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  1. Schuster, Claire MSN, RN, APRN-BC, CWS


When the nurse becomes the guest.


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I met Miss Elsie on a hot, humid afternoon in July. She lived in a forgotten neighborhood of narrow old row houses on the fringes of the city. Standing on her slat-floored porch, I knocked on the screen door and peered into the dark interior. A little boy emerged, his tiny face lifted up, a small brown hand shading his eyes.

Figure. Illustration... - Click to enlarge in new windowFigure. Illustration by Eric Collins /

"Hello," I said. "I'm the nurse. I'm here to see Miss Elsie."


"I know," he answered, grabbing my wrist and pulling me inside.


The heat of the cramped house slammed into my face. The windows were closed and the shades pulled down. Without a word, my little escort guided me down a narrow hallway into a room not much bigger than a closet, then deftly released my wrist and slipped out of sight.


The room was dark, its one window closed and thickly curtained. A rotating fan parked in the center of the room screeched each time it swiveled side to side on its rickety base. Surprisingly, this room was a cool oasis from the heat of the rest of the house.


Miss Elsie lay on her side, on a twin bed anchored against a wall of peeling paint. A pink cotton nightgown, worn thin as film, billowed up and over her thin frame in rhythm with the rotation of the fan. Her head was perched against two pillows that were layered with a bundle of dried lavender. The bones of her skull were accentuated by perfectly tight plaits of oiled hair. Although her small body was marooned in the darkened room, a survey gradually revealed her to be a person deeply cared for and loved.


Like an origami swan, her body was folded into itself-long fingers curled into the palms, arms bent at the elbow meshed into her chest. Her knees were so highly flexed they grazed her elbows, feet and toes so tightly pressed together they appeared fused. Except for the ulcer blooming large and deep over her right hip, her papery ebony skin was flawless.


I approached her and introduced myself. "I'm the home health nurse," I said, "here to change the dressing on your hip. Is that OK with you?"


The edges and planes of Miss Elsie's skeletal face were sharp as slate. Her eyes were dark and glossy. Between the deep purple lines of lips, a slip of pink tongue paused at a scattering of large white teeth.


Her eyes focused on mine. She blinked once. Though she was unable to speak, her eye movements became a mute vocabulary.


"Does one blink mean yes?" I asked.


She blinked once.


"OK, great," I said. "Are you hurting anywhere?"


Two blinks.


"Do two blinks mean no?"


She licked her lips and blinked once.


Her eyes traveled across the room to the window, where a small shelf had been screwed to the sill. The meager space was dominated by a pale blue glass pitcher marked "Sugared Ice Tea" and two matching glasses, one of which held an old-fashioned glass straw.


"May I pour you some tea?" I asked.


Miss Elsie blinked once.


As I poured the tea, a sliver of light from between the curtains struck the glass straw, and it occurred to me that the last time I'd seen a straw like that was in the home of my grandmother, when I was just five years old. I remembered marveling at its shape, the angle blown into the glass perpetually held in anticipation of a sip.


I turned to offer the tea to Miss Elsie-someone else's grandmother, but at this moment, mine too. "Here's some cold sweet tea for you," I said, guiding the straw to her lips.


Miss Elsie blinked, widened her eyes, and looked over at the shelf. Then she looked back at my face, the shelf, my face, and again the shelf. I followed these rapid eye movements, frustrated that I couldn't decipher her message.


Then I noticed the second glass.


"May I join you for tea, Miss Elsie?" I asked.


Her eyes eagerly returned to my face. She blinked once.


Miss Elsie, the reclining hostess, sipped tea through an antiquated straw, and I, the invited guest, sipped tea from a blue glass. How easy it would have been to ignore the little wooden shelf, adorned with the simple means of connecting two people. But then I would have betrayed what it meant to nurse someone, to be there, to surrender to the needs of my patient.


Not long after that visit, Miss Elsie died. What remains with me is the memory of taking tea with her one hot July afternoon, in a tiny shaded space cooled by a whirring fan-the lavender scent of her pillows, the curled comma of her body, the rhythmic billowing of her gown, the glass straw, her eyes lit from within.