A striking, red-haired woman whose square shoulders and firm jaw add to her aura of confidence, Julia arrived at Mass. General in August 2004, certain she would be a good nurse. Sure, she was a little intimidated by the place, and the fact that its ICUs take the patients too sick or badly injured for smaller hospitals to manage. But Julia was no kid — she had lived in three countries and had two children — and she had prepared well, getting excellent grades in nursing school and doing an internship in a community hospital ICU.
In fact, if not for the twists and turns of family life, Julia would be a doctor herself by now. Growing up in Omsk, a river city in West Siberia, it was her dream. “I knew I was going to be a doctor,” she remembered, her pale-blue eyes wide at the memory. “I had no doubt.”
Her vision was matched by drive. Julia’s parents, a scientist and a voice instructor, had long stressed that she and her brother needed to outdo other students if they were to overcome the anti-Jewish bias in Russian society. “If there were 10 Russians all with the same [test scores], you would be the last chosen,” she recalled them saying. A voracious student who loved Russian translations of novels by William Faulkner, Julia won acceptance to the Omsk State Medical Academy, a six-year program that combines undergraduate and graduate education.
But three years into her training, in 1990, Julia’s family got long-awaited permission to immigrate to Israel. Newly married and pregnant with her son Michael, Julia moved to Haifa, and began learning a new language and culture. She tried, and failed, to get into Israeli medical schools, which were awash in applications from Soviet emigres. “It was the most frustrating experience of my life,” she recalled.
Still, she gamely shifted gears, getting a business degree and taking a job at an electronics plant, where she eventually supervised 10 employees. By 1998 the family had moved into a big new house and she had given birth to a second son. “I had a really good life,” she recalled. Medicine, it seemed, was part of her past.
Then everything changed. Her husband, Valery, was offered a job in Massachusetts, and Julia reluctantly agreed to go along, believing the relocation would be temporary. The family settled into a smaller home in a country where Julia didn’t yet speak the language fluently and knew only two Israeli families. The brilliant foliage was the saving grace that fall.
Loneliness was soon the least of her concerns. Two months after she arrived in the United States, her toddler, Daniel, started to become apathetic and unresponsive, even to his parents. Doctors diagnosed him with a rare — and fatal — genetic disorder.
For two years, as Dan became progressively sicker, Julia cared for him round the clock. Finally, in the spring of 2001, she bought Dan a one-way ticket to Israel and the family returned to the country she loved so that her son could spend his final days surrounded by his extended family.
Until Dan’s illness, Julia had assumed she would eventually resume her business career. But now that seemed an empty prospect. The hours she had spent at her child’s side, at home and in hospitals, “sort of captured me and brought me back to what was mine when I was growing up.” She began talking to one of the visiting nurses about the possibility of becoming a nurse, a family-friendly alternative to getting an MD. “Medical school is OK when you’re 25,” she said, “but I wanted to enjoy my life.” Just before she left for Israel with Dan, Julia applied to the UMass-Lowell program.
She would have a new baby, Eran, to look after by the time she began her studies in the fall of 2001. Nonetheless, she completed the four-year program in three years while still finding time to take English courses. Finally, she could read her beloved Faulkner in the original.
“She’s an amazingly committed woman,” said Stephanie Chalupka, director of the nursing program in Lowell. “She knew what she wanted, and she knew what she needed to do to get there.”
From the beginning of nursing school, Julia had known she wanted to work in intensive care. After graduation, Julia was accepted to ICU training programs at two Boston teaching hospitals. She chose Mass. General, believing that at such a busy, prestigious place she would have more freedom to make decisions. By the time she arrived one of the oldest “new” graduates in the ICU, Julia recalled, “I felt I was ready to go to work.”
M.J. wasn’t so sure. Julia had much less bedside experience than the three other intensive care nurses M.J. had trained, and she knew from the day the two met that she would have to work a little harder to prepare Julia.
And M.J. worried that Julia might be slow to accept a fact of nursing life: Though a nurse can influence doctors’ decisions, ultimately she must defer to them in diagnosis and treatment. M.J. suspected that Julia might approach her job like the doctor she once planned to be.
“Sometimes it’s hard for her,” M.J. said one day early in Julia’s training. “She’s used to telling other people what to do.”