Excerpt from Never Change by Elizabeth Berg, plus links to reviews, author biography & more

So you're eating lunch and a code is called over the loudspeaker, and you get up and run back to the unit. It's likely you'll be needed, no matter where in the hospital the arrest occurred. The other people in the cafeteria watch you leave your bowl of soup sitting there, and they nod at you as you pass by. In the army of nurses, you wear four stars.

The pay is pretty good, too, especially for a single woman with no obligations -- only child with no children, parents dead. I bought a little two-bedroom house a couple of blocks from the center of town. I bought a Porsche Carrera 911, too. Black, tan leather interior. Incredible sound system. The boys look when I pull up next to them; then look away. I beat them off the line, every time.

The problem with intensive care is that the patients usually can't speak. They're on respirators. Or they're unconscious. Or they have such messed up chemistry that they're confused. Or they stay just until they're stabilized, and then they're out of there and another train wreck comes in. That's what the bad cases are called: train wrecks. It doesn't mean what it sounds like. What it means is: right now, I can't get close to you, you're halfway to death. And anyway, I don't have time.

So there's no opportunity, in the unit, to sit at the side of the bed and shoot the breeze with patients. To get to know them. To admire pictures of their children, to style their hair, to slowly help them eat. Not that many of them eat. Tubes. I know a nurse who works in the unit precisely because the patients don't eat. "I didn't go to four years of nursing school to load mashed potatoes onto a fork," she says. But I like feeding people. It doesn't feel demeaning. It feels like high privilege.

The best day I had in the unit came when we had a boarder, someone who couldn't get put onto the floor where she belonged; it was full. She ate. She sat up in a chair. She was oriented to time, place, and person. She dug in her purse for lipstick after her bath. The unit was light that day; she was my only patient. She told me she had a crush on her doctor -- no surprise, everyone had a crush on Dr. LaGuardia, with his dark, South American looks -- so I told her I'd curl her hair, and she'd look beautiful when he came to visit her. We used 4 x 4 gauze pads to make rag rollers, and she did look beautiful when he came. I stopped him outside her cubicle, told him to be sure he noticed her hairdo. He's a good guy, Dr. LaGuardia. He walked in the room and stopped dead in his tracks. "Where was the beauty contest?" he asked, in the accent you could feel in your knees. "Where's the trophy?" Then he told her she could transfer to her floor now, there was a bed available; and twenty minutes later I was taking care of a gray-faced man with multisystem failure.

I stayed working in the unit for a long time. I mixed drugs, counted drops, monitored machines, resuscitated people who arrested, then resuscitated them again when they arrested half an hour later. I rarely had enough time to talk to their distraught family members. I had to walk away from their sad, worried clusters; I had to go and milk chest tubes while they wept and talked in church-quiet voices.

Oftentimes, I worked in my dreams. I heard the beep-beep of the IV telling me the infusion was completed, the rhythmic sighs of the ventilator, the dull bong of the alarm on the heart monitor. I changed dressings in my sleep, emptied urine and bile and drainage from wounds into toilets, sent polyps and kidney stones and spinal fluid to the pathology lab. I tested feces for blood, tested urine for blood, tested vomit for blood, kept track of each ounce that went into a patient and each ounce that came out, monitored levels of consciousness, listened to lungs, to hearts, to various levels of activity in the four quadrants of the abdomen. I awakened after those nights feeling exhausted, feeling like I'd just put in eight hours at the hospital after having just put in eight hours at the hospital. Or nine. Or sixteen.

Copyright © 2001 by Elizabeth Berg