happened in the back of that truck bore more than a passing resemblance to Jim’s moment of weakness on the Patna and his attempt to re-live the test for the rest of his young life.

My test, such as it was, came in the black of night, 30 minutes outside Lichinga, when I was jolted awake from the verge of sleep to the feeling that something was terribly, terribly wrong. I sensed immediately that the truck was going over the side of the road, with 20 or 30 people piled into the back with no protection and no expectation of safety, and when I saw someone fly over the side I assumed that the end had come for all of us. I don’t remember precisely what went through my head in the 5 or 6 seconds that elapsed before I realized I was still alive, but I do remember the strange sensation of being newly awake in an unfamiliar environment and suddenly about to die, the fog of sleep mixing with the fog of my own impending death, each second crawling by Inception-style as the most primitive part of my brain hit the eject button and prepared to shuttle off this mortal coil.

And then it was over, and I was still alive, and suddenly very awake, but everything was definitely not all right. I forget the mechanism of how I went from being in the back of the truck to being on the road; I just remember looking at the injured man with a crowd of people all around me, the only Westerner for miles around, and through the lens of my 50-word Portuguese vocabulary being able to tell that they expected me to be able to help this man, to be able to do something for him. I had nothing; I was completely overwhelmed, and even if I’d been able to think clearly there was nothing I had, no skill, no life experience, that would have been useful to him, applicable to the situation. I tried as best I could to communicate that I was sorry, that there was nothing I could do, but I still remember the reproach in the eyes and voices of the other passengers, the sense that I was breaking an implicit social contract by being in their community and not having something to offer, by not being someone with medical training who could help a man whose life may well have depended on it. He was bundled into the first car that came along and sped off to the local hospital; I have no idea what happened to him, but the experience has stayed with me.

It was sometime that night or in the days that followed that the idea of becoming a paramedic, or at least being trained as one, first occurred to me. I’ve conflated it now with Doctors Without Borders, and wanting to volunteer in a refugee camp or a war zone as a way to maximize the value of my contribution; that eventually became a component of it, but my nursing impulse, as you could call it, certainly began as a desire for atonement.

8 days after that truck ride I found out that my mom had been diagnosed with what would eventually turn out to be stage IV uterine cancer; a week after that I came down with an almost fatal bout of malaria in Johannesburg; and 4 days after that I was on a plane back to Texas, the trip on hold indefinitely and my life forever changed.

Aside from a 4-month trip in the fall of 2005 I spent the next 2 years and 4 months in Fort Worth with Mom before she died, and I saw firsthand the enormous positive impact that good nurses had on her quality of life. Ever since I was a kid I’d seen hospitals as cold, mechanical places, fundamentally lacking in human warmth, but I’d never spent an appreciable amount of time in them before. I quickly came to understand that while doctors may do the technical work of diagnosing and cutting and stitching, nurses are the human layer of the healthcare system, the part that’s responsible for patients being treated like people instead of just data points. I’ve always enjoyed being on the front lines of any organization that I’m a part of, and being a nurse, to me, held the appeal of being a foot solider in the fight against a fundamentally broken American healthcare system.

I was back in town to spend time with Mom and save up money for when I eventually made it back out, though, so the seed of nursing grew slowly in my mind. It started to push through the dirt a bit in late 2006, and in early 2007 I signed up for an EMT course to get some hands-on experience in the busy county ER at John Peter Smith (JPS) Hospital. I already had a full-time job that met my needs, so my immediate goal was to be able to work there 8 hours a week without having to leave my job; actually going to nursing school wasn’t yet on the table.

The clinicals for the EMT course were eye-openers for me—I got to ride along in ambulances with paramedics and work side by side with nurses and doctors in emergency rooms and pediatric wards, and I realized that I enjoyed it; I found meaning in the tangible acts of healing and support that constituted the workflows of the people in whose world I was a visitor, and I began to think more seriously about working in the field in one way or another myself someday.

After looking into EMT and paramedic salaries a bit more I decided they were both out as possible career paths, but nursing really appealed to me for a number of reasons, at least in the abstract: based on my limited experience I thought I would enjoy the day-to-day experience of being a nurse, the money was good, there were plenty of branches to the career path, I would never have to worry about being unemployed or trying to find a job again, and it was something that I could do virtually anywhere on earth, so I wouldn’t have to worry about being tied to one particular location. I can’t say that I was passionate about it, but at that point I’d never worked at a job that I was passionate about; if anything I lived in a cycle of working followed by pursuing my passions, and nursing seemed like a good way to prolong that cycle sustainably. I started looking into going to nursing school in Texas, but I didn’t take any action on it.

My mother’s death in March of 2007 affected me profoundly in a number of different ways, one of which was that I started to think much more seriously about settling down and starting a family than I had at any other point in my life. I had just gotten a promotion at work, and as part of that nesting impulse I decided to keep going down the Mercedes-Benz Financial career path, to pursue stability for the first time in my life. Working a super-part-time shift at JPS turned out not to be in the cards, but I volunteered there occasionally and spent the next year of my life focusing on dating and work.

By late 2007 my interest in my job was flagging (as I put it at the time, it felt like my soul was slowly dying day by day), but in early 2008, just about the time that I started volunteering for the Obama campaign, a Retail Credit Analyst position came up in southern California. My manager pulled me aside to let me know that she’d shortlisted me for it, and I decided that it would be a good stepping stone to the Dealer Relations Manager position I really wanted, so I applied, but I ended up missing it by one slot. There was talk of another Retail Credit Analyst position that was going to be posted soon in New Jersey, so I started orienting myself towards that while preparing a backup plan that involved making one last epic overland trip from Cape Town to Jerusalem and then coming back to the States and going to nursing school in Austin.

The New Jersey operations ended up moving to Fort Worth without the position ever posting; at the end of April I met Carolyn in a campaign office in rural Pennsylvania on the last 3 days of my vacation time for the year, quit my job to volunteer full-time the day after I got back, and eventually got hired as a field organizer in Ohio for the general election; and then in early November I found myself unemployed and rootless, with very little aside from an S2000 to my name and a stronger desire to settle down in one place than to overland across Africa. I joined my co-workers from Ohio for a road trip across the southwest, spent Thanksgiving with my family in Texas, drove the best driving roads in the South en route to volunteering on an unsuccessful Senate runoff campaign in Georgia, and then spent three days lying in a hammock in Key West re-reading my old journals and figuring out what I wanted to do with my life now that it truly was an open book again.

There were two questions, really, what to do and where to do it, and by the end of my little retreat the answers were clear: I was going to settle down in Seattle, because in all my travels I hadn’t found a city that I’d enjoyed living in more; and I was going to go to nursing school, partially because it made more sense to me than any of my other options and partially because I knew that the only way to find out if it was really right for me was to dive in headfirst.

I got all of my affairs in order in Texas, reduced my life down into whatever I could fit in the trunk of the convertible and a box of clothes that I mailed ahead of me, and then I headed out for California and Highway 1, to start over in the Pacific Northwest for the second time in my adult life.

I arrived in Seattle in February of 2009, signed up to volunteer at the UW Medical Center, and started doing my nursing prereqs at Seattle Central Community College in preparation for applying to the UW’s 2-year BSN program by the end of the year. Classes were going well, I was enjoying the volunteering and starting to really look forward to being back in school full-time…and then I ran into the McGinn for Mayor campaign. It was a case of passion vs. utility—I started volunteering for McGinn shortly before the end of the Spring quarter, fell in love with the campaign and took the Summer quarter off to throw myself into the general election full-time as the campaign’s volunteer coordinator, and then split my time between class and campaigning in the Fall quarter. I loved the race but I had no intentions of working in the administration, so after he won I set myself up with a nursing assistant job at the UW Medical Center, joined the union, and started sketching out a 40-year career path…that I ended up staying on for about 3 weeks.

When I got an offer to work in the McGinn administration it was something I had to really sit down and think about, and I spent a whole week turning it over in my head—on the one hand was nursing, a safe, stable, well-paid career track with plenty of options that I knew I enjoyed, and on the other side was the unknown experience of working in the Mayor’s Office in a major American city, a once-in-a-lifetime opportunity with much bigger potential upsides and downsides, temporary security, and very few opportunities for advancement. I took a leap of faith and chose the riskier, more interesting experience, a strategy that’s generally been one of the guiding principles of my life. It was the right decision.

I talked to my manager at the hospital, she agreed to let me keep working one 8-hour shift per week in perpetuity (Friday nights, 10 pm – 7:30 am), and I was off and running. Because I felt guilty about having essentially quit so soon after I started, though, I told her that I would keep working both jobs full-time for the first month to give her time to find a replacement for me, and I spent January of 2010 working the night shift at the hospital, busing straight down to City Hall, working all day, and then crashing for 4 or 5 hours before getting up and doing it all over again. I was really glad when January ended and my 30th birthday rolled around.

I kept up my 8-hour-per-week nursing schedule through Easter weekend of 2011, but I finally had to call it quits—I was missing a lot of shifts for work events; Carolyn and I were dating long-distance by that point, and trying to schedule time off in advance for weekend visits and trips was tough; and working through the night every Friday and then catching up all day on Saturday was starting to take its toll. I told myself that I was going to start volunteering again once I had some more time, but free time isn’t one of the perks of being a political appointee, and what ultimately drove me to start volunteering was the need to get a definitive answer to the question of whether or not I really want to be a nurse.

My immediate goal as a nurse would be to work in the Harborview ER, so, in the aftermath of the breakup with Carolyn and almost two years after I completely quit my nursing assistant job, I signed up to volunteer at Harborview to a) test the waters and b) start building some connections in case I decided that I did want to pursue a job there some day. I signed up for the Friday night shift, 6 – 10 pm, because it was the only one that fit with my schedule.

When I first moved back to Seattle four years ago, I remember driving up Pike from 1st, getting to Pike & Boren and stepping out of the car into my new life, and instantly feeling like I’d returned to my spiritual home.

My first volunteer shift at Harborview two weekends ago was the precise opposite of that feeling.

This was the locus of what I’d thought I wanted to do, one possible answer to the question of what I wanted my impact on the world to be, but I realized within minutes that it’s not where my future lies. Nursing was always my safety net, my compromise with benefits; as I observed the comings and goings of paramedics and flight nurses and rollover victims and x-ray technicians and surgeons that night, though, I realized that my job in the Mayor’s Office and my relationship with Carolyn changed something fundamental in the way I think about work and my relationship to it.

Nursing was always about surviving for me, and helping others to survive. It grew out of a period in my life that was oriented towards travel and exploration, in which meaning was something that happened out on the open road and I decided not to pursue a career as a travel writer largely because I didn’t want to dilute the purity of my passions by having to use them to earn a living. It kept growing because I wanted work to be compartmentalized and my life to be my own otherwise, and nursing seemed to me like the best way to achieve that—when I was on my own it held the promise of a fantastic work-life balance, and when I was with Carolyn it was a flexible career path that could adapt to wherever her career took her and make it easier for me to take time off to take care of the kids if we decided to have any. What I was missing at the time, and what I think a lot of people who are close to me recognized before I did, was that passion is a necessary component of life for me, and now that I’m happily settled in a post-travel phase of my life it’s not sustainable for me to think about doing something for a living that I’m not passionate about. Just surviving and helping others to do the same isn’t enough, in other words.

The Harborview ER has been an almost mythical place for me the entire time that I’ve been back in Seattle, and being there “in anger”—the phrase Martin always used to talk about tying knots out on deck while we were under sail as opposed to sitting around practicing and thinking about them in port—was the experiential answer to a question that had been in the back of my head for a long time. There are a lot of things that I think I would enjoy about being a nurse, and all of the benefits on paper are still there, but in my heart of hearts it’s just not something that I’m passionate about, and in the end that’s all that counts.

Living without a safety net is what I have to thank for all of the best experiences of my life: leaving behind all of my friends and family to sell cars on the other side of the country after college; signing on to crew across the Indian Ocean without knowing anything at all about sailing; quitting a well-paid job in Texas to volunteer on a Presidential campaign based largely on the hope that a girl I liked might happen to be single; taking a blind leap of faith into the uncharted territory of local government; putting all my travel money into a down payment on my apartment to be sure my escape routes were blocked; and, 2½ years after we first met, taking a chance with that same girl on what I knew would at best be a 3-year long-distance relationship, and being happier for the 2½ years of my life that followed than I ever had been before.

It feels good to have the nursing question out of the way, but now comes the harder question: what am I really passionate about?

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