Wednesday, May 2, 2012
Dusty Souls and To Do Lists
There are no ghosts here, as far as I can tell. Though, I've only been calling this place home for a month, so suppose I can't be certain. Perhaps they're just shy, quiet, or exceedingly polite. Though, when I cannot perceive the thoughts, feelings and worries of living people with any skill, then how could I expect to sense such things in the deceased. Nonetheless, there are however, visible remnants of her past, that even a dope like me can see. An old workbench rests under a thick layer of dust and spider webs, in a basement with walls of brick and an old cement floor, one that was laid in 1888, and has yet to crumble and disappear as most things have from that particular year.
These dusty and unused relics, inside of a newly revitalized home, resonate with me all too personally.
Her peaked roof spies Lake Michigan from the modest hill upon which she rests. Barely visible, as a result of other homes to her east as well as the new spring foliage, the water-filled trough carved by an ancient mile deep glacier is undoubtedly near, as proven by the occasional sea gull squawk. The home stands proud, sturdy, and handsome both inside and out a mere three blocks from the icy deep. There is almost nothing remaining of her former, dilapidated, uncared for, and conquered self. This is most certainly a good thing. For, if you knew her before this, you would not have liked what you'd have seen.
When I found her, it seemed that my year long vagrancy, though extended beyond simply one year, had come to an end. I have planted my feet into this soil, and am allowing myself to twist and turn deeper into that earth and take root.
I am now an arithmetic year older, but far older still as measured by life itself.... whatever that means. But, I suspect you understand what I mean to say. You see, my vocabulary now includes words like 'escrow' and 'property taxes'. I have the immediate desire to tinker with things around the house (and add the word 'tinker' to my list of new words). My favorite places to spend money have gone from the Homebrew supply shop, to places like Home Depot and Lowe's. I spend less time listening to broken heart, break-up, punk song ballads and more time listening to nautically themed Decemberists songs. I am contented and oddly disturbed in the same moment. But what disturbs me is how undisturbed I am by it all.
I feel older. I feel less my former self, for better or worse.
No, it was not simply the act of buying a house that made such a change occur. Though, it may have capitulated it. No singular thing could, or has, created this change. I would guess that it's been a great number of things over the years that have brought me to this place. This house, and that old workbench in the basement, have simply made me see it with some degree of clarity.
This house was vastly different a few years ago. An older couple lived here for thirty-some years, then, as people do, grew old, sick, and had to leave their home. They moved to an assisted living community in the area, where the husband died, and the wife still resides. When they lived here, the home itself was full. Full of life, family, different furniture than today, different conversations, smells, appliances and tools. All the while, the workbench sat amongst these tools, useful and busy, helping keep the home alive, and creating much of its beauty both then and now. All the while, it sat then in the same place as it does today. Then abruptly, the house went quiet, and was alone for a number of years, until a couple of people found it, purchased it, and brought it back to life. It had to be torn down to the studs to make it what it is today. But, they kept what they could (which was quite a lot, in fact) of the old character of the house. The built-in china cabinets remain, the original woodwork is impressive still, and the leaded glass windows shine.... all with new minor facelifts. Throughout all of this, untouched in the basement sat the workbench, collecting dust.
It seems to me, as I stare at this dirty, grimy, but very promising workbench, that this house and I have been speeding towards each other for some time now. Like it, I had been very different some years ago, and then was empty for some time. The years had slowly picked away at my siding, foundation, and insides, deliberately rebuilding a Newhouse along the way. (get it?) Now, what's left over, when I really look at it critically, is difficult to recognize.... though some of my woodwork and leaded windows remain.
I am different. I am a New House. But, I am yet a home. The work is left undone.
When I look deep down into myself, down my creaky stairs, through my cold cement basement, and into my dimly lit workshop, I see my old workbench. It is untouched, unblemished, and still unused. It is the last bit of me that has remained unchanged through this rebuilding process. It was protected from these changes by keeping itself hidden, or by allowing me to keep it hidden. I can see the layers of dust piled atop its face. I smell it, as I easily wipe some away, sending particles wildly riding through the stale air, revealing an intact treasure; with its sturdy metal legs and beautiful hardwood surfaces - albeit, weathered through the years, but more beautiful for it. It is calling out for ME to restore it. As I look at it, I realize that it can be renewed and used yet again. It has its best years ahead of it, and will be the heart of my home once again. It will take some work, yes, but this is my charge alone.
Monday, May 23, 2011
Rest and Digest, I'm only para-sympathetic
Each tiny limb pointed in slightly different directions.
But imagining their common origin to be the same, not unlike the flashes of a firework spraying outward from the center of the explosion, I was able to envision them before the plumping. The right was a reflection of the left, and the left of the right. And for a brief moment, among the mechanical-like rotatory movements of the wiry stubs, there was perfect symmetry. I had a sudden flash of Violet from Charlie and the Chocolate Factory (or Willie Wonka & the Chocolate Factory, if you're instead, a fan of the original) rapidly enlarging into a blue sphere, arms and legs stretched as if on the rack. She, unable to walk, had to be rolled out of the factory.
It occurred to me that this wasn't so different. Then, a new flash of thoughts barreled through my mind which seemed to center around the science and logic of this, and phenomena like it.
"Why would this be the plan that evolution chose? It seems terribly vulnerable at this very moment." I think, as I'm walking palm up, channeling my inner child for a horrible prank.
"Come to think of evolution and vulnerability, why in the world do we sleep? I mean, how vulnerable are we when we are unconscious? Very! Not as much NOW with locks on doors, burglar alarms and such, but, back when we had to worry about those effing saber tooth tigers.... it just seems awfully dangerous to fall asleep. You'd think the insomniacs would have been the only survivors, right Darwin? Our dozing ancestors would have been devoured in their sleep. With all the risk, I guess that makes the act of sleeping, for some reason, really important. At least I'm good at one important thing. I'm going to evolve the hell outta this body.... or, well, wait.... I don't think it works that way. Wait, what am I doing again?"
I look down at my gloved hand, "Oh, right!"
The 8 mechanized pistons swirl like the hands of a clock moving far too quickly.... Though they do nothing but wriggle in the empty air.... they propel not this glutton.
"Ugh, it's like me after I eat a Chipotle burrito. Man, I hate it when people pronounce it Chi-pole-tay.... it's Chip-oat-lay. Wow, I get annoyed easily by grammar related missteps. Speaking of missteps...."
I then think to fake a slip and send flying my recently plucked iron filled epicure. But, I think better of this. "Must.... be..... professional...."
I am, after all, recently aged 28 years. And, I am at work, so I should act like it.
I turn the corner and enter the bathroom, peer down at what looks like an oversized flesh colored kernel of corn, with red, wriggling hairs, 4 on either side. At the point of the kernel sits a tiny maroon spec that moments ago was buried in a quite brave, and cute, little girl who had been playing in the woods with her family 3 days prior. She had left not only with memories of s'mores, fishing and campfires. She had even taken with her the actual scent of their smoke in her hair, but also tucked in her golden locks hid an unwelcome and parasitic gourmand... a hitchhiker of sorts. Across state lines, and eventually into my ER it rode.... gorging itself to the point of immobility along the way. It looked of the obese restaurant patron in "Monty Python's: The Meaning of Life" just prior to exploding.
"How is it that you've evolved into this? How can this be the best version of you? You can't even move. You've eaten so much so that you are unable to touch any of your 8 legs onto the ground. Don't you just get eaten by a bird the instant that you detach yourself from your host? If not, what do you do while you wait for your body to digest your greedy meal? You can't move... so, I guess you just sit there. Ugh, I hate ticks."
This is my second to last thought as I flush the vampiric insect down the toilet of the ER.
My last one being, "What exactly do I diagnose this girl with... 'Attached wood tick, removed???' And I wonder if there's an ICD 9 code for it?"
But imagining their common origin to be the same, not unlike the flashes of a firework spraying outward from the center of the explosion, I was able to envision them before the plumping. The right was a reflection of the left, and the left of the right. And for a brief moment, among the mechanical-like rotatory movements of the wiry stubs, there was perfect symmetry. I had a sudden flash of Violet from Charlie and the Chocolate Factory (or Willie Wonka & the Chocolate Factory, if you're instead, a fan of the original) rapidly enlarging into a blue sphere, arms and legs stretched as if on the rack. She, unable to walk, had to be rolled out of the factory.
It occurred to me that this wasn't so different. Then, a new flash of thoughts barreled through my mind which seemed to center around the science and logic of this, and phenomena like it.
"Why would this be the plan that evolution chose? It seems terribly vulnerable at this very moment." I think, as I'm walking palm up, channeling my inner child for a horrible prank.
"Come to think of evolution and vulnerability, why in the world do we sleep? I mean, how vulnerable are we when we are unconscious? Very! Not as much NOW with locks on doors, burglar alarms and such, but, back when we had to worry about those effing saber tooth tigers.... it just seems awfully dangerous to fall asleep. You'd think the insomniacs would have been the only survivors, right Darwin? Our dozing ancestors would have been devoured in their sleep. With all the risk, I guess that makes the act of sleeping, for some reason, really important. At least I'm good at one important thing. I'm going to evolve the hell outta this body.... or, well, wait.... I don't think it works that way. Wait, what am I doing again?"
I look down at my gloved hand, "Oh, right!"
The 8 mechanized pistons swirl like the hands of a clock moving far too quickly.... Though they do nothing but wriggle in the empty air.... they propel not this glutton.
"Ugh, it's like me after I eat a Chipotle burrito. Man, I hate it when people pronounce it Chi-pole-tay.... it's Chip-oat-lay. Wow, I get annoyed easily by grammar related missteps. Speaking of missteps...."
I then think to fake a slip and send flying my recently plucked iron filled epicure. But, I think better of this. "Must.... be..... professional...."
I am, after all, recently aged 28 years. And, I am at work, so I should act like it.
I turn the corner and enter the bathroom, peer down at what looks like an oversized flesh colored kernel of corn, with red, wriggling hairs, 4 on either side. At the point of the kernel sits a tiny maroon spec that moments ago was buried in a quite brave, and cute, little girl who had been playing in the woods with her family 3 days prior. She had left not only with memories of s'mores, fishing and campfires. She had even taken with her the actual scent of their smoke in her hair, but also tucked in her golden locks hid an unwelcome and parasitic gourmand... a hitchhiker of sorts. Across state lines, and eventually into my ER it rode.... gorging itself to the point of immobility along the way. It looked of the obese restaurant patron in "Monty Python's: The Meaning of Life" just prior to exploding.
"How is it that you've evolved into this? How can this be the best version of you? You can't even move. You've eaten so much so that you are unable to touch any of your 8 legs onto the ground. Don't you just get eaten by a bird the instant that you detach yourself from your host? If not, what do you do while you wait for your body to digest your greedy meal? You can't move... so, I guess you just sit there. Ugh, I hate ticks."
This is my second to last thought as I flush the vampiric insect down the toilet of the ER.
My last one being, "What exactly do I diagnose this girl with... 'Attached wood tick, removed???' And I wonder if there's an ICD 9 code for it?"
Friday, May 6, 2011
Hot Monotony
From algorithms and equations my decisions are made.
In response to fragmented sentences on the screen in front of me... my fingers swipe and command orders. Electrical impulses from the computer illicit electrical impulses from my brain, to my nerves, and eventually to my muscles. Sodium and Potassium frantically trade places again and again within my cells. Action potentials are fired; a series of unconscious chemical messages that dictate my body's action... fueled by ATP... the gasoline for us all.
The result: click, point, click, clack, fwiiip... slide, tap, tap, tap.... ENTER.
Often times, before I even see you.... before I meet you, shake your hand, see the fear in your eyes, feel the deceit from the lack of their contact with mine, or judge the honesty (or lack-there-of) in the animated writhing of your body in this room, I have decided.
I already know what I am to do with you today.
These formulas usually find a very repeatable, reliable and calculable result. This is why they are useful, yes, but they are not mathematic certainties. To believe this, and to practice this, will create for you a brief career in this business.
Like many other in this world, my profession is defined, and decided, within the 'gray areas.'
Black and white is easy. It's the haze of the gray that causes confusion, panic and accidents.
When the computer screen and chart read, "vaginal bleeding x10 hours, +6 weeks pregnant," it triggers the automatic response from my brain, nerves and muscles to order the appropriate labs, and imaging. "This," I think to myself, "is about a mathematical as they come." (In the emergency setting, there are only a couple of things to worry about here, and really, only ONE work-up. If there was ever a time to put in the orders before seeing the patient, (to speed up their stay in the ER) now's that time.
As I head towards room 31, and leave the computer to perform its task of electronically sending my orders throughout the hospital on wires of copper, fiber-optics and ethernet, to separate destinations... (lab, nurses, techs and radiology), I find my patient outside of said room, waiting in line for the bathroom.
She is youthful, petite, and has the look of a scared young child in line for a haunted house, one that she would not have dared to step in to, if it were not for her braver, and older sister. Though today, she is alone here in the ER, and she is buried in her far too large hooded sweatshirt as if to hide from the ghouls in this place. Oh the horror she must feel as she thinks of all the terrible possibilities. She disappears further into her sweatshirt.
We begin talk. More specifically, I ask questions and listen to her answers, marking down the responses in the correct area on my chart, making sure to look up frequently and capture her gaze. Though rather than look at me, she aims her stare at the cuffs of her sweatshirt, as she teases at a loose thread in the cotton seam. This, a nervous gesture I have seen before. Still, I attempt to be more of a person while listening to her, rather than appear as the robot that I am, programmed with algorithms that will (or have already) led me to my implemented plan.
I am an accountant of words.
She tells me of her trip yesterday to planned parenthood, of her positive pregnancy test, and her diagnoses of a 6 week pregnancy. Her last period being about 6 weeks ago, and had not bled since then, until today. Now, there is pain, too, accompanying the crimson.
I finish logging her words, like a transcriptionist.
My hinges squeak while being pushed by the various pistons positioned nearest them as I set down the clipboard, and pick up the ophthalmoscope to check pupillary reflexes, then look in her throat. There are no surprises here. Next, check lymph nodes in the neck and listen for bruits. Now the heart and lungs.... I hear clicks of S1 and S2, no murmurs, rubs, gallops. Lungs are clear to auscultation, no wheezes rhonchi or rales. Now I have her lay back to check her abdomen.....
Does not compute.
As I pull back her oversized sweatshirt, her last line of defense... her big-sister-stand-in, the fear permeates from her pregnant belly, and fills the room, banging at my metal exterior. There is nowhere for her to hide now. Her exposed belly is convex, and hard to the touch.... and resembles the harvest moon.
She is full term. She is in labor.
This forces my circuitry to immediately rewire and demand a manual override.
I snap into action.... decipher how far apart contractions are... explain to her that she is much farther along than 6 weeks, in fact, she appears to be full term, and beginning to have contractions (I still am unsure if she really didn't know, or did, but was just in denial). I quickly perform a pelvic exam, the cervical os is partially open, admitting a finger, which now feels the calvaria of another living being, yet to officially join this world, and unknown (supposedly) to its mother only moments before.
Mother and surprise child are immediately transported to another facility where OBGyn can handle the delivery.
I, on the other hand, call the producers of "I didn't know I was pregnant" and tell them that I've got another story for their show.
In response to fragmented sentences on the screen in front of me... my fingers swipe and command orders. Electrical impulses from the computer illicit electrical impulses from my brain, to my nerves, and eventually to my muscles. Sodium and Potassium frantically trade places again and again within my cells. Action potentials are fired; a series of unconscious chemical messages that dictate my body's action... fueled by ATP... the gasoline for us all.
The result: click, point, click, clack, fwiiip... slide, tap, tap, tap.... ENTER.
Often times, before I even see you.... before I meet you, shake your hand, see the fear in your eyes, feel the deceit from the lack of their contact with mine, or judge the honesty (or lack-there-of) in the animated writhing of your body in this room, I have decided.
I already know what I am to do with you today.
These formulas usually find a very repeatable, reliable and calculable result. This is why they are useful, yes, but they are not mathematic certainties. To believe this, and to practice this, will create for you a brief career in this business.
Like many other in this world, my profession is defined, and decided, within the 'gray areas.'
Black and white is easy. It's the haze of the gray that causes confusion, panic and accidents.
When the computer screen and chart read, "vaginal bleeding x10 hours, +6 weeks pregnant," it triggers the automatic response from my brain, nerves and muscles to order the appropriate labs, and imaging. "This," I think to myself, "is about a mathematical as they come." (In the emergency setting, there are only a couple of things to worry about here, and really, only ONE work-up. If there was ever a time to put in the orders before seeing the patient, (to speed up their stay in the ER) now's that time.
As I head towards room 31, and leave the computer to perform its task of electronically sending my orders throughout the hospital on wires of copper, fiber-optics and ethernet, to separate destinations... (lab, nurses, techs and radiology), I find my patient outside of said room, waiting in line for the bathroom.
She is youthful, petite, and has the look of a scared young child in line for a haunted house, one that she would not have dared to step in to, if it were not for her braver, and older sister. Though today, she is alone here in the ER, and she is buried in her far too large hooded sweatshirt as if to hide from the ghouls in this place. Oh the horror she must feel as she thinks of all the terrible possibilities. She disappears further into her sweatshirt.
We begin talk. More specifically, I ask questions and listen to her answers, marking down the responses in the correct area on my chart, making sure to look up frequently and capture her gaze. Though rather than look at me, she aims her stare at the cuffs of her sweatshirt, as she teases at a loose thread in the cotton seam. This, a nervous gesture I have seen before. Still, I attempt to be more of a person while listening to her, rather than appear as the robot that I am, programmed with algorithms that will (or have already) led me to my implemented plan.
I am an accountant of words.
She tells me of her trip yesterday to planned parenthood, of her positive pregnancy test, and her diagnoses of a 6 week pregnancy. Her last period being about 6 weeks ago, and had not bled since then, until today. Now, there is pain, too, accompanying the crimson.
I finish logging her words, like a transcriptionist.
My hinges squeak while being pushed by the various pistons positioned nearest them as I set down the clipboard, and pick up the ophthalmoscope to check pupillary reflexes, then look in her throat. There are no surprises here. Next, check lymph nodes in the neck and listen for bruits. Now the heart and lungs.... I hear clicks of S1 and S2, no murmurs, rubs, gallops. Lungs are clear to auscultation, no wheezes rhonchi or rales. Now I have her lay back to check her abdomen.....
Does not compute.
As I pull back her oversized sweatshirt, her last line of defense... her big-sister-stand-in, the fear permeates from her pregnant belly, and fills the room, banging at my metal exterior. There is nowhere for her to hide now. Her exposed belly is convex, and hard to the touch.... and resembles the harvest moon.
She is full term. She is in labor.
This forces my circuitry to immediately rewire and demand a manual override.
I snap into action.... decipher how far apart contractions are... explain to her that she is much farther along than 6 weeks, in fact, she appears to be full term, and beginning to have contractions (I still am unsure if she really didn't know, or did, but was just in denial). I quickly perform a pelvic exam, the cervical os is partially open, admitting a finger, which now feels the calvaria of another living being, yet to officially join this world, and unknown (supposedly) to its mother only moments before.
Mother and surprise child are immediately transported to another facility where OBGyn can handle the delivery.
I, on the other hand, call the producers of "I didn't know I was pregnant" and tell them that I've got another story for their show.
Saturday, April 2, 2011
Into The Abyss
It's not as much a call to arms, as it is a call to legs. He meant for them to get up and balance on theirs. Deftly taking steps, small at first, but with poise and intent. Weak from decades of neglect, they're at first, best at simply wobbling about, flapping under the weight from above. But with time, they remember the cadence.
They're running now. I can see them in the streets. Though steps filled with intent and poise have turned into stomps of criminal intent and poison; a visual cacophony before us all. Chaos is a word too hackneyed to properly encapsulate the blur of escalation that is occurring. Like slowly walking down a steep embankment inevitably turns into an uncontrolled sprint, and an eventual failure to keep pace with gravity. Face, meet earth.
The sudden stop takes away your breath... and leaves your face numb, with watercolors of green and yellow floating over your field of vision... like the unavoidable bruise that will soon paint your nose and cheekbones. This, a clear sign that you let yourself go to far... and that you need a lesson in restraint.
I, on the other hand, could use some passion.... so you've said. And, again repeat as you pick up your chosen weapon, and depart down that steep hill once more. I suspect you will be surprised upon your return, with a face bruised almost as badly as your ego.
But green and yellow will undoubtedly relent to purple, black, and finally flesh again. Bones heal, and egos forget past failures. But these things are only true under the most normal of circumstances. And these, my friend, are not normal circumstances. So, proceed with caution. This new path is unpaved, and is rife with danger and uncertainty.
They're running now. I can see them in the streets. Though steps filled with intent and poise have turned into stomps of criminal intent and poison; a visual cacophony before us all. Chaos is a word too hackneyed to properly encapsulate the blur of escalation that is occurring. Like slowly walking down a steep embankment inevitably turns into an uncontrolled sprint, and an eventual failure to keep pace with gravity. Face, meet earth.
The sudden stop takes away your breath... and leaves your face numb, with watercolors of green and yellow floating over your field of vision... like the unavoidable bruise that will soon paint your nose and cheekbones. This, a clear sign that you let yourself go to far... and that you need a lesson in restraint.
I, on the other hand, could use some passion.... so you've said. And, again repeat as you pick up your chosen weapon, and depart down that steep hill once more. I suspect you will be surprised upon your return, with a face bruised almost as badly as your ego.
But green and yellow will undoubtedly relent to purple, black, and finally flesh again. Bones heal, and egos forget past failures. But these things are only true under the most normal of circumstances. And these, my friend, are not normal circumstances. So, proceed with caution. This new path is unpaved, and is rife with danger and uncertainty.
Wednesday, January 12, 2011
Nose Dives and Car Rides
It was quiet in the car.
I remember this because it was not so much quiet, as it was silent. And I, over the years, have become a connoisseur of sorts with respect to silence. Not many people know that there are different kinds of silences. There are at least 14 that I know of... though I won't get into the subtleties of this here. All you need to know, is that this particular silence was one that signified more than awkwardness, more than tension, more than hurt.... It generated an unsaid, but all too well understood, sense of finality, a realization that so many things had gone unsaid over the years... but perhaps most importantly, an admission of mistrust.
Though, as I suspected, she didn't seem to care... neither the silence, what it signified, or even the statement following seemed to penetrate her exterior.
It was nothing new, it had been too late for years. This story isn't about that. I just remember this particular day, not because it's when I admitted to her that I felt as if PA school was perhaps a dream that would never come true for me, or because she didn't seem to care, or because it may have been the last time I saw her in that city (I really don't remember), or because it was the first time I discovered this specific brand of silence, but because it's when I admitted to myself that I might not ever get into PA school.
In looking back, it tells me something about my resolve.... or perhaps my persistence, whether or not it was supported by sound judgement. As you know, I made it.... and did well, and am doing well in my chosen career. Here's the problem... I've achieved my goal, my seemingly unachievable goal. Really, one that I thought I may never accomplish. Now, here I am.... and the problem is this.... I haven't a new goal.... or, let me rephrase that. I hadn't a new goal, until not too long ago. This lack of an endpoint, a distant and perhaps impossible goal, bothered me. It turns out, I'm goal oriented, and perhaps a bit more type A than I'd like to admit. I am now, however, cool and unbothered, for I have a new impossible dream.
I love what I do, I love my career. But that's it, it's a career, a job.... it's work. The people who have it figured out have managed to do something that they cannot even bring themselves to call 'work' or a 'job.' It's just what they do, it's their passion... and they happen to get paid for it... and yes, they may be few and far between. And for me, it sure as hell is a long shot.... but so was the thought of PA school while I sat inside that old Cadillac.
Here's to the impossible.
I remember this because it was not so much quiet, as it was silent. And I, over the years, have become a connoisseur of sorts with respect to silence. Not many people know that there are different kinds of silences. There are at least 14 that I know of... though I won't get into the subtleties of this here. All you need to know, is that this particular silence was one that signified more than awkwardness, more than tension, more than hurt.... It generated an unsaid, but all too well understood, sense of finality, a realization that so many things had gone unsaid over the years... but perhaps most importantly, an admission of mistrust.
Though, as I suspected, she didn't seem to care... neither the silence, what it signified, or even the statement following seemed to penetrate her exterior.
It was nothing new, it had been too late for years. This story isn't about that. I just remember this particular day, not because it's when I admitted to her that I felt as if PA school was perhaps a dream that would never come true for me, or because she didn't seem to care, or because it may have been the last time I saw her in that city (I really don't remember), or because it was the first time I discovered this specific brand of silence, but because it's when I admitted to myself that I might not ever get into PA school.
In looking back, it tells me something about my resolve.... or perhaps my persistence, whether or not it was supported by sound judgement. As you know, I made it.... and did well, and am doing well in my chosen career. Here's the problem... I've achieved my goal, my seemingly unachievable goal. Really, one that I thought I may never accomplish. Now, here I am.... and the problem is this.... I haven't a new goal.... or, let me rephrase that. I hadn't a new goal, until not too long ago. This lack of an endpoint, a distant and perhaps impossible goal, bothered me. It turns out, I'm goal oriented, and perhaps a bit more type A than I'd like to admit. I am now, however, cool and unbothered, for I have a new impossible dream.
I love what I do, I love my career. But that's it, it's a career, a job.... it's work. The people who have it figured out have managed to do something that they cannot even bring themselves to call 'work' or a 'job.' It's just what they do, it's their passion... and they happen to get paid for it... and yes, they may be few and far between. And for me, it sure as hell is a long shot.... but so was the thought of PA school while I sat inside that old Cadillac.
Here's to the impossible.
Wednesday, September 29, 2010
Catch and Release
I sometimes think about you, and our brief, yet terrifying, encounter. Almost never do my thoughts rest solely on you; what you might be doing, or how you've been. But instead, on my great escape.
I think about you all the time. More than just our magical, and all too short time together, but about what could have been. And, I am filled with regret.
I am overtaken by joy. As I today still feel the heart pounding in my chest, I recall the feeling of it slowly giving up, in some sort of agonal rhythm while the rest of me starved for oxygen, and as I gasped for a breath. My body shivered and convulsed in your hands... dying. You just grinned, as if taking pleasure in my demise.
When thinking about our tryst of sorts, I remember smiling gently as I held you in my hands. I had never seen such a perfect specimen. Such life, color and mystery.... such promise.
Trapped in your grip for what seemed like an eternity, I nearly slipped into unconsciousness, I almost gave in. Instead, I somehow slipped back into the sea. Whether it was a result of a last, desperate escape attempt, (a swift swing of my tail), or from a flash of pity that you felt for me, which made you loosen your grasp, I do not know. All I know is that I dove from your vessel, head first into the waves. Like a knife, I plunged through the surface of the water, and cut the hangman's noose from my neck. My heart began to beat more strongly, my muscles began to respond to my commands, my color returned, and the fog began to evaporate from my mind. I am alive.
I let you go. Whether it was clarity of mind and heart that allowed for this, or, just the opposite, was uncertain at the moment. (And, had remained this way for quite some time.) I watched you disappear into the depths of the ocean, as well as the ripple you left behind. With both you, and any evidence that you were actually real, gone, I am left alone... in silence. Nothing remains but the churning of my mind that mimics the slapping of the waves against the hull of the boat. I am left only with questions, most of them begin with "Why".
When the trance was broken, and Fear laid down to rest, I was left with a new feeling of confidence. I swam through the shallows of the clear blue sea, darted through the tapestry of coral, and rode the warm currents through my vast underwater home. I continued on with caution, yes, but more so with bravery... with wisdom and with an overwhelming sense of freedom. I had never felt so alive. It's strange when I think of it... that it took nearly dying to make me truly live.
Why did I let you go? Why did I not pull you in completely, bring you to the bottom of the boat, and lay there with you until your end? I could have made your beauty last forever. You would never have grown old, never have felt hurt, hunger, loss or pain again. You could have stayed with me for the rest of my days, frozen in time... this day, and this time. It only would have cost you your life. Instead, you're gone. And I'm left only with a memory, and the sorrow that is loss. I am alone.
Since our battle, I have met many other fish. I have swam to distant, foreign seas, seen amazing things that I thought impossible, and I have become even more beautiful as I've grown. I've never returned, in mind or body, to the spot of my near death... and subsequent new life...
I've not left the spot where we met all that time ago, in body, or mind. I float, alone and silent in my aluminum boat. I still cast a line for you, from time to time, but you never bite. I doubt you come around here anymore. I have caught other fish since you, but they all seem pale, lifeless and ordinary by comparison. None the less, I continue casting, it's all I can do anymore...
You will never have me again, for I know you and your lures. You must come to terms with it. I will stay away, never to see you again... but oddly thankful for our chance encounter...
I fear I will never see you again, but I cannot accept this. I am regret personified.
In nearly suffocating me, you gave me true life.
You gave me a glimpse of true happiness, then took it away.
I thank God every day that I am the one that got away.
I curse His name each day, for you are the one that got away.
I think about you all the time. More than just our magical, and all too short time together, but about what could have been. And, I am filled with regret.
I am overtaken by joy. As I today still feel the heart pounding in my chest, I recall the feeling of it slowly giving up, in some sort of agonal rhythm while the rest of me starved for oxygen, and as I gasped for a breath. My body shivered and convulsed in your hands... dying. You just grinned, as if taking pleasure in my demise.
When thinking about our tryst of sorts, I remember smiling gently as I held you in my hands. I had never seen such a perfect specimen. Such life, color and mystery.... such promise.
Trapped in your grip for what seemed like an eternity, I nearly slipped into unconsciousness, I almost gave in. Instead, I somehow slipped back into the sea. Whether it was a result of a last, desperate escape attempt, (a swift swing of my tail), or from a flash of pity that you felt for me, which made you loosen your grasp, I do not know. All I know is that I dove from your vessel, head first into the waves. Like a knife, I plunged through the surface of the water, and cut the hangman's noose from my neck. My heart began to beat more strongly, my muscles began to respond to my commands, my color returned, and the fog began to evaporate from my mind. I am alive.
I let you go. Whether it was clarity of mind and heart that allowed for this, or, just the opposite, was uncertain at the moment. (And, had remained this way for quite some time.) I watched you disappear into the depths of the ocean, as well as the ripple you left behind. With both you, and any evidence that you were actually real, gone, I am left alone... in silence. Nothing remains but the churning of my mind that mimics the slapping of the waves against the hull of the boat. I am left only with questions, most of them begin with "Why".
When the trance was broken, and Fear laid down to rest, I was left with a new feeling of confidence. I swam through the shallows of the clear blue sea, darted through the tapestry of coral, and rode the warm currents through my vast underwater home. I continued on with caution, yes, but more so with bravery... with wisdom and with an overwhelming sense of freedom. I had never felt so alive. It's strange when I think of it... that it took nearly dying to make me truly live.
Why did I let you go? Why did I not pull you in completely, bring you to the bottom of the boat, and lay there with you until your end? I could have made your beauty last forever. You would never have grown old, never have felt hurt, hunger, loss or pain again. You could have stayed with me for the rest of my days, frozen in time... this day, and this time. It only would have cost you your life. Instead, you're gone. And I'm left only with a memory, and the sorrow that is loss. I am alone.
Since our battle, I have met many other fish. I have swam to distant, foreign seas, seen amazing things that I thought impossible, and I have become even more beautiful as I've grown. I've never returned, in mind or body, to the spot of my near death... and subsequent new life...
I've not left the spot where we met all that time ago, in body, or mind. I float, alone and silent in my aluminum boat. I still cast a line for you, from time to time, but you never bite. I doubt you come around here anymore. I have caught other fish since you, but they all seem pale, lifeless and ordinary by comparison. None the less, I continue casting, it's all I can do anymore...
You will never have me again, for I know you and your lures. You must come to terms with it. I will stay away, never to see you again... but oddly thankful for our chance encounter...
I fear I will never see you again, but I cannot accept this. I am regret personified.
In nearly suffocating me, you gave me true life.
You gave me a glimpse of true happiness, then took it away.
I thank God every day that I am the one that got away.
I curse His name each day, for you are the one that got away.
Sunday, September 12, 2010
Let us mend this first
Her knees give way under the force of her own body's weight. Though she is slight, it is enough to make them creak during their descent to the earth. It is a somewhat painful reminder of the years that they have weathered in concert with the rest of her equally talkative joints. Despite the pain, she continues to the ground, which has recently become a much more difficult, and dangerous, task. Though she knows the danger lies not within the bend, or even the possible break, but with the perception of such a bend.
Her squeaking hinges speak in some foreign language that only others who share her collection of years and experiences seem to understand. They ask not for pity or help, but only for someone to listen.
No one can seem to hear her over the ever present screams, bickering and explosions that poison her surroundings. How could they, she wonders. It is difficult to hear whispering in one ear while someone shouts in the other.
She is the whisper.
She continues to let gravity pull her to the ground until her arthritic patellae find the mat lain over the linoleum floor. With a slight jolt of pain that shoots up her thighs, her downward plunge is halted, and she is halfway there.
Other whisperers, and whispers alike, surround her. They slowly grow and build to a quiet crescendo, barely audible to even the keenest of ears, but somehow easily palpable and impossible to ignore.
As she wills her body nearer the floor, her ancient bones somehow keep pace with the other, less prehistoric skeletons, wrapped in equally less wrinkled skin. In this moment, what she sees, what she hears, and what she feels, is love. Though she knows that others may not interpret it in quite the same way.
She knows that we are scared, and that we are hurt, and that in times like these, even the best of us can loosen our grip on even our tightest held convictions.
At the conclusion of her daily bend, the whispers fade, and yet again give way to the now usual barks and fire that are the blaring minority. Though, none of us even seemed to notice the symphony of whispers in our one ear, as we were being bombarded with the lonely screeches in the other.
As she exits the mosque and steps back into the cacophony of the city where she was born so many years ago, through the throngs of protest signs, burning Qurans and angry faces, she feels as distant from an American citizen as she believes possible, yet instead of finding sadness, or hatred, her mind focuses only on one solitary thought. She hopes that her prayer is one day answered; please let them hear our whispers through the screams.
Her squeaking hinges speak in some foreign language that only others who share her collection of years and experiences seem to understand. They ask not for pity or help, but only for someone to listen.
No one can seem to hear her over the ever present screams, bickering and explosions that poison her surroundings. How could they, she wonders. It is difficult to hear whispering in one ear while someone shouts in the other.
She is the whisper.
She continues to let gravity pull her to the ground until her arthritic patellae find the mat lain over the linoleum floor. With a slight jolt of pain that shoots up her thighs, her downward plunge is halted, and she is halfway there.
Other whisperers, and whispers alike, surround her. They slowly grow and build to a quiet crescendo, barely audible to even the keenest of ears, but somehow easily palpable and impossible to ignore.
As she wills her body nearer the floor, her ancient bones somehow keep pace with the other, less prehistoric skeletons, wrapped in equally less wrinkled skin. In this moment, what she sees, what she hears, and what she feels, is love. Though she knows that others may not interpret it in quite the same way.
She knows that we are scared, and that we are hurt, and that in times like these, even the best of us can loosen our grip on even our tightest held convictions.
At the conclusion of her daily bend, the whispers fade, and yet again give way to the now usual barks and fire that are the blaring minority. Though, none of us even seemed to notice the symphony of whispers in our one ear, as we were being bombarded with the lonely screeches in the other.
As she exits the mosque and steps back into the cacophony of the city where she was born so many years ago, through the throngs of protest signs, burning Qurans and angry faces, she feels as distant from an American citizen as she believes possible, yet instead of finding sadness, or hatred, her mind focuses only on one solitary thought. She hopes that her prayer is one day answered; please let them hear our whispers through the screams.
Tuesday, August 10, 2010
The Sound of Science
It's physical... elemental even.
With the water splashing about me, shielded by my yet to be named car, I am hummed into a trance. Whether it be simply from the noise, and subtle low buzz from the spay hitting my black beauty... or from the tune flooding from her speakers, which dwarfs the water's buzz with it's own, deeper, stronger core-shaking earthquake-like rumble that comes in sequence. Cecil Otter seemed to calculate the baseline with this moment in mind, just for me. As the robotic arms encircle us, spinning too, in sequence, like a choreographed dance with Cecil's masterpiece, I enjoy every deep low of the base as it hits, with an extended shake, like that of a strong, yet smooth blast of thunder. It fills my body with a buzz, which feels strongest in my chest, and radiates outward like heat from a fire.
It's moving.
Even if I were to focus merely on the feeling that the sound waves bore into me, and ignore the poetry recited, it is still like a drug. It reminds me of the sensation of holding two magnets near, like-polarized ends together, and feeling the push-back of an all but invisible, and seemingly imaginary force. You wouldn't believe it if you hadn't felt it for yourself.
The arms of the car wash continue their repetitive journey around my nameless car, and I continue to slip deeper into my trance. I stare, helpless and smiling, at the rearview mirror to my left which has become a happy victim of the artificial thunder around us. With each roar, the largest beads of water, as if connected to one another, move in gravity's direction only during the buzz of sound's wave.
It's beautiful.
In a car-wash in downtown Milwaukee, music roaring, and miles away from the nearest tree, I feel connected to nature. Not trees, or animals, but elements; science.
I found myself, just as the beads of water did, at the mercy of the thunderous rumble of the bass. And, when I really thought about it a bit more, I realized that I really had no hope at a different fate than those drops of water, for I am indeed, made mostly of water. I'm elemental. Why would it then, in my body, be any less prone to being shaken in such a way than if it were not, strictly speaking, a part of me.
I guess the only real difference is that I could appreciate the words being sung to me, whereas the water that did not belong to my body, could not. Though, sometimes, I wonder about that too.
With the water splashing about me, shielded by my yet to be named car, I am hummed into a trance. Whether it be simply from the noise, and subtle low buzz from the spay hitting my black beauty... or from the tune flooding from her speakers, which dwarfs the water's buzz with it's own, deeper, stronger core-shaking earthquake-like rumble that comes in sequence. Cecil Otter seemed to calculate the baseline with this moment in mind, just for me. As the robotic arms encircle us, spinning too, in sequence, like a choreographed dance with Cecil's masterpiece, I enjoy every deep low of the base as it hits, with an extended shake, like that of a strong, yet smooth blast of thunder. It fills my body with a buzz, which feels strongest in my chest, and radiates outward like heat from a fire.
It's moving.
Even if I were to focus merely on the feeling that the sound waves bore into me, and ignore the poetry recited, it is still like a drug. It reminds me of the sensation of holding two magnets near, like-polarized ends together, and feeling the push-back of an all but invisible, and seemingly imaginary force. You wouldn't believe it if you hadn't felt it for yourself.
The arms of the car wash continue their repetitive journey around my nameless car, and I continue to slip deeper into my trance. I stare, helpless and smiling, at the rearview mirror to my left which has become a happy victim of the artificial thunder around us. With each roar, the largest beads of water, as if connected to one another, move in gravity's direction only during the buzz of sound's wave.
It's beautiful.
In a car-wash in downtown Milwaukee, music roaring, and miles away from the nearest tree, I feel connected to nature. Not trees, or animals, but elements; science.
I found myself, just as the beads of water did, at the mercy of the thunderous rumble of the bass. And, when I really thought about it a bit more, I realized that I really had no hope at a different fate than those drops of water, for I am indeed, made mostly of water. I'm elemental. Why would it then, in my body, be any less prone to being shaken in such a way than if it were not, strictly speaking, a part of me.
I guess the only real difference is that I could appreciate the words being sung to me, whereas the water that did not belong to my body, could not. Though, sometimes, I wonder about that too.
Thursday, July 22, 2010
Bewitched, Bothered and Bewildered
03:45; three quarters of the way through, what I've been told, is the bewitching hour, and it's darker than usual in here. Except of course, for the yellow glow emanating from the street lamp outside that is sneaking through the closed blinds of my bedroom. With each subtle, yet clumsy move of my head, the light dances, flicks, and pierces my half opened eyes through the gaps in the aluminum, cutting straight through my night-vision like a welding flash; it is nearly blinding.
I dream awake.
Fifteen minutes remain, and as the ghosts dance about the land of the living, doing their ghostly deeds, I have been reluctantly plucked from my recurrent hibernation (where I am hidden away from such ghosts... on a different plane) out of the in between... in between alive, and.... not so much, and placed into another, different, in between... in between sleep and wake, with a brain that is, also, in between... useful, and useless... on, and off.... under my control, and also, no so much.
I sleep awake.
My brain, as if possessed, or stubborn, continues its story, without paying reverence to the welding-flashes in my eye, the beating of the air from the fan as it smashes against my bare back, or the plain fact that I am now awake, at least in the sense that I see, smell, feel, walk and talk. I test it; "I am awake." Still, the grey matter continues without the slightest of hesitations, the disc is scratch free, there will be no skips, freezes or stopping here. The movie, unrelenting, plays on. If only this were the one with that girl from 40 days and 40 nights.... or that mystery girl who joins me every so often, and seems to be perfect in every single way. Instead, it had to be this.
I wake to dreams.
Is it the ghosts, in their last unencumbered fifteen minutes of the day, that haunt me and possess my synapses? It couldn't be, for ghouls of the in between, in my new, forced in between, would be unknown to me, unrecognizable. Yet, I know these faces. I know these scenarios. These came from my life... came from my day, my yesterday... my in.... forget the between. These were real. Why is my conscious spilling into my somewhat conscious, and, why must I still be unable to stop the disc from spinning as my feet hit the wood floor of my kitchen.
I walk to dream's beat.
The slap of my feet as they hit the cold oak serves to bring me to reality, at least it should. The scenes continue, though I've left them at work, and let it all go, my mind, apparently, has not.
I worry in dreams.
Did you do right? Did you do wrong? Can you let it go? Can you live with your mistakes? How did you simply punch the clock and leave? How are you still smiling? These are all questions chirped to me relentlessly, by some cricket with a top hat and cane. Day, night, dreams, sleep, awake, alone, surrounded and all the imaginable in betweens, he chirps. At least, I hope it's him, and not the recently departed... who've left this world too early on because of me and my mistakes, and have thusly decided to spend their least captive hour with me, in my extra dark and ominous apartment, reminding me of our fateful encounter.
I hold on to it all.
I dream awake.
Fifteen minutes remain, and as the ghosts dance about the land of the living, doing their ghostly deeds, I have been reluctantly plucked from my recurrent hibernation (where I am hidden away from such ghosts... on a different plane) out of the in between... in between alive, and.... not so much, and placed into another, different, in between... in between sleep and wake, with a brain that is, also, in between... useful, and useless... on, and off.... under my control, and also, no so much.
I sleep awake.
My brain, as if possessed, or stubborn, continues its story, without paying reverence to the welding-flashes in my eye, the beating of the air from the fan as it smashes against my bare back, or the plain fact that I am now awake, at least in the sense that I see, smell, feel, walk and talk. I test it; "I am awake." Still, the grey matter continues without the slightest of hesitations, the disc is scratch free, there will be no skips, freezes or stopping here. The movie, unrelenting, plays on. If only this were the one with that girl from 40 days and 40 nights.... or that mystery girl who joins me every so often, and seems to be perfect in every single way. Instead, it had to be this.
I wake to dreams.
Is it the ghosts, in their last unencumbered fifteen minutes of the day, that haunt me and possess my synapses? It couldn't be, for ghouls of the in between, in my new, forced in between, would be unknown to me, unrecognizable. Yet, I know these faces. I know these scenarios. These came from my life... came from my day, my yesterday... my in.... forget the between. These were real. Why is my conscious spilling into my somewhat conscious, and, why must I still be unable to stop the disc from spinning as my feet hit the wood floor of my kitchen.
I walk to dream's beat.
The slap of my feet as they hit the cold oak serves to bring me to reality, at least it should. The scenes continue, though I've left them at work, and let it all go, my mind, apparently, has not.
I worry in dreams.
Did you do right? Did you do wrong? Can you let it go? Can you live with your mistakes? How did you simply punch the clock and leave? How are you still smiling? These are all questions chirped to me relentlessly, by some cricket with a top hat and cane. Day, night, dreams, sleep, awake, alone, surrounded and all the imaginable in betweens, he chirps. At least, I hope it's him, and not the recently departed... who've left this world too early on because of me and my mistakes, and have thusly decided to spend their least captive hour with me, in my extra dark and ominous apartment, reminding me of our fateful encounter.
I hold on to it all.
Saturday, July 17, 2010
Our Knot
We are a tangled mess of Christmas lights.
One that, once, was placed with care, adorning snow capped trees, radiating a gentle golden-white glow that served to bring joy to those lucky enough to stroll by.
Instead, we now sit cold and dark in a snarl that only serves to frustrate.
To remember us as that soft glow, illuminating those around us - trees, streets and people alike - would be to forget the other 48 or 49 weeks of the year when we sat, twirled up in a box, tucked away in a cold, dark and musty attic, where our knots tightened and our bulbs cracked. Neither of us retain the patience to fix each bulb, one by one, or unbind what was bound.
Though our ensnared wires have become familiar, if not comfortable, we are of no good to each other or to those around us as we exist now.
Instead, perhaps it's best to simply buy a new strand
of lights.
One that, once, was placed with care, adorning snow capped trees, radiating a gentle golden-white glow that served to bring joy to those lucky enough to stroll by.
Instead, we now sit cold and dark in a snarl that only serves to frustrate.
To remember us as that soft glow, illuminating those around us - trees, streets and people alike - would be to forget the other 48 or 49 weeks of the year when we sat, twirled up in a box, tucked away in a cold, dark and musty attic, where our knots tightened and our bulbs cracked. Neither of us retain the patience to fix each bulb, one by one, or unbind what was bound.
Though our ensnared wires have become familiar, if not comfortable, we are of no good to each other or to those around us as we exist now.
Instead, perhaps it's best to simply buy a new strand
of lights.
Monday, April 26, 2010
Get Your Garmin
"It tastes.... like, chemicals." I say out loud in my empty apartment.
Nothing but disappointment and I share this bitter moment together, as my beer induced curled-lip frown slowly fades away. Unfortunately, the taste lingers far longer than the stupid look on my face.
"Six weeks." I utter, with bitterness that nears the level of my failed beer.
It took six weeks from boil, to bottle... to get the crappiest tasting beer that has ever coursed across my tongue. It was simply undrinkable.
I don't know what went wrong.... whether I contaminated it during the fermentation, or if the sterilizing mix didn't get rinsed out properly, or if I managed to screw up the recipe during the boil somehow.
I guess it's all moot at this point, what matters to me, while stuck motionless in my kitchen... still staring at this flavor-forsaken, anti-freeze tasting home-brew, is that it sucks.... bad.
However, after getting some advice, I've learned that it's possible, (though unlikely) that my windex-infused ale just might need a few more weeks "bottle conditioning." Well, alright then.... all I have to do is wait.
Waiting and I have, if not gotten along quite well over the years, at least grown accustomed to each other, for, I am patient. Or, at least I can feign patience.
I've spent many tortured hours in malls, holding purses.... or stuck in traffic, tempering my temper.... waiting for my love to get ready for our dinner reservation that was 20 minutes ago, or keeping my cool when the computer decides to freeze up at the most inopportune of moments. All the while my insides scream out so loud that I'm sure someone could hear, or somehow see the pain bubbling over; but they never do. They never discover my secret, that I am a fake.
But, maybe that's all patience really is; pretending to be patient. I think that patience, by definition, requires some inner turmoil; when your mind screams out in frustration, but your outward appearance remains cool. Because without something to get you all hot and bothered, you wouldn't HAVE to be patient.... you would just, be.
It's like overwhelmed.... can you be just whelmed? I think not. Whelmed isn't even a word. And, to me, that is weird.
Anyway, that's alright with me, I can do that; pretend... but, today I noticed the first signs of my inner impatience bursting through the confines of my own personal world, and into my very public actions.
Someone caught me.
I walked into a patient's room today, sat down, and asked why they came to the ER. And, after explaining what a PA is, and what I do, (and for the very first time in my career, had to verbally judo someone into allowing me to see them, instead of "the doctor") the long and convoluted story began.... none of which could even begin to answer my first, well, my ONLY question of "What brings you to the ER today?" Before I had the chance to interrupt this person, and redirect them into a more useful course for the conversation, so I could understand why they were there, and thereby narrow down my options from doing a full-body scan, and a compete smattering of blood tests, their cell phone rings, which they proceed to pick up, and have a full conversation with their family member. "Yes, I'm in the hospital....... yea, no, I fell........... I don't know, there's a guy here..... who are you again????" "Chris." (sigh) "well, he's asking me a bunch of questions....." (I asked one) and it goes on for a while longer before I simply stand up, and walk out of the room, without words...
I. Need. To. Leave.
before I explode from pure and total frustration.
Why are you here? = my back hurts
how long has it hurt? = 1 day
did you have some sort of trauma? = no
I wish it was this simple... i wish people could just tell me what I needed to know, with me asking open-ended questions, like we were taught in school..... but we can't.... and, if it were only as easy as above. OH, that would be sweet.
I can't say it's like pulling teeth, because that would be easier than this. Much of the time, I can ask simple yes or no questions....or things like, "better or worse?" ...and get nothing... well, in fact, worse than nothing... I get a whole lot of words that equate to nothing close to an answer that addresses my question. So, I ask again.... is it BETTER, WORSE or the SAME? Like I'm talking to a 2 year old....
But somehow, I've managed to fake patience with my patients. I seem very calm, caring and level headed.... empathetic even. Not today.... I just walked out, without a word. Before I could get more than a few steps out the door, the patient calls out to me, "Hey, are you leaving?!?!"
"Well, yes, I have other patients here that I need to take care of." I say, very curtly.
"Wait, hold on.... I've got to go, he's getting mad at me.... ok, bye."
I wish we didn't allow cell phones in the ER.... this is not the first time this has happened to me, but usually, they answer, and tell whoever it is, "hey, the doctor's here, i'll call you back." -click-
Not this one.... there would have been a full on conversation while i stood there like a moron, waiting. So I left... or tried. Then, I think my patient realized how they had upset me.... it's not that they had realized that they were being rude or inappropriate, but instead, that they pissed me off.
So, in an instant, I bottle up my frustration, like my failed beer, and let it sit.... I turn around, and walk back in, kneel down at the bedside.... With my hands resting on the hospital bed, I apologize for making the patient feel as if she'd upset me. I say in a very empathetic tone, that I understand that her family is just worried about her, and that it's important to keep them informed.
I then finished the interview and physical in a much more directed manner, with leading questions and statements like, "You're not having chest pain today, no?"
My inner-carbonation began to settle as I took control of the conversation, and then left the room in the usual, much calmer, manner. But, it's still volatile. Nearly failing in an instant, it barely passed this test. In time, I will find out if my newly weakened veneer will regain its prior fortress status, or if it will crack and poison my insides, like a solitary bacteria in a fermenting batch of beer.... growing, reproducing and turning a clean and crisp Pale Ale into a death soup.
And, as for my real beer? Well, it needs a couple more weeks to mellow out.... and then I can test it again. Hopefully, not unlike my impatience, it will calm, and morph into something palatable... something respectable. For now, on both fronts, the direction is still unclear.
Nothing but disappointment and I share this bitter moment together, as my beer induced curled-lip frown slowly fades away. Unfortunately, the taste lingers far longer than the stupid look on my face.
"Six weeks." I utter, with bitterness that nears the level of my failed beer.
It took six weeks from boil, to bottle... to get the crappiest tasting beer that has ever coursed across my tongue. It was simply undrinkable.
I don't know what went wrong.... whether I contaminated it during the fermentation, or if the sterilizing mix didn't get rinsed out properly, or if I managed to screw up the recipe during the boil somehow.
I guess it's all moot at this point, what matters to me, while stuck motionless in my kitchen... still staring at this flavor-forsaken, anti-freeze tasting home-brew, is that it sucks.... bad.
However, after getting some advice, I've learned that it's possible, (though unlikely) that my windex-infused ale just might need a few more weeks "bottle conditioning." Well, alright then.... all I have to do is wait.
Waiting and I have, if not gotten along quite well over the years, at least grown accustomed to each other, for, I am patient. Or, at least I can feign patience.
I've spent many tortured hours in malls, holding purses.... or stuck in traffic, tempering my temper.... waiting for my love to get ready for our dinner reservation that was 20 minutes ago, or keeping my cool when the computer decides to freeze up at the most inopportune of moments. All the while my insides scream out so loud that I'm sure someone could hear, or somehow see the pain bubbling over; but they never do. They never discover my secret, that I am a fake.
But, maybe that's all patience really is; pretending to be patient. I think that patience, by definition, requires some inner turmoil; when your mind screams out in frustration, but your outward appearance remains cool. Because without something to get you all hot and bothered, you wouldn't HAVE to be patient.... you would just, be.
It's like overwhelmed.... can you be just whelmed? I think not. Whelmed isn't even a word. And, to me, that is weird.
Anyway, that's alright with me, I can do that; pretend... but, today I noticed the first signs of my inner impatience bursting through the confines of my own personal world, and into my very public actions.
Someone caught me.
I walked into a patient's room today, sat down, and asked why they came to the ER. And, after explaining what a PA is, and what I do, (and for the very first time in my career, had to verbally judo someone into allowing me to see them, instead of "the doctor") the long and convoluted story began.... none of which could even begin to answer my first, well, my ONLY question of "What brings you to the ER today?" Before I had the chance to interrupt this person, and redirect them into a more useful course for the conversation, so I could understand why they were there, and thereby narrow down my options from doing a full-body scan, and a compete smattering of blood tests, their cell phone rings, which they proceed to pick up, and have a full conversation with their family member. "Yes, I'm in the hospital....... yea, no, I fell........... I don't know, there's a guy here..... who are you again????" "Chris." (sigh) "well, he's asking me a bunch of questions....." (I asked one) and it goes on for a while longer before I simply stand up, and walk out of the room, without words...
I. Need. To. Leave.
before I explode from pure and total frustration.
Why are you here? = my back hurts
how long has it hurt? = 1 day
did you have some sort of trauma? = no
I wish it was this simple... i wish people could just tell me what I needed to know, with me asking open-ended questions, like we were taught in school..... but we can't.... and, if it were only as easy as above. OH, that would be sweet.
I can't say it's like pulling teeth, because that would be easier than this. Much of the time, I can ask simple yes or no questions....or things like, "better or worse?" ...and get nothing... well, in fact, worse than nothing... I get a whole lot of words that equate to nothing close to an answer that addresses my question. So, I ask again.... is it BETTER, WORSE or the SAME? Like I'm talking to a 2 year old....
But somehow, I've managed to fake patience with my patients. I seem very calm, caring and level headed.... empathetic even. Not today.... I just walked out, without a word. Before I could get more than a few steps out the door, the patient calls out to me, "Hey, are you leaving?!?!"
"Well, yes, I have other patients here that I need to take care of." I say, very curtly.
"Wait, hold on.... I've got to go, he's getting mad at me.... ok, bye."
I wish we didn't allow cell phones in the ER.... this is not the first time this has happened to me, but usually, they answer, and tell whoever it is, "hey, the doctor's here, i'll call you back." -click-
Not this one.... there would have been a full on conversation while i stood there like a moron, waiting. So I left... or tried. Then, I think my patient realized how they had upset me.... it's not that they had realized that they were being rude or inappropriate, but instead, that they pissed me off.
So, in an instant, I bottle up my frustration, like my failed beer, and let it sit.... I turn around, and walk back in, kneel down at the bedside.... With my hands resting on the hospital bed, I apologize for making the patient feel as if she'd upset me. I say in a very empathetic tone, that I understand that her family is just worried about her, and that it's important to keep them informed.
I then finished the interview and physical in a much more directed manner, with leading questions and statements like, "You're not having chest pain today, no?"
My inner-carbonation began to settle as I took control of the conversation, and then left the room in the usual, much calmer, manner. But, it's still volatile. Nearly failing in an instant, it barely passed this test. In time, I will find out if my newly weakened veneer will regain its prior fortress status, or if it will crack and poison my insides, like a solitary bacteria in a fermenting batch of beer.... growing, reproducing and turning a clean and crisp Pale Ale into a death soup.
And, as for my real beer? Well, it needs a couple more weeks to mellow out.... and then I can test it again. Hopefully, not unlike my impatience, it will calm, and morph into something palatable... something respectable. For now, on both fronts, the direction is still unclear.
Monday, March 29, 2010
A Terrible Deed
Finesse.
Right, finesse, I'm thinking, as the beads of sweat drip down my face.
From the edge of my fifteen year-old-esque sideburns, down, what could only be labeled as a '4 o'clock shadow', (it never quite reaches 5 o'clock... and not because I'm diligent when it comes to shaving, but simply for a lack of growing) to the greater angle of my jaw... where it swells to a bead so large that my face's grip can no longer resist gravity's pull, and it falls through the frenzied air, full of odd noises, limbs and chemicals.
I picture the anatomy in my head, as if this will assure that I make all the appropriate moves by which to ensure my eventual success. The leg bone's connected to the..... hip bone.... the hip bone's connected to... my wristwatch. Wait, that's not right...
The bead of sweat falls from A to B in the most direct of paths, nearly colliding with a swinging limb. The sodium-infused sphere ends up dodging a field of blue to end up on the only green in the room. In an instant, the glob turns the green where it has just landed, a darker shade of the same. Its wild, perilous and hasty exodus from me ends in a calm silence that stands in stark opposition to the way it began, which makes me think about the duality of such a singular thing. How in the world did chaos turn into tranquility? How in the world do these things happen? And they do!
With a sudden grunt that seemed to escape my lungs without my consent, I am immediately aware that the recent resolve to work out again is making this whole situation more painful. My entire upper body feels as if it's a sneeze away from complete spasm - a full body charlie-horse. This is not only painful in a physical sense, but is a terrible blast to my ego, for it is only the result of about 50 pushups and some rotator cuff exercises the day prior.
I reposition, bracing my right knee on the rectangle of green in order to get some damn leverage.... my left foot still on the ground, now flexing so that only my toes touch the ground, my heel raising off the linoleum causing my left calf to tighten into what feels like a solid piece of granite.
Still nothing.
Now, my left leg abandons the cold white floor, rises the two vertical feet, and rejoins its counterpart on the green cloth... feet now planted firmly on the soft cushion below. My left hand grips my right wrist so tightly that my right hand begins to change color. No matter, the two joined hands create more strength and stability. The force is directed from the crook of my right elbow, which is mashed into another person's flesh, to the union of my right and left hands. It feels strong. If only I could take some of this strain of my back, I think, as I reposition closer to the blob of carbon below me, now barely conscious. I get my feet under me, finally, and my back quiets its shriek somewhat. With my feet directly under me, my knees no longer bearing my weight, I am towering above everything.
The sweat is now pouring, and is dampening my clothes, which I'll have to change later. From powder blue, to navy blue... to salty blue.
She isn't fighting as much now.... how much total? Is she breathing? Did you feel it? Did you feel anything?
And then, as unexpectedly as the initial failure that got us to this point, a snap, slide, thunk and quiet signal the end.
Seconds tick by, silently. We stand motionless.
The duality reenters my mind. From chaos to peaceful, albeit uneasy, silence.
The silence remains for what seems like minutes.
I stare at the green sheet on the bed.
"How do you feel?"....... nothing.
"How do you feel?" is asked yet again.
The carbon blob begins to take more of a human shape, and is reclaiming some of her misplaced consciousness. The monitor beeps, signaling to us that it has been in some way displeased by what we have done to this poor woman.
"How are you feeling?" is again asked. In fact, it is nearly shouted, and spoken in a manner that is nearly identical to that which you'd speak to an infant, or a dog.
She looks up from the hospital bed, the forest green sheet surrounding her, a haze of amnesia surrounding that, and a mass of blotchy powder blue, navy blue and recently farmer-tanned, 4 o'clock shadowed PA standing on top of her cot, dripping sweat onto her hospital gown, still holding that same bit of flesh.
"How are you feeling?" I ask.
A pause....... (thinking, or i suppose she was thinking.... taking a bit longer than normal... dredging her way through the medicines; propofol and fentanyl)
"Good." She says. "Much better.... can I have another blanket?"
And that's how you relocate a hip.
Right, finesse, I'm thinking, as the beads of sweat drip down my face.
From the edge of my fifteen year-old-esque sideburns, down, what could only be labeled as a '4 o'clock shadow', (it never quite reaches 5 o'clock... and not because I'm diligent when it comes to shaving, but simply for a lack of growing) to the greater angle of my jaw... where it swells to a bead so large that my face's grip can no longer resist gravity's pull, and it falls through the frenzied air, full of odd noises, limbs and chemicals.
I picture the anatomy in my head, as if this will assure that I make all the appropriate moves by which to ensure my eventual success. The leg bone's connected to the..... hip bone.... the hip bone's connected to... my wristwatch. Wait, that's not right...
The bead of sweat falls from A to B in the most direct of paths, nearly colliding with a swinging limb. The sodium-infused sphere ends up dodging a field of blue to end up on the only green in the room. In an instant, the glob turns the green where it has just landed, a darker shade of the same. Its wild, perilous and hasty exodus from me ends in a calm silence that stands in stark opposition to the way it began, which makes me think about the duality of such a singular thing. How in the world did chaos turn into tranquility? How in the world do these things happen? And they do!
With a sudden grunt that seemed to escape my lungs without my consent, I am immediately aware that the recent resolve to work out again is making this whole situation more painful. My entire upper body feels as if it's a sneeze away from complete spasm - a full body charlie-horse. This is not only painful in a physical sense, but is a terrible blast to my ego, for it is only the result of about 50 pushups and some rotator cuff exercises the day prior.
I reposition, bracing my right knee on the rectangle of green in order to get some damn leverage.... my left foot still on the ground, now flexing so that only my toes touch the ground, my heel raising off the linoleum causing my left calf to tighten into what feels like a solid piece of granite.
Still nothing.
Now, my left leg abandons the cold white floor, rises the two vertical feet, and rejoins its counterpart on the green cloth... feet now planted firmly on the soft cushion below. My left hand grips my right wrist so tightly that my right hand begins to change color. No matter, the two joined hands create more strength and stability. The force is directed from the crook of my right elbow, which is mashed into another person's flesh, to the union of my right and left hands. It feels strong. If only I could take some of this strain of my back, I think, as I reposition closer to the blob of carbon below me, now barely conscious. I get my feet under me, finally, and my back quiets its shriek somewhat. With my feet directly under me, my knees no longer bearing my weight, I am towering above everything.
The sweat is now pouring, and is dampening my clothes, which I'll have to change later. From powder blue, to navy blue... to salty blue.
She isn't fighting as much now.... how much total? Is she breathing? Did you feel it? Did you feel anything?
And then, as unexpectedly as the initial failure that got us to this point, a snap, slide, thunk and quiet signal the end.
Seconds tick by, silently. We stand motionless.
The duality reenters my mind. From chaos to peaceful, albeit uneasy, silence.
The silence remains for what seems like minutes.
I stare at the green sheet on the bed.
"How do you feel?"....... nothing.
"How do you feel?" is asked yet again.
The carbon blob begins to take more of a human shape, and is reclaiming some of her misplaced consciousness. The monitor beeps, signaling to us that it has been in some way displeased by what we have done to this poor woman.
"How are you feeling?" is again asked. In fact, it is nearly shouted, and spoken in a manner that is nearly identical to that which you'd speak to an infant, or a dog.
She looks up from the hospital bed, the forest green sheet surrounding her, a haze of amnesia surrounding that, and a mass of blotchy powder blue, navy blue and recently farmer-tanned, 4 o'clock shadowed PA standing on top of her cot, dripping sweat onto her hospital gown, still holding that same bit of flesh.
"How are you feeling?" I ask.
A pause....... (thinking, or i suppose she was thinking.... taking a bit longer than normal... dredging her way through the medicines; propofol and fentanyl)
"Good." She says. "Much better.... can I have another blanket?"
And that's how you relocate a hip.
Tuesday, March 16, 2010
i don't feel the break, but i feel the bend
I find it interesting, or perhaps perplexing better describes it, how our perspective can dictate exactly what we see.
As I stare at the floor I can see where the hardwood meets the wall. It is flush, strait.... perfect. Well, for the most part. As my eyes trace the line it makes with the wall, running horizontally along my living room, I see a gap. It starts ever so small, like a poorly timed smile you dare not let escape for fear of reprimand. And not unlike that smile, it widens in the center, and tapers near the other end.
As I sit, staring at the smile in my floor, I try to decide whether it's the floor that has strayed from the strait and narrow, or if it is the wall which has warped with time. I decide it is the wall which is flawed, then, I rescind this assertion and call the floor a poor excuse for a level surface.
And then the argument begins again, and again.
I peer at a shadow, and call the floor crooked.... I inspect the light reflecting from the wooden floorboards and name the wall the culprit.
Though I know not who is at fault, I know that something displeases me. I wish for a more put-together seam.
I cannot decide who is to blame. I cannot blame the floor if it has bent with age... and I cannot blame the wall if it has curved with time. It would only be their natural reaction to a stress applied. One, or both, had to react in some way to the pressure of time, age, weather, hurt and consequence.
To blame an inanimate object for a less than desirable reaction to stress, I decide, is at least equally unfair as to blame an inherently flawed person for a similar bend.
No matter who is to blame, (if anyone at all), at least the bend creates a smile.
So, I lean back, release my held breath into a sigh, and let it all go.
As I stare at the floor I can see where the hardwood meets the wall. It is flush, strait.... perfect. Well, for the most part. As my eyes trace the line it makes with the wall, running horizontally along my living room, I see a gap. It starts ever so small, like a poorly timed smile you dare not let escape for fear of reprimand. And not unlike that smile, it widens in the center, and tapers near the other end.
As I sit, staring at the smile in my floor, I try to decide whether it's the floor that has strayed from the strait and narrow, or if it is the wall which has warped with time. I decide it is the wall which is flawed, then, I rescind this assertion and call the floor a poor excuse for a level surface.
And then the argument begins again, and again.
I peer at a shadow, and call the floor crooked.... I inspect the light reflecting from the wooden floorboards and name the wall the culprit.
Though I know not who is at fault, I know that something displeases me. I wish for a more put-together seam.
I cannot decide who is to blame. I cannot blame the floor if it has bent with age... and I cannot blame the wall if it has curved with time. It would only be their natural reaction to a stress applied. One, or both, had to react in some way to the pressure of time, age, weather, hurt and consequence.
To blame an inanimate object for a less than desirable reaction to stress, I decide, is at least equally unfair as to blame an inherently flawed person for a similar bend.
No matter who is to blame, (if anyone at all), at least the bend creates a smile.
So, I lean back, release my held breath into a sigh, and let it all go.
Wednesday, February 10, 2010
Betty, 1989-2010
"Was that you?" I ask.
It was as if Betty took offense to this simple question, because she then seemed to begin to shut down.
"All I was wondering, Betty, was if you made it smell... like, that, in here? Or, was it the car next to us?"
It was too late.... she took it personally. Though, I doubt she would have if it actually hadn't been her. I truly believe that, rather than upset, she was embarrassed, ashamed and frightened of what was happening to her more than anything.
She was dying in my arms.
Her last breathes were sour, and filled her insides where I sat. The aroma slowly faded, as did her strength.
"Betty, please... please get me home," I plead.
She responds as best she can, though rigor mortis is beginning to creep inside of her tissues, and it is slowly winning the battle- the wheel begins to tighten.
Betty's responses slow.... new and unknown lights begin to flash on, off, then on again. She seems to quiet with every passing block. Her usual rumble dissipates under my feet; she becomes oddly smooth- discordant, only slightly... but eerily noticeable to me, when compared to her normal dysarthria.... which was never obnoxious, but comforting instead- like the voice of Louis Armstrong.
She had been singing to me for 5 years... and now all I could hear was "what a wonderful world...." fading into the dark of the night.
As I wrestled with the ever stiffening wheel, begging her to make the corners, I feared the worst. Though, I had fleeting thoughts that this was not Betty's goodbye, but only a power steering problem. Perhaps we would part on better terms, on our own time, when we decide. Though, after the body was cold, I realized that this is the way it had to be. Only death could part us.... neither she nor I would be able to let go otherwise.
It had to be this way.
She left a trail of blood... or perhaps it was tears, or perhaps both. It led from the streets, where we used to roam together, into the garage. She was bleeding out. Steam was rising from her chest, like her soul was escaping from the mess that had become her withering body. It was as if it needed to finally be free of its ever aging cage, one that failed a little bit more every day.
She needed a tow to get to the car doctor, where the diagnosis was terminal. It would be that Sunday, February the 7th was our last ride together.
She will always hold a place in my heart. Even in the end, she never failed me. She did, in fact, get me home.
There were no long goodbyes, reminiscing, or tears shed as I cleared the remaining things from her comforting, yet stark and now empty interior. She had gone. All that was left were pieces of metal, rubber, glass and leather. So, I didn't fear for her when I snapped off the hood ornament that had, throughout her life, adorned Betty as a proud, strong and beautiful Cadillac.
She wasn't there to feel the break. I, however, did.
It was as if Betty took offense to this simple question, because she then seemed to begin to shut down.
"All I was wondering, Betty, was if you made it smell... like, that, in here? Or, was it the car next to us?"
It was too late.... she took it personally. Though, I doubt she would have if it actually hadn't been her. I truly believe that, rather than upset, she was embarrassed, ashamed and frightened of what was happening to her more than anything.
She was dying in my arms.
Her last breathes were sour, and filled her insides where I sat. The aroma slowly faded, as did her strength.
"Betty, please... please get me home," I plead.
She responds as best she can, though rigor mortis is beginning to creep inside of her tissues, and it is slowly winning the battle- the wheel begins to tighten.
Betty's responses slow.... new and unknown lights begin to flash on, off, then on again. She seems to quiet with every passing block. Her usual rumble dissipates under my feet; she becomes oddly smooth- discordant, only slightly... but eerily noticeable to me, when compared to her normal dysarthria.... which was never obnoxious, but comforting instead- like the voice of Louis Armstrong.
She had been singing to me for 5 years... and now all I could hear was "what a wonderful world...." fading into the dark of the night.
As I wrestled with the ever stiffening wheel, begging her to make the corners, I feared the worst. Though, I had fleeting thoughts that this was not Betty's goodbye, but only a power steering problem. Perhaps we would part on better terms, on our own time, when we decide. Though, after the body was cold, I realized that this is the way it had to be. Only death could part us.... neither she nor I would be able to let go otherwise.
It had to be this way.
She left a trail of blood... or perhaps it was tears, or perhaps both. It led from the streets, where we used to roam together, into the garage. She was bleeding out. Steam was rising from her chest, like her soul was escaping from the mess that had become her withering body. It was as if it needed to finally be free of its ever aging cage, one that failed a little bit more every day.
She needed a tow to get to the car doctor, where the diagnosis was terminal. It would be that Sunday, February the 7th was our last ride together.
She will always hold a place in my heart. Even in the end, she never failed me. She did, in fact, get me home.
There were no long goodbyes, reminiscing, or tears shed as I cleared the remaining things from her comforting, yet stark and now empty interior. She had gone. All that was left were pieces of metal, rubber, glass and leather. So, I didn't fear for her when I snapped off the hood ornament that had, throughout her life, adorned Betty as a proud, strong and beautiful Cadillac.
She wasn't there to feel the break. I, however, did.
Saturday, January 2, 2010
Betty's Kicks
Each and every day I have to fill up my left rear tire. (I suppose Betty can't be perfect, though I still think she is.)
It seems to be slowly leaking; I find it nearly flat every morning. It's been quite a nuisance the past few days... and it serves to remind me of the constant drain, and subsequent refill that is my energy, my confidence and the joy for the work that I do.
I have had wins, and I have had losses. But when the tire empties, I continue to fill it back up, despite the losses.... and I am happy.
I recently filled the tire by nailing my first solo Lumbar Puncture.
"Champagne", as they say.... and, just like that, I was filled to 30 PSI.
Today, I suppose, was neutral. My love for procedures was fed, but... to the point of nausea and bloating.... like the horrible feeling you get when you eat a whole Chipotle burrito and weren't really ready for it.
I'm on day 5 of a 5 day stretch tomorrow... and, it's the longest stretch of work days in a row I've had in 3 months at the ER. So, I guess I should just count my blessings and shut my face.
I still love life, and I still love my job.
oh, and I still love Chipotle.
It seems to be slowly leaking; I find it nearly flat every morning. It's been quite a nuisance the past few days... and it serves to remind me of the constant drain, and subsequent refill that is my energy, my confidence and the joy for the work that I do.
I have had wins, and I have had losses. But when the tire empties, I continue to fill it back up, despite the losses.... and I am happy.
I recently filled the tire by nailing my first solo Lumbar Puncture.
"Champagne", as they say.... and, just like that, I was filled to 30 PSI.
Today, I suppose, was neutral. My love for procedures was fed, but... to the point of nausea and bloating.... like the horrible feeling you get when you eat a whole Chipotle burrito and weren't really ready for it.
I'm on day 5 of a 5 day stretch tomorrow... and, it's the longest stretch of work days in a row I've had in 3 months at the ER. So, I guess I should just count my blessings and shut my face.
I still love life, and I still love my job.
oh, and I still love Chipotle.
Tuesday, December 1, 2009
Chasing Circular Logic
We are all in hot pursuit of something. And, something is always in hot pursuit of us.
The unaligned reality of it however, is that this is usually not one after the other, like a dog after its own tail. At least in this never ending chase, one is connected to the other; they both are following one another, admittedly, in a snare of the most basic of logic. But, if they were to just stop with the chase, they might see that they are connected, and find each other... sans the dizzying venery.
We toil, preen, plan, plot, hide away and quietly attempt to garner attention from the tail, as if we didn't care. But we can't help it. Our quiet actions couldn't be enough, and we lack patience, so we begin the nauseating spin... calling out in the middle of the hunt.
We are all too recluse, in the deepest sense of the word, to really know our neighbors, our friends and our loves without boisterous shouts and oversized signs that even the deaf and blind would have to acknowledge. We have lost the art of subtlety, and therefore, the art of deciphering such subtlety.
I blame facebook.
I shout there, with such a quiet whisper... and I whisper here in such a loud voice.
I suppose it doesn't really matter, the nystagmus hasn't quite yet gone after all the spinning.
The unaligned reality of it however, is that this is usually not one after the other, like a dog after its own tail. At least in this never ending chase, one is connected to the other; they both are following one another, admittedly, in a snare of the most basic of logic. But, if they were to just stop with the chase, they might see that they are connected, and find each other... sans the dizzying venery.
We toil, preen, plan, plot, hide away and quietly attempt to garner attention from the tail, as if we didn't care. But we can't help it. Our quiet actions couldn't be enough, and we lack patience, so we begin the nauseating spin... calling out in the middle of the hunt.
We are all too recluse, in the deepest sense of the word, to really know our neighbors, our friends and our loves without boisterous shouts and oversized signs that even the deaf and blind would have to acknowledge. We have lost the art of subtlety, and therefore, the art of deciphering such subtlety.
I blame facebook.
I shout there, with such a quiet whisper... and I whisper here in such a loud voice.
I suppose it doesn't really matter, the nystagmus hasn't quite yet gone after all the spinning.
Tuesday, November 10, 2009
I Am The Angel Of Death
We don't save lives; we palliate the dying.
In just over a month of working in the ER, I have yet to pull someone back from the grips of death. In fact, the Reaper has yet to make an appearance in any of my workdays. (Though he has been ever present in someone's day in the ER) I have not pumped on a chest in order to force the blood from the ventricles to the rest of a gasping body, dying for air. I have yet to administer the epinephrine, and the life saving shock of 360 joules to an ailing heart.
I doubt I've saved a life. But I can say with a high degree of certainty that I've crushed more than one.
I recently had a very pleasant 60-something gal visit me in the ER. She was sent to us after being seen by her regular doctor earlier that morning for ankle swelling that was noticed by her husband while eating breakfast. Her primary care doctor did an EKG and and exam, and told her to come to the ER to get looked over a bit more thoroughly.
This is precisely what I did. With my words, my hands, and the tools at my disposal, I did my best to uncover what might have been causing her swelling. And, to keep a long (and as is usually my mode of operation) wordy, story short. I discovered that it was not her heart, nor trauma, nor a clot that was causing her ankle swelling, but was a result of ascites. Her liver was full of lesions, and her enzymes were quite elevated.
They were metastatic lesions; spread from another, primary tumor site- at least, this was the read of the CT by the radiologist.
"SHI........" I mutter when reading the CT report.
By now, not only was her husband present, but a handful of family had amassed to accompany their hospitalized family member. It wouldn't be easy, for any of us involved.
All who stood in the cold, curtained room of 5A, were forever changed by the news that passed over my lips. The words penetrated each of the vastly unprepared masses of flesh in front of me like shrapnel ripping through unsuspecting soldiers, blown away by a hidden IED... placed by the most vicious of insurgents.
I am the insurgent.
My words are the Improvised Explosive Devise.
I exit, leaving destruction, smoke and confusion in my absence.
"Saving lives in the ER..." or, what do I do at work? 'Save lives, duh!" These are things l hear, and read from time to time from other health care workers, none of which ever seem to be doctors, PAs or NPs. Though I doubt this to be the case.... that souls are being grasped from the edge of the abyss, and snatched back by my fellow healthcare troops, I hope this is happening. I, however, have no such delusions of grandeur. I realize that I may heal certain conditions, treat the sick, and palliate those in pain.... but I do not save. I am no savior, nor do I jest about it.
I suppose those who have been in the position that I was, find it difficult to say that they've saved lives. When you, in some sense of the word, have killed someone, there are no number of souls you can pull from the fire that will be enough to claim status as a life saver. There is no more room for playful, and boastful banter.
If I do anything comparable, in permanence, importance, and power, to that of saving a life, it is to recite death sentences.
I am someone's bearer of bad news, bringer of death, and Reaper himself.
Don't misunderstand, I love my job. I love what I do. I'm happy that I've found myself to be where I am today. I just realize that I'm only prolonging the inevitable. I'm not saving lives, at best, I'm simply making them longer.... perhaps long enough for me to tell them that they are going to die from their metastatic cancer that has spread to their liver.
Only if I'm good enough to preserve them for that long, and, only if I'm that unlucky.
I guess you could say we're damned if we do, and damned if we don't.
I wouldn't, but you could.
In just over a month of working in the ER, I have yet to pull someone back from the grips of death. In fact, the Reaper has yet to make an appearance in any of my workdays. (Though he has been ever present in someone's day in the ER) I have not pumped on a chest in order to force the blood from the ventricles to the rest of a gasping body, dying for air. I have yet to administer the epinephrine, and the life saving shock of 360 joules to an ailing heart.
I doubt I've saved a life. But I can say with a high degree of certainty that I've crushed more than one.
I recently had a very pleasant 60-something gal visit me in the ER. She was sent to us after being seen by her regular doctor earlier that morning for ankle swelling that was noticed by her husband while eating breakfast. Her primary care doctor did an EKG and and exam, and told her to come to the ER to get looked over a bit more thoroughly.
This is precisely what I did. With my words, my hands, and the tools at my disposal, I did my best to uncover what might have been causing her swelling. And, to keep a long (and as is usually my mode of operation) wordy, story short. I discovered that it was not her heart, nor trauma, nor a clot that was causing her ankle swelling, but was a result of ascites. Her liver was full of lesions, and her enzymes were quite elevated.
They were metastatic lesions; spread from another, primary tumor site- at least, this was the read of the CT by the radiologist.
"SHI........" I mutter when reading the CT report.
By now, not only was her husband present, but a handful of family had amassed to accompany their hospitalized family member. It wouldn't be easy, for any of us involved.
All who stood in the cold, curtained room of 5A, were forever changed by the news that passed over my lips. The words penetrated each of the vastly unprepared masses of flesh in front of me like shrapnel ripping through unsuspecting soldiers, blown away by a hidden IED... placed by the most vicious of insurgents.
I am the insurgent.
My words are the Improvised Explosive Devise.
I exit, leaving destruction, smoke and confusion in my absence.
"Saving lives in the ER..." or, what do I do at work? 'Save lives, duh!" These are things l hear, and read from time to time from other health care workers, none of which ever seem to be doctors, PAs or NPs. Though I doubt this to be the case.... that souls are being grasped from the edge of the abyss, and snatched back by my fellow healthcare troops, I hope this is happening. I, however, have no such delusions of grandeur. I realize that I may heal certain conditions, treat the sick, and palliate those in pain.... but I do not save. I am no savior, nor do I jest about it.
I suppose those who have been in the position that I was, find it difficult to say that they've saved lives. When you, in some sense of the word, have killed someone, there are no number of souls you can pull from the fire that will be enough to claim status as a life saver. There is no more room for playful, and boastful banter.
If I do anything comparable, in permanence, importance, and power, to that of saving a life, it is to recite death sentences.
I am someone's bearer of bad news, bringer of death, and Reaper himself.
Don't misunderstand, I love my job. I love what I do. I'm happy that I've found myself to be where I am today. I just realize that I'm only prolonging the inevitable. I'm not saving lives, at best, I'm simply making them longer.... perhaps long enough for me to tell them that they are going to die from their metastatic cancer that has spread to their liver.
Only if I'm good enough to preserve them for that long, and, only if I'm that unlucky.
I guess you could say we're damned if we do, and damned if we don't.
I wouldn't, but you could.
Tuesday, October 20, 2009
You're one in 1,271.... and not in the good way.
I've been wasting time today, on my day off, since it's kind of cool, cloudy and rainy outside.
Though, if I were a smarter man, I'd have walked around in it, if only to remind me of Portland. Maybe I would have been able to fool myself into thinking that I was walking around in the Alphabet district... only steps away from my favorite sushi joint, where it's happy hour all day, every day. (i guess it's not really happy hour, just happy day, or days... without the Fonz though) or from my favorite microbrew and restaurant, The Laurelwood... where it feels like you're at an old friend's house... not just because of the service, but because it really is an old house, though the beer is much better than any friend has ever served me.
And, oh Lord... how I wish I could sit and have a burger at the Helvetia Tavern, with its thousands of hats hanging above my head.... forget to bring cash, and have to use the ATM there, sacrificing 7 dollars in fees to get a single crisp 20 dollar bill to pay for the best burger I've ever had, along with the several beers to wash it down.
From here, I'd be teasingly close to the coast, a surfboard and a post-session coffee at the best coffee shop known to this man; Waves Of Grain Bakery in Cannon Beach, OR. I could, yet again, pretend I'm the 8th Goonie... combing the beach and its caves for buried treasure. Walking along the ocean, befriending the countless dogs that happen to be running around unleashed, chasing Frisbees, tennis balls and other members of the same species.
I did none of these things, regrettably. However, I do not regret that I am here, in Milwaukee. I just miss Portland; I miss Oregon. I miss my old haunts, I miss my old friends... I miss parts of my old life.
I guess that's what pushed me to spend some time pointing and clicking on facebook, and other's 'blogs' this evening. Has it been long enough to term it nostalgia; the force that led me to this? It feels like ages ago at this point...... somehow.... ages since my last night on the lawn of the Donelson house; the last badminton match, the last study session, the last sushi night, the last night of wings... the last chat session.... the last drive away.
What I'm left remembering; what I'm left thinking, is that I made some great friends. I can't say I made 41.... though, I suppose some would claim such a virtue on facebook..... but I can say I made more than a handful. I can name them without thinking. I can tell you something personal about each of them... nothing bad.... but something that makes them uniquely them..... at least in my mind.... something that I always equate to their name, their face.... and their voice.
To be able to know this, makes me feel something that is better than good.
And this isn't something that is fleeting, superficial, or selfish. It is not to garner attention, or mere numbers. It is, simply because it is. Time and care made these friendships what they are. They were not made one night at a bar, through a friend of a friend of a friend, or on an internet site where a florid picture caught my eye; they were made in the proverbial trenches of friendship, of hardship, of obsession, of love... of devotion and tears.
This is why I laughed a sardonic laugh when I laid my eyes upon a friends' facebook profile who had 1,271 "friends." 'I dare you to name a quarter of those souls!' I thought.
but then i thought, could i name the same quarter of my 203 'friends?'
perhaps.
perhaps not.
Maybe I'd rather not know.
What I do know are the faces and stories of those who mean the most to me.... and, I bet that the person with the 1,271 acquaintances has a similar, much smaller group of people, whom she'll never forget, even when she's in the tightest grips of dementia some 70-plus years from now. She just points and clicks more than I do.... So, I decided that I should stop silently judging others, and just live.... and let live, or click.
Though, after I came to this conclusion, and was well with myself again... I began to wonder if I'm one of the quarter she'd be able to name?
Perhaps.
Perhaps not.
Maybe, I'd rather not know.
Though, if I were a smarter man, I'd have walked around in it, if only to remind me of Portland. Maybe I would have been able to fool myself into thinking that I was walking around in the Alphabet district... only steps away from my favorite sushi joint, where it's happy hour all day, every day. (i guess it's not really happy hour, just happy day, or days... without the Fonz though) or from my favorite microbrew and restaurant, The Laurelwood... where it feels like you're at an old friend's house... not just because of the service, but because it really is an old house, though the beer is much better than any friend has ever served me.
And, oh Lord... how I wish I could sit and have a burger at the Helvetia Tavern, with its thousands of hats hanging above my head.... forget to bring cash, and have to use the ATM there, sacrificing 7 dollars in fees to get a single crisp 20 dollar bill to pay for the best burger I've ever had, along with the several beers to wash it down.
From here, I'd be teasingly close to the coast, a surfboard and a post-session coffee at the best coffee shop known to this man; Waves Of Grain Bakery in Cannon Beach, OR. I could, yet again, pretend I'm the 8th Goonie... combing the beach and its caves for buried treasure. Walking along the ocean, befriending the countless dogs that happen to be running around unleashed, chasing Frisbees, tennis balls and other members of the same species.
I did none of these things, regrettably. However, I do not regret that I am here, in Milwaukee. I just miss Portland; I miss Oregon. I miss my old haunts, I miss my old friends... I miss parts of my old life.
I guess that's what pushed me to spend some time pointing and clicking on facebook, and other's 'blogs' this evening. Has it been long enough to term it nostalgia; the force that led me to this? It feels like ages ago at this point...... somehow.... ages since my last night on the lawn of the Donelson house; the last badminton match, the last study session, the last sushi night, the last night of wings... the last chat session.... the last drive away.
What I'm left remembering; what I'm left thinking, is that I made some great friends. I can't say I made 41.... though, I suppose some would claim such a virtue on facebook..... but I can say I made more than a handful. I can name them without thinking. I can tell you something personal about each of them... nothing bad.... but something that makes them uniquely them..... at least in my mind.... something that I always equate to their name, their face.... and their voice.
To be able to know this, makes me feel something that is better than good.
And this isn't something that is fleeting, superficial, or selfish. It is not to garner attention, or mere numbers. It is, simply because it is. Time and care made these friendships what they are. They were not made one night at a bar, through a friend of a friend of a friend, or on an internet site where a florid picture caught my eye; they were made in the proverbial trenches of friendship, of hardship, of obsession, of love... of devotion and tears.
This is why I laughed a sardonic laugh when I laid my eyes upon a friends' facebook profile who had 1,271 "friends." 'I dare you to name a quarter of those souls!' I thought.
but then i thought, could i name the same quarter of my 203 'friends?'
perhaps.
perhaps not.
Maybe I'd rather not know.
What I do know are the faces and stories of those who mean the most to me.... and, I bet that the person with the 1,271 acquaintances has a similar, much smaller group of people, whom she'll never forget, even when she's in the tightest grips of dementia some 70-plus years from now. She just points and clicks more than I do.... So, I decided that I should stop silently judging others, and just live.... and let live, or click.
Though, after I came to this conclusion, and was well with myself again... I began to wonder if I'm one of the quarter she'd be able to name?
Perhaps.
Perhaps not.
Maybe, I'd rather not know.
Monday, October 12, 2009
details: crossing my t's and dotting my lower case j's
There are so many things that I'm enjoying at this point in my life. Most of them are simple pleasures; small victories that may go unnoticed to the casual observer, but are brightly shining stars in my eyes.
I have a new place of my own, albeit, one without a couch or a bed yet. I have a fold up lawn chair in the middle of my bare-naked looking living room. and, I sleep on a pile of surprisingly comfortable comforters, blankets and quilts that rest upon a roll-up foam camping mat. so, it doesn't quite feel like a home yet, but... it does feel like my home. and, it's nice, new and in a great area of downtown; The "Third Ward," where I have a view of the river, and a 2 minute walk to any number of coffee shops, restaurants, bars and local organic markets I could want.
I have cable... and I also have internet, which I am not stealing from a nearby neighbor... which has been the case for the past 3 or 4 years now. I don't even know what to watch and do.... I'm far too connected and far too entertained.
I'm working now, for the first time in 2 and a half years, at a place where I'm actually being paid. It's the all important C instead of the S that made that possible.
I'm really liking my job. There's such a mix of absolutely everything that medicine has to offer.... it's just wonderful. Broken bones, bleeding vaginas in pregnant mothers, gallstones, influenza, MI, liver failure, CVA, psych issues, DT's, lawnmower vs foot, stab wounds, urinary retention and of course the all important migraines and low back pain. It's keeping me on my toes, mainly because I'm running all over the place trying to keep up.
Milwaukee has pleasantly surprised me. It absolutely does have some character and some class. It's definitely more confined than Portland, meaning that these nice areas of Milwaukee are much smaller and segregated than that of Portland, which, in my mind, doesn't really have any bad areas.... well, even those that ARE "bad areas" really aren't that bad. It's just a different feel I suppose, and while I like the feel here in Milwaukee so far, I really do miss Portland.
And another thing that I found myself appreciating is the fact that I remembered the difference between Labyrinthitis and Vestibular Neuritis the other day.... which really came in handy when nailing down the diagnosis of one of my patients. It's all about the hearing loss....
anyway...... happy as a clam..... miss you all, and tired as can be after a good shift tonight... I'll be enjoying my middle of the week weekend the next two days.... goodnight.
I have a new place of my own, albeit, one without a couch or a bed yet. I have a fold up lawn chair in the middle of my bare-naked looking living room. and, I sleep on a pile of surprisingly comfortable comforters, blankets and quilts that rest upon a roll-up foam camping mat. so, it doesn't quite feel like a home yet, but... it does feel like my home. and, it's nice, new and in a great area of downtown; The "Third Ward," where I have a view of the river, and a 2 minute walk to any number of coffee shops, restaurants, bars and local organic markets I could want.
I have cable... and I also have internet, which I am not stealing from a nearby neighbor... which has been the case for the past 3 or 4 years now. I don't even know what to watch and do.... I'm far too connected and far too entertained.
I'm working now, for the first time in 2 and a half years, at a place where I'm actually being paid. It's the all important C instead of the S that made that possible.
I'm really liking my job. There's such a mix of absolutely everything that medicine has to offer.... it's just wonderful. Broken bones, bleeding vaginas in pregnant mothers, gallstones, influenza, MI, liver failure, CVA, psych issues, DT's, lawnmower vs foot, stab wounds, urinary retention and of course the all important migraines and low back pain. It's keeping me on my toes, mainly because I'm running all over the place trying to keep up.
Milwaukee has pleasantly surprised me. It absolutely does have some character and some class. It's definitely more confined than Portland, meaning that these nice areas of Milwaukee are much smaller and segregated than that of Portland, which, in my mind, doesn't really have any bad areas.... well, even those that ARE "bad areas" really aren't that bad. It's just a different feel I suppose, and while I like the feel here in Milwaukee so far, I really do miss Portland.
And another thing that I found myself appreciating is the fact that I remembered the difference between Labyrinthitis and Vestibular Neuritis the other day.... which really came in handy when nailing down the diagnosis of one of my patients. It's all about the hearing loss....
anyway...... happy as a clam..... miss you all, and tired as can be after a good shift tonight... I'll be enjoying my middle of the week weekend the next two days.... goodnight.
Wednesday, September 30, 2009
The Real World: Milwaukee
I'm still alive.
I haven't forgotten how to write, type, or speak.
I just haven't been very good at doing it on this computer.
Here's a brief synopses of what's gone in the past few months, just to get you up to speed......
1. Graduated August 15th
2. Studied for the boards for 10 or so days
C. Took the boards
4. Worried about my pass/fail status on the boards for 48 hours
D. Sent myself into SVT when checking my scores on Thursday
E. Celebrated my rocking of the boards with a loud scream/shout, to which no one but myself was around to hear
6. Packed up everything that would fit into Betty and took off
7. 4 Days later, I found myself in Milwaukee at my new place.... moved in
H. Day after that, hopped a bus to Chicago O'Hare airport where i met my good friend Marit and headed to Frankfurt Germany
I. Spend 2 weeks in Germany, France, Switzerland and Austria.
8. Marveled at the beauty Europe had to offer
9. Reluctantly returned
10. Sat around and finished project A, so I could start project B, then begin project C. All of these things needed to be completed in sequential order for credentialing/licensing... NPI number, DEA #, state license.... blah blah blah.
J. DONE with all of that.
K. I start tomorrow, for real, on my own. I'm excited, and a bit nervous. But mostly excited. Plus, I need some money rolling in. (I spent too much in Europe, and I have no money for a couch, or a bed.)
Consequently, I'm sleeping on the floor.
But I'm really happy to have a floor, and a job, and now a daily purpose.
Say a prayer for me, recite a spell, wish me luck, or whatever it is that you would do to bestow wisdom, good fortune and luck upon me for tomorrow.
I haven't forgotten how to write, type, or speak.
I just haven't been very good at doing it on this computer.
Here's a brief synopses of what's gone in the past few months, just to get you up to speed......
1. Graduated August 15th
2. Studied for the boards for 10 or so days
C. Took the boards
4. Worried about my pass/fail status on the boards for 48 hours
D. Sent myself into SVT when checking my scores on Thursday
E. Celebrated my rocking of the boards with a loud scream/shout, to which no one but myself was around to hear
6. Packed up everything that would fit into Betty and took off
7. 4 Days later, I found myself in Milwaukee at my new place.... moved in
H. Day after that, hopped a bus to Chicago O'Hare airport where i met my good friend Marit and headed to Frankfurt Germany
I. Spend 2 weeks in Germany, France, Switzerland and Austria.
8. Marveled at the beauty Europe had to offer
9. Reluctantly returned
10. Sat around and finished project A, so I could start project B, then begin project C. All of these things needed to be completed in sequential order for credentialing/licensing... NPI number, DEA #, state license.... blah blah blah.
J. DONE with all of that.
K. I start tomorrow, for real, on my own. I'm excited, and a bit nervous. But mostly excited. Plus, I need some money rolling in. (I spent too much in Europe, and I have no money for a couch, or a bed.)
Consequently, I'm sleeping on the floor.
But I'm really happy to have a floor, and a job, and now a daily purpose.
Say a prayer for me, recite a spell, wish me luck, or whatever it is that you would do to bestow wisdom, good fortune and luck upon me for tomorrow.
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