Monsters in my chest.

It was the summer of 1978. I was a relatively young registered nurse and had volunteered to go out as camp nurse to a place I had attended myself as a camper, leader and college-age program staff. I remember reading first-aid books and praying earnestly that nothing bad would happen.

It was the second day of camp when I first met Nathan. From die window of the Health Hut I saw a little eight- or nine-year-old boy accompanied by two leaders, moving up the hill with difficulty. He was walking slowly, bent over with both hands leaning on his knees, as children do when they are making-believe an "elephant walk." It was obvious that be was in some type of distress, but what, I was not sure.

Once inside I could tell he was having much difficulty breathing. He was calm and worked with us easily. I pulled out my stethoscope and heard, for the first time, distinct expiratory wheezes, the hallmark of asthma. Remembering everything I had been taught about pediatrics, I asked him if he wanted to listen. Yes, he agreed without words but with a round-faced grin and a sparkle to his eyes. "Nurse," he said upon listening, "there are monsters in my chest." Yes, I explained, including that we were going to the doctor to get some medicine for those "monsters."

His health history form was pulled and indeed, there was the indication of a history of asthma, but no medication had been sent to camp. A short trip was made to the nearest small town where a clinic doctor who handles camp problems prescribed aminophylline elixir, a drug which dilates the air passages making it easier for an asthmatic to breathe.

For the remainder of the day, Nathan stayed in the Health Hut for rest, fluids, escape from the heat and for time for the medicine to work. That afternoon I sat on his cot, listening to a clear chest, then passing the stethoscope earpieces to him. "Nurse," he said. "There are no more monsters in my chest."

Nathan came to the Health Hut a lot that year. He had to come for his medicine, but the bond between us was stronger than that. He was a doll, a round-faced, smiling young boy who had come on a campership sponsored by someone who wanted more opportunities for children to go to a summer camp. He loved the horses, pool and canoes. Nothing was beyond his reach. On the day camp broke, I met with his mother and we talked at length. She stated that it had not occurred to her that she should send his medicine with him. I reinforced that he should plan to carry his medicine with him wherever he went. Nathan and I parted company with a smile and a wave.

My "city job" is lecturer in pharmacology at the University of Alabama School of Nursing, and for 15 years I told the story of Nathan whenever I discussed asthma drugs.

Last summer my week of camp nursing began like most years. But at supper on the first night I noticed a new staff member across the dining hall. It was a round-faced, bright-eyed young man, 23 years of age. He was a member of the college-age program staff - and his name was Nathan. It took me two more days to get up the courage to talk to him.

One early morning before breakfast we met at the coffee pot by accident and I could no longer resist. "Nathan?" I asked. "My name is Ellen Buckner and I'm the camp nurse." He returned my gaze. I continued, "Were you a camper here when you were eight or nine years old?" "Yes," he said, nodding slowly. "And did you have asthma?" He reached in his pocket and pulled out an inhaler. "I was the camp nurse that summer," I explained, "and I treated you when you had some problems early in the week. Do you remember any of that?" "No," he shook his head.

Not to cause him any further pain I sought a way to cut the conversation short, so I said, "Well, you were very brave; you said that there were |monsters in your chest,' but the medicine made them go away." "Really?" he said, grinning and turning, "monsters in my chest." We exchanged good to see you agains and he went on smiling.

Nathan worked that summer as program staff on the horses. He never had any problems with his asthma and seemed to enjoy the work. I will always remember Nathan, the little boy, and pray that the inner strength he had then will keep him strong as he goes forth.

Ellen Buckner, RN, DSN, is associate professor of nursing at the University of Alabama School of Nursing in Birmingham, Alabama. In summer term she conducts an independent study in camp nursing.