Tough Skinned

Ask more questions. It’s a lesson I learned from one of my preceptor’s example during my final internship in nursing school. I’ve always been inquisitive and a good listener, but when you put me in a time crunch, or get me on the phone, then it is all business. Tell me what I need to know and I’ll stop you when I feel like I have enough information. It’s a useful tool in nursing, allowing you to quickly weed through a patient’s story and gather the tidbits that might actually explain what’s causing their issue (chances are it wasn’t last night’s episode of The Biggest Loser, but that doesn’t stop them from filling me in). This direct approach is generally fine for treating someone, but not always for caring for them.

“She’s a druggie” the nurse told us, “a real piece of work. I can’t get an IV on her to save my life. You guys want to try?” My preceptor and I accepted the challenge. I was eager to try a tough stick and secretly hoping to attain some bragging rights with a lucky shot. We walked into the room and there was a forty-something year-old woman who looked seventy. Her balding head had thin tangles of whitish unkempt hair, and her face looked pathetic. She was withered, beaten to her knees by life and crushed under the weight of her own terrible choices. We introduced ourselves and began searching her arms for any tiny vein still left after years of self-induced torture. Her skin was beyond thick and worse than scarred. It was scaly, more of a tough hide than anything resembling human flesh. “Oh great,” I groaned to myself, my vanity dashed by assured defeat, “she’s a skin popper.” For those not as familiar with drug use, skin popping is when the drug (usually heroin) is injected into the upper layers of the skin and fat instead of into the vein or muscle, producing a longer high, but also leading to gross disfiguration and nasty infections. We looked in vain for a spot where she had not been shooting up, but everything that she could reach had been used.

“How long have you been using?” my preceptor asked in a surprisingly gentle voice.

“About 25 years,” the woman responded quietly.

“So at this point it’s nearly impossible to get through the day without it then?”

It was barely a question, more of a sympathetic statement, but I could see the release it had on the woman. It carried no judgment, just a hand extended to her in a hard place. She relaxed, she breathed easier, she opened up.

“Yes,” she said. “It’s almost like I don’t have a choice now.”

As we prodded and poked her, the woman offered more of herself, explaining what her life was like and I realized that my heart towards her was changing. She was no longer just another druggie who’d made a wreck of her life. She was a woman whose life had made an unfortunate turn many many years ago that had sent her on a path that was slowly tearing apart her heart. She was not pathetic, she was just hurting. I had missed it because my heart was full of judgment. I had been so caught up by what I had been told about her that I had put her out of my mind before even laying eyes on her.

I wouldn’t have chosen to engage her if it had just been her and I. I would have done what was needed for her treatment, get the IV and get out, so I could move on to my next task. What good would talking have done? What could I learn from her? But now I will never forget her. I come back to her every time I catch myself passing judgment on a patient, which I’m sad to say, is frequently. I work with many patients who I’d just as soon avoid outside the doors of the hospital, because they make me uncomfortable. It is easier to sit in judgment of them, mistaking their choices and circumstances for their worth as a person, than to engage and connect with them. But I can tell you from experience that there is value that we miss when we judge others like this, the value of someone’s story. It is much harder to pass judgment on someone once you have taken the time to openly hear them out. It seems sentimental, I suppose, but I believe story is essential to our hearts. We have lost sight of it maybe, but I think we all long to be part of a story worth telling. I also think on some deep level we all find immense validation and acceptance when others have taken the time to hear and know our stories.

I think of the verse that stirs my heart more than any other: “Now we see but a poor reflection as in a mirror; then we shall see face to face. Now I know in part; then I shall know fully, even as I am fully known.” – 1 Corinthians 13:12

To be fully known, that is, I believe, at the core of every person. It is God’s gift to us, the thing that draws us together to love one another in friendship, romance, and family. But there is only one who truly knows us better than we even know ourselves.

So I offer this one bit of advice that was never even said to me, just modeled well: when your heart is not where you’d want it to be towards another person take the time to get to know their story in spite of every inclination to the contrary. Ask them more questions.