1. Gerber, Lois RN, CS, BSN, MPH

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SHEETS OF RAIN pummeled the windshield as I parked my car. Grabbing my nursing bag, I raced up the winding sidewalk to my new client's spacious home.

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"It's Lois, your nurse," I called through the screen door.


A man's voice crackled, "I don't need a nurse. Go away."


I stood on the porch wondering if I should leave and tell my supervisor that the client refused care. Harry Goldman, 79, had suffered a stroke after abdominal surgery. Released from rehab, he was to get nursing care, physical and occupational therapy, and social services from our home health care agency.


A home health care assistant appeared, and the voice crackled, "I told you not to answer it, Lydia." I motioned her outside.


"He's angry and depressed, and I haven't been able to get him out of bed since he came home yesterday," she reported.


"What else can you tell me about him?" I asked.


"He's a wealthy businessman who holds several patents. He retired from his own business 5 years ago, and his wife died last year."


Finally, Lydia persuaded him to let me in.


In the midst of great thinkers

In the bedroom, Mr. Goldman was propped up in a hospital bed, his face pale and gaunt. Books lined one wall from floor to ceiling, many of them by or about such people as Albert Einstein, Emanuel Swedenborg, and Thomas Aquinas. Watercolor landscapes and portraits of Einstein hung on the opposite wall.


He looked up. "Damn stroke. I'm not trying to be difficult; I just don't want a nurse."


"It's hard when you can't do what you want to do," I said.


"How would you know?"


Taken aback, I had to agree with him. "You're right. I really don't know."


He smirked. "I'm sick of exercises. Why should I learn to walk better? I have enough money to pay people to care for me."


"You were walking in rehab," I said.


"I just wanted to get well enough to come home to die," he said, his voice flat. He tried to make a fist with his right hand. "I still can't do my watercolors."


"You did all these?" I asked.


He nodded as tears filled his eyes.


Fingering my stethoscope, I asked if I could check him over. He agreed, so I completed his physical assessment. He had right-sided weakness, particularly in his arm.


For Adam's sake

On my visit a month later, Mr. Goldman was dressed and sitting in a chair. Smiling, he showed me a photograph. "My grandson Adam's bar mitzvah is next month. He's a good boy, and I need to be there for him. My grandfather was there for me until[horizontal ellipsis]." He cleared his throat and looked into my eyes. "He died in Auschwitz."


He straightened his shoulders and changed the subject. "I told the physical therapist to work me hard, and now I can walk across the room."


At the next case conference, the physical therapist concurred. "He's improving. Now he can walk 20 feet with his quad cane."


"He's still depressed," the social worker said. "Antidepressants help, but he has a lot of unresolved grief."


"We've had a breakthrough," I said. "Lydia and I have been reading to him from a book by Einstein, and some quotes got to him, like 'Anger dwells only in the bosom of fools' and 'In the middle of difficulty lies opportunity.' He used a pencil with a grip to copy them into a journal."


Calls for help

The following week, Mr. Goldman began to telephone the agency's on-call evening nurse with vague complaints. Although he refused a nursing visit, he wanted the nurse to talk with him.


On my next visit, he explained, "I'm looking for a connection to life. At night I panic and start thinking I'll have another stroke. Lydia and the other aides are fine, but something in the nurse's voice makes me feel protected."


I remembered the softness in the nurse's voice the night my mother died.


"I was a workaholic," he said. "Work gave me purpose. Now I'm useless."


"Your courage is an example to Adam, Lydia, and me."


"I gave what I could to my children and to charities. Einstein said it's better to serve than to rule. Nursing is service, isn't it?"


"Yes." My voice cracked.


"I wish I could've done more for my people. I grew up in Warsaw, Poland, before the war. My father, my mother, my grandfather, and my sisters were all lost in the camps during the Holocaust. I was the only one who got out. I can't talk about it; it hurts too much." Tears came to his eyes. Turning away, he took a handkerchief from his pocket.


"Another time?"


He nodded. "My feelings are either dead or overwhelming. Dead is better."


"Even when we feel dead, embers burn underneath."


He turned to face me. "I'm waiting for them to burn out, but at night they flare up."


I took his hand, saying, "Nights can be harder because less is going on."


"Maybe that's why I call the agency, but I didn't call last night. Instead, I read Bible verses about the lilies of the field. I've always liked those verses. I'm not religious, but I find comfort from many faiths."


He pointed to a watercolor on the wall. "I painted that meadow of anemones. Some scholars say it was really anemones that grew in the lily field Matthew wrote about."


Looking at the pink, blue, and lilac blossoms, I complimented him on the painting.


"This passage helps me believe that God will take care of me, like the anemones, and that I don't have to worry about tomorrow. Each day is a gift and a challenge unto itself."


I squeezed his hand. "You're going to be all right. You have courage, character, and wisdom, and no one can take them from you."


Sunshine through the clouds

On my last visit to Mr. Goldman, the sun was shining through the clouds after an early-morning rain. He answered the door and welcomed me in.


After I reviewed his discharge instructions, Mr. Goldman handed me a small watercolor of Einstein. "What you've done for me is too much to talk about, so I've painted this for you."


The watercolor now sits on my desk, a symbol of the client who'd tried to send me away but then welcomed me into his heart after finding new meaning in life. Under Einstein's image, he'd signed his name in shaky handwriting and then written, Without a sense of wonder, life is empty.