Saturday, October 07, 2006

62 Hours

Sunday was long enough ago that I have to dig, with a square shovel, to uncover the memories of that day. I wore dark blue scrubs. My assigned patients were all "normal;" no psychopaths nor Republicans among them.

One gal did schiz out on me. In an anesthesia-induced haze she thought I disapproved of her non-traditional marriage arrangement. Later she got better and it all slid away unmemorably like a bit of Brie on a cracker.

I'll tell you about my own wedding someday.

Monday I wore black scrubs and all my assigned patients were either sent home or transferred off to skilled nursing facilities by 5 p.m. Hints to my clinical lead nurse were shut down without pity.

Another nurse offered to report off her own patients so she herself could go home a couple hours early. She got swatted down like a bug in July. After an hour of just keeping busy helping other nurses, they flew in a new patient from Kingman, just for me.

After two busy days at work I had a short nightmare that awoke me from my shallow sleep. Godzilla was outside our sliding-glass door peering in at the cats, who were staring and hissing back, ears flattened. I thought, in my dream, "That sliding-glass door isn't going to be much of an obstacle" for the giant lizard outside.

Tuesday I napped and played through a guitar transcription of the "L'Infidele" sonata by Sylvius Leopold Weiss. I have a wonderful Renaissance 10-course lute made by the notable Richard Berg of Ottawa, but mostly I just struggle through guitar transcriptions, though my lute would allow me to play most any Renaissance work, if only I could. Someday I'd like to obtain an 11 or even a 13-course Baroque lute, in D-minor flat tuning, to see how things like Weiss feel under original conditions.

The lute sounds like the brain.

The guitar sounds like the heart.

And on Wednesday my nurse heart was broken by a patient who aquired a nasty case of Valley Fever which had settled into their spine and pelvis.

Valley Fever typically takes away a piece of lung, but it can attack any body tissue, including brain. Brain fever. Necrosis.

My particular patient needed new spine tissue cemented in to replace bone material eaten away by cocci. I gave antibiotics and we got the pain issues straightened out with the help of the nurse specialist. That was good. The patient awaits another surgery soon. The surgeons here are amazing.

Thursday and Friday blurred together. I wore black again on Thursday. It's a tradition.

One of my assigned patients was a young adult who required an AICD implant. They shared a condition with their own progeny, known as prolonged QT syndrome, which can cause ventricular tachycardia or fibrillation and sudden death. So now thay have an implanted device that will sense and shock if the deadly heart rhythm occurs. Their 2-year-old child also has one.

You don't see that every day.

I ran a strip of their rhythm and showed them what runs of V-tach and V-fib look like, using a textbook that was lying around, and explained that their AICD would reset the pacer node of their heart with a not-so-gentle shock.

People always do better when you explain things. They were very thankful.

Once in a while I get that "I wish the nurse would shut up" look, but most people say to me "why didn't anybody tell us this before?"

They had been well-prepped because the procedure and device had been applied to their young child, but by doing a little show-and-tell they came to a fuller understanding of this.

I recall an episode Thursday in which I was so tired that I was dreaming while awake.

Sitting at the computer I had charted that one of my patients had refused their stool softener "because of Hitler's disingenuous overtures to the Russians early in World War Two." I deleted that as soon as I was awake enough to realize where I was and then I walked to get a cup of coffee. I should have left that entry in the chart. Somebody may have later gotten a laugh out of it.

Friday drizzled by like the moderate rain that started the day. I wore dark blue scrubs. My cocci patient looked better, and they said they felt better too. Another patient had orders to wean their Dobutamine drip, and without the IV attached to them they did a lot more walking around, which is always good.

The dobutamine was only going at 2mcgs/kg/min. It didn't take long to "wean" it off.

Saturday I wandered around the bookstore where I saw an elderly couple who noted that a book they had special-ordered for themselves was available out on the shelves; Chomsky's "Imperial Ambitions." I told them that they had just made my day.

"How so?" the gentleman asked, smiling in recognition of a member of the reality-based community.

"I had a long week," I said, "And seeing somebody special order Chomsky makes me happy."

"My favorite thing," said the man, "was seeing Hugo Chavez at the U.N. holding up this book and telling people to read it."

I had seen that. It was great. And I picked up a copy, too.

1 comment:

Eli Blake said...

Now, I bet that patient you wrote about who was complaining about everything, except when he had the two lawyers come in and visit him, he is the Republican.