Mea Culpa. Sort of.

So I spoke too soon last night. It really wasn't Ibrahim's fault my tasty cheese dish went missing. Well, not directly his fault, any way. Apparently he brought it to work with him last night, and his manager, seeing that the container was three-fourths full and all, and who the hell would be interested in eating more of that old thing, threw it away. Rat bastard. Oh well. At least now there's an object on which to displace my anger at having to heat up a lowly, sad SmartOnes weight watcher meal last night instead of nosh on tasty goodness I'd been dreaming of all shift long. So, sorry, spouse, for besmirching your character, and a great big "Phooey on you!" to the guy that inadvertantly threw my supper away.

Also, as a sidebar. "It" happened again at work last night. "It" being the dreaded "Do you know that show, Grey's Anatomy? You know that character... you know, the one you look like? Sandra Oh! You look exactly like her!" Which I guess is a nice compliment, because at leas people don't tell me I look like one of the Olsen twins or Jack Black or something. But still, I'm pretty sure Ms. Oh would agree with me--we both look like ourselves, thank you very much. The funny thing about the whole scenario-- people get so damn excited when they tell me how much I look like her.

I should write Sandra a fan mail letter, "Dear Sandra: Did you realize how much you look like me? Well, neither did I until I worked in a hospital..." (Except I won't, because fan mail is a bit scary, although I once wrote a letter to Dan Quayle, of potato(e) fame. It was in eighth grade, I think, and my exact words as I recall were "Your ties look spiffy." I can't believe I actually wrote the word spiffy in a letter addressed to the Vice President of the United States. I think I was kidding. I'm not really sure any more. Eighth grade was a long time ago and I'm sure there's more stuff along those lines I'm glad I don't remember having done.

Selective Hearing

So I just came home from Wurk, very excited to rip into my stash of paneer makhani (ordered this afternoon along with the masala dosa), only to find it has Not So Mysteriously Disappeared. Because, lo, this is what I told my husband over the phone today:

JAMIE:
So, there's masala dosa for you in the bag, but there's also some paneer makani. I want some when I get home, so DON'T EAT IT ALL, OKAY?

IBRAHIM:
Okay.

And the following, apparently, is what Ibrahim heard:

JAMIE:
So, there's masala dosa for you in the back, but there's also some paneer makani. Blah blah blah blah blah, so blah EAT IT ALL, OKAY?

IBRAHIM:
Okay.

Goddamit. I WANT MY INDIAN CHEESE AND TOMATO SAUCE DISH, AND I WANT IT NOW.

Food of the Gods

It's well documented elsewhere, but Lord knows I am no domestic goddess. I hate cleaning the house (although I'll do it because the alternative, namely living in one's own filth, is not that great an option) and I don't "do" cooking. Occasionally I get a weekend or two of inspired, frenzied cooking activity, only to realize that my cooking a) sucks b) sucks even worse after it has acquired freezer burn from sitting undisturbed in the freezer for a month.

So I've decided while I don't have kids to worry about developing scurvy, rickets, failure-to-thrive or some other nutritional-deficit disorder, that I could just pop a multivitamin a day and live on microwavable food stuffs and to hell with fiber and fresh vegetables. No doubt I'm going to end up with gout and colon cancer, and as I sit in my hospital bed years from now averting my eyes from my colostomy bag and popping my allopurinol pills, I'll regret it, but hey, maybe I'll be like one of those freaky people who smoked two packs a day and drank gallons of bathtub gin throughout life and each pregnancy, went on to deliver normal babies, and lived to the ripe old age of ninety five, dying peacefully in her sleep with a normally sized and functioning liver and having never once been tubed, trach'ed, vented or otherwise artificially respirated.

Freakish end-of-life issues aside, I write now eating yummy masala dosa,
which is South Indian for tasty rice pancake filled with spicy potato goodness. There's actually a place in town which cooks authentic Indian food, except it's a hole-in-the-wall and you'd never see it unless someone pointed it out to you (which someone did, thank goodness). It's also surprisingly cheap, and if you can do without stellar service and cramped, diner-like atmosphere, it's a great place to eat. They even deliver which is the kiss-of-death for the budget conscious but lazy such as myself.

In other news, Pointless Pseudo-Intellectual Endeavors With Jamie Hour had me pulling out Kant's Critique of Pure Reason last night. I realized two things while suffering needlessly through the preface: 1) I can't handle more than twenty minutes of concentrated Kant reading at a time without my thoughts wandering to those of me imbibing massive amounts of liquor 2) I have no idea how I read this book in undergraduate school, and then went on to read two more of his works (although I suspect large quantities of liquor had something to do with achieving this feat, too).

Then again, this statement comes from someone with peculiar academic tastes. I remember spending weekends in my little senior thesis carrel in the Jane Bancroft library, with my little copy of Critique of Practical Reason in front of me and my stacks of Latin notecards at my side, feeling the glory of scholarly pendantry without actually ever achieving anything notable in academe. (Collector of random academic memorabilia that I am, I have kept certain tokens of my favorite objects of labor throughout my meandering decades of school, including an eighth grade report on "Hawks" replete with a laboriously painstaking pencil sketch of a hawk on the cover, my hundreds of Latin notecards and all the exams, all of my essays plus comments for my undergraduate German Theology and The Historical Jesus class, plus a hard copy of a graduate school paper on George Eliot's Daniel Deronda that from inception to last draft I wrote in under twenty six hours straight. It was the paper that made me wish I could go back in time and write my undergraduate thesis on Daniel Deronda instead of Kant's concept of the highest good, because who the hell is interested in reading that stuff?)

I still have no idea what Kant was saying about pure practical reason, and that kind of bums me out, because you'd think I would have learned something about my undergraduate thesis topic. Or maybe all the stuff I learned back then has been shoved out of my brain by all the algorithims I had to learn in nursing school, and the fact that I now have the responsibility of people's lives in my hands when I go to work like everybody at the hospital.

Speaking of work, I have to go to hospital pretty soon, a fact that reminds me of The First Noble Truth (something else I learned in undergrad): all is suffering.

Mathman Lives. Rock on.

I had another Bad Dream last night, in which I was sitting in a college Geometry class panicking, because the teacher was drawing M.C. Escher-looking diagrams on the board and I was thinking in that not-quite-coherent way of dream-thought, "Hey, no fair! Isn't this supposed to be Euclidean Geometry? All about two-dimensional planes and shit?" Then, the discussion turned to astrophysics, and everyone was apparently getting it, nodding their heads sagely and even raising their hands and offering new, brilliant insights of their own. Meanwhile, I was breaking out in a light sweat, flipping through the textbook, which seemed to be full of ominous-looking sines and cosines and ugly looking differential equations that looked like calculus, freaking out because I didn't get, and everyone else does!

Variations on the Academic Insecurity dream typically land me in chemistry labs, or taking a French test (Quel horreur! or is it Quelle horreure? or Quelle horreur? You see, this is why I have nightmares about French.) Every once in awhile, however, the dreams will be about my ultimate Academic Arch-Nemesis: math. I never went beyond pre-calculus in either highschool or college because I Suck At Math, And Why Pretend It Exists Outside of School If I Don't Have To. (Reasons that make me glad I wasn't born in the former Soviet bloc, and slotted erroneously from childhood to become an Engineer Comrade for the state or else work in a gulag, because I would have ended up in a gulag, and probably not for very long given my lack of giftedness in physical education.)

Other people have dreams about being naked in front of others, I have Academic Failure dreams to highlight and underscore my insecurities, I guess. Great. You can take the geek out of the classroom, but you can't take the classroom out of the geek.

P.S. Does anyone else remember that character "Mathman" from that old PBS show SquareOne that also featured "Mathnet"--a spoof on Dragnet? For those who need the refresher, Mathman was the little computerized dude on a pac-man-like game, and, as I recall he used to run around a little maze and stop periodically to consider little math equations, or whatever, and then gobble up the right answer. If he failed, he had to hightail it out of there, because the little tornado thing would eat him. In fact, the best part of the whole cartoon, the point of watching the thing at all, I daresay, was when he fucked up and ate the wrong number, and would have to hightail it out of there, screeching "Mathman! Mathman! Mathman!" in his cute little robotic voice as he tried to escape the tornado thing. Maybe you had to be there, but he was the stuff of legend, I'm telling you.

Come on. Don't tell me you don't remember Mathman, super PBS icon that he was?

No. I'm not kidding, there was such a thing as Mathman, and apparently I'm not the only person who remembers watching the show as a young geekling, either. Click on the Mathman link. There are others out there that remember him, and pay tribute. Even after what must be at least a decade and a half of being buried in the obscurity of PBS cancelled show archives-- Mathman lives. All hail, Mathman!

Gobble, Gobble, Goblet

Ibrahim and I went to see Goblet of Fire last night, without first however having a mild squabble over whether we should go see a movie at all. You see, I am the Anti-Social, Misanthropic one, and hate Saturday night crowds and traffic, whereas Ibrahim is the I'm Bored, It's Saturday, Let's GO ALREADY one in the relationship. So we tend to butt heads a bit when it comes to Saturday Night Plans.

I finally gave in after about an hour of miffed silence, realizing I, too, was bored silly and dreaded the alternative, which was watching Science Channel all night long. (Ibrahim has become a major devotee of the Science Channel, much as I had been of CourtTV before the cable company realized what a bargain they were giving people by including it in the basic, ultra-stripped down, cheap-o cable package ascetics and cheapskates like myself subscribe to, and duly ripped it away once they detected their error). We actually did watch the Science Channel when we came back, but that was because they had this way-cool special on about the Roman Coliseum. It was kind of funny, not because learning about gladiators wacking each other for sport is droll (although apparently ancient Romans thought so) but because they kept attributing all the "miraculous knowledge finds" to the program rather than the scholars who did the actual work, as if had the Science Channel not thought to air a special on the Coliseum, no one would have bothered researching it in the first place, because yawn, how passe, the stupid ancient Coliseum, who cares about that old thing, it's all falling apart any way, dude.

Back to the movie, though. Despite my original protestation of Saturday night crowds being unbearable, it wasn't bad, except for the lameass parent in the backrow who kept up a pointless play-by-play-spoiler all fucking movie long. As in, pointing out people we've seen before, because they are the main characters and all, and doing so in a loud, distracting whisper tone: "Hey! Isn't that Hermione? Wow. She got really tall." Or he'd say something like, "Wait! The trophey thing is a portkey." just seconds before Harry, or Cedric, or whoever the hell it was figures it out on screen in the real movie and shouts the line "Hey, the trophey is a portkey!". Like, duh, stupid parent guy, shut up already.

We enjoyed the movie. I can't figure out why critics lavish so much praise over Alfonso Cuaron's take on the third movie in the Potter series, The Prisoner of Azkaban because frankly I wasn't as enchanted, but maybe I am just a stupid American film goer as well who doesn't have the aesthetic taste and trained eye of a Real Live Film Critic. Or maybe it's just the year for critics to kiss Cuaron's ass, or something.

I did, however, like Goblet of Fire quite a bit. For one, it eschews the obligatory Dursley scene, which was getting lamer and more painful to watch by the installment, and for two, it was quite a bit scarier than anything that preceeded it, which makes sense as the novels get darker in tone progressively. Some of the amateurish acting still makes me cringe a bit, but seeing as I couldn't act my way out of a paperbag, I have to give the young trio of starlets props, because I don't think any of them were professional actors before their Harry Potter stint. Oh, and Michael Gambon is playing one helluva scary Dumbledore. I mean, I always thought of Dumbledore as an even-tempered, grandpa-with-a-PhD-old bloke, but in the cinematic version of Goblet anyway, Gambon has him going around kicking ass and taking names with medieval vengence. It was a little scary and I wondered if I am the only one to miss Richard Harris's more subdued portrayal of the wise old wizard headmaster, but I suppose being dead now and all he wouldn't do Dumbledore's character very much good. Dammit Richard, why couldn't you have waited another decade or so before succumbing to mortality? Why? !

Goblet of Fire was never my favorite book (perhaps at a hefty 700 plus pages I was just too distracted by all the many, many subplots, like the whole Hermione/ S.P.E.W. thing, and Winky the House elf, and the endless Quidditch matches, which yawn is my least favorite aspect of the Wizarding World) but it is my favorite movie. Especially endearing were the Yule ball scenes, with all the little adolescent nerdlings in puppy love. I don't quite remember teenage years being that sweet and goofy and innocent (mostly I remember being a painfully introverted, cynical outsider) but maybe when we were like, ten or eleven, or something, we were cute and awkward like that around the opposite sex. Any way, a nostalgic reminder of the good times I never had, because no one ever bothered asking dorky, bookworm little me out to the prom. Bastards. Not that I'm bitter, or anything.

Dr. Who?

I'm bored, and since I'm bored, I wish to reflect on that age-old (ed. note: not really, it's only about three months old) conundrum: Why do the elderly think I'm a doctor?

Yes, it happened again, although at least this time I was spared the whole "Hey! I know you! You play that doctor on t.v., right?" thing. (Yes, and because primetime t.v. just ain't paying the way it used to, I also moonlight at the hospital on holidays, playing my doctor character as-seen-on-t.v.)

I hyperbolize, of course, nobody really thinks I'm actually Sandra Oh (dammit, because that would be cool. I'd be a sizzling hot actress with a blockbuster primetime hit American series and a Canadian citizen!) but I still somehow get mistaken for a doctor every once in awhile by elderly patients and their families.

I've figured out between the visibility of Asians-playing-doctors on t.v., and the fact that somehow the public must have some weird stereotyping thing going on whereby all Asians-in-the-hospital are instantly linked with the title "medical doctor," I get pinned for one from time to time, as I go about my lowly business of assessing pedal edema and hanging IVs. (Seriously, folks, have you ever seen a doctor hang an IV before? Maybe anaestheseologists with their bags of Lactated Ringers a'plenty, but on a medical floor, I've yet to see a doctor hang a bag of normal saline and prime the line, much less load the tubing onto the IV pump and connect the line to the patient's saline lock. Because nurses do that stuff. Because it's our job, and attending doctors do other stuff, or as often is the case, make housestaff and PAs do their "other stuff" for them.)

And I suppose if I were to verify my lame theory with actual research (were there any one one out there with similarly lame statistical information) I would find that most Asian Americans are destined from conception to go to medical school and become doctors, if their first-generation parents have anything to say about it, so it's really an understandable misconception when patients get confused about my role (that, and how many dozens of medical looking people sashay in and out of their rooms during a typical day. I mean, even the housekeepers wear scrubs. No wonder patients get confused. To them, I probably look like the same fresh-fashed intern from GI or Surgery that saw them earlier in the day, all happy and eager and full of brand spankin' new enthusiasm. Or maybe like me they've lost the enthusiasm part and just look exhausted and hypoglycemic because it's their third night in a row on call and if someone pages them again today they are going to lose it).

So this holiday, I was assessing a really advanced case of PVD (peripheral vascular disease) on someone's husband, and the wife happened to be on the phone and I overheard her say, "Oh. I have to go now. The doctor is here taking a look at [name of husband]."

Inside, I squirmed, thinking maybe I should have qualified my name with my position, which I usually do when introducing myself to family and patients. But I figured on a holiday it would be pretty self explanatory that you know, except for poor housestaff, pretty much all the doctors were at home with their families, stuffing themselves with tryptophan-rich meats and eggnog and shit, just as I would have been doing if I had the forethought a) to have been born in 1945 and thus have already completed four years of medical school, 4 plus years of residency plus god knows how many years of overtime and nights on-call while building my now successful private practice or b) been smart enough to get a M-F 9-5p.m bank teller job or computer programmer like everybody else that got the day off.

And then, because I'm self-depreciating by nature, I kept thinking how I'm That Stupid Asian Chick, because I know, deep down inside, for as much as I cherish nursing and value its many insights into the human body and soul (like by way of a stage 4 decube on the butt so deep I could actually see the man's coccyx bone) I would have never, ever made it in medical school/residency, because it just sounds so damn grueling and hard, and my job has plenty of that without going into six figure loan debt for the privilege.

Another recent case in point:

My mom and I went shopping once, and my mom made some offhand comment about my being in healthcare to the store clerk, who got all excited and dreamy eyed and chirped, "Oh, how lovely! So you're a medical student?" I said no, I wasn't, in fact, a medical student, I was a nurse.

Her response? Zip. Zero. Zilch. Nada. She instantly busied herself with arranging the storefront, as if too embarrassed to say anything further. It was almost as if I had said, "No, my mom was just kidding, I'm really an exotic dancer and my stage name is Jasmine."

Any way. I think it's really ironic and kinda funny, because as much as I bitch about nursing, I like being a nurse, and I would have totally sucked at medical school, because when it comes down to it, I'd much rather sit on my ass surfing the internet on weekends than study or be on call endlessly for weekends at a time. And I would have never made it through pre-reqs like Calculus any way, seeing as I still count on my fingers and can't subtract in my head beyond single digits.

I could go on and on and on about the sociopolitical and economic ramifications of this discussion, but that would be to deconstruct more than I'm willing, and there are entire books on the subject, namely Suzanne Gordon's Nursing Against the Odds.

Besides, I'm just poking fun at the whole oddity of stereotyping, and stuff. (By the way, I've always wanted to end a formal essay with a crap conclusion, like, "Therefore, the implications of of Kant's Copernican revolution are such that the shortcomings of Rationalism cannot be overlooked, and stuff. The end.")

Dream Weaver

Last night I was all hunkered down in REM sleep, and instead of having pleasant academic geek dreams about winning university honors in Latin, I had one of my Nightmares. (N.B.: I actually had that dream about university Latin honors once, and I was so proud until I woke up and minutes later discovered it wasn't true and that I was just some poor schmuck with a copy of Wheelock's Latin on her bookshelf like just about everybody else who took Elementary in college and still has to look up what "gerundive" means.

As a sidebar, yesterday while I was examining my booksehlves, I noticed that my copy of Wheelock's is next to a copy of Hatcher's Contraceptive Technology, which is a title, by the way that is going to sound really quaint and old fashioned in a century or so, not that it doesn't already. Any way, What could be better prophylaxis against getting laid than having a copy of a Latin textbook sitting on your bedroom bookshelf, I thought. Then I saw a copy of Kant's Critique of Pure Reason on the other side of the Wheelock book, and a copy of Critique of Pratical Reason right next to Pure Reason. It was then I realized there are indeed geekier things out there and that those in glass houses should not throw stones, even when making fun of themselves.

My Nightmares come in about three categories, so far as I can tell. There's the Wurk Nightmare, which typically involves a code in which someone is invariably yelling at me to Do It Right This Time, Goddamit (that, or simply waking up and going to work, depending on the day). The second kind is the Falling Off of the Universe dream, in which I jerk myself I awake just in time to avert tumbling off a ravine and dying tragically before taking my qualifying exams, or something. The third flavor is the one I'll talk about here, the School Nightmare. There's subdivisions in this category, like the Taking a Test and Not Knowing the Answers Dream (to counterbalance the Good Dreams in which I win university honors or a Fulbright) and then the kind I had last night, the kind that puts the fear of G-d into slightly-built, massively hand-eye uncoordinated weakling nerds like myself: the Phy Ed Dream.

Invariably, in these dreams, I am either playing a) volleyball or b) dodge ball, both of which I was miserably terrified of in elementary school and junior high, because I was just no good at these things, and why should I have to suffer this way, God, why? My hatred of dodgeball was formed early on in elementary school, after my face (glasses and all, as I recall) became the x-marks-the-spot target for one of those really hard red rubber balls that I hope they've since banned from the playground, because man, getting one thrown at your face and having it connect hurts like hell, not to mention the PTSD-acquired phobia I now have of dodgeball and large red rubber balls. I hope by now public school Phy Ed has evolved a little bit anyway, if nothing else to save the expensive eye-wear of myopic dorks like my young self who need those glasses in order to be able to read a whole lot and learn fancy words so as to grow up and write dissertations on Hegelian hermeneutics and save the world by curing cancer and stuff. In other words, I hope they've stopped teaching kids to play dodgeball in elementary school because what the hell are we teaching children when we say it's okay to use human beings as moving targets for projectile objects capable of inflicting bodily harm?

Last night's Phy Ed nightmare involved b) dodgeball. In this particular remnant of REM sleep, I decided I'd rather skip school than risk damage to vital organs. Not that I didn't blow off entire sections of grad school by formulating the theory that watching lousy NBC primetime was a better way to spend time than going to class, but at the tender age when dodgeball was constantly threatening to shatter whatever fortress of Newberry award winning books I'd built around me, skipping school was the ultimate sacrifice. I remember dragging my carcass to school with a pre-chicken-pox fever despite maternal protestations that I should stay home, because to miss school was so terribly unthinkable at the time that I'd rather infect all my colleagues with Varicella-virus than miss a day of Apple Logos programming and reading the next chapter of Ellen Raskin's The Westing Game.

Any way, when I got home (in the dream) my mom had left a note saying the dog smelled and to clean out his kennel, so I woke up thinking frantically,"Does the dog really smell? When's the last time he had a bath? Should I clean his kennel?"

Then I woke up to find the dog wasn't in his kennel at all (nor did he smell overlyripe) and when I let him out for his morning constitutional, I witnessed three deer promenading through the woods in my backyard. It's kind of like having your very own live-version of the Nature Channel.

Snow Falling on Pavement

Thanksgiving was blissfully quiet on our unit, although three codes were called on the same patient over on one of the ICUs. Apparently they cancelled the third one because the patient pulled him/herself out of V-fib. Whoa. That's like, something to be thankful for, huh? I didn't even think you could spontaneously convert out of that kind of lethal arrhythmia but hey, what do I know? I suppose there are weirder things in life, like how a graduate of a theology program finds herself documenting the amount, color and consistency of liver abcess drainage for a living.

The end of daylight savings time is screwing with me though. It's all dark out by 5p.m., and despite the fact that I'm probably still working on my initial med pass and logic points to a different conclusion, I still get all excited when I look out of the windows at the black stillness and think, Homer Simpson-style, "Ooo! It must 9pm already! Almost time to go home!" only to look at the clock and realize I've only been at work for two hours. Doh!

We had about an inch worth of snow, yesterday, too, except all that's left of it is big crappy patches on the side of the road; a portent of the weather we still have left to endure. Sigh. A big fan of snowy, cold winters, I am not.

Maybe we'll go see the new Harry Potter movie this weekend, although book four is my least favorite in the series, and I tend to wait a few weeks to see a movie with such potential kid-draw because I am a curmudeongly old bitch in my dotage and can't stand sitting in a theater full of loud mouthed, mostly ill-behaved rugrats.

Pilgrim's Pride.

Let me just make the following statement outright. Granted, it will not make me a very popular person on this day of bountiful feasts and happy family reunions nationwide (ending in a rash epidemic of drunken all-out Hatfield and McCoy type clan warfare as a prelude to that old holiday standing tradition, The Post Prandial Family Emergency Room Visit) but I don't care.

Here goes. I hate turkey in any form (especially the pressed, cubed turkey parts molded into slab o' meat that is unconvincingly fashioned to look carved turkey and will constitute a good portion of my free holiday meal courtesy the hospital today). Also, for the record, Thanksgiving is a lameass holiday, especially when you have to work said day, because then what am I supposed to be thankful for? Being stupid enough to choose a job in a facility that never, ever closes, not even for one single minute, unless bombed or otherwise completely obliviated?

What are we thankful for, today, working our little scut jobs and having patients throw food at us when they're not happy? The fact that holidays make people fatter, stupider, and more apt to eat sodium and purine rich foods, washing it all down with vast quantities of ETOH, thereby throwing themselves into congestive heart and acute renal failure and buying themselves a bed on our floor?

Don't mind me.

I'm just bitter because I've had a massively shitty two weeks at work and I somehow have to go back again today, all bright eyed and bushy tailed (as my mother would say) and pretend it's actually not part of my job description have to obtain C-diff stool cultures from diarrehetic patients, when really, it is, plus a sputum culture and a urine culture while I'm at it.

And I have to admit, the whole Sandwich Incident 2005 last night really threw me off. I try really hard to be understanding, but at the point patients start chucking perfectly good food around their rooms and throwing temper tantrums, I start to lose patience. I mean, wouldn't you? It's a hospital, folks, not a five-star spa/hotel, and throwing Camille-worthy fits (and your sandwich) every five minutes isn't going to make your life any easier, or make magical plates of gourmet food appear any faster, either.

Especially when I have real nursing work to do, like write up your admission, chart, make sure you have all your orders intact, and figure out what your plan of care is going to be, chart, check and re-check your MAR to make sure we aren't going to kill you by giving you incompatible or wrong doses of medicine, chart, call Pharmacy half a dozen times to get your meds, pass your meds, chart, change dressing, change IV fluids, take down IV fluids, call IV team at get the IV line restarted because you either pulled it out or it got occluded, give your pain medicine through said IV line, collect specimens, chart, assess and reassess your condition to make sure you are stable, chart, and help stabilize you if God forbid you aren't, and you know, stupid shit like that. And did I mention I can have a total of five or six patients throughout the day betweens discharges, admits, and picking up patients at change of shift?

So, uh, just to clarify: a goddamn sandwich is way down there on the list of nursing priorities, especially when you've refused to eat your perfectly fine hot meal tray minutes beforehand.

Okay. Think I've just about gotten that out of my system.

Nonsequitar now:

It snowed last night, and now it's all melting, which means Winter is Here. I'm bitter about Winter, too. It's just a damn inconvenient season up here in Yankeeland, in my opinion.

And now, to change the emotional scenary up a little bit, how about some Thanksgiving Madness With Jamie And Ibrahim to cleanse the palate? To preface, Ibrahim has the day off today, and brought home a chicken last night to bake.

JAMIE:
[seeing frozen chicken on the counter]
Is that a chicken you bought?

IBRAHIM:
[evidently very proud of said poultry purchase]
Yes; I'm going to cook it for Thanksgiving tomorrow!

JAMIE:
[gently, so as not to burst his enthusiastic bubble]
Honey, you know we cook turkeys for Thanksgiving, not chickens, right?

IBRAHIM:
Yeah, but what the hell are we gonna do with all that turkey, right?

JAMIE:
[sensing it's time to concede the point]
Yeah, I guess so.
[eyeing chicken again]
You're going to be the one cooking the chicken, right?

Any way, to those in my American audience, Happy Thanksgiving, for whatever you've got to be thankful about (or not).

No Free Lunch

The following is an exchange I had with a patient I admitted this evening. A patient who, may I add, is younger than my mother but wanted me to dial the phone for her [ed. note: patient did not have bilateral transmetacarpal amputations--her hands amputated at the wrists for nonmedical folks--and could damn well dial the phone herself. Needless to say I did not comply with request, believing in the Power Of Self-Actualization and living to pass it on.]

You'll see why I qualify her age the way I did when you read the dialogue:

Patient:
Flails about haplessly in bed, moaning and shrieking in apparent distress. Looks oddly like beached whale. A beached whale with nasal cannula oxygen, but a beached whale nonetheless.

Jamie:
[entering room]
What is it you need?

Patient:
[still flailing and moaning]
Where's my sandwich?!

Jamie:
I'll get it in a minute but you have to be patient; I've been doing your admission paperwork and checking your meds. You had a tray of hot food you didn't want so now you'll have to wait for a sandwich.

Patient
[disregarding my well-thought out reply/rationale, apparently]:
I WANT MY SANDWICH!

Jamie:
[supressing finely honed rage]
Fine.
[stalks off to kitchen to get sandwich, brings back sandwich, sets it down in front of patient]

Patient
[acidly]:
What's this?!

Jamie:
[leaving room so as not to throttle patient and make her blood gases look even shittier than they already are]
A sandwich.

Patient
[raving to self, apparently, as no one is left in the room]
What kind of a place is this?! I don't want this sandwich! Get me something else! How horrible! I can't believe this!

The Poor Sandwich in Question:
[hurled across the room by angry patient, who is now demanding macaroni and cheese].

Must. repeat. following. mantra: I love my job. I love my job. I love my job.

Sunrise, Sundown! The Hospital Musical Numberl!

I've been thinking lately that if Wurk was a musical number, it would be modeled in the fashion of Fiddler on the Roof's "Sunrise, Sunset," except Tevye et al would be wearing hospital johnnycoats and singing numbers like, "Sunrise, Sundown" (for that wonderful and magical phenomenon whereby calm and manageable by day elderly folks turn into combative, confused shadows of themselves, as the name suggests, "When The Sun Goes Down" (and not like the Kenny Chesney/Cracker song of the same name, either. And shut up already, because I like Kenny's Chesney's music.)

Or, as one nurse suggested last night, what about a number entitled, "Let it Snow, Let it Snow, Let it Snow?" ("Snow" = hospitalspeak for giving doses of powerful anti-psychotics and benzos like Haldol (beloved Vitamin H) and Ativan in hopes of achieving some semblance of "behavioral modification" in confused/psychotic/delirious/demented patients who are using nurses and housestaff as punching bags, etc.

Ah yes, 'Tis the Season, my friends. It never fails. The weather turns colder, and people get sicker, especially the elderly. The floor continues to "be heavy" which is Nursespeak for "Run and hide!" All we have left in our arsenal is bitching, and god knows we do. Because we are Nurses, and it's our God given right to bitch and moan endlessly, because so little else actually is within our power.

Personally, my favorite last night was emptying a liver abscess drainage bag. Let me tell you, nurses have it all over Fear Factor contestants, those pansy-assed twerps. Ah. Drainage. Mmmm. Goop. Almost the consistency of a milkshake, I thought, as hovered dangerously above the foul-looking and biohazardous stuff, trying deseperately to a) get to my happy place, which definetely doesn't have anything to do with liver abscess drainage but does have a lot of alcohol b) figure out how to accurately document the color, consistency and amount of the noxious drainage oozing from the spout in sickening gloppy splat splats. "Goopy, shit-colored and nasty" was actually all I could come up with the time, along with a mental note to start beefing up my CV in case Nursing Dream Job 3000 ever comes up and takes me away all Calgon stylet... adios, abscess drainage! Oh yeah. We all have to have dreams.

Speakin fo which, in non-Wurk news, I had a confusing dream last night about writing a longhand essay about Daedalus (I know, I know, I have geeky dreams. Once I dreamt I was given a book on Cicero, and it made me feel all comfy and warm inside. Scary.) The confusing part of the dream (other than why I should be dreaming about Greek mythological characters in the first place) is that when I looked up primary and secondary sources (can you tell I find footnotes sexy?) I was really looking at stuff about Atlas. Quel nightmare!

I really am a Humanities Dork wearing a nurse's uniform, I swear.

Happy Shiny!

So, enough gloom and doom for the moment. Let's talk about pleasant things for the time being, shall we?

Like, for instance, PIPER!!

Who lately, to tell you the truth, has been just the slightest pain in my ass. I'm not sure what happened to the grungy, smelly and altogether miserable but quiet and meek pooch we picked up eight week ago from his temporary digs, but he's certainly, uh, blossomed in the time we've had him since.

Typical for a Westie, he pretty much thinks he rules the roost now, and this has manifested itself in bark-a-thons. Well, let's qualify that. Piper bark-a-thons, which are barely a whimper, guttaral growl and short, staccato couple of barks. I know, it's not much, but it's totally out-of-character for him, and I can only think that he's starting to get the notion he's Alpha-dog around here. So we've been diligent about restricting his many freedoms, and crating him when we go out (for all our hard work he rewarded us with a couple dog marbles on the bedroom carpet yesterday to show his disgust with that idea, thank you very much). Whoever said dogs aren't in the business of calculated revenge obviously never met a Westie with a mission.

As you can see by the sample photographs, we've been taking the dog everywhere with us, including the fabulous town boardwalk on the Sound, which everyone is quite proud of here, and for good reason. It's gorgeous, especially in late fall with the crystal-blue persuasion type skies and a cornflower blue sound to match. We took pictures, but it was such a bright, sunny and atypically warm day for Yankeeland that they turned out bleached and grainy. But I salvaged some of the Piper pictures, in which he is practicing his very best Look-Away-Right-Before-The-Shutter-Clicks (or whatever the shutter does now that cameras are all newfangled and digital) moves.

Here's one of us on a pier, which that day we never quite reached the end of, because there were some grizzled, smelly-looking men monopolizing said space, no doubt scratching themselves and hawking loogies into the Sound or something equally distasteful as they pretended to fish but we're probably really drinking hard liquor out of those tastefully concealing paperbags. Wanting to keep Piper away from such Bad Influences, we took these pictures at a Safe Distance From Riff-Raff. We're practicing for teaching our future children Stranger Danger and all that, you know.

We're still enjoying our new place to the hilt, too. I'm in awe of living in a place new enough that when I clean spaces they actually stay clean-looking for more than fifteen minutes. Not that I'm some big fanatical Dear Heloise-reading housekeeper, because I'm not, but neither do I like to live in absolute squalor. After so many years of living in subpar housing out of necessity/poverty, it's nice to be able to afford something clean, quiet, and in a decent, middle-class neighborhood.

I've finally adjusted to evening schedule, insofar as that is possible, and my circadian rhythms have adapted accordingly. I'm now able to tolerate staying up until 1 or 2a.m. in the morning and still get up at a decent hour. It's not that I don't feel like utter shit at work some days, but it's usually not because I'm tired. Work was hard this week, but I've detailed that ad naseum elsewhere.

It's also finally gotten cold here, after stalling blissfully in a sort of Yankee Version of Indian Summer. We had recent days when the temps were as high as the low seventies, and it was just lovely. I'm grateful for whatever reprieve from the cold winter months as I can get, because if I never believed there was such a thing as Seasonal Affective Disorder before, I certainly do now. Maybe living in a nicer place will be a panacea for all that sulky miserable cold (not to mention fucking endless) though. Any way, there's definetly a bracing chill in the air now, and I noticed frost on the cars this morning when I woke up (far too early at 5 a.m., may I add).

Oh shit. I just realized it's going to be Thanksgiving next Thursday. I'm not obliged to cook big fancy turkeys for anyone (thank God, because no matter how hard I try to be that good little engine that could, I just can't get into cooking on a regular basis) but I am required to work. Working isn't what the "oh shit" moment was about though. It's the dismay at the thought that pretty soon all the radio channels will be clogging the airwaves with noxious repeats of holiday Christmas classics. I mean, I'm no Grinch, and I still watch Peanuts Holiday Specials and all that, but there's only so many times you can listen to "It's Beginning to Look at a Lot Like Christmas" without wanting to strangle your neighbor instead of loving him/her.

Oo, it's the weekend! Time to luxuriate in happy thoughts, afternoon naps, sprawling hours of dreaming up new knitting projects and maybe even starting a new book. I recently finished The Known World by Edward P. Jones, but I couldn't quite get excited about it in the Pulitzer-prize way I was apparently supposed to. So shoot me.

The Death-Eaters

Hi, there, everybody! You remember me from my previous post, wherein I was a disgruntled employee of the healthcare system.

I'm still somewhat disgruntled after Thursday, but for different reasons (namely, trying to keep a nonagerian in end stage renal failure "alive" with hardcore antibiotics for a new diagnosis of "rule out sepsis" and pointless CT scans for vague and highly questionable patient complaints of tummy pain.) All this mania occured *after* she drops her temp to 94.1 overnight and we have to bring in the Bair hugger to raise her temps. Then she had hemodyalisis, so of course her temp is elevated by the time ID (Infectious Disease) folks comes to see her. At which point they examine her and get their panties all in a bunch; the rational, I'm sure, being something along the lines of: Oh my Gawd! Her temp is slightly elevated at 100.6! Bring on the cavalry! Let's break out the IV Vanco, stat! Let's draw some ABGs, stat! CXR! Abdominal CT scan!

Uh, thanks, ID intern and resident consultants, for making this particular exercise in futility possible.

Of course, this is also after I've spoken to both interns regarding the Bairhugger issue and the hemodyalsis issue (as in, "Are you sure you think she's septic? Maybe she's just having a slight hemo reaction, or uh, maybe we warmed her up a tad much in the Bairhugger. Don't you want to wait and see before we bring out the Big Guns and shut down her system even more with the whole broad-spectrum antibiotic thing?" Or at least that was the point I was trying to get across. Perhaps I should not have been so subtle. I must have given the woman intern a funny look when she said she was going to order the Vanco dose, stat, as in, "Am I hearing you correctly?" But I figured that perhaps the covering PA could talk some sense into these folks, so I kept my mouth shut.

And okay, so I realize that the temp was just part of the clinical picture, but still. How much fucking lamer could this medical plan get? I wondered. Never ask a stupid question, because it will be answered for you all too soon, and probably with results you won't care for much, too.

By the time I realized they were drawing ABGs on her recently-made-DNR/DNI-person (Why? To prove what we already know, which is that she's acidotic?) , I realized I was fighting a losing battle. I think it was at the point when they sent up the contrast-dye for her CT scan that I just about about lost it.

As in, Shit, guys, I know to you I'm just a dumbass-know-nothing nurse, but when I tell you THREE TIMES EACH the woman is ASPIRATING ON A TEASPOON OF WATER AND HAS STOPPED TAKING ANYTHING PO LITERALLY OVERNIGHT, I really really mean it. It also means you should get a goddamn clue already, and not order contrast abdominal CT scans on a woman whose mental status has vastly deterioriated overnight and of whom you claim said she had "belly pain" (a complaint neither I nor the PA who went in to do the scutwork of drawing ABGs, etc, could not elicit from the client, because basically she can no longer tell you what's hurting her, much less why.) Sigh. Ergo, phone call number one to house officer initiated.

I have often wondered these formative salad years of nursing, what the fuck everyone must be thinking when it comes to these lovely patients, who are clearly dying, and why it is some feel they must try absolutely everything on a body and spirit that is giving up the will and ability to live? Everything I was seeing clinically in my patient pointed to the fact that she is not long for the world and had suffered significant, dramatic drawbacks in the mere 16 hours between my last shift and the one following, and there was nothing on this side of heaven and hell that would have made me believe she was on some miraculous road to recovery because of one goddamn last minute ID consult.

And yet here I was, shuffling this poor lady off to CT scan in the middle of the night, wondering bitterly why it was she had everything else ordered for her but what she really needed, something to control her suffering, which was starting to manifest itself in heartwrenching, stacatto moans peculiar to the dying. To be fair, I believe part of the reason nursing perspectives can be so vastly different from the actual plan of medical care falls on the different roles we play in healthcare, and the fact that consults come in with little or no knowledge about your patient except for what's been passed on (formally or informally). They see a snapshot of the clinical picture, a moment frozen in time, and they are obliged to act on it, even if it seems silly or irrelevant from another standpoint, namely nursing, which has the advantage of knowing a patient over time.

What they don't stick around long enough to see or hear is the actual, dying patient, unless they are dying in an acute situation like a code. As nurses, we do. It is a unique privilege, but it is also a burden, because to listen and watch a dying patient tormented by the increasing inability to breathe, let along control their own bowel function, voluntary movements, speech, and tolerance to pain, is to be privy to a world of anguish I never thought possible. And sometimes we watch them die over months, although usually it takes a few days or weeks at most once they start the process of actively dying. The question then becomes for me, How do we justify prolongation of a patient's suffering in light of the inevitable? Is the justifcation valid and sufficient evidence to continue treatment? Under what moral argument and reasoning?

So, on the phone again with the house officer for what would be one in a half dozen times over my shift, I secured an order for IVP morphine and it did the trick, allowing her to rest comfortably for a few hours, but my heart ached to know that my hand, too, was implicated in protracting her suffering. It was the only measure of nursing care from a pharmalogic standpoint that I felt good about the entire night, and that, my friends, is unbearably sad. No, tragic.

Chief Complaint

Alright, so I'm gonna post about Wurk, so this serves as a caveat to all those who are fed up enough with their own Wurk scenarios and can't bear the thought of listening to someone else's maudlin griping.

So. Last night (well, day, actually, it was another fabulous 11a-11p) sucked. Big time.

I'm sure there's probably weirder job descriptions than mine out there, but if there is, some days I'd be hard pressed to figure out exactly what they are, and who works them. Because I doubt there are too many careers in which one gets to deal with statements/situations like, "He's bleeding out his butt!" and "My pecker hurts." (Well, I can think of one black market profession, but let's not go there, shall we? And I'm not kidding. Those are actual statements made to me last night.)

Yes, that was pretty much my day yesterday, dealing with ornery old men complaining about their genitalia and the various things wrong with their plumbing, internal and external. That, and emptying colostomy bags after massive doses of Kayexalete (for someone who doesn't have a colon, note). Sample conversations ranged from "hurting peckers" to fabulously circular conversations such as the sample below:

PATIENT:
I'd like 1000 mg of Tyelenol, please.

ME:
I can give you 650mg, that's how it comes.

PATIENT:
No. I want 1000 mg.

ME:
I'm sorry, but the doctor orders 650mg as a standard order.

PATIENT:
Who?! What doctor?

ME:
To tell you the truth, offhand, I don't know which doctor actually ordered your meds, but it's a standard order and I can only give you that much every four hours.

PATIENT:
What do you mean?! It's over the counter, for God's sake! I take it at home every night! I want 1000 mg of Tyelenol!

ME:
(Hurls self out of window and falls three stories into oncoming traffic).

If I had to choose a metaphor-of-sorts for the futility of last night, the above conversation, I believe, perfectly illustrates my vain and questionably valiant attempt to a) be a good nurse (and by good nurse I mean the kind that does not garrott her patients with their own oxygen tubing) b) keep it together and not actually hurl self or others out the window. (Politcally correct ed. note: I would never garrott my own patients with their oxygen tubing. I would find something more suited for the task.)

I don't know what it is about twelve hour shifts (which automatically turn into 13 hour shifts, somehow, as if to prove The Hosptial Owns Your Soul, and You Will Never, EVER Be Able to Get Out on Time, No Matter How Efficient You Are During Your Shift [insert maniacal Mr. Burns-esque cackle here]. Maybe it's the fact that I feel I'm a decent, maybe even good, nurse for the first eight hours, caffeinated and well-rested enough to deal with the rivers of various bodily fluids flowing forth from various orifices of patients, able to tend to the needs of the very sick and very dependent with relative efficiency and aplomb as well as juggle the perennial chore of hunting-down-and-badgering-of-housestaff requisite to get what I need done for my patients.

Then, after about eight hours, I start to get hypoglycemic, tired, cranky and hazy about important philosophical things, like "What was I thinking!?" and "Why am I here?" After eight hours of a shift, even money doesn't seem to be a real reason for being chained to a hospital floor full of sick and constantly needy patients, and my sense of Vocation and Purpose in Life has long since packed up and gone home for the day (and is presumably kicked back at home with a beer watching sexy "Law and Order" episodes I can no longer view due to my schedule).

There are many nurses who love twelve hours shifts because they free up most of the week (these nurses typically work three twelve hour shifts per week) but I, personally loathe them, for the above stated reasons. And God Bless the interns and residents who work those nightmarish sounding 36 hour on-call shifts, because I would not last through even one of them without having a complete psychotic break.

Luckily I am only on for an eight hour shift today, but it still doesn't help, because I dreamt about being at work last night, all night long. D'you think that'd count as working a shift?

Mac Attack

So I got a little crazy this week and bought a computer, because I have nothing better to do than spend my life's savings (that, and agree like a dumbass to work four extra hours on a Friday when a) we are short a nurse b) three patients are sick enough to be sent to the unit between 11a-3p, including one of mine c) we get seven admissions between 3p-11p, two of which were mine).

And my not-so-trusty and barely a year old Averatec laptop has been dying a slow, painful, non-morphine-drip-aided death-by-battery-and-fan-and ac-adapter-issues, in my non-professional diagnostic opinion. It finally gave up the ghost on Tuesday, having gotten hot enough to meld the male part of the ac adaptor to the computer port. (Ouch!)

So I decided, armed with nothing but gut instinct and the rumor heard sometime in the past that "Apples don't crash as much as PCs" that I'd strike out from PCworld into unfamiliar computer territory, and get a Mac. Aided by my trusty, interest-free-for-fifteen-months credit card, today I bravely purchased a 15" screen Powerbook G4.

All PC users may now make mockery of me, but I'm happy, any way. And it's not that the little Averatec was bad or anything (I blame the notorious Microsoft Windows for most of my issues; not that it didn't have it's own remarkable construction faults). It certainly didn't crash-and-burn in the grand, great-balls-of-fire tradition of my old Toshiba (which has long since made it's way to Laptop Heaven, or Hell, whichever way you prefer to think of it). But I wasn't so happy about the crappy battery life, nor the noxious and rather alarming smell of burning plastic emitting from my computer on Tuesday afternoon, either.

Why an expensive computer with specs I don't even understand? Well, why not, I say. Why not say "yes" to gratutious and extravagant electronicware purchases? I can't justify it, just like I can't justify why it feels good to spend a long time in the shower, luxuriating in world eco-system depleting first world decadence, or eating a slab of milk chocolate or sleeping in an extra three hours on a sunny Sunday.

Knowing next to nothing about computers, and relying heavily on the old fashioned notion that it seems more prudent to buy quality at a heftier pricetag than suffer the results of a thrifty but ill-constructed piece of hardware, it just seemed like a good idea, and I'm happy, and what's a few extra hours at work to pay for more gigaws and gimmicky jazzy things I won't even use, right? It does come with a DVD burner, and when I get Roxio's Toast 7, I should be able to add to my skimpy DVD collection, as well as make home videos with my nonexistent camcorder.

Ah, it's the old Catholic justification-by-guilt-mental-mind-tricks, coming back to haunt me. What theological maneuvering. (Well, really, it's all-too-human-rationalization, but whatever).

Pictures later; I'm tired and need to calibrate the battery on this bad boy.

The Skinny

I know, no one has been wondering: Where have I been all this time?

Where, indeed, my friends. Where, indeed.

I went to Florida to visit my parents this weekend. And while taking part in the customary visiting of parents (and their one-year-old Westie, Patrick, who looks suspiciously like my ten-year-old Piper, except with a lot more exhuberance and "Whhuzzhuh?") I also went shopping. For stuff. Seriously.

Since I've lived the last ten years (college and graduate school, plus Graduate School: The Sequel) in abject poverty, this having a Real Job thing and having Real Money thing has revolutionized the way I spend money. That is to say, I actually have money now, and can spend it. No lies! It's true!

So I bought Stuff I Needed: like a new pair of Nikes to replace those that have more than quadrupled their lifespan and need to be retired, stat. I also bought new scrub tops with the crucial bottom pockets to replace those with the breast pocket tops, because a nurse cannot live alone with one top pocket, out of which floweth saline flushes, alcohol swabs and tuberculin syringes every time she leans over to hook up her patient's IV fluids. I also bought a pair of chunky heeled Mary Janes on sale, because dammit, they were on sale, and I wanted them. So there.

I also had to buy a new pair of jeans and dress pants, because lo, my size two jeans and dress pants I bought in May don't fit any more. I have lost about 10-12 lbs this summer, going from a mildly svelte 5'1", 107-109lbs down to 98lbs soaking wet. Ergo, I am now hanging out in size 0 pants, my size 2s having an excess 3-4 inches around the waist. I could pull my pants from my waist, as in those Weight Loss Commercials. Kinda scary.

My doctor suspects hyperthyroidism. I suspect work, moving and general stress is the culprit and secret to my weight loss success. That and being totally clueless I was losing any weight until about a month ago, when people at work started commenting on my weight.

Dude.

I haven't been under 100lbs in years. It's nice, but now I have to worry about gaining it all back again, and feeling like a bona fide fat ass. Yuck.

Back to work today. The dog is looking at me from a corner, as if to say, "Stay home and hang out with me!" I only wish I could.

And then there was one

So after all was said and done, we couldn't keep Toby due to his overt and chronic interest in our bunny friends. Ibrahim came home last night to a slightly ajar cage door, two very frightened bunnies huddled behind our couch in a puddle of wide-eyed fur, and evidence everywhere that a not-so-friendly game of Dog-and-Rabbit-Chase had taken place in the wake of our work absences. (Yes, the bunnies are unscathed! Miracle bunnies!)

We took him back to the shelter today and I felt like The World's Shittiest Human Being, but the animal control officer was all very understanding (while probably secretely thinking, "You bastards!"). Toby, however, seemed undisturbed by the whole thing. Perhaps he's spent so long "on the inside" that this weekend was the doggy equivalent of happy-fun-time parole and he didn't really expect to be sprung for good (even the animal control officer likened his weekend to "a spa vacation weekend").

Meanwhile, Piper is typically nonplussed about the whole thing. Sometimes its hard to gauge his reactions to life events because he's so mellow. (I'm starting to seriously wonder where he's been keeping his stash of Mary Jane).

In non-pet news (yes, I realize there are other things to talk about), we are loving our new place. It's so, uh... for lack of a better word, grown up what with the wall-to-wall carpeting, real solid wood furniture (with names we can't even fathom!), and washer and dryer. It's also amazingly quiet around here, especially after living in the hub of a busy urban hellhole situated within a five block radius of two major area hospitals. It's so quiet I can actually drop off to sleep at night minutes after my head hits the pillow, instead of listening to various drug deals below my window go sour and the typical sirens and noise that follows.

A good night's rest is no small thing, espcially since The Night From Hell. It was a revolving door of issues; every time I stablized one patient, another one would have start having chest pain, or start oozing out of their nice new dialysis port, or sundown and start kicking and screaming at the nurses. Bottom line, I was still finishing up the paperwork to my 5p.m. admission at 9p.m. and still passing 10 o'clock meds at 11p.m. I finally finished with my paperwork at 12:30a.m. I. love. my. job. I. love. my. job.

And just think! It's possible I get all of my assignment back today! And tomorrow!