Postcards From the Edge

If I didn't know myself better, I'd say I was a couple steps from losing it all together.

Fortunately, I do know myself better, and I've already lost it completely, any way.

My life isn't objectively shitty, but I am kind of pissed off with it at the moment. I plan on making some major moves towards sanity very shortly.

First of all, I'm resigning from fulltime hospital nursing, and going per diem. Maybe then I won't look an anorexic Buchenwald survivor and actually do something with my days off rather than curl up in the fetal position and spout angry tantrums at the world. As the French say (or used to say, back in 1985, probably, you can never tell with slang you learn in the classroom, because it's probably outdated and went the way of big hair and ugly Modrian-inspired sweaters) "Change le disc." or maybe "Changez le disc." Or whatever. I hate French.

Second, I'm moving back South. I can't stand the Northeast. I wish I could be more eloquent about that statement, but right now, I'm so furious with my latest encouter with Yankee riffraff bastards, I can't. This is the shittiest place I've ever lived in my life, and so far, pretending Everything Is All Right is losing it's charm as well.

Third, this vanilla rum I'm drinking is very tasty and smooth, you should try it if you are partial to things like that.

Okay, so enough of being proactive, kind of, let's go back to our daily dose of bitching. Oh wait, I was bitching.

Happy Birthday, Piper!

So my dog is going to be a decade old tomorrow.

Every birthday, he gets a birthday cake. Granted, the birthday cake is usually less a cake and more of a hamburger, but what the hell does he care?

Funny: My mom insists that I give him one of my pillows, so he has somewhere warm and Eau de Jamie to place his furry rump. Not only am I to give him one of my pillows (because I can apparently just buy myself a new pillow at Kohl's, or go without) but I am to wrap it, with a bow. Because he'll know the difference.

Okay, so Piper is very intuitive. For instance, if I say to him, "Go get your stuffed animal, and we'll play fetch," he'll shoot a very calculated, pissy look that clearly states, "Go get it yourself, what do I look like, slave labor?" If I say, "Please get off of my my knitting/clothing/pillow!" I get another look which very clearly indicates, "I'm much too comfortable. Please fuck off, and get your own knitting/clothing/pillow."

He also, according to our Christmas photo shoot, was very into presents once he figured out stuff is inside all that pointless shiny wrapping paper and stupid boxes.

But I want to know what the hell difference it makes if I wrap up my pillow and give it to him as a birthday present.

After all, isn't giving him fruit off the forbidden tree (or my pillow in this case) much like letting your sixteen-year-old smoke an entire carton of cigarettes in front of you, just to take all the mystique and coolness out of smoking?

And more to the point, it's not as if he's going to care about the pillow any more than he cares about the American economy, or the latest winner of Dancing With the Stars. In fact, I predict if I give him my pillow, he will completely ignore it and go sleep on any random surface available where the pillow is not.

In other news, the patient we all love to hate keeps syncoping, despite the Lexus-price-equivalent pacemaker we inserted. She's also a complete crank, but in a demented way, which makes the following conversations priceless:

NURSE:

Hi there, how you doin'?

PATIENT:
You know, you look like you need to go home and "get some."

Or this one (in which I was the nurse):

JAMIE:
I need to fix your telemetry leads.

PATIENT:
[proudly]
I have some really nice boobs for a ninety year old, don't I?

Finally, one of my favorites:

TECH:
I need to take your blood pressure and pulse while lying down, sitting, and standing.

PATIENT:
How 'bout while having sex?!

I've decided to stop lying to myself about my motivations for staying in nursing. It's not to help people, it's to laugh. And laugh and laugh and laugh.

And eventually, go stark raving mad, like my patients.

How far is heaven?

Yesterday was one of those crazy-ass days in nursing where you think, "Gee, I'd like to be a carnie."

And then you realize you are a part of a freak show, staffed by weirdos, and none of the rides work properly, sending hundreds of innocent folk--who think they are going for a crazy little loop around the rollercoaster--on a one way ticket to their untimely death.

Okay, so that metaphor doesn't work really well, but somedays I still feel like I work at a carnival, and not even a state-fair quality one, either, but one of those super-scary "Are you sure this is legal?!" kinds in the frontlots of Walmart. Don't ask me why. It just feels that way.

On a different note, one of my favorite patients ever has come back to the hospital, and she's only been out for a couple of weeks. She and her sister are the only surviving members of the family, and both are very elderly, and have no one to care for them. I mean, they live at some kind of old folks home, but that isn't family, nor is it really home.

It's terribly sad, because all she's got is her sister, and she worries about her constantly when she's in the hospital. "My sister is blind, and I'm deaf. What a pair we make." Then she worries, "Who will cut her food so she can eat it?" Talk about taking a piece of your heart.

I went to visit her today, and it was so sad: she was sitting in front of her lunch, staring listlessly out into the distance, looking sad and lost in the thought. She talked to me about how all she wanted to do was die peacefully in her bed, and that she didn't think she'd be back in the hospital so soon, and it scared her.

After I left I thought, "When she dies, who will go to her funeral? Who is left to remember her? And how many elderly people are out there, living virtually all alone, with little company and no one to look after them?"

The number is probably more than I want to know, or think about.

The Five People You Meet in Hell

So...working 12 hour days at a hospital is hard.

On the other hand, you get funny quotes, like this one from a demented syncopal woman:

"I'm ninety-one... or ninety-two years old!!"

A basic conversation with her was like dealing with someone with a bit of Assberger's or Tourette's syndrome. It didn't matter what you said, she'd come back with something really, really mean and ironically extremely humorous, not to mention laced with profanity:

"Goddamit it, get away from me! [Pause, face brightens]. Did you know you have the name of my grandson? [Face darkens into nasty scowl again.] Hey! Watch it! What do I look like, stupid?! Goddammit, let me out of bed! I demand to get up and go pee! This bedrest is stupid! If I fall, I fall. I'm ninety one years old-- screw you, get out of my room."

Or maybe it's only humorous if you are already crazy yourself.

I thought it was really funny, because I've learned at this job you either laugh at the crazy demented people or you end up on your days off driving sharpened sticks under your fingernails to distract you from the residual annoyance and emotional stress.

Meanwhile, another Wurkplace irony was brought to my attention. We're in the middle of what is getting to be a very ugly shortage of nurses on my floor, forcing the day folks to rotate to nights. It's causing a lot of bad feelings all the way around (the night nurses are complaining day shifters should just suck it up and realize it's a day-night rotating position, and the day nurses complaining because hey, there's a reason we didn't sign up for nights, and that reason is that we've already tried various combinations of smack and speed to stay awake all night, and guess what... IT DIDN'T WORK.)

Any way, petty infighting aside, one of the nurses noted that now that we're short staffed, the evening/night people won't get their retention bonuses. The mysterious "rationale" for this brilliant idea comes from the same executive management that is proudly announcing a $15 million dollar satellite cancer center but cries poverty when hiring nurses to properly staff their already existing facilities. As far as I understood it, the evening/night bonuses are only paid out if we maintain adequate staffing numbers. So, practically speaking, if five of your co-workers quit (and it's actually like seven or eight, plus two going on maternity leave in a month) then you don't get your retention bonus, even though you are still showing up at your job and haven't left, and now in order to fill in staffing gaps, you're also working overtime and rotating to shifts that only the undead and their victims prefer.

Not that I get a retention bonus, because I am a day-night rotator, and haven't been there long enough to qualify, but that's hardly the point, is it? The point is that given this kind of "logic", the next thing executive management will dream up is that nurses on poorly staffed floors should receive a five percent wage decrease just for showing up at our jobs, because obviously now that we're working short staffed, we're just going to be working even more overtime to compensate, thus wasting more of the hospital's budget with stupid pointless shit like nursing care.

Reality Bites

Ever had a [insert period of time here] when you woke up, on your day off, and felt miserably bored and tired of yourself in a petulant, adolescent way that recalls the collective teen angst found in the movie The Breakfast Club or Kevin Costner at the beginning of Dances With Wolves?

You know where I'm going with this line of thought... do I really need to elaborate?

Any way, work was pheomenonal this weekend. Everybody needed IVP Cardizem, stat, or was choking on a big fat old mucous plug while hypoglycemic, or spiking a temperature, or climbing over the bedrails and wobbling over to the bedside commode while some tech who was supposed to be watching the patient was off snorting coke, dealing illegal weapons, or whatever it is they do while the rest of run ourselves ragged.

My days off aren't much better. I basically sit at home, knit, look up useless shit on the internet, and become increasingly withdrawn from society. Pretty soon I'm going to be drawing up dinner menus consisting of human liver and fava beans.

Meawhile I'm trying to figure out what to do with all the cigarette butts left outside on my sidewalk by those damned inconsiderate teenage wahoos who visit the other dumbass teenager who lives below us. I have half a mind to pick them all up using disposable tweezers, put them in the discarded cigarette box I found (thrown under my porch, the assholes!) and tape them to his mother's door with a note saying, "Don't be bitter, please don't litter!" or something innocuous .

The little fuckwads.

Diagnosis: Rule out future litigation.

Yesterday was busy but again, I was blessed with cute patients. Adorable.

Although, one of them smelled, well... a little ripe.

Apparently our friend, Herb (his name isn't remotely Herb, but he strikes me as a Herb, so that's what I'll call him) was admited for a "fever" of 98.4 and ROMI for chest pain, which clearly was pleuritic and secondary to his raging bronchitis.

He also, according to my nurse's-desensitized-to-all-but-the-most-foul-odors nose, smelled like rotten goat cheese. Seriously. I've cleaned up umpteen GI bleeds, C-diff poop, raging, cheesy yeast infections, purulent sputum, urine, liver abcess drainage the consistency of a milk shake, bilious vomit--all of which would qualify for inclusion in national bio-warfare arsenals-- and nothing has made me want to lose my cookies the way that pervasive funkiness did.

I didn't get the pleasure of scrubbing him down until after he came back form his rule-out-future-litigation stress test (I joked to a friend of mine that our cardiac department should boast the slogan, "Thanks to our multimillion dollar diagnostic equipment and respected team of health care providers, we are able to diagnose a healthy heart years and years before it never becomes a real issue!" ).

He was so bad I actually said the hell with the bed bath, put him in the shower stall, and scrubbed him thoroughly from head-to-toe, including two bar-soap-hair-shampoos and a complimentary foot soak.

When I got to the peri area, I finally figured out that part of his odd funk was due to a raging yeast infection in his groin, which was beefy red and very tender looking.

JAMIE:
[to patient]
My God, Herb, did you know you had this rash here?

PATIENT:
[chuckling]
Oh yes! That! I've had that.

JAMIE:
Uh, does your doctor know about this?

PATIENT:
Yup.

JAMIE:
Did he give you anything to put on it?

PATIENT:
Oh yeah. Some powder. [in extra-inspired tone of voice] Hey, do you think I can just use talcum
powder and it'll go away?

JAMIE:
No, Herb. That's gonna need some serious Nystatin powder.
[patient's living circumstances suddenly crystal clear]
Say, Herb, say, do you have anyone to help you at home?

PATIENT:
[Good naturedly]
Oh yes, my girlfriend. She lives in the building next to mine.

JAMIE:
[concealing note of disbelief]
Your girlfriend? Uh, does she help you bathe?

PATIENT:
Oh yes, all the time. I can do the rest myself.

JAMIE:
[thinks to self]
I can see that, clearly.

So the irony of the situation was manifold. Not only did the guy come to our floor on a bullshit ROMI (rule out heart attack) admission, with a faked "fever" for bronchitis (bronchitis we were treating with oral antibiotics, even)... but we did the five star, million dollar work up on him negative despite negative cardiac enzymes, only to find out that his heart was perfectly normal, thank you very much. What the guy really needed was a couple hot baths, nystatin powder on his groin, physical therapy, and social service to figure out how in the hell it is he's managed to live on his own without a) falling down b) going septic from his lack of personal hygiene.

None of his actual issues, note, needed a hospitalization, still more more to the point, none of them required thosands of dollars worth of an extensive cardiac work up.

He could have gone to the doctor as an outpatient, gotten an Xray, a prescription for the bronchitis, and a referral to a visiting nurse service, who would come to his home and do a throrough evaluation.

But, as Paul Simon once pointed out, "Who am I to blow against the wind?"

Jamie's Guide to Interpreting Coworkers' Statements

Attendings:
What they say: "You're incompetent!"
What they mean: "I'm incompetent!"

PAs
What they say: "Yes, I agree, that patient might have an emergent problem. I'll
look into it."
What they mean: "It's five o'clock, the house officer can deal with that shit,
I'm out of here."

House officers
What they say: "I'll be up to evaluate your active chest pain/GI
bleed/hypotensive patient in five minutes."
What they mean: "I'll be up in an hour, after you've paged me an additional half
a dozen times for worsening condition, or when the code is called, whichever
comes first."

What they say: "I'll put those orders in the computer right now."
What they mean: "You'll have to take a verbal order."

What they say: "The pager system was down."
What they mean: "I turned off my pager/flushed it down the toilet."

Interns/Residents
What they say: "Let's just watch the patient for now."
What they mean: "I have no fucking clue what to do next."

What they say: "Let's work up rule out sepsis."
What they mean: "I really have no clue what to do."

What they say: "That isn't my patient."
What they mean: "That patient is thirty seconds away from coding."

What they say: "I'm surgical service; you'll have to page the medical resident for orders."
What they mean: "Fuck off."

Nurses
What they say: "Oh! That's a bad assignment you have! Good luck!"
What they mean: "Ha ha! I had that crap ass assignment *yesterday*, you sorry
bastard."

What they say: "I'm sorry, I didn't have time to do the admission database/give
an enema/digitally disimpact the patient/give the Golytely."
What they mean: "Do I look like I'm stupid?"

What they say: "I had a great day with the demented patient; s/he's really sweet."
What they mean: "The patient will need four point leather restraints fifteen minutes into your shift."

What they say: "The patient is stable, alert and oriented X3."
What they mean: "The patient is swirling the drain and crazy as a jaybird."

Techs
What they say: "Yes, I cleaned up that patient."
What they mean: "No, I didn't. Fuck you, do it yourself, bitch."

What they say: "The patient is unresponsive."
What they mean: "The patient is fine, I just don't want to go in there and feed him/her."

Housekeeping:
What they say: "That's not my room to clean. Page someone else."
What they mean: 'That's not my room to clean. Page someone else."

What they say: "I already cleaned that room!"
What they mean: "The room isn't cleaned."

Transport:
What they say: "We're sending someone."
What they mean: "No we're not."

Unit Clerks
What they say: "What's that noise?"
What they mean: "The phone is ringing. Somebody should pick up the line."

Pharmacy
What they say: "That med should really be in pyxis, look again."
What they mean: "I have no idea when we're going to restock that med so quit
calling me."

Midlevel management
What they say: "Yes, I understand your concerns and will look into them."
What they mean: "Fuck you."

Upper level management
What they say :"We care about everyone's point of view and well-being."
What they mean: "Except yours, of course."

What they say: "We all have to work as a team to solve our problems."
What they mean: "Nursing will have to work harder than ever to solve everyone else's problems."

What they say: "We hold everyone accountability to the highest standards of excellence in patient care."
What they mean: "We hold nurses accountable to the highest standards of excellence in patient care. Every one else can fuck up at will."

What they say: "We are preparing for a new and exciting era of productivity and growth."
What they mean: "Get ready for a fifty percent increase in paperwork and bullshit."

All hospital employees
What they say: "Have a nice day!"
What they mean: "Fuck you!"

The Imaginary Invalid

Last night, on a whim, I decided to look up adult ADD (attention deficit disorder) on the web.

Afterwards, I was really sorry I did, because immediately after reading some websites, I thought, 'Uh oh, that sounds like me.'

I've always thought my short attention span, inability to keep anything organized for longer than five minutes, free-association stream-of-consciousness thoughts, hot temper, forgetfulness, fidgetiness, procrastination and mild dyslexia were all just part of the quirky, flawed package that is me.

Now I find I share these characteristics with untold numbers of Americans, and I'm not as special as I thought I was.

I guess the consolation prize is that folks with ADD are supposed to be creative.

Great. I can start the World's Greatest Novel and because of my disorder, I'll end up never finishing it, or I'll finish it and forget to send it to the publisher, or forget where I put the manuscript for five years, during which time someone else publishes a similar novel.

Hmm, it even makes sense that I do well at nursing; I perform extremely well at something I like when I have external pressure applied, but when the pressure is off, I revert back to a state of complete ass-numbing inertia.

Speaking of which, isn't it time for a nap yet?

Viva life.

So I probably will wuss out and not quit just yet, because in reality, I have bills to pay, and student loan debt.

The realization that I have real responsibility makes me wish I was twenty again, when you could say, "Aww, screw this, I'm outta here" pack up your suitcase, and head out of town.

Life can be inconveniently cumulative. Damn it.

Take This Job And Shove It

So, I wrote up my resignation letter.

The irony is, I'm not quitting because I hate my job. Sure, it's incredibly stressful and there are days and many things about it that I do hate. But I'm just now getting comfortable with everything, and I like my coworkers. When I think about the horror stories that I've heard from other floors, I know it could be a lot, lot worse. I really don't mind. It's a known quanitity, and even on a really bad day, I know it's going to be over at some point and I can go home.

The problem is, "home" sucks. I hate living in this fucking hellhole.

It's bad luck, and no mistake. In the last month alone I've had two people damage my car (someone keyed the passenger side door just recently--unfortunately I think I know exactly who--and then there was the whole baby-buggy-bumper incident last month, too). I feel like nearly every day I'm dealing with some jerk-off who's nasty and snarling at me for no good reason, making my life a living hell.

For example, a couple of weeks ago I called the prosecutor's office to get some information on how to ask for restitution for my damaged car and was yelled at by someone who said they were an "attorney" but refused to actually help me properly. When I asked if I could speak with someone else because she sounded 'busy' (which was my code for "premenstrual bitch from hell") she actually screamed, no, nobody else has time for you either.

Feel the love, people.

It's bad enough I can feel doctors sneer at me over the phone, I have to deal with this kind of shit on my day off. I can't think of one day in the past two months that I've actually wanted to go outside of my house and do something for fun, and not worry about someone damaging my property, screaming at me, or otherwise accosting me.

I feel like I live in the exact same socioeconomic strata from which Jerry Springer chooses his guests and audiences. It's like having Joe Pesci throwing mafia type tantrums every time you pick up the phone, ask a simple question, or try to figure out how to do something innocuous and within your rights as a citizen without pissing off everybody and his Uncle Tony.

I just can't win, and it's dragging me down into the depths of a truly nasty depression and sense of despair and resgination that is starting to shut me down from the world of the living. (Yes Katy, there is such a thing as an undead person.)

Just this weekend, a frustrated house officer started yelling at me for something that wasn't even remotely my fault. I just kind of stood there, numbly, and instead of trying to defend myself, just shrugged and said, "Yeah, I'm sorry about that," and waited for her to finish her tirade because in the end, she was going to have to write the order any way, so let her rant and take it personally so I can get the hell out of there and take care of my patients.

I was just too tired of being yelled at without cause to fight it. Luckily, a fellow nurse was sitting around, and he cut in and rationalized with the doctor, who then calmed down, but remained pissy with me for the rest of the weekend. The nurse was like, "You didn't deserve her to yell at you."

Yeah, but no one really seems to care, do they?

It's really not about work any more, because work is work, and yeah, we all have really bad days (or months) where we want to quit. It goes with the territory.

I'm just beyond demoralized living here, and it hasn't a thing to do with work dissatsifaction, although being beaten about the head in my daily life I've found is starting to make me look like I'm on massive doses of thorazine at work. "Huh? what'd you say? Still yelling? Okay, get back to me when you've finished, and we can go over your orders."

I'm scared to death to leave my job, because it's the only hospital job I've ever had, and walking into the unknown can be scary business. It's also risky to quit working full time and lose medical and dental insurance, but as my mother pointed out, "Sure, the money's great, but at what cost?"

And that's when it hit me: I'm literally going crazy living here. I haven't slept or eaten decently in six months. My overall general emotional state is some fucked-up combination of angry, defeated, depressed, anxious and full of attendent apprehension and dread. It's horrible. I can't remember feeling genuinely happy about anything for months now. Nor do I ever remember what it was like to feel calm and relaxed. I don't even remember what it was like to enjoy living, rather than face each day wondering what kind of hellish, fucked up experience is going to bite you in the ass today.

I feel like I'm Meg Ryan in that scene from "You've Got Mail" where she's decided to close her mother's book store, and her accountant says, she's doing the brave thing. Meg Ryan's character gives her this funny disbelieving look, to which the accountant says something like, "Oh, I know it doesn't feel like that all. You feel like a big fat failure. Imagine yourself going out into a world of opportunities... armed with... well, nothing."

That's exactly what I feel like. Hopefully my boss will let me stay per diem instead of let me quit outright, at least until I figure out where I'm going to go next, but I figured it either had to be now or never, because at this point I'm becoming a complacent pink collar slave.

Last night I had a prophetic dream: I was on the beach, flat on my tummy, crawling over hard packed sand, which was cracking and breaking off like ice on a pond in those dog-saves-drowning-girl movies, and beneath the sheets of sand were deep chasm-like tombs. I just kept thinking, "If I could only just get to the end of this bit of sand, I'll be safe, " only to realize the beach just kept going on like that for miles.

I won't beat you around the head with the metaphor, but you get how symbolic this is of my current plight.

I also had a dream I had that new nurse manager from recent episodes of ER. She was training me, and I was running around trying to hang a bag of TPN. When I came back, she was very angry, pointing at her watch sternly and saying, "That took seven whole minutes for you to do! How do you think you're going to be able to function efficiently as a nurse if you don't learn how to be more productive?! I'm very disappointed in you, Miss Campbell. You're going to have to work a lot harder than that if you expect me to keep teaching you anything."

Some days I think my life would be a lot better if I was just really, really stupid and happy with my life.

The American Dream

I rarely have this daydream, but when I do, I know I've really sunk to a new level of depression.

In this daydream, I am a very rich, powerful woman. No one fucks with me, and if they do, I have teams of lawyers , secretaries, personal assistants and henchmen... errrr, bodyguards, to "get rid of the problem" as per popular Mafia language. DMX is my personal rapster, and I can call him at midnight and have him write and record a badass rap song about whoever is pissing me off, by the next day the radio stations are playing it, and by the end of the week, I've had my team of lawyers work the offender over so hard that I've totally financially and emotionally devastated my foe. I'd leave them withjust enough money to eke out a crappy existence in social exclusion, disenfranchised from most avenues of power and privilege, and make them personally supplicate on bended knee, but to one of my personal bodyguards, because I'm off traveling the world and don't have time to take the ass-kissing personally.

Money would never be an object again, and while I'm much too solidly middle-class now to do anything but become gauche nouveau riche American aristocracy, I'd at least not have to worry about all the things you worry about when money is in issue.'' I'd be able to donate large sums of money to worthy causes but never actually do any of the scut work. Trips to the spa would become regular instead of a luxury, I'd have nice clothes and shoes (and someone to wash the clothes, iron them, and put them away), I'd be able to buy pretty jewerly I want "just because." I could buy a sexy luxury car or two...

But then I think that person and that life isn't at all I'd want, and because I'm so used to being poor by American economic standards (a standard of living that is vastly superior in some respects compared to most of the people on the planet, which is why this discussion is merely academic, may I add) I really have very simple, if on the finer points, impossible dreams. (And by "vastly superior" I don't mean to take the elitist view, because I think America is fucked up and full of a fuck-ups. I just mean I have access to shelter, food, electricity, water, medical care, education, transportation, and other things that I take for granted, whilst others can't make enough to feed their starving family of eight, let alone dream about formal education and basic medical care.)

My Ideal Life, by Jamie (to be followed by "What I Did This Summer")

In my ideal dream life, I would have a house in the country, but yet not. Kind of like Brentwood-is-to-Nashville. It's basically an extension of Nashville, but you're right smack dab in the middle of very pretty, country land. There I would have a large amount of property, and I could keep a full of abandoned pets. On the other hand, nearly ever day in Nashville, I ran by a stone-faced house with a large front yard (picket fence!). If I ran early enough, the elderly lady who owned the place would be sitting on her front porch, watching her dog play in the yard, and she used to wave at me, and I to her (can't remember when that's ever happened here. I always hoped one day I'd be able to buy that house, if I moved back. Silly, isn't it?

In this house, I'd like to have two rooms: a library and a conservatory with a Steinway grand piano (I've wanted this as a part of my house since I was about nine-years-old). I'd have floor-to-ceiling shelves of well-loved books, reference materials... and a comfy couch and good lighting by which to read them. Someone would come in and clean and do my laundry. It'd have beautiful hardwood floors.

I'd be able to jog for as long and as far as I wished without getting hit by a car, cat-called, or stared at rudely. I'd be able to have children, but still go to work a couple days a week if the mood struck me. The winters would never get very cold or last very long, and the spring, summer and fall would be pretty and cheery.

I'd have enough money not to worry about paying the bills, and just enough that I could drop money on a plane ticket to see my parents, or splurge on my family and friends whenever I liked without having to work overttime. I'd have excellent medical insurance and never have to worry that I won't be sent for a crucial diagnostic test only to have my plan reject it and make me wait another thirty days. I'd be able to get a manicure and pedicure and a massage at least once a month. I could spend money on knitting, books, and music knowing full well I've no staggering monthly loan debt to pay off. I'd be able to buy some nice, expensive clothes if I wanted, on occasion.

Most of all, I could stay home, sit in my room, and not be bothered by people.

I'm not a social person, although nursing has forced me to be more gregarious. I am painfully socially awkward and shy, and, probably a hang-over from adolescence, always have a bad feeling people think I'm a dipshit, which no doubt some people do. I don't really like being around crowds of people, I hate traffic (ever since my car accident in 2004 I haven't really felt safe in a car, and highway driving is not something I enjoy doing any more) and when it comes right down to it, it probably wouldn't bother me very much if I didn't talk to people other than my husband and family for days on end.

I like spending a lot of time alone. Is this wrong? Am I hiding from life? Maybe, but also, maybe not. I do like to think environment plays a part (freezing weather for months doesn't make outside look enticing at all) but all-in-all, if I were in prison, I'd probably act out just enough to buy days in solitary confinement, where I could just marathon sleep.

Speaking of which, time for bed.

Okay, so maybe not.

But if someone would tell me what the objective point of getting out of bed and making a living is, I'd like to know, because seriously, I really could just sit at home all day and be happy. No one to yell, no one to get angry, no one to be pissed off at for being inefficient, rude, lazy or incompetent.

Imagine

Let me just get a little bit John Lennon here, because I was just thinking, "Imagine what the world would be like if there were no assholes?"

I don't mean literal assholes, obviously because imperforate anuses wouldn't be very useful (although it would keep a lot of pedi surgeons in business I suppose).

Any way, big things have been happening around here.

Well, one big thing, any way:

Ibrahim was granted his conditional permanent residency today! !

YEY IBRAHIM! YEY JAMIE!!

It really wasn't the probity-probe inquisitorial interrogation of urban legend, either. Very short and simple, and we were out of there in about twenty minutes.

I'm kinda surprised, especially since my haircut is starting to grow out significantly and now is reaching pouffy-bed-head style worthy of a Crazy Poet, or someone Suspect To American Governmental Bureacracy Types. Hopefully I'll get it cut soon.

I'm worn out these days. Feeling a bit defeated, really. I spend most days vacillating between indifferent, lethargic stupor and full blown psychotic rage. What's getting a little troubling is that I'm beginning to see a blur in the distinction between the two.

Last night, while working frantically (short staffed. again. no surprise there.) we all went a bit cracked and started joking about the patients we were going to be when elderly and bed-ridden. I suggested I was going to be the little old frail lady who climbs over all four side rails of the hospital bed and breaks a hip, and has to be on suicide watch about every other day. One of the other nurses said she was going to be the one to crap the bed just to make someone come in and deal with the mess. Still funnier, another nurse said she was going to gain massive amounts of weight, require bariatric equipment, and then demand that no one come into her room for fear they will sexually assault her.

(If the above seemed ghastly and not funny in the least, then you are obviously not a nurse--although you may be a student nurse-- and two, every single one of things we mentioned is based on a culmination of nursing experience. Psychiatrists aren't the only ones who deal with crazy people).

Actually, I had a good assignment this weekend. I had one little elderly lady I wanted to wrap up in tissue paper, put in my pocket and take home. She was soooooo sweet, and she'd say things like, 'Golly, that's a lot of medicine you have there!" I haven't heard any one say "Golly!" since I was seven-years-old. All my patients were these sweet little folks, just nice as you could ever wish for.

Meanwhile, back to figuring out a scheme to make money while essentially sitting at home all day long, internet surf, knit and watch syndicated re-runs of Law and Order.

My Name is Luka

If you were to have asked me three years ago if I thought Suzanne Vega's "My Name is Luka"--a song that sketches a child's perspective of parental abuse--would ever speak to me as a metaphor for workplace violence, I would have laughed and asked you what made you think of that theory.

Alas, no longer.

Now if you brought it up I'd probably see it as a badge of identity in the Sisterhood and say, "Oh yeah, you a nurse, too? Thought so."

I think an abusive, codependent, passive-agressive game of power play describes exactly what half if not some days all of my encounters with people at work are like.

"If you hear something late at night/Some kind of trouble, some kind of fight/Just don't ask me what it was.../They only hit until you cry/And after that you don't ask why/You just don't argue anymore..."

Suddenly, Vega's stark lyrics of profound isolation and brutal violence take on a new, deeper meaning, as I realize she may as well have meant "don't argue with a paged on-call attending who spends five minutes of your life roundly insulting your intelligence, without, however, actually doing anything about the patient's condition." Half of the time they hang up in fine dudgeon, and you either get a response that "buffs the chart" (medical argot for an order set that does not address the problem but makes it appear something was done) or an extension of "benign neglect" in which they do nothing, hoping the patient will miraculously stop bleeding out their ass of their own accord, or whatever, and waits to code preferably after they're post-call.

Of course, no one (other than severely confused and combative demented patients) has ever hit me before at work, but it seems at least once a week I get yelled at, cursed at, put down and my intelligence underestimated and belittled.

And I have to wonder how normal can this ruthless subjection to abuse be in a workplace?

Sometimes the power play is very subtle. You might miss if i you weren't a human being with higher intellectual capabilities than say, that of an invertebrate.

I have had charts ripped out of my hands or pawed through as I'm reading them/doing an admission. I had one resident who came in with her attending, sighed huffily and drawled impatiently: "Are you about done with that chart, already?" This was after she'd attempted to read part of the chart while I was, you know, using the chart myself already. At which point I looked up and said, "Actually, no; the patient just got on the floor, and I'll need the chart for a few more minutes to do her admission. You can have it if you'd l when I'm through."

I think I scared her though, because the next time the attending came in and asked for the chart. Like people with manners might.

Beee-yatch.

It seems to me that the already marginal socialization skills of most medical students were quashed in favor of cramming loads of bullshit into their heads about what great fucking healers they are all going to grow up to be.

Fuckwads.

I can see people have an off day or three during, like, an entire year at work... I get it, if your car gets broken into and you snap at the secretary for not faxing documents or something unrelated, because hey, we all have shitty days... but dude, every week?!

I'm trying to deduce whether or not the prevalence of limp-dick attitude I meet at my job is a feature representative of other professions. I mean, do people in other departments of a business, say accounting, come up to the their coworkers in some unrelated office, like risk managment, and start sniggering loudly and deriding said folks professionally and personally because their opinion was needed in a company matter? Does this cycle of passive-aggressive-sniping-lack-of-anger-management-skills occur as frequently as I've noted in our profession? Or do I just I work in some Jerry Springer Memorial Hospital set-up and no one ever clued me in? (Some days I refer to my job as Hospital Staff Smackdown).

I mean, dude, what gives?!

Any way, a friend of mine who is much wiser to these sorts of morale-crushing workplace violence fests had one of her usual brilliant observations: it would be better use of our time, and actually kind of funny, if when some White Boys Can't Jump "personality deprived" pseudo-intellectual prat starts insulting us roundly s/he actually used said something inspired, and amusing. So at least that way you could kind of laugh and see if you can rap with it.

You see, we also both share a theory about gangsta rap and its cathartic effects on a nurse's psyche, as well as its sheer brilliance at capturing the fine art of The All American Put-Down. We both have our favorite de-stressing rhymes, but I vote for DMX's quintessential "Up In Here": "First of all, you ain't rapped long enough to be fuckin with me /and you you ain't strong enough/ So whatever it is you puffin on that got you think that you Superman/ Igot the Kryptonite?should I smack him with my dick and the mic?"

I love that song so much that I think, if I ever got a nursing union going somewhere, I'd personally write DMX and ask the rapsta if he wouldn't mind being one of our official spokespersons.

And one more random thought before I give myself high blood pressure by thinking about my job on my day off... another similarity to family violence: the honeymoon phase. Had a verbal tete-a-tete with some snotty prig with a stick clearly impaled up his or her arse yesterday? Well, today, said asshole will pretend it never happened, and smile and ask you how your day is going. Then later, more yelling and pointless arguing. (Why always the yelling? With the anger? And the noise?!)

It's like working with a bunch of Joan Crawfords in "Mommy Dearest."

Plays Well With Others.

Okay, so two big Life Lessons were learned tonight:

1) The way to hell is paved with well-intentioned pages, including paging attendings five minutes post office hours. This includes pages specifically requested by the patient, legitimate pages, and pages done in good faith at 5p.m. on a work weekday. JUST DON'T DO IT. Kind of like Nike's evil twin slogan.

2.) By the same token, the root of all evil lies in answering a paged attending's phonecall. (Hell hath no fury like an attending scorned. Or challenged, for that matter). For ye, though I walk through the shadow of the valley of patient gross hematuria and inability to spontaneously void, I fear no evil, (nor the attending or the scary clueless resident sent forth to do thy scutwork. ) For thy 18 French coude catheter and thy skilled float nurse come-to-the-rescue shalt comfort me, and I shall walk free all the days of my life. (After I get cool private duty nurse gig with a rich elderly socialiate who will pay me enormous amounts of money to sit, knit with her, and give her a gout pill before I leave for the day.)

I am soooo not getting the Plays Well With Others award this year. Pity, that.