Stories from the World of Medicine
Season
7
Episode
2
|
Sep 19, 2024
Healing Waters
Nurse Roshni Shah shares how the simple ritual of bathing became a powerful act of love during her mother’s final days, bringing serenity and connection to a fraught time of balancing family caregiving responsibilities with working night shifts in the ICU.
0:00/1:34
Ben Konkol
Stories from the World of Medicine
Season
7
Episode
2
|
Sep 19, 2024
Healing Waters
Nurse Roshni Shah shares how the simple ritual of bathing became a powerful act of love during her mother’s final days, bringing serenity and connection to a fraught time of balancing family caregiving responsibilities with working night shifts in the ICU.
0:00/1:34
Ben Konkol
Stories from the World of Medicine
Season
7
Episode
2
|
9/19/24
Healing Waters
Nurse Roshni Shah shares how the simple ritual of bathing became a powerful act of love during her mother’s final days, bringing serenity and connection to a fraught time of balancing family caregiving responsibilities with working night shifts in the ICU.
0:00/1:34
Ben Konkol
About Our Guest
Roshni Shah, MSN is a heart-centered & compassionate community advocate, nurse, & educator. She founded Meri Mira, a nonprofit organization, in honor of her mother, to anchor spaces of love across the globe. She was awarded the 40 under 40 Emerging Nurse Leader Award for her work in health equity. Roshni is an avid meditator dedicated to self-healing as a means to transformation. You can follow her on social media @FollowTheRoshni.
About The Show
The Nocturnists is an award-winning medical storytelling podcast, hosted by physician Emily Silverman. We feature personal stories from frontline clinicians, conversations with healthcare-related authors, and art-makers. Our mission is to humanize healthcare and foster joy, wonder, and curiosity among clinicians and patients alike.
resources
Credits
About Our Guest
Roshni Shah, MSN is a heart-centered & compassionate community advocate, nurse, & educator. She founded Meri Mira, a nonprofit organization, in honor of her mother, to anchor spaces of love across the globe. She was awarded the 40 under 40 Emerging Nurse Leader Award for her work in health equity. Roshni is an avid meditator dedicated to self-healing as a means to transformation. You can follow her on social media @FollowTheRoshni.
About The Show
The Nocturnists is an award-winning medical storytelling podcast, hosted by physician Emily Silverman. We feature personal stories from frontline clinicians, conversations with healthcare-related authors, and art-makers. Our mission is to humanize healthcare and foster joy, wonder, and curiosity among clinicians and patients alike.
resources
Credits
About Our Guest
Roshni Shah, MSN is a heart-centered & compassionate community advocate, nurse, & educator. She founded Meri Mira, a nonprofit organization, in honor of her mother, to anchor spaces of love across the globe. She was awarded the 40 under 40 Emerging Nurse Leader Award for her work in health equity. Roshni is an avid meditator dedicated to self-healing as a means to transformation. You can follow her on social media @FollowTheRoshni.
About The Show
The Nocturnists is an award-winning medical storytelling podcast, hosted by physician Emily Silverman. We feature personal stories from frontline clinicians, conversations with healthcare-related authors, and art-makers. Our mission is to humanize healthcare and foster joy, wonder, and curiosity among clinicians and patients alike.
resources
Credits
Transcript
Note: This transcript has not yet been reviewed for errors. The Nocturnists is created primarily as a listening experience. The audio contains emotion, emphasis, and soundscapes that are not easily transcribed. We encourage you to listen to the episode if at all possible. Our transcripts are produced using both speech recognition software and human copy editors, and may not be 100% accurate. Thank you for consulting the audio before quoting in print.
Emily Silverman
You're listening to The Nocturnists stories from the world of medicine. I'm Emily Silverman. We've had a lot of physicians on this show, but I'm really thrilled today to be speaking with a nurse. Her name is Roshni Shah, and she told a story at our live show in New York City, produced in partnership with Bellevue Literary Review on the theme of taking care. In Roshni stories, she transports us to a really difficult chapter of her life. She was living at home, she was taking care of her aging mom, and she was working difficult night shifts in the ICU. But despite all this, despite the stress, despite the sleep deprivation and the bickering in her family around that time, Roshni manages to find a moment of intense serenity in the shower with her mom as they bathe together one morning early after Roshni returns from work, I loved this story, which gives us an intimate glimpse into roshni's family Life, and I also really loved my conversation with Roshni afterward, where we talked about the elemental significance of water the hushed hour between three and four in the morning in the ICU that can feel almost mystical, and the differences between caregiving as a daughter and Caregiving as a nurse. But first, let's hear Roshni story from our live show in New York healing waters.
Roshni Shah
I pull into my driveway, windows down, music blasting, Bollywood, nose dripping. But despite the cold Chicago air, I can barely keep my eyes open, all I can think about right now is going to sleep. It's as if the medications I've been giving my patients overnight in the ICU has somehow gotten into my own bloodstream. All I can hear in my skull is the sound of bed alarms and patience cries. I am so exhausted to turn the car off and walk towards the door, I realize my reality is quite different between me and my bed lies one more nursing task. I have to give my mom a bath. I opened the door, and it's utter chaos. My dad in the living room watching Fox News, shouting at my mom across the house while she's in the kitchen, the sound of Donald Trump screeching, mixing in my mom's spiritual music permeates the house. My mom's not quite used to using her walker yet, so she's just has it kind of sitting there in the kitchen. And she uses it to pivot from the fridge to the stove and back, grabbing fresh ginger and cardamom and nutmeg for her morning jaw, and grabs a handful of onions and mustard seeds, and she throws into hot onion, and as it sputters, all these smells permeate into my nostrils. My stomach grumbles. My mom looks at me, hi, Bita, welcome home. I made you breakfast now I have just been really nice and patient for the past 14 hours, and I do not have it in me anymore. I have been in my head calculating nurse math. For those that don't know, Nurse math is the math nurses use when we're constantly looking at our watch, calculating the best way to get the job done most efficiently, to maximize our time for rest. And right now, the one task that remains is giving my mom a bath. And I have calculated, if I do this now, I can get enough sleep before my next shift. So I'm not proud, but I shout at my mom, Mom, can we take her shower? Now she looks up startled. She stares at stove in front of her, and then she looks at my dad, I know I have to act fast. You see, growing up as the youngest in my family, I've learned all the tricks, and this is my best one. I make my face extra pathetic, my eyes extra sad, and I plead mom. I'm so exhausted. She looks at me, and I know I've got her Okay. Beta, 10 minutes, I slump to the ground to play with my dog, and I pull up my phone. I have so many messages from my friends that I have to get back to. I see the first one. Our friend is on her honeymoon in Italy, sending me photos of PA. And wine, great. Another friend sends me an update that her annual bonus just wasn't what she thought it was going to be. But there's always next year. I know I should have some sympathy or something inside of me, but my exhaustion is now rage. I look around me, this was not what I had imagined from my life in my 30s. I should be coming home to my own family, taking care of my husband and kids, or at least planning a trip to Italy. I don't even know what an annual bonus is, so I respond with some likes and comments, and I look at my watch. It's been way over 10 minutes I'm mad. I pop up mom. She turns the stove off, finally pours my dad's tea and breakfast, yes, and finally makes progress as she walks towards the stairs, okay, take me up. I look at the 20 stairs that she's pointing at. My mom just fell down these stairs and broke her hip a few weeks ago. She just got back from rehab, not even a week ago. There was no way we were making it up there. So I look at her mom. That's not happening. Come I want to show you something I made, okay. Side note here, I am a first generation daughter of immigrants. So growing up, the way we decorated our home was all about functionality and efficiency. Our walls were plain and bare to preserve the newness of the home. We just recently got the plastic off the couches to that was a good bonus. But my parents didn't really believe in decorating. We had the same furniture from the 80s, and if it wasn't glued back together, we covered it up with something and made it work. I, on the other hand, am a proper millennial. I grew up inspired by Martha Stewart Living, and I couldn't wait to be an adult and decorate my home. So when my mom was in rehab, I knew I had my chance. I jumped at the opportunity to decorate the downstairs bathroom, which was bare. I spent way too much time and energy picking out the perfect plush, trendy rug. I got the beaded matching shower curtain. Hell, I had money. I splurged on the matching towels and candles. I put hooks for her robe and gowns, and I was really proud of myself. In fact, the hole in the wall, quite literally, my most rebellious act was putting a hole in the wall with my own artwork. So you know, that was awesome, as my mom hobbles over with her walker, still not quite sure how to use it, I couldn't wait to show her. I turned the light on for this big reveal, and I hear a big gasp. What did you do in here? How much did this cost? Your dad's gonna I was so disappointed. This is not how the big reveals happen on TV. How could she be so ungrateful? As she continues to scream at me and walk in her walker gets stuck in the rug that I had picked out, and I realize my mom has a point, but I'm as stubborn as she is, so I'm not gonna give in. I roll my eyes and tell her mom, just get in the shower and get undressed. She rolls her eyes right back at me as she wobbles to the bathroom. As she opens the shower curtain, she sees it. You see, I had to install one of those ugly hospital grade, plastic and metal Shower chairs, and I tried my best to bedazzle it, but it didn't work. She stares at that chair, and her eyes drop. I know those eyes. It's the look of when your freedom gets snatched away from you. I know my mom can't believe that this is what her life is like either she's only 60. Something inside me softens. I realize this is not a patient. This is my mom. I walk over to the bathroom and turn on the water, and as she gets undressed, still slowly from the surgeries that she just had, I see her naked body. It's still covered in bruises and scars from her previous surgeries, and I can't help but picture her like a little baby. She looks so fragile and delicate when the water warms up, I grab it, and maybe it's because I'm not wearing gloves, but as my hands touch her back, I'm instantly transformed. I'm in the hospital as a child when my mom bathes me in the sink for days, I'm transformed back to India when my mom's hands are rubbing my head when I had pneumonia for weeks, my mom's skin is so soft it feels like whipped silken tofu that's soaked in a syrup of rose and cardamom. In fact, as the water hits her skin, I swear the bathroom starts to smell like her smell. Smells of jasmine and orange and cloves and cinnamon and smells of home, I realize this is not the ICU. For the first time in many hours, my body relaxes. I hand my mom the shower bar. She looks at me with gratitude and something both of us shifts. Now, her conversation goes from formalities to more important topics, like, you know, who's sleeping with who at work, and by the way, are there any cute single residents that like you yet? And as I look at my mom and answer her questions, she's very nosy, I grab her loofah and her dove body wash. I like the efficient immigrant daughter that I am. Squirt out two efficient squirts and start lathering her. She grabs my hand. I laugh. You see, my mom sacrifices and gives to everyone, and she has to be really savvy everywhere. But for as long as I've known her, the shower was where she gave herself the biggest indulgence, and today was no different. So I grabbed that dove body wash, and I squeezed to her satisfaction what ended up being over half of the bottle. Literally, there is soap falling to the ground in wasteful heaps. I hide my frustration and I go with it. This is her shower, and I shout, lathering her. I lather her underarms and under her breasts and under other more intimate areas. And we're no longer mother daughter. We become friends. In fact, now that I'm over 30, my mom thinks of me as one of her girlfriends that she can tell one of her non veg jokes to. If you don't know what that means in our culture, it's raunchy humor. The thing is, my mom's joke telling doesn't really ever get to the punchline. So she starts one of her infamous jokes that I've heard millions of times, not fully. Of course, she's about five words in this time, which is progress, and her head pops back, her body starts convulsing, and she makes no noise. Don't worry. Don't be alarmed. You see, my head is also thrown back, my body is also convulsing, and we are now exchanging in our shared signature, mom, daughter, silent cackle. It's the laugh that my mom and I share, that I have inherited it proudly or not, it is what it is, and as both of us clutch our stomachs hard, laughing so much from nothing, I realize I haven't checked my watch because I don't really care what time it is anymore. Thank you. The Hello.
Emily Silverman
I am here with Roshni Shah, Roshni, thanks so much for coming on the show. Thanks for having me so I loved your story. It was so vivid. I loved all the sights and the smells and the sounds and the details, and I really felt like I was there with you. I'm just curious to hear your reflections on that night. How was it to tell the story on stage?
Roshni Shah
It was scary, and it was so amazing to get to share a part of my mom with people I feel like the best, the best gift, has been to share her legacy and her story in ways outside of her sickness, you know, and the story I share about this ritual of bathing and all of us do this, babies, old people. So it's just such a seems like innocuous and not important, but it was so nice to get feedback after the show of like, how much that was like a, you know, a pivotal, or, you know, poignant part of someone's day. And because I sometimes take for granted what we do as caregivers, day in, day out.
Emily Silverman
You mentioned ritual bathing, one of my favorite TV shows of the last few years has been this show, pen 15. I don't know if you've yes for the audience, if you aren't aware of it, it's these two young, awkward girls in school navigating adolescence and puberty. And one of the girls has this tradition where she and her mom will take baths together, and they have this, like, really nice bathtub. It almost looks like a Jacuzzi indoors. And there's these, like, angsty scenes where the character's name is Maya, she'll have just gone through something really hard at school, and she'll get in the tub, and her mom will be in there with her, and you can tell how calming and soothing it is, even if they're bickering with each other. I just loved that so much. And so when you just said, like, Mother Daughter ritual bathing, it made me think of that. And I just was curious if you had seen that TV show, and if you had any reflections on mother daughter ritual bathing. Yeah, well, I
Roshni Shah
definitely had a bowl cut. I'm a first generation immigrant American, so definitely relate to that show. I was cracking up watching it and agreed, right? Like, I think, I don't know if it's a cultural context, but I grew up bathing with my mom, you know, bathing with my sisters. I still, to this day, love going to spa or a bathhouse or Korean spas, where we're amongst sisterhood of women. It's actually such an empowering space. We're gabbing and we're gossiping and we're bickering with one another, but it's also just a space to kind of let the things that we hold on to in our day to day life and just exist from a very young age, my mom bathed me, not related, but similar. I'm like my dog is geriatric, and I bathe her once a week because she has wound and as a nurse, I bathe people, right? I bathe lots of people, and babies and kids. And you come to each shower, literally, you figure it'll be dirty, and you get to leave kind of cleansed and lighter.
Emily Silverman
I remember after I gave birth to my first daughter, it was a C section, and the first thing the nurse said to me, once I cleared up from the drugs, she was like, why don't you take a shower? And I just remember I went in and took a shower, and I came out feeling like such a different person in that way that a shower can do that, you know, not all showers, but like, there are certain showers in your life that just have this, like, elevated healing aspect. And it sounded like in your story, this was definitely one of those encounters. What do you think it is about water that is so healing?
Roshni Shah
After my mom passed away. I actually went to India. And I did. I called it The Freedom Trail, and I spread my mom's ashes across bodies of water that meant a lot to me, places that I wanted to take her in the world, spiritually significant places. And then I have one more spot I want to take her to Kauai, and I don't have any ashes left, but I think part of her is in me, so that's counts, and there is something innately sacred about the bodies of water. I've always intuitively knew that, like rain feels cleansing, water's able to adapt and shape shift, ice, boil, soft, nurture. I mean, it's such a powerful metaphor for so many things. But I think when you go through grief, things take on different meaning. And I never understood why I felt called. I went by myself to India to do this like my family wasn't pushing me to do it. Like part of her getting freedom was having access back to places that she longed to be in, or I longed to take her to. And when you're doing these rituals, the way they explained, how you know, we come from Earth, we go back to Earth, how we the water is actually takes the Earth into the sky and back into the ground for generations, right? This now goes beyond just this lifetime, but how this water is carrying ashes of my ancestors and it will, you know, one day, hold mine. I'm getting goosebumps thinking about it. I Something about being in the Ganga, right? And being in these, like, holy waters. I can feel it. I felt moved tears, and it's disgusting water. You look at it, it's full of garbage. It's not like it's anything powerful. It's like Lake merit water. But I've always been drawn to water, like I always want to live by a body of water. There's something about being in the ocean that just, I can't even swim, which is ironic, but like, I love that I know going into the water, it's connecting all of the elements of the world, and it's connecting me to this, like womb space. And I always joke with my mom. I used to always tell her, like, Let's hang out in the womb, which is us cuddling. Because I feel like my earliest memory my mom and I, is me and her womb and just being enveloped in this, like, warm, soft, secure, it's like, the place I long for the most in this world. But think being in the water, expecting my mom's ashes, I was like, oh, like, this is the womb space, like we're coming back to this. Like it's a circle.
Emily Silverman
Yeah, there is something about water that feels connected to the divine feminine. And I had never thought about it like that, like the waters of the womb, and, you know, being curled up inside that warm incubator or the hot tub, as my OB GYN said, Yeah, my
Roshni Shah
mom joked I was, I was a C section baby. My arms ripped behind my head. Feet were crossed. I was not trying to leave. I was real cozy. My mom was 89 pounds. She was like, maybe under 100 pounds, and I was nine pounds. My mom was like, You were really comfortable in there. I was like, Yeah, that was my happy place, for sure.
You so
Emily Silverman
when did this story take place? And when did your mom pass?
Roshni Shah
My mom passed away in 2020 maybe less than a month after the lockdown in Chicago. I've been a caregiver for her, kind of on and off since college, but it became more prominent in my life in 2015 it's kind of the reason why I became a nurse that was kind of the catalyst. Honestly, the story is one of. Many stories, because it's not just one time. It's many times of her health going up and down and being in the hospital and she broke her hip, or when she would have a pneumonia, or, you know, she had dialysis issues, or, I mean, like the hospitalizations were kind of ongoing, and as her health declined over time, there's just something about bathing that is so vulnerable and in such a space of independence. And my mom was fiercely independent in her mind, but like her body, she had to be dependent. There's a lot of love, there's a lot of anger and frustration that happens within a mom and a daughter relationship that no one can understand unless you're a mom and daughter and you get it. And it's not like it was one way, like I would shower in the bathroom and talk to my mom while she was in the bathroom, like it was like our space, where we got to be girls and vent and tell jokes, make fun of everyone, and it just calmed the energy down from, like, both of our mutual frustrations, caregiving, for me, isn't this like glorification of being some kind of hero? It wasn't a job I chose. Think it was like a mutual care for one another to give back to my mom in a way that she's given to me and in these little ways, making a meal, taking a shower, she would wash my clothes. We gave to one another to make life simpler for one another in the ways that we knew how to or could
Emily Silverman
tell us about your decision to go into nursing and coming into your own as a nurse, I moved
Roshni Shah
to India for a year. I worked in health administration post college, and I think that experience kind of shed light to the work of medicine. I felt really afraid of being a doctor. I didn't think I was smart enough. Slash, I didn't really like doctors. I had a lot in my family, and just didn't seem like something I enjoyed. But in my first profession, I worked with a lot of nurses, so I learned about nursing as a job, just really fascinated by them. And then India, I got to volunteer across the country and just see the impact of doulas and midwives and nurses. And I was enamored by how hands on they were and then when I came back from India, my mom had gotten extremely sick and was in ICU for a few months. And because I was the unemployed daughter, that was the caregiver by proxy, and I got to experience one the nurse I didn't want to be, but I got to experience how a nurse's brain work, because it got they got to be a storyteller, a creator. They got to connect the dots how impactful they were to our family and guiding us. And I just loved how the nurses took care of my mom, culturally, listening to what we said and what we needed, and giving her the dignity that she deserved. I felt like I was naturally fit for the job, and I actually, genuinely, for a long time, felt such a head, heart alignment with that career. I love patient care. You know, I get to be the journalist. I get to be creative. I say I'm like, I'm not rich in cash, but I'm rich in prayers. Like, I have a lot of patients who have prayed for me. I've gotten a lot of Daisy awards, all these things that, like, you know, aren't resume things, but things that I value. You know, I've made a lot of impact because it felt so easy and natural to care for someone. I feel like nurses are my people. I always say that no one else can get the like crudeness and the heart. They're both there, the sassiness that you have to have. Like my friends, who are NICU nurses, are very sassy and like they have to be. But the softest people I know,
Emily Silverman
you mentioned when you were in the hospital with your mom, you saw examples of the nurse that you want to be and the nurse that you don't want to be. So tell us, like, what are the signs of a good nurse and what are the signs of a nurse who maybe could be doing better?
Roshni Shah
So we all know the nurse, it's, I don't take anything personal, but it's the staff member who doesn't want to be there or isn't, you know, doesn't want to hear feedback or doesn't want to hear pushback. And every patient is special, of course, you know. And my mom, to me, is my VIP, and she has a lot of medical anxiety, just from her experiences growing up in India, and also her body was just very delicate to like everything. And so, you know, daily labs, or things that like getting poked extra, or she's vegetarian, and they would just like slab on, like eggs and ham sandwiches. And like, She's sensitive to smells, she would puke. And like, the bad nurse is annoyed by this, the good nurse is, I mean, my dad has a ritual of massaging my mom's feet every night with his concoction of lotions he makes for her. And some nurses were so against it in the good nurses, like, yeah, like, let your dad, like, he wants to contribute in this way. You know, this, these things that I'm like, I get that there's rules. And I'm like, I think rules are meant to be broken and for certain situations, and that's the rebellious person in me. But I'm like, you know, I have patients who are Muslim, who are fasting, and I let the family come break Iftar in the room. Like, go ahead. You want to pray on the floor. Pray on the floor like you want me to cover up your wife and like when I bathe them, I will, you know, I'm very mindful, I think, because culturally I come from that background, people were just taking my mom's gown on and off, and she wasn't conscious. But, I mean, she I could just and. Energetically, be like, mortified for her. You know, my mom's the kind of lady, like she was flirting with doctors trying to get me married as she was being rolled into the or, you know, she's like, that lady. She's super charming, you know, proper Leo woman, like, wants to look good. And I think when she woke a lot of consciousness, the first thing she was like, why am I why am I hand so ugly? Because they're all swollen and like, full of holes, and she's like, I'd rather die than look like this, like she was pissed, you know, because she just felt so degraded, like her body was just taken out of her control. And it is so important for me to everyone feel autonomy over their body, even if I don't agree with it. My number one thing is, I want every patient to feel empowered over their own body, if that means you refuse medications or you don't want something that I think you need. Let me talk to you about it, but I'm not going to discount it. And
Emily Silverman
you did a lot of work in the ICU and some work in the pacu as well the post Anesthesia Care Unit, so people coming out of procedures and operations, but also a lot of work in the ICU, which for people listening who aren't aware, you know, the ICU is the sickest patients in the hospital, and the nursing ratios are really low. So you might have one patient or two patients, and the patient might have IVs or a ventilator or, you know, lots of machines attached to them, and the nurse is really responsible for that person, that body. Sometimes they're not even conscious, and you know all the tubes and the catheters, and you're just so intimate with the patient and their body. And I'm wondering, after 10 years of doing that work like, what have you learned about the body? What have you learned about people? What have you learned about just being in such intimate proximity with others.
Roshni Shah
One I share this with anyone who's worked night shift, there's something just magical or spiritual about three to 4am in a hospital. I cannot explain it. That's usually my bath and labs time in an ICU before morning rounds. There's something in my body, viscerally that just feels like this is a very sacred time, you know, through ecmos, which are like, you know, tubes that are connecting people's hearts, or I have fecal tubes, and I you have a million tubes in someone's body. When you're exhausted, it is sometimes frustrating to have to do a menial task, like a bath. And I say menial because it's like, God, like they're subtle, they're sleeping, they're rested. It's not beeping. And I think that's what I'm like, okay, but like, mentally, I feel like, if I can make them feel good right now, if I can pray over their body, if I can just give them some energy shift work, maybe it'll help them decide what they want to do next. And I do think the souls and bodies decide what they want to do. To some extent,
Emily Silverman
what you just said about the 3am to 4am hour feeling kind of magical. I feel that too. I think it's obviously different from the doctor's perspective, because we're not right there at the bedside 24/7 but having worked 28 hour shifts and night shifts like I kind of feel like I can tap into what you're saying. What is it about that hour that gives it that quality?
Roshni Shah
I feel like it's the space where there's no management, there's no doctors, there's no protocol, like nothing needs to be done at that hour, it's the time when families or visitors are gone or sleeping. It's just this time where I think the patient, or the soul inside the patient gets to be in power. It's the one time where I'm like, I don't know this is not scientific, but this is something like, this is something that I can't explain. Things happen, miracles happen, moments happen. We're like, that, did you see that like, that is like, did you feel that like it's just something that I can't explain? And I think it's because it's, it's just A time where no one's paying attention you?
Emily Silverman
Music. You've talked about souls and bodies, and I imagine, as an ICU nurse, you've been around a fair bit of death, and I'm just wondering, from the ICU nurse perspective, you said, I think souls do have some say, maybe not entirely, but they do have some say. And just would love to hear more about what that feels like, and if you can actually feel that happening in the room, families
Roshni Shah
and friends and people who love you want to hold on to versions of you always. But the truth is, you will not come in and leave the hospital the same person you shouldn't, not as a new mom, not as a diagnosis, not as a patient, and there is so much ICU trauma that happens that we don't talk about enough. There's not enough resources to provide PTSD care to patients, because even if you're not experiencing something your neighbor might be, or someone across the hall will, or you're hearing moaning and screaming, and I have. Beeping fatigue. I can't imagine what patients are trying to get sleep or feeling. So I have conversations with my patients who are intubated. I talk to them like they're awake. I play music. I pray in whatever faith they are praying in, if they're Muslim, if they're Hindu, if they're Catholic, if they're Jewish, I find that song, or I find something on Spotify, and I play it for them. While I'm giving them a bath, I'm trying to give them a sense of autonomy and power in a position when they feel probably their body is completely powerless. That allows someone some dignity. Is why I think a shower is so powerful. You walk in the shower, you walk out powerful. I don't know if that's my life's work, but I feel like that's what means the most to me, is to watch someone step into their power and get to choose what they want, not what I'm telling them they need, not what me deciding what's best for them, not some surgeon telling them what they should do, how much they should fight, how much of a warrior they should be. Like we're all warriors in life. Tell us
Emily Silverman
about the difference between caring for someone in your family and caring for a patient as part of work. You're the same human. You're the same empathetic person with the same, you know, wonderful, cheerful, caring disposition, but obviously a very different context. You know, one of them is paid labor for strangers, and one of them is unpaid, I guess, sometimes paid if you're getting benefits, but often unpaid labor with someone like your mom, with whom you have an extremely intimate, long term relationship. Definitely,
Roshni Shah
I would say number one is any caregiving role deserves space to vent without judgment, obviously, when it's professional setting, we have to be careful how and where and who we vent with. I think also, when it's someone that you love, it's a lot harder to give them the autonomy they want, because you want what you want for them. And I am my mother's daughter, so as stubborn as she was, is as stubborn as I am, and my family jokes that were the same but opposite. So I want an orange pillow. She wants a green pillow. Both of us are right. Both of us are experts, and that will become a fight. I share that in my story, like how he decorated the house, or how I wanted to set up the bathroom, or just little things. And I think my inner Martha Stewart a personality, loved being an ICU nurse. I mean, I come in my shift in the first 30 minutes, I'm just cleaning and organizing, and it's celebrated. It's a job where that, that kind of detail orientation, is celebrated. And my patients, if they were healthy when I left in the morning, they looked good in that bed, you know. And I took pride in that my mom is not a patient that I can do that with. She is, at the end of the day, my mom, I'm a little bit scared of her, and I'm a little bit, you know, like, there's a different level of power there, and she's taking care of me, but I don't always necessarily want it. So it's an interesting dynamic. I think, in caregiving, turning that switch on and off, sometimes I want to be cared for in a professional setting. I get to clock out be done, or I can call in sick, or I can ask a co worker to help me, or I can go in the break room and eat a piece of like, still pizza and like, forget about something for 10 minutes, right? Like, I'm not attached to the outcome of this person after my 12 hour shift is done with my mom. If I make a mistake, that mistake is going to impact me for the rest of my life and her life. I don't show up for her. She falls on the stairs. She doesn't get a bath, her medicines are incorrect. She misses an appointment or a surgery. Those things impact our entire family. So the pressure to like be on all the time is there, like, I don't think I slept deeply until the day she died, which is the weirdest thing to recognize her last breath was the first time I took a deep breath. I have a lot of, I don't want to say shame around that, but just a lot of, like, sadness around that. I don't I don't think I even knew that I was holding my breath for that long.
Emily Silverman
Yeah, I know when we were preparing your story for the stage, we talked a lot about this idea of caregiving. You know, the word giving is built into that word, because obviously, you are giving. You're giving of yourself. You're giving your time, your energy, your attention, your labor, both physical and emotional and spiritual, but how there's also receiving built into caregiving. You know, the caregiver, in a way, gets to receive. I think there's a Mary Oliver poem that says something like, give until the giving feels like receiving. And I always thought that was so beautiful. And that idea is also complicated by the reality that caregiver burnout is such a real thing in this country, you know, especially as the population ages, and it's a lot of women who are shouldering the burden of doing. Doing that caregiving, and it often is unpaid work. It's often thankless work.
Roshni Shah
I think the best gift for me has been allowing my mom to become my friend much sooner in my life than I think I expected to happen, because us working in a dynamic where there was a power differential was going to frustrate both of us, slash, she was sick at really pivotal points in my life, recessions, job losses, breakups, you know, my mom and I have a lot of parallel stories in her family and my family and feeling misunderstood, or just having these big dreams and wanting to do so much, but feeling obligated and stuck in certain ways. You know, I was super adamant about all three of us daughters, having more autonomy and freedom that she has ever given. You know, she never pressured us to get married. She wanted us to be educated, travel and like, do what we cared about. You know, I think my both my parents were so powerful and giving me that space to know that I could always come home and be taken care of, that is a very powerful place to give back from. It's a privilege, because I can come down, Whittle my savings to zero and have nothing to my name, and my parents, to this day, my dad, will take me in and figure something out. So I think in that sense, when I give, I give from that same space of generosity. There's no obligation to pay it back. There's no I'm not doing this to scheme how I can get something out of it. It's just that I've been given so many gifts from so many people. That is where the giving receiving cycle feels so naturally, like I don't want to hold on to anything in life. Think my mom's biggest teaching is that you leave life empty handed. You don't hold on to your wealth. You don't hold on to any tangible item. You leave behind your legacy of love. You know, and my mom, when she died, you know, 411 immigrant women, but her cell phone and, you know, her funeral and stuff was during the pandemic, so we had these, like, Zoom calls, I mean, people from like, a gift shop, a random employee, all my friends, all my sister's friends, her dialysis driver came the Costco wave person they, like, loved her. Like the people that I'm like, why are you at my house? Like, why are you on the Zoom call? How'd you find out about this? Right? Because it's the impact that she left on people my mom didn't always speak fluent English, and like, people who spoke Spanish came to our house, like, Yo, your mom and I were friends. I'm like, oh, okay, I had no idea, right? Like, I was going through her phone. And I'm like, she's getting my friends dating advice. I'm like, when did you call my friends talk about this? Like, I don't get it right. And so I think that's the biggest teaching for me is like, what's the point of holding on to love if you can't share it? And it always multiplies. And I genuinely believe that or I've never taken a nursing contract. I've never traveled the world and not come back with way more, and it's not money
Emily Silverman
to end. I'm wondering if you would be willing to share any thoughts or advice with people listening who are caregivers. So maybe they're a nurse, maybe they're a doctor, maybe they're a mother or a daughter or a father or a son or a sibling who's responsible for the care of another person. Any words of advice or meditations to circle back to as they move forward with their caregiving work.
Roshni Shah
What I wish I had space for sooner was room to be angry, to be annoyed, to be frustrated, to have all these feelings that I felt shamed for having. You know, even new moms and like, you can hate that child for a little bit, because when you're exhausted and you're just a cow for the first few months, you can love something and hate something at the same time. And it's not permanent. It doesn't mean anything. And then, on a smaller scale, who in your life can you go to and talk to? Which friends can you be like, listen when you have space just just show up my house, wash my dishes and let me scream, let me vent. Let me talk about how much I hate doing this job. If you ever go to a bar at like, 7:45pm with a table full of nurses, and you listened, you would not think that we are the most compassionate kind, like gentle people. We have to get it out. We're so frustrated. Humans are complicated beings, and giving of yourself is depleting. We need those spaces. There's no shame in that. Well,
Emily Silverman
I have loved this conversation. I think what you said about love multiplying is really true, and this is one of those conversations where I leave the conversation with more energy than I had coming into it, and I think that speaks a little bit to your magic. So thank you so much for telling your story on The Nocturnists stage and for coming here to speak with me today.
Roshni Shah
Thank you so much.
Emily Silverman
Note: This transcript has not yet been reviewed for errors. The Nocturnists is created primarily as a listening experience. The audio contains emotion, emphasis, and soundscapes that are not easily transcribed. We encourage you to listen to the episode if at all possible. Our transcripts are produced using both speech recognition software and human copy editors, and may not be 100% accurate. Thank you for consulting the audio before quoting in print.
Emily Silverman
You're listening to The Nocturnists stories from the world of medicine. I'm Emily Silverman. We've had a lot of physicians on this show, but I'm really thrilled today to be speaking with a nurse. Her name is Roshni Shah, and she told a story at our live show in New York City, produced in partnership with Bellevue Literary Review on the theme of taking care. In Roshni stories, she transports us to a really difficult chapter of her life. She was living at home, she was taking care of her aging mom, and she was working difficult night shifts in the ICU. But despite all this, despite the stress, despite the sleep deprivation and the bickering in her family around that time, Roshni manages to find a moment of intense serenity in the shower with her mom as they bathe together one morning early after Roshni returns from work, I loved this story, which gives us an intimate glimpse into roshni's family Life, and I also really loved my conversation with Roshni afterward, where we talked about the elemental significance of water the hushed hour between three and four in the morning in the ICU that can feel almost mystical, and the differences between caregiving as a daughter and Caregiving as a nurse. But first, let's hear Roshni story from our live show in New York healing waters.
Roshni Shah
I pull into my driveway, windows down, music blasting, Bollywood, nose dripping. But despite the cold Chicago air, I can barely keep my eyes open, all I can think about right now is going to sleep. It's as if the medications I've been giving my patients overnight in the ICU has somehow gotten into my own bloodstream. All I can hear in my skull is the sound of bed alarms and patience cries. I am so exhausted to turn the car off and walk towards the door, I realize my reality is quite different between me and my bed lies one more nursing task. I have to give my mom a bath. I opened the door, and it's utter chaos. My dad in the living room watching Fox News, shouting at my mom across the house while she's in the kitchen, the sound of Donald Trump screeching, mixing in my mom's spiritual music permeates the house. My mom's not quite used to using her walker yet, so she's just has it kind of sitting there in the kitchen. And she uses it to pivot from the fridge to the stove and back, grabbing fresh ginger and cardamom and nutmeg for her morning jaw, and grabs a handful of onions and mustard seeds, and she throws into hot onion, and as it sputters, all these smells permeate into my nostrils. My stomach grumbles. My mom looks at me, hi, Bita, welcome home. I made you breakfast now I have just been really nice and patient for the past 14 hours, and I do not have it in me anymore. I have been in my head calculating nurse math. For those that don't know, Nurse math is the math nurses use when we're constantly looking at our watch, calculating the best way to get the job done most efficiently, to maximize our time for rest. And right now, the one task that remains is giving my mom a bath. And I have calculated, if I do this now, I can get enough sleep before my next shift. So I'm not proud, but I shout at my mom, Mom, can we take her shower? Now she looks up startled. She stares at stove in front of her, and then she looks at my dad, I know I have to act fast. You see, growing up as the youngest in my family, I've learned all the tricks, and this is my best one. I make my face extra pathetic, my eyes extra sad, and I plead mom. I'm so exhausted. She looks at me, and I know I've got her Okay. Beta, 10 minutes, I slump to the ground to play with my dog, and I pull up my phone. I have so many messages from my friends that I have to get back to. I see the first one. Our friend is on her honeymoon in Italy, sending me photos of PA. And wine, great. Another friend sends me an update that her annual bonus just wasn't what she thought it was going to be. But there's always next year. I know I should have some sympathy or something inside of me, but my exhaustion is now rage. I look around me, this was not what I had imagined from my life in my 30s. I should be coming home to my own family, taking care of my husband and kids, or at least planning a trip to Italy. I don't even know what an annual bonus is, so I respond with some likes and comments, and I look at my watch. It's been way over 10 minutes I'm mad. I pop up mom. She turns the stove off, finally pours my dad's tea and breakfast, yes, and finally makes progress as she walks towards the stairs, okay, take me up. I look at the 20 stairs that she's pointing at. My mom just fell down these stairs and broke her hip a few weeks ago. She just got back from rehab, not even a week ago. There was no way we were making it up there. So I look at her mom. That's not happening. Come I want to show you something I made, okay. Side note here, I am a first generation daughter of immigrants. So growing up, the way we decorated our home was all about functionality and efficiency. Our walls were plain and bare to preserve the newness of the home. We just recently got the plastic off the couches to that was a good bonus. But my parents didn't really believe in decorating. We had the same furniture from the 80s, and if it wasn't glued back together, we covered it up with something and made it work. I, on the other hand, am a proper millennial. I grew up inspired by Martha Stewart Living, and I couldn't wait to be an adult and decorate my home. So when my mom was in rehab, I knew I had my chance. I jumped at the opportunity to decorate the downstairs bathroom, which was bare. I spent way too much time and energy picking out the perfect plush, trendy rug. I got the beaded matching shower curtain. Hell, I had money. I splurged on the matching towels and candles. I put hooks for her robe and gowns, and I was really proud of myself. In fact, the hole in the wall, quite literally, my most rebellious act was putting a hole in the wall with my own artwork. So you know, that was awesome, as my mom hobbles over with her walker, still not quite sure how to use it, I couldn't wait to show her. I turned the light on for this big reveal, and I hear a big gasp. What did you do in here? How much did this cost? Your dad's gonna I was so disappointed. This is not how the big reveals happen on TV. How could she be so ungrateful? As she continues to scream at me and walk in her walker gets stuck in the rug that I had picked out, and I realize my mom has a point, but I'm as stubborn as she is, so I'm not gonna give in. I roll my eyes and tell her mom, just get in the shower and get undressed. She rolls her eyes right back at me as she wobbles to the bathroom. As she opens the shower curtain, she sees it. You see, I had to install one of those ugly hospital grade, plastic and metal Shower chairs, and I tried my best to bedazzle it, but it didn't work. She stares at that chair, and her eyes drop. I know those eyes. It's the look of when your freedom gets snatched away from you. I know my mom can't believe that this is what her life is like either she's only 60. Something inside me softens. I realize this is not a patient. This is my mom. I walk over to the bathroom and turn on the water, and as she gets undressed, still slowly from the surgeries that she just had, I see her naked body. It's still covered in bruises and scars from her previous surgeries, and I can't help but picture her like a little baby. She looks so fragile and delicate when the water warms up, I grab it, and maybe it's because I'm not wearing gloves, but as my hands touch her back, I'm instantly transformed. I'm in the hospital as a child when my mom bathes me in the sink for days, I'm transformed back to India when my mom's hands are rubbing my head when I had pneumonia for weeks, my mom's skin is so soft it feels like whipped silken tofu that's soaked in a syrup of rose and cardamom. In fact, as the water hits her skin, I swear the bathroom starts to smell like her smell. Smells of jasmine and orange and cloves and cinnamon and smells of home, I realize this is not the ICU. For the first time in many hours, my body relaxes. I hand my mom the shower bar. She looks at me with gratitude and something both of us shifts. Now, her conversation goes from formalities to more important topics, like, you know, who's sleeping with who at work, and by the way, are there any cute single residents that like you yet? And as I look at my mom and answer her questions, she's very nosy, I grab her loofah and her dove body wash. I like the efficient immigrant daughter that I am. Squirt out two efficient squirts and start lathering her. She grabs my hand. I laugh. You see, my mom sacrifices and gives to everyone, and she has to be really savvy everywhere. But for as long as I've known her, the shower was where she gave herself the biggest indulgence, and today was no different. So I grabbed that dove body wash, and I squeezed to her satisfaction what ended up being over half of the bottle. Literally, there is soap falling to the ground in wasteful heaps. I hide my frustration and I go with it. This is her shower, and I shout, lathering her. I lather her underarms and under her breasts and under other more intimate areas. And we're no longer mother daughter. We become friends. In fact, now that I'm over 30, my mom thinks of me as one of her girlfriends that she can tell one of her non veg jokes to. If you don't know what that means in our culture, it's raunchy humor. The thing is, my mom's joke telling doesn't really ever get to the punchline. So she starts one of her infamous jokes that I've heard millions of times, not fully. Of course, she's about five words in this time, which is progress, and her head pops back, her body starts convulsing, and she makes no noise. Don't worry. Don't be alarmed. You see, my head is also thrown back, my body is also convulsing, and we are now exchanging in our shared signature, mom, daughter, silent cackle. It's the laugh that my mom and I share, that I have inherited it proudly or not, it is what it is, and as both of us clutch our stomachs hard, laughing so much from nothing, I realize I haven't checked my watch because I don't really care what time it is anymore. Thank you. The Hello.
Emily Silverman
I am here with Roshni Shah, Roshni, thanks so much for coming on the show. Thanks for having me so I loved your story. It was so vivid. I loved all the sights and the smells and the sounds and the details, and I really felt like I was there with you. I'm just curious to hear your reflections on that night. How was it to tell the story on stage?
Roshni Shah
It was scary, and it was so amazing to get to share a part of my mom with people I feel like the best, the best gift, has been to share her legacy and her story in ways outside of her sickness, you know, and the story I share about this ritual of bathing and all of us do this, babies, old people. So it's just such a seems like innocuous and not important, but it was so nice to get feedback after the show of like, how much that was like a, you know, a pivotal, or, you know, poignant part of someone's day. And because I sometimes take for granted what we do as caregivers, day in, day out.
Emily Silverman
You mentioned ritual bathing, one of my favorite TV shows of the last few years has been this show, pen 15. I don't know if you've yes for the audience, if you aren't aware of it, it's these two young, awkward girls in school navigating adolescence and puberty. And one of the girls has this tradition where she and her mom will take baths together, and they have this, like, really nice bathtub. It almost looks like a Jacuzzi indoors. And there's these, like, angsty scenes where the character's name is Maya, she'll have just gone through something really hard at school, and she'll get in the tub, and her mom will be in there with her, and you can tell how calming and soothing it is, even if they're bickering with each other. I just loved that so much. And so when you just said, like, Mother Daughter ritual bathing, it made me think of that. And I just was curious if you had seen that TV show, and if you had any reflections on mother daughter ritual bathing. Yeah, well, I
Roshni Shah
definitely had a bowl cut. I'm a first generation immigrant American, so definitely relate to that show. I was cracking up watching it and agreed, right? Like, I think, I don't know if it's a cultural context, but I grew up bathing with my mom, you know, bathing with my sisters. I still, to this day, love going to spa or a bathhouse or Korean spas, where we're amongst sisterhood of women. It's actually such an empowering space. We're gabbing and we're gossiping and we're bickering with one another, but it's also just a space to kind of let the things that we hold on to in our day to day life and just exist from a very young age, my mom bathed me, not related, but similar. I'm like my dog is geriatric, and I bathe her once a week because she has wound and as a nurse, I bathe people, right? I bathe lots of people, and babies and kids. And you come to each shower, literally, you figure it'll be dirty, and you get to leave kind of cleansed and lighter.
Emily Silverman
I remember after I gave birth to my first daughter, it was a C section, and the first thing the nurse said to me, once I cleared up from the drugs, she was like, why don't you take a shower? And I just remember I went in and took a shower, and I came out feeling like such a different person in that way that a shower can do that, you know, not all showers, but like, there are certain showers in your life that just have this, like, elevated healing aspect. And it sounded like in your story, this was definitely one of those encounters. What do you think it is about water that is so healing?
Roshni Shah
After my mom passed away. I actually went to India. And I did. I called it The Freedom Trail, and I spread my mom's ashes across bodies of water that meant a lot to me, places that I wanted to take her in the world, spiritually significant places. And then I have one more spot I want to take her to Kauai, and I don't have any ashes left, but I think part of her is in me, so that's counts, and there is something innately sacred about the bodies of water. I've always intuitively knew that, like rain feels cleansing, water's able to adapt and shape shift, ice, boil, soft, nurture. I mean, it's such a powerful metaphor for so many things. But I think when you go through grief, things take on different meaning. And I never understood why I felt called. I went by myself to India to do this like my family wasn't pushing me to do it. Like part of her getting freedom was having access back to places that she longed to be in, or I longed to take her to. And when you're doing these rituals, the way they explained, how you know, we come from Earth, we go back to Earth, how we the water is actually takes the Earth into the sky and back into the ground for generations, right? This now goes beyond just this lifetime, but how this water is carrying ashes of my ancestors and it will, you know, one day, hold mine. I'm getting goosebumps thinking about it. I Something about being in the Ganga, right? And being in these, like, holy waters. I can feel it. I felt moved tears, and it's disgusting water. You look at it, it's full of garbage. It's not like it's anything powerful. It's like Lake merit water. But I've always been drawn to water, like I always want to live by a body of water. There's something about being in the ocean that just, I can't even swim, which is ironic, but like, I love that I know going into the water, it's connecting all of the elements of the world, and it's connecting me to this, like womb space. And I always joke with my mom. I used to always tell her, like, Let's hang out in the womb, which is us cuddling. Because I feel like my earliest memory my mom and I, is me and her womb and just being enveloped in this, like, warm, soft, secure, it's like, the place I long for the most in this world. But think being in the water, expecting my mom's ashes, I was like, oh, like, this is the womb space, like we're coming back to this. Like it's a circle.
Emily Silverman
Yeah, there is something about water that feels connected to the divine feminine. And I had never thought about it like that, like the waters of the womb, and, you know, being curled up inside that warm incubator or the hot tub, as my OB GYN said, Yeah, my
Roshni Shah
mom joked I was, I was a C section baby. My arms ripped behind my head. Feet were crossed. I was not trying to leave. I was real cozy. My mom was 89 pounds. She was like, maybe under 100 pounds, and I was nine pounds. My mom was like, You were really comfortable in there. I was like, Yeah, that was my happy place, for sure.
You so
Emily Silverman
when did this story take place? And when did your mom pass?
Roshni Shah
My mom passed away in 2020 maybe less than a month after the lockdown in Chicago. I've been a caregiver for her, kind of on and off since college, but it became more prominent in my life in 2015 it's kind of the reason why I became a nurse that was kind of the catalyst. Honestly, the story is one of. Many stories, because it's not just one time. It's many times of her health going up and down and being in the hospital and she broke her hip, or when she would have a pneumonia, or, you know, she had dialysis issues, or, I mean, like the hospitalizations were kind of ongoing, and as her health declined over time, there's just something about bathing that is so vulnerable and in such a space of independence. And my mom was fiercely independent in her mind, but like her body, she had to be dependent. There's a lot of love, there's a lot of anger and frustration that happens within a mom and a daughter relationship that no one can understand unless you're a mom and daughter and you get it. And it's not like it was one way, like I would shower in the bathroom and talk to my mom while she was in the bathroom, like it was like our space, where we got to be girls and vent and tell jokes, make fun of everyone, and it just calmed the energy down from, like, both of our mutual frustrations, caregiving, for me, isn't this like glorification of being some kind of hero? It wasn't a job I chose. Think it was like a mutual care for one another to give back to my mom in a way that she's given to me and in these little ways, making a meal, taking a shower, she would wash my clothes. We gave to one another to make life simpler for one another in the ways that we knew how to or could
Emily Silverman
tell us about your decision to go into nursing and coming into your own as a nurse, I moved
Roshni Shah
to India for a year. I worked in health administration post college, and I think that experience kind of shed light to the work of medicine. I felt really afraid of being a doctor. I didn't think I was smart enough. Slash, I didn't really like doctors. I had a lot in my family, and just didn't seem like something I enjoyed. But in my first profession, I worked with a lot of nurses, so I learned about nursing as a job, just really fascinated by them. And then India, I got to volunteer across the country and just see the impact of doulas and midwives and nurses. And I was enamored by how hands on they were and then when I came back from India, my mom had gotten extremely sick and was in ICU for a few months. And because I was the unemployed daughter, that was the caregiver by proxy, and I got to experience one the nurse I didn't want to be, but I got to experience how a nurse's brain work, because it got they got to be a storyteller, a creator. They got to connect the dots how impactful they were to our family and guiding us. And I just loved how the nurses took care of my mom, culturally, listening to what we said and what we needed, and giving her the dignity that she deserved. I felt like I was naturally fit for the job, and I actually, genuinely, for a long time, felt such a head, heart alignment with that career. I love patient care. You know, I get to be the journalist. I get to be creative. I say I'm like, I'm not rich in cash, but I'm rich in prayers. Like, I have a lot of patients who have prayed for me. I've gotten a lot of Daisy awards, all these things that, like, you know, aren't resume things, but things that I value. You know, I've made a lot of impact because it felt so easy and natural to care for someone. I feel like nurses are my people. I always say that no one else can get the like crudeness and the heart. They're both there, the sassiness that you have to have. Like my friends, who are NICU nurses, are very sassy and like they have to be. But the softest people I know,
Emily Silverman
you mentioned when you were in the hospital with your mom, you saw examples of the nurse that you want to be and the nurse that you don't want to be. So tell us, like, what are the signs of a good nurse and what are the signs of a nurse who maybe could be doing better?
Roshni Shah
So we all know the nurse, it's, I don't take anything personal, but it's the staff member who doesn't want to be there or isn't, you know, doesn't want to hear feedback or doesn't want to hear pushback. And every patient is special, of course, you know. And my mom, to me, is my VIP, and she has a lot of medical anxiety, just from her experiences growing up in India, and also her body was just very delicate to like everything. And so, you know, daily labs, or things that like getting poked extra, or she's vegetarian, and they would just like slab on, like eggs and ham sandwiches. And like, She's sensitive to smells, she would puke. And like, the bad nurse is annoyed by this, the good nurse is, I mean, my dad has a ritual of massaging my mom's feet every night with his concoction of lotions he makes for her. And some nurses were so against it in the good nurses, like, yeah, like, let your dad, like, he wants to contribute in this way. You know, this, these things that I'm like, I get that there's rules. And I'm like, I think rules are meant to be broken and for certain situations, and that's the rebellious person in me. But I'm like, you know, I have patients who are Muslim, who are fasting, and I let the family come break Iftar in the room. Like, go ahead. You want to pray on the floor. Pray on the floor like you want me to cover up your wife and like when I bathe them, I will, you know, I'm very mindful, I think, because culturally I come from that background, people were just taking my mom's gown on and off, and she wasn't conscious. But, I mean, she I could just and. Energetically, be like, mortified for her. You know, my mom's the kind of lady, like she was flirting with doctors trying to get me married as she was being rolled into the or, you know, she's like, that lady. She's super charming, you know, proper Leo woman, like, wants to look good. And I think when she woke a lot of consciousness, the first thing she was like, why am I why am I hand so ugly? Because they're all swollen and like, full of holes, and she's like, I'd rather die than look like this, like she was pissed, you know, because she just felt so degraded, like her body was just taken out of her control. And it is so important for me to everyone feel autonomy over their body, even if I don't agree with it. My number one thing is, I want every patient to feel empowered over their own body, if that means you refuse medications or you don't want something that I think you need. Let me talk to you about it, but I'm not going to discount it. And
Emily Silverman
you did a lot of work in the ICU and some work in the pacu as well the post Anesthesia Care Unit, so people coming out of procedures and operations, but also a lot of work in the ICU, which for people listening who aren't aware, you know, the ICU is the sickest patients in the hospital, and the nursing ratios are really low. So you might have one patient or two patients, and the patient might have IVs or a ventilator or, you know, lots of machines attached to them, and the nurse is really responsible for that person, that body. Sometimes they're not even conscious, and you know all the tubes and the catheters, and you're just so intimate with the patient and their body. And I'm wondering, after 10 years of doing that work like, what have you learned about the body? What have you learned about people? What have you learned about just being in such intimate proximity with others.
Roshni Shah
One I share this with anyone who's worked night shift, there's something just magical or spiritual about three to 4am in a hospital. I cannot explain it. That's usually my bath and labs time in an ICU before morning rounds. There's something in my body, viscerally that just feels like this is a very sacred time, you know, through ecmos, which are like, you know, tubes that are connecting people's hearts, or I have fecal tubes, and I you have a million tubes in someone's body. When you're exhausted, it is sometimes frustrating to have to do a menial task, like a bath. And I say menial because it's like, God, like they're subtle, they're sleeping, they're rested. It's not beeping. And I think that's what I'm like, okay, but like, mentally, I feel like, if I can make them feel good right now, if I can pray over their body, if I can just give them some energy shift work, maybe it'll help them decide what they want to do next. And I do think the souls and bodies decide what they want to do. To some extent,
Emily Silverman
what you just said about the 3am to 4am hour feeling kind of magical. I feel that too. I think it's obviously different from the doctor's perspective, because we're not right there at the bedside 24/7 but having worked 28 hour shifts and night shifts like I kind of feel like I can tap into what you're saying. What is it about that hour that gives it that quality?
Roshni Shah
I feel like it's the space where there's no management, there's no doctors, there's no protocol, like nothing needs to be done at that hour, it's the time when families or visitors are gone or sleeping. It's just this time where I think the patient, or the soul inside the patient gets to be in power. It's the one time where I'm like, I don't know this is not scientific, but this is something like, this is something that I can't explain. Things happen, miracles happen, moments happen. We're like, that, did you see that like, that is like, did you feel that like it's just something that I can't explain? And I think it's because it's, it's just A time where no one's paying attention you?
Emily Silverman
Music. You've talked about souls and bodies, and I imagine, as an ICU nurse, you've been around a fair bit of death, and I'm just wondering, from the ICU nurse perspective, you said, I think souls do have some say, maybe not entirely, but they do have some say. And just would love to hear more about what that feels like, and if you can actually feel that happening in the room, families
Roshni Shah
and friends and people who love you want to hold on to versions of you always. But the truth is, you will not come in and leave the hospital the same person you shouldn't, not as a new mom, not as a diagnosis, not as a patient, and there is so much ICU trauma that happens that we don't talk about enough. There's not enough resources to provide PTSD care to patients, because even if you're not experiencing something your neighbor might be, or someone across the hall will, or you're hearing moaning and screaming, and I have. Beeping fatigue. I can't imagine what patients are trying to get sleep or feeling. So I have conversations with my patients who are intubated. I talk to them like they're awake. I play music. I pray in whatever faith they are praying in, if they're Muslim, if they're Hindu, if they're Catholic, if they're Jewish, I find that song, or I find something on Spotify, and I play it for them. While I'm giving them a bath, I'm trying to give them a sense of autonomy and power in a position when they feel probably their body is completely powerless. That allows someone some dignity. Is why I think a shower is so powerful. You walk in the shower, you walk out powerful. I don't know if that's my life's work, but I feel like that's what means the most to me, is to watch someone step into their power and get to choose what they want, not what I'm telling them they need, not what me deciding what's best for them, not some surgeon telling them what they should do, how much they should fight, how much of a warrior they should be. Like we're all warriors in life. Tell us
Emily Silverman
about the difference between caring for someone in your family and caring for a patient as part of work. You're the same human. You're the same empathetic person with the same, you know, wonderful, cheerful, caring disposition, but obviously a very different context. You know, one of them is paid labor for strangers, and one of them is unpaid, I guess, sometimes paid if you're getting benefits, but often unpaid labor with someone like your mom, with whom you have an extremely intimate, long term relationship. Definitely,
Roshni Shah
I would say number one is any caregiving role deserves space to vent without judgment, obviously, when it's professional setting, we have to be careful how and where and who we vent with. I think also, when it's someone that you love, it's a lot harder to give them the autonomy they want, because you want what you want for them. And I am my mother's daughter, so as stubborn as she was, is as stubborn as I am, and my family jokes that were the same but opposite. So I want an orange pillow. She wants a green pillow. Both of us are right. Both of us are experts, and that will become a fight. I share that in my story, like how he decorated the house, or how I wanted to set up the bathroom, or just little things. And I think my inner Martha Stewart a personality, loved being an ICU nurse. I mean, I come in my shift in the first 30 minutes, I'm just cleaning and organizing, and it's celebrated. It's a job where that, that kind of detail orientation, is celebrated. And my patients, if they were healthy when I left in the morning, they looked good in that bed, you know. And I took pride in that my mom is not a patient that I can do that with. She is, at the end of the day, my mom, I'm a little bit scared of her, and I'm a little bit, you know, like, there's a different level of power there, and she's taking care of me, but I don't always necessarily want it. So it's an interesting dynamic. I think, in caregiving, turning that switch on and off, sometimes I want to be cared for in a professional setting. I get to clock out be done, or I can call in sick, or I can ask a co worker to help me, or I can go in the break room and eat a piece of like, still pizza and like, forget about something for 10 minutes, right? Like, I'm not attached to the outcome of this person after my 12 hour shift is done with my mom. If I make a mistake, that mistake is going to impact me for the rest of my life and her life. I don't show up for her. She falls on the stairs. She doesn't get a bath, her medicines are incorrect. She misses an appointment or a surgery. Those things impact our entire family. So the pressure to like be on all the time is there, like, I don't think I slept deeply until the day she died, which is the weirdest thing to recognize her last breath was the first time I took a deep breath. I have a lot of, I don't want to say shame around that, but just a lot of, like, sadness around that. I don't I don't think I even knew that I was holding my breath for that long.
Emily Silverman
Yeah, I know when we were preparing your story for the stage, we talked a lot about this idea of caregiving. You know, the word giving is built into that word, because obviously, you are giving. You're giving of yourself. You're giving your time, your energy, your attention, your labor, both physical and emotional and spiritual, but how there's also receiving built into caregiving. You know, the caregiver, in a way, gets to receive. I think there's a Mary Oliver poem that says something like, give until the giving feels like receiving. And I always thought that was so beautiful. And that idea is also complicated by the reality that caregiver burnout is such a real thing in this country, you know, especially as the population ages, and it's a lot of women who are shouldering the burden of doing. Doing that caregiving, and it often is unpaid work. It's often thankless work.
Roshni Shah
I think the best gift for me has been allowing my mom to become my friend much sooner in my life than I think I expected to happen, because us working in a dynamic where there was a power differential was going to frustrate both of us, slash, she was sick at really pivotal points in my life, recessions, job losses, breakups, you know, my mom and I have a lot of parallel stories in her family and my family and feeling misunderstood, or just having these big dreams and wanting to do so much, but feeling obligated and stuck in certain ways. You know, I was super adamant about all three of us daughters, having more autonomy and freedom that she has ever given. You know, she never pressured us to get married. She wanted us to be educated, travel and like, do what we cared about. You know, I think my both my parents were so powerful and giving me that space to know that I could always come home and be taken care of, that is a very powerful place to give back from. It's a privilege, because I can come down, Whittle my savings to zero and have nothing to my name, and my parents, to this day, my dad, will take me in and figure something out. So I think in that sense, when I give, I give from that same space of generosity. There's no obligation to pay it back. There's no I'm not doing this to scheme how I can get something out of it. It's just that I've been given so many gifts from so many people. That is where the giving receiving cycle feels so naturally, like I don't want to hold on to anything in life. Think my mom's biggest teaching is that you leave life empty handed. You don't hold on to your wealth. You don't hold on to any tangible item. You leave behind your legacy of love. You know, and my mom, when she died, you know, 411 immigrant women, but her cell phone and, you know, her funeral and stuff was during the pandemic, so we had these, like, Zoom calls, I mean, people from like, a gift shop, a random employee, all my friends, all my sister's friends, her dialysis driver came the Costco wave person they, like, loved her. Like the people that I'm like, why are you at my house? Like, why are you on the Zoom call? How'd you find out about this? Right? Because it's the impact that she left on people my mom didn't always speak fluent English, and like, people who spoke Spanish came to our house, like, Yo, your mom and I were friends. I'm like, oh, okay, I had no idea, right? Like, I was going through her phone. And I'm like, she's getting my friends dating advice. I'm like, when did you call my friends talk about this? Like, I don't get it right. And so I think that's the biggest teaching for me is like, what's the point of holding on to love if you can't share it? And it always multiplies. And I genuinely believe that or I've never taken a nursing contract. I've never traveled the world and not come back with way more, and it's not money
Emily Silverman
to end. I'm wondering if you would be willing to share any thoughts or advice with people listening who are caregivers. So maybe they're a nurse, maybe they're a doctor, maybe they're a mother or a daughter or a father or a son or a sibling who's responsible for the care of another person. Any words of advice or meditations to circle back to as they move forward with their caregiving work.
Roshni Shah
What I wish I had space for sooner was room to be angry, to be annoyed, to be frustrated, to have all these feelings that I felt shamed for having. You know, even new moms and like, you can hate that child for a little bit, because when you're exhausted and you're just a cow for the first few months, you can love something and hate something at the same time. And it's not permanent. It doesn't mean anything. And then, on a smaller scale, who in your life can you go to and talk to? Which friends can you be like, listen when you have space just just show up my house, wash my dishes and let me scream, let me vent. Let me talk about how much I hate doing this job. If you ever go to a bar at like, 7:45pm with a table full of nurses, and you listened, you would not think that we are the most compassionate kind, like gentle people. We have to get it out. We're so frustrated. Humans are complicated beings, and giving of yourself is depleting. We need those spaces. There's no shame in that. Well,
Emily Silverman
I have loved this conversation. I think what you said about love multiplying is really true, and this is one of those conversations where I leave the conversation with more energy than I had coming into it, and I think that speaks a little bit to your magic. So thank you so much for telling your story on The Nocturnists stage and for coming here to speak with me today.
Roshni Shah
Thank you so much.
Emily Silverman
Transcript
Note: This transcript has not yet been reviewed for errors. The Nocturnists is created primarily as a listening experience. The audio contains emotion, emphasis, and soundscapes that are not easily transcribed. We encourage you to listen to the episode if at all possible. Our transcripts are produced using both speech recognition software and human copy editors, and may not be 100% accurate. Thank you for consulting the audio before quoting in print.
Emily Silverman
You're listening to The Nocturnists stories from the world of medicine. I'm Emily Silverman. We've had a lot of physicians on this show, but I'm really thrilled today to be speaking with a nurse. Her name is Roshni Shah, and she told a story at our live show in New York City, produced in partnership with Bellevue Literary Review on the theme of taking care. In Roshni stories, she transports us to a really difficult chapter of her life. She was living at home, she was taking care of her aging mom, and she was working difficult night shifts in the ICU. But despite all this, despite the stress, despite the sleep deprivation and the bickering in her family around that time, Roshni manages to find a moment of intense serenity in the shower with her mom as they bathe together one morning early after Roshni returns from work, I loved this story, which gives us an intimate glimpse into roshni's family Life, and I also really loved my conversation with Roshni afterward, where we talked about the elemental significance of water the hushed hour between three and four in the morning in the ICU that can feel almost mystical, and the differences between caregiving as a daughter and Caregiving as a nurse. But first, let's hear Roshni story from our live show in New York healing waters.
Roshni Shah
I pull into my driveway, windows down, music blasting, Bollywood, nose dripping. But despite the cold Chicago air, I can barely keep my eyes open, all I can think about right now is going to sleep. It's as if the medications I've been giving my patients overnight in the ICU has somehow gotten into my own bloodstream. All I can hear in my skull is the sound of bed alarms and patience cries. I am so exhausted to turn the car off and walk towards the door, I realize my reality is quite different between me and my bed lies one more nursing task. I have to give my mom a bath. I opened the door, and it's utter chaos. My dad in the living room watching Fox News, shouting at my mom across the house while she's in the kitchen, the sound of Donald Trump screeching, mixing in my mom's spiritual music permeates the house. My mom's not quite used to using her walker yet, so she's just has it kind of sitting there in the kitchen. And she uses it to pivot from the fridge to the stove and back, grabbing fresh ginger and cardamom and nutmeg for her morning jaw, and grabs a handful of onions and mustard seeds, and she throws into hot onion, and as it sputters, all these smells permeate into my nostrils. My stomach grumbles. My mom looks at me, hi, Bita, welcome home. I made you breakfast now I have just been really nice and patient for the past 14 hours, and I do not have it in me anymore. I have been in my head calculating nurse math. For those that don't know, Nurse math is the math nurses use when we're constantly looking at our watch, calculating the best way to get the job done most efficiently, to maximize our time for rest. And right now, the one task that remains is giving my mom a bath. And I have calculated, if I do this now, I can get enough sleep before my next shift. So I'm not proud, but I shout at my mom, Mom, can we take her shower? Now she looks up startled. She stares at stove in front of her, and then she looks at my dad, I know I have to act fast. You see, growing up as the youngest in my family, I've learned all the tricks, and this is my best one. I make my face extra pathetic, my eyes extra sad, and I plead mom. I'm so exhausted. She looks at me, and I know I've got her Okay. Beta, 10 minutes, I slump to the ground to play with my dog, and I pull up my phone. I have so many messages from my friends that I have to get back to. I see the first one. Our friend is on her honeymoon in Italy, sending me photos of PA. And wine, great. Another friend sends me an update that her annual bonus just wasn't what she thought it was going to be. But there's always next year. I know I should have some sympathy or something inside of me, but my exhaustion is now rage. I look around me, this was not what I had imagined from my life in my 30s. I should be coming home to my own family, taking care of my husband and kids, or at least planning a trip to Italy. I don't even know what an annual bonus is, so I respond with some likes and comments, and I look at my watch. It's been way over 10 minutes I'm mad. I pop up mom. She turns the stove off, finally pours my dad's tea and breakfast, yes, and finally makes progress as she walks towards the stairs, okay, take me up. I look at the 20 stairs that she's pointing at. My mom just fell down these stairs and broke her hip a few weeks ago. She just got back from rehab, not even a week ago. There was no way we were making it up there. So I look at her mom. That's not happening. Come I want to show you something I made, okay. Side note here, I am a first generation daughter of immigrants. So growing up, the way we decorated our home was all about functionality and efficiency. Our walls were plain and bare to preserve the newness of the home. We just recently got the plastic off the couches to that was a good bonus. But my parents didn't really believe in decorating. We had the same furniture from the 80s, and if it wasn't glued back together, we covered it up with something and made it work. I, on the other hand, am a proper millennial. I grew up inspired by Martha Stewart Living, and I couldn't wait to be an adult and decorate my home. So when my mom was in rehab, I knew I had my chance. I jumped at the opportunity to decorate the downstairs bathroom, which was bare. I spent way too much time and energy picking out the perfect plush, trendy rug. I got the beaded matching shower curtain. Hell, I had money. I splurged on the matching towels and candles. I put hooks for her robe and gowns, and I was really proud of myself. In fact, the hole in the wall, quite literally, my most rebellious act was putting a hole in the wall with my own artwork. So you know, that was awesome, as my mom hobbles over with her walker, still not quite sure how to use it, I couldn't wait to show her. I turned the light on for this big reveal, and I hear a big gasp. What did you do in here? How much did this cost? Your dad's gonna I was so disappointed. This is not how the big reveals happen on TV. How could she be so ungrateful? As she continues to scream at me and walk in her walker gets stuck in the rug that I had picked out, and I realize my mom has a point, but I'm as stubborn as she is, so I'm not gonna give in. I roll my eyes and tell her mom, just get in the shower and get undressed. She rolls her eyes right back at me as she wobbles to the bathroom. As she opens the shower curtain, she sees it. You see, I had to install one of those ugly hospital grade, plastic and metal Shower chairs, and I tried my best to bedazzle it, but it didn't work. She stares at that chair, and her eyes drop. I know those eyes. It's the look of when your freedom gets snatched away from you. I know my mom can't believe that this is what her life is like either she's only 60. Something inside me softens. I realize this is not a patient. This is my mom. I walk over to the bathroom and turn on the water, and as she gets undressed, still slowly from the surgeries that she just had, I see her naked body. It's still covered in bruises and scars from her previous surgeries, and I can't help but picture her like a little baby. She looks so fragile and delicate when the water warms up, I grab it, and maybe it's because I'm not wearing gloves, but as my hands touch her back, I'm instantly transformed. I'm in the hospital as a child when my mom bathes me in the sink for days, I'm transformed back to India when my mom's hands are rubbing my head when I had pneumonia for weeks, my mom's skin is so soft it feels like whipped silken tofu that's soaked in a syrup of rose and cardamom. In fact, as the water hits her skin, I swear the bathroom starts to smell like her smell. Smells of jasmine and orange and cloves and cinnamon and smells of home, I realize this is not the ICU. For the first time in many hours, my body relaxes. I hand my mom the shower bar. She looks at me with gratitude and something both of us shifts. Now, her conversation goes from formalities to more important topics, like, you know, who's sleeping with who at work, and by the way, are there any cute single residents that like you yet? And as I look at my mom and answer her questions, she's very nosy, I grab her loofah and her dove body wash. I like the efficient immigrant daughter that I am. Squirt out two efficient squirts and start lathering her. She grabs my hand. I laugh. You see, my mom sacrifices and gives to everyone, and she has to be really savvy everywhere. But for as long as I've known her, the shower was where she gave herself the biggest indulgence, and today was no different. So I grabbed that dove body wash, and I squeezed to her satisfaction what ended up being over half of the bottle. Literally, there is soap falling to the ground in wasteful heaps. I hide my frustration and I go with it. This is her shower, and I shout, lathering her. I lather her underarms and under her breasts and under other more intimate areas. And we're no longer mother daughter. We become friends. In fact, now that I'm over 30, my mom thinks of me as one of her girlfriends that she can tell one of her non veg jokes to. If you don't know what that means in our culture, it's raunchy humor. The thing is, my mom's joke telling doesn't really ever get to the punchline. So she starts one of her infamous jokes that I've heard millions of times, not fully. Of course, she's about five words in this time, which is progress, and her head pops back, her body starts convulsing, and she makes no noise. Don't worry. Don't be alarmed. You see, my head is also thrown back, my body is also convulsing, and we are now exchanging in our shared signature, mom, daughter, silent cackle. It's the laugh that my mom and I share, that I have inherited it proudly or not, it is what it is, and as both of us clutch our stomachs hard, laughing so much from nothing, I realize I haven't checked my watch because I don't really care what time it is anymore. Thank you. The Hello.
Emily Silverman
I am here with Roshni Shah, Roshni, thanks so much for coming on the show. Thanks for having me so I loved your story. It was so vivid. I loved all the sights and the smells and the sounds and the details, and I really felt like I was there with you. I'm just curious to hear your reflections on that night. How was it to tell the story on stage?
Roshni Shah
It was scary, and it was so amazing to get to share a part of my mom with people I feel like the best, the best gift, has been to share her legacy and her story in ways outside of her sickness, you know, and the story I share about this ritual of bathing and all of us do this, babies, old people. So it's just such a seems like innocuous and not important, but it was so nice to get feedback after the show of like, how much that was like a, you know, a pivotal, or, you know, poignant part of someone's day. And because I sometimes take for granted what we do as caregivers, day in, day out.
Emily Silverman
You mentioned ritual bathing, one of my favorite TV shows of the last few years has been this show, pen 15. I don't know if you've yes for the audience, if you aren't aware of it, it's these two young, awkward girls in school navigating adolescence and puberty. And one of the girls has this tradition where she and her mom will take baths together, and they have this, like, really nice bathtub. It almost looks like a Jacuzzi indoors. And there's these, like, angsty scenes where the character's name is Maya, she'll have just gone through something really hard at school, and she'll get in the tub, and her mom will be in there with her, and you can tell how calming and soothing it is, even if they're bickering with each other. I just loved that so much. And so when you just said, like, Mother Daughter ritual bathing, it made me think of that. And I just was curious if you had seen that TV show, and if you had any reflections on mother daughter ritual bathing. Yeah, well, I
Roshni Shah
definitely had a bowl cut. I'm a first generation immigrant American, so definitely relate to that show. I was cracking up watching it and agreed, right? Like, I think, I don't know if it's a cultural context, but I grew up bathing with my mom, you know, bathing with my sisters. I still, to this day, love going to spa or a bathhouse or Korean spas, where we're amongst sisterhood of women. It's actually such an empowering space. We're gabbing and we're gossiping and we're bickering with one another, but it's also just a space to kind of let the things that we hold on to in our day to day life and just exist from a very young age, my mom bathed me, not related, but similar. I'm like my dog is geriatric, and I bathe her once a week because she has wound and as a nurse, I bathe people, right? I bathe lots of people, and babies and kids. And you come to each shower, literally, you figure it'll be dirty, and you get to leave kind of cleansed and lighter.
Emily Silverman
I remember after I gave birth to my first daughter, it was a C section, and the first thing the nurse said to me, once I cleared up from the drugs, she was like, why don't you take a shower? And I just remember I went in and took a shower, and I came out feeling like such a different person in that way that a shower can do that, you know, not all showers, but like, there are certain showers in your life that just have this, like, elevated healing aspect. And it sounded like in your story, this was definitely one of those encounters. What do you think it is about water that is so healing?
Roshni Shah
After my mom passed away. I actually went to India. And I did. I called it The Freedom Trail, and I spread my mom's ashes across bodies of water that meant a lot to me, places that I wanted to take her in the world, spiritually significant places. And then I have one more spot I want to take her to Kauai, and I don't have any ashes left, but I think part of her is in me, so that's counts, and there is something innately sacred about the bodies of water. I've always intuitively knew that, like rain feels cleansing, water's able to adapt and shape shift, ice, boil, soft, nurture. I mean, it's such a powerful metaphor for so many things. But I think when you go through grief, things take on different meaning. And I never understood why I felt called. I went by myself to India to do this like my family wasn't pushing me to do it. Like part of her getting freedom was having access back to places that she longed to be in, or I longed to take her to. And when you're doing these rituals, the way they explained, how you know, we come from Earth, we go back to Earth, how we the water is actually takes the Earth into the sky and back into the ground for generations, right? This now goes beyond just this lifetime, but how this water is carrying ashes of my ancestors and it will, you know, one day, hold mine. I'm getting goosebumps thinking about it. I Something about being in the Ganga, right? And being in these, like, holy waters. I can feel it. I felt moved tears, and it's disgusting water. You look at it, it's full of garbage. It's not like it's anything powerful. It's like Lake merit water. But I've always been drawn to water, like I always want to live by a body of water. There's something about being in the ocean that just, I can't even swim, which is ironic, but like, I love that I know going into the water, it's connecting all of the elements of the world, and it's connecting me to this, like womb space. And I always joke with my mom. I used to always tell her, like, Let's hang out in the womb, which is us cuddling. Because I feel like my earliest memory my mom and I, is me and her womb and just being enveloped in this, like, warm, soft, secure, it's like, the place I long for the most in this world. But think being in the water, expecting my mom's ashes, I was like, oh, like, this is the womb space, like we're coming back to this. Like it's a circle.
Emily Silverman
Yeah, there is something about water that feels connected to the divine feminine. And I had never thought about it like that, like the waters of the womb, and, you know, being curled up inside that warm incubator or the hot tub, as my OB GYN said, Yeah, my
Roshni Shah
mom joked I was, I was a C section baby. My arms ripped behind my head. Feet were crossed. I was not trying to leave. I was real cozy. My mom was 89 pounds. She was like, maybe under 100 pounds, and I was nine pounds. My mom was like, You were really comfortable in there. I was like, Yeah, that was my happy place, for sure.
You so
Emily Silverman
when did this story take place? And when did your mom pass?
Roshni Shah
My mom passed away in 2020 maybe less than a month after the lockdown in Chicago. I've been a caregiver for her, kind of on and off since college, but it became more prominent in my life in 2015 it's kind of the reason why I became a nurse that was kind of the catalyst. Honestly, the story is one of. Many stories, because it's not just one time. It's many times of her health going up and down and being in the hospital and she broke her hip, or when she would have a pneumonia, or, you know, she had dialysis issues, or, I mean, like the hospitalizations were kind of ongoing, and as her health declined over time, there's just something about bathing that is so vulnerable and in such a space of independence. And my mom was fiercely independent in her mind, but like her body, she had to be dependent. There's a lot of love, there's a lot of anger and frustration that happens within a mom and a daughter relationship that no one can understand unless you're a mom and daughter and you get it. And it's not like it was one way, like I would shower in the bathroom and talk to my mom while she was in the bathroom, like it was like our space, where we got to be girls and vent and tell jokes, make fun of everyone, and it just calmed the energy down from, like, both of our mutual frustrations, caregiving, for me, isn't this like glorification of being some kind of hero? It wasn't a job I chose. Think it was like a mutual care for one another to give back to my mom in a way that she's given to me and in these little ways, making a meal, taking a shower, she would wash my clothes. We gave to one another to make life simpler for one another in the ways that we knew how to or could
Emily Silverman
tell us about your decision to go into nursing and coming into your own as a nurse, I moved
Roshni Shah
to India for a year. I worked in health administration post college, and I think that experience kind of shed light to the work of medicine. I felt really afraid of being a doctor. I didn't think I was smart enough. Slash, I didn't really like doctors. I had a lot in my family, and just didn't seem like something I enjoyed. But in my first profession, I worked with a lot of nurses, so I learned about nursing as a job, just really fascinated by them. And then India, I got to volunteer across the country and just see the impact of doulas and midwives and nurses. And I was enamored by how hands on they were and then when I came back from India, my mom had gotten extremely sick and was in ICU for a few months. And because I was the unemployed daughter, that was the caregiver by proxy, and I got to experience one the nurse I didn't want to be, but I got to experience how a nurse's brain work, because it got they got to be a storyteller, a creator. They got to connect the dots how impactful they were to our family and guiding us. And I just loved how the nurses took care of my mom, culturally, listening to what we said and what we needed, and giving her the dignity that she deserved. I felt like I was naturally fit for the job, and I actually, genuinely, for a long time, felt such a head, heart alignment with that career. I love patient care. You know, I get to be the journalist. I get to be creative. I say I'm like, I'm not rich in cash, but I'm rich in prayers. Like, I have a lot of patients who have prayed for me. I've gotten a lot of Daisy awards, all these things that, like, you know, aren't resume things, but things that I value. You know, I've made a lot of impact because it felt so easy and natural to care for someone. I feel like nurses are my people. I always say that no one else can get the like crudeness and the heart. They're both there, the sassiness that you have to have. Like my friends, who are NICU nurses, are very sassy and like they have to be. But the softest people I know,
Emily Silverman
you mentioned when you were in the hospital with your mom, you saw examples of the nurse that you want to be and the nurse that you don't want to be. So tell us, like, what are the signs of a good nurse and what are the signs of a nurse who maybe could be doing better?
Roshni Shah
So we all know the nurse, it's, I don't take anything personal, but it's the staff member who doesn't want to be there or isn't, you know, doesn't want to hear feedback or doesn't want to hear pushback. And every patient is special, of course, you know. And my mom, to me, is my VIP, and she has a lot of medical anxiety, just from her experiences growing up in India, and also her body was just very delicate to like everything. And so, you know, daily labs, or things that like getting poked extra, or she's vegetarian, and they would just like slab on, like eggs and ham sandwiches. And like, She's sensitive to smells, she would puke. And like, the bad nurse is annoyed by this, the good nurse is, I mean, my dad has a ritual of massaging my mom's feet every night with his concoction of lotions he makes for her. And some nurses were so against it in the good nurses, like, yeah, like, let your dad, like, he wants to contribute in this way. You know, this, these things that I'm like, I get that there's rules. And I'm like, I think rules are meant to be broken and for certain situations, and that's the rebellious person in me. But I'm like, you know, I have patients who are Muslim, who are fasting, and I let the family come break Iftar in the room. Like, go ahead. You want to pray on the floor. Pray on the floor like you want me to cover up your wife and like when I bathe them, I will, you know, I'm very mindful, I think, because culturally I come from that background, people were just taking my mom's gown on and off, and she wasn't conscious. But, I mean, she I could just and. Energetically, be like, mortified for her. You know, my mom's the kind of lady, like she was flirting with doctors trying to get me married as she was being rolled into the or, you know, she's like, that lady. She's super charming, you know, proper Leo woman, like, wants to look good. And I think when she woke a lot of consciousness, the first thing she was like, why am I why am I hand so ugly? Because they're all swollen and like, full of holes, and she's like, I'd rather die than look like this, like she was pissed, you know, because she just felt so degraded, like her body was just taken out of her control. And it is so important for me to everyone feel autonomy over their body, even if I don't agree with it. My number one thing is, I want every patient to feel empowered over their own body, if that means you refuse medications or you don't want something that I think you need. Let me talk to you about it, but I'm not going to discount it. And
Emily Silverman
you did a lot of work in the ICU and some work in the pacu as well the post Anesthesia Care Unit, so people coming out of procedures and operations, but also a lot of work in the ICU, which for people listening who aren't aware, you know, the ICU is the sickest patients in the hospital, and the nursing ratios are really low. So you might have one patient or two patients, and the patient might have IVs or a ventilator or, you know, lots of machines attached to them, and the nurse is really responsible for that person, that body. Sometimes they're not even conscious, and you know all the tubes and the catheters, and you're just so intimate with the patient and their body. And I'm wondering, after 10 years of doing that work like, what have you learned about the body? What have you learned about people? What have you learned about just being in such intimate proximity with others.
Roshni Shah
One I share this with anyone who's worked night shift, there's something just magical or spiritual about three to 4am in a hospital. I cannot explain it. That's usually my bath and labs time in an ICU before morning rounds. There's something in my body, viscerally that just feels like this is a very sacred time, you know, through ecmos, which are like, you know, tubes that are connecting people's hearts, or I have fecal tubes, and I you have a million tubes in someone's body. When you're exhausted, it is sometimes frustrating to have to do a menial task, like a bath. And I say menial because it's like, God, like they're subtle, they're sleeping, they're rested. It's not beeping. And I think that's what I'm like, okay, but like, mentally, I feel like, if I can make them feel good right now, if I can pray over their body, if I can just give them some energy shift work, maybe it'll help them decide what they want to do next. And I do think the souls and bodies decide what they want to do. To some extent,
Emily Silverman
what you just said about the 3am to 4am hour feeling kind of magical. I feel that too. I think it's obviously different from the doctor's perspective, because we're not right there at the bedside 24/7 but having worked 28 hour shifts and night shifts like I kind of feel like I can tap into what you're saying. What is it about that hour that gives it that quality?
Roshni Shah
I feel like it's the space where there's no management, there's no doctors, there's no protocol, like nothing needs to be done at that hour, it's the time when families or visitors are gone or sleeping. It's just this time where I think the patient, or the soul inside the patient gets to be in power. It's the one time where I'm like, I don't know this is not scientific, but this is something like, this is something that I can't explain. Things happen, miracles happen, moments happen. We're like, that, did you see that like, that is like, did you feel that like it's just something that I can't explain? And I think it's because it's, it's just A time where no one's paying attention you?
Emily Silverman
Music. You've talked about souls and bodies, and I imagine, as an ICU nurse, you've been around a fair bit of death, and I'm just wondering, from the ICU nurse perspective, you said, I think souls do have some say, maybe not entirely, but they do have some say. And just would love to hear more about what that feels like, and if you can actually feel that happening in the room, families
Roshni Shah
and friends and people who love you want to hold on to versions of you always. But the truth is, you will not come in and leave the hospital the same person you shouldn't, not as a new mom, not as a diagnosis, not as a patient, and there is so much ICU trauma that happens that we don't talk about enough. There's not enough resources to provide PTSD care to patients, because even if you're not experiencing something your neighbor might be, or someone across the hall will, or you're hearing moaning and screaming, and I have. Beeping fatigue. I can't imagine what patients are trying to get sleep or feeling. So I have conversations with my patients who are intubated. I talk to them like they're awake. I play music. I pray in whatever faith they are praying in, if they're Muslim, if they're Hindu, if they're Catholic, if they're Jewish, I find that song, or I find something on Spotify, and I play it for them. While I'm giving them a bath, I'm trying to give them a sense of autonomy and power in a position when they feel probably their body is completely powerless. That allows someone some dignity. Is why I think a shower is so powerful. You walk in the shower, you walk out powerful. I don't know if that's my life's work, but I feel like that's what means the most to me, is to watch someone step into their power and get to choose what they want, not what I'm telling them they need, not what me deciding what's best for them, not some surgeon telling them what they should do, how much they should fight, how much of a warrior they should be. Like we're all warriors in life. Tell us
Emily Silverman
about the difference between caring for someone in your family and caring for a patient as part of work. You're the same human. You're the same empathetic person with the same, you know, wonderful, cheerful, caring disposition, but obviously a very different context. You know, one of them is paid labor for strangers, and one of them is unpaid, I guess, sometimes paid if you're getting benefits, but often unpaid labor with someone like your mom, with whom you have an extremely intimate, long term relationship. Definitely,
Roshni Shah
I would say number one is any caregiving role deserves space to vent without judgment, obviously, when it's professional setting, we have to be careful how and where and who we vent with. I think also, when it's someone that you love, it's a lot harder to give them the autonomy they want, because you want what you want for them. And I am my mother's daughter, so as stubborn as she was, is as stubborn as I am, and my family jokes that were the same but opposite. So I want an orange pillow. She wants a green pillow. Both of us are right. Both of us are experts, and that will become a fight. I share that in my story, like how he decorated the house, or how I wanted to set up the bathroom, or just little things. And I think my inner Martha Stewart a personality, loved being an ICU nurse. I mean, I come in my shift in the first 30 minutes, I'm just cleaning and organizing, and it's celebrated. It's a job where that, that kind of detail orientation, is celebrated. And my patients, if they were healthy when I left in the morning, they looked good in that bed, you know. And I took pride in that my mom is not a patient that I can do that with. She is, at the end of the day, my mom, I'm a little bit scared of her, and I'm a little bit, you know, like, there's a different level of power there, and she's taking care of me, but I don't always necessarily want it. So it's an interesting dynamic. I think, in caregiving, turning that switch on and off, sometimes I want to be cared for in a professional setting. I get to clock out be done, or I can call in sick, or I can ask a co worker to help me, or I can go in the break room and eat a piece of like, still pizza and like, forget about something for 10 minutes, right? Like, I'm not attached to the outcome of this person after my 12 hour shift is done with my mom. If I make a mistake, that mistake is going to impact me for the rest of my life and her life. I don't show up for her. She falls on the stairs. She doesn't get a bath, her medicines are incorrect. She misses an appointment or a surgery. Those things impact our entire family. So the pressure to like be on all the time is there, like, I don't think I slept deeply until the day she died, which is the weirdest thing to recognize her last breath was the first time I took a deep breath. I have a lot of, I don't want to say shame around that, but just a lot of, like, sadness around that. I don't I don't think I even knew that I was holding my breath for that long.
Emily Silverman
Yeah, I know when we were preparing your story for the stage, we talked a lot about this idea of caregiving. You know, the word giving is built into that word, because obviously, you are giving. You're giving of yourself. You're giving your time, your energy, your attention, your labor, both physical and emotional and spiritual, but how there's also receiving built into caregiving. You know, the caregiver, in a way, gets to receive. I think there's a Mary Oliver poem that says something like, give until the giving feels like receiving. And I always thought that was so beautiful. And that idea is also complicated by the reality that caregiver burnout is such a real thing in this country, you know, especially as the population ages, and it's a lot of women who are shouldering the burden of doing. Doing that caregiving, and it often is unpaid work. It's often thankless work.
Roshni Shah
I think the best gift for me has been allowing my mom to become my friend much sooner in my life than I think I expected to happen, because us working in a dynamic where there was a power differential was going to frustrate both of us, slash, she was sick at really pivotal points in my life, recessions, job losses, breakups, you know, my mom and I have a lot of parallel stories in her family and my family and feeling misunderstood, or just having these big dreams and wanting to do so much, but feeling obligated and stuck in certain ways. You know, I was super adamant about all three of us daughters, having more autonomy and freedom that she has ever given. You know, she never pressured us to get married. She wanted us to be educated, travel and like, do what we cared about. You know, I think my both my parents were so powerful and giving me that space to know that I could always come home and be taken care of, that is a very powerful place to give back from. It's a privilege, because I can come down, Whittle my savings to zero and have nothing to my name, and my parents, to this day, my dad, will take me in and figure something out. So I think in that sense, when I give, I give from that same space of generosity. There's no obligation to pay it back. There's no I'm not doing this to scheme how I can get something out of it. It's just that I've been given so many gifts from so many people. That is where the giving receiving cycle feels so naturally, like I don't want to hold on to anything in life. Think my mom's biggest teaching is that you leave life empty handed. You don't hold on to your wealth. You don't hold on to any tangible item. You leave behind your legacy of love. You know, and my mom, when she died, you know, 411 immigrant women, but her cell phone and, you know, her funeral and stuff was during the pandemic, so we had these, like, Zoom calls, I mean, people from like, a gift shop, a random employee, all my friends, all my sister's friends, her dialysis driver came the Costco wave person they, like, loved her. Like the people that I'm like, why are you at my house? Like, why are you on the Zoom call? How'd you find out about this? Right? Because it's the impact that she left on people my mom didn't always speak fluent English, and like, people who spoke Spanish came to our house, like, Yo, your mom and I were friends. I'm like, oh, okay, I had no idea, right? Like, I was going through her phone. And I'm like, she's getting my friends dating advice. I'm like, when did you call my friends talk about this? Like, I don't get it right. And so I think that's the biggest teaching for me is like, what's the point of holding on to love if you can't share it? And it always multiplies. And I genuinely believe that or I've never taken a nursing contract. I've never traveled the world and not come back with way more, and it's not money
Emily Silverman
to end. I'm wondering if you would be willing to share any thoughts or advice with people listening who are caregivers. So maybe they're a nurse, maybe they're a doctor, maybe they're a mother or a daughter or a father or a son or a sibling who's responsible for the care of another person. Any words of advice or meditations to circle back to as they move forward with their caregiving work.
Roshni Shah
What I wish I had space for sooner was room to be angry, to be annoyed, to be frustrated, to have all these feelings that I felt shamed for having. You know, even new moms and like, you can hate that child for a little bit, because when you're exhausted and you're just a cow for the first few months, you can love something and hate something at the same time. And it's not permanent. It doesn't mean anything. And then, on a smaller scale, who in your life can you go to and talk to? Which friends can you be like, listen when you have space just just show up my house, wash my dishes and let me scream, let me vent. Let me talk about how much I hate doing this job. If you ever go to a bar at like, 7:45pm with a table full of nurses, and you listened, you would not think that we are the most compassionate kind, like gentle people. We have to get it out. We're so frustrated. Humans are complicated beings, and giving of yourself is depleting. We need those spaces. There's no shame in that. Well,
Emily Silverman
I have loved this conversation. I think what you said about love multiplying is really true, and this is one of those conversations where I leave the conversation with more energy than I had coming into it, and I think that speaks a little bit to your magic. So thank you so much for telling your story on The Nocturnists stage and for coming here to speak with me today.
Roshni Shah
Thank you so much.
Emily Silverman
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