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Mindful Practice

The ocean between us

Hampton, Joy M. MS, PA-C

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Journal of the American Academy of Physician Assistants: May 2019 - Volume 32 - Issue 5 - p 1
doi: 10.1097/01.JAA.0000554744.47053.6e
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I walked off the fifth-floor hospital elevators and the smell hit me immediately, causing a sudden wave of nausea. It was as if the ocean itself had followed him here, sinister and laughing. I followed the scent to his room, where the familiar “big bong” of a malfunctioning wound vac greeted me. The wound care nurse was working on troubleshooting the issue, making sure tubes were connected, the canister emptied. His lower leg lay there, limp and swollen, like a bloated dead fish. Coffee grounds were scattered in containers around the room, but no amount of absorption could erase this funk.

His eyes were closed, his thumb spica splint was positioned up near his mouth, as if that long-lost little boy was trying to comfort his 18-year-old body with an attempt at thumb sucking. I tapped his shoulder and asked how he was doing. He smiled bravely, masking the pain. The familiar “woosh” of the wound vac soon interrupted us, and the nurse, satisfied with her work, walked out the door.

I know what happened that day. I know all the decisions that led to his condition. How he was on a family camping trip in the Outer Banks of North Carolina with his dad, stepmother, and siblings. How they opted for an ocean swim over the pool that afternoon. What a beautiful day it was. How he was sure to wear his sunblock. How unusually warm the water was, but murky. How they were all together, all five of them. Jumping waves. He wore a diver's mask, submerging again and again, looking for ocean life.

They swam in that water for a long time, noisy and happy under the bright afternoon sun, with many other people in the water. Then a yell, about his leg hurting. His stepmother rolled her eyes, must have been a crab. Then the glossy gray fin with black markings that rose from the water. A stingray? Then the tail fin. Finally the dark, demon eye of the shark. His dad, rushing and grabbing him under the arms, pulling a weight that would not move. His stepmother, rushing out of the water with the other two children. Then suddenly, the release. The dark red ocean water, the waves that would not stop for his tragedy. The noises of children at a distance, playing, unaware. The slow motion of it all. The raw piercing scream for help, to an audience that wasn't listening. The wind, the sand in his eyes. The filleted limp leg, the bleeding hand. The helicopter. The OR. The ICU. The floor. The wound vac.

I took a seat in the chair next to his bed, looking down at my flip-flops, still with sand in my toes. I spoke again, voice still hoarse from those screams, asking if I could get him anything. He looked at me with a half-smile and said no. I had to look away from those eyes, dark and sad, now as cold and flat as the shark that attacked him. I sat there next to him for a long time, in a state of purgatory. Not quite his mom. Not quite his PA. Not quite his friend. I sat there next to him, floating away sadly on a wave of guilt, sorrow, and regret.

In 2015, when this happened, there was a new record set for shark attacks around the world, with 98 incidents and six human fatalities. On the North Carolina coast, where we live, there were eight attacks over the course of a month.

Why did we swim that day? I struggle with this question all the time. I am a believer that it is important not to live in fear. What were the chances of being attacked by a shark? Still pretty slim. But it happened. It happened to my family. Fortunately, my stepson kept his leg and hand. He has some amazing scars, a permanent foot drop, and wears an ankle-foot orthotic. He is living and working independently.

These experiences help us reset ourselves. They help us remember what it is like to be on the other side of healthcare.

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