Monday, April 18, 2022

Have you ever been a hero to someone? Has anyone been a hero for you?

 Whether I've ever been a hero to someone is really a story to be told by others not me.  Some would say that being a hospital corpsman on the battlefields of Vietnam might qualify me as a hero.  Having administered in excess of 40,000 anesthetics over a 50-year career as a CRNA has possibly made me a hero in some of my patient's eyes.  Aside from just doing my job, I like to think that the quality that qualified me to be called a hero is my unwavering attempts to alleviate fear and despair in my patients.  I'm not talking about the drugs I administer to that end but the emotional support I provide while interacting with them.

How is that accomplished?  By listening to them and acknowledging their distress and answering their questions with utmost honesty.  While interacting with patients, or people in general for that matter, I like to hold their hand or touch them on the shoulder during our entire conversation; establish a tactile bond.  Maintaining eye contact is extremely important.  Let them know that their concerns and only their concerns are important to you.  You might think that that is what everybody in my situation does but you'd be mistaken on that point.  You may remember an anecdote I relayed in a previous essay where a fellow CRNA said to me, " I didn't go into anesthesia to talk to patients, I went into anesthesia so I wouldn't have to talk to them."

On the battlefield during Operation Starlite while attending to a fellow marine who'd been mortally wounded. I stayed close to him by positioning myself with my leg in constant contact with his right leg and alternately touching him on various parts of his body including a soft touch on his face. While he was screaming saying, "help me Doc, help me, I'm going to die!!! I looked him in the eyes and said, "I right here buddy and you're going to be OK.  You are going home buddy.  I'm going to give you a shot in the leg and your pain will be tolerable in just a few."   After giving him a 1/4 grain of morphine intramuscularly, I began bandaging his multiple wounds.  I noticed his face relax and a sense of comfort filled his face.  And then he died.  Did you say to yourself just now, you lied to him grandpa!?  Did I?  The look on his face showed me that his pain left him, and his fear had dissipated.  And yes, he went home.  Then I moved to the next wounded marine and gave him my full attention all the while a dozen other marines where calling Doc, Doc.  One at a time, full attention, touch them and talk them down.

Fort Campbell Kentucky Christmas Eve 1974, I'm on call for the OR. A call comes in after midnight, car accident, emergency surgery.  One of our nurses who worked the psychiatric ward was returning from a party in Hopkinsville, Kentucky gets in a car accident.  She is in the OR on the table when I arrive; I'm less than 5 minutes from the hospital.  Attaching the monitoring devices, EKG, B/P, pulse oximeter, and a large bore IV is the first order of business.  The patient says, "Bob, am I going to die?"  Placing both hand on either side of her face, I say, "Janet, nobody dies on Bob LaRock, we're going to fix you up right away and I'll be your guardian angel through it all, OK?"  Her vital signs are dangerous: extremely low B/P, and tachycardia.  The surgeon, by way of hand signals, indicates, Let's go, let's go.  After administering a small amount of intravenous anesthetic and providing 100% oxygen she slips off to neverland saying, "thanks bob, I'm glad your here."  The surgeon makes the abdominal incision and quarts of blood immediately flow out from her belly.  I start another 14 gauge IV in her other arm and start pumping blood in both IVs as fast as physics will allow.  So much blood in the belly that the surgeon can't find the source of bleeding.  Cardiac arrest.  Open cardiac massage, continue rapid infusion of blood.  Heartbeat returns, B/P 60/20.  This scenario repeats itself 3 more times.  Still the surgeon fails to find the bleeding.  On the 4th cardiac arrest, we fail to resuscitate her.  She's dead.  Of course, the bleeding stops. The surgeon finds that the Hepatic vein was ruptured and separated from the posterior liver.  There was never a chance that we would save her.  Did I lie to her?  Yes, I did, and I would again.  Infact the exact same scenario played out the following Christmas Eve, and yes, I was on call and yes, I lied to her too.

All surgery is frightening to the patient.  Attempting to allay those fears is my primary goal.  If that makes me a hero well then for many, I guess I'm a hero.

Depending on how you define it, I have many heroes.  I'll confine this essay to two.  In keeping with the foregoing examples, I'm fourteen, a freshman in high school and I get an attack of appendicitis.  I have a fever and an 8 out of 10 pain level.  I'm in the hallway just outside the operating room and scared shitless.  A woman in a white dress and a hat covering her hair meets me when I arrive.  "Hi, I'm Bernadette Sovie.  I'm going to put some medicine in your IV to help take away your pain, OK?"  She injects some drug, Demerol I think, and stays by my side chatting, asking me my name, how old am I, where do I live, where do I go to school etc. etc..  Soon I'm feeling better and say, "can I go home now?"  She chuckles, puts her hand on my shoulder and says, "in a few minutes I'm going to wheel you into the operating room, it'll be cold but I'll cover you with a warm blanket.  Then once you're comfortable I'll check your blood pressure and I'll put some more medicine in your IV like I did a couple of minutes ago and you'll fall asleep, OK?"  I nod.  "After you're asleep, Doctor Loughren will remove that nasty appendix from your belly.  I'll be with you the whole time and keep you safe, OK?"  "Okay" I respond.  She never leaves me alone, wheels me into the operating room where staff lift me off the gurney and lay me on the OR table.  She covers me with a warm blanket, all the while asking me more questions about my life.  After placing a wrap on my arm which gets excruciatingly tight for a few minutes, she asks, "do you have a paper route?"  I don't remember if I answered or not, because unbeknownst to me, she is injecting Sodium Pentothal into my IV.  I wake up puking in a bed, in the ward for patients after surgery, with dad by my side.

The next time I encountered Bernadette, I was a 24 year-old brand new nurse starting my career as an OR nurse in the very same OR where I had my appendectomy.  I observed her administering anesthesia there for the next year.  She treated every single patient that came under her care with the same care and demeanor she applied with me that scary time 10 years previous.  After 1 year, and with advice and encouragement from Bernadette, I enrolled in Albany Medical Center's school of nurse anesthesia.  I tied my darndest to become a nurse anesthetist she role modeled to me.  I like to think I succeeded, but that will be for the multitude of student nurse anesthetists I taught along the way to tell.  To me, Bernadette Sovie epitomizes the definition of Hero.

My, now deceased, brother, Jeffery Michael LaRock is my hero.  Jeff was the standard bearer of love.  In his too short life he gave more love than he received.  I will never be able to reach the level of selfless caring he offered to everyone he encountered.  From the day he was born he endeavored to please.  He was no saint by any measure.  Still, his heart was what grandpa Walton would refer to as "a giving heart."  Being 10 years older than Jeff, I didn't have much time to give to my annoying kid brother.  By the way, his hero, I can say without doubt, was Aunt Nellie.  He tried daily to be my best friend.  Sometimes I think that because of his ardor for his big brother was the reason mom tried to make me his "father."  She asked me many times to intercede to guide him and set him on the straight path just because he would do whatever i implored him to do.  I left his life when he was seven and when I returned he was off pursuing his grown-up life.  A long stretch of his life was spent in Nevada and we didn't get to enjoy time together.  He called me often from Las Vegas, I never called him.  We talked for hours and he would regale me with tales of his adventures and he delighted in making me laugh 'til my sides ached.  Our calls always left me uplifted, and that was his aim.    When he returned to live out his remaining years in Ogdensburg and environs we would meet, at least, monthly at a local diner for breakfast.  He was the only person in my life that I could be completely honest with.  I never felt the need to embellish, exaggerate or be less than honest with him, because he was a superb listener who withheld criticism, if he even had any, and was my chief consoler.  I have many regrets about my relationship with Jeff. in particular my lack of trying to emulate his giving nature.  He offered many lesson in that regard, but unfortunately, I was a poor student.  he lived his life always endeavoring to please.  he accepted his coming death with equanimity and I hope I can get an A+ from that lesson when my turn comes up..  He is my hero because he was a caring compassionate soul.

So how about you all:  who are your heroes?

Wednesday, April 13, 2022

It's OK


A lifetime ago two saplings briefly transplanted in a foreign land

Their roots entwined in a primative hostel on an island 

She whispered; “ It’s OK.”

Instantly a band of love, to last all of their lifetime entwined his heart

Not constrictive nor restricting but a cocoon of encompassing passion

A time capsule to be rediscovered decades in the future.

A parting gift of seeds of grass imbedded on a yarn wrapped card, framed

Would be his link to remind him of their bond

Even as they drifted along different paths to build new and fulfilling lives.

Over that thread of ardor, seemingly impossible, a reconnection through the ether

Holding each other’s invisible hands, exchanging tentative remembrances

Hoping the roots of their aging trees can one more time say, It’s OK.