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Writer's pictureInformation VOICE_TRIBUNE

Gray Shadows In The ICU

By Milan Calendine • Photos by Kathleen Dreier


"WAKE UP, WAKE UP" a nurse shouted. My eyes opened, and I could see the hazy outline of two nurses looking at me. The nurse, speaking, expressed a professional detachment and maternal impatience in her voice. A soft, repetitive electronic sound pulsed a few times, then ceased. The nurses walked away into a soft glow behind a long blue curtain. I knew where I was, yet I was unaware of any ordinary reality. Objects around me were recognizable, but at the same time, they were unimportant. I was in a cationic stasis. Observing without feeling was surreal as if my consciousness floated free of blood, bone, and gravity. I wanted to float away. The world turned gray and then black again. 


“Wake up, wake up,” the nurse shouted. This time, when I came to, the weight of my body flooded through my chest and limbs with oppressive intensity. My head felt crushed and heavy. Startled, I focused on the nurse as she spoke to me. 


“Do you know where you are?” she demanded, her tone edged with irritation. 


What felt like only a few minutes before, I hopped off a gurney in an operating room. Then I climbed onto a very tall, hard metal operating table in what seemed like an unreasonable amount of effort. The surgical staff around me seemed jovial as I quipped about the comfortable accommodations and the large number of people around my half-naked body. It seemed as if the table held me for only a few seconds before everything went black. 

“You are in the ICU! You are having a reaction to the anesthesia, and it is causing your heart rate to get dangerously low. We want you to stay awake!” 


In my case, dangerously low translated to a heart rate of 40 beats per minute. Each time my heart rate dropped below 40, the heart monitor’s alarm would alert the ICU staff. Staying awake seemed impossible. My body wanted to sleep, and I wanted what my body wanted. Despite everything the nurse said, I nodded off again. Then came the beeping, then came the nurse, this time gently shaking my leg. “Wake up, wake up!” We played this game a few more times, and I realized that I needed movement to stay awake. 


When a person is under general anesthesia, they undergo a complete loss of consciousness. They lack awareness, sensation, and memory. The phase that follows the loss of consciousness is called the emergence from anesthesia. This is where we check back into reality, passing through cognitive dysfunction and delirium. It’s fucking great for about 30 minutes while your mind adjusts and your body feels like a marionette without a puppeteer. 


“I want to take a walk,” I said, hoping the nurse would think this was a good idea. When visiting friends and family in the hospital, the nurses usually encouraged them to get up and walk around. In this situation, it seemed like a positive request. However, they laughed at me. Really laughed. With snickers and rolled eyes as if it was the funniest thing they had heard all day. 


“No! You can’t take a walk,” the nurse said with a smile. 

“Seriously?” I said. 

“We don’t think that would be a good idea.” 

“Can we call my doctor?” 


Quickly, the nurse’s expression went from jovial to that of an angry mother whose child insisted on consulting the other parent instead of trusting her judgment alone. What began as an attempt to be more compliant morphed into becoming a problematic patient with an attitude. She called my doctor and put the conversation on speakerphone. The entire ICU could hear every word. 


“Hi, Dr. Pang; this is the nurse in the ICU; your patient wants to take a walk. We told her it was not a good idea, but she insisted we call you.” 


“If she can stand and support herself, she can take a walk.” 


“But her heart rate is still low, and every time she doses off, the monitor alarm goes off.” 

“It’s good to get her up; if she can stand, she can take a short walk.” 

“OK, we will give it a try.” 


Hell, yes, this chick knew what she needed. Two nurses came over to assist me. They disconnected the monitors and IV, put down the bed rails, and helped me to my feet. Then, in a supreme act of mercy and professionalism, the male nurse caught me inches from face-planting into the solid concrete floor. Yes, I am an asshole! Still somewhat delirious, I insisted we try again. Walking with the male nurse was possible after a few moments of catching my balance, but he was holding on to me as if our lives depended on it. 


I noticed a strange stillness as we entered the dimly lit ICU corridor. All the other rooms were dark and empty. Even the nurse’s station, the central hub typically bustling with action and importance, was cloaked in long gray shadows. The ICU was empty, but for me, the space I occupied cracked open the darkness in the large, quiet ward. 


“I appreciate you,” I said as we held onto each other. “I really needed to walk.” 

“You got what you wanted,” he said. 

“And thank you for catching me.” 

“You’re not my first catch.” 


As we walked, there was something surreal about this moment. This place, the ICU, I was not supposed to be here. Did they do everything they were supposed to do to my face? Did they have to stop short; did they finish? My heightened anxiety and tragic inner dialogue twisted their way down a familiar rabbit hole toward my demons and worst assumptions. 

“I understand you work in the geosciences?” he asked, abruptly yanking me back to the surface and catching me off guard. 


“Yes,” I replied, frowning slightly and wondering where he got that information. I was not in the mood, nor did I have the mental bandwidth to care how he knew something so oddly personal. The next question that spilled from his mouth seemed entirely out of place for an ICU nurse. 


“What do you think of the Flat Earth Theory?” 

I paused and thought to myself, “I don’t.” 


With his question, my post-surgery cognitive fog and delirium evaporated, leaving me stunned in clarity. I wanted to laugh, to sneer in a moment of dark triumph, while my inner demons clamored to bore a hole into his skull and twist my hard-earned scientific knowledge into his gray matter—the part absent on the day science class covered why the Earth and all planets, suns, and moons are round. My internal arrogance in fine, disgusting form, completely dismissing this person as a rational, intelligent human being. The sin here is what each and every one of us has to deal with relentlessly day after day: as David Foster Wallace put it.’ The freedom to be lords of our tiny skull-sized kingdoms, alone at the center of all creation.’ Tragically, each of us believes our perspective is reality’s definitive, unquestionable truth, and we arrive at this conclusion without any compassion or thoughtfulness as to why another person believes what they believe. 


The instant I judged this person’s intellect and very existence, the absurdity of our situation hit me like a camera flash. I, a transgender person, was in the hospital for facial feminization surgery. While I twisted my knife into my nurse’s delusion, he could just as easily twist his into mine. Perplexed, my mind spiraled, comparing and contrasting the strangeness of our situation. 


“Well, to start with, a flat earth is not a theory. A theory is based on information confirmed through experimentation and observation. Tell me why you think the Earth is flat?” I said. 

He began with the usual flat earth tropes: a deep mistrust in science, the insistence that people can’t feel the earth spin, and other misguided notions. While half-listening to his reasoning, my internal dialogue confronted the unsettling thought that maybe my belief system was just as twisted as his. But then, a small wave of clarity cut through the moment; we both needed compassion and understanding. 


For him, the fringe view of a flat earth was born from an increasing distrust in mainstream media and science, fueled by a social media echo chamber that continually reinforced his beliefs. For me, being transgender was as deeply rooted in my psyche as any core belief. I had fought against it for most of my life, only to realize, as Julia Serano states in her book Whipping Girl, “When I made the decision to transition, I honestly had no idea what it would be like for me to live as female. The only thing I knew for sure was that pretending to be male was slowly killing me.” 


The terrible truth of the transgender reality I can tell you with almost 100% certainty is that every transgender person has a plan; whether it’s a bridge, a bullet to the head, or a poison pill, there is a plan in place for the day it all becomes too much. This was why I was here, a fight for survival—a pathway to stay alive with some enduring positivity towards life. 


It’s easy to run this story through our filters with chin high, peering through educated rose-colored glasses. But honestly, this is not about science or intelligence. After all, it takes somewhere between 5 and 6 years of training and education to become a practicing ICU nurse. What this is really about is a choice—the choice to choose how we treat another person, the choice to consider aspects of another person’s thought process and be curious about who they are and how they see the world. We make incredibly disgusting, abhorrent judgments about who and what other people are every second of every single day. And I will offer that we are usually wrong. I know for sure that I am usually wrong. The point here is that it is hard work to bypass our hard-fought-for filters, to give people more than 100 milliseconds before we judge them as lesser human beings with only a glance. 


While we never broached the subject of my gender, I listened to his reasoning and gently countered with some arguments as to why the Earth is, in fact, round. We walked and talked for over 45 minutes, enjoying each other’s company. As he reattached the heart monitor and IV, I felt we both had learned something about forging genuine human connections. I may never know if our discussion changed his mind, but I learned that compassion always trumps ego and leading with thoughtfulness can shape human connections towards more positive outcomes.

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