By Iris Graville

Recently I received my membership card for the Pacific Northwest Writers Association. The next day I deleted my name from a listserve for the state public health association. One rite of passage followed another as I make a living as a nurse, writer, and artist – a balancing act I’ve been refining for nearly ten years.

Since 1974 I have worked as a nurse. In my teens, I felt called to a healing profession and entered nursing ready to save the world. I spent my first years working in a large university hospital surgical intensive care unit, then in a community hospital caring for people with cancer. I went to sleep at night with the beeps of respirators and heart monitors ringing in my ears. My patients, often only partly conscious, had jaundiced skin, gunshot wounds, coronary arteries repaired in multiples, and IV’s dripping in life while catheters, chest tubes, and drains leaked it out.

Later I lived and worked in an inner city neighborhood, riding my bicycle to visit elderly patients at home. I monitored their medications, cleaned their diabetic leg ulcers, and called their doctors when their emphysema, heart disease, or cancer threatened to outsmart medical treatment. In their living rooms, bedrooms, and bathrooms I massaged their tissue-paper skin, smoothed ointment on lips cracked from the drying air of oxygen masks, monitored how well the morphine drips eased their pain, and cleaned up vomit and stool when their bodies revolted against disease and its remedies.

At two different nursing schools, I taught even younger and more idealistic people than myself about how the body works, what to do when it doesn’t, and to raise their voices for health care for all. When I became a parent, my focus shifted to the needs of children and the promise of preventing illness by getting them off to a healthy start. In homes, clinics, and child care centers, I discovered that for some parents, feeding, bathing, and clothing their children was a struggle; getting immunizations or giving medicine for an ear infection or asthma was a challenge. And for many children, early life included slapping, pinching, cutting, burning, and shaking. Witnessing such pain and distress led me to state government and the presumption that I could decrease suffering by shaping social and health policy.

My dedication took its toll. Early signs of burnout came in 1989, four years after finishing graduate school. They nudged me to move to a smaller town, take a job in a smaller organization, and get back to hands-on nursing care after my stint as a public health bureaucrat. Within a couple years, instead of being re-energized, I was overwhelmed by the never-ending stream of pregnant teens and young women ill-equipped to deal with parenting complicated by poverty, drug and alcohol abuse, or domestic violence. Naively, I sought refuge in middle management. Soon I discovered the impotence I felt in direct service was magnified in my new role caught between those with power and those in need.

A series of communicable disease outbreaks, including the well-publicized onslaught of E-coli in 1993, followed by my demotion from supervisor to staff nurse during government downsizing, pushed me to re-think my commitment to nursing. It was changing into something I no longer recognized – more paperwork, politics, and financial management than caring and healing. I wondered if I would leave nursing, or if it had already left me.

At the same time, my husband and our twelve-year-old twins felt squeezed by middle America’s compulsion to move faster, consume more, and question less. The treadmill was circling at a frantic pace, leaving us all gasping for breath and grabbing for a hand-hold. When I proposed a one year family sabbatical, their positive response was unanimous.

In May 1994, after a year of planning, paying off bills, and finding renters for our house, my husband and I quit our full-time jobs and packed up our family for Stehekin, a remote mountain village in the North Cascades of central Washington. This community of less than 100 year-round residents had been our summer refuge for nearly ten years; now it was home.

Generations ago, Skagit and Salish Indians named this spot at the end of 55-mile -long Lake Chelan. For them, Stehekin was “the way through ” the mountains. Later, highways were blasted through parts of that range, but none ever made it all the way to the tiny village. Today, most people get “uplake” by a commercial passenger-only ferry that sails daily in the summer and three times a week in the winter. Telephone lines from the “downlake” world never made it to Stehekin either. Communication there takes place face-to-face, and contact with the rest of the world is by mail. A single public telephone, for outgoingcalls only, haltingly relays voices via satellite when communication is urgent. Stehekinites send shopping lists by post and receive groceries by boat.

There are no nursing jobs in Stehekin. The first summer there I worked in a log cabin bakery, freed from thinking about sickness, patients, or health policy. That fall, my children entered seventh grade in Stehekin’s one-room school. It was as though I returned to school, too, responding to a small voice crying out for attention. My classrooms were the mountains and the river, my teachers towering pines, black bears, and spindly-legged fawns. With the help of Julia Cameron’s The Artist’s Way, I strengthened my flaccid, under-used creative muscles with daily and weekly exercise – writing, reading artist-affirming words, noticing beauty, pampering the artist within, and dreaming of a life as an artist. I experimented first with music and drawing, then block printing, and always the written word.

Our one-year sojourn turned into two. My children finished elementary school in Stehekin, and when it was time to move elsewhere so they could go to high school, we relocated to our current home on Lopez Island. It has some of the best of Stehekin but is not so isolated. We still get to our home by boat, but there are phones (as well as e-mail and fax), a grocery store, a library, twelve grades of school, and about 2,200 neighbors.

While in Stehekin, I discovered there’s a market for the expertise I’ve acquired over twenty-five years of nursing practice. Since then, I’ve been self-employed as a public health consultant, doing only the parts of nursing I enjoy the most. I’ve learned to manage the fluctuations and variations of intermittent contracts, providing training, doing program evaluations, and teaching community college courses while maintaining time to pursue other passions. It is paper arts I’m drawn to now – bookbinding, paste paper, handmade paper, collage – and the constant in my creative path, writing.

In October of 2000, instead of attending the usual fall public health conference, I enrolled in a week-long writing course. During group discussions about how to fit writing into our lives, I realized a number of my nursing contracts would be completed by the end of the year. I saw an opening then to try a new schedule. Why not fit consulting work around writing instead of the other way around? I announced to my fifteen classmates that in January 2001 I would start a new job.

The metaphor works for me. Now I block off the time on my calendar WRITING, 10-12. I give it my two best hours of the day, Monday through Friday. On Tuesdays, that time slot is reserved to write with a group of five other women committed to this craft. On the other days, I don’t answer the phone (that’s what voice mail is for). I don’t check e-mail (it will be there in a couple hours). I don’t schedule anything else during that shift, or if I must, I make up my two hours of writing later in the day. I do sit at my desk, surrounded by the tools I need for my vocation – a computer; one of my hand-bound blank journals; a wooden ball point pen made by a friend in Stehekin; the five-pound, red-covered Synonym Finder by J.I. Rodale; and a list of writing exercises.

Some mornings I watch the clock, hoping my two hours are nearing their end. On other days, I lose track of the time, and the grumblings of my stomach remind me to quit. Sometimes my head hurts, as I dig for understanding like tulip bulbs I planted too deep. Often I cry. As with nursing, I believe God moves through me in this work. The words, sentences, and paragraphs I string together lead me down a path of discovery, of knowing, of hearing God’s whisper.

After I write, I divide the rest of my work day between nursing consultation, paper arts, and learning about the business ofwriting. The nursing brings in enough to contribute to the household bills. As a member of an artists’ cooperative, my earnings from the hand-bound journals and cards I sell in our gallery pay for papers and paints. So far, the monetary compensation for my writing has been minimal, but I am committed to finding paying markets for it as well.

There’s no denying my current lifestyle would have been much harder, if not impossible, when I was younger, going to graduate school, caring for two young children, and then later when my husband and I bought our first house and juggled part-time and full-time jobs with parenting. It would have been harder if my kids hadn’t gotten scholarships for half of their college tuition and if my in-laws hadn’t been able to help with the rest. And I would still be working full-time as a nurse if our family hadn’t shifted our priorities and decided that doing what we love and living simply in a remote, rural community, is more important than acquiring.

Now I carry two business cards. One lists my name and a degree in bold, black print and identifies me as a public health consultant. On the other, an elegant heron silhouetted by a full moon joins with my name in blue script. This card for Blue Heron Studio proclaims me an artist and writer. Perhaps some day I will need only one card, but for now I am grateful for the balance these two provide. And for the first time in many years, I am excited about going to work every morning.

©2004 by Iris Graville