Thursday, April 28, 2005

This is what's good: or, What I cook on my day off

Onions (red) and mustard seed (black), a handful of each. Cumin seeds, a lesser handful. Fried in olive oil until the mustard seed starts to commit pop-kari and hop all over the stove. Then, add a bag of baby spinach that's been rinsed and shaken out. Let the spinach wilt.

Serve with basmati rice. Bitter, sweet, spicy, crunchy, chewy, all at once.

Zucchini: tiny baby zucchini, the size of your thumb. Cut 'em in half or thirds. Saute in REAL thank you butter, just a bit, until they're vaguely golden brown on the cut side. Eat. Spring in a frypan.

Asparagus: roasted dry so all the sugars carmelize, then drizzled with a tiny bit of olive oil and salt and lots of fresh black pepper.

Broccoli is good any way you make it. If anybody has any idea how to make a garlic-and-broccoli aspic (solid uniform light green, not clear) like I had at L'Express in Montreal, please do tell. Mmmmmm. Not at all what I expected, not edible-looking, delicious.

Eeeen-tee-ninesy strawberries from the pick-yer-own patch, sliced and served with really, really good balsamic vinegar and a dash of fresh ground black pepper. Trust me on this.

Right now I'm hunting for a blackberry patch. My secret old half-acre tangle of blackberries got bulldozed, dammit, for overpriced McMansions, so I'm scouting the fields and back roads. When the blackberries ripen, I will pick them and eat them immediately, then turn the rest into jam. Recipe to come then.

Ooooooh. And blackberries with cream. And blackberry shortcake. Mmmm.

Monday, April 25, 2005

"Do you practice what you write?"

Just saw that comment on another medical blog, one written by a doctor.

It got me thinking: do I practice what I write?

Most of the time, the answer to that should be "God, I sure hope not." If ever I did, there would be nastiness flying that would make Dr. House look like a kinder, gentler Florence Nightingale. (Not that that would be hard, you understand. Ol' Flossie was a bit pushy, then a bit weird. But you get my meaning.) If I had one day to say what I *really* thought...goodness. The building, with its overfed administrators and clueless management, would likely burn down. Hopefully with the aforementioned people still inside it.

So most of the time, no, I don't practice what I write. I don't often write about how difficult it is to find something to say to the wife of a young man with a highly aggressive and atypical glioma. I don't write about how often I have to tell people that they will *not* get any better, that where they are is as good as they're going to get.

I don't write about the times I don't say anything. Those times are the most important, in the larger scheme of things, and you never know they're coming until they're on you. Sometimes the most therapeutic (I'm making bunny-ears in the air to signify quotes around that word) thing you can do is shut the hell up and let the other person vent. Sometimes that happens at the very most inconvenient time possible, like at the end of the shift when you're exhausted, because that person decides to trust you when your hand's on the door.

A lot of this job has to do with reminding yourself nearly-constantly that it is not about you. People will bitch, moan, complain of being abused by the physical therapists, and be insulting to you...but they'd do that to any willing ear that came in. They'll compare you to other nurses. (Nota bene: Other nurses are always better than you in retrospect.) They'll be nasty.

Then, all of a sudden, it really *is* all about you. For some weird reason, this person has decided that you, with all your faults and pettiness, are the person that they want to express their fears to. And you have to be ready for that, and not make any huge blunders.

Then it stops being about you again, if you do your job right. I don't practice what I write. What I write casts me as Super Nurse, with the big S on my chest and the cool boots. (No capes.) I wish I could write what I practice, but there's a delicacy to the interactions that I just can't do justice to.

Eventually, maybe, I'll get there. In the meantime, though, what I do is this: imagine my day, before I even get out of bed, as though everything is going perfectly smoothly. I think of the ideal responses, the ideal emotions. I store those away. And then, for the next twelve hours or so, I try--not to live up to the ideal--but not to kill anybody or dope-slap anyone out of frustration.

Sunday, April 24, 2005

Yesterday I read four books.

I got home to find three books in my mailbox and a fourth waiting for me at the office. Hooray for Amazon's used book service! Hooray for ALibris!

I walked into the apartment and said to the cat, "Kitty, we're rich! Wealthy beyond our wildest imaginings! We have BOOKS!!" She mumbled something about tuna and went back to sleep.

So, without delay, reviews:

1 and 2. Life on the Border and Bordertown, both edited by Terri Windling:

I'm a big fan of the book Finder and a lesser fan of the book Nevernever. Both of those are part of the "Borderland" series conceived by Terri Windling, who apparently has nothing better to do with her life than convince other people to write fantasy novels. She's also responsible for Tam Lin, a modern (1970's) retelling of the Scottish ballad by Pamela Dean. I got sucked into all this, by the way, when my sister sent me a copy of War For The Oaks, a very funny and fast-paced first book by Emma Bull.

LotB and Btown are basically interchangeable as books go. They're both collections of short stories that deal with what happens when Elfland shows up with a bang after millenia of not being around. Elves and humans start to mix in large cities, portions of New York and San Franciso disappear, dogs and cats run wild in the streets, and I'm sure at some point there're some sheeted dead gibbering there too. Nice concept, brutal execution in spots.

Or maybe I'm just not in the fiction-reading habit. Or maybe I got spoiled by reading Sayers and Edmund Crispin over the last weekend. Who knows? Point being, there are some gems in both books, but the titles and plots of the gems escape me. There are also lots of folks with pointed ears, and a surprising number of in-jokes, mostly having to do with Minneapolis. Charles de Lint continues to suck dead rat. Emma Bull and Will Shetterly retell bits of stories I'd read previously, but from a different point of view.

Bottom line: worth it for serious Bordertown fans, which I'm not sure I am. If anybody wants to read 'em, don't spend $20 at ALibris. I'll let you borrow 'em.

3. Gullible's Travels, by Cash Peters:

Love Cash Peters's commentaries on NPR. Love 'em.

Too bad this isn't like those. He's essentially put together a tale of all the bizarre places he's visited as NPR's Bad Taste Tourist, mixed in with healthy doses of not-too-subtle sarcasm and a touch of misanthropy, and put it on paper. *sigh*

4. Neither Here Nor There, by Bill Bryson:

Now *this* is a travel book. Bill Bryson retraces his steps through Europe, seventeen years or so after his first trek. It's funny, it's informative, it has hilarious moments, like when he tries to go down a staircase in an Italian hotel only to find the door at the bottom locked. He gets drunk in Nyhavn, cold in Oslo, frustrated in Naples, and enraged with the Visa travelers' check office in Geneva. His experience in Denmark mirrored mine--I realized at the end of the book that we'd been there at roughly the same time--and his retelling of spraining his ankle in Split had me gasping for air.

Bottom line: I'm planning to read everything else travel-related that he's written, having already exhausted his books on language.

Next up: Elizabeth's London by Liza Picard, and Inside the Victorian Home by Judith Flanders. I have another Bordertown book coming as well, one I'd forgotten I'd ordered. Also an out-of-print Gerald Durrell and a book on ravens, which I'm really looking forward to. Amazon tells me that their estimated ship date is Not Soon Enough and the delivery date is Long Enough Away To Make You Scream.

Now I'm off to take some aspirin for this over-reading headache I've got.

Saturday, April 23, 2005


IV pumps beep when there's a problem. Sometimes that problem is a kink in the line, or air in the line, or you've run out of fluid. Be that as it may, they beep.

Some IV pumps set up an outraged, high-decibel, high-pitched screaming fest when they run out of batteries. One of them did yesterday as I was settling in a patient, a fresh post-rotator cuff repair. I jabbed futilely at buttons for a few seconds, then dragged the thing outside the room. It continued to wail. It was *off* at that point, but that didn't seem to make a difference. The Evil One had gotten into that IV pump and wasn't letting go. It was the Amityville IMED.

Result? I couldn't hear very well for the next couple of hours, being's as I had my head down near the damn thing when it went off.

That, as it turned out, was a good introduction to the day.

I started with five patients, had a total of seven all day, and only kept one patient for the full twelve hours. You can do the math on discharges and admits on that one.

We ran out of IV needles, urinals, toilet paper, and patient belonging bags at about 1500. Since I'd already had to tap into my stash of dressing change supplies and soap, this did not make me happy.

My charge nurse seems to have lost his mind and decided I'm the go-to girl for unexpected admits and discharges. That post-op patient I had? I got less than thirty seconds' warning that she was coming. While this might be normal, it does not make for a relaxed Jo. "Oh, by the way, that's your patient" is not what you want to hear from your charge as a bed rolls down the hall.

One of my patients didn't like her Jell-O and threw it at me. Another didn't like the world and decided to delay asking for a shower until 1645. A third had two negative ultrasounds for DVT and a positive VQ scan for pulmonary emboli.

And they were out of chocolate cake in the cafeteria. Daaaaaamn, what a day.

Wednesday, April 20, 2005

Would you like fries with that new nurse?

Guess it's time I addressed the "nurses eat their young" thing, as I got three--count 'em--emails on the subject yesterday. (Shout out to Yolanda, holdin' it down in her commhealth clinicals!)

Yes, there are some really nasty, disgruntled, embittered nurses out there. There are also some really nasty, disgruntled, embittered bookstore employees, gas station attendants, soldiers, airline pilots, fashion models, and so on. Nurses are not the only folks who eat their young. Reparatory theater actors, for instance, are *much* worse.

But the public has this outmoded idea that nurses are angels of mercy who are always sweet, patient, kind, and dressed in white. They don't realize that we're highly trained, exhaustively educated people who are taking care of sick people and don't have time for B.S.

If you are a student and attempt to bullshit us, we will cut you off at the knees. Not only is bullshitting a waste of my time, and unprofessional, but it's irritating. If you don't know the normal values of potassium and sodium or what Lopressor is for, and you're a last-term student, you *bet* we'll bite your head off. Your job is to have some idea of what's going on. If you don't, you're not safe and you won't work with me.

If you're preternaturally stupid, we'll deal with you with patience and tact until management can get you transferred somewhere less challenging or to another hospital. And yes, that has happened with a new nurse I worked with--she didn't check vitals once during a twelve-hour shift and recorded *every* patient as having the same neuro exam.

However. If you're a new student who's showing some enthusiasm for what's happening, even if you're clumsy and ignorant, we will make sure you get the best possible clinical opportunities we can muster. Same with a new nurse: if you're a decent human being and willing to work hard, we don't care what you know or what you don't.

Same with residents. Same with new techs. We're a pretty forgiving group, provided you don't either ask us out during the shift (as an eighteen-year-old nursing student did with me once) or act like a jerk.

Of course, I work in a really good environment. If you're unlucky enough to be stuck in a hospital where people are ground down and unhappy, *everybody*, from the unit secretaries to the attendings, will be taking bites out of one another. That's called "a bad work environment", not "nurses eat their young."

Funny point: the people most willing to promulgate NETY as a truth are nursing instructors. Who usually haven't worked on a floor in years. Who have limited contact with clinical nurses. I had twelve instructors over the course of my schooling. Ten of them, when I asked 'em, said they'd gone into teaching because they hated floor nursing. Two of 'em said they loved teaching--and those two still worked weekends and off-days in the NICU or PICU or on the floor.

The ten who hated floor nursing were the ones who told us that nurses eat their young. The two who loved nursing and teaching, both, were not coincidentally the best instructors I've had in *any* course I've taken.

It's not hard to do the math, here. Point being, don't be afraid of nurses. You might be soft on the outside, crunchy on the inside, and taste good with ketchup, but that's not an automatic guarantee that Dragon Lady will eat you alive on your first day as an RN. Fall back on what you've learned in school and in your previous jobs and keep your eyes open. Be willing to learn from everybody. And, just to be on the safe side, do not bring large bottles of seasoned salt with you to work. It's just too much of a temptation.

Tuesday, April 19, 2005

What I do on my day off

"Sweet creeping zombie Elvis" Karen said as I walked into the bar, "Don't you own any sandals?"

I had put on a black short-sleeved sweater, jeans, and red pointy-toed cowboy boots. Karen's reaction caught me off guard until she explained that it's *spring*, dammit, and I ought to be showing off my toes.

"As a matter of fact," she continued, "I don't think you own anything that isn't a T-shirt."

She had a point.

Next thing I knew, she was pulling out her Palm Widget and making plans for us to go shopping. In a few days, I'll be heading out with a woman who is well over six feet tall and who holds a BA in fashion merchandising.

I forestalled her, though. Today I went shopping. Heh.

I bought two--*two*-- pairs of sandals. One is brown and low-heeled, with complex straps across the top of the foot; the other is black with one big strap across the toes and a pair of D-rings for decoration. The black pair has higher heels. Don't ask me why the D-rings; I assume it's Fashion.

Also a nice handbag. "Don't you own another purse?" Karen asked, eyeing my Peruvian woven shoulder-bag distastefully. The new one is black leather, shaped like a doctor's bag, and has muted white stitching and silver hardware. It's softer than the nicest pair of shoes I own and the handles fall over perfectly when you set it down.

And a linen suit. Nota bene: check out Target's new spring suits. And a pair of black cropped pants. And a blue linen man's shirt.

And three V-neck Hanes T-shirts. Hey, a girl's gotta be true to her inner Fashion Maven.

Friday, April 15, 2005

Simple definitions from life

We occasionally use the phrase "jacked up" at work. This is somewhere between "on vulture precautions" and "train wreck", and is a source of confusion for those people not versed in the cynical and bitter humor of a neuroscience unit. Therefore, I present examples of "jacked up" and "not jacked up" for your perusal. It is to be hoped that they will clarify the issue.

Migas: not jacked up.
Migas with store-bought pico de gallo: jacked up.

Hole in your belly I could put my head through: not jacked up.
Hole in your belly secondary to an abcess that's been cooking for twenty years, ever since you had gastric stapling: jacked up.

Hemiparetic after a stroke: most definitely not jacked up.
Hemiparetic and in respiratory distress: potentially severely jacked.

Spontaneous Creutzfeld-Jakob disease: jacked up. No question.

Asshole third-year resident: not jacked up, as there is still hope.
Asshole third-year resident in peer review: irretrievably jacked up.

Twinkies: total jacked-uppery.
Deep fried Twinkies with Hershey's syrup: not jacked up.

Fractured pelvis and dislocated hip: only semi-jacked-up.
Fractured pelvis, dislocated hip, history of polio: jacked. Up.

Nurse on day one of a three-day week: not jacked up.
Nurse on day three of a three-day week: jacked up.

Having a kneecap kicked off by a horse: jacked up.
Getting inadvertently stepped on by a one-ton bull: not jacked up.

Brain tumor: depends. If it's a meningioma: not jacked up. Glioblastoma multiforme? Jacked.

I hope that's a little clearer now.

Thursday, April 14, 2005

A place I never imagined I'd be.

So I'm sitting on the couch, reading the local nurses' news magazine (they're very unhappy about unions, but more of that in a later rant) and wondering how much Zappo's is charging for Danskos these days, when I realized:

I'm a nurse.

As in, an actual nurse. Jo, RN. I can sign my name with those initials, and sometimes do, by mistake, on checks. I ache all over after a busy shift, I eat things for breakfast that would make most normal people cringe, I speak a language that only a few people really understand. I'm a nurse.

Back in the day, fresh out of school with a BA in music performance and sociology, I had no clue what my life would be like. I'd had an interest in health and health-care for years, but I couldn't see combining that with the music degree that Dad had his heart set on my getting. I spent ten years working in bookstores, recording voice-mail mazes, and singing commercials before I got a job at Planned Parenthood and realized that I was really good at this odd thing. For some reason, people relaxed when I walked in the room; they told me secrets and embarrassing things without a qualm.

So I gave in and fell in love with my job. Rabid advocate? That was me. Trying to empower people to ask questions and take control of their care? Sometimes it worked, sometimes it didn't. Wanting to know more, to learn more, to have more input? Yep. And so it was off to chemistry, and a harrowing microbiology class, and several semesters of maths, both basic and advanced, and finally, Nursing School.

I've been a nurse now for just about three years--a "new nurse" in a lot of people's eyes, still. I remember my second semester of clinicals, wondering what it was about nursing that made these women I worked with tough, impatient, and unwilling to say something more than once. It got to the point that I could pick out a nurse, even if she or he was in civvies at the grocery store, just by the way they looked.

Now I'm one of them. My sense of humor hasn't tanked completely, and I'm not willing to fake a kidney stone attack to get out of working with students, but I'm a nurse. Jo, RN. Looking through catalogs, wondering exactly who it is that buys avacado green scrubs. Wondering if the liver function profiles on that undiagnosed patient ever came back. Setting my alarm for four-twenty in the morning, then explaining things once to everyone I meet and expecting them to get it.

If you'd told me when I was 21 that I would be doing this, I wouldn't have laughed. I would've gazed at you in utter disbelief, wondering what planet you hailed from. At 31, I wondered if I would survive nursing school (yes), if my marriage would survive nursing school (no), and if I would ever get to the point that "Nurse" became a part of my personality.

I did. It did. And here I am.

Two of my fondest memories from my career so far: Hearing a patient say, "Thank you, Nurse" as I left the room, a raw fresh-grad preceptee, and having another patient tell me that I reminded him of a nurse he'd had during World War II.

It's a fortunate person who falls into what they were born to do. If I'd continued singing commercials and saying "To speak with an operator, press zero", I would've been good at it. I could've been good at any number of things, without thinking about it much. This is a challenge and a joy and a source of pride. The fact that I'm good at it, the fact that I feel like I was born to do *this thing*, is an extra benefit. I'm a lucky girl. A lucky Jo, RN.

Wednesday, April 13, 2005

Various random notes

First and foremost, Grand Rounds is up at Grunt Doc's place.


"He looked so well-cared-for last week!"

The patient's wife was obviously distressed. Her husband was partly uncovered, in restraints, and unshaven. She was upset with me mostly about the "unshaven" part, and couldn't understand why I hadn't managed to get four days' worth of beard off his face. She was also upset (but less so) about the soft restraints on his wrists.

He had constant myoclonic jerking--uncontrollable, spastic movements of all his extremities and his head--and facial grimaces. Last week he could walk, with two people helping him. This week we'd had to restrain him to keep him from gouging out his own eyes accidentally. There was no chance we could've shaved him; his head kept bobbing up and down of its own accord, and I didn't want to cut his nose off. The jerking of his legs had thrown his covers down around his ankles.

"He just looks so much worse this week than last week."

I had to find a kind way to tell her that yes, he did look worse, but that with CJD, he would continue to look worse every week until he died.


A note to all nursing students who read this blog: Please Bathe.

Especially if you are a tall nursing student. My nose will be right at armpit level every time I work with you, so I will notice if you haven't bathed that day. Or for several days.

This is Nursing 101, folks. I know you're in a well-regarded, prestigious four-year program, on your way to getting your BSN. But frankly, not bathing daily would not have made it in my podunk two-year program.

If your nails are not clean and short, if you smell of pit-funk, if you have the remnants of last night's makeup on your face or a three-day growth of beard, I will not precept you. If you show up in wrinkled scrubs, with dirty shoes, I will not precept you. Period. End of story. I will send you back to your teacher with instructions to keep you out of the public eye for the day.

Frankly, you don't have enough knowledge yet to dress like Dr. House. None of us do. Looking professional--and smelling professional, for Christ's sake--inspires confidence in your patients.

So fucking BATHE, already.


Do not bring your long-haired chihuahua into your room at the hospital and expect me to keep it a secret. Especially if you're in reverse isolation because of a compromised immune system.


That is all.

It seemed like a good idea at the time.

He couldn't bend over easily, due to a combination of spinal arthritis and a frontal-lobe glioblastoma multiforme that had made it harder for him to coordinate what he was hearing with what he wanted to do. Unfortunately, bending over, or rolling up into a ball, or sitting slumped forward was exactly what we needed him to do, since we had to get a cerebrospinal fluid sample to figure out why he'd suddenly gotten so weak.

So I balanced him on the edge of the bed with his toes barely touching the floor. If his feet touched completely, he would try to stand up. Then I braced his knees against mine and wrapped my arms around his shoulders, pulling his upper body against my shoulder. Then I went into a half-crouch and supported 150 pounds of dead weight as the neurosurgeon tried to get the spinal tap needle into his back.

I stayed in that position for twenty minutes. By the end of it, I was alternately cursing my idiocy and thanking God that I'd been taking the stairs for six weeks. This morning my butt and legs are tight, my shoulders hurt, and my abdominals feel like I've done an hour of Pilates. But the patient didn't fall, we got the lumbar puncture done, collected the CSF, and everybody is happy. Especially the neurosurgeon. She thanked me repeatedly, then said, "I had no idea that you were that strong."

Neither did I, frankly. I did *not* take the stairs up to my car yesterday evening.

In other news, I had another Hospital Hobbyist yesterday for eight hours. She decided around noon that she didn't like her nurse, given that he wouldn't shoot her full of Dilaudid as often as she would've liked. She's been on our floor for a month, getting four milligrams of Dilaudid (a very strong painkiller, highly addictive) every hour. That's a bolus on top of her patient-controlled anesthesia pump, which delivers a milligram of Dilaudid every ten minutes. We're not sure what's wrong with her; general consensus is that she must have nudie pictures of the neurosurgery team stashed somewhere to stay as long as she has. Of course, since she hasn't worked in fifteen years (on "disability", probably because of her Dilaudid preference), she has plenty of time to spend in the hospital.

Your tax dollars at work, people.

On the other side of the coin, I got to tell a marvelous man that no, he'd have to go to the Veterans' Administration hospital to get the medicine he so desperately needed, since there are no community programs in place to help him. He has insurance. He even has prescription drug coverage. Unfortunately, the job he's had for ten years pays so little that, after taking out what he needs to support three other people, he can't afford the deductible or co-pay for his prescriptions.

He's just had brain surgery, is newly-diagnosed as hypertensive, and has bad blood sugar control.

I won't bother to point out the contrast between my two patients.

Saturday, April 09, 2005

Total Fluff.

Say what you want about Charles and Camilla. I think they looked happy as clams and were just cute as could be. I really hope the Queen had some of those cream-and-silver napkins printed up--the sort with the wedding bells and doves and "Chuck and Millie: April 9, 2005" below.

Tuesday, April 05, 2005

Paging Doctor Orac!

Paging Doctor Orac! Doctor Orac to Head Nurse's station, please.

My folks just got back from the Oregon Vortex. Mom claims it cured her arthritis for two days.

What's a skeptic to do?

Did I mention that the turkey was bad?

Those turkey legs. Love 'em. The smoker crew couldn't keep up with demand. I think they were a little chintzy with the thermometer.

Today my general misery has declined, only to be replaced by a general itch.


Monday, April 04, 2005

What I do on my day off

I exhibit all the signs of being an incomparable genius, that's what I do.

The Beau and I went to a semi-local VW Fest yesterday. This is the state where good VWs go when they die, to be reborn as either all-stock show cars, all-stock daily drivers, or some combination of dropped and street racer and wildly painted wacko machine. Ever seen a VW Bus drag-racing? Neither had I, before yesterday.

Anyway, we went to the VW Fest. Got there about 11, left about three. Spent those four hours in the gorgeous sunshine--not a cloud in the sky, about 70 degrees--looking for NOS (new old stock) parts and refurbishable things for the 1967 Beetle David just bought. I found, by the way, a window crank from 1967 and felt quite proud of myself. He found the other. Then I found an NOS gearshift head and giggled. Then he found a turn signal relay and started acting like Gollum. Then we got some sausage and a turkey leg.

Then I noticed that I had forgotten sunscreen.

I am the odd redhead that doesn't generally sunburn. Yesterday, though, I sunburned. So badly, in fact, that I had to call in today because I can't wear clothing. My normally buttermilk-colored arms are a shocking shade of dark pink, and my neck is a study in ow yow yeesh augh ouch. Let's not even talk about my nose.

I don't *think* I'll blister. It's been 16 hours and no sign of it yet. I'm living covered in aloe vera gel and cold wet rags. I did not sleep last night; turning over was a lesson in what it means to be truly stupid.

If ever I get badly burned in a fire (probably when some VW or another goes up in my face), please either unplug me immediately or feed me lots of morphine along with my Parkland-formula fluids. Thank you.

Saturday, April 02, 2005

What he said:

"You're way too smart to be a nurse."

What I did not say:

"You want somebody stupid at the bedside?"

"What would you rather I do: teach students, or teach you?"

"Are you saying that nurses are dumb?"

"How many hours of microbiology and chemistry do you think we all have to pass?"

"Should I be a doctor instead? Do you have to be smarter than a nurse to be a doctor?"

What he said:

"You should get your PhD or something."

What I said in return:

"What I love doing is this. I love being here at the bedside, helping people heal. I like working with very intelligent, dedicated people. I have a good time, and I don't want anything different."

I once, more than half my life ago, took a stage movement and modern dance class at Carnegie-Mellon University, as part of a summer theater program. At one point during the semester we were joined by the local high-school football team. A couple dozen teenaged boys (we were all teenagers) came in snickering about how "faggy" it was that they had to take a dance class with all these theater geeks.

Not a one of them made it to the first break. What they thought was easy and low-status and faggy actually took a combination of incredible strength, concentration, and stamina.

This is how I feel about people who say "You're way too smart to be a nurse." They have no idea.

You can't educate people like that. You can't change their perceptions in the twelve hours you have with them. The best you can do is remind yourself that murder is still a capital crime, then put all the pillows out of reach.