Yesterday I had to tell a 50-something year old guy that he had hepatitis C. Turns out, when at Emanuel in the early 90's... when they saved his life, but not his left arm, they managed to give him Hepatitis C along with the life saving blood transfusions.
I thought about the fake patient I had to give bad news to, back in first year, trying to prepare us for this type of thing.
When it's the real thing, it's different, though I went about it in the same way. It feels different. As it should, I suppose, because this isn't make-believe. This is real. This man is real. This disease is real.
He had come in for a pain management visit, for his phantom limb pain. He woke up this morning, got himself ready for the day, for his appointment, unaware of what was to come. Just another day....
He had, in the early nineties, been working in some sort of large warehouse, and managed to get his arm caught in the door of an elevator. Bad enough, you'd think, but it grew much worse when the cable snapped, and took his arm to the bottom of the elevator shaft, leaving him behind. It was like something out of an action movie, or a bad horror flick. In fact, in Resident Evil, it happened to some poor soul, though it was her body that was taken down the shaft as fast as gravity could pull; 9.8 meters per second squared... leaving her head on the top floor of some office building.
To save his life, the doctors at Emanuel had to transfuse him with massive amounts blood, and other blood products, donated by altruistic souls, or perhaps destitute college students... trading plasma for tuition money. It's too bad though, that one of these life savers had Hepatitis C, and gave it away as freely as they had given their blood.
As I explained what the next steps would be- uncovering the genotype (which would likely determine if he could be cured of this, or eventually lose his life due to it) and the eventual biopsy to stage the progression of the disease; the destruction it had wreaked on his liver.... he just looked at me, silently, with an empty stare.
I think it's true, once you tell someone the bad news, "you have cancer" or "sorry, the HIV test was positive," they don't hear anything after that for some minutes.
I don't think he heard anything I said for a few minutes after the initial uppercut that was the bad news. He was dazed, punch drunk with just one shot; though a haymaker it was.
It took some time, and much repetition, but I think it sank in... as much as it could anyway.
It must have all seemed so surreal. I imagine being in his position, taking the handful of papers with information on Hepatitis C, the information I had written, the orders for bloodwork, biopsy and follow-up instructions...
Though it took over a half hour for the whole encounter, it must have seemed like it happened in a flash.... a complete blur. Not unlike when as a child, you took your bike down too steep a hill, with too little emphasis on the brakes, and a blatant disregard for your own health. you'd crash- with a flip over the handlebars, arms and legs flailing, torso flipping in what seems a far too fast manner for nature to allow. All you manage to see in a blur of colors as you're flung about, and you feel what you know should be pain, but it just comes to quickly to hurt now, it just feels.... unkind, and terrifying.... but it will, it will hurt. once your brain catches up to the physical assault, it will hurt.
I'm not sure if his brain caught up before he left... but i am sure of one thing; when it does, he will hurt.
Saturday, February 28, 2009
Thursday, February 19, 2009
Love and Mathematics
Nothing is working.
The cell phone doesn’t get any reception. I’d call T-mobile and complain, but I’ve got no reception. I’d throw the dang thing, but that’s how I ended up with this cheap replacement phone anyway. I guess i shouldn’t complain, it actually works. well, it would if i had any reception. but the good thing is that it has an alarm that actually works, my fairly recently deceased (assassinated) “smart phone” had the dumbest alarm. i don’t know where ‘HTC’ hired their engineers from, but they need to cut ties with that place.
i can’t seem to update my epocrates... not only that, but somehow, in my attempt to update- validating the hundred some dollars i spent on it, i was DOWNgraded by the smart folks at Epocrates. i’ve tried all that i know how to do, short of asking for help from the jerks that screwed me.... so, i did that. still haven’t heard back been able to fix the problem after several emails and a half hour conversation this AM. I know I’m a screw up sometimes, but, I’m having a hard time understanding how I could have possibly messed things up so badly that no one can figure out how to fix it. so, i blame them.
I don’t get any wireless signal out here, which is why, at the moment, I’m typing this on apple works and then will copy and paste it into its final destination to be broadcast to my thousands of adoring readers.
and i need to be near a wall when writing, not because I so love walls, but i’m in dire need of their marriage with power outlets. It seems that Apple specifically engineers their batteries to completely stop working after about 2 years. It wasn’t a slow death.... my computer did not battle cancer, COPD, or some other long, and draining disease. It was hit by a train.
boom. done. it’s over.
i’d like to have a word with a few of these engineers. it’s a good thing that they’re normally weakling nerds, surrounded by calculators, crumpled up papers, pencil sharpeners, rulers and computers. at least that’s how i think of them. it makes me think i could win in a physical battle, not a battle of logic... i’d lose that for sure to those nerds.
anyway, nerds and their nerd equipment aside, I feel sort of cut off.
i hate it. but, i love it too. I guess then, by definition, it’s a love hate thing.
there’s the desire to connect... to share what I’m experiencing with someone who’d give a damn. someone who’d hike falcon cove with me, or watch the sunset through twin rocks, build a fire on the beach and have one too many beers before having to just sleep right at the scene of the crime. I guess that’s why there’s the part of me who keeps telling my stories here, and sending pictures to friends and family. It’s not because I want to show everyone what I’ve done, or so I have proof that I was once where I claimed to be, and it’s certainly not so I don’t forget.... These pictures cannot imitate, not even slightly, the beauty that is burned into my mind from the actual moments I’ve experienced; the things that i’ve seen. I’ve tried, I’ve tried to capture this... and i fail, every time, i fail. What I send to you, what i post online, are failures. They have failed to capture the actual sights i’ve seen, what i’ve experienced; they are lies. and they cannot capture the feeling of it all. no... they are not proof, cues, nor are they trophies.
they are only invitations.
invitations to each of you, to sit next to me - your back against an ancient, washed up cedar log that is perfectly aligned with the waves rolling into shore- the sand under your backside, growing slightly cool after sitting for a few minutes. you’d notice how the sun makes you squint, so much so that your brow begins to ache, but you’re still grateful that it’s sunny.
Though it’s warm enough, maybe 55, you hug your arms to your chest as if to help pull the sun’s warmth straight into your core. and when you close your eyes, you notice that you’ve stared at the sun one too many times, for you see spots in your vision, even with eyes closed.... 9 or 10 perfectly round orbs in the otherwise darkness of your closed eyes. It was hard to avoid though, as the sun was near eye level just above the horizon, perfect yellow, orange and pink above the curling waves as it neared the end of its daily journey over the pacific. and the phantom suns in your vision seem a fair price to pay for this luxury. .
With eyes closed, you’d begin to notice the constant and reassuring sound of the waves.... low, bellowing, and heavy as they continually climb up the shore, trying their best to nip at your bare feet. They threaten, but don’t quite reach your toes... in fact they’re much farther away than you thought once you open your eyes.... you see that they’re breaking about 100 yards away... though you could have sworn that if you weren’t diligent, you’d be caught in the rush of a rogue wave and swept out to sea.
to the quickest thought, this doesn’t sound so bad. as you stare at haystack rock, all you can think of doing is climbing it... and if the current would just swallow you up, it just might take you right to its rocky shore.... from there, wouldn’t you get a view! for, from the beach, you can see for miles. Seemingly the only thing that disallows you to see strait to Canada as you gaze north, is the far off mist that slides into the coves that give birth to delicately up-sloping fir covered hills, as well as sheer vertical rock faces that appear as if they’ve been scraped from the sky to the water with a knife fit for God Himself.
If from the beach, this is your view, why, imagine what you could see from atop that monstrous rock. Maybe you could see Russia...
maybe not...
You’re soon snapped from your slide into memories of election season, back into a much sweeter reality. “I hate white rabbits, I hate white rabbits, I HATE, WHITE, RABBITS... ecchuuhh, eecchuuuhmm!” I’d cough, after my failed attempt at thwarting away the smoke from my face, which now seems to be flickering with light from the fire.... though it’s somewhat obscured by smoke that’s made me physically cry, as if cutting a powerful onion.
You just smile, and hug yourself tighter, grateful for the warmth of the fire now that the sun has gone.
It’s much darker now, and growing cooler... the stars have been awakened, and have begun their nocturnal duty, now that the rainbow of colors, and subsequent lingering twilight has disappeared from the not so quickly forgotten sunset. You close your eyes; the orbs remain.... as if to remind you of who’s the biggest and brightest in the universe... but the proud sun is unaware that while his image, burnt into your eyeballs, reminds you of the newly faded sunset, it seems to serve more so as your very own starry constellation. It leaves you in want for a shooting star, a constellation that you could actually pick out... could actually see. Though, you have only ever been able to recognize the big dipper, maybe Cassiopeia or orion’s belt, and it’s been so long since you’ve laid out and stared at the stars.
“Why don’t I do this every night?” You’d ask yourself, as you stare into the abyss.
I look in your direction as I tend to the fire in the middle of what seems to be the largest beach i’ve ever known, and I notice you have the biggest little grin on you face. It’s like the Reno of smiles. If I’ve ever seen someone truly content, it’s you right now, with eyes fixed towards the darkness, connecting points of light with your index finger.
Like a conductor, you wave your finger with purpose, though much slower, much more deliberately. From brighter, to dimmer, to blueish... to reddish.... to the brightest of white. At each tiny ball of fire, you stop for a moment, with a tap of your finger- like you’ve touched the star itself.... then slowly trace the line of best fit, in your mind, to the next numbered target in your cosmic connect the dots.
“What are you drawing?”
“I’m not sure yet.” You’d reply.
“Will you tell me when you figure it out?” I’d ask.
“You’ll be the first to know.”
This is how the night goes.... and it goes.
-------------------------------------------------------------------------------------------------
So, since you all can’t come and enjoy this with me, i hope you managed to paint yourself into this story, into the beach side with me.
I’m painting you guys in too.
Thanks for reading.
The cell phone doesn’t get any reception. I’d call T-mobile and complain, but I’ve got no reception. I’d throw the dang thing, but that’s how I ended up with this cheap replacement phone anyway. I guess i shouldn’t complain, it actually works. well, it would if i had any reception. but the good thing is that it has an alarm that actually works, my fairly recently deceased (assassinated) “smart phone” had the dumbest alarm. i don’t know where ‘HTC’ hired their engineers from, but they need to cut ties with that place.
i can’t seem to update my epocrates... not only that, but somehow, in my attempt to update- validating the hundred some dollars i spent on it, i was DOWNgraded by the smart folks at Epocrates. i’ve tried all that i know how to do, short of asking for help from the jerks that screwed me.... so, i did that. still haven’t heard back been able to fix the problem after several emails and a half hour conversation this AM. I know I’m a screw up sometimes, but, I’m having a hard time understanding how I could have possibly messed things up so badly that no one can figure out how to fix it. so, i blame them.
I don’t get any wireless signal out here, which is why, at the moment, I’m typing this on apple works and then will copy and paste it into its final destination to be broadcast to my thousands of adoring readers.
and i need to be near a wall when writing, not because I so love walls, but i’m in dire need of their marriage with power outlets. It seems that Apple specifically engineers their batteries to completely stop working after about 2 years. It wasn’t a slow death.... my computer did not battle cancer, COPD, or some other long, and draining disease. It was hit by a train.
boom. done. it’s over.
i’d like to have a word with a few of these engineers. it’s a good thing that they’re normally weakling nerds, surrounded by calculators, crumpled up papers, pencil sharpeners, rulers and computers. at least that’s how i think of them. it makes me think i could win in a physical battle, not a battle of logic... i’d lose that for sure to those nerds.
anyway, nerds and their nerd equipment aside, I feel sort of cut off.
i hate it. but, i love it too. I guess then, by definition, it’s a love hate thing.
there’s the desire to connect... to share what I’m experiencing with someone who’d give a damn. someone who’d hike falcon cove with me, or watch the sunset through twin rocks, build a fire on the beach and have one too many beers before having to just sleep right at the scene of the crime. I guess that’s why there’s the part of me who keeps telling my stories here, and sending pictures to friends and family. It’s not because I want to show everyone what I’ve done, or so I have proof that I was once where I claimed to be, and it’s certainly not so I don’t forget.... These pictures cannot imitate, not even slightly, the beauty that is burned into my mind from the actual moments I’ve experienced; the things that i’ve seen. I’ve tried, I’ve tried to capture this... and i fail, every time, i fail. What I send to you, what i post online, are failures. They have failed to capture the actual sights i’ve seen, what i’ve experienced; they are lies. and they cannot capture the feeling of it all. no... they are not proof, cues, nor are they trophies.
they are only invitations.
invitations to each of you, to sit next to me - your back against an ancient, washed up cedar log that is perfectly aligned with the waves rolling into shore- the sand under your backside, growing slightly cool after sitting for a few minutes. you’d notice how the sun makes you squint, so much so that your brow begins to ache, but you’re still grateful that it’s sunny.
Though it’s warm enough, maybe 55, you hug your arms to your chest as if to help pull the sun’s warmth straight into your core. and when you close your eyes, you notice that you’ve stared at the sun one too many times, for you see spots in your vision, even with eyes closed.... 9 or 10 perfectly round orbs in the otherwise darkness of your closed eyes. It was hard to avoid though, as the sun was near eye level just above the horizon, perfect yellow, orange and pink above the curling waves as it neared the end of its daily journey over the pacific. and the phantom suns in your vision seem a fair price to pay for this luxury. .
With eyes closed, you’d begin to notice the constant and reassuring sound of the waves.... low, bellowing, and heavy as they continually climb up the shore, trying their best to nip at your bare feet. They threaten, but don’t quite reach your toes... in fact they’re much farther away than you thought once you open your eyes.... you see that they’re breaking about 100 yards away... though you could have sworn that if you weren’t diligent, you’d be caught in the rush of a rogue wave and swept out to sea.
to the quickest thought, this doesn’t sound so bad. as you stare at haystack rock, all you can think of doing is climbing it... and if the current would just swallow you up, it just might take you right to its rocky shore.... from there, wouldn’t you get a view! for, from the beach, you can see for miles. Seemingly the only thing that disallows you to see strait to Canada as you gaze north, is the far off mist that slides into the coves that give birth to delicately up-sloping fir covered hills, as well as sheer vertical rock faces that appear as if they’ve been scraped from the sky to the water with a knife fit for God Himself.
If from the beach, this is your view, why, imagine what you could see from atop that monstrous rock. Maybe you could see Russia...
maybe not...
You’re soon snapped from your slide into memories of election season, back into a much sweeter reality. “I hate white rabbits, I hate white rabbits, I HATE, WHITE, RABBITS... ecchuuhh, eecchuuuhmm!” I’d cough, after my failed attempt at thwarting away the smoke from my face, which now seems to be flickering with light from the fire.... though it’s somewhat obscured by smoke that’s made me physically cry, as if cutting a powerful onion.
You just smile, and hug yourself tighter, grateful for the warmth of the fire now that the sun has gone.
It’s much darker now, and growing cooler... the stars have been awakened, and have begun their nocturnal duty, now that the rainbow of colors, and subsequent lingering twilight has disappeared from the not so quickly forgotten sunset. You close your eyes; the orbs remain.... as if to remind you of who’s the biggest and brightest in the universe... but the proud sun is unaware that while his image, burnt into your eyeballs, reminds you of the newly faded sunset, it seems to serve more so as your very own starry constellation. It leaves you in want for a shooting star, a constellation that you could actually pick out... could actually see. Though, you have only ever been able to recognize the big dipper, maybe Cassiopeia or orion’s belt, and it’s been so long since you’ve laid out and stared at the stars.
“Why don’t I do this every night?” You’d ask yourself, as you stare into the abyss.
I look in your direction as I tend to the fire in the middle of what seems to be the largest beach i’ve ever known, and I notice you have the biggest little grin on you face. It’s like the Reno of smiles. If I’ve ever seen someone truly content, it’s you right now, with eyes fixed towards the darkness, connecting points of light with your index finger.
Like a conductor, you wave your finger with purpose, though much slower, much more deliberately. From brighter, to dimmer, to blueish... to reddish.... to the brightest of white. At each tiny ball of fire, you stop for a moment, with a tap of your finger- like you’ve touched the star itself.... then slowly trace the line of best fit, in your mind, to the next numbered target in your cosmic connect the dots.
“What are you drawing?”
“I’m not sure yet.” You’d reply.
“Will you tell me when you figure it out?” I’d ask.
“You’ll be the first to know.”
This is how the night goes.... and it goes.
-------------------------------------------------------------------------------------------------
So, since you all can’t come and enjoy this with me, i hope you managed to paint yourself into this story, into the beach side with me.
I’m painting you guys in too.
Thanks for reading.
Saturday, February 14, 2009
Hi, Atus.... it's Valentine
I've been a recluse. It's work, eat, sleep, repeat. I don't mind, but it leaves little time for the click and clack of keystrokes on this failing mac. Sorry if in my absence, your days have grown slightly more grey; I'm sure they haven't.
Life on the coast still humbles me every day, whether it be at work... when I realize I know even less than I think, or whether it be by the landscape itself. It has a way of making you feel very small; not unimportant, in fact, it makes you feel nearly the opposite somehow.
I went to Hug Point today, it was low tide. That's the only way to see it, or so I'm told. It apparently got its name when early settlers of the west waited until low tide to sneak around the point, safe from the breaking waves of the Pacific. At high tide, the rock faces, and solitary boulders jutting out of the sand are buried by the sea. The beach disappears. So, you can picture how the adventures found it necessary to 'hug' the edge of the point, when even at low tide, the water threatens to bite at your ankles.
I like the story, but I like to think it was a bit more simple... and directly related to actual hugs. The irony was not lost on me, that I was at hug point today, Valentine's Day, without anyone to hug. It sort of made me laugh.
I didn't see anyone else there hugging... though there were plenty of candidates. It seems that maybe they ascribe to the historical naming story of this part of the Oregon Coast, not my simple-minded - but more Valentine related one.
I think next time I go back, I might ask someone to take a picture of me hugging the rock-face. It's rather silly, I know.... but, eh... don't care. I love to spread the hug love.
I guess that's about it for now... I'll try to be better at keeping up with this online journal of mine, for whoever out there is interested.
Until then....
Life on the coast still humbles me every day, whether it be at work... when I realize I know even less than I think, or whether it be by the landscape itself. It has a way of making you feel very small; not unimportant, in fact, it makes you feel nearly the opposite somehow.
I went to Hug Point today, it was low tide. That's the only way to see it, or so I'm told. It apparently got its name when early settlers of the west waited until low tide to sneak around the point, safe from the breaking waves of the Pacific. At high tide, the rock faces, and solitary boulders jutting out of the sand are buried by the sea. The beach disappears. So, you can picture how the adventures found it necessary to 'hug' the edge of the point, when even at low tide, the water threatens to bite at your ankles.
I like the story, but I like to think it was a bit more simple... and directly related to actual hugs. The irony was not lost on me, that I was at hug point today, Valentine's Day, without anyone to hug. It sort of made me laugh.
I didn't see anyone else there hugging... though there were plenty of candidates. It seems that maybe they ascribe to the historical naming story of this part of the Oregon Coast, not my simple-minded - but more Valentine related one.
I think next time I go back, I might ask someone to take a picture of me hugging the rock-face. It's rather silly, I know.... but, eh... don't care. I love to spread the hug love.
I guess that's about it for now... I'll try to be better at keeping up with this online journal of mine, for whoever out there is interested.
Until then....
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