My very independent husband, in entirely sound mind and good health apart from pancreatic cancer, was in the hospital to recover from a pancreatectomy and splenectomy. Although the surgery went well, his lungs did not recover as expected. On the second night, we were suddenly transferred to the ICU around midnight to get him to stronger oxygen support. He was terrified and confused by the experience -- not only the gasping for breath but the great commotion with many people talking at once, bright lights, and so on. I understood the medical plan and rationale, but he couldn't follow them.

When we got to the ICU, a doctor and a nurse warned us that they might recommend intubation. That tipped him into delirium with paranoid delusions. He had watched his father die on a ventilator as he begged for the tube to be removed. He panicked over his lack of control over the situation, as well as the possibility of intubation. His anxiety rose to such a pitch that soft restraints were placed on him overnight. He struggled and screamed throughout the night. Restraints were especially difficult for a claustrophobic man who had been hyperactive since childhood. They were removed in the morning, when we met Martha, his day nurse.

I will always be grateful to her for her extraordinary psychological sensitivity and skill in discussing my husband's situation with him, which helped win back enough of his trust that he became more cooperative with the medical staff. She summoned the fellow in the unit, and the two sat and talked with my husband for what seemed like an hour, listening to his grievances and worries and reassuring him. The fellow, leading off, made a valiant effort but was unable to reach him; his words and manner made my husband more suspicious. Martha had far less formulaic ways, more specific and sophisticated, to address his confusion and terror. She was able to win enough of his confidence to get him to cooperate thereafter with at least the most essential of the medical orders and advice, despite persistent delirium.

As I write, we are nearing the end of our fourth week in the hospital; his lungs have largely recovered, and we are still working on the digestive tract. Delirium is better. We have worked with numerous nurses who have astounded us with their knowledge, stamina, and care. However, without Martha's exceptionally skilled and dedicated help on that critical day in the ICU, I believe the recovery would have been much more arduous and prolonged. In addition, Martha showed me, by example, how to listen more effectively to my husband and address his concerns more effectively. I'll keep those lessons in my heart for the rest of my life.