By: Debbie Moore-Black, RN

Denial. That perfect defense mechanism.
I know it well. You convince yourself that all is well. And then you convince others…

That you have that perfect marriage.

That you have a terminal disease but you’re the exception because it certainly can’t happen to you.

That you’re in poor health with mysterious aches and pains but you don’t go to your physicians because you pray to Jesus to take your pain away. To cure you of whatever.

Denial.
I was a work horse. Three children to feed and clothe and always wanting the best for them while their father, highly educated but willing to work for minimum wage, while his wife (me) worked 60 hours a week night shift as an ICU nurse.
But he was a “great” father.
And I was great also at pretending that all was well, while frequently being gaslit, disregarded, disrespected and trapped in a verbally abusive marriage…. But it all looked great with the photos we took and presented  eventually on social media. the awareness of realizing he had multiple infidelities one after the other.
The realization that I would live my life through my children while sadly knowing that I had a miserable marriage.

Denial. His cancer. Pancreas, liver, lungs, lymph nodes. His surgeon and  oncologist promoting his denial…. “You’ll live another 6 years”..: and my husband saying “Do everything” while I drove him to the oncologists,  the surgeons, the chemo, the palliative care, the therapists, all along working nightshift and overtime.

Denial. Every day was a new ache. and pain. Her back, her bones, her chest, her unusual edema in her neck and hands and feet.
Every day. On social media. Not being proactive. Not going to her physician, but requesting her friends to pray for her. Waiting for that miracle from Jesus.
That miracle that never happened.

Denial. The nurse. Who comes in late to work. Disheveled  with  bruises up and down her arms. I ran into the walls. I fell. It’s not him. It’s me. I’m clumsy. Verbal abuse from her husband easily escalating to physical abuse.

And the list is endless. And so is denial.
It is not until you come to admit the truth first to yourself and then to others.

Denial is your protection in dealing with the truth.
It involves ignoring the reality of a situation to avoid anxiety. To avoid anger. To avoid the truth.
To protect yourself from the consequences of reality.

With therapy from a licensed therapist, you can come to grips with the truth. With chipping away at denial. And being honest with yourself and your situation.

They say “the truth will set you free.”   
Set yourself free. You deserve to live in truth.

By: Debbie Moore-Black, RN

My mother. 63 years old. Colon cancer.
She first noticed rectal bleeding. She made excuses. Maybe it’s hemorrhoids.

She put her physician on a pedestal. He said “you’re too young to die” and there was no need for further tests.

Her daughters, both RN’s (one an ICU nurse, the other an anesthetist) pleaded with her to get a colonoscopy. She refused.
Pleaded with her to get a second opinion.
She refused.
Her once plump body shrunk as she drastically began losing weight.

Her brothers flew in from New Jersey to visit her. They told her she looked great. And her response was “I’m too young to die”

We hired a hospice nurse for her. Mom would go in and out of comas. She was dying. Us daughters would help.
I would help turn and reposition my mother. Clean her bowel movements in bed.
Mostly an act of guilt, feeling that I was supposed to do this. Feeling obligated.

While remembering my painful past.

She was a negligent mother. A narcissist. Undiagnosed mental illness I suppose.

We lived in the big house but the inside told the secrets. The secrets of her neglect and failure to clothe us children while she wore designer clothes.

The secrets of my dad climbing the corporate ladder all along bumping into walls after he drank his daily gallon of wine.
Losing our lake house. Daddy losing both jobs because of his alcoholism. We were told he was taking an “early retirement”.
As I cleaned my mother, the memories flooded back.
The lies. The neglect.

She died at the age of 63 years old.
Yes. I also always felt she was “too young to die.”
I always wondered: “What if?”
What IF she had gotten a second opinion and went to another physician?
What IF she had listened to her 2 nurse daughters.
What IF she had been proactive?

A colectomy eventually was performed. But her colon cancer had frantically spread. Liver, pancreas, lungs.

Too young to die.
Too little, too late.

Denial and a long wait to face the truth.

Dad gave her the grande funeral.
The mahogany casket.
Large photos of her with her “Jackie Kennedy-like” hairdos.
As her casket lowered to the ground. A still and hot sunny day, a wind gust through. I guess that was her final goodbye.

The grande funeral that left me thinking: “What If”
And I cried.
I cried for the mother I never had.

*** In retrospect….to say: “I’m too young to die” doesn’t validate anything. No one is too young to die….. especially when you are not proactive in your diagnosis and treatment and finding a physician that speaks the truth to you!!

By: Debbie Moore-Black, RN

His mom was 14 years old when she had him.
He grew up in the projects and grew up in chaos.
The chaos was reflected in school. He was disruptive, and angry, and seeking some type of validation. Granny took over the household.
And beyond having a stable grandmother, he had nothing else.

A young teacher had heard about him and his antics and requested to have him as a student in 5th grade.
This teacher knew that she could guide him in the right direction. That he was special.
And she had the time, patience and love to guide him appropriately.

His young teacher noticed that he was a smart kid but with little confidence or guidance. She teamed him up with a school partner.
Jerome and David were different colors but that didn’t matter. They became best friends and partners and easily wove their way through math and science classes.

Though he had random outbursts, his new teacher saw his hidden glow. She knew he just needed guidance and a glimmer of hope.

Jerome grew up in the projects. He didn’t always know if he’d have dinner at night. They were poor and besides having grandma, he had no nurturing from his mother who had birthed him when she was only 14 years old.
He never knew his father until he was an adult.

His teacher stuck by him for that year in 5th grade. Made sure he always had pencils and paper and lunch and nutritious snacks after school.

Recently Jerome contacted his dear teacher and they met for lunch.

He has a wife and 5 children now. And a good job. With therapy and realization he easily talked to his once young teacher who found a little kid. A little kid that was confused, angry, and disruptive. And needed to know someone cared. Someone to guide him in the right direction.

He told her during this reunion that SHE was the reason he found a purpose in life.
He spoke to her saying “You were beyond giving me hope. You gave me life. I am the man I am today because of you.”

The ultimate compliment for any teacher.

His hierarchy of reverence was God, Grandma and his teacher from 5th grade!
And of course, his wife and children.

One child. One life.
And a chance to find hope and purpose in a crowded chaotic life growing up.

(This is a composite story that has been fictionalized)

By: Debbie Moore-Black, RN

I cradled  my guitar in my arms.
The dearest Christmas present I would ever receive from my daddy.
Christmas was always a time for great anticipation but easily let down when we would discover 2 presents each under the tree.

My two presents would be an extra large polyester shirt. The second present was matching pants with an elastic waistband.

Extra large because mom said it would last me longer.

I was a shy child. And lonesome. I had few friends.
My mother was mentally absent with us kids. Negligent. We wore rags in unmatching outfits. Kids laughed at us, while mom wore designer clothes. Dad climbed the executive ladder of IBM. Alcohol was his friend.
Until it wasn’t.
It was a Christmas I’d wake up to with no presents for me.
Daddy opened a closet door and brought out an oddly shaped present. I was clueless.
A guitar. A classical Yamaha guitar.
I was in 3rd grade.
I cradled this guitar like it was a baby.
I insisted on lessons, taught myself also how to play.
And suddenly “All my troubles seemed so far away”….. the Beatles came to life. Eleanor Rigby, Yesterday, Let it be…
Stairway to heaven.
I learned them all

My guitar became my best friend.
How could my dad know?
I named her “Stella”

I haven’t played it for a long time.
It’s officially 60 years old.

I remember strumming to my babies as they grew. I played a few tunes with my guitar at church “folk” mass. A few tunes at church for fund raisers for the homeless.

My sacred guitar may have emotionally saved my life.

Today I ordered new strings for my guitar.

Today I picked her up and strummed “My guitar gently weeps”…. And Yesterday and Stairway to heaven….
I didn’t forget those famous songs.
Stella fit so nicely in my hands.

I felt her breathe new life in me!!!!!!!

(Photo: me at 17 years old with “Stella” playing to my little brother and his friends. 1973)

By: Debbie Moore-Black, RN

My first post-op night from my nephrectomy was short of fantastical to almost devastating.

I woke up in the PACU after my surgery. Extremely confused and disoriented. I felt like I was inside a video game and trying to frantically escape.

When I entered my new post op room on a medical surgical unit, it had that brand new hotel-like decor. A shiny and new unit.

The nurses and techs and NP’s greeted me. Great surgery, pathology reports will come soon of your nephrectomy, Renal Cell Carcinoma. You did well.

I always made sure to never work on a Medical-Surgical unt because the truth is, they are grossly understaffed. It’s a hard job.

Throughout the night, I heard an old woman chant repeatedly “help me , help me” over and over again, an older man obviously going through DT’s, falling out of bed and screaming incoherently.
It’s a hard unit.
I wanted to be the ideal patient!! Best behavior. No complications.

Night shift came, a vintaged nurse in her 50’s came to check in. She told me she was a traveler. Nurse patient ratio on this Med-Surg unit was typically 6 patients per nurse.
She appeared savvy, smart, practical.

She let me know she was a Sagittarius.

Interesting and strange because I would never be concerned about someone’s horoscope alignment. Especially a nurse. Odd.

0300 came. I started to have pain. Intense abdominal pain, at least an 8 on the pain scale of 1-10.
She gave me Dilaudid IVP.
Everything seemed well, the pain eased off,
But
Within 30 minutes I started to have shallow breathing. Forcing myself to breathe.
And I got scared.
I went into ICU nurse mode. Instructed my son (a highschool Math teacher) where the Code blue button was. If I deteriorated, I instructed him to call out “rapid response team stat”
Call my nurse, something is wrong with me. Shallow rapid breathing I thought I was going to code. The response time for this nurse was unusually slow.
I begged for a stat CBC as my hemoglobin was already under 9. The nurse refused. She said the lab will obtain my hgb at 5:00 am.
I need a nebulizer. I started to spout out orders that a typical ICU nurse would do.

She was lethargic, gave me an Ativan. Granted I was also having some type of psychotic reaction to the dilaudid but she was slow to move and obviously didn’t feel the impending doom that I did.
I apologized to her but said I needed help. I told her “I know too much”
Her response was “I know too much also. I’m a Sagittarius “

I made it through that night. I did not become a code blue or RRT, my NP came to make rounds on me, I told her my situation from last night. The NP said the only communication she had from this nurse was that I needed a Tylenol for a headache.
And by the way… my hemoglobin had dropped to 7.6.
She certainly put a big smear on this unit. This Medical -Surgical unit of nurses and techs working so hard. High acuities understaffed unit.

I’m thankful my son was with me. I gave him his first lesson in what it’s like to be an ICU nurse.
The importance of listening to the patient and the symptoms . The importance of being readily available to the patient and using critical thinking skills.

And the importance of never ever telling a patient your horoscope sign. A totally inappropriate response.

My first post op night: nightmare and incompetence. And reportable.

By Debbie Moore-Black, RN

(Warning: Sensitive topic)
** This is a composite story but based on facts. In 1997/1998 and in 2000. The difference in my story and the truth is several and many babies died from bacteria traced back to nurses fingernails as a contributing factor.

---

That small cliquish bevy of nurses working their way through orientation in the NICU. Straight out of nursing school.
They were happy and thrilled to be accepted into this specialized nursing unit: the NICU.

Practicing good hygiene, washing your hands up to your elbows with soap each time you entered a babies cubicle, gowning and gloving was standard and mandatory protocol  before touching the babies.

These were preemies in the NICU.

Molly and her friends felt privileged and honored to get this job straight out of nursing school.

It was a fast paced NICU with levels 2-4. The higher the level, the higher the babies acuity. They were tiny and frail and had weak immune systems. Most were born prematurely. Others had defects, congenital anomalies and immature lungs. Some babies had to be fed by a feeding tube. Some were on the ventilator.             

This was the most sacred unit in the hospital because every nurse that came aboard knew they must always be meticulous in everything they did.

The basic cardinal rules though was to always wash your hands. And keep your fingernails trim.

The new nurses were fashionable. And pretty and smart. But they refused to let a protocol like having short nails bother them.
Management looked the other way when they saw the new grads parade in, with their glossy fingernails, long stiletto type nails.
I guess if they just looked away everything would be ok.

Baby Jessie  was a level 2 baby in the NICU. She was born prematurely, hypoglycemic, grossly underweight, and unable to feed without a feeding tube inserted through her nose that landed into her stomach.
She was frail but had big eyes and a hint of fine red hair. She was a beauty.

Her parents, washed their hands, gowned and gloved, held their new baby close to them. Every day they’d come for a visit. Hoping and praying for a progress report.
Each day seemed to be a new accomplishment.

Baby Jessie seemed to be progressing.

Though one day her status was changing.and changing rapidly.
Poor Jessie with her rapid respirations, diarrhea, a rash developed on her abdomen.
Fever developed, lethargy and Jessie was rapidly decelerating.
The sepsis protocol was initiated, stat labs drawn, ABG’s and an LP preformed.

A code blue was called. The code team rushed in. CPR, ventilator as baby Jessie went into asystole rapidly. Rounds of epi, bicarb and the code team couldn’t bring Jessie back.

After what seemed a lifetime, the NICU physicians pronounced her death, and sadly met her devastated parents.

An autopsy was preformed, bacteria was found. Ecoli. It was mandatory to report this to Infection Control and Epidemiology. The CDC was involved.
E. coli was found in Jessie’s bloodstream.

That new bevy of nurses. The fashionable ones, the ones with those long stiletto nails, the bacteria was traced back to their nails upon scraping and microscopic findings.

It was determined that two of these nurses
contributed to the death of this Neonatal premature NICU baby.

Beyond respecting and acknowledging the protocol on wearing short nails, of always washing your hands up to your elbows without fail each time a nurse entered a babies room in the NICU….. because of these nurses that failed to honor this mandatory protocol, a death was pronounced of this small innocent newborn baby.

Years of trying to finally get pregnant, yearning for that new baby, baby room decorated, crib with pink ruffles …..baby showers and happiness …..

Endless tears as baby Jessie lay lifeless in her parent’s arms.

.

.

By: Debbie Moore-Black, RN

After 32 years as an ICU nurse, I felt that I had navigated death well with my patients. The typical co-morbidities, multi-system organ failure, stat intubations, ventilators, pressers, central lines, art lines, failure to thrive, code blue, cpr. And hearing the brittle and brutal crunches on the ribs of the poor souls we were forced to do during CPR.

Families screaming “do everything “ when there is nothing left to do but hope and pray they will allow their loved one to die peacefully.

I even navigated my own scary situations of breast cancer during a routine mammogram ( no symptoms) and lumpectomy and radiation to follow. Leaving me with a distorted and disfigured left breast.

Many years later I discovered a mole that become discolored and irregularly shaped at my neck and yes, positive for a melanoma, but fortunately no lymph node involvement. Surgery was uneventful and I went home the same day.

But…
This is different.
Asthma resurrected itself after being dormant for 15 years. And I went to my pulmonologist… Chest X-ray was clear, most likely it was a virus that eventually cleared up, but my pulmonologist recommended a CT scan of my lungs.

A visualization and results of my CT of lungs revealed a solid mass which appeared on my left kidney.
I was in shock and not expecting that. Asymptomatic. Kidney mass? I only expected the typical asthmatic lung views.
Not this.

And then I felt the grip of my mortality.

I easily had thought in the past that I would die around the age of 83 in my bed while I slept.
Amen hallelujah day is done.

But I’m 67. And now I’m fearful.
CT with contrast reveals a solid mass.
Down the road
Most likely a Nephrectomy.

And now I’m invaded with thoughts:
How long will I live? Will someone take care of my dogs?
Will I see my grandchildren grow older?
Will I have a few years left with my children?

When your cognizant of dying
You enter into that territory of the unknown.

I could think of the spiritual aspect:
Dying. Going to heaven and my soul floating around.
But the truth is
Death is the end.
Death is final.
Maybe.

I worry that I’ve run out of physical and emotional strength. Another cancer. Why.
I can accept this
Do all the surgery and treatments
But the fear is real.

Fear of flying

Into the next dimension
That we are all unprepared to do.

We’ve lived this life on earth
But how do we do the next act of leaving our physical self and enter the hemisphere of unknown territory?
Yes
I am afraid.

I now understand the fear of flying.

By Debbie Moore-Black, RN

Nature’s Lullabye

I kept a little red book close to me. I wrote poetry.
It was November of 1974 and I did not know where my future life would be.
I was a lonely and sad neglected child. With a narcissistic mother and an executive father who moved up the business ladder quickly until his alcoholism caught up with him.

I remember the screaming, the fighting, watching my daddy run into the walls after he drank his gallon of wine.

I desperately wanted to go away to college but was told by my mother I would become a nurse and go to a local community college and stay at home.

My quiet peaceful place of serenity was the cottage my dad had built on a lake. I would go there to visit by myself to find peace and tranquility.

Months later, daddy lost his job, lost our lake cottage.
Alcoholism.
And I lived a continuous nightmare only to finally escape that house….

Give your children love and respect and positive building blocks for them to grow on.

Building blocks

“You’re fat and stupid and ugly” told repeatedly to me by my parents only led me to a dysfunctional marriage that was riddled with verbal abuse, neglect and frequent infidelities from my husband.

My saving Grace were my three children.

Today, I breathe in this crispy fall air and remember with wonderment the peace I once found in nature.

Here is my poem which I recently resurrected:

Nature’s Lullaby

By: Debbie Moore-Black, RN
11.16.1974

Peaceful splendor finds my soul
Hitting every tender feeling,
Finding every hurt.

Solitude asks me to join him.
What a perfect team we would be.

Breezing trees
Ruffled waters
Floating clouds
~a part of nature
~a part of God.

I am accepted
I am wanted

I and nature hold each other
And join to fit
a part of His world.

Silence like a spreading vine
Cradles my mind
And we are a forever lasting unity.

We are One.

By: Debbie Moore-Black, RN

I like to thrift shop.
Aisle after aisle weaves a story of people and their lives. Pieces of trinkets I’ll never need.
BUT… I can feel the hidden simple beauty and then I have to have it. My children can line my gravesite with the thousands of collectible pottery ….those awkward strange gems I know I can’t take with me.

And then there it was.
A simple coffee mug with a simple message:

Begin.

Of course right then and there… I had to reflect and cerebralize.

I’m in the “Fall Season” of my life. After 46 years of being a nurse…. I finally called it a day.
ICU nursing was my favorite. Intense. Daring. Strategic. Saving lives. And letting go.
46 years of clocking in and out. Many years of overtime to provide for my children.
To provide happiness and a lifestyle that wouldn’t leave them embarrassed or shy because of what they wore. Like me.
To give them a healthy environment where we had fun and learned about life and people and respect for each other … for the love of books and traveling.

Sadly they had to learn of the darker side though. The tears, the fighting of me and their father. Begging for him to be faithful. Begging for him to find a different job that may pay more so I didn’t have to work 60 hours a week. Another infidelity. Another discovery. Another forgiveness. And never a change.

Reflection.

I loved my life as a mother.
I loved my life as an ICU nurse.
I had good managers and bad managers. Good nurses, and technicians and Respiratory therapists. A tight working machine. And then we had the bullies we had to muddle through.

We traveled and had nice vacations… always after I worked my overtime hours.
Beach trips, different cities and states and countries and cruises… many times bringing one of the children’s best friend along.
Our home was their home. Our door was open.

Reflection.

Soccer games and track and football and tennis tournaments and chorus and plays and proms and colleges and marriages and babies.

Reflection.

I hold the newest grand baby boy in my hands. His perfect beautiful self.

Though I made some bad decisions, I can’t help but think God was always there to guide me and somehow protect me.

A sad childhood filled with neglect and verbal abuse. A sad marriage, fooled by breadcrumbs of love and charm.

But the aftermath. Our children. Happy and thriving, and keeping that eternal flame alive.
Happiness for them. It’s all I ever wanted.

So this coffee cup that simply states:
Begin.
Well I have begun. Every day I wake up. Every day that I realize I have a second chance to be nice to someone. To greet them with a smile, to hold the door for them, to respect them no matter their race, creed or culture.

There had to be a reason I was put here on earth. I am not afraid of death. I made my mark and I continue to do so.

Every day is a new day. A new day to make good decisions. A new day to reinvent yourself.

Begin.

By: Debbie Moore-Black, ICU RN

She was oil. I was vinegar.
We didn’t mix. Ever.
Even though we wanted the best outcome for our ICU patients, we stood on opposite poles of the earth.
Sometimes there’s only room for one alpha dog. One ultimate bully.
And that wasn’t me.

Mr. Williams, 68 years old, received the tragic news from his physician. He was having strange and unusual symptoms like slurred speech, muscle weakness and lack of coordination, muscle spasms, weight loss, difficulty swallowing. Tripping and falling. And the worst: difficulty breathing.

His death sentence. ALS: amyotrophic lateral sclerosis. Also known as Lou Gehrig’s Disease. That famous baseball player from days gone by.

Mr. Williams gathered his loving family together upon his diagnosis. It wasn’t one of those cook-out family get togethers.
The family knew something was wrong.
Mr. Williams called the meeting. He explained that he had an unusual deadly diagnosis. It would be progressive deterioration of his body.
There was no cure.
Mr. Williams did not want to be put on a ventilator when the time came. He requested that he be made a DNR/DNI.
He wanted his family together when the time came.
No heroics.
Just a peaceful passageway to his hereafter.

He was admitted to our ICU. His physician wanted the ultimate care for this patient. He wanted Mr. Williams to have that last gathering with his family. And so per the physicians request, there was no EKG monitor. No loud beeping noises. Just IV fluids slowly infusing in his vein. And his entire family in a semi- circle surrounding his bed.
At times, you could see Mr. Williams looking up. As if he saw the gates to heaven. He smiled.
His wife, his children. His grandchildren. A priest all at his side.
I was given orders by his ICU physician to give this patient morphine IVP prn.
There would be no suffering.

I stood in a corner hoping to not be visible.
The family stood close together. Holding hands. Laughing about the fun times they all had growing up. The family man. The neighborhood father.  The loving husband. The perfect granddaddy.
Laughing turned to intermittent tears.
I tried to stay strong though I was ready to crumble.
But my job was to prevent any suffering.

As I gave Mr. Williams morphine IVPush as needed, I made sure he was not gasping for air. That he was comfortable. That the family was comfortable.
I had prepped the family on what my role was. But told them to freely talk, laugh. Cry.
It was a beautiful passageway.

But then Jackie came barging through his ICU room. I was dismissed and told in front of the family members that I could not give morphine prn. That I was creating “euthanasia”. That despite my orders from the ICU physician, I could not do this anymore and I was told to leave the room. And Jackie took over.

Jackie told the patient, who was in and out of consciousness, that he would soon be in heaven with his wife.
His wife was actually present in room. She was very much alive.
Jackie had  such a negative affect on this family. On this situation.

Mr. Williams died two hours later. But the family was in shock over the turmoil that Jackie created.
The family reported her to supervision.
But nothing was done.
Jackie was a workhorse and would clock-in to work at any given time when needed by our manager.

I’ll never forget the beauty of this family. The togetherness. The love.
And the shattered moment of when a fellow nurse had to be in control.
The ultimate bully.
Her ego rode on the expense of a dying patient surrounded by his loving family.

Some things we can’t forget. As hard as we try.

(Fictitious names and Google stock photo)