Welcome to one of my least favorite days of the year.
Thirteen years ago today, one of my dearest ones chose to leave his skinsuit behind and, in the language I use with my kiddos, rejoin the stars. My life, and arguably, my capacity to love, has never been quite the same. Greg’s departure from this planet altered my being at the cellular level. It sent me into the deepest despair I’ve ever known, and then raised me up and grew me into the mama, nurse, and healer–this expanded and aware human–I’ve since become. I’m grateful to have walked beside him in the flesh, and though I softly mourn his absence nearly daily still, I’m equally grateful for his continued presence in my consciousness. He’s gone, but he’s never quite left me, and I’m so so grateful..
Today, to honor him, I thought I would share a little of the joy that he brought to me, and to this planet. Please enjoy our “Meet Cute” story–a short chapter from my book, “The Kind of Woman Who Would.” Bear in mind that this scene took place circa 2006. I’d like to believe that much has changed in the practice of critical care medicine–particularly around the way physicians treat their patients. Back then Greg’s behavior was the exception. Now I believe it to be the rule.
Also, for those of you who are curious, here is the recording of Ogden Nash reading “Portrait of the Artist as a Prematurely Old Man.” It’s worth a listen.
The first time I ever laid eyes on Noah Goldstein, I knew I needed to know him. Yes, he was precisely my type—tall, dark, and handsome in a geeky sort of way, soft and skinny and smart—but romance was not the primary motivation behind my immediate desire to know him. In fact, the very idea of romance made me rather uncomfortable that day—I was still busy believing I was already in love and planning to move into that sweet little A-frame in the Santa Cruz mountains with Kris. But despite my discomfort, I knew I needed to know him because in one less than 20-minute interaction, Noah Goldstein completely blew my mind.
I was a brand new nurse in my first official week of employment at Stanford, working side-by-side with Jenni, my mentor. Noah was a surgical resident on rotation in our ICU for the month. We called him in to place a new arterial line in our patient, to help us monitor his tenuous blood pressure in real time. The patient, Mr. Torres, was a new admission—a 47-year old polytrauma, the victim of a T-bone collision somewhere in the farm country of the central valley. The accident had happened in the early hours of the morning on one of those crazy two-lane roads, the kind where the 55 mph speed limit is only occasionally punctuated by a traffic light, or a stop sign. According to the police report, an eyewitness stated neither the patient, in his 1980s Ford pick-up truck, nor the semi that broadsided him, slowed down, much less stopped at the four-way stop signs.
Mr. Torres was flown in from the tiny local hospital by Stanford’s helicopter and taken straight to the operating room where his shattered pelvis, and ruptured spleen, small bowel, and bladder were surgically repaired. He arrived into our care in the ICU late in the day with his belly still open, nothing but some moist gauze separating me from the entire contents of his abdomen. Jenni explained he was “left open” to allow room for everything to swell without cutting off circulation to the major blood vessels inside. He was also still in need of multiple other non-life-threatening orthopedic repairs, but these would have to wait until he was stable enough to endure another round of anesthesia. In the meantime, we were to monitor him closely for signs of bleeding and infection, and the arterial line that had been placed in the helicopter was beginning to fail. We needed a new one—Dr. Goldstein to the rescue.
“Noah! We’re so happy to see you!” Jenni beamed as he came through the sliding glass doors.
“Finally! Someone’s happy to see me today.” He flashed her a wry smile as he moved across the room toward the patient’s bed.
“We’re always happy to see you here in the ICU.”
“Well, you’re just about the only ones. I’m sporting four brand spankin’ new assholes this afternoon and I’m not even the one holding the trauma pager!”
“Who’s out to get you, Noah? Tell us all about it.”
“Who isn’t, Jenni?”
“Really?”
“Of course not. I’m totally kidding. I only have two new assholes today—one from Dr. Green, and one from Dr. English.”
“Uh oh, what did you do?”
“It’s what I didn’t do—I’m afraid mine were sins of omission.”
“Oh god,” Jenni scowled, “What did you forget?”
“Coffee and donuts.”
“Oh jeez—you scared me for a minute. I was envisioning instruments left inside some poor guy’s gut.”
I smiled. “If there’s some kind of sin you must be pursuing, remember to do it by doing, rather than by not doing.”
Dr. Goldstein wheeled around and cocked his head at me.
“You said it was a sin of omission–” I tried to clarify.
“I know. What’s that from?”
“It’s an Ogden Nash poem. But I’m sure I screwed it up.”
“Interesting.” I could see his wheels spinning.
“One of my college roommates had a recording of a bunch of poets reading their work aloud. His voice was unforgettable, plus it’s funny as hell, so it stuck.”
“Noah, do you know Dana? She’s been a student here for the last year. Now she’s brand new staff.”
“Straight into the ICU from nursing school. That’s badass,” he said.
I blushed.
“And she knows her poets,” he said to Jenni, “Also badass.”
“Not really,” I said, “Maybe one or two.”
“Why do I doubt that?” He glanced at me for a moment too long. I looked away.
“I’ll let you two be brainy together while I catch us up on some charting,” Jenni said, “We’re way behind on his admission documentation.”
“No, no, let me do that. I need the practice. I still hardly know what I’m looking at in that stupid computer.”
“Go for it. I’ll take myself on a little stroll then. Noah, do you need anything? Your pressure line is all set up, and Dana pulled you some lidocaine.”
“It’s on the table.” I gestured with my chin.
“Got it,” he said, flipping the vial into the pocket of his white coat. “No, I’m good here.”
“Alright, I’m gonna pop next door to visit Annie for a minute. Buzz me in 42 if you need me.”
“Okay.” Noah and I both said simultaneously.
I wheeled the computer around to face Noah and the patient so that I could keep an eye on them both as I charted.
Noah was in the process of sorting the contents of the large Rubbermaid tub that contained the supplies he needed to place the line.
“Senor Torres,” he began, addressing the patient, who was intubated and heavily sedated, in flawless Spanish, “Me llamo Noah. Estoy su medico. Estoy aqui para poner un IV especial en su muneca.”
Wow. It was a rare doctor who even bothered to address an intubated and sedated patient at all before performing a procedure much less address them in their native tongue. This guy was good. He continued his monologue in Spanish, narrating his every move as he began to set up his sterile field. I continued charting, but I was distracted.
“Are you—are you setting up two sterile fields?” I asked him. He had one sterile towel set out on the bedside table, and another on the counter. A package of sterile gloves was laid out next to each of them.
“Why yes, I am.” There was a mischievous glimmer in his eye.
“Because one is never enough?” I questioned.
“They’re for two separate procedures.”
“What else are you doing besides placing an art line?”
“Music therapy.”
It was my turn to cock my head and look at him.
He pulled a Ziplock baggie from his coat pocket and emptied the contents—an iPod and a speaker dock—on to the sterile field on the counter. He then donned a set of sterile gloves, placed the iPod in the dock, and dialed up a musical selection. The room filled with the sound of salsa.
Was this guy for real?
“Now, is your choice of music for the benefit of the patient, or your own?” I asked him.
“I’d like to think we’re all gaining a little something from the experience. Isn’t your day a little brighter, Nurse Freedman?”
Somewhere in the last ten minutes he had made note of my last name, which was on my ID badge on my chest, but still, “It is, Dr. Goldstein, it is.”
I continued to watch Noah as he readied himself to float the arterial line into Senor Torres’s left wrist. He shimmied a little, and rhythmically moved his feet to the music as he worked. When he was just about ready to make the actual stick, I went to the patient’s bedside and prepared to hand off the monitor end of the pressure tubing for him to secure once he hit the artery. This last bit had to be done swiftly or arterial blood would spurt out all over the place making a giant mess. A second set of hands, when available, always made things a little tidier, and helped to avoid excess blood loss.
Noah pierced the radial artery and bright red blood flooded the catheter.
“Nice work,” I said, as I handed him the tubing. He fumbled for a moment and the blood pulsed out on to the barrier cloth that he had placed beneath the patient’s wrist, and then shot on to the floor. “Hey, hey!” I teased, “Don’t go bleeding him out all over my room!”
“Now, now. I put down a Chux to contain my mess.”
“I noticed, and I appreciate it.” Very few doctors ever took the time to do this. Nurses were forever changing sheets following bedside procedures—no small feat considering our patients were largely immobile, sedated, and attached to all sorts of delicate equipment. “Thank you.”
“I try.” He secured the tubing, and resumed dancing as he sutured the line into place.
I went back to my computer. But I was still watching.
A minute or two went by before I spoke. “You learned to dance salsa on the west coast.” I stated matter-of-factly.
“What?” He paused at the biohazard bin, suspending his armful of trash above the lid, and looked up at me.
“Salsa. You learned to dance out here.”
“What makes you say that?” The trash landed safely in the bin.
“You’ve been moving on the one and the five. My boyfriend and I (I said it just to be clear)—we’ve been taking lessons, but I learned the basics from some busboys I worked with back east.”
“You learned on the two and the six, then.”
“I did—if you can call drunk dancing with busboys learning. It can be kind of confusing, especially since Chris can’t hear the music very well yet. He leads on all sorts of beats, and I tend to fight him instead of following.”
“A good follow can follow any lead.”
I rolled my eyes. “Did they teach you that in medical school?”
“Dang, you’re quick!”
“Yeah, well, that’s what they teach us in nursing school.”
“Well, that explains a whole heck of a lot about what happens around here.” There was a pause as he collected his sharps—needles, and glass vials—from his sterile tray. “I learned on the two and six in London, on a semester abroad a few years ago. But I live here now. When in Rome—“
“Oh, do they move on the one and five in Rome?”
“I don’t know.” There was that wry smile again. “Maybe we should find out.”
I had the distinct feeling he was suggesting something slightly more intimate than a Google search on the subject. I could feel myself turning red again.
He washed his hands and turned toward me. The next thing I knew he was wheeling me in my chair out from behind the computer and pulling me to my feet. “Let’s see what you’ve got?”
“Oh no, no, no!” My face was on fire.
“Do you want the one and the five or the two and the six?”
“C, none of the above.”
“Wrong answer. Please try again.” But we were already dancing—on the one and the five. When in Rome…
All of the sudden, the sliding doors parted. I nearly jumped out of my skin.
“What in the world are you two doing?” Jenni laughed, and quickly closed the door behind her.
“Arthur Murray here is giving me a dance lesson,” I said.
“Arturo,” Noah corrected me.
“I’m sorry, Arturo Murray.”
“Did you get that charting done, missy?” Jenni scolded, but she was teasing.
“Mostly?” I said sheepishly.
Noah’s pager went off.
“Aaand, I gotta go.” He quickly grabbed another ziplock baggie from the counter, turned it inside out, and snatched up the iPod and dock, terminating the music and stowing it away in his pocket in one fell swoop.
“Thank you for the dance, doctor,” I called after him as he scurried toward the door.
He paused in the doorway, turned, and looked me square in the eye. “The pleasure was all mine.” With that he spun around and walked away.
“Wow,” Jenni said.
I stood there staring after him for a moment before I turned toward her, puzzled. “Who IS that guy?”
“That. Is Noah Goldstein. He’s one of the good ones.”
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