I must admit to a slight nervousness approaching The Language of Kindness – fearing "kindness" is another word gaining currency in the way "mindfulness" did a few years ago. But as someone who spent 15 years in radiography, I had to reach for a book subtitled A Nurse's Story.
I was soon ashamed of my fear because preaching doesn't approach what Christie Watson does here. No one is harder on herself, no one is funnier. More than a memoir, The Language of Kindness exerts the power of a gripping novel threaded with science, philosophy, history and ethics. Like poetry, it resists paraphrase. A quick summary is out of the question, this brilliant life-changing book has to be experienced.
Watson tells how single human cells in separate dishes beat in “a different time Yet if the two touch, they beat in unison. A doctor can explain this with science. But a nurse knows that the language of science is not enough. The nurse in theatre translates ‘your husband/wife/child died three times in there, but . . . with a large amount of electricity and some chest compressions that probably broke a few ribs, we managed to get them back’ into something that we can hear. A strange sort of poetry.” Rarely do we get the nurse’s side of the story because nurses are just too busy and exhausted to tell us about it:
Montaigne described doctors as having the advantage that “the sun lights their success and the earth covers their failures”. I already know there is a difference in the way nurses are treated following a mistake – differently from their medical counterparts. “We don’t stick up for each other in the way that doctors do,” says a colleague, after a child is given a drug intrathecally that travels straight into the spinal canal or into the subarachnoid space, instead of intravenously, with devastating consequences. A simple thing. Right drug, right patient, right dose; wrong method of administration. “It will be the nurse who gets struck off, for carrying the drug to the doctors, I’ll bet, not the doctors who administered it.”
Watson’s unique talent and humanity opens a new clear window on to one of most underrated, underpaid and oldest of professions, “. . . we are all nursed at some point in our lives. We are all nurses”. Illness, old age and death touches all our lives eventually yet we manage to hide from this knowledge. “A&E teaches us that we are small: despite our best efforts . . . We can’t predict which of us will need our bed changing because we are incontinent, and who will change that bed.”
Watson compares nursing to poetry, a place where “metaphorical and literal meanings cross borders”. A hole in the heart is a hole in the heart; the nurse is the thing at the centre: between the surgeon’s skill at fixing the literal hole, and the patient’s anxiety and loss, the metaphorical hole. Nursing is – or should be – an indiscriminate act of caring, compassion and empathy.”
Time is beautifully managed here. Watson draws us into the intriguing maze of a busy hospital, her instinct for just the right details exactly positioned give a wonderful sense of place.
Soon after Watson’s crash bleep goes off, the present drama gives way to the story of her teenage years when she trained as nurse and then progresses through the various stages of her 20-year career in nursing.
We pass through psychiatric wards, maternity wards, paediatric intensive care units and geriatric wards before ending up in the morgue with a detailed lesson on how to lay out the dead.
Within each chapter, the narratives ebb and flow between life and death before everything folds back to the present as Watson rushes to answer the last Crash Call of the book as a patient is brought back from the dead and a baby is born in the hospital car park.
Watson is a funny, totally lovable narrator but this book is a serious shock to the system – a journey to the underworld, our hard-working guide an observant Virgil for the 21st century. While the crash team work behind a makeshift screen in the patient-transport area, “One of the patients in the waiting area is filming on a phone, another is shouting that he has been waiting for a taxi for 40 minutes. People seem numb to such catastrophic events in front of them. This is new, something I’ve only noticed in the last five years or so.”
The survival rate for cardiac arrests in UK hospitals is less 20 per cent, “despite our advances in technology and training, we can’t seem to improve much on the numbers. It appears that when your time is up, it’s up, regardless. Children have even less chance . . .”
Yet the cardiac arrest survival rate in a Las Vegas casino is 75 per cent. There are a number of possible reasons for this but it helps that people are watched continuously for cheating. Even more importantly, chest compressions and/or shocks are performed immediately by trained security staff whose “job depends on them passing regular assessments every four months . . . In hospitals, the nursing staff are given basic lifesupport training every year, sometimes every two years and, in some trusts, threeyearly, despite the guidance and recommendations from the Resuscitation Council.” And more training could save money too. In Scandinavia where children are offered cardiac-arrest training, the survival rates out-of-hospital is 20 per cent higher than in the UK. “Maybe more regular training would improve the figures. More funding. The cost of saving a life.”
As Watson steals a blanket from a private ward for a shivering NHS patient, it’s hard to be numb to the dedication of those working with diminishing resources as the corporate takeover of the NHS marches on. For all Watson’s humour and heart, her belief in power of kindness, this is a frightening trip. One wishes that government ministers might have the courage to take it before the NHS melts away and darkness takes over completely.
- Martina Evans is a poet and novelist, the author of 'The Windows of Graceland' and Now We Can Talk Openly About Men due from Carcanet next month
