When Talking Gets Hard | Katherine Toler
I can still feel the outline of the blood bulb in my hand. When it’s full, it’s pleasantly cool, and fits in your palm perfectly like an egg out of the refrigerator. Deep red and primed with saline, my job is to stand there and squeeze.
1 unit.
2 units.
3 units.
The task is mindless, but my body is alert. Each chirp of the monitor, every waveform on the screen, could signal her deterioration.
There are things that need to be done, and done well, to keep this woman alive.
I do them and hand off to the next nurse.
Home.
Dinner detritus litters the kitchen. A sauce-spackled spoon is on the floor. Half a glass of milk, spaghetti strands hanging over the lip of the cup, antagonize me in my post-shift haze. I am so fucking hungry.
The kids are summoning me upstairs with excited pterodactyl screeches. Have I been gone for 14 weeks or 14 hours? From their reactions, you wouldn’t know the difference.
My husband has checked off all pre-bedtime tasks.
Two children: pajamas on, teeth brushed, books read, meds taken, stuffies found.
My reward is giving the announcement, “The tuck train is coming! Choo choo! Better get in bed before you miss it!”
“Hurry, Maxine, hurry! The tuck train!” My four-year-old Miles is the only one moved by the fake train leaving the station.
Kisses are given, love is bestowed, departures are made. No one misses the tuck train.
I emerge from the nightlight-soaked sanctum, eyes adjusting, blood sugar hovering just above desperation.
Nick is on his phone in bed. We make eye contact. Or maybe we don’t.
When I interact with my kids, my face switches on. The muscle memory of joy rearranges the blandness in my cheekbones. When I introduce myself to my patients, the muscle memory of necessity fixes the scowl and the fuck this shit expression.
When I talk to the doctor, the patient’s husband, and the housekeeper who scolded me for dropping the isolation gown on the floor, my demeanor, my attitude, and my disposition click into place.
Now I’m confronted by the face I’ve always called home. Brown eyes, hat askew, salt-and-pepper in the beard that scratches my upper lip when I let him kiss me.
I want my features to rearrange like they’re supposed to.
I want my eye contact to linger, a half-smile forming, the suggestion that snaps everything into sharp relief when I raise an eyebrow.
I want to press my nose into that spot near his jawline, behind his ear, freckles dotting the skin wherever the sun hits.
I am so hungry.
I microwave a frozen burrito and eat in silence. The relief of not being needed breaks the tension I still feel in my shoulders, the ache from logrolling my patient back and forth all day.
She was an oversized rag doll, pumped full of vasopressors, antibiotics, and other people’s blood, too critical for consciousness, too heavy.
Her husband, picking at his nails, asking obnoxiously obvious questions, because that’s what you do when the face you’ve always called home is swollen, bloodied, and bruised. When a machine has replaced every organ.
Our room is dark when I come to bed. My husband is a ghost in his phone light. He’s reading another New York Times article about the genocide in Gaza. Face set in lines, his civic duty to stay informed. “What else am I supposed to do?”
I want to reach out, to shoulder some of his altruistic overwhelm.
I can’t.
I swallow magnesium, melatonin, ashwagandha, and a Lunesta prescription that isn’t mine—my cocktail of nocturnal desperation. A megaphone message for my mind in pill form: please, please stop.
Now I’m a ghost too.
We’re side-by-side. AirPods in. Noise-cancelling headphones on. Ears encased in cotton and stolen quiet.
Maybe we say goodnight, or maybe we don’t.
Because this is when talking gets hard.
And I wish I knew how to say what I needed.
To tell him about the blood I transfused. The stroke they suspected.
The high-risk operation that did not go well.
How pointless it feels to pour energy, resources, and hope into someone who won’t ever walk out of the hospital.
How my fingers ache from squeezing.
How I ache in the space between us in our king-sized bed. The one we bought to make room for the tiny people always climbing in.
How I want to be held, but being touched makes my skin crawl.
But I remember how good that cool egg blood bulb feels in my hand, and I know I’m going to keep squeezing.
Keep dumping all the resources, energy, and hope into our high-risk operation because that’s what you fucking do.
Keep aching.
Keep trying.
Bonus audio of Katherine reading her piece…
about the author:
Katherine Toler is an ICU nurse who writes about the physical and emotional work of taking care of other people—at the hospital and at home. Her essays focus on routine, rupture, and the moments when language falls short. Her work has appeared in Raw Lit and Intima and is forthcoming in Survive and Thrive: Journal of Narrative Medicine and American Journal of Nursing: Reflections. She lives with her husband and two kids.