The stories of our personal lives often become the lessons that guide our professional lives. I am reminded of a story about my father as I glance at the contents of this issue and think about the concept of commitment.

At age 84, my father moved from his lifelong home in Oklahoma to live with me in California, 2 years after my mother's death from lung cancer. My daughter, Annie, home from college and then 22 years old, was sitting at the dining room table and watching my father, preparing for bedtime, emptying his pockets. The contents included his "pocket change," a key to the pickup truck (although he had not driven in 4 years), assorted toothpicks, pocket liter, and a rock. Annie observed this nightly ritual and the treasure laid on the table to be reassembled in the morning and then she asked her grandfather the obvious question, "What's with the rock?"

My father, without pause, replied, "You gave it to me to hold for you. And I did." She sat confused, but as my father explained, the story became vivid in my mind as if it were yesterday. It was the summer when she was 3 years old and my parents were providing summer day care as I juggled work and school. My mother was exhausted by day's end so my father would take Annie on a walk in the park, and one day, Annie picked up a shiny stone, handed it to her grandfather, and told him to hold it for her. And he did. For the next 19 years.

My father smiled and climbed the stairs to go to bed and Annie and I sat in awe. Yet it was exactly what anyone who knew my father would expect. He was always faithful, ever calm, a constant humble presence. He was committed to my mother for 55 years of marriage from the day they married when she was 17 years old to the last day when he turned and fed her as she died of lung cancer. He was a man of no fame, no money, no formal education, and absolutely no fanfare. But he was a model of commitment. To carry that rock for 19 years was the only choice because she asked him to carry it.

I think of what I know about commitment from my father every time I see a palliative care nurse at work. The best of the nurses are like my father. They have a clear sense of what is important. They are present, focused, heads down, doing the work. Their work is so intimate, so sacred, so focused, that there is no time to speak of it.

This issue of the journal is about the daily, sacred work of nurses. The topics range from basic human needs such as controlling diarrhea to complex new technologies such as ventricular assist devices. This one issue spans the life spectrum from pediatrics to geriatrics and from the most practical to the most profound. The studies in this one issue represent settings from the living room to the emergency department. The topics address what most in society would consider unspeakable topics such as adolescents facing cancer, perinatal hospice, and dilemmas regarding artificial nutrition and hydration. And every article is a story of commitment. Every article is a nurse, carrying the rock.

My father lived 5 years with me, then died in my home with the loving care of hospice. It was the only care that could have honored the life he led. It has been 10 years this month since my father died. His worldly possessions fit easily in a box in my closet, but he left for me an understanding of commitment and one shiny rock. I am forever grateful.

Betty Ferrell, PhD, MA, FAAN, FPCN, CHPN

Editor-in-Chief

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