by Lisa Dietrich for AJN/ all rights reserved
The January Reflections essay in AJN is called “Touching Death, Touching Life.” The author, Yaffa Vinikoor, is a public health nurse who describes a patient she refers to as Sidney. Over time, she’s come to know the worn furniture of Sidney’s small apartment and the details of his life, such as Arnold, his paid caretaker, and Sidney’s younger wife, who lives separately. Sid has dementia and several other conditions and is in decline. “Sid,” she writes “usually lay slanted, like he’d been haphazardly dropped onto the enormous mattress, hair askew and face contorted.”
The essay explores what it’s like to be pregnant while doing such work. Vinikoor’s situation that summer puts her in relation to two very different currents:
I continued to do my work in the city as a public health nurse with the chronically ill homebound up until the day I went into labor. . . . I continued to walk miles per day, the nursing supplies in my backpack bowing my back and the baby in my belly guiding me forward . . . . As I cared for those whose lives were in steady decline, I thought about what giving birth to new life would be like.
As the summer draws to a close, Sidney’s health takes a turn for the worse and the author finds herself negotiating the uncharted emotional and instinctive space between a patient’s end and her own child’s impending birth. Are these processes in tension, or part of the same flow of existence that we all belong to? In retrospect, she contemplates the experience:
I still don’t know what all this means. Birth. And death. Two processes I have witnessed so closely. Yet on most days what I do know is that having found the space to hold life and death together has made me a more complete person.
The essay is free until February 10, and well worth reading in its entirety.
I enjoyed the article and certainly appreciated the perspective of endings and beginnings. I have an objection however I wish to share. I have done “home health” and “home hospice” nursing, and I am married to a “public health” physician. I cannot help but question the author’s self-designation as a “public health nurse”, when what she seems to be doing is “home health”, or “visiting nurse” work. Public Health focuses on population health care, and on primary prevention, neither of which appear to be the author’s focus. Titles matter. The Journal would likely not have allowed a nurse in L&D to self designate “pediatric nurse”. I would respectfully request closer scrutiny of the term “public health nurse”.
Thanks for your comment. It’s an interesting question you raise. However, the author’s job title at the Visiting Nurse Service is exactly that: Public Health Nurse. So perhaps there are other components to the job than those she describes here. -Jacob M., senior editor