For all Georgia's boundless patience and energy, there was one type of patient she couldn't warm up to. In the early Eighties DGH had begun seeing its first people with what the medical communities on the East and West coasts were calling the "gay disease." By 1984 it had a new name: AIDS. But not a lot was known about the disease, and medical personnel were afraid to treat its victims for fear that they, too, would contact it.
There was another reason for Georgia's reluctance. The disease was mostly confined to intravenous drug abusers and young homosexual men. Despite her years in Denver General's emergency room, Georgia was still a good Catholic girl, and she neither understood nor condoned the gay lifestyle. This loathsome disease seemed a punishment for immorality.
One night a young man came into the emergency room and coughed up a black, evil-looking substance. AIDS, someone said; the black stuff might even be tissue from his lungs. Repulsed, Georgia swore she would give up nursing before she would care for patients with the disease.
It was years before the humor and life-embracing flamboyance of a young homosexual named Theo changed her mind. They met at a coffeehouse on Colfax. Georgia was trying to counsel young street kids when he came in, newly arrived from California and looking for a friend.
Theo was in his early thirties, funny and theatrical--he had worked in the theater in California. He was bright and loved music, and he charmed Georgia with his stories about life in Hollywood. Theo taught her that homosexuality had a lot less to do with genitalia than with following one's heart. He started attending Georgia's church, and she looked forward to seeing him.
Georgia stayed in Denver General's emergency room for seven years. By 1989 the job was beginning to take its toll--and she no longer had singing with the symphony as an outlet for her stress, because she couldn't take the time away from the people who needed her. As the streets grew meaner, the pace got crazier. Police officers were being shot. She was on duty the night a paramedic called over the radio to say that he, too, had just been hit by a bullet. The violence compounded her old fears. She had burned out--and she knew it.
One afternoon Georgia received a call from Dr. Adam Myers, who asked if she would come see him in his DGH office. When she arrived, he got right to the point: He'd received a large federal grant to start a clinic for patients with AIDS, and the grant included funding for a nurse to work in both the cancer and HIV clinics.
But he was having a difficult time finding anyone willing to accept the job, Myers told Georgia. He'd heard a lot about her and wanted to know: Would she take it?
Georgia asked for time to consider the offer. Her whole career had been spent trying to make people well; now she was being asked to nurse people who would never be well again. Still, she knew she really didn't have a choice: These people needed her. She called Myers and took the job.
At about the same time, a friend asked Georgia if she wanted to go in on a house in Lakewood. Again she hesitated; technically, this could violate the Denver residency rule. But ever since the assault, she hadn't felt at home in Denver. And she knew that other nurses, doctors and administrators had broken the rule without being punished.
She agreed to help buy the house. But because she didn't want to lie about her address, she also rented an apartment in Denver and went out of her way to conduct all of her business within the city's borders. She voted in Denver, got her driver's and nursing licenses in Denver, even served on a Denver jury. The church she attended was a Denver church, and all her outreach work was in Denver. She felt she was in compliance with the spirit of the rule that called for employees to be committed to the city in which they worked. And at work, Georgia was more committed than ever. In the emergency room she'd always felt needed--but while ministering to patients with AIDS and cancer, she knew she had found her true calling. These people needed someone who could take care of not just their bodies but--with hugs and attention--their souls as well.
Tam Skinner was tall, thin and intellectual. A cellist with a chamber group, he was among the first Denver General patients to be treated with interferon for his Kaposi's sarcoma, a formerly benign skin cancer that turned deadly when infecting AIDS patients like himself. Georgia met Tam and his friend Brent Berry, who took care of him, at the clinic. The two had grown up in Iowa, childhood friends who became lovers. They'd parted ways in the late Seventies but had come together again when Brent learned that Tam had AIDS.
To Brent, it seemed Georgia was sent from God. He would watch her in the hospital waiting room, moving from person to person even if they weren't her patients. She would stop to say hi to Tam, who always brightened when he saw her, then turn to the old lady sitting next to him to tell her how much she loved her shoes.
As his disease progressed, Tam found it increasingly difficult to move around; ultimately, he was unable to come to the clinic at all. So Georgia would go to his home.
On Thanksgiving weekend in 1990, Georgia came by one last time. Tam was fading fast, but he was still cheered by a visit from his favorite nurse. "I brought you these cookies I baked in my spare time," Georgia said.
Brent looked at her. What spare time? he wondered. This woman has no spare time. She feeds the poor. She looks under bridges to take care of people. She is not even of this earth.
When Tam died the next day, Brent thought of Georgia. If it hadn't been for her, his friend and lover might have given up much sooner. He swore that if he could ever do anything to repay her, he would.
He soon got the chance. That same year Myers and Julie Adams, the director of nursing for ambulatory services, nominated Georgia for the Florence Nightingale Award for Nursing Excellence, named after the heroine of the battlefields.
"Florence Nightingale, if alive today, would consider herself fortunate to have Georgia Caven as a role model in the area of human compassion, sensitivity, and giving," Myers wrote to the award committee. "She is never impatient, she is never abrupt, she listens, she consoles, and reassures patients who are anxious, depressed, frightened and desperate.
"I have never worked with a health care provider who is so regularly embraced, hugged and greeted with enthusiasm, respect and friendship by her patients as is Georgia."
Noting that AIDS care was a field where burnout was common among health-care providers, Adams went on to note that "Georgia, however, has gained strength, gained confidence and grown personally and professionally while working within this demanding environment. She has provided the motivation to others to find the will and means of developing self empowerment to support themselves through some of the most complex and stressful clinical and personal situations that I have witnessed anyone endure."
There were many supporting letters from peers and patients.
Cancer patient Barry Selberg wrote: "Some days it is just knowing that somebody who cares is waiting on the other side of the bureaucracy that lets me deal with the long waits at the hospital and the sickness that follows [chemotherapy]."
But the most touching came from Brent Berry.
"There are not adequate words to describe my feelings of admiration and respect for Georgia Caven," he wrote. "She has become a friend and family member to me after helping me through the most difficult moments of my life.
"Georgia gently guided me toward the realization and acceptance that my friend Tam was going to die...She always had time for us, whether our concerns involved the patient or the care partner...She brought us baked goods on her days off. And she took time during her busy work schedule to hold my hand, to wipe my tears, and to help me smile again.
"Georgia is a living benediction. She is an answer to people's prayers. She is a guardian angel."
In April 1991 Georgia Caven was given the Florence Nightingale award for Colorado, winning over 1,300 nominees. At the ceremony, she was surrounded by her proud family, Brent Berry and Adam Myers. Theo was too sick to come: He'd been diagnosed with Kaposi's sarcoma.
Georgia pleaded with him to come to the clinic and let Myers, one of the top Kaposi's specialists in the country, take a look. But Theo said he was comfortable with his own doctor and not impressed with Denver General's reputation for long lines and interminable bureaucracy. As he continued to weaken, though, he finally agreed to see Myers. The two hit it off, but Theo didn't want to deal with the effects of the recommended chemotherapy, such as hair loss and constant sickness.
As his condition worsened, Georgia tried to contact Theo's family--his parents in Florida and a sister in northern Colorado--but they wanted nothing to do with him. She found a place for Theo to live in the basement apartment of some friends, but soon he couldn't climb the stairs. The disease had spread to his lungs, and he was having trouble breathing.
She took him to the hospital, where Myers scheduled a lung biopsy. To Georgia, he confided that he was worried Theo's body was self-destructing in order to rid itself of the virus.
The day before the surgery, Theo decided not to go through with it. He was tired and wanted nature to take its course. Georgia held on to her friend for a long time that day. Despite the courage of his decision, he was frightened. He had no place to go. No family who wanted him.
She decided then to break one of the cardinal rules of medicine, particularly for those who work with the terminally ill: Don't get too close. But Theo had been a friend long before he became her patient. She took him home to Lakewood. There was only one provision he had to agree to: He would do nothing to accelerate the dying process. "I will not allow you to take your life in my home," she said. He nodded, and they said no more about it.
Taking care of Theo was a full-time job. He was too weak to clean up his own vomit and diarrhea, so she bathed him, changed his sheets and wiped the floors. Her sleep was often broken as Theo, racked by horrible fevers, woke up screaming. She frequently found him sitting in her living room, staring at the statue that had come with her award of Florence Nightingale stroking the fevered brow of a child.
One night Georgia sat up in bed, awakened by the sound of Theo gasping in the room next to hers.
Rushing in, she discovered he had removed the oxygen mask he needed to live. He weakly tried to fend off her efforts to replace it. "I'm tired. I'm so tired," he complained.
"No, Theo," she told him firmly. "This is not our agreement. You can go in God's time, but not before."
She sat up the rest of the night, stroking his hair. As he fell into a deep, peaceful sleep, she sang him lullabies and his favorite songs.
Together they got through the night, but they both knew he had only a short time left. He called his parents, who at last said they would come to Colorado and find a place to stay where he could live with them until the end.
Theo's parents were shocked to see the living skeleton their son had become. It was soon apparent to Georgia that they had no intention of finding a place where they could care for him. Instead, they asked Georgia to talk him into going to a hospice.
Georgia did as she was asked. Theo was hurt. If his parents didn't want him, couldn't he stay with Georgia? The request cut her to the heart, but she had begun to worry about Theo dying in her house. Her housemate had put up with a great deal already; it wouldn't be fair if Georgia was working when Theo's final hour came.
She explained this to Theo, and he agreed to go to the hospice. His only request was that he be given a sunny room to die in, surrounded by friends singing hymns. Without another word of complaint, he allowed Georgia to take him to St. John's Hospice. The following day, in a sunny room and surrounded by friends singing hymns, Theo died quietly.
He was gone before Georgia could arrive from work. When she got there, she was shocked to learn that Theo's parents had left town immediately without leaving instructions on what to do with his body.
So Theo's friends decided they would hold a service, and they asked Georgia to sing at the funeral. She selected a song that had been one of his favorites: "Home Where I Belong."
One day I'll be sleeping when death comes,
Then I'll awake to find that I'm not homesick anymore,
Because I'll be home where I belong.
Denver General employees have challenged Denver's residency rule before. Some have gone as far as filing court motions to stop enforcement, arguing that the hospital services patients from outside of Denver. But so far, the courts have always upheld the constitutionality of the rule.
On November 6, 1990, former mayor Federico Pena issued an executive order stating that "anyone found to be in violation of the residency requirement will be dismissed from employment." And in May 1991 Denver voters again ratified the rule they first approved in 1978.
In the spring of 1993 a Denver General nurse sued the Denver Department of Health and Hospitals, contending that the rule was being enforced unevenly. The nurse had been attempting to fight a transfer from night to day shift when hospital administrators discovered she not only lived in Boulder, but also had a Boulder nursing license. Citing the residency rule, they fired her.
The nurse's lawyer contended that his investigation had identified as many as 170 of the department's 2,700 employees who were not in compliance with the rule. The nurse still lost her case. And later, Mayor Wellington Webb said that supervisors who "aided and abetted the deception of employees," as well as employees who did not comply with the rule, would be subject to disciplinary action, including termination. The Department of Health and Hospitals stepped up efforts to enforce the regulation, following suspect employees to their homes and taking down license-plate numbers to discover where employees were sleeping.
C.L. Harmer, the department spokeswoman, says the lawyer's statistics were exaggerated by as much as 80 percent. According to Harmer, "a couple hundred" department employees--mostly nurses, though doctors and administrators were affected, too--resigned as a result of stepped-up enforcement of the rule. Those who resigned from the department voluntarily were allowed to reapply for employment when they moved into the city, although they lost seniority.
Most who resigned did not reapply, but "we were able to fill the positions," Harmer says.
Still, today not all Denver General employees live in Denver. Some were grandfathered in. Others, especially doctors with hard-to-find specialties, are hired on a contract basis and aren't required to live in Denver. Such hirings are not an attempt to get around the residency rules, Harmer says, adding, "We have not hired some doctors we would have liked just for that reason."
Lawyer Ross Goldsmith, a former city attorney who worked with Career Services and argued the city's cases against rule violators, disagrees. He argues that Denver General specifically contracts with doctors and some specialized nurses in order to get around the residency rule. "Otherwise, there's no way they could get these people," he says.
"The rule had been ambiguous from the start," he continues. "I mean, how much do you have to sleep somewhere to reside there--70 percent of the time, 100 percent? What about someone who has a residence in Denver, but sleeps with her boyfriend most of the time in Aurora?"
Georgia hired Goldsmith shortly after she learned of the investigation this summer. "Georgia is a perfect example of how ridiculous this rule is," he says. "I mean, whenever they argue for it, they talk about how city employees should owe their allegiance to the city. And how city employees will be more committed if they have to live here.
"Well, show me one person who is more committed to this city than Georgia Caven. Their arguments ring hollow."
Georgia's Career Services Authority hearing is set for September 21. Harmer says she can't speculate as to whether Georgia will be fired or allowed to resign with the possibility of returning--stripped of her seniority. "It might depend on how flagrant the violation is," she says.
"Georgia is a saint," Harmer adds. "It would break our hearts if she had to go. She is the perfect match with Denver General. But for every Georgia, there are many others who do not fit that description...And it's the voters who decided that this is what they wanted."
Georgia is not the only one whose job is in jeopardy. If she is found to have violated the rule and Dr. Myers is found to have known about the violation, he also may face disciplinary action, Harmer says.
Myers says he's not worried about himself. "I don't think it's a supervisor's job to track where employees are sleeping," he says. "It's B.S. I've acted in good faith. I think Georgia is in compliance with the spirit of the law and is a unique case.
"I suspect there could be consequences, but I'm a big boy. My concern is seeing that Georgia gets a fair hearing. Anything I can do to make sure she continues to work for us and the community is primary."
News of what Georgia is going through has angered and dismayed her patients, friends and colleagues.
Joseph Yagudayev, who with his wife came to Colorado from the Soviet Union four years ago, calls the investigation "a crime." He met Georgia when his wife came down with cancer. "Georgia visits her, even though my wife, she doesn't speak English," he says. "Yet they understand each other. She is a gift from God."
Hossein Avakolian, a professor of physics at Colorado State University until leukemia forced him to resign, recalls seeing Georgia the day after Theo died. "I asked her why she looked so sad," he says. "She says, `Someone I loved died.' But then she smiles and asks me how I am doing. That is who she is: nothing for herself, everything for everybody else."
At the HIV clinic, patients sitting with intravenous tubes feeding life-sustaining chemotherapy into their veins--tubes fastened by Georgia--speak out in anger and sorrow.
One patient cries to Georgia, "You promised me you would always be here for me." All she can do is promise to visit.
Others quietly recall the little things. The medicine or cookies she brought to their homes. The times she simply sat and held their hands.
"Who are you going to get to do that?" asks another patient, wiping at the tears that course over his gaunt face. "What a stupid law." He gets a hug from Georgia, who tells him everything will be all right.
Wyatt Britt can't understand how Denver could let Georgia go. He owes her his life--and so much more. Five years ago, when he was sober and employed, his children decided to come back and live with him. Now his son is going to college and his daughter is nearly inseparable from Georgia.
"She wouldn't have a problem getting another job," Britt says. "But it would be stupid to let her get away when she is needed here."
Georgia doesn't know what to do. She still has her Denver apartment, where she occasionally sleeps after she works late at the hospital, but she still doesn't feel safe in the city and she can't afford to take another financial loss on a home. She has considered leaving her job quietly, but people are dying in the cancer and HIV clinic. They need her. She can't just leave them.
So she waits and works. Her voice, still sweet and clear, leads singalongs in the clinic, at the hospices, at the shelters. She says she's sustained by the love of people who know her.
"I cannot ever repay Georgia," says Brent Berry. "You know, I always wanted to meet Mother Teresa; I think I've come awfully close by knowing Georgia.
"She makes me believe that there are angels. And no angel should ever be kept from her mission of mercy."
end of part 2
