People think about their reactions in 2D but live in 3D.
What that means is this: if somebody came to you saying, "I want to write a really funny book using you as the main character and it would make a zillion dollars that I'd split with you and we'd both retire comfortably" you'd probably say Yes, of course, go ahead.
Until the book got written.
Then you would have to deal with the difference between how you *thought* you would react to the book (gentle amusement, vague pleasure at being an immortal literary character) and how you actually *did* react to the book (shame at having your weaknesses exposed, irritation at what the other person thought was funny).
We tend to predict our reactions to situations and to other people with the unconscious assumption that other folks are chess pieces. In other words, we think, "Well, that person will do *this*, so I'll do *that* in response, and it'll work out *this* way." What actually happens is that the other person does that instead of this, you do this in response, and it works out *that* way. We feel off-balance and sometimes more than a little betrayed as a result.
A lot of folks call this tendency "expectation" and caution against having any of it. "No expectations" is to relationships what "No Irish" was to job hunting in the 1890's.
But it's that weird disconnect between how you think you'll react and how you do react that makes life interesting. Not interesting hellish, but interesting interesting.
Take this example: You correspond with a person for years via email. You finally get to meet that person. If you've done this before, you'll know that for some reason, even if you've not seen a picture of them, you'll recognize them at the airport right off, picking them out of a crowd.
You've gotten to know that person free of any inflection. You've never seen their facial expressions, never heard their tone of voice. You don't know that they pause for a slow count of five before answering a question that they think is important. In short, they'll do things you can't predict. But you know them. Well.
For a while, this is disconcerting. You wonder what on earth made you think this person was a friend of yours. If you're frightened of interesting things, you'll stop there, put 'em on the return flight home, and breathe a sigh of relief.
If you're a little more courageous, or willing to fight back your own fear, you'll try to see what the differences are between the person you'd created in your mind and the person in front of you. You'll work out compromises. You'll learn things you never expected to learn. You'll eventually have a synthesis of the person from the email and the person in front of you, a synthesis of 2D and 3D.
This is what makes life worth living. "Comfortable" and "free of fear" are two ways of saying "wrapped up in a blanket, hiding under the bed." You cannot interact with people without being uncomfortable. You cannot do it without fear. The secret to being alive is to learn to say "to hell with fear" and figure out what makes the other person *them*. You have to figure out what makes them interesting to you, what makes them tick, what you can learn from them.
Without that, life would suck.
"But," you say, "if I end up meeting somebody interesting and like them, and they don't like me as much as I like them, I'll feel hurt. Hurt sucks."
At which point I lose all compassion and say Deal With It. Pull your finger out and grow up. Either take the chance, or borrow a blanket and a bed. You get one--ONE--opportunity to do this thing that we're all doing. As far as we know, you don't come back again knowing what you know now. The folks who keep saying that Life Is Not A Dress Rehearsal are irritating, but they do have a point.
Hurt is a part of life. I get hurt every time I open the envelope containing my paycheck. I get hurt every time I like somebody more than they like me. I get hurt every time a patient dies. I get hurt indeed if somebody I thought was a friend does something absolutely shitty, like sleeping with my husband.
But the interesting part of life is there, too. Awful events give you the opportunity to figure out the difference between your perception (2D) and reality (3D). They let you analyze where you were an idiot and where you were right. And they give you the opportunity to behave better, to treat people better, than you ever thought you could.
So you have a choice. You can live, and experience the strange mess of hanging out with other living people, or you can stay wrapped up in a blanket. You can accept the fact that dealing with other people, even the people that you love, will occasionally be uncomfortable and draining and a hell of a lot of work and haggle. You can be open to learning interesting things about boring people. You can find something to be grateful for in every day. Or you can be afraid.
To hell with fear, people. Unwrap the blanket. Pull your thumb out. Accept that reality will differ--sometimes substantially--from your preconceived notions. And do it anyhow.
The most freeing thing in the world is accepting the fact that you will get hurt, be miserable, be heartbroken...and that there's nothing you can do about it. That frees you to live. It frees you to see that really *good* stuff happens too.
To hell with fear. Repeat after me.
To hell with fear.
... ... ...
*Written at the suggestion of my Beloved Sister, who calls me "wise". I didn't tell her that most of the stuff I poured into her ear for an hour was what she's taught me over the years.
Saturday, May 29, 2004
A whole raft of stuff
Loose ends
God Only Knows What Woman went home yesterday, beautiful smile and all. She's lost fifty pounds in the last few months, so moving her on to a stretcher was like lifting a kitten.
Mystery Man wrote *again*. I think this might be a record.
And Man A sent a nice note in response to a condolence email I shot off on the spur of the moment yesterday. I think this might be detente. Even if I was/am temporarily insane, it would be nice to have a long-time buddy back.
Bizarre Diseases
Into the category of Bizarre Stuff That Can Go Wrong shuffles a disease I'd only vaguely heard of before now: Ehler's-Danlos Syndrome. There are six types, all having to do with a genetically-linked problem with collagen. Type IV, or vascular EDS, is the most dangerous, as it affects the integrity of the blood vessels, both arteries and veins, and can cause ruptures and hemorrhages and other fun things it doesn't do too well to think about.
Life expectancy with EDS type IV is shortened. Appreciably. And of course, who should come in with EDS type IV but a beautiful, brilliant young woman with a loving family and a hell of a lot of potential?
Warning: Medical Detail, some of it not in English, Ahead:
She had come to us for a pulmonary function test. She'd been coughing up blood for several months, and the docs decided to see if there was some sort of major problem lurking undiscovered. Since the type of EDS she has causes blood vessel troubles, they were concerned about an aneurysm somewhere in the vascular bed of her lungs.
We talked politics and summer internships while I took her history. During her PFT, she'd had to breathe in, then blow out that breath, hard. That raised her intrathoracic pressure (the pressure in her chest, in other words) and caused--my theory--some of the vessels to collapse or become less efficient at carrying blood to her head.
She had one arm and the opposite leg go dead, one side of her face droop, and her speech go kerfuffled. That was bad enough, but then her frontal lobes decided to take a little vacation, and she started laughing and crying uncontrollably and was unable to do anything but babble incomprehensibly. All of this happened in the presence of the poor pulmonary test technician, who had no clue as to what to do.
So they sent her up to us.
At one point yesterday, a well-meaning cardiology resident suggested that she try to recreate the symptoms while having an EKG, so he could see if her problem stemmed from some sort of heart arrhythmia. It was all I could do to maintain some veneer of calm (this was near the end of the day) rather than screaming down the hall, hair afire, to tell him what a BAD IDEA this would be.
Nurse Jo: "Um...are you following Patient X?"
Cardiologist: "Yeah. What's up?"
NJ: "You realize that her Ehler's-Danlos is type IV? That she has vascular bed compromise?"
C: "Yeah..."
NJ: "Um, well, if you get her to try to get those same symptoms to show up again, it might do damage that we can't repair. I mean, she had a transient cerebral ischemia, and I'm not certain that it would resolve this time."
C: (backing away rapidly, in a metaphorical sense) "Er...well, we can have her just, er, you know, breathe deeply. I'm looking for any fib, you know?"
NJ: "Deep breathing is fine. Just don't raise her ITP, okay? I don't want to have to call for an emergent EC/IC bypass at sixteen on a Friday."
The EKG was normal, she stayed asymptomatic throughout, and she's going home today. Or, rather, back to her internships with two enviro-political groups and her life inside the Beltway.
And dear God, I wish her well.
In other news
It strikes me that I'm running out of creative cuss words that don't sound like cuss words. You can't trot down a hallway saying "Fuck fuck fuckety fuck, fuckety fuckety fuck fuck fuck" and still look professional. Therefore, I'm thinking of asking the Cute Goateed Greek Neurologist, who has a sense of humor, to teach me some really foul phrases in Greek to supplement the Danish I already use. There's also a Presentable, Dignified Russian Pulmonary Fellow who might unbend long enough to tell me what "lousy pustulous sonofabitch" is in Russian.
Next time I wanna be a hero by taking six patients and then settling in a seventh, somebody please remind me of yesterday.
I was planning a three-day drunken orgy of self-pity this weekend to celebrate The First Anniversary of the Debacle, but I'm far too cheerful to do that. Instead I think I'll wear a dress at some point and also wash my car.
Time for more coffee.
God Only Knows What Woman went home yesterday, beautiful smile and all. She's lost fifty pounds in the last few months, so moving her on to a stretcher was like lifting a kitten.
Mystery Man wrote *again*. I think this might be a record.
And Man A sent a nice note in response to a condolence email I shot off on the spur of the moment yesterday. I think this might be detente. Even if I was/am temporarily insane, it would be nice to have a long-time buddy back.
Bizarre Diseases
Into the category of Bizarre Stuff That Can Go Wrong shuffles a disease I'd only vaguely heard of before now: Ehler's-Danlos Syndrome. There are six types, all having to do with a genetically-linked problem with collagen. Type IV, or vascular EDS, is the most dangerous, as it affects the integrity of the blood vessels, both arteries and veins, and can cause ruptures and hemorrhages and other fun things it doesn't do too well to think about.
Life expectancy with EDS type IV is shortened. Appreciably. And of course, who should come in with EDS type IV but a beautiful, brilliant young woman with a loving family and a hell of a lot of potential?
Warning: Medical Detail, some of it not in English, Ahead:
She had come to us for a pulmonary function test. She'd been coughing up blood for several months, and the docs decided to see if there was some sort of major problem lurking undiscovered. Since the type of EDS she has causes blood vessel troubles, they were concerned about an aneurysm somewhere in the vascular bed of her lungs.
We talked politics and summer internships while I took her history. During her PFT, she'd had to breathe in, then blow out that breath, hard. That raised her intrathoracic pressure (the pressure in her chest, in other words) and caused--my theory--some of the vessels to collapse or become less efficient at carrying blood to her head.
She had one arm and the opposite leg go dead, one side of her face droop, and her speech go kerfuffled. That was bad enough, but then her frontal lobes decided to take a little vacation, and she started laughing and crying uncontrollably and was unable to do anything but babble incomprehensibly. All of this happened in the presence of the poor pulmonary test technician, who had no clue as to what to do.
So they sent her up to us.
At one point yesterday, a well-meaning cardiology resident suggested that she try to recreate the symptoms while having an EKG, so he could see if her problem stemmed from some sort of heart arrhythmia. It was all I could do to maintain some veneer of calm (this was near the end of the day) rather than screaming down the hall, hair afire, to tell him what a BAD IDEA this would be.
Nurse Jo: "Um...are you following Patient X?"
Cardiologist: "Yeah. What's up?"
NJ: "You realize that her Ehler's-Danlos is type IV? That she has vascular bed compromise?"
C: "Yeah..."
NJ: "Um, well, if you get her to try to get those same symptoms to show up again, it might do damage that we can't repair. I mean, she had a transient cerebral ischemia, and I'm not certain that it would resolve this time."
C: (backing away rapidly, in a metaphorical sense) "Er...well, we can have her just, er, you know, breathe deeply. I'm looking for any fib, you know?"
NJ: "Deep breathing is fine. Just don't raise her ITP, okay? I don't want to have to call for an emergent EC/IC bypass at sixteen on a Friday."
The EKG was normal, she stayed asymptomatic throughout, and she's going home today. Or, rather, back to her internships with two enviro-political groups and her life inside the Beltway.
And dear God, I wish her well.
In other news
It strikes me that I'm running out of creative cuss words that don't sound like cuss words. You can't trot down a hallway saying "Fuck fuck fuckety fuck, fuckety fuckety fuck fuck fuck" and still look professional. Therefore, I'm thinking of asking the Cute Goateed Greek Neurologist, who has a sense of humor, to teach me some really foul phrases in Greek to supplement the Danish I already use. There's also a Presentable, Dignified Russian Pulmonary Fellow who might unbend long enough to tell me what "lousy pustulous sonofabitch" is in Russian.
Next time I wanna be a hero by taking six patients and then settling in a seventh, somebody please remind me of yesterday.
I was planning a three-day drunken orgy of self-pity this weekend to celebrate The First Anniversary of the Debacle, but I'm far too cheerful to do that. Instead I think I'll wear a dress at some point and also wash my car.
Time for more coffee.
Tuesday, May 25, 2004
Insomnia, divas, personal ads, and so on
Insomnia
This is the second time in two weeks I've awakened, bright-eyed and bushy-tailed, at two o'freakin' clock in the morning. Last week it was because I had had a beer too many prior to bed and woke up when I had slept it off. This time it was because I was so tired yesterday that I went to bed entirely too early. I seem to be programmed for seven hours' sleep, no exceptions.
The sad thing about waking up this early is that there's a limited amount of stuff you can *do*. I don't watch much T.V., so that's right out--especially since I don't have cable. I suppose I could go have the weight room to myself, but there's something obscene about working out in the wee small hours. And vacuuming or moving furniture is not an option, either. Neither is, say, refinishing my kitchen table or running to the hardware store to buy a drill.
So when I'm done here, I'll probably end up doing a little book-sorting and bill-paying.
Diva
Poor Man A. He's put up that online personal ad with the headline "Passionate Man Seeks Diva". He'll probably be wondering six months from now, as he surveys the wreckage of his bank account and the chewed stumps where his limbs used to be, where he went wrong.
Divas are bad news. I know one. I used to know her quite well, but I lost her in the divorce. She was tall and beautiful and energetic--the sort of woman you expect to be a complete woman-hating man-eater until you talk to her and discover that you're wrong. Then, several months later, you discover that you were right after all.
Divas expect presents. This particular Diva (she described herself and her friends that way, so it's not like I'm being nastier than usual) would guilt the men she was dating into gifts by comparing what she'd gotten from whom. She was highly irritated that an otherwise-presentable man couldn't buy her what she wanted because he was a high-school teacher.
Divas expect to be supported. Even with a good job, they don't take as much pride in independence as they do in being able to con some poor male into subsidizing them.
Divas remove all their pubic hair as a matter of habit. I have only one example of this behavior, but I'm feeling safe in my assumption. A Diva's goal, after all, is to Land A Man...and what better way of doing it than by making him think that you're actually much more unconventional than you are?
Divas vow respect for the distaff sex and love for their own...but only on their own terms. The most dangerous group in the world is a bunch of self-described Divas in a bar. If you're not Diva material, you won't be treated badly--oh, no--but you will be subject to a makeover attempt or two. If you're intelligent and funny, but under five foot five, you'll become the Smart Funny Friend of sitcom fame. (For what it's worth, this did not bother me when I was hanging out with Diva & Co. Smart and Funny are unusual enough in their world that I was a bit of a stumper and so avoided trouble.)
Divas eat reduced-fat frozen lunches. 'Nuff said.
Personal Ad
So, obviously, Man A needs a Diva like he needs a Whipple procedure.
If I were writing his personal ad--and keep in mind I've known this man for a decade and like him pretty well, dating or not dating--I would say this:
"My friend needs a girlfriend. He's small and light-boned but strong and flexible. He does a great Reagan impersonation. He knows more about the Beatles and VW microbuses than anybody else on the planet. He's funny and smart and good with kids. He has a marvelous Dachshund. He's good with money and real estate. He cooks like a god and makes it look easy. Better, he's gainfully employed. He's not much to look at right at first, but his brains and humor make him handsome. Plus, he's got a dimple in his right cheek that only shows up in certain lights. He's not going to treat you like an idiot if you don't know how to pronounce things on the menu. He likes a woman with brains and good tits. Give the man a chance! I dated him for five months and have nothing but mad props for him."
Writing a personal ad for myself (not that I plan to) would be much more difficult. "Thuddingly Dull Nurse Seeks Non-Trollish Male" is not exactly a winner in the headline department. Though, come to think of it, it beats all hell out of "Passionate Man Seeks Diva." "Short, Vaguely Overweight Redhead Seeks Man She Can't Beat At Arm-Wrestling" is true for the first clause but not the second. "Not Afraid of Brains?" might be a good opener, since it's a qualifier both in the literal and figurative sense. "I Spend My Workdays Up To My Elbows In Other Peoples' Guts; Come On and Show Me A Good Time" is accurate but wordy.
And so on...
Warning: this will be very girly.
I ordered a truckload of clothes from Victoria's Secret. They arrived yesterday. VS has good, sturdy clothes with realistic sizing and, as long as you stay away from the slutwear, it's realistic to expect you can wear it in public as well.
The haul includes two short-sleeved knit cotton snap-front dresses, one navy and one black, a plaid linen shirt dress which may have been a mistake, three bras and two tank tops to replace ones that I wore out after three years, and a bunch of underwear of various prints. All cotton. Oh, and a pair of Dr. Scholl's high-heeled X-strap clogs that are *very* silly. Two pairs of shorts are on back-order.
I can't wear polka skirts and vintage all the time; this makes a nice change. And all of the outerwear, except for maybe the shirt dress, will go with Converse sneakers.
The look on the face of the UPS man as I opened the door was priceless. Imagine the woman you'd expect to get a large box of goods from the leading lace-bra manufacturer in the U.S. Now imagine her diametrical opposite. That's me.
It's pleasant to have more real clothes in my closet than I do scrubs. Now if I only didn't live in pajamas when not working...
Off to sort books. Anybody who wants any, let me know.
This is the second time in two weeks I've awakened, bright-eyed and bushy-tailed, at two o'freakin' clock in the morning. Last week it was because I had had a beer too many prior to bed and woke up when I had slept it off. This time it was because I was so tired yesterday that I went to bed entirely too early. I seem to be programmed for seven hours' sleep, no exceptions.
The sad thing about waking up this early is that there's a limited amount of stuff you can *do*. I don't watch much T.V., so that's right out--especially since I don't have cable. I suppose I could go have the weight room to myself, but there's something obscene about working out in the wee small hours. And vacuuming or moving furniture is not an option, either. Neither is, say, refinishing my kitchen table or running to the hardware store to buy a drill.
So when I'm done here, I'll probably end up doing a little book-sorting and bill-paying.
Diva
Poor Man A. He's put up that online personal ad with the headline "Passionate Man Seeks Diva". He'll probably be wondering six months from now, as he surveys the wreckage of his bank account and the chewed stumps where his limbs used to be, where he went wrong.
Divas are bad news. I know one. I used to know her quite well, but I lost her in the divorce. She was tall and beautiful and energetic--the sort of woman you expect to be a complete woman-hating man-eater until you talk to her and discover that you're wrong. Then, several months later, you discover that you were right after all.
Divas expect presents. This particular Diva (she described herself and her friends that way, so it's not like I'm being nastier than usual) would guilt the men she was dating into gifts by comparing what she'd gotten from whom. She was highly irritated that an otherwise-presentable man couldn't buy her what she wanted because he was a high-school teacher.
Divas expect to be supported. Even with a good job, they don't take as much pride in independence as they do in being able to con some poor male into subsidizing them.
Divas remove all their pubic hair as a matter of habit. I have only one example of this behavior, but I'm feeling safe in my assumption. A Diva's goal, after all, is to Land A Man...and what better way of doing it than by making him think that you're actually much more unconventional than you are?
Divas vow respect for the distaff sex and love for their own...but only on their own terms. The most dangerous group in the world is a bunch of self-described Divas in a bar. If you're not Diva material, you won't be treated badly--oh, no--but you will be subject to a makeover attempt or two. If you're intelligent and funny, but under five foot five, you'll become the Smart Funny Friend of sitcom fame. (For what it's worth, this did not bother me when I was hanging out with Diva & Co. Smart and Funny are unusual enough in their world that I was a bit of a stumper and so avoided trouble.)
Divas eat reduced-fat frozen lunches. 'Nuff said.
Personal Ad
So, obviously, Man A needs a Diva like he needs a Whipple procedure.
If I were writing his personal ad--and keep in mind I've known this man for a decade and like him pretty well, dating or not dating--I would say this:
"My friend needs a girlfriend. He's small and light-boned but strong and flexible. He does a great Reagan impersonation. He knows more about the Beatles and VW microbuses than anybody else on the planet. He's funny and smart and good with kids. He has a marvelous Dachshund. He's good with money and real estate. He cooks like a god and makes it look easy. Better, he's gainfully employed. He's not much to look at right at first, but his brains and humor make him handsome. Plus, he's got a dimple in his right cheek that only shows up in certain lights. He's not going to treat you like an idiot if you don't know how to pronounce things on the menu. He likes a woman with brains and good tits. Give the man a chance! I dated him for five months and have nothing but mad props for him."
Writing a personal ad for myself (not that I plan to) would be much more difficult. "Thuddingly Dull Nurse Seeks Non-Trollish Male" is not exactly a winner in the headline department. Though, come to think of it, it beats all hell out of "Passionate Man Seeks Diva." "Short, Vaguely Overweight Redhead Seeks Man She Can't Beat At Arm-Wrestling" is true for the first clause but not the second. "Not Afraid of Brains?" might be a good opener, since it's a qualifier both in the literal and figurative sense. "I Spend My Workdays Up To My Elbows In Other Peoples' Guts; Come On and Show Me A Good Time" is accurate but wordy.
And so on...
Warning: this will be very girly.
I ordered a truckload of clothes from Victoria's Secret. They arrived yesterday. VS has good, sturdy clothes with realistic sizing and, as long as you stay away from the slutwear, it's realistic to expect you can wear it in public as well.
The haul includes two short-sleeved knit cotton snap-front dresses, one navy and one black, a plaid linen shirt dress which may have been a mistake, three bras and two tank tops to replace ones that I wore out after three years, and a bunch of underwear of various prints. All cotton. Oh, and a pair of Dr. Scholl's high-heeled X-strap clogs that are *very* silly. Two pairs of shorts are on back-order.
I can't wear polka skirts and vintage all the time; this makes a nice change. And all of the outerwear, except for maybe the shirt dress, will go with Converse sneakers.
The look on the face of the UPS man as I opened the door was priceless. Imagine the woman you'd expect to get a large box of goods from the leading lace-bra manufacturer in the U.S. Now imagine her diametrical opposite. That's me.
It's pleasant to have more real clothes in my closet than I do scrubs. Now if I only didn't live in pajamas when not working...
Off to sort books. Anybody who wants any, let me know.
Monday, May 24, 2004
This page intentionally left blank.
Random nibblets from the last week:
I got an email from Man A. and was surprised at how visceral my reaction was. It's a shock when your palms start to sweat, even though your brain stays calm. Luckily, it was a mass email about the draft starting in 2005, taken from an independent Vancouver weekly.
Man A. has also put up a personal ad on the Net. I found it last night by chance and couldn't decide whether to laugh or barf. After laughing for several minutes, I decided that I'd made up my mind. It's almost impossible, no matter how nice you are, to write a truthful personal ad and not come out looking like a complete prat.
Thanks to E. for the word "prat".
Speaking of E., the world's most compulsive matchmaker...
Mystery Man, the person E. wanted me to meet via email, actually emailed.
(pause for gasps of disbelief)
He sounds interesting. And paradoxically courageous. It's easy to be frightened and whistle in the dark as compensation; it's harder to admit that you're that dented can of green beans and keep on going anyhow.
Now the hard part starts
The woman with God Only Knows What had a decent day yesterday. She had almost four hours of only coarse tremors of her head, legs, and arms, with no spasms.
Then the spasms started, when she wasn't distracted, and after she and her husband and I had been talking about her prognosis and her drugs.
She asked me, in the midst of a spasm that made the musculature of her neck stand out like a dissection, "Will this ever get better? Will I ever be able to *do* anything again?"
The answer I gave her was yes and yes. What else could I say? That she'll probably return to some level of functioning with careful medical management and a load of expensive and wacky drugs? That she won't be able to maintain that level for long, and eventually her brain's going to start to go? That's the truth, but it's too ugly. Hell, it's too ugly to even think, let alone say.
The beauty of CJD (not the variant that comes from beef with screwy prions, but the ordinary sort that hits humans in their late 60's or 70's) is that the patients seem unaware of what's happening to them. They get distant. They'll still respond appropriately to you, and to their family members, but there's a sort of curtain there that they can't and don't want to break through.
By the time their limbs start contracting and their pupils stop, there isn't much higher brain function left. It's as though the person has been de-souled.
Cut me some slack here
Patients with traumatic brain injury who will never walk or talk or feed themselves again and who lie, their limbs contracting into the fetal position, in air beds, nonetheless are *home*. You can look in their eyes, no matter how severe the damage is, and see *something* human.
People in the last stages of CJD don't have that behind their eyes. It's as though someone has come in and pithed them, like a frog, removing whatever it was that made them them...and worse, removing whatever it is that gives them a sense of commonality with other people.
It's frightening. Not can-of-beans frightening, or avoid-a-wreck frightening, but deeply and darkly scary.
I was talking to a fourth-year resident about a CJD patient I'd had and said what I said in those two long paragraphs above, thinking that he'd laugh and give me some sort of mechanical explanation for what I was seeing and feeling.
He agreed with me.
So back to reality
So my patient with the undiagnosed illness can be seen as being blessed by having an intact brain. Or cursed with the same thing. There won't be any quiet retreat into apathy for her until much, much later. She'll be aware of what's happening most of the way down the path.
Whether this is a good thing is not my call.
Much, much lighter
My current favorite T-shirt is the one I'm wearing right now: baby-cut, with a wide neck and a drawing of two cartoonish semi-robots. The logo is "Robots like Brave Combo too." One of the robots has an artichoke on his head. It was the artichoke that decided me. Robots and artichokes: what more could you ask?
I realized last night on the drive home that even if I were driving the only car on the highway for, like, fifty miles, I would still check my blind spot before changing lanes. I don't know what this says.
My beloved sister sent me a box of Anne Taintor treasures the other day. If you don't know who Anne Taintor is, I would suggest typing annetaintor.com into your location bar and checking her work out.
I got an email from Man A. and was surprised at how visceral my reaction was. It's a shock when your palms start to sweat, even though your brain stays calm. Luckily, it was a mass email about the draft starting in 2005, taken from an independent Vancouver weekly.
Man A. has also put up a personal ad on the Net. I found it last night by chance and couldn't decide whether to laugh or barf. After laughing for several minutes, I decided that I'd made up my mind. It's almost impossible, no matter how nice you are, to write a truthful personal ad and not come out looking like a complete prat.
Thanks to E. for the word "prat".
Speaking of E., the world's most compulsive matchmaker...
Mystery Man, the person E. wanted me to meet via email, actually emailed.
(pause for gasps of disbelief)
He sounds interesting. And paradoxically courageous. It's easy to be frightened and whistle in the dark as compensation; it's harder to admit that you're that dented can of green beans and keep on going anyhow.
Now the hard part starts
The woman with God Only Knows What had a decent day yesterday. She had almost four hours of only coarse tremors of her head, legs, and arms, with no spasms.
Then the spasms started, when she wasn't distracted, and after she and her husband and I had been talking about her prognosis and her drugs.
She asked me, in the midst of a spasm that made the musculature of her neck stand out like a dissection, "Will this ever get better? Will I ever be able to *do* anything again?"
The answer I gave her was yes and yes. What else could I say? That she'll probably return to some level of functioning with careful medical management and a load of expensive and wacky drugs? That she won't be able to maintain that level for long, and eventually her brain's going to start to go? That's the truth, but it's too ugly. Hell, it's too ugly to even think, let alone say.
The beauty of CJD (not the variant that comes from beef with screwy prions, but the ordinary sort that hits humans in their late 60's or 70's) is that the patients seem unaware of what's happening to them. They get distant. They'll still respond appropriately to you, and to their family members, but there's a sort of curtain there that they can't and don't want to break through.
By the time their limbs start contracting and their pupils stop, there isn't much higher brain function left. It's as though the person has been de-souled.
Cut me some slack here
Patients with traumatic brain injury who will never walk or talk or feed themselves again and who lie, their limbs contracting into the fetal position, in air beds, nonetheless are *home*. You can look in their eyes, no matter how severe the damage is, and see *something* human.
People in the last stages of CJD don't have that behind their eyes. It's as though someone has come in and pithed them, like a frog, removing whatever it was that made them them...and worse, removing whatever it is that gives them a sense of commonality with other people.
It's frightening. Not can-of-beans frightening, or avoid-a-wreck frightening, but deeply and darkly scary.
I was talking to a fourth-year resident about a CJD patient I'd had and said what I said in those two long paragraphs above, thinking that he'd laugh and give me some sort of mechanical explanation for what I was seeing and feeling.
He agreed with me.
So back to reality
So my patient with the undiagnosed illness can be seen as being blessed by having an intact brain. Or cursed with the same thing. There won't be any quiet retreat into apathy for her until much, much later. She'll be aware of what's happening most of the way down the path.
Whether this is a good thing is not my call.
Much, much lighter
My current favorite T-shirt is the one I'm wearing right now: baby-cut, with a wide neck and a drawing of two cartoonish semi-robots. The logo is "Robots like Brave Combo too." One of the robots has an artichoke on his head. It was the artichoke that decided me. Robots and artichokes: what more could you ask?
I realized last night on the drive home that even if I were driving the only car on the highway for, like, fifty miles, I would still check my blind spot before changing lanes. I don't know what this says.
My beloved sister sent me a box of Anne Taintor treasures the other day. If you don't know who Anne Taintor is, I would suggest typing annetaintor.com into your location bar and checking her work out.
Saturday, May 22, 2004
Another one will bite the dust, but God only knows why.
As if two cases of CJD in six weeks weren't enough, today I had a patient who has something. We don't really know what it is. Current ideas range from something called OPCA (olivoponto cerebellar atrophy, and don't ask, because I Googled it and *still* don't understand it) to various metabolic disorders that only hit in mid-adulthood.
More than likely, we'll get a diagnosis on autopsy. That's how these things normally work.
I'm betting against CJD. Well, only sixty percent against at the moment. People with CJD have a sort of distance and flatness that this woman doesn't have. She's right there with you the whole time you're talking to her, she doesn't hallucinate. All she does is shake. And tremor. And occasionally spasm, her thigh muscles becoming rock-hard in half-second bursts. Her pupils are dilated and she has gaze deficits. She loves her poodle and her bulldog and her cat who takes over the seat of the wheelchair whenever she's not in it.
She's been all over God's green acre trying to get a diagnosis with no luck so far. I doubt we'll be able to do more. I mean, hell, if Mayo can't figure it out, the only way we'll be able to is because her disease has progressed to the point where we could find something with a biopsy.
This is when the job gets frustrating. This is when it gets scary. And this is when the sight of a person whose brain is deteriorating can make you bitter and resentful.
But when her eyes opened wide on my face and she laughed or smiled, I felt glad that she was still in there and that I was able to hang out with her.
So I make lists on the way home of things I like, things I'd like to do, things I'm grateful for. My time off got approved today, so I'll be heading to Canada to see friend Joey during the hottest part of the summer. I had good fried rice for lunch. Our weather has been better lately than Ohio's. My car is still running. My dishwasher works. My cat is healthy and as crazy as ever. I found a pair of texturing shears at the beauty supply store and didn't ruin my hair with them. My cup overfloweth.
But at the same time...I'd really, really like to know what's wrong with her.
More than likely, we'll get a diagnosis on autopsy. That's how these things normally work.
I'm betting against CJD. Well, only sixty percent against at the moment. People with CJD have a sort of distance and flatness that this woman doesn't have. She's right there with you the whole time you're talking to her, she doesn't hallucinate. All she does is shake. And tremor. And occasionally spasm, her thigh muscles becoming rock-hard in half-second bursts. Her pupils are dilated and she has gaze deficits. She loves her poodle and her bulldog and her cat who takes over the seat of the wheelchair whenever she's not in it.
She's been all over God's green acre trying to get a diagnosis with no luck so far. I doubt we'll be able to do more. I mean, hell, if Mayo can't figure it out, the only way we'll be able to is because her disease has progressed to the point where we could find something with a biopsy.
This is when the job gets frustrating. This is when it gets scary. And this is when the sight of a person whose brain is deteriorating can make you bitter and resentful.
But when her eyes opened wide on my face and she laughed or smiled, I felt glad that she was still in there and that I was able to hang out with her.
So I make lists on the way home of things I like, things I'd like to do, things I'm grateful for. My time off got approved today, so I'll be heading to Canada to see friend Joey during the hottest part of the summer. I had good fried rice for lunch. Our weather has been better lately than Ohio's. My car is still running. My dishwasher works. My cat is healthy and as crazy as ever. I found a pair of texturing shears at the beauty supply store and didn't ruin my hair with them. My cup overfloweth.
But at the same time...I'd really, really like to know what's wrong with her.
Friday, May 21, 2004
I is a collidge grajuit. I swear.
There is nothing worse (okay, there is something worse) than having someone pass on your blog address to another person by way of introduction, before you discover a glaring subject/verb agreement problem. I am, of course, talking about E The Matchmaker and Mystery Man.
The problem has been corrected (thank God for edits) and from what E says, he didn't scream and stab his eyes out with a fork when he read it.
Which means he's either illiterate or forgiving.
The Weekly Case Study
In other news, I'd like to tell you about an interesting case that came some time ago.
Several weeks ago, we had a patient come in who had broken her neck somehow. God only knows how she'd managed it; her stories ranged from "my boyfriend hit me" to "I fell getting out of bed." Getting a clear story out of her family was impossible. They were obviously frightened of her outbursts and wouldn't talk about what happened.
Anyhow. Hysterical Woman had surgery, made it through the recovery period, and was discharged home in a C-collar and with medication, with instructions to follow up in two weeks.
You can see where this is going, right? After all, when you're dealing with a person who screams bloody murder all the way down the hall on the way to surgery, takes swings at people, refuses to cooperate with assessments, and calls nurses "bitch", it can't be simple.
And it wasn't. About two weeks after surgery, just before the office appointment that would've cleared her to go back to her normal activities, she showed up at our affiliated hospital's emergency room. The story was that her boyfriend had hit her, knocked her down, and she had no feeling or movement below the waist.
Now...that's difficult, but not impossible, to accomplish. Cervical operations with instrumentation result in a stronger structure than was there prior to surgery. I mean, you've got titanium whatsits in there and screws and so on.
Plus, the spinal cord is a nice, logical thing. Hurt it up high and your deficits will start up high. Hurt it down low and your deficits will start low. It's not unheard-of for a high injury to result in normal function of arms and hands and paralysis of the legs, but it's...well. It's unusual.
Besides *that*, this woman's legs moved of a piece with the rest of her body when we turned her. That and her Babinski reflex was as it should've been (that's that irritating test in which the doctor or nurse scrapes a fingernail down the sole of your foot, hard, to watch what your toes do). When somebody's actually paralyzed or dealing with a spinal cord injury of some magnitude, their Babinski is all messed-up and their legs don't move with 'em when you roll 'em.
Doctor came in, residents came in, they looked her over, they pronounced:
Hysterical Paralysis.
I could see that. Really. And I get irritated by diagnoses that presume a psychological cause for a physical disorder without first ruling out physical causes. But this woman was a piece of work from the great fiery beyond. Normally I can find something to like about every patient I care for. This time I couldn't.
Which made me wonder what on earth would drive a person to act like this. I have an insane ex-mother-in-law who, on various occasions before and during my marriage, threatened to kill me, kill herself, cut us off completely (please! Please!) and ruin our lives. This patient was easily an order of magnitude worse. At least Crazy Ex-MIL could put on a veneer of appropriate behavior when the occasion demanded; this patient was past all of that.
What causes that sort of craziness? What makes people ambush themselves at every turn? How come some of us turn out nuts and some of us turn out okay? Is there a possibility that every sane person could turn wacko, and vice-versa? Does the person who's wacko realize they're like they are, or is everything enslaved to their view of the universe?
I wonder these things sometimes.
The problem has been corrected (thank God for edits) and from what E says, he didn't scream and stab his eyes out with a fork when he read it.
Which means he's either illiterate or forgiving.
The Weekly Case Study
In other news, I'd like to tell you about an interesting case that came some time ago.
Several weeks ago, we had a patient come in who had broken her neck somehow. God only knows how she'd managed it; her stories ranged from "my boyfriend hit me" to "I fell getting out of bed." Getting a clear story out of her family was impossible. They were obviously frightened of her outbursts and wouldn't talk about what happened.
Anyhow. Hysterical Woman had surgery, made it through the recovery period, and was discharged home in a C-collar and with medication, with instructions to follow up in two weeks.
You can see where this is going, right? After all, when you're dealing with a person who screams bloody murder all the way down the hall on the way to surgery, takes swings at people, refuses to cooperate with assessments, and calls nurses "bitch", it can't be simple.
And it wasn't. About two weeks after surgery, just before the office appointment that would've cleared her to go back to her normal activities, she showed up at our affiliated hospital's emergency room. The story was that her boyfriend had hit her, knocked her down, and she had no feeling or movement below the waist.
Now...that's difficult, but not impossible, to accomplish. Cervical operations with instrumentation result in a stronger structure than was there prior to surgery. I mean, you've got titanium whatsits in there and screws and so on.
Plus, the spinal cord is a nice, logical thing. Hurt it up high and your deficits will start up high. Hurt it down low and your deficits will start low. It's not unheard-of for a high injury to result in normal function of arms and hands and paralysis of the legs, but it's...well. It's unusual.
Besides *that*, this woman's legs moved of a piece with the rest of her body when we turned her. That and her Babinski reflex was as it should've been (that's that irritating test in which the doctor or nurse scrapes a fingernail down the sole of your foot, hard, to watch what your toes do). When somebody's actually paralyzed or dealing with a spinal cord injury of some magnitude, their Babinski is all messed-up and their legs don't move with 'em when you roll 'em.
Doctor came in, residents came in, they looked her over, they pronounced:
Hysterical Paralysis.
I could see that. Really. And I get irritated by diagnoses that presume a psychological cause for a physical disorder without first ruling out physical causes. But this woman was a piece of work from the great fiery beyond. Normally I can find something to like about every patient I care for. This time I couldn't.
Which made me wonder what on earth would drive a person to act like this. I have an insane ex-mother-in-law who, on various occasions before and during my marriage, threatened to kill me, kill herself, cut us off completely (please! Please!) and ruin our lives. This patient was easily an order of magnitude worse. At least Crazy Ex-MIL could put on a veneer of appropriate behavior when the occasion demanded; this patient was past all of that.
What causes that sort of craziness? What makes people ambush themselves at every turn? How come some of us turn out nuts and some of us turn out okay? Is there a possibility that every sane person could turn wacko, and vice-versa? Does the person who's wacko realize they're like they are, or is everything enslaved to their view of the universe?
I wonder these things sometimes.
Thursday, May 20, 2004
Oh, for the love of Mike.
Most decidedly not about work.
Yes, yes, I know this is my third entry in one day.
My friend E, one of those online friends that I've not yet met, wants to introduce me to a friend of *hers* via email.
Now, then. I don't know how compulsive a matchmaker E is, but I have to wonder. She's never seen me, never talked to me on the phone; all she knows of me comes from some online transactions we've made (she has the coolest business in the world) and our participation on a childfree-themed message board. She knows I have red hair and a large butt. She knows I'm a nurse and that I have an insane cat.
Apparently, this is enough to make her want to offer up a friend of hers as some sort of sacrificial victim.
Dirt.
I am divorced. I am thirty-four years old. I lived with the same person from the time I was twenty-one until I was thirty-three. The entirety of my adult life, therefore, was built around one other person (well, two--my husband and my best pal) until he decided to trade me in on a new model (the best pal).
It was like getting hit with a truck. Twice.
In the six weeks after I left, I got asked out eight times and propositioned twice by patients or patients' family members. The joke around work was that only the neurologically non-intact would look twice at me. The extension of the joke was that anybody who told me I looked nice or was pretty warranted a stat MRI to look for a tumor. The people who decided I was most attractive when I was flailing to stay afloat were emotional remoras, but still. The lesson stuck.
The point of this is...
...that I'm the human version of the dented can of green beans on the shelf at the dollar store. Most of the time I feel okay. Sometimes, like the last few days, I feel damaged and old, a pre-owned person.
What on earth would E be thinking? What in hell?
Reading her email about her friend was enough to make me put down the cup of coffee I'd just made and open a beer instead.
The fear is not that I'm damaged goods. The fear is that somehow I might be the person she sees--funny, talented, smart, kind, and deserving--and that I might have to live up to that.
Yes, yes, I know this is my third entry in one day.
My friend E, one of those online friends that I've not yet met, wants to introduce me to a friend of *hers* via email.
Now, then. I don't know how compulsive a matchmaker E is, but I have to wonder. She's never seen me, never talked to me on the phone; all she knows of me comes from some online transactions we've made (she has the coolest business in the world) and our participation on a childfree-themed message board. She knows I have red hair and a large butt. She knows I'm a nurse and that I have an insane cat.
Apparently, this is enough to make her want to offer up a friend of hers as some sort of sacrificial victim.
Dirt.
I am divorced. I am thirty-four years old. I lived with the same person from the time I was twenty-one until I was thirty-three. The entirety of my adult life, therefore, was built around one other person (well, two--my husband and my best pal) until he decided to trade me in on a new model (the best pal).
It was like getting hit with a truck. Twice.
In the six weeks after I left, I got asked out eight times and propositioned twice by patients or patients' family members. The joke around work was that only the neurologically non-intact would look twice at me. The extension of the joke was that anybody who told me I looked nice or was pretty warranted a stat MRI to look for a tumor. The people who decided I was most attractive when I was flailing to stay afloat were emotional remoras, but still. The lesson stuck.
The point of this is...
...that I'm the human version of the dented can of green beans on the shelf at the dollar store. Most of the time I feel okay. Sometimes, like the last few days, I feel damaged and old, a pre-owned person.
What on earth would E be thinking? What in hell?
Reading her email about her friend was enough to make me put down the cup of coffee I'd just made and open a beer instead.
The fear is not that I'm damaged goods. The fear is that somehow I might be the person she sees--funny, talented, smart, kind, and deserving--and that I might have to live up to that.
Things nobody tells you, but really ought to.
In honor of Nasty, Brutish, and Short Day (that being my temper at the moment), here is a list of things nobody tells you, but really ought to.
1. Dansko and Birkenstock have their excellent reputations as work shoes not by chance, but by design. Go ahead and spend the rent on clogs; your feet will be thrilled. Nursemates, Candies, and other lesser brands are recommended only by podiatrists with boat payments to make.
2. Any budget that passes a hospital review board must include ridiculous cuts in differentials and holidays. Therefore, cheer not before you read the fine print.
3. If your spouse leaves you for another person, you will be angry for a long time. Not kick-ass angry, not drive-fast angry, but angry to the point where all love song lyrics sound bitter and vengeful. Angry to the point of contemplating the purchase of a sledgehammer. Angry to the point that you review, every few months, the ways in which you still hold your ex-spouse's balls (figuratively) in your hands. Angry in such a way that you will wait years, if necessary, for the one fleeting opportunity to fuck up his or her life beyond recognition.
4. Most of the time, though, after the first few months, you won't be angry. It'll just surprise you now and then, when it comes.
5. Sixteen pounds of hand weights is more in the bag when you're hauling it upstairs than when you were lifting them earlier.
6. Puppies are good mojo for almost anything that ails you.
7. The difficulty you will have with any medical equipment is directly proportional to the status of the patient on whom it is being used.
8. The amount of feces in a patient's bowels is inversely proportional to their level of consciousness and geometrically inversely proportional to their level of orientation.
9. Tincture of benzoin will never come out of white fabric. Don't even try.
10. A shopping spree at Target may not mend all wounds, but it sure will make you feel better. Combined with a puppy encounter, it's almost unbeatable.
1. Dansko and Birkenstock have their excellent reputations as work shoes not by chance, but by design. Go ahead and spend the rent on clogs; your feet will be thrilled. Nursemates, Candies, and other lesser brands are recommended only by podiatrists with boat payments to make.
2. Any budget that passes a hospital review board must include ridiculous cuts in differentials and holidays. Therefore, cheer not before you read the fine print.
3. If your spouse leaves you for another person, you will be angry for a long time. Not kick-ass angry, not drive-fast angry, but angry to the point where all love song lyrics sound bitter and vengeful. Angry to the point of contemplating the purchase of a sledgehammer. Angry to the point that you review, every few months, the ways in which you still hold your ex-spouse's balls (figuratively) in your hands. Angry in such a way that you will wait years, if necessary, for the one fleeting opportunity to fuck up his or her life beyond recognition.
4. Most of the time, though, after the first few months, you won't be angry. It'll just surprise you now and then, when it comes.
5. Sixteen pounds of hand weights is more in the bag when you're hauling it upstairs than when you were lifting them earlier.
6. Puppies are good mojo for almost anything that ails you.
7. The difficulty you will have with any medical equipment is directly proportional to the status of the patient on whom it is being used.
8. The amount of feces in a patient's bowels is inversely proportional to their level of consciousness and geometrically inversely proportional to their level of orientation.
9. Tincture of benzoin will never come out of white fabric. Don't even try.
10. A shopping spree at Target may not mend all wounds, but it sure will make you feel better. Combined with a puppy encounter, it's almost unbeatable.
Knackered, buggered, and jacked-up.
Here's a new one for the Life's Little Ironies column:
A soldier goes to a combat zone for a year. He returns unscathed. Two months later, he's riding his motorcycle to work and clips a car that's been left parked in the middle of an off-ramp with no lights, no blinkers, no nothin'. This is in a city which routinely leaves large areas of the highways unlit in an attempt to save money.
So the poor bastich degloves most of his right arm (don't ask; you really don't want to know) while breaking a bone, breaks a major artery in said arm, breaks two toes, slices his nose open, and generally gets screwed up. Luckily for everybody, his head and its contents are undamaged.
He's been my patient for the last few days. You know you're doing good work when a patient and his family--which includes nurses--ask for you by name.
In other knackered knews, I forgot to write closing notes on not one but all of my patients yesterday. Let's hope none of 'em decide to sue me, eh?
The hospital, speaking of buggered, is being bought by the medical school that supplies our residents and attendings. We (the hospital staff) found out about this via an article in the newspaper last week.
This peeves me. Last year at about this time, the hospital board brought in a consulting group to help us cut costs and streamline operations. The general rule with medical consulting groups is that every decision they make, without fail, is a bad one. All recommendations will be ridiculous, and a good portion of them will be dangerous. This is because consulting groups are not made up of people who have hauled patients, cleaned rooms, or taken care of sick people. They're made up of rich fat white guys with names like Woodall McPherson the Third.
We dealt with it. We dealt with seeing our old friends--support staff who'd worked for the hospital since its opening--fired to make room for newer, cheaper employees. We handled losing most of our transportation staff on the grounds that (according to the consulting group) it made more fiscal sense to have a nurse leave five of her patients to transport a sixth rather than paying somebody else one-third the money to do it for her. We handled increased patient loads, not a small thing when the unit you're working on is more like progressive care than medical-surgical.
We're even continuing to deal, as best we can, with the fact that our supply room--the place that stockpiles urinals, catheters, toothbrushes, and other necessities of life--has moved two miles away into a different facility.
*Now* we find out, along with everybody else who reads the paper, that we're being bought and consolidated with another hospital. In a few years we'll be losing our building and moving elsewhere. In the meantime, God only knows what changes will be on tap. State institutions are notorious for funding research (good) and not funding basic needs (very very bad). They're good about benefits and holidays and crappy about paying market wages. We're probably going to get even more layers of bureaucracy and bullshit. Given that the management currently is made up of very nice people who turn into bellicose tin tyrants the minute they punch in, I am not hopeful.
This hospital is probably the best place to work in the area. I love my job. I don't plan to leave unless they call security to escort me out the door. I've seen things here that you don't even read about in textbooks. I've taken care of patients who'll have research papers written about them because they're the first person, ever, to have X happen to 'em.
But I dread what's coming. Maybe it'll all work out. More likely, though, it'll be another year of layoffs, cutbacks, increased loads, lowered supply pars, and general jacked-up-ness.
*sigh*
A soldier goes to a combat zone for a year. He returns unscathed. Two months later, he's riding his motorcycle to work and clips a car that's been left parked in the middle of an off-ramp with no lights, no blinkers, no nothin'. This is in a city which routinely leaves large areas of the highways unlit in an attempt to save money.
So the poor bastich degloves most of his right arm (don't ask; you really don't want to know) while breaking a bone, breaks a major artery in said arm, breaks two toes, slices his nose open, and generally gets screwed up. Luckily for everybody, his head and its contents are undamaged.
He's been my patient for the last few days. You know you're doing good work when a patient and his family--which includes nurses--ask for you by name.
In other knackered knews, I forgot to write closing notes on not one but all of my patients yesterday. Let's hope none of 'em decide to sue me, eh?
The hospital, speaking of buggered, is being bought by the medical school that supplies our residents and attendings. We (the hospital staff) found out about this via an article in the newspaper last week.
This peeves me. Last year at about this time, the hospital board brought in a consulting group to help us cut costs and streamline operations. The general rule with medical consulting groups is that every decision they make, without fail, is a bad one. All recommendations will be ridiculous, and a good portion of them will be dangerous. This is because consulting groups are not made up of people who have hauled patients, cleaned rooms, or taken care of sick people. They're made up of rich fat white guys with names like Woodall McPherson the Third.
We dealt with it. We dealt with seeing our old friends--support staff who'd worked for the hospital since its opening--fired to make room for newer, cheaper employees. We handled losing most of our transportation staff on the grounds that (according to the consulting group) it made more fiscal sense to have a nurse leave five of her patients to transport a sixth rather than paying somebody else one-third the money to do it for her. We handled increased patient loads, not a small thing when the unit you're working on is more like progressive care than medical-surgical.
We're even continuing to deal, as best we can, with the fact that our supply room--the place that stockpiles urinals, catheters, toothbrushes, and other necessities of life--has moved two miles away into a different facility.
*Now* we find out, along with everybody else who reads the paper, that we're being bought and consolidated with another hospital. In a few years we'll be losing our building and moving elsewhere. In the meantime, God only knows what changes will be on tap. State institutions are notorious for funding research (good) and not funding basic needs (very very bad). They're good about benefits and holidays and crappy about paying market wages. We're probably going to get even more layers of bureaucracy and bullshit. Given that the management currently is made up of very nice people who turn into bellicose tin tyrants the minute they punch in, I am not hopeful.
This hospital is probably the best place to work in the area. I love my job. I don't plan to leave unless they call security to escort me out the door. I've seen things here that you don't even read about in textbooks. I've taken care of patients who'll have research papers written about them because they're the first person, ever, to have X happen to 'em.
But I dread what's coming. Maybe it'll all work out. More likely, though, it'll be another year of layoffs, cutbacks, increased loads, lowered supply pars, and general jacked-up-ness.
*sigh*
Tuesday, May 18, 2004
Irony.
Irony is feeling wide-awake and looking forward to going to work, then getting a call that you're cancelled until 11 a.m.
We (the full-time nurses, as opposed to the 3/4 time nurses) get cancelled on a rotating basis to save money. What this means in real terms is that we get called at the last minute and told to stay home, then the four (or eight, or twelve) hours that we don't work get reimbursed through our paid time-off fund.
So the hospital isn't saving any money, and they're not reducing overtime, but it makes them feel good. And it gives us extra time at home to do things like wash dishes and fulminate.
Fulmination
Is it a bad sign that neither of the men I've left in the last year have shown even the slightest interest in getting me to stay? (My tongue is firmly in cheek, here.) Man A. has a blog, which I read now and then. His last entry said nothing about how the most gorgeous, talented, intelligent, funny woman he'd ever met had walked out on him, but did mention his online flirtation in the first sentence.
This (and here the tongue comes out of the cheek, because I'm serious) is something I'm glad I read. For one, it reinforces that I made the right call in cutting him loose. This other person must be really something. For another, reading it made those "Species"-like spikes sprout out of my back again...and that reinforces that I was right to cut him loose. I'd like to take the word "possessive" and tie a brick 'round its neck and drown it, but that's not happened yet. Until it does, I have *no* business dating.
Which leads me to...
Desperation
Maybe it's because I've hit my mid-thirties, or maybe it's because I've already done the white dress/trot down the aisle thing, but I don't understand the fascination women my age and younger have with Getting Married.
I have an acquaintance who was nuts to Get Married. It didn't seem to matter to whom; she dated with an eye to Getting Married. She dated multiple men with an eye to Getting Married, as a matter of fact. Desperately. Searchingly. Beseechingly, in a couple of cases.
And she got what she wanted, I guess: a mutual pal told me she now has a rock on her left hand the size of a birdbath. *shrug* I hope to hell she's happy--she'll Be Married in a few months, and much good may it do the both of them.
I read blogs by women younger than me that talk about finding somebody to marry. Hell, these women talk (I hope jokingly) about not putting out until they have some sort of sign of commitment.
Which is all alien to me. Oh, I can understand the fear of loneliness--that hits me sometimes, and not always in the middle of the night. I can understand that some women want children really badly, and want to raise them well. But I cannot for the life of me understand the attitude that My Life Hasn't Begun Yet And Won't Until I'm Picking Out Cocktail Napkins For The Reception.
Because what do you do after the wedding? There you are, tied to this person for the rest of your life, short of death or an expensive legal process, and you find that your life is just the damn same as it was before, but with more laundry and more complicated tax forms. Do you then decide that life will start when you Have A Baby or Buy A Hummer or Go On A Cruise?
No, thanks.
My life is what it is. My life is what I live. Boyfriend or not, married or not, alone or not, this is it. It ain't *starting* in a few weeks or months; it's already *here*. I refuse to have some sort of moving target that I have to hit to have a life.
I won't deny that it's sweet, sweet to feel the weight of someone else's arm across your waist in the middle of the night, or to share inside jokes, or to bring them chicken soup when they're feeling bad. But that's not all that a relationship--of any sort--is about, and your life isn't on hold if you're not doing that.
You can always bring yourself chicken soup, after all. And it's awfully nice to be able to spread out on the bed.
Oh, and one last thing...
Something friend Michael said the other week:
"It's not the amount of baggage you carry. It's how well you have it packed."
We (the full-time nurses, as opposed to the 3/4 time nurses) get cancelled on a rotating basis to save money. What this means in real terms is that we get called at the last minute and told to stay home, then the four (or eight, or twelve) hours that we don't work get reimbursed through our paid time-off fund.
So the hospital isn't saving any money, and they're not reducing overtime, but it makes them feel good. And it gives us extra time at home to do things like wash dishes and fulminate.
Fulmination
Is it a bad sign that neither of the men I've left in the last year have shown even the slightest interest in getting me to stay? (My tongue is firmly in cheek, here.) Man A. has a blog, which I read now and then. His last entry said nothing about how the most gorgeous, talented, intelligent, funny woman he'd ever met had walked out on him, but did mention his online flirtation in the first sentence.
This (and here the tongue comes out of the cheek, because I'm serious) is something I'm glad I read. For one, it reinforces that I made the right call in cutting him loose. This other person must be really something. For another, reading it made those "Species"-like spikes sprout out of my back again...and that reinforces that I was right to cut him loose. I'd like to take the word "possessive" and tie a brick 'round its neck and drown it, but that's not happened yet. Until it does, I have *no* business dating.
Which leads me to...
Desperation
Maybe it's because I've hit my mid-thirties, or maybe it's because I've already done the white dress/trot down the aisle thing, but I don't understand the fascination women my age and younger have with Getting Married.
I have an acquaintance who was nuts to Get Married. It didn't seem to matter to whom; she dated with an eye to Getting Married. She dated multiple men with an eye to Getting Married, as a matter of fact. Desperately. Searchingly. Beseechingly, in a couple of cases.
And she got what she wanted, I guess: a mutual pal told me she now has a rock on her left hand the size of a birdbath. *shrug* I hope to hell she's happy--she'll Be Married in a few months, and much good may it do the both of them.
I read blogs by women younger than me that talk about finding somebody to marry. Hell, these women talk (I hope jokingly) about not putting out until they have some sort of sign of commitment.
Which is all alien to me. Oh, I can understand the fear of loneliness--that hits me sometimes, and not always in the middle of the night. I can understand that some women want children really badly, and want to raise them well. But I cannot for the life of me understand the attitude that My Life Hasn't Begun Yet And Won't Until I'm Picking Out Cocktail Napkins For The Reception.
Because what do you do after the wedding? There you are, tied to this person for the rest of your life, short of death or an expensive legal process, and you find that your life is just the damn same as it was before, but with more laundry and more complicated tax forms. Do you then decide that life will start when you Have A Baby or Buy A Hummer or Go On A Cruise?
No, thanks.
My life is what it is. My life is what I live. Boyfriend or not, married or not, alone or not, this is it. It ain't *starting* in a few weeks or months; it's already *here*. I refuse to have some sort of moving target that I have to hit to have a life.
I won't deny that it's sweet, sweet to feel the weight of someone else's arm across your waist in the middle of the night, or to share inside jokes, or to bring them chicken soup when they're feeling bad. But that's not all that a relationship--of any sort--is about, and your life isn't on hold if you're not doing that.
You can always bring yourself chicken soup, after all. And it's awfully nice to be able to spread out on the bed.
Oh, and one last thing...
Something friend Michael said the other week:
"It's not the amount of baggage you carry. It's how well you have it packed."
Monday, May 17, 2004
Summer comes in with a whack
Summer is here.
It's supposed to be 87* here tomorrow, which, given the humidity of the past few days, will feel ten degrees warmer. I am not looking forward to driving back from the city in that.
But summer means it's time to lie on the couch in your underwear--or, if you're lucky enough to have a friend out in the country, to lie naked on the porch--drinking white wine or a good dry pale ale. It's time to read the Brother Cadfael books that take place during the mild and green summers of the twelfth century. It's time to wear the absolute bare minimum of clothes. It's time to dispense with sunscreen, sunburn and melanoma be damned, because it's just too damned hot.
By August I'll be sick of it, praying for winter. But now, I can look back on June nights when the Erstwhile Hub and I had just met and we slept and made love on his porch in the middle of nowhere, in air that was the temperature of blood. Now I can imagine going to one of the rivers that cut through the middle of the state and bathing in cold spring water with the sun beating down on my back. I can fantasize about taking three months off between now and August and lying like a turtle in the sun, redheadedness notwithstanding, and basking.
We're not past storm season yet. There are a few more weeks of blown sirens and wallclouds to get through, though this year has (as yet) been calmer than any in recent memory. And we're not yet to the point where the cicadas buzz all night long or the yarrow is blooming, filling the air with an indescribable, unmistakable smell.
A few years ago, during the first semester of nursing school, I went north a few hours to a waterfall. I waded in the river that formed it and swam in a pool under it, and felt the ancient calm air of the mountains surround me. The rivers here are younger, formed by tectonic shifts and sanctified by humans for millenia. The rivers north of us are older. They flow through beds cut by receding glaciers. The mountains are worn down to gentle rolling hills. These mountains could've changed the Rockies' diapers. The rivers here love humans, and heal them, and the spirits that live in the springs are gentle and kind and understanding. A few hours north, the spirits are ancient. They've seen everything. They no longer root for us or against us; they simply let us be.
I'm going back. Since it's summer.
It's supposed to be 87* here tomorrow, which, given the humidity of the past few days, will feel ten degrees warmer. I am not looking forward to driving back from the city in that.
But summer means it's time to lie on the couch in your underwear--or, if you're lucky enough to have a friend out in the country, to lie naked on the porch--drinking white wine or a good dry pale ale. It's time to read the Brother Cadfael books that take place during the mild and green summers of the twelfth century. It's time to wear the absolute bare minimum of clothes. It's time to dispense with sunscreen, sunburn and melanoma be damned, because it's just too damned hot.
By August I'll be sick of it, praying for winter. But now, I can look back on June nights when the Erstwhile Hub and I had just met and we slept and made love on his porch in the middle of nowhere, in air that was the temperature of blood. Now I can imagine going to one of the rivers that cut through the middle of the state and bathing in cold spring water with the sun beating down on my back. I can fantasize about taking three months off between now and August and lying like a turtle in the sun, redheadedness notwithstanding, and basking.
We're not past storm season yet. There are a few more weeks of blown sirens and wallclouds to get through, though this year has (as yet) been calmer than any in recent memory. And we're not yet to the point where the cicadas buzz all night long or the yarrow is blooming, filling the air with an indescribable, unmistakable smell.
A few years ago, during the first semester of nursing school, I went north a few hours to a waterfall. I waded in the river that formed it and swam in a pool under it, and felt the ancient calm air of the mountains surround me. The rivers here are younger, formed by tectonic shifts and sanctified by humans for millenia. The rivers north of us are older. They flow through beds cut by receding glaciers. The mountains are worn down to gentle rolling hills. These mountains could've changed the Rockies' diapers. The rivers here love humans, and heal them, and the spirits that live in the springs are gentle and kind and understanding. A few hours north, the spirits are ancient. They've seen everything. They no longer root for us or against us; they simply let us be.
I'm going back. Since it's summer.
Days off
Yesterday I bought summer clothes in sizes that I can actually wear. (Here beginneth the requisite Female Blogger's Ruminations On Weight, Fitness Level, and Body Image.) Given that this size is the number I wore when I started nursing school, doubled, it took some huevos to mouse down to that size in the online catalog. But at least I'll have shorts that don't make me look like I'm five months gone.
Yesterday I also did a fun new workout: rather than simply walking on the treadmill at a speed that killed me in thirty minutes, I walked at a killing speed *while holding three-pound hand weights*. And five-pounders, but only for a lap or two. I may technically be twenty pounds overweight, but I don't know many women who could walk 2.25 miles in 30 minutes with extra weight in their paws.
Pal Joey (yes, her name really is Joey) invited me to Banff in July for a visit. Given that where I live is Heat Hell from early June to mid-September, I'm taking her up on the offer. It'll mean living poor and applying for another credit card, but what the hell. The Canadian Rockies in July sound a lot better than the inner city does, and I've never been to that part of Canada before.
Given my last entrance into Canada (in a fish truck), though, I suppose I should be careful and not get too excited.
In other news, I'm cleaning house today and making pounds and pounds of salad. I'll work the next two days, then have two off, then work the weekend. The differential is nice, and it's been a while since I've done my duty for weekend shifts.
*yawn* Off to scrub the bathroom floor.
Yesterday I also did a fun new workout: rather than simply walking on the treadmill at a speed that killed me in thirty minutes, I walked at a killing speed *while holding three-pound hand weights*. And five-pounders, but only for a lap or two. I may technically be twenty pounds overweight, but I don't know many women who could walk 2.25 miles in 30 minutes with extra weight in their paws.
Pal Joey (yes, her name really is Joey) invited me to Banff in July for a visit. Given that where I live is Heat Hell from early June to mid-September, I'm taking her up on the offer. It'll mean living poor and applying for another credit card, but what the hell. The Canadian Rockies in July sound a lot better than the inner city does, and I've never been to that part of Canada before.
Given my last entrance into Canada (in a fish truck), though, I suppose I should be careful and not get too excited.
In other news, I'm cleaning house today and making pounds and pounds of salad. I'll work the next two days, then have two off, then work the weekend. The differential is nice, and it's been a while since I've done my duty for weekend shifts.
*yawn* Off to scrub the bathroom floor.
Saturday, May 15, 2004
Odds and Ends
Go on, piss me off.
I was hauling a patient around yesterday who outweighed me by a good fifty pounds. After I'd repositioned him and gotten him all comfy and cozy, I went outside to discuss his plan of care with his family. As is usual in these situations, the conversation turned to nursing as a job.
"Gee whiz," said one of the man's relatives, "it must be nice just to have to work three or four days a week, and get the rest of the week off. My sister's a nurse, and it seems like she's never at work."
I was on my third of three shifts in a row yesterday, with the usual heavy (both physically and care-wise) patients. I looked at him narrowly and asked what he meant by "never at work."
"Well, you know, she has all this time off, and she works those twelve hours and then just goes home. Sounds like a great job to me."
Go on, buddy. Make me peevish. Sure, I might work "only" three or four days a week, but those days are a combination of hard physical labor--the hardest I've ever done, including working in a book warehouse--and mental strain. If you ask any honest nurse what she or he does on the first day s/he has off after a long run, s/he'll tell you "I go from the bed to the couch and back, and maybe manage a load of laundry."
Spoiled Rich Boy, on the other hand, works eight to ten hours a day sitting behind a desk. For him, a workout at the end of the day is a nice interlude, not another hour and a half of hell.
...and then piss me off again...
Our hospital does not celebrate Nurses' Week. Instead, we have "Hospital Week."
Must be a great budget savings, that one.
This is one of those "don't get me started" things that I simply can't talk about without getting all het up. Nurses' Week isn't all about manicures and massages--though, honestly, it would be nice to have a five-minute backrub over lunch. If we get lunch that week, that is. It's also an opportunity to recognize the scientific and psychological contributions we make every single day to the field and to related fields.
But no, we get "Hospital Week." And a calculator on Friday, to show what Valued Members of the Health Care Team we are.
This one time, at band camp...
The longer I'm single the nerdier I get. A patient wrote a thank-you note the other day that contained a quote from a "Star Trek: The Next Generation" episode. Not only did I know that, I knew who said it, the context, and to whom.
It may be time to start getting the J. Crew catalog, just so I have something other than science and technology on the brain.
Put me on top or change the odds...
I went to bed hoping Man A would call. He didn't. Of course. But still.
As nerdy as I am, and as unconvinced of the possibility of a decent relationship with anybody, I kind of hoped for a "SHANE!!" (or "STELLA!!") moment. Hopeless romantic, that's me.
The thing that bugs me most about The Debacle (the breakup with Erstwhile Hub) is that he let me go so easily. That man had my stuff packed and me moved in four days. Amazing.
Oh, well. The anniversary of The Debacle will come and go and I'll start on Year Two of the new life.
I was hauling a patient around yesterday who outweighed me by a good fifty pounds. After I'd repositioned him and gotten him all comfy and cozy, I went outside to discuss his plan of care with his family. As is usual in these situations, the conversation turned to nursing as a job.
"Gee whiz," said one of the man's relatives, "it must be nice just to have to work three or four days a week, and get the rest of the week off. My sister's a nurse, and it seems like she's never at work."
I was on my third of three shifts in a row yesterday, with the usual heavy (both physically and care-wise) patients. I looked at him narrowly and asked what he meant by "never at work."
"Well, you know, she has all this time off, and she works those twelve hours and then just goes home. Sounds like a great job to me."
Go on, buddy. Make me peevish. Sure, I might work "only" three or four days a week, but those days are a combination of hard physical labor--the hardest I've ever done, including working in a book warehouse--and mental strain. If you ask any honest nurse what she or he does on the first day s/he has off after a long run, s/he'll tell you "I go from the bed to the couch and back, and maybe manage a load of laundry."
Spoiled Rich Boy, on the other hand, works eight to ten hours a day sitting behind a desk. For him, a workout at the end of the day is a nice interlude, not another hour and a half of hell.
...and then piss me off again...
Our hospital does not celebrate Nurses' Week. Instead, we have "Hospital Week."
Must be a great budget savings, that one.
This is one of those "don't get me started" things that I simply can't talk about without getting all het up. Nurses' Week isn't all about manicures and massages--though, honestly, it would be nice to have a five-minute backrub over lunch. If we get lunch that week, that is. It's also an opportunity to recognize the scientific and psychological contributions we make every single day to the field and to related fields.
But no, we get "Hospital Week." And a calculator on Friday, to show what Valued Members of the Health Care Team we are.
This one time, at band camp...
The longer I'm single the nerdier I get. A patient wrote a thank-you note the other day that contained a quote from a "Star Trek: The Next Generation" episode. Not only did I know that, I knew who said it, the context, and to whom.
It may be time to start getting the J. Crew catalog, just so I have something other than science and technology on the brain.
Put me on top or change the odds...
I went to bed hoping Man A would call. He didn't. Of course. But still.
As nerdy as I am, and as unconvinced of the possibility of a decent relationship with anybody, I kind of hoped for a "SHANE!!" (or "STELLA!!") moment. Hopeless romantic, that's me.
The thing that bugs me most about The Debacle (the breakup with Erstwhile Hub) is that he let me go so easily. That man had my stuff packed and me moved in four days. Amazing.
Oh, well. The anniversary of The Debacle will come and go and I'll start on Year Two of the new life.
Friday, May 14, 2004
All I know
It seems a good time to mention that I ditched Man A. I was becoming fond of him, and my head wasn't as together as I thought it was.
He was having an online flirtation with a woman far enough away so as not to be too much of a problem. Unfortunately, my brain and body reacted as they did when The Erstwhile Hub and The Erstwhile Pal got together; namely, I went berserk.
I figured it was too much to ask of an uncommitted person to stick with me while I worked my head out, so I dumped him. Badly and baldly and I miss him.
... ... ...
Glioblastoma multiforme is a type of brain tumor that arises from the structural cells that keep your brain from being one big pile of mush sloshing around in your skull. It's the most common and most lethal type of brain tumor. You don't get better with a glio.
Today I had a patient come in who'd had a glio, been given four to six months to live (the average, though sometimes we can keep 'em alive and functioning well for two years or so), and was back because she'd had a bleed. This is a common complication of glioblastoma simply because of how it operates:
It meshes normal brain tissue and cancerous brain tissue together so closely you can't take it out all the way.
Think about that for a minute. This cancer destroys, slowly and with your full awareness, your memories, your personality, and finally your most basic functions.
It is what I fear most.
So, anyway. This woman came in. It became apparent early on that she couldn't feed herself; the sight of a plate of food overwhelmed her. Besides that, her motor skills had declined to the point that she couldn't get a forkful of salad to her mouth unaided. So I fed her, and we talked. She thanked me for being understanding and not making her feel bad.
She told me, "I'm not sure how this is going to turn out. I mean, I know how this is going to turn out, but I'm not sure what it's going to be like getting there."
Then she said, "When the doctor told me 'four to six months' I wanted to say to my husband, 'Honey, let's not do this.' But we've been married so long and we're so devoted to each other, I couldn't tell him no. Even though I wanted to."
She looked me dead in the eye as she said that. I replied that maybe it was time to talk to her doctor and husband, if she really didn't want to do this ("this" being more treatment, more radiation, more steroids). I didn't know what else to say. It was borne in upon me at that point that maybe this was one of those things that might make me cry.
When you see people like this, the progression of the disease is fairly predictable: they lose short-term memory first, then function, then finally, before they end up dying, the only thing they retain is the awareness of who's most important to them.
But the ending always comes at last
Endings always come too fast
They come too fast
But they pass to slow
I love you and that's all I know.
He was having an online flirtation with a woman far enough away so as not to be too much of a problem. Unfortunately, my brain and body reacted as they did when The Erstwhile Hub and The Erstwhile Pal got together; namely, I went berserk.
I figured it was too much to ask of an uncommitted person to stick with me while I worked my head out, so I dumped him. Badly and baldly and I miss him.
... ... ...
Glioblastoma multiforme is a type of brain tumor that arises from the structural cells that keep your brain from being one big pile of mush sloshing around in your skull. It's the most common and most lethal type of brain tumor. You don't get better with a glio.
Today I had a patient come in who'd had a glio, been given four to six months to live (the average, though sometimes we can keep 'em alive and functioning well for two years or so), and was back because she'd had a bleed. This is a common complication of glioblastoma simply because of how it operates:
It meshes normal brain tissue and cancerous brain tissue together so closely you can't take it out all the way.
Think about that for a minute. This cancer destroys, slowly and with your full awareness, your memories, your personality, and finally your most basic functions.
It is what I fear most.
So, anyway. This woman came in. It became apparent early on that she couldn't feed herself; the sight of a plate of food overwhelmed her. Besides that, her motor skills had declined to the point that she couldn't get a forkful of salad to her mouth unaided. So I fed her, and we talked. She thanked me for being understanding and not making her feel bad.
She told me, "I'm not sure how this is going to turn out. I mean, I know how this is going to turn out, but I'm not sure what it's going to be like getting there."
Then she said, "When the doctor told me 'four to six months' I wanted to say to my husband, 'Honey, let's not do this.' But we've been married so long and we're so devoted to each other, I couldn't tell him no. Even though I wanted to."
She looked me dead in the eye as she said that. I replied that maybe it was time to talk to her doctor and husband, if she really didn't want to do this ("this" being more treatment, more radiation, more steroids). I didn't know what else to say. It was borne in upon me at that point that maybe this was one of those things that might make me cry.
When you see people like this, the progression of the disease is fairly predictable: they lose short-term memory first, then function, then finally, before they end up dying, the only thing they retain is the awareness of who's most important to them.
But the ending always comes at last
Endings always come too fast
They come too fast
But they pass to slow
I love you and that's all I know.
Tuesday, May 11, 2004
Strange dreams.
I think I might have PTSD. Seriously.
On Memorial Day last year, I came home from work sick. I found my husband and my best friend be-bathrobed, standing in the kitchen, drinking coffee. There was a bottle of Astroglide on the kitchen table. When I looked again, it had disappeared, but the guilty looks on the faces of the other two people in the room stayed.
I'll omit all the horrible screaming that followed. By the end of August, it was All Over. We'd all managed to divorce fairly amicably (I only punched him once) and then things went to hell.
Last Friday I had a dream that I was standing in front of Man A with my favorite pair of polka-dot pajama pants on, and he grabbed my hips and said, "Your ass is *huge*."
Last night I had a dream that he told me, quite calmly, that he'd met somebody with much better legs than I have, and that he didn't want to see me any more.
Now, then. I am not normally obsessed with my own concept of my body. I put on about twenty pounds after I left nursing school, but that wasn't entirely a bad thing--the last semester of school I'd lost that much through a combination of stress and IBS.
The woman who replaced me is lithe and catlike. She's built on a much different scale than I am. Where I'm short and stocky and strong, she's long and flexible and slender. We used to joke that it took her until she was thirty to both break the 90-pound mark and get an ass.
She's got perfectly regular features, a generous mouth, and large green eyes. Her skin is like opals. I've got a rubber face, freckles, and I'm frankly kind of funny looking. People often remark on facial expressions I'm not even aware I have.
So. With the anniversary of The Debacle coming up, all I can figure is this: my subconscious is revisiting the things that made me most upset back then; namely, that the person who'd always told me I was the most beautiful woman he'd ever seen had suddenly changed his mind. And that he traded me in on a new model that was so much different from me.
Strangely, my self-concept regarding my brains and my sense of humor hasn't changed. I'm not having dreams in which people tell me I'm stupid or simply not funny any more.
Why this is playing out in dreams starring Man A is beyond me. (Man B, by the way, has been moved to the column labeled "Nice Friend To Have". Friends are more valuable than dates, anyhow, and I feel sort of like I've ended up with a marvelous big brother.) Maybe it's that he's the first person I've gotten involved with since The Debacle, and if it had been Rush Limbaugh I was dating, the dreams would involve him instead. Maybe he's merely a convenient stand-in for my subconscious in my dreams.
Fear not, faithful readers. I'm not going to be throwing myself on the floor and wrapping my arms around A's ankles, begging him not to leave me. I'm certainly not going to starve myself in an attempt to look more like the woman my ex-husband is still living with. The butter in my refrigerator will not be replaced with weird processed garp that's supposed to taste like butter and make you slender and green-eyed to boot.
I'll just be acting a little stranger than usual for the next couple of months, I think.
Nobody warns you about this when a relationship ends. There are lots of things you don't get warned about, of course, but this one came out of nowhere for me. The last thing I expected was to be sitting on the edge of the bed this morning at 0500, shaking and leaking tears and feeling frightened and frustrated again.
Off to go walk a couple of miles. And lift some weights. And then eat butter.
On Memorial Day last year, I came home from work sick. I found my husband and my best friend be-bathrobed, standing in the kitchen, drinking coffee. There was a bottle of Astroglide on the kitchen table. When I looked again, it had disappeared, but the guilty looks on the faces of the other two people in the room stayed.
I'll omit all the horrible screaming that followed. By the end of August, it was All Over. We'd all managed to divorce fairly amicably (I only punched him once) and then things went to hell.
Last Friday I had a dream that I was standing in front of Man A with my favorite pair of polka-dot pajama pants on, and he grabbed my hips and said, "Your ass is *huge*."
Last night I had a dream that he told me, quite calmly, that he'd met somebody with much better legs than I have, and that he didn't want to see me any more.
Now, then. I am not normally obsessed with my own concept of my body. I put on about twenty pounds after I left nursing school, but that wasn't entirely a bad thing--the last semester of school I'd lost that much through a combination of stress and IBS.
The woman who replaced me is lithe and catlike. She's built on a much different scale than I am. Where I'm short and stocky and strong, she's long and flexible and slender. We used to joke that it took her until she was thirty to both break the 90-pound mark and get an ass.
She's got perfectly regular features, a generous mouth, and large green eyes. Her skin is like opals. I've got a rubber face, freckles, and I'm frankly kind of funny looking. People often remark on facial expressions I'm not even aware I have.
So. With the anniversary of The Debacle coming up, all I can figure is this: my subconscious is revisiting the things that made me most upset back then; namely, that the person who'd always told me I was the most beautiful woman he'd ever seen had suddenly changed his mind. And that he traded me in on a new model that was so much different from me.
Strangely, my self-concept regarding my brains and my sense of humor hasn't changed. I'm not having dreams in which people tell me I'm stupid or simply not funny any more.
Why this is playing out in dreams starring Man A is beyond me. (Man B, by the way, has been moved to the column labeled "Nice Friend To Have". Friends are more valuable than dates, anyhow, and I feel sort of like I've ended up with a marvelous big brother.) Maybe it's that he's the first person I've gotten involved with since The Debacle, and if it had been Rush Limbaugh I was dating, the dreams would involve him instead. Maybe he's merely a convenient stand-in for my subconscious in my dreams.
Fear not, faithful readers. I'm not going to be throwing myself on the floor and wrapping my arms around A's ankles, begging him not to leave me. I'm certainly not going to starve myself in an attempt to look more like the woman my ex-husband is still living with. The butter in my refrigerator will not be replaced with weird processed garp that's supposed to taste like butter and make you slender and green-eyed to boot.
I'll just be acting a little stranger than usual for the next couple of months, I think.
Nobody warns you about this when a relationship ends. There are lots of things you don't get warned about, of course, but this one came out of nowhere for me. The last thing I expected was to be sitting on the edge of the bed this morning at 0500, shaking and leaking tears and feeling frightened and frustrated again.
Off to go walk a couple of miles. And lift some weights. And then eat butter.
Monday, May 10, 2004
Big stars, baby, big stars.
Because the hospital where I work is in a big city, we occasionally get famous people in, either as patients or as visitors. And no, I'm not going to tell you who they are--HIPPA and all that.
I was thinking today about who I'd go agoggle over if they walked off the elevator. I've only gone agoggle once over a visitor--a journalist whom I really admired before they retired. I babbled. A lot. And had trouble with the IV pump. It was embarassing.
Anyway, I figure it would be best to be prepared in case some Big Big Star ever walks through the door. So here, in no particular order, are the people who would make me drop my teeth:
1. Isaac Asimov (were he to come back from the dead, that is)
2. Dolly Parton. I would gibber about bluegrass, then faint.
3. Emmylou Harris. See #2.
4. Bob Edwards
5. Patrick Stewart (yes, I am a huge geek)
6. Diablo Cody of Pussy Ranch fame. I'd fall over, then sneak out for a bottle of tequila to share.
7. Garrison Keillor
8. Queen Margarethe of Denmark
9. Nelson Mandela (they'd have to put me in ICU for that one; I'd have an aneurysm form and blow, just like that.)
10. Any one of the guys from Moxie Fruvous
This probably says something dark and terrible about my psyche. If so, I don't want to hear about it.
I was thinking today about who I'd go agoggle over if they walked off the elevator. I've only gone agoggle once over a visitor--a journalist whom I really admired before they retired. I babbled. A lot. And had trouble with the IV pump. It was embarassing.
Anyway, I figure it would be best to be prepared in case some Big Big Star ever walks through the door. So here, in no particular order, are the people who would make me drop my teeth:
1. Isaac Asimov (were he to come back from the dead, that is)
2. Dolly Parton. I would gibber about bluegrass, then faint.
3. Emmylou Harris. See #2.
4. Bob Edwards
5. Patrick Stewart (yes, I am a huge geek)
6. Diablo Cody of Pussy Ranch fame. I'd fall over, then sneak out for a bottle of tequila to share.
7. Garrison Keillor
8. Queen Margarethe of Denmark
9. Nelson Mandela (they'd have to put me in ICU for that one; I'd have an aneurysm form and blow, just like that.)
10. Any one of the guys from Moxie Fruvous
This probably says something dark and terrible about my psyche. If so, I don't want to hear about it.
Sunday, May 09, 2004
Who will take care of you when you're old?
Friday was One of Those Days at work. My sweet, angelic man with the brain tumor went to hospice. The funny, cheerful guy with the cerebrospinal fluid leak and the charming wife went home. One patient finally got out of bed and walked, and we got ten admissions in the last three hours of the day.
One of those admissions was a woman with metastatic breast cancer. It's a virulent sort that will kill her; she really ought to be seen by pain management doctors with an eye to palliative care...but instead we'll be doing surgery for a couple of pathological fractures and trying to thereby improve her quality of life.
Seven will get you ten, by the way, that she never gets out of bed again. It's that bad.
Anyway, she came in and one of my coworkers started asking the usual admission questions, including, "Who's been taking care of you at home?" Keep in mind that this person can't get out of bed, can't get to the bathroom, can't cook, can't do *anything* strenuous on her own.
The answer came back that her daughter had been taking care of her. Singlehandedly. For months at least, if not years.
Her daughter is ten.
Forget who'll take care of you when you're old, people. The question for a lot of folks seems to be "who can I get to take care of me if I get sick?" Often, the sick person doesn't have a basic level of support from friends and family, and so you end up with situations where the twelve- or ten-year-old child or the elderly parent or the equally-ill spouse is killing themselves to keep the person alive.
The best thing to have as a hedge against disaster, next to decent health insurance, is a wide network of people that love you. Doesn't matter if they're related to you or not.
In other news, I went to the weddingest wedding there ever was last night. I sacrificed five hours in three-inch heels (a bad purchase) to see two very happy-looking people get married in a stereotypically Perfect Church Wedding. It was nice, I guess. The good bit was seeing that they knew exactly what they were getting into, were totally into doing it, and had no doubts whatsoever.
Now I have a little box of cake to eat for breakfast.
One of those admissions was a woman with metastatic breast cancer. It's a virulent sort that will kill her; she really ought to be seen by pain management doctors with an eye to palliative care...but instead we'll be doing surgery for a couple of pathological fractures and trying to thereby improve her quality of life.
Seven will get you ten, by the way, that she never gets out of bed again. It's that bad.
Anyway, she came in and one of my coworkers started asking the usual admission questions, including, "Who's been taking care of you at home?" Keep in mind that this person can't get out of bed, can't get to the bathroom, can't cook, can't do *anything* strenuous on her own.
The answer came back that her daughter had been taking care of her. Singlehandedly. For months at least, if not years.
Her daughter is ten.
Forget who'll take care of you when you're old, people. The question for a lot of folks seems to be "who can I get to take care of me if I get sick?" Often, the sick person doesn't have a basic level of support from friends and family, and so you end up with situations where the twelve- or ten-year-old child or the elderly parent or the equally-ill spouse is killing themselves to keep the person alive.
The best thing to have as a hedge against disaster, next to decent health insurance, is a wide network of people that love you. Doesn't matter if they're related to you or not.
In other news, I went to the weddingest wedding there ever was last night. I sacrificed five hours in three-inch heels (a bad purchase) to see two very happy-looking people get married in a stereotypically Perfect Church Wedding. It was nice, I guess. The good bit was seeing that they knew exactly what they were getting into, were totally into doing it, and had no doubts whatsoever.
Now I have a little box of cake to eat for breakfast.
Friday, May 07, 2004
I'm not there for you.
I can now say with pride that I have made it through an entire decade of "Friends" without ever having once seen an episode of the show.
Or of "Frasier," whatever that is.
Or of "Frasier," whatever that is.
Wednesday, May 05, 2004
Mostly not about work.
So I took an early cancel today. So what? So what if I'd been off for four days?
I wonder sometimes why brain tumors seem to hit the really nice people. All of the people I've known with nasty brain tumors, be they gliomas or metastatic cancers, were *nice* people. The guy I've got right now, who has an oligodendroglioma (say that five times fast) is an angel.
You remember all of their faces, you remember all of their names, you remember all of their personalities, even after the tumor takes away their ability to respond or speak.
As long as we're remembered by somebody, we're immortal.
In other news: One of the men I'm seeing filed for divorce yesterday. Long story. I'm hoping that Der Tag will be as anticlimactic for him as it was for me. Rather than having the whole damned history of my marriage blow up in my face in front of a judge, it was quick, clinical, and quiet.
My sister called it a "fleh bomb" and described it thusly: "Something you've been dreading finally arrives in the mail, ticking ominously. You watch it as it sits in the corner until it finally does its thing. It doesn't explode, though: it just dissolves into a puddle of lukewarm goo. And that is a fleh bomb."
Divorce is one of those things, like birth and death, that you have to go through alone. It's not usually as monumental as those other things, though it feels like it at the time...or maybe it is. You have a baby, you adjust to your new life. You die, and presumably you either adjust to your new whatever-it-is, or there's nothing there, so it doesn't matter.
You divest yourself of the person you spent most of your adult life with, and...you adjust.
It's a bare three weeks short of a year since I came home early from work and found my husband and best friend fresh out of bed. It's been less than that since we all divorced. She and he are still living in the same house--the house I grew up in--and I'm in a small apartment in the sort of development I've always despised.
That sounds bitter, and I don't mean it to. A lot of history and a lot of physical space doesn't always give you the mental space you need to make changes. I've become much more myself in the last year, without other people giving me their opinions of what I ought to be or am.
Whatever's happened to them in the last year, I hope they're happy. It would be a terrible waste if three of us were hurt this badly and only one of us turned out as happy as I am.
Home early or not, it's time for bed.
I wonder sometimes why brain tumors seem to hit the really nice people. All of the people I've known with nasty brain tumors, be they gliomas or metastatic cancers, were *nice* people. The guy I've got right now, who has an oligodendroglioma (say that five times fast) is an angel.
You remember all of their faces, you remember all of their names, you remember all of their personalities, even after the tumor takes away their ability to respond or speak.
As long as we're remembered by somebody, we're immortal.
In other news: One of the men I'm seeing filed for divorce yesterday. Long story. I'm hoping that Der Tag will be as anticlimactic for him as it was for me. Rather than having the whole damned history of my marriage blow up in my face in front of a judge, it was quick, clinical, and quiet.
My sister called it a "fleh bomb" and described it thusly: "Something you've been dreading finally arrives in the mail, ticking ominously. You watch it as it sits in the corner until it finally does its thing. It doesn't explode, though: it just dissolves into a puddle of lukewarm goo. And that is a fleh bomb."
Divorce is one of those things, like birth and death, that you have to go through alone. It's not usually as monumental as those other things, though it feels like it at the time...or maybe it is. You have a baby, you adjust to your new life. You die, and presumably you either adjust to your new whatever-it-is, or there's nothing there, so it doesn't matter.
You divest yourself of the person you spent most of your adult life with, and...you adjust.
It's a bare three weeks short of a year since I came home early from work and found my husband and best friend fresh out of bed. It's been less than that since we all divorced. She and he are still living in the same house--the house I grew up in--and I'm in a small apartment in the sort of development I've always despised.
That sounds bitter, and I don't mean it to. A lot of history and a lot of physical space doesn't always give you the mental space you need to make changes. I've become much more myself in the last year, without other people giving me their opinions of what I ought to be or am.
Whatever's happened to them in the last year, I hope they're happy. It would be a terrible waste if three of us were hurt this badly and only one of us turned out as happy as I am.
Home early or not, it's time for bed.
Monday, May 03, 2004
Ten books I can't live without
Stiff (The curious lives of human cadavers), by Mary Roach
An Anthropologist on Mars, Oliver Sacks
War for the Oaks, Emma Bull
Stardust and Neverwhere, Neil Gaiman
Last Chance to See, Douglas Adams
Brother Cadfael's Penance, Ellis Peters
The Phantom Tollbooth, Norton Juster
Gaudy Night, Dorothy Sayers
How to Cook Everything, Mark Bittman
An Anthropologist on Mars, Oliver Sacks
War for the Oaks, Emma Bull
Stardust and Neverwhere, Neil Gaiman
Last Chance to See, Douglas Adams
Brother Cadfael's Penance, Ellis Peters
The Phantom Tollbooth, Norton Juster
Gaudy Night, Dorothy Sayers
How to Cook Everything, Mark Bittman
Sunday, May 02, 2004
Things that make me cry and things that do not.
Patients dying, on the whole, do not make me cry.
A person who faces their death from something nasty, like a glioblastoma (a particularly evil form of brain tumor) with humor and grace makes me simultaneously happy and sad, but not to the point of crying. Wait: I take that back: One patient greeted the news that the entire left side of her brain had been taken over by a tumor with the observation that things could be worse. That made me tear up, laugh out loud, and finally fall into bed next to her, where we spent the next half hour talking.
Sometimes my coworkers make me so angry I'd like to toss their bodies into the alley behind the building, but only once have I actually broken into tears at work (and that was this past week, actually).
"Extreme Makeover: Home Edition" makes me cry. Reliably. So much so that if I feel in the need of a good howl, I clear my Sunday night schedule (or Thursday night, when there's a rerun on) and sit down on the couch with ice cream and a box of Kleenex.
My old job used to make me cry. In that job, I talked to women and men of all ages about sex, genetics, cancer, pregnancy, abortion, general health issues, STDs including HIV, domestic abuse, rape, and anything else they wanted to bring up. I used to head to the bar straight from work on a semi-regular basis.
This job doesn't have that perk. When you're a sexual health counselor, you have something tangible to fight against: stupidity or fear or ignorance. When you're working with people who have brain troubles, the enemy is intangible, or so completely beyond anything you can do, that you go home simply tired out to your toenails.
Stories of cruelty to animals make me cry. I then get so angry that I want to kill someone. The one case of cruelty to a helpless human being that I've run across so far in this job made me so angry I wanted to kill someone, but without the tears.
I'm certain that whoever abuses/neglects old people, children, or animals will go to a particularly hot spot in Hell. And I'm also certain that I will have a seat right up front so I'll get to watch 'em for all eternity.
When our coworker John died, I didn't cry. I wish now that I'd've been able to. I miss him an awful lot.
Assholes who don't call when they say they will don't make me cry. Instead, they make me work out elaborate and untraceable revenge plots.
You'll be sorry, Man B. I just got this month's "Smithsonian" magazine, which includes an interesting article on obscure natural poisons. That'll teach you not to call.
A person who faces their death from something nasty, like a glioblastoma (a particularly evil form of brain tumor) with humor and grace makes me simultaneously happy and sad, but not to the point of crying. Wait: I take that back: One patient greeted the news that the entire left side of her brain had been taken over by a tumor with the observation that things could be worse. That made me tear up, laugh out loud, and finally fall into bed next to her, where we spent the next half hour talking.
Sometimes my coworkers make me so angry I'd like to toss their bodies into the alley behind the building, but only once have I actually broken into tears at work (and that was this past week, actually).
"Extreme Makeover: Home Edition" makes me cry. Reliably. So much so that if I feel in the need of a good howl, I clear my Sunday night schedule (or Thursday night, when there's a rerun on) and sit down on the couch with ice cream and a box of Kleenex.
My old job used to make me cry. In that job, I talked to women and men of all ages about sex, genetics, cancer, pregnancy, abortion, general health issues, STDs including HIV, domestic abuse, rape, and anything else they wanted to bring up. I used to head to the bar straight from work on a semi-regular basis.
This job doesn't have that perk. When you're a sexual health counselor, you have something tangible to fight against: stupidity or fear or ignorance. When you're working with people who have brain troubles, the enemy is intangible, or so completely beyond anything you can do, that you go home simply tired out to your toenails.
Stories of cruelty to animals make me cry. I then get so angry that I want to kill someone. The one case of cruelty to a helpless human being that I've run across so far in this job made me so angry I wanted to kill someone, but without the tears.
I'm certain that whoever abuses/neglects old people, children, or animals will go to a particularly hot spot in Hell. And I'm also certain that I will have a seat right up front so I'll get to watch 'em for all eternity.
When our coworker John died, I didn't cry. I wish now that I'd've been able to. I miss him an awful lot.
Assholes who don't call when they say they will don't make me cry. Instead, they make me work out elaborate and untraceable revenge plots.
You'll be sorry, Man B. I just got this month's "Smithsonian" magazine, which includes an interesting article on obscure natural poisons. That'll teach you not to call.