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.