Nina Gaby

Essays, art, and healthcare


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For National Nurses Week, 2018: “On Legacy and Ego Integrity vs. Despair”

 

(2015 submission rejected by the American Journal of Nursing)

 

  1. Nursing school

It was May, 2015. I’d been trying to percolate some sort of blog entry that would bring my author’s platform up to date and also commemorate National Nurses Week, Mothers Day, and my upcoming 65th birthday. Is there a quatrofecta that lets me write a four for one?

 

In an essay a couple years ago, published in I Wasn’t Always Strong Like This: True Stories of Becoming a Nurse, I write about when I said goodbye to the relative freedoms of an artistic life and became a nurse: “At 34, I was the third oldest person in my Bachelor’s program, several of us ‘non-traditionals’ in a group of otherwise very bright and age appropriate young women. I was the wildest, with the most energy, and I looked nothing like a nursing student, whatever they were supposed to look like.

She’s an artist,” people would whisper. “She’s old.”1

 

My new friend Fran was ten days older.

 

We met the first day of nursing school in 1984. We were both the same age, with careers, entering nursing in our thirties as a means of achieving goals we otherwise might not. We were both interested in a myriad of health and social issues. Fran was to focus on patient education, and I switched gears from wanting to be a nurse midwife to settling on psychiatry and eventually becoming a specialist in addictions and a psychiatric nurse practitioner.  That very first day Fran told me Florence Nightingale wrote about nursing as an art.

 

Along the way I had a baby and Fran moved to Arizona.  Then I moved to Vermont.

 

We established a ritual to keep us connected. Every May, between our birthdays, we would exchange “Flo.” Flo is a little plastic nurse doll we named after Florence Nightingale,  the cake topper my mother put on our graduation cake in 1986. I made a special foam-lined box, “the official Flo transport system,”so she could travel safely between Arizona and Vermont.  This year, I would be getting her around Mothers’ Day. I miss my mother, and the ritual, of which I have very few, helps me feel connected to the best parts of her as well as to my friend.

 

2. Legacy

Fran planned. She had a year planner, a five year planner. I was lucky if I could plan the next five minutes. She gets to retire this year at age 65. I made impulsive life changes along the way; I will never be able to afford to retire.  Fran wins awards.

In the morning, when I called to congratulate her on her three newest awards, she tried to brush them off but I wouldn’t let her get away with it. “You got a freakin’ legacyaward,” I insisted. At our age the word legacy is fraught with meaning.

We overdosed on Erik Erikson in nursing school, feverishly memorizing his Stages of Psychosocial Development along with Maslow’s Hierarchy of Needs for exams. But who thought it would ever be us we were talking about?

 So here we are, leaving Generativity vs. Stagnation, the stage of middle adulthood, for our last phase: Ego integrity vs. Despair. Late adulthood. Age 65 through death.2

Cheery.

We are those people now wondering what our legacy will be.  At least I am. Fran got an award to define it.

What I didn’t tell her on the phone was that when I read the news of her awards I had been sitting at my desk for twelve hours trying to master a new electronic medical record system. Everyone else in the clinic had gone home. I put my exhausted head in my hands and sobbed.  No one’s going to give me a legacy award for spending my life feeding a hospital computer system, I cried. I can admit stuff like this now, old enough to know it is a universal thing, this is jealousy and despair. This is human messiness, and we nurses know about all that.

 

3. Mothers Day

What she did remind me was that I had had a child. She did not have, nor were having children ever in her plan. She reminded me that I was not factoring in the 25 years of pregnancy, bed rest, postpartum depression, motherhood. Would I have gotten a doctorate if I’d not had my daughter? Probably not. Written more essays? Made more money? Would my legacy feel any different? No. I’m a direct-care clinician, on the front lines. I help people. And now my daughter, in graduate school to become an end-of–life specialist will as well, help people. I am proud of her, I am proud of my friend. And yes, I am grieving my youth and worrying about the continued integrity of my ego. I will probably sob again before the month is over.

My Mothers Day card reads:

 “No one is useless in the world who lightens the burden for another.”

Charles Dickens3

1  Gaby, N. (2013). Careening Towards Reunion. In Lee Gutkind (Ed), I Wasn’t Strong Like This When I Started Out: True Stories of Becoming a Nurse   Pittsburgh, P.A. : In Fact Books.

2 “Erikson’s stages of psychosocial development” Wikipedia.

3Dickens, C. (originally published in 1865, 2013).  Dr. Marigold.  On line publisher at OverDrive: A Word To The Wise.

 

 Addendum 2018: Fran got yet another award for which I congratulated her on yesterday, and I’ve quit and started several jobs since the original writing of this, and have finally settled in a medical clinic as their psychiatric provider and feel as though I’ve come home. As I sent the box with Flo carefully tucked inside to Arizona, I told the story to the postman and started to cry. He had a similar story of his own.

 

 

 

 

 

 

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More than the Sum of its Parts

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Book collage in process

Composite/collage. Synchronicity in text and image, transparency, translucency, opacity. How do we make it work?

In order to write in any sort of intimate way about mental health and addiction, I essentially make a hybrid of characteristics of an individual, spanning time, place, gender, symptoms. The point is to paint an accurate image of what without focusing on the who, on the why without the where. For obvious reasons, this allows me to shine a light on an issue without breaking confidentiality, and allows me to honor without alarm. I want the reader to understand what goes on for people in this world of addiction and psychiatric disturbance, within that understanding we might see impact or at least volition for change.

It’s a dilemma. CNF (creative non-fiction writers) will often say, if you can’t tell the whole truth than don’t bother writing about it. Others will find it good enough just to blur the lines. Others use permission contracts and footnotes. At conferences I’ve listened carefully to experts such as Lee Gutkind and Susan William Silverman, Dinty Moore and Jacquelyn Mitchard. My work has been picked apart by editors and lawyers. I don’t have an answer except that there are narratives that need to be told and images that need to be made.

I collage 3-D memoir from mixed media and think about whether transparency can truly exist. I work in porcelain and encaustic as well as words, all radiant in their translucency. I think about politics and the opacity that crushes us. I am proud of these stories I write about people I have been honored to know.

Here is my latest, a Monthly Muse contest winner from New Millennium Writings, “The Sum of its Parts.”

https://newmillenniumwritings.org/nina-gaby-sum-of-its-parts-musepaper-2018/


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A Kind of Gratitude

turkeyThe patient was in her fifties, simple alcoholism (as if any addiction is simple) and doing well in her treatment. It was twenty two years ago and the big relief for her was that she had never added crack to her repertoire. “I want to quit smoking cigarettes too,” she told me, so one of her recovery goals was finding something she enjoyed that did not involve bars or bad men and kept her hands busy. She joined one of those ceramic classes that I used to joke about with my art school friends. Once upon a time, during my own days struggling with “simple alcoholism” I was a serious art student, getting a BFA in Ceramic Art and would go on to have my work in the permanent collection of the Smithsonian and support myself and my studio selling my handbuilt porcelain objects in fine craft galleries across the country. Selling pieces I could never have afforded to buy myself, and very much a craft snob. My work was professionally photographed and I was featured in coffee table books. My friends and I called those little hobby shops where ladies went to paint bisqueware “s’ramics” and we often made fun of them. Of course that was just a cover up for shame at our own beginnings, at least my own, in an aesthetically barren, or at least questionable suburb of the fifties, where housewives like my own relatives and neighbors did crafts when their husbands would let them out of the house. Our own living room was full of ashtrays that my aunt had glazed, often in holiday themes, although the pieces I still own and have grown to cherish include a boomerang shaped nut dish in a gold and turquoise crackle and a plate with a shadow image of a little girl in pigtails with my name across the bottom.

One day, after I had closed my clay studio and become an advanced practice nurse, still a snob regarding the university I had chosen but nonetheless somewhat more humble, the patient came in for her monthly “check up.” She had completed the group portion of treatment and was now in AA and reunited with her daughter and grandchildren. Maybe she got her driver’s license back, maybe she was working again. Her appointment was the day before Thanksgiving. She was carrying a box which she set down on my desk with a flourish, lifting out a ceramic turkey with a fan of lollipops as its tail and carefully painted eyelashes. “I made this for you and your family!”

My first inclination, a nod to the loyalty of art school snobbery, was an “oh no” and my second was to remind her that therapists can’t accept gifts. But I did neither, instead I thanked her and in good therapist form we discussed what this turkey represented to her (sobriety, love of family, gratitude for my help, finding a new way to be) and I brought it home and put it in a prominent place on the holiday table, where others said things like “what the hell is that” and my three year old daughter was thrilled and my nieces and nephews stole all the lollipop tail feathers over the course of the holiday afternoon. Twenty two years later it’s hard to find those same lollipops and nothing else fits the little holes quite right so I just put him out without a tail.

For a number of years after I left healthcare and we moved to Vermont, I couldn’t find the ceramic turkey. My husband said it’s just as well, he could never understand my attachment to it, and my daughter forgot about it. We went through some hard times, I gained humility and managed to stay sober. I found the turkey.

I never lost him again, although every year I worry that he won’t be in the plastic holiday crate with my grandmother’s menorah and the handmade ornaments from my daughter’s elementary school days and the frayed felt stockings from my husband’s childhood and my own. I admit there are a few aesthetically pleasing objects in the crate but less than my old self would have thought. Every year now I put out the ceramic turkey as I make dinner for a much smaller crowd-one year it was just me and the tail-less turkey, as my daughter was doing her Junior year abroad and my husband was sick and stayed in bed and my mother had died and the rest of my family was in another state. The turkey flirted with me from his perch on the piano. And I understood a kind of gratitude, a new way to be.


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Blogger Block? Me?

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Valid excuses abound for my lack of follow through to my commitment of blogging twice a week to develop a presence. A “platform” as the new vernacular insists. How hard could that be for someone with boundless opinions on everything and insatiable energy for anything to do with the written word?

Yes me. Caught in a wash of the ennui that has always made me pity others. Me, of the “just do it” mentality. Legions of exhausted wordsmiths, I humbly join you. Hands folded, the laptop keyboard about as inviting as the treadmill in the corner that I am also avoiding. I can get mildly energized by the metaphor of laptop and treadmill, thinking I’m on to something, but it passes. I go get a yogurt, throw laundry in the washer. I have prepped for writing, I remind myself. I spent yesterday, a work day from home, writing up a pile of overdue psychiatric evaluations for my day job, got some discharge notes done, took a nap, and yes I will admit this to you, caught up on the Young and the Restless. All that so I could write today.

Or at least try to untangle the loop-de-loop that my anthology project has become. An interested agent needs me to include in my proposal some writers of household name stature before a publisher will even look at it. Household name writers don’t write on spec so I need a publisher. Generous women willing to help, waiting for more info. I wait for the universe to toss me some secret tool to unravel the loop or at least get more of my pleading emails answered.

I list all the reasons I can’t write today, all the reasons I am planning to go to a matinee with a friend instead. Why I spent last weekend eating fried seafood along the coast of Maine instead. A double sabotage, nothing pokes a hole in the energy reserve like overly oxidized trans fats. Actually I am doing a lot of stupid things to avoid how I feel about some really bad things that are going on, things I should be writing about. Like that my cat had to have her leg amputated this week. Like that a friend has been given two to seven days to live. Another friend has relapsed. Another friend’s dog died. A family member has had a serious exacerbation of a chronic illness. I’m worried about my daughter. I can’t keep up with the need for my services at work, and Obama-care isn’t helping with that. I cannot write about what’s important in mental health care right now because the state that I live in has an even broader interpretation of confidentiality laws than the feds. I have a sore throat. Headache for weeks. Cataracts. My house is a mess. Where does the list end, where does it cease to be valid? At any rate, I have to share the yogurt with the cat, it’s the only thing she’ll eat. And then I’ll post this, knowing you will understand.