Once in a Lifetime, by Pat Gourley

It was in the summer of 1973 and I was living on Elati Street in Denver in a railroad duplex we were renting from a landlord who I seem to recall lived in Texas. There was at any one time 3-6 folks inhabiting the place. We had all recently relocated from Champaign, Illinois. The men all had homosexual tendencies, which for the most part were still in a state of unactualized potential and a couple of, I believe, straight women who were fluidly moving in and out of residence.

One of these women named Sue had recently checked out the hospital a few blocks to the east named at that time Denver General, now called Denver Health. She came home telling the mostly under-employed men in the household that the hospital was hiring several different positions and maybe we should check it out. I was at the time working down in Englewood at Craig Rehab hospital in their kitchen and having some minimal patient contact. Having no car it was a bus ride back and forth down Broadway and I was anxious for a more challenging change closer to home.

In August of that summer of 1973 I was hired as a hospital attendant at Denver General on the inpatient psychiatric ward, 4-West. The attendant staff was all male and all my co-workers conscientious objectors. I had avoided the draft by having a high lottery number and the good sense to not volunteer and end up possibly coming back to the States in a body bag from Vietnam.

The attendant staff was all male I suspect to provide muscle for the all female nurses so I am not sure why I got the job being all of 145-pounds soaking wet in those days. This turned out to be my “once in a lifetime” decision that has given my professional life direction for the past 42-years. I am assuming that something that is once in a lifetime should have more impact that one’s usual run of the mill life happenings and this decision to wade into nursing was it for me. The duties of the attendants did include elements of what I call real nursing i.e. hands on interaction with clients. No advanced degree was necessary with the ability to communicate with people in distress being the main requisite of the job.

Back in the early 1970’s the mentally ill, especially the homeless mentally ill, had a much better chance of hospitalization rather than today's all too frequent option of incarceration. And so began my several decades of interacting with Denver’s most disenfranchised. I did detour for 10-years to what was then called Colorado General but in those days they actually served the indigent uninsured as part of their mission.  That hospital has also changed its named, moved to Aurora and now has TV ads featuring Peyton Manning. I find the tone and pitch of these commercials to be very off-putting but I will not explore that further at this time.

This personal lifetime of nursing is particularly poignant for me today since back on the 28^th of November 2015 was my last day of work as a nurse at Denver Health. It was a long very busy 13-hour day in Urgent Care attending to many of the same type of folks and their issues as I was back in 1973.

I’ll close this piece with a couple things. First, is that Colorado has the chance to vote on single payer health care in November 2016. We as a state currently have a very high rate of medically insured thanks in large part to accepting federal Medicaid support through the Affordable Care Act. Single payer would though be a great improvement in spite of this current commendable high-insured rate.

Secondly, I want to share a series of encounters I had with a homeless fellow I ran across on my walks into work my last two days on the job. The first occurred at 0600 on Friday the 27^th. It was a cold snowy morning and this fellow was under a blanket on the Cherry Creek Bridge on Broadway just south of Speer Blvd. This is often a favorite spot for the homeless folks and he seemed bundled up and out of the wind so I proceeded to work thinking though I might see him later in Urgent Care.

At the end of my shift about 7:15 pm I walked home the same way and was surprised he was still in the same spot but now sitting up and still covered in his blanket. My assumption, perhaps wrong, was that he had spent the day out in the sub-freezing elements. I kept walking but after crossing Broadway I turned around thinking this is really not OK even for a seasoned homeless person.  I cautiously engaged him and he popped his head out of the blanket. He said he was OK that the blanket was warm. The next words out his mouth were to ask if I had a smoke. Despite the obvious health issues related to smoking to lecture him on this under the current circumstances seemed ludicrous. Instead I gave him the four bucks I had and encouraged him to walk the one block down to Denver Health where he could spend the night in the Emergency Department waiting room at least.

The next morning walking into work again I was stunned he was in the same spot. Still under his blanket, a thick coat and pretty good hat and rhythmic breathing quite noticeable. He was not lying directly on the pavement but still this could not have been comfortable. I have over the years encountered numerous homeless who prefer even sub-zero weather to the shelters for a variety of reasons. I decided I would walk home later the same way and if still there I would give him the $20 bucks I had. He was however not there in the evening and I wondered if he had walked down to the hospital or to a shelter or much more likely just moved on.

He had selected a spot out of the wind, temperatures in the high teens with lots of traffic and pedestrians within a few feet and he was reasonably dressed so I never thought the situation life threatening but if not careful frost bite could have been an issue for his toes at least. The greatest clothing need for homeless shelters is socks. I should have brought him a couple pairs from work. Since I walk central Denver a lot I plan to always venture out especially in wintertime with an extra pair in my bag.

© December 2015 

About the Author 

I was born in La Porte Indiana in 1949, raised on a farm and schooled by Holy Cross nuns. The bulk of my adult life, some 40 plus years, was spent in Denver, Colorado as a nurse, gardener and gay/AIDS activist. I have currently returned to Denver after an extended sabbatical in San Francisco, California.

Horseshoes for the Homeless by Pat Gourley

I have never had a horse in my life with shoes or without. I am aware of the game of horseshoes but this is something I have never played despite growing up on a farm. We never had horses and I never even got a pony for my birthday.

So the topic of shoes for horses is not something I can relate to at all. However, the topic of shoes for people and the feet that go into them are a frequent issue for the clients I find myself serving these days in the Urgent Care Clinic where I work.

Most folks coming into the clinic do no not have specific foot issues but two populations accessing care do. The first and larger group is the diabetics. Uncontrolled diabetes tends to affect not only circulation but in relation to one’s feet, sensation. Many diabetics often have numb feet having diminished or no feeling in their feet. This leads to bangs and bumps, to toes especially, that create small wounds they are unaware of and if not attended to can lead to big problems including infection which along with compromised circulation can eventually lead to amputation. Some of the best nursing advice out there is to look at your feet every day especially between the toes and the soles. If you can’t see down there get a friend to look for you or a small hand held mirror. If you have a friend to take a look you can also then guilt trip them into a bit of a foot rub maybe.

The other group that often has foot problems is the homeless and of course some of them are also diabetic. Living on the street or shelters if lucky often does not lend itself to good management of your blood sugars. This winter we have seen quite a few cases of frost bitten toes. Sometimes, if not too severe, this sort of resolves on its own but it can be bad enough that necrosis sets in and parts or sometimes-whole toes have to come off.

So perhaps one of the most useful interventions I can provide for homeless folks these days are dry socks. I am sure you have seen these hospital issue socks perhaps you have even worn a pair for a while. The current ones we have are grey or green with these raised horizontal racing stripes top and bottom I suppose to create some traction and prevent slips. If we have them I always prefer giving out the green ones, it really is a pretty shade of green.

One of my recent homeless foot issues involved a fellow with some rather significant frost bite that he had been neglecting and so in addition to some rather intense probably foot fungal odor I think there was bit of rotting flesh involved. The smell made my old nurse eyes water to say the least. I drew the short straw and got to try and get him to clean up his feet a bit before hitting the streets again. He was having none of it saying he had been at another hospital the night before and they had tried to clean up his feet and the pain was unbearable.

One technique is to use shaving cream on them, which can be less astringent than most soap. He was having none of that either. His plan was to get his check the next day and a
cheap hotel room where he could clean them up on his own. He wasn’t a shelter guy so the plan was to spend one more night outside. This was mid-week last week with temps in the single digits. The shoes and socks he had were of course wet despite the plastic bags he had lining them. He was definitely not going to part with the shoes which he said were very fine just wet. He did however take a pair of dry socks I gave him, green ones of course. This was the only part of our interaction that seemed to elicit genuine appreciation on his part.

These folks, during inclement weather, can spend the night in the waiting room once we have addressed as best we can whatever brought them in though most prefer to head out no matter what the weather. If they come in late in the day with some issue they feel can’t wait until the next morning they often then miss the cut-off time, usually early evening, to get into a shelter for the night.

So the topic of horseshoes made me thing of one more crazy-ass aspect of life in America in 2015 and that is that our horses often have better foot wear than our homeless. I might start carrying a dry pair of socks or two and on snowy, wet, cold days offer them to folks I encounter on the corner with their signs. A more useful gift than spare change perhaps. Maybe I can appropriate a few of the green pairs and hand them out some wintry nights on my walk home from work.

© March 2015

I was born in La Porte, Indiana in 1949, raised on a farm and schooled by Holy Cross nuns. The bulk of my adult life, some 40 plus years, was spent in Denver, Colorado as a nurse, gardener and gay/AIDS activist. I have currently returned to Denver after an extended sabbatical in San Francisco, California.

Reputation by Pat Gourley

It has been some months at least since I have quoted Grateful Dead lyrics in one of my written pieces here so I think it’s about time. A line from one of their classic songs, Uncle John’s Band – a tune by the way covered by the Indigo Girls, states “all I really want to know is are you kind”. If I address “reputation” from a personal perspective I would most want to be known and remembered for being kind.

While watching a 60 Minutes piece last night that featured a few of the Dallas nurses who cared for Mr. Duncan the first Ebola patient in the U.S. I was actually moved to tears by their genuine empathy and kindness toward this man who was dying a horrifying death while at the same time at considerable risk of infection themselves. As a nurse myself I can attest to the fact that while we are not necessarily immune to the sight of human suffering we are not often easily shocked either. This disease apparently is an exception to that rule. Large amounts of human secretions are often part of the game with nursing in certain settings. Ebola though seems to take that to a whole new level most often in the form of voluminous amounts of vomit and diarrhea. In the end stages of the disease even small droplets of these secretions are teaming with literally millions and millions of viral particles and it only takes one to pass it on.

They interviewed four nurses and all four seemed to exude genuine kindness but I was most impressed with an African American woman and a portly man with a definite and beautiful fey-air about him. Though not the case anymore gay men were at one time a preponderance of the male nursing population and we are still quite well represented. I will remember these nurses not so much for their bravery but their dignified and uncompromising acts of human kindness, wiping his tears and holding his hand albeit through multiple layers of protective gear among many such acts in his last days. I would like to have the epithet “he was a kind queen” attached to my tombstone or rather an urn full of my ashes before they get scattered in San Francisco bay.

I suppose there was a time in my distant past when I did not want the rather large “queer’ part of my being to be sullying my reputation in anyway. I do think though I was lucky and got over that one quickly. One sort of throws caution to the wind in that regard when you enter certain health care professions and nursing in particular as a male in the 1970’s. I was probably at my most flamboyant professionally in the 1970’s and I am sure had the “reputation” as being the flaming homo nurse. Only once though in 40 years of nursing, when working ICU, did a patient openly verbalize that he didn’t want the “queer” touching him. My co-workers were much more upset about this than I was at the time and it’s probably safe to say that the amount of kindness directed this man’s way may have been severely curtailed during his intensive care stay. Efficient and appropriate medical care does not necessitate kindness but it sure goes down a lot easier with that in the mix.

As I alluded to I was quite out of the closet during both nursing school and on the job in the 1970’s. I think my ‘homosexual-reputation’ if you will was solidly cemented one night in the ICU at University Hospital when I had just returned from recovering from a bout of hepatitis. Hepatitis was being discussed by a group of us including some docs and folks were speculating whether or not I may have gotten the hepatitis on the job, something not uncommon for nurses in those days before the advent of “universal precautions” and good hepatitis vaccines. As I recall without missing a beat I quite flippantly said that it was much more likely I was infected at the Empire Bathes with my legs in the air. That was the end of that discussion.

As Andy Warhol so famously said everyone gets at least 15 minutes of fame, which I suppose you could say, then becomes a significant part of his or her reputation. For me personally though I certainly hope that is not the case. In early 2000 a writer with Westword came to Denver Health wanting to do a piece on the current state of the AIDS epidemic. I had always shunned the press wanting to do AIDS pieces because they so seldom got it right and what could be worse for one’s ‘reputation” than to be grossly misquoted. The reporter, a fellow named Steve Jackson, was a frequent freelance contributor to the paper often doing long feature pieces. He apparently became bored with the usual AIDS talking heads, mostly docs, at Public Health and was steered in my direction by someone in the building.  He and I actually hit it off having some sort of Grateful Dead connection as I seem to recall and I spent quite a few hours telling him my story.

A long story short I became the entire focus of the piece and wound up on the cover of the next issue. My own fifteen minutes of fame if you will. The piece was insufferably long as it appeared in print and I was still the case after the editor, Patty Calhoun, had cut a full third of it before publication. I have never posted it to my web site in part because I found it to be embarrassing, not because it affected my reputation at all but it really seemed to focus on my own personal drama in a very over the top fashion. If any good came out of it though I hoped it might have persuaded some folks at risk to finally get tested and get on meds. I was, as was graphically laid out in the piece, probably twenty years into my own HIV infection and still walking, talking, working full-time and posing for Westword cover stories.

One might think, and I suppose I did too, that such exposure would have major repercussions but it actually had virtually none. For one thing it was too long for most folks to get through and secondly I attribute this lack of fallout to the strength of coming out. If all your secrets are already out their in your personal and work circles and most folks are already bored with the old queen’s story and simply adding a few thousand more Westword readers to that mix doesn’t much effect one’s life or reputation and it did not.

In fact the response at least that blew back to me was quite muted. Oh a few mostly gay positive men came up to me in person and were very supportive but most responses ranged from “oh is he still alive” to my personal favorite “I thought they only put convicted felons on the cover of Westword”.

The lesson for me seems quite obvious. One’s reputation hopefully is not in anyway significantly influenced by any particular 15 minutes of fame but rather by a lifetime of being kind or at least trying to be to all you encounter. In that respect I am great believer in Karma and what goes around eventually, despite frequent bumps in the road, comes around.

© October 2014 

About the Author 

I was born in La Porte Indiana in 1949, raised on a farm and schooled by Holy Cross nuns. The bulk of my adult life, some 40 plus years, was spent in Denver, Colorado as a nurse, gardener and gay/AIDS activist. I have currently returned to Denver after an extended sabbatical in San Francisco, California.