A bizarre form of déjà vu took hold of me. It had been almost four years since I left my career as an English professor and started working as a bedside nurse in a Midwestern teaching hospital. This was the first time when the life I created for myself in this new, radically different profession aligned in any way with the one I had envisioned when I first started toying with the idea of a career in medicine. While it is not uncommon for aspiring humanities professors to explore alternative lines of work when their tenure-track dreams collide with the harsh reality of the academic job market, few consider nursing. This unconventional option presented itself to me through my research. HIV/AIDS literature had been one of my longstanding interests. In the record left by the novels, memoirs, plays, and poems written during the dismal early days of that pandemic, the nurses who bravely cared for the sick and dying, when the virus was still poorly understood and extremely stigmatized, appear as some of the few heroic figures. Maybe I could do that, I had thought during my final two years of graduate school. Now, here I was, risking my safety to care for the sick on the front lines of another pandemic.
Working on a Covid unit was more or less exactly the kind of work I had dreamed about doing when I embarked on the circuitous path that would take me to nursing. I love almost every aspect of the work — it’s just comically different than what I had pictured as a young, idealistic scholar. Reading AIDS memoirs like Mark Doty’s Heaven’s Coast, I imagined myself massaging the aching feet of beautiful, if gaunt, young men and explaining the dying process to their brilliant poet-lovers in pellucid language they would find both helpful and moving. Seeing my name in the acknowledgements to the autobiography would bring a bittersweet smile to my face.
Well, perhaps I wasn’t that idealistic. I knew it would be a messy job. My grad-student friends laughed (or rolled their eyes) when I announced that I didn’t see much difference between wiping butts and grading undergraduate essays, but I was right that my relative indifference to the sight and smell of bodily fluids would serve me well as a health-care professional. In almost every other respect, my work as a nurse is completely different than what I imagined as a graduate student.
The unquestionable realness of nursing was part of its appeal. Explaining to one of my mentors my decision to leave the academy, I proclaimed, “I want to change the world. I’m sick of studying representations of it.” This distorted version of Marx’s 11th thesis on Feuerbach became my guiding principle for the next decade. I took introductory biology and sociology courses at a local community college while finishing my dissertation and teaching my own classes. After I graduated with my Ph.D., my wife got a job at the University of Wisconsin at Madison, and I followed her there to adjunct. The labor uprising that rocked the state Capitol in 2011 inspired me to drop (almost) everything to devote myself to activism, and I spent the next three years trying (and failing) to save the local radical bookstore. When the bookstore closed, I took up the idea of becoming a nurse again.
My first year as a full-time nurse was a carnival of humiliation. It upended any expectation that my graduate training in the humanities would translate neatly to health care. Nursing rewards critical thinking and verbal dexterity, to be sure, but these capabilities are worthless unless grounded in a basic competence in the skills that nurses need to keep patients alive. Operating an inpatient unit is kind of like running a busy restaurant in a city that is actively under siege. For each patient there is a list of specific tasks that must be accomplished quickly and at a specific time: medications, dressing changes, procedures, repositioning in bed to prevent bedsores, physical assessments, and so on.
On top of this daunting list of tasks, the nurse must also manage the needs and wants that patients cannot or will not satisfy on their own: meals, snacks, fresh ice-water, bathroom trips, finding the football game on television. While all of this is happening, fate lobs emergencies into the swirl of activity like hand grenades. One minute you’re rushing to the kitchen for a small cup of ice chips to appease a grumpy old man, the next you’re desperately trying to awaken a patient who has suddenly and unexpectedly become unresponsive. Nurses refer to the suite of physical and psychological abilities that enable us to contend with this unending barrage of demands as “time management.” This was something for which the academy did not prepare me. In fact, scholarly habits were an obstacle to my success as a nurse — something my preceptor (an experienced nurse assigned to help train me) noticed right away. A brilliant and intimidatingly proficient nurse more than 10 years younger than me, she did not hesitate to chastise me for spending too much time on aspects of the work that allowed me to focus on researching new terms and illnesses. During one of our first shifts together, she snapped at me. “I’m not worried about what you’re doing here,” she said, gesturing toward the computers in the charting room. “I’m worried about how you’re doing out there,” pointing to the hallway lined with patient rooms. “It’s just not clicking for you yet, and I don’t know why.”
She was right. In my first few weeks on the floor, my days would go smoothly until I confronted something new to me. The only way I knew how to solve problems was to deploy the careful and deliberative style of thinking that I had honed (and been rewarded for) in graduate seminars. One time my entire day was thrown off course by a patient who had a heparin drip. When my shift started, the drip was in the room, but the patient wasn’t — he had been taken to another part of the hospital for a CT scan. I knew that it was my job to titrate this drip, recalibrating the chemistry that determined how quickly his blood would clot. Under normal circumstances, this process is straightforward. But what was I supposed to do when the drip had been stopped for an hour unexpectedly? I printed out a set of lengthy instructions and began scouring the pages. I highlighted relevant passages and analyzed their meaning. Meanwhile, my list of chores to complete during my shift got longer and longer.
Sympathetic co-workers could see I was struggling and jumped in to help, but even that couldn’t conceal that my slowness was a burden on the unit. My difficulties spiraled. Knowing that others saw me as a problem made me hesitate to ask for help or advice when I needed it, a misguided effort at independence that slowed me down even more. Six months into my second career, I was regularly being called into the manager’s tiny office for meetings about my lack of progress. I was certain I was about to fail. My anxiety became debilitating. At work, I did what I knew how to do: analyze and write. Without being asked by anyone, I wrote a weekly journal accounting for each shift and describing what I was doing to improve, producing pages and pages of exacting reflection on my inadequacy. Outside of work, I started to see a therapist again. I drank whiskey to fall asleep on my nights off.
The process that made me the nurse I have become was one of the most transformative educational experiences of my life. Success in nursing necessitated unlearning habits of mind for which I was rewarded in the academy and that I thought would add value to my work in the hospital. That was wrong. My tendency to subject every problem to exhaustive inquiry was met with confusion and growing concern from my new, practically minded colleagues. The insight did not fully take shape until months later. During a program designed to help nurses survive their first year on the job, an instructor was leading a class on how to talk to patients about death. As a catalyst for discussion, she showed us a brief excerpt from a film of Margaret Edson’s play, Wit. This was a play I knew well. In fact, I had taught it myself several years before in a class on literature and medicine.
In the scene we watched, a nurse named Susie develops a friendship with her patient, Vivian Bearing, a Donne scholar who is undergoing an unusually painful treatment for advanced ovarian cancer. Susie uses a shared popsicle to set up a conversation about Vivian’s code status. She gently pushes her to accept that death is inevitable and persuades her to choose DNR.
When I taught this scene, I had students read it aloud before asking them to consider what the patient learns through this conversation. In my class, the point was that, sometimes, the best healer is the one who helps her patient come to terms with the fact that she will never get better. In the class for new nurses, my instructor neatly inverted this lesson plan. After we watched the scene, she asked us what we could learn from the nurse. One of my fellow new nurses spoke up, mirroring my own thoughts: How did a nurse make the time to have the conversation at all, let alone to share a leisurely popsicle with her patient?
My literature class had approached mortality as an existential problem. For me and my fellow first-year nurses, the problem was logistical: How could we create the time and space for this kind of conversation? “Could I hand my pager off to another nurse to do this?” I wondered.
Almost four years into my second career, I am no longer a newbie. I now have a fundamentally different relationship with my co-workers — one that privileges collaboration and mutual responsibility. I also make decisions much more quickly and confidently. My humanities education furnished me with infinite curiosity and attention to nuance, but I no longer bring those qualities to bear on every problem I encounter. Instead, my professor brain now happily cohabitates with a new, nurse brain. Confronted with a patient who has become unable to breathe on his own, I act quickly and decisively. Only later, when the emergency has subsided, will I replay the episode in my mind and consider its deeper significance.
In a sense, I do use my Ph.D. in English every day. Watching a career collapse around me has shown me what it’s like to see your world fall apart. I learned from the care shown to me at the end of my graduate training — the professors and fellow students who listened patiently as I grieved for the end of my academic career. I remember the adviser who carved time out of her busy schedule to discuss what I could do with my life if my academic job search failed. After we reviewed the pros and cons of several alternative careers, she told me to go home and watch a movie. “It’s going to be OK,” she said, “Take tonight off.” She recognized that I was suffering, showed compassion, and suggested what I could do to feel a little bit better. In a way, that moment was the beginning of my education as a nurse.
Colin Gillis is a registered nurse in Wisconsin.