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Thursday, Jan. 26, 2006 09:20 pm

Give and get

How a nurse’s life turned on the kindness of a stranger

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PHOTO BY DON CLEGG/CARLE FOUNDATION HOSPITAL
On days she had to see the doctor, 11-year-old Kim Rogers would sneak out of bed at 5 a.m. to jump rope in the garage, trying to force her body to soak up the insulin it couldn’t produce and hide the sugar in her blood. She would go into the garage so that no one would hear her. Still dressed in her bedclothes, Kim, who had type I juvenile diabetes, would skip rope for half an hour, her skinny frame landing lightly on the concrete floor. Jump, skip. Jump, skip. Pause, breathe. Just a few more minutes. Jump, skip. ‘Don’t worry about it, Kim,’ her mom, catching her in her ritual, would say. Their appointments at the small community hospital in Tuscola, Ill., were at 7 a.m. Kim didn’t want to fail anyone. She was afraid of the doctor. Every two to three months she would go to his office, with Highlights magazines in the waiting area and two examination rooms that smelled of antiseptic and impersonality. He would go over the results from that morning’s blood test: If they weren’t good, he would lecture her about the importance of bringing her sugar levels down, and they would repeat the test the next day and for as many days as it took for her blood sugar to stabilize. Throughout junior high and high school, Kim performed her own urine tests four times a day — after every meal and before bed — by placing five drops of urine, 10 drops of water, litmus paper, and a chemical tablet in a tube, then watching it fizz. If the paper turned blue, she was OK. If it turned an ugly brownish yellow, it meant that her kidneys weren’t keeping up with her blood sugar, that they were spilling the excess into her urine and she would have to be stricter with her diet. I would give anything to have this instead of you, her mom would tell her. But if one of my kids had to have it, it was probably a good thing it was you, because you are able to handle it better than your brother would be able to. The disease worked as a kind of motivation. You can do everything anyone else does, little Kim would tell herself, then try to prove it. At 16, she got a job at a pizza place in Tuscola. She worked for two years, saved her money, graduated from high school in 1980, and bought a 1974 burgundy Corvette for $6,000. She postponed plans to attend college and got a well-paying job as a truck dispatcher in nearby Champaign. Kim grew into a tall woman of sturdy build with blond hair and a gap between her front teeth that she didn’t seem to mind. She was secure and happy at work, but, after eight years, she felt the tug of another calling: “How do you explain when you get a call? I don’t know. I feel a strong pull within me to do certain things, and nursing was one of those.” Still working full time as a dispatcher, 27-year-old Kim enrolled in Parkland Community College in Champaign as a full-time nursing student. She also started working weekends at Carle Foundation Hospital in Urbana to gain experience in the medical field. “To throw all that together — it was just meant to be,” she says. Kim graduated from Parkland in two years, became a nurse and then an ambulance nurse, a helicopter nurse, and a firefighter. She also married Maury Busboom and became a mother to his son, Brad. Kim did not shrink from the challenges nursing gave her — learning to be more organized, to think critically, to relate to patients and co-workers and to learn the hospital’s policies and procedures. “I always just wanted more. I never shied away from anything.” By 1997 she had worked herself into Carle’s sought-after surgical intensive-care unit. She thrived on the independence it offered her — a fast-paced ward where physicians depend on the nurses’ judgment to treat the hospital’s worst-case scenarios. Patients range from newborns to the aged. Kim says that she has always given attention to the families of victims. She believes that it is especially important in the ICU because the hospital is the last place the families of the patients expect to be. Family members come to the unit to see loved ones who were fine a few hours before but, after being stricken by illness or sustaining a serious injury, now lie in one of the unit’s 12 beds, set behind a set of double security doors on the seventh floor of the hospital. Each is hooked up to a ventilator and a monitor that beeps every 60 seconds to let the nurses know that the patient’s condition is stable. A short, dull, deep tone means that all is well, but if it changes to a continuous, fast, high-pitched tone, the nurses come running. Kim tries to put herself in the family’s position but realizes that she can’t know how they feel. She will sit with them, talk with them, pray with them, or cry with them. It is in this environment that Kim has found her home: “I could not work anywhere else. . . . It’s just like another family for me out there.” Later in 1997, Kim got involved in another calling — Carle’s volunteer parish-nurse program. Trained registered nurses bring spiritual health back into nursing through service in religious congregations. Carle’s 44-hour certification program has graduated more parish nurses than any other program in the country — 352, serving 193 congregations, 74 towns, 28 counties and three states. Kim volunteered to serve as parish nurse for her church, Immanuel Lutheran Church in Flatville. Immanuel Lutheran is a mostly German, rural congregation. Flatville’s population of 50 is dwarfed every Sunday by the average crowd of 300 drawn from surrounding farming communities. Kim tries to educate her aging congregation. She provides monthly blood-pressure screenings and holds blood drives and programs on de-stressing the holidays, dealing with grief, and senior-citizen issues. However, much of her work has less to do with formal programs and more with just being available to people — a Sunday-night phone call about a new baby, advice after the Sunday service on finding a new physician, a visit with a parishioner while she’s at Carle to answer questions about her surgery.
By 2000, Kim was juggling all the work, volunteer and family roles she had given herself. She never wanted to tell people that she couldn’t help them, though sometimes she told them she had to “switch hats” to do it. You can do everything anyone else can, the now-38-year-old Kim told herself. But this time, her kidneys disagreed. The chronic renal disease caused by her diabetes took a turn for the worse, and on Dec. 14, 2000, Kim learned that she had end-stage renal disease: her kidneys had stopped working, bringing her whole life to a halt with them. “I had to go on dialysis,” Kim recalls. “It was Jan. 12, 2001. I was on dialysis three days a week, and . . . was put on a transplant list for a kidney and a pancreas both.” The nurse who had spent a decade at the bedsides of the severely injured and ill was now in the bed. Her red-blood-cell production plummeted, leaving her with persistent acute anemia. She suffered fatigue, as well as nausea from erratic electrolyte levels, and walked around with a pallor as toxins built up in her bloodstream on days she didn’t go in for dialysis. When your name is placed on the organ-transplant list, Kim says, you’re told that the summer holidays are good times for organ donation. Vacationers flood congested roads and interstates, creating a recipe for deadly traffic accidents. Kim went on the transplant waiting list May 1, 2001. That day, she packed two bags: one for her — a leopard-print duffel her mother had bought her — and a big black suitcase for Maury. They sat in a corner of Brad’s room, waiting to be taken to the hospital. She visited them every day. Will this be the day I get to use them? One by one, she added things to them. She made sure that each bag had everything she and Maury would need: underwear, pajamas, toothbrushes and toothpaste, deodorant, shampoo, combs, brushes, socks, jeans. Everything. She kept a music box her mom had given her in her bag. Every day she sat on the bed with the mahogany box, open it, and look at the pictures inside — family, friends, cats — a childhood rosary, and a prayer book, as the box’s high-pitched tinkling of “Too Rah Loo” slowly wound down. Sometimes she wound the box a second time. And she waited. Months passed as Kim prayed that someone would die so that she could live. Months passed as the guilt of that wish grew larger: “You think I didn’t pray about that every day — and I didn’t apologize for praying for that?” From the first day on the transplant list she prayed for the family of the person who would die. Memorial Day came and went, the first of the big summer holidays. No one called. June. Still nothing. The leopard-print bag grew bigger as Kim kept adding items. The duffel was getting harder to zip shut. July 4, the next big holiday. No phone call. For 28 years she had handled her illness and had proved to herself that she could do everything anyone else could. Now it was all slipping away. Finally Kim lost control one summer morning, a nondialysis day. Her energy was down, and she was dragging. She got out of bed but left her pajamas on she opened the shade that covered a big bay window in her living room. She walked to a small wooden bench on the opposite wall of the living room and, just like every morning, picked up the rock that sat there and held it in her palms, close to her chest, feeling the word written on its face — hope. But on this morning, Kim didn’t have any left. She collapsed to her knees and began to sob and pray. “It opened the floodgates; everything just came out,” she recalls. “I needed to stop trying to fix it. The biggest thing was I kept worrying what I could do to fix the problem; I gave that to God. I started focusing on what I could do to get through each day.” She started doing little things — bargain-shopping with her mother for groceries and secondhand clothes and decorations after dialysis — that brought her joy. She quit worrying about when her organs would come but kept praying for the family that would be giving them.
The phone call came when she was at work on Oct. 31, 2001. She sat down at the phone in the ICU at Carle, where she still put in a few hours three or four days a week. It was 3 o’clock in the afternoon, and she wanted to order a cheeseburger to take home with her. She was feeling good that day and had managed a long shift at work — six hours, half of a normal 12-hour shift. Before she could dial out, a call came in for her. “Kim Busboom?”
“This is she.”
“Your organs are waiting.” She was home by 4 o’clock; Maury was waiting. Her mother arrived at 4:10, and 10 minutes later they all left in her Dodge Caravan for the hospital, located at the University of Wisconsin-Madison. They drove north on Interstate 39 through a warm October night, with the temperature in the 70s. The full moon lit the countryside. They hardly needed their headlights. “We weren’t anxious; we weren’t nervous,” Kim recalls. “It was the most calming soothing peaceful drive.” They arrived at 10 p.m. on Halloween night, and the surgeons operated the next day. Before they had finished the surgery, the new kidney was making urine, and, 10 days later, instead of the usual 14, Kim was on her way home. The new pancreas worked — Kim’s could leave the jumprope in the garage. Her body now made its own insulin. Kim was no longer diabetic. “It’s like a gift. It is a gift. . . .” Kim says. “It’s like a whole different life. I’m so grateful for all the little things — driving to work. Getting off the off-ramp for work I stop and say thanks for letting me drive to work today. I lived getting up in the morning and throwing up just because I felt sick. When I got the transplant, that went away.” Now 43, Kim doesn’t try to prove to herself that she can do what everyone else does anymore. She still pushes herself — that will never change — but she’s happy with where she is and what she has. Now she wants to share that with other people. Her heart is her biggest strength, says James Lehman, Kim’s pastor at Immanuel Lutheran. It’s also her biggest weakness: “Because she cares so deeply, she hurts deeply. I’ve kind of wanted to take her aside and say, ‘Kim, it’s OK.’ ” Kim is working on a letter to the family of her donor. She sent one after her surgery, but the family never replied. Now she’s writing a second, telling them about the award she received in Chicago last year from the Gift of Hope Organ and Tissue Donor Network in her donor’s honor, as well as what she does every day in the ICU, at church, and in her family with her new organs: “I would be a fool to tell you I wish it hadn’t have happened, because I wish it had never happened, but I will also tell you . . . that everything we go through makes us who we become. I truly believe that I’ve become the person I am through everything I’ve gone through. So I can’t fault it.”
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