Friday, April 28, 2006

HN Special Feature: TeeVee Show Review!

I was really, really not wanting to put too much mental effort out tonight; two days straight of The Great Influenza and starting Pinker's How The Mind Works had left my brain box empty except for a quivering lump of greyish Jell-O.

So I flipped on the tube and stumbled on something called "The Ghost Whisperer." I was intrigued: a show about a person who trains ghosts to canter, trot, and gallop? A medium with laryngitis? You gotta understand, I may not get out much, but I watch TV even less.

What I got was Jennifer Love Hewitt and some guy I vaguely remember from the old one-season wonder "Relativity" (as well as Snow White: A Tale of Terror, with Sigourney Weaver as the evil stepmom) playing a paramedic (him) and an antique store owner (her) living in a small, peaceful Eastern Seaboard town.

So far so good.

As things progressed, though, I started to wonder: if this chick who sees dead people (all the time!!) and tries to send them into the light has been doing this since she was six, how come she's still flipped out by manifestations of what should be, by now, a fairly routine occurance? I mean, even her husband and business partner are treating her visitations with the sort of wry humor that connotes total acceptance of the weird.

Also, what up with the hallucinations? I mean, she's hallucinating all the damn time. Either that, or the dead aren't very good at communicating, since a planeload of people about to come down (this week's plot) can only focus their combined energies on one person. Everybody else is missing the obvious, like half-frozen people in pilot's uniforms wandering around. If J-Love's character is living in a small town, and her husband's a paramedic, you *know* somebody's said something to him about this by now. "Uh, know, I hate to mention it, but your wife keeps screaming and clapping her hands over her ears in line at the Wal-Mart. Has she seen a doctor?"

Furthermore, what up with the eyeliner and Goth-Girl costumes, dawg? There was one scene in this week's episode in which Our Heroine was walking across Ye Olde Towne Square, the only person in town (and they all seemed to be on the square at that moment) wearing head-to-toe black and eyeliner fit for a Mod Squad audition. That, in most small towns I know, would get you looked at funny at the least, and probably not guarantee a lot of business for your antique store. ("Same As It Never Was." Cute, guys.)

At one point in a subplot, an architect stops in for a consult on remodelling the antique store and mentions that he's "passed by this place" a number of times. At that point The Cat snorted and said, "Yeah, 'cause he's freaked out by Little Miss Death Hallucinatron, here."

Then there's the subplot with the rookie paramedic who gets freaked out by the sight of blood, and Sensitive Husband Paramedic Guy has to be his big-brother type and get him over it in time for a plane full of sort-of-dead, mostly-frozen people who've been talking to J-Love for the last fifty minutes to crash...right into Smallton! Or Greenville, or whatever it's called.

According to the preview for *next* week's show, the whole upshot of the dealie-o is that J-Love will have to somehow armor her black lace cardigan and go up against The Devil Himself (dun dun dun) to save the souls of the mostly-dead, pretty-well-freezer-burned folk on the plane. There's a lot of symbolism about a pocket watch and doves coming back to life and love never dying, and Beelzebub wears a really, *really* bad hat and hisses a lot in J-Love's ear.

The Cat, pausing in her paw-licking, opined that Satan is getting lamer and lamer every year. "Whatever happened," she asked, "to 'Sinners in the Hands of an Angry God?' Or Dante? Or even 'The Gospel of Peter?'"

I told her I had no good answer, and so we're going to bed.

Tuesday, April 25, 2006

I'm blaming The South Bitch Diet.

So, um, you know when you get a scary troll on your blog? And you go and enable the "moderate comments" dealie on the blog template? And you forget to, um, type in your email address in that thingy so that the Blogger software can let you know when a comment's been posted? And none of the comments get posted, for, like, six weeks, so you think nobody's reading your stuff and you start posting titles like "BOOBIES!" and stuff?

Just be glad I'm not a programmer or proofreader, people. I figured out the comments glitch today, and let's just say boy is my face red.

It should work now. I take back all the nasty things I said about you, Blogger. It was entirely my own fault, mea culpa. And thank you, various commenters, for the nice things you've said.

On to bigger and worser things:

All you folks who have done SBD or who know patients or family members who have done it, I have a question: How do you get the freaking headaches to stop?

I'm well-hydrated, I'm eating everything I should. Last night I was in the grips of a three-day-long headache and finally ate a pita sandwich. The headache disappeared and hasn't returned since. I had a half-cup of rice today, which I think might account for that. Is this headache going to continue through the first phase of the diet? If it's that bad, should I just say to heck with it and start with Phase II? I don't eat much in the way of simple carbs anyhow, so that wouldn't be too bad.

It was bad enough yesterday that I took four ibuprofen, something I never, ever do, and the headache *still* didn't disappear. It went from "making me afraid to try to drive" to "moderately distracting". And no, I haven't cut down on caffeine. I wasn't having that much anyhow.

I can handle hunger and muscle aches and bad skin. I can handle constipation, the Plagues of Egypt, bad relationships, and traffic. I just cannot handle unrelenting headaches of near-migranous intensity. Any help would be appreciated.

In other news, since The Boys are off at the AANS conference, I'm home today, huzzah! Things will begin to pick up on Thursday, when they return, but I'll be off work then and (I hope) refinishing my dining table. The Cat and I had a little mutual-admiration society going this afternoon, so she should be able to handle being not At The Forefront of The Human's Mind for a day or so.

Note on the last big post: The song lyrics in italics are from Barenaked Ladies's "The Old Apartment" and Jackson Browne's "In the Shape of A Heart", mixed up together. "The Old Apartment" can be found on the album Rock Spectacle, while "In the Shape of A Heart" is on Lives In The Balance. You can hear lots of Browne cuts on his website,, which almost makes up for him being a drunken wife-beater. And for imbuing me with a lifelong *thing* for skinny dark-haired guys with dark eyes.

And that is all for now. Comments remain moderated, but now I know how to fly this bitch, so we'll do fine.

Sunday, April 23, 2006

Blogger Band-Aid

Suggested by Les, brilliant correspondent.

Blogger's bug won't allow people to post on the first post on the page, so I'm trying something new: A band-aid post to knock the *real* post down a notch, so it can be commented upon.

Let me know how it works.

Finally, enough time off.

Of course, I'll pay for it starting tomorrow.

I had two days off this week and three last week and actually put them to good use. Chef Boy and I went to a food show, a nightmare of fried things and processed things attended by the chefs of places like Applebee's and Chili's.

I kid you not: I saw six people so obese that they could not walk and had to use those little scooters to get around. Obesity doesn't necessarily lead to mobility problems, but the lightest of these folks was, by my estimation, somewhere north of 400 lbs. That's gonna give you problems at some point.

Apparently, this particular food show is a big draw with church groups and social groups: people buy tickets for however much, then grab a to-go box from one of the product booths and fill it with fried things.

The only booth that had fresh food had no samples available. It was torture, walking past heirloom tomatoes and bags of salad and not being able to eat anything but chicken-chili-cheese dogs (the most foul thing I've ever put in my mouth) and crawfish empenadas (a close second). There's a list of about eight things I will never eat again, even under duress, and the food show provided all but three. (The other things are Danish ammonia-and-salt licorice, anything flavored with asafoetida, and Tofu Pups.)

I also bought books, to wit:

The Tale of Despereaux, by Kate DiCamillo. I was not crazy at all about Because of Winn-Dixie, but this is a charming story well-told. I like the style, I like the rat Chiaroscuro, I like Miggery Sow.

Eragon, by Christopher Paolini. So far it's failing to entrance me, but I understand it gets better after the first eight chapters or so.

How the Mind Works, Steven Pinker. Because I felt like I oughta, and because I liked the interviews with Pinker that I saw on YouTube.

John M. Barry's The Great Influenza. I'm not sure I haven't read this one before, but if I did, I don't remember it and so should read it again.

The South Beach Diet. Yes. My belly measurement has reached truly worrying levels, as have my fasting blood glucose and cholesterol numbers. Two of the internal med docs I work with recommended this book, independently of one another, and they're both the biggest fitness-freak Diet Cops I've ever met, so I'm going to give it a shot. Hell, I can do anything for two weeks, especially an induction plan that includes things like broccoli and Brussels sprouts and black beans.

Lesson learned: If you don't listen to your doctor when he tells you you need to make small changes, you'll end up having to buy diet books and looking askance at potatoes. Which is probably a good thing, as I don't want to end up like Miggery Sow, cauliflower ears and all.

Dinner with Chef Boy's family, a whole bunch of laundry, and some more naps rounded out my days off. Work I'm not even going to mention; Eric over at eric135 says, rightly, that February and March are the nastiest months of the nursing year, and April isn't far behind, at least at our facility. We seem to be having a run on subarachnoid hemorrhages and glioblastomas (with six you get eggroll!) and I'm just plain tired of thinking about it.

Besides, it's nice to have something like a life now and then.

Monday, April 17, 2006

The shape of a heart

I drove past the old house today. It's the house I grew up in; the one the 'Rents sold to us shortly after we got married.

I hadn't driven past it in three years. Not through trying, but because my daily life doesn't take me to that end of town any longer.

The Erstwhile Hub and the Erstwhile Best Buddy are living there, still. Shortly after I left, and she left, she moved back in.

It was a time I can't forget
Full of sorrow and regret
And the shape of a heart
And the shape of a heart

There were two things left that I cared about, the dog that I saved that I left behind, because it was better for him, and the rose bush that had grown as tall as the second-story windows when Mom and Dad bought the place.

Why did you paint the walls?
Why did you clean the floor?
Why did you plaster over the hole I punched in the door?
This is where we used to live.

I walked around to the back fence (stalking behavior, I know; email me if you're in a chastising mood) to see if the dogs were still there; I guess they'd been taken in for the night.

The rose bush is gone. Dug up, cut down, it doesn't matter. It's gone. All ten feet of it, each way, with blooms that used to come like clockwork in April and again in June and then sometimes in December if it was warm.

these things used to be mine
I guess they still are, I want them back

Now there's nothing that ties me there. For three years or more, I'd assumed that they'd keep the rose bush at least. In some weird sense, I'm free of the two of them, of all the badness that happened unexpectedly after an amicable divorce, when it turned out that he couldn't let go and she was determined to put herself in the right.

That's twelve years of my life you're talking about. Which isn't much, given a life expectancy of 107 years, but it's a lot to me now.

You keep it up
You try so hard
To keep a life from coming apart
And never know
What breaches and faults are concealed
In the shape of a heart

More than twelve years, it's the two people who made me mostly what I am now, more than I ever made myself. I had known her from the time I was 18. She had stood by me, mostly, through the roughest parts of my life and the best. And he was the first person I'd ever met, and so far the only one, that I thought I could stay with until I died.

And I held it in my hand
For a little while
And dropped it into the wall
Let it go, heard it fall

We bought an old house on the Danforth
She loves me and her body keeps me warm
I'm happy here
But this is where we used to live

Only memories, fading memories
Blending into dull tableaux

Saturday, April 15, 2006

First things first....

Blogger has a bug which disallows comments on the newest post on every page, unless you're using some combination of IE and luck which I've only hit on once. I know some of you have encountered that bug, and I apologize. There's no way I know of to fix it in the template, so you'll have to keep either emailing me with comments or wait until a new post comes up to comment on the second-newest.

Today, as I was manhandling a casserole into the fridge, I caught the third finger of my right hand against the corner of a drawer I had carelessly left open. The corner (being that weird melamine veneer stuff) ripped a swath of skin and meat off the first knuckle of that finger. For the first time in a very long time, I looked down after doing myself an injury and saw I was bleeding.


Luckily for me, it didn't involve a fingernail. I'm sure I've told this story before, but I once sliced a chunk out of a fingernail with a mandoline as I was slicing some vegetable or another. I actually fainted when I had to change the bandage on that finger. I had foreseen that possibility and so had a friend standing by with ammonia and Scotch and ice packs, all of which she put to good use.

So I stood there, watching in fascination, casserole forgotten, as I bled. I don't usually injure myself with sharp or penetrating things; my hurts tend to be more of the blunt-trauma, falling-over variety. Or of the roundhouse-to-the-left-kidney variety, one of which I sustained a week ago and am only now feeling normal after.

One of our patients with no risk whatsoever for seizures had a seizure. He's a big guy--six-eight and three hundred pounds at least, and not fat. We're talking Olympic athlete standard of fitness and muscles from here to Toledo. And he, of course, is the one who has the tonic-clonic seizure to end all tonic-clonic seizures. I've never seen anything like it.

His wife screamed out over the call system, so the charge nurse and I hit the door at a dead run. Credit to the charge for saying simply, "Shit." and turning on his heel for oxygen and Ativan and the crash cart, but I had to stay in the room and get this guy on his side.

Down goes the bed--they're heavy when you grab the CPR emergency release--and I hauled the patient over on his side so he wouldn't choke on the blood and vomit and foam that was seeping out from between his clenched teeth. A rigid, tall, heavy, muscular patient who's in the grips of a seizure that's made every muscle tetanic is not easy to get over onto his side; it amazed me that I could manage. But I did.

He seized long enough that we could run for a mask, for more Ativan, for a suction setup and O2 monitor and blood pressure monitor and EKG leads and he *still* hadn't finished. Conservatively, I know his seizure lasted at least forty seconds, and probably more like two minutes, with no dimunition until after we'd given him a total of 4 milligrams of Ativan, fast push.

Then it was suction and Venti mask and EKG leads and where the hell's that respiratory therapist and more sedatives and Jesus Christ somebody get me a four-by for all this blood, then reasoning out that the goose-egg on his forehead came from his repetitive pounding of said head against the bedrail during the clonic portion of the seizure, and then off to CT scan.

And I went away and gibbered for a few minutes, even though he wasn't my patient, because if there's one thing I hate more than a code it's a seizure. And this one...dear sweet Christ on a crutch, I can honestly say I didn't know the human body could make such sounds. Or that eyes could roll quite like that. Or that people actually, really and truly, *foamed at the mouth*.

Years ago, when I was still at PP, a patient's boyfriend had a seizure that culminated in one of our waiting-room chairs being kicked through a tempered-glass window. This one was much, much worse. I'm just glad that we had three bedrails up; there's no way I could've held him on the bed without the support of the rails. Even so, one was bent so far out of alignment that it's not usable.

And at some point I sustained a really lovely bruise over my left kidney. I'm not sure if I got it during the scrum to get Ativan into the guy, or if he whacked me with a flailing leg without my noticing, but it's there. It's *still* there, I should say, and still makes me wince when I roll over in bed. I guess I'm lucky not to be peeing blood.

Just thinking about it makes me gibber some more and feel sort of shaky.

The best part? Dude had a bladder infection from a catheter we'd had in him during back surgery. We gave him Levaquin, which apparently lowers seizure thresholds in otherwise normal folks.

So his risk factor, looking back, was a commonly-used antibiotic.


I think I'll tough-out the next sinus infection, thanks.

And go put an ice pack on this flank.

Tuesday, April 11, 2006

Boobies! Boobies! Boobies!

Nota bene: there are no boobs in this post. The title line is merely an attention-getting device.

A nice guy came in a couple weeks ago with a huge tumor. This particular huge tumor is growing in his chest, wrapping around his spinal column, compressing his lungs and heart, and dropping down to involve one kidney. His symptoms started about five months ago and got steadily worse; he's lost the use of his legs and bowel and bladder control.

He came to us through a relative of a friend of a former patient who *also* had a huge tumor. She had heard somehow of the guy's predicament and called her relative's friend's former surgeon, who said to bring the guy in.

His predicament, to wit: being discharged from a charity hospital because the only surgeon who was not willing to operate gratis demanded full payment for service up front. This particular wanker apparently works on contract with The Other Hospital, so there wasn't a lot anybody could do. He was also apparently the only surgeon willing to attempt a tricky and complicated resection, so my patient was screwed. To the wall.

Now, as in all great Suthun states, we have one city which continually congratulates itself on its international appeal, its liberalism, its ability to absorb people of all ethnicities and cultures into a huge melting pot/salad bowl of wonderfulness. This particular guy emigrated from his home country during a time of, shall we say, political unrest, and landed in That Great City.

Whereupon, after working and paying taxes and so on for umpty-ump years, he was told by one nurse to "go back to your own country to get your surgery". Yeah, I'll bet the Khmer Rouge established *great* surgery programs in its medical schools. Then there was the accusation by a doctor at the hospital that the patient was over-playing his symptoms in order to get free treatment for himself and the presumed ten kids he had, because, as the doctor pointed out, people like that come here to take advantage of the system.

And then there were the nurses and nurses' aides who pulled slanty-eyed faces and spoke with fake Chinese accents to him and his family.

Lovely crowd, that. There is something to be said for a well-aimed tornado or six, eh?

At any rate, he's with us now, and he'll get treatment for free. He had his first surgery over the weekend, an anterior resection of the bulk of the tumor, in order to allow him to breathe. The neurosurgery and kidney stuff will come a little later in the week. I think he's glad he left Self-Absorbedville and landed with us, poor sot.

It still amazes me, even after (*cough*) years of being on this planet, that people can be outright viscous hateful bigots. Especially people who have a professional charge and a moral responsibility to be better than everybody else when it comes to their job. There don't seem to be enough tornadoes to go around.

Thursday, April 06, 2006

Is it a sin to call in sick when you're really not?

Because I have a bottle of Becker Vineyards' Viognier here, and a slab of salmon, and a little miniature Dachshund across town that would love to play tug with a sock.

(Nota bene: Becker Vineyards is in a place called Fredricksburg, in Texas, in the Hill Country. It produces a really superior Viognier. You should have some, even if you have to scour your local wine store for it.)

I also have a kitty-cat who hasn't seen me for Two Whole Days, and for whom I just installed a Cat-A-Comb (one of those corner groomer widgets that contains catnip). And I have a bed, which I haven't seen much of lately, and a Chef Boy who's feeling a bit put out that I haven't seen much of *him* lately.

At work, it's Glioma Season. Any nurse will tell you that things like appendicitis, brain tumors, and heart attacks tend to come in waves; this is our Glioma season. Subarachnoid Hemorrhage Season starts in a few weeks, when the thunderstorms and resultant pressure drops start to get *really* nasty...but for now, it's all tumors.

She has a glioma that extends from the bottom of her right frontal lobe, just above her sinuses, to the middle of her frontal lobe, and might have fingers reaching into her temporal and parietal lobes. So far it's skinny and isn't affecting her thought processes, though her balance is a little off. I discharged her on Monday. She'll come back next Monday for a biopsy. There's not a lot we can do besides a confirmatory biopsy and gamma-knife radiation; her tumor is in a really, really nasty spot and a really, really nasty configuration.

"So," she said, "the doctor was just in here telling me that this is probably brain cancer."

"Yep," I replied.

"And it's going to kill me if it is?" she asked.

"If it is, it will." I said.

"Mmmm. I suppose I ought to do all those things I always wanted to do, then," she mused.

"That would probably be a very good idea." I said.

"How long do I have before I...(flapping hands helplessly, crossing eyes, and sticking tongue out of mouth)?"

"Maybe six months. More probably three." I replied.

I wasn't telling her anything she hadn't already heard from the doc, and she isn't the sort of person that appreciates bush-beating.

Unexpectedly, she asked me, "Do you know Trout Fishing In America's version of 'Last Days of Pompeii?'"

Do I. "On the last day of Pompeii/Thought I heard some poor boy say/Oh, wow, man/If I knew then what I know now..."

I giggled. She giggled. One of the lines is about "I woulda filled up on chocolates, cigarettes and booze/given some perfect stranger the blues". We were both thinking about that.

"If I don't show up on Monday," she said, "I'm in France. I'm spending all my money and eating good cheese and chocolate and flirting madly with men two decades younger than I am."

"Rock on," I said. "Have some Camembert for me."

She won't be back for that biopsy.

Down the hall is a woman with three children, in her late twenties; a totally non-average patient for a glio. Hers is large and aggressive and likely to take her body before it takes her mind, yet she's cheerful and happy.

"I can't believe how blessed I've been," she says, after a group of her friends from church leave. "One of my friends told me that I'm the sort of Christian that she wants to be. All of these people have shown me such love and such tenderness. I feel like I've fallen into a whole group of Good Samaritans."

She thanks me for her care and promises to pray for me. She leaves a lovely thank-you note that mentions me by name and lavishes praise on all of us.

"Serious denial" says the PA, whom I'm not real fond of these days.

"Maybe she really *is* blessed" I retort.

And here is where I find the motivation *not* to call in sick, *not* to spend the day with perfectly healthy people, doing perfectly pleasant things. I've met two people who've gotten the worst possible news a person could get, yet they intend to live the hell out of their lives in the twelve or fourteen weeks left to them.

I'm going in tomorrow with the express purpose of living the hell out of the day, no matter how many are given to me thereafter. If I drop dead of an aneurysm at 19:08, at least I'll have had fun. And maybe made a difference.

One thing's for sure: I'll be humming, "And now that I'm a goner/All that lava rushing 'round that corner/Oh, wow, man--I ain't complaining/Only thinking out loud/You know that my life would be different/My love would be different/If I knew then what I know now."

Sunday, April 02, 2006

long trung thanh

She's a nice woman; a little thin for her height, but solid muscle and bone. She had a brain tumor in an odd spot; although we managed to get it all out, it still had an impact on her legs. She's learning to use them now, just yesterday she walked 300 feet with only a gait belt.

She's the head of the SWAT team for the town two counties over. Not something you'd expect a pretty blond to be doing for a living. But she is, and she's apparently very good at it--good enough that the Thin Blue Line has been in evidence 24 hours a day outside her room since her surgery.

See, when a cop gets hurt in the line of duty, it's a tradition for the other cops to sit outside his or her room, one at a time, all day and all night long. I don't know if they run errands or just sit and eat sandwiches and read the paper, but I've seen them in every case where a cop has ended up at our hospital.

It's more unusual for cops to pull their vigil when one of their own gets hurt, or gets sick, outside the line of duty, but that's what these guys and women are doing. On their own time, they come and occupy a chair outside her room. Inside, there's a party going on--somebody brings in grinders and a sixer of beer, and shares everything with the nurse ('cept the beer, of course; it wouldn't do to drink on duty) and we all have a nice time.

Three rooms down is a gangbanger. He got part of the top of his head taken clean off by a bullet about a week ago. He's beginning to come around now, but he's going to have problems with speech and spatial relations for the rest of his life. His room is quieter. When his mom or aunties show up, there's a lot of talk but not much laughter. Sometimes, they pray.

And outside his room, on a chair, down the hall from the cop, is one of his buddies. Every hour around the clock, in shifts, they come to sit and keep vigil in the same way the cops do.

The khaki shirts and brown pants clash a little with the tattoos and blue bandannas, but we're all getting used to it. Grinders and beer in one room, wings and Pibb in the other. They'll all get along fine as long as they're here.

I asked one kid who showed up for the night shift why he was giving up his time to sit in the hallway in the hospital. "Respect." he said. "Loyalty."