The Making of a Nurse

by Tilda Shalof

  Yikes! These were not the so-called “special needs” kids. These were the “normal needs” kids! They weren’t dealing with illness or disease, only with daily life and now, on top of that, being away from their homes and families. I was beginning to have an uneasy feeling. What had I gotten myself into? Give me septic shock, pulmonary edema, or fulminant hepatic failure any day. I could recognize a skin erythema, but had no idea what a poison ivy rash looked like – much less the plant that caused it in the first place.* Besides, I wasn’t sure I was doing everything correctly with my own kids, much less someone else’s. It was as if my practice in the ICU took place at the narrow end of the funnel of the health-care system. Now, I would be at the wide end, attending to the ordinary – as well as extraordinary – things that poured into the open mouth of the funnel.

  A GROUP OF COUNSELLORS waved their arms in welcome as I reached the gate of the camp property. “The nurse is here! The nurse is here!” they called out. I had told them ahead of time what car I was driving. Their recognition of me was not due to any cartoon image they might have had of a camp nurse in khaki shorts, with a whistle on a string around her neck, a clipboard in hand. I wore a white peasant skirt and a sparkly T-shirt and had lots of luggage, including an electric fan, a radio, a deck chair, a fluffy purple rug, a case of Coke, and an ironing board.

  A long, dusty road led to the centre of camp, where, high on a hill, was the main office and beside it, the infirmary cabin. At the back of it was my room with a view of the lake. I stood on the hilltop, breathing in the air that smelled and tasted so fresh. I could hear the wind rustling in the trees. I looked out over the whole camp, right down to the waterfront and the rippling lake. It was beautiful. Nestled in the trees were the campers’ cabins, and one for arts and crafts, one for “campcraft” (s’mores, campfires, tying knots, the camp brochure explained), another for ceramics. Rimming the edge of the campgrounds, from one end to the other, the lake sparkled in the sun and invited me to jump in – but not just yet.

  Terry met me at the office and took me to lunch in the huge dining hall that had a stone fireplace and large bay windows overlooking the lake. It was noisy, teeming with kids chanting camp songs and cheers and acting out different parts of the songs. Conversation was impossible over the din but later the kids at my table introduced themselves and it turned out they were in fact counsellors, heads of water-skiing, “tripping” (hiking and canoe trips), and arts and crafts. I felt old. Compared to them, I was old.

  After lunch, I unpacked. I was nervous and excited, but the calming breeze coming off the lake, whispering through the pine trees surrounding the cabin, was so relaxing that I fell onto my cot and into a deep, refreshing sleep.

  THE NEXT MORNING it rained and the only visitors to the infirmary were the small group of campers I would get to know well over the next three weeks because I would be seeing them every day, three times a day, for their medication for Attention-Deficit Disorder, ADD. They received their pills on outstretched palms, swallowed them without water, and were quiet and polite, but the parents stated on their health forms that without those meds, they were hellions, out of control, hyperactive, fidgety, and unfocused. Yet Damian, Stephanie, Jackson, Dustin, and Greg were the sweetest, most docile kids I’d ever met. (Well, Greg seemed a bit wild, but I figured it would take him a little longer to settle into camp.)

  Otherwise, there were no “patients” on that first wet, grey morning, so I busied myself by tidying up and scrubbing the floors and cupboards, which included removing a few mice skeletons left over from winter merry-making. I made up the four beds with crisp white sheets and organized the supply of common medications for aches, pains, coughs, colds, nausea, and allergic reactions. I prepared first aid kits to distribute around camp and for the trippers to take on canoe trips. I unpacked the dozens of emergency epinephrine pens – a veritable “epidemic” of epi pens – that had been sent to camp by worried parents. Though none of their children had ever actually had an anaphylactic reaction, the parents sent the pens, just in case. We’d certainly be well equipped in the event of an emergency. The infirmary was clean, organized, and well stocked with Band-Aids, sunblock, insect repellent, tensor bandages, sanitary pads, aloe gel, and a hot water bottle. I was ready.

  BY THE SECOND DAY of camp, I recognized my regulars who came for their meds. I especially liked blond-haired Jackson. “Hey, d’ya wanna see my pet snake?” he greeted me.

  Were little boys still getting mileage from that old chestnut? I decided to play along. “Yeah, sure, Jackson, I’d love to see your pet snake. Why don’t you take it right out?” I folded my arms across my chest and waited. From the pocket of his jeans, he pulled out a live, bright green snake and I backed up.

  “Don’t worry. She’s harmless.” He cuddled it close to his face and the forked red tongue flicked in and out. “I find her every year. This is my third time. She waits for me. Her name is Rosie.”

  By the third morning, things picked up. A mild sore throat, two headaches, a bloody nose, and a tiny burn on a pinkie finger from an ember that had blown off the campfire the night before. I dug out a sliver from a finger and examined a camper with a history of asthma who sounded “tight.”

  “Where are your puffers?” I asked.

  “In my friend’s knapsack.”

  “Where’s your friend?”

  “On a hike.”

  I gave him another one to use until he got his own back and made a note to myself to follow up. I could see I was going to have to stay on top of some of them and be a bit of a nag.

  By day four there was a steady steam of blisters, scrapes, cuts, bruises, and always a few kids with vague complaints of aches and pains. I gave them a hug or we sat and talked and they went back to their cabin. Some kids wanted Band-Aids, ointments, and painkillers, and other kids with similar sores, even ones encrusted with blood and dirt, cleaned them up with their own spit and kept on going. As far as I could tell, they all healed about the same. My own preference was to clean them, but I disliked Band-Aids. I hated coming upon them later that day or the next, floating in the lake or over the drain in the showers.

  By the fifth day, there were more sore throats, headaches, stomach aches, and fatigue, and I began to see an emerging pattern, but was interrupted just then by someone shouting.

  “Help! Where’s the nurse?” It was Greg, one of the boys with ADD. “I can’t feel my arm,” he groaned, cradling his right arm in his left. “I’m paralyzed.”

  He sat down and I examined his arm. There was complete range of motion and it looked perfectly normal. Nothing seemed out of the ordinary with his arm, but he could use a shower at some point. “What happened?”

  “I rubbed up against a tree,” he said, crying out a little and jumping up and down. I cleaned the area and put a Band-Aid on it. “I might die,” he moaned.

  “You’ll be fine,” I said, patting his shoulder.

  “It might get infected. People can even die from being tickled. You can die from laughing too much.”

  “No laughing for you for the rest of the day,” I said in as stern a voice as I could muster.

  Another problem was that the swim test jitters were going around camp. Not everyone took to the lake like a fish to water. They wanted swim excuse forms. “That nurse is mean,” I heard one say after I refused her the note and told her to go change into her bathing suit.

  So far, the camp’s youngest kids, the seven-to nine-year-olds, rarely came to the infirmary. The teenagers required the most attention, along with a few counsellors. Sarah, the dance instructor, worried me. She came after every meal to weigh herself, and as far as I could see, ate only tuna and lettuce. She looked anxious. “I can’t stop weighing myself,” she admitted, “then I get angry at myself for whatever I’ve just eaten.”

  I looked at her robust young body, bouncy breasts spilling out at the top of her leotard, and her pretty, downcast face. I asked her about the cute guy I’d seen her entwined with around camp and she said it wa
s Sean the head tripper and yes, they were a love connection. I’d caught sight of them late one evening behind the canoe shack, he clearly appreciating her curves, even if she couldn’t.

  “Do you want to talk about it?” Did she want me to make a referral to a counsellor or therapist in the city? Would she go see a doctor or a dietician to discuss her issues?

  “I’m okay,” she insisted. “I used to have an eating disorder when I was younger, but I’m good now.” I guess I didn’t look convinced. “No worries,” she added with a forced smile.

  By the end of that first week, I felt like a real camp nurse. All that was left was to call reveille at the crack of dawn, start barking out orders over the chirping of crickets, lead the sing-songs around the campfire, and take them on a ten-kilometre hike. I was actually enjoying myself.

  At the end of each day, I fell easily into a deep sleep, but almost every night there was at least one knock on my door. Often it was Melanie, who had nightmares or anxiety attacks that made her feel like she couldn’t breathe. Sometimes she just wanted to hold on to her epi pen, she said, as if it were a teddy bear. Sometimes a cup of hot chocolate or an overnight stay in the infirmary was all it took. Another night it was a counsellor who had gotten hit in the knee at a soccer game. I trudged out of bed and flip-flopped to the freezer in my pink Hello Kitty slippers. I was sleepy and my hair was a mess. “Please excuse my appearance,” I said as I bent down to examine his knee.

  “Don’t worry,” he said agreeably. “I have a mother at home. I’m used to what they look like.”

  I slapped a bag of ice on his knee and returned to bed.

  “Feels great, Nurse Buffy, Camp Nurse Slayer,” he called out to me after a few minutes and discharged himself, “I’m good to go.”

  But apparently not good enough because an hour later, he was back.

  “Hey, Nurse Buffy, now I got hit in the balls with a ball.”

  “Ice!” I yelled out without getting out of bed. “Get it yourself.”

  “Sounds like a plan,” I heard him mutter as he bashed into the refrigerator and helped himself to one of my Cokes.

  EVERY MORNING, before the mosquitoes and the kids descended, I started the day with a long walk. I felt happy, useful, productive, and awake to this new world. One morning I looked up into a tree and saw a blue jay that I recognized from the Toronto baseball team logo. I walked past a farmhouse along the road just outside of camp and suddenly came upon a deer, strutting out in front of me, her baby close at her heels. Bambi and her mother! I would know a bear (Yogi Bear) but had no idea what to do if confronted with one. A moose I would recognize from the Canadian quarter coin. Spiders I spared because I considered them all descendants of the gentle, wise arachnoid whose ingenuity and generosity had saved Wilbur the Pig in Charlotte’s Web.

  ON THE FIRST DAY of the second week, there were still a few campers who balked at getting into the cool lake. I had to admire one boy who showed up daily, determined in his pursuit of a swim excuse note. On the third day his beguiling smile finally did me in and I wrote him one, warning it was the last time and that everyone had to learn to swim at some point.

  “I knew you’d cave.” He grinned and bounced out of there, prize in hand.

  That day dragged on, interrupted only by macaroni and cheese and popsicles for dessert. After lunch, it rained again. The kids stayed in their cabins. I sat at my office desk and rifled through the huge drug compendium. I twisted a few paper clips. I thumbed through the local telephone book and noted with amusement that there was actually a Mr. Harry Potter residing in the nearby town and a Ms. Julia Roberts who owned and operated a beauty salon. I stretched out on the worn couch and listened to the raindrops on the roof. I heard a sound that I think was a chipmunk. There were major gaps in my outdoor education, but surely camp would rectify that situation. I was drifting off and didn’t even try to stop it …

  There was a knock at the door.

  “Come on in,” I called out and sat up on the couch. What time was it? Who knocked, anyway? Most of the kids just barged right in. An obese, freckled, red-cheeked boy of about thirteen stood there in long, baggy shorts and big shoes, the laces undone. “Hey, Nurse Tilda, I’m Mitchell.” He stood on the porch at the screen door, looking worried.

  “Come in and sit down.” I sat up and moved over to a chair to let him sit on the couch.

  “How are you doing, Nurse Tilda? Do you like camp? I hope you’re enjoying camp,” he said. “The nurse last year left after two days.”

  “Yes, I am. How about you, Mitchell? Are you enjoying camp?”

  “Yeah, it’s sweet.” He looked to see if I bought that line. “It’s really good. Well, good-ish.”

  “What do you like about camp?”

  “The food.” He brightened at that. “The tuck shop.”

  “Are there things you don’t like?”

  “Nothing really, except that I don’t want to go on the canoe trip.”

  Aha! “Is there anything in particular that worries you about the canoe trip?”

  He fell silent. “Not really.” He sat slouched deep into the couch.

  “Anything else bothering you?” He shook his head, but I sat quietly waiting and it came.

  “Well, about a gazillion things.”

  “Such as?”

  “I hate camp. My parents send me because my behaviour sucks at home, but I didn’t want to come this year.”

  “This is your fourth year at this camp. Does this time feel different?”

  “There’s a big difference between being thirteen and being like fourteen, you know. When you’re thirteen it’s the beginning of being a teenager, so that’s sweet, but like once you’re fourteen, you’re all grown-up.”

  “I see.” Oh dear, the infirmary was starting to fill up now that the rain had cleared. I could hear them gathering on the porch. “Mitchell, I’m pleased you’ve come to talk to me. You can come to me anytime with anything that’s bothering you. The canoe trip is not for another week. Let’s talk more about it later, okay?”

  “Please don’t call my parents. They’re on vacation in Colorado, white-water rafting, and you’d have to speak to my grandmother. If you do, tell her I’m having a great time.”

  There was plenty more to talk about, but at that moment, Bill, the camp’s handyman, burst through the door with a wound on his hand that was gushing blood. No Band-Aid for this one! I slapped clean gauze over it, showed his wife how to elevate it and put pressure on it, and the camp director drove him to the hospital for stitches and a tetanus shot. No sooner had I done all of that than thirteen-year-old Melanie rushed in, crying.

  “I’m having an allergic reaction! I need my epi pen or Benadryl or something!” Her face was scrunched with fear and streaked with tears. I took her vital signs and her heart rate, blood pressure, and breathing were all normal. Her chest sounded clear. “What happened?” I asked, removing the blood pressure cuff.

  “Someone was eating a nectarine and it sprayed on me. I’m having an allergic reaction.”

  She looked perfectly fine. I put my hand on her shoulder. I put her down on one of the beds to rest, close to where I could keep an eye on her. An hour later, she felt ready to rejoin her cabin.

  After dinner I walked over to check in on Mitchell in his cabin. He was playing a card game with his cabin mates and when he saw me, flashed me a thumbs-up signal to indicate he was feeling better, but still, I planned to keep a close eye on him.

  OCCASIONALLY, I TRIED to get a glimpse of my own kids, but Harry ran off when he saw me coming because he didn’t want any preferential treatment. Max gave me a hug each morning at breakfast and I didn’t see him again until the evening. They passed their swim tests with flying colours.

  Despite my afternoon naps, I was tired at night and afraid I would sleep through a knock at my door. So I always left my radio on softly and kept the walkie-talkie with its occasional bursts of static, by my bed, just in case. I had no trouble dropping into a deep sleep each night, b
ut just before I did, I took a moment to look out of my window. Fireflies darted by. I marvelled at a sky so full of stars. The lake was a glossy sheet, frosted with ripples, illuminated by the light of the moon. One night a bat swooped past me and I congratulated myself on not screaming. How brave I was becoming! I heard a bird and looked into the tree branches. It hooted again, and yes, it was an owl! Maybe one day I would reach the pinnacle of the great outdoor tradition: I would become a tripper – a strapping, hearty legend.

  Midway into the second week, the after-breakfast line-up of miserable-looking kids was growing. The porch and waiting room of the infirmary were filled with campers, all dressed in baggy sweatpants, cozy hoodies, thick, grey woolly socks, and Birkenstocks or Crocs. They regaled me with their woes all at once and quickly figured out that the more tragic and urgent-sounding their malady, the higher up in triage they might rank.

  “My mosquito bites are huge and they’re keeping me up all night. I didn’t sleep at all.”

  “I touched a poisonous frog and Jamie said I’m going to die unless I get the anti-venom.”

  “I’ve got a splinter and it hurts sooo much.”

  “My finger is infected.” A girl pushed forward to show me. With a glance I could see it was not, so I put her at the end of the line. “Maybe it’s broken?” she asked, to improve her standing.

  What was provoking this onslaught of neediness? After determining there were no real emergencies, I treated the littlest ones for whom waiting was the hardest and then turned to Paul, a fourteen-year-old who had tripped over a rock and had a painful, slightly swollen ankle.