Trigger warning: All posts labeled “SANE Nursing” make references to patients who are survivors of sexual assault.
~ ~ ~
My patient doesn’t have to say, I could have survived being raped, but what I can’t survive is finding out that while I was drugged and unconscious and being raped someone was recording the whole thing.
They show me by digging and dragging their nails into their forearms, over and over and over again, the pressure leaving deep purple lines from their wrists to their elbows.
I say, without thinking, “Do you want me to ask the doctor to give you something for your anxiety?”
My patient, who was literally drugged into unconsciousness, pauses their fingertip flagellation for just a beat, and I realize what I’ve done.
They don’t have to say, no, thanks, I’ve been given plenty of sedatives recently.
They say, “No, thank you, I’d rather not take anything.”
*
I’m such a jerk.
*
I say, as I do to all my patients, “Do you have any feelings of hopelessness, or like you might want to hurt yourself?”
They don’t have to say, I never did until this morning, when I heard about the video.
Even I can hear that answer.
But I can only write the answer they speak out loud, and that one is: “No, I’m ok.”
*
They immediately flashback when I try to collect swabs, and scream, and begin to gag and vomit.
Their unconscious remembers, and reacts.
I stop the exam.
*
They don’t have to say, I can’t take this anymore, because when they say, “Can I have a few minutes to myself?” I think I understand the question.
I lock up my feeble evidence, four swabs and terror in a shallow grave, and leave the room.
In the time it takes me to move my evidence cart back to my office, 40 feet away down the hall, my patient has put their shoes on and fled the Emergency Department.
*
Turns I didn’t understand the question at all.
Because they run from the hospital and down the street and run into the center of the highway, flinging themselves in front of cars as drivers swerve and slam on their brakes and sit on their horns in shock.
The police are there in moments, and when my patient is restrained to try to stop them from dying under the wheels of a delivery truck, they flashback again, and begin to fight for their lives, and strike out at the paramedics who have just arrived on scene.
And the circle completes itself as they, yet again, aren’t given a choice, and sedative medications are administered and they lose their connection to the world, and they lie there, tied to a bed in a world that has betrayed them over
and over
and they cry
and cry
and cry.
*
I pack up my four little swabs into two little boxes, and seal the kit and sign my initials across the big red sticker that says EVIDENCE, and I count the ways I fucked up that encounter, so profoundly, so badly, and my fuckups outnumber my swabs by a factor of x.
*
There are days when I can carry the porcelain figure, the delicately painted china teacup, the blown glass ornament; I can carry them over obstacles above and below and from the side and navigate them to a quiet corner cupboard, a gently padded linen closet, a place of safety, be it only a calm moment in the gathering storm.
But there are days when I drop the figurine, when I trip and the teacup flies from my hand, when the ornament slips through my fingers, and I stand uselessly by and watch as worlds shatter at my feet.
*
I am home, now, after a 13-hour day.
The storm outside spits rain on the windowpanes and sends the winds howling to shake the frames.
It will weaken and blow out to sea by 4am, and the air will be calm again when I wake up.
*
I cannot imagine what it would feel like to believe that the storm engulfing you would never,
never
never
end.
A Canticle for Lazarus 
Resonated to my toes! You are so articulate and always capture yoursand your patient’s-experiences so profoundly! You are the perfect person for doing what you do-for your patients, your team, those you educate and for your advocacy. Thank you, thank you from all of us!
Thank you profoundly for this work you do. So hard, so important. I’m struggling to say something about the story you told here, how you feel you failed and how feeling that way is a reason you are so good at this work. Hugs from an internet stranger if you want them.