By Marybeth Curtis, RN, BSN, WOCN

It was the first day of clinical in my Bachelor of Science in Nursing program. Time to actually bring real patients into the picture! We were visiting a local nursing home to work on our communication skills. Each student was assigned a nursing home resident. We were to spend the day with the patient, interacting, laughing, and assisting them with their daily activities. This was a time for making memories!

Our instructor went over the interpersonal communication worksheet that we would complete as our homework. Once we had our room assignments, we were on our way to meet our first patient! I remember walking into her room. She was lying in bed with her back turned to the door. I walked over to the bed and called the name that was on my paper. “Mrs. Taylor.”  “Mrs. Ruby Taylor.” Nothing.

I patted her on her shoulder so not to startle her from her slumber. “Mrs. Taylor.” A wrinkled, slender face slightly turned to smile back at me. Dark brown eyes twinkled through the narrow openings. Some strands of thin, grey hair fell into her eyes as the remainder of her hair stood on end with static electricity working its magic. I remember hiding a startled expression as I noticed a tiny mole perched on the tip of her nose. All I could do was smile back.

I introduced myself. Talking a mile-a-minute, as I usually do when nervous, she just lay there smiling back at me. Never nodding. Never making a sound. Just smiling. I began to sit her up in bed, fluffed her pillow, and straightened her covers. One of the duties on our checklist was to dress the patient, assist them to their wheelchair, provide toileting as needed, and feed them their morning meal. During all of this, we were to make mental notes addressing questions on our interpersonal communication worksheets without being too obvious, of course.

As I leaned over to cradle Mrs. Taylor in my arms, and pivot her to the edge of the tiny bed, she reached her gnarled, little hand to the side of my face.  She patted my cheek and pressed her forehead to mine. It felt as though time stood still. I have no idea how long we sat there. I loved her patting my cheek and no one ever pressed a forehead to mine so sweetly. I was in love immediately.

I ready my notes. “Non-communicative,” appeared by Mrs. Taylor’s name.  She had not spoken in the past year! What was my teacher thinking? How was I supposed to communicate with her? How was I to complete my assignment? I felt a sense of panic creeping over me. As I looked back at the small-framed beauty at the side of the bed, it suddenly did not matter. I began to brush her thinning, grey hair. She had it in a braid. I brushed it out and sang to her as I gathered up the dangling strands. There! It was a beautiful braid again and Mrs. Taylor’s smile stretched from ear to ear. 

I washed her gnarled hands and rubbed them with lotion. I rubbed her legs with lotion and placed socks and shoes on her tiny feet. We chose a blue dress. Well, I chose a blue dress. Mrs. Taylor just smiled and I took that as approval. I talked and talked as I did the things that were necessary to prepare for breakfast. Soon, it was time to eat and she patted my face and smiled as I spooned small bites of oatmeal into her toothless mouth. I noticed I was now the one leaning my forehead against hers as I offered her sips of milk and orange juice. Her happiness engulfed me.

How quickly the time had flown! It was almost time for me to leave. I could not think of leaving my new friend. I told her I would be back.  I told her that she was my friend and I loved her. I wanted to have something for her to remember me by so I drew a picture. I drew a bright, yellow sunshine, green grass, and bright flowers. In big, red letters I wrote the words, “I love you, Ruby!” I held the picture in front of her for her to see. She took the picture from my hand and with her crooked index, finger she pointed to the words and said, “I…Love…You…Ruby.”  

I was suddenly the one who was speechless! One of the nursing home staff told me it was the first time she had ever heard Mrs. Taylor speak! I was crying I was so happy. I hugged her and kissed her good bye. She patted my face again and smiled.  I promised to return soon…to talk.  I learned a valuable lesson in interpersonal communication that day I will never forget. As I reflect back, I understand now that you should never go into a situation without looking for hidden treasures.  I definitely found mine…and it was a Ruby.

---

Marybeth Curtis, RN, BSN, WOCN, is a Nurse Educator in the Division of Community Health and Education in the Department of Family and Preventive Medicine at UAMS.

by Paulette Mehta M.D., M.P.H.               

Before COVID-19, I had a daily routine: Leave for the hospital at 7:00 AM,  return home at 9:00 PM or later. Days were filled with treating cancer patients, writing academic papers and proposing projects. Evenings were filled with meetings, potlucks, restaurants, and workouts at the gym.  

Everything changed when the pandemic arrived in Little Rock, Arkansas.  Restaurants, gyms, clubs, and theaters closed. Even the mall, where I often did a nighttime run, closed. The city was deserted. People were told to socially distance and not to go near each other. The mayor of our little city imposed a 9:00 PM curfew. The only way I kept up connections was at the hospital. There, I talked to patients and colleagues, albeit from six feet away.  

Until the quarantine. 

I had spiked a fever to 100.6 degrees but I had not been exposed to anyone with the COVID-19 infection yet, as far as I knew. I wasn’t able to be tested because there were not enough tests to go around yet. I had been exposed to many sick cancer patients, I therefore decided to be extra careful and self-quarantine for 14 days. 

What would I do alone at home for 14 days? I wondered. I could play the piano.

That was always a refuge when I felt sad. I could choose songs of hope, solace and love. I had often soothed myself from pain on my grand piano, the one we had bought for our daughter when she turned five so many years before. Then I remembered, I had sent the piano to her for my grandson’s fifth birthday, an heirloom they could both enjoy.  

What else could I do? I could paint. 

My mother had been a wonderful artist who stirred me to draw and paint. I could do landscapes inspired by the beautiful rolling hills just outside my house where daffodils and dogwoods were beginning to bloom, indifferent to the virus. But then as I searched my house, I realized I didn’t have canvas, paints, or paintbrushes. Despite these items being essential for me for my healthy living, they were not officially considered essential and therefore not available for sale. 

 What else could I do?

Alas, I could simply just walk the perimeter of my house, back and forth, over and over, careful to stay at least 10 feet away from anyone else. There were endless pathways outside my house at the 12^th hole of the Pleasant Valley Golf Club, but I decided to just loop around the perimeter of my house again and again until I reached 10,000 steps.     

One day, I saw my neighbor Fred across the street. I called out, “Hi Fred, how are you doing?”

“Not so good,” he answered.

 “Why not?” I inquired.

 “Well you know, my wife, she isn’t getting any better.”

 “What’s wrong?” I asked.

 “You remember, when she had that stroke, well she never recovered,”  he said, his voice trailing off as he started walking away. 

 I kept walking, feeling bad I hadn’t followed up with them, my closest neighbors. as I would have done had she been my patient. 

As I continued walking, a lady stopped her car and yelled, “How are you, darling?  I haven’t seen you in so long!” 

 “Fine,” I answered, not at first remembering who she was. 

 “How is everything?” I asked. 

 “It’s hard,” she admitted, “The schools are closed. My kids are all over the place and I have run out of things to do.”

Then I heard myself saying “Well, you need a village to raise a child, maybe we can do something together for the children since there must be so many kids with nothing to do.”

 She laughed, “What are you thinking? A bear hunt?”

I heard myself answering, “Yes, that would be a good idea. We could each put our teddy bears in our front windows and let the children look for and count the bears. The one who finds the most bears wins. We could change the bears every day.”

She answered, “Yes, and that way they would get exercise and they would get to know the neighbors.”

Finally, she asked me: “Let’s talk about it, let’s work on it, are you free this time every day to walk together?” 

 “Yes,” I say surprising myself, then I remembered the quarantine. “Well no, not really, can we text instead? “

That night I got a text from her. “Let’s announce the bear hunt through the neighborhood app. The first hunt could be next Monday, that will give everyone a chance to get ready.”

“Yes,” I answered, “I already found my teddy bears!”  The bears were lying in the attic they were old, ragged, and torn.  It’d been more than 30 years since my children were young enough to play with them and I had kept them at their insistence. They were attached to their childhood toys and wanted to show them to their children when and if that opportunity would arise.  

My neighbor wrote back: “Let’s tell the neighbors to add a ribbon if they need help.  They could tie a red ribbon if they need help urgently; a blue ribbon if it can wait a day or so.”  

Meanwhile, I continued my walks, occasionally waving hello to people driving by or speaking to those who stopped to see why I was home.  I noticed  bright yellow daisies and daffodils in the back yard. I had never seen them before. I found rocks on the ground and arranged them into sculptures. I picked up sticks and put them in piles. I fertilized my garden. I planted rosemary and thyme. I was beginning to feel one with nature. I was feeling peaceful and soulful.  

Fourteen days passed and I was well enough to return to work. I wore a surgical mask and parked in an auxiliary parking lot. The main lot was now a make-shift fly-by-night field hospital. I  walked through endless yellow tents designed to keep people distanced from each other.  I walked through the lobby where chairs had been rearranged to be six feet from each other and where people were walking in masks and gowns. I hurried to the cancer ward, seeing my patients one by one, using the one and only N95 mask assigned to me. 

Patients confided their fear of getting COVID-19. One patient said she had  finally found something worse than having cancer. Messages from 21 patients had stacked up: afraid of the virus, they wanted to be treated by phone.  

This was a different country than the one where I had just spent my quarantine. This country was a busy, bustling war zone for the sick and weary. The other the French Riviera for the rich and leisured. Here were the halls of hell with people crying and scared; there there were serene, ghostlike streets of people with nothing to do. Here, I was working to the bone, thinking of intravenous chemo and blood; there, I was convalescing and dreaming of teddy bears and ribbons.  

As I entered my home that first night after returning back to work, I noticed a box on my front porch. I opened the box and saw three teddy bears in white, brown, and black, all completely brand new and each one wearing a  ribbon around his neck. Inside the box was a note written in a child’s handwriting which read: THANK YOU FOR  STARTING THE TEDDY BEAR  HUNT.  I picked up the teddy bears and hugged each of them. Then, I put one of them aside to bring to work the next day hoping to finally integrate my two worlds together.

---

Paulette Mehta, M.D., M.P.H., is a professor in the division of Hematology – Oncology in the Department of Internal Medicine at UAMS.