November 8, 2006, 9:04 pm

Running in the Shadows


Now, most people would not describe me as “kinky”.

Whatever that adjective is supposed to mean.

Then again, I am a conservative Republican, so it might be an apt description depending on your viewpoint.

But I have to tell you, the sight of Tim Curry in fishnets in the “Rocky Horror Picture Show” sends me to the stratosphere!

You might say it fills me with



Sorry, I had to say it!

If you’ve never seen Rocky Horror, you may not know what I just said.

And if you ever do see the “Rocky Horror Picture Show”, you may actually be horrified, but not for the reasons you think.

It’s a hilarious send-up of the old B movie science fiction genre.

And certainly not for the morally sqeamish.

I had to watch it, nay, force myself to view it three times before I could get my jaw off the floor.

I mean really!

And no, I’ve never been to a midnight showing. Yes, I do know the words to “Time Warp”.

And I have been known to do the Time Warp in my family room. On occasion.


That was, I hope, a lighthearted intro into an emotionally loaded subject; namely sexual/gender orientation.

The impetus for this post came from a question posed by ER chaplain Susan Palwick over at Rickety Contrivances of Doing Good.

Susan asks, and I quote:

“What kind of education do emergency-medical personnel get about gender and sexual identity? If they don’t get any, how can that be changed?

The answer? None.


Oh yeah. We get classes on “diversity” and being “sensitive” to cultural differences, and occasionally sexual orientation is included in the general topic.

So where did I get my training on handling patients with sexual orientation/gender issues?

It’s called nursing school.

Remember that? Where we were educated to take care of a group of mammals known as “human beings”?

Did I have a class that actually focused on how to “deal” with those whose sexual mores or identity or behaviors might veer off the “normal” path?

No. I was educated in the nursing care of, let me repeat it again, human beings.

And guess what?

That guy in the sequined gown? That gal who looks like a walking ad for the House of Leather?

Human beings.

The two men who are obviously life partners and trying very hard not to show any public displays of affection because, well, it might be frowned upon?

Or the two young women who never use the word other than “my friend” but you can sense their feelings are deeper than the words they are using?

Human beings. All of them.

Are you detecting a pattern here?


I guess you can say my classroom in the nuances of sexual orientation/behaviors is the San Francisco Bay Area.

It didn’t come from instructors or textbooks.

  • It came from my patients.

I talked to my patients.

I wanted to know what it was like living the life of the opposite sex for that year before undergoing any surgery. I wanted to know what it was like to live with the changes after surgery.

I’d actually ask what bathroom they were more comfortable using, often eliciting some humerous anecdotes about visits to the potty gone awry.

I listened to my patients express humiliation that they wound up in my ER secondary to some form of sexual stimulation.

And yeah, I’ve raised an eyebrow or dropped my jaw over an x-ray with some unusual foreign bodies standing out in stark relief against the view screen. But those foreign bodies resided in a very scared, embarrassed human being laying in the gurney.

  • It came from many friends and some family members.

I wanted to know when they first knew that something was “different”, ie: when did they know they were attracted to the same sex. How did they handle keeping that secret? Were they ashamed? How did their families react?

In some cases I was well aware of it because I was talking to member of my own extended family.

I learned a lot. I learned that someone can be gay or lesbian and come from a stable, loving, two-parent, Christian heterosexual household.

I know for a fact that homosexual does NOT equal pedophile.

That two of the strongest Christians I’ve ever known in my life are gay men. If we are judged on our service to our fellow man, I’ll be a thousand miles behind these guys at the pearly gates.

I’ve had men I respected die from AIDS early in the epidemic.

That sucked. Big time.


As far as ridicule in the emergency department, perhaps there is less of that here in my area of the world, only because sexual identity and gender issues are so openly discussed.

What little I’ve ever been exposed to has been out of patient ear-shot (no excuse). And it shows , IMO:

  • The need for some people to ridicule to help them deal with their own discomfort in dealing with those whose sexual identity, behavior, mores are different than their own.

Truly, I don’t care what your sexual orientation is or whether your even male or female, your heath issues are the same health issues as every other member of your sex, whether it be the sex you were born into or the one you grew into.

And we’ll treat you accordingly.

I may ask, though, what you would like to be addressed as, who you consider to be your significant other (if any) and maybe, just maybe, if you’re up to it, sharing a bit of your life experience with me.


So, in terms of how to provide education to the ER staff, I don’t think you can force understanding or even tolerance though classes. Understanding comes through experience and the only way most of us will be exposed to the experience of what it’s like to live outside the societal, sexual “norm” is to TALK TO THE PATIENTS.

It’s truly amazing how willing people are to talk if they know you are interested in them.


Now lest you think I’m Mother Theresa when it comes to the gay/lesbian question, please understand that I struggle with many questions, politically, socially and spiritually where sexual orientation is concerned.

What I don’t struggle with is how to treat my patients, no matter how they present to the department.

That doesn’t make me a saint.

I hope it makes me a good nurse.


Epilouge: Emergiblog is a 99.9% politically free zone. Since I’ve already broached a politically sensitive topic, please be kind to any Christian, conservative Republicans today. To use a current phrase going around: we got “bitch-slapped” last night.

My cheeks still hurt.

The title to this post is a phrase from an old Fleetwood Mac song, “The Chain”. When I started this post, it seemed like a good title. It still is, but I wasn’t able to incorporate it into the post itself. But I really like it. So I’m keeping it!


  • Susan

    November 8, 2006 at 10:14 pm

    Great post, Kim: thank you! But my sense is that some of your colleagues — while they treat the patients as human beings — also wouldn’t be sure what questions to ask, or might not even be aware that the questions were there to be asked, or wouldn’t be sure how to start a conversation about certain topics. You said:

    “I may ask, though, what you would like to be addressed as, who you consider to be your significant other (if any) and maybe, just maybe, if you’re up to it, sharing a bit of your life experience with me.”

    The point is that at least some nurses don’t do these things. How would you recommend encouraging them to do so? That’s really what I meant by “education.”

  • Kim

    November 8, 2006 at 10:49 pm

    Well…now you’re making me think. It comes pretty natural to me

    I usually just acknowledge the obvious and use humor to ease the situation. Say the patient is wearing a wig and has asked to be called “Jane” and not “Jim” and is obviously a man.

    You can ask why they are using the name “Jane”. If it’s because they are living the “year” as a woman before surgery, why did they choose Jane?

    I once told a man who was wearing a great dress that I wanted to know where he got it (and it looked GOOD on him!) and that it was pretty depressing to meet a man who looked better in it than I would!

    I guess I see the “elephant” in the room and I, well, acknowledge that it is there.

    It shouldn’t be hard if you are truly interested in the patient. You don’t ask abruptly, you just follow the lead in the conversation, like you would for any patient. I tend to talk to my patients. This would be much harder if you aren’t as gregarious.

    But asking how the patient wants to be addressed and asking who their “partner” is so that you can accord them the same status as a wife or husband should be pretty easy. Even if that is all you’re comfortable with, it should help the patient feel at ease.

  • TuxBaby

    November 9, 2006 at 6:30 am

    Not to make it into a political thing here, but I know just what you mean about the recent elections. But what I don’t get is that how the Dems can have this attitude of gloating now, when just 2 years ago, they all acted like the election results were the end of the world? But for me, and the Repubs I know- we didn’t gloat 2 yrs ago. We just tried to avoid the angry arguments. And now, we’re not acting like it’s the end of the world. It’s just time for a change, and I think the cycle just happens. That’s the greatness of living in a democracy- that the political cycle CAN happen. But geez… it was NOT the end of the world 2 yrs ago- just like it isn’t the start of a utopia now! What is up with that?


  • Wendy, S.N.

    November 9, 2006 at 6:53 am

    Nice topic, Kim.

    W. 🙂

  • Candy

    November 9, 2006 at 7:37 am

    I’d say “took a whoopin'” on the political front, but you’re dead on with this sensitive and lovely post.

    It might be time to quit your night job…

  • Candy

    November 9, 2006 at 7:38 am

    Oh, yeah — running in the shadows is also a Lionel Richie song…

  • Mother Jones RN

    November 9, 2006 at 7:54 am

    Hi Kim:

    Your picture of Tim Curry takes me back to my youth. I attended many midnight showings of “Rocky Horror Picture Show.” No showing was complete without dressing up in a costume. I always brought my umbrella and a roll of toilet paper.

    As a long time supporter of gay rights, I applaud your post. It’s not a question of morality, it’s a question of human rights. Back in the 1980s, I nearly lost my job because I let a gay man sit at his partner’s bedside after visiting hours. His partner died of AIDS during my shift. In the morning I was suspended for breaking the rules about non-family visitation. My boss wanted to fire me, but when word got around, the hospital backed down.

    Thanks for your excellent post. MJ

  • TC

    November 9, 2006 at 8:33 am

    You know, Kim, you’re not bad for a Conservative(grin). God Bless you for being a good, sensitive nurse and a sensible human being.

    p.s. I have my own football fanatacism. You might want to check out donorcycle. Tee Hee.

  • jen

    November 9, 2006 at 12:14 pm

    seeing lots of posts on diversity across the blogsphere lately, and I love it!
    Did you take your squirt gun and toilet paper to the showing?
    You are exactly right. It often seems like I learn more from my patients than I did in school. School just taught me the basics.

  • Judy

    November 9, 2006 at 3:33 pm

    I work in a very conservative Catholic hospital and we get more than a few babies in our NICU who have 2 mommies. One of my less tolerant, but very professional co-workers once asked me why they come to us, of all places.

    My response: It’s because the word is out that our mission is the same to all our patients. They know that as individuals, the staff may not approve of their choices, but as nurses, we’re all there for them as new moms.

    Great post!

  • Deacon Barry

    November 9, 2006 at 3:36 pm

    When I’m asking patients for their next of kin, I sometimes have to explain that all I’m looking for is the person they want to contact first in the event of an emergency. If it’s a choice between a gay partner or a twin brother in Australia, it’s more useful to be able to contact the one who’s on the scene.
    Also, asking ‘what’s your marital status?’ is so much easier than saying ‘are you married?’ Especially if the patient turns out to be widowed, divorced, or gay.

  • Peggy

    November 10, 2006 at 4:40 am

    I did go to one midnight showing of the Rocky Horror show, complete with squirt guns, umbrellas and chanting crowds, and it was hilarious. There was also a haze of smoke and for some reason, back home, I headed for the cookie jar. LOL

  • MandyHamm

    November 10, 2006 at 9:00 am

    Damn Kim, you are an awesome writer. The things you relate to nursing, i.e. the Lindsey post, this past post…just great. I wish I could reign my runaway thoughts in enough to make a sensible blog! Keep them coming!
    Loooooove finding you and this post…keep in touch…

  • Jen

    November 10, 2006 at 12:54 pm

    Hi Kim,

    Great post! I wanted to address Susan’s question as a current student. We’ve had sexual orientation (the gay, lesbian and bi) and gender issues (the transgender, trans-sexual) and both (the queer and two-spirit) covered in our curriculum (Ottawa, Canada) in our health assessment (year 1), family health course (year 2), in our community course (year 3) and in our professionalism seminars (small group sessions weekly or monthly with a reflective journaling component).

    Some of the instructors have covered this well, others not so much. One of my instructors just today, in a discussion about death said that “people are more comfortable talking about sex than death”. That may be true, but who are they talking to and how about either subject? I can talk with my (non-nursing) friends about sex easily, but we’re likely all lesbian or bi so there is alot of assumed knowledge/experience leading into the conversation. I’m less comfortable talking to classmates (and they to me) because they are mostly straight or not out, they are alot younger than me so there is a knowledge gap.

    In a professional situation you gotta ask the tough questions often (about this topic and others obviously–“death” anyone?). Do all nurses ask ’em? Nope. Do all of those that ask ’em, ask ’em well? Nope. Sadly, there are alot of things that we go through in school that we don’t carry with us into practice.

    The reflective practice part of it is huge, especially with sexual & gender “other” issues. What is it that makes me uncomfortable talking to heterosexual classmates about sex? I’ve been immersed in the hetero mainstream since birth–you’d think I’d know the lingo… I imagine it’s as tough for my classmates who ask with honest sincerity “but you and [my partner] could date any guy you wanted” to not recognise what’s wrong with that statement.

    Remember, alot of nursing students are fresh out of high school, and only about 21 when they graduate. Even if they know the right questions, do they know enough about themselves to a) be comfortable asking them, b) handle the answers they might get and c) understand the answers in a meaningful way? Of course, that’s true of alot of people far older than 21!

    Anyways, I’ve gone on far too long–my 2cents(Cdn) is worth 20 today!


  • NPs Save Lives

    November 10, 2006 at 6:11 pm

    This was a wonderful post! I took a Human Sexuality class for one of my NP classes and it was VERY enlightening. There were people from all walks of life as well as orientations. I’m far from being a prude and I think I surprised some in the class about being as knowledgable as I was. (Not that I’ve done it all, just heard about a lot of it.. hee hee hee).

  • Susan

    November 11, 2006 at 9:35 am

    I’d just like to thank everybody who’s left comments about this; it’s good to know there’s indeed education happening out there!

  • weha-nz

    November 11, 2006 at 7:15 pm

    Love your blog/retro piccys/comments.
    Spent many enjoyable nights at the mid night screenings of Rocky during my mis spent youth- dont forget the rice!.
    Did you know it was written by Riff raf who’s a Kiwi?

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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