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Descent Into Madness

Deni Ann Gereighty

    She slammed her locker door shut and sat down heavily on the bench, collecting her purse, work bag, which contained her fetal monitoring test to be completed, breath mints, remains of her lunch, hemostats and scissors, hand cream, pens, ID tag, water bottle and the other odds and ends of a working nurse, and picked up the plastic bag containing her white nursing shoes, now splattered with blood, and scrub shirt, soaked with more of the same new mother’s blood. Katrina thought back over the shift wearily, Rushing around, she had barely gotten to work on time, and it was an exhausting shift, with four admits and six deliveries.
    She was the charge nurse and it was very busy. Around 0300 one of the nurses with a diabetic antepartum patient with frequent emesis called her to say the patient was shaking and complaining she felt bad. Her blood sugar was fifty-six and she had been vomiting all day yesterday. Arriving at the patient’s room, Katrina introduced herself and sat down on the bed, noting the patient getting more anxious and sweating. She was drinking apple juice. Giving a diabetic with a low blood sugar juice was good, but why had this happened?
    “Connie, what were you able to eat for dinner?”
    “The only thing I have been able to hold down is apple juice and mashed potatoes. So just mashed potatoes for dinner, nothing else on the tray was appealing,” she replied. “They started me back on insulin today and I told them I couldn’t eat yet. Please don’t leave me alone.”
    Katrina sent the patient’s nurse, Jo, out to call the doctor and look for any mashed potatoes and more apple juice. Sitting there, they chatted about diabetes and how things had been going with this pregnancy. Suddenly, Connie gasped!
    “What is it,” Katrina inquired, reassuringly placing her hand on Connie’s arm.
    “I can’t see you sitting there, “ She replied.
    “Then it’s time for another blood sugar.” This one was forty. Katrina called Jo and the doctor and the nursing supervisor. She had to be very assertive but she made the nursing supervisor go to the Safeway grocery store across the street and get microwavable mashed potatoes.
    Connie quietly whispered, “Are you still there? I can’t hear you anymore.” Katrina nudged herself closer to Connie’s leg and squeezed her hand several times, but never letting go. She had been afraid exactly of this kind of ‘crash’ occurring. Her blood sugar read 30 this time, much lower than the bottom range of 70 a pregnant woman should have. With some mashed potatoes and 2 more cups of apple juice Connie’s blood sugar was up to ninety-eight, her vision was fine, she could hear, and she could try to go back to sleep. Katrina had a long discussion with Dr. White about starting insulin on a patient who was still vomiting. Jo gushed with thanks that she had not been in the room when Connie had said she could not see.
    “I would not have known what to do. How did you get the supervisor to go get mashed potatoes?” Jo queried.
    “Just experience that we would have had a bigger problem if he had not just run across the street for us to get them. It’s a small thing, but it made all the difference in the world for the patient. Be sure to tell the day shift what happened and not to give insulin if she is not eating,” Katrina finished wearily.
    She was then called to see another laboring patient, who came in with the family all jabbering in an unfamiliar language. The only person who spoke up in English to answer any questions looked about twelve. A look and one feel of the strength of her contractions told Katrina this one did not need the triage room, but was a direct admit to a labor suite. She quickly led the patient and family to a room and handed the patient a gown, explaining to undress and she would get her into bed and the fetal monitor started. Going to the computer, Katrina knew there was no labor nurse she could pull from another assignment; she was it. Calling the midwife to come in from home, Katrina turned around as the woman came out of the bathroom, pointing to her crotch. The baby delivered as soon as mom got into bed, without the midwife, a set up delivery table or time for Katrina to get a pair of gloves. “Thank you so much, I feel so much better,” the woman had said, in perfect English. “I was in a lot of pain.”
    This patient’s attitude and gratitude was in sharp contrast to her co-workers’ scathing comments this week, which were running over and over in her mind, like an inane commercial jingle, which, once popped into her consciousness, refused to vacate.
    “Scrubs are getting a little tight, eh?”
    “Your hair’s growing so fast! All the curl’s almost out of it.”
    It’s not like I’m not trying, she thought, blinking back tears, aware such simple comments would mean little to most people. I just got my hair cut and permed nine days ago! My hair was ‘too severe’ in a bun, ‘too casual’ in a clip on top of my head like Erin wears hers, everyone said it was such a shock to see me get it permed and now it’s not curly enough? I took the high road about my appearance, how far do I have to go? And I exercise and swim! She moaned to herself, and got up, trudging out of the fourth floor nurses locker room, down the hall to the elevator and parking garage.
    The crux of the problem was her employee evaluation two weeks ago had been deplorable, all the more incredible because the assistant manager had said none of it should come as a shock to her, although it had been a shattering experience. Katrina’d had no idea there were such multiple negative assessments about her or that numerous patients had complained about her weight and perceived abilities; that she sat down at the computer to chart, she asked relatives to hand her the blood pressure cuff if it was on the opposite side of the bed, and worst of all, pre-teen and teen-aged family members were asked to plug in the fetal monitor as the electrical outlet was 4 inches up from the floor and under a cabinet so that she almost had to get flat on her belly to reach it, whereas a pre/teen was able to plug it in easily. Supposedly her patients were claiming she was ‘too fat’ to take care of them. It had been a devastating meeting, the screaming inside her head making her want to run and hide while all the while trying to appear calm and remain professional as she asked questions to clarify points, answered a few questions she was sure were not legal, like what were her diet and exercise programs, and signed the double dammed document, right where it says this signifies receipt, not agreement, with the contents.
    “Unkempt, unprofessional appearance.” How to take that, especially since this was the first time her weight had been officially discussed. Patients commented, she had been told, that she came into the room breathing heavily, as though, ‘they’ said, she could barely walk, was ‘unable to move them— when they had a good epidural and needed to be turned or in delivery when a family member was required to hold one or both legs back during the ‘pushing phase;”so the nurse could get supplies— did that mean I’m too weak?... and ‘did not seem able to take care of them because of her size’. Having been super-sized the entire fourteen years she had been an RN, seven of them on this same unit, Katrina was confused. I can’t pass a bedpan, run a bed and patient into the C/section room along with the charge nurse or patient’s nurse and the surgical tech and the doctors, diaper a baby or start an IV line because of my size? That hardly seems likely, when I do it all the time, I’m even often the charge nurse, responsible for everything that all the six to twelve nurses do on the unit. I still walk too fast for the laboring women when I take them back into the exam room; I didn’t know there was a minimum speed for nurses!
    Katrina got into her beloved, comfortable, late-model black Chrysler Cirrus, and sat a moment before turning on the engine, the tears flowing now. “I gave up my hair wrap and my long hair, I bought new clothes, use breath mints, see the dentist frequently, all the things I could identify. Goddess! I even employed both an image consultant for my hair and a fashion consultant for my clothes. I had a close friend give me a sniff test, and I always shower directly before work and wear clean scrubs. I can’t hide my size. I feel like I don’t even have a right to exist!”
    Katrina wiped her face and drove carefully out of the garage. “So you finally decided to join us, did you?” “Wish I could get a good sleep like that.” She relived those embarrassing comments from last week at the beginning of the shift, when she had arrived forty minutes late for her third twelve hour night shift in a row. It’s the second time this year, but it’s not as if I don’t set two alarm clocks. Katrina didn’t really want to point out the ultimate reason, that she had central sleep apnea, to her employer. Awakening dozens of times during the night to breathe while her brain, busy in REM or dream sleep, pure and simple, forgot to stimulate a respiratory response, caused her to have to gasp her way awake, breathe, and go back to sleep. Despite medication and the ever-wonderful CPAP machine that blew air into her nose so she did not stop breathing while asleep, it was hard for her to wake up. Becoming conscious enough to get out of bed was a difficult task, all the harder because sleeping exhausted her. She joked that whenever she got up, she was ready for a nap. Falling asleep on the sofa on her days off was not helping, as she wound up not taking her medications, yet, her sleep med was so sedating, that if she took it, she’d need to go to sleep again and sleep around the clock! Now was not the best time for her to have been late again, that was certain. It set off even more alarm bells (haha) in her head that her job was on the line.
    Katrina thought about stopping at the grocery on her way home. She needed to buy a turkey soon, before there were none left, but she was too tired and drained. Like an idiot, she berated herself, I asked to work the night before Thanksgiving (which counted as the night shift holiday), needing the money and not having someone special to share it with, then I invite people over for Thanksgiving, only to find I have to work Thanksgiving night too!
    Katrina undressed, leaving her clothes on the bathroom floor, and climbed into bed, munching a Dove chocolate ice cream bar as she tried to calm down and get into a constructive frame of mind for her days off and back into her book on fat-positive self-esteem. She wanted to be upbeat, really, but she was lonely. Not even anyone to love me, she thought dejectedly. I hate being single!
    She woke to a dark, silent house. Glancing at the clock, she already knew she’d overslept her alarm again. Nine o’clock already on Monday night! Katrina listlessly dragged herself up out of bed and installed herself on the living room couch half an hour later, after eating a sandwich and tending to her piteous Minou Cat’s complaint that she was starving (untrue), unloved (possibly true if she continued to nip people), cold (not true, the heater was on and what was that fur for anyway), and the litter box was stinky (always true, it was a toilet for the Goddess’s sake!) After a while watching TV, she fell asleep for another six hours. She awoke, pissed at herself. ‘WAKE UP,’ she demanded of herself, and DO something! Laundry seemed the most pressing need, boring, but active.
    Eventually, she checked her voicemail. The two messages were both from work. One was to work that night-obviously that was out. The second was from the payroll clerk. Her Thanksgiving holiday (which was separate from the night before Thanksgiving, that netted overtime) could not be paid on her upcoming check, as it was payable after it was earned, not before, despite what the program assistant had told her. So, she was going to be twelve hours short on this paycheck. She’d planned on that money or she would not have stayed home on call one night last week. How the hell was she going to pay the mortgage on time, not to mention her car registration, which was a couple hundred short out of this check to begin with. Time to raid her small savings account, but her brain began shrieking ‘stupid, unworthy, useless’ as a background litany again.
    She washed the dishes and lit a few candles, putting the TV on for company, and fixed herself a comfort meal, steak, caramel-topped cinnamon rolls, with sauteed mushrooms and green beans. Quickly picking a few dishes up afterwards, she knocked over a brand new ceramic cannister she’d just bought last week and had yet to fill with flour. Looking down at the fragments behind her microwave, she just shook her head and left it. Katrina went out with the morning haze that passed for sunrise and got the mail, another error, she soon discovered reading it, as it brought a nice, fat bill from Firestone, her six months deferred payment for her snow tires was up; she’d forgotten all about it.
    She decided she needed a change of ... ‘atmosphere’ ... seemed like the best word. She put on one of her Libana CDs, and carefully cast a circle around herself in her ritual room (or spare bedroom, as it was also called.) She drew the physical boundary with salt, unlike her usual use of incense to define the circle. Calling the four quarters and the Goddess, she smudged herself and did a self-blessing ritual she had learned a few years ago at Wicca summer camp.
     “Goddess, please help me out here,” She beseeched. “I am so anxious about my job and my life right now. I feel like I am being persecuted because of my size. Why am I so fat? Being on insulin does not seem to let me lose weight! Will I gain weight forever? I know I am created in Your image. You know I don’t spend all of my time pigging out! What should I do to make my life better? I don’t want to lose my job and my house and be homeless. I’ve been applying for other jobs for months, I exercise..........Help me!”
    Katrina took a shower, put on one of her favorite dresses and went to the store Tuesday morning. The turkeys were picked over and her favorite brand, Norbest, were all sold already. She knew from prior experience that this was the only store that carried any number of them. Long gone was the day she had brung a turkey home only to find her partner had bought a turkey also, requiring one of them to go back. Nina, ah well, no sense thinking about her, that was ten years of another life. Katrina picked out a nice fresh turkey, selected a bunch of cheery flowers for the holiday table, cranberry sauce, turkey broth and another can of pumpkin she needed for the menu. She was having two friends over. Maybe they’d use her Grandmother’s china and silver, all she had to remember the only unconditional love she felt she had ever really had.
    Stopping at the Chevron gas station, she discovered her wallet was missing. Thanking the Goddess she wasn’t on fumes, she called the grocery store, but it had not been turned in. Cursing all the way home, she thought furiously of all the times she was going to go through that wallet and xerox all the cards, or write them down or even sign up with one of those credit card registrations she so frequently saw stuffed into the bills. She’d have to call the driver’s license bureau and see if they were open the day after Thanksgiving. Can’t write a check where she’d be asked for ID either. Damn it all to hell in a handbasket anyway!
    Katrina turned on the oven and discovered once it was hot and she was putting the turkey in that she had forgotten to remove one of the racks, spilling water and giblets all over the floor. Going over her important papers file, she thought she located all the credit cards and made the calls to report them missing. Going out to the garage in the endless pursuit of laundry, she checked the glove compartment for her insurance certificate. Closing the car door, she glanced in the back seat and dropped the half full soda cup she was putting in the trash all over her dress—her wallet was on the back seat of the car! At least she didn’t have to get another driver’s licence, but all her credit cards were now cancelled..
    Ensconced on the sofa reading the old yet new to her Sunday paper, she dozed off, only to awaken to the blare of the new smoke detectors she’d had her housekeeper install last month. She’d put the turkey in nine hours ago! Opening the front and back doors did not help much. Katrina, coughing, had to pull two of the smoke alarms off the ceiling and disconnect them to shut them up. Pulling the charred turkey out, she splashed her arm with hot grease, which blistered immediately, despite the cold water she promptly applied. She would deal with a new turkey later, or never, she decided.
    Going into work Wednesday evening, traffic was impossible. She was fifteen minutes late, again. Mortified, she walked into the report room, steeling herself for comments. No one was in there! What was the deal, this was very unusual. She changed into scrubs and took the elevator down to the third floor, walking into the unit bravely. Everyone was silent as she walked into the nurses station and her manager was sitting there. Ms. Sandra Watson never stayed late, hers was an 0800 to 1700 type of job and 1930 was not a time she was around. Her extra hours were morning ones. It boded less well as Sandra said, “Come into my office,”
    Following her down the stairs, trying not to huff, be too slow, or fall from missing a step she could not see, Katrina knew something was terribly wrong. Her greatest fear was losing her job and thus her house and all she had. No one in their right mind would hire a floor nurse as big as she; fat-positive she was, but at over three hundred and fifty pounds, she was also realistic. Watson confirmed her worst fears.
    “Katrina,” she began, “I have had complaints about you from six patients in the last two weeks and two charge nurses. You have been late twice in two weeks. You sit down to do vital signs and ask family members to hand you the blood pressure cuff, even asking a family member to move to another seat so you can sit at the computer. They do not feel you can give good care as you are not like the other nurses. This is totally unacceptable. You are too fat to work as a nurse. I have no choice but to terminate you effective immediately. Please clean out your locker and go home. Here is your last paycheck, with two weeks severance pay in lieu of notice”
    Katrina had no idea how she got home safely. She couldn’t see from the tenacious torrent of tears, could hardly breathe from crying searing her sinuses, and didn’t much care if she stomped on the accelerator and closed her eyes on the high rise bridge. Except that she didn’t go home over the high rise bridge on her accustomed way home and the car was on autopilot. She wished she could feel numb, instead of horrified, embarrassed, terrified, angry, stupid, fat, ugly, unloved, depressed and miserable. What was she supposed to do now? It was a very good question, to which she feverently wished she had an answer. “OH Goddess, please help me,” she sobbed! She wanted to hide from the world, and not have to think, not have to try, and always be found wanting.
    Katrina let Minou Cat out as she arrived home, barely noticing her, lost in recollecting another Thanksgiving, nine years ago, when she had been pointedly left out of the festivities at work at another hospital, clearly uninvited to the potluck meal and given responsibility for the whole floor while everyone celebrated. She had not even been told there was a potluck! She had had fish for lunch at home, telling her partner Nina to bring her home a Thanksgiving plate with turkey from the friends she was going to be with while Katrina was at work. Katrina had never dreamed she would be stuck with all the work of the floor while her coworkers of over two years partied without her! Nina had just let her cry when she had gotten home, not even offering her a hug. “Even then,” she murmured, “I should have known the relationship was dying.” Nine years ago, Katrina had gone into the bathroom and taken handfuls of pills. Nina hadn’t stopped her, hadn’t taken her to the hospital, hadn’t called her therapist, or her mother. It would have been so easy, Katrina had realized then, and stopped before taking too many pills.
    Katrina looked down at her hands, hands that had soothed, calmed, massaged, held, comforted, acknowledged and encouraged so many women, and saw them opening bottles of pills. Everything was disjointed, like a dream that switches scenes without segue. She was in the bathroom, and there were empty pill bottles around the sink and on the floor. She was gobbling pills by the handful, tears coursing torrentially down her face. The comments that had been thrown at her for years resounded like a Greek chorus; “You’re too fat to live.” “I ought to run you over right now, fatso” “I’d kill myself if I let myself get that big!”
    She could not get the soul searing taunts she had heard over and over out of her brain, but she was falling further and faster away as she kept scooping up and popping left-over drugs, in the kitchen now, with Vacation—good for sleeping with pain and permanent liver damage; Lor-tabs-good for pain relief, sleep, and heart rhythm changes and liver damage too; Valium—good for mellowing out and sleeping,; Alluvial—good to cause sleep and possibly fatal changes in heart rhythm, Phenergan—no nausea or vomiting....She knew antibiotics, cholesterol drugs or ibuprofen weren’t lethal. She thought she had done so well, was getting her life back on track, but the last two weeks had destroyed it all again.
    Katrina crawled into her waterbed, phone unplugged and pulled the covers over her head. She was already feeling dizzy and very sleepy. Now she wouldn’t have to think, strive to fix ‘unkempt’ and ‘unprofessional,’ worry about how fat she was, if her breath offended, what people thought of her. Probably no one would even hold a funeral, and a casket would be a problem—but not mine, she giggled to herself. She had on her best new lace nightgown, one of three she’d bought hoping to need for a new partner; it wouldn’t do to just be wrapped in a sheet like poor Christina Carrigan.
    Much better just to go to sleep, get away from the name-calling, taunts, disapproving looks, the ‘your hair needs cutting,’ ‘your purse is getting pretty worn,’ ‘maybe you need a breath mint,’ I don’t want you to have a heart attack and die,’ ‘we’ll buy you new clothes when you lose wight,’‘you have such a pretty face.’ ‘It doesn’t come any larger than this,’ ‘you’re late, again,’ ‘I don’t love you anymore and haven’t for a long time,’ ‘you’re too fat to be a cheerleader,’ ‘I didn’t think she could take care of me,’ ‘face it, you’re fat because you don’t bother to take care of yourself,’ nobody wanted you anyway, you fat pig.’
    “I’m not unkempt and unprofessional, damn it!” Katrina asserted.
    “I quite agree.”
    “What?”
    “I said, I quite agree with you. You were not unkempt to begin with and you made some serious changes, cut your lovely hair, changed your mouthwash, worked out several times a week, got a new alarm clock, employed a fashion consultant. The clothing you picked out was very becoming. Stellar, actually. I was very pleased with your selections.”
    “Who are you? Is this some part of myself suddenly getting chatty? Katrina inquired, while becoming very sharply and clearly alert, if not awake, although perhaps she was both. This was not exactly what she thought would happen next. White light, the Goddess looking at her sadly, expressing disappointment, stern lectures, vivid dreams, discovery of a gross miscalculation vis-a-vis religious beliefs perhaps, but not acceptance and agreement with her heart’s opinion!
    “What Name would you like to use for Me?” She laughed with the tinkle of a brook and the music that moves mountains in Her voice. Katrina became aware that she was being held in two or ten or twenty warm, loving arms, just as she had longed for, prayed and visualized the Goddess holding her in times of need and worship, safe, supported, understood, accepted, loved. She saw/knew/intuited a beautiful woman as all women are beautiful, in every culture, time and race, shifting colors, features, sizes, shapes, clothes; brides, amazons, mothers, dykes, crones, wise, accepting, innocent, loving, all real and all One.
    “Aren’t You mad at me?” Katrina ventured. “Killing myself, being a failure.....” She knew being fat wasn’t her fault and she knew she wasn’t going to be weighed for pounds of flesh; good deeds maybe, but not her body size/mass.
    “Anger at My Beloved for freely choosing your own way? I gave you free will. But your life is not over,” Isis/Ishtar/Inanna replied, Queen of Heaven being preeminent in Katrina’s mind at the moment.
    “But Mother Goddess, I took all my pills,” Katrina protested.
    “Yes, you did. Now you have begun to sleep. You cried out to Me and I came, as I always have. You do not always remember. I am She whom you have beseeched and called into Being. I am She who you breathed into immanence with every breath you take, as you so eloquently phrased it once, in sacred space. I am She Who know your heart and when that heart breaks, I must come.”
    “Then this is all in my mind,” Katrina despaired sadly.
    “No! I am She Who created the stars, and all things, and I am that which is attained at the end of all desire, as I believe it is currently phrased. But it is a little like Tinkerbell in that there must be belief/recognition/acceptance of the Divine, the Creatrix or as has been said the old goddesses diminish and fade as another Aspect grows. It is not that I cease to exist but that it is harder to hear ME when belief is weak or gone. I am as MY creation perceives Me, as you also have believed. But you time in this space grows short and your decision awaits you. What would you have of Me?” Her face continued to change as Kore/Isis/Astarte/Innana/Maat/ Demeter/Gaea/Hecate/Diana/Ceridwen/Aradia Spoke.
    “Well, I was fired. People have been complaining about me, about my size....” Katrina trailed off uncertainly.
    “Yes, illegally fired I believe. You have a union and the Americans with Disabilities Act and moral superiority,” She replied, with an amused smile. “If you want to continue your current job. But does it bring happiness anymore? Perhaps a new job would suit this stage of your life better. Have you found work that you like in your job search?”
    “What was that?” Katrina asked, not sure she had heard right. She had not expected a sense of humor and delight, although that had always been a part of her belief about both the Goddess and the universe. Perhaps she was depressed and chained down to the this twelve hour night job for too long. She was always tired and she did slow down on the third shift in a row. There were one or three jobs she’d love to try that she had interviewed for recently. Daytime jobs even! But no one had called her back with a job offer yet.
    “I do indeed delight in a righteous battle and you have right on your side. Fat is not evil. It is form and substance, potential energy, stored light. One of My better creations, actually. Big smile, big burger, big moose, big boat, big house, big fish, big, fat check, big breasts, all of these things are good. Big people, large, fat, stout, queen sized, zaftig, are good. I like them. I like you, Katrina. You are doing things right. Go back to where you were dreaming.” She touched Katrina’s forehead and for an instant, Katrina was immanent Goddess manifest.
    Katrina awoke to sunshine streaming into her home. What day was it? She had been lying on the sofa and there was a wonderful smell in the air. Working nights and sleeping through strange snatches of time, she’d been through the what day is it and even the is it am or pm game. She grabbed the TV channel changer and began clicking channels. That succulent smell sought her attention as she stared at the TV daily news and then slowly followed her nose into the kitchen just as the timer went off. Ding! Katrina opened the oven door and gazed at the beautiful, fat, golden brown turkey within. She took the turkey carefully out of the oven and placed it on the counter to cool before wrapping it for the refrigerator. The ring of the telephone startled her on her way back to the TV. She crossed into the dining room and picked up the receiver.
    “Hello, Katrina, can you come into work tonight?” the staffing office assistant asked. We have seven labor patients and some sick calls already. I know you were able to get your request to be off tonight granted but I was told to call everyone who worked here and wasn’t scheduled.”
    “What time is it?” Katrina murmured, thinking about her ‘dream.’ Hanging up the phone, she told herself, Monday. The staffing office was used to getting “NO” in its various permutations. She didn’t ask if she was still employed there. The phone rang again.
    “May I speak to Katrina, please? This is Madeleine Westron. You interviewed with me a few weeks ago. Are you still interested in the position we have open. I’m sorry not to have gotten back to you sooner, but I had a family emergency and was out of the office for a while. We would provide all the training for you to be a consulting nurse in our call center. We would love to get you started right away.”
    The phone rang a third time. “Three’s the charm,” she thought, almost giddy with whirling emotions of joy and wonder. “Thank you, Great Mother Goddess.”
    “Hello, Katrina, I’m going to bring apple cider for Thanksgiving dinner. Listen, is it ok for me to bring a friend with me? She is a woman of size and a dyke too. She just moved here and is single. I think you’d really like her. She loves science fiction and fantasy too.”
    “Let me tell you about my day so far.”

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