The Dark Side of the Moon

My first years in the Emergency Department flew by, and I suddenly found myself considered an actual ER nurse, no longer a newbie. I had performed CPR numerous times now and could easily participate in treating a myriad of life-saving interventions. I could be trusted to act without being told. I no longer thought before shoving my hand over bleeding wounds or jumped at the sight of bugs creeping out of bandages. I had lost a number of patients, old and young. I was seasoned, because less surprised me. I had seen enough.

But along with that seasoning, I began to notice a harshness, a sternness. I was now also less empathetic to simple problems and more quickly annoyed by things that weren't actual emergencies. Quite frankly, I was even a little dejected. The mountain tops were receding into shadows. The vision I had had of being some agent of rescue in active emergencies was idealistic of a world where people came to the Emergency Room after a car accident or a heart attack, and we somehow gave them some secret healing potion and popped them back into their merry lives as though the horrendous incident had never even occurred.

But even a small injury or illness can lead to lengthy recovery times. Or a newly found diagnosis required learning adjustments, which means never really going back to the way it was before. Sometimes the emergency wasn't just a one-day event. Sometimes there weren't happy endings for me to send someone back to. And for some, it seemed as though the world itself was a perpetual horrendous incident. It was a much harsher place than I had known. Brokenness and pain were more real, more encompassing, and much more difficult to escape than anything I could provide in a few short hours on any given shift.

While I did not even know it was happening, each day I showed up at the ER, I was slowly being awakened to how imperfect and broken this world can be. So many patients came to me unsure of where else to go. Patients came in for depression, anxiety, and suicidal thoughts, sat for days waiting for psychiatric placement, and gazed at me with expressionless faces. Mothers wept over their children, their illness, and sometimes their deaths. Patients sat alone in rooms with no family to hold their hands, to wipe their tears, leaving all their basic needs to fall to me, who couldn't provide one-on-one care for any person. They quickly proved I was very incapable of providing real solutions for many of the lifelong problems they faced. It was like I had grown up and learned that the big white circle in the sky that makes up the moon isn't all glorious or all brightness and white light. In fact, it's filled with dark shadows, unswimmable lakes, and freezing temperatures. The ER was not some big, glorious, wonderous world. It was the dark side of the moon.

It was one of these particularly frustrating shifts that I had a particularly frustrating patient. She was a young woman, maybe early 20s, who had come in for some vague complaint. I read the chart and sighed. Yet one more person coming to the ED for something I couldn't actually fix, and who probably didn't need to be here at all. What was worse, she had a child with her, a boy about 2-3 years old who kept running off, screaming, or tearing the drawers and shelves apart.

Since she was clearly my least sick patient, I put her last. Prioritization is key. More medically pressing complaints first. And I went to take care of my other patients. When I returned to the nurses' desk, she was standing at the counter, bouncing her son on her hip and demanding angrily that someone explain to her why no one had done anything for her and what was taking so long. My anger instantly burned back. What right did she have to yell at us? We were just trying to help. And quite frankly, she hadn't been waiting that long. I had other patients, too. Someone told her to return to her room to wait. Someone would be there shortly. This response only further ignited her sense of injustice, to which she responded with louder demands for attention. To end this escalation, I escorted her back to her room and introduced myself. However, I kept my stern composure, professional and polite. I would not reward her yelling by letting her think she was getting some prioritization with my presence. It was simply now her turn anyway.

I swiftly completed the orders, drawing her labs, getting her medicine, and putting her on the heart monitor. I asked her if she had called someone to come get her child, as it was hospital policy for children to be with an adult who was not the patient. Someone had to be able to care for the child if she needed to go for tests, or heaven forbid, what if she had to go to emergent surgery or got suddenly worse? Besides, she couldn't chase him around while on a heart monitor. She said she would call, and I said I would come back to check on her.

A few hours passed, and as predicted, her labs came back perfectly fine. There was nothing wrong with her. Nodding satisfactorily that she could now be on her merry way, I went to prep her for the discharge I was certain the doctors would be placing soon.

Entering the room, I found her attempting to wrestle her kid and stay on the heart monitor and charge her phone from an outlet the cord wouldn't reach unless she held her phone over the head of the bed. I sighed again and shook my head. More nonsense. "Were you able to call anyone for your son? Or do you have a ride? I think we will be discharging you soon. Your labs looked perfect."

She seemed surprised and disappointed. She wanted answers. She didn't feel well. Something had to be fixed. She couldn't go on like this. I prepped my "this isn't an emergency" speech, a speech I had perfected through endless repetition. We did what we could. We ruled out the emergencies. We checked the things we could check. But we are an ER. We can't run every test. We can't get to the bottom of every problem. The good news is you're ok. Now you can follow up with a regular care doctor or a specialist for more testing if you're still experiencing your symptoms.

It was at this moment that she broke down in tears. After being in the ER for hours, she finally told me the truth. She was there because she was tired. She hadn't slept in days. Her kid kept her up all day, and she was working nights at two jobs. She didn't call anyone to come get her son because she didn't have anyone to call. She looked at me, and I saw despair. It was the first time I saw anything besides anger in her eyes. And I realized, all her projected anger towards me was really her frustrations with her world of unsolvable problems. The same way my less-than-warm welcome of her was misdirected frustration with the heaviness of the world I was experiencing. She had come to us because the door was open, and she had nowhere else to go. Her emergency wasn't physical. But this was her emergency.

During this conversation, her son had come over to me and was now standing at my feet, face pressed into my thigh, arms raised. I scooped him up, and he hid his face in my neck. For the first time that evening, he was still. And suddenly, I understood what she really needed. Safety. In a world where everything was on her, tonight, she just needed a break. I couldn't solve the daily stresses, her financial problems, or her single motherhood. But I knew how I could help her. I told her to wait; I would be back.

My shift was going to be over in a few minutes, and there was no nurse taking over for me, a common thing when we ended odd-hour shifts at 1 or 3 am. This also meant my section of the ER would close for the night. I went to the charge nurse and asked if my patient could stay just for a little bit. She had no ride. It was late. She said no; no patients were left unmonitored in the ER, and no nurse was taking a discharged patient. Fine. I would watch her. The charge nurse shrugged. "What you do with your time is your thing. Just clock out. We aren't paying you for that."

I nodded and quickly straightened up my desk and discharged my last patient. Grabbing some warm blankets, I returned to her room. "OK. You have a few hours to sleep." I said as I silenced all the beeping and turned off the monitor. I scooped up her son, who was running around the room again and covered her with a blanket. I turned off the light and then sat down in the visitor chair by her bed. The young boy turned to me and I wrapped him up with a blanket, forcing his head to my shoulder. It was just a few short minutes until both of them collapsed into deep sleep, finally allowing the safety of the moment to win over their exhaustion. And as I listened to the soft breathe of the sweet baby boy laid in my arms, I let the peace of the moment start to erase my exhaustion too.

 This was when I started to realize that the ER does a phenomenal job of skewing the way I saw the world. Yes, the world was heavy and very broken. The deaths of those that slipped through my hands were just as poignant as the weeping families who landed in my arms. Cancers lingered on for years, causing pain and perpetual weakness. Broken relationships culminated in fights and isolation, sometimes right in front of me. But what I had failed to see, was that I was seeing the worst of the worst. For some people, I was the last place they turned.

I don't see many minor cancers, the ones that get caught from a first biopsy. I don't see perfectly born babies, just the unexpected or miscarried. I don't often see happy, healthy homes full of positivity and support because those aren't the ones who come to ER at two in the morning for help. I see the bad car accidents. I see the strokes from the diabetes and blood pressure that were never treated in the first place. I see the falls that end in broken bones. I see the lonely deaths of those forgotten. I see the parents who weep over their teenage children's time reckless night. I only see the bad problems, the broken homes, the loves lost to pain. I had wallowed so long in the dark side of the moon, I had forgotten that there was a moon that could shine at all.

But the sun does not fail to shine nor the moon to glow simply because my eyes are closed. Suffering had not won over joy and hope as a balance of the world in general, just in my view of it. Nor had evil somehow usurped my God simply because it appeared so to me.

As it turns out, there is no dark side of the moon at all. The sun still shines on the side of the moon I cannot see. It only appears to be shadowed because the moon exists between me and the sun. The side I can see, I perceive as light. The side I cannot, I assume to be dark. But my perception can be wrong.

For me that night, it was holding that small baby boy that brought me joy again. I couldn't solve all of my patient's problems, but I could give her a reprieve from motherhood for a night. Once rested, maybe she would be ready to go battle the next day. And as we acknowledged the heaviness of the pain, we rekindled hope for each other. My presence reminded her that maybe she was not so alone in the world after all. Her sweet son's love reminded me that the presence of pain does not deny the existence of joy.

So dear friend, if the world is very heavy, if trials are accumulating, and all that is around you seems to confirm that hope is lost in the dark side of the moon; I promise you, Joy is not dead. God is still very much alive and shining. This may be a season too dark for you to see it right now. If so, don't be afraid to look at someone, even a stranger, and let them believe for you if you can't. Or pull those near to you and let them help you see a different world, let them lighten the load, or just let them be present with you. For that presence is a gift, not just for you but for them too. For these are the tangible expressions of love that remind us that even the darkest of nights cannot stop the Son from rising. Love does conquer all. God will be faithful to sustain you. Just keep waiting until the world rotates just a little more. Wait with anticipation: for joy will come in the morning.

Merry Christmas, sweet friend.