An immunosuppressed clinician realizes that limits does not mean that you are limited.


“She would (if she could) put her arm around the girl she'd been and try to tell her Take it easy, but the girl would not have listened. The girl had no receptors for Take it easy.”

— Abigail Thomas, Safekeeping: Some True Stories from a Life

Today from the sidelines, I talk to patients over a computer screen. My immunosuppressed lungs and I hide out in my kitchen, as I listen for clues from individuals I have not even met. I am a psychiatric nurse practitioner, and because of risk factors–age, medical vulnerability–I am no longer who I always have been. I am no longer in the clinic joking irreverently with my colleagues, maybe unraveling an emergency or two. No, today I am the smiling face in the corner of your computer screen, asking about side effects and if this isolation is making you want to hurt yourself.

Today’s “me” signs up for the state’s emergency task force but cannot pass the questionnaire. I am stunned by my own inadequacy–that my lungs are not only old but harbor granulomas in dark pockets, where a virus could hide and, to be frank, kill me.

The real me is on the front lines. Double shifts if necessary. Whatever it takes! No personal protective equipment (PPE)? No problem, I will make my own. Because the real me is the nurse who skidded through long nights in the psychiatric emergency department, slipping on urine from accidents when we could not get patients up out of their restraints fast enough to get them to the bathroom because there were not enough security staff to help us. Sopping it all up with dirty gowns from the laundry bin. Breathless from laughing so hard we almost peed on the floor ourselves, because what else was there to do?

That me fought the crack wars alongside the Black grandmas who were left to care for their children’s children in an epidemic of another decade. That me held the hands of patients in florid psychosis, swabbing their flushed faces of demons between injections of haloperidol and lorazepam. I did crisis and I did it well. I like to think somewhere someone’s life is just a little better for it. I know mine is.

Today I battle not only with unstable airways but with unstable internet connections that often refuse to send my electronic prescriptions to the right pharmacy, or do not work at all. I try to assess danger and safety and need over my ancient landline, which still works better than the stupid cell phone.

Directly overhead, F-35s fly, as if on cue for my 70th birthday. The planes are a Vermont thing; some deal with the government that drowns out my patients’ voices, and now my own thoughts as I take a break to trudge up the 7 acres of hill behind our house, as I do every day to stress my lungs and keep them pliable. The rumble in the sky deepens, and I look up into the blinding blue that was silent moments ago, except for the crows arguing with a songbird for top billing.

Neither the crows nor the songbird win as the fighter jets circle the state from the VA in White River Junction, south, and then back up over our tiny rural hospitals here in central Vermont, and finally back north, over me, to the teaching hospital in Burlington. Ninety minutes of fuel and fanfare to honor the first responders and those on the front lines, as I shield my eyes from the sun.

I pretend that they are in perfect formation over my head, as if to bang a pot or a pan just for me, alone on my little mountain. Yes, they might say. Happy Birthday! Take a deep breath and a bow, you badass, because you are still here.

Nina Gaby is a writer, visual artist, and advanced practice nurse who specializes in addiction and psychiatry. She has been working with words, clay, and people for 5 decades. Her essays, fiction, prose poetry, and articles have been published in numerous anthologies, journals, and magazines, and her artwork is held in various collections, including the Renwick Gallery of the Smithsonian, Arizona State University, and Rochester Institute of Technology. She maintains a clinical practice in Vermont and has been on faculty at the University of Rochester, John Fisher College, and Norwich University.

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