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Nursing, Writing, and Humanity: An Interview with Theresa Brown
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0 of 0
0:00
Hello
0:03
and welcome to the latest
0:04
installment of the University of
0:05
Pittsburgh Humanities podcast, a
0:07
series devoted to exploring the
0:08
humanities, their intersections with
0:10
other disciplines, and their value
0:12
in the public world.
0:13
I'm Dan Kubis, assistant director of
0:14
the Humanities Center at Pitt.
0:19
My guest today is Theresa Brown,
0:20
nurse, columnist, and author of
0:22
The Shift: One Nurse, Twelve
0:24
Hours, Four Patients' Lives.
0:26
Even if all I do is go in and flush
0:28
an I.V. line, I try to always just
0:30
reach down and just touch their hand
0:32
when I'm done because it's also
0:34
a way of saying, "I see
0:36
you.
0:37
You're not just a task, but
0:39
you're a person." And that's
0:40
probably the connection that nurses
0:42
need to make, which is
0:45
different from physicians but
0:46
equally as important.
0:48
Theresa began her career as a writer
0:49
in 2008 when she published an essay
0:51
in the New York Times about a
0:52
dramatic and emotional experience
0:54
she had with a dying patient.
0:56
The piece received national
0:57
attention and was anthologized in
0:58
the Best American Science Writing
1:00
and the Best American Medical
1:01
Writing in 2009.
1:03
Since then, she has written dozens
1:04
of pieces about nursing and has
1:05
become a leading voice for nurses
1:07
and nurse advocacy across the
1:08
country.
1:09
Her first book, Critical Care, was
1:11
published in 2010 and is widely
1:13
used as a textbook in nursing
1:14
schools.
1:16
Theresa's writing frequently pulls
1:17
back the curtain on the experiences
1:19
and challenges that nurses face in
1:20
their daily work.
1:22
Sometimes this reveals frustrating
1:23
working conditions or difficulties
1:24
dealing with hospital
1:25
administration. But just as
1:27
frequently, it shows the strength,
1:29
skill, and commitment that nurses
1:30
need to provide their patients with
1:31
the best care they can.
1:33
So it's no surprise that President
1:34
Obama quoted from Theresa's blog
1:36
when he was advocating for the
1:37
Affordable Care Act in 2009.
1:38
In
1:40
what she calls her past life,
1:41
Theresa received a Ph.D.
1:42
in English from the University of
1:44
Chicago and was an English professor
1:45
at Tufts University.
1:47
I began by asking her about this
1:48
past and about the somewhat
1:50
nontraditional path she took to
1:51
becoming a nurse.
1:56
As I've said many times before, this
1:57
is the million-dollar question.
1:59
Why would an English professor
2:00
become a nurse?
2:03
And there are a lot of people who
2:05
thought I was nuts. So I think
2:06
I've convinced some I'm not.
2:08
But essentially,
2:10
my dad was a professor, and growing
2:12
up it just seemed like a really
2:13
great job.
2:14
You could get paid to be in this
2:15
world of ideas and books.
2:17
And I loved that.
2:18
I got my Ph.D.
2:19
in English. I was teaching at Tufts,
2:21
and I found out that the job itself
2:24
for me was not the ideal.
2:26
I liked it. I think I was good
2:28
enough at it, but it just didn't
2:29
quite do it for me.
2:30
So it's kind of like, oh, now,
2:32
what am I going to be when I grow
2:33
up? And then, I became
2:35
a mom in the middle of that and
2:38
had our son, and then got pregnant
2:39
with twins.
2:40
And that just caused
2:43
a huge life change
2:45
and in hard ways because of the lack
2:47
of sleep and all the laundry,
2:49
but in really great ways, like
2:51
all the love and the fun.
2:53
And then I thought, "Oh, well,
2:55
this is the kind of job I want to
2:57
do, but what kind of job is that?"
3:00
And I had midwives
3:02
for that pregnancy, and I was
3:03
telling a friend of mine who's a
3:04
nurse, "Well, I just thought the
3:05
midwives had the coolest job in the
3:07
world." And she said, "Theresa,
3:09
you could do that job."
3:11
And it had never occurred to me
3:13
that I could become a nurse.
3:16
But then I did it.
3:19
Well, I want to also ask
3:21
you, then, about your description in
3:23
the beginning of your first book,
3:24
Critical Care. You
3:26
made your change from being
3:28
an English professor to being a
3:29
nurse, and it felt right
3:31
to you. But it took a while for
3:32
there to be a kind of crystallized
3:34
moment where you realized why it
3:36
felt right. And you talk about an
3:37
experience you have with an 11 year
3:38
old boy as being a moment where
3:40
you did have that realization and
3:42
talking with him at night about the
3:44
condition that he was in.
3:45
Can you talk a little bit about that
3:46
moment and what it was in particular
3:48
about that that caused that
3:49
realization for you?
3:50
Well, it was my last night
3:52
of clinical as a student.
3:54
So really the end of my
3:57
journey as a student nurse.
3:59
And I was
4:01
not working on an oncology floor,
4:03
but he was an oncology patient.
4:04
Came in with his dad,
4:06
and they'd been there a lot and were
4:07
obviously trying to make it fun
4:10
by eating a big bag of potato chips
4:12
and watching TV.
4:14
But it's not
4:16
really fun.
4:17
I mean, I admired the effort.
4:18
And then, in the middle of the
4:19
night, he just started to feel
4:22
really terrible
4:24
and most
4:26
likely was septic
4:28
and really low blood pressure.
4:30
And I ended up--
4:33
the nurse I was working with, we
4:34
ended up having to send
4:36
him to the pediatric intensive care
4:38
unit, and his dad
4:40
slept through a lot of it, which
4:42
at the time was kind of shocking
4:44
to me. And then afterward, when he
4:46
woke up, and I saw the look on his
4:48
face. I realized that he had
4:50
just been through this so many times
4:53
that either he was sound
4:54
asleep or he just couldn't face it.
4:56
And then, thank goodness that we
4:58
were there, right?
4:59
So that he didn't have to.
5:01
But the amalgam
5:03
of need and
5:05
being able to care for someone
5:07
and having to do
5:09
it on their time,
5:11
but also being able to help
5:13
them.
5:14
That combination
5:16
is what really sold me.
5:17
And that nursing is so
5:19
intimate.
5:20
Of course, we had to call in an ICU
5:22
fellow and the resident,
5:25
but it was really me
5:27
there with him. I love
5:29
that, that close connection with
5:30
people.
5:31
Yeah.
5:32
Speaking about that connection, one
5:33
thing that I really liked reading
5:34
about also in your first book
5:36
is you write about not only
5:38
how much you enjoyed the
5:40
process of hearing people and being
5:42
there for them but also you found it
5:44
important, despite the fact that you
5:45
had been counseled in
5:47
nursing school, not to share
5:49
that much-- not to disclose personal
5:51
details. You found that that was a
5:52
really important thing for you to be
5:53
doing, not only to be hearing what
5:54
people say but also to be sharing.
5:56
And that you talk about a-- and you
5:57
tell an anecdote about feeling like
5:59
you can't use cell phones.
6:00
Something like that.
6:01
Little details.
6:02
But they're important for you.
6:03
And that was I really thought that
6:04
was interesting that you can create
6:06
that kind of two-way street with
6:07
your patients.
6:08
Yeah. And I think it's all about to
6:10
use our words now, boundaries
6:12
and appropriateness.
6:16
I mean, that was the situation.
6:17
In fact, I call that chapter
6:18
Openings because the patient had
6:20
this huge opening in his abdomen
6:22
from surgeries. And it was about
6:24
that opening and also me finding
6:27
a way to communicate with him
6:28
because he was having a really hard
6:29
time.
6:31
But I found also that even
6:32
on a much more basic level, people
6:35
want to know that I'm a person
6:37
because it makes them feel like
6:38
they're not just a patient.
6:40
So in the hospital, people
6:42
would say, "Well, how are you
6:43
doing?" And they really wanted
6:45
an answer.
6:46
They didn't want me to just say,"
6:47
I'm fine." Now, they didn't want
6:49
me to say, "Oh, my God, I'm
6:51
overwhelmed. Our cat just died.
6:56
And the heater won't work."
6:58
Too much sharing is also bad.
7:00
Yeah. And they don't want
7:02
to hear about all
7:04
my pain. And that's not why I'm
7:05
there. But they want
7:07
to feel like I'm a human.
7:09
Because they're human then too.
7:12
Another thing that I thought was
7:13
great in terms of
7:16
things you learned while being a
7:17
nurse, and you write about this in
7:19
The Shift, is the importance of
7:20
physical contact.
7:22
You reference another, a physician
7:23
writer, Abraham Verghese, who talks
7:25
a lot about that.
7:26
And for him, he talks
7:28
about touch being important not only
7:29
in terms of making a diagnosis but
7:31
also in terms of getting
7:34
a patient to join you
7:36
in his or her
7:38
care of something.
7:40
Have you found that it's a similar
7:42
kind of importance that touch plays
7:43
a similar role for you?
7:44
I do think it really matters.
7:47
We don't diagnose as nurses, so
7:49
it's not at that level, but
7:52
it really establishes a sense of
7:53
trust and also connection.
7:56
And it's
7:58
also a way of saying, "You know, no
8:00
matter what's going on with you, if
8:01
you have a terrible rash, if
8:03
you're in pain, if
8:05
you
8:07
don't smell very good, because we
8:09
need to get you cleaned up.
8:11
You know, I am not
8:13
afraid of your body." And
8:15
I think it's really important to
8:18
say that to people.
8:20
Yeah. I remember a talk
8:22
from Abraham Verghese where he
8:24
talks about there's a
8:27
belief that a patient has that the
8:28
doctor will always be there
8:30
for him and do what the doctor
8:32
can to care for this patient.
8:34
And the touch is the thing that kind
8:35
of seals that.
8:36
Yeah, I think that's right.
8:37
Yeah.
8:38
And with nurses too.
8:42
It's that even if-- I think I wrote
8:43
about this in the shift. Even if all
8:44
I do is go in and flush an I.V.
8:46
line, I try to always just
8:48
reach out and just touch their hand
8:50
when I'm done because it's also
8:53
a way of saying, "I see
8:55
you.
8:55
You're not just a task, but
8:57
you're a person." And that's
8:59
probably the connection
9:01
that nurses need to make.
9:03
Which is different from physicians
9:06
but equally as important.
9:07
Yeah, I'm reminded
9:09
of some of when you
9:11
talk about in nursing school, you
9:13
learn not to disclose too many
9:14
things, but you learned how
9:16
important it was to do that.
9:18
You talk also in some of your
9:19
writing about the fact that you were
9:21
not prepared in
9:22
nursing school to do some of the
9:24
things that have been the most
9:26
important parts of your work.
9:27
Talking about death, I'm thinking
9:28
about in particular. This isn't
9:29
something that you're prepared for.
9:31
Have you found that you did
9:34
need to learn a lot
9:36
on the job? I suppose it's
9:37
inevitable that you will have
9:39
to do that. But could you have been
9:40
prepared better for those things?
9:42
Is it a problem with nursing
9:43
education that these things aren't a
9:44
part of the education process?
9:46
Yeah, I think so.
9:47
I mean, I went to Pitt. So
9:50
I actually feel like it was a really
9:51
great program, and I got what
9:53
I needed. But yeah.
9:55
And I think medical students too.
9:57
Particularly on the subject of death
9:58
and dying, they're starting to
10:01
learn more about it.
10:02
And I'm guessing that nursing
10:04
schools are, too, although I don't
10:05
know about that.
10:07
So it might have just been that
10:09
everybody was so busy
10:10
hiding from that topic, and now
10:12
we've brought it out from under
10:14
the shadow.
10:17
But yeah. There's definitely
10:19
actually all kinds of things about
10:21
communication that
10:23
would make the first job easier
10:25
if we learned more about
10:27
them. What do doctors want to hear
10:29
from us? How is it best to talk to
10:32
another nurse?
10:33
We learn a lot about talking to
10:34
patients, but we don't learn about
10:36
talking to each other.
10:38
Yeah. I mean, it's interesting.
10:39
I also wanted to ask you a little
10:40
bit about working in
10:42
hospital settings. Because
10:45
one of the things I found that was
10:47
really interesting in The Shift
10:49
is you talk about one of your
10:50
patients there, a patient named
10:52
Sheila, and
10:54
the time that you spend dealing--
10:56
she's been misdiagnosed in the book,
10:58
and you spend some time
11:00
talking with her.
11:01
And she's very concerned.
11:02
Her family's there.
11:03
They're very concerned.
11:04
And you write about the time that
11:06
you spent talking with all of them
11:07
about her condition.
11:08
And then, you say afterward that
11:10
even though it may be the most
11:12
important thing you do during your
11:13
shift, it goes unrecorded.
11:15
Right.
11:17
But you also spend a lot of time
11:18
talking about how much work you have
11:19
to do to record so many other parts
11:20
of your job. Yet this is the thing
11:22
that made me want to ask is it
11:24
the case, then, that hospitals are
11:26
not incentivizing
11:28
the most important part of the job
11:30
that you can do as a nurse?
11:32
Wow. What an amazingly smart
11:33
question.
11:34
Yes, I think that is true.
11:36
No one's ever put it like that
11:37
before.
11:38
Yes. And yet still,
11:40
the expectation is that we will
11:42
be empathic and we will be there for
11:43
people.
11:44
But then, there's so many more
11:47
task-oriented things that we get
11:48
evaluated on that
11:51
it really is not
11:53
incentivized.
11:54
Hate to use that word, but it's the
11:56
right word, I think.
11:57
Yeah.
11:59
We're expected to do
12:01
the human things that actually
12:02
nurses love doing, but we're not
12:04
judged for doing those
12:06
things unless you really, really
12:07
screw it up.
12:08
You know, somebody complains. And
12:11
I was just at a conference,
12:12
actually, where people were talking
12:14
a lot and a lot about that.
12:15
But thinking
12:18
that small fixes can make a big
12:20
difference. And I
12:22
don't think so.
12:23
I think we've put our values
12:25
on the wrong things, and there's got
12:26
to be a change in
12:28
that way.
12:31
Do you have any thoughts about some
12:32
kind of big-picture changes that
12:34
might move us in a
12:36
direction where some of these
12:39
human and very important parts of
12:41
being a nurse could take center
12:43
stage more than they currently do?
12:45
I think there's two issues.
12:46
One is now documentation
12:49
has gotten to the point where it
12:50
seems like we're supposed to record
12:52
everything.
12:54
Every little detail in triplicate
12:56
from multiple dropdown menus.
12:58
And it's extremely time-consuming
13:00
and alienating and
13:02
doesn't lead to supporting
13:04
nurses giving whole care
13:06
to the patient. So there's that.
13:09
But that, I think, springs from a
13:11
kind of lack of trust in the value
13:14
of actual human
13:16
connection.
13:17
And I see as an analog to
13:19
this what's going on in education.
13:21
We can't just trust that if we have
13:23
good teachers and normal-sized
13:24
classrooms and standard
13:26
equipment, that they'll do a good
13:28
job. There has to be all this
13:29
evaluating and standardization
13:31
and looking at metrics. And
13:34
I'm not saying there's no value to
13:35
any of that, but
13:37
when you're talking about
13:39
human-to-human interaction, you've
13:41
got to trust at some level
13:43
that you
13:45
pick the right people. And they can
13:47
pull that off, and they can achieve
13:49
from that interaction what they are
13:50
meant to achieve.
13:52
And maybe you can't measure
13:54
that,
13:56
or you need to think really, really
13:58
creatively about how to
14:00
measure it.
14:01
And we're not doing that.
14:02
Yeah.
14:03
In The Shift, you write about two
14:06
articles by a psychiatrist, Leonard
14:08
Stein, The Doctor-Nurse Game.
14:09
You say these are two of the best
14:10
articles you know of.
14:11
He wrote in 1967 about it and then
14:13
again in 1990, revisited
14:14
the issue. Said there had been some
14:16
changes. Can you talk a little bit
14:17
about those articles and why they
14:19
mean so much to you?
14:21
Yeah. And I
14:23
love it that those articles are just
14:24
so old school.
14:27
There's no data, but what they're
14:29
saying rings totally true.
14:31
So he calls it The Doctor-Nurse
14:33
Game in the sense of a psychological
14:35
game, not like a game like Monopoly.
14:38
The communication is always loaded
14:41
in some way.
14:42
So in the earlier version of the
14:44
article, he says nurses
14:46
have to act as if every idea
14:49
is actually the physician's idea.
14:50
So
14:52
I make a phone call saying, "Mrs.
14:54
Jones is vomiting.
14:56
Do you think that Zofran would be a
14:58
good idea?" A standard
15:00
antiemetic drug.
15:01
And everything has to be presented
15:03
like that. And then.
15:04
In the revision of The Doctor-Nurse
15:06
Game, he says that
15:07
now nurses are "stubborn
15:10
rebels." We're going from
15:13
an era where women especially
15:15
were more compliant to the-- women's
15:17
movement starting, right?
15:19
We're having political protests.
15:20
So the nurse is now a stubborn
15:22
rebel, and the same
15:24
phone call would turn into, "Well,
15:26
Mrs. Jones is vomiting.
15:27
Are you going to do anything about
15:29
that?"
15:30
Very different tone.
15:31
Yes.
15:33
And what I like is I will admit
15:35
that I've done both those things and
15:37
more.
15:38
I have wheedled, I have argued.
15:41
And what's sad is
15:43
that it seems like there's not
15:45
that many situations where I can say
15:47
a doctor and I just talk to each
15:49
other as colleagues and equals.
15:51
That there's always
15:53
a feeling of, okay, how am I going
15:54
to get what I want
15:56
here? And even more
15:58
than that, how am I going to get
16:00
this person to share
16:02
his or her knowledge with
16:04
me so together we can make the best
16:06
decision?
16:08
Well, you mentioned the bullying
16:09
being another topic. I did not know
16:11
that this was as big an issue
16:13
as it was before reading your work,
16:15
but you talk about your experience
16:16
with it between nurses.
16:18
And after
16:20
learning a little bit about it from
16:21
your work, I kind of looked into it
16:22
and realized there's a vast amount
16:23
of literature, and that is a big
16:25
problem within the field.
16:27
Yes.
16:28
You write a little bit about it
16:29
being related to this hierarchy
16:32
issue and where kind
16:33
of nurses fall on that hierarchy.
16:36
Being
16:38
lower down on the totem pole, as you
16:40
say, when things go wrong,
16:42
you take it out on other nurses.
16:45
Have there been any changes since
16:46
you've been in the field in this?
16:48
Are there promising
16:50
attempts being made to address the
16:51
issue?
16:53
Well, first of all, the issue being
16:54
a lot more public.
16:55
So I see that
16:57
as a huge change, and
16:59
people acknowledging it as a
17:00
problem.
17:02
I've given talks on this, and people
17:03
ask me, "Do you know a place
17:06
where this really works?
17:07
What can we do about this?"
17:09
The best talk opportunity
17:12
I had was to talk
17:13
to a group of not
17:15
malpractice lawyers but people who
17:17
do risk assessment for health
17:19
care systems.
17:20
And it was one of those few moments
17:22
where I felt like from my mouth to
17:23
God's ears because
17:25
I could say to them, "You know,
17:27
you should really care about this
17:29
because this is what
17:31
can cause an event that
17:33
actually ends up leading to a huge
17:35
malpractice suit." And there
17:37
had just actually been one announced
17:39
in Pittsburgh. I won't go into the
17:40
details. Like right before I gave my
17:42
talk, which was perfect because the
17:44
whole issue was a
17:46
middle-of-the-night communication
17:47
between a nurse and a doctor.
17:49
And I said, "You know, you can look
17:51
at this, and you can say,
17:53
'Seems like this nurse didn't know
17:54
how to do her job.' And that may be
17:55
what happened.
17:57
Or it may be that there's
17:58
a whole history of bad communication
18:00
between this physician and this set
18:02
of nurses.
18:04
And someone
18:06
ended up having a really, really,
18:08
really bad outcome as a result
18:10
of that." So that's what I hope
18:12
is that people are
18:14
starting to understand
18:16
that letting
18:18
these bad boy doctors -
18:20
and it usually is bad boys -
18:22
behave the way they are is really
18:25
detrimental to the system overall.
18:28
And the other point to make is that
18:30
people always say, "Well, it's these
18:31
doctors who are the big earners."
18:34
Those doctors are not earning
18:36
all that money for the hospital
18:38
and themselves by being
18:40
jerks and abusive.
18:42
It's in spite of that.
18:44
So that can't be an
18:46
excuse.
18:47
And when I talk to people who
18:49
work with physicians who have
18:50
these issues, they say, "Actually,
18:52
you know, the doctors don't really
18:54
like how they're behaving either.
18:55
I mean, it's not like these are
18:57
sociopaths.
18:58
They're just really overwhelmed
19:00
and stressed, and they
19:03
have issues, right?" But
19:05
for them, the opportunity to learn
19:07
a different way to be
19:09
tends to come as a relief.
19:10
And if it doesn't, then they
19:12
leave. They just find another job.
19:17
So you've spent, I think,
19:19
most of your career
19:21
as a nurse working in a hospital
19:22
setting. But recently, you've
19:24
changed, and you provide in-home
19:26
end-of-life care now.
19:27
Is that right? So you're outside the
19:28
hospital setting?
19:28
Yes.
19:29
Has working in
19:31
that-- has that change allowed you
19:33
to focus more
19:35
on doing some of the things that you
19:37
feel are most important in nursing?
19:38
That is, having a personal
19:39
relationship, providing personal
19:41
care to someone, and
19:43
doing some of those things that you
19:45
value most about being a nurse.
19:46
Yes. In particular, being able to
19:48
have uninterrupted conversations
19:51
with people, because honestly, after
19:53
working in the hospital and writing
19:55
The Shift, I was being sort of
19:56
stuck. And one day in the hospital,
20:00
I was feeling a little bit burned
20:01
out with just the level of
20:03
interruption and never being able
20:05
to focus on one
20:07
person at a time.
20:08
And I love it that I can
20:10
do that.
20:11
It's amazing.
20:12
My phone might ring
20:14
once.
20:16
It's very different from the
20:17
experience you describe in The
20:18
Shift.
20:19
Yes, yes.
20:20
And even then, I can usually say,
20:22
"I'm at a patient's home.
20:23
Can I call you back?" So
20:26
I love
20:28
that. And it's given me back
20:30
a sense of why I
20:32
got into this job.
20:35
There's also times when I miss the
20:37
hospital, and I feel nostalgic,
20:38
but I've loved
20:41
that aspect of the work.
20:42
And I also love, oddly
20:44
enough, that people
20:46
are in charge in their own homes.
20:47
The classic
20:49
example of someone who's on oxygen
20:51
who still smokes,
20:54
which is dangerous.
20:55
Right? And my supervisor,
20:57
we were talking about this at a
20:58
meeting, and she said, "Sometimes
21:00
all you can do is say to them,
21:01
'Could you please just turn the
21:02
oxygen off while you're smoking.'"
21:04
Like they're not going to stop
21:05
smoking, and they need the oxygen.
21:08
And I really love
21:10
that. That there's a negotiation,
21:12
like, well, you know?
21:13
Well, I don't always feel like
21:14
taking this pill, like, okay.
21:16
Well, let's talk about of these
21:18
three pills, which one is the
21:19
most important for you to take every
21:21
day? Because in the hospital,
21:23
it's you'll do this, and you'll wear
21:25
this, and you'll eat this, and
21:26
you'll go here, and you'll stay
21:27
there.
21:29
And it's very hard on people.
21:32
So maybe patients-- maybe your
21:33
patients get to be themselves a
21:35
little bit more when they feel like
21:36
they're in a place they can have
21:37
some more autonomy.
21:37
Yes.
21:39
Yes.
21:39
Yeah, that's interesting.
21:41
Well, I want to ask you a little bit
21:42
about writing as well.
21:45
When you started as
21:47
a nurse, you did not think, "I'm
21:48
going to write about this." That was
21:50
something that you did because of
21:52
a certain experience.
21:54
I wonder, can you talk a little bit
21:55
about what that experience was and
21:56
what prompted you?
21:58
Why that particular experience led
21:59
you to need, really, to
22:01
write about it?
22:02
Yes, I was still a pretty
22:04
new nurse, and I had
22:06
a patient who was set to go home
22:09
that afternoon and start coughing
22:11
up blood. And then, start
22:14
basically
22:15
spitting up blood or almost like
22:17
spewing up blood and
22:19
dying. And we
22:21
called the code and ran the code,
22:23
but she
22:27
wasn't going to make it.
22:28
And she didn't make it.
22:29
And
22:33
I couldn't get past the experience.
22:35
I mean, I went back to work, but I
22:36
felt very haunted,
22:39
and I thought, "Well if I can write
22:40
this down,
22:42
it will be contained." And
22:45
that doesn't really work.
22:46
I feel like basically what I've
22:47
realized is you never get over
22:49
something like that, but you make
22:51
peace with that.
22:53
But it's just a part of
22:55
who you are as a health care
22:57
provider.
22:59
And when I talk about it, I see
23:01
a lot of nods in the audience.
23:02
So I think it's a pretty common
23:04
experience.
23:05
That first sudden, violent
23:07
death.
23:09
But I liked what I wrote, and
23:11
so I thought, "Well, aim high.
23:13
I'm going to send this to the New
23:14
York Times." And actually, a friend
23:16
of my brother's is
23:18
on the editorial staff, and I
23:20
sent it somewhere else to the
23:21
magazine. I never heard from them,
23:23
but he said, "You know, this is
23:24
really good. I hope this is okay." I
23:25
sent it to the Science Times, and
23:27
they liked it.
23:28
And they took it.
23:30
So very, very excited.
23:32
Took six months to actually get into
23:34
print.
23:37
But then, when it came
23:39
out, it got a huge,
23:42
huge national
23:44
reaction, which I'm not
23:45
saying as a way of bragging.
23:47
I really didn't expect it at all.
23:49
And I started hearing from editors
23:51
and agents saying,
23:53
"This is a voice. We never hear the
23:55
voice of a bedside nurse,"
23:57
which was so incredibly
23:59
empowering to me.
24:01
And you've written more or less
24:03
continuously since then.
24:05
In the times I mentioned earlier,
24:06
all of the attention that you got
24:08
for the piece you wrote about
24:09
doctor-nurse relationships in 2011,
24:12
I think. You mentioned in one
24:13
interview I read that you actually
24:14
had to talk to an administrator
24:16
after that. So that's one
24:18
kind of, I guess,
24:20
repercussion of being a public
24:22
writer and being a nurse.
24:23
How has that
24:25
experience been for you all along
24:26
the way? Are you looked at with some
24:28
kind of suspicion?
24:29
I can imagine that being one way
24:30
that people would relate to you.
24:32
But what's that been like in
24:33
general?
24:33
Yeah, there's definitely been
24:35
suspicion.
24:36
There were nurses who loved what I
24:38
did, and there were
24:40
a few nurses who,
24:42
for different reasons, didn't.
24:45
And I sort of worked with
24:47
talking to them and saying, "Oh, I
24:48
was thinking about writing about
24:49
this, and you were
24:51
in it." And they
24:53
were always fine with it.
24:55
But then, there were times when,
24:57
even when people were de-identified
25:00
or they just they felt kind
25:02
of exposed, even though no one would
25:03
know who they were.
25:06
And the hard thing for me was that
25:08
people wouldn't necessarily
25:09
come to me directly and say,
25:12
"Here's how I feel," which
25:14
I can see that that's hard.
25:16
But when you're all working
25:17
together, just I wish people had
25:19
done that, but whatever.
25:21
But since leaving
25:23
that job, I found more hospitable
25:25
employers.
25:27
And the challenge
25:29
for me is to just make it clear that
25:31
I'm there to work.
25:33
I'm not there to be super nurse
25:35
or Theresa
25:37
Brown, the author.
25:38
And people get that, and they go
25:40
with it. So they'll kind of say,
25:42
"Oh, you're that writer, right?" And
25:43
we sort of talk about it.
25:44
And then I'm like, "Okay, so what
25:45
about this patient?"
25:46
Yeah. I imagine if you did have
25:48
people come up to you and talk to
25:49
you, whether they agreed with you or
25:51
not, that would be
25:53
a really productive experience for
25:55
you. But instead, it's a shame that
25:56
that's not more of the reaction that
25:58
you get from your colleagues.
26:00
Yeah. I would have appreciated
26:02
that. Yeah. Like, let's
26:04
have a conversation about this.
26:06
But I don't know if it's
26:09
the power of being in print that
26:10
makes people feel intimidated
26:12
or especially talking
26:14
about end of life.
26:15
That was not
26:17
always popular in oncology
26:19
because a lot of oncologists just
26:21
feel like you shouldn't
26:24
talk about that.
26:24
You shouldn't talk about hospice.
26:26
You just should never bring
26:28
it up. And
26:30
I would love it if that would
26:31
change.
26:33
So that created tension.
26:35
People felt like I just shouldn't be
26:37
going there and writing about it.
26:39
Yeah, yeah.
26:40
It's interesting because you said
26:42
death-- you write this in maybe
26:44
both of your books, but death is so
26:45
present in your work.
26:47
And then, also when you're writing.
26:48
For that to be something
26:50
that is-- that
26:53
there's some kind of a taboo against
26:55
talking about it. Seems like that
26:56
would be one of the most important
26:57
things that you could prepare
26:59
yourself for.
27:00
Yeah. Well, that gets back to the
27:02
question you asked at the start
27:03
about are we prepared to talk to
27:05
patients about death and not
27:08
really. I mean, I even remember, as
27:09
a student, having
27:12
a patient who the husband
27:14
had made the decision to put
27:16
his wife in hospice.
27:18
I don't remember why, but it was
27:20
this patient that ended up doing a
27:21
kind of write-up about.
27:22
And my instructor said, "Well,
27:23
you're just basically sending this
27:25
woman to the funeral home." I
27:27
said, "You know, no.
27:29
This is the husband's decision.
27:31
It's very well-founded." And I
27:33
actually ended up
27:35
talking to him a fair amount about
27:37
it.
27:38
And that was kind
27:40
of the start of saying, "Oh, I can
27:42
do this." It's not you don't
27:44
know you can do it because we don't
27:45
get a lot of opportunities in life.
27:47
Yeah.
27:48
There's a fascinating study
27:50
that you've referenced, and that is
27:51
also, I think, I read in Atul
27:53
Gawande. His latest book from
27:54
Massachusetts General Hospital, of
27:56
patients who accept hospice
27:58
care, not only having less suffering
28:00
towards the end of their lives but
28:02
actually living longer.
28:03
Yes.
28:03
Yes.
28:06
It's not you're saying sending this
28:07
person to the funeral home.
28:09
It's quite the opposite, in fact. The
28:11
numbers show.
28:11
Right.
28:12
And that's one of the big
28:14
misconceptions we have to struggle
28:15
against in hospice that
28:17
people think the goal
28:19
of hospice is for people to die.
28:21
And it's not.
28:22
It's for people to live the
28:24
absolutely best life they can
28:27
until they die.
28:28
And certainly, if there was someone
28:30
on hospice with a certain kind of
28:32
cancer and an amazing treatment
28:34
came out. And they wanted to
28:36
try it, and they could stand
28:38
it, I'd be the first person to say,
28:39
"You should definitely do that."
28:42
We want everybody to live as well
28:44
as they can, but we
28:46
are all going to die.
28:48
It sucks, but it's true.
28:49
That's the effort to prolong
28:51
life at all costs.
28:52
It seems like there's
28:54
a strange kind of goal
28:56
of immortality somehow behind that.
28:57
Once you accept mortality,
29:00
then you can get all kinds of
29:02
positive results from that.
29:03
That otherwise, you wouldn't
29:05
be able to do. Quality of life being
29:06
one of them.
29:07
Right.
29:07
Right. And just do you want to end
29:09
your life in
29:11
an ICU hooked up to machines?
29:13
You can't talk to your family.
29:16
And if somebody wants that,
29:18
that's fine.
29:19
But do people understand
29:21
that they're making a choice,
29:24
and they could be at home?
29:26
They could have the people they love
29:27
around them. They could actually
29:28
have conversation.
29:30
And usually, if you present it like
29:32
that, people
29:34
will choose that.
29:36
And then, it's how do we help them
29:37
make the most of that time.
29:39
Yeah.
29:41
Well, one other question about your
29:43
writing I wanted to ask is about
29:44
your style.
29:46
As someone who was an English
29:48
professor, I'm sure you're aware
29:49
of style. The writing style.
29:51
You paid a lot of attention to it in
29:52
your past life.
29:53
How did you come to the style you
29:55
currently use? Have you thought
29:56
about it a lot over the years?
29:57
Was it something you worked on a lot
29:59
before you sent your first piece
30:00
out? And how has it changed since
30:02
you've been writing over the years,
30:04
or how do you think about that?
30:05
Oh, I think
30:07
the truth is I don't think about
30:09
it. It's just what
30:10
I do.
30:13
It's sort of what goes on in my
30:15
head.
30:16
That kind of spare
30:19
style.
30:20
And when I try to get too
30:23
flowery or metaphorical, it usually
30:26
just is like embarrassingly bad.
30:28
Those must be in early drafts.
30:31
So I
30:33
think what I've learned is what I'm
30:35
good at.
30:37
Interesting
30:39
detail, which I hope it's
30:41
interesting to other people, but
30:43
I'm also very spare with commas.
30:45
And so, the copy
30:47
editor went through and added
30:50
a whole bunch of commas.
30:51
And then, I went through and took
30:52
some of them out
30:54
and then got a note back
30:56
saying, "Well, we
30:59
went along with the comma decisions
31:01
to accommodate the writer's spare
31:03
style."
31:08
So the point being that
31:10
even at that level, it was important
31:13
to me to have a sense of
31:15
flow and control over the sentences.
31:18
That's just the way it
31:20
comes out.
31:21
Yeah.
31:23
I was kind of thinking about it as
31:25
I was reading and knowing your
31:26
background. And I had thought about
31:27
it in terms of the-- some of the
31:29
words that came to mind were
31:30
measured and kind of respectful in
31:31
a way. And then, I read a passage
31:33
of yours talking about the kinds of
31:35
relationships you have in
31:36
friendships you form with other
31:37
nurses, and you talk about it being
31:39
no-nonsense.
31:40
And it seemed to me that it was kind
31:41
of the way that you were writing
31:43
was, in a way, kind of like
31:44
respectful of the work that you were
31:46
doing as a nurse.
31:47
And that it had that no-nonsense
31:49
kind of character to it.
31:50
Oh, that's interesting.
31:52
Yeah. Yeah.
31:53
I mean, I love Joseph Conrad.
31:55
I love Faulkner.
31:57
I love their incredible writing.
31:59
But I think the styles
32:01
that really speak to me are
32:03
Hemingway, Raymond Carver.
32:06
I mean, I just
32:08
love that spareness.
32:10
And apologies for mentioning all
32:12
women. Flannery O'Connor also has
32:13
that.
32:14
I mean, all men.
32:15
I'm sorry. Mentioning all men.
32:17
Yeah.
32:18
Well, it's really the very-- it
32:20
creates a very moving work
32:23
for me when I read.
32:24
Definitely.
32:25
My last question is, what are your
32:26
plans for your writing from here on?
32:28
Do you have anything-- I mean,
32:29
you're going to keep, I hope, writing
32:30
for The Times. But other than that,
32:31
are there other projects you have in
32:32
mind that are larger than that?
32:34
There will be a third book.
32:36
It's sort of a light
32:38
on the back burner of my brain, and
32:39
that's about as far as
32:41
it's gotten.
32:44
It might be something about
32:45
end-of-life and hospice, but
32:48
there are so many books about that
32:49
now. I need to make sure I have
32:51
something that's
32:53
new enough to be worthwhile to
32:56
say.
32:57
But yeah, I will keep at it.
32:59
Well, we look forward to more of
33:01
your work. And Theresa Brown, thanks
33:03
so much for joining us.
33:04
Thank you.
33:09
That's it for this edition of Being
33:10
Human. Stay tuned next time when my
33:11
guest will be Jeff Williams,
33:13
professor of English at Carnegie
33:14
Mellon University and author of How
33:15
to Be an Intellectual.
33:17
Thanks for listening.
In collections
Being Human Podcast Recordings
Order Reproduction
Title
Nursing, Writing, and Humanity: An Interview with Theresa Brown
Contributor
University of Pittsburgh (depositor)
Brown, Theresa (interviewee)
Kubis, Dan (interviewer)
Date
August 5, 2016
Identifier
20230127-beinghuman-0010
Description
An interview with Theresa Brown, nurse, New York Times columnist, and author of "The Shift: One Nurse, Twelve Hours, Four Patients' Lives". Theresa's talk and reading at Pitt in September, 2015 was the kick-off event for the Year of Humanities. This interview focuses on her work as a nurse, and the relationship between her lives as a writer and health care professional.
Extent
33 minutes
Publisher
University of Pittsburgh. Department of English
Type
sound recording-nonmusical
Genre
interviews
Subject
Nursing
Women authors
Brown, Theresa
Source
Being Human
Language
eng
Collection
Being Human Podcast Recordings
Contributor
University of Pittsburgh
Rights Information
In Copyright. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s).. Rights Holder: University of Pittsburgh
http://rightsstatements.org/vocab/InC/1.0/
Rights Holder
University of Pittsburgh
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