Mile High Shenanigans 

Driving through the mountains I love looking for the hidden secrets that the mountains are protecting from our prying eyes. A peek of yellow, a little waterfall tucked away from the highway. 

My heart breaks a little when we drive past the trees that have been killed from some strange beetle. These trees don’t belong here, so they didn’t survive. Sometimes transplants are not a good idea. 
We pull through the last tunnel and turn into Dillon. I am always blown away by the vision. I could never live here, but I love the feelings I experience after the drive through the mountains. This year is especially lovely. The aspens are turning and I am so happy to see this. 

We pull into the shopping center parking lot that I will forever associate with Jill. Standing proudly to the West of the shops is “my mountain.” 

My mountain is different than the others. She is rounded and to my eyes a warm reddish hue. The other mountains are sharp and angled, somehow they seem to be imposing their will on the wind and the land. 

My mountain is different, she is inviting. I feel like she is protecting us.
The clouds roll over these peaks casting long, dark shadows, while the sun seems determined to break through the gray. 
This year my mountain is shrouded in a light, opaque haze. It’s from the smoke of distant wildfires. This week is better than other days recently. However, her red hue seems muted to the point of obliteration. 
We meander over to a spot overlooking a cove on the lake. My friends’ effervescent giggles float in the wind up to my spot where I am sitting on what I think is a big piece of granite. The wind is slightly chilly, and the sun feels intrusive despite the shimmering diamonds it is dropping on the ripples of Lake Dillon. 

I forgot my wallet. (Yes, I am well aware my friends would front me the money for lunch, but I am disgustingly embarrassed… I packed a whole bag for this adventure and forgot my wallet!) 

We drive over to Breckenridge, which is more than a little contrived and touristy. I like it there, but I don’t love it. I did get this gem of a photo, so it may have been worth it. 

I love my time in Colorado. I love spending time with these girls. I may even love the mild confusion I feel from the lack of oxygen at this elevation. 

Already excited for next year. I suppose I left out the shenanigans. Guess you had to be here. 

Mr. Right… Now

I am not embarrassed or ashamed. 

No apologies or excuses. 

I am not looking for a soul mate. 

I don’t want Prince Charming. 

I’m just a girl… and I wanna to have fun. 

That’s all I really want. 

Some fun. 

I am 36 years old. I have never been married. I have not shacked up or had a ridiculously long engagement that ended in heartbreak. I’m not some jilted lover who is pining for the one that got away. My biological clock is not shrieking because it is almost too late. 

Yes, I cry at weddings. Of course I have imagined hosting a huge, expensive party where 500 of my closest friends watch me exchange nuptials. Most girls have. We are taught that is we what are supposed to want. The wedding industry has been telling us that is the ultimate goal of dating. I’m still not actually under any delusion this is going to happen. I don’t even think it would be that much fun. I would probably resent the expense and get drunk and ruin the whole thing anyway. It’s still fun to think about though. 

I’ve also daydreamed about magically falling into a huge sum of money that would allow me to never worry about finances again. 

If we want to talk about fantasies I am also a broadway actress and Olympic athlete who has a multiplatinum record that has been nominated for a Grammy. 

In my rich fantasy life I have jumped out of airplanes, climbed mountains, and rescued kittens from trees. I have penned bestselling novels and my memoir is the hottest book in all the book clubs. I’ve made the rounds on all the late night talk shows. Jimmy (both of them) loves me and I am his favorite guest. I hide from the paparazzi because I am just a humble artist doing what I was born to do. 

I play on Tinder and I flirt with cute bartenders. Now don’t get me wrong, I am not looking for a booty call or a string of sexual conquests. I don’t have any intention of sleeping with every man who makes an offer. By the way, has anyone ever noticed how quick so many men make that offer??? It feels like they are just casting a net and hoping to drag in the days fresh catch. 

I am looking for interesting, smart, funny people to have some adventures with. That’s all. If we are exceptionally lucky we will end up friends. I want to spend time with someone special. I want to invest energy in getting to know them and equally as important, I want them to get to know me. 

I want to know what makes him smile and laugh. I want to know how his day has been. Does he like puppy and otter videos? Will he see an owl and think of me? Better yet, will he snap a quick photo and send it to me just to make me smile? I can still have all of that even if I don’t want to plan our joint retirement, can’t I? 

What book is he reading right now? What movies can we share with each other? Can we watch the sunset and marvel in the beauty of our planet, both of us reveling in the fact that we got to see it together? Will he know and appreciate the fact that I am a cryer and I actually enjoy it? Will he think it’s cute that I cry at Folger’s commercials? 

At some point in the near future I will be moving on to the next grand adventure. Can we part ways without hurting each other’s feelings? Can we acknowledge the bittersweet feelings goodbyes bring? Can we be excited for the other’s future escapades? Can we actually fall in love a little and still move on when it’s time to go? 

Is it possible to share your present life with someone without planning a future? 

Yeah. I think so. I want this to be true. 

I don’t want to be rescued because I am not a damsel in distress. I don’t want to be caught because I don’t need a cage to keep me safe.

I just want to have fun. Maybe with a little love sprinkled in so I don’t get tired of traveling alone. I may not be looking for Mr. Right, but I am looking forward to hanging out with Mr. Right Now. 

Beautiful People

Call it nostalgia. 

I was looking through the photos on my phone and I realized all of my friends are so damn beautiful! 

We can be all sweaty and gross, even covered in mud… and they are so good looking. 

That’s not the best part though. They are smart, kind, generous, and funny. These photos remind me of all the adventures sometimes misadventures, we have shared. 

How did I get so lucky? I’m not going to stop getting selfies with my beautiful friends. I want a reminder I can carry with me. 

I hope they know how much they mean to me. 

Here’s to all the beautiful people in my life. I’m so lucky they are my people. I wouldn’t trade them for anything. 


Warm and fuzzy memories popping up on Facebook. Catching up with old friends. Seeing everyone post their wedding and baby pictures. Instagramming my martini (it was really good.) Sharing another photo looking out an airplane window. 

We can share the mundane parts of our lives and our friends can get a little glimpse into what we do sometimes. 

Unfortunately, this has led us to have hundreds of “friends”. People we probably would not even recognize if we saw them out in public. 

It’s important to remember the people who are actually there for us. The people who would call us even if we disappeared from social media forever. 

Maintaining relationships is especially difficult when you are rarely in the same place for more than a few months. It requires effort and a commitment to honesty. Unfortunately, it is also a two-way street. You may believe someone is a friend and it turns out they may just be a “friend.” 

It’s funny how many different meanings the word friend has. 

  • super close friends that are really more like family 
  • good friends who know some of your secrets
  • occasional good time friends who are good for an entertaining evening
  • friends you love to hate 
  • friends you stalk on social media
  • friends you can’t seem to get away from
  • friends who used to be friends but you have grown apart 
  • friends from work 
  • friends of friends who you call friend because it’s just easier than explaining the connection
  • people you like and want to befriend

Are we completely devaluing the word friend? How do you separate each person’s role in your life? Does it matter? 

Probably not. 

Just make sure you let the people who mean something to you know. Don’t drop off the face of the earth. Be present and available when they need you. 

Don’t keep your enemies closer than your friends- you may just lose the ones you really love. 

Colorado Mornings

I love coming to Colorado. 

The insane traffic seems horribly out of place in the rugged frontier world of the mountains. I guess there are lots of people who love coming up here. 

The morning is crisp and cool. Perfect weather for shorts and a hoodie, neither of which I brought with me. 

I love the freedom I have to travel and I am certain this life is more fulfilling than the one I used to lead. 

Sometimes I miss having a place I was expected to be at every day. Well, most days anyway. I guess being untethered is a double-edged sword. 

I have to be vigilant with keeping relationships a priority despite the distance. I don’t want to become a stranger. I like the idea of doing something special with my closest people once a year. We always know when we will see each other again. 

Yeah, that’s a good idea. 

Today is our second annual wine fest. Yum. 

Independent. Not Isolated.

Somewhere along the way I convinced myself to path to true happiness included falling in love with a man, settling down in a suburb, and living happily ever after. I could not understand why I would not successfully find my dream life.

I now know I was wrong all along.

I’m Not Defective.

It is perfectly acceptable for me to pursue anything I am interested in. I do not need the approval of other people. I can take a boxing class, do Tough Mudders with groups of strangers, and date strange men I meet on Tinder. I can leave my job and start working as a locum. I can write this blog. I can take stupid selfies and edit them however I want to. I don’t have to be cool. It does not matter who approves or disapproves.

I get to be me.

Boxing, Obstacle Course Races, and Friends

I am a TERRIBLE boxer. I have not even been to class in over a year. I still consider myself a boxer. I learned so much about overcoming the voice in my head and pushing past my own fears. I cannot wait to get back to Lubbock and to the gym. I know it will hurt and I have to work my way through the pain, but it is worth it. The satisfaction I get from making it through a class is worth every drop of sweat.

As far as obstacle course races, I don’t know if I will ever do another one. To tell the truth it is more an excuse to see friends than anything. I have realized I do not need an excuse to see friends. I can just go see them. I don’t have to suffer through a miserable experience in the name of bonding. We can find fun things to bond through. Like movies, music, and wine.

I have the option to make friends wherever I am. I can put forth some effort and continue to nurture the relationships I have as well. There is no rule that says you have to choose between your new friends and your old friends.

Dating and Relationship Stuff

I do not know where I got the idea you could only date people you wanted to marry. I could never go out with anyone because I did not imagine myself married to them. For the first time in my life, dating is fun! Nope, I did not get all thin and beautiful. I just got over myself. I relaxed. I stopped looking for a hero. I stopped judging the people I am with because they have the audacity to want to be with me.

I am very happy in the situation I have now. There is a guy who I like a lot. I always enjoy the time we spend together. I even look forward to seeing him when our schedules don’t allow us to work it out for a bit. It is not entirely casual and there are also no expectations. I don’t feel like I should behave a certain way or say the right thing. I am myself. We date other people and yet I am happy when I get to be with him. There is no jealousy or resentment. I don’t feel smothered or annoyed because he is demanding more from me than I have to offer. It is the perfect relationship.

I have met some other people who I enjoy spending time with too. I don’t have to choose just one. I am not looking for a life partner. I am looking for shared experiences. I can get to know someone and even develop feelings for them without the need to tie them down and demand they pay attention to me for the rest of my life.

I can date! I can meet new people. I can even fall in love with someone if I want to. Removing all the pressure has made the whole experience better for me. My refusal to engage in what I considered “healthy” relationships in the past made me feel broken. I thought I was incapable of loving other people. I thought I was inherently flawed. I was doomed to be a spinster.

I require a lot of quiet time. Time to myself where I can think, daydream, or just be still. When I have too much interference in my personal space I become desperately unhappy. My relationship with Tinderbabe does not interfere with my time for me at all.

I am not a bad person because I may want to kiss more than one person in my lifetime. And by kiss I might mean… oh, well. You know where this is headed.

There may be a cute guy in Canada who I want to spend time with. I could meet someone at the grocery store next week. I have no need to settle down and raise a family. I can support myself. Why do I have to find someone to become bound to? Would it be the end of the world if I simply followed my heart from day to day?

Work Stuff

Just a blurb about work. I did not let anyone down when I left my dream job. I did not waste everything they taught me. I simply moved on to another opportunity. I can still go home from time to time. They can still be my professional home base. They are still there for me. I don’t owe anyone anything except for gratitude and respect.

I changed my mind.

Just because my life is not turning out the way I always thought it would does not mean I am a loner, loser, or unhappy. I was wrong. My biggest mistake was believing I had to convince myself to want a dream that wasn’t mine. It’s okay to change your mind. It is okay to do what makes you happy. I don’t have to fit into any mold except mine. What a relief. I am glad I am not broken.

Selfies are about memories


I know. It’s funny to make fun of all the silly people who take selfies all the time. I completely disagree with those folks though. There was a time I went out of my way to avoid being in pictures. I hated seeing myself. It was entirely too easy to avoid being in the photos.

This all started to change when I was taking my son to New York City. I found a walking tour with a photographer. I realized how few pictures there were of the two of us together, and I desperately wanted them. This was the beginning of my commitment to my son to give him photographic evidence of our life together. I have never heard someone lament they had too many photos of their loved ones.


These photos and the selfies I have been taking with my friends and family are a way to demonstrate I care enough to want a reminder of our relationship.

There are so many people from my past I can barely remember. I have almost no photos of us together (that is if I am lucky to have any at all.) I will not live life that way anymore. I understand before we had instant access to a camera and seemingly unlimited electronic storage it was more difficult. There is no excuse now.

Trust me, most of the time I think I look horrible in these pictures. I got the wrong angle, my chin is super fat, or my nose is all wrinkled up. The people who know me know what I look like. They love me no matter what face the camera managed to catch. If they don’t, I don’t give a shit anyway. I am not totally made up and looking fabulous in all of these photos. I am just my most authentic self.

When I was choosing these photos I was deliberate about choosing memories I loved and not focusing on my perception of my flaws. This is hard for a girl like me. I tend to focus on all the reasons I should not be in the pictures.

Then I get a grip. Of course I should be in the photos of my life! I should get as many photos of me with the people I love as possible. We should really stop worrying about what we think people are thinking about us, and realize most people don’t care. We are hurting ourselves and our friends and family when we refuse to take a picture with them.



These are just a few of my favorite memories from this year. I have been so lucky to be able to go out and meet new people. I have had so many awesome adventures. These people are so special to me and I am excited to have photos I can reminisce over. I would not trade any of these photos for one airbrushed inaccurate representation of my life.

I have no intention of stopping the selfie craze. I refuse to hide from the camera anymore. I hope more of us continue this zany trend.

It is rare for me to have no words.


Looking more than a little tired.

I have so many things I want to say, and yet I have no words.

We are not guaranteed anything in life. We have a responsibility to let the people we love know how we feel about them. We have an obligation to be kind and to try to leave the world a better place. Don’t waste your life waiting for it to begin.

So, in the spirit of that sentiment, here are a few of the people and memories I love the most.

I love this picture so much. This costume was logistically more difficult than I thought it would be. He was the perfect little mummy.
bran pics for gradbook0145
May as well continue with the Halloween pics. Look, it’s my baby brother- wearing eye shadow! Looking tough Bubba.
bran pics for gradbook0154
I would not go to school with crazy witch hair and makeup. I did not want to be seen ugly. (One of my family’s favorite stories.)
me and ang at grad
I can’t believe it has been so long. We did it! One of my favorite pics of my BFF and I.
Good times with my dear friends. Love these women so much.
Me and my little buddy. My nephew, Kyle. I love this kid so much!
Tough Mudder Adventures. I can’t wait for the next one!
Me and my other nephew, My Squishy.
Kurt and I before the Tough Mudder. He basically held my hand, and let me flirt shamelessly with him all day. Love all my superhero friends. It certainly helps how easy on the eyes he is.
My “little bro”- Trevor and my brother, also named Trevor- are two of the nicest guys I know. I am a lucky girl to have all these great dudes in my life.
I vote for: it’s always a good idea to get a selfie with the guy in chains.
This is one handsome dude. I love his heart. I do not know how I got to be so lucky with a kid like him.
Fun times with fun friends.
Hanging out in Memphis.
Just because we don’t have shot glasses, does not mean we don’t do shots. However, the lack of a corkscrew- did lead to wine bottle breakage… Live and learn.
Love these peeps. You guys look so cool.
Me and my beautiful mom. She’s pretty much awesome. I am lucky to have her.
My first time! With Sushi, get your head out of the gutter…
Ty and Granny… He played my favorite song for his talent show. The Entertainer from one of my favorite movies: The Sting.
bran pics for gradbook0161
Just a girl and her dog. This was Cinnamon. She was the bomb-diggity.
Gracie Belle 053
Ty’s first time! …. With Sushi!!! NYC was so awesome. I am so glad I got to share the experience with my favorite person in the whole world.
Just us grandkids with Mamaw. Always a good time. I love it when she is game for selfies.
Just one of the random things I miss most from my other job…. getting to take random selfies with this hottie. (He is Shannon’s husband- I always send them to her….) It makes me smile.
Oh, my Gracie Belle. She is the coolest cat. Moody, temperamental, and my sweet girl. She nurses on my blanket, and she is always glad to see me when I get home. Her sister Bonnie Blue on the other hand…. not so much.
My girl Brooke, who refuses to bleach my hair ever again… because the bleach makes me cry and whine… and then I demand to go dark again after the wounds on my scalp heal. Love that she humors my many whims when it comes to my hair.
pics for gma82
My dear brother and sister-in-law. Trevor and Robin, you guys are a good example of what a decent marriage should be. You love and respect each other every day. I love that you two found happiness with each other.
My four guys. I always wanted a “red-headed step brother,” JT, thanks for making that wish come true.
I love having all these strong, beautiful, brilliant women as my friends. I think I may have the best group of people in the world. I am indeed a lucky girl.
Selfies are always better when you are wearing shades.
Yeah…. now, we are all professionals and responsible for real human lives. Scary thought.

So, what’s the point? Well, my life is meaningful because of all these people. There are a lot of other people who mean the world to me too. I am lucky. We have to remember to love our people. Don’t take them for granted. My heart is with my family in California tonight. I will be sending you all the loving vibes I can. I love you guys!

Do you wanna be my friend?

Hi Dave. May I call you Dave? Please? I think you are pretty fantastic. We could be friends.

Okay, I admit it. I am one of those annoying people who fantasizes about famous people. I actually size them up and wonder if they would be a good friend. Now, most people know I am obsessed with Dave Grohl. I am pretty sure he would fantastically fun to hang out with. I am also convinced he would like me and my friends. Oddly enough, as I write about him there is a commercial for the Foo Fighters to be on The Today Show. Funny, because watching The Today Show is what prompted this post. 

This is one of my favorite movies EVER! I love a good coming of age story.

Remember that scene from Almost Famous where Billy Crudup hangs out with some good Topeka people? That may be one of my favorite fantasies. Come on! Who wouldn’t want their favorite star to come hang out with them at a party full of their friends? Perhaps minus the acid trip.

Doesn’t she look like a fun person? I love how she presents herself and I am pretty sure we would have a great time.

Perhaps my biggest fan crush is still Sandra Bullock. I am CONVINCED she would love to hang out with me and my friends. I love the people who seem real. Yes, I am very aware they are just normal people. That is the point. So am I! We already have something in common.  This all started this morning as I was watching the rerun of The Today Show and Jenna Bush Hager was choosing with Hoda Kotb. She looked so cute in her yellow dress, and she seems so down to earth and fun. I found myself wishing I could be her friend. The first thing I would tell her is how adorable that dress was.

This image released by NBC shows Jenna Bush Hager on NBC News'
Obviously not this dress. However, still adorable. She comes across so friendly and open on air. I love watching her. I am still sure we could be friends. LOL

Now, I have real friends. Lots of them. I also have a whole tribe of new friends who I get to go on adventures with. So, why do I judge people on whether or not I think they would make a good friend? It is a good yard stick. So, what makes a good friend?

  1. Honesty paired with kindness. If I look terrible in something, tell me! It is highly probable I did not realize how off I was that day. However, if I am excited about whatever outfit, hairstyle, or makeup technique I have tried, please be kind. You may gently redirect me if I am way off, but don’t humiliate me. I am sensitive.
  2. Always up for a laugh or a cry. You have to be willing to be with your friends in good times and hard times. If you bail as soon as the good times are over, you pretty much suck.
  3. You like me for me. I am quirky at best. Some people enjoy my quirks. Others, not so much. It is okay if we don’t necessarily gel, but don’t pretend we do.
  4. You forgive mistakes. I am not perfect. I make lots of social mistakes. I am not comfortable in many situations. This is getting better, however I still need lots of reassurance and advice. I want to fit in and have a good time. Help a girl out.
  5. You enjoy getting my random selfies from time to time. Yep. I am a selfie girl. This is new for me. I went years avoiding the camera because I felt fat. I finally realized it is fun to take silly, not always flattering pics of myself. I share them with you to make you laugh. Or just to be funny. LAUGH! That’s the point. I am not shallow I think these selfies mean anything. It has become funny. The middle-aged chick taking selfies like a teenager. Jump in the selfie with me. It is fun.
See? It’s all about having fun. Not taking everything so seriously. Friends are fun!

I spent years feeling awkward and just not fitting in. Then, I learned to just be myself. I have nothing to prove and I am a lot nicer when I am comfortable being me. It helps that I have surrounded myself with people who enjoy my company and laugh when I am being funny. They also laugh at times when I am not trying to be funny… oh well, you can’t win them all. 

Well, you gotta mix the selfies up.
One of my favorite pics of all time There is a video that was accidentally shot first. We were having such a good time.
Yes, it is completely appropriate to force the waiter into out selfie shenanigans. Don’t worry, we tip well.
Processed with Moldiv
It is all about having a good time. You can be there in the not so good times, but in the end- we are having fun.
You know, Angela has been making me take pics for years. She may be the first person who insisted on chronically our adventures with a camera. So, thank her or blame her. Man- Yet another time I was horribly sunburned.
Highly posed selfies are the best. You don’t actually think these funny moments just happen do you? Of course they do! Sometimes they are recreated for the camera… but where do you think we get the idea?
Obligatory group pic! The pretty lady in white was about to be a married woman.
Of course only one of us was ready for this photo…. This is part of the fun!
We are about to get Muddy!!!!
I wish Kristianne’s face wasn’t cut off… but, I think Angela and I look great! We were having such a good time.

Angela, my best friend probably deserves some recognition. She has been essentially a photo journalist for as long as I have known her. I used to make fun of her for always having a camera, however she deserves credit. She was the first person besides my family who made me get in the picture. I am so grateful for that. It has allowed me to have a lot of memories I could have lost without the record. One important point: not all selfies have to flattering and at just the right angle. We need to stop trying to hide all our imperfections. They are just part of us. The people who love us, love us with our imperfections. They are well aware of those occasional skin breakouts. They know all about that funny face we make when we are laughing genuinely. They love it. Stop trying to make everything so perfect. Our people love us exactly as we are. If they don’t, they are not our people. Nyki, what is your point? You are rambling and for some reason walking down memory lane posting random pics on your plea for famous people to come hang out with you. Well, the point is our friends are the people who we pick to become part of our lives. We share our true selves with them. You can never love too many people. You just have to let them in. It is a good idea to get lots of pics, you never know when you will want to reminisce and enjoy a meandering stroll through your adventures and shenanigans with your friends. PS. If anyone knows Sandra Bullock, Jenna Bush Hager, Dave Grohl, or Vince Vaughn please let them know they are more than welcome to come hang out with me and my friends. I promise plenty of selfie opportunities, and we may just have to take a trip to Target. Why Target? Because that is what we do.

The hardest extubation

Sometimes people go to a hospital, and we cannot save them.

That is one of the worst parts of my job. The toughest thing is when it is one of your people. This story is one that I have hesitated to write, but I think it is time. My biggest fear is that I will be unable to fully convey what this woman meant to me.

In May, 2011 I am graduating from graduate school. (Well, we were walking then, we still had a summer session of clinical work to do.) I have a great weekend. Angela comes from California, My friend Aneta, who I had not seen in years comes from New Mexico, and we all have a great time. Angela and I stay up all night after my party Saturday night talking. So, the next day after I take her to the airport I am in dire need of sleep.

I did not realize that I had never turned my phone ringer back on. When I woke up later that day, I have missed several missed calls and voicemail from my friend Stacy. She sounds confused and lethargic (encephalopathy sucks.) Then, the last two messages are the worst. Steve (her husband) and Christopher (her son that is a year younger than my son,) have left messages asking me where I am, and that there is something wrong with her. I call their house and get the answering machine. I figure that she is either okay, or that they have taken her to the hospital. I have to be at the hospital early on Monday for clinical time, so I jokingly tell myself, “Worst case scenario, she will be in my unit in the morning.”

The next morning, I walk into the unit, look at the patient assignment sheet, and there is the worst thing I can imagine. Stacy’s name. I am instantly pissed. What is this all about? I look at the monitors, she is stable, so I wait to go talk to her. I am confused and hurt. I do not understand what is going on.

We meet at the opposite end of the unit for rounds. We methodically go through the unit until we are at Stacy’s room. I stand back out of the group. I am not sure of what my place is here. Am I her friend? Am I a nurse? Am I a student? What the hell is my role?

Finally after rounds, I go in to talk to her. I ask her what on earth is going on. She says she did not take anything. She had been complaining of vague stomach pain for several weeks. Nothing too serious. Steve has brought her medicine, and there is the proper amount in the bottles. This was not an overdose or suicide attempt. Now, she is in liver failure. I feel guilty that I did not know that immediately. I just assumed the admitting diagnosis was accurate.

Unfortunately, there is not a lot to do for this. We consult specialists, and they come and offer their best advice. I am not aware of how sick she is. I tell the nurses to please call me if anything changes. I tell them that she is one of my best friends, and that she is like family to me. I go home, do some homework, and fall into bed exhausted. I leave my phone right next to bed, with the ringer on high.

The next morning, I walk into the unit and she is on a ventilator. Things have gotten so much worse. She was having seizures, and was not able to protect her airway. I am furious that no one called me. I cannot say anything for fear that I will make people mad. After all, I still work with these people. I spend a lot of time biting my tongue. Stacy’s friends and family are crowded into the waiting room. I am struggling to maintain a professional demeanor.

These people have known me since I was a (for lack of a better word,) troubled teenage punk. Now, I am updating them on the condition of our friend, My “Momma Stace.” I am confused and desperately hurting. At one point, I go into the break room and have a minor meltdown. This is one of the most stressful events of my life. I am terrified.

I go home and I am sick. I have rarely felt so helpless. That night I do not sleep. Finally, I give up and get dressed in jeans and a baseball cap. I go to the hospital. Every one is gathered outside her room. She is desperately unstable, she is no longer breathing over the ventilator. Her blood pressure is being supported with high doses of vasopressors (and still falling.) It is my worst nightmare. Once again, no one called me. I only got there by chance.

I am frantically trying to ascertain what is happening, and I am trying to wrap my brain around the situation. I knew this was a possibility. Fulminant liver failure is serious. There is not much you can do once the liver is that sick. She had every major organ system failing. We are losing her.

Now, Stacy had been my confidant many times. We had an understanding. She said she would never want to be in the situation that she was in. She would never want to be kept on machines if she was not going to survive. Her death is imminent. Her husband and her family are at her bedside. I have to be honest with them. I have to tell them that she is dying. It is hard enough to admit it to myself. I know she would want the tube out of throat before she dies.

Her husband asks me what happens now. I tell him that we can wait for her heart to stop, and start CPR, and do the horrendous code blue that has no chance of saving her. We can leave her on the ventilator, but make her a DNR- which means we will not do CPR. The last option, the one that I know Stacy prefers, is to stop the machines, and let her go naturally. This option is the scariest one to choose. It feels so final. It means that you are accepting the inevitability of losing your loved one.

After he and I talk in the quiet waiting room, I go back into the unit to stand guard. I feel responsible. I feel like if I loved her, I would do something to save her. There is absolutely nothing to do. We are doing everything, and she is still dying.

Steve tells me his decision. We have to call the physician, and get orders to change her code status, and remove the machines that she is hooked up to. I am reeling at this point. I want to run away and go home. I never want to step foot in this building again. I am seriously considering switching careers. When it is time to remove the tube, I go to head of the bed. Just like I have done so many times as a nurse. She is wearing sunglasses that we bought in the gift shop to hide the scleral edema  that comes with this kind of devastating illness. I do not take them off.

She is no longer here. She has no brain function. She has no reflexes. Her pupils are fixed and dilated. I am still so careful when I pull on the tape that secures her ET tube in her airway. I do not want to pull her hair, or rip her swollen skin. Once the tape is loose, I lean over and whisper in her ear. I am telling her goodbye, I love you, and I am so sorry I could not save you. Once the tubes are out, and I see that she is not going to breathe, I walk outside the door, and Jamie immediately hugs me and I start sobbing.

It does not take long for her heart to stop. She never takes a single breath and she was already hypoxic due to the ARDS that prevented us from oxygenating her. Once she is gone, someone hugs me and tells me that she is in a better place. I am incensed. No, she is not. THIS is the place she wants to be. She wants to be here for her son. She wants to be here for her husband. She wants to be here for me. However, I say nothing. I go downstairs and sit on the curb. I am crushed. I do not know what to do.

One of my favorite cardiologists pulls up, and he knows that it must be bad. He knows her condition was grave,  because I had asked him questions earlier that day. He gives me a hug, and I am undone all over again. I tell him that I hate people, and that they are assholes. He just agrees with me, and offers that perhaps they are just trying to provide the only comfort they can.

After a while, I go back upstairs. Her family is gone. I walk into her room and shut the door. I sit beside her bed, and don’t move. I do not know how long I sit there. I am not leaving. I know what happens next. We prepare the body to go to the morgue. I hate that part. I will spare you the details.

I do not want any of this to happen to Stacy. So, I sit there. Finally, Tracy walks in and convinces me that it is time to go. She promises to take care of her. I finally go home. I take several days off that week, and stay home until after her funeral. Several of us spoke. I agonized over what to say, and if I had it to over again, I would do it better. My mother helped me arrange for flowers, and I had a ribbon placed on it that said, “My Friend.” She was MY friend. I was bereft and inconsolable. My life had a huge gaping hole. I did not think I would ever feel joy again.

I have struggled with this situation for years. I have read about liver failure and I have experienced regret and sadness. I have grieved for my dear friend a lot. Whenever I have a patient with this condition, I feel sick to my stomach, and I am bombarded by the grief all over again.

You see, Stacy was a very important person in my life. She had been a high school english teacher, and she was helping me get through some of the books that I had missed by not finishing high school. She would discuss them with me, and she helped me process what it was that made the book “important.” She and I had been close for many years. She and Debbie were two of the small number of friends that I had to come to my baby shower. She was very much a mentor, and a confidant. She had seen me grow from an obstinate, rebellious teenager into a responsible (mostly) professional.

She was one of my closest friends. We talked almost every single day. She was the one person I wanted to talk to about my grief and she was gone. I was also hurt that my coworkers had not called me when she started to do worse. They had promised me that they would, and I felt betrayed. It took me a long time to forgive them. Her friends and family assumed that I had been called.

I finally realized that the nurses were busy trying to take care of her. I had no justifiable reason to be angry. So, I forgave them.

To this day, I still tremble a little when I am removing the tape that is securing someone’s life support. My heart races, and I have to take a deep breath and banish the thoughts of that night. I have to focus on the task at hand, and not allow it to be about my grief. That is my responsibility, and it is the best way I can honor her memory.

Writing is the other way I pay homage to Stacy. I imagine that she would have been one of my biggest supporters, and likely would have been willing to offer grammar advice and maybe even some editing. She invested a lot of time and effort in my growth with language. She listened to me prattle on and on about whatever paper I was writing. She wanted me to succeed.

It took a while, but I think it is getting better. I am no longer a student, and I work in the same unit I worked in when she was my patient. Stacy would not have wanted me to give up on my dream of this position. She would have wanted me to be every thing I ever dreamed of and more. I owe it to our friendship to be the best person I can.

I have managed to find joy. I am very happy in my life. There are so many things that I still get excited about. I love a great many people, and I have a group of wonderful friends. I have a family that loves and supports me unconditionally. I have a job that I love. I am learning to write, and I am obsessed with it. I love the process. I want to do more. I want to live my life to the fullest. I cannot allow myself to become bitter and unhappy just because I am sad that my friend died. That would be selfish.

This is one of the reasons that my profession is so difficult. We eventually run into a situation that is personal. One that we cannot escape. We know the course that these situations often take, and we are facing a helplessness that is brutally painful. It can cause you to question your worth. It can make you doubt your abilities. It takes effort, time, and patience to work through all those feelings.

If you are lucky, you find peace on the other side of grief, even if it is after the hardest extubation.