Christie Watson

Katie Jarvis talks to the first woman to write about nurs­ing since Florence Nightin­gale, ahead of her ap­pear­ance at the Stroud Book Fes­ti­val

Cotswold Life - - INSIDE - STROUD BOOK FES­TI­VAL Š NOVEM­BER 7-11

Christie Watson has seen it all. As a nurse in A&E, she saw (the list is too long to re­peat in full) heart at­tacks, brain aneurisms, diabetic ke­toaci­do­sis, en­cephali­tis, malaria, liver fail­ure, ec­topic preg­nan­cies, burns, as­saults. She treated peo­ple who were dog-bit­ten, drug-over­dos­ing, men­tally ill, im­paled, shot and stabbed.

Once, she dealt with a head half-sawn off.

As a 16-year-old carer – be­fore she started her nurse-train­ing – she reg­u­larly helped a 58-year-old man use the toi­let, wip­ing him af­ter­wards; help­ing him pee into a bot­tle.

In theatre dur­ing an op­er­a­tion, the ECMO ma­chine (that car­ries a per­son’s cir­cu­lat­ing blood) split, soak­ing ev­ery­thing and ev­ery­one with hor­ror-film gore.

She’s been to par­ties (cig­a­rettes, booze and even (some­times; for some) weed can help) where the main point is to ban­ish the sights of the day: a baby born with en­cephalo­cele: the brain out­side its head. (The mother held it; the fa­ther couldn’t look.)

Within two weeks of work­ing in pae­di­atrics on Hack­ney Road, she caught sca­bies, im­petigo, nits; she was bit­ten by a child and had to have a hep­ati­tis booster – fol­lowed by an eye washout when hit by ex­plo­sive di­ar­rhoea. (Later, in the way Girl Guides col­lect badges, she was awarded a dose of ring­worm, to boot.)

One time (the de­tails are changed but the sit­u­a­tions true), Christie is sit­ting with par­ents, lis­ten­ing to a doc­tor telling them their pre­ma­ture baby has died. A few sec­onds later, a nurse knocks to have an ur­gent word. Cry­ing has been heard from the sluice room where the baby lies in a bas­ket, await­ing a porter to the mor­tu­ary. A short while later, the baby ‘dies’ again – this time for good. Grief, twice-fold.

Some­times, Christie feels noth­ing. Empti­ness. Burn-out.

Some­times, the tears pound to be re­leased from her eyes like mad­men in Vic­to­rian Bed­lam. Such as when she looked af­ter Tommy, nine years old, who turned his face from the sun each dawn. For many months, she sat by his side, nurs­ing him through her 12-and-ahalf hour shifts. Tommy was paral­ysed from the neck down fol­low­ing a road ac­ci­dent; his tra­cheostomy meant the only sounds he made were rasp­ing breaths as he sobbed.

“I won­der what he was like be­fore,” she asks. (She of­ten tries to imag­ine the lives of pa­tients be­fore they were pa­tients.)

Christie washes Tommy, rolls him, mon­i­tors him, med­i­cates him, feeds him with gi­ant bags of fluid that nour­ish through a tube in the stom­ach.

But. “…it is his mind that needs nurs­ing most of all.”

She talks to him; lis­tens to him; reads him Harry Pot­ter when he can’t sleep.

On his 10th birth­day, the nurses dec­o­rate his bed with tin­sel, and stick cards along the edges.

His par­ents pile presents on his bed un­til Tommy is wide-eyed with won­der. When he fi­nally falls asleep, ex­hausted, his mum turns to Christie.

“He wanted a bike,” Tommy’s mum says, in pain that de­fies de­scrip­tion. “I al­ways promised him that he’d get one on his tenth birth­day.”

These are some of the sto­ries a nurse can tell; a nurse such as Christie used to be for 20 years un­til turn­ing to writ­ing.

They’re the kind of sto­ries you might not have heard be­fore. Be­cause Christie Watson’s won­der­ful mem­oir about nurs­ing – The Lan­guage of Kind­ness – could well have been called The Lan­guage of Si­lence.

Books by doc­tors abound. When Christie Watson be­gan her book, she looked ev­ery­where for ‘nurse’ lit­er­a­ture. She had to go back as far as Florence Nightin­gale be­fore she found any. I’m amazed, I say to Christie Watson. Truly, star­tlingly amazed. Amazed that I’ve never no­ticed it be­fore.

I mean - you know. We all come into con­tact with pro­fes­sional nurses, at some point in our lives. We all thank god for them.

But I’m also talk­ing be­yond the hos­pi­tal block; be­yond the GPS’ surgery. Be­cause we all nurse – we nurse our chil­dren; our par­ents; our part­ners. We make soup and tempt with small spoons­ful when loved ones are ill. We all – ev­ery now and then – lan­guish in bed, too ill to get up; too un­well to want to, hop­ing some­one will nurse us in re­turn.

Nurs­ing is ev­ery­where. Yet, as I’ve de­voured books by doc­tors - Reach­ing Down the Rab­bit Hole: A Renowned Neu­rol­o­gist Ex­plains the Mys­tery and Drama of Brain; Do No Harm: Sto­ries of Life, Death and Brain Surgery – I’ve never no­ticed what wasn’t there. Any­thing by nurses.

The ab­sence in plain sight.

“And I have to say,” Christie ad­mits, when I phone her for our in­ter­view, “I feel em­bar­rassed my­self that, as a writer and as a nurse, it didn’t even oc­cur to me for many years.”

Be­fore The Lan­guage of Kind­ness, you’d have found Christie’s books in the fic­tion sec­tion – her novel, Tiny Sun­birds Far Away, was writ­ten while on ma­ter­nity leave and won the Costa First Novel Award; she fol­lowed it with a sec­ond, Where Women are Kings, in 2014.

“A heart cell beats in a Petri dish. A sin­gle cell. And an­other per­son’s heart cell in a Petri dish beats in a dif­fer­ent time. Yet if the two touch, they beat in uni­son. A doc­tor can ex­plain this with sci­ence. But a nurse knows that the lan­guage of sci­ence is not enough” – The Lan­guage of Kind­ness: A Nurse’s Story, by Christie Watson ‘We’re in a sit­u­a­tion where so many of the pa­tients on chil­dren’s wards are teenagers who are self­harm­ing’

When she first con­sid­ered writ­ing about nurs­ing, her thoughts turned back to fic­tion. It was her agent who put her on the right track. “She sug­gested non-fic­tion about nurs­ing, which seems like such a no-brainer now; but, at the time, it hadn’t re­ally oc­curred to me. And then I looked around for sto­ries writ­ten by nurses and I couldn’t find any.”

It speaks vol­umes about what we value, I guess. But why ex­actly do we fail to at­tach value to some­thing so im­mensely pre­cious? To car­ing for each other.

“I think it’s pri­mar­ily be­cause nurses are women – 89 per­cent of nurses in the UK are women - and it does say a lot about our value sys­tem. Even the skills at the heart of nurs­ing - com­pas­sion and care and kind­ness – are still seen as fem­i­nine traits: seen as less im­por­tant than the bom­bas­tic, med­i­cal, tech­nol­ogy model that we’ve al­ways lived by.

“And that, I truly be­lieve, is be­cause we’re liv­ing in a gen­dered so­ci­ety that val­ues men above women.”

Soft skills. That’s the im­plic­itly dis­mis­sive term that’s of­ten em­ployed.

Yet those same soft skills are the ones Christie de­tails in pages where the ‘soft­ness’ forces you to push aside the book in hor­ror; to try to take your mind off Jas­min, dy­ing from in­juries sus­tained in the fire that killed the mother so des­per­ate to res­cue her and her brother from their bed­room. Be­fore Jas­min’s dis­traught aunt comes to visit, Christie and her col­league gently wash the tragic girl’s smoke-sat­u­rated hair, tipping away the soot-black­ened wa­ter so the acrid smell re­cedes just a lit­tle.

Or as she helps mas­sage the joints of a corpse to stop dis­coloura­tion or pool­ing. (A corpse with a pho­to­graph of dearly-loved chil­dren by his side.) “Noth­ing worse than pool­ing, for the fam­ily.”

Or as Christie holds her breath, try­ing not to show re­vul­sion as a man with an ab­dom­i­nal block­age vom­its his own fae­ces.

“It is,” she writes, “a priv­i­lege to wit­ness peo­ple at the frailest, most sig­nif­i­cant and most ex­treme mo­ments of life...”

To have the ca­pac­ity to love com­plete strangers. That’s the hard­est skill of all.

The other in­ter­est­ing thing about go­ing back to Florence Nightin­gale (Christie’s book en­com­passes his­tory, phi­los­o­phy, sci­ence, tech­nol­ogy, po­lit­i­cal thought; a panoply of vi­sion) is how much tech­nol­ogy has changed; but how much be­sides re­mains hor­ri­bly the same.

Christie was of­fered coun­selling just twice dur­ing her nurs­ing ca­reer – in the same way nurses such as Florence’s (no mat­ter what they ex­pe­ri­enced) were sim­ply ex­pected to be “a bit tough”. And while sol­diers of the world wars were di­ag­nosed with shell­shock, that con­di­tion was never of­fi­cially recog­nised in those who tended them.

Per­haps that’s why the sui­cide rate amongst fe­male nurses is cur­rently the high­est oc­cu­pa­tional sui­cide rate of all.

“It’s the best job in the world but it’s def­i­nitely the hard­est job in the world,” Christie says. “I don’t think there’s any­where near as much men­tal-health sup­port or clin­i­cal su­per­vi­sion as there should. I’m ab­so­lutely sure I’ve had post-trau­matic stress symp­toms – not dis­or­der but symp­toms. And I’ve cer­tainly had flash­backs to re­ally hor­rific, trau­matic events. I don’t imag­ine any nurse work­ing in the

front­line in the NHS, or oth­er­wise, has not seen things they wish they could un-see; been in­volved in sit­u­a­tions that are ex­treme hu­man ex­pe­ri­ences.”

Some things haven’t changed over the years; that’s true. But oth­ers have – and not for the bet­ter.

Such as the huge rise in men­tal ill­ness that Christie writes about – par­tic­u­larly among teens. (“I’d rather have can­cer than a se­ri­ous men­tal ill­ness,” a men­tal-health pro­fes­sional says to Christie.) One in 10 chil­dren now has a di­ag­nos­able men­tal ill­ness.

“I think we’re fac­ing a re­ally big and dif­fi­cult prob­lem,” she tells me. “When I started nurs­ing, it was chil­dren with asthma, di­a­betes; they’d come in with var­i­ous con­di­tions: you knew what it was; you gave them the treat­ment and they’d go home. So lots of the chil­dren’s nurses – bright, chirpy young women – started out, like me, think­ing, ‘This will be a lovely job – I’ll be cud­dling ba­bies!’

“Now we’re in a sit­u­a­tion where so many of the pa­tients on chil­dren’s wards are teenagers, of­ten girls, who are self-harm­ing; or boys who are hav­ing their first psy­chotic episode.”

Not that we can sep­a­rate body and mind any more. The time has come to ditch the terms adult nurse, chil­dren’s nurse, men­tal-health nurse, she says.

“Be­cause we are such a jum­bled-up mix­ture of ev­ery­thing. You can’t cut peo­ple into slices. So much of what we see in hospi­tals is phys­i­cal and men­tal ill­ness at the same time that we need train­ing in ev­ery­thing.”

And per­haps – I sug­gest – per­haps from a pa­tient point of view, there’s a feel­ing that a lot of this is of our own mak­ing. Orthorexia (a ‘re­cent’ con­di­tion cen­tred around an ob­ses­sion with healthy foods); al­co­hol, obe­sity, stress, smok­ing; all could be ban­ished if we just put our minds to it.

But. Isn’t it too sim­plis­tic to blame peo­ple for things that, in the­ory, they look as if they could avoid?

“I used to have a bit of that my­self. But pa­tients teach you so much – far more than nurs­ing books. We had a pa­tient who used to come in with drug and al­co­hol prob­lems. He had long-term se­ri­ous men­tal-health is­sues; he had vas­cu­lar dis­ease; he had re­ally badly man­aged di­a­betes be­cause he wouldn’t man­age it. He was in and out of hos­pi­tal, and all the nurses and doc­tors – all of us – had the po­ten­tial to get very frus­trated with him.

“But it turns out he had been look­ing af­ter his mum, at home, who had de­men­tia for years and years; he had kept her out of hos­pi­tal and he’d kept her out of a nurs­ing home.”

That’s the thing about health­care pro­fes­sion­als. They walk in other peo­ple’s shoes; they see their lives.

“If you fol­low these peo­ple home, you’ll un­der­stand much more than you see at face value in hos­pi­tal.” Christie Watson talks about many things. About how Filipino nurses – amongst the best she’s worked with – are hor­ri­fied to come to the UK and see el­derly pa­tients with empty chairs at vis­it­ing time.

She talks of how a black new-born in Amer­ica is twice as likely to die as a white new-born. “Right now. To­day.”

About the fact that we’re 40,000 nurses short; and un­til we have nurses on the wards, we can for­get all those big con­ver­sa­tions we’re hav­ing about AI and other ad­vanced tech­nol­ogy.

There are good things, too. Sur­pris­ingly sim­ple things. “Like so­cial pre­scrip­tions – so, for ex­am­ple, pre­scrib­ing some­body po­etry. I was speak­ing to a GP re­cently who said he of­ten pre­scribes gar­den­ing as a way to help some­body’s men­tal health. That’s a great thing.”

Death cafes are an­other pos­i­tive. “Ev­ery­one de­serves a good death. And the only way we can achieve that is to talk about it.”

Yes, some things are chang­ing for the bet­ter. And, even with the neg­a­tives, it’s still a job to beat all jobs.

Christie’s cur­rently work­ing on a script to bring The Lan­guage of Kind­ness to TV. And she knows – to her great de­light – of two other books (one by a nurse; the other a mid­wife) due out soon. The si­lence is be­ing bro­ken.

And the mes­sage re­ver­ber­at­ing through that si­lence is clear. Value shouldn’t just be at­trib­uted to ob­jects with pound-signs on them. Value shouldn’t just be at­trib­uted to glitzy new won­der-drugs or to great leaps for­ward in med­i­cal sci­ence – won­der­ful as they are.

“That’s the thing about nurs­ing,” Christie Watson tells me. “It doesn’t try and cure peo­ple. It’s not based on cure: it’s about help­ing.

“Even when cure is not pos­si­ble, that’s when nurs­ing be­comes re­ally im­por­tant.” The Lan­guage of Kind­ness: A Nurse’s Story, is pub­lished by Chatto & Win­dus

Christie Watson will be speak­ing along­side Sam Guglani (writer and con­sul­tant clin­i­cal on­col­o­gist in Chel­tenham) on what it means to de­vote your life to the care of fel­low hu­man be­ings. ‘The Car­ing Kind’ takes place at Stroud Subscription Rooms, 2-3pm, on Sun­day, Novem­ber 11: stroud­book­fes­ti­val.org.uk

Photo by Lot­tie Davies

Christie Watson

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