Seeing the world through the Nurse's Eye

Learning to Read the Water: Three Years Home

Three years ago today, we drove away from 32 Honeysuckle Close and departed from Gate 32 at Heathrow, heading back to the United States. The start of our story, but now taking in our old home from a new reference point, our life in England. In England, we experienced life as foreigners. We learned about bank holidays, absorbed the 7 weeks of paid time off starting from day one, relaxed with accessible, affordable healthcare and walkable cities, and basked in the calm of a society without gun violence.

The first year back home, I was a ball of anxiety and dread. Crying daily, then weekly, then finally monthly. Why? Having to read nutrition labels again and telling Alvin he could not have yogurt here because of the sugar content. Paying $900 a month for healthcare, yet having to wait 8 months to see my primary care provider (general practitioner) for the first time. Worried about an immigration raid, and worried our country would elect a man who would make that more likely, which it did.

The Lobster in the Pot

However, three years later, I now only cry every couple of months. The culture shock has worn off; now I feel more like a lobster in a pot of boiling water. I know I am in the water, but I wonder if I will realize when I am done. Walking the store aisles, formula, laundry soap, and deodorant behind locked doors no longer make me boil with frustration; it is normal. Seeing an innocent two-year-old as a bystander victim in a shooting no longer rattles me; I am just grateful they survived, aware it was their luck of the draw.

Locked up Formula, feeding the future is too expensive at this time

I have lost count of the public shootings since I arrived home. I know they include an intersection I often cross, an emergency room I previously worked in, a food festival I might have attended, even my current university; the list goes on and on. My reality now is that I could have been the two-year-old, but it does not paralyze me; I hope the universe is on my side. I have learned to carry a high level of vigilance as I walk out the door, for my family’s and my safety, a weight that cannot be put down, as the risk is too high. Two years ago, the anxiety was too much, and now I have tamed it with antidepressants. To live at home, I must be medicated. What does it say about our home?

Sucker Punched

But this year, this anniversary of being back home is like a sucker punch from left field; every moment from here on out will be diluted even further by the present time. The three years we spent in England have impacted every decision for the last three years. Alvin recalls our time in keen detail, the building blocks of the adult he will become. I do not have the memory of a child, and the last three years have been fueled with cortisol. As I took inventory of our return, using photos to guide me, I realized that through all the bad, I can see what brought me back and what will propel me even further. I hope that the memories of those 3 years in England continue to drive us toward a better way of life, not closed in by geography.

My Roots

Being home pulls in at the roots of my life. The things that have made me and will make me. Yes, life is hard here; healthcare is only accessible to those with the right funds, and by moving home, I have decreased my son’s survival into adulthood by two years due to gun violence, the leading cause of death for children. And I have made peace with it, not because I like it, but because all my boys (my husband, my stepsons, my birth son, my dogs) have a stronger hold on me than this country does, and that is enough. I have stopped waiting to like it. The salve for my realities is the glorious mountains that cannot be captured in photos, the smell of the ocean as you ride the ferry, lighthouses all around, Thanksgiving with family laughter echoing long after dinner. Blending our life home with habits from England, searching and attending Pantomime, learning to be explorers in our home, new waterfalls, or old charming cities.  

Garibaldi Lake BC

The Math in the Middle of the Road

There have been many moments since being back home, some good, some not, like the time I was side-swiped by a car while cycling to work. Nothing was broken, but I was hurt badly. As the bystanders were attempting to call 911 while I lay on the road doing my own assessment of my injuries, I yelled, “NO, I am fine.” Not because I was, but because I was doing the math in the middle of the road. The emergency department copayment versus urgent care. And I had already booked our trip to Chihuahua, Mexico, to visit family, which meant I did not have the time off to be hurt. In England, neither of those numbers would have existed. I got up from the road intending to go to work, but I did not make it. I was too injured, so I took two days off anyway, the very days I had been protecting.

The Origin

And then there is another extreme. Standing among the trees, watching my birth son get married, fourteen people, counting the bride and groom. Alvin carried the rings. The first time I saw him, his parents’ hands reached for him before mine ever did. I chose that. I chose them, out of hundreds of letters narrowed to ten, then three, then two. What I did not understand at eighteen was that choosing is not the same as ending. He has been in my life every year since. And this time, he did the narrowing. Out of everyone he could have stood among, fourteen, and I was one of them. I watched him marry her in a clearing of trees, with my other son beside him holding the rings, and I did not need a word for it. I was where I was meant to be, back home.

He is part of my roots. The first time I heard his heartbeat, something turned over in me, a new sense of wonder. How did the human body create life, something I had never been told it could do, and I wanted to know more. Everything I have done since, started in that room. I would not be a nurse if not for him. I would not have worked in England. I would not be back here now, going to school to change the system of how care is delivered.

Learning the Vocabulary

Now back home, I am using the knowledge I gained about life and healthcare in England, including its focus on prevention and safeguarding, the effects of a walkable city, and how these impact society’s health. These ideas encourage me to pursue my doctoral degree, and for the last year, I have been in school full-time, learning how to make these changes a reality

I am getting my degree in Population Health and Systems Leadership through the School of Nursing at University of Washington

It is a strange relief, learning the vocabulary for a thing you have been living. England gave me the comparison. This year has given me the mechanism. I am learning where the money moves and who decides. I am learning which levers exist and who is holding them. Why our healthcare system is broken and how we got here. Most of what arrives in my emergency department was set in motion years earlier, in a room with no patient in it, by people who never see the child or the family in need.

For twenty years, I have stood at the bottom of the waterfall, catching. I am good at catching. But I have started walking upstream, and it turns out the water has a source, and the source has an address, and the address has a budget.

I am not good at this yet. I am a student again, late in life, taking notes on my own country like a foreign correspondent. But I no longer only feel the temperature. I am learning to read it. I may be the lobster in the boiling pot, but I feel the water getting warmer, and I’m not one to sit still; I’m attempting to climb out and cause havoc.

Keep an eye out next week. I will tell you about the havoc I am in the midst of.

1 Comment

  1. Bruce

    Brilliant, moving piece of writing; such broad perspective, yet so heartfelt. Not only are you causing havoc, you give courage to other others to join you! Keep it up!

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