Friday, November 28, 2008

The Thanksgiving Party At Sunnydale General...



I'm on the left.

(Stolen from Manolo For The Big Girl, with thanks.)

Monday, November 24, 2008

In which Jo gets a bit snippy

When one blogs, one gets comments. One also gets emails.

It's amazing what people will say in emails that they won't say in comments. It's like the kid who bullies only when he's alone with another kid, not in front of witnesses. 

Apparently, folks don't like my grammar. They don't like my tone. A couple of 'em really hate the personal posts, while others don't like the posts about Manglement (or the fact that I refer to Manglement as Manglement). A few take issue with the new layout of the blog and get personally insulting in the process. There have been more than a few men (all have been men) who have gotten their socks in a twist because of my silly insistence that perhaps a) nurses ought to think of themselves as professionals and b) health care is one of those things that you shouldn't have to mortgage your life to get. Those guys are by far the worst in terms of being just plain rude. Guys, guys: you kiss your mother with that mouth?

I have this to say:

People. This is a blog.

There are approximately seventeen quintillion blogs out there. Approximately half of those are medical or nursing blogs. The other half, as near as I can tell, are divided about equally between cute animals doing cute things and beauty/celebrity/fitness topics.

The influence of this particular blog on anything going on in the world is proportional to its share of the Great Blogging Pie. In other words, with eight-and-a-half quintillion nursing and medical blogs out there, this one is just not that important.

You can relax, I swear. Nobody is gonna read HN and decide that it's time to overthrow the medical establishment, thus depriving you of whatever it is about your career that you find so important to protect. There is not a secret cabal of coruscating feminist nurses somewhere underground that uses HN as its template for revolution, its manifesto, its creed. HN is not going to raise your taxes, restructure your insurance company, take all the profits you make by inventing drugs and devices, turn nursing into some Amazonian society, or kick your puppy. Especially not that last bit.

Also, I am not undermining your attempts at formalized writing. See above: this is a blog. You ought to be concentrating on blogs that have posts that begin with letters and numbers and leet-speak, for God's sake. 

I am not making fun of you. Well, maybe a little. If you're the sort of doctor who reads a fictionalized account of my day and assumes that the doctor I'm talking about is you, rather than a composite of all the docs I deal with on a daily basis, then yes, I'm going to mock you. Relentlessly. You deserve it for being so damned self-important.

I do not talk to my patients the way that I write. Come on.

If you're so moved, either positively or negatively, by something that I write here, you're welcome to email me. The link's to the right. If you want to fawn, compliment, or give me big props, that's lovely. It gives me a nice warm feeling that lasts about a second, until everything snaps back into perspective.

If you want to send criticisms, that's lovely too. Just make sure they're rational and not personally insulting, okay? Ad hominem attacks will be promptly forwarded to the trash folder.

And if you just want to rant about how HN is destroying the foundations of nursing as a Blessed, God-Ordained Helping Role or how HN is fomenting revolution or how HN is a Feminazi mouthpiece, please, turn off the computer. Go outside. Pat your puppy.

It is just a blog. There are seventeen quintillion of them out there. Keep that in mind.

Thursday, November 20, 2008

What to Expect When You're Expecting A Craniotomy!

Here beginneth, by the way, a series on what patients can expect from various fun procedures that are common at Sunnydale General.

So you're having a craniotomy. Let's gloss over, for the moment, whether it's for a tumor or an aneurysm clipping or an external-to-internal carotid bypass, shall we? Most craniotomies have the same side effects and recovery time, so we'll ignore the whole range of reasons for them and focus on the important thing: Somebody way smarter than you will have his (or her) fingers in your skull.

Actually, that's not quite accurate. Somebody way smarter than you will have a series of microscopic instruments inside your skull. The point is, though, that your skull will be opened up (a thing that's never meant to happen) and closed again. Great. What can you expect from the process? Read on:

Prior to Surgery

The day of surgery, you'll be expected to show up at the hospital early in the morning, probably with freshly-shampooed hair. You'll be hungry and thirsty, having not had anything to drink or eat that morning. Somebody will start an IV line on you and fluids, which will help with the thirst part, and give you a dose of something to make you happy. Then you'll be wheeled into the operating room.

Surgery Itself

At this point, one of two things will happen: you'll either be put out completely by the friendly anesthesiologist, or you'll be moved to the operating table, *then* be put out by the F.A. Your head will be positioned in a head-holder (tough medical terms, I know!) and anything from a small strip of hair to half your head will be shaved, depending on the surgeon.

Note: Most docs now shave only what they have to, so don't think you'll lose all your hair.

While you snooze, your head will be scrubbed with a sterilizing soap and draped with sterile drapes. Somebody else will be working on your other end, putting in a urinary catheter.

Once everything is ready, you'll have surgery. Since I have no clue what actually goes on inside the brain during surgery, and you'll be asleep for it, let's move on to the post-surgery period.

After Surgery

You'll wake up, more or less, in the ICU. You'll have wires on your chest, IV and intra-arterial lines in your arms and possibly feet, and you'll feel like hell. Your throat will be sore from the breathing tube they put down you to keep you breathing, and you'll still have that damned catheter in. You'll also probably have a doozy of a headache. This will all cease to matter as the fact that you're in the ICU dawns on you, and you have to cope with bright lights, beeping machines, and nurses coming in every few minutes to make sure your neurological exam hasn't changed. Expect them to ask you silly questions like "What day is it?" and shine bright lights into your eyes over and over. 

After a night or two in the ICU, you'll be moved to a neurosurgical acute care unit. All but one or two IVs will come out, along with the line in your wrist that monitored your arterial pressure. Expect some major bruising there, by the way.

After I introduce myself, I'll take out your catheter. You have eight hours to pee, which shouldn't be a problem. The catheter removal doesn't hurt (at least the way I do it) and you'll feel a lot better after it's gone.

You'll be able to eat regular food if you can, and I'll manage your nausea if you're feeling queasy. Don't ask for Phenergan, by the way, since you won't get it. It makes you too sleepy.

I'll be checking your neuro status every four hours, or more often if I'm a tad worried about you.

The first afternoon out of ICU, you'll probably sleep. This is normal. You might feel *great*, what with all the anesthesia still in your system, but you'll be sleepy the next day for sure. Either way, sleepy or not, you're getting up into a chair and walking a little bit, just so I can be sure everything got put back into the right place.

Okay, So Now What?

Let's take a look in the mirror, shall we?

You'll notice that, if your incision is along the front or side of your head, you have a whopping black eye and a whole lot of swelling on your face. This is totally normal and will go away completely within about ten days. You'll also see a shaved strip or patch of hair with either staples or sutures in it. That's where they went in, and those staples/sutures will come out in about ten days, just as you're looking less like you've been hit by a truck.

You might have punctures in your forehead from that head-holding widget I mentioned earlier. Those will heal and leave very small scars if there are any scars at all.

There are probably bruises on your arms from the IV and a huge bruised area on your right wrist from the intra-arterial line. Your jaw (if your incision is in the front or side) is sore, or your neck (if it's in the back) feels like you have one hell of a crick in it. We can take care of that; just ask for pain meds.

You will probably hear ticking, dripping, thunking, swishing, or popping noises inside your skull, especially if the incision is on the front or side, or around your ear. That is Totally Normal, and is a result of air in your head moving around. You are not insane. The surgeons *always* forget to mention that, and it makes people worry.

You will get very tired very easily. Keep this in mind. You'll find that mental things, like crosswords or reading, tire you faster than physical things. This is because you're basically trying to walk on a sprained ankle--in other words, you have to keep using the part of your body that's been injured or insulted, even as it heals.

Even with the tiredness, you may have trouble sleeping. This is due entirely to the fact that you're getting Decadron, a steroid, to reduce swelling inside your brain. That side effect will go away as soon as we start tapering (lowering the dose) of Decadron, so don't fret. In the meantime, ask for a sleeping pill.

You'll notice that I'm loading you up with laxatives and stool softeners. This is a major deal, since constipation goes hand-in-hand with pain medicine, and I don't want you straining. If you go more than two days without pooping, I will take Drastic Measures. 

Speaking of pooping and peeing, I'll take great interest in how much you drink and how much you pee. This is because opening the brain or spine can lead to various problems with how your body handles fluids, and I want to make sure that's not happening with you. 

After Discharge

When you go home, you'll want to take it easy for two to six weeks. Walk, eat, sleep, sit up in a chair, be calm. You'll have a followup appointment in about two weeks with your surgeon, at which time you'll chat about the surgery and he'll make sure he didn't leave any bits out. 

Make sure your diet is good. Your appetite will probably suck, so eat good food when you get hungry. Include protein and some fat. Avoid junk. Drink plenty of water.

Nap occasionally. Let your body tell you what it wants to do.

And don't worry about screwing something up. Depending on your doctor's orders, you may or may not put antibiotic ointment on your incision or take oral antibiotics. As long as you don't scrub the incision line with a toothbrush (and yes, I have had people do that), it won't get infected.

Don't perm or dye or relax your hair for about six weeks after the staples or sutures come out, though, 'cause that scar is still delicate. And don't use a hairdryer: it'll cause staples to become uncomfortably hot.

Finally, remember that you have had brain surgery. It might be six months before you get your stamina back, okay? Take it easy. In a year, this'll all be a bad memory.

Here endeth the first lesson.

Tuesday, November 11, 2008

11.11, 90 years ago.

In Flanders Fields the poppies grow 
Between the crosses row on row, 
That mark our place; and in the sky 
The larks, still bravely singing, fly 
Scarce heard amid the guns below.

We are the Dead. Short days ago 
We lived, felt dawn, saw sunset glow, 
Loved and were loved, and now we lie 
In Flanders fields.

Take up our quarrel with the foe: 
To you from failing hands we throw 
The torch; be yours to hold it high. 
If ye break faith with us who die 
We shall not sleep, though poppies grow 
In Flanders fields. 


And one for Canela Cruz, in Iraq now...


Ashbah

The ghosts of American soldiers
wander the streets of Balad by night,
unsure of their way home, exhausted,
the desert wind blowing trash
down the narrow alleys as a voice
sounds from the minaret, a soulful call
reminding them how alone they are,
how lost. And the Iraqi dead,
they watch in silence from rooftops
as date palms line the shore in silhouette,
leaning toward Mecca when the dawn wind blows.

Monday, November 10, 2008

What I cook on my day off, when I have a cold

It's been raining buckets all day. Just now it's raining double-buckets, which makes me glad that I have a cold and the next two days off. The cold isn't bad, really; I've been taking loads of zinc, which really does seem to help hold off the worst of the symptoms.

I also have a loaf of bread and a pot of soup. Therefore, the recipes:

Nurse Jo's When-You-Have-A-Cold, Clean-Out-The-Fridge Soup

1 small box chicken or vegetable broth
1 normal-sized can of diced tomatoes in juice
1 normal-sized can of red kidney beans, drained and rinsed

Dump all of these into a big pot. In a skillet, saute without browning

A half of a fist-sized yellow onion, diced 
A couple of cloves of garlic, minced (I use, like, six; but I'm weird)
A couple of stalks of celery, de-stringed (you do this by breaking the tops off and zipping the strings down the stalk)

Dump the skillet's contents into the pot once everything is nice and soft and fragrant. Turn the heat under the pot on to the point where it's not quite boiling. Add:

A small potato, peeled if you like and cut into cubes
Some corn (I used frozen)
A couple of handfuls of sliced-up green beans (I used frozen)
Some carrots, chopped 
Zucchini, yellow squash, peppers, more tomatoes; whatever you have in the fridge.

Simmer for about twenty minutes, or until the potatoes are almost done. Add:

A biggish bunch of parsley, tied with a string if you've got it
Some lemon zest if you've got it; if not, try thyme
A little rosemary (everybody has rosemary, right?)
A shocking amount of ground black pepper
More salt than you would think

Continue to simmer until the potatoes are nice and soft and come to bits when you poke them.

Eat with Basic White Bread:

Sometime earlier in the morning, if you want bread, you will have wanted to mix up in a nice, big bowl:

4 cups high-gluten ("Better for Bread") flour
A cup and a half, roughly, of water (room temp is fine)
A packet of instant ("Rapid Rise", "Better for Bread Machines") yeast
A tablespoon of salt

Mix that mess on up until it makes a big lump in the middle of your bowl. The dough should look shreddy and weird and kind of like it doesn't really want to stick together.

Dump that mess onto a clean counter that's been lightly floured, or onto a big cutting board, ditto. Knead it by pushing down with the heels of your hands in the middle of the mass, pushing outward, and then folding back in toward you. Do this for ten to twelve minutes. Don't skimp. Turn the dough around between foldings to make sure it's all evenly beaten up. Meditate on something pleasant while you knead. Pleasant thoughts make good bread.

At the end of 12 minutes, you will have a cohesive mass of still-fairly-dry dough. It'll be tacky, but not sticky, and you won't have to have flour under it to keep it from sticking to the counter or cutting board. 

Scrape the remnants of dough etc. out of your bowl and toss in a tablespoonful or so of good oil. Toss the dough ball into the bowl, turn it once so it's nicely coated, and cover the bowl with a damp towel. Set it all aside and forget about it for one and one-half hours. First, remove a stick of butter (not margarine not Promise spread not I Can't Believe It's Not Nuclear Waste--BUTTER) from the refrigerator.

At the end of 90 minutes, which I suggest you use for a nap, punch the dough down. Without removing it from the bowl, push into it gently but firmly with your fist, all over, until it looks sort of deflated and defeated and flaccid. It will give off a nice yeasty smell when you do this. 

Cover it back up and go do something else for another 90 minutes.

At the end of your second nap, dump the now-floofy and soft dough back out on your countertop or cutting board. Rummage around until you find a pan that measures 9 by 3 by 4 inches, or a good flat cookie sheet, or something to hold the dough while it bakes. Butter or grease the pan/sheet/flowerpot well.

Turn your oven to 350 degrees.

Return your attention to the dough. Squoosh and push and coax it into something resembling a loaf, or a round peasant loaf, or a long baguette, or a bust of Elvis. Put it into your greased pan/onto your greased cookie sheet/into your flowerpot and let it rise for, oh, 30 minutes or so, or until its top is nicely rounded over the top of the vessel it's in. You'll know it when you see it; your brain will say, "Oh! That's a loaf of bread! Dayum!"

Put bread in oven. Bake for anywhere from 45 minutes to an hour and 15 minutes. It's ready when it's a nice, even, golden brown all over (this bread will not get very dark) and when the bottom makes a good, hollow THUNK when you tap it. 

Note: If this is the first time you've made bread--and I swear you can, with this recipe--you will be entranced with the THUNK the bread makes when you thwack it with your finger. Do not sit in front of an open oven, bread in your oven-mitted paw, THUNKing the bread over and over.

Take it out of the oven and let it cool on a rack, out of the pan, for about 40 minutes. This part is REALLY FUCKING IMPORTANT, okay? If you cut into it when it's still hot, not only will it accordion on you and smoosh all down and get weird, but it will taste of uncooked dough. Bread continues to bake on the inside when the outside is done. So leave it alone. Do what I did today: take some cold medicine and have a whiskey-and-lemon and read for a bit. The butter will be soft enough to spread, and I promise the bread will still be warm when you cut into it.

If you're *really* smart, you'll start the soup when the bread is about ten minutes from being done--that is, when it's blonde instead of golden and doesn't *quite* smell like bread yet. That way, you can have your finished soup and your bread and butter and your hunk of smoked cheese from a dude that makes such things out of buffalo milk for dinner, and your dog will (as Max did tonight) sit quietly next to the table, whining and hoping you feed him some bread.

And then you can take some more zinc and feel good about your day off.


Sunday, November 09, 2008

What the hell is WRONG with you people?

Quick update: My folks are apparently in Mexico and are fine. Uh...okay.

Now, then: What the hell is WRONG with you people? Are you all mad as a sack of badgers? Where the hell do you get off? Whiskey Tango Foxtrot, you guys?

I mean, really. Do not (I repeat, do not) start a fistfight with your relative in your elderly and ill other relative's hospital room. If you do, I will be forced to call the police. And the po-pos, having dealt with your lousy self already, will not be happy that they have to come break that shit up.

Again.

Also, do not piss and moan and complain until I move heaven and earth to find an interpreter that speaks the same language as your patient from Furthest Backobeyondistan, then fail to show up at the hospital, or even return your pages, after I find the one person in the very large metropolitan area that speaks East Wanganese. The East Wanganese interpreter will be very disappointed, and the family members will be disappointed, and there will be unhappy people wandering around, wanting to start fights in some language other than English.

Luckily, since I know exactly no East Wanganese, the torrent of abuse that was levelled at me because of your idiocy, Doctor, rolled off my back like so much milk off a cornflake.

And finally, and I can't believe I am having to say this yet a-bloody-gain, the hospital is not the place to host Tupperware parties, drinking bouts, drug deals, furniture sales, porn movie festivals, panhandling competitions, the 2008 TV-Stealing Olympics For The Poorly Dentitioned, or any other harebrained, jackassed idea you might have.

Whatever you think is a good idea, I can tell you right now is totally inappropriate, will probably have the aforementioned police showing up at your room, and might get your rhino-assed self kicked straight back to County General. 

I am now going to finish this Scotch and go back to bed. Your behavior had better have improved by Wednesday, or else I'll give you something to whine about.


Thursday, November 06, 2008

JAMES JAMES MORRISON'S MOTHER/SEEMS TO HAVE BEEN MISLAID


Has anybody seen my parents? If so, could you please contact me and let me know they're okay? 

I'm afraid, what with the outcome of this election, that they've decided to move somewhere more right-wing without telling Beloved Sister and me.

*** *** *** *** ***

Max has learned to bay.

He's made great friends with an extremely wiggly, extremely friendly half-grown Basset hound down the street (whose owners are kind enough to let her off-leash to come visit him) and has learned her tricks.

Given that she's a bass and he's more tenor-to-alto in his baying, it makes for a funny duet. You hear the lower, deeper dog noise and expect that Max would be making it, but instead it's Gretchen The Basset. Max is the one whining and whickering in a high voice and baying way up, an octave above Gretchen's bay.

Max and I sang a duet to the passing ambulances and firetrucks the other day, and Gretchen joined in from four houses down. 

*** *** *** *** ***

Today I did 60 pushups, military-not-girly, and then did 60 lat pullups with 20 pounds and some shoulder rows (30 lbs) and some shrugs (20 lbs) and 60 Aaaahnuhld bicep curls with 15 libs apiece. My upper body is a thing of beauty. It's also very, very sore.

*** *** *** *** ***

If you are a rehab nurse with a patient on a bowel program, please, please make sure the patient actually takes a shit now and then. Especially after they have a barium swallow. That will save me from the fun of milk-and-molasses enemas followed by slow Go-Lytely feeds followed by projectile vomiting (the patient's, not mine), followed by the realization that there are now no bowel sounds where there used to be a few, followed by Reglan IV, followed by erythromycin in an attempt to get the bowels loosened up, followed by an admission of failure, a GI service consult, and surgery.

Thank you. Really.

*** *** *** *** ***

I do not think, coruscating feminist that I am, that it is sexist to ask what the fuck was up with Michelle Obama's dress the other night.

*** *** *** *** ***

Have I mentioned how glad I am that we will have a vice president who doesn't believe that Adam and Eve co-existed with dinosaurs? I mean, really. Do people like Sarah Palin (young-Earth creationists, that is) use antibiotics? Or any sort of genetic testing? Or any of the boons that science has granted us? Because if they do, they should be outed as hypocrites.

It puts me in mind of a Doonesbury cartoon from a year or more ago, in which a doctor was telling his patient that he (the patient) had TB. He offered the patient the option of prayer or antibiotics, reassuring the guy that the antibiotics were "intelligently designed".

*** *** *** *** ***

If anybody has any good sources for upholstery fabric, please email me at the link to the right.

Wednesday, November 05, 2008

Housekeeping note:

I've deleted a couple of links.

They were to blogs that were, for the most part, much more conservative politically than I am. It's not because the authors are conservatives that I deleted them; I agreed with those authors more often than you'd think, and on a wider variety of issues.

The reason I've deleted the links is this: in the aftermath of the Presidential election, the comments sections of those blogs, including comments left by the authors of the blogs, contained some of the most vicious, mean-spirited, and even out-and-out racist shit I've ever read. 

I understand that Republicans and other conservatives must be angry and disappointed as hell right now. If Obama had lost, I would probably still be in bed, planning only to nurse a hangover and learn French prior to my move to Montreal. I would be peevish about a stolen election and bitter and crying. So it's understandable that there's some serious, serious grouchiness out there in Conservative-Land.

What's not acceptable is the amount of vitriol and the thinly-veiled racism. Vitriol is understandable and even allowable in small amounts, but gallons of it poisons discourse. Racism isn't understandable or allowable, even in small doses. If you want to make jokes about getting rocks of crack at the polling station or how watermelon is going to be the new national food, you go right ahead--but I'm reserving my right not to have that sort of crap linked from here.

This isn't a pouty, I'm-not-reading-your-blog-any-more whine. It's an explanation of why, the day after the election, my links list is shorter. 

When the code doesn't work

Everybody loses patients. Everybody remembers the patients they lost--maybe not by name, or even by face, but you remember. Every patient who dies leaves a little hole in you.

The first one is the worst for most people. And it's bad enough when it's a patient who's been shifted to comfort care; it's worse when it's a failed code. When you walk into a room to find a person, who was fine half an hour or an hour before, is just plain dead, it's shocking. Codes are shocking, too, in their violence and their (usual) pointlessness.

That happened to a coworker of mine the other day. Her patient had been fine and stable and cheerful all shift long and had laid down to take a nap near the end of the shift. He was scheduled to go home the next day. When she made her last put-'em-to-bed rounds of the day, she found him not breathing, not pulsing, not responding. Just plain dead.

And we coded and coded and coded and it had the predictable result.

So what do you do when a code fails?

Well, first, you allow yourself a little freak-out. If you're lucky enough to work where I do, the other nurses on the floor will pick up the slack for ten minutes while you lock yourself in the bathroom and flip your lid. If you're not lucky that way, you'll have to do it while you fill out paperwork and call the eye harvester folks.

Then you figure out what went wrong. In most situations, absolutely nothing anybody could've done would've prevented the death. Short of overdosing a patient on medications or giving them the wrong blood or shoving a tube feed into an arterial line, dying is not something we have a whole lot of input into. Still, it's helpful to think about what led up to your patient's stopping breathing, if only because it'll reassure you that you didn't screw up.

Then you deal with your other patients. It's easy to forget, in the aftermath of a code, when you're overwhelmed with emotion and paperwork, that there are four or five or six other people that are still alive that are depending on you. 

Finally, at the end of the shift, you go home. 

Think about your patient. Raise a toast to 'em, if that's how you roll. Talk to your partner. Hug your kids or your dog or your cat. Roll into bed, with or without the general anesthetic of your choice onboard, and remember that every shift is a new one.

Everybody dies. Some of us die more easily than others, and in better situations. There is not a damned thing you, as a nurse, can do to prevent a death if it's gonna come anyhow. The best you can do is learn from the situation if it's less-than-ideal and use that knowledge to improve the lot of the next folks you take care of.

Tuesday, November 04, 2008

Yes, We Did.

Is there a physicist in the house?

You remember, I'm sure, the high school physics demonstration of the space/time continuum and how gravity affects both space and time. It's the one that uses a rubber sheet and balls of varying sizes and weights.

Your teacher (or the guy on the public-access cable channel who had sticky-up white hair and a bad lab coat) stretched the rubber sheet tight to illustrate space/time. Then she (or he) dropped a marble or a tennis ball or a bowling ball into the middle of it, and the sheet bent around the ball. Right? You with me so far? After that first object was dumped into the sheet, everything that came after gravitated toward the heaviest thing on the sheet, remember?

So here's my theory: a patient arriving from post-op or directly from admissions has the same effect on the space/time continuum as that bowling ball did when dropped on the rubber sheet. Every other patient you have will proceed to call, fall, bawl, or maul the lab tech, even if they've all been quiet and happy all day long. 

Here's what got me thinking about this, and I wish I were making this up: a patient arrives post-op. I settle them in and take vitals. As I'm doing this, I get paged that another patient has arrived from the admissions department. I settle that person in, return to the post-op patient to tie up some loose ends, and get paged that a doctor wants to see me. On the way to the desk, my phone rings with the news that another patient needs pain medication. As I'm talking to the doc at the desk, six people--and Lord, do I wish that were an exaggeration--come up to me within two minutes to let me know that *another* patient has a headache. Meanwhile, my final patient has fallen in the bathroom after an entire day of walking independently and having been discharged by physical therapy.

Ten minutes before the first patient arrived from the post-op unit, I had finished my rounds and made sure everybody was comfy.

I need a physicist to confirm that post-op patients and outside admissions bend the fabric of space/time, please. Anybody?

Saturday, November 01, 2008

Saying Goodbye.



Today I loaded Strider into the car.

We drove east along a little state highway. Over the lake, across the creek, past the McCain/Palin billboard, up and down the hills where the oaks are just turning color. The sky is cloudless and blue today, and Strider had his nose out the window when he wasn't resting his head on my arm.

When we got to the place where I had gone to pick him up six months ago, he got very excited. He greeted his foster mom by rearing up and putting his front paws on her shoulders, then bending down to lick her face. She was thrilled at how beautifully his coat had come in, and how all the mange he'd had was gone. I was glad to see that he still remembered the person who'd held him on her lap (all 80 pounds of him, at the time!) and sung to him when he was so sick with pneumonia that he couldn't sleep.

Then his foster mom introduced him to her female Anatolian shepherd, popped them both into the back seat of her truck, and I hugged him goodbye through the window. The last thing I saw was his butt, tail wagging, as he got comfortable with the other dog in the truck.

Strider did well here for the first four months. Then, as he got out of puppyhood, he started developing a personality that just didn't jive with Max's. They were fighting every day, and Max (being slightly smaller and older) was getting the worst of it. I was having to patch him up nearly every night. Max was scared and miserable, Strider was turning into an aggressive bully, and I was at my wits' end.

So Strider-Man is now going to be on a farm in the far, far northeast corner of Texas, up beyond Dallas, near the Red River. It's border country, hilly and green with creeks on the property he can swim in and coyotes he can chase. That'll be his job: he'll be running the fenceline on fifteen acres and protecting everything on the property. He'll be good at it, and it'll be good for him to have both a job and almost-unlimited space to run. I expect him to be rippling with muscle, tougher than leather, and completely his own self by the middle of next year.

I am going to miss him a lot. He's a good boy. Very nearly the best boy ever, if Max hadn't already had that title.

Max, meanwhile, is basking in the sun, somehow aware that nobody's going to come out of the corner of the yard, knock him down, and worry his head. He's looking forward to renewing his acquaintance with the pug next door and going for long sunset walks.

Maybe someday I'll try another buddy for Max. For now, though, he has to get his mojo back and remember what it's like to be Top Pup.

Stridey-boy, Big Stupid Goofball, Snorgle-Pup, Scrimble-Nimble, Nom-Hound, I'll miss you.