Civic gratitude: CNAs

In this media moment of accusations and epithets, I would like to pause and acknowledge some hardworking citizens of the USA.

Caring for the extreme elderly is hard, and I use this blog post to praise Certified Nursing Assistants and home health aides–a largely female workforce that, despite being underpaid and overworked (therefore, on occasion, justifiably terse or grumpy) provides crucial assistance and genuine caring for human beings who can no longer manage full  independence.

The nursing career has become a medical and social science that has sometimes more to do with observations, measurements, communications with physicians, and data entry than with assisting patients through touch, eye contact, and conversation. I have no criticism about the need for scholarship among today’s nursing force; in fact, my job permits me to work with many aspiring nurses as they pursue their studies, and I feel confident in these young people’s abilities. I just want to take a minute to thank CNAs, who do the majority of hands-on, personal helping of patients and at-home clients, especially in highly-populated regions with huge hospital networks.

Many CNAs are from lower-income backgrounds. Or they are recent immigrants. They willingly take on shift work and plenty of manual labor as they provide help for those who need it. They bathe patients, assist with bedpans, clean up when there is no bedpan, turn patients, monitor patients’ comfort levels, rub down fragile skin or sore muscles, all while managing to respect each person they care for as an individual human being. Even when they are ignored or treated like servants, when people (stressed, ill, or deeply anxious people) basically ignore them, don’t learn their names, resent their accents, these workers do their difficult jobs. And they smile at people.

Sometimes that smile is so needed–by a patient or a member of the patient’s family.

Bless you, folks. You are doing the kind of work every compassionate and ethical society needs in some way or another.



Jonathan Franzen’s The Corrections revolves in part around a family’s interconnected–and expanding–circles of influence (of harm, mostly, but also of steps toward healing) as the “patriarch” begins to lose his health and independence. It’s a depressingly familiar scenario for many of us who have aged parents. I often hear anecdotes from friends and colleagues about how an elderly parent’s decline tears apart family connections and lately have been living the problem a bit more close at hand.

So I am mulling about how we are interconnected, and also about how we decide to narrate our connections: the stories we tell ourselves, the stories we tell others. That’s the poet/observer in me mulling; but I also want to find out more about the psychological side of the equation, so I recently read Christakis’ and Fowler’s book Connected: The Surprising Power of Our Social Networks and How They Shape Our Lives, which takes a social-science and statistical look at what connects human beings to other human beings. 330px-Broad_chain_closeup

Writers are often our keenest social observers, and as it happens, Hungarian poet and writer Frigyes Karinthy wrote a story (“Chains”) that more or less posited the six degrees of separation theory back in 1929. Franzen’s novels tend to explore how even seemingly-minor disruptive or dysfunctional human relationships create butterfly-effect chaos among those connected to it–even among people not closely connected to the ‘disrupter.’

Christakis and Fowler examine much more than the six-degrees theory, such as how those human connections build themselves into social cascades, cultural norms, support systems, clans, families, political parties, and economic outcomes. On the one hand, these claims seem obvious: of course our relationships are based upon shared connections, and of course those relationships have impacts upon our lives. We know this intuitively, but now scientists want to give us proof.

Stuart Kauffman’s book At Home in the Universe offers “hard science” studies (though based upon theoretical computer- or math-based simulations) in physics and biology that suggest random disturbances, or chaos, can create chain or even lattice-like behavior. He suggests that if molecules or genes behave the way the simulations do, the cosmos may continually undergo a sort of self-organization that leads to forming connections.

Hence: life. Or life as we experience it. In which small differences in initial conditions can be amplified into transformational events that do not affect anyone in exactly the same way.

That’s more or less the butterfly effect, but it could not happen in social situations among human beings if we were not so interconnected or interdependent. Social beings require other social beings as support systems: that’s how humans work (with, naturally, the occasional outlier).

butterflyOur poets, playwrights, and our fiction writers–the narrators of human existence–understand isolation and community in non-scientific but no less valuable and authentic ways. They have been telling us for thousands of years the many ways we are connected.

Maybe what the scientists should do next is read hundreds of years of great literature as evidence of how social networks shape our lives. Science can learn as much from the humanities as the humanities have learned from scientists…

What we, as observant human beings in a chaotic world, intuitively understand.