A Final Arc of Sky: a Memoir of Critical Care

Culkin, Jennifer

Primary Category: Literature / Nonfiction

Genre: Memoir

Annotated by:
Davis, Cortney
  • Date of entry: Apr-13-2009
  • Last revised: Apr-08-2009


Author Jennifer Culkin has been involved, for all of her nursing career, in high stakes, heart stopping, instant-decision-making areas of critical care.  After years working in Neonatal Intensive Care, she became a flight nurse--and giving intensive care to trauma victims while trying to maintain balance and sterile technique in a wind-buffeted helicopter has to be one of the most difficult tasks a nurse might undertake.  Her memoir, A Final Arc of Sky, opens with such a scene.  The patient, Doug, is soon crashing, and the nursing team, Jennifer and her partner, have to make a series of tough decisions (pp. 8-12).  From this scene on, the action rarely wavers.  And although Culkin keeps the pace moving, she is not always, or even most often, telling us about similar traumas.  She deftly weaves her personal narrative--husband and sons and dying parents--in and out of scenes from her nursing career, braiding the plot lines of her life in chapters both moving and compelling. 

In those chapters that deal with the often dangerous helicopter transports Culkin has flown, we learn (and we feel) just what it's like to be a flight nurse crammed in-between patient and helicopter door, juggling instruments that too often slip to the floor and trying to save patients that too often want to die.  In those pages that deal with family, we are privy to Culkin's internal debate about how to separate family from nursing (what she calls "the great neuronal divide between my work and my life" (p.136), and we see that she sometimes doesn't have much energy left at the end of the day to draw close to those she loves.  Part of what makes this memoir difficult to put down is the persona of the narrator herself: Culkin comes across as an honest, often irreverent risk taker, a woman who likes to ride her bike down dangerous hills at breakneck speed and allows her son to do the same (see chapter six, p. 57); a woman who loves the dangerous drama of flight nursing and doesn't worry about crashing (p. 80)--in fact she enjoys strapping herself "into the eye of a maelstrom" (p. 80). 

This memoir entertains, and it provides a glimpse into how some caregivers not only risk their lives to save the lives of others but also shoulder the responsibility of making split second decisions upon which a patient's life might depend.  And there is a surprise in this memoir, one that I can't too fully divulge because to do so would be to rob potential readers of their own discovery.  Suffice it to say that near the end, Culkin reveals something about her own health, an illness she has fought against in every chapter.  When we learn the details of her own illness narrative, we look again, with new understanding, at her fascinating career and her interactions with her loved ones.   


Culkin is a powerful writer.  Every page is well crafted and alive with striking language and original metaphors.  Here's an example from the opening chapter, a description of Doug, Culkin's patient: "And there at hell's heart, Doug just looked end-stage. He was skin and bones, shadowed hollows instead of mounded pink flesh, a victim of his own holocaust.  His hair and eyes were brown, but he was so ashen an Impressionist would paint him in shades of gray" (p. 5).  She is also adept at portraying characters from her own life in such a way that we come to know and care about them.  When, along the way, she loses some of her team to helicopter crashes, we mourn their loss as well.  Her parents, sons and siblings are full characters as well.

But for me, one of the most fascinating aspects of this memoir is the author's depiction of herself.  She is unfailing open about her own occasional lack of empathy as a caregiver (p. 73) and her own flaws as a family member.  So close to death at work, she can barely stand to touch her dying father's back or her dying mother's feet: "The other dirty little truth is that the touchy-feely has been all but bred out of me.  Too many people, too many bodies" (p. 113).  Although she is present at so many deaths, she misses her parent's dying moments.  

I wondered, as I read, about the underlying personality of those who choose such intense caregiving jobs, careers that depend on technology, guts and sheer nerve.  This memoir allows us to glimpse, as well, a bit of the damage that such caregiving might do, as well as the fragile core that such caregivers might need to protect.  An excellent memoir that will engender discussion on many levels.


Beacon Press

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