I’m losing count of the times I’ve sat on a plane with my heart pounding, wondering why I hadn’t just stayed at home and kept things status quo. I’m not even entirely sure how this happened – the result of an impromptu phone interview for a job I didn’t remember applying for. I said yes to the interview just to see what the job was about, telling myself it didn’t matter, and still watched my heart rate skyrocket on my FitBit as they grilled me for an hour.

“Let’s say that in your community, each provider has a vehicle. There’s a clear policy that you cannot transport patients and families on these vehicles. Let’s say that a mom calls, concerned about her newborn. You make a home visit to find that the baby is much sicker than you anticipated and needs to be brought back urgently to the clinic. The mom tells you she has no way to take the baby there. How do you proceed?”
“Can I ask her family members to take the baby?”
“No one is able.”
“Can I reach out to all the neighbours to see if anyone has a vehicle and can help?”
“Everyone you can reach isn’t able to help.”
I pause. I have my answer, but I don’t think this is what they want to hear for a government job. Screw it, I think. Either they can take me exactly as I am, or not at all.

“I don’t love this option,” I say quietly, “but honestly, I would drive that baby back myself.”
“Yes! Excellent. Exactly what I wanted to hear. We have a lot of policies, and some of them contradict each other. Your patient’s safety is your priority, and you can always deal with the policies later.”
This is something I can get behind, but I almost ask her what other hard decisions I’ll have to make if she’s already leaving it at my discretion when I’ll have to break the rules.
Every time I’ve told someone that I’m going to work up North, the reactions have been similar. “Wow! How exciting. That’s going to be such a great learning experience! How are you feeling?”
“Uhh…pretty nervous.”
“Don’t be! You’ll be great! I want to hear all about it when you get back.”

I’ve been grateful for all of their faith in me, but it has never really eased the pit in my stomach. There’s an unspoken rule in emerg nursing that you’re supposed to take the fear and adrenaline that make most people panic in stride. When you hear your own blood pounding in your ears, you tune it out to listen to your patient’s heart beat, the stridor in their airway, the beep of the monitors. We’re better at talking about things after – what we could have done better, what we should try next time. But we almost never talk about the fear of our limitations in the moments before.

I’m afraid of a lot of things.
I’m afraid of the loneliness and desolation of working up North. I’m afraid of second-guessing myself about everything. I’m afraid that I’m a phony running around in shoes too big for me – that I’ve fooled everyone into believing I’m far smarter and more capable than I actually am. I’m afraid that I’m not actually equipped to do this. I’m afraid of all the unknowns.

But we don’t talk about this part. We push it aside and steady our hands as we throw in IVs, hook people up to monitors, press our stethoscopes to their chests. We pull up chairs for terrified family members and use our calm nurse voices. “I know this looks scary. This is what’s happening. This is what we’re going to do.”

We don’t tell them that sometimes, we’re scared too.
“Okay. Last question, we’re almost through. Let’s say that you’re experienced in your area of practice; you’re trusted and respected by your colleagues. But you come up here and find yourself completely overwhelmed. Everything is new and unfamiliar, and you’re exhausted. You’re trying your best, but you feel your new colleagues are unnecessarily hard on you. You have no friends or family here to turn to. How do you cope?”

I tell her the story of being a student in the ER. It wasn’t so long ago that I stood in our ambulatory zone, staring out at a sea of 40 patients in the waiting room. There was a massive stack of orders to be done, but I didn’t know how to do anything without asking for help and slowing everyone down.
You’re completely useless, I remember thinking to myself. You’re never going to earn your place here.

“But that feeling passed one day,” I tell her. “Even though for a long time, it felt like it never would.”
“And I write,” I add. “I write to make sense of things. I write to cope.”
“Good,” she says. “Remember those things.”
I feel nauseous enough on planes, and my racing heart rate isn’t exactly helping. I take a few slow breaths.

If you can remember all the reasons you were afraid to do this, I tell myself, certainly you can remember why you still decided to come.

Because I have so much to learn. Because I need to hone my skills where there aren’t other people or machines to rely on. Because I was privileged enough to be born into a safe, easy, comfortable life, and I promised I’d use it to do something for the people who weren’t.

I feel a little better as I finish this litany and put my tray table up. I take one more look at the guy in 21G who has looked a little pale and sweaty since we boarded, and then tell the triage nurse in me to please shut up. One thing at a time. Two more flights after this before I get to my destination, and I have no idea what to expect when I do.

Here we go.


  1. You wrote this on the plane? For someone who gets nauseous on planes, that's incredible. I can barely manage to get through a movie without my body shutting down!


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