WEBVTT 1 00:00:00.685 --> 00:00:01.685 Hello 2 00:00:03.980 --> 00:00:04.789 and welcome to the latest 3 00:00:04.790 --> 00:00:05.929 installment of the University of 4 00:00:05.930 --> 00:00:07.579 Pittsburgh Humanities podcast, a 5 00:00:07.580 --> 00:00:08.839 series devoted to exploring the 6 00:00:08.840 --> 00:00:10.789 humanities, their intersections with 7 00:00:10.790 --> 00:00:12.169 other disciplines, and their value 8 00:00:12.170 --> 00:00:13.189 in the public world. 9 00:00:13.190 --> 00:00:14.719 I'm Dan Kubis, assistant director of 10 00:00:14.720 --> 00:00:15.800 the Humanities Center at Pitt. 11 00:00:19.130 --> 00:00:20.809 My guest today is Theresa Brown, 12 00:00:20.810 --> 00:00:22.759 nurse, columnist, and author of 13 00:00:22.760 --> 00:00:24.589 The Shift: One Nurse, Twelve 14 00:00:24.590 --> 00:00:26.569 Hours, Four Patients' Lives. 15 00:00:26.570 --> 00:00:28.309 Even if all I do is go in and flush 16 00:00:28.310 --> 00:00:30.349 an I.V. line, I try to always just 17 00:00:30.350 --> 00:00:32.029 reach down and just touch their hand 18 00:00:32.030 --> 00:00:34.249 when I'm done because it's also 19 00:00:34.250 --> 00:00:36.289 a way of saying, "I see 20 00:00:36.290 --> 00:00:37.099 you. 21 00:00:37.100 --> 00:00:39.079 You're not just a task, but 22 00:00:39.080 --> 00:00:40.669 you're a person." And that's 23 00:00:40.670 --> 00:00:42.799 probably the connection that nurses 24 00:00:42.800 --> 00:00:45.349 need to make, which is 25 00:00:45.350 --> 00:00:46.849 different from physicians but 26 00:00:46.850 --> 00:00:48.529 equally as important. 27 00:00:48.530 --> 00:00:49.879 Theresa began her career as a writer 28 00:00:49.880 --> 00:00:51.619 in 2008 when she published an essay 29 00:00:51.620 --> 00:00:52.759 in the New York Times about a 30 00:00:52.760 --> 00:00:54.169 dramatic and emotional experience 31 00:00:54.170 --> 00:00:56.089 she had with a dying patient. 32 00:00:56.090 --> 00:00:57.139 The piece received national 33 00:00:57.140 --> 00:00:58.879 attention and was anthologized in 34 00:00:58.880 --> 00:01:00.229 the Best American Science Writing 35 00:01:00.230 --> 00:01:01.309 and the Best American Medical 36 00:01:01.310 --> 00:01:03.289 Writing in 2009. 37 00:01:03.290 --> 00:01:04.549 Since then, she has written dozens 38 00:01:04.550 --> 00:01:05.899 of pieces about nursing and has 39 00:01:05.900 --> 00:01:07.339 become a leading voice for nurses 40 00:01:07.340 --> 00:01:08.629 and nurse advocacy across the 41 00:01:08.630 --> 00:01:09.679 country. 42 00:01:09.680 --> 00:01:11.119 Her first book, Critical Care, was 43 00:01:11.120 --> 00:01:13.309 published in 2010 and is widely 44 00:01:13.310 --> 00:01:14.659 used as a textbook in nursing 45 00:01:14.660 --> 00:01:15.660 schools. 46 00:01:16.250 --> 00:01:17.629 Theresa's writing frequently pulls 47 00:01:17.630 --> 00:01:19.069 back the curtain on the experiences 48 00:01:19.070 --> 00:01:20.509 and challenges that nurses face in 49 00:01:20.510 --> 00:01:22.009 their daily work. 50 00:01:22.010 --> 00:01:23.509 Sometimes this reveals frustrating 51 00:01:23.510 --> 00:01:24.949 working conditions or difficulties 52 00:01:24.950 --> 00:01:25.789 dealing with hospital 53 00:01:25.790 --> 00:01:27.559 administration. But just as 54 00:01:27.560 --> 00:01:29.149 frequently, it shows the strength, 55 00:01:29.150 --> 00:01:30.529 skill, and commitment that nurses 56 00:01:30.530 --> 00:01:31.879 need to provide their patients with 57 00:01:31.880 --> 00:01:33.619 the best care they can. 58 00:01:33.620 --> 00:01:34.939 So it's no surprise that President 59 00:01:34.940 --> 00:01:36.619 Obama quoted from Theresa's blog 60 00:01:36.620 --> 00:01:37.729 when he was advocating for the 61 00:01:37.730 --> 00:01:38.793 Affordable Care Act in 2009. 62 00:01:38.794 --> 00:01:39.794 In 63 00:01:40.670 --> 00:01:41.809 what she calls her past life, 64 00:01:41.810 --> 00:01:42.979 Theresa received a Ph.D. 65 00:01:42.980 --> 00:01:44.059 in English from the University of 66 00:01:44.060 --> 00:01:45.619 Chicago and was an English professor 67 00:01:45.620 --> 00:01:47.389 at Tufts University. 68 00:01:47.390 --> 00:01:48.829 I began by asking her about this 69 00:01:48.830 --> 00:01:50.329 past and about the somewhat 70 00:01:50.330 --> 00:01:51.799 nontraditional path she took to 71 00:01:51.800 --> 00:01:52.800 becoming a nurse. 72 00:01:56.040 --> 00:01:57.869 As I've said many times before, this 73 00:01:57.870 --> 00:01:59.399 is the million-dollar question. 74 00:01:59.400 --> 00:02:00.574 Why would an English professor 75 00:02:00.575 --> 00:02:03.449 become a nurse? 76 00:02:03.450 --> 00:02:05.069 And there are a lot of people who 77 00:02:05.070 --> 00:02:06.899 thought I was nuts. So I think 78 00:02:06.900 --> 00:02:08.319 I've convinced some I'm not. 79 00:02:08.320 --> 00:02:10.288 But essentially, 80 00:02:10.289 --> 00:02:12.029 my dad was a professor, and growing 81 00:02:12.030 --> 00:02:13.259 up it just seemed like a really 82 00:02:13.260 --> 00:02:14.069 great job. 83 00:02:14.070 --> 00:02:15.749 You could get paid to be in this 84 00:02:15.750 --> 00:02:17.399 world of ideas and books. 85 00:02:17.400 --> 00:02:18.744 And I loved that. 86 00:02:18.745 --> 00:02:19.679 I got my Ph.D. 87 00:02:19.680 --> 00:02:21.419 in English. I was teaching at Tufts, 88 00:02:21.420 --> 00:02:24.029 and I found out that the job itself 89 00:02:24.030 --> 00:02:26.879 for me was not the ideal. 90 00:02:26.880 --> 00:02:28.139 I liked it. I think I was good 91 00:02:28.140 --> 00:02:29.639 enough at it, but it just didn't 92 00:02:29.640 --> 00:02:30.719 quite do it for me. 93 00:02:30.720 --> 00:02:32.579 So it's kind of like, oh, now, 94 00:02:32.580 --> 00:02:33.749 what am I going to be when I grow 95 00:02:33.750 --> 00:02:35.579 up? And then, I became 96 00:02:35.580 --> 00:02:38.039 a mom in the middle of that and 97 00:02:38.040 --> 00:02:39.449 had our son, and then got pregnant 98 00:02:39.450 --> 00:02:40.979 with twins. 99 00:02:40.980 --> 00:02:43.049 And that just caused 100 00:02:43.050 --> 00:02:45.839 a huge life change 101 00:02:45.840 --> 00:02:47.489 and in hard ways because of the lack 102 00:02:47.490 --> 00:02:49.439 of sleep and all the laundry, 103 00:02:49.440 --> 00:02:51.479 but in really great ways, like 104 00:02:51.480 --> 00:02:53.049 all the love and the fun. 105 00:02:53.050 --> 00:02:55.079 And then I thought, "Oh, well, 106 00:02:55.080 --> 00:02:57.209 this is the kind of job I want to 107 00:02:57.210 --> 00:03:00.089 do, but what kind of job is that?" 108 00:03:00.090 --> 00:03:02.039 And I had midwives 109 00:03:02.040 --> 00:03:03.479 for that pregnancy, and I was 110 00:03:03.480 --> 00:03:04.709 telling a friend of mine who's a 111 00:03:04.710 --> 00:03:05.969 nurse, "Well, I just thought the 112 00:03:05.970 --> 00:03:07.589 midwives had the coolest job in the 113 00:03:07.590 --> 00:03:09.659 world." And she said, "Theresa, 114 00:03:09.660 --> 00:03:11.519 you could do that job." 115 00:03:11.520 --> 00:03:13.529 And it had never occurred to me 116 00:03:13.530 --> 00:03:16.469 that I could become a nurse. 117 00:03:16.470 --> 00:03:18.007 But then I did it. 118 00:03:19.830 --> 00:03:21.659 Well, I want to also ask 119 00:03:21.660 --> 00:03:23.219 you, then, about your description in 120 00:03:23.220 --> 00:03:24.449 the beginning of your first book, 121 00:03:24.450 --> 00:03:25.450 Critical Care. You 122 00:03:26.520 --> 00:03:28.379 made your change from being 123 00:03:28.380 --> 00:03:29.279 an English professor to being a 124 00:03:29.280 --> 00:03:31.199 nurse, and it felt right 125 00:03:31.200 --> 00:03:32.789 to you. But it took a while for 126 00:03:32.790 --> 00:03:34.409 there to be a kind of crystallized 127 00:03:34.410 --> 00:03:36.209 moment where you realized why it 128 00:03:36.210 --> 00:03:37.529 felt right. And you talk about an 129 00:03:37.530 --> 00:03:38.849 experience you have with an 11 year 130 00:03:38.850 --> 00:03:40.709 old boy as being a moment where 131 00:03:40.710 --> 00:03:42.599 you did have that realization and 132 00:03:42.600 --> 00:03:44.069 talking with him at night about the 133 00:03:44.070 --> 00:03:45.239 condition that he was in. 134 00:03:45.240 --> 00:03:46.469 Can you talk a little bit about that 135 00:03:46.470 --> 00:03:48.239 moment and what it was in particular 136 00:03:48.240 --> 00:03:49.859 about that that caused that 137 00:03:49.860 --> 00:03:50.699 realization for you? 138 00:03:50.700 --> 00:03:52.739 Well, it was my last night 139 00:03:52.740 --> 00:03:54.929 of clinical as a student. 140 00:03:54.930 --> 00:03:57.569 So really the end of my 141 00:03:57.570 --> 00:03:59.399 journey as a student nurse. 142 00:03:59.400 --> 00:04:01.379 And I was 143 00:04:01.380 --> 00:04:02.999 not working on an oncology floor, 144 00:04:03.000 --> 00:04:04.111 but he was an oncology patient. 145 00:04:04.112 --> 00:04:06.329 Came in with his dad, 146 00:04:06.330 --> 00:04:07.979 and they'd been there a lot and were 147 00:04:07.980 --> 00:04:10.379 obviously trying to make it fun 148 00:04:10.380 --> 00:04:12.239 by eating a big bag of potato chips 149 00:04:12.240 --> 00:04:14.009 and watching TV. 150 00:04:14.010 --> 00:04:16.289 But it's not 151 00:04:16.290 --> 00:04:17.398 really fun. 152 00:04:17.399 --> 00:04:18.587 I mean, I admired the effort. 153 00:04:18.588 --> 00:04:19.979 And then, in the middle of the 154 00:04:19.980 --> 00:04:22.169 night, he just started to feel 155 00:04:22.170 --> 00:04:24.869 really terrible 156 00:04:24.870 --> 00:04:26.939 and most 157 00:04:26.940 --> 00:04:28.889 likely was septic 158 00:04:28.890 --> 00:04:30.989 and really low blood pressure. 159 00:04:30.990 --> 00:04:31.990 And I ended up-- 160 00:04:33.120 --> 00:04:34.529 the nurse I was working with, we 161 00:04:34.530 --> 00:04:36.389 ended up having to send 162 00:04:36.390 --> 00:04:38.309 him to the pediatric intensive care 163 00:04:38.310 --> 00:04:40.859 unit, and his dad 164 00:04:40.860 --> 00:04:42.869 slept through a lot of it, which 165 00:04:42.870 --> 00:04:44.969 at the time was kind of shocking 166 00:04:44.970 --> 00:04:46.469 to me. And then afterward, when he 167 00:04:46.470 --> 00:04:48.179 woke up, and I saw the look on his 168 00:04:48.180 --> 00:04:50.009 face. I realized that he had 169 00:04:50.010 --> 00:04:53.039 just been through this so many times 170 00:04:53.040 --> 00:04:54.929 that either he was sound 171 00:04:54.930 --> 00:04:56.819 asleep or he just couldn't face it. 172 00:04:56.820 --> 00:04:58.109 And then, thank goodness that we 173 00:04:58.110 --> 00:04:59.339 were there, right? 174 00:04:59.340 --> 00:05:01.169 So that he didn't have to. 175 00:05:01.170 --> 00:05:03.179 But the amalgam 176 00:05:03.180 --> 00:05:05.579 of need and 177 00:05:05.580 --> 00:05:07.409 being able to care for someone 178 00:05:07.410 --> 00:05:09.269 and having to do 179 00:05:09.270 --> 00:05:11.189 it on their time, 180 00:05:11.190 --> 00:05:13.169 but also being able to help 181 00:05:13.170 --> 00:05:14.099 them. 182 00:05:14.100 --> 00:05:16.019 That combination 183 00:05:16.020 --> 00:05:17.369 is what really sold me. 184 00:05:17.370 --> 00:05:19.379 And that nursing is so 185 00:05:19.380 --> 00:05:20.579 intimate. 186 00:05:20.580 --> 00:05:22.709 Of course, we had to call in an ICU 187 00:05:22.710 --> 00:05:25.199 fellow and the resident, 188 00:05:25.200 --> 00:05:27.089 but it was really me 189 00:05:27.090 --> 00:05:29.069 there with him. I love 190 00:05:29.070 --> 00:05:30.539 that, that close connection with 191 00:05:30.540 --> 00:05:31.229 people. 192 00:05:31.230 --> 00:05:32.249 Yeah. 193 00:05:32.250 --> 00:05:33.449 Speaking about that connection, one 194 00:05:33.450 --> 00:05:34.559 thing that I really liked reading 195 00:05:34.560 --> 00:05:36.389 about also in your first book 196 00:05:36.390 --> 00:05:38.669 is you write about not only 197 00:05:38.670 --> 00:05:40.499 how much you enjoyed the 198 00:05:40.500 --> 00:05:41.999 process of hearing people and being 199 00:05:42.000 --> 00:05:44.129 there for them but also you found it 200 00:05:44.130 --> 00:05:45.569 important, despite the fact that you 201 00:05:45.570 --> 00:05:47.429 had been counseled in 202 00:05:47.430 --> 00:05:49.889 nursing school, not to share 203 00:05:49.890 --> 00:05:51.179 that much-- not to disclose personal 204 00:05:51.180 --> 00:05:52.169 details. You found that that was a 205 00:05:52.170 --> 00:05:53.339 really important thing for you to be 206 00:05:53.340 --> 00:05:54.839 doing, not only to be hearing what 207 00:05:54.840 --> 00:05:56.159 people say but also to be sharing. 208 00:05:56.160 --> 00:05:57.689 And that you talk about a-- and you 209 00:05:57.690 --> 00:05:59.249 tell an anecdote about feeling like 210 00:05:59.250 --> 00:06:00.359 you can't use cell phones. 211 00:06:00.360 --> 00:06:01.229 Something like that. 212 00:06:01.230 --> 00:06:02.230 Little details. 213 00:06:02.670 --> 00:06:03.659 But they're important for you. 214 00:06:03.660 --> 00:06:04.619 And that was I really thought that 215 00:06:04.620 --> 00:06:06.329 was interesting that you can create 216 00:06:06.330 --> 00:06:07.589 that kind of two-way street with 217 00:06:07.590 --> 00:06:08.459 your patients. 218 00:06:08.460 --> 00:06:10.319 Yeah. And I think it's all about to 219 00:06:10.320 --> 00:06:12.389 use our words now, boundaries 220 00:06:12.390 --> 00:06:13.491 and appropriateness. 221 00:06:16.260 --> 00:06:17.729 I mean, that was the situation. 222 00:06:17.730 --> 00:06:18.899 In fact, I call that chapter 223 00:06:18.900 --> 00:06:20.369 Openings because the patient had 224 00:06:20.370 --> 00:06:22.769 this huge opening in his abdomen 225 00:06:22.770 --> 00:06:24.959 from surgeries. And it was about 226 00:06:24.960 --> 00:06:27.269 that opening and also me finding 227 00:06:27.270 --> 00:06:28.589 a way to communicate with him 228 00:06:28.590 --> 00:06:29.909 because he was having a really hard 229 00:06:29.910 --> 00:06:31.109 time. 230 00:06:31.110 --> 00:06:32.969 But I found also that even 231 00:06:32.970 --> 00:06:35.249 on a much more basic level, people 232 00:06:35.250 --> 00:06:37.049 want to know that I'm a person 233 00:06:37.050 --> 00:06:38.579 because it makes them feel like 234 00:06:38.580 --> 00:06:40.499 they're not just a patient. 235 00:06:40.500 --> 00:06:42.449 So in the hospital, people 236 00:06:42.450 --> 00:06:43.829 would say, "Well, how are you 237 00:06:43.830 --> 00:06:45.809 doing?" And they really wanted 238 00:06:45.810 --> 00:06:46.709 an answer. 239 00:06:46.710 --> 00:06:47.879 They didn't want me to just say," 240 00:06:47.880 --> 00:06:49.799 I'm fine." Now, they didn't want 241 00:06:49.800 --> 00:06:51.299 me to say, "Oh, my God, I'm 242 00:06:51.300 --> 00:06:53.099 overwhelmed. Our cat just died. 243 00:06:56.650 --> 00:06:57.650 And the heater won't work." 244 00:06:58.880 --> 00:07:00.339 Too much sharing is also bad. 245 00:07:00.340 --> 00:07:02.199 Yeah. And they don't want 246 00:07:02.200 --> 00:07:04.119 to hear about all 247 00:07:04.120 --> 00:07:05.559 my pain. And that's not why I'm 248 00:07:05.560 --> 00:07:07.389 there. But they want 249 00:07:07.390 --> 00:07:09.099 to feel like I'm a human. 250 00:07:09.100 --> 00:07:10.300 Because they're human then too. 251 00:07:12.100 --> 00:07:13.659 Another thing that I thought was 252 00:07:13.660 --> 00:07:14.739 great in terms of 253 00:07:16.000 --> 00:07:17.919 things you learned while being a 254 00:07:17.920 --> 00:07:19.209 nurse, and you write about this in 255 00:07:19.210 --> 00:07:20.229 The Shift, is the importance of 256 00:07:20.230 --> 00:07:22.119 physical contact. 257 00:07:22.120 --> 00:07:23.739 You reference another, a physician 258 00:07:23.740 --> 00:07:25.269 writer, Abraham Verghese, who talks 259 00:07:25.270 --> 00:07:26.469 a lot about that. 260 00:07:26.470 --> 00:07:28.449 And for him, he talks 261 00:07:28.450 --> 00:07:29.949 about touch being important not only 262 00:07:29.950 --> 00:07:31.539 in terms of making a diagnosis but 263 00:07:31.540 --> 00:07:34.239 also in terms of getting 264 00:07:34.240 --> 00:07:36.129 a patient to join you 265 00:07:36.130 --> 00:07:38.649 in his or her 266 00:07:38.650 --> 00:07:40.599 care of something. 267 00:07:40.600 --> 00:07:42.039 Have you found that it's a similar 268 00:07:42.040 --> 00:07:43.719 kind of importance that touch plays 269 00:07:43.720 --> 00:07:44.679 a similar role for you? 270 00:07:44.680 --> 00:07:47.229 I do think it really matters. 271 00:07:47.230 --> 00:07:49.149 We don't diagnose as nurses, so 272 00:07:49.150 --> 00:07:52.029 it's not at that level, but 273 00:07:52.030 --> 00:07:53.739 it really establishes a sense of 274 00:07:53.740 --> 00:07:56.679 trust and also connection. 275 00:07:56.680 --> 00:07:57.680 And it's 276 00:07:58.540 --> 00:08:00.099 also a way of saying, "You know, no 277 00:08:00.100 --> 00:08:01.689 matter what's going on with you, if 278 00:08:01.690 --> 00:08:03.699 you have a terrible rash, if 279 00:08:03.700 --> 00:08:05.559 you're in pain, if 280 00:08:05.560 --> 00:08:06.560 you 281 00:08:07.390 --> 00:08:09.459 don't smell very good, because we 282 00:08:09.460 --> 00:08:11.139 need to get you cleaned up. 283 00:08:11.140 --> 00:08:13.209 You know, I am not 284 00:08:13.210 --> 00:08:14.522 afraid of your body." And 285 00:08:15.880 --> 00:08:18.459 I think it's really important to 286 00:08:18.460 --> 00:08:20.289 say that to people. 287 00:08:20.290 --> 00:08:22.239 Yeah. I remember a talk 288 00:08:22.240 --> 00:08:24.189 from Abraham Verghese where he 289 00:08:24.190 --> 00:08:25.514 talks about there's a 290 00:08:27.130 --> 00:08:28.899 belief that a patient has that the 291 00:08:28.900 --> 00:08:30.819 doctor will always be there 292 00:08:30.820 --> 00:08:32.829 for him and do what the doctor 293 00:08:32.830 --> 00:08:34.178 can to care for this patient. 294 00:08:34.179 --> 00:08:35.229 And the touch is the thing that kind 295 00:08:35.230 --> 00:08:36.219 of seals that. 296 00:08:36.220 --> 00:08:37.719 Yeah, I think that's right. 297 00:08:37.720 --> 00:08:38.720 Yeah. 298 00:08:38.830 --> 00:08:40.029 And with nurses too. 299 00:08:42.190 --> 00:08:43.509 It's that even if-- I think I wrote 300 00:08:43.510 --> 00:08:44.889 about this in the shift. Even if all 301 00:08:44.890 --> 00:08:46.599 I do is go in and flush an I.V. 302 00:08:46.600 --> 00:08:48.519 line, I try to always just 303 00:08:48.520 --> 00:08:50.829 reach out and just touch their hand 304 00:08:50.830 --> 00:08:53.079 when I'm done because it's also 305 00:08:53.080 --> 00:08:55.119 a way of saying, "I see 306 00:08:55.120 --> 00:08:55.899 you. 307 00:08:55.900 --> 00:08:57.879 You're not just a task, but 308 00:08:57.880 --> 00:08:59.499 you're a person." And that's 309 00:08:59.500 --> 00:09:01.659 probably the connection 310 00:09:01.660 --> 00:09:03.849 that nurses need to make. 311 00:09:03.850 --> 00:09:06.129 Which is different from physicians 312 00:09:06.130 --> 00:09:07.569 but equally as important. 313 00:09:07.570 --> 00:09:09.669 Yeah, I'm reminded 314 00:09:09.670 --> 00:09:11.649 of some of when you 315 00:09:11.650 --> 00:09:13.389 talk about in nursing school, you 316 00:09:13.390 --> 00:09:14.799 learn not to disclose too many 317 00:09:14.800 --> 00:09:16.239 things, but you learned how 318 00:09:16.240 --> 00:09:18.279 important it was to do that. 319 00:09:18.280 --> 00:09:19.479 You talk also in some of your 320 00:09:19.480 --> 00:09:21.069 writing about the fact that you were 321 00:09:21.070 --> 00:09:22.959 not prepared in 322 00:09:22.960 --> 00:09:24.729 nursing school to do some of the 323 00:09:24.730 --> 00:09:26.199 things that have been the most 324 00:09:26.200 --> 00:09:27.519 important parts of your work. 325 00:09:27.520 --> 00:09:28.869 Talking about death, I'm thinking 326 00:09:28.870 --> 00:09:29.919 about in particular. This isn't 327 00:09:29.920 --> 00:09:31.569 something that you're prepared for. 328 00:09:31.570 --> 00:09:34.089 Have you found that you did 329 00:09:34.090 --> 00:09:36.129 need to learn a lot 330 00:09:36.130 --> 00:09:37.179 on the job? I suppose it's 331 00:09:37.180 --> 00:09:39.129 inevitable that you will have 332 00:09:39.130 --> 00:09:40.569 to do that. But could you have been 333 00:09:40.570 --> 00:09:42.069 prepared better for those things? 334 00:09:42.070 --> 00:09:43.089 Is it a problem with nursing 335 00:09:43.090 --> 00:09:44.349 education that these things aren't a 336 00:09:44.350 --> 00:09:46.563 part of the education process? 337 00:09:46.564 --> 00:09:47.799 Yeah, I think so. 338 00:09:47.800 --> 00:09:48.800 I mean, I went to Pitt. So 339 00:09:50.410 --> 00:09:51.969 I actually feel like it was a really 340 00:09:51.970 --> 00:09:53.799 great program, and I got what 341 00:09:53.800 --> 00:09:55.719 I needed. But yeah. 342 00:09:55.720 --> 00:09:57.062 And I think medical students too. 343 00:09:57.063 --> 00:09:58.899 Particularly on the subject of death 344 00:09:58.900 --> 00:10:01.059 and dying, they're starting to 345 00:10:01.060 --> 00:10:02.709 learn more about it. 346 00:10:02.710 --> 00:10:04.389 And I'm guessing that nursing 347 00:10:04.390 --> 00:10:05.739 schools are, too, although I don't 348 00:10:05.740 --> 00:10:07.269 know about that. 349 00:10:07.270 --> 00:10:09.009 So it might have just been that 350 00:10:09.010 --> 00:10:10.899 everybody was so busy 351 00:10:10.900 --> 00:10:12.789 hiding from that topic, and now 352 00:10:12.790 --> 00:10:14.949 we've brought it out from under 353 00:10:14.950 --> 00:10:15.950 the shadow. 354 00:10:17.290 --> 00:10:19.539 But yeah. There's definitely 355 00:10:19.540 --> 00:10:21.399 actually all kinds of things about 356 00:10:21.400 --> 00:10:23.829 communication that 357 00:10:23.830 --> 00:10:25.779 would make the first job easier 358 00:10:25.780 --> 00:10:27.729 if we learned more about 359 00:10:27.730 --> 00:10:29.349 them. What do doctors want to hear 360 00:10:29.350 --> 00:10:32.199 from us? How is it best to talk to 361 00:10:32.200 --> 00:10:33.139 another nurse? 362 00:10:33.140 --> 00:10:34.569 We learn a lot about talking to 363 00:10:34.570 --> 00:10:36.219 patients, but we don't learn about 364 00:10:36.220 --> 00:10:37.270 talking to each other. 365 00:10:38.470 --> 00:10:39.759 Yeah. I mean, it's interesting. 366 00:10:39.760 --> 00:10:40.839 I also wanted to ask you a little 367 00:10:40.840 --> 00:10:42.969 bit about working in 368 00:10:42.970 --> 00:10:43.970 hospital settings. Because 369 00:10:45.340 --> 00:10:47.049 one of the things I found that was 370 00:10:47.050 --> 00:10:49.059 really interesting in The Shift 371 00:10:49.060 --> 00:10:50.799 is you talk about one of your 372 00:10:50.800 --> 00:10:52.119 patients there, a patient named 373 00:10:52.120 --> 00:10:53.409 Sheila, and 374 00:10:54.520 --> 00:10:56.589 the time that you spend dealing-- 375 00:10:56.590 --> 00:10:58.209 she's been misdiagnosed in the book, 376 00:10:58.210 --> 00:11:00.189 and you spend some time 377 00:11:00.190 --> 00:11:01.149 talking with her. 378 00:11:01.150 --> 00:11:02.319 And she's very concerned. 379 00:11:02.320 --> 00:11:03.159 Her family's there. 380 00:11:03.160 --> 00:11:04.599 They're very concerned. 381 00:11:04.600 --> 00:11:06.009 And you write about the time that 382 00:11:06.010 --> 00:11:07.179 you spent talking with all of them 383 00:11:07.180 --> 00:11:08.799 about her condition. 384 00:11:08.800 --> 00:11:10.989 And then, you say afterward that 385 00:11:10.990 --> 00:11:12.459 even though it may be the most 386 00:11:12.460 --> 00:11:13.659 important thing you do during your 387 00:11:13.660 --> 00:11:15.519 shift, it goes unrecorded. 388 00:11:15.520 --> 00:11:16.520 Right. 389 00:11:17.230 --> 00:11:18.069 But you also spend a lot of time 390 00:11:18.070 --> 00:11:19.119 talking about how much work you have 391 00:11:19.120 --> 00:11:20.859 to do to record so many other parts 392 00:11:20.860 --> 00:11:22.689 of your job. Yet this is the thing 393 00:11:22.690 --> 00:11:24.549 that made me want to ask is it 394 00:11:24.550 --> 00:11:26.349 the case, then, that hospitals are 395 00:11:26.350 --> 00:11:28.389 not incentivizing 396 00:11:28.390 --> 00:11:30.249 the most important part of the job 397 00:11:30.250 --> 00:11:32.049 that you can do as a nurse? 398 00:11:32.050 --> 00:11:33.759 Wow. What an amazingly smart 399 00:11:33.760 --> 00:11:34.779 question. 400 00:11:34.780 --> 00:11:36.399 Yes, I think that is true. 401 00:11:36.400 --> 00:11:37.449 No one's ever put it like that 402 00:11:37.450 --> 00:11:38.259 before. 403 00:11:38.260 --> 00:11:40.269 Yes. And yet still, 404 00:11:40.270 --> 00:11:42.099 the expectation is that we will 405 00:11:42.100 --> 00:11:43.899 be empathic and we will be there for 406 00:11:43.900 --> 00:11:44.889 people. 407 00:11:44.890 --> 00:11:47.139 But then, there's so many more 408 00:11:47.140 --> 00:11:48.969 task-oriented things that we get 409 00:11:48.970 --> 00:11:51.039 evaluated on that 410 00:11:51.040 --> 00:11:53.739 it really is not 411 00:11:53.740 --> 00:11:54.739 incentivized. 412 00:11:54.740 --> 00:11:56.149 Hate to use that word, but it's the 413 00:11:56.150 --> 00:11:57.239 right word, I think. 414 00:11:57.240 --> 00:11:58.240 Yeah. 415 00:11:59.120 --> 00:12:01.279 We're expected to do 416 00:12:01.280 --> 00:12:02.659 the human things that actually 417 00:12:02.660 --> 00:12:04.459 nurses love doing, but we're not 418 00:12:04.460 --> 00:12:06.289 judged for doing those 419 00:12:06.290 --> 00:12:07.789 things unless you really, really 420 00:12:07.790 --> 00:12:08.809 screw it up. 421 00:12:08.810 --> 00:12:09.810 You know, somebody complains. And 422 00:12:11.420 --> 00:12:12.739 I was just at a conference, 423 00:12:12.740 --> 00:12:14.149 actually, where people were talking 424 00:12:14.150 --> 00:12:15.480 a lot and a lot about that. 425 00:12:15.481 --> 00:12:16.481 But thinking 426 00:12:18.770 --> 00:12:20.509 that small fixes can make a big 427 00:12:20.510 --> 00:12:22.369 difference. And I 428 00:12:22.370 --> 00:12:23.359 don't think so. 429 00:12:23.360 --> 00:12:25.339 I think we've put our values 430 00:12:25.340 --> 00:12:26.959 on the wrong things, and there's got 431 00:12:26.960 --> 00:12:27.960 to be a change in 432 00:12:28.850 --> 00:12:29.850 that way. 433 00:12:31.280 --> 00:12:32.959 Do you have any thoughts about some 434 00:12:32.960 --> 00:12:34.819 kind of big-picture changes that 435 00:12:34.820 --> 00:12:36.739 might move us in a 436 00:12:36.740 --> 00:12:38.299 direction where some of these 437 00:12:39.860 --> 00:12:41.599 human and very important parts of 438 00:12:41.600 --> 00:12:43.579 being a nurse could take center 439 00:12:43.580 --> 00:12:45.139 stage more than they currently do? 440 00:12:45.140 --> 00:12:46.369 I think there's two issues. 441 00:12:46.370 --> 00:12:49.579 One is now documentation 442 00:12:49.580 --> 00:12:50.959 has gotten to the point where it 443 00:12:50.960 --> 00:12:52.309 seems like we're supposed to record 444 00:12:52.310 --> 00:12:53.310 everything. 445 00:12:54.380 --> 00:12:56.689 Every little detail in triplicate 446 00:12:56.690 --> 00:12:58.369 from multiple dropdown menus. 447 00:12:58.370 --> 00:13:00.019 And it's extremely time-consuming 448 00:13:00.020 --> 00:13:02.359 and alienating and 449 00:13:02.360 --> 00:13:04.699 doesn't lead to supporting 450 00:13:04.700 --> 00:13:06.799 nurses giving whole care 451 00:13:06.800 --> 00:13:08.480 to the patient. So there's that. 452 00:13:09.560 --> 00:13:11.419 But that, I think, springs from a 453 00:13:11.420 --> 00:13:13.999 kind of lack of trust in the value 454 00:13:14.000 --> 00:13:16.249 of actual human 455 00:13:16.250 --> 00:13:17.539 connection. 456 00:13:17.540 --> 00:13:19.399 And I see as an analog to 457 00:13:19.400 --> 00:13:21.229 this what's going on in education. 458 00:13:21.230 --> 00:13:23.119 We can't just trust that if we have 459 00:13:23.120 --> 00:13:24.799 good teachers and normal-sized 460 00:13:24.800 --> 00:13:26.839 classrooms and standard 461 00:13:26.840 --> 00:13:28.099 equipment, that they'll do a good 462 00:13:28.100 --> 00:13:29.179 job. There has to be all this 463 00:13:29.180 --> 00:13:31.759 evaluating and standardization 464 00:13:31.760 --> 00:13:32.760 and looking at metrics. And 465 00:13:34.070 --> 00:13:35.689 I'm not saying there's no value to 466 00:13:35.690 --> 00:13:37.609 any of that, but 467 00:13:37.610 --> 00:13:39.259 when you're talking about 468 00:13:39.260 --> 00:13:41.359 human-to-human interaction, you've 469 00:13:41.360 --> 00:13:43.669 got to trust at some level 470 00:13:43.670 --> 00:13:45.589 that you 471 00:13:45.590 --> 00:13:47.209 pick the right people. And they can 472 00:13:47.210 --> 00:13:49.099 pull that off, and they can achieve 473 00:13:49.100 --> 00:13:50.689 from that interaction what they are 474 00:13:50.690 --> 00:13:52.729 meant to achieve. 475 00:13:52.730 --> 00:13:54.829 And maybe you can't measure 476 00:13:54.830 --> 00:13:55.830 that, 477 00:13:56.810 --> 00:13:58.369 or you need to think really, really 478 00:13:58.370 --> 00:14:00.259 creatively about how to 479 00:14:00.260 --> 00:14:01.429 measure it. 480 00:14:01.430 --> 00:14:02.929 And we're not doing that. 481 00:14:02.930 --> 00:14:03.859 Yeah. 482 00:14:03.860 --> 00:14:06.169 In The Shift, you write about two 483 00:14:06.170 --> 00:14:08.059 articles by a psychiatrist, Leonard 484 00:14:08.060 --> 00:14:09.409 Stein, The Doctor-Nurse Game. 485 00:14:09.410 --> 00:14:10.399 You say these are two of the best 486 00:14:10.400 --> 00:14:11.269 articles you know of. 487 00:14:11.270 --> 00:14:13.099 He wrote in 1967 about it and then 488 00:14:13.100 --> 00:14:14.959 again in 1990, revisited 489 00:14:14.960 --> 00:14:16.429 the issue. Said there had been some 490 00:14:16.430 --> 00:14:17.389 changes. Can you talk a little bit 491 00:14:17.390 --> 00:14:19.639 about those articles and why they 492 00:14:19.640 --> 00:14:21.319 mean so much to you? 493 00:14:21.320 --> 00:14:23.149 Yeah. And I 494 00:14:23.150 --> 00:14:24.559 love it that those articles are just 495 00:14:24.560 --> 00:14:25.710 so old school. 496 00:14:27.680 --> 00:14:29.149 There's no data, but what they're 497 00:14:29.150 --> 00:14:31.009 saying rings totally true. 498 00:14:31.010 --> 00:14:33.169 So he calls it The Doctor-Nurse 499 00:14:33.170 --> 00:14:35.689 Game in the sense of a psychological 500 00:14:35.690 --> 00:14:37.775 game, not like a game like Monopoly. 501 00:14:38.960 --> 00:14:41.359 The communication is always loaded 502 00:14:41.360 --> 00:14:42.649 in some way. 503 00:14:42.650 --> 00:14:44.179 So in the earlier version of the 504 00:14:44.180 --> 00:14:46.789 article, he says nurses 505 00:14:46.790 --> 00:14:49.009 have to act as if every idea 506 00:14:49.010 --> 00:14:50.749 is actually the physician's idea. 507 00:14:50.750 --> 00:14:51.750 So 508 00:14:52.880 --> 00:14:54.799 I make a phone call saying, "Mrs. 509 00:14:54.800 --> 00:14:56.869 Jones is vomiting. 510 00:14:56.870 --> 00:14:58.309 Do you think that Zofran would be a 511 00:14:58.310 --> 00:15:00.409 good idea?" A standard 512 00:15:00.410 --> 00:15:01.281 antiemetic drug. 513 00:15:01.282 --> 00:15:03.319 And everything has to be presented 514 00:15:03.320 --> 00:15:04.249 like that. And then. 515 00:15:04.250 --> 00:15:06.049 In the revision of The Doctor-Nurse 516 00:15:06.050 --> 00:15:07.879 Game, he says that 517 00:15:07.880 --> 00:15:09.306 now nurses are "stubborn 518 00:15:10.370 --> 00:15:13.489 rebels." We're going from 519 00:15:13.490 --> 00:15:15.619 an era where women especially 520 00:15:15.620 --> 00:15:17.629 were more compliant to the-- women's 521 00:15:17.630 --> 00:15:19.069 movement starting, right? 522 00:15:19.070 --> 00:15:20.989 We're having political protests. 523 00:15:20.990 --> 00:15:22.819 So the nurse is now a stubborn 524 00:15:22.820 --> 00:15:24.799 rebel, and the same 525 00:15:24.800 --> 00:15:26.329 phone call would turn into, "Well, 526 00:15:26.330 --> 00:15:27.709 Mrs. Jones is vomiting. 527 00:15:27.710 --> 00:15:29.029 Are you going to do anything about 528 00:15:29.030 --> 00:15:30.030 that?" 529 00:15:30.620 --> 00:15:31.489 Very different tone. 530 00:15:31.490 --> 00:15:32.490 Yes. 531 00:15:33.320 --> 00:15:35.269 And what I like is I will admit 532 00:15:35.270 --> 00:15:37.039 that I've done both those things and 533 00:15:37.040 --> 00:15:38.179 more. 534 00:15:38.180 --> 00:15:40.730 I have wheedled, I have argued. 535 00:15:41.900 --> 00:15:43.759 And what's sad is 536 00:15:43.760 --> 00:15:45.799 that it seems like there's not 537 00:15:45.800 --> 00:15:47.929 that many situations where I can say 538 00:15:47.930 --> 00:15:49.219 a doctor and I just talk to each 539 00:15:49.220 --> 00:15:51.089 other as colleagues and equals. 540 00:15:51.090 --> 00:15:53.239 That there's always 541 00:15:53.240 --> 00:15:54.709 a feeling of, okay, how am I going 542 00:15:54.710 --> 00:15:56.539 to get what I want 543 00:15:56.540 --> 00:15:58.459 here? And even more 544 00:15:58.460 --> 00:16:00.259 than that, how am I going to get 545 00:16:00.260 --> 00:16:02.179 this person to share 546 00:16:02.180 --> 00:16:04.249 his or her knowledge with 547 00:16:04.250 --> 00:16:06.349 me so together we can make the best 548 00:16:06.350 --> 00:16:07.999 decision? 549 00:16:08.000 --> 00:16:09.589 Well, you mentioned the bullying 550 00:16:09.590 --> 00:16:11.209 being another topic. I did not know 551 00:16:11.210 --> 00:16:13.249 that this was as big an issue 552 00:16:13.250 --> 00:16:15.139 as it was before reading your work, 553 00:16:15.140 --> 00:16:16.339 but you talk about your experience 554 00:16:16.340 --> 00:16:17.340 with it between nurses. 555 00:16:18.740 --> 00:16:20.719 And after 556 00:16:20.720 --> 00:16:21.799 learning a little bit about it from 557 00:16:21.800 --> 00:16:22.969 your work, I kind of looked into it 558 00:16:22.970 --> 00:16:23.989 and realized there's a vast amount 559 00:16:23.990 --> 00:16:25.789 of literature, and that is a big 560 00:16:25.790 --> 00:16:27.109 problem within the field. 561 00:16:27.110 --> 00:16:28.110 Yes. 562 00:16:28.940 --> 00:16:29.929 You write a little bit about it 563 00:16:29.930 --> 00:16:32.059 being related to this hierarchy 564 00:16:32.060 --> 00:16:33.919 issue and where kind 565 00:16:33.920 --> 00:16:36.894 of nurses fall on that hierarchy. 566 00:16:36.895 --> 00:16:37.895 Being 567 00:16:38.720 --> 00:16:40.369 lower down on the totem pole, as you 568 00:16:40.370 --> 00:16:42.559 say, when things go wrong, 569 00:16:42.560 --> 00:16:44.569 you take it out on other nurses. 570 00:16:45.590 --> 00:16:46.909 Have there been any changes since 571 00:16:46.910 --> 00:16:48.259 you've been in the field in this? 572 00:16:48.260 --> 00:16:50.299 Are there promising 573 00:16:50.300 --> 00:16:51.829 attempts being made to address the 574 00:16:51.830 --> 00:16:52.830 issue? 575 00:16:53.270 --> 00:16:54.409 Well, first of all, the issue being 576 00:16:54.410 --> 00:16:55.579 a lot more public. 577 00:16:55.580 --> 00:16:57.469 So I see that 578 00:16:57.470 --> 00:16:59.389 as a huge change, and 579 00:16:59.390 --> 00:17:00.559 people acknowledging it as a 580 00:17:00.560 --> 00:17:01.999 problem. 581 00:17:02.000 --> 00:17:03.979 I've given talks on this, and people 582 00:17:03.980 --> 00:17:06.259 ask me, "Do you know a place 583 00:17:06.260 --> 00:17:07.489 where this really works? 584 00:17:07.490 --> 00:17:09.618 What can we do about this?" 585 00:17:09.619 --> 00:17:12.049 The best talk opportunity 586 00:17:12.050 --> 00:17:13.879 I had was to talk 587 00:17:13.880 --> 00:17:15.889 to a group of not 588 00:17:15.890 --> 00:17:17.449 malpractice lawyers but people who 589 00:17:17.450 --> 00:17:19.368 do risk assessment for health 590 00:17:19.369 --> 00:17:20.299 care systems. 591 00:17:20.300 --> 00:17:22.159 And it was one of those few moments 592 00:17:22.160 --> 00:17:23.539 where I felt like from my mouth to 593 00:17:23.540 --> 00:17:25.699 God's ears because 594 00:17:25.700 --> 00:17:27.559 I could say to them, "You know, 595 00:17:27.560 --> 00:17:29.149 you should really care about this 596 00:17:29.150 --> 00:17:31.159 because this is what 597 00:17:31.160 --> 00:17:33.049 can cause an event that 598 00:17:33.050 --> 00:17:35.089 actually ends up leading to a huge 599 00:17:35.090 --> 00:17:37.009 malpractice suit." And there 600 00:17:37.010 --> 00:17:39.709 had just actually been one announced 601 00:17:39.710 --> 00:17:40.909 in Pittsburgh. I won't go into the 602 00:17:40.910 --> 00:17:42.259 details. Like right before I gave my 603 00:17:42.260 --> 00:17:44.089 talk, which was perfect because the 604 00:17:44.090 --> 00:17:46.039 whole issue was a 605 00:17:46.040 --> 00:17:47.299 middle-of-the-night communication 606 00:17:47.300 --> 00:17:49.339 between a nurse and a doctor. 607 00:17:49.340 --> 00:17:51.019 And I said, "You know, you can look 608 00:17:51.020 --> 00:17:53.029 at this, and you can say, 609 00:17:53.030 --> 00:17:54.199 'Seems like this nurse didn't know 610 00:17:54.200 --> 00:17:55.909 how to do her job.' And that may be 611 00:17:55.910 --> 00:17:57.079 what happened. 612 00:17:57.080 --> 00:17:58.969 Or it may be that there's 613 00:17:58.970 --> 00:18:00.979 a whole history of bad communication 614 00:18:00.980 --> 00:18:02.659 between this physician and this set 615 00:18:02.660 --> 00:18:04.099 of nurses. 616 00:18:04.100 --> 00:18:05.100 And someone 617 00:18:06.650 --> 00:18:08.329 ended up having a really, really, 618 00:18:08.330 --> 00:18:10.159 really bad outcome as a result 619 00:18:10.160 --> 00:18:12.229 of that." So that's what I hope 620 00:18:12.230 --> 00:18:14.209 is that people are 621 00:18:14.210 --> 00:18:16.399 starting to understand 622 00:18:16.400 --> 00:18:18.259 that letting 623 00:18:18.260 --> 00:18:20.089 these bad boy doctors - 624 00:18:20.090 --> 00:18:21.230 and it usually is bad boys - 625 00:18:22.940 --> 00:18:25.639 behave the way they are is really 626 00:18:25.640 --> 00:18:28.549 detrimental to the system overall. 627 00:18:28.550 --> 00:18:30.409 And the other point to make is that 628 00:18:30.410 --> 00:18:31.789 people always say, "Well, it's these 629 00:18:31.790 --> 00:18:34.549 doctors who are the big earners." 630 00:18:34.550 --> 00:18:36.529 Those doctors are not earning 631 00:18:36.530 --> 00:18:38.479 all that money for the hospital 632 00:18:38.480 --> 00:18:40.849 and themselves by being 633 00:18:40.850 --> 00:18:42.259 jerks and abusive. 634 00:18:42.260 --> 00:18:44.389 It's in spite of that. 635 00:18:44.390 --> 00:18:46.279 So that can't be an 636 00:18:46.280 --> 00:18:47.089 excuse. 637 00:18:47.090 --> 00:18:49.009 And when I talk to people who 638 00:18:49.010 --> 00:18:50.959 work with physicians who have 639 00:18:50.960 --> 00:18:52.879 these issues, they say, "Actually, 640 00:18:52.880 --> 00:18:54.319 you know, the doctors don't really 641 00:18:54.320 --> 00:18:55.939 like how they're behaving either. 642 00:18:55.940 --> 00:18:57.019 I mean, it's not like these are 643 00:18:57.020 --> 00:18:58.399 sociopaths. 644 00:18:58.400 --> 00:19:00.439 They're just really overwhelmed 645 00:19:00.440 --> 00:19:01.646 and stressed, and they 646 00:19:03.020 --> 00:19:05.119 have issues, right?" But 647 00:19:05.120 --> 00:19:07.219 for them, the opportunity to learn 648 00:19:07.220 --> 00:19:09.079 a different way to be 649 00:19:09.080 --> 00:19:10.459 tends to come as a relief. 650 00:19:10.460 --> 00:19:11.610 And if it doesn't, then they 651 00:19:12.890 --> 00:19:14.379 leave. They just find another job. 652 00:19:17.690 --> 00:19:19.639 So you've spent, I think, 653 00:19:19.640 --> 00:19:21.469 most of your career 654 00:19:21.470 --> 00:19:22.939 as a nurse working in a hospital 655 00:19:22.940 --> 00:19:24.589 setting. But recently, you've 656 00:19:24.590 --> 00:19:26.239 changed, and you provide in-home 657 00:19:26.240 --> 00:19:27.289 end-of-life care now. 658 00:19:27.290 --> 00:19:28.429 Is that right? So you're outside the 659 00:19:28.430 --> 00:19:28.969 hospital setting? 660 00:19:28.970 --> 00:19:29.422 Yes. 661 00:19:29.423 --> 00:19:31.249 Has working in 662 00:19:31.250 --> 00:19:33.133 that-- has that change allowed you 663 00:19:33.134 --> 00:19:35.089 to focus more 664 00:19:35.090 --> 00:19:37.039 on doing some of the things that you 665 00:19:37.040 --> 00:19:38.080 feel are most important in nursing? 666 00:19:38.081 --> 00:19:39.889 That is, having a personal 667 00:19:39.890 --> 00:19:41.119 relationship, providing personal 668 00:19:41.120 --> 00:19:43.279 care to someone, and 669 00:19:43.280 --> 00:19:45.139 doing some of those things that you 670 00:19:45.140 --> 00:19:46.969 value most about being a nurse. 671 00:19:46.970 --> 00:19:48.829 Yes. In particular, being able to 672 00:19:48.830 --> 00:19:51.019 have uninterrupted conversations 673 00:19:51.020 --> 00:19:53.899 with people, because honestly, after 674 00:19:53.900 --> 00:19:55.095 working in the hospital and writing 675 00:19:55.096 --> 00:19:56.989 The Shift, I was being sort of 676 00:19:56.990 --> 00:20:00.199 stuck. And one day in the hospital, 677 00:20:00.200 --> 00:20:01.939 I was feeling a little bit burned 678 00:20:01.940 --> 00:20:03.199 out with just the level of 679 00:20:03.200 --> 00:20:05.179 interruption and never being able 680 00:20:05.180 --> 00:20:07.039 to focus on one 681 00:20:07.040 --> 00:20:08.449 person at a time. 682 00:20:08.450 --> 00:20:10.369 And I love it that I can 683 00:20:10.370 --> 00:20:11.479 do that. 684 00:20:11.480 --> 00:20:12.679 It's amazing. 685 00:20:12.680 --> 00:20:14.989 My phone might ring 686 00:20:14.990 --> 00:20:15.990 once. 687 00:20:16.730 --> 00:20:17.779 It's very different from the 688 00:20:17.780 --> 00:20:18.859 experience you describe in The 689 00:20:18.860 --> 00:20:19.079 Shift. 690 00:20:19.080 --> 00:20:20.179 Yes, yes. 691 00:20:20.180 --> 00:20:22.189 And even then, I can usually say, 692 00:20:22.190 --> 00:20:23.149 "I'm at a patient's home. 693 00:20:23.150 --> 00:20:24.250 Can I call you back?" So 694 00:20:26.480 --> 00:20:28.519 I love 695 00:20:28.520 --> 00:20:30.769 that. And it's given me back 696 00:20:30.770 --> 00:20:32.659 a sense of why I 697 00:20:32.660 --> 00:20:35.209 got into this job. 698 00:20:35.210 --> 00:20:37.009 There's also times when I miss the 699 00:20:37.010 --> 00:20:38.869 hospital, and I feel nostalgic, 700 00:20:38.870 --> 00:20:40.999 but I've loved 701 00:20:41.000 --> 00:20:42.439 that aspect of the work. 702 00:20:42.440 --> 00:20:44.479 And I also love, oddly 703 00:20:44.480 --> 00:20:46.369 enough, that people 704 00:20:46.370 --> 00:20:47.895 are in charge in their own homes. 705 00:20:47.896 --> 00:20:49.849 The classic 706 00:20:49.850 --> 00:20:51.949 example of someone who's on oxygen 707 00:20:51.950 --> 00:20:53.239 who still smokes, 708 00:20:54.290 --> 00:20:55.189 which is dangerous. 709 00:20:55.190 --> 00:20:57.679 Right? And my supervisor, 710 00:20:57.680 --> 00:20:58.579 we were talking about this at a 711 00:20:58.580 --> 00:21:00.169 meeting, and she said, "Sometimes 712 00:21:00.170 --> 00:21:01.879 all you can do is say to them, 713 00:21:01.880 --> 00:21:02.959 'Could you please just turn the 714 00:21:02.960 --> 00:21:04.969 oxygen off while you're smoking.'" 715 00:21:04.970 --> 00:21:05.869 Like they're not going to stop 716 00:21:05.870 --> 00:21:08.449 smoking, and they need the oxygen. 717 00:21:08.450 --> 00:21:10.459 And I really love 718 00:21:10.460 --> 00:21:12.169 that. That there's a negotiation, 719 00:21:12.170 --> 00:21:13.699 like, well, you know? 720 00:21:13.700 --> 00:21:14.719 Well, I don't always feel like 721 00:21:14.720 --> 00:21:16.789 taking this pill, like, okay. 722 00:21:16.790 --> 00:21:18.139 Well, let's talk about of these 723 00:21:18.140 --> 00:21:19.969 three pills, which one is the 724 00:21:19.970 --> 00:21:21.739 most important for you to take every 725 00:21:21.740 --> 00:21:23.929 day? Because in the hospital, 726 00:21:23.930 --> 00:21:25.279 it's you'll do this, and you'll wear 727 00:21:25.280 --> 00:21:26.359 this, and you'll eat this, and 728 00:21:26.360 --> 00:21:27.679 you'll go here, and you'll stay 729 00:21:27.680 --> 00:21:28.680 there. 730 00:21:29.330 --> 00:21:32.269 And it's very hard on people. 731 00:21:32.270 --> 00:21:33.619 So maybe patients-- maybe your 732 00:21:33.620 --> 00:21:35.179 patients get to be themselves a 733 00:21:35.180 --> 00:21:36.439 little bit more when they feel like 734 00:21:36.440 --> 00:21:37.249 they're in a place they can have 735 00:21:37.250 --> 00:21:37.939 some more autonomy. 736 00:21:37.940 --> 00:21:39.019 Yes. 737 00:21:39.020 --> 00:21:39.799 Yes. 738 00:21:39.800 --> 00:21:41.299 Yeah, that's interesting. 739 00:21:41.300 --> 00:21:42.769 Well, I want to ask you a little bit 740 00:21:42.770 --> 00:21:45.139 about writing as well. 741 00:21:45.140 --> 00:21:47.029 When you started as 742 00:21:47.030 --> 00:21:48.679 a nurse, you did not think, "I'm 743 00:21:48.680 --> 00:21:50.329 going to write about this." That was 744 00:21:50.330 --> 00:21:52.189 something that you did because of 745 00:21:52.190 --> 00:21:53.190 a certain experience. 746 00:21:54.140 --> 00:21:55.099 I wonder, can you talk a little bit 747 00:21:55.100 --> 00:21:56.569 about what that experience was and 748 00:21:56.570 --> 00:21:58.249 what prompted you? 749 00:21:58.250 --> 00:21:59.929 Why that particular experience led 750 00:21:59.930 --> 00:22:01.759 you to need, really, to 751 00:22:01.760 --> 00:22:02.959 write about it? 752 00:22:02.960 --> 00:22:04.909 Yes, I was still a pretty 753 00:22:04.910 --> 00:22:06.829 new nurse, and I had 754 00:22:06.830 --> 00:22:09.649 a patient who was set to go home 755 00:22:09.650 --> 00:22:11.809 that afternoon and start coughing 756 00:22:11.810 --> 00:22:14.029 up blood. And then, start 757 00:22:14.030 --> 00:22:15.889 basically 758 00:22:15.890 --> 00:22:17.449 spitting up blood or almost like 759 00:22:17.450 --> 00:22:19.279 spewing up blood and 760 00:22:19.280 --> 00:22:21.649 dying. And we 761 00:22:21.650 --> 00:22:23.899 called the code and ran the code, 762 00:22:23.900 --> 00:22:24.900 but she 763 00:22:27.410 --> 00:22:28.379 wasn't going to make it. 764 00:22:28.380 --> 00:22:29.449 And she didn't make it. 765 00:22:29.450 --> 00:22:30.450 And 766 00:22:33.370 --> 00:22:35.589 I couldn't get past the experience. 767 00:22:35.590 --> 00:22:36.939 I mean, I went back to work, but I 768 00:22:36.940 --> 00:22:39.069 felt very haunted, 769 00:22:39.070 --> 00:22:40.599 and I thought, "Well if I can write 770 00:22:40.600 --> 00:22:42.759 this down, 771 00:22:42.760 --> 00:22:43.884 it will be contained." And 772 00:22:45.520 --> 00:22:46.599 that doesn't really work. 773 00:22:46.600 --> 00:22:47.949 I feel like basically what I've 774 00:22:47.950 --> 00:22:49.899 realized is you never get over 775 00:22:49.900 --> 00:22:51.639 something like that, but you make 776 00:22:51.640 --> 00:22:53.199 peace with that. 777 00:22:53.200 --> 00:22:55.209 But it's just a part of 778 00:22:55.210 --> 00:22:57.039 who you are as a health care 779 00:22:57.040 --> 00:22:58.040 provider. 780 00:22:59.320 --> 00:23:01.269 And when I talk about it, I see 781 00:23:01.270 --> 00:23:02.739 a lot of nods in the audience. 782 00:23:02.740 --> 00:23:04.599 So I think it's a pretty common 783 00:23:04.600 --> 00:23:05.559 experience. 784 00:23:05.560 --> 00:23:07.509 That first sudden, violent 785 00:23:07.510 --> 00:23:08.510 death. 786 00:23:09.160 --> 00:23:11.259 But I liked what I wrote, and 787 00:23:11.260 --> 00:23:13.119 so I thought, "Well, aim high. 788 00:23:13.120 --> 00:23:14.229 I'm going to send this to the New 789 00:23:14.230 --> 00:23:16.299 York Times." And actually, a friend 790 00:23:16.300 --> 00:23:18.129 of my brother's is 791 00:23:18.130 --> 00:23:20.019 on the editorial staff, and I 792 00:23:20.020 --> 00:23:21.579 sent it somewhere else to the 793 00:23:21.580 --> 00:23:23.019 magazine. I never heard from them, 794 00:23:23.020 --> 00:23:24.459 but he said, "You know, this is 795 00:23:24.460 --> 00:23:25.929 really good. I hope this is okay." I 796 00:23:25.930 --> 00:23:27.609 sent it to the Science Times, and 797 00:23:27.610 --> 00:23:28.809 they liked it. 798 00:23:28.810 --> 00:23:30.159 And they took it. 799 00:23:30.160 --> 00:23:32.529 So very, very excited. 800 00:23:32.530 --> 00:23:34.329 Took six months to actually get into 801 00:23:34.330 --> 00:23:35.330 print. 802 00:23:37.310 --> 00:23:39.429 But then, when it came 803 00:23:39.430 --> 00:23:42.189 out, it got a huge, 804 00:23:42.190 --> 00:23:44.019 huge national 805 00:23:44.020 --> 00:23:45.909 reaction, which I'm not 806 00:23:45.910 --> 00:23:47.139 saying as a way of bragging. 807 00:23:47.140 --> 00:23:49.299 I really didn't expect it at all. 808 00:23:49.300 --> 00:23:51.429 And I started hearing from editors 809 00:23:51.430 --> 00:23:53.529 and agents saying, 810 00:23:53.530 --> 00:23:55.149 "This is a voice. We never hear the 811 00:23:55.150 --> 00:23:57.189 voice of a bedside nurse," 812 00:23:57.190 --> 00:23:59.289 which was so incredibly 813 00:23:59.290 --> 00:24:01.749 empowering to me. 814 00:24:01.750 --> 00:24:03.129 And you've written more or less 815 00:24:03.130 --> 00:24:05.019 continuously since then. 816 00:24:05.020 --> 00:24:06.849 In the times I mentioned earlier, 817 00:24:06.850 --> 00:24:08.919 all of the attention that you got 818 00:24:08.920 --> 00:24:09.939 for the piece you wrote about 819 00:24:09.940 --> 00:24:12.099 doctor-nurse relationships in 2011, 820 00:24:12.100 --> 00:24:13.359 I think. You mentioned in one 821 00:24:13.360 --> 00:24:14.949 interview I read that you actually 822 00:24:14.950 --> 00:24:16.209 had to talk to an administrator 823 00:24:16.210 --> 00:24:18.339 after that. So that's one 824 00:24:18.340 --> 00:24:20.259 kind of, I guess, 825 00:24:20.260 --> 00:24:22.089 repercussion of being a public 826 00:24:22.090 --> 00:24:23.293 writer and being a nurse. 827 00:24:23.294 --> 00:24:25.179 How has that 828 00:24:25.180 --> 00:24:26.859 experience been for you all along 829 00:24:26.860 --> 00:24:28.299 the way? Are you looked at with some 830 00:24:28.300 --> 00:24:29.229 kind of suspicion? 831 00:24:29.230 --> 00:24:30.789 I can imagine that being one way 832 00:24:30.790 --> 00:24:32.049 that people would relate to you. 833 00:24:32.050 --> 00:24:33.459 But what's that been like in 834 00:24:33.460 --> 00:24:33.729 general? 835 00:24:33.730 --> 00:24:35.319 Yeah, there's definitely been 836 00:24:35.320 --> 00:24:36.609 suspicion. 837 00:24:36.610 --> 00:24:38.139 There were nurses who loved what I 838 00:24:38.140 --> 00:24:40.089 did, and there were 839 00:24:40.090 --> 00:24:42.129 a few nurses who, 840 00:24:42.130 --> 00:24:45.099 for different reasons, didn't. 841 00:24:45.100 --> 00:24:47.529 And I sort of worked with 842 00:24:47.530 --> 00:24:48.789 talking to them and saying, "Oh, I 843 00:24:48.790 --> 00:24:49.959 was thinking about writing about 844 00:24:49.960 --> 00:24:51.939 this, and you were 845 00:24:51.940 --> 00:24:53.979 in it." And they 846 00:24:53.980 --> 00:24:55.839 were always fine with it. 847 00:24:55.840 --> 00:24:57.699 But then, there were times when, 848 00:24:57.700 --> 00:25:00.189 even when people were de-identified 849 00:25:00.190 --> 00:25:02.049 or they just they felt kind 850 00:25:02.050 --> 00:25:03.939 of exposed, even though no one would 851 00:25:03.940 --> 00:25:06.069 know who they were. 852 00:25:06.070 --> 00:25:08.019 And the hard thing for me was that 853 00:25:08.020 --> 00:25:09.969 people wouldn't necessarily 854 00:25:09.970 --> 00:25:12.579 come to me directly and say, 855 00:25:12.580 --> 00:25:14.439 "Here's how I feel," which 856 00:25:14.440 --> 00:25:16.659 I can see that that's hard. 857 00:25:16.660 --> 00:25:17.709 But when you're all working 858 00:25:17.710 --> 00:25:19.329 together, just I wish people had 859 00:25:19.330 --> 00:25:20.330 done that, but whatever. 860 00:25:21.580 --> 00:25:23.439 But since leaving 861 00:25:23.440 --> 00:25:25.779 that job, I found more hospitable 862 00:25:25.780 --> 00:25:26.780 employers. 863 00:25:27.910 --> 00:25:29.769 And the challenge 864 00:25:29.770 --> 00:25:31.809 for me is to just make it clear that 865 00:25:31.810 --> 00:25:33.249 I'm there to work. 866 00:25:33.250 --> 00:25:35.102 I'm not there to be super nurse 867 00:25:35.103 --> 00:25:36.266 or Theresa 868 00:25:37.300 --> 00:25:38.589 Brown, the author. 869 00:25:38.590 --> 00:25:40.269 And people get that, and they go 870 00:25:40.270 --> 00:25:42.009 with it. So they'll kind of say, 871 00:25:42.010 --> 00:25:43.509 "Oh, you're that writer, right?" And 872 00:25:43.510 --> 00:25:44.619 we sort of talk about it. 873 00:25:44.620 --> 00:25:45.579 And then I'm like, "Okay, so what 874 00:25:45.580 --> 00:25:46.419 about this patient?" 875 00:25:46.420 --> 00:25:48.159 Yeah. I imagine if you did have 876 00:25:48.160 --> 00:25:49.599 people come up to you and talk to 877 00:25:49.600 --> 00:25:51.369 you, whether they agreed with you or 878 00:25:51.370 --> 00:25:53.349 not, that would be 879 00:25:53.350 --> 00:25:55.329 a really productive experience for 880 00:25:55.330 --> 00:25:56.859 you. But instead, it's a shame that 881 00:25:56.860 --> 00:25:58.539 that's not more of the reaction that 882 00:25:58.540 --> 00:26:00.249 you get from your colleagues. 883 00:26:00.250 --> 00:26:02.439 Yeah. I would have appreciated 884 00:26:02.440 --> 00:26:04.569 that. Yeah. Like, let's 885 00:26:04.570 --> 00:26:06.909 have a conversation about this. 886 00:26:06.910 --> 00:26:09.009 But I don't know if it's 887 00:26:09.010 --> 00:26:10.719 the power of being in print that 888 00:26:10.720 --> 00:26:12.549 makes people feel intimidated 889 00:26:12.550 --> 00:26:14.619 or especially talking 890 00:26:14.620 --> 00:26:15.579 about end of life. 891 00:26:15.580 --> 00:26:17.709 That was not 892 00:26:17.710 --> 00:26:19.899 always popular in oncology 893 00:26:19.900 --> 00:26:21.789 because a lot of oncologists just 894 00:26:21.790 --> 00:26:24.059 feel like you shouldn't 895 00:26:24.060 --> 00:26:24.869 talk about that. 896 00:26:24.870 --> 00:26:26.399 You shouldn't talk about hospice. 897 00:26:26.400 --> 00:26:28.259 You just should never bring 898 00:26:28.260 --> 00:26:29.260 it up. And 899 00:26:30.420 --> 00:26:31.589 I would love it if that would 900 00:26:31.590 --> 00:26:32.590 change. 901 00:26:33.540 --> 00:26:35.729 So that created tension. 902 00:26:35.730 --> 00:26:37.379 People felt like I just shouldn't be 903 00:26:37.380 --> 00:26:39.629 going there and writing about it. 904 00:26:39.630 --> 00:26:40.409 Yeah, yeah. 905 00:26:40.410 --> 00:26:42.029 It's interesting because you said 906 00:26:42.030 --> 00:26:44.099 death-- you write this in maybe 907 00:26:44.100 --> 00:26:45.419 both of your books, but death is so 908 00:26:45.420 --> 00:26:47.429 present in your work. 909 00:26:47.430 --> 00:26:48.887 And then, also when you're writing. 910 00:26:48.888 --> 00:26:50.909 For that to be something 911 00:26:50.910 --> 00:26:51.910 that is-- that 912 00:26:53.130 --> 00:26:55.049 there's some kind of a taboo against 913 00:26:55.050 --> 00:26:56.759 talking about it. Seems like that 914 00:26:56.760 --> 00:26:57.959 would be one of the most important 915 00:26:57.960 --> 00:26:59.369 things that you could prepare 916 00:26:59.370 --> 00:27:00.359 yourself for. 917 00:27:00.360 --> 00:27:02.069 Yeah. Well, that gets back to the 918 00:27:02.070 --> 00:27:03.359 question you asked at the start 919 00:27:03.360 --> 00:27:05.279 about are we prepared to talk to 920 00:27:05.280 --> 00:27:06.532 patients about death and not 921 00:27:08.000 --> 00:27:09.889 really. I mean, I even remember, as 922 00:27:09.890 --> 00:27:12.079 a student, having 923 00:27:12.080 --> 00:27:14.479 a patient who the husband 924 00:27:14.480 --> 00:27:16.309 had made the decision to put 925 00:27:16.310 --> 00:27:18.649 his wife in hospice. 926 00:27:18.650 --> 00:27:20.239 I don't remember why, but it was 927 00:27:20.240 --> 00:27:21.379 this patient that ended up doing a 928 00:27:21.380 --> 00:27:22.317 kind of write-up about. 929 00:27:22.318 --> 00:27:23.899 And my instructor said, "Well, 930 00:27:23.900 --> 00:27:25.609 you're just basically sending this 931 00:27:25.610 --> 00:27:27.559 woman to the funeral home." I 932 00:27:27.560 --> 00:27:29.243 said, "You know, no. 933 00:27:29.244 --> 00:27:31.609 This is the husband's decision. 934 00:27:31.610 --> 00:27:33.169 It's very well-founded." And I 935 00:27:33.170 --> 00:27:35.599 actually ended up 936 00:27:35.600 --> 00:27:37.879 talking to him a fair amount about 937 00:27:37.880 --> 00:27:38.749 it. 938 00:27:38.750 --> 00:27:40.609 And that was kind 939 00:27:40.610 --> 00:27:42.199 of the start of saying, "Oh, I can 940 00:27:42.200 --> 00:27:44.029 do this." It's not you don't 941 00:27:44.030 --> 00:27:45.469 know you can do it because we don't 942 00:27:45.470 --> 00:27:47.869 get a lot of opportunities in life. 943 00:27:47.870 --> 00:27:48.709 Yeah. 944 00:27:48.710 --> 00:27:50.599 There's a fascinating study 945 00:27:50.600 --> 00:27:51.619 that you've referenced, and that is 946 00:27:51.620 --> 00:27:53.299 also, I think, I read in Atul 947 00:27:53.300 --> 00:27:54.379 Gawande. His latest book from 948 00:27:54.380 --> 00:27:56.629 Massachusetts General Hospital, of 949 00:27:56.630 --> 00:27:58.639 patients who accept hospice 950 00:27:58.640 --> 00:28:00.799 care, not only having less suffering 951 00:28:00.800 --> 00:28:02.119 towards the end of their lives but 952 00:28:02.120 --> 00:28:03.049 actually living longer. 953 00:28:03.050 --> 00:28:03.949 Yes. 954 00:28:03.950 --> 00:28:04.950 Yes. 955 00:28:06.500 --> 00:28:07.459 It's not you're saying sending this 956 00:28:07.460 --> 00:28:09.799 person to the funeral home. 957 00:28:09.800 --> 00:28:10.999 It's quite the opposite, in fact. The 958 00:28:11.000 --> 00:28:11.869 numbers show. 959 00:28:11.870 --> 00:28:12.799 Right. 960 00:28:12.800 --> 00:28:14.059 And that's one of the big 961 00:28:14.060 --> 00:28:15.799 misconceptions we have to struggle 962 00:28:15.800 --> 00:28:17.779 against in hospice that 963 00:28:17.780 --> 00:28:19.669 people think the goal 964 00:28:19.670 --> 00:28:21.859 of hospice is for people to die. 965 00:28:21.860 --> 00:28:22.909 And it's not. 966 00:28:22.910 --> 00:28:24.769 It's for people to live the 967 00:28:24.770 --> 00:28:27.049 absolutely best life they can 968 00:28:27.050 --> 00:28:28.729 until they die. 969 00:28:28.730 --> 00:28:30.649 And certainly, if there was someone 970 00:28:30.650 --> 00:28:32.239 on hospice with a certain kind of 971 00:28:32.240 --> 00:28:34.129 cancer and an amazing treatment 972 00:28:34.130 --> 00:28:36.289 came out. And they wanted to 973 00:28:36.290 --> 00:28:38.119 try it, and they could stand 974 00:28:38.120 --> 00:28:39.799 it, I'd be the first person to say, 975 00:28:39.800 --> 00:28:41.259 "You should definitely do that." 976 00:28:42.470 --> 00:28:44.539 We want everybody to live as well 977 00:28:44.540 --> 00:28:45.540 as they can, but we 978 00:28:46.830 --> 00:28:48.029 are all going to die. 979 00:28:48.030 --> 00:28:49.349 It sucks, but it's true. 980 00:28:49.350 --> 00:28:51.569 That's the effort to prolong 981 00:28:51.570 --> 00:28:52.349 life at all costs. 982 00:28:52.350 --> 00:28:54.359 It seems like there's 983 00:28:54.360 --> 00:28:56.399 a strange kind of goal 984 00:28:56.400 --> 00:28:57.656 of immortality somehow behind that. 985 00:28:57.657 --> 00:29:00.149 Once you accept mortality, 986 00:29:00.150 --> 00:29:02.009 then you can get all kinds of 987 00:29:02.010 --> 00:29:03.263 positive results from that. 988 00:29:03.264 --> 00:29:05.099 That otherwise, you wouldn't 989 00:29:05.100 --> 00:29:06.449 be able to do. Quality of life being 990 00:29:06.450 --> 00:29:07.019 one of them. 991 00:29:07.020 --> 00:29:07.949 Right. 992 00:29:07.950 --> 00:29:09.749 Right. And just do you want to end 993 00:29:09.750 --> 00:29:11.609 your life in 994 00:29:11.610 --> 00:29:13.559 an ICU hooked up to machines? 995 00:29:13.560 --> 00:29:15.329 You can't talk to your family. 996 00:29:16.450 --> 00:29:18.269 And if somebody wants that, 997 00:29:18.270 --> 00:29:19.889 that's fine. 998 00:29:19.890 --> 00:29:21.839 But do people understand 999 00:29:21.840 --> 00:29:23.999 that they're making a choice, 1000 00:29:24.000 --> 00:29:26.129 and they could be at home? 1001 00:29:26.130 --> 00:29:27.629 They could have the people they love 1002 00:29:27.630 --> 00:29:28.649 around them. They could actually 1003 00:29:28.650 --> 00:29:30.419 have conversation. 1004 00:29:30.420 --> 00:29:32.189 And usually, if you present it like 1005 00:29:32.190 --> 00:29:34.049 that, people 1006 00:29:34.050 --> 00:29:36.059 will choose that. 1007 00:29:36.060 --> 00:29:37.709 And then, it's how do we help them 1008 00:29:37.710 --> 00:29:39.819 make the most of that time. 1009 00:29:39.820 --> 00:29:40.820 Yeah. 1010 00:29:41.970 --> 00:29:43.139 Well, one other question about your 1011 00:29:43.140 --> 00:29:44.819 writing I wanted to ask is about 1012 00:29:44.820 --> 00:29:46.619 your style. 1013 00:29:46.620 --> 00:29:48.089 As someone who was an English 1014 00:29:48.090 --> 00:29:49.919 professor, I'm sure you're aware 1015 00:29:49.920 --> 00:29:51.179 of style. The writing style. 1016 00:29:51.180 --> 00:29:52.289 You paid a lot of attention to it in 1017 00:29:52.290 --> 00:29:53.699 your past life. 1018 00:29:53.700 --> 00:29:55.109 How did you come to the style you 1019 00:29:55.110 --> 00:29:56.099 currently use? Have you thought 1020 00:29:56.100 --> 00:29:57.289 about it a lot over the years? 1021 00:29:57.290 --> 00:29:59.039 Was it something you worked on a lot 1022 00:29:59.040 --> 00:30:00.419 before you sent your first piece 1023 00:30:00.420 --> 00:30:02.639 out? And how has it changed since 1024 00:30:02.640 --> 00:30:04.079 you've been writing over the years, 1025 00:30:04.080 --> 00:30:05.279 or how do you think about that? 1026 00:30:05.280 --> 00:30:07.169 Oh, I think 1027 00:30:07.170 --> 00:30:09.089 the truth is I don't think about 1028 00:30:09.090 --> 00:30:10.090 it. It's just what 1029 00:30:10.920 --> 00:30:11.920 I do. 1030 00:30:13.480 --> 00:30:15.149 It's sort of what goes on in my 1031 00:30:15.150 --> 00:30:16.619 head. 1032 00:30:16.620 --> 00:30:19.499 That kind of spare 1033 00:30:19.500 --> 00:30:20.969 style. 1034 00:30:20.970 --> 00:30:23.129 And when I try to get too 1035 00:30:23.130 --> 00:30:25.079 flowery or metaphorical, it usually 1036 00:30:26.130 --> 00:30:27.509 just is like embarrassingly bad. 1037 00:30:28.650 --> 00:30:29.970 Those must be in early drafts. 1038 00:30:31.050 --> 00:30:33.149 So I 1039 00:30:33.150 --> 00:30:35.489 think what I've learned is what I'm 1040 00:30:35.490 --> 00:30:36.490 good at. 1041 00:30:37.320 --> 00:30:38.320 Interesting 1042 00:30:39.570 --> 00:30:41.399 detail, which I hope it's 1043 00:30:41.400 --> 00:30:43.559 interesting to other people, but 1044 00:30:43.560 --> 00:30:45.959 I'm also very spare with commas. 1045 00:30:45.960 --> 00:30:47.879 And so, the copy 1046 00:30:47.880 --> 00:30:50.009 editor went through and added 1047 00:30:50.010 --> 00:30:51.059 a whole bunch of commas. 1048 00:30:51.060 --> 00:30:52.859 And then, I went through and took 1049 00:30:52.860 --> 00:30:53.860 some of them out 1050 00:30:54.990 --> 00:30:56.909 and then got a note back 1051 00:30:56.910 --> 00:30:58.499 saying, "Well, we 1052 00:30:59.610 --> 00:31:01.589 went along with the comma decisions 1053 00:31:01.590 --> 00:31:03.329 to accommodate the writer's spare 1054 00:31:03.330 --> 00:31:04.330 style." 1055 00:31:08.070 --> 00:31:10.829 So the point being that 1056 00:31:10.830 --> 00:31:13.199 even at that level, it was important 1057 00:31:13.200 --> 00:31:15.539 to me to have a sense of 1058 00:31:15.540 --> 00:31:18.839 flow and control over the sentences. 1059 00:31:18.840 --> 00:31:20.699 That's just the way it 1060 00:31:20.700 --> 00:31:21.479 comes out. 1061 00:31:21.480 --> 00:31:22.480 Yeah. 1062 00:31:23.340 --> 00:31:25.319 I was kind of thinking about it as 1063 00:31:25.320 --> 00:31:26.369 I was reading and knowing your 1064 00:31:26.370 --> 00:31:27.629 background. And I had thought about 1065 00:31:27.630 --> 00:31:29.219 it in terms of the-- some of the 1066 00:31:29.220 --> 00:31:30.119 words that came to mind were 1067 00:31:30.120 --> 00:31:31.949 measured and kind of respectful in 1068 00:31:31.950 --> 00:31:33.929 a way. And then, I read a passage 1069 00:31:33.930 --> 00:31:35.669 of yours talking about the kinds of 1070 00:31:35.670 --> 00:31:36.659 relationships you have in 1071 00:31:36.660 --> 00:31:37.769 friendships you form with other 1072 00:31:37.770 --> 00:31:39.569 nurses, and you talk about it being 1073 00:31:39.570 --> 00:31:40.619 no-nonsense. 1074 00:31:40.620 --> 00:31:41.879 And it seemed to me that it was kind 1075 00:31:41.880 --> 00:31:43.529 of the way that you were writing 1076 00:31:43.530 --> 00:31:44.789 was, in a way, kind of like 1077 00:31:44.790 --> 00:31:46.469 respectful of the work that you were 1078 00:31:46.470 --> 00:31:47.310 doing as a nurse. 1079 00:31:47.311 --> 00:31:49.229 And that it had that no-nonsense 1080 00:31:49.230 --> 00:31:50.219 kind of character to it. 1081 00:31:50.220 --> 00:31:51.420 Oh, that's interesting. 1082 00:31:52.800 --> 00:31:53.909 Yeah. Yeah. 1083 00:31:53.910 --> 00:31:55.703 I mean, I love Joseph Conrad. 1084 00:31:55.704 --> 00:31:57.269 I love Faulkner. 1085 00:31:57.270 --> 00:31:59.609 I love their incredible writing. 1086 00:31:59.610 --> 00:32:01.499 But I think the styles 1087 00:32:01.500 --> 00:32:03.809 that really speak to me are 1088 00:32:03.810 --> 00:32:06.149 Hemingway, Raymond Carver. 1089 00:32:06.150 --> 00:32:08.009 I mean, I just 1090 00:32:08.010 --> 00:32:09.010 love that spareness. 1091 00:32:10.140 --> 00:32:12.059 And apologies for mentioning all 1092 00:32:12.060 --> 00:32:13.655 women. Flannery O'Connor also has 1093 00:32:13.656 --> 00:32:14.656 that. 1094 00:32:14.970 --> 00:32:15.779 I mean, all men. 1095 00:32:15.780 --> 00:32:17.099 I'm sorry. Mentioning all men. 1096 00:32:17.100 --> 00:32:18.100 Yeah. 1097 00:32:18.600 --> 00:32:20.699 Well, it's really the very-- it 1098 00:32:20.700 --> 00:32:21.700 creates a very moving work 1099 00:32:23.910 --> 00:32:24.750 for me when I read. 1100 00:32:24.751 --> 00:32:25.751 Definitely. 1101 00:32:25.890 --> 00:32:26.879 My last question is, what are your 1102 00:32:26.880 --> 00:32:28.679 plans for your writing from here on? 1103 00:32:28.680 --> 00:32:29.519 Do you have anything-- I mean, 1104 00:32:29.520 --> 00:32:30.509 you're going to keep, I hope, writing 1105 00:32:30.510 --> 00:32:31.589 for The Times. But other than that, 1106 00:32:31.590 --> 00:32:32.879 are there other projects you have in 1107 00:32:32.880 --> 00:32:34.409 mind that are larger than that? 1108 00:32:34.410 --> 00:32:36.059 There will be a third book. 1109 00:32:36.060 --> 00:32:38.249 It's sort of a light 1110 00:32:38.250 --> 00:32:39.839 on the back burner of my brain, and 1111 00:32:39.840 --> 00:32:41.699 that's about as far as 1112 00:32:41.700 --> 00:32:43.109 it's gotten. 1113 00:32:44.580 --> 00:32:45.989 It might be something about 1114 00:32:45.990 --> 00:32:48.089 end-of-life and hospice, but 1115 00:32:48.090 --> 00:32:49.589 there are so many books about that 1116 00:32:49.590 --> 00:32:51.149 now. I need to make sure I have 1117 00:32:51.150 --> 00:32:53.639 something that's 1118 00:32:53.640 --> 00:32:54.750 new enough to be worthwhile to 1119 00:32:56.190 --> 00:32:57.359 say. 1120 00:32:57.360 --> 00:32:59.819 But yeah, I will keep at it. 1121 00:32:59.820 --> 00:33:01.559 Well, we look forward to more of 1122 00:33:01.560 --> 00:33:03.389 your work. And Theresa Brown, thanks 1123 00:33:03.390 --> 00:33:04.289 so much for joining us. 1124 00:33:04.290 --> 00:33:05.290 Thank you. 1125 00:33:09.089 --> 00:33:10.079 That's it for this edition of Being 1126 00:33:10.080 --> 00:33:11.699 Human. Stay tuned next time when my 1127 00:33:11.700 --> 00:33:13.109 guest will be Jeff Williams, 1128 00:33:13.110 --> 00:33:14.309 professor of English at Carnegie 1129 00:33:14.310 --> 00:33:15.989 Mellon University and author of How 1130 00:33:15.990 --> 00:33:17.579 to Be an Intellectual. 1131 00:33:17.580 --> 00:33:18.580 Thanks for listening.
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