The Beauty of Uncertainty 

My cousin was everything I wanted to be and more. More importantly, I could tell that we were family.

In the ICU, uncertainty is the main ingredient. The lobster in the bisque. The cabbage in the slaw. You don’t know what you’re leaving with that day as a healthcare worker or a visitor. You simply know what you came in with: a heavy heart, a tired body, an ounce of energy, a kiss good morning, a cup of hot, black coffee.

You may leave lighter, empty or high spirited. You may leave loved ones or faith. You can lose it all in that trap (or savior) called doubt.

But uncertainty keeps you grounded. It allows for excitement in the form of dread and in hope all in one. A scale that hovers up and down, revealing no clear, sure thing. Don’t bother looking up the definitions of doubt and uncertainty. The words are listed as synonyms but the two words do not evoke the same feelings, the same amount of skipped beats within my heart.

I thought I felt doubt, but really it was uncertainty. And at the ripe, old (young n dumb) age of 25, I am seeing now that understanding the difference between the two can be the difference between fulfillment and despair. As I gripped the rocks, nails strong but ragged, scratching the dust and pebbles into my face. I was climbing for the first time outside. “Doubtful” I would reach the end of the rope 60 feet above me. Too bad what I was feeling wasn’t really doubt. Doubt would have kept me a little more safe, me being without health insurance. Yikes!

Visiting my cousin was a half hearted idea I had thought up back in June of last year. I casually asked my aunt about the cousin who had reentered the Garcia family a few years back while I was away and unable to visit. I had finally made it to Florida to visit with family and catch up. I heard all about my hilarious cousin, who had been living in Argentina, who had existed outside my knowledge for 20 plus years. She was living in Denver and apparently I had to meet her.

Somehow, the stars aligned and I reached out to her in time to book a flight to Denver on my way out to Jackson Hole to run my first marathon. Two months after I had heard talk of my hilarious cousin, we were giggling in her steal of an apartment in the mile high city. Planning out a day of biking, yoga, and the climbing gym. All of this was followed by warm sake. Like I said, everything I wanted to be and more.

A few days after that, and I was squinting up as I watched her finish leading on the first outside climb I would attempt. Moments before I had been drinking matte in a truck with her and her boyfriend, discussing traveling and searching for a spot to pull off of the highway to make our way towards the climb. Her boyfriend, D. was a California native punk who had moved to Peru for two years and was now fluent in Spanish and sarcasm. In contrast with my bubbly self, he held the line of conversation tightly enough for a tight rope walker to chance a crossing. These are the conversations for which I live. The kind of conversation that never leaves me empty handed.

I left that 20 minute car ride a better traveler. I had mentioned that one of my friends had not enjoyed Peru, and not felt safe, and he responded with an intense, yet valid, counter to that statement. How long had this person been in Peru? What experiences were they basing this judgment on? The force of impact of a first impression is natural, but is it rational?

This conversation has made me careful (a word I usually do not like to associate with myself) when telling others where I have been. The cities I have traveled to and the cities I have been assigned to have been brief encounters. Three months here, a week there, a few hours in a city in between. The first question a person asks is “what is that place like?”.

The writer in me wants to gush. LA is like the cold shoulder of the cool kid who really wants to be liked. LA is like the sun shining on a 24 carat diamond ring of a well polished finger holding a ten dollar Alfred latte with a homeless person in the background faking a seizure. LA is like a nobody dancing on the beach in her bikini, having head shots taken by an amateur photographer trying to get laid. But LA isn’t like that, or it can’t be quantified in a matter of three months and gradients of tan lines.

And I want to say that Seattle is like a cool cedar closet where you store your skis and hopes. Seattle is like standing on top of the world and understanding that all the clouds don’t always foreshadow some ominous event. Seattle is the promise but not the guarantee that rain and shine are as ever changing as a wall forever being filled with chewed gum. But it isn’t like that.

And I want to say that Tokyo is like a $30 cover charge including a show and two scallops for an additional $60. Tokyo is a garden with cherry blossoms and a flat gray sky lined with buildings. Ireland is one green hill after another, except when it is a bustling street as busy as NYC. NYC is a good humored middle finger with a saxophone playing in the background. Nicaragua is a shanty with a smile. The Dominican Republic is on an island where many have not seen the ocean but it doesn’t stop anyone from dancing. Belize is sweat and rain mixed on your skin as monkeys howl. Iceland is sliding boots on ice and pitch black mornings at 9am. But it isn’t like that.

And the questions only multiple. How is the food? How are the people? Would you go back? How foolish have I felt trying to think about my answer. The people were nice, well maybe rude? I’m not sure, I didn’t speak the language. I actually had the best conversation of my life but the food was just okay. Granted all I could afford was the pasta. How expensive! And maybe if the trip was free, but I have so much more to see!

I am not a fan of small talk. I get enough of that at my job. These questions have always disguised themselves as important to me. Not to be cynical, but I no longer see these questions as a way of understanding another culture, but rather a tool to figure out the next big vacation. A personalized yelp review. And while that is all well and good, I now see that I am responsible for my judgments in a larger way. It takes a long time to truly understand a place and a people. I want so badly to say I know, but I don’t. Travel nursing, it isn’t like that.

It is a constant state of uncertainty, which means a mind with the door propped all the way open. I have an idea of what a place could be like, now prove me wrong, prove me right, or confuse the shit out of me. In any case I will try to understand, understanding that I cannot fully understand. Recognizing the smallness of my being, while taking responsibility for the enormity of my actions and words.

And in that openness is where I leave doubt behind, giving the possible and impossible a 50/50 shot. Scratching at the overhang I was trying to climb over, I realized the evenness of my uncertainty. That I could possibly make it to the top. Take a breather. Try again. I heard my cousin call down to me that I was going to do it, while my arms shook and my feet slipped. I didn’t believe her, but I didn’t believe my weak limbs either.

I did it. I pushed through and uncertainty became certainty. I was certain of my capability, and I was certain a second time. I later discovered that the two below me were doubtful of me during that time. Funny how the voice of doubt had been my spotter at the bottom of the rock. Nothing could have prepared me better mentally for the marathon I would later run that week. More importantly, nothing could have prepared me better mentally for the patients I would care for in the ICU these past few months. Sometimes the climb is too tough. Sometimes the other 50% wins. But to understand that, I had to recall that feeling I had at the bottom of the cliff.

I’ve been expanding my experience by being flexible and growing my basis of knowledge by taking on new assignments. My current job has included neuro/trauma, a patient population with which I have worked with very little. An impact or a clot can quickly change a person from being very much alive to being certainly comatose, with an uncertain recovery. The chances of regaining consciousness may not be 50/50 scientifically, but in the eyes of loved ones, it is 50/50. I say this because whatever small percentage science offers, love magnifies and multiplies. A person is walking, talking, joking, laughing, crying, dancing, one day, and silent the next. So whatever chance there is, most of the time it seems like a great possibility, because what were the chances in the first place that this would happen to their boyfriend, girlfriend, sister, brother, husband, wife, mother father? If luck can be so bad, why can it not be so good?

But doubt has a place in the hospital. It has a wing, it has a stock, it pays its rent. It ends suffering and it quiets a restless mind. Sometimes I wish it could take the place of uncertainty, but I know why it can’t. I had two patients recently where recovery was questionable. Families would call and visit, asking what updates I had, and I had none. There were no changes. And I walked the fine line of belaying them, telling them they could recover when I thought they very well might not. Anchoring a rope that only leads up and then back down again. Let the patients surprise me like I surprised my cousin.

Unfortunately, there is a rather indie movie ending to this post. I don’t know if those patients reached the top. If heaven or earth was their destination after an unfortunate turn of events. Because of the sporadic nature of my schedule, I rarely am able to find out. So I live in the uncertainty with their loved ones. I am grateful to share that space with them, because doubt occupies my mind all too much when caring for the critically ill. It protects but it also hinders. Doubt is like saying no to the rock from the car. And yes, in this case, it is like that.