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Nursing and caring from the realm of silence

It’s National Nurses Week. In my mind, I’ve been turning over an interaction with a nurse I had during the thick of my ordeal with a drug-resistant infection. It was one of the briefest exchanges two people can have, but it still had its impact, and has been a kind of touchstone for my work since then.

During one of my many, many trips to Interventional Radiology, the team was doing what they had to do. I don’t remember if they placed a new IV, or readjusted one of the many preexisting tubes in my body, but I winced.

The nurse standing at the head of the table put her hand on my shoulder.

That’s all.

I don’t know her name, and I don’t recall ever seeing her before or since. I’m sure whatever I was having done that day was routine and ordinary for her.

She heard me in (brief, fleeting) distress. She registered that this then-late-twentysomething half-naked on a cold slab was a human being. She comforted me.

Despite the fact that the entire interaction took three seconds if it happened slowly, I struggle not to become emotional when I think of her. I was a person. I was cared for. Someone in the room was on my side, not merely executing an efficient procedure.

She did that without a word.

In my training, there’s an concept called the “realm of silence”. The idea is that speech and language is an overflow: when all of our needs and wants are met, language is unnecessary. Even some desires and objectives can be obtained without the need for words. Teaching young directing students to create and produce scenes that happen in silence is a way of emphasizing the tipping point when language becomes absolutely necessary to carry out our lives.

Even then, there is an entire realm of silence underneath our speech, and the miraculous thing that day was that the nurse didn’t have to break her silence to tell me she recognized me as a person.

There are layers and layers of words and language and processes and initiatives and metrics on top of the realm of silence we use to get good health outcomes and guide patient experience. The question I carry with me from that nurse is, are we enabling an environment for healers and for patients where care happens before language is necessary and after words have ceased?


Featured Image: Photo by Zhang Kenny; used under Unsplash’s License