Warm Beer and Grimy Chacos

I’m seated inside the Toamasina port drinking a lukewarm beer that cost less than $1, staring at striped fish in transparent waters beneath my feet. The quiet moment invites contemplation; thoughts swarm my mind, tugging about, and I continue to stare.

My gaze focuses on my sandals–Chacos, to be exact. They’re great, aren’t they? If you’re from the United States, you’re probably nodding your head. If you’re from Michigan, it’s likely that the word “Chacos” itself causes you to salivate.

Most Chaco owners invested in the sandals because they are particularly nifty for walking, traveling, hiking, and water activities. They are sturdy and dry easily. I don’t typically wear mine to work or to run errands (clarification: they’re so comfortable that I want to wear them everywhere. Sometimes I do wear them to the grocery store). But more often than not, if I don my Chacos I’m probably headed for something slightly out of the ordinary. These sandals are, inevitably, tied to fond memories. And weird tanlines.

Right now I am especially grateful for footwear that has accompanied me around the globe, across and through nine countries and many more to come. I am astounded that slabs of brilliantly-shaped rubber could last for many years and graze a variety of terrains.

If I didn’t clean my Chacos they would smell like bus floors, rotten soil, stale sweat, and animal shit. The cleansing and refitting of these sandals, my favorite job, is 100% necessary in order to keep using them.

But you know what? I swear that as soon as I clean them, they dirty again.

Alas, my fondness for the footwear urges me to scrub again and again. I’m happy to do it because they are worth investing in. If I take care of them they can endure many years (that’s what my parents always taught me about owning quality items. I didn’t actually start listening to this advice until I turned 24).

I take another sip of beer, glance at my feet, and pause.

I’m basically a dirty Chaco sandal.

Come again?

I think God treats me like a Chaco sandal.

That seems a bit odd, but the analogy holds truth. God leads me on journeys I would never tread if I were alone. When he (or she?) cleanses me, a lazy scratch at the surface doesn’t suffice. A deep clean, often with some sort of uncomfortable, wiry brush, is necessary to release and rid the grime.

Because I am human, I also will “dirty” again, but the best thing about love is that it never ceases. God’s love for me is unending and given generously. He will never give up on me even though I mess up repeatedly. In fact, I will probably screw up before I finish writing this. I’ll probably drink way too much beer (just kidding, it’s too warm for that. I also don’t think God would be upset with me–he probably has far more to worry about than my beer consumption in Madagascar). Regardless, it won’t be long before I do something stupid or hurt someone.

The whole point of Jesus’ teachings, I think, is to never give up and always persevere. God didn’t give up on me and if I claim to follow Christ, I also cannot give up on God’s promises. He promises in the Bible to fight for me, redeem me, give me hope and a life that never ends.

Damn.

So don’t give up! Even if a person or situation feels dirty, hopeless, or useless. Refuse to give up on your marriage, your children, each other, or yourself.

If you do, come to Madagascar, sit by the Indian waters and drink a lukewarm beer. I promise that you will gain the strength to continue. I might even feel inspired to buy you your own Chacos*, if that’s what it would take to prove my point.

Cheers!

*let’s discuss this offer after I start earning an income again

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Have Yourself A Merry Little Pity Party

Yesterday marked my first Christmas away from home, in a warm climate, and aboard a ship. Rough life, huh? In all sincerity, I wasn’t particularly excited to celebrate this year. Since I arrived on the Africa Mercy five weeks ago I have battled a severe case of “scrambled egg brain.” This self-diagnosis reflects the ever-changing emotions and tired, mushy state of mind I now possess. Anyway, Christmas:

At 0640 an abrupt alarm unkindly reminded me I had to work. After a mostly sleepless night, I rolled out of bed with a scowl on my heart.

I arrived on the ward and took report from the night shift nurse. As I planned out my shift I grew more and more annoyed. Every task and assessment felt unnecessary and too involved. I convinced myself that the job requirements today were too taxing because it was Christmas. I sat down anyway and created my schedule.

My co-workers and I soon discovered a slight problem. Three of the nursing staff wanted to eat brunch at 1130 but only two could attend. We had signed up for time slots with our friends. I planned to meet three close friends and eat our Christmas meal together.

Guess who drew the short straw.

In addition to the morning excitement, I’d get to eat my holiday meal alone. It was only 0737 and I was already fighting back tears. Every muscle in my body wanted to fight the injustice. I felt sorry for my poor self.

I’m away from home. I’m tired. I have to work on Christmas. I can’t eat brunch with my friends. I have to measure urine and clean vaginas and take care of a diabetic and convince a child to exercise and…

Thankfully, these depressing thoughts prompted me to take a break early. I walked to the cafe to collect a coffee and croissant. My already sad heart almost broke when I saw the length of the line. I didn’t have to check my watch to calculate I would not have enough time to even place an order.

I asked an acquaintance if I could jump ahead. Almost immediately I was at the front. My friend, Krystal (also the holiday barista), asked me what I wanted.

“Uh, something peppermint?” I muttered.

The man in line ahead of me turned to face me. I had met him before. The spunky Aussie was the principal of the school. He spoke.

“Oh, dont worry, yours is already being made then! There, set your mug down.”

“What?” Confusion contorted my face into a funny expression.

“My wife and I had another drink made to give away. It’s peppermint and coffee. You take it! It’s for you. On us. Merry Christmas!”

I smiled, thanked him, took the coffee and sat down at a nearby table. I knew the coffee was cheap, if not free today. Why was I so touched by his kindness?

I returned to work feeling slightly more grateful. I smiled at my patients. I provided better care. I began to see all the blessings that followed in the day.

This Christmas I am thankful for different things. I appreciate the British stranger who served as a delightful brunch companion. I am thankful for the fellow Midwesterner who stopped by the ward on her Christmas to bring me delicious coffee. For the first time in a month I tasted coffee so smooth that I could drink it black. I will never forget the sweet, motherly pharmacist who spoiled me with a back massage after I told her I missed my touchy family. I am thankful for the drizzly evening weather and a close friend who sang beneath the moon with me.

It’s amazing, you know, just how much simple kindness can change your perspective. Open your eyes. Reset your mind. The feeling that comes from knowing someone is taking care of you can gently force you to start thinking of someone other than yourself.

I think God’s love works in me quite the same way. After I have spent time praying and praising in whatever form (singing, writing, taking a quiet walk) my heart transforms, shifting my gaze. The Lord’s peace, grace, and mercy cleanse my mind. They remind me of my responsibility to look after others.

What would have happened without that peppermint coffee? Sure, things could have turned around. But it would have taken longer. My endangered spirit would have stayed tucked beneath self pity, lying to people, “I’m good. I’m okay.” All for the sake of preserving a stupid sorry-for-myself attitude.

I hope this resonates with you somehow. If not, learn from my mess. Do something kind for a stranger. Pause. Share a little love. You never know what could follow.

Left: the lovely Fifaliana, who rocked her exercises on Christmas

Right: two patients from our ortho program ambulate with candy cane assistive devices

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Don’t Envy Me

I left Grand Rapids in a whirlwind and didn’t get a chance to tell loved ones my thoughts. Or perhaps I just hadn’t yet articulated my goodbyes. Either way, during my 13 hour flight across the Atlantic I finally had time to process–shortly after the middle-aged Ethiopian passenger convinced me (quite easily) to ask the flight attendant for wine, and sometime before I fell into REM sleep.

I’m extending a ginormous THANK YOU to everyone who went out of their way to see me and/or bid farewell. I couldn’t see all of you but I so appreciate the thought behind your efforts. For those who I did have the opportunity to see, I carry those heartfelt and intermittently tearful conversations with me.

The final, face-to-face (because I’m certainly not dead) conversations were decorated with various words, but almost all contained the same one: “Have so much fun on your adventure!” I felt a little guilty when I heard this over and over again. I felt like a real life quitter who decided to pursue my generation’s chronic  disease known as wanderlust. But, really, I think I felt guilty because you are absolutely right: my seven month journey through Africa is, undoubtedly, an adventure.

But why are these seven months, specifically, an adventure? Because I’m in Africa? I think it has to be more than that. For the Malagasy people “going to Africa” might not be an adventure, and I know plenty of folks who live adventurously without stepping across a foreign border.

These months are an adventure because I chose risk.  I quit my job and willingly entered the unknown. I am surrounded by new faces, smells, sights, and sounds. I got electrocuted by a shower faucet. I have to reconnect to wifi at least a dozen times just to have a short conversation with a friend. I didn’t pack enough underwear (Kelsey, I should’ve listened to you). All of these mishaps are what construct said adventure.

You, also, have the capability to live adventurously. Maybe you’ve hesitated to spend money on that seemingly irresponsible vacation. Go now. Maybe you’ve thought about accepting the new job offer but you’re afraid you will like it less than what you have now. Dare to hope a little! Perhaps you’ve always wanted to talk with the teary-eyed woman you see at mass every week. Why not ask her how she’s feeling? Why not treat the homeless man to pizza instead of walking away with a full pocket and a guilty heart? Why not visit the local restaurant even if it’s not as cheap as Applebees after 9 pm? Why not ask that girl out? For crying out loud, WEAR the purple lipstick you bought months ago and stop worrying what people will think.

Adventure is all around you. You just need to choose it.

On a related note, I want to share that my days leading up to my depature were exhausting and challenging. I experienced every emotion and feeling possible during the last two weeks: pain, loss, heartache, fear, anger, joy, surprise, love, disgust, fatigue, excitement. I left like a hurricane and secretly expected that all the kinks would even out once my chacos greeted new soil. That hasn’t exactly been the case.

I’m struggling to be fully present here because I am still so connected to home. But I think it’s okay to have this struggle, and I don’t think it’ll go away anytime soon because these connections (people, really) are incredibly meaningful to me.

I miss my roommates. I miss Bekah’s word puns, Brittney’s palpable energy, Sarah’s laugh, and Christina’s passion for Chuck. I miss hospital banter with Ashley and Andrea and encountering those ridiculous RAZ moms. I miss my brothers’ hugs, my parents’ advice, and my sister’s sense of humor. I miss my pastor’s quirky sermons and the rowdy priest from mass at St. Andrews. I miss long happy hours and late night conversations and spontaneous salsa dancing lessons and Paddy’s irish accent when he reads out loud.

AND IT’S ONLY BEEN FOUR DAYS. Good things are to come, but not without sacrifice.

That’s what I ask you to remember. You can wish me well on my adventure but ONLY if you promise to see your own potential for adventure, right where you are. Sacrifice some comfort for the unknown. Start small and see where you end up. And, of course, tell me all about it!

Cheers to YOU! I love you all.
P.S. I realize that I used the word “adventure” a million times in this post, and I actually thought about using my friend, the thesaurus, to mix it up. But I thought it’d be better to use it as many times as I heard it before I left!

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I Would Never Do That

“Alright, it’s time!”

No. I close my eyes, pretending to sleep.

“Come on, Kayla, you have to come.” My co-worker, Kim, bounces eagerly, her shoes spitting sand on my face. She knows I’m awake.

I sit up, arms crossed with tension. “If you pressure me then I definitely won’t go. I have to decide on my own terms.”

“Ok, then, just come along and we’ll just…look.”

Kim, my roommate Christina, and I ascend the jagged rock behind my little brother, Jaron, who is leading the way. My skin has already transformed into a bizarre looking layer of bumpy raw chicken. “Guys,” I try one last time. “I’m already freezing cold and I’m DRY right now. I don’t want to jump in the water…” They ignore my dramatic monologue and we continue climbing.

The sun’s warmth is the day’s only redeeming factor. Unfortunately, the trek to the designated point is completely shaded, and the physical discomfort I feel intensifies the emotional dread I’m battling. My eyes widen in awe as we approach the cliff. I can’t move my gaze from the majestic beauty of Michigan’s Pictured Rocks lakeshore. The water is aquamarine and as clear as a glass of water. Powerful swells of Lake Superior assault the rocky peninsula beneath our feet. I shiver.

Jaron stands near the edge, pauses momentarily, and then jumps. I count at least three full seconds before I hear a splash. A moment later he emerges over 40 feet below, grinning at us from icy waters. He sports a stupid grin across his face, waving frantically for a follower. “Come on! IT’S AWESOME!”

Kim and Christina look at Jaron, glance at the shore, and then at each other. It’s clear they’re less concerned about the jump itself and more worried about the hazardous swim to safety. All I can think is that my little brother currently has one up on me.

I walk briskly to the edge, realizing that I don’t actually have a choice. My competitive nature and thirst for adventure win out. Behind me the girls are talking to each other, shocked that I’m even considering the plunge.

I blink. My mind and feet betray me. I jump. Behind me Kim is yelling, “STAY STRAIGHT,” but there’s only one thought on my mind that I can actually vocalize: “Shhhhhhhiiiiiiiiiittttttttttt!!!!!”

Three seconds later someone punches me in the face. Or did I just transform into a sock inside of a washing machine? Hard to say. I try to swim as waves argue with each other, pushing and pulling me in opposite directions. I sputter toward the surface.

Little relief comes after I inhale fresh air. I’m certain an old, fat woman is churning these waters around me, cackling, while I (a small particle of cream) fight desperately to remain afloat. I’m mostly upset that my boobs, which represent 90% of my body fat, aren’t helping me AT ALL. Good for nothin’. I guess I’ll have to use my arms and legs. 

The journey back to shore is both treacherous and tiring. Thankfully, my brother is a strong enough swimmer to support himself and act as my personal lifeguard. I love him for it–but let’s be real: I would’ve loved (even more) to receive first aid and mouth-to-mouth from a shirtless and muscled Coast Guard rescuer. Maybe next time. Right now all I want is food, warmth, and bed.

Several hours later, thanks to northern pasties and subpar coffee, I am thawed from the inside out. The four of us depart the flannel-filled establishment in search of a nearby campsite. No luck. Instead, we decide to make use of our time and drive to St. Ignace, which is over two hours away.

Jaron is navigating us through the darkened world. I peek at the stars, thankful to retreat to reflection. I can’t help but relish the delight of my cliff jump. Yes, it sucked, but I’m so glad I did it. I laugh, thinking of how I initially resisted the idea. Why was I so opposed? More importantly, what inside of me changed at the cliff’s edge? Why did I do it?

I suppose I was opposed because I didn’t consider that other factors (such as competition and adrenaline) would outweigh my fears. I realized at the moment, watching my brother below, that I could handle twenty minutes of bone chilling cold to achieve the satisfaction of a new experience. But those are influences I never considered until I was at the point of decision.

I’m starting to think that this happens more often than I realize. I ponder an opportunity or path and conclude, I would never do that. Or more often, I could never do that. When I finally come to the moment of decision, BAM. I’ve decided to do exactly what I had previously deemed improbable. 

I remember feeling deeply discouraged when I received my midterm grade during my first year of nursing school. Just before that term had started I told my parents that I was going to quit nursing school and move abroad to work with YWAM (Youth With A Mission). They laughed and responded, “no” (I wasn’t laughing). I began my pediatric rotation and suffered through the courses, receiving my worst grade in all of nursing school that term. What did I tell myself, looking at my scores? It doesn’t matter. I would never work with kids anyway.

Three years later I applied for a job at a children’s hospital. When the HR representative called me and offered the position, I still had hesitations even though I had sought them out. I was confused because I had always told myself I would never… But guess what: I did, and I’m so glad I did. 

A few years ago I considered (for a hot second) making a commitment to being single, but the thought actually made me nauseous. Several friends did this during college and all reported good things, saying they pursued healthy friendships, learned about themselves, and invested time in their faith. I, however, abhorred the idea of relinquishing control. I could never do that. What if I meet an awesome guy? Woof. So I said no and concluded I never would. 

Late this summer I sat at Reeds Lake, feeling an unusual craving, almost a burden, to pursue romance. I’ve been single for the last year and a half so this newfound pressure felt unnecessary. Deep down I knew that I didn’t want to start anything before moving to Africa in November. I also don’t want to pour my energy into a relationship while I’m working with Mercy Ships. Frankly, the timing just seemed right and I felt peaceful about it. So I’ve decided that I’ll stay single until I return from my worldwide endeavors–and this time around I haven’t felt nauseous.

Cheers to saying you’ll never do something and then doing it!

   

    
   
 
[yes, I did wear the same outfit for four days. You can see the photos were taken on different days by subtle changes in headband positioning.]

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From Michigan to Madagascar

“That sounds so cool. You should totally do it,” I affirmed, cupping my steamy, tea-filled mug.

Kelsey, my dear friend and college comrade, smiled. “You should think about doing it with me.”

I inhaled earl grey steam and pondered. “Mercy Ships? Nah. I’ll do my own thing.” I withheld my genuine reason for declining. Truthfully, my heart yearned to work overseas but I wasn’t interested in volunteering and raising money. I was already paying twice the required monthly payment on my student loans. Even though I tried (so hard) to sweet talk the Chase Bank man during our chats, I was certain those loans weren’t going anywhere. It seemed silly to ask for money when I still owed the bank thousands.

Yet it wasn’t absurd for Kelsey to ask me to join her. For over a decade I have felt a stirring as a living idea grew within me. In college I studied nursing and Spanish and traveled as often as I could: I taught English in Nicaragua, climbed Mayan ruins in Mexico, worked on farms in Cambodia, and visited Buddhist temples in Thailand. I’ve visited Costa Rica, Guatemala, Belize, the Dominican Republic, Hungary, Poland, France, and the UK. Oh, and let’s not forget our friendly neighbor, Canada. All of these excursions have fueled my passion for working overseas.

After college I pursued my international dream by applying for jobs in Honduras, the Dominican Republic, and Abu Dhabi. None of these came to fruition. Frustrated and discouraged, I harbored bitterness toward God, convinced that I was never going abroad again. I felt trapped in Grand Rapids, but the truth is that I was being unbelievably dramatic and, more importantly, I was actually trapped in my own self-pity and limiting stipulation for working abroad: I still refused to consider volunteer work.

I remember the moment my perspective changed. Six months ago I accompanied a group of Calvin nursing students on a trip to Belize. I recall one morning walk along a dirt road in the western mountains. I had arisen early that morning, grabbed my Bible and notebook, threw on a pair of sandals and tiptoed out the door while my roommates slumbered steadfastly. I headed for the hills before the coffee was brewing.

I’m not sure when the thought came to me. Maybe it happened when the sun illuminated the landscape; or perhaps it was the prior day’s memory of patients at the rural clinic, but a quiet, firm thought whispered, you love being abroad. You love it enough that you can ask people to help you come back.

I couldn’t disagree with this notion. I love international travel because the world wakens me. All five senses are heightened when I’m abroad: I inhale fresh scents and odd smells; I hear sounds of languages and the buzz of traffic; I perceive different faces and rugged landscapes; I taste new cuisine and flavors; I feel harsh climates against my skin. These awarenesses make me feel alive.

After that morning walk in Belize the window to volunteer work opened so I could no longer invent a reason to say no to Mercy Ships. I called Kelsey and asked her to meet with me again.

We sat in a different coffee shop. I told her about my recent Central American experiences and then braced myself to reveal the good news.

“I’m going to apply to Mercy Ships. I think I can raise the money and it’d be ideal to go together.”

She grinned. “Yes!”

I headed for home and filled out the application before I could talk myself out of it.

One week later I logged into my email account and read:

Possible Dates of Service in Madagascar

I blinked, anticipating that the message would change. It didn’t. I read that Mercy Ships had an assignment for me. From November 22, 2015 to May 14, 2016 I would be aboard the Africa Mercy, which is currently anchored in the Indian Ocean off the coast of northeast Madagascar. The position they offered is on a pediatric ward where I’d take care of children after they’re released from surgery.

I didn’t waste any time. Of course I wanted to go! But concerns drowned my mind: Kelsey? Housing until November? Loans?

The Lord addressed all of these concerns within a few days. Unfortunately, I’m gifted at crafting countless worries so I’ve already thought of a thousand more. I’m asking for prayer that I am organized and diligent. I need at least one friend to pray specifically that I don’t lose my passport. I’m asking another to pray I receive my immunizations and don’t contract malaria. Maybe two or three could pray lemurs do not attack me. If these don’t interest you there is another way you can help me.

I’m requesting that some contribute financially to help me raise $7,000. If you’re willing I would deeply appreciate donations to either my Mercy Ships account or to my personal volunteer account. If you donate to Mercy Ships (http://mercyships-us.donorpages.com/crewmates/KaylaInnis/) you’d pay for things like housing and travel costs (and receive a tax deduction). If you donate to my personal account you’d supply me with essentials like deodorant and coffee, which would be an answer to ALL the volunteers’ prayers.

I’m determined to make it to Madagascar but I can’t do this alone. I don’t want to do this alone. So let’s chat. I have much more to tell you!

Peace & Blessings,

          Kayla

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photo credit: Hannah Innis

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Coffee with a Dollop of Yogurt

“Good morning, honey.”

I glance up from my journal and exchange a greeting with my dad. He silently settles into the wicker chair to my left as we listen to the salty waves tumble over the sand. At nine o’clock in the morning Costa Rica already cultivates heavy morning air, which clings and sticks and drowns the pores. Despite the heat, my father and I routinely enjoy our morning cups of coffee. I sip my third cup when a strange sight catches my vision.

“What’s wrong with your cream? Is it spoiled?”

Hearing the confusion in my voice, my dad smirks and dunks a spoon in his glass mug, whirling the mixture around and around. The chunky cream remains distilled.

“Oh, it’s not cream. It’s yogurt.”

What.

“You put yogurt in your coffee?”

“Mhm,” he says with a light in his eyes, and slurps the concoction. “It’s milk-based, so it’s basically the same thing as cream.”

Now you’ve met my father. His name is Jim.

I was thirteen when my dad was in a life-altering car accident, which resulted in a traumatic brain injury. I have few fragments of memories before the accident in 2003 which include him singing me to sleep or frequently holding a litter of puppies in his arms (he’s a Veterinarian). Oh, and one other memory.

A few months ago I blogged about what it was like to grow up with four brothers. In short, I chronically strove to be part of the group and begged to be invited to anything and everything that the boys were doing. Once, my brother Steve and our neighbor Garrett were playing a game that consisted of swinging punches to injure each other’s groins. They were laughing hysterically so (naturally) I asked to join.

“You can’t play! You’re a girl.”

“That’s not fair!” I screamed (not) dramatically, as I stormed away in a cloud of malice and frustration.

Hours later, my dad came home from work, walked through the door and shouted, “I’m home!” as I simultaneously jumped out from behind the wall and punched him right between the legs. HA. See, guys! I can too play!

My six-year-old victory was short-lived as my father bent in half in a pleading grimace. I didn’t understand why he wasn’t laughing; I just knew something was wrong—so I bolted.

An hour later he coaxed me out from behind the sofa. I could tell from his tone that he had already forgiven me. Still, he took the opportunity to educate me on the anatomical differences between boys and girls, and since then I haven’t attempted to play this particular game a second time.

Besides these few memories I don’t actually remember much about my father before the car accident, but I do know that he lost a little bit of discernment. Lack of discretion produced an attitude in him that wasn’t concerned with how others viewed him along with a whole new level of weird.

The great thing about Jim is that he has no qualms about discussing topics that aren’t typically acceptable in society. For example, he’ll initiate a conversation with a new acquaintance about lactose’s effects on one’s intestines, or warn my friends about hot-tubbing during menstruation (as if he knows anything about menstruation. ALL WE WANT IS A HOTTUB, DAD. AND WINE).

Whether my dad is spaying a cat for a science class, asking my friends for their urine for his garden, or mixing us gin & tonics, he’s consistently sporting a smile and a twinkle in his eye. I appreciate his willingness to be laughed at, his eagerness to be weird, and his desire to attempt new endeavors.

It’s important to add that people unanimously agree I inherited my weirdness from my dad. And I don’t have a brain injury—so what exactly does that say about me?

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Why You Shouldn’t Triage Your Date

“Welcome to the Emergency Department. What brings you in tonight?”

“I’m having chest pain.”

(I now initiate eye contact and pay more attention)

“Okay. [typing noises] When did it start?”

“Five days ago.”

(less concerned now)

“Does it hurt more when you breathe or cough?”

“Yea. It hurts the worst when I cough.”

Bingo. You can wait.

I motion the patient to sit at a nearby chair and continue with the next person in line. The whole purpose of triaging is to decide who needs to go back to a room immediately and who can acquaint themselves with the waiting room. Survival of the fittest applies to many situations in life, but the ER is not one of them. If you’re the most fit you will wait longer.

The word “triage” came to us from France. It means “to separate out.” This is a wise idea to implement in the healthcare setting, right? Large volumes of patients requires a steadfast system to organize such chaos. As a triage nurse gains experiences, he/she learns to ask specific questions and listen for key words.

By working as a pediatric emergency nurse I have learned quite a bit about triaging children, and it’s actually remarkably different from triaging adults. For example, a fever of 103 F and a fast heart rate in a happy, pink-cheeked 9 month old isn’t really concerning to me. However, adults don’t have fevers as often and they’re generally less healthy than children, so my ears would perk up and ask for more details of an adult patient with the same symptoms.

There are multiple factors that contribute to a child’s triage, but there are three that I have learned are most important. First, how does the child appear? Is he acting normally for his developmental age? Is he sleeping? Screaming? When provoked, does the child react? Next, I look at the breathing pattern. Is this toddler breathing really quickly or irregularly? Do I see any ribs or abdominal muscle use? Nasal flaring? Lastly, I check the circulation to skin. Is the capillary refill on her fingernails < 2 seconds? Are her lips and skin pink? Dry? Flushed?

All of this happens with a glance, a lift of the shirt, and a tap to the nailbed. Within seconds a nurse can categorize a child as “sick” or “not sick.” (“not sick” indicates that they can wait, not necessarily that they’re totally healthy–although sometimes they are, and the parents are just nervous). In addition to “sick or “not sick” the nurse assigns an acuity (basically, a number 1 through 5) that communicates how delicate the patient’s condition is. I won’t bore you by explaining each number but the point is that a “priority 1” means someone is actively dying and needs intervention immediately, whereas a “priority 5” means that no resources will be used during this patient’s stay and he/she is completely stable–usually if they’re only being seen for a prescription refill or suture removal. (Yes, people come to the Emergency Department for these reasons.)

Unfortunately, my triage mindset has leaked out into my personal life, and I now do this with men.

Yup, it’s true: I triage my dates.

I didn’t try to, and I didn’t realize I was doing this until recently. The fact is that I just like to know my disposition towards a guy I’m dating. Basically, instead of sick/not sick I want to know like/dislike. There’s no in between. Obviously, I don’t use the same assessment criteria, although there have been times when I’ve wanted to lift up a shirt to “check breathing.” (Kidding…kind of? Can you blame me?)

So what assessment criteria do I use to triage my dates? I’m glad you asked. Again, three come to mind. First, I want to know about his faith. Does he have a personal relationship with Jesus? Is he actively pursuing his faith? Does he seek to be challenged? Second, I want to discover his sense of humor, and I really want to know if he thinks I’m funny. This is crucial. I think I’m hilarious…I want him to think so, too. Does he appreciate sarcasm? Puns? Can he be goofy? The last category is travel, and it’s just as important as humor. Does he care about the world? Does he think that all the adventure lies in a suburban house (boring) or in a hostel in Brazil? Does he respect people who are different and believe there’s something to be learned from them?

As you can see, my triage process for men is way more involved than it is for my patients. I know it’s not fair and I shouldn’t do it. Here’s the big difference: ER triage is based on appearance, while my personal triage is based on qualities and attributes–information you can’t gather sitting across from someone at a nice dinner, especially if it’s the first time you’ve met! Obviously, these things take time, but I put pressure on myself to assign an acuity to each man I date. I don’t want to waste time or end up feeling apathetic about someone while I wait for interest to accrue.

*Sigh*

Do you see my challenge? Maybe I need to leave the ER so I’m not constantly triaging the people around me. Who knows, maybe that priority 5 will suddenly become a priority 1 in the midst of my assessment.

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