Thank You Miss Gravely

by Martha Danielson, R.N., B.S.

As I remember she was generously proportioned, badly dressed, and unflappable. Most every sentence that came out of her mouth began with “You can’t,” or “You shouldn’t,” or simply, “Don’t”. Miss Gravely was my favorite teacher. She taught grammar, spelling and reading as if the words were living, breathing. I listened with both nostrils.

Miss Gravely introduced me to words. Words are powerful. Words can hurt, heal, build up, or tear down. They can be beautiful (e.g. mother, lullaby, precious, whisper, love, peace) or ugly (e.g. dumb, fungus, creep, snort, gripe, gut, fat). In our culture, language conveys a great deal of information about how we are perceived. Part of what the word means is relative to how it is manipulated.

The best example I can think of to illustrate the link between words and attitudes, emotions, and assumptions is a mother interacting with her children. Behavior is where the meanings of her words come from, not the dictionary. Often metaphors full of action are used. As a Mom, I am “not so far apart” from my own mother’s thinking. I am “over my head” or even “out of touch” with the notion that much goes unsaid in this world. For me, life is a matter of attention: how to get it, how to keep it, how to feed off of it. Words are my friends when society is not. I’m talking about expressing myself here. For forty years now I’ve been looking at everything as if there were something creative — poetic, tragic, or mysterious — about it. My life’s a story, right? A well-written tragedy, a stylish comedy, or a trashy novella — I’m an open book whose endeavors and escapades may outlive the author. Act naturally; keep reading. I’m up, I’m down. Constantly looking for another Miss Gravely to define the situation.

It’s all about the words. I want to be able to express myself with a vocabulary and a style that works for me. The very acceptability of my words is necessary to me. Comparisons and usage guide my choices. What good is my “Once-upon-a-time” tall tale if I can’t describe it beyond that opening blurb? Thank you, Miss Gravely, for hovering over me. Where is your successor?

Enter, Dr. Xxxx. I was 45 when Dr. Xxxx finally gave a name — bipolar disorder — to my behavior pattern of 30 years. The very techniques that facilitated our therapeutic communication depended on the ability to express ourselves with words. As the months became years, a solid bond of trust was formed. I followed her careful clinical management and took my prescribed medication, lithium, every day. Once I was stable, she offered a creative logic, “Why don’t you go to college? You could start by taking one course.”

It made sense. I qualified for all sorts of financial help. So, I signed up for three courses, and soon discovered the language of love; anatomy and physiology. I saw it through to completion, a first for me.

You have probably heard of the old saying: “Don’t give up your day job.” From a practical point of view, I need a way to support this word play habit as I busy myself generating new ideas. These days, I’m a registered nurse. The wages and the health insurance benefits of the job are very practical reasons by anyone’s standards. And it’s respectable.

Creatively speaking, one of the best things about the job is the language I get to use. Having special language skills is a real plus for a bipolar personality like me. It’s very attention-getting. Foreign root words, prefixes, suffixes, and combining forms of commonly used medical terms are commonly used by me. I can easily spout scores of drug names, and recognize several hundred more, taking into consideration both trade and generic names. I also know hundreds of abbreviations. Sometimes the language of anatomy, physiology, pathophysiology, and pharmacology are more interesting than the practice of such nursing-related things.

I know about bradycardia and erythematosis; I have a sternocleidomastoideus and a gastrocnemius, and I know what and where they are. Distal and proximal are locations. Onco-,

-osis, and -oma tell me something about the disease. In my nursing practice, I now know how to evaluate nearly anything. It’s necessary to document everything. The fun, creative part for me is that I must not use the words good, bad, or normal in my assessments. Those terms are relative to personal interpretation. Something I think is bad may be acceptable to someone else. I am thrilled

to find out I am not normal.

An accurate description of me now, at age 55, reveals that

_ Skin is intact, warm, and dry. No senile lentigines (age spots).

_ Hair distributed correctly. No hirsutism (chin hairs) or alopecia (hair loss) noted.

_ Facial features are symmetrical.

_ Nasal and oral airways patent (freely open).

_ Neck supple. Trachea midline.

_ Heart has a series of unvaried, symmetrical, pulse strokes auscultated (heard) over the 2^nd intercostal (rib) space.

_ No kyphosis (hunchback), lordosis (waddling gait), or scoliosis (lateral curvature of the spine) noted. Thoracic spine, waistline, and hips are symmetrical.

_ Atrophy of breasts noted (flabbier and smaller).

_ Protruding abdomen reveals no hepatosplenomegaly (bumps, bulges, or masses).

_ No cyanosis, edema, or clubbing (I’m not blue, swollen, or making a fist).

_ Colon is unremarkable (without problems).

_ Metacarpophalangeal joints with full range of motion (lift a finger, make a fist).

_ Cranial nerves (body’s primary motor and sensory pathways between the brain, head, and neck) intact.

I could go on. There are so many words to describe me — but NOT the simple terms good, bad, or normal.

The notion of a perfect form, a writer’s myth of sorts, hovers over me. I am living in a five-syllable diagnostic world punctuated with one-syllable meanings: touch, fall, scream, hit, kiss, love, cry, live, yes, die. Hovering is a good thing, especially if I can be more than just another good, bad, or normal person. Thank you, Miss Gravely. Thank you, Dr. Xxxx.