For Donna,  Linda and Kelly

When I was an Internal Medicine intern, my very first rotation was in the Coronary Care Unit, aka “the CCU.”  Nothing could be more frightening to both the intern and the patient than an acute myocardial infarction the first week in July.  It is a well-known fact that hospital mortality blips upward in July of every year, as the new interns take over from their now seasoned peers.   I learned VERY quickly that there was only one person I could depend on without fail and her name was Donna.  She was an intensive care unit nurse who took me under her wing and quite literally, told me exactly what to do so I wouldn’t kill anyone.  She was my guardian angel, and she took her responsibility quite seriously.  I am quite sure that her expertise has been the dividing line between life and death for hundreds of patients (and hundreds of interns!) both before and after my time.

When I was a medical student rotating through the various hospitals, patients were still admitted to “wards”, something you never see today, at least not in this country.  Large open rooms, containing six or eight beds, presided over by a charge nurse, with various “team members”, meaning medical students, lab techs,  interns, residents and attendings all scurrying around like busy mice.  Invariably, as I would pass by a patient’s bed, he or she would call out emphatically, “NURSE!”.   On my good days, I would turn to the patient and say, “Sir, I am a medical student, NOT a nurse, but can I help you?”   On a bad day, I would just keep walking.  I was not a nurse.  I considered it an insult to my upcoming doctorhood.   I was young and stupid.

In the real world, it is not the doctors, but the nurses who truly take care of, and CARE for the patients.  Nowhere is it truer than in oncology nursing.  They are the ones who stand between the patient and the abyss of the “Big C”.  Their dedication, humor, inquisitiveness, persistence and above all, their compassion can mean the difference between a patient who is an anxious fearful “victim” versus a  “warrior” ready to face the challenges of treatment.  As the front line, the “advance man”  between me and the patient, my nurses establish trust, instill confidence, inform, educate and LISTEN.  In short, they make my life easier, and they make the patients’ lives, no matter how short or long, more comfortable. After all, in what other context would a patient knowingly lie down and offer their arm to a person who is ready to infuse a–to use the general public’s term for chemotherapy—”poison” into their veins.  I can think of none.

I have learned so much from my nurses over the years.   Now, when I walk by an exam room (and this doesn’t happen very often anymore), and a patient yells “NURSE!”,  I still correct them, saying, “Can I help you?  I am Dr. Fielding.”  But secretly, I know that I’ve been paid a compliment.


  1. you are 1000% correct about the critical role nurses play in health care. We physicians are the architects but the nurses are the builders as well as the foundation. Without them, there would be no structure at all. We’re fortunate when they are willing to work with us!

  2. I also agree 100% about the essential importance of nurses. I have had some amazing nurses the few times I have been hospitalized and they really make the difference. It has changed so much over the years and I think the continuing increase in paperwork has really caused the most critical aspects of ‘nursing’ to suffer. I will always remember the awesome nurses I have had.

  3. Thank you acknowledging the role of nurses who learn so much from doctors like you. Although I did well in nursing school, most of my important knowledge was received, day by day, from experience working with physicians who actually explain why they make certain decisions. Over the years, I absorbed as much as I could from those who were taught things that I wasn’t. I was recently hospitalized, for the first time since giving birth 42 years ago, for an acute medical problem. The kindness & expertise of the nurses who cared for me were amazing. I will never forget them. It brought a new reminder of seeing things from another view. No matter what our job or career path, just showing kindness to others can make a big difference. Thank you, Miranda, for your wonderful blog.

  4. Never analyzed it– but I consider my med team for both treatment and research to be my two University hospital docs, you, my dog breeding partner veterinarian, and my sister the head nurse of the Cystic fibrosis clinic.

    That is not the oddest (?) thing. I am an over 60 male with a background in biology; all my docs plus are under 50 females. I must ponder this

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