Chapter 2: Just a Nurse

“Hello Mr. Johnson, my name is Kiva and I’ll be your nurse this evening. I have your scheduled blood pressure medications but first I’m going to do my assessment. How are you feeling right now?” 

Mr. Johnson assured me he was fine. The big truck driver was admitted to my ICU two days earlier, confused and disoriented with a hypertensive emergency, a blood pressure so severely high, he was on the verge of a stroke and kidney failure. Thanks to careful administration of intravenous medications and intense monitoring, his blood pressure was now stable. He was expected to be transferred out of the ICU in the morning.

I recorded the blood pressure, heart rate, respirations and oxygen saturation. I auscultated the heart sounds, then the lungs, then pressed my stethoscope on his abdomen. IV sites were clean and intact. Arterial line was working fine. The electrodes on the chest were reliably recording the heart rhythm to the telemetry monitor. I turned away from him, bending over slightly to adjust the tubing connecting the IV bag to the vein in his arm. I turned back toward him in time to catch him ogling my ass.

“Hmmm, mmm,” he grinned, “I must have been a good boy to get such a fine looking lady for my nurse. I think I might have died and gone to heaven.”

For female nurses, comments like that come with the territory. Maybe he meant it as a harmless but lame attempt at humor. Maybe that would be the only such comment but my harassment warning alarm was activated. Wearing my game face, I ignored it and stuck to business.

“Mr. Johnson,  these two pills are for your blood pressure. This one is for cholesterol. Do you have any questions?”

“Yes,” he replied, “can I have a drink of water?”

“Yes,” I answered, “but you’re on a fluid restriction. I can only give you a small cup. Anything else?”

“Why yes,…when are you going to get me naked and give me a sponge bath?”

Alright, he was pushing it. “Sir, one of the male nurses will help you into the shower as soon as you can come off the cardiac monitor,” I responded, my poker face in his full view. Usually, a serious business-like demeanor is enough to end this type of behavior.

“I’ll draw a blood sample for the lab at eleven o’clock,” I resumed. “No food or drink after midnight for a possible procedure tomorrow. You’re scheduled for an echocardiogram first thing in the morning.”

“What time do you leave?” He asked.

“My shift is over at seven a.m.”

“I see,” he said with an impish smirk while stroking his beard. “What time do you sneak off to the doctors call room for a booty call?  There must be some hunky doc waiting for a pretty little thing like you to help him relieve some stress.”

OK, time to act. “Sir,” I begin, “You are a patient in the ICU. You came here with a very serious condition. I am a healthcare provider responsible for your care. I do not care for inappropriate sexual comments. You must let me do my job.” In an attempt to quickly diffuse the awkwardness, I brought the topic back to the issues at hand. 

“I’ll be closely watching your blood pressure overnight. Your heart rhythm is being observed at all times. The techs can see it in the monitor room. And there is another monitor in this room right here….over….your….head.”  OH SHIT!  Fortunately, I stopped myself from uttering those words. But I still gasped.

Above Johnson’s head, the heart monitor displayed a new rhythm not present a minute ago.  The rhythm was fast….very fast…way too fast… suddenly changing from 60 to 150 beats per minute in just seconds. OK, deep breath I tell myself.  Stay calm.  I’ve seen this hundreds of times.

“Is something wrong?” my sexually inappropriate patient asked.

Briefly, I’m disappointed with myself. I should not have gasped. A nurse with my experience should have better self control than to alarm a patient. However, Johnson’s heart converted into a potentially dangerous rhythm. We would need to identify the rhythm immediately.  He might need an electric shock to the chest to defibrillate him. Maybe we could control it with medications and won’t require a shock. We needed to know what rhythm this is. However, the immediate priority in that situation is assessing the patient.

“Mr. Johnson, are you having chest pain or shortness of breath?”

“No.”

So far, so good.  Blood pressure is….excellent.  We have a little time.

“Mr. Johnson, your heart rate is fast at the moment,” I explained.

“Well, of course it is, babe. With a hottie like you in my room, how can it not be.”  I’m too busy to respond to this shit. 

“Monitor tech,” I yell out.  “What are you seeing.”

“Wide complex tachycardia,” a voice called back.

I called on my colleagues, “We need a 12-lead EKG stat in bed 10. Please page the intern on call.”

“Did you say to page the intern?” one of my fellow nurses asked, nearly snickering.

“Yes,” I answered.

“Well, good luck with that,” she warned.

“Why do you say that.”

“Because the intern from hell is covering tonight.”

Oh great, I tell myself. It happens every summer in academic teaching hospitals across the U.S.  The academic new year begins July 1. That’s when fresh graduating medical students take their very first steps as newly minted doctors and begin their residency. The most senior residents will have moved on while an influx of first year residents or interns arrive. There’s a meme that says July is the most dangerous month to be hospitalized due to the inexperienced residents, although studies have not shown that poor patient outcomes are increased due to resident errors during the summer.

The system works by an hierarchical structure of supervision. The first year resident (intern) takes the first calls and is backed up by a more senior resident, who, in turn, is backed up by a full fledged veteran doctor.

However, the system can create interesting situations in doctor-nurse relationships. In the ICU, a very seasoned nurse may be paired with a very inexperienced physician. In an emergency situation, a veteran nurse has all the experience but the doc has all the decision making authority. Most residents are wise enough to recognize this disparity and view the nurse as a priceless resource. In turn, good nurses know how to tactfully make suggestions and steer the fledgling doc in the right direction while still respecting the doctor’s training and status. I had gotten along great with residents and watched many of them go on to establish prominence in their fields. Some of them still thank me for bailing them out of trouble during the infancy of their careers.

Occasionally, we’d get a problem child for an intern. Almost always, it would be an insecure, socially inept soul lacking self-confidence. These types perceived knowledgeable nurses as a threat to their own self esteem. Therefore, accepting suggestions by nurses was viewed as a sign of weakness and, in their minds, they could only build themselves up by demeaning highly skilled confident nurses. I know these types, I told myself. Been there and done that. I’m ready.

“Who is this demon intern?” I asked my colleagues.

“Her name is Freda,” one nurse answered.

“Freda….Freda,” I wondered….”Where do I know that name? What does she look like?”

“Thin, red hair.  All the personality of a garden slug. She doesn’t get along with very many people. I only ever see her with that miserable bitch Deanna from physical therapy.”

“OH MY GOD,” I nearly gasped audibly.  FREDA?  That bitch that stared at me like she wanted to fight me? That woman with a profile on the catfight website? She’s a DOCTOR?  An INTERN?  The one I have to work with TONIGHT?  I take it back.  I haven’t been there and done that.  FREDA? OH…MY….GOD!

OK, I told myself. I’ll get through this. This is the hand I’ve been dealt. Time to take a deep breath. I’ll just need to keep my head straight. The only thing that matters is getting Mr. Johnson’s heart rhythm under control.

While waiting for Dr. Freda to arrive, I examined the rhythm strips printed out by the monitor tech. I saw something encouraging. Then I studied the 12 lead EKG. It was good news, I thought. It’s atrial fibrillation, a common rhythm disorder where the two upper chambers of the heart, the atria, contract in an uncoordinated chaotic rhythm like a bowl of jello. This sends erratic electrical messages to the lower chambers, the ventricles, which contract at an irregular rate. Because Johnson has a good blood pressure and no symptoms, we should be able to slow this thing down with intravenous medication. He may even convert back to a normal rate and rhythm. My fear was that he might have had ventricular tachycardia, a more serious rhythm disturbance and a worse prognosis. I was relieved this wasn’t the case.

“What’s taking the intern so long?” I groaned.

“Par for the course,” answered my fellow nurse. “And when  she shows up, don’t expect a ray of sunshine.”

I returned to Johnson’s bedside. “Mr. Johnson, we’ll need to slow down your heart rate tonight. As soon as the doctor gets here, we’ll give you some medicine that I think will do the trick.”

“Well Alleluia,” he bellowed. “Then afterwards, you and I can go out dancing.”

Oh please, what a repulsive thought. Then from behind me, from the doorway of Johnson’s room, I heard a female voice.

“Did you page me? What d’ya want?” Charming. No introduction. The tone suggested the page was an annoyance. I turned around. It was her, standing in green scrubs and a white jacket, a stethoscope draped around her neck. The face, the serious expression, the look of contempt was the same as during the last time we met.

“Hello, doctor, I’m Kiva. I believe we …sort of….met….at the gym.”

“Yeah, I know who you are,” she replied.

“Look, I know this is awkward for both of us,” I said, “But I think we can put the incident between Deanna and Kelli behind us and work together tonight.”

“So why was I called?,” her voice gruff, the facial expression unchanging. No Miss Congeniality here.

“Doctor, this is Mr. Johnson. He was admitted with a hypertensive emergency. He was doing well but suddenly went into this rhythm ten minutes ago. No symptoms. Here’s his EKG. It looks like atrial fibrillation. If you agree, I can draw up metoprolol and we’ll get started.”

The surly redheaded doc gave Johnson a cursory physical exam, glanced at the EKG, then gave an order that made my blood run cold. “It’s ventricular tachycardia, charge the defibrillator. We’ll need to shock him.”

Oh good lord, I thought. This will require all the diplomacy skill I can muster immediately.

“Doctor, I understand your concern this might be ventricular tachycardia, but the EKG shows an irregular rhythm. The QRS axis doesn’t change. And the complex appears wide because of left bundle branch block. I’m quite certain this is atrial fibrillation. How much metoprolol would you like?”

“Whoooweee,” Johnson interjected. “I have no idea what the hell you just said, but you sure are sexy with your brainy medical talk.”

I slowly backed out of Johnson’s room and into the hallway, motioning Freda to follow me.

“You heard what I said,” she asserted. “Get the defibrillator and charge it…NOW.”  And with the same look of utter derision she gave me on that day behind the gym, she sneered, “You shouldn’t even be looking at EKGs. You are …just…a…nurse.”

Those words stabbed me through the heart. Nevertheless, I pushed onward.

“Doc, I’m certified in critical care nursing. I spent a semester studying EKGs. Plus this isn’t my first rodeo. I’ve worked in critical care for years and have seen just about every heart rhythm imaginable. If you still wish to defibrillate Mr. Johnson, your senior resident will need to be present.”

“I know what I’m doing,” she grumbled. “I’ll need an anesthetist to sedate and intubate and I’ll do the rest.”

“No,” I responded, “This is not a decision appropriate for an intern alone. You need to bring in your senior.”

“OK, why don’t we work together as a team,” her voice dripping with sarcasm. “I’ll make the medical decisions and you clean the poop and wipe the asses.”

That did it. I thought that kind of attitude was largely a thing of the past. Yes, there was a time when nursing was mostly about cleaning, dressing, and making patients comfortable. In recent decades, the profession has grown into a clinical science. Today, advance practice nurses perform procedures and prescribe medications. At least the newer generations of doctors get it. Whenever, I hear a comment like that, it usually comes from an old fart doc who should have retired years ago. But no, not this dipshit I was stuck that night. I offered no response. Quietly, I made my way to the defibrillator. Instead of charging it, I ducked into the break room and lifted the phone. As Johnson’s nurse, it was my prerogative to call the senior resident with advanced level concerns.

“Jeff, it’s Kiva. Mr Johnson in bed 10 has wide complex tachycardia. I think it’s atrial fibrillation with RVR. You need to come down to take a look.”

“Did you call the inter

“Yes, and she’s planning …to…shock…him.”

“Oh shit!  Coming.”

Jeff was one of the best senior residents and we had a great relationship of mutual respect and trust. I had no doubt that when he arrived, Mr. Johnson would be in good hands. When he showed up in the ICU that night, I felt a burden lift from my shoulders.

“Hello, Mr. Johnson, how are you tonight,” he smiled showing exemplary bedside manner.  “Let’s listen to your heart and lungs. Great! Now let’s look at your EKG.”  With Freda and I standing to the side, Jeff delivered his verdict. “OK…it looks like you have a rhythm called atrial fibrillation. We can take care of that. Kiva, would you be so kind as to draw up 15 milligrams of metoprolol and give the first 5 now.”

The redhead remained expressionless. “Freda, come with me,” Jeff instructed. “I have some pointers about EKGs that might help you next time…Thanks Kiva…Great job!”

As the two of them departed, I pushed the medication through the IV catheter. Then I stood at Johnson’s bedside momentarily lost in thought…Just a nurse… I wanted to scream.  I have a patient who wants me to be a sex kitten. I have a sociopathic intern who wants me to be a handmaiden. I want to scream at the universe…Just a nurse…Why do I bother? Why do I do this? Dr. Freda and Mr. Johnson deserved each other. Had I not intervened, he might have been dead by morning and her career would have been over. Would have served them both right….Just a nurse…Why do I do such bloody hard work for 12 straight hours? I asked. I didn’t have an answer. The only thing I knew was I wanted to scream.

Johnson’s voice snapped me back to earth. “Hey nurse, you and that lady doctor don’t get along well, do you?”

“Why do you say that,” I asked.

“Well, when you walked out into the hallway, she told me she’s gonna kick your ass.”

“Oh Lord no,” I sighed under my breath.

“Yes sir,” Johnson continued. “You and that redhead lady doc rolling around on the floor, pulling hair and scratching while ripping each other’s clothes off. Hell, I’d pay good money to see that. I’d like to throw both of you hens into my barnyard pen and watch the two of you settle it. The winner gets me for the night.”

I….cannot…take…this.

“I would bet my money on you,” Johnson added. “That lady doc looks tough and scrappy but you’re bigger and smart. I think you can take her.”

I really, really, really…wanted to scream.

Finally, a day off and I badly needed to get to the gym. Fantasies of fighting other women still crept into my mind. I periodically revisited the website to watch catfights. I really admired Kelli for going through with this hobby of hers. I was even more impressed, if not a little envious, that her husband Jake was totally involved in it with her. At this point I said nothing more to my husband about it.

At the gym, I started kickboxing classes. It focused more on fitness than actual combat but I found I loved the feel of striking the bag. As I improved my technique and learned to throw harder punches, I felt a rush as I buried my fists into the bag.

Feeling physically spent but elated after a workout, I sat on the locker room bench sipping my water. With my head down, my thoughts turned toward work. I was on night shift again. I would take my daughter shopping for school clothes, then try to get a few hours of sleep before work. I sure hoped Freda wasn’t on call.

“Hey you,” a female voice interrupted my thoughts. I knew who it was before lifting my head. There she was in her black sports bra and yoga shorts, the red hair pulled back, the thin stern face glaring at me.

“I want to make one thing very clear,” Freda spoke in a low monotone voice. “Don’t you EVER embarrass me at work again.”

“I didn’t embarrass you,” I retorted. “I simply gave my opinion on the patient’s heart rhythm. And it turned out I was right. If you were embarrassed that you were wrong, I can’t help that.”

“Why did you go over my head and call my senior?”

“Because you wanted to shock the patient. Seniors are ALWAYS involved in those decisions. That’s not something an intern can do alone,” I asserted.

“Calling the senior is MY decision. You are….just a nurse.”

There it is again. With my blood beginning to boil, it was clear this is about insecurity and power. But is this a female thing? I wondered.  Would she react this way with a male nurse? Traditionally, doctors were overwhelmingly male. Today women make up half of all medical school graduates.  Over time, I’ve noticed gender differences in how doctors interact with nurses. Unlike their older counterparts, most young male physicians, like Jeff, prefer nurses to call them by their first names and view us as colleagues. Female doctors tend to want us to refer to them as “doctor” until they get to know us well and seem to be more hierarchy conscious.  Freda, on the other hand, was on her own planet.

“Is that your problem?” I shot back. “You can’t accept a nurse knew something you didn’t? That a nurse could teach you something? That I have light years of more experience than you in critical care? Is that it? Did I ruin your fantasy that I’m a submissive subservient chambermaid? Does it threaten you that I’m a highly trained clinician?”

She stood there expressionless. I was on a roll. “Well let me tell you something, doc. Unless you learn quickly your own limitations and what everyone brings to the table, your career is doomed. I’ve been at this game a long time. It’s OK to be wrong. We’re all wrong at times. But it’s inexcusable to stay wrong. You can accept the Mr. Johnson episode as a learning experience or you can be pissed at me and the rest of the world. The choice is yours. Remember, I may be just a nurse but you’re just …a….trainee….And from I’ve seen so far, you’re not going to make it.”

Freda stood still for a moment, her face blank, looking downward. Finally, she looked me in the face, and in a raspy but low voice uttered four utterly shocking words, “Let’s take it outside.”

I jolted upright. “Did you just say you want to fight? Are you calling me out?”

“You heard me,” she said sternly.

I was shocked. I fantasized about decking this bitch but never expected she’d challenge me. I already felt a surge of adrenaline. For a few moments, we stared silently at each other. Then I spoke words I never dreamed of saying, “OK, let’s fight. Down the hill, in the clearing where Kelli and Deanna fought.”

Suddenly, a boisterous voice interrupted the tension, “Oh yeah, baby, did I hear that right? You two are finally going to tangle.” It was Deanna, standing in the locker room dressed in her gym clothes, her long wavy dark hair and large brown eyes, hovering over me as I remained seated on the bench.

Directing her venom at me, Deanna added, “I don’t like the way you’ve been disrespecting me at work. My girl Freda is going to teach you some manners.”

Before I could process that I was outnumbered by two creeps, an assertive voice spoke from behind me in that familiar self-confident Texas drawl.  Kelli. Thank goodness.  “What’s going on here?” she demanded.

“I’ll tell you what’s going on here, Blondie,” Deanna answered, her voice sounding rushed with enthusiasm. Your friend and Freda here are finally going to settle it…outside.”

“A fight?” Kelli asked incredulously. “These two are going to fight?…Seriously?…Kiva, is that true?”

“Yes,” I answered.

The four of us said nothing for a few seconds. Then Kelli broke the silence, “ I’d like to speak privately with Kiva for a minute.”

“Go ahead Blondie, talk her out of it,” Deanna taunted. “Tell her it’s OK to chicken out. She ain’t gonna be so pretty after my girl pulverizes her.”

Kelli led me to an empty row of lockers, then said in a soft direct voice, “Kiva, are you sure you want to do this?”

“Yes”

“I mean, you’re really going to fight that redhead?”

“Yes”

“Look,” Kelli offered, “I’ll be honest. I really don’t think this is a good idea. You know I like fighting. I don’t want to be a hypocrite but if your having problems with these two at work, perhaps you should speak to their supervisors or HR department. Fighting is usually not the best solution.”

“It’s more than that,” I countered. “Remember when you said many women have a drive to compete?  Well, I’ve always felt that. I just kept it suppressed for many years. You and Deanna didn’t need a reason to fight. You didn’t even know each other. But you both had an itch to decide who was the better woman. I get it now. I’ve been feeling that itch.”

“Really?” Kelli asked.

“Yes, really.”

“But…you have very little fighting experience,” Kelli warned, “and we know nothing about this chick. For all we know, she could be some type of martial arts expert.”

“She isn’t,” I replied. “She’s scared. I can see it. It’s in her eyes and mannerism. Just like in the ICU. She was scared shitless but it was all bluster. I’m seeing it again. She talks big but she has nothing.”

“Last chance, Kiva,” Kelli spoke with a solemn tone. “It’s OK to walk away.”

“I’m not,” I replied. “She challenged me. I’ve got to do this.”

“You’re sure?”

“I’m sure.”

“OK,” Kelli breathed with resignation in her voice. “I’ll be there to support you but understand that once the fight starts, you’re on your own. Anytime you want the fight to stop, yell it out or tap with your hand. At that point, I’ll look out for you to make sure nothing funny happens. Got it?”

“Got it.”

I followed Kelli back to row of lockers where Deanna and Freda waited, both looking smug with their hands on their hips.  “A fight it is,” Kelli announced. “You know the spot. Let’s be there in five minutes.”

“May I make a proposal,” Deanna interjected. “If my girl Freda wins, I get a rematch with Blondie.”

“And if Kiva wins,” Kelli countered, “the two of you will find another gym and never come back here again.” 

Our two adversaries looked at each other, then Deanna, speaking for both of them replied, “Deal.”

The four of us said nothing as we walked down the hill. As we approached the foot bridge over the creek, the reality of the situation hit me.  It’s going to happen now, I thought. It’s really going to happen. I’m in a fight. There will be striking, grappling, hair pulling. And it’s about to happen now. Butterflies flew in my stomach like crazy. My heart pounded out of my chest. My mind was delirious. This walk was taking forever. What if I lose? What if I’m humiliated? Or injured? No, impossible. No such thoughts allowed. A lump grew in my throat. This is it.

Finally, we arrived at the grassy clearing. My opponent and I were both wearing sports bras and yoga shorts. Mine are matching brown and hers are black. We removed our shoes and socks. Kelli tied my long dark brown ponytail into a knot. Deanna was giving Freda last minute instructions. At 5’7” and 128 lbs, I was two inches taller and 10-12 lbs heavier. Her body looked wiry. Compared to my 34C chest, she looked flat chested. I clearly had more muscle mass and curves. And I had a reach advantage. At age 33, I was probably seven or eight years older.

Kelli and Deanna positioned us about four feet apart from each other. Her face was serious, her lips were tightly pursed, her fists were clenched. Our eyes locked. I won the stare down as her eyes looked toward the ground.

Deanna began, “Ready ladies…one…two…three…FIGHT!”

I immediately felt the surge of adrenaline. No more time to be nervous. No more butterflies. Now I know what “fight or flight” response means. With our hands up at chest level, the ginger bitch and I briskly approached each other until our hands grabbed and slapped at the other’s. I knew we looked like two inexperienced fighters. Using my reach advantage, I shoved her shoulders pushing off with my weight, sending her back several steps. Slightly off balance, she quickly recovered, charging at me with her hands swinging wildly. I blocked the slaps coming toward my face and gave her a harder push at the chest. This time, I moved her back further and watched her stumble, almost falling to the ground.

Seeing my advantage, I rushed in. Again, Freda recovered her balance quickly and caught me with a stinging slap to the face as I drove in. Dumb, I thought, how could I have left myself so wide open? I backed up but had zero time as Freda was running at me. I felt another slap to the side of my head, then another one on my neck. A third one caught me on the nose.

The slaps kept coming in rapid fire. Some of them I blocked. Others got through to my face, head and chest. Freda was now firing slaps faster and faster. I covered up my head with my arms and backed up. She pushed forward firing blows all over me. I felt like I was fighting an airplane propeller or an octopus with eight arms. With my arms up to protect my head, I felt a fist land on the right side of my ribs.

I had to do something. Backing up wasn’t the answer. Instinctively, I crouched and lunged forward reaching out with my arms. As expected, the move came with a price, costing me a hard slap on the cheek. I got through my attacker’s arms, grabbing on to her hair with both hands. It wasn’t the best grip as her hair was pulled back tightly but it was enough to take control of her head as I dug in my nails into her scalp. The nasty doc managed to seize my hair as well largely undoing my tied up bun. Both of us screamed and yelled obscenities as we pushed and pulled each other’s head by the hair. My height and reach advantage helped as I started swinging her body with more force as my own scalp singed with pain. Freda didn’t let go as we swung in circles together until we finally both lost our balance, tumbling to the grass.

We both squirmed for position still holding on to hair. Together we rolled, pulling hair and slapping. Our legs kicked at each other with neither of us gaining an advantage. Suddenly, a sharp pain, like from razor blades, seared my bare shoulders. Fuck, I thought, she’s scratching me. She’s digging her claws into my skin. Another mistake. I should have expected it and scratched her first. My arms felt paralyzed. Next thing I knew, I was on my back with the smaller but wiry redhead on top of me.

She was mounted on my belly, throwing slaps at my face, as I kicked and screamed. Covering up again, I blocked most of the blows but now felt her claws in my stomach behind her back where I couldn’t reach. I braced my abdominal muscles as she plunged her fists into my belly. Bucking and kicking as hard as I could, I wasn’t able to dismount my enemy. She finally seized my wrists pinning my arms above my head. Breathing rapidly, the realization occurred I was losing this fight. Still, the adrenaline level was still sky high. Any rationality was long gone.

Freda kept me pinned for several seconds as if contemplating her next attack. As I lay there panting, I could hear Deanna call out, “That’s it, Freda, kick her ass.” From the corner of my eye, I saw Kelli watching intently, looking concerned. I noticed she flexed her knee while standing and grabbed her foot to stretch her quad muscles. Shit, I thought, she’s expecting to fight Deanna next and I caused this.

The skinny doc wrapped my left arm around my head while using her left shoulder to block my right arm. Then, I saw her eyeing my vulnerable left breast. No, I thought, no, NO! Tell me she’s not planning what I think she is. I panicked when her free hand went for my sports bra. I howled as she groped and squeezed my left breast. The cruel bitch tugged at the bottom elastic band lifting it upward until the left tit was exposed. The next sensation I felt was nails penetrating into the skin over my breast as she squeezed to add to the torture. Never in my life, had I experienced such excruciating breast pain. Not content with one exposed boob, Freda was determined to remove the sports bra altogether, pulling the left side over the shoulder and stretched arm, leaving the bra still attached to my right shoulder, back, and right breast.

With all the effort she took trying to remove my bra, the asshole raised her body upward enough to create a target. As hard as I could, I sent my right knee crashing into her back eliciting an uummmpph sound. It was enough to knock her off balance. Seeing my opportunity to escape, I grabbed her left arm pulling her off me to the side, as I rolled away from between her legs.

I scrambled to my feet as quickly as possible but was sucking wind and felt a bit unsteady. I saw my foe stalking me as I tried to prepare. Freda moved in again in a stance that told me she was planning to throw strikes. This time I’m not backing up, I told myself. Sure enough, the two of us exchange slaps. Unlike last time, I stood there and swung with her. She was faster and  landed more blows but I knew I hit harder. My face stung but I kept my bearings, landing a hard slap that turned her face and caused her to stagger. Quickly, I moved in and shoved her to the ground.

As I approached her, she rapidly got to her knees. I shot in to try to grapple her into submission, when suddenly, I felt something like a rock hit me in the cheek. Stunned, I froze for a few seconds before the reality hit me. I was hit in the face by a closed fist. When you’re not used to being punched, the feeling is horrifying. I rubbed my numb cheekbone.

“That’s against the rules, bitch,” I protested. “No closed fist punches to the face.”

“What rules?” my foe replied, “This is a fight, dumb ass. We didn’t discuss rules.”

I seethed. The opportunistic piece of shit. Funny how punching was allowed once when she was at a disadvantage. I now felt a surge of energy. And raging pure hatred.

“You fucking cxnt,” I screamed. With my fists clenched, I charged at her as she rose to her feet. I threw a flurry of punches, all wildly swinging through the air or landing on blocking bony arms. Freda responded with her own punches with bad intent but with no more success than I had. The fight now turned into an all out anything goes brawl as we both flailed away like the two unskilled boxers that we were. Both Kelli and Deanna, hovered nearby as if they were considering stopping the fight before one of us became seriously hurt.

Frustrated by being unable to land a hard blow, I decided to swing for the fences. I reared back my right hand and threw the hardest right hook I could. My fist sailed over Freda’s head, the momentum from the force of the swing spun me around. My opponent did not miss her easy counter. My body wide open, she dug a right hook into my belly, doubling me over.

Gasping for air, I was unable to defend against the arms wrapping around my body, swinging me back and forth, until my feet were tripped, sending me crashing to the ground, with my opponent on top.

Freda mounted my back, wrapping her legs around my waist trying to apply a body scissors. I lay down flat on my belly before she could lock her ankles together, realizing I was again in a bad position. I felt an arm slip under my right arm pit reaching its hand behind my head, pushing it forward into a half nelson. I lied on my side between Freda’s legs. My weight was on her right leg, immobilizing it, making it difficult to lock her ankles into the scissors. I braced against the pressure in the back of my head and neck.

I felt exhausted and winded, my neck racked with pain, lying on the grass as my foe tried to tie me up and probably finish me. I grunted and gasped with tears in my eyes, my naked left breast skimming the grass. With my nose pushed toward the earth, I could smell the green vegetation and the soil. And something else. No, don’t tell me, I panicked. It was the smell of dog shit. Judging by the strength of the odor, it was in close proximity to my face. That fact was not lost on my tormentor.

“Look, nurse,” the doctor taunted, “You have some work to do.” Now I see it. A moist pile of turd just inches from my nose. “Didn’t I tell you that your job is to clean up the shit. WELL, LOOK AT THIS!” She screamed as she positioned my face in direct view of the feces. “But we don’t have any towels, do we?,” the sadistic bitch continued. “Too bad. So I guess you’ll need to use your tongue. That’s right, nurse. I want you to EAT IT.”

My right arm was trapped in the half nelson. My left arm was underneath my body. She was behind my back trying to lock her legs around my waist. She applied pressure to my head pushing it toward the dog shit as I resisted with what strength I had left. Realizing her half nelson wouldn’t quite connect my face to the shit, she tried to roll me to the right to complete the deed. She shifted her weight right, moving me with her. “A little more,” she taunted, “and you’ll be tasting it.”

It was not enough as we rolled back. She attempted again. This time, as we rolled, I freed the left arm from the weight of my body. As we rolled back left, I flung my left elbow back, striking the miserable intern on the chin.

“You fucking bitch,” she yelled, as I broke her half nelson hold and rolled away from between her legs, dodging the dog shit along the way.

Battered and exhausted, I was still on my knees when Freda rose to her feet. Yes, she dominated the fight but I did not consider quitting. Her facial expression and body language said it all. She believed she had me beat and it was a matter of time before she’d finish me. She had the advantage standing over me but arrogantly did not take the opportunity. She smirked. She sneered. She swaggered. “I thought you’d be tougher,” she insulted. “I thought you’d be a better fighter. Oh well, I should have known. You’re….just…a…nurse.”

Just a nurse. That phrase again. The one that makes me want to scream. How can anyone be so fucking ignorant. I could almost feel blood rushing toward my head about to cause me to explode. Maybe I’m delirious, I thought. Maybe I’m dehydrated. Maybe it’s the blows I took to the head. Maybe I’m just nuts. But I hear a voice that isn’t audible to anyone else. It’s an internal voice. And that voice is…my own.

Just a nurse. Yes, I’m just a nurse. Yes, I clean poop and wash patients. Every day. I’m good at it. It’s just one of the thousands of things I do every day. Like administering medications, placing IV catheters, drawing blood samples for lab work, placing bladder catheters, checking vital signs, oxygenation, fluid intake, urine output, ventilator settings, central venous pressure, titrating drips. Like preventing bed sores, moving patients, prepping them for procedures. Like writing daily care plans. Like finding time for the massive amount of documentation required every day.

How dare you bitch! Who the fuck are you? And you’re going to act like I’m beneath you?  You make me want to scream. You know that? You make me want to….want to….want to…..”AAAAAAAAAAAAAAAAAAUUUUUUUUUUUGGGGGGGGGGGHHHHHHHHHHH!!!”

Freda looked startled as I rushed at her following my blood curdling outburst. Her hesitation prevented her from getting out of the way as I lowered my shoulder and charged her, sending her flying backward and landing on her ass.

Just a nurse? Tell that to the dozens of patients I’ve taken care of this month. Maybe you can ask the patient with the near fatal myocardial infarction, or the pulmonary embolism, or septic shock, or the young asthmatic on the ventilator. How about the flesh eating necrotizing fasciitis? Ask the one with pulmonary edema. Or stroke. Or COPD. Or the gastrointestinal bleeder. Or the one with the uncontrollable seizure. The code blues.  And on and on…

Freda pulled herself up and looked at me with utter disgust as I stood glaring at her looking like a wild woman. With a face of determination, she again clenched her fists and ran at me, obviously planning to swing.

Everything was a blur. The two of us stood swinging at each other with everything we had. Wild punches flew in ever which direction. Then I heard that sound. I heard it before I felt it. Like the sound of a golf ball struck by a driver club as it launches from the tee box for its 300 yard flight. The sound of my right fist cracking Freda’s jaw. The thin redhead stumbled backward, her eyes vacant before unceremoniously falling to the ground in a heap. I watched her struggle to get up on all fours, lost and disoriented. I noticed she had fallen into the dog shit as it smeared into her shoulder and upper chest. I was still drowning in my own rage to have any compassion. As she lay on the ground, I dove on top of her. Gripping her head in my arms in a tight headlock, I drove her forehead into the ground.

Just a nurse? Tell that to the terminally ill man whose hand I held on the last night of his life. Or his wife and children I sat with. Or the woman whose tears I wiped after she learned her diagnosis of metastatic breast cancer. Or the woman who gave birth to a stillborn. Or the husband who lost his wife of sixty years. The countless patients in physical pain. The anxious. The depressed. The despairing….

“Kiva…Kiva…LET GO. Stop it. You won. Now get off her.” I now gained enough awareness to realize Kelli and Deanna were both prying me off of Freda.

“What the fuck,” Deanna grumbled. “You’re a psycho.”

“Kiva, what happened?” Kelli asked. “What was that about? What was in your head?”

“Oh,” I answered. “That I love being just a nurse.”

Freda wobbled a bit as Deanna helped her up. “Let me help,” I insisted. “After all, I am a nurse.” After a quick exam, I did not see signs of neurological damage. I did advise that she not drive home and to put ice to her jaw. “Freda,” I said, “If we work together again, no hard feelings OK?” She smiled faintly but it was the most animated I had ever seen her. “And one more thing,” I added. “I would be more than honored to wash the poop off of you. I’m very skilled at it, you know.”

She smiled a little more broadly. “No thanks. I can do it myself.”

I adjusted my sports bra as Kelli and I walked back to the gym. Pain all over my face and body was settling in. And my scratched up boob. “Kelli,” I said, “I think I need my Neosporin back.”

A thousand things raced through my mind, not the least of which was what to tell my husband.  How will I feel about fighting when the pain wears off? Then there was the simple fact that I got dominated by a smaller opponent for most of the fight. If I’d fight again, I’d have a lot of work to do. So much to learn.

Three days after the fight, Kelli sent me a text message. My fight was on the website. Deanna recorded it and had it uploaded. Already, I felt a rush watching it. Freda’s profile was now displaying a record of 0-1.

“Welcome to my world, sis,” Kelli texted. “U have arrived” 

This Story is Continued in Chapter 3. Click Here to Keep Going!

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