Once a nurse, always a nurse. For those of you who are retired from nursing, or have left nursing because your back, or psyche, can no longer bear the weight of patients, does this phrase sound familiar? Maybe you’ve changed careers – maybe you’re now a lawyer, or a writer. But you’re still a nurse.

You’re a nurse when your mother calls and says, “My leg has a red spot on it and it’s been itching for three days, what do you think it is?” You wonder if she could possibly think that you have superhero vision and can see through the telephone wires into the red spot. You tell her to stop scratching it, to put some cream on it.

You’re a nurse when a good friend asks you if you would mind telling her alcoholic brother that drinking is bad for his liver and he is at risk for liver cancer. You want to tell her that he probably won’t listen to you any more than he’d listen to family, but you know she’s desperate. You want to tell her you don’t have experience with liver disease, that you’re background in nursing is with babies, and they don’t drink, as far as you know. She says she’ll get you her brother’s phone number, but the next time you get together with her, she forgets it. You’re relieved and careful not to ask how her brother is doing.

You’re a nurse when your sister-in-law asks you what to do about her bee sting. “It’s swollen,” she says. You tell her to put ice on it. And when your mother-in-law complains of a headache, you tell her to put ice on her head. “It decreases blood flow to the area, you say, “it should help the throbbing” You’re sister-in-law, who is in the room at the time, asks, “Is ice your answer to everything?” We laugh. But I think she’s on to something. Maybe ice is the answer. Maybe the next time my mother or father, or my husband or stepchildren ask what they should do for a stubbed toe, a twitching eyelid, or a paper cut, I’ll tell them to put ice on it.

Since “you’re the nurse in the family,” you’re assigned as your father’s health care proxy. He has Alzheimer’s and can no longer make decisions for himself. He requires caregivers to help him bathe, dress, and sometimes eat. His doctors call you for consent to admit him to the hospital when he suffers from pneumonia, or diverticulitis, or a blood clot. You are called upon to decide whether or not your father should have surgery to remove a lesion that might or might not be cancerous. You are asked to weigh the risks and benefits of every medical intervention your father faces. Sometimes you wish you never became a nurse.

But you are a nurse –no amount of ice can change that.

When learning a new tune on the fiddle, how do you begin? I start by listening to the tune, or song, again and again. I hum it – sometimes I try to sing it (because I’m not a very good singer, I prefer humming). I do this until the melody keeps me awake at night, joins me for breakfast, for every meal, when I’m washing the dishes or while I’m driving or taking a shower. Then I pick up my fiddle and play the tune (Okay … I admit that sometimes I try playing it before my brain is well-oiled – I can’t help it).

I’m no musical prodigy, so I won’t make any false claims here and tell you that, once the tune is etched into my brain, I pick up the fiddle and play the entire piece all at once. I focus on one phrase at a time. For instance, if I wanted to play The Silver Spear, a reel in the key of D, the first phrase includes the following notes: F, A, three A’s bowed as a triplet, B, A, F, A. I would play that over and over until my fingers moved from string to string as if they possessed their own nervous system, or what is called “muscle memory.” In other words, you want your fingers to be able to dance along the strings without conscious effort. Then I would move on to the next phrase.

Years ago, at the Irish Heritage Festival in the Catskills, I participated in a workshop lead by master fiddler Kevin Burke. He told us that, when practicing a tune, he plays a phrase over and over while reading the newspaper. I’ve tried it, but I’m not very good at multi-tasking, and found myself getting too absorbed in the headlines, the news of the latest winter storm barreling our way silencing the melody in my head.

If you haven’t learned the tune yet, here’s a link to The Silver Spear. Give it a try and let me know how it goes.

At this year’s Boston Book Festival, I plodded into a standing-room-only venue to attend the session, “Writer Idol.” I stuffed a page with the first two hundred fifty words of my memoir in progress into a box bulging with dozens of other submissions, then sat in an aisle seat, in case I decided the session was not for me after all. I stared ahead, waiting for three agents – Kimiko Nakamura, Sorche Fairbank, and Amaryah Orenstein – to enter the stage, where they would listen to two authors take turns reading anonymous submissions. I recalled the description of the event in the brochure: “This session is not for the thin-skinned.” I can handle this.

A few moments later, the agents settled in their seats, and the show began. One of the authors plucked a submission from the box, and started reading. The agents were still, concentrating with their eyes closed. The secret writer knew that an agent could react at any moment, bringing the reading to a halt. The reader finished almost the entire piece before Ms. Fairbank’s hand waved in the air, indicating where she would stop reading and reject the piece. Soon after, Ms. Kimiko raised her hand. Clichés, and too many words are “symptoms of the rest of the manuscript,” Ms. Fairbank explained. Ms. Kimiko agreed. Buried in the audience, the writer knew that if their full manuscript came across either one of the agent’s desks, there would be a good chance they would reject it. As I imagined how that writer felt, a warm current whirled in my chest.

The second submission was weighed down by “too much exposition,” and encumbered with “meaningless” words, Ms. Fairbank said. “I don’t know what’s happening,” Ms. Orenstein said about the third submission. The fourth one was also interrupted. “The scene seems like it’s about to drag on,” Ms. Fairbank commented. I scribbled notes, visualizing my piece. Do I use clichés? I don’t believe I use wasted words.

“The Peach,” a reader called out. I sat up straight, gripping my pen, readying myself for the critique of my piece:

I dig my nails into my thigh, scrape the center of the raw, six-inch scar that reminds me of a scythe. Despite my efforts to relieve the itch, it won’t let up. Then, like a crescent moon, the sliver emerges from my skin. A splinter?  No. A sliver of glass the size of a fingernail tip. I touch it, motion to flick it away as if it were a poisonous insect, but stop, and hold it under the lamp for a closer look. A dull yellow glimmers from its core. Its amorphous – ”

At the same time, all three agents hands shot up. I dropped my head into my notepad, heat gushing into my face. I had read the passage again and again, and “amorphous” seemed fitting. But now hearing it, it sounded as if I were trying too hard. So when Ms. Fairbank said my piece is “over-wrought with language,” I nodded. I nodded again when she questioned my use of “poisonous insect.” The other two agents agreed – too much focus on detail for the start of the manuscript. Ms. Fairbank suggested I have a “fresh pair of eyes” read it.

For the rest of the session, even though I burned with disappointment, I focused on the responses of the agents, telling myself that this was my chance to learn what they are looking for in a manuscript. I jotted notes: “Start off simple. Don’t dump information onto the page. Don’t create long sentences at the start of the book. Don’t use description for description’s sake, and watch out for piling descriptions on top of each other.”

The next day, after my husband read my piece out loud to me, I revised it:

I dig my nails into my thigh, scrape the center of the raw, moon shaped scar. The itch won’t let up. My nail catches on something hard and sharp. A splinter?  I tweeze it with my nails. I pull out a sliver of glass, the size of a fingernail tip. Where did the glass come from? The windshield of the Buick? Is that possible? Has it been inside me for two months?

Though I had left the session feeling as if I could use a transfusion of confidence, what if I had not attended, or not submitted my piece? I would not have benefited from the trio of raised hands?

This post was published in Brevity on October 30, 2014, at  http://brevity.wordpress.com/2014/10/30/writer-idol/

Photo: courtesy of http://www.bostonbookfest.org

Many people experience moments when they can’t come up with the exact word, or words, they want to express, and resort to the hackneyed phrase: “It’s on the tip of my tongue.” But for those suffering from a traumatic brain injury, this phrase extends beyond its timeworn use. Word finding, or word retrieval, is one of the most common cognitive difficulties in TBI survivors. The language center of the brain is located in the left hemisphere – the frontal and temporal lobes. Difficulty with word retrieval usually means the damage has occurred in the frontal lobe, the location of most TBIs.

What does this mean for individuals who have suffered a frontal lobe injury? Called dysnomia, or anomia, they tend to have difficulty naming objects, people, and places. They may know what the object is that they are looking at, but cannot identify it.  Sometimes the process is selective, say, to colors. For instance, individuals might know the difference between blue and pink, but cannot name them. In other cases, individuals might be able to identity an object through sound – the ringing of a bell – or touch – a needle – but not sight. Others might use the wrong word. For example, instead of saying, “Can you please pass the salt,” they might say, “Can you please pass the tire?” http://www.speech-therapy-on-video.com/wordfindingdifficulty.html

Circumlocution, a strategy where you “talk around” the name of the object, person, or place you are attempting to identify, often helps. If you’re looking for your cell phone, and you want to ask your husband if he has seen it, you might say, “It’s portable and it rings.” That way he will know what you are talking about. Also, this might prompt you to remember the object. Reciting the alphabet is a strategy that triggers words for me, especially if I can’t recall someone’s name, which happens all the time, even if I just met the person five seconds earlier. So, if I’m trying to recall the name Nancy, I say the alphabet in my head until I get to N. You can also visualize the word written out on a chalkboard, or whiteboard, or even a pad of paper. Similar to circumlocution, if someone cues me by sounding out the beginning of a word I’m struggling to express, my brain synapses suddenly come to life. http://www.speech-therapy-on-video.com/wordfindingdifficulty.html

For writers with a TBI, difficulties with word retrieval interfere with crafting poetic sentences for our readers to chew on. I typically find myself staring at a sentence for several minutes, rubbing my forehead and biting on my pencil. It’s not unusual for me to spend hours working on one paragraph. I usually end up resorting to my pile of notebooks of quotes I’ve collected from some of my favorite authors. For instance, if I’ve used “walk” a hundred times in my manuscript to describe someone entering a room, I flip through the notebooks, scanning the pages for unique ways other authors describe this same action. Of course, I do not steal their phrases, but seeing alternative ways to express “walk” is similar to someone verbally cueing me: My brain lights up with all kinds of options to consider, and I feel as if I just won the lottery.

Give these exercises a try, and feel free to share what works for you.

(FYI: Including research, it took me five hours and twenty-eight minutes to write this bog post).

More than six years after an older driver ran into me, causing multiple injuries including post-traumatic stress disorder, I decided I wanted to write a memoir about the tragedy and its aftermath. I wrote (actually I typed) nearly everyday. Essentially, I dumped my brain onto the page, ignoring the logical left side as I typed fast and furious without thinking about the structure of my story. Six months later, I had 365 pages of facts muddled with emotion. Though I felt proud of myself for my accomplishment, a puddle of grief muddied the moment. I thought I was ready to write about the accident, but maybe I wasn’t. Maybe I hadn’t yet figured out how to navigate my PTSD speed bumps. As the months and years passed, I read the pages again and again, examined with a closer eye what I had written, pondered the subterranean meaning of each passage and turn of phrase. The combination of time, taking breaks from my story, and reuniting with it from the perspective of a maturing writer, helped me gain insight into my work. In essence, I had stepped outside of myself, outside of my PTSD, and looked at the endless pages from a different, non-PTSD angle.

I’m glad I stuck with writing because research shows that it helps heal PTSD, even brief periods of putting pen to paper. http://www.sciencedirect.com/science/article/pii/S0005796712001088

When we experience a trauma, physical and/or emotional, our brains work overtime to process it, interfering with our ability to be present for others, and ourselves. Writing our thoughts down helps to release the emotional burden, and helps us to organize, put our thoughts in order – clean up our metaphorical cluttered homes. Writing has been shown to benefit the immune system, and overall health. But a professor of psychology at the University of Texas in Austin, Dr. James Pennebaker, cautions: “Standing back every now and then and evaluating where you are in life is really important.” Speaking from experience, I agree.  https://www.utexas.edu/features/2005/writing/

So, where to start? Here are my ideas:

1) Journaling: Even if you jot down one sentence each day.

2) Carry a pad of paper with you at all times – when a disturbing thought crowds your brain, write it down.

3) In first person (from the perspective of “I”), write about an emotional, or traumatic, event that has kept you awake at night. Just write. Don’t think about who might see it – lock it in a safe deposit box if you have to. The rub: put it away for a month, or two, or three, and then go back to it.

4) Take the same piece you worked on in number three, and write it from a different point of view – second or third person – forcing yourself to step outside of your hypersensitive skin (I’ve engaged in this exercise – it opened a vault door I never knew existed).

Feel free to share how this exercises worked for you?

“There is no greater agony than bearing an untold story inside you.”  Maya Angelou, I Know Why the Caged Bird Sings

Additional Resource:

http://healmyptsd.com/2014/08/writing-for-ptsd-healing.html