The Door of Last Resort: Memoirs of a Nurse Practitioner

Preface

ix Preface I was born a first-generation American to immigrant Scottish parents who settled in Kearny, New Jersey. From a diachronic perspective, my life as nurse and nurse practitioner was grounded in my early growth in this town. Maturing in a loving home shaped by the values of hard-working immigrant British parents, I enjoyed the luxuries of American higher education. As a student, I was a sponge. With education and experience, I immersed myself over time in unique events in distinct contexts, with dreams of an equitable health care system. Synchronically, certain tropes emerged in time, evidenced in behavioral outcomes; patterns of power relationships—equality, dualisms, reasoning, and valuing—evolved, invariably influencing what I live for. Perhaps more a blurred genre than either memoir or autobiography, my narrative recounts a life as a first-generation participant in the dismantling of medical autocracy in the United States—and the establishment of an alternative: the care of patients on their terms, in their context. Over Time The location of two Scottish manufacturers in Kearny—the Clark Thread Company and the Nairn Linoleum Company—cloaked the town in British values of hardiness, work productivity, and frugality. No one believed in the American dream more than my father. A highly skilled ship’s carpenter in Scotland, in his early years in the United States he was termed a “Mick,” mistaken as just another Irish immigrant looking for work. Once a member of the carpenters union, however, he had regular employment and benefits. Born in Dumbarton , Scotland, he was one of twelve children, completing the fifth grade in school. He married my mother, Frances, also from Dumbarton; but, as he wryly said, she was from the other side of the tracks. Also one of twelve, her family was engaged in the whiskey and liqueur trade; she completed high school and became a beautician. A British loyalist, she joined the Royal Army in World War II, becoming a front-line jeep driver. When the war ended, they came to the United States and married, eager for a new life. My sister, Maureen, was born in 1948 and I was born in 1950. Living in Kearny with Scottish values, we were a close foursome. Schoolwork came first; phones were for business, not idle chatter; no television on weeknights; dinner at 4:30 p.m. after my father came home from a construction site; and play was x Preface outside, with pinky balls, jump ropes, and adventures in the Meadowlands. I’d walk into Newark to my favorite bookstore, where I bought Russian novels with saved bus fare money. We spent summers on the beach in Ocean Grove, beginning the day after school closed until Labor Day; my father worked in Kearny during the week and joined us on weekends. Time for work, time for play—and the ethic creed: If something is worth doing, it is worth doing well. I watched my mother roll saved pennies once her change jar was full. While summers in Ocean Grove depleted their savings for a home, they wanted my sister and me to enjoy summers away from the city. Only in retirement did my parents purchase their small dream home in Florida. At the end, they had plants, a lemon tree, jalousie windows, and air conditioning. New Port Richey was their home until my father, James Francis Ward, died five years after their move. Rutgers—Into Newark After my Catholic grammar and high school education, my life seemed to take on limitless potential in 1968 when I entered Rutgers University College of Nursing in Newark. From a sheltered Scottish environment to the swirling chaos of Newark, one year after the race riots—amid activist efforts of Students for a Democratic Society, the National Organization of Women, civil rights, Black Power, and the anti-Vietnam War movement—I achieved a stellar academic record, all the while stringing love beads, painting peace symbols, and sympathizing with all efforts at equality on any front. My father, a quiet man with pro-freedom fighter, anti-Crown inclinations, had shaped my thinking. I watched and listened to all events on the Newark campus between 1968 and 1972, the year I graduated with my Bachelor of Science degree. At Rutgers I felt the value of America’s Declaration of Independence. Freedom of speech. Equality for all, including women and minorities. And health? Do not all Americans warrant quality health care? Equally influenced by my stoic army mother, I obtained my first nursing position after...