1. Hughes, By Kathleen MSN, RN, PNP-BC


The first day of the rest of my life.


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Medical students start with cadaver dissection; nursing students start with bed baths. In preparation, I got the hair-washing cap from the supply room and warmed it in the microwave like a gas station burrito or a baby bottle. He wanted the basin water as hot as he could stand it, but I worried that my version of hot water might be more extreme than his. I brought in at least six washcloths and towels. There were many deep, quiet breaths.

Figure. Illustration... - Click to enlarge in new windowFigure. Illustration by Neil Brennan

And then the only thing to do was to begin. I started with his upper body, his chest. He leaned forward for me to wash his back. I draped him with towels as his hospital johnny got a little damp. I washed his legs and feet, and made a mental note to see if there were any nail clippers in the supply room, not yet having learned that nurses don't clip nails-whether because it's a billable service, or curiously dangerous, or simply too time consuming, I still don't know. He liked football, so I chatted about the Colts and Notre Dame, careful not to insult his Patriots or USC loyalty. His daughter was on another floor of the hospital birthing his first grandchild, so he turned on the newborn care channel. When he stood, not quite wobbly, to wash his own groin, I held up his gown and watched out for his iv and oxygen lines. Then I washed his bottom, donned him in clean hospital wear, and sat him in the chair. Last, I used the cap. As I massaged his scalp through it, and then dried and combed his hair, he sighed like I was a master masseuse or a magician who had cured his stubborn, inelastic lungs.


Should I describe his skin, his body, his face, so you can see him as I did? It was pale but not translucent, aged but not ancient, weathered but not beaten-and otherwise, I don't remember. Though I believed I would never forget his name, my first patient, it was gone from my mind within days, as if I'd internalized HIPAA rules as a command to forget, to deidentify. He had been a stranger to me when I arrived that morning, and if I bumped into him on the street a week later, he'd be a stranger again. In the moments of his exposure and my tending to him, his skin was both everyone's and his alone, as my hands were both mine and his.


Once he was clean and dry, I took another set of vitals, made some notes, got my lunch, and left the hospital-that intimidating and marvelous interior metropolis that I would like to call the Death Star for its massive, self-sufficient hive of wonder and industry, if not for the "death" part of the title. I have learned that the institution's preferred moniker, not entirely facetious, is Man's Greatest Hospital. Outside, it was blindingly bright, a cerulean October sky, and the old stones paving Beacon Hill seemed wise.


An Ivy League degree and 15 years of teaching and writing did not prepare me any better than my mostly 20-something counterparts in the ways of giving a bed bath to a 72-year-old man I'd never met. What might be different for me is that I have known many kinds of professional challenges. What might also be different is that I have lived enough longer to have attended my father's hospital-bound illness and death, and to have given birth to and cared for two young children. And so when I washed this man, I was washing my father, I was washing my children; I became one of those people who cared for us. Though giving a bed bath is not anything like lecturing to AP students on Faulkner, or writing a newspaper article on gun control or university library funding or modern exorcisms, I am not sure that either of those tasks made me hunker in a corner for five minutes, gathering myself before striding into the room. I've also never left a room feeling like I've had as simple and visceral an impact as I did that morning.


My work will get more technical and cerebral as I train toward my master's degree and NP certification, and yet my work will remain what it was that first day: bearing witness to the body in wellness and suffering, and honoring the dignity in that body, the dignity in the desire for the most basic of human care.