January 21, 2008, 1:59 pm

Behind Those Hazel Eyes


Ah, don’t you just love tea break at work?

We just barely get a pee break, let alone a tea break!

Oh my, look how the cookies are placed just so on the tray.

In my ER, the food is strewn across the break table so we can graze like cows.

(Standing up, of course, because there is not enough time to sit down. Literally. Sitting down takes one second off the five seconds you’ve allowed yourself to scarf down processed carbohydrates and salt licks, also known as chips.)

That nurse in the middle is the unit gossip. The one on the left can hardly keep a straight face as she locks eyes with the one on the right. You just know they are going to talk about the old biddy when she leaves.

Little do they know that the old biddy intends to write them up for not extending their pinky fingers while they drink. Except they won’t be allowed to see the write-up or know who wrote it.

But they’ll know…


Don’t forget to send in your submissions for Change of Shift to beth at pixelrn dot com! She’ll be hosting this week at Pixel RN!

And I get to host Grand Rounds on the 29th! This will be my third hosting of the weekly collection of the best of the medical blogosphere, so get those keyboards a’flyin’!


I knew in an instant that this would be one patient I would not be addressing by his first name.

Mr. Smith was elderly, handsome, distinguished and well dressed. Even in the wheelchair I could tell he stood over six feet tall.

His piercing hazel eyes shot right through your soul.

Or so it seemed.


There was nothing in report that made me think this patient was different from the others. And there were many “others”. The unit was a zoo. Every room full, the waiting room occupied and five waiting for triage. Half the county on ambulance diversion. Every patient required a full work up, including Mr. Smith.

The orders for Mr. Smith had just been placed in the rack. I grabbed the chart and walked into the room.

Thank goodness his caretaker was with him. That would make things easier.


Mr. Smith was a victim of the disease that gradually steals your mind before it takes your life. Alert and aware, he was not ambulatory nor did he speak. He obviously recognized his caregiver. I was observed with suspicion. I think.

I could see it in his eyes.


I wrestled with Mr. Smith as I placed his IV and drew his labs and performed a few other actions that could be listed under “noxious stimuli”.

And I do mean wrestled.

This guy was strong. Hulk Hogan would have lost a match with this man!

He may not have known who he was or where he was, but he sure as hell knew what he didn’t want! And what he didn’t want was me messing with him in any way, shape or form. It wasn’t hard to tell. I’d look up to reassure him during the procedure.

Right into those eyes.


I had been in and out of the room with medications. I was talking with the caretaker, but I found myself addressing Mr. Smith. He had a way of commanding your attention. His face was expressionless.

His eyes were not.

The caretaker asked if I knew Mr. Smith’s history. I rattled off what I knew about his health.

No, she wanted to know if I knew who Mr. Smith was. What he had done, where he had been and who he had known during his life.

I admitted I did not.

She told me. I was floored.


Mr. Smith wasn’t famous. At least not in the way that we define “famous”. The average person would not know his name. Even at the apex of his career, the average citizen would not have been able to tell you who he was.

But long before the Beatles landed in New York, Mr. Smith had served his country at the highest levels. He worked with, socialized with and counted as friends people most of us know only from old newsreel footage and history books.

I’ll learn more when his book arrives in the mail. A book I’ll never be able to have autographed.

The stories he could have told, if only he could have spoken.

I sensed something when I walked into that room.

Maybe it was the sense of nearly a century of history, once lived and now residing,

Behind those hazel eyes.


  • AlisonH

    January 21, 2008 at 7:21 pm

    I don’t know. It might be that if you showed him his book and asked him to sign it, it might still connect to part of his brain somewhere, especially if you asked him at his home–or if his caretaker did. Old people surprise you sometimes.

  • NPs Save Lives

    January 22, 2008 at 9:16 am

    I try to have caregivers bring in photographs of patients of their past so that the nursing staff can see what the patient was like before the steely web of confusion set in. It helps us to treat people with the respect they deserve. I’m so glad that you took the time to look into those eyes. He may not have been able to tell you thanks but I’m sure deep down he did. Great story!

  • Marijke

    January 22, 2008 at 11:03 am

    What a powerful post and a good reminder. I have that phrase in my head now and that’s a good thing.
    Thank you.


    January 22, 2008 at 5:29 pm

    Wow. What a post.

    Somewhere, behind thos eyes, he is still there.

  • Nurse + Blog = PixelRN

    January 24, 2008 at 12:31 am

    […] at Emergiblog tells a fascinating story about communicating with a non-verbal patient in Behind Those Hazel Eyes. Kim, my curiosity is peaked – I might be asking you to borrow a certain […]

  • Corey

    January 24, 2008 at 8:22 am

    Wow, i know exactly what you’re talking about with the eyes thing though.

    My father passed from Lou Gherig’s Disease, so i know the feeling of being in a room with someone who is at home inside somewhere, who just can’t move, trapped within themselves. Capable of emoting only through their eyes.

    Oddly enough its an extremely powerful situation. EXTREMELY.

    Great post

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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