Wednesday, September 30, 2009

Happy Birthday!

My blog is a year old this week, hence the really scary cake. And what the Hell is that cake trying to communicate to us? I love it! Just ridiculous enough for me to say, yup that looks like my kind of gif! (the freeze frame doesn't do it justice, see it here)

I don’t have much to say today except thank you to my invisible friends, real life family and real life friends who stop by my blog and read it. I’m honored and touched every time someone says,”Hey, I read your blog this week and I thought. . .” I do the Sally Field thing in my head: “they like me they really like me!”

It’s been a weird week: I got it in my head I needed a break from the Chaos of the Fifth Circle Of Hell and worked a couple of night shifts. Just enough to screw up my circadian rhythm and make me appreciate I don’t have to work nights. It didn’t help that after Night 2, Bob the builder was crushing concrete about 30 feet from the side of the house, shaking the house and my precious perennial garden. I didn‘t bother to go to bed until about 4:30 that afternoon. Once upon a time I could sleep through anything: including having a roof installed directly over my head while I slept off a night shift. But that was 22 years ago. I seriously slept through our bungalow roof being stripped of shingles. The noise was steady enough it became white noise. What I couldn’t sleep through, nine years later was a two year old poking me in the forehead with his wet thumb saying: “Mommy UP! NO SLEEPING.” The Beav is still a post night shift buzz kill. He called the second I shut my eyes Monday evening to lecture me about NOT taking something to the post office.

I’m pretty shy about telling people I keep a blog. When they ask me what it’s about and I say ’stuff’, I get the baffled blink. What I should say, “It’s a place I can vomit my feelings and insights and goofy humor without being interrupted.” Sometimes that‘s all this place is, a big ole’ vomitorium. aren’t you glad I didn’t find a gif for that? I confess I looked for one but my 48 year old brain shushed the 12 year old so I didn‘t post either of them. Besides, I couldn’t decide which would be less offensive: Stan from Southpark just sort of letting bile run out of the corner of his mouth; or a smiley that turns to the side, pukes what appears to be a piece of bacon and then turns back to face the reader flashing us a big smile. Which is actually hilarious is you’re a nine year old but I hope there aren’t any nine year olds reading because my sailor mouth gives this blog a NSFW rating. I could change the title to Edgyjunecleaver’s Vomitorium. Or not. Because, ick.

I’m probably not going to blog next week because I’ll be working until the minute I leave for the airport for my high school reunion. I’m pretty nervous about going: I’m not the same person I was ten years ago. About the only thing that’s the same is my gender and my political affiliation. But if it’s boring or I am overwhelmed with shyness I’ll just hang in my hotel room or go home to Dad’s. The last two reunions have been a blast and completely without drama (as far as I was concerned if you experienced drama at either previous reunion, for the love of god, email me and dish about it!) This trip to Texas is going to be bittersweet because Dad has decided to sell his house and move to a different part of Texas. Except for a semester of college and the summer after I graduated I never lived in that house but it still remains the place I call “home”. Which is ridiculous because I’ve lived here for twenty-two years and haven’t lived there since 1984! I suppose it’s home because it’s where my parents lived. So now a different part of Texas will be home? But it won’t be because I haven’t lived there since I was four. Oldest Friend has written several essays which deal with feeling homeless and wandering. She was an army brat and her parents continued to move every few years after her father retired. She refers to herself as a wanderer and she has indeed continued to wander as an adult; living on the other side of the globe. Her parents last home was the city where we met. It’s a place that haunts me because this is the place the façade of my safe little family began to erode. According to OF, our “raw suburban houses were without soul”. Twelve years ago, I returned to the neighborhood after her mother’s funeral. The trees had grown and the edges were softened but the souls acquired were sort of desperate and sad; like the mesa that once surrounded them. That the city is perhaps one of the ugliest on Earth doesn’t help with the whole emotional subtext, either. The only other place more repulsive than Albuquerque is Lubbock Texas. And I can’t get away from Lubbock because I dream about it. And I’m dreaming about I more because I’m working a story set in Lubbock. It is rare I dream of Albuquerque. Thankfully my parents didn’t settle there; I would have felt without roots long before now.

I can’t imagine how my father must have felt this past year; his house being a sort of monument to my mother. Gah, I would have sold it last November but he is sensible and waited to be sure he was ready. The only reason I’m not ready is I’m hopelessly sentimental. It’s just a simple house in a quiet and humble neighborhood. It isn’t like they lived there from the time they were married until my mother died. My family wandered until the early seventies and I in turn wandered for ten years until I settled--purely by default--where I am now. I know the attachment rests in the fact my adolsesnce was spent in North Texas with all those rights of passage. I guess my definition of home is where the most important rights of passage occurred. My only right of passage in San Antonio was my birth. (insert groan or guffaw here, your mileage may vary on the pun)

We are planning on moving back to Texas after Beav is finished with high school but this sentimental bent to my personality leads me to waffling about ever leaving here. I’ve been here almost half my life and I’m contemplating leaving late in mid-life to start another life. I’m compelled to leave because I despair over winter and the cost of living is much higher here than it is in Texas. But are my sentimental feelings cloaking a fear of making a decision? I’m not one of these people who travels in a big posse of friends so it‘s not like the going away party would be at a hotel with caterers to accommodate all the well-wishers and friends. Trust me this absence doesn’t bother me because the idea of a huge posse of friends exhausts me on a core level. But I do have enough history with this city I can experience three degrees of separation. It’s a cozy feeling for me when I‘m out with a friend for coffee or whatever and we run into someone we both know who knows someone one of us knows but the other is meeting for the first time. However, this kismet is something I’m likely to miss out upon if I leave because I’m just introverted enough it has taken years for me to achieve this sort of thing. Besides that, the place I live is a small town wrapped up in a big city package. Where I want to live is much bigger. My other consideration is my boys. If I moved would I be taking the roots with me? Would my sons feel homeless if I left here? Fortunately, I have four years to beat this with a stick. I just hope my tiny cadre of readers comes along for the ride.

Thanks for reading. Thanks for being my friends. Happy birthday blog!

Wednesday, September 23, 2009

Driving Under the Influence

This past July (oh lordy that was a lifetime ago) I was issued a traffic ticket, my first in about twenty years. When I saw the lights flashing in my review mirror it scared me because I didn’t have a clue what I had done wrong. I was driving at the speed limit on a street I had driven down almost every day for the last sixteen years. I pulled over and waited for the deputy sheriff to lean down and speak to me. She was a plump blonde woman, very young very polite and to the point, “Do you know why I pulled you over, ma’am?”
“Um…actually I don’t have a clue.”
“You failed to stop at that stop sign”
that’s impossible! I have stopped at that stop sign for sixteen years, sheesh there’s a school up one street and the community pool up the other, I could mow down a kid if I didn’t stop!
“Did you stop at the stop sign?”
I know I looked at her like she had two heads because I thought it was a silly question. “Well…if you didn’t see me stop then I suppose I didn’t stop.” I’m very distracted today; a week ago my fourteen year old had his wisdom teeth out and he’s still in a lot of pain and feels like crap; my stupid ex husband and his nasty wife kicked my nineteen year old out; and he just announced his ship date was moved up and he leaves for Georgia in about six weeks rather than in twelve weeks. Did I mention my job really sucks right now?
“Do you have your proof of insurance?” well f*ck me runnin’, no I don’t have my proof of insurance, and it’s at home on my kitchen table. Let’s see if I can remember the big ass speech I gave my son about always always always ALWAYS have your proof of insurance in the car because just this minute I need to hear it!
“I’m not sure, can I look for it?” The very polite officer allowed me to toss my car looking for my proof of insurance and alas and alack the only one I found was a year old even after I did everything but tear out the carpet and rip open the seats.
“Ma’am this is a year old.”
“I know” I sighed, “Can we call my insurance agent, and you can confirm I’m insured?”
“No, but you can go to court on this date and then you can prove you have insurance. And thank you for not lying to me.”
thank you for not lying to you? Are you high? Why the hell would I lie to a sheriff’s deputy? People lie to you? People blatantly run stop signs and do illegal maneuvers and then lie about it? Are they high? Dude, you have so much power in that little notebook that the last thing I’m going to do is lie to you. (Obviously, I’m not one of these people who cries or acts stupid to get out of tickets.)

So yesterday morning I had my day in court, it was the first day of autumn, snow on the mountains, errant flakes driven by a damp cold wind hitting my face as I walked into the court house. I gulped when I saw my name was the first on the arraignment list. I was being arraigned . Damn, when I saw I was being arraigned I felt like I should have brought F. Lee Bailey’s protégé or something for this serious business. I checked in with a clerk who looked--I swear this is not an exaggeration-- eerily like Della Street’s older sister. There were only five of us to be arraigned that day and the other four were my children’s age. I was the only matron jailbird in the bunch. Della Street gave us a copy of our rights and I was immediately fascinated I could plead guilty by reason of insanity, for a moving violation! Awesome! I wonder if anyone has ever done that. I imagined the look on the judge’s face when I told him I ran the stop sign because I was insane. “Ok, Your Honor, I wasn’t actually insane, insane. Have you ever had teenagers? I mean those people are enough to drive you OVER THE EDGE! And I was at the edge of the brink that day with the Ward and Alexis Asshat Show much less dealing with two teenaged boys. You know it’s just amazing I didn’t wreck the car. . .“ Ummmm probably not a good idea to plead insanity. I could also plead “no contest” because this wasn’t really a moving violation because I rolled through the stop sign. I know I rolled through it because if I had driven through that tight corner I would have toppled the Mitz onto it‘s right side. You can‘t take a corner like that at 30 in one of those things without terrible repercussions. No Contest seemed like the better option because Reason by Insanity could also mean a 72 hour M1 hold, and my State Nursing Board frowns on nurses having M1 holds on their medical records. Besides, they might decide to keep me and the mental health option on my health insurance is probably the most craptastic in the industry (aside from Medicaid which is next to nothing but I’ve already beaten that dead horse with a few sticks). My final option was the least amusing but the most sound: just plead guilty, pay the fine and eat the insurance points for failure to stop at a stop sign. I quietly tallied how much money I had and said good bye to the new shoes and jeans I wanted as I listened to the names being called and people were ushered into a room to discuss their cases with an associate DA who looked fresh out of law school and probably had visions of being Mayor or God or something. After they had their little face to faces with Doogie Houser Esq, they quietly walked into the courtroom, tails between legs. I was really nervous about all of this failiing to have insurance is a really serious offense(OMG as it should be!) and if proof isn't valid, too bad. One of my co-workers--a hot 40ish blonde MILF type, told me this would be a piece of cake, just show up and they will dismiss the ticket, she had done it a few times over the years. Well, yeah of course it was thrown out, look at you! was my response. Oh no, she insisted, that county’s DA is really easy-going. When it was finally my turn and I followed him into a little office trying to look law abiding and NOT my usual bitchy MO.

“So Ms Cleaver, you failed to stop at a stop sign, is this true?”
“Yes it is.” rolled, I rolled through the intersection, an intersection I have pointedly stopped at for years. . .
“And you didn’t have proof of insurance. Did you have insurance on this date?” He looks at me like he wants to give me the chair because I had left my effin’ insurance card on the kitchen table.
“Sir, I’ve had auto insurance since I was sixteen” I pushed the card over to him.
“It appears you did have insurance.”
yay! He can read!,
“How is your driving record?”
“Oh you clever boy, I know you have my driving record resting in your hand. What kind of idiot would sit opposite you and lie. This is another chance to be caught in a lie and then you send me into the court room to get scolded by a judge. I know this game, sonny. ( I wonder what he would have done if I had said: Let‘s see, over the past ten years I have been issued fourteen DUI‘s; one night I was going 120 and when they finally caught me I was given a speeding ticket; I ran over a small child; and I’m wanted in California for a minor little road rage incident involving a hand gun and a fist fight.
“I haven’t had a ticket since about 1987”
“How are your points?” He leans towards me and glares when he asks me this. I thought any minute he was going to hand me a phone so I can hear Beav pleading with me to tell the truth so they won’t kill him. I’m thinking Doogie's nanny let him watch too many LA Law episodes on Lifetime television when he was 12 and I’ve watched too many conspiracy flicks on TNT.
“I don’t think I have any points on my license.”
“That’s correct, Ms. Cleaver, you don’t!” So now he is morphing into Monty Hall. I can hear the DING DING DING and applause in the background, pretty purple, green and red lights are flashing because I’ve just picked door number two and I get a new washer/dryer, a year’s supply of Rice-a-Roni and a Dismissal!
“I’m dismissing this.”
“So I don’t have to pay a fine for the moving violation and I’m not getting any points?” I’m feeling paranoid, this was way too easy. He didn’t really dismiss it and next week there will be a warrant out for my arrest.
“Just be a better driver!” He said peering down at me like I’m NOT old enough to be his mother.
Be a better driver? Look you little bug, I taught my oldest son to drive and I’m teaching the other one to drive. . .don’t tell me to be a better driver…if you want to be all bad ass why don’t you get a real lawyer’s job. . .

“Thank you, sir I will.”

So it was dismissed I didn’t have to plead insane or no contest or even sit in the courtroom. I can buy new jeans! And shoes!

Life is sweet sometimes, innit?

Thursday, September 17, 2009

Last Call

The lingering party guests are milling about; conversation wanes as they look one to the other and glance down at watches; calculating and planning their exits. It’s late and time to leave until everyone reconvenes for next year’s celebration. Most will be welcomed back to the celebration in my flower beds and garden; unfortunately, some of my garden guests were unruly or troublemakers. Like this thing: It’s The Four O’clock That Ate The Flower Bed.

I was a little horrified to take it out because it’s so huge and came from a tiny seed...and I have never grown anything so huge from a tiny seed... Anyhow, The Girl cut it down with the big lopping thingies used for tree branches but she couldn’t dig out the root because it has adhered to the stone wall. Hopefully it won’t return and repeatedly require being cut back. I want to put something smaller in that spot. I must admit it made me smile or laugh whenever I pulled into the drive way. Yesterday, before TG made the first cut I was reminded of this book. The scene I recalled, Beloved was sitting on the porch in a diaphanous white dress, the rest of the family stunned at how large she had become. Sethe sacrificed her family as she cared for Beloved. Beloved soon expands and grows as she existentially consumes the family and the delicate infrastructure is destroyed. Fortunately, the 4 O’clock didn‘t do this to my family; we’re actually doing ok despite a weird summer and my propensity to piss off Ward and create waves and drama. My weird leap to a novel I haven’t read in seventeen years was probably owing to the delicate and old fashioned blossoms which remind me of Victorian tea gowns.

The other unruly guests were the sun flowers. They weren’t specifically the unruly ones; in fact they were statuesque and elegant and they created nice shade. However, their hanger ons followed them. The naughty birds and despicable squirrels knocked the blossoms off and left a big mess and rotting stalks. Sadly, the sunflowers won’t be asked back because of their rowdy entourage. To add insult to injury they haughtily refused to turn to the north and never faced the rest of the garden’s guests.

How lucky we were the squirrels and birds were distracted by the sunflowers and didn’t notice the yummy vegtables. I think we were able to rabbit proof our garden with the ugly chicken wire and making sure the fence was without big chinks or holes. One morning in early June I was surveying my patch and I saw a large hole neatly excavated into my onion berm. I ran over to the garden saying something like: “Oh no you did int!!” and reached for a hoe a la Farmer McGregor; like I actually possessed the courage to bludgeon a rabbit to death. Ewww, that would be messy and cruel. I just wanted to scare it into leaving the yard. They aren’t afraid of the dog because he’s a bit challenged mentally and physically. The rabbit had left the scene of the crime without consuming all of the onions and we managed to fix the fence. The enclosure came about because Kip loves tomatoes and we didn’t want to lose our entire crop to the greedy dog. We were very fortunate our crop wasn’t a victim of Blight which destroyed tomatoes on the east coast. It was certainly wet enough this summer.

Indian summer is proving to be a textbook example of what Indian summer is supposed to be. Every day has been dry and temperate beginning with early morning ground fog and mist burning off by lunchtime. Today we went for a walk in one of the many large and older parks near downtown. Surprisingly, the trees aren’t beginning to turn there but some are almost completely golden as you go to the east of the city. The sun has shifted to a different place and I am driving to work in half light. I knew this would happen; summer would not stay forever. In some ways I’m glad for this; I would not want the Ground Hog Day syndrome; perpetually nursing Beav after he had his wisdom teeth out with the odd but not unheard of Fentanyl reaction of inconsolable crying; repetititively calming my oldest son after his father told him he was no longer welcome at Alexis house; nor do I want to constantly revisit the tumultuous emotions of a child leaving home for the military. Hell, I don’t ever want to do any of those things again. But always, everyday the backdrop to these changes and these emotions was summer. The Girl told one of our friends this summer possessed the “best weather I have ever experienced!” I had to agree with her; we had a summer which mimicked a July in Seattle. The upheaval would have been unbearable in triple digit heat. Indian summer is God’s gift to me before I am handed the short days of winter. I remember when Wally was about two; I called A, tears in my voice because it was 4:45 and I had to turn on lights because it was so dark outside. Now it is a ritual for me to note the time lights are necessary afterDecember 21st as a way to usher in hope for summer.

A few weeks ago, I pondered the whole back-to-school feeling this time of year gives many of us. I think this man says it best. The desire to grasp onto September is great but if I hold onto September Wally would never finish in Georgia or come home to us for a few days in December. For the first time I can ever remember I am looking forward to Winter.

Thursday, September 10, 2009

Can I Go Home Now?

0630: I arrive at work, pick up my assignment sheet and quickly scan the written report describing the five patients the night shift charge nurse has deemed I care for during the next thirteen hours.

A: Morbidly obese, noncompliant diabetic with a really nasty wound on his backside. He’s also known for his verbal abuse. Let’s see how many times he tells me he won’t cooperate and he doesn’t need that medicine because we don’t know what we are doing in the first place. I’ll make it a “Hi Bob” game and get a beer tonight each time he tells me I’m stupid or refers to me as “girl”.

B: Her. Yeah, her. Fuck, I can’t stand this woman. I want to shake her and tell her to fucking get a shrink and get the hell over her childhood trauma that is leading to this chronic existential angst masquerading as belly pain. Twenty-five years old with chronic belly pain. Wow, all this belly pain, how did she manage to get obese? We’ve scanned her, scoped her, opened her up and have done everything but transplant her pancreas and liver. Everything is always normal. Let’s see…she refused the psychiatric consult the last time she was here. But she never EVER refuses the 2mg of dilaudid push every two hours. I thought she wouldn’t be returning to us because we no longer offer IV push phenergan on our menu of treatments at the Spa. Not enough beer if I get to take a swig each time she asks me for more dilaudid and it isn't time yet.

C: Oh for the love of God, this man is back? I knew it! I knew he would bounce back but in three days? Gah we spent hours with this daughter helping her make the decision to place her father because she can no longer take care of him. Hmm….did he fall…no…Oh great. “Weakness” Fuckin’ A we aren’t gonna get paid for this one, are we! Weakness is not a diagnosis it’s a symptom. Shit, I hope his daughter takes a respite day and stays the fuck away from the hospital. He‘s a piece of cake to care for if she isn‘t hovering over him. Such a dear sweet old demented guy. He’s funny and kind, doesn’t scream or hit. Any facility would LOVE to have this guy live with them! I wonder if we can get him a daughter transplant while he is here.

D: Son of a bitch. I thought this guy had died. I could have sworn he died last winter. “Fever” Oh great, this could be anything from liver failure to pneumonia to “I‘m hunger and some asshat beat the crap out of me under the bridge last night so I came here“. I’m voting for pneumonia and an ass kicking because I actually really like this homeless guy and I’m not sure I have the emotional fortitude today to attend to him at the end of his life. please god, let it be pneumonia pneumonia pneumonia“ Maybe I should rethink this whole drinking game so I don't end up with a liver like D's.

E: Nononono NO! We fixed you last time! You were better! And had a home! You agreed to take your meds and live at the half way house! If the case manager didn’t hook you up with enough meds and directions to the homeless clinic: she gets to come up here and sit with you, follow you around the unit making sure you don’t wander off and listen to your endless--oh thank goodness or not, your liver function is off the map. GREAT!! YAY way to go God! The meds killed her liver! Yay! Now we get to find a place for her to live. Yup, she’ll be a resident with us for a month or so because this country absolutely sucks when it comes to mental health care and well there aren’t any beds for people like this poor soul; just streets and alleyways.

After report, I start planning my first cocktail at 1955, should I stick to beer or have something stronger. . . oh yeah, I need to think about my liver.

I take a deep cleansing breath outside of A’s room.

“That goddamned nurse gave me insulin last night for my blood sugar and she gave me ten units! “
“Well good morning to you, too! Hmm…your blood sugar was 450! Of course she gave you insulin.“
“But now I’m only 200 and I feel funny! I’m too low, I’m gonna go into shock!!“

(What I want to say) “Oh boo-fucking-hoo that stupid nurse gave you insulin for a high blood sugar. Why we oughta report her to the state for...I dunno...doing her job you stupid asshat. If you don't want us to treat you then don't come to the fucking hospital and don't call 911! And, Dude, if you go into insulin shock, I will eat your nasty shoes. Yeah buddy you feel funny because your blood sugar averages at 300. But hey, you won’t have much of a brain left in about a year, so make your complaints now while you can string a coherent sentence together. Oh and I hope you aren't too attached to your toes or legs cuz those are outa here too if you keep this up.”

I do the hair patting thing through gritted teeth, and by rote explain to him what a normal blood sugar is and if he would just work with us we would bring his glucose down to manageable levels…“blah blah blah…sir…blah” Is what he hears.

I exit the room and brace myself for B’s room and ask God to deafen me against her whining. She’s sleeping soundly and I weigh not waking her up but I know her dilaudid was given exactly two hours ago and if I don’t wake her and she wakes up in an hour or so, she will see the time and realize it’s been three hours since we hooked her up with a fix and “OMG WTF I’m having a pain crisis!!” I would rather wake her up and get her high than have to explain to the patient over and over again why she can’t have an additional two milligrams of dilaudid.
“B, good morning, I’m your nurse today. How is your pain?”
“Really? Your nurse said you were sleeping every time she rounded through the night.”
“Why didn’t you tell the nurse?”
“I DID AND NO ONE LISTENED TO ME” (cue her tears)
“B, I trust the nurse who gave me report. I want you to think and feel carefully; how bad is your pain right now this minute. Is it the worst pain you’ve ever felt or is it just the pain you normally feel.
(cue baby voice added to tears)”It’s not the worst I’ve ever felt but it’s…it’s…really…really…bad!”

(What I want to say)”You know what you need B, you need a shrink. You need drug rehab and a shrink. I shutter to imagine the serial sexual and or physical abuse suffered upon you when you were a child or a teenager. And it makes me sick one person or a few people have broken you like this. But you know what? You are an intelligent 25 year old woman with her whole life ahead of her. Other people have gotten over these things and have gone on to more than look forward to spending a few days in the hospital! So just suck it up and go to rehab and see a shrink and move up and away from the abuse. YOU ARE LETTING THE ABUSER WIN EVERYTIME I GIVE YOU DILAUDID OR BENADRYL OR YOU ALLOW THE GI DOCS TO DO SCOPES AND THE SURGEONS TO CUT YOU OPEN. THE BAD PEOPLE ARE WINNING HERE!” (And yes I want to shout at her, because I am Nurse Tough Love in my head unlike my hero who said it out loud and to the patient. “Oh I forgot, you don’t work and have Medicaid and drug rehabs for people like you--the people who need it--are few and far between. It isn’t your fault the system is broken. So I’ll get your two milligrams of dilaudid, dear. (Insert hand pat)

After medicating B, I find myself outside of C’s room girding up for the daughter with her apologies and excuses for bringing her father back to the hospital. I luck out and she isn’t there yet. I gently stroke the top of his dear head and softly call his name. His eyes flicker open and his smile is distant and vacant. “Where am I?”
“At the hospital and I‘m lucky enough to be your nurse Mr. C.”
“Why am I here? I want to be at home in my chair.”
“I know but your daughter felt like you needed to stay with me a few days.”
“Is she here, where am I?”
(What I really want to say) “She isn’t here; It seems like she is greedy and won't sell your million dollar house in Very Prestigious Hills so you can live at a lovely Alzheimer’s facility. My guess is she is taking a well deserved spa day on your nickel because she quit her job to care for you. So she tells us you have fallen or almost fallen or might have had a stroke or were choking or couldn’t wake up or had a fever or stopped speaking or lost the feeling on one side of your body or something which will lead the ER to admit you to the hospital; when really she needs a break because it must be hard to take care of a frail elderly man who is confused and incontinent 24/7. I know I couldn’t take care of a demented loved one 24/7 for all the million dollar houses in the world. So daughter feels it is her right to contribute to the bankruptcy of the Medicare system with your frequent admissions. So you’ll stay here for 72 hours, get some fluids (when you keep your IV in); we will hover over you to make sure you don’t fall; keep your skin dry so you don’t get a wound; make placement recommendations--which will be ignored--and send you home. Again. Please don’t stop breathing or allow your heart to stop because I really don’t want to do compression on your 90 year old ribs; they will break with the first compression and it will make me physically ill. Find it somewhere in your mind to lucidly explain to your daughter you don’t want CPR because at this point, we must attempt resuscitation. Attempt is the key word here.”

D’s room is as quiet as a tomb. Damn, what if he died in the last hour and he was alone, how terrible for him he always liked lots of peo-- D interrupts my conclusion jumping with a twitch of a leg. I take his hand; it’s hot to the touch, clammy and very edematous. I say good morning and he speaks to me without opening his eyes. “I feel like crap.”
“I’m sure all this fluid is very painful. I’ll do my best to make you comfortable today. You’re burning up, too. Hey, I thought we had an agreement, the next time we saw each other it was going to be downtown on your corner!“
(What I want to say) “You look like crap, too. I think you might just die this time. Dude, you need a new liver. Hell, you need a new body. So I’m going to do my best to make you comfortable, k? And hopefully if your liver doesn’t kill you, the alcohol withdrawal won’t land you in the ICU for a few days. D, I think you just won today’s Most Medically Fragile award! And your prize is I get to treat your fever, your infection, your edema and make sure you don’t have seizure when you finally start withdrawing from the booze. And all of this with--you guessed it-drugs that could damage your liver with a side order of renal failure! Oh and another thing, I thought you were dead when I came in the room. Please don’t die today. I really want you to get well enough to tell me those crazy stories that may or may not be true.”

I press my ear to D’s door; I can hear her chanting to herself. Its quiet and a sing song repetition of the word: “camping”. Sure enough, she’s in the Veil Bed. A huge tent of a thing over the bed. It keeps us from harms way and we can sorta kinda control her behavior with limits and threats to “put her in the bed”. D doesn’t actually mind the bed and the last time she was here (cellulitis or gout or something like that) I remember she quietly approached me at the desk: “Lady I’m going to go off and I need to be put in that there bed so I don’t hurt you or anybody else what’s here today.” After I helped her to bed, she told me thank you and we had a very quiet afternoon until she called and said she felt better. It was a Zen moment. The split second before I awakened her I promised Buddha an orange slice if she had a quiet day because between crowd control in A’s room, liver control in D’s room and pain control in B’s room, E was going to have to give me a break. We don’t have the budget for a sitter so the bed and meds are going to have to keep all of us safe. I was in luck, D was smiling when she saw me and told me she was very hungry and wanted to sit in a chair because “camping” time was over.
“Camping? What do you mean?”
“Nurse yesterdee tol me I was a campin’ in this here bed! I likes to camp! Good thing too cuz wheres I lives is a sayin I cain’t come back there.”
“The group home?”
“Uh huh. The voices made ‘em tell me I couldn‘t live there no more” Tears spill from her eyes and she doesn’t bother to wipe them away. I gently reach toward her, asking, “My I?” and wipe her cheeks with a Kleenex. “I don’t have any answers for you, E but I can get your breakfast set up. The case manager will see you later and you can make a plan with her.” E follows my directions and safely maneuvering around the bed’s curtain and lets me lead her to a chair. Her gait is unsteady and my hands on help keep her from falling when her knees buckle.
“I’m too fat, I shouldn’t eat.”
“It isn’t fat, it’s fluid from your liver and it’s building up around your stomach.”
“I’m not fat?”
“Nope, hardly. You’re very thin.”
(What I want to say)”You’re very thin because sometimes your thought processes are so disorganized you don’t eat. I fear for you and if I dwell too long on what your future is without a group home. I will weep for the injustice of it all because the best place for you, Fort Public Mental Institution, is closing in a few months. We treat our stray animals better than the mentally ill in this country. I’m so deeply saddened your psyche is broken. If I had a magic wand I would wave it around your heart and head and you would have the capacity and the competency to care for yourself.”
“E I will be back in thirty minutes with your medicine.”
“Oh OK lady. I’ll be here.”

*Patients A, B, C, D and E are composites of patients I care for. When I say “care” I sincerely mean this. As much as the drug seekers make me crazy and the Notreallysickjustreallysuffering people make me; I care for them. But I’m allowed to have an opinion about their stupid, self-destructive and dangerous behaviors. If you leave me a nasty comment, I’ll match your nasty. And if you keep a blog, well let’s just say you were warned. . .

I glance at the clock in the hall and the little hand is resting on the eight. Only eleven more hours. . .

I wish I could call my professional malaise burn out but it’s more like caregiver fatigue. For the most part, my fatigue isn‘t from the patients, their diseases and their demands on me but it stems from the system. Our system is hopelessly broken. If I knew the answer I would shout it from the mountains twenty miles to the west of where I’m writing and hope the powers that be hear me.

I’m fortunate my own psyche is such that just writing this blog entry helps me see the value of the work I do which in turn buoys me up I can face the five patients assigned to me tomorrow morning at 0630.

First and foremost, I will do no harm.

Tuesday, September 1, 2009

Taking The Scarlett O'Hara Approach

Gad zooks, what a weird horoscope this week!

The month of August brought you some peculiar advances. You got a reward that didn't mean as much to you as it might have had you received it earlier. You outgrew an enigma that had puzzled and frustrated you forever. And you finally wriggled free of a shadowy game that you had been attached to long after it lost its power to educate you. As curious as these wistful breakthroughs have been, they are prologue to what's headed your way. Get ready to solve a problem you didn't even know you loved.

That's what I get for checking in with Rob this morning before I start to blog. I was going to blather on about heirloom tomatoes and large giggle inspiring phallic English cucumbers. But NoOOoOOooo Rob has induced more navel staring; staring I'm going to spare anyone who stumbles into my blog. I will say this, I've had wistful breakthroughs this summer, some I've shared here and some I am holding close. But this final line: "get ready to solve a problem you didn't even know you loved?" Oh for the love of God, what's next. I don't really want to know the answer to that question so I'm just going to let life unfold all by itself which is actually what I do best. Trying to control what happens around me only pisses me off when cosmic circumstances don't go. exactly. the. way. I. want. them. to. go.

So I'm going to put my fingers in my ears and sing "la-la-la-la-la- I‘ll just think about this tomorrow" and proceed with a blog about my garden.

It's the time of year when lettuce bolts and the kale gets crisp around the edges while the basil threatens to flower if I don’t harvest it for the freezer. The gaillardia daisies are spreading themselves a bit too thin and are lying (lying? lain? Bueller...anyone...seriously, email me with the correct tense) on their sides like drunken party girls the morning after, just before they resurrect themselves from a strangers bed or a friend's couch and make the inevitable "Walk of Shame". Pretty maroon petals are a bit mooshed and have dirt scattered over them, leaves a little limp, some blossoms are face down while others are to the side; only a few are left standing. The coreopsis are being over taken by zombie blossoms and hopefully my diligent deadheading on Sunday will stave off the winter and the zombie attack for a few more weeks. My lavender is thriving this late summer as are the cone flowers and weedy looking sunflowers. The sedum has been diligently plodding their way towards pink. Novice that I am, I made some tactical errors in planting the front bed and ended up not only with very tall bee balm in the front but one single four o’clock that has defied the back of the package and is at least 48 inches tall! It's standing in the front of my cheerful and completely utilitarian blanket flowers; reminding me of the pretty little girl in your first grade class who always won the spelling bee, spoke two languages, played the violin and had a mother who looked like a 1955 version of Elizabeth Taylor. You know the one, she would push herself to the front of the kindergarten choir or cry if she didn't get to be the princess in the play. The Ieneangabe (TG's German word for show off) girl everyone secretly deplored and feared but every mother privately wished her little girl would be.

Despite my obvious issues with show offs I'm not moving the heavily laden shrub because I'll kill it at its peak. That seems like an unfair end to a plant that didn’t actually ask to be up front and center stage. But I have started moving my mistakes and hopefully not killing them in the process. I have moved one of the drunken and unkempt gaillardias and a couple of the zombie threatened coreopsis now live in different spots and are languishing this morning. As a novice I also ended up with big clumps of yellow or too much red in spots so I'm spreading the wealth of colors. Hopefully I haven't killed my perennials in my quest for aesthetic perfection.

I'm already shopping for seeds and have a different plan for the veg garden next year. I'm including a wider variety, having learned to make better use of my little space. Namely, the "Breakfast Bar" (TG‘s clever nickname for the sunflowers) took up too much room and had the audacity to turn their lovely heads away from the backyard and directly into the path of the greedy squirrels who hurl themselves at the heads making a snack of things (plus a mess on the ground below). Next year, we shall have yellow beets, fancy French green beans, heirloom tomatoes, cucumbers, kale, garlic, English peas, and a staggered crop of lettuces. I can’t wait. This garden is feeling like the end of a love affair. You know the type, it leaps into your life in a swell of passion and pheromones but then a few months later. Nothing. Nada. What was your name again? (Lesbians specialize in this sort of serial monogamy, or some I’m told)

I've selected the bulbs I'm setting out in a few weeks and will have a variety of tulips, very fragrant old fashioned purple iris, white iris and red hyacinths. My goal like most gardener‘s goals is to have nonstop varietals color from May until October. Our growing season is so short here. I don't think I will ever get used to daffodils blooming in May rather than late February. So I feel I must take advantage of the short season with wild bursts of color to brace me for the onslaught of the dead winter colors. It feels akin to what the French must have experienced when they knew the Nazi's were nearing Paris and they tried to drink all the champagne and hid the art.

It's been such a strange, exciting, sad, happy, thrilling, sobering week at my house I can't seem to wrap my head around it so I'm leaning towards the whimsical and when I have a bit more chronographic distance I can probably explain what it means to watch my son take an oath more important than the one I took about twenty-six years ago; an oath I'm not even sure I could uphold. But enough of that! Let's talk about how silly Kipper looks in this picture!