Committment to Excellence

A few weeks ago I was honoured to be selected to give a speech at Duke University School of Nursing to commemorate their annual Commitment to Excellence ceremony.  Here is my speech:


    Good evening Fellow ABSN students, Faculty, and Guests,
    My name is Nathan Hatch, and I’m a fourth semester ABSN student at Duke University School of NURSING!  I stand up here looking out at all of you in amazement and excitement and sincere gratitude.  Who would have guessed that a small town kid from California like me, would end up standing here, at a renown institution like Duke University.  Seriously, a little less then a year ago I was sitting where you are all today.  New, naive, and foolishly, just a little bit indignant at having to sit there and listen to people talk about “excellence.” But here I am, three semesters later, a little older, hopefully a little wiser, and a witness to how the faculty and staff of the School of Nursing have stood to the meet the commitment to develop, deliver and promote excellence in education, nursing care, and community involvement.

    One of my favourite quotes on excellence is from Murali Chemuturi, and as I read it I want you to hold it in your mind as I’ll be referring back to it.  “Excellence,” he says, “is a continuously moving target, pursued through actions of integrity.  It is being the frontrunner, providing safe and reliable service to others, meeting all obligations,” and yet, “continuously learning and improving in all spheres, to pursue that moving target.” I cannot think of a better working definition for excellence in the practice of nursing.  To have integrity, striving for safe and excellent care for others, and committing to being lifelong learners. It requires a strong dose of humility and constant self-examination.  Excellence starts with a question.  A question I will end with later.

    In my studies here at the Duke School of Nursing there is a term that has been given to us that I consider as an umbrella mindset for nursing practice, and some of you may know it as the Holistic approach to medicine.  The Holistic approach, to me, is stepping away from reactive medicine, and instead being proactive, and considering all options of care.  It is how we as nurses (and future nurses) can maintain a mindset of excellence.  To think critically through the nursing process about what we know, while analyzing all spheres of influence of our patients, and assuming responsibility to educate ourselves about what we do not know, in order to maintain the highest level of service to our communities and the people that place their lives in our care.  
    As of now, we sit here because we have been chosen by members of this University who see us as individuals meeting the standard of having “outstanding character, ability and vision” to be the next generation of leaders in this ever changing field of medicine. While this is a great honour, I challenge you to be more than just that, because after all excellence isn’t simply meeting someone else’s standards, it is setting your own and exceeding them.
    I want to tell you a little bit about Esther.  A woman who led me to aspire to join this amazing profession.
    I met Esther nearly three years ago, when I stepped off a crammed 15 passenger van which was currently holding 32 people, into a tiny highland village in Kenya which I was to call home for a time.  Esther is a nurse who’s energy and dedication was the key in transforming the unassuming Dispensary in Ngorika, to a place of excellence in healing.  I went to Kenya as a Public Health Volunteer full of ambitions and expectations in the hopes of making some small difference in the community that I was placed, never expecting to meet a woman who would so inspire me and change the direction of my life forever, and it all started with a simple question of curiosity.
    “Kwa nini hapa Ngorika, Esther? Why here? You could be working ANYwhere else in Kuyu-land, or even Nairobi at any of the best hospitals. Why this Dispensory? Why Ngorika?”
She turned to me and smiled as if the answer was completely obvious, “They need me. Yes, I could have gone anywhere I chose, and cared for any number of sick or injured people, but that is all I would be doing -- mending, fixing. As a Nurse I want to heal. In Ngorika I can do that. Yes, I can mend people’s bodies but I can also mend the system broken by corruption, I can heal the hearts damaged by tribalism, here I can mend the soul.
Who else is there but me?”

That is the question.  And you may be answering, “Plenty, there are plenty of people who can.”  I know I have said that to myself many times through this program, comparing myself to others. Thinking, “They are so much better at this then I.” or “I know so little, how am I supposed to do this?”  But then I recall my first day of clinical in the hospital. During Maternity.  Being the Greenest of the Green.  I was placed in a room with a laboring mother, her knowing little of English.  And against such barriers I was able to provide comfort and care, to which I was asked specifically to remain throughout her birthing process.  In that moment, I felt like I knew next to nothing.  But I utilized the knowledge I had and gave my best to provide safe, and effective care, and it made all the difference.
So, considering that rhetorical question, and do everything in your power to hit that moving target called excellence.  As you move forward in this program, and work with this wonderful faculty who will push you in every way imaginable; Think critically, breathe deep, and aim high.

Thank You.

Of Stardust and Sand

When I was young. There was a song I used to know.  

It lightened me up and made me glow.

As I grew, it's tune did change, 

and I discovered the clarity of it's full range.

The days continued to flow. 

and the strength of it's tune challenged me and made me grow.

"Man is born free," it used to say to me.  

"Equal and free. Born into dignity."

Every one born with reason and conscience. 

In the land of the Dream; full of hope and of promise.

But that dream; it turned sour, 

As the men who touted it fell abuses of fame and of power.

That song all but faded, 

It's true meaning no longer bolstered, nor paraded.

The tune diminished in sound, 

As the deep beats of fate marched it into the ground.

For the boy from the beginning is now but a man.

Made of only his wits, stardust and sand.

Why it Matters (Pt. 2)

When I could receive internet connection, I remember spending time reading the posts of someone I had met at camp four years earlier.  His writing expressed vulnerability; of being honest with himself, and others.  He wrote on coming out, his struggles with faith (by-the-way he was originally on track for seminary) -- a lot of nuances that were uncomfortably open and "shocking" to innocent me at the time.  At first, I thought, "That will never be my life".  Yet, his writings gave me a different perspective. They allowed me  fanciful thoughts of a different life that could be possible.

Freedom.

Being yanked out of Peace Corps service threw me downstream without a paddle.  I had little to my name, shoulders burdened by loss, confusion, and doubt, and no particular place to go.  So, I did as any good gold-miner would do, and headed for Oregon.  I began to dig a new life; a new identity.  I discovered a few diamonds amidst a lot of coal; friends who expanded my world and opened my eyes to new bubbles of existence.  They didn't know my past, though I did divulge some, but helped me discover who I was, and what I could become.  I stayed up reeeeeally late to go out with coworkers and play 'dare or dare'. I went naked hiking/sunbathing with Alex, Travis, and their friends.  I went on biking adventures with Megan and Justin, and listened to Jacob's intellectual rants about philosophy, art, and music.  I, for the first time, witnessed a committed, loving [gay] partnership, up-close and for the first time through Chet and Craig.  I went on dates. I had my first kisses. I met a boy, who, inadvertently, showed me what it feels like to fall for someone.

Love.

It's 2015.  A week ago, a ruling was given that again changes the possibilities and the potential course of my life.  I've pondered endlessly about the sacrifices people have made before me to make, what I will someday get to enjoy, a reality.  It's a different life then I was expecting, but it is a good one.  When I asked myself, "Why should I continue to write?"  I think back to that lost, broken and confused, twenty-something in Africa, reading years-old blogposts from someone that I met one time.  I remember what it meant to hear someone's vulnerability and be able to relate. To find hope.  So, if my words can help just one person on their way to the happiness, the pride, and freedom that I have found in being alive, then that's why

It matters.

Why It Matters (Pt. 1)

I have tended towards being an open and honest human for the majority of my life.  I don't like to hide things, or at least haven't since I graduated high school.  Most of my friends and family will tell you that I divulge (or seek to discover) the deepest parts of myself more often then maybe warrented.

However, there have been many secrets I have kept from select groups of people for long periods of time:

My being bullied through out my primary, junior high, and high school years,
My suicide attempt,
My sexuality,
My depression,
My loss of faith,

Not because I was never willing to discuss them, but because I never felt they were important to share unless directly asked...


I lay in the sun.  Trying to recover after experiencing another crippling panic attack from trying to walk to the market to buy groceries.  I couldn't get past the second road marker.  "Iwona will be here tomorrow, seeing a familiar face will help--she'll talk some sense into me," I thought to myself. Iwona was a Peace Corps Volunteer, like myself, but seemed somehow hardier.

Tougher.

This was the fifteenth panic attack in the last week, since moving to site. I needed some form of peace-of-mind.  I entered my closet and picked up the copy of Jesus Calling my mom insisted I bring with me.  I had tried several times earlier to read the bible I had brought but it's words were too dry, to cerebral.  I needed encouragement;

Conversation.

I remember in church being constantly told that American culture was too ernest, too productivity-centred, too noisy, to hear God's voice.  That I, as someone seeking to Hear, needed to find time to be  still, quiet--seeking.  This was the perfect time to truly listen for it.  Kilometres from 'civilisation', minimal distractions, and open sky.  So, I did.  I prayed, I sat in silence, I wandered in the wilderness. Sought peace and the Voice of God, and found;

Silence.

It was devastating. My faith had been a cornerstone of my life for so long.  It kept my chin up when I was continually punched in the gut, and name-called, and isolated relentlessly.  It guided and focused my healing process after losing hope.  It exposed me to the injustices of the world and gave me reason to push for change and the future.  It also made me cry myself to sleep at night; praying that I could be someone, something, different then I was; wishing beyond wishes that the roof would fall in on me so that I would no longer exist and find peace from the internal turmoil that was me vs. what the bible said people like me were.

Sinner.

Love Wins

May love's pure light come to you in a time of fettered uncertainty.

May it cling to you with an enveloping brilliance you've never before experienced,

or may ever experience again.

Let it show you the way forward,

guiding you in the best of times and the worst of times.

Let it find you in the places where you feel overlooked.

So that you can say, "if love can come to a man like me, it can come to someone like you."

A Rushing Flood, A White Water Bloom

There is an incredible thought forming in my mind.

A deep, dark and maddess within me; the fear of being left behind.

Slow and steady, foot by foot. To let it go, you have to keep moving.

Marching on, one foot in front of the other.

This road is long, and I hope it leads to heaven

'cause right now it seems to run straight through miles of clouded hell.

This is what I meant, when that I said that I was spent and I never wanted to let you down.

I'm sorry, so sorry if I let you down, it's not what I intended.

But our best laid plans slip away between shaken and feeble hands.

I know you don't understand, I don't always myself, but I can't change who I am.

You might not like me anymore, I'm not completely like I was before.

This house didn't burn down slowly, so I was forced to sell.

I try, but always seem to break, cause this uphill battle always lasts so long.

but this is me, this is my love, this is where I have to sleep.

The rain will fall again, this I know, and the sun to shine again.

It brings life; strength and power.

Bringing with it a rushing flood, a white water bloom.

Please, don't you worry!

All these problems aside, I think you taught me well.

Ghosts, though they come, howling, continuing to reappear

I've been given the torch, that leads lost souls from fear.

Passing the wondering eyes of the ones who choose to be left behind.

Turning my back to the sea, now painted red with sorrow

I face the mountains once stacked with fear.

I will climb and stand atop that mountain

To overcome the creatures that lurk below in the dark

cause he's the king and I desire to be the Lionheart.

Good Beginnings

Its good beginnings that make a positive difference. It's our Birthings that matter.
How we begin to perceive our bodies own abilities
Events that shake and shape us,
To feel our first impressions of the greater, wider world.

Naturally placed upon us, or thrown upon us like a knife in surgery
Trials are the reformers that we lack.
Having done away with rites and rituals, how do we draw that line in the sand
and cross over to the new Us?

Good god, let me give you my life.
Used to everyone's disapproval, this is all I can do.
When my back is sore from the labours.
Trying to keep the starving faithful in their stables

If there's one thing that I've learned, it's the comeback
It's not in the fall, you have to reach for it all.
We were born sick they say, creatures of darkness and treachery.
Pagans of the good-times.

Command me, Command me to be well
Only then I can be clean, can I be faithful.
How was I to know?
I hate to see hearts break

If there is one thing for me to learn, it's humility
Not that tomorrow will bring me new opportunities
The cold reality's that nothing is there for me.
I'm not scared to hurt anymore, I'm scared I won't feel the pain.

He is...

He is often in transit, place to place, person to person, experience to experience.

Restless, he tries to live on many levels at once.

Contradiction appears to be his sustenance. His modes of expression are polar.  Whatever he is feeling, his first instinct is to disguise it. 

In a constant tug of war between wanting to go experience everything right now and "whoa, I need to process what just happened," he loves to be at the party but a party with contemplative people alternating between being crazy and discussing the meaning of life.

He abhors schedule and will not be prisoner to the clock.  Rarely will he take meals at set times or be regular on sleeping and waking, regularly forgetting his physical needs exist. 

Routine suppresses his energy and when subject to it may become restless and argumentative. Keep him guessing, he is piqued by uncertainty. This constantly stresses out friends who don't like straying from the original plan.

He owns the gift of gab, flirting between subjects and topics. Although his restlessness is evident in his conversation, he adores words, preferring them as weapons.  He tries to speak with a special glitter and radiance. Unfortunately, gossip intrigues him. Weighing in with scathing comments, especially in the sphere of morality. Don't take it too seriously though, this isn't an indicator of overall opinion.  His are situational and entirely different based on background.

Honest to a T, he tries to keep it tactful but real.  He would never intentionally lie, whatever he tells you he absolutely means and believes in that moment, but hold him to his word and keep up with reminding him, cause he's likely to forget a promise a few days later.

Debate excites him. He doesn't have to be right, though he will argue like he does, it's the process that gives him the trill.  Some resistance, some form of protest must be given before he can be satisfied and feel there is victory. Though people often confuse his need to process things out loud with either a search for advice or the search for argument.

Free flowing and spontaneous, highly volatile at times, he seems. He desires the impression of magnetism, to seem fascinating and many-sided, intellectual and wise.  He may feel, rather, to have lack of control and painfully aware of how people react, and perceive him.

His enthusiasm draws him thin, enterprising on many things.  Launching many projects with great initiative out the gate, he struggles to stay on course. Boring to quickly, he will have thousands of ideas he's like never to follow up on. Once the main thrust of a challenge has been met he, unfortunately, begins to look for the next challenge, something new and different. 

Intellect and imagination are as important to him as realism and practicality; interested in a wide range of experiences, from classical concerts to your neighborhood roller rink, he has to mix things up.  

Eager to take blame on himself, he does not do well with failure, triggering depressed emotions. Failure, it seems, confirms his secret feelings of inadequacy.  This cyclothemia is short lived, as another interest zooms in to send his emotions soaring once again.

He is a hard worker, an unstoppable force of productivity and creativity, for the short stretch of twenty minutes. A mental challenge encourages his best work.  Though play trumps work anytime. He begrudgingly accepts Peter Pan as his proposed spirit animal.  

Within him wells deep curiosity and fascination with story.  He may ask you a million questions without realizing how intrusive they may seem and beg for the most telling stories.  However, hold some information in reserve, mystery is tantalizing and indicates secret depth. Remember, he is eternally curious.

He loves love and will take it wherever he can find it, gravitating to new strangers often, the stranger the better. Touch and time are his modes of expression. A bear hug or a meaningful conversation means the world to him.  He will pull one into conversation, overflowing with ideas and interesting experiences, attempting to get them laughing as soon as possible. Unfortunately this can mean everyone thinking he's flirting with them, all the time.

Unbreakably calm and laid back his actions are often confused as indecision.  Rather, it is the time spent with him, more then the activity that means something.  However, he will express his lack of desire to participate in an activity he doesn't like.  

Extremes or fanatical conviction in religion or politics turn him off.  He is liberal and tolerant by nature, able to see multiple sides to any question. Narrow or close-minded people won't go far with him. However, he owns surprisingly strong in opinions and beliefs despite his easy-going nature.

He needs significantly more alone time then other extroverts, he wants to be alone, but, ya know, with other people nearby. He is fiercely independent, but bored without company.

Stubborn beyond belief, he may bite off more then he can chew... and continue chewing, because plot and because he is a walking contradiction in almost every way but wouldn't change a thing, even if he could.

Messy People

I love messy people.  The type of people who don't always have their shit together.
The ones with vices. Who, in whatever they lack, make up for in unadulterated realness.
A rawness, carved out by the chaos of the life that surrounds them.

I love people the people that stick out.
The ones who don't always choose the "correct" path.  The ones with unwavering convictions and an integrity all their own.

I love grey people.  The ones who would never claim to have "the answer".  The ones that always question, always observe, always yearn to learn. They, who don't think in black and white but try to understand.

I love people who dissolve convention and model different standards.  The ones who speak with words wrought with colour and intensity.  The ones who seek truth in art, and let music guide their soul. The sparks of creativity in an increasingly desolate world.

I love broken people.  Strong in their own ways, but may need a leg up.  The ones who've seen things unspeakable and yearn to never see another without a smile one their face.  They, who remind me that the fires that soften the oldest potato are the same flames that harden the egg.

I love those who love because it's the only thing they have left.  The ones who are just a little bit naive but don't let it get them down.

I love....