Monday, August 31, 2009

Meanwhile...Back in Texas.....

Okay, so I'm back at my beautiful mother's house.

But I'm leaving for Kansas tomorrow night, again on the infernal Amtrak train.

Mamo, as predicted, is "lingering" due to the institution of a dialysis regimen. A doctor buddy of mine says she could linger for weeks or even months. She sleeps much of the time, wakes up for meals, and is experiencing abdominal pain due to constipation since she does not have the strength to have a "movement". She is so weak that she cannot do any physical movement except to turn her head slightly. When she is awake and can speak, she is coherent in the things that she says--- which means that she is very much in her right mind and totally understands all that is happening to her.

My uncle goes to visit and feed her twice a day. And the only thing the rest of us can do is to wait... and wait.... and wait... hoping like hell that she is comfortable and not in any distress. But I can only imagine her state of mind--- and I pray to God that she is not miserably depressed or feeling lonely.

The rest of the family has all returned home since none of us (nor the doctors) have any idea how long the dialysis will keep her alive, and we're not able to stay there indefinitely. But we jump every time the phone rings, thinking that it's "the" phone call.

I am spending a couple days here at my mother's home and so I decided to do something to distract myself from all the misery--- so I took photographs of my mother's home and art.

My mother is a well-known artist in these parts. Most people are wide-eyed and agog when they view her fantastic art pieces--- she has a personal style and flair that is different from any artist I've ever seen. It's beautiful, wildly colorful, and interesting as well as thought-provoking. She's been featured in newspapers and on the internet. She has been asked to give classes. And she sells some of her work, frequently asking me to advise her on the pricing of particular pieces.

My mother's artwork varies from gorgeous oil painting, to mosaicing (whereby she cuts each and every piece of the glass/tile/ceramic mosaic pieces herself with her vast array of tools and saws), to mixing and constructing concrete buttressing structures, to lamp-making, to custom upholstery and cushion-making. She's partial to rich, lush colors of burgundies, purples, reds, golds, mirror tiles, and even leopard print. It's impossible to describe-- you'll have to see it for yourself.

Whenever I visit my mother's home, I calm down immediately. It is a place of unimaginable beauty and wonder. The floors are covered with authentic Persian carpets of varying sizes and all the upholstery and fabrics are richly colored with matching tassles. Here is where I keep a bedroom--- and in it I keep my collection of Painted Ponies. My mother's breathtaking art pieces are spread out within the house and also outside, in her amazing English style gardens. She is frequently asked to give tours of the entire place. (And I sigh with delight when I use the imported French soap in my bathroom.) (But you knew that I like French things, right?--- it's Mamo's French blood in my veins....)

Right now my mother's current work is a fountain. Yes, you heard that right---she is making a fantastic fountain which has three upper bowls emptying into a main pool. Her handymen help her with the underground plumbing for it--- right now they're installing valves or something--- and it will be surrounded by tropical plants such as a banana tree, ferns, and flowers. It will be in the front of her garden area--- but she has another fountain on her side patio, where she takes her meals.

So....I've decided that I will show you her art. Truly, it is so beautiful and unique that I think you might find it fascinating. I'll download the pics when I get to Kansas.

Anyway, I'm boarding my train tomorrow night and will be home in Kansas on Wednesday, where Blaine will pick me up at Union Station. (Lord, that man has phoned me incessently.) (And I lost my dadblamed cell phone and have to go get another one tomorrow....) As usual, I reserved a little room on the train so I can stretch out and watch videos on my laptop.

(Word to the wise---"Race to Witch Mountain" was very disappointing. I could have told you the entire plot and ending of the movie simply by watching the first five minutes. Mediocrity, Thy Name is Disney.... )

But I won't stay home long--- because I will be returning to Texas in the second or third week of September to accompany my mother to Dallas where we will celebrate my niece's 21st birthday. (Yikes! How did she get to be 21 already?...... I feel so old!!...) And my sister just put in a greenhouse and fountain in her own garden--- so I'll have to get pics of those things, too...)

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Sunday, August 30, 2009

The Watch Continues...

Since Mamo is extremely lethargic and isn't in the correct frame of mind to declare whether or not she wants to revoke or amend that document stating she did NOT want dialysis, the doctor asked the family if she had ever generated a "Living Will", which lo-and-behold she had--- and in it she stated that in the case such as the present one she did not wish to be kept alive by "aggressive measures such as defibrillation, a ventilator, or a feeding tube."

Unfortunately, it was just vague enough to make deciphering whether "aggressive measures" included dialysis or not. Dialysis wasn't mentioned.

So.....the doctor stated he "would do whatever all three siblings agreed upon". My mother and her sister again deferred to my uncle, who demanded that the dialysis proceed.

And so, they put in a temporary AV-shunt and proceeded with dialysis. My grandmother couldn't tolerate the whole 4 hours of dialysis the first day, and so they performed it again on the second day..... and again on the third day.....

Each time she emerges from dialysis she appears utterly and completely exhausted, barely able to open her mouth to accept food (eating less and less each day) and she does not appear to recognize people at times. And she sleeps almost totally round the clock.

Due to the fact that nobody can predict how long the dialysis will keep her alive, much of the family has gone home to wait it out. My mother and I were the last hold-outs, but we finally left today. I have got to catch a train soon and have got to get back to Kansas for some doctors' appointments which I must attend before my trip to Dallas in the third week of September.

So my mother and I left Lousiana today and are back at her house in Texas. But we stopped by the hospital before we left. My uncle is sitting vigil by Mamo's bedside. We were able to see Mamo for a few minutes before the nurse took her away to receive an IV infusion of 4 units of Packed Red Blood Cells, which shocked the hell out of me.

FOUR UNITS???? She must be so anemic that you can practically see through her. But I am wondering why they are infusing the PRBC's before the platelets that she needs, since her platelet level is desperately low. So low, in fact, that she's been bleeding steadily from skin tears and that area around her jugular where they placed the temporary AV shunt.

And she looked.....deathlike. I am amazed that she has lasted this long. And I have come to the conclusion that she is struggling mightily to live. I don't think she wants to leave my uncle, who has lived with her for his entire 64 years of life (except for 6 months in the military and a few other odd, short periods.) He has always been "her baby boy". The bond between them is so strong that I think she doesn't want to go---due to her worrying about who will take care of him when she's gone.

Anyway, I am exhausted, as is my mother. In fact, I am so exhausted that I did not even yell back when one of my cousins yelled at me for my opinion that the dialysis should not have been instituted. (Remember, my mother and I were of the opinion that the dialysis should not have been instituted on a 90-year old in kidney failure, heart failure, and other health problems.)

The... uh.... person (I'm going to refrain from calling her a bad name here) had apparently been building up her resentment towards my mother and myself over the last few days--- since she worships her dad (my uncle) and doesn't believe that he could ever be "wrong" about anything. And then yesterday morning at the breakfast table I had innocently remarked: "Mother says that Mamo is eating less and less each day". To which my cousin SCREAMED HIDEOUSLY into my shocked face: "When she was fed this morning, she ate almost a WHOLE BOWL of oatmeal!!!"

You know, I must have matured in my life. Because if this had been 5 (or even 2) years ago, I would have totally gone off on her and informed her at the top of my own lungs, accompanied by some choice cuss words, that EATING OATMEAL DOES NOT CONSITUTE A CURE FOR TERMINAL RENAL FAILURE. (And I might have called her a couple choice names....if you get my drift.)

But I didn't say anything. I simply let it go and wandered into the living room. I did not want to make a bad situation worse.

And I feel good that I did that. Because if I had gone off on her, I would have totally regretted it and it would have hurt family relations.

Sigh....and so we wait....

And I ain't sending that particular cousin a Christmas card this year...

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Thursday, August 27, 2009

Good Lord --- Now There's Been A Legal Complication....

This morning it was discovered that while Mamo was in her home hospital (before the transfer to the big hospital for the dialysis) that she had signed a "Do Not Resuscitate/No Code" document whereby she stated that she did not want any aggressive attempts to save her from dying....

....including dialysis!!!

How in the world, then, did my uncle persuade her doctor to transfer her to the bigger hospital in order to begin the process of dialysis? How then did that doctor "forget" that Mamo had signed the "Do Not Resuscitate/No Code" document outlining her wish to forgo dialysis? It was written there plain as day and she was in her right mind when she signed it. And then how did that doctor "forget" to notify the accepting physician (in the new hospital) of this legal document?

How was that document missed?

Now, the current hospital's attorneys have become involved and there's to be all kinds of meetings today.....

Meanwhile, Mamo is in pain for the first time in days, and they gave her pain meds. Her exact words were: "I'm in misery....."

Thank you, all of you, for your prayers, because we surely do need them....

Wednesday, August 26, 2009

The Waiting is the Hardest...

My uncle won the argument.

He wanted Mamo to get dialysis. And so the doctor said "Okay" and Mamo was subsequently transported via ambulance to a large hospital 30 miles away.

When Mamo arrived, the receiving doctor was aghast. His exact words were: "The transferring doctor misled me about the dire nature of her condition. I had no idea she was this unstable. She has so few platelets that we cannot risk putting a dialysis shunt in as she might bleed to death. We cannot give her platelets because she is retaining so much fluid that the platelets infusion would worsen that condition--- and her lungs are already filling up, placing her at risk of drowning in her own fluids. And it may be useless to give her diuretics to drain off the fluid since her kidneys have failed. And her blood pressure is dangerously low to boot."

Mamo threw up while they were wheeling her around on the guerney.

And all of our hearts are breaking that she has to be put through this....

I am so angry that it is difficult for me to speak to my uncle. I cannot even look at him.

Tuesday, August 25, 2009

As We All Gather Together....

*

Gradually, much of the extended family has arrived here in the swampland of Louisiana, and we sit for hours and hours by Mamo's bedside....her deathbed. The few times Mamo has been able to converse, she talked of Indian things---perhaps remembering her parents, especially her half-French/ half-Indian mother...

At first, everybody pretty much got along with each other. But now things have changed...

My uncle has suddenly changed his attitude around 360 degrees.

When Mamo first went into renal failure, he stated that he would not consider dialysis, as it is very rough on a person's body and she is 90 years old. Mamo is bedridden, so weak that she is unable to turn herself in bed or even hold an object in her hand, her body is swelling up with retained fluids, and she is sleeping most of the time--- but, nevertheless, she states that she is not in any pain or discomfort.

The doctor said that as her creatinine lab value goes up, she will sleep more and more--- and that she will, at some point, simply "go to sleep" and pass away peacefully. And both of Mamo's doctors have stressed the need for hospice care.

But suddenly my uncle is desperate and grasping at straws---and he is pressuring the doctors to send her to a nearby town's hospital, which is bigger and has kidney specialists, nephrologists. He states that he wants Mamo to begin dialysis--- so that he can "keep her alive longer".

No matter how much you tell my uncle that the stress of dialysis will change Mamo's present status from being pain-free and comfortable to that of the extreme fatigue and pain which a dialysis regimen would cause, he simply will not listen.

He even lost his temper and "had words" with my mother, the only voice of reason in the room. My mother wants Mamo to die painfree and comfortable--- not in the trauma of dialysis, which will not reverse her terminal condition but only prolong the inevitable by a few days or a month or two.

My mother and uncle's other sister is right in the middle of the fray, and is not helping much. Every time there's an uncomfortable moment, her usual response is: "I need another Ativan....."

I'm praying a lot. I pray that Mamo passes away without suffering. And I pray that I can be of maximum help to my beautiful mother as she goes through this horrible time.

Monday, August 24, 2009

Update....

Mamo is dying.

But we stay at her bedside all the day long, and her son stays there throughout the night. So she is never alone and has her family with her during the day.

She is in End Stage Renal Failure, and her "creatinine" level is rising by about ten points a day. But so far she declares that she is "comfortable" and not in any pain.

My aunt and I have come home briefly to get tonight's dinner and deserts made-- and we always take Mamo some of the good home cooked food, which she enjoys so much more than the hospital fare.

My uncle's brother-in-law has enabled my laptop to be connected to the internet through his modem. So I can keep you guys updated now.

Thank you all so very much for your prayers and good wishes---it means a whole lot to me.

Bo *

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Friday, August 21, 2009

In Case You Don't Hear From Me.....

Not to interrupt the post below, the last chapter of the "Who Ya Gonna Call?" series, but I needed to tell you that you may only hear from me sporadically in the next couple of weeks.

I am in a rush, having to hurry and pack in order to leave on the Amtrak train for Texas in the morning, where my mother will meet me on Sunday in order to drive me to my grandmother and uncle's home.

It is because my grandmother is on her deathbed in Louisiana.

This is my beautiful mother's mother, who everybody calls "Mamo". Mamo was always a strong, wonderful person, genteel and ladylike to the core---but, like many well bred Southern women, could outshoot any man with a pistol. (Or, as my uncle puts it, "If you told her which pecan you wanted she could shoot it off the tree at 100 yards...")

My sister will be coming in from Dallas, and there are other relatives coming from California and Arizona.

It will be not unlike the story in Pat Conroy's "Beach Music".....

"No story is a straight line. The geometry of a human life is too imperfect and complex, too distorted by the laughter of time and the bewildering intricacies of fate to admit the straight line into it's system of laws."

("Beach Music", Pat Conroy)

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"Who Ya Gonna Call?"---Final Chapter: While The Angels Watched....

*

*

The wild dogs cry out in the night,

As they grow restless longing for some solitary company,

I know that I must do what's right,

Sure as Kilimanjaro rises like Olympus above the Serengeti,

I seek to cure what's deep inside,

frightened of this thing that I've become...

("Africa", Toto)
* *
Time, time, time, see what's become of me,

While I looked around for my possibilities,
I was so hard to please,
But look around... leaves are brown,
And the sky is a hazy shade of winter...
("Hazy Shade of Winter", Simon & Garfunkel)
*
*
Graduation was upon us...

And all of us were in a frenzy of anticipation--- not only because we were excited to be graduating but because our long ordeal was almost over and we could finally see the light at the end of the tunnel. Sadly, there had been many casualties in our seemingly endless struggle to complete the Shadyside Hospital School of Nursing Diploma Program. Out of the 60-odd students who had begun the program, only 39 would be graduating. Nearly half of our numbers had fallen by the wayside.

But Marla, and Cindy and I had held on steadfastly, never wavering in our relentless drive to complete the program and become "real nurses". When any of our fellow students dropped out of the race, it only encouraged the three of us simply to sprint even more desperately towards the finish line.

But even in the last few weeks of the program, the nuns never let up their pressure on us. No, it was almost like they had redoubled their efforts to force us to the point of exhaustion in our studies so as to "weed out" the last few unacceptable candidates, ensuring that only those of us which they considered topnotch RN material would survive the program.

But I knew that it wasn't just nursing knowledge or clinical skills on which the nuns had been evaluating and judging us---I knew that the other half of their agenda over the last two years had been an attempt to forcibly mold us into responsible, mature, professional young ladies who would hopefully become models of integrity and honor in our communities.

But as graduation approached, there were times where I didn't think I could make it. Many were the nights I sat crying over my books at my desk, sure that I would never be able to memorize all the information required for the next morning's quiz. My tears would blur my vision as I looked at the text on the pages before me, so I would wipe them away and try to re-focus--- but then new tears would come and I would have to wipe those away as well...

I no longer cared anymore whether I heard the ghostly chem lab stools moving above me in the chem lab during the night. Ghost or no ghost, I had work to do.

One night while I was trying to memorize the anatomy of the kidney, I heard the stools moving again and I yelled out: "STOP IT! I'm trying to fucking study here!"

And, obligingly, the stools stopped moving.

For two solid years we students had worked ourselves to the bone in every single one of the hospital's wards, learning all sorts of nursing tasks, medications, procedures, and scientific knowledge. We had taken care of the sick and dying--- bathing them, feeding them, medicating them, bandaging them, and comforting them and their families. But throughout those two years of caring for those patients, we had done so with the ever-present fears that we were totally inadequate and incomplete in our nursing knowledge.

We hadn't graduated yet---and thus, we knew we were of even lower status than that of a rookie nurse.

Death, suffering, and illness was a world that most of us young girls had never experienced. But at Shadyside we had been thrust into the world of overwhelming, cloying sickness and the myriad of complicated medical weapons which fought that sickness---sometimes successfully and sometimes not. And it had slowly dawned on us that this was the world in which we had chosen to live on a daily basis for the rest of our nursing careers.

But there were many who simply could not stomach it.

Student after student dropped out of the school, citing various excuses such as they had "changed their mind" about which profession they wanted to pursue, or that they "wanted to take a break for a semester", or that their parents "really wanted them to go to the university", etc., etc.--- but we who stayed in school knew only too well why they had left Shadyside.

Very simply, they left because they couldn't bear the daily working within an endless parade of diseased and broken bodies while slogging through endless puddles of blood, pus, feces, urine, and vomit---and the blood, sweat and tears demanded of both nursing students and patients alike...

And sometimes they left because the nuns threw them out.

One day I was struggling to keep up with my patient workload on the orthopedic ward when Sister Kathleen suddenly swept into the room where I was giving a patient a bedbath. She looked extremely irritated and exclaimed: "You there! Bo! I have thrown Judy off the ward! Now come with me to give the Z-track injection that Judy didn't know how to perform!"

Doggedly, Marla, Cindy and myself plunged ever forward....but not without suffering war wounds which would never really heal. Each of us had been emotionally bloodied in various ways, and yet our battered psyches attempted in vain to apply temporary "band-aids" which allowed us to continue fighting onwards on our personal battlefields, helping us to duck and dodge the persistent enemy fire of terror, self-doubt, the fears of making a mistake, and the ever-present Catholic guilt which the nuns heaped in bushels upon our sacrificial heads.

And Cindy...

She had never been the same since the day she and I had fought our way through the protest line at the abortion clinic. The very life seemed to have been drained out of her and she was no longer the same person she had been before that horrific incident. The sweet merry spark had never returned to her eyes and she wandered through the last weeks of the program looking hollow-eyed, sad, and vaguely angry--- never again to act like the Cindy of old who could always come up with hilariously clever quips, play practical jokes on her buddies, and make mischevious mockery of the nuns behind their backs.

How I missed the old Cindy...

And Marla had turned into a tunnel-visioned studying demon, using every free minute to obsessively pore over her notes and textbooks, frightened to death that she would screw up her grade point average at the last minute. She looked a deathly shade of pale with pronounced dark circles under her eyes, and on more than one occasion I caught her crying in her room. She had lost weight and so I knew she wasn't eating well. I worried terribly about her.

And I, myself, was losing my own edge. I had gone beyond putting myself on autopilot---I was now the walking dead and was simply cautiously putting one foot forward after the other, hoping I wouldn't falter. I had lost weight myself and my uniform hung on me as if on a bag of bones.

Even my infamous sense of humor had vanished. Situations which used to crack me up didn't seem as funny to me anymore. And I found that I was actually listening to the stern lectures of the nuns without immediately thinking up insolent, sassy retorts in my mind.

At night, my prayers had degenerated from chummy conversations with God to desperate cries for help, like those of a mortally wounded foot soldier lying near death on a horror-filled battlefield....

Help me, Lord, please help me!

Where are you, Lord?!

I can't take it, Lord! I just can't take it anymore!

And just when I figured that it was too close to graduation for any more of the nuns' personal war room strategies of lobbing crippling cannonballs towards my head or planting deadly Bouncing Betty mines in my path, I discovered that I was sorely mistaken. For Shadyside nuns were a rare breed. They were possessed of seemingly mythical strength--- religious Amazons militarily swathed in nuns' habits--- who never surrendered nor retreated from any battle.

And what terrified me even further was that I knew they prayed to the SAME God that I prayed to....

One day during the last week of my Medical/Surgical rotation, I arrived at my assigned ward to begin my shift and found Sister Diana waiting for me at the nurses' station. I wondered why she was sitting there in public. Sister Diana was well known for skulking sneakily around the wards in the hopes of discovering some hapless nursing student doing something wrong, at which point she would pounce on the poor soul, pronouncing that they were the worst nursing student since before the Florence Nightingale era.

"Bo," she said simply.

"Yes, Sister?" I replied with a sigh, trying not to roll my eyes.

What the hell had I done now?

"I need to give you some information about one of your patients," she stated.

A feeling of dread began creeping into the back of my mind....

"I know that on this rotation you are supposed to be assigned only Medical/Surgical patients," she began. "But one of your patients today is.... well.... not only a Med/Surg patient.... but she's also a psychiatric patient."

Okay....

"I assigned this patient to you because you don't seem to panic easily," she remarked. "I gave her to you because this particular patient might prove to be.... somewhat difficult."

I said nothing and waited for her to go on. I was used to the traps the nuns routinely laid for us. And Sister Diana knew damn well that I panicked just as easily as the next student--- I just hid it better than the others behind a mask of sarcasm and defiance.

And so, once again, I grimly set my jaw in stubbornness against my nemesis, a brutal nun---because I wasn't about to let this woman get the best of me.

"She is in the hospital to get her diabetes under control," Sister Diana was saying. "But her psychiatric illness is somewhat acute right now, most likely due to the stress of being hospitalized."

Big deal, I was thinking to myself. I'd had my psychiatric rotation, during which I had experienced no major problems. I had performed well and made excellent grades during my stint in the psychiatric wards, thoroughly studying and familiarizing myself with all the various mental disorders, the meds which treated them, and the particular symptoms of each condition. I had even enjoyed good relationships with my assigned patients and found that I rather enjoyed the arena of psychiatric nursing although critical care was still my chosen favorite.

"Okay, Sister," I finally replied. "I'll do my best with her."

But Sister Diana wasn't finished warning me. "The patient is in an extremely delusional state despite her medications," she continued. "She experiences both visual and auditory hallucinations---in other words, she sees things and hears things that are not really there."

"Okay, so she's a schizophrenic or an extremely manic bipolar, right?" I asked.

"Paranoid schizophrenic," Sister replied. "Look, Bo, just remember to use the therapeutic techniques you were taught for dealing with delusional and hallucinatory patients during your psychiatric nursing rotation. The most important thing to remember is that whenever she shows signs of being out of touch with reality, you must gently, but firmly, re-orient her to reality. You remember how you were taught to do that, right?"

"Of course, Sister," I replied. "If she becomes delusional or experiences hallucinations I will re-orient her to reality. Yeah, I can do that, no big deal."

"Alright, then...." Sister said, a skeptical expression on her face. And then, just to make sure she'd warned me sufficiently, she repeated herself. "Just remember..... re-orient her to reality."

And with that she left the nurses' station, probably off to find herself a good hiding place from which she could jump out and frighten a heart attack into some unsuspecting nursing student.

Her doubtful attitude had bugged me. What was the big deal? I'd taken care of lots of schizophrenics on my psych rotation. And this one was going to be easy because she would simply lie in bed all day and all I would have to do would be to check her blood sugar regularly, give her the prescribed insulin, give her a bath, and change her bed linens.

Easy schmeesy.....

After I listened to "report" about my assigned patients from the night nurses who were going off shift, I gathered my notes, attached them to my clipboard, and set off to perform an assessment of my three assigned patients. There was a lady who was post-op after having her gallbladder taken out, a gentleman who'd undergone prostate surgery, and the diabetic schizophrenic, who I left for last.

When I finally entered the schizophrenic lady's room, I noticed that she looked perfectly normal and was lying in bed, docile and quiet.

"Good morning," I said. "I'm Bo, your student nurse for the day shift. How are you feeling today?"

She turned to look at me....and then suddenly screamed out, while pointing to the wall: "There's rats crawling up the wall over there! Can you get those rats off the wall?"

Just re-orient her to reality....

"Now, now," I said in what I hoped was a firm, but gently reassuring voice. I looked at where she was pointing and said: "I am looking at the wall and I see no rats there. But there is a nice picture of a beautiful lake scene. Now then, is it okay if I check your blood sugar?"

She allowed me to check her blood sugar and then inject her with the prescribed amount of insulin. A little bit later she allowed me to put clean linens on her bed after assisting her with a bed bath. She didn't have any more outbursts during that time and so I proceeded with the rest of my day's nursing tasks, confident that I had successfully re-oriented her to "reality". I was already writing my post-clinical notes in my head, hoping to get a high score for my successful use of "therapeutic technique" on a psych patient for whom I had also performed Med/Surg nursing tasks.

The shift wore on normally, and I was gratified that my other two patients did not exhibit any complications from their own illnesses. Things were going so smoothly that I was actually able to snatch a few extra minutes to gobble down a Velveeta Cheese sandwich I'd brought with me.

And then the schizophrenic patient's call bell lit up.

I hurried to her room and found her pacing frantically in front of the room's window. She kept looking out the window while shaking her head ominously. She was muttering unintelligible things to herself.

"Can I help you?" I asked.

"They're taking movies of me!" she screeched at the top of her lungs. She looked out the window again and shouted again. "They're taking movies of me! Why are they taking movies of me, Nurse? Why?"

I realized that her hallucinations had begun to worsen. She seemed to be having visual hallucinations that somebody was taking movies of her, which was triggering delusional thinking. She was definitely NOT in reality at this point.

Again, I calmly but firmly re-oriented her back to reality. I assured her that nobody was "taking movies of her". I gently led her back to her bed and implored her to lie down and rest. She laid down obediently, but kept muttering to herself, over and over, that "they're trying to take movies of me".

"And what if the devil sees me on TV??" she suddenly asked. "If he sees me on TV he'll probably kill me--- and then send me to hell!"

I remembered from my psychiatric rotation that religious preoccupation is a frequent theme of the delusions of psychotic patients...

"The devil is not going to kill you," I reassured her. "You are safe here in Shadyside Hospital. And nobody is taking movies of you. You are safe here."

And then I tried another tactic--that of "redirecting", which meant I would steer the conversation to another, reality-oriented topic in order to distract her from her current non-reality thoughts.

"You're having Salisbury Steak for lunch today," I offered. "And the lunch trays should be coming around in just a few minutes."

I pitied the poor thing, whose mind was telling her frightening things, things which were causing her severe agitation and emotional distress. I heartily wished that there was something more I could do to comfort her. So I decided to let the Charge Nurse know about it in case she felt the patient's doctor should be notified.

I hunted down the Charge Nurse and told her about it, and she agreed with me. She paged the patient's doctor.

When I took the patient her lunch tray she was again out of bed, pacing in front of the window again, beside herself with anxiety. I was unable to get her to concentrate on eating her lunch. And she continued to shake her head while muttering to herself.

"I'm trying to tell you, Nurse! They're taking movies of me!" she repeated. "They are making movies of me and I don't want to be in a movie! If I'm in a movie then the devil will see it and send me to hell!"

I put my arm gently around her and walked her back to her bed, murmuring comforting words while re-orienting her to reality at the same time. I was getting desperate to find a way to calm this poor woman.

"Don't worry, I won't let anybody take any movies of you," I again reassured her. "You're safe and sound here in the hospital. Why don't you let me help you eat your lunch? The Salisbury Steak looks so delicious---yummy!--- and there's mashed potatoes with gravy!"

She appeared to calm down for the moment and finally allowed me to help her eat the lunch. But I was very worried about her. And my heart went out to her for having to live with such a frightening mental condition in which evil and threatening hallucinations lurked in every corner---even causing her to fear for the safety of her very soul from the clutches of the devil.

She was living a horrifying existence of constant, exhaustive misery and terror, and I desperately wanted to provide the poor creature with some relief.

Finally, the Charge Nurse notified me that the doctor had ordered a sedative for the woman, and I walked over to the Pharmacy to retrieve it instead of waiting all afternoon for them to deliver it. When I returned to the patient to give her the med, she was lying in her bed but had an angry, accusatory look on her face.

"I thought you said you wouldn't let anybody take movies of me!" she exclaimed. "And yet they're STILL doing it!"

I again gently re-oriented her to reality and gave her the pill, hoping to high heaven that the medicine would enable her to calm down. And thankfully, about 45 minutes later, the pill did its work and the patient fell asleep. I was truly happy that she would finally get a few hours of respite from her disturbing delusions.

At the end of the shift, I gave my report to the oncoming nurse and then went to the nurses locker room to retrieve my sweater and school books. Marla was already there, and she and I gathered our things for the walk back to the nursing school building. We took the elevator down to the main floor of the hospital.

While riding the elevator we chatted about our day.

"How did your shift go?" I asked.

"Don't even ask," Marla replied. "All I did was clean poop all day. And that Sister Diana thinks she's so sneaky. But today I turned the tables on her. I knew she was lurking outside my patient's room and so I hid in the bathroom. And when she burst into the room to surprise me she was disappointed--- because she thought I wasn't there.... until I burst out of the bathroom and yelled 'Hiya Sister Diana!', which startled the hell out of her. She must have jumped three feet, heh!"

After we both chuckled over the sight of Marla frightening old Sister Diana out of her wits, Marla asked me about my day.

"Oh, I had a real doozy," I said. "I had a schizophrenic who was actively hallucinating. All day long she kept telling me that somebody was 'trying to take movies of her'. I finally had to get the doctor to order her a sedative."

The elevator reached the main floor and Marla and I exited. Then we walked towards the main entrance lobby of the hospital.

"Yeah," I continued. "It was an interesting delusion--- one I hadn't seen during our psych rotation. The poor thing totally believed with all her heart that somebody was making a movie of her. So I just kept re-orienting her to reality."

"Wow," Marla remarked. "And here you thought you were finished with your psych rotation."

We reached the main entrance of the hospital and pushed through the lobby's huge doors, still aimlessly chattering back and forth.

"Hey, did you hear that the mayor was brought to the hospital today?" Marla asked.

"No---for real?" I replied, surprised that I had not heard about something so important. "Is it something serious?"

"I don't know," she said. "But I heard that he was admitted to the 5th floor. One of my patients had his TV on and I kept seeing updates about it on the news all day long. Apparently he's been in here since early this morning."

As we left the hospital, we noticed a commotion to our left.

It was a local television channel's mobile-news truck. They had set up a temporary reporting station on the lawn in front of the hospital. And they had erected two huge TV cameras on high tripods--- and both cameras were aimed directly at the window of the mayor's hospital room.....

.... which just happened to be the room directly above my schizophrenic patient's window.

* * * * * * * * * * *

It was the week before graduation.

And all three of us, Marla, myself and Cindy, decided that we simply couldn't take the pressure any longer without some intervention to let off steam. And so that Friday night we invited all of our buddies to go out with us down to good ole Joe's Bar. We wanted to whoop it up one last time because we knew that it would be the last time we'd get the chance to have any fun like that before graduation.

After everybody finished up with either class or work on the wards, we left the school and trekked the four blocks to Joe's Bar, where we proceeded to play pool, feed quarters to the juke box, and drink wine until we were tipsy. I must have made that juke box play Don Johnson's song, "Heartbeat", 15 times. And I won every pool game I played, even when I played against one of the burly workers from the auto repair shop next door.

We three girls took umpteen camera pictures of ourselves and our friends playing pool, doing shots of tequila, hugging good-looking men, and other tomfoolery. And we had one of the bartenders take a group photograph of just the three of us best friends....

I still have that photograph of me, Marla, and Cindy sitting brazenly upon a pool table, hugging each other... big happy grins on our shining faces....

We barely made it back to the nursing dorm by curfew and the Housemother angrily shooed us up the elevator to our perspective dorms while scowling at our obvious drunkenness. But we didn't care--nothing could have stopped us from having our "last hurrah" before graduation.

But Marla and Cindy and I didn't want to go to bed just yet. We still felt chatty and wanted to hang out together a little while longer. So we turned on the TV in the lounge room and stayed up talking and laughing until the wee hours of the night. In fact, we stayed up so late that eventually all three of us fell asleep in there--- Marla on the couch, Cindy in a dilapidated arm chair, and me on the floor in front of the TV.

I woke up early the next morning with a mean hangover, my body sore and aching from having slept all night on the hard floor. I chuckled to myself when I noticed that I'd slept all night with my room key clutched in my hand. I knew that I had probably intended to go to my room at some point but had been so drunk that I'd fallen asleep first.

Wearily, I got up, turned off the TV, and went to my dorm room, leaving Marla and Cindy to snore it out, both still asleep on the couch and the armchair. I smiled at their sleeping forms, planning how I would mercilessly tease them about their loud snoring.

The previous night's fun at Joe's Bar would become one of those magical, treasured memories forever sealed into my brain's jewel box--- a shining, precious gem which could be retrieved nostalgically whenever I thought of my good friends....

I loved my two best friends with all my heart, and I knew that there would never again be a time like this in our lives. I was realizing more and more, as graduation loomed, that we would all grow up and go our separate ways, each into our separate nursing careers---and that I would eventually lose Marla and Cindy since we all came from three different states in the country.

And this fact saddened me terribly.

Once in my room, I went to bed and slept off my hangover. I rose late in the afternoon. I had promised Marla that we would walk to the grocery store together to refill our stock of snacks like Cokes, potato chips, Swanson's Pot Pies, and our favorite---Kraft Macaroni & Cheese.

After I finished dressing and combed my hair I was ready to go. I reach over to my dresser to grab my pocketbook.....

And it wasn't there.

Where was my pocketbook? I always kept it on my dresser...

I began searching for the pocketbook, getting more and more anxious by the minute when I couldn't find it. Panic began to set in and I practically tore up my entire dorm room in my frantic search.

Where could it be? Why wasn't it where it was supposed to be?

And then the ugly truth made itself clear in my brain.... and I felt a level of anger that I had never felt before in my entire life. There was no other answer but that my pocketbook had been stolen...

And I knew that it had been stolen by the dorm thief!

I had been hearing tales of the "dorm thief" for months---- tales about disappearing pocketbooks, wallets, jewelry, and money. But I had never given it much thought.

Until now.

And what was worse, everybody in the dorm who whispered about the "dorm thief" had declared their suspicions that one person, and one person only, was responsible for the thefts--- since that person had frequently been seen entering other students' rooms without permission, claiming that she was "looking for somebody", after which a student's money or jewelry would turn up missing. And there had been other occasions when her behavior had been suspicious surrounding the circumstances of missing items--- so suspicious in fact that it was almost common knowledge that this particular person, despite her vehement denials, was believed to be the dorm thief.

Pammie.

Slowly, trying in vain to control my growing rage, I stomped down to Marla's room where I found her getting ready for our shopping trip.

"What's wrong with you?" she asked, puzzled at the enraged expression on my reddening face.

"My pocketbook is missing," I stated. "It's gone.... I can't find it anywhere."

"Maybe you left it at Joe's Bar," she replied logically.

Just then, Cindy walked in.

"Hey, what are you guys doing?" Cindy asked cheerfully, still in a good mood from the fun we'd had the night before.

"No, I couldn't have left it at Joe's Bar," I was saying to Marla with a meaningful look. "And that is because I didn't take it to Joe's Bar. I had put a few dollars into my back pocket for the evening and left my pocketbook back in my room, which was locked. There was $250 cash in my pocketbook, including a check from my parents--- and now it's gone!"

Suddenly, as she realized what we were talking about, Cindy's eyes widened and her mood changed from cheerful to angry.

"Your pocketbook is missing?" she asked furiously. "I bet I know who took it! It was the damn dorm thief, that's who! And everybody knows that it's Pammie!"

"But if you locked your room, how could anybody get in there to steal your pocketbook?" Marla asked, rightfully puzzled.

As we all three paused for a minute, trying to think, the answer came to me suddenly, in a blinding flash. And it was at that moment when things changed forever between our trio.... and they would never be the same again...

"I know EXACTLY how it was done, you guys...." I said in a whisper, hardly able to believe the degree of criminal sneakiness which I knew would have been required to accomplish such an evil deed. And then, to the astonishment of Marla and Cindy, I told them exactly how I believed the daring theft had been done.

"Remember how we all fell asleep last night in the lounge? And I was on the floor in front of the TV?" I began. "Well I woke up with my room key in my hand. I must have started to go to my room but was so drunk that I fell asleep before doing so---- and so I ended up falling asleep on the floor with my room key still in my hand."

I let that set into their minds for a minute and then I continued.

"I slept on the floor all night with the key in my hand... get it?"

They both stared at me as wide-eyed as gigged frogs, still not comprehending. And so I clarified the details for them.

"The thief found us all sleeping in there," I said patiently. "And they saw me sleeping with my room key in my hand, drunk as a skunk. So the person slipped the key out of my hand, used it to open my room and steal my pocketbook--- and then put the damn key back into my hand!"

Both of them stared mutely at me, still unable to come to terms with such a dastardly scheme---and yet they both knew that I always locked my room. And they both knew me well enough to know that I wouldn't make such a wild accusation lightly.

And they also both knew that a dorm thief had, indeed, been stealing things from students on a regular basis for months.

"Bo..." Marla warned, seeing something in my face which frightened her. "Don't do whatever it is that you're thinking of.... just calm down....please, just calm down...."

Oh, Marla knew me so well....

"You guys know damn well it was Pammie!" Cindy declared. "She's the damn dorm thief and everybody knows it! And I know for a fact that she stole my gold necklace. I was friends with her at the beginning of the year and she used to hang out in my room all the time. But then one day my gold necklace--- the one my grandmother gave me--- disappeared--- and I've always known that it was Pammie who stole it!"

"Don't do it, Bo!" Marla screamed, but I had already fled the room. And she knew where I was headed.

Her screams had absolutely no effect on me....

I sprinted down the hall towards Pammie's room, Cindy in hot pursuit, Marla's screams echoing down the hall behind us--- startling all the other students on the 4th floor dorm. But I was no longer myself---I was an unrecognizable angry fiend on a mission. And I was damn well going to accomplish that mission for myself and all the other victims of the dorm thief.

When I reached Pammie's door, my brain was so clouded with righteous rage that I was barely aware of what was going on around me---but I could heard Marla's screaming, faintly, in the background, echoing the same phrase over and over again...

"Don't do it, Bo!"

But I did do it.

I violently kicked Pammie's door in.

The door burst open, slamming against the wall with a horrendous cracking sound--- and both Cindy and I swept into Pammie's room like madwomen. Luckily for Pammie she wasn't there, because both Cindy and I began wildly ransacking her room, brutally searching through every nook and cranny, tossing Pammie's things hither and yon in our quest--- me searching for my pocketbook and Cindy for her gold necklace.

I was vaguely aware that Marla was standing at Pammie's doorway, frozen in shock at what Cindy and I were doing. Because the two of us were so insanely angry that we had lost all reason or self-control. Purely for spite, I swept all of Pammie's cosmetics off her sink cabinet shelves. And I saw Cindy knock over all of the photograph frames which Pammie had placed on the top of her dresser.

No location was spared in our frenzy as we turned out the contents of Pammie's desk and dresser drawers onto the floor. Then we forcefully swept every single one of the books off the bookshelf to look behind them. Together we ripped all the bed linens off the bed and tossed them into a heap on the floor. And then, while Cindy began probing Pammie's footlocker, I turned my attention to the closet and began tearing out all of Pammie's clothing off the cross pole while simultaneously burrowing into the stack of shoe boxes on the closet's floor.....

Which is where I found it.

I suddenly spied my pocketbook on the closet floor, hidden behind a stack of shoe boxes. Gasping in surprise, I triumphantly snatched the bag up and looked inside. The $250 cash was missing but the check from my parents was still there.

Because she wouldn't have been able to cash the check.....

As I turned to tell Cindy I'd found my pocketbook, I noticed Cindy had found Pammie's jewelry box in the footlocker.

"Look, Cindy!" I exclaimed triumphantly. "I found my pocketbook! My cash is gone but the check is still here."

I turned to show Marla, who was still standing stockstill in the doorway, aghast at the scene before her, unable to speak.

"But I haven't found my gold necklace," Cindy said. "She probably pawned it for cash. But Pammie's got a nice 14k gold bracelet here---and I'm going to take it. That'll show the bitch how it feels to have somebody steal your jewelry!"

And then suddenly I came to my senses.

"No, Cindy!" I cried. "You can't do that! Two wrongs don't make a right! You can't steal her bracelet because then you would be no better than she."

"Too bad, so sad," Cindy mocked in a sing-song voice, pocketing the bracelet. "I'm taking it."

Finally Marla found her voice.

"No, Cindy....you're not taking that bracelet!" she hollered hoarsely, starting to cry as she surveyed the mess that Cindy and I had made. "You know damn well that you can't do that! Put it back!"

But Cindy had an ugly look in her eyes. And then, she suddenly ran out of the room, yelling to nobody in particular something about "an eye for an eye". We heard her entering her own room and slamming its door shut, leaving Marla and me standing on the threshold of Pammie's trashed room, me holding my pocketbook and Marla leaning against the door jam, her shoulders heaving as she sobbed and weeped.

Help me, oh Lord!

I'm out of control! What shall I do, Lord?

Marla and I noticed that there were a number of other students standing in the hallway, silent witnesses to the terrible thing which had just happened. Not one of them uttered a word, but their shocked expressions spoke volumes.

"Oh my God!" Marla exclaimed, crying hard. "This is terrible! What in the hell are we gonna do?"

I thought for a minute....and then I knew what I had to do next.

"Go back to your room, Marla," I told her, patting her gently on the shoulder. I was suddenly more calm than I had been in a long time. "It's going to be alright, do you hear me? Just go back to your room, honey, and I'll deal with this shit....."

She did as I instructed, walking slowly but crying all the way until she reached her room and closed the door behind her. And then, pocketbook in hand, I walked past the mute gauntlet of stricken students to the elevator and took it down to the housemother's desk.

* * * * * * * * * * *

After I told the wide-eyed housemother everything, she closed her eyes for a few minutes, probably trying to gather the strength for what she knew must be done next.... and then, wordlessly, she led me to Mother Superior's office. Mother Superior was not there so I stood alone, in silence, nervously shuffling my feet, waiting for the certain doom that I knew was coming my way. And not long after that, Cindy arrived, flanked on either side by Mother Superior and Sister Kathleen.

Mother Superior calmly entered the room and sat down at her desk--- and then tersely instructed us two girls to sit down and "explain ourselves".

Cindy refused to speak and sat quietly defiant in her chair, staring at the floor. So I spoke first. I confessed everything down to the last horrid detail. I related the entire tale of falling asleep on the lounge room's floor with my room key in my hand, the discovery that my pocket book was missing, and that I had come to the conclusion that the only way a thief could have entered my room was with my own room key, since I always kept my room locked.

And then I related the fact that everybody in the dorm considered Pammie the "dorm thief" due to her suspicious behaviors and close connections to situations surrounding missing objects and money.

I paused.... wanting desperately for Cindy to pipe in and tell her end of things, sparing me from Mother Superior's steel-eyed gaze. But Cindy was still refusing to speak--- and was still staring at the floor, refusing to meet anybody's eyes.

So I took a deep breath to gather some courage for the next part of the story....

And then I confessed that I had kicked Pammie's door in--- and that Cindy and I had ransacked Pammie's room. I related how I had subsequently found my pocketbook and, although my parents' check was still inside it, the $250 cash was missing.

And then, since Cindy was still refusing to speak, I said it.....

I said the one thing which would forever divide a trio of friends--- and also the entire student body of the nursing school.

"Mother Superior," I began, avoiding Cindy's gaze, which I noticed was now leveled at me, a fire burning in her eyes. "Cindy was understandably upset because she thinks Pammie stole her gold necklace---but she couldn't find it when we searched Pammie's room. And... well.... Cindy took Pammie's gold bracelet in revenge. And I don't think that she should have done that."

Mother Superior sat, not speaking, for what seemed like an eternity. Her face betrayed no particular emotion. But her eyes were lifted somewhat upwards....almost as if she were attempting to find an answer from the heavens.....

Finally, after taking a deep breath, she turned her eyes back down to us two girls.

First, she turned to Cindy. And she had a gentle look on her face---an understanding look.

"Cindy?" Mother Superior asked, holding out her hand, palm upturned.

And slowly, because she knew it was inevitable, Cindy retrieved the stolen bracelet out of her pocket and placed it into Mother Superior's hand.

"I understand that you are upset," Mother Superior told her. "But we must remember the words Our Lord God told Moses on Mt. Sinai: 'Thou Shalt Not Steal'. And Bo's right---two rights don't make a wrong. So I am going to return the bracelet to Pammie."

She paused, and then added one more thing.

"And nothing more will be said of this matter."

Then Mother Superior turned to me. I was quaking in my seat, wondering what punishment I would suffer for my own violence on Pammie's room. I was frightened, but I couldn't help wanting to get a word in for my own defense before she laid down the law. For some reason my usual insolence had resurfaced, and so I piped up and spoke my piece...

"In Matthew 10:34 Jesus said 'I come not to bring peace, but to bring a sword....", I told Mother Superior, my quavering voice belying the bravado I was trying to portray--- and having no earthly idea why I chose that particular Biblical quote to throw at her.

"Bo," she said simply, sighing heavily. "Your life will not be an easy one if you do not tame your temper. I truly worry about you. And so I want you to pray long and hard about it tonight, on your knees, in the hospital's chapel."

She let that settle in my thoughts for a minute before she spoke again. And then she asked me a question which surprised me.

"What are you going to do about the $250 cash which was stolen?"

"I'm going to do the same thing anybody else would do about a theft," I replied evenly. "I'm going to notify the police."

Out of the corner of my eye I thought I saw Sister Kathleen nodding her head in the affirmative, but I couldn't be sure.

* * * * * * * * * *

Later that day I did report the theft to police. But soon after, Pammie's mother called and tearfully pleaded with me to drop the charges so that the incident would not interfere with Pammie's graduation, which was now only a few days away. She promised to return my $250 cash if I would drop the charges against Pammie.

In the end, I did as she asked.

But the entire incident proved to be a divisive force in the dorms, turning student against student, depending upon their opinion of mine and Cindy's actions.

Half of the students felt that I had "tattled" on Cindy for taking Pammie's bracelet, an unforgivable sin in the dorms. Even though Cindy had not gotten punished for it, they still considered me as having "snitched" to Mother Superior. And moreover, they believed that Cindy should have been allowed to keep the bracelet out of pure revenge.

But the other half of the students were on my side. They believed strongly, as I did, that two wrongs don't make a right. They believed in truth and justice---and that stealing for any reason is purely wrong. And, thus, they believed that I had done the right and honorable thing by telling Mother Superior the entire truth, no matter the consequences.

But oh, how heavy were the consequences.....

Because Cindy never spoke to me again...

And now a bitter pall was hanging over the looming graduation festivities. The atmosphere in the dorm was gloomy and sad, the joy over graduation snuffed out like the dying flame of a melted candle.

And so I was surprised as hell one day when I heard that Donna, the President of the Senior Class, was looking for me. It was very unusual because Donna, one of the most popular students in the school, had always made it very plain that she heartily disliked me for being what she considered an "irreverent, undisciplined, rebellious misfit" who didn't belong in an honorable program like Shadyside.

She probably hadn't spoken to me in nearly a year but yet here she was, searching me out. She finally found me in the dorm lounge, sharing a bag of stick pretzels with Marla as we watched television.

"Bo," Donna said.

What now?.....

"What are you doing on the fourth floor, Donna?" I asked rudely, trying to appear uninterested. "Don't you usually hang out with all the other goodie-goodies on the third floor?"

Donna ignored my sarcasm, simply rolling her eyes. "I wanted to tell you something," she stated. "I wanted to tell you that I think.... I think you did the right thing about that whole stealing issue."

I almost choked on one of my pretzel sticks. And I could see Marla's eyes widen in surprise.

And then Donna continued. "You know, Bo, I'm sure you know that I've never thought very much of you. But I'm going to admit here that I am proud of you for telling the truth about what happened, even though I understand that doing so cost you dearly--- in fact, I understand that it cost you one of your very best friends."

"You're right about that," I murmured, my eyes threatening to well up with tears. "It surely did cost me...."

"Well, anyway," Donna said, looking uncomfortable. "What we should all do now is to turn our attention towards our graduation." And with that she left.

Neither Marla nor I said anything. We both simply sat there, staring stupidly at the TV in silence, our thoughts not on the TV program at all but on another sad detail, a detail which Donna had not mentioned. Marla and I realized that Donna did not know the full extent of the consequences of my actions. They had not only cost me one of my best friends---but they had cost Marla, too. Because Cindy considered Marla's continued loyalty to me as a betrayal.

And thus, Cindy also never spoke to Marla again....

* * * * * * * * * * * *

And then... it was Graduation Day.

Arthur William Edgar O'Shaughnessy once said: "For each age is a dream that is dying, or one that is coming to birth".

And that seemed to be what was happening to those of us who had survived the brutal two years at Shadyside. Each of us, in our own way, was trying to come to terms with the fact that our long ordeal was finally over--- and also the fact that we needed to shake off the trauma of the past and look, with hope, towards a bright future.

We were going to graduate!

The graduation ceremony was going to be held in a nearby Catholic church, presided over by certain revered members of the Board of Directors of the Foundation of Shadyside Hospital. It was an event which we all nervously feared but yet looked forward to as the final stamp of proof that we had actually done it---that we'd finally achieved our goal of becoming "real nurses" at one of the finest nursing schools in the nation.

And so, on that wondrous day, we all carefully dressed ourselves in our best starched white uniform dresses and white nurses' caps. All that was missing on our attire was the pin....that coveted golden school pin which only a graduate of the Shadyside Hospital School of Nursing could wear.

And we had dreamed of wearing that pin for such a long, long time...

The entire staff of the nursing school, both nuns and non-religious staff, would be in attendance at the graduation ceremony, as well as the students' parents and friends. Even my own parents had returned to America from Brazil and had arrived in town for the occasion.

Once we had all been transported to the church, I found my parents out on the neatly trimmed lawn in front of the lovely, Gothic church. Since they had been stationed overseas for such a long time, I hadn't seen them in years--- and I was thankful to God that they were able to make it to this very important occasion in my life. And not only had they returned to America, but they planned on retiring to Texas after working a few more months in Washington, D.C. And I would be going with them, as I would be applying to the the Critical Care Internship at Baylor University Medical Center in Dallas. My father was a Baylor alumni and was proud that I'd chosen that particular hospital to further my nurse's training.

After a little while, in which everybody excitedly introduced each other to their parents, it was suddenly time for the students to line up for the ceremony......

* * * * * * * *

The ceremony was held inside the church's breathtakingly beautiful sanctuary.

The graduates sat in the two front pews on the left side of the center aisle, and the nursing school staff (and the nuns) sat on the right. The parents and friends of the graduates sat behind, on both sides of the center aisle. There were hundreds of people and every pew was filled tightly. It was standing room only in the back.

The presiding members of the Board of Directors stood on the main alter, directly in front of the Cross of the Crucifixion, under a huge, umbrella-like ceiling fresco painted with a glorious, shining scene of guilded angels and Jesus Christ ascending to Heaven.

And then, after the prayer and preliminary speeches, the pinning part of the ceremony began. One by one, each graduate was called to come up to the alter, whereby the Chairman of the Board would congratulate her, give her the graduation certificate, and then attach the golden pin she had earned to her dress lapel. And then the next student would be called.

It was an extremely solemn, dignified, and almost silent ceremony. The only sounds which could be heard were that of the quietly murmured congratulations of the Board members to each graduate as she accepted her certificate and pin.

When my name was finally called, I nervously slid my way out of the pew to the center aisle and then nervously stumbled my way up to the alter platform, terrified that I would trip and fall flat on my face.

And then, all of a sudden, an unexpected loud round of applause began!--- accompanied by loud whistlings, foot-stomping, and cheering!

What the hell?

The Chairman of the Board, who had been about to hand me my certificate and pin, stopped short for a moment, surprised by the loud, lengthy applause and noisy cheering.

"Wow," he remarked. "You must be a popular student...."

And then he attached my pin to my lapel.

I fairly floated back to my seat, almost beside myself with excitement.

Because I had done it. It wasn't a dream any longer---it was a reality.

I finally wore the Shadyside school pin.

And I knew something that the Chairman of the Board didn't know. The applause hadn't been because I was such a "popular" student. It was because so many people were relieved and proud that a "rebellious, undisciplined, and irreverent misfit" like me had successfully made it through the bitterly difficult, brutal program at Shadyside.

And there was one more thing......

I had been notified by Sister Kathleen that morning that I had, indeed, graduated at the top of my class.

* * * * * * * * *

The next morning I finished packing and loading all my belongings into my car. My parents had given me the directions on how to drive to their home in Washington, D.C., where we would live for a couple of months before making the trek to Texas, where they had bought a large, Victorian home for their retirement--- and then I would head for Dallas.

When I had said all my goodbyes, I returned to my room to make sure that I hadn't forgotten anything. And then I paused for one last moment of reflection. As I stared around the now-empty space and reflected on the totality of my experiences of the last two years, memories, both good and bad, flooded my brain--- and I realized that I had just gone through an experience which had changed me forever.

I had never worked so hard for a goal in my entire life. I had never wanted anything so much in my entire life.

And I had made so very many mistakes---horrible mistakes which had brought down terrible consequences upon my very young soul. I had made emotional blood sacrifices for which the wounds would never really heal. I had been victimized--- and I had loved and lost---and I would always wonder why...

I had fought battles which had left me bitter and broken--- and yet a better person for it--- but I would never understand how it had happened or when....

Finally, the painful memories were just too much to bear.... and so I walked out of the room, down the hall, and took the elevator down to the housemother's desk. She was busy with a First Year student, helping the girl to figure out how to sign up for extra cash by working for the nursing school's babysitting service.

I turned and slowly descended the lobby's beautiful grand staircase to the ground floor and exited through the main doors of the nursing school.

I got into my beautiful red Camaro, the one Mother Superior had saved from the repo-man......

And I drove away.

* * * * * * * * * * * * * *

Prologue:

I did get accepted into the Baylor University Medical Center's Critical Care Internship, where I began my training for a career working in ICU's and Emergency Rooms. Although I would work in other nursing arenas during my nursing career, ICU's and ER's would always be the places to which I would return, over and over.

Marla went to work for a children's hospital as she had planned. And she was my Maid of Honor at my first wedding.

Cindy never spoke to either of us again and thus we don't know what happened to her.

We heard Pammie went to work in a hospital in Washington, D.C.

Shadyside Hospital School of Nursing was eventually closed when Shadyside Hospital was absorbed into the UPMC system.

And, actually.....

No Catholic "diploma" hospital programs are in existence in the United States anymore. Such hospital-based schools were the old-fashioned way of training nurses, a system which eventually became too costly and unnecessary in light of the proliferation of nursing programs in community colleges and universities.

But there are some of us around who still remember.....

*

*

I was feeling part of the scenery,
I walked right out of the machinery,
My heart is going boom boom boom,
"Hey" he said "Grab your things,
I've come to take you home....
("Solsbury Hill", Peter Gabriel)

*

*