I’ve gone to visit children in the hospital several times throughout my life. Sometimes it was a happy occasion, such as the birth of a new baby. Other times, it’s been serious, such as a critically ill friend or sibling.
In some cases, I could have chosen not to go, but as a young kid myself, I didn’t always have that choice. But I think the exposure was good for me. It was happening, whether I saw it with my own two eyes or not. And dealing with it head on made it possible to handle tough situations in the future.
But it’s one thing to visit someone in the hospital. It’s another to be the one treating them hour by hour, whether it’s a parent staying by their side for days, months, or even years, the doctors struggling to come up with effective treatment options, or the nurses who work hard to maintain that treatment plan, field questions from concerned family members, and do the, sometimes literally, dirty work that maintaining that treatment involves.
Author David Metzger has shared what it’s like to be the caregiver of sick children and how that has shaped his role as a parent in his memoir, Nurse Papa. Below is my review of Nurse Papa along with an interview with Metzger about his work and his writing.
Nurse Papa book summary
Nurse Papa follows author David Metzger as he works by day as a pediatric oncology nurse taking care of sick and dying children and comes home to his wife and two healthy children at night. Throughout the book, Metzger reflects on this almost “double life” and how he balances the two both physically and emotionally. He tells stories of some of his most memorable patients, both those who got better and those who did not, how the families coped with the illness and outcome, and how it affected him as both a nurse and a person. Like all difficult jobs, his is both taxing and rewarding, full of highs and lows and teachable moments that accepts the unfairness of life and celebrates the happiness, silliness, and gratitude that it can bring along with the sorrow.
The format
Metzger organizes his chapters by theme rather than a linear overview of his career. Each theme describes a different aspect of pediatric nursing, from how to treat pain, to finding humor in devastating situations, to how to mourn the dead while still maintaining a sense of professionalism.
He utilizes stories of patients that he has treated to explain these philosophies and life lessons. These stories range from lighthearted to tear-jerking. Sometimes these situations can be hard to listen to let alone experience.
Each chapter starts with a quote from either a co-worker, parent, or former patient which ties into the theme of the chapter. These quotes offer advice, observations, and first-hand perspectives of childhood illness and how it overtakes not only the child’s life but the lives of everyone around them.
Some cope better than others. And Metzger shows that there is no one way to handle a situation well. It’s a personalized experience from which no guidelines or manual can be created in order to help the next set of families who will be coming in as old ones leave.
The narration
Metzger has a descriptive, flowery style of writing that surprised me for someone who works in the medical field where thoughts are often communicated with straight-forward, surface-level, sometimes emotionless clarity. He is remarkably reflective and philosophic in his recollections while still being clear and on track.
Metzger doesn’t simply retell the stories. He relives them with the added clarity of time that helps him to empathize with his patients and their families. He never loses touch with the fact that these children have been stripped of time, whether temporarily or permanently.
The unfairness of it is still prevalent, but it’s also unavoidable. So, they make do, forging relationships with his patients that allow them to open up to him about their fears and their questions. He listens as a friend rather than an authority figure, explaining that while he is exposed to illness and death everyday, he has never been the patient in the bed dealing with it. So, his advice is more guiding than instructive, helping the patient to deal with their individual situations on their own terms.
If he has any advice to disclose to his readers, Metzger harps on the idea of dignity. Dignity is a concept that we tend to relate to older patients, but it also applies just as strongly to children. From bathing their bodies after to death to helping their parents to accept their devastating situation in order to unburden their children from the fear of what will happen to their family after they die, the nurses play huge roles in helping their patients to get through the roughest patches of their journey, even if it is from the sidelines.
My recommendation
I recommend Nurse Papa to anyone who is fascinated by the medical field, particularly pediatric medicine, who can handle the tough stories that reside within its pages, and who want to find ways to get through their own present or future forms of suffering. You don’t have to have known a child with cancer or have been a family member sitting at a bedside in order to appreciate the content of this book.
You don’t have to be a nurse or a doctor or even a parent. These lessons transcend the sad situations that are presented, and they help readers to pull through tough times, to embrace the feelings that come with seeing these sad situations, and to accept their ultimate outcome.
An interview with David Metzger
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Your book isn’t just about what it’s like to be a nurse taking care of sick children but specifically how that relates to being a parent yourself. What inspired you to write a book about the parallels and contrasts between your work life and personal life?
It’s true. Nurse Papa is about so much more than my experiences at the bedside. At first, I was simply trying to capture the rarified happenings in these hospital rooms, but it soon became clear that this book could become so much more.
As these kids live and die, they have so much to teach us. As their parents join them in this often-harrowing journey, they too offer so much sage wisdom. I began to wonder if readers might be able to experience and benefit from these stories without actually experiencing the same happenings – the best of two worlds, really.
As this developed, it was impossible to separate my own experiences as a dad to two healthy kids and my role as a nurse to sick and dying kids. The two roles influence, intersect, and change each other constantly. That is truly the heart of Nurse Papa – the phenomena and rare gift of how deeply my parental mind and heart have been altered by nursing sick kids and vice versa.
When did you find time to write your book between working and parenting? How long did it take you from start to finish?
Well, for me, one of the true gifts of becoming a dad was learning how to do a lot in a very little amount of time. The experience of parenting, and nursing too, teaches great time management. I simply did the work when time allowed for it. Sometimes that meant sitting down to write for 10 minutes while my kids were occupied.
Finding the writing flow state has always been easy for me too. I am able to sit down and write. I don’t know what writer’s block feels like because I have very rarely experienced it. One reason for that is that I am always writing in my mind, prepping for the moment when I can sit down and get it in a Word doc. Nurse Papa took about four years to reach its formed completion. It was a huge commitment.
Each chapter deals with a different theme or observation when it comes to nursing. Did you write the book in order? How did you decide which stories to put in that fit with the theme of each chapter?
I did not write the book in order which you read it. I wish I had, but I was unable to approach it in that way. Because my book relied upon so much information outside of myself (interviews and stories from others), I was able to organize their stories into relevant themes, but so much of what started in the book ended up being cut in the process of editing and finding the important themes to focus on. Ultimately, the way the book is organized now – a meditation in each chapter – was a format which felt accessible for the reader. I think it ended up being successful in this way.
What input did your former patients’ parents and co-workers have in the construction of your book? Did you give anyone pages to read and critique while you were writing it? If so, what feedback did you receive?
Any person who gifted me their stories for this book were also given the opportunity to read and reflect on what I wrote, but most did not take that opportunity. It was too close for many of them.
A few people did read and offer opinions and critique, but most of my editing and criticism came from readers and editors not intimately connected to the hospital. It can be such an intense experience caring for kids and being on the other side of that as well. I think it was helpful for readers and editors to not have direct encounters with these happenings in order for them to provide useful and unbiased criticism.
If your story was adapted into a movie or series, what creative input would you like to have (casting, writing credit, serve as a producer, etc.) in producing it?
I am keenly interested in film and actually think that there is a very cinematic quality to many of the stories in this book. I would absolutely love to see Nurse Papa inspire a movie or series and I think it is possible. Of course, I would want to have a part in writing the script, but I also think I could serve as a nurse consultant. To this day, I have never seen a truly accurate representation of what a nurse’s experience in the hospital truly looks like. That would a be a very valuable thing to be able to contribute.
You have a really profound way of reflecting on your experiences and describing sometimes devastating situations in clear yet descriptive prose. Do you have any formal writing training, or is it part of a natural storytelling ability?
Thank you very much. I actually do not have any formal writing training. I was a sculpture, a painter, and then I was a nurse. I’ve always felt compelled to write, though, and I believe that a writer perfects their craft simply by writing. Pen to paper. Fingers to keyboard. In truth, I learned to become a real writer while writing this book. That’s what it took.
You don’t sugarcoat parenting, and you’re not afraid to humanize your children’s faults and less-than-desirable behavior as well as your weaker moments as a parent in contrast with the near superhuman patience that you have to exhibit at work. How intentional were you in conveying the different roles that we play with people we act with in our work versus personal lives? What do you hope both parents and non-parents to gain from hearing about your struggles with burnout and work-life balance?
Highlighting the dichotomy of my experience as a dad and my role as a nurse was very intentional. I believe that how these disparate and sometimes intersecting roles play off of and influence each other is what makes Nurse Papa interesting.
I do not sugar coat parenting. Being a parent is so hard and it is not for the meek of heart. To accurately write about the experience one cannot shy away from the basic truth that we are all very flawed and beautiful individuals at the same time. We are all growing, sometimes getting better, sometimes getting worse.
Being human and definitely being a parent is messy and our growth is nonlinear. I believe that accurately depicting my less than stellar moments helps to normalize the reality that we all have hard times. It’s okay to be imperfect.
You detail your experiences being in the room with patients who are in immense physical pain and parents who are in immense emotional pain. What advice do you have for readers who may one day find themselves suffering as a patient, as a loved one, or as a helpless bystander in enduring both types of pain? What are some tips that both patients and visitors can do to help make nurses more efficient and effective in helping to treat their patients or prevent roadblocks that could inhibit nurses from doing their jobs?
Oh man, that is a good practical question because most of us will indeed end up in a hospital bed at some point in our lives. It is important to know how to navigate this experience both as a patient or somebody who loves that patient.
The first advice I would offer is that your nurse is often your closest and most invested advocate. We care a lot about our patients, even the ones we have just met. We know our patients the best – often better than the MDs – and it is our job to protect them. Always express your concerns and needs to your nurse because we depend on your subjective experience in order to best care for you.
It is almost inevitable that you as a patient will experience pain and discomfort in the hospital. It is the job of your nurse to help facilitate a remedy to that pain and the symptoms that are causing it, but remember that we are not miracle workers.
We can’t just make all pain disappear, but we can usually make it better. We often can change a 10/10 pain to 5/10. It’s not gone, but it’s manageable and that is SO much better. Help us do this by communicating how you feel both emotionally and physically. Nothing is off limits as far as that goes. By being open and honest, you can form a therapeutic relationship with your caregiver.
In the book, you struggle to explain death to your young daughter despite your daily exposure to death, particularly in young children. Has that conversation gotten easier, and do you have any further advice for parents as to when and how to tackle this subject when it comes up?
The conversation has not necessarily gotten easier, but it has certainly shifted. What I have learned as a parent and as a nurse is that I must meet my child or my pediatric patient, for that matter, where they are emotionally and mentally, rather than where I want them to be. This is really important.
It’s not that I don’t sometimes lie or withhold truth from my child. I do, but I only do that when it serves them. My daughter, who is six years old, still wants to believe in the tooth fairy. Who am I to disabuse her of this fantasy? Why is my truth that the tooth fairy does not exist trump my daughter’s need to believe in her? In our house, the tooth fairy is named Nikita, and her existence gives my daughter great joy.
On the other hand, when my daughter or son asks me about a hard and complicated subject, like death, I tell them what I believe. If they have the curiosity and courage to seek a truth, I will respond in an honest and open manner. This does not mean that conversations like this are easy. They absolutely are not, but when I am truthful with my children it strengthens our bonds. It helps ensure that they will both keep coming to me in the future with new hard questions. One thing I will add, though, is that it is helpful to have formed some of these answers to these difficult questions before they are asked.
Do you think there will ever be a cure for cancer and the other common diseases that you see in your patients on a daily basis? If so, do you think we will see it in our lifetime?
I might be the wrong person to ask this question. I do deliver these therapies, but I don’t develop them. That being said, I do indeed hope that one day the human race will develop a cure for cancer. With some cancers that once guaranteed a very imminent death, we have come so far. Kids reach remission and go on to live long and rewarding lives. With other fairly common cancers, though, we are a very long way away from developing cures. We’ll get there, though, I’m sure. I’d love to be out of a job if it meant kids didn’t need me.
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