Dear Nurses Who Tried to Start my IV,

I've got a thing about veins. I don't like them. That's not to say I don't appreciate what they do, transporting blood about the body and whatnot; it's just that the thought of slicing, poking, stuffing, inserting, or otherwise manipulating these blood channels totally grosses me out.

I once watched a movie in a film studies class about AIDS in Cuba. In the movie a protester intentionally injects himself with HIV-infected blood. They showed a real nice, long close up of the needle sinking into his inner arm and I just about threw up at my desk. I'm shuddering and making a pursed-lip expression of disgust right now as I write about it.

Some people seem to like making movies in which a depressed person lights some candles, fills a bathtub, puts on some weepy music, undresses, slips into the warm water... and slits their wrists. I'm aware that the effect here is not supposed to be a comfortable one, but I find this trope to be especially unpleasant. I typically focus on some point along the edge of the screen so it looks like I'm still watching the movie and the people I'm with don't think I'm a pussy who can't stand the sight of blood. And as I suppress a grimace and stare hard at the edge of the screen, I wish death upon this movie character and hope she cut down the highway and not across the street (shuddered while writing that) because a couple days in the hospital and judgmental glances from the nursing staff is not punishment enough for grossing me out like this.
And it really is the veins themselves that I have an aversion to, not so much the blood. I'm not sure why. Maybe it has something to do with the phobia of worms I had as a very small child. I watched a made-for-TV movie about King Herod in which his guts burst open and a pile of writhing worms emerge from his entrails. I think that may have set things in motion. It's weird the arbitrary things that have such an earth-shattering impact on you as a child. I'm sure I was exposed to a hundred things more traumatizing than that around the same period, but no, it was some bad special effects from a movie I saw on my grandmother's black and white TV that stuck.

Shortly thereafter I had a nightmare that I was eating spaghetti and then realized mid-bite that the noodles were actually long, sickly worms, squirming their way down my throat. Later that year I went to some kid's Halloween party dressed up as a mouse. Things went pretty well until I caught sight of my costume's tail lurking behind me. It looked a lot like a worm, and I ran around feverishly, looking back and screaming in terror until my parents removed the worm tail. Stupid children. Although in my younger self's defense, on occasion I still run around feverishly, looking back and screaming in terror because of things that are attached to me. Death, for example. 

But maybe it's simply the tender vulnerability of veins that disturbs me, or their association with self-harm fostered by the vein-slitting movie trope. Whatever the origin of my vein phobia, the upshot is it's made going to the hospital an even more unnerving experience than it normally is. A couple years back I broke my arm playing football and I got into an argument with the ER nurse over whether starting an IV was really a necessary part of my treatment. 

Whether starting an IV or drawing blood, rolling up my sleeve for the nurse is an exercise in solemn, controlled breathing and mind-over-matter, zen-like non-concentration. It grosses me out every time, but I have always had the good fortune of being in the hands of competent professionals who made the process as quick and painless as possible. That is until last week.

Last Tuesday I went into the doctor's office for a relatively routine outpatient procedure and was shocked and horrified to learn that it involved starting an IV. I tried to sound out the nurse a little without betraying that I was nervous. My theory is that if the nurse finds out I'm nervous it'll make her nervous, and people who are nervous sometimes get twitchy hands.

"So we're going to go with an IV for this one, huh?"

"Yes. You can go ahead and change into this gown."

"Is it always necessary to get an IV for this procedure, or is it more of a doctor's preference sort of thing?"

"It's standard procedure."

"But like standard everywhere or just standard for this clinic?"

"I don't know what the other clinics do."

"Are there perhaps alternate methods that would not require..."

"Sir, if you're afraid of needles we could always..."

"WHOA, Whoa, whoa. Hold on there. Nobody said anything about being afraid of needles."

"Ok, then just change into this gown and we'll get started."

So I changed into the gown. And we got started. I laid back on the little vinyl chair/table with the long strip of paper down the middle. I always lay back when the opportunity presents itself so I can fool my body into thinking it's time to get comfortable and have a little rest. My body knows better. A second nurse entered the room and closed the door behind her. 

I notice that the second nurse seems young. Like really young. I hope she isn't going to be the one with the needle in her hand. She walks over to the cabinet and pulls out an IV starter pack. Oh God please tell me your only task today is handing that pack to the older (but still too young) nurse. It's not. She saddles up beside me with an expression on her face that I would describe as "overly concentrated" for someone who's comfortable starting an IV and has a long track record of successfully doing so. My eyes almost roll back in their sockets reflexively. I take a deep breath and stare up at the fluorescent lights.

"This is the right needle gauge, right?" the nurse at my side asks the slightly older one. From this angle she looks to be about 12 years old. "The blue one, right?"

"Yes," the slightly-older-but-still-too-young nurse responds. But now the slightly older nurse has a look of uneasy concentration in her eyes as well which sends a shiver of panic down my spine. The slightly older nurse comes around to supervise as the tween takes my right arm into her tiny, child-like hands. No one who knows what they're doing requires this level of microscopic supervision, I think to myself as the slightly older nurse looks directly over the tween nurse's shoulder. The tween nurse takes the IV needle out of its packaging and squints at my arm. "Make a fist" she adds, still squinting.

I can't watch this part, for obvious reasons. I pump my fist furiously, hoping to make the job easier for her. I stare at the furrowed brow of the slightly older nurse and realize that we are essentially in nursing school, and I have been offered up, without my consent, to be a training doll for someone who is obviously more likely than not to fuck this up.

And she does. I feel like barfing as she slides the needle into my arm and then shakes her head sadly. She tries to wiggle the needle around a bit. My respiratory rate is increasing. 

"It's just not... hmmmph. The vein is too small. I can't hit it."

The slightly older nurse steps in immediately, shooing the tween away.

"You'll get it. Just watch me do it again." 

I'm getting light-headed but I feel a wave of relief rush through my body at the older nurse's sense of competent command. Surely she will put an end to my suffering. 

"Let's try the other arm," she suggests. 

Swing and a miss. She botches the other arm. I can feel my stomach cramping and a cold sweat breaks out on my forehead. In my minds eye I see the needle digging around under the skin, tearing up my vein, even after she's given up.

Both nurses are starting to get excited now. They decide to try my right hand. She jabs the needle into the tendons of my hand instead. At this point I am sweating profusely from every pore in my body. I feel like I'm freezing and roasting to death at the same time. "This is a nightmare," I whisper out loud, still staring at the fluorescent light while my stomach contracts. I can't resist the urge to wiggle my body after the nurses are finally done digging around in the tendons of my hand. Finding a comfortable position is impossible. I'm breathing ever more rapidly.

"Let's try again in the left arm," the nurse suggests. A sober, rational me in complete command of my faculties would have refused at this point and demanded they bring in someone else, but I wasn't sober or in complete command of my faculties, I was writhing in phobia, trapped in blank-faced confrontation with an ancient demon. So they tried the left arm again. And failed again. I imagined I could feel the steel searching around under my skin, the vein sliding to the left or the right of it. I was getting tunnel vision and everything around me seemed to be getting darker and darker.

"Go get the doctor," the slightly-older-but-still-too-young nurse told the tween nurse; her face ashen and herself on the edge of panic. 

"Every time I try to put in the IV, the vein rolls to one side or the other," the nurse explained as the doctor came in. He didn't seem pleased. 

I looked around in a state of semi-shock and tried to focus on swallowing. My throat wouldn't allow it.

"Is this the needle you've been using? What is this, a blue?"

"Yes," a nurse answered bashfully.

"You never use a blue. Give me a red pack."

"We thought the red would be too big." The doctor didn't dignify this with an answer. Instead he opened the IV starter pack, took the cap off the needle, eyed up my left hand for a moment and inserted the IV in what seemed like one swift motion. I felt like vomiting for a second and then a wave of relief flooded over my body. Seconds later Propofol was also flooding through my body and I drifted away into a beautiful sleep with warm, fuzzy dreams. I was drinking beer with best friends I'd never met before in a field on a summer day. Sun flowers bobbed their heads in the breeze and we were making plans for the weekend. It's no wonder this stuff killed Michael Jackson.

So thanks for the immersion therapy, tween nurse and older-but-still-too-young nurse. I'm still grossed out by veins, and the way my arm looks makes people suspect my wife of spousal abuse, but I feel like I could be one step closer to overcoming my phobia.



And to think, all these years I thought I had an irrational fear of people sticking needles into my veins.


On second thought, no, I'm not closer to overcoming my vein phobia. Not at all actually. If anything it's worse now. I just hope I never run into this sadistic House of Horrors nursing duo again.

Sincerely,
Sebastian Braff

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