Why do people catch asthma?

What are the bumps on your tongue for?

"Why are boys attracted to girls and vice versa?"

Unlike hospitals, where I worked for many years, schools have few available diagnostic or therapeutic tools. Accustomed to intravenous solutions, radiology departments and nice, clear physician orders, I was initially indecisive when students showed up with headaches, weird rashes, bumps on the head. Was Alicia's stomachache bad enough to warrant a phone call home (waking up Mom, who had just come off night shift), or would 10 minutes with a hot-water bottle and some crayons do it? What about Gustavo, the lonely new boy who fell down the stairs and then claimed he couldn't open his eyes? Most troubling, what should be done with 5-year-old Justin, who -- feverish, coughing, miserable -- burst into hysterical tears when I prepared to call his mother and cried, "I don't want to go home!"

The job consists of constant judgment calls and I'm slowly acquiring a few tricks. I have learned, for instance, that some children simply need occasional breaks from class. Last week, 8-year-old DeShawn appeared at my door with a headache. I handed him a jigsaw puzzle and he settled down on the floor while I resumed my paperwork. It was perhaps 10 minutes before he rose and told me, "My headache's better," and dashed back to class. Splinting injured fingers with adhesive tape is also surprisingly effective. And, at least for kindergarteners, there seem to be few ills that cannot be remedied -- if not cured -- by stickers.

When I described the job to my parents, what my father found most puzzling was my statement, "I'm not really supposed to do first aid." Like most of us, he has an image of the school nurse as someone mopping up blood, soothing stomachaches, applying Band-Aids and ice.

"So what do you do?" he asked me.

It was surprisingly difficult to explain. I have a six-page job description that discusses interdisciplinary team meetings about problem kids, the school crisis response team, classroom health lessons, faculty in-services, and PTA meetings. I have an administration-created to-do list that mandates -- among a hundred other things -- snagging a space with a desk and a phone (also surprisingly difficult); publishing a monthly newsletter for parents about lice, nutrition, dental care, etc.; teaching puberty lessons for fifth graders; and ensuring that there is a legal and safe system for administering medications at school.

The job sometimes seems impossible, unmanageable, constantly spiraling out of control. I ricochet among the various responsibilities and needs, never quite doing enough. One month I'll teach lots of health lessons, bringing intestines, bones or stethoscopes into classrooms. Then I'll spend time calling parents whose children aren't current on their immunizations. At any one time I have 50 items on my list. Out of the 300 or 400 students at each school, there are 20 or 30 who show up regularly and make themselves known. In the meantime, of course, I get pulled in to first aid, and -- although my department keeps telling me that we're not there for that; that the secretaries do it on the days we're not there, anyway -- it seems unnatural and downright churlish to refuse. Besides, so much of what I do is social work, case management and teaching -- disciplines in which I have not been trained or licensed. It's a relief to occasionally do some actual nursing.

Can African-Americans get head lice?

Why do we have teeth?

If you eat nothing but junk food, will you die?

Often, I'm uncertain whether I'm making an impact at my schools. I know the kids enjoy rubbing Glitterbug cream on their hands (a potion that glows under a black light to indicate how well you have washed) and trying out my stethoscope. But Javier still falls asleep in class and Angelina just can't seem to retain her letter sounds, even though her mother practices nightly with her.

Still, last month a kindergartener pointed me out to his mother in the hallway: "She brought the real lungs to our class." The mother stopped me and recounted how her son had come home and described the two sets of lungs I had lugged over in heavy Tupperware: healthy lungs and lungs blackened from decades of smoking. "I knew all that," she said, "but somehow hearing it from my son was different." She had stopped smoking that week.

Several weeks ago, after a day at school spent putting out one small fire after another -- tantrums, fights, students running away from the school, children falling (or pushing each other) off the monkey bars -- without crossing a single item off my list, I indulged in a fantasy about a quiet office job, just me and a stack of papers and only one place to be that week.

Before I left that afternoon, I reached into the Manila envelope on my door, as usual, to take the week's questions home to type up.

"Can you bring back the lungs?"

"What are we doing in health club next week?"

"Where do babies come from?"

At the bottom was a card that made me decide to hold off on the office job, at least for now. There was no question on it, just the words:

"Help us."

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