Braised Lambchop
a nurse trying to work while suffering with chronic pain - she rambles a bit

Carmen was smart, deeply religious, had a great sense of humor, and was a talented singer. She won all kinds of vocal music awards, and was one of the girls who went to Oklahoma Girls State when I did in 1981. Everybody called her 'Squeaky' because her speaking voice was high and when she got excited she would squeal.

After high school, Carmen married an Air Force enlisted man and became an RN. As Air Force families do, they moved frequently and lived all over the world – at Holloman AFB in New Mexico, at Incerlik in Turkey, and most recently at Langley AFB in Virginia. Carmen always made friends easily and quickly became a kind of community "mom," with neighborhood children always in and around her home. She worked in home health and was a lay minister at her church. Her husband, by then a senior master sergeant, was deployed overseas, leaving Carmen to care for their three girls. And everyone still called her 'Squeaky,' only now it was 'Ms. Squeaky.'

On the evening of February 9, Carmen went out on a routine home visit to one of her regular, daily clients, a disabled man who lived alone in a small apartment. Some kind of argument ensued after she arrived, and Carmen was shot in the chest seven times. She died almost instantly.

I didn't find out about this until this Thursday morning, thus the late post about it. I was looking at the website of the El Reno newspaper (the weirdest newspaper website I've ever seen) about an unrelated issue. I found Carmen's obituary after I figured out how to get to previous issues. There were no details about how she died, but when I told my best friend from high school about it (her husband is also stationed at Langley AFB now), she remembered hearing about the incident on television but didn't put the name and and face together. The link embedded in the above headline will take you to a story with details of the slaying.

I remember riding with Carmen and her mom down to Ada for Girls State, the Sunday before Memorial Day in 1981. I had driven to Ada a few times previously and knew the way. Carmen's mom, who was driving, didn't tell me that she did not know the way. I fell asleep in the back seat, woke up, and we were almost to the Arkansas border. (From El Reno, the easiest way is to first go south to Pauls Valley, then east to Ada.) I think Mrs. Howell just figured she would keep driving on I-40 east and would eventually get run into it. It's hard to convince another girl's mom that she doesn't know where she's going, so I sort of played dumb and asked her to stop for directions. Good thing we left about four hours earlier than we had to. It was really pretty funny – once we got there.

So, I am con dolor today. I'll be con dolor tomorrow, and for a few days to come. Really makes the whole cap issue stupid and silly. I am so angry and full of heartache for Carmen's family, and I'm just as angry and full of heartache that a patient would murder his nurse, and one as good and as well-intentioned as I know Carmen was. Our profession shouldn't require us to risk our lives for $20 an hour, yet some of us are injured or killed every day. How is it that in America – this "beacon of light, illuminating the darkness," supposedly the greatest country in the world – going to work in 2006 still means risking your life? It's not just nurses... it's delivery people and bus drivers and engineers and bank tellers. There is no reason – no good reason – for anyone to die at work, and that's what this was. Carmen died due to workplace violence of the worst kind. I can't imagine what that argument was about, but it doesn't matter – there's no reason to shoot and kill your nurse. A patient vomiting all over you, hurting your back while lifting, a psychotic ED patient kicking you, and the like are things an American RN can imagine happening to them at work. You do not go on a routine visit, identical to the three dozen previous visits to the same patient, and have the slightest inkling that you could be shot. Our PPE doesn't include body armor. Maybe it should.

I'm not sure what's going on with this particular number, but Carmen is the seventh murder victim who I personally know or knew. I don't know if that's a high number or a low one. Believe it or not, Carmen's death is not the most violent of the seven – sadly, that goes to a dear, dear neighbor of ours, Virginia Thompson – but Carmen is the first RN. I guess it's true that only the good die young.

I got turned off to home health nursing during my community health rotation in nursing school, when I and my clinical partner accompanied a home health nurse on a visit to a truly disgusting shack somewhere out in the country southwest of Little Rock, close to Arkadelphia. These people were, and I hate to say this, the result of inbreeding among some of the poorest people in Arkansas – outdoor plumbing (in the 1990s), no running water, unemployed, mentally and physically impaired from the lack of variation in their genes. We were standing and observing in the front room, holding our breath because the stench was so overwhelming, where the patient was lying in feces and urine, surrounded by filthy clothes, dirty dishes – the most nauseating home I had ever entered. Suddenly my clinical partner, who was standing next to me, turned to me and said, "Did you feel that? Is the roof leaking?" It wasn't raining outside, and I said I hadn't felt anything, but then I did sense what felt like a raindrop on my right shoulder. I said, "Okay, I felt that," and while I was looking at my partner I saw something fall onto her arm. It was a cockroach. The place had cockroaches falling from the ceiling.

That was all I had to learn to understand that home health wasn't going to be my thing. I know – I let one bad experience (and another one very similar to it shortly thereafter) poison my attitude toward the whole specialty. It's not just that, though. The risk of going alone to unfamiliar places is too much for me, so I'll never be comfortable in home health. I'm so hyperaware of my surroundings and wary of walking alone to my car that I always hold my car keys so they stick out between my fingers, kind of like brass knuckles with spikes, when I'm in a parking lot. I want to do some serious damage to an attacker if I were forced to defend myself. I'm too concerned about stuff like that. Home health just isn't for me.

But it was exactly the right thing for Carmen. The girl I remember was perfectly suited for it – trusting, kind, loving, and eager to give of herself to others. Carmen was one of the kindest women I've ever been lucky enough to know. Peace to her spirit.