Cutting for Stone - Abraham Verghese [17]
Yet it wasn't fate that stymied the probationer when she came to her clinical years, and it wasn't her clumsiness with the Amharic language, or with English, since she soon overcame these obstacles and became fluent. She discovered that memorization (“by-hearting,” as Matron called it) was of no help to her at the bedside, where she struggled to distinguish the trivial from the life threatening. Oh yes, she could and did recite the names of the cranial nerves as a mantra to calm her own nerves. She could rattle off the composition of mistura carminativa (one gm of soda bicarb, two ml each of spirit of ammonia and tincture cardamom, point six ml of tincture of ginger, one ml of spirit of chloroform, topped off with peppermint water to thirty ml) for dyspepsia. But what she couldn't do, and it annoyed her to see how effortlessly her fellow probationers could, was develop the one skill Matron said she lacked: Sound Nursing Sense. The only reference to this in her textbook was a statement so cryptic, more so after she memorized it, that she'd begun to think it was put there to antagonize her:
Sound Nursing Sense is more important than knowledge, though knowledge only enhances it. Sound Nursing Sense is a quality that cannot be defined, yet is invaluable when present and noticeable when absent. To paraphrase Osler, a nurse with book knowledge but without Sound Nursing Sense is like a sailor at sea in a seaworthy vessel but without map, sextant, or compass. (Of course, the nurse without book knowledge has not gone to sea at all!)
The probationer had at least gone to sea—she was sure of that. She was determined to prove that she did have map and compass, and so she would regard every assignment as a test of her skills, an opportunity to display Sound Nursing Sense (or to hide the lack of it).
SHE RAN AS IF jinn were chasing her, through the sheltered walkway between the theater and the rest of the hospital. Patients and relatives of those being operated on that day were squatting or sitting cross-legged on either side of her path. A barefoot man, his wife, and two small children shared a meal, dipping fingers into a bowl lined with injera on which a lentil curry had been poured, while an infant, all but hidden by the mother's shama, suckled at the breast. The family turned in alarm as she ran by, and it made her feel important. Across the yard she could see women in white shamas and bright red and orange head scarves crowding the outpatient benches, looking at that distance like hens in a chicken coop.
In the nurses’ quarters she ran up the stairs to my mother's room. When she knocked there was no answer, but the door was unlocked. In the darkened room she saw Sister Mary Joseph Praise under the covers, her face turned toward the wall. “Sister?” she called softly, and when my mother moaned, the probationer took that to mean she was awake. “Dr. Stone sent me to tell you …” She felt relieved to have remembered all the parts of the message. She waited for a response, and when my mother didn't volunteer one, the probationer imagined that my mother might be annoyed with her. “I only came because Dr. Stone sent me. I'm sorry to disturb you. I hope you feel better. Do you need anything?” She waited dutifully, and after a while, she eased out of the room. Since there was no return message for Dr. Stone, and since her pediatric nursing class was about to start, she did not return to Theater 3.
IT WAS EARLY AFTERNOON by the time Stone went to the nurses’ quarters. He had finished the appendectomy, then two gastro-jejunostomies for peptic ulcer, three hernia repairs, one hydrocele, a subtotal thyroid resection, and a skin graft, but by his standards it had been tortuously slow. An ordeal. With knitted brow he ascended the stairs. He understood that his swiftness as a surgeon depended to a large degree—more than hed ever imagined—on the skills of Sister