Joel: Memoir of a Love

By M. Justine Foster

One evening in 1980, ICU Nurse Maryann Foster walked into a patient room expecting nothing out of the ordinary. What she found on the other side of the door, however, changed her life forever. A love story, a tragedy - and, most importantly, the truth, Joel: A Memoir of a Love constructs an intricate web around the concept of unconditional love

• Language: English
• Publisher: Atmosphere Press
• Release date: Jun 15, 2021
• ISBN: 9781639446568

Book preview

prologue

why poetry

I was fifteen when I started writing poems, usually when I was troubled about something. It helped me to put my feelings on paper. Most of the time I never showed them to anyone. Then, I fell in love for the first time at about the age of sixteen. I wrote about my feelings and shared them with him. His name was Cliff and he was very touched by the poem. That was when I started sharing the poems I had written with the person who inspired the poem. Cliff and I dated for about two years, but I began to outgrow him, though I never outgrew poetry.

Before I met Joel, I had entered a restless period. Nothing felt right. Something was missing. I had little joy in things.

strange stage of life

fall 1979

It’s strange

this stage of life

not being in love

or recently out

I’ve been so placid

lately

happy—but not high

sad—but escaping

despair

Without the valleys

and peaks

my pen as well as

my soul

runs dry

personal fuel shortage

A cutting north-wind

has blown through

taking the last of

Autumn’s leaves

Leaving the countryside

cold and bleak

matching my mood

Only flames

from the fireplace

warm my senses

Even fire needs

refueling

To keep it

from becoming

cold, gray ashes

I think I’m suffering

an emotional fuel

shortage

won’t you help me

replenish myself?

foreword

a reader’s orientation to ICUs

1979–1982

I was a thirty-three-year-old registered nurse (RN) working the night shift in the Surgical Intensive Care Unit of a 240-bed hospital on the fifth floor of a seven-floor hospital building. I had worked at three other hospitals, but I finally settled at this hospital because the nurses there were members of the California Nurses Association (CNA).

CNA is a very effective union. Nurses didn’t have to put up with behaviors that occurred at other hospitals. The nurses had rights to not be messed with in any way that was distasteful. Today it is called sexual harassment, and CNA protects nurses from it very strongly.

Our hospital was one of the most modern hospitals in Northern California. Our Emergency Room and Intensive Care Units (ICUs) were recently remodeled and fitted with every conceivable up-to-date monitor, oxygen service, suction service tubes, a drop-down sanitary flushing toilet next to each patient’s bed, and new hospital beds that were easier to move as well as more comfortable for our patients.

A hallway that circulated the outer portion of the intensive care floor was built with industrial strength glass windows serving as the outer wall for the visitors hallway—even our visitors had a more modern and convenient place to access the rooms of their loved ones without walking through the middle of the ICUs and the Nurses Stations.

Architecturally, the north and south wings of that floor were shaped like an hourglass: the desks in the middle, more narrow part of the hourglass and eight rooms fanned out in a circular pattern at the top and bottom of the hourglass shape. This allowed for easier access to the patient’s room and adequate visibility for the hospital staff. This was as opposed to long, straight hallways of old-fashioned hospitals or the old-fashioned ICUs that consisted of eight to ten beds in one large room, each bed only blocked off from the neighboring patient by a curtain.

The fifth floor consisted of a Coronary Care Unit (CCU), where patients who had critical illnesses specific to the heart, including myocardial infarctions (heart attacks), coronary failure (severe weakness of the heart muscle), pericarditis (inflammation of the heart muscle causing severe pain with each heartbeat), cardiac tamponade (acute pressure in the heart caused by blood in the heart outer lining), and myocarditis (inflammation of the muscular walls of the heart, also painful with each heart beat) among others.

Also on the fifth floor was a Medical Intensive Care Unit (MICU) for patients who were severely ill due to specific medical illnesses that do not include problems of the heart and are not specific to an illness that required surgery. Examples of illness that we worked with there include stroke, hepatitis, diabetic coma, medication overdose, body fluid imbalances, and alcohol abuse usually causing bleeding from the esophagus, or stomach, and intestinal bleeding.

Finally, there was the Surgical Intensive Care Unit (SICU) for patients whose illnesses required serious surgery and resulted in critical conditions. These critically ill patients need to be within sight and sound of specially trained RNs and highly qualified licensed vocational nurses (LVNs) capable of using and reading the multiple patient monitoring machines that gave constant read-outs for things such as heart rate, blood pressure, oxygen saturation, cardiac-output pressure, and urinary output.

Some of the patients were on respirators because they were not able to breathe on their own enough to sustain life. Respiratory therapists are the experts when it comes to the respirators. The therapists were not in the ICUs all the time—they had schedules for checking most of the various patients that were on respirators throughout the hospital—but the ICUs were usually visited first.

The RNs were also well trained on working with the patients that were on the respirators so as to be able to take care of issues when they arose, such as a need for suctioning the endotracheal tube or tracheotomy.

RNs also took readings of blood sugar levels, temperature, respiratory rate, and administered ordered medications orally, intravenously, intramuscularly, and occasionally subcutaneously. They were expected to be able to start new intravenous (IV) sites, as well as check the current IV site to make sure it was not getting inflamed or infiltrated, thus making sure that the patient’s IV was maintained.

Our hospital had eight-hour shifts. The nursing staff arrived thirty minutes before the previous shift of nurses were scheduled to end their shifts. The oncoming nurses learned about the patients they were to be taking care of by taking report.

When taking report, we were told about our patients, why they were there, what their condition had been, their mental and emotional status, and their pain levels and any medications ordered for them. Each patient had unique needs, which required complex, specific information.

We were able to see into the patients’ rooms because the interior walls were mostly windows and sliding glass doors. There were curtains that could be pulled to give patients more privacy and block the bright lights that were usually on in the nurses stations. Starting at about 10:30 p.m., the nurses station overhead lights were dimmed to allow the patients to have a sense of day and night, which in some cases helped cut down on confusion.

From our desk in the CCU and the SICU, we could see all eight patient monitors because the monitor read-outs were on display at the desk with a beeping sound that could be heard with every heartbeat. An alarm sounded if the heartbeat changed significantly and beyond ten seconds. Even with eight separate monitors beeping, after working around cardiac monitors for so many years, most experienced ICU nurses only noticeably heard the monitor sounds when a rhythm changed. Whenever that occurred, we noticed immediately, and anyone observing would see all of the nurses’ chins rise up and eyes going over the monitors to see which one changed. In most cases, the change was brief and returned to a normal rhythm for each particular patient.

In the event of a change that could be dangerous or life threatening, one nurse (usually the assigned nurse) went quickly into the affected patient’s room to do an assessment. If the patient was unconscious, the nurse would call the patient’s name