For care they have provided, many of us owe great debts of gratitude to nurses.

Nurses have more to offer than care.

At their best, nurses teach us how to care.

One of the surest ways to flourish is to rejoice in the goodness of others. To thrive as patients, we need to sincerely and gratefully acknowledge the contributions of health professionals, foremost among them nurses. There are about 900,000 active physicians in the U.S., but about 4.1 million active nurses. One intensive care unit study at a Midwestern medical center showed that when at least one health professional was in a patient’s room, it was over six times as likely to be a nurse as a physician.

It is vital that we appreciate the difference a good nurse makes, not just in terms of implementing medical orders but also offering support and comfort and enhancing patient experience. Nurses care in ways that many physicians are only dimly aware of. A shining example in literature is found in Leo Tolstoy’s 1878 masterpiece, “Anna Karenina.” Professional journals and meetings offer many insights, but until we see excellence in patient care through the eyes of such a master, we are likely to miss the deeper story.

The protagonist of Tolstoy’s book is Levin, a wealthy and well-educated farmer in search of the meaning of life. His new wife is Kitty, who was once sent to a spa to recover from a broken heart and there learned to care for the sick and invalids. Shortly after their marriage, Levin receives word that his brother, a dissolute rebel who has squandered his property, is dying from consumption. Levin knows that he must go to him, but he grows angry when Kitty, ignorant of his brother’s disreputable life, insists on accompanying him.

When Levin first sees his brother lying in a bed, he thinks, “This cannot be my brother.” He does not know what to say. He is so horrified at the sights, sounds, and smells in the dying man’s room, and especially at the realization that this dead body is his living brother, that he does not know what to do. He can think only of escape, ridding himself of his agony. He considers going to get Kitty, but then he asks himself, “Why should she suffer as I am?” Little does he know.

To Kitty, the situation looks, feels, and means something altogether different. She pleads to be taken to the sick man. Kept apart, she sees only her husband, which is much more difficult than for her to see and be useful to them both. She entreats her husband as if her life’s happiness depends on it, which is at least partly true, though in reality peace and comfort for them all depend almost entirely on her. Arriving on the scene, she walks into the sick man’s room, turns around, and silently closes the door.

Levin cannot look at his brother calmly. He smells horrible odors, sees filth, hears moans, and feels utterly helpless. It never crosses his mind to consider the details of the situation and question whether he might at least make things less bad, if not better. Levin is constantly going out and coming back, because being there is agony for him, yet not being there is even worse. He has pondered the meaning of life and death, but meeting them up close and personal, he is paralyzed with fear.

Kitty is completely different. At the sight of the sick man, she feels compassion for him, which in her produces “the need to act, to learn all the details of his condition, and to help him.” Since she has not the slightest doubt that she should help him, she does not doubt that she can, and she sets about doing so. There begins a great deal of sweeping, dusting, and washing. New sheets, pillowcases, towels, and shirts appear. When the sick man expresses irritation at his nakedness, she responds, “I’m not looking!”

Kitty sends Levin away to get something. When he returns, he finds the sick man tucked in and everything around him completely changed. Kitty has replaced the foul odor with aromatic vinegar, which she sprayed through a little tube, her cheeks puffed out. There is no dust to be seen anywhere, and a new rug is under the bed. On the other side of the bed is something to drink, a candle, and his powders. The sick man himself is lying on clean sheets, in a clean shirt. He does not take his wondering eyes off Kitty.

Kitty not only nurses the dying man but also engages her husband in his care. It is awful for Levin to take the terrible body in his arms, to hold on, under the blanket, to places about which he has no desire to know, and to feel his own neck embraced by the long, emaciated arms. While he does so, Kitty quickly and silently turns the pillow, plumps it, and tidies the sick man’s thinning hair. The dying man holds his brother’s hand in his own, then pulls it to his mouth and kisses it. Levin, wracked by sobs, is unable to utter a word.

Kitty is not a physician, weighing various differential diagnostic possibilities and therapeutic alternatives. She is not a philosopher, contemplating in the dying man’s presence the meaning of life and death. She is, however, a compassionate human being, someone whose kindness finds expression in action. Levin feared to bring her there, but she proves herself far more indispensable than he. She not only cares but also teaches her husband what it means to care. Thank goodness for good nurses.

© Psychology Today