1. Sergi, Paula MFA, BSN, RN

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When asked how I shifted from a career in nursing to one in writing, I once tried to describe my 10 years in home health care. Struggling for the right words, I began by saying, "It isn't that I didn't want to touch them . . ."

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My friend, a poet as I am, was astonished by this response, shocked by the suggestion that a nurse could hesitate to touch her patients. But I knew that with those words I had hit on an emotional truth, albeit an uncomfortable one-one that my training as a nurse had taught me never to speak.


My friend challenged me to write a poem inspired by that line. The result, a poem I titled "Home Visits," reads in part:


But I was distracted: the corners of their homes, the cobwebs and cuckoo clocks, veneered end tables, scratched woodwork, what the windowsill figurines could say. Sometimes I'd hear about lovely mothers, the children they never saw again.


The work of a poet is not entirely different from that of a nurse. Keen observation is central to both. Yet for me as a nurse-poet, writing "the truth" requires exposing feelings about a patient, a procedure, or a diagnosis that can conflict with patient confidentiality. In the first decade of my life as a writer, this confusion held me back from writing about my experiences as a nurse. Could I find the aesthetic distance necessary to write a poem about other peoples' misery? Would such writing trigger a negative response from readers? Could I be true to the topic, with its attendant joy, despair, guilt, and vulnerability?


Locating the authority to write presented another challenge. Cultural norms have propagated the myth of the nurse as subservient and silent. After all, despite Cherry Ames's dedication and cleverness, wasn't she really always under the influence of Dr. Joseph Fortune?


Yet it was my work as a nurse that inspired me to become a poet. As a home health care nurse I was welcomed into strangers' homes, invited to sample favorite recipes, encouraged to look at family photographs. But I was also forced to confront the patients' most difficult realities: joints that ached and limited mobility, wounds that would not heal. Long afternoons, with a ticking clock the sole companion. Imagination became a way for me to cope.


Who scratched the end table? Was it a child, busy at play with his cars and trucks? The neighbor who brought over cookies, only to drop the plate? The young wife, going into labor, clutching the table as her water broke? And what about those figurines? Gifts from a spouse, commemorating a special event? Family heirlooms? Or a bargain from a neighborhood yard sale? I found myself wanting to record and expand on these details, to explore, develop, and fictionalize them.


My patients also taught me to go beyond observation of small details to an awareness of what matters. One woman had lost much; spouse, siblings, friends, a steady income. Her only son lived far away. But when I visited she always greeted me with a smile. "You seem so happy," I observed one day. "Well, yes, my dear, I am. Because today there is a blossom on my African violet."


Recording the details that confound and inspire me gives me clarity. It helps me to confront my actions, admit my fears, and address the split between my strengths and vulnerabilities. And in the process, a spiritual leap may occur, as when in "Home Visits," I begin to see the frail, homebound elderly in a new light, in a state of transition, nearing a state of grace.


I'd see it when I washed their bony backs, a used-up body about to lift off with scapular wings. The glitter of dust motes above their bird-like heads as they sat by their windows watching me coming and going, still lives of another kind. Above little cloud-tufts of hair, haloes for the almost dead.


The surprise of a new perspective. "Split the Lark-and you'll find the Music" wrote Emily Dickinson. My music: the patient who greeted me at the door wearing only one earring. When I commented on her missing ornament, she smiled and explained, "Oh, no, dear. Don't you see? I found this one. Isn't it lovely?"