Reflection on 2013...hopes for 2014

So, facebook has this cool little thing where you can review your previous year in pictures and posts.

It's kind of nice to relive all the fun -- My Girls' visit here in January, my best time (so far) on a half marathon in Sarasota, getting the Nurse Banana-Hammock, Memphis with My Girls, friends getting married, friends having babies, spending a beautiful, carefree month in the Land of Enchantment with the Rickster.

But, I can't share that on my fb like a lot of my friends are because the very first thing on it is a post I wrote about my friend losing her husband.  I don't want her to have to read that. Her memories of that are with her every day, I know.

It's a lot like most years, for me.  But for some people I care about it's been awful.

And for a few people who have faced the most awful kinds of things, watching them struggle to keep on and to live past their loss has been a real inspiration to me. And, I have been fortunate to have developed a deeper friendship with someone who is a daily model of positivity, mental strength and LIFE, even while she is daily fighting for her life.  She does it without any need for martyrdom or "look at me and my struggle".  In fact, almost no one in our circle of friends even knows what she goes through almost daily -- the nausea, the pain, the fatigue, the trips to the hospital -- because all she ever publicly does is smile and focus on the good in life and she brings joy to the lives of everyone around her.  

Another friend lost both her parents tragically last year, and yet recently, she posted this:

So, I fully realize that for me, it's been a pretty good year.

It's also the year that I determined to live every single day as best I can and to actively fight against negativity.  I want to find the good in every day.  It's definitely a work in progress.  Unfortunately, my initial reaction to a lot of stuff is to bitch about it.  But, I'm learning and I am getting better.

Looking forward to 2014, I will continue to hold myself to a standard of positivity and finding the joy in life and facing whatever challenges come along with the knowledge that life is made up of all of it, the good and the bad.

Just how attached ARE you to your scrotum?

That's what I wanted to ask the pissy little medic today.

Now, lemme start by saying that I love medics and respect them.  Respect?  Goes both ways.  And, in some situations, in more than 2 directions.

So, here's what happened...

I just happened to be caught up, so went in to help another nurse who was getting an ambulance patient.  Cute little old lady.  I was "doing bedside" (getting patient undressed, into a hospital gown, getting vital signs, hooking up the patient to monitoring equipment) while the primary nurse took report from the medics. One of the medics was still in the room with me and the patient, re-organizing their stretcher and equipment.  The other stepped outside the room to give report.  I closed the door behind him and started to disrobe the patient.  Just as I'd taken off her top and her floppy little old lady boobs were exposed to the world, he -- without knocking -- opened the door wide, left it open and walked into the room.

I said, "could you please close the door?"

His response, the one that practically begged me to slice his dangly bits off with my trauma shears?  "I will, calm down."

Really?

"Calm down"?

Me: "Oh, I'm calm.  But, my patient is naked.  Close the door."

He did.

I finished as quickly as I could with getting the patient settled in and then bee-lined for the ambulance bay to set junior straight.

When I got to the bay, he was talking to his partner, so I waited for him to finish, because I'm considerate like that.  Then?  Feeling my anger mount as I opened my mouth, I said,

"Two things:

First?  The absolutely fastest way to piss off someone who didn't start out pissed off is to say 'calm down'.

Second?  If that was YOUR grandma in there --"

(he cut me off with something that sounded like Charlie Brown adults taking)

"No!  Listen.  If that was YOUR grandma in there and you saw someone treat her with such indignity you'd be pissed."

"Look, I was just trying to...look, my bad, ok --"

(he started to say a "but", but I cut him off)

"Right.  Your bad.  That's what I was getting at."

And I walked away.

There was no justification for his complete lack of consideration for this patient.  I hope he gets that THAT was the issue.

I cannot abide when healthcare workers begin to treat their patients as cargo.  That's a person, jackhole!  Perhaps, you could find it within yourself to remember that and to treat her as such.

/rant over.

Thin skinned need not apply

Here's why I love when people come to work in ER and they get it.

New nurse, just came off orientation, very smart, hard-working, really good nurse. She also happens to be fucking gorgeous with big boobs, a tiny waste and just generally very pretty. She was assigned next to another gal that is also new-ish, also a very solid nurse, and she is nearly 6' tall and genuinely looks like a runway model.

Problem was, we *actually* had a tech on the floor today, but he was basically camped out by the two hot girls being their little bitch while myself and another middle aged nurse floundered with no help of any kind except from each other when we could.

Finally, when I'd literally discharged 3 people in 15 minutes and then got 2 back to back ambulances, one of them a 4 yr old with an obvious fracture that was going to need -- at minimum procedural sedation for closed reduction and EMS hadn't put in an IV and it was almost 6 o'clock and he was over flirting with Nurse Hotty #1 and Nurse Hotty #2...

I'd had it.

HAD it.

I said, really loudly, directed at HIM, not them, "I guess I'm gonna have to lose a bunch of weight and get a boob job if I need some help in here, huh?"

Nurse Hotty #1, the big boobed one, thought it was a jab at her. She immediately just said, "Chill out. I'll give you the name of my surgeon."

I laughed my ass off. I LOVED that she jumped right back when she thought I was dissin' her. Of course, I wasn't. So, I also loved it that she understood and agreed when I explained that I was directing it at him and not at her.

I even told her, later, that I totally didn't realize they were fake, I had just meant I needed bigger ones than I have if I wanted to get the tech's attention. She said, "Oh, no, totally fake. My husband got them for me. Aren't they great!?"

She totally deflated my pissy mood. It was awesome.

The least of these...

Back in the day, when I was a tech in Albuquerque at a busy, downtown ER, our hallways were literally lined with stretchers holding homeless drunk guys every night.  Particularly in winter.

It was a constant source of frustration for the staff at the ER to spend so much time and energy, essentially, being a homeless shelter.  Especially because, as a rule, they tend to be very unpleasant, demanding, uncooperative and a risk to themselves and staff when they belligerently insist on trying to get up and leave while still very drunk and unsteady on their feet.

I became locally somewhat famous among the homeless population because of my fervor for a particular adherence to the letter of the law where vital signs were concerned.  In ER, every patient has to have vital signs done at least every 2 hours.  So, I would dutifully and cheerfully wake every single homeless guy every two hours to check their vital signs and assure that they could be roused.  Just doing my job.  But, knowing that they weren't going to get a good nights' sleep if they came to my ER, they would elect to be "found" closer to other facilities.

Over the years and in various cities in several states I have taken care of homeless drunk folks (not all homeless are drunks, btw, but the drunks are the portion of the homeless population who make most use of ERs).  I still make sure that they are made aware that the ER is for medical care and not a soft, warm bed for the night (or day as I primarily do days shifts now).  There are generally beds available at local shelters, you just have to show up by a particular time and not be drunk.  But, also, a certain amount of diligence is necessary because long term alcohol abuse puts one at risk for quite a few legit medical emergencies and some of them (bleeding into the brain for instance) can easily be mistaken for intoxication.

I was reminded of this years ago when I had a patient, I'll call him ICY, who -- as I was told in report -- had been witnessed to have fallen and bystanders called 911.  He was well known to EMS staff as a homeless alcoholic.  As I was taking report, ICY was walking from his stretcher to the bathroom.  His gait was a bit wobbly, but he made it.  I waited for him outside the bathroom and made sure he got safely back to his stretcher, got him undressed and gowned, got him a warm blanket -- for which he thanked me profusely and was generally just very sweet -- checked his vital signs and then sent him off to CT.

About 30 minutes later, I went in to recheck on ICY.  I couldn't get him to wake up.  At all.  I checked his pupils.  Not good.  One was about 3mm the other was probably 6mm.  He was breathing, but irregularly.  I put him on the monitor, rechecked his vital signs and discovered that his heart rate was slow, his blood pressure had a larger than normal difference between the top (systolic) and the bottom (diastolic).  Cushing's Triad.  Definitely NOT good.  He had pressure on his brain.  Just as I was about to go get the doc and let them know of this change, the radiologist had apparently called the ER doc to notify about the GIANT brain bleed that ICY had.

We pretty quickly intubated him and I got in a couple of big IVs and we gave him a powerful medicine to help reduce the swelling.  The neurosurgeon showed up  not long before I transferred ICY to the intensive care unit.  After looking at the CT, ICY's history and doing a physical exam, the neurosurgeon said to me, "This guy is going to die."  Yeah.  I thought so too.

Flash forward about a year.  I had left to go on a couple of travel assignments but was now back in the area where ICY lived.  Lo and behold, who is brought into my ER by EMS because he was found "down and out" by some kindly citizen who helpfully called 911?  Yes!  He was not only alive, but was now rocking a giant, old incision on his scalp that still had staples in it.  In the time I was gone, he survived his brain bleed after having had a hole bored into his skull.  He was sent to a rehab facility (no alcohol rehab, physical rehab) after discharge from the hospital, but then from rehab returned to his previously homeless state.  Rather than follow up at the local clinic or even return to the ER for re-evaluation after his ordeal, he just kept drinking and sleeping out of doors.  Predictably, he got an infection in his skull.  Yes.  The actual skull.  He ended up back in ICU having IV antibiotics and having part of his skull removed.  Now he'd been released again and still had his staples.  I finally convinced one of the ER docs that the better part of valor was to remove the staples.  I gave ICY a blanket and some food and, as per his usual, he was very sweet and grateful.

ICY has become one of those homeless alcoholics who could essentially give the ER as their permanent address.  He is known by name by all of the staff.  Most feel he is just another homeless drunk guy and are frustrated every time he returns.

Somehow, the lump of stone that resides just the other side of my sternum melts whenever I take care of him.  I always take great care to really look him over and make sure he's ok and then I get him a warm blanket and some food.  And, he is always very grateful and sweet.

And he makes me remember why I love being a nurse.

Gee...I can't *imagine* why you're alone...

It's amusing to me.

I have at least half a dozen  female friends and/or acquaintances who qualify as model level beautiful with perfect or near perfect bodies.  All but one of them are with guys who are, let us say, average looking.  And they are deliriously happy.  Probably because their criteria for choosing a mate had little if anything to do with physical appearance.  And, they've all chosen men who realize that they are far more than how they look.

And yet?  I know at least a couple of guys who rank in the "average looking" category (in one case this is actually being gracious) who have had their hearts ripped out by beautiful little hard-bodies and yet?  Their major criterion for a mate is that she is hot.

Huh.  And you can't find love?  Imagine that.

I suppose it could have something to do with the truth that lies in the humorous picture attached here.  Many women who are gorgeous by any objective standard don't see it in themselves.  They see their perceived flaws instead.  Whereas there are a surprising number of men who see themselves as a real catch when, in fact, they may bear a striking resemblance to a Jimmy Carter caricature.

I'm not so hypocritical as to try to pretend that physical attractiveness is completely unimportant.  But, it seems to me that if someone can't get past physical appearance, they are likely to miss out.

My husband, I think, is a pretty good lookin' dude.  After nearly 20 years together, I still get hot for him.  I still get occasional butterflies.

But, it didn't start out that way.  I was not physically attracted to him at the beginning (we began as platonic friends).  And, I wasn't looking for a relationship with him.  I've always assumed that because I'm overweight that he had a similar experience of developing sexual attraction as we got to know one another.  Oddly, I learned only recently that -- as he so romantically put it -- he "wanted to nail" me pretty much from the beginning.   But, he had also made an active decision, after years of chasing an image, to seek out substance.  Lucky for me.  I'm pretty substantial...heh...

I just wonder how it is that some guys -- and these are nice guys, not jerks, generally -- can be so short-sighted as to make physical appearance their number one priority in a mate.

And it makes me kinda sad for them.

The Duke City Half Marathon, or? How I nearly ran a 10k and still managed to only get a little pin

I lived in the Duke City for nearly a decade, year round.  I now bounce around between here and FL and also to various travel assignments as a travel nurse.  I didn't start running until after I started travel nursing, so I've not done a ton of races here.

Yesterday, though, I ran my 10th half marathon.  I've done 9 others.  In, lemme think, 4 other states.  I've done many, many, many shorter races, some 10ks but mostly 5ks.  As well as a couple of local 5 mile races that I routinely do in FL.

The Duke City, for a fairly large race in a fairly large town was...different.  Which is, I suppose, as it should be.

Now, the route was great.  We got to run up Central Ave. (which is also part of historic Route 66)

It was gorgeous.  Gorgeous.

The now famous Dog House from Breaking Bad

and onto the Bosque Trail, a paved multi-use trail that follows the scenic Rio Grande.  Now, the advisability of using a 5' wide trail with 5000 participants?

Another problem was, they had one giant chute into which they channeled all the runners of all the various races (5k, 10k, 20k walk, half and full marathon).  They just had different start times for each distance.  The announcer was not very vociferous or very cheerful and certainly not very informative.  I stood in the chute, and noticed that a lot of people were all sort of bunching up and we all were asking each other, "Is this the 10k?  Did the marathoners already go?"  Eventually, there was a cheer from the crowd and the group in the chute dutifully headed toward the start line.  Thank God I realized before I got too close that it was the 10k start.

I then worked my way toward the back of the crowd (I'm slow, and knew that between not enough training and not enough time at altitude, I was going to be even slower in this race).  Once my race actually started, I felt great.  Started out strong.  It was crisp and quite cool, my favorite running weather, so it was tough to hold back my pace.

When I got to the turnaround, I was a bit surprised to see that 2 volunteers with clipboards, you heard me, clipboards, were writing down the bib numbers of the people who came through the turnaround.  No timing strip.  What if a volunteer was inattentive?  Would my race be voided?  This was disconcerting.

At least as disconcerting as the very low tech turnaround check was the deep, painful gluteal cramp that would. not. let. up.  I stretched and rubbed and stretched and finally had to walk it out.  Once the cramp seemed to be gone, I was at mile 7 and had a very hard time convincing myself to start running again.

I had (for me) gotten a respectable time for the first half and knew that I could speedwalk to the finish and have a time that was not horrible.

Eventually, I did run some more, but I was feeling the lack of training and the altitude.

While I most definitely did enjoy the beautiful scenery and the occasional chats with other participants along the way, the thing that pushed me was the 10th medal I would soon receive.

One of the best things about the route was turning that corner from Central down 3rd street and being able to see the finish line.  Talk about a burst of energy.  Suddenly I felt FABULOUS and put on a sprint.  I knew that the Rickster was there (this is only the 3rd of my half marathons he's actually attended) and he was happily holding the camera and ready to catch the big shot of my victorious dash across the finish line.

He tried.

Just as the Rickster lined up the perfect shot, a 7' tall, over-achieving marathoner dashed in front of me.  You can sort of see the bright orange "Team EMS" shirt, black tights and one white hobbit foot.  I would have posted a better, professional picture of me crossing, but those monopolistic bastards want $40 for one digital picture.  Really?

Still, I wanted a bottle of water and there was still that medal to be put around my neck.



Yeah.  About that.

Bling

There was someone there with little plastic wrapped somethings, I nearly bypassed her because I thought it was some sort of free sample.  Nope.  It was my "bling".  No medal.  Just a little 1" pin.  Oh and?  No bottled water at the end.  Cups.  The same as when you're running past.

Now, there are several big races I've run that I will run again.  The Cleveland Half, I've already signed up.  The Sarasota half, oh, absolutely (best route. ever).  The Rock & Roll in St. Pete, were they ever to do it again, happily.  But this?  Nah.  I feel much the same way I did about Graceland.  I truly am glad I did it.

I never need to do it again.

Clearly, I need psychotherapy

...or meds, or something.

Cuz, here was my day:

1. Sign up for a bunch of races

2. Go for a hike

3. Start arranging to go back to work

4. Finalized plans with My Girls for a Caribbean Cruise

...and which one am I kinda most excited about right now?

#3. 

How IS that?!

 

 

Well, yeah, that's part of it, but, it's more than just making money.  I mean, they don't actually pay me enough to do what I do...







...or be exposed to the stuff I'm around every day...

 

 

or spend countless hours breaking the bad news to people that, really, despite what they read on WebMD, they are NOT going to die...

 



It's mostly because of this

 

 



 

 

 

and this

and this

It's the humor and the camaraderie in a setting that can be scary, and traumatic (pun intended) and sad as hell.

I love what I do.  But, mostly, because of the people with whom I do it.

My challenge for Hollywood writers

 

 

Walter White.  Man.  What an emotional roller coaster this character took us all on.  <spoiler alert!>  In the end, there was a sort of karmic symmetry, but beyond Walter & Jesse -- who admittedly have a special place in my heart because they have made my hometown of Albuquerque be nearby on my screen even when I couldn't be here -- there are other television shows that have captured my attention and even my heart, to some degree.




Tony Soprano.  When James Gandolfini suddenly passed away recently, I actually felt as if someone I knew had died.  I had a definite emotional reaction to this actor's death.  Because he breathed such life into the character of Tony Soprano.  Tony, who, by the show's own description was a sociopath.  Who killed numerous people and ordered the deaths of several others, including people he ostensibly loved.  Who cheated on his wife repeatedly and who didn't actually seem to know what love actually was unless the object was an animal.



                                                                                       

Then there's Jax Teller.  The opening scenes of the first episode are him smiling, happy, riding free on his motorcycle through his town.  The show is all about his struggles to be a better man, make his club better.  Stop the violence,  but he resorts to violence rather easily and when it isn't even obviously necessary (beating then forcibly drugging his ex-wife to avoid a custody battle).


These characters are all, in the end  bad people.  These are not individuals you would actually want in your life.  You would be afraid of these people.  And rightly so.  So, how did this sort of character become our protagonists?  Well, because the characters are so conflicted and flawed, which makes them interesting.

It seems that if a character is honorable, or genuinely tries to be, makes good choices or at least faces up to the consequences of his/her bad ones and is generally a good, moral person, they are necessarily not interesting.

So, here is my challenge to Hollywood writers:

Write a TV series whose protagonist is  moral and does face their responsibilities with integrity and honor.  I am not saying that this character should be religious, in fact, some of the more genuinely moral, honorable and reliable people I know identify as either agnostic or atheist.  Does this person sound boring?  Then, how good a writer you must be to make them interesting!

The Land of Enchantment

My return to la tierra de encanta is necessarily a brief one, but I have, once again, been enchanted.  From the first time I came here for a visit, I fell in love with New Mexico.

The drive back here was epic, filled with fun and visits with friends and was the most perfect driving of any long road trip I've ever attempted.  Nearly no construction, no major traffic hassles, no bad weather.

As I headed from Kansas City, MO to Denver, it was overcast and rainy, but the mountains were, nonetheless, a sight for sore eyes.  But, coming south into NM, then turning off from I-25 toward our home in the east mountains outside Albuquerque was so scenic and beautiful that it almost literally took my breath away.  The sky was cloudless and blue and the incredible amounts of rain received this summer during monsoon season had everything so green that it boggled the mind.

Since arriving, I've been running (so, so hard with the elevation and steep hills!) and hiking nearly every day.  The hiking has been amazing.  The mountains are LUSH.  In fact...maybe a bit TOO lush.  Today, while the Rickster and I were hiking, it was actually warm and windless.  So, the flies made their presence known.  By hovering about our faces, attempting to nestle in my eyeballs and up my nose.  As I hike with trekking poles (handmade from sotol by the Rickster) I couldn't easily bat them away.  It must be what horses feel like.  It was AWFUL.  But, still not enough to diminish the joy and the beauty of the hike.

Another cool thing about my return is the timing.  Turns out that Breaking Bad's finale was this past Sunday.  The days leading up have been some fun ones here in the environs surrounding the Burque.  Lots of donuts with blue crystal sugar on them, lots of parties where people dress as their favorite character.  And, I've noticed a LOT of older model RVs.  I've always assumed they were the white trash/east mountain version of a guest room, but now I wonder!

Too soon, it will be time to return to FL, but for now, I'm going to enjoy the mountains, the cool mornings and maybe, before we leave...snow?

Smoke 'em if you've got 'em

I remember watching old black & white movies, noir stuff maybe, from the 40s.  Back then practically everybody smoked.  And still, when someone was about to light up, they'd say, "Mind if I smoke?"

Now, even though the tobacco companies have had to pay MILLIONS to people for hiding the ill effects of cigarette smoke (in some cases even seeming to promote smoking as a health aid) there are still lots and lots of smokers.  And in compliance with the rage of the age, they all feel entitled to smoke.  They have a right to smoke.  Ok.  I don't guess I disagree...to a point.  Smokers have a right to smoke, right up to the point where it infringes on someone else's right to breathe.

Seem fair?  My mother never smoked a cigarette in her life, but guess what?  She has COPD, chronic obstructive pulmonary disease, which is what killed her mother.  My mother lived in houses with smokers her entire life.  I grew up with cigarette smoke everywhere I went.  It was Kentucky.  Tobacco, whiskey and horses are kind of their thing.

Somehow, I managed to not become addicted to smoking.  Thank God.

I've watched people try to quit.  It's hard as hell. 

I got a glimpse into how hard once when I had a patient who used to come to the ER all the time with shooter's abscesses or overdoses.  IV heroin user.  I didn't see her for a couple years, and because she had been a rather frequent flyer, I noticed.  We sort of assumed she'd probably OD'd.   Then, one day, a very well dressed, nice-looking woman came to the ER for a cut on her hand.  She'd been making breakfast and trying to slice something, sliced herself instead.  At one point while caring for her, she said, "You don't remember me, do you?"  Then I realized...it was the junkie.  But she wasn't anymore.  She had been college educated when she got hooked on IV drugs, now she was off drugs, had a great job and was making a life for herself.  A true success story.  But, she told me, even though she'd been able to get off heroin, she could not quit smoking.



So, I understand what a grip cigarettes can have on people.


...but, why do they seem to make some people into assholes?

Why is it, that when patronizing a facility, such as a restaurant, that has a no smoking policy, smokers will then gather in hordes immediately outside the door to said facilities so that everyone who wants to go in or out is forced to walk through a fog of cigarette smoke?  Do I get to sue these people?   I mean, no one forced  anyone to spend their money on cigarettes, people chose to do that, but they were able to hold cigarette companies liable for the outcomes of their own decisions.  Now that there is no doubt in anyone's minds and there have been warning labels on cigarettes for 50 flippin' years, who is responsible? 

NOW can we hold the individuals responsible who will spend money on cigarettes even when their houses foreclose for lack of money?

And then there are coworkers who will take break after break after break to go smoke -- and want/expect me to cover their patients.  A nurse whom I have always liked just became my idol, because she said out loud to another nurse, a smoker, what I've wanted to say for years and will now always say, "I will not cover your patients while you go smoke.  Put a nicotine patch on and get back to work."  There is nowhere on hospital property, no hospital in this country anymore, really, where smoking is allowed.  So, suck it up, buttercup. 

And who do I hold responsible when I can't catch my breath from coughing after having to walk past or through someone else's cigarette smoke?

And, if I dare try to politely ask someone to please, at least move away from the door so that I can try to avoid the poisonous fog they're spewing, I get responses like, "I can smoke if I want." Don't I get an opportunity to NOT smoke if I want????

Why be a jerk?  If you want to suffocate slowly over time, mazel tov, but I have the right to breathe.  That one is actually in the constitution.  I never saw the "right to smoke" amendment. 

What difference does it make?

We all have our memories of that day.

Mine is that I had tickets, for weeks, to go to the wedding of my dear friends' daughter.  The wedding was to be the 15th.  I was to fly out on the 12th.

The morning of the 11th, I had to get to class (nursing school pre-reqs) and the Rickster was supposed to be at a 7a shift and was running late.  We were in NM. 

My friend, Joe, who was in Cincy, called me and said, "Turn on the TV"

"What channel?"

"It doesn't matter."

Those words made a chill run through me.   I turned on the Today show as she quickly told me that a plane had crashed into the World Trade Center.  I pictured a small, private plane that had accidentally gone off course.  While we watched, I saw a large airliner run into one of the buildings.  I was confused, because I could still see smoke, but the only thing that made sense was, "...that's a replay, right?"

<silence>

"No.  It's another plane."

Rick was in such a hurry that he didn't really process what had just happened and ran out the door.  My classes were cancelled and I just sat there, alone, watching the coverage nonstop all day.

At work, later, I discovered that my then charge nurse's sister-in-law was killed at the Pentagon.

All flights were cancelled.  Kids in your twenties, let that sink in -- ALL FLIGHTS WERE CANCELLED.  For days.

I was finally able to fly to Cincy on the 14th, and it was so odd.

Security was the same as always (all the ridiculous, pointless changes came later) and so it actually seemed like a normal flight.  At first.  The plane was virtually empty and the flight crew was so deferential.  Everybody got food, everybody got to watch the in-flight movie, they kept thanking us for flying.   My original flight, with a layover -- somewhere -- was now a direct flight.  For some reason, as the pilot announced we were approaching to land, I got a weird, frightened feeling.  Thinking about those people on the planes.  It still gives me nightmares.

As awful as it all was,  for a while after this country came together in a way that must have been reminiscent of the 1940s, during WWII. 

I miss that feeling that we were really and truly one country.









Where were you?

I also want to pay tribute  Christopher Stevens, Sean Smith, Glen A. Doherty and Tyrone S. Wood.   Our former Secretary of State, after being part of a ridiculous story about a video prompting the attack on our consulate in Benghazi, then had the temerity to ask, "What difference, at this point, does it make?"

Ask the families of these men. 

It makes a difference.

The kindness of strangers...

Some days, I see things on my job that make me feel that the human race is damned.  Doomed to a miserable hell by man's inhumanity to man.

Then, sometimes, I get to see things that remind me that kindness exists in the world.  And it restores my hope for humanity.

I got a patient one day, brought in by private vehicle.  She was nearly 80, and so skinny as to be skeletal.  She had a giant bruise on her forehead and dried blood all over her face.  Her next door neighbor, maybe 30, who has no relationship to her other than proximity, checks on her every day.  She has no family.  No one. The neighbor, who had to get up to the bathroom in the middle of the night, noticed my patient's light on.  He then went over to check and found the patient on the floor, picked her up and brought her to ER.

He stayed with her for hours, though she was confused and couldn't even tell me her own name.  I cleaned her up, started an IV, drew blood and did all the other things we do to check on little old folks who fall under circumstances when no one saw them fall and we have to figure out why they fell, what kinds of injuries were caused from the fall, etc. 

As she was hydrated with IV fluids and started to become more lucid, she awoke,  looked across at her neighbor and smiled and said, "Hey, buddy.  How ya doin'?"  The neighbor smiled with such relief.

I wanted to hug both of them.

What a concept

It's amazing how much easier it is to run when I follow the rule of not letting more than 3 days go by without running.  I'm going to start holding myself to my old every other day schedule again. 

I'd started slipping on that by first starting to take it easier on myself on pace on my short runs then convincing myself, "Well, I don't have time to  get in my full 3 miles before work because I'm too slow" then just skipping those runs altogether.

Decided this morning that instead of setting a 3 mile goal on work days, I'd set a 30 minute limit and just get in as much distance as possible, but know that I only need half an hour.  A light bulb went off when I realized this is a lot smarter in more than one way  --  duh.  If I set a limit of half an hour, and don't skip runs, I may actually get to the point where I can get in my full 3 miles in said 30 minutes.  That's been my goal.  I want to be a real runner who can run a 10 minute mile, consistently.

So, that's the deal now.  On work days, 30 minutes.  On off days, 4 miles and then my long run.  That will be my half marathon training schedule, which will be my schedule for about 4 or 5 months as I have a half marathon per month coming up.

And, after doing my half hour this morning, I feel great.  I'm remembering that I actually do love to run.  I feel like I've cheated myself for the last few months by convincing myself that running is a chore to be avoided.  It's actually a favor I do for myself.

Labor Day

I grew up loving Jerry Lewis and getting to stay up for his nationally televised telethon was a big thrill when I was a kid.  How many times did we try to spot Pop on the local cutaways, hoping he was answering phones rather than stuffing envelopes?  Then, after age 13 or 14, I was allowed to volunteer as well. They were always great experiences and there was a real sense of triumph when the previous years' total was exceeded. 

(btw, if you didn't know, MDA is still a great organization that has very low overhead so that nearly all of the money raised goes directly to research and treatment and helping people and families of people who have any of over 40 neuromuscular diseases. Learn more and give here)

That and the WEBN fireworks.  That was always Labor Day.

For us, on the "Kentucky side" of the Ohio River, back in the day, that meant sitting on either our roof (we lived only a few blocks from the river) or on a grassy flood wall, being eaten alive by chiggers to watch the amazing fireworks display.

Some of the friends I made volunteering for the MDA Telethon and then for MDA camp remain some of my closest friends.  But, I haven't lived in Cincy for years and have only gotten back once...10 years ago?....to see the fireworks.

(photo by David Schwier)

But, I've sort of created a new tradition.  And, I promise that this will be the last sad "Pop" post...well, for a while at least...

Labor Day 2010 was the day of Pop's funeral.  I remember thinking how entirely appropriate that was. 

When making the funeral arrangement, I did realize that I had already signed up, weeks before, for a local 5k race.  I briefly considered skipping it, but then what?  I'd have sat home alone going crazy.

Running it that day was sort of healing.  Got me in a much more healthy frame of mind to face the funeral later in the day.

I'll be running that same race this morning.

It's probably going to be slow.  I've refound a few pounds since then.  That was my lowest weight since high school.  But, I'm still running, such as it is.  I'll be thinking of Pop, of course, while I do this race, but it will be different than the mind-numbing grief of that morning. I intend to focus on the joy and the feeling of strength and accomplishment.  It's a beautiful cross country course that twists and turns through a lot of lush greenery.  I'm really looking forward to it. 

ADDENDUM:

Short race report: LABOR day is appropriate, because it was laborious.  I started fairly strong but halfway through felt my half-assed training.  Slow finish, one of my slowest 5ks ever.  But, I did ride my bike there and back so it's been an active morning.  Still, this was a wake-up call.  I need to get serious about training.  I have a half marathon to run at 5000 feet elevation in about 7 weeks. 

So, it was hot, I was sweaty and fat and slow.  But, I finished, and I actually did push myself (until the last mile when I had *nothing* left) and I will feel good about that and take that fat, sweaty, slow feeling with me to make me keep up with training and eating right.

On the bike ride there, I was awed by the beautiful, billowing clouds with the pink cast from the sunrise highlighting them.  On the ride home, those same clouds had turned into ominous, gray storm clouds.  I didn't quite beat the storm home.  But, at least there was no lightning or thunder.

So, all in all, it was still a great start to my day.

Living the dream...

I had good parents who really did their best to raise productive citizens.  My biggest influence was my Pop.  He was the 8th of 10 kids in a working-class Northern Kentucky family.

My paternal grandparents were very "live and let live" sorts who I never heard express any strong opinions about anything except working hard...well, and being quiet when grandpa was watching TV.

From very early on, though,  I remember my Pop making a point of teaching us to take people as they come and not to be fooled by how someone appears, but rather decide what kind of person someone was based on how they behaved and the choices they made.

Race was never even mentioned in our home -- except by my mother's mother and my father quickly made it clear that racism and racist statements were wrong.

  The whole of my early life, my Pop attempted to put Dr. King's dream into effect by teaching his own children to judge people only on the content of their character.

Now, don't assume that this means I was unaware that there was racism.  Of course, I saw things on TV and, sadly, in my own town that proved to me that there were people who would mistreat people of color only because they were people of color.  But, these were the "bad guys" and it seemed to me that there were far fewer of them than there were "good guys".  Good guys took people as they were and would only dislike you if you were dishonest or mean.

So, imagine my sadness and confusion when I grew up and realized that wasn't how the world actually functioned.  Suddenly, as an adult, I realized that there were those who assumed I was racist simply because I was white.  I had no hope of proving anyone wrong who made that assumption, because they weren't interested in hearing differently. 

Thankfully, as I've grown older, I've come to the conclusion that taking each individual human being as they themselves are is still the only way I can live.  I would have missed out on many fulfilling friendships in life if I hadn't held on to that precept. 

But, I remain disheartened and sometimes downright angry that this country has been so torn apart by racial hatred and that the worst perpetrators of racial hatred are those who profess to seek an end to racism.

However, the anniversary of my Pop's death is also the anniversary of Dr. King's famous speech and it just brought it all full circle for me.

I will continue to live my life as someone who would make Pop proud, and so I will continue to do my part to see Dr. King's dream fulfilled.

....so, where was I?

Oh right!  Stretch came to play!

This pic was taken at a local watering hole near a beautiful bit of actual water, at sunset.  This view is from a bar that is directly behind my current place of work.  It is a piece of magic.  And staff in my ER get a discount.  It' pretty sweet.

Stretch was here for several days, that flew by like a minute.  We mostly chilled, although there was lunch at another waterfront restaurant that we both love, some serious goofing off including Rickaritas and skinny-dipping, and tending to Stretch's knee, which has a boo-boo.

But, we both also shed a few tears.  I miss Pop and having Stretch here was definitely reminiscent of that summer.  And, she misses her baby girl AngelHeart.  There were hugs all around. 

Since Stretch was here, and she is pretty finicky about eating healthy, it has sort of rubbed off.  I'm on a good kick of actually managing to eat right AND work out regularly.

I've been keeping up with my run schedule (have a half marathon in the Burque in October) and strictly cooking at home and packing lunches and snacks for work.

I've also been working up a couple of more politically/socially bent blog posts that will soon be forthcoming.

Right now?  I am lounging on the NurseBananaHammock with a beer and a couple of puppies and listening to the cicadas and generally enjoying life.

It does get better, eventually

Pop nearly visible, AA's bruises definitely visible

The Auburn Amazon is headed home.  Just dropped her at the airport.  We did imbibe here and there, but rather than the raucous, party-like-rockstars get together we imagined, it ended up being a pretty mellow, relaxing visit.

She was thoroughly exhausted from having to defend her Master's thesis, then pack up and move a couple states west and then make her way here for a conference in my state a couple hours away.  So, by the time I picked her up, she was beat.  And, I'm emotionally a bit fragile right now so wasn't truly in party mode (though I tried to be). 

So, we took it very easy, she got to see some local sights, I kicked her ass at mini-golf (don't judge, it's fun!  No matter WHAT Stretch says), I made my own take on the famous Rickaritas and we kicked back here in my digs for one night before heading south a smidge.  There, we had lunch at a great restaurant and had a pitcher o'mojitos, then lounged poolside (where, AA tried to get some color other than the black and blue she's sporting from moving) then enjoyed a very laid back sunset booze cruise, watched dolphins and laughed at a group of seasoned citizens as they got toasted, moved about in what we believe was supposed to be dancing and took side bets on who would break a hip. 

This morning, we both woke and had a very nice breakfast and then picked up my pups from the kennel and wandered around my Preserve for a bit, taking a few pics and trying not to die from heat exhaustion before returning to my digs where I attempted to introduce her to some fine 90s TV shows (NYPD Blue and the Sopranos).  Having been in grade school in the early 90s, I don't think AA truly appreciated either, but she did a good job of humoring me.

In the midst of all the fun, I fairly successfully avoided moping about and missing Pop.  Working a lot of shifts coming up, then Stretch will be here and I will be reminded that one can move on from loss.  Stretch lost a child.  I can't imagine anything worse than that.  And yet, she soldiers on and lives.  And she does it well.  And, so, I will endeavor to do.  I can miss Pop and remember him, I don't have to hold on to the pain the way I have.  It doesn't minimize the place he held in my life or the impact he had in the world to continue to live my life as best I can. 

In fact, I honor him by living the best life I can.  

On the day of his funeral, now 3 years ago, I ran the Canes Classic 5k.  Because of travel assignments, I haven't been able to run it the last 2 years.  But, I signed up for it today.  I'll run it thinking of him.

Suddenly....it was August

You have to imagine that title being voiced by the Rickster doing his best (which is awful) Jacques Cousteau impression.  It's been his go to sentence when imitating the French explorer for as long as I've known him.  First time he did it, we were canoeing along the Little Manatee River, nearly 20 years ago.  And it's always brought a smile to my face.

Still does, but it's a bittersweet little smile now because August has become a month I rather dread.

Pop's birthday is August 5, and while I will always cherish that last birthday that I tried so hard to make special (not really knowing, but feeling that it would be the last) it was the last.  Only a few weeks later, he went into the hospital for his radical neck dissection (thyroid cancer) and while he came through that surgery like a champ and went home in 4 days, it was only for long enough to get his wish -- to die at home. 

So, I was alone, the Rickster tending to our house in NM while I worked and tried to hang on to normalcy while feeling that everything had just broken in me.

Thankfully, that summer my good friend, Stretch, came to stay with me for a few days just after Pop's funeral.  It was sanity for me. 

Now, while I am temporarily Rickster-less for the summer again, the Auburn Amazon is coming for a visit tomorrow.  Both Stretch and the Amazon are amazing friends whom I originally met through an online chat group on a weight loss website.  Over the years many of the folks in that group have met in real life and become a very large support network, and a smaller group of them have become good friends, and even smaller group the very best of friends.The first example of the amazing support of that group was actually put together by the Amazon.  She called it "Project Hand" and had a bunch of the folks in the group make decorative hands as a symbol that I had a hand to hold onto.  It meant so much. Still does.  I'll be talking more about these women later. 

Stretch, who has become one of my very closest friends -- ever -- is also slated for a return visit in a couple weeks and I imagine she'll provide a now very lean and well-muscled shoulder for me to cry on while I miss the hell out of my Pop.

Let's discuss when you should vs shouldn't call an ambulance

Somehow we have GOT to get the word out.  Because in one shift I received a patient via ambulance who had been having foot pain for 3 months and another patient whose family members frantically ran into the triage area asking for help to pull Dad out of the car, and when we did he was in cardiopulmonary arrest.

And why did arrest guy's family drive him in?  "At first we thought he just passed out, and we thought this would be faster."  Now, that may strictly be true, but the ambulance could have recognized that he was in distress and been giving medical interventions already.  Also?  If the moron with the 3 month foot pain wasn't calling 911, response time to CPR guy might be quicker.

Now, I fully admit that there may be times when it's legitimately hard to know whether you do or don't need an ambulance, but usually?  If you have time to discuss it?  You probably don't.

And, generally speaking, if you are under 50, never had any medical problems and take reasonably good care of yourself, there will almost never be anything wrong with you that requires an ambulance except maybe a car crash or other trauma.

It's important that you understand that saying you don't require emergency transport doesn't mean you don't need medical care.  But requiring medical care does not necessarily mean you have a medical emergency.  And far, far too many people have no concept of what is an actual medical emergency.  Anything for which you can call a Dr. and make an appointment or sit on line at an urgent care?  You should do that.  If you find yourself saying, "Well, it's just faster at the ER"?  YOU are the reason that it is actually NOT faster at the ER.   But, that's a whole other blog post...

So, lemme give you a brief lowdown  (for the legal types, I do not pretend to be the final authority nor is this list complete) of reasons for which you should ABSOLUTELY call an ambulance:

• You're just sitting there and suddenly experience excruciating chest pain that doesn't go away or is accompanied by shortness of breath or dizziness
• You're engaging in some sort of physical activity that you normally do without trouble and now developing crushing chest pain or shortness of breath
• You fell 10 ft or more, even if you think you're fine and have family who can drive you, because you need to be immobilized
• You have an allergic reaction that causes your lips to swell or feel short of breath and have hives -- ESPECIALLY if you have nut allergies, even if you just took a  hit of your epipen (Girl with nut allergy dies)
• You've cut yourself sufficiently badly that you have to hold continuous pressure to stop bleeding and so can't drive yourself and are alone
• Weakness/heaviness/numbness on one side of the body, sudden blurring or loss of vision,  inability to talk or facial droop or slurred words

And here?  Here is a list of things for which, really, you will NEVER need an ambulance:

• Foot pain for 3 months
• ANY complaint that you've have for an extended period of time 
• Any complaint that still allows you to be on the cell phone when the EMS stretcher rolls you into my ER
• If you are not having anything on the other list and there are 3 people in the house with you and 6 cars in the driveway

 In the end?  I would rather see people come in by ambulance who don't need to than have someone not call who should have.  Problem is, it's never either/or.

Strike!

Strikes have been useful tools, in the past, to hold employers' feet to the fire and ensure a safe work environment or higher wages (since the advent of organized unions, it's usually money).  Part of the reason they were effective was that it tended to be skilled laborers (coal miners) or even highly trained professionals (pilots) who were necessary and who couldn't easily be replaced. 

But I just read a story about McDonalds' staff in NYC who'd walked off the job to demand "a living wage".

Um...

I have a friend in New Hampshire who is a trained, educated paramedic who saves lives for a living and makes $1/hr more than the burger flippers are now demanding.

Do we really think that people with (potentially) NO education who LITERALLY flip burgers should get the same pay as a medic? Does anybody REALLY think that you are SUPPOSED to raise a family on minimum wage or are minimum wage jobs MEANT to be transitional, either starter jobs for kids or supplemental income for older folks?
Although, I guess Nanny Bloomberg would be happy if people stopped eating at McDonald's because burgers are now $30 to ensure that the staff gets a "living wage".
pffftt....

Look folks, it's a bad economy out there right now and there actually are people who would be happy to get paid the $7.25/hr that you are now eschewing.  You can (and in a reasonable world will) be very quickly and easily replaced.

You think getting paid minimum wage sucks?  You're right.  You hate your job flipping burgers?  You should.  You should also aspire to more and make some plans and put them into action to get out of there and into a job where you really do have value and something to offer the world.

Look into Mike Rowe's website, there is a HUGE shortage of skilled workers in this country.  Go be a plumber, carpenter, bricklayer, etc. and leave the crappy fast food jobs for the teens in high school.

Ambulance drivers and brainless butt-wipers

There was a local news story recently regarding an elderly woman who ran into an ambulance.  I happened to know the crew of that ambulance.  A couple of good medics.  The news outlet ended the story with this line, "Two ambulance drivers were uninjured." 

Reading that infuriated me.  Paramedics are highly trained (and many EMS systems now require that medics be Bachelor's prepared) and go into dangerous situations every day to save lives.  Referring to them as "ambulance drivers" demeans them.  The concept among the general public that the job of these heroes is simply to provide a ride to the hospital is probably at least part of the reason that we continue to see stories about patients and/or standers-by assaulting medics.

I actually left a comment on the online story, requesting that they correct the story and show these medics the respect they deserve.

Of course that didn't happen. 

But, as an ER nurse, I work with these folks every day and have a great deal of respect for what they do.  We are a team. 

Now, this morning, a medic friend posted this

Here's the thing.  I don't need permission.  RNs, particularly RNs in critical care areas, have a great deal of autonomy and actually, to a large extent, drive the care of our patients.  Also, the idea that medics work as total lone wolves is mistaken.  They work within protocols and actually do have to radio in occasionally for "permission" to go outside those protocols.

But, more than feeling -- initially -- anger at this dig at nurses, then disappointment at not only the medic who posted it, but other medics I know who "liked" it, I feel frustration that this ridiculous antagonism between nurses and medics helps NO ONE.  The public hears nurses berate medcs and hears medics berate nurses and they think that their disdain for both of us is justified.

Divider in chief

The ultimate weakness of violence is that it is a descending spiral,
begetting the very thing it seeks to destroy.
Instead of diminishing evil, it multiplies it.
Through violence you may murder the liar,
but you cannot murder the lie, nor establish the truth.
Through violence you may murder the hater,
but you do not murder hate.
In fact, violence merely increases hate.
So it goes.
Returning violence for violence multiplies violence,
adding deeper darkness to a night already devoid of stars.
Darkness cannot drive out darkness:
only light can do that.
Hate cannot drive out hate: only love can do that.

Dr. Martin Luther King, Jr.




This is more the kind of speech, if he had to address the Trayvon Martin/George Zimmerman case, that the president might have made.

Instead, he ratcheted racial tensions up just the one more notch.  What productive thing was accomplished by his statement a couple days ago?

Praying for this country.  Praying that our president realizes that his job is no longer that of "community organizer" but commander in chief.  Of the WHOLE country.  

Remember another great quote, Mr. President, "A house divided against itself cannot stand."

You have a constitutional right to be a jerk...and a social responsibility to, maybe, not.

I just saw someone post this on Facebook.

I really don't get all this antagonism against the police.

It's one thing to be aware of your rights and to exercise them, it's a completely different thing to set out with the idea of being a pain in the ass to the men and women who risk their lives every single day to make our lives safer.

Again, you know that, in the absence of a warrant or exigent circumstances you can refuse a search. Knowing that doesn't mean that you have an obligation to refuse a reasonable search.

There is a BALANCE between the mindless, "Well, if I'm not doing anything wrong, I don't have anything to worry about" crowd and this need to challenge the police on every little detail.  The answer to leftist administration and a complicit media is not to be as extreme as they are.  We can exercise our rights and still be responsible, reasonable people.

I have several friends and acquaintances who are cops and they are good people who actually give a damn about their communities.  Are there bad cops?  Of course, because there are bad people, but I honestly believe that the HUGE proportion of them are decent, honest people who became cops because they want to make things better.  They did not leave their houses and go to work to strip you of your constitutional rights. 

Here's an interesting thought -- statistically, probably around half of those cops are conservatives and are likely to feel just as strongly about constitutional freedoms as the people who came up with this graphic. 

So, why -- when there is NO reason (other than being a smug asshole) be a confrontational jerk?  And, trust me, the little pissant in "the video" who refused to roll down his window was just trying to be a confrontational jerk.  He wanted to make some sort of point.  The only point he made, in the end, was that he has the right to be an ass.  



This is still America. 


You have the right to be an ass.  Congratulations.