Evidence

A towel that hangs in the bathroom was covered with bug debris and spider web bits. Yesterday it was clean. I wondered first if it had been dropped on the floor or dragged about the house and then hung back up. My husband and daughter wouldn't have done that. They would have thrown it in the hamper. My 3 year old is too short to hang it there. Bug debris? I looked up. There, above the toilet, was the light. It is an old-fashioned light with a glass dish that is held on by something that screws in at its base. There was a clear area, where some large bug had buzzed and scattered debris of previous bugs clean.

Two days ago I was startled by an ivory beetle buzzing around my bathroom, after I had gotten naked for the shower. I caught the beetle in a jar and identified it. It was of the ilk of the elm borer, for which purple bags hang about trees all through the midwest. The ivory beetle eats (and kills) hardwood trees. It was enormous, in comparison to the gnats, moths and mayflies that are found in my bathroom in the morning. I concluded it must be bad beetle season. I saw no beetles today, but the debris on my towel and my dislike for that ivory beetle convinced me that a bad beetle was the culprit of such an evil deed.

Evidence is a puzzle. We don't always come to the correct conclusions about what it means, but it takes us closer. We are natural borne hunters. We spent much more of our evolution looking for tracks in the woods than we did shopping for deals at grocery stores. We are hard-wired for curiosity. Perhaps that is why I find books like "Tracker" so engaging, and the nursing field and nursing theory so interesting at times.

My first nursing instructor traumatized me, but she also fascinated me. She could tell what was wrong with someone by looking at them. Painstakingly, she taught me these skills also.

It has come to amuse me when a patient - or an acquaintance - wonders how I know something about them. After 12 years of helping doctors figure it out, I've become fairly good at it. But like all clues, they don't always lead one to the correct conclusion. There are tricky situations that baffle even the smartest or most educated.

Still, a simple "head to toe assessment" done thoroughly can find a book of information about a person. Slightly jaundiced sclera and a bulging right upper abdomen are telltale signs that someone may like their beer, for instance. Trying to get an IV in someone with seemingly good veins, only to have them pop and bleed one after the other is sometimes a pretty good indicator that a person is on a steroid. Going to work is a daily puzzle. It is the craziest part of the day, those morning assessments, looking 5 people over, getting their vitals, writing it into the computer, and then sorting through the slue of doctors bombarding the nurse's station with the most pertinant finds of the day so they can order tests and treatments. It is maddening, but in a hunter-gatherer sort of way, it has come to be something like a fun board game. The object of the game is to get the person better and send them home.