It's about the hands. She pulls back on the paper peeling to open the tray of surgical instruments while conversing with 15-year-old patient Kristen Bergh. "Where do you go to school? Do you have any pets? What are your hobbies? Do you have a boyfriend?" she asks. I think to myself, "dear god, leave the patient alone. She's suffering enough. You don't need to ask her all these questions." Then I realize that the awkward silence and nervousness felt by the patient is diminished by conversation. It's as if all the years of gossiping had some sort of benefit--aside from the embarrassing situations in which I caught myself when I introduced my mother to my friends.

    The hands are fifty-two years old, weary from years of marriage, raising kids, and working. The fine lines, aged pigmentation, and dullness are clearly visible. It is with these hands that she gingerly touches Kristen and reassures her that the catherization procedure will not be painful. Kristen, who likes to fence and debate, looks into my mother's eyes for some comfort. She is in the hospital for osteomyletis, a chronic bacterial infection localized in the bone, and needs to have a Peripherally Inserted Central Catheter (PICC) line inserted in her arm. According to my mother, a PICC line is a "type of central line that is inserted into one of the larger veins of the arm and where it is threaded into the superior vena cava." The line is then used as an access point for the patient's medication, including chemotherapy, as well as nutrition, antibiotics and fluid hydration.

    As my mother begins to stick Kristen, the brown-haired, brown-eyed girl turns her head to look away. The entire procedure takes only thirty minutes to complete. After washing her hands, my mother picks up a pen and writes in her chart. She brings her cart back to the IV office on the 10th floor of the Tower Building of Fairfax Hospital where she then proceeds to sit down, make notes and checks her beeper. There are no patients for the time being so she sits down and eats her an orange for breakfast. She tells me, "sometimes you don't know what to expect. It can get awfully busy or things can be relatively slow. How busy I am depends on how many requests I have. If I have a lot of requests, I am busy. If I don't, I can watch t.v. or read magazines in the IV office."

    My mother, Jeoung Yoo, is a specialized nurse and works as part of the IV Therapy Team at Fairfax Hospital. The team consists of a group of people who are skillful in placing IVs in patients; they are called when difficult cases arrive or when other nurses have tried unsuccessfully to thread the needle into the vein. They stick patient one last time with the hope that the patients' blood supply will soon be able to be accessed with appropriate drugs and life-sustaining nutrients. When I asked, my mother told me that her job consists of "putting in PICC lines, repairing central lines, declotting the catheter, and accessing PORTS." The latter is an alternative device to the PICC, and consists of a tube underneath the skin. The benefit comes in that the patient doesn't have to be stuck with needles over and over again.

    Soon her beeper rings and she is off again. This time the patient is a baby, only 37 days old. "Children and babies need to be sedated," my mother says, "since they move too much and do not understand what is going on." The baby's grandmother brings him into the treatment room, a brightly lit, colorful room especially designed for the purpose of administering medical procedures to pediatric patients. The boy is chubby and cute, with light brown hair, blue eyes, and the softest skin you can imagine. As I bring back some toys from the "distraction box," I can imagine him starring in a Pampers or Huggies commercial. My mother examines the baby's legs with her hands for some veins. She takes off her glasses and peers closely, commenting that the good veins are taken. After sticking once, twice, and then a third time, my mother shakes her head. "I can't do it," she says in a frustrated tone of voice. She lets go of the baby's leg and gives him back to his grandmother. His grandmother takes him into her arms and thanks my mom for trying. My mother is standing by the door with her arms crossed against her chest watching the grandmother take the baby back to his mother in his room. I ask how many times they fail, meaning the IV team. In "1% of all cases they cannot find the vein," she says. It happens "very seldom." In these cases, patients are sent to the department of intervention radiology, where a mechanical procedure called fluoroscopy is performed to better visualize the obstructed vein. The patient is then sent to the operating room and a surgeon puts in the catheter.

    We then head to the X-ray department, where my mother asks for the film of the first patient. She takes the film from the technician and holds it against the white lamp so she can check the proper position of the catheter. It is amazing how one can see the catheter on the film, a thin wire among all the skeleton on the x-ray. My mother takes out the measuring tape and with her hands, checks the distance of the insertion. It is slightly too long, so my mother must go back and pull some of the tubing from the patient's arm.

    The next patient is an elderly Vietnamese woman with cancer. In contrast to the baby, her skin is leathery and aged. Laying in bed with various tubes hanging on the side of her bed, she looks frail and weak. Her right arm is a bit distended and has a purplish-blue hue. This is because the person who had previously changed her dressing had not been so careful and had caused the needle to shift in her arm. My mother is incensed about this and demands that the nurses on the wing come to the room to see how a dressing is properly changed. In the process of demonstrating, my mother takes on a serious, commanding tone of voice. This reminds me of the times when she yells at me for not picking up after myself after I take a shower and leave the towels astray all over the bathroom floor.

    With all her years of experience, my mother has seen many things. She tells me about the IV drug users who tell her what to do. "Put it here, put it there," they say knowingly from shooting drugs. Like babies, there are adults who cry because they don't want to be poked or prodded anymore. Some confused patients will even pull their catheters out. One time a catheter could not be found anywhere in the patient's room. After extensive searching people came to the conclusion that the patient had pulled it out, chewed it, and ate it.

    At the end of the day, the hands push the cart back to the IV office and write notes in a log commenting on the patients that she has treated. After taking care of some phone calls and wrapping up loose ends, her shift has ended. I change out of my scrubs and take the elevator to the first floor of the main lobby of the hospital where I wait for her near the gift shop. We soon walk out together in the drizzling rain and I hold her hand, the one that will drive me home.