Munge.

I've spent a nice portion of the last two days cleaning munge out of my own house and out of Chef Boy's. That is what happens when you're in a profession that deals with cleanliness and service; you find it necessary to be clean and serviceable when you're not working.

Which I'm not. CB and I were supposed to travel way south and east this weekend, to the place where the Wild Things are and Spanish moss grows, but we decided against it. So instead, I cleaned. And as I cleaned, I thought back to the last few weeks...

I was cleaning a patient's room. Sometimes we do this, especially if things have gotten disorganized and messy. I do this a lot if things in my "work area" (ie, anywhere I say) have gotten kerfuffled.

He's a frequent flyer, through no fault of his own. Neurofibromatosis has left him, for lack of better words, lumpy and blind, with crippled feet and hands. He has a bad case of NF. It's not just pigmented spots here and there; it's large aprons of skin with huge tumors on them. Three years ago his father, in an excess of concern, offered me money to "make sure (my son) don't turn gay." Despite that, the patient and I are still friendly. The fact that his dad is mad as pants has nothing to do with him.

He's young. "I'm almost twenty-four," he said from the cardiac chair, "and I haven't ever been on a date."

"I'm almost thirty-seven and I haven't either," I replied, rather tartly.

"Yeah, but you're not covered with tumors," he said.

"How do you know? You're blind, man!"

He shot back, "You don't sound lumpy."

"You don't sound lumpy" will go down for posterity along with "You don't sweat much for a fat chick" as Weird Compliments to Pay Somebody.

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

Okay, so we've established that eventually, after you watch enough people die, your soul gets to be like that Baby Swiss cheese, full of itty-bitty holes.

My pal Carolita brought up a person we'd both taken care of some months ago; a person who'd died on my shift. In my care. And I'd bathed his body and comforted his mother and wife and bagged & tagged him and sent him to the morgue.

I had forgotten about him.

Not just his name; his entire existence.

I had promised myself when my first patient died that I would never, ever forget a person who died under my hands. Midwifing a soul out of a body is the most honorable and sacred thing I do. I can't allow the frailties of memory to screw that up.

And yet, here was one I'd forgotten. Other people had died more tragically and more unexpectedly and more horribly in the intervening year, so this guy had gone on to be one of those people you only remember if they're brought to your attention.

I still feel bad about that. As long as somebody somewhere remembers a person, they're not really, truly dead...and who better to remember them than the person who was with them when they died? What makes it worse is that I was actually in the room when this patient died. That doesn't happen often; it's a matter of chance that you're there.

So my soul is full of little bitty Swiss cheese holes. And apparently my brain is, too. The only thing now, I guess, is to write about people as they die, to make sure they stay alive in electrons if not in neurotransmitters.

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

Success Story:

The woman in the doorway looked at me and said, "You don't remember me, do you?" I had to admit that while I had forgotten her name, I remembered that she had a big bear of a husband and a huge, weird, dysfunctional family, and that her husband had been diagnosed with a brain tumor about six months ago.

She had brought her husband back. He was having seizures, a natural consequence of having a glioma invading your brain.

"I want you to see one of your success stories" she said.

She told me that he had been given a prognosis of six weeks at the most, but that steroids and chemo had allowed him to live that many months. Yeah, he wasn't himself most of the time, but he was still here, and that was all that mattered, right?

Right.

I was confronted with a bloated, vacant man who had none of the charm and spice of the man I'd cared for. He sat uncomprehending, staring at nothing, until I touched his arm and said, "Hey. Big guy. What's up?"

Then he looked at me without remembering who I was, or where he was, and made some sort of reply that didn't make sense.

But he's there. In body, at least.

I was reminded that "success" differs for each person and in each situation, and that I can't always be the arbiter of what defines a good outcome.

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

In other news, I have an interview tomorrow, by phone, for a nursing magazine. Part of the interview will be about mistakes new bloggers make. God knows I've made 'em all, so I'm well-qualified to speak.

I will be doing the interview on my brand-new Hello Kitty telephone.

How good is that?