Monday, February 27, 2006

What I heat up on my day off...

...because I really can't call it cooking.

Warning: girly foof ahead.

The local Quick-ee-Mart had a sale on various frozen entrees this week, so I tried some off-brand eggplant parmesan and a box of frozen fish.

I hesitate to say this, but both of them were quite yummy.

I'm sure I'll bloat up like a pufferfish from the amount of salt they contained, but *damn*. TV dinners sure have come a long way since the 1970's. Not that I ate them then, you understand, Mom being given to soy products and home-made bread, but I remember seeing them in the chest freezers at friends' houses.

It's a good trick to have stashed up a sleeve for one of those nights when, after work, seven minutes seems like too long to wait for dinner. I'm not going to be eating them regularly, though.

In other news, Beloved Sister seems to have settled on a wedding dress. The pattern she loves is the pattern I had originally chosen for a bridesmaid's dress, which is fine and dandy. I was having doubts about the fullness of the skirt for a morning wedding, so I was happy to have her take it off my hands.

Though, as she pointed out in an email, having two people in a wedding wearing the same cut of dress would give the old biddies something to talk about.

In that spirit, I've gone for this:

Hello, Tiger

sans bows and in the narrow-skirt version. The temptation to have it made in black duopioni is almost overwhelming, but that would give the biddies too much to talk about, so I'm thinking of going with a sedate olive green or gold. Maybe even a deep brown, with cut-and-polished hunks of amber to go with. The only requirements for the wedding are "Vintage Preferred" and "You Must Rock, Roll, and Destroy Hotel-Room Furniture, In A Metaphorical Sense, Of Course", so I'm good to go.

Hell, I've got 'till October to decide. If all else fails, I can always find something in orange and silver taffeta with an ass bow.

(This is the point in each post where I normally bring up some fine thing about work, but I am *so* not in the mood this week. The past week has seen collective asses saved by good charting (yours truly's), insane family members abusing patients in my presence, and a knock-down-drag-out between one of the management team and myself, so scruit. Maybe I'll blog about it later; maybe not.)

In the meantime, is anybody doing anything special for Lent this year? I'm observing Eastern Orthodox Lent, primarily because it falls on the Monday following the big Scottish Hoedown, and I want to have a Hair-Down Hoedown this year and drink plenty of warm beer.

I will not be wearing sackcloth and ashes, unless you count Dickies scrubs as sackcloth.

Wednesday, February 22, 2006

The horror of the ordinary

Mom and Dad bought me a set of barrister bookshelves for my birthday. They arrived last week, but I only managed to bribe Chef Boy into helping me haul five bulky boxes up the stairs today.

Barrister bookshelves are those nifty things that come in sections, with glass fronts that lift up and slide out of the way. These are a walnut finish, a dark glossy brown, with small brass knobs on the front of each to help you lift-and-slide. They stand just over five feet high, all put together, and sneer at the rest of the furniture in the bedroom with undisguised snootyness.

So I set them up (releasing, in the process, approximately forty metric tonnes of packing material; Dad warned me) and put the books from the shelf they're replacing into them.

Into, that is, one and one-third shelves of them. Maybe one and a quarter shelves.

So, naturally, the solution is to buy more books.

It did occur to me, briefly, to simply move the books from the shelves in the living room into the new shelves. But what good would that do? I'd be left with another set of empty bookshelves (these built by my grandfather) and would *still* have to find something to fill them.

Meanwhile, the desk I use is looking shabbier and shabbier every second. It's one of those Target specials that's meant to look like Mission, except it comes in a big flat box and never quite goes together correctly. Every time I type, there's a subtle oscillation because the nuts and bolts *almost* work.

So, naturally, I'll have to look for a new desk. An antique one, I think, maybe even a rolltop. (Wouldn't *that* be schwank.)

And, now that I think about it, the filing cabinet that sits next to the desk has never been entirely satisfactory either. It's good to hold the printer, but it's another Target buy, from a flat box, with pre-drilled screwholes that didn't quite go in on center.

Or maybe I'll build a desk. They rarely make 'em as small as I need 'em, and I'm not a bad rough carpenter. Chef Boy has a shopful of woodworking equipment and the skill necessary not to remove digits while dremmelling, or whatever you call it.

Anyway, it won't be an ordinary desk. Nor will it be an ordinary filing cabinet that replaces this one. The bookshelves will see to that; they're gazing in disgust at the horror of the ordinary that is my furniture.

Saturday, February 18, 2006

Pour, sip, read. Pour, sip, read. Damn.

Just a cautionary note for readers:

I ordered two Bill Bryson books on a Barnes & Noble gift card. Both of them arrived in the mail yesterday. I picked them up from the same apartment office that holds my bookshelves today.

"I'm a Stranger Here Myself" is a very, very funny rendition of what it's like to move back to the US after two decades in Britain. I was giggling at the beginning and laughing so loudly at the end I was afraid I'd bug the neighbors.

Especially endearing was his description of having all his belongings spray across an airport floor: "My hair, concerned and unable to help, went into panic mode." Possessed of Panic Mode hair myself (note: gorgeous ringlets only happen past eight inches in length; before that, hair stands on end), I snorked and snorked and snorked some more.

But: Oh, dear. "In A Sunburned Country" made me want to go to Australia. So much so that the only thing keeping me from running up the credit cards was the bottle of Dalwhinnie, and that to such an extent that I just eyed it balefully and said out loud, "Dear sweet Jesus. Is that how much Scotch I've had? Oy." Pour, sip, read is likely to be my M.O. for the next day or so.

Mom testifies, hand on heart, that the only thing keeping her from Oz is the idea of flying there coach-class. DVTs, apparently, are enough to keep at least one Parental Unit in the Pacific Northwet. One of my colleagues, on a long-term assignment to the cardiac care unit, is planning to go there for three months--at least--in a few weeks. I doubt she'll ever come back, working as she will be in a place where men outnumber women three to one. And she's a natural blonde, too.

I must go to Australia. Beer is the national pastime and the national drink; it's been compared favorably with the state in which I live. Geographic state, I mean, not the state of pour-sip-read. Australia has a whole lot of venomous critters, which means I'd fit right in.

It would only cost me US$2830 for a non-stop. Maybe I could get the credit limit raised.

Edited to clarify: Mom writes that it's not the threat of DVT that's stopping her from flying to Australia again, rather, "it's the idea of having to see a movie like 'Titanic' both over and back.'" Having been subjected to "Dick Tracy" on the way to Denmark and "Titanic" en route to somewhere I can't recall, I sympathise.

Does Qantas have films of cute lil' ol' platypi?

And, (query for those better-versed in monotrematics than I), what exactly is poisonous about a platypus's spurs? What sort of poison is it?

Lashings of Parmesan

The weather went to shit night before last. In less than a day--in less than twelve hours, actually--the temperatures dropped from 82* to 22* Fahrenheit (for those of you who measure in Cee rather than Eff, that's from 28 to -6). It began to rain, then sleet, then "wintry mix", which translates no matter where you live into something that will coat your car and in which you do not want to drive.

I was prepared. I had stolen a Bill Bryson book, "The Mother Tongue: English and How It Got That Way" from the hospital library, had bought a bottle of Dalwhinnie, and had stocked the fridge with coffee and milk and eggs and bacon.

What I wasn't prepared for was this: that my sister's shipment of birthday presents would arrive this week, as would a five-box shipment containing a barrister bookshelf from my parents. I hauled the boxes from Beloved Sister up three flights of stairs, but left the crates of bookshelf bits in the apartment office. Until such time as I can enlist the help of some poor idiot to haul them up 45 vertical feet, there they'll stay. I wasn't about to carry them myself (or hump them, nod to Paeds RN) because, while they're not particularly heavy or ill-balanced, they are bulky. Three flights of steep concrete-and-metal stairs coated with ice do not mix well with bulky boxes containing glass-fronted bookshelf parts.

Beloved Sis sent many items that could be construed as scrubs or as pajama pants, depending on the offensiveness of their color combinations. I am not being insulting with that observation, by the way; the tag on one particularly strident set of scrubs read "these colors may not be a good idea." She also sent four antique medical books. I *love* ancient medical books--and these, while not particularly ancient (the oldest dates from 1914)--are stunning examples of their type.

There's one on "A girl's responsibility for race progress", one on Our Mysterious Life Glands (with disturbing pictures), one about Reading Character Through Analysis of the Features, and the crowning touch, a book (published in 1931) entitled "Studies In Ethics For Nurses." That last will, I expect, produce plenty of fodder for future blogging, provided I can get through it sober.

Anyway, dealing with that embrass de riches took most of the morning, after which I took a nice long nap. Then I got up and whipped up some spaghetti with things found in the fridge and lashings of Parmesan, and read Bryson and stuffed my face.

Provided I ever get the bookshelf bits up the stairs (that is, if the ice ever melts), "Studies In Ethics For Nurses" will look nice in the top one.


A tip for those who plan to spend a significant amount of time in the hospital, any hospital:

No matter how long you plan to stay, or how important you think you are, please do not bring your own furniture. And try to keep the amount of stuff in your room to a minimum. Three potted plants and a couple of tchochkes, fine. Twelve, not so good.

Because after I'm done hauling your console table bedside table potted plants various knickknacks bedside table chest of drawers ottoman clothing books magazines two bags full of makeup up three floors and installing them in another room, I will have a serious talk with you and your wife.

And your wife will cry. Not because I'm being mean, hard as it is to believe, but because she wanted to make your room "homey" and "comfortable" and I'm telling her that that's a no-go. Because, see, when the room is full of stuff of varying sizes, purposes, and fragilities, it's very difficult to see how I'll get a code cart into your room if, Frog forbid, I should ever need to.

And, you know, no matter how long you're staying here, please remember that it's a hospital, not a studio apartment. When three-quarters of the stuff I've humped on the elevator is your wife's, there's a problem.

Nobody, and I mean nobody, needs to be keeping a three-quarter length fur coat with fox trim in the closet in their hospital room. Really.

Aside from that forty-five minute period when I was wondering what, exactly, the facility was paying me for as I moved furniture, this was a good week. A busy week, true, with every floor full to the gills and overflow all over the post-anesthesia care unit, but a good week. Nobody coded, the person who *did* seize on me lo those many months ago went home mostly intact, and I only had to pull out the Mean Nurse Jo persona once, on a guy younger and stronger than me with an inch-long incision in his back.

All the faceless people have gone home to heal. One of them will be coming back next week for further plastics work, but that won't be the same caliber of treatment he's undergone thus far, so he ought to bounce back pretty quickly.

The two difficult folks I had this week, one with status epilepticus and one with status migraine, both seemed to respond to the massive doses of drugs we kept throwing at them and have left. Migraine Man went home with a drug that might destroy his kidneys but will keep him pain-free, while Epilepticus Woman went over to the monitoring unit to make sure that she's not having subclinical craziness in her head even on drugs.

The very nice man who came back completely unresponsive died easily and quickly, saving his family the hell of having to wait a week or even two while his breathing slowed down and he got more agonal. That's an odd thing to be thankful for, I guess, but I'll be thankful nonetheless. Occasionally a massive heart attack or pulmonary embolus or re-bleed can be a merciful thing, and not just for the patient.

Drama-filled weeks at the hospital make for great blogging but hellish working conditions. As does hauling furniture.

Tuesday, February 14, 2006

What I Cook On My Day Off When The Flyboys Are Being Assholes

Or, Gosh, I'm Glad I Didn't Have A Souffle In The Oven

Fruit Salad: honeydew melon that actually smelled like melon, alors!, pineapple ditto, alors! strawberries that taste like strawberries, and a can of sour pie cherries. What is *up* with the Quickie-Mart's produce section this week? In addition to thumb-thick asparagus, they had real fruit.

The cherries are in there primarily because I had a can of cherries that I was about to eat all in one sitting and didn't feel like torturing myself.

Rice cakes, made out of jasmine rice squished into a 1/3 cup measure (greased) and quick-fried in ghee until the outsides are crunchy.

To be served with corn relish: fresh sweet corn off the cob, tiny black beans, garlic sauteed until it's golden and crunchy, a hit of soy, a hit of chili paste, and some sesame seeds, toasted. (Weird, I know.)

Thumb-thick asparagus will be roasted. Yum. I got two pounds. Does anybody realize how much TWO POUNDS of asparagus is?

I also made chicken salad with pecans and cucumbers and red bell peppers, all very finely chopped up, and some onion.

About midway through the ghee-making process came the first of three sonic booms. The flyboys from the local AFB were breaking the rules again, making the windows shake and things fall off the shelves and freaking out all the dogs in the neighborhood. They do this about twice a year; fly fast and high over town, so fast you can't see much more than a black speck, and you don't know what's going on until the booms hit. Very irritating.

At least it's better, though, than the yearly airshow. My apartment is under the takeoff path at the municipal airport. When the airshow comes to town, I get treated to the sight and sound of dozens of WWII and Korean War-era bombers and fighters laboring up into the air entirely too slowly. I'm always afraid that the last remaining model of whatever rare bomber is there this year won't make it and will crash into my roof.

The biplanes and triplanes aren't as bad. You get the feeling that one could run straight into you and it wouldn't hurt, much.

In other news, my birthday was Sunday. Chef Boy took me to brunch, where we ate entirely too much and I had three mimosas (gee, mimosas are good! Why didn't anybody tell me before?) made from mandarin orange juice. The restaurant is Argentinian, the food is pricey but plentiful, and I'll never want to eat scrambled eggs again.

Beloved Sis sent a copy of a book that's been out of print for years ("The Dog Days of Arthur Cane") and which I'm saving for dinner reading.

And that is all. I have no work stories, having been mercifully absent from The Land Of Brain for three days now.

Friday, February 10, 2006

The sun's over the yardarm *somewhere*.

Another entry in the Person With No Face contest:

Weird eye tumor extending into the bone of the skull near the temple and up over the brow. Weird eye tumor (and half the patient's face) removed by our crack team of Weird Eye Tumor Removal Pixies. Weird eye tumor site becomes very swollen and starts to leak Weird Eye Tumor Post-Removal Fluid.

So here comes one of the Pixies with a giant needle attached to the end of a giant syringe and whams it into the person's face in order to draw out some of the fluid.

I left the room precipitously.

And I did not have the egg-drop soup for lunch, no sir.

In other news, Amazon has a nifty widget I'm thinking about getting to carry lunch in. The bento box has always appealed to me, but a bento jar? Even better.

I also may have a supplier for my vintage glasses and sunglasses fetish. My crazy optometrist has a crazy father who recently found a cache of new-old-stock 1950's and 1960's glasses frames. He's promised to bring some of the best ones to the shop so that I can spend my hard-earned tax refund on them. Cat's eyes, here we come!

It's raining here, for the third time since July. I've promised myself a beer and a nap, in that order, so I'm off to get started.

Wednesday, February 08, 2006

The joke around here is...

....that there'll never be a "CSI" set here, because there's only one DNA sample and no dental records.

I just watched a neighbor pour about a gallon of used oil onto the parking lot, with no plans to clean it up. Genius.

It has been an annoying day.

Tuesday, February 07, 2006

Coolest Thing Ever....

Care for another monotreme? This one not in Australia?

Oooo. I get so cheerful and happy and giggly when I read things like this.

I will never be a normal goil.

Monday, February 06, 2006

Simplify, simplify, simplify!

Thoreau never had a cell phone, that's for sure. And a land line, and a T1 connection for his computer, which he also didn't have. Still, I'm taking his words to heart--in this case. I'm ignoring the bit about "beware any enterprise that requires new clothes" as Beloved Sister would probably not be happy if I showed up in sweatshirt and jeans to her wedding. "Who's the chippie in the sweatshirt? Is she the bride?" "No, the one in the big white dress is the bride."

Anyhow. I'm ditching the land line (not yet, Mom; I'll give you plenty of warning) and switching cell phone plans to the one that lets you talk for four hours for $29.99 rather than the one I have, which charges double that much for nothin'. And I've got a new cell phone coming at some point, thanks to Working Assets Wireless (yes, Dad, that hippy liberal commie pinko phone company) that will replace my two-ton dinosaur-fueled current cellblock. They say they're sending me a phone that takes pictures. Who'da thunkit? With the technology available nowadays, somebody really ought to make a new version of "King Kong". That would be cool.

I've also cleaned out my fridge and the cabinet under the sink in the bathroom, so I can tell if I have soap or not. Mom and Dad left me with the legacy of the 1970's in that I am always prepared for stagflation, invasion by Cuba, or nuclear war. I have so much backstock of everything from soap to water that the local Mormons are envious. (No joke. I have, like, *edible* stuff backstocked. Not mixes.) Chef Boy, not being much of a backstocker and not ever having lived with a chemical toilet in the pantry (the pantry built, by the way, especially to stock Perma-Pak dried foods and vacuum-packed wheat), is scared. I think he thinks I have a complex.

I planted basil seeds today in those little pop-up peat pots that come in 12, 24, or 36-pot sets. That'll save me from having to drive thirty minutes to find more than an ounce of one kind of basil for $6.99. This might not be considered *simplifying*, exactly, since I'll now have to take care of three different basil plants, but it'll save me some bucks. Plus, those little peat starter kits are just too damned cute.

So, if I head out next days off (in eight days) and get me one o' them mighty-fine rollup shades of shadecloth, I should be able to get a little container garden going on the porch. Believe me, with the money I spend on produce (the farmer's market guys smile when they see me coming), this is simplifying.

I wonder if I could grow melons on the third floor, or if that would constitute an unreasonable hazard to my downstairs neighbors.

Many apologies....

First, to those of you who couldn't access the blog reliably over the last couple of days: Blogger has been having some unscheduled downtime for the last week as they migrate things and try to fix disks. There's going to be another outage this evening at 7 pm PST. The Blogger folks say that'll be the end-all, be-all fix.

Second, to those of you concerned that I might either leave nursing altogether or move to Seattle and disappear, don't worry. I think it was a combination of too little sleep and too much "Dancing With The Stars" that put me in such a foul mood.

I had planned to make chicken biryani this week, but a patient with an AVM pretty much blew those plans. Arterio-venous malformations aren't uncommon in people's brains, but they can appear anywhere on the body, sometimes with disturbing results. One of the most disturbing things is the color of the skin around them; it looks a lot like biryani before it's cooked.

This particular patient had an untreated facial AVM that was about the size of my hand, fully extended and with fingers together. I wear a size 7 glove, by the way, so that ain't a small AVM. The thing had displaced her right eye down onto her cheekbone and had puffed her eyelids out (and the rest of her periorbital tissue) to the point that the right side of her face looked like nothing human. When your eyeball and eyelid extend past the end of your nose, that's a problem.

Apparently the thing had come up suddenly and had grown so fast that there wasn't much she could do about it; AVMs can be like that. We'd embolized the thing a couple of times already, and she'll have surgery to remove it today. She'll lose her right eye--there's nothing we can do to replace an eye that's been displaced that far for more than a few hours--and will need some pretty extensive plastic surgery to minimize scarring, but at least she'll keep most of her skull.

Which is not the case, unfortunately, with another patient. This one had had basal cell cancer on his nose and had had it frozen off years before. Note to the interested: NEVER have a basal cell carcinoma removed by freezing. The process might not get all of it, and you may end up with a migrating basal cell cancer that invades your sinuses, your eye socket on one side, and your frontal bones.

Whereupon we would have to remove the whole damned upper quarter of your face and replace it with a flap graft from your scalp, or thigh, or chest. This is not a way to spend a week, never mind the disfiguring consequences of having thigh skin and muscle taking up what used to be your eye socket and frontal sinus.

Still, even that's better than having some piece of artillery go all crazy on your ass and blow off one side of your face. I'm not sure if it was a shoulder-mounted grenade launcher or what; all I know is that Walter Reed did all they could for the guy and then shipped him to us for definitive plastics and skull reconstruction. Thankfully his brain escaped harm, though I don't know how. We got him for a couple of days so that we could do the cranial reconstruction; he'll be shipped down a few floors sometime this week for the facial part of the deal.

All those, though, pale in comparison to what it must be like to be the parents of a twelve-year-old with a major aneurysm. Unruptured, so the question is this: should we go ahead with a carotid sacrifice and try to bypass and remove the aneurysm, knowing that our kid will likely be gorked out and severely disabled for the rest of his life, or should we skip the surgery and try to control his pain, living with the knowledge that the aneurysm could blow at any point and kill him?

You can see why "Dancing With George Hamilton's Tan" seemed like a good idea at the time.

Thursday, February 02, 2006

When it absolutely, positively cannot be about work.

I go back to work tomorrow after five days off, the first three of which I spent incredibly tired and feeling as though someone had scrubbed my left maxillary sinus with Brillo. The last two days I've spent running around doing errands, getting my teeth cleaned and my eyes checked, and doing laundry.

Fun times.

This evening I'm drinking Scotch (thanks, Beloved Soon-to-be-Brother-In-Law!) and watching, to my faintly bemused horror, "Dancing with the Stars". And trying to plan what to do for my 36th birthday and reading the latest issue of "Mental Floss" during the commercial breaks.

Oh, mercy. George Hamilton's tan is doing a slowed-down samba to a live version of "Do the Samba" or whatever that awful Miami Sound Machine song is, and I'm worried it might fall and break a hip. If tans have hips.

Anyway, I'm waiting to go to bed before work. Michelle has, as usual, an intelligent take on one of the most common problems that nurses and invisible doctors like anesthesiologists have: we know before the patient does what's going on. And that sucks.

I've been wondering over this week if it's maybe not time to get back into non-hospital nursing, more because of the commute time (40 minutes each way is long, especially on the 3rd of 3 days) than because of the emotional stress, though that stress is playing a role. I've had some really difficult cases this past fall and winter, and I'm getting stress-related illnesses as a result. For me, that means tummy trouble and sinus infections and possibly an aneurysm down the line, as well as trouble sleeping the night before I go back to work.

Don't get me wrong: I love what I do. Neurology and neurosurgery are ripe with opportunities to educate, amusing in the variety of problems we see, and incredibly elegant. I never knew how damned elegant the human nervous system could be; it fills me with awe and joy every time I see a manifestation of a tiny problem writ subtly on a patient's behavior or body.

But it's getting tiring, seeing people who will probably not get much better. Say what you want about working with pregnant teenagers, women in their 30's with unsuspected STDs, and women needing abortions: at least it opened up avenues to the future. Those folks had an entire future opened up to them that was multifaceted and unbounded; the patient with a massive bleed or thalamic stroke often doesn't have that option.

Ha. This was going to supposed to be an essay on the various options I have for spending my 36th birthday, which unfortunately coincides with Chef Boy's prep day for The Biggest Holiday Of The Year (Valentine's). Instead of pondering flying out to The Palms of Dubai or getting a mani-pedi, I'm missing working public health.

I don't know. I decided, the day the 27-year-old mother of a pregnant 13-year-old came in with her daughter, that I needed a new job. I had, in fact, just told the 13-year-old, who was in methadone treatment, that she was pregnant. Her mother looked at me and said, "What do you expect? Do you want me to cry? 'Cause I'm not gonna cry."

I wanted to shout, Yes, I want you to cry, because your daughter has somehow repeated the awful life that you lived. Your daughter has made her future that much more difficult and that much more bleak by deciding that her mama did it, so she can too. I want you to cry for whatever failure of yours it is that allowed your otherwise bright and engaging daughter to start shooting up heroin and sleep with God knows how many men.

Instead I went to the bar and stared at the wall for hours, hoping that I could down enough alcohol to make it possible for me to sleep without making it impossible for me to drive.

I'd take Lunesta, but Miss Cat would flip out over the glowing butterfly.

Planned Parenthood needs a recovery room nurse for a clinic. It's part-time, and it's forty miles away (again), but...well.

Every nurse has the chance to make a difference every day she works. Even if you have five vent-dependent, gorked-out patients, you have the ability to make a difference. Somebody, somewhere, if you're doing your job right, will end the day feeling better than they did when the day started.

I suppose it's a difference in type of heartbreak. The same heartbreak over and over gets old; eventually, trading 32-year-olds with gliomas for 13-year-olds with unplanned pregnancies (Query: Can a 13-year-old plan a pregnancy?) begins to sound like an option. Again.