Verbatim conversation with a patient today:
Patient: You got a husband?
Me: No.
Patient: A boyfriend?
Me: No.
Patient: Is that blood on your shoes?
Me: Uh. Yeah. Looks like it.
Patient: No wonder you ain't married yet.
14 October 2010
14 September 2010
highs & lows of the last 14 hours
Doctor: Hey, you're doing great. I had no idea you are new nurse. Keep up the great work.
Patient #1: Get out of my face, you ugly @#%$*. I'm going to get my people and come back and crush you.
Medical Student: Here. I bought you a diet coke to thank you for helping me so much with that patient earlier.
Patient #2: What do you mean you don't know what's wrong with me. Go tell your boss I want someone taking care of me who's not stupid.
Hospital Police Officer: Girl, you're a hustler. I can tell you're a hard worker. I respect that.
Patient #3. You look like a hunchback.
Me: Excuse Me?
Patient: Bend over so I can look at your back.
Me: I'm not going to bend over. I don't have a hunchback.
Patient: You are a very rude young woman. I'm trying to help you.
Man who delivers clean linens: I been watching you lady and if you take care of your husband half as good as you do your patients, he's a lucky man.
Patient #4 just swung at me.
Patient #1: Get out of my face, you ugly @#%$*. I'm going to get my people and come back and crush you.
Medical Student: Here. I bought you a diet coke to thank you for helping me so much with that patient earlier.
Patient #2: What do you mean you don't know what's wrong with me. Go tell your boss I want someone taking care of me who's not stupid.
Hospital Police Officer: Girl, you're a hustler. I can tell you're a hard worker. I respect that.
Patient #3. You look like a hunchback.
Me: Excuse Me?
Patient: Bend over so I can look at your back.
Me: I'm not going to bend over. I don't have a hunchback.
Patient: You are a very rude young woman. I'm trying to help you.
Man who delivers clean linens: I been watching you lady and if you take care of your husband half as good as you do your patients, he's a lucky man.
Patient #4 just swung at me.
07 September 2010
cash cow
I tell my parents that I have a secret account - a place where I squirrel away a little money here and there so that when the time comes, I'll have the cash I need to buy some cattle. They are not particularly impressed by my foresight. My mom asks when I'm planning to do this exactly. My father suggests I go stick my head in the dairy case at the store and take a few deep breaths -- nothing like the smell of stale milk to snap you back to reality. They laugh, but I'm serious. Few things evoke in me such simultaneous longing and contentment -in perfect harmony- as cows, and every version of the future that I imagine for myself includes cattle.
Grahamcracker told me once that my grandfather loved the sight of cattle grazing on a hillside, that he could watch them for hours. I think of my grandfather, a difficult man, and all his characteristics that my father didn't inherit, didn't pass down to me. When I sift through my memories of my grandfather - of his hollering & cussing - and add it to what I know of my father's childhood, I can not see the line from him to me. My father is nothing like his father and I am like my father, so by the transitive property of inequalities, I am nothing like my grandfather, right? Save this genetic bovine blip, right?
Maybe I should get a milk cow, just to practice, until I get my herd. We could have fresh milk and butter! My mom reminds me that I don't live with them, that I live in the city, and that she is not getting up at 4:30 to milk it. My father says that when he was a child he made butter out of the raw milk from their cow and put it on his popcorn and even the thought of it still makes him want to throw up to this day. Fine. I want beef cattle and not dairy cattle, anyway. Just you wait and see.
Driving home from work tonight through the dark city, I think about all the hours I just worked, about my tiny little fund, and all the hours more I'll have to work to be able to buy even a single Red Angus heifer, never mind a bull. For a few more minutes I worry about my non-existent herd dying of starvation (because I miscalculated the amount of alfalfa hay we'd need to get us through the long winter). What if I ruin my imaginary children's lives by making them mend fences after school? My parents created a childhood for my sister, brothers, and me so vastly different than their own and here I am, trying to go back to where my father came from, to the plains states where many of my mother's father's people still live. I flip on the radio to distract myself and when Diane Rehm's voice fills the car, I almost flip it back off immediately. Her guest is talking about his mother, though, so I wait, my hand hovering over the knob. Family. It is so complicated and yet so simple. We are like them except for all the things we do to not be like them. I turn it off. I don't need to hear another thing.
Grahamcracker told me once that my grandfather loved the sight of cattle grazing on a hillside, that he could watch them for hours. I think of my grandfather, a difficult man, and all his characteristics that my father didn't inherit, didn't pass down to me. When I sift through my memories of my grandfather - of his hollering & cussing - and add it to what I know of my father's childhood, I can not see the line from him to me. My father is nothing like his father and I am like my father, so by the transitive property of inequalities, I am nothing like my grandfather, right? Save this genetic bovine blip, right?
Maybe I should get a milk cow, just to practice, until I get my herd. We could have fresh milk and butter! My mom reminds me that I don't live with them, that I live in the city, and that she is not getting up at 4:30 to milk it. My father says that when he was a child he made butter out of the raw milk from their cow and put it on his popcorn and even the thought of it still makes him want to throw up to this day. Fine. I want beef cattle and not dairy cattle, anyway. Just you wait and see.
Driving home from work tonight through the dark city, I think about all the hours I just worked, about my tiny little fund, and all the hours more I'll have to work to be able to buy even a single Red Angus heifer, never mind a bull. For a few more minutes I worry about my non-existent herd dying of starvation (because I miscalculated the amount of alfalfa hay we'd need to get us through the long winter). What if I ruin my imaginary children's lives by making them mend fences after school? My parents created a childhood for my sister, brothers, and me so vastly different than their own and here I am, trying to go back to where my father came from, to the plains states where many of my mother's father's people still live. I flip on the radio to distract myself and when Diane Rehm's voice fills the car, I almost flip it back off immediately. Her guest is talking about his mother, though, so I wait, my hand hovering over the knob. Family. It is so complicated and yet so simple. We are like them except for all the things we do to not be like them. I turn it off. I don't need to hear another thing.
29 August 2010
This [place/job/world] will change you, if you let it.
My very first patient in the ER was a 65 year old woman picked up by the cops after she fell down at the bus stop. She was high. She had no shoes or underwear on, just a big t-shirt with Tweety Bird on the front and a pair of black jeans with a hole in the left knee. Her matted hair was full of leaves and bits of twigs. When she came around, spitting invectives one minute and calling me angel the next, she admitted that she'd shot up with dope every day for as long as she could remember, probably since before you was born. No one saw her fall, so the doctor ordered a head CT to make sure that she wasn't bleeding into her brain. When I told her it was time to go get the test done, she looked at me as though I was out of my mind. You want me to go out of this room looking like this? I can't go out of here looking like this. I need to comb my hair. Hand me my pocketbook.
Like a song or a smell that takes you back to a place you can't quite name, something about the way that woman rifled through her purse - handing me her tattered address book, nubby tissues, a tube of lipstick, demanding a clean blouse before going out in public- reminded me of my grandmother so keenly I felt my throat catch. Oh no you don't. We are not playing this game. You can not see yourself and everyone you know in these patients. TOUGHEN UP NOW. GO ON.
So I have, mostly. I didn't give it a second thought when the principal with chest pain comes in, don't blink when I see the constant stream of patients with the same birthday as my friends & loved ones, don't think twice about the girl my age who was raped a few blocks from where I used to live. I ignore connections and shun similarities. These are other people. What do they have to do with me? Watch me shrug my shoulders as I give them their medications and send them on their way.
And then today the paramedics bring in a patient, another woman in her 60's, my lot in life it seems. She collapsed this morning, they tell us, she didn't have heart beat but we threw some epi at her and now she's got a pulse, they practically grin. She is unconscious, with a tube down her throat, and when I cut off her clothes I see that her emaciated body is literally eaten away by cancer. Her hair is cut stylishly and she is wearing earrings, complete with a tiny diamond in a third hole mid-way up her ear, just like Squirrel. There is no family, someone tells me, and after awhile, a woman with grey hair and a brave smile comes back, looking for my lady. I'm not technically family she tells me, but I might as well be. We've been friends for 44 years and we've been through a hell of a lot together. We met when we were 18 and then moved here. She looks over my shoulder, where her friend is lying on the stretcher, a tangle of wires and sheets. Is she in pain? If she were awake she'd say 'Lou, who cares if it's 10 am, we need a scotch.' Oh God, I hope she fed her cats this morning. She starts sobbing uncontrollably.
After the friend calms down and I walk her over to talk to the doctor, another nurse and I begin the task of making my patient look more like a human and less like a power strip. The smell rising off her body is terrible, and as I work, holding my breath, all my unanswered questions about life and death bubble to the surface. She is covered in drainage from her wounds and her own excrement. We work from head to toe and when I wash the excrement off her feet I notice 1) that her soles are mottled, which any nurse will tell you is a sign of imminent death and 2) her toenails have been freshly painted bright red. My 6 week old resolve cracks and I feel my throat catch once more. It is Sunday morning and everyone I love is at church and I am washing excrement off the feet of woman who is alive but dead and this is Squirrel and me in 40 years and I am not tough and really, does being human meaning living with half broken hearts our whole damn lives?
My patient's best friend of 44 years makes it clear in no uncertain terms that she would not want to live this way and produces the necessary papers to back up her claim. Someone comes over and removes the tube from the lady's mouth. I turn all the alarms on the monitor off, and pull up 2 chairs. As best as I can, I explain what all the lines on the screen mean, that no one can say for sure how long she'll hold on, that the medicine going in her arm keeps her from feeling any pain. She asks if her friend can hear us and I tell her that it's very unlikely, but I could be wrong, so we talk to her and tell old stories about their double dates, their trip to Europe. Before she leaves, the friend clutches my hand and says I could not have done this without you and instead of falling apart, my heart fills -- stronger, fuller.
The rest of my shift passed in the typical blur of people, their need, my ineptitude, cold coffee, paperwork, alarms. At 23:15 I clocked out and walked through the empty halls of the hospital to my lonely car, exhausted but oddly hopeful. It is a strange & abundant grace that allows us to see ourselves so clearly in our neighbors; that erases the line between us & them and bids us wash their feet, go on.
Like a song or a smell that takes you back to a place you can't quite name, something about the way that woman rifled through her purse - handing me her tattered address book, nubby tissues, a tube of lipstick, demanding a clean blouse before going out in public- reminded me of my grandmother so keenly I felt my throat catch. Oh no you don't. We are not playing this game. You can not see yourself and everyone you know in these patients. TOUGHEN UP NOW. GO ON.
So I have, mostly. I didn't give it a second thought when the principal with chest pain comes in, don't blink when I see the constant stream of patients with the same birthday as my friends & loved ones, don't think twice about the girl my age who was raped a few blocks from where I used to live. I ignore connections and shun similarities. These are other people. What do they have to do with me? Watch me shrug my shoulders as I give them their medications and send them on their way.
And then today the paramedics bring in a patient, another woman in her 60's, my lot in life it seems. She collapsed this morning, they tell us, she didn't have heart beat but we threw some epi at her and now she's got a pulse, they practically grin. She is unconscious, with a tube down her throat, and when I cut off her clothes I see that her emaciated body is literally eaten away by cancer. Her hair is cut stylishly and she is wearing earrings, complete with a tiny diamond in a third hole mid-way up her ear, just like Squirrel. There is no family, someone tells me, and after awhile, a woman with grey hair and a brave smile comes back, looking for my lady. I'm not technically family she tells me, but I might as well be. We've been friends for 44 years and we've been through a hell of a lot together. We met when we were 18 and then moved here. She looks over my shoulder, where her friend is lying on the stretcher, a tangle of wires and sheets. Is she in pain? If she were awake she'd say 'Lou, who cares if it's 10 am, we need a scotch.' Oh God, I hope she fed her cats this morning. She starts sobbing uncontrollably.
After the friend calms down and I walk her over to talk to the doctor, another nurse and I begin the task of making my patient look more like a human and less like a power strip. The smell rising off her body is terrible, and as I work, holding my breath, all my unanswered questions about life and death bubble to the surface. She is covered in drainage from her wounds and her own excrement. We work from head to toe and when I wash the excrement off her feet I notice 1) that her soles are mottled, which any nurse will tell you is a sign of imminent death and 2) her toenails have been freshly painted bright red. My 6 week old resolve cracks and I feel my throat catch once more. It is Sunday morning and everyone I love is at church and I am washing excrement off the feet of woman who is alive but dead and this is Squirrel and me in 40 years and I am not tough and really, does being human meaning living with half broken hearts our whole damn lives?
My patient's best friend of 44 years makes it clear in no uncertain terms that she would not want to live this way and produces the necessary papers to back up her claim. Someone comes over and removes the tube from the lady's mouth. I turn all the alarms on the monitor off, and pull up 2 chairs. As best as I can, I explain what all the lines on the screen mean, that no one can say for sure how long she'll hold on, that the medicine going in her arm keeps her from feeling any pain. She asks if her friend can hear us and I tell her that it's very unlikely, but I could be wrong, so we talk to her and tell old stories about their double dates, their trip to Europe. Before she leaves, the friend clutches my hand and says I could not have done this without you and instead of falling apart, my heart fills -- stronger, fuller.
The rest of my shift passed in the typical blur of people, their need, my ineptitude, cold coffee, paperwork, alarms. At 23:15 I clocked out and walked through the empty halls of the hospital to my lonely car, exhausted but oddly hopeful. It is a strange & abundant grace that allows us to see ourselves so clearly in our neighbors; that erases the line between us & them and bids us wash their feet, go on.
19 August 2010
Alone, Together
IT is a standard question and we ask every patient: Do you live alone or with others?
My patient is old, really, old -- with lovely smooth skin and cataracts turning her eyes that hazy, gentle blue. She tells me that she lives alone, that she's lived alone for all of the 30-odd years since her husband died. When I tell her I have to start an IV, she sees the dread on my face and tells me to think of her as my grandmother. I tell her this makes it worse, that I would hate to hurt my grandmothers. Oh no baby, she says, your grandmother loves you and is happy to see you, even with that big needle in your hand. She laughs and I laugh, resisting the impulse to lean in and kiss her cheek. I tie the tourniquet around her bird bone arm and ask, as casually as I can, so...do you mind living alone? Are you ever scared? Scared, honey? What do you mean? What do I have to be scared of? Everything comes and goes and everyone dies alone in the end now don't they? Well...yes, but do you have anyone to help you? I am flicking the backs of her hands, trying to coax her veins to stand up for me, trying to focus on the task, trying to do my job. She laughs again. I've got more people to help me than I can shake a stick at and would you believe it, there are still people who need my help? She cackles and shakes her head. No being alone is easy, it's the being with people that takes so much out of me. Are you seeing any good veins? They usually find something right... in.... here. She runs her knobby finger along the back of her hand and I think now here's someone who knows the back of her own hand.
I get the bright red flash, advance the catheter, send the color topped tubes off to the lab. My work here is done, Miss Grandma, I say. I hope I didn't hurt you too bad. Oh no baby, I didn't feel a thing. Well, is there anything else I can get you? Hopefully the doctor will be with you before too, too long. I am sitting on the edge of her bed and she puts her hand on my knee, the sort of reassuring touch that I'm meant to be giving her. No sweetie, I'm just going to sit right here and think of Lawrence, my late husband. Being around him was never hard. Thinking about him keeps me from ever really being alone.
My patient is old, really, old -- with lovely smooth skin and cataracts turning her eyes that hazy, gentle blue. She tells me that she lives alone, that she's lived alone for all of the 30-odd years since her husband died. When I tell her I have to start an IV, she sees the dread on my face and tells me to think of her as my grandmother. I tell her this makes it worse, that I would hate to hurt my grandmothers. Oh no baby, she says, your grandmother loves you and is happy to see you, even with that big needle in your hand. She laughs and I laugh, resisting the impulse to lean in and kiss her cheek. I tie the tourniquet around her bird bone arm and ask, as casually as I can, so...do you mind living alone? Are you ever scared? Scared, honey? What do you mean? What do I have to be scared of? Everything comes and goes and everyone dies alone in the end now don't they? Well...yes, but do you have anyone to help you? I am flicking the backs of her hands, trying to coax her veins to stand up for me, trying to focus on the task, trying to do my job. She laughs again. I've got more people to help me than I can shake a stick at and would you believe it, there are still people who need my help? She cackles and shakes her head. No being alone is easy, it's the being with people that takes so much out of me. Are you seeing any good veins? They usually find something right... in.... here. She runs her knobby finger along the back of her hand and I think now here's someone who knows the back of her own hand.
I get the bright red flash, advance the catheter, send the color topped tubes off to the lab. My work here is done, Miss Grandma, I say. I hope I didn't hurt you too bad. Oh no baby, I didn't feel a thing. Well, is there anything else I can get you? Hopefully the doctor will be with you before too, too long. I am sitting on the edge of her bed and she puts her hand on my knee, the sort of reassuring touch that I'm meant to be giving her. No sweetie, I'm just going to sit right here and think of Lawrence, my late husband. Being around him was never hard. Thinking about him keeps me from ever really being alone.
26 July 2010
inception
I paid such careful attention all day. To the doctors' orders and the lab results and the endless, endless ringing of monitors. I paid attention because I was scared to death - scared that I might hurt someone, scared that I might kill someone, scared that I might look stupid in front of any of the 50 people within earshot. And because I wanted to tell you in the brightest detail of the 98 year old woman who drove herself to the hospital, the homeless man who used the world punctilious and said Why! I do believe your eyes are the color of adamite. About all the blood, the small kindnesses & relentless chaos. But like a dream, I can not remember the beginning or the end, how I got from 06:45 to 19:45 in one piece, my patients only a little worse for wear. And if I do not go to sleep right this minute, I don't know how I'll wake up in time to go back to that place where crazy is perfectly normal.
06 July 2010
The Odyssey: Part I
My grandmother gallivants; she straps on her gold sandals, packs her suitcase with linen skirts and turquoise jewelry--right up to the weight limit-- and sets out. Katie she said Soon as you finish school let’s take us a trip to celebrate. Somewhere warm! So we found a ship, booked our tickets, and counted down the days during the hard months between winter and summer. In between taking practice exams, I bought a pair of gold sandals. Squirrel signed on and the party was complete: 3 single gals on the high seas! And then my grandmother called with the news that her gallbladder was acting up again and that the doctor said it was time to have it out – 2 days before we set sail. So Squirrel and I packed our trunks and met in New York. We boarded at the pier in Brooklyn and stood on the open air deck, waving goodbye to our grandmothers and our great-grand parents as our ship passed Ellis Island and the Statue of Liberty—two single gals in gold sandals where there should’ve been three.
***
***
Bermuda is 26 square miles or so, a chain of rock slabs in the middle of the North Atlantic. The local pilot sails out to meet our ship in the hours before dawn and guides us toward the Royal Navy Shipyard. The night before, we stood along the rail of the promenade deck, looking toward the indistinguishable line of the horizon, where cobalt sky meets obsidian sea. Seafaring has always fascinated me -- the crazy-brave (mostly) men who boarded wooden vessels and used rope, cloth, stars, and wind to navigate unknown lands and unknowable depths. I picture our mammoth ship as a tiny speck in a vast ocean of blue, days away from any firmament, any green. I feel the imaginary pitch and reel of our vessel as the squall bounces us from crest to trough, flooding the deck and hull with brine faster than the bilge can pump it out. Retreating from my imagining, we turn and find refuge in the martini bar where the piano man plays the shanties of our day. We fall asleep in our air conditioned state room that night, and I can’t help but think that perhaps I would not be so intrepid and bold as I’d like to think. Maybe I would’ve stayed in London, in Barcelona or Lisbon, sweeping my narrow patch of ground, tending my lot in life, pushing back thoughts of anything more and bidding God speed to those brave enough to seek their fortune elsewhere. The next morning, though, we stand on our little balcony as the pilot leads us through the rocky channel. Our ship slices through water so aquamarine and sky so turquoise, that I can scarcely take it in. I begin to understand what compelled even ordinary people to leave their homes and loved ones. For all the men who never came back, swallowed up by the sea, it only took one safe return, one first-hand tale to play down the risks, to talk up the possibility. You must see it for yourself to believe it. The blues and the greens. The chance of gold.
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