E.J. Montini has a piece in the local inky compost-liner in which he cites the words of Beth Pearson, mother of fallen paratrooper Sgt. Brice Pearson:
"When Brice was home in March on leave, his biggest comment was, 'Gee, you'd never know that we're at war.' People like to argue about the war. But it's all very clean. If you don't have a loved one over there fighting, it's as if it doesn't exist. You can ignore it."
No, we can't ignore it and we don't, but huge components of the mainstream media do. They are encouraged to do this by, for example, honoring Bush's coldly pathological injunction against displaying the return of the flag-draped caskets.
Anyone anywhere who tries to put out the simple facts about the cost of Bush's Iraq quagmire is visciously accused of lack of patriotism. As if the truth had some kind of anti-war ideological bias, instead of just being the truth.
*The financial costs of the war are not figured into the national budget.
*Flag-draped caskets are banned from portrayal.
*The Defense Department makes no efforts to catalogue the deaths of Iraqi people, especially innocent civilians. When independent investigators make counts they are dismissed with great hostility.
*Returning veterans are tossed away, and if they speak out against the war they are rounded up for punishment.
These kinds of costs are seldom fully calculated for all to see in mainstream newspapers, magazines, and television, but the dirty-hippie foul-mouthed leftie bloggers are all over them like wet paint on a bench. The corporate media serves us wee little tiny portions of Iraq occupation news. Only when they are forced to by the enormity of it, or only when their masters deem it useful. For inciting fear, for example.
At least Montini is trying with this column. And his coverage of the Frazier tee-shirt issue has been about as fair as one could expect.
Maybe Montini is not like the anvil-headed creepy bootlickers who also scribble at his place of employment. Maybe he has a real reason for producing this kind of material. Perhaps the role of toady-slash-sociopath-enabler chafes him and he himself is not indifferent to the damage caused by Bush's criminal invasion.
Or maybe he's just a "Colmes." It's hard for me to say one way or another. But just look at the kind of business he's in... whatever.
Please: Honor the Fallen.
Sunday, September 30, 2007
Sunday Plath Poetry on Percy
"Among the Narcissi"
Spry, wry, and gray as these March sticks,
Percy bows, in his blue peajacket, among the narcissi.
He is recuperating from something on the lung.
The narcissi, too, are bowing to some big thing :
It rattles their stars on the green hill where Percy
Nurses the hardship of his stitches, and walks and walks.
There is a dignity to this; there is a formality-
The flowers vivid as bandages, and the man mending.
They bow and stand : they suffer such attacks!
And the octogenarian loves the little flocks.
He is quite blue; the terrible wind tries his breathing.
The narcissi look up like children, quickly and whitely.
Sylvia Plath
In the spring of 1962 the fields around Devon were covered with such flowers.
There actually was a "Percy." Percy Key. He was a handyman sort who lived with his wife in a cottage by the one Ted and Sylvia had in Devonshire. He helped the young couple with some house remodeling.
After lung surgery he was recuperating at home. On that Easter Sunday Ted, Sylvia, and their children were outside in the garden taking family pictures.
They heard Rose Key next door frantically shouting to them for help. They rushed to see Percy; he was slouched in a chair, stricken by a lethal stroke. (They didn't have post-operative Lovenox therapy to reduce risk of embolism back then.)
Plath and Hughes attended his funeral in late June and Sylvia wrote one of her more famous poems, the stunning and substantial "Berck-Plage," about Percy's death and burial though in that long poem Plath does not cite him by name.
Spry, wry, and gray as these March sticks,
Percy bows, in his blue peajacket, among the narcissi.
He is recuperating from something on the lung.
The narcissi, too, are bowing to some big thing :
It rattles their stars on the green hill where Percy
Nurses the hardship of his stitches, and walks and walks.
There is a dignity to this; there is a formality-
The flowers vivid as bandages, and the man mending.
They bow and stand : they suffer such attacks!
And the octogenarian loves the little flocks.
He is quite blue; the terrible wind tries his breathing.
The narcissi look up like children, quickly and whitely.
Sylvia Plath
In the spring of 1962 the fields around Devon were covered with such flowers.
There actually was a "Percy." Percy Key. He was a handyman sort who lived with his wife in a cottage by the one Ted and Sylvia had in Devonshire. He helped the young couple with some house remodeling.
After lung surgery he was recuperating at home. On that Easter Sunday Ted, Sylvia, and their children were outside in the garden taking family pictures.
They heard Rose Key next door frantically shouting to them for help. They rushed to see Percy; he was slouched in a chair, stricken by a lethal stroke. (They didn't have post-operative Lovenox therapy to reduce risk of embolism back then.)
Plath and Hughes attended his funeral in late June and Sylvia wrote one of her more famous poems, the stunning and substantial "Berck-Plage," about Percy's death and burial though in that long poem Plath does not cite him by name.
Friday, September 28, 2007
Wednesday, September 26, 2007
Daughter, Yours
She'd been a party-girl all of her life and looked twenty years older than her stated age of forty-one. The last time she came to visit us she had been down for a while outside during the very hot summer months and had developed a nasty rhabdomyolysis.
Her CPK levels were in the one-hundred-thousands, or about a thousand-or-two times higher than normal. Multiple injection sites, urine drug screen positive for cocaine, dehydration, and general abuse of the body were all in play.
This slammed all hell out of her kidneys and she ended up on dialysis for a few weeks. The case managers had gotten her set up with our state Medicaid system so we'd get paid a little bit of money to cover a fraction of the cost of the care she needed.
She was discharged with an intact permacath and hemodialysis scheduled for three times a week.
She never followed up with dialysis, she never took her medications, and she never stopped partying... until a couple weeks went by and she was shivering with fever and came back to the hospital with an infected permacath, sepsis, and really crappy lab values.
The indwelling hemodialysis catheter was immediately removed and antibiotic therapy initiated. The workup revealed a blood clot in the aorta, too. A big sucker, that one, but on follow-up trans-esophageal echocardiograms it didn't appear to be moving around.
Oh lucky day.
Medicaid coverage has to be re-upped every six months and hers needed doing, but they had lost their copy of her birth certificate which she had presented on her last go-around. She was basically homeless and in no condition to go scouting about the town to find it, so the case managers were stuck and unable to establish insurance for her.
This meant that the local skilled-nursing facilities, which would typically provide the weeks of long-term intravenous antibiotic therapy she needed; well, none of them would accept her as a patient without any ability to pay.
So we had to keep her and provide the care at the hospital. Just staying in a telemetry-monitored hospital bed likely costs over a thousand dollars a day, plus the antibiotics, blood transfusions, routine medications, labwork, supplies, food services, linens, and all that jazz. Like my pay. Beaucoups bucks.
Nobody says beaucoup around here. Mucho dinero, maybe, but she wasn't of Mexican heritage.
The hospital will have to absorb the six-figure cost of her stay. I can hear the howls from the compassionate conservatives. She's a poster-girl. But really. This is somebody's daughter.
And this is the best healthcare system in the world. I'm not in this gig for the money but if they don't pay me, I cannot afford to be a nurse. No nurses means no hospitals, and you will be driving to Mexico for your own healthcare.
Her CPK levels were in the one-hundred-thousands, or about a thousand-or-two times higher than normal. Multiple injection sites, urine drug screen positive for cocaine, dehydration, and general abuse of the body were all in play.
This slammed all hell out of her kidneys and she ended up on dialysis for a few weeks. The case managers had gotten her set up with our state Medicaid system so we'd get paid a little bit of money to cover a fraction of the cost of the care she needed.
She was discharged with an intact permacath and hemodialysis scheduled for three times a week.
She never followed up with dialysis, she never took her medications, and she never stopped partying... until a couple weeks went by and she was shivering with fever and came back to the hospital with an infected permacath, sepsis, and really crappy lab values.
The indwelling hemodialysis catheter was immediately removed and antibiotic therapy initiated. The workup revealed a blood clot in the aorta, too. A big sucker, that one, but on follow-up trans-esophageal echocardiograms it didn't appear to be moving around.
Oh lucky day.
Medicaid coverage has to be re-upped every six months and hers needed doing, but they had lost their copy of her birth certificate which she had presented on her last go-around. She was basically homeless and in no condition to go scouting about the town to find it, so the case managers were stuck and unable to establish insurance for her.
This meant that the local skilled-nursing facilities, which would typically provide the weeks of long-term intravenous antibiotic therapy she needed; well, none of them would accept her as a patient without any ability to pay.
So we had to keep her and provide the care at the hospital. Just staying in a telemetry-monitored hospital bed likely costs over a thousand dollars a day, plus the antibiotics, blood transfusions, routine medications, labwork, supplies, food services, linens, and all that jazz. Like my pay. Beaucoups bucks.
Nobody says beaucoup around here. Mucho dinero, maybe, but she wasn't of Mexican heritage.
The hospital will have to absorb the six-figure cost of her stay. I can hear the howls from the compassionate conservatives. She's a poster-girl. But really. This is somebody's daughter.
And this is the best healthcare system in the world. I'm not in this gig for the money but if they don't pay me, I cannot afford to be a nurse. No nurses means no hospitals, and you will be driving to Mexico for your own healthcare.
Sunday, September 23, 2007
Sunday Poetry: Smells Like a Butcher
Fiesta Melons
In Benidorm there are melons,
Whole donkey-carts full
Of innumerable melons,
Ovals and balls,
Bright green and thumpable
Laced over with stripes
Of turtle-dark green.
Chooose an egg-shape, a world-shape,
Bowl one homeward to taste
In the whitehot noon :
Cream-smooth honeydews,
Pink-pulped whoppers,
Bump-rinded cantaloupes
With orange cores.
Each wedge wears a studding
Of blanched seeds or black seeds
To strew like confetti
Under the feet of
This market of melon-eating
Fiesta-goers.
(Sylvia Plath)
In October of 1962 Plath and her estranged husband Ted Hughes took a brief make-up vacation together on the Ireland coast. He didn't stay for long. After a few days he disappeared and it's now believed he'd shuttled back to his lover Assia and they went off together for a couple weeks to Spain.
Sylvia didn't know that, but she had always hated Spain even though she had honeymooned there after marrying Ted.
Benidorm is famous for its ongoing festivals.
This poem is mysterious in its simplicity. It's as if there's no there there.
In Benidorm there are melons,
Whole donkey-carts full
Of innumerable melons,
Ovals and balls,
Bright green and thumpable
Laced over with stripes
Of turtle-dark green.
Chooose an egg-shape, a world-shape,
Bowl one homeward to taste
In the whitehot noon :
Cream-smooth honeydews,
Pink-pulped whoppers,
Bump-rinded cantaloupes
With orange cores.
Each wedge wears a studding
Of blanched seeds or black seeds
To strew like confetti
Under the feet of
This market of melon-eating
Fiesta-goers.
(Sylvia Plath)
In October of 1962 Plath and her estranged husband Ted Hughes took a brief make-up vacation together on the Ireland coast. He didn't stay for long. After a few days he disappeared and it's now believed he'd shuttled back to his lover Assia and they went off together for a couple weeks to Spain.
Sylvia didn't know that, but she had always hated Spain even though she had honeymooned there after marrying Ted.
Benidorm is famous for its ongoing festivals.
This poem is mysterious in its simplicity. It's as if there's no there there.
Friday, September 21, 2007
Washcloths, Melodic Minor Scales, and Plate Techtonics
The patient had some kidney problems so the doctors had ordered Bicitra a couple times a day. It tastes nasty, like aspirin dissolved in quinine. The patient blubbered a little when sucking it up through a straw. The front of her hospital gown got a wet spot on it. There weren't any washcloths in the patient's room so I had to step out to get one, maybe along with a fresh gown.
"I'll be back in a flash," I told the patient.
My phone rang as I moved to the door and it was Transportation wanting to take another patient off for a test, so I stopped there to get them ready to go. They had Heparin running and the bag of solution was nearly empty. I had to replace that because their test might take a while and I didn't want it to run out while they were gone.
My phone rang again while I was in the medication room and it was PACU calling report on a post-op patient that went down that morning for surgery. Rather than hold them up and call them back later I just took a few minutes right there to get report. Then I sent the other patient off with their fresh bag of Heparin.
I heard the patient in room 13 calling out for her mother and I was worried that she might be getting tangled up in something. She was 95 years old and a touch demented. Of course her mother was long gone but when this patient got (more) confused she became fearful and appealed to her loved ones who had died years ago.
She was soiled so I cleaned her up and repositioned her. Then my phone rang again and it was one of the residents wanting to know if a stress test report had become available for one of my other patients who was admitted for a myocardial-infarction rule-out. I checked the fax machine and asked the unit secretary about this but the preliminary report had not come yet.
By this time, the post-op patient was being wheeled back into their room so I followed them in and started to look them over. They said they "felt fine" but I talked them into taking some pain medication anyways. I do not always medicate patients for the pain they are having presently; I medicate them for the pain I do not want them to develop in an hour or two.
Their drains and dressings looked good, they were alert and taking oral fluids but their blood pressures were a little low: 82/52. But they were also generally puffy and edematous. Not a lot of urine in the Foley bag, either. Aside from their surgical problem, which was renal in nature, they had aortic stenosis. The doctors wanted to see systolic pressures over 110. I called the medical hospitalist on their case; he was at home, and he suggested that I get orders from the cardiologist.
We took a few more pressures and these still hovered in the 80's. When the cardiologist called back we talked about the low BP's and edema and he told me to cut back on the intravenous fluids, which were running at 150 milliliters per hour, and to start a Dopamine drip at 5 mics. He said he really wasn't too worried about the pressures but thought this might help.
For a moment he considered sending this patient to Intensive Care but if we weren't going to titrate the drip there was no need to transfer the patient.
I was expecting the Dopamine order and had told another nurse about that a moment before the cardiologist had actually called back. We set it up, double-checked the rate, and got it going. Soon we were getting systolic pressures in the 102-106 range. Close enough for jazz. They were putting out urine too.
One of the family members had called during all this and basically harangued me with "what are you going to do about her blood pressures" and "you should call doctor-so-and-so (who was a urologist!) right now" and otherwise putting the rush on me, as if he didn't think I had enough fast-twitch muscle-fiber or something. Fuckhead.
The patient was feeling a little nauseous so I gave her some Zofran and a few minutes later that problem had subsided.
My phone rang again and it was one of our monitor techs to tell me that the post-op patient just had a little run of SVT. I explained the nausea, which probably went along with that, and told them about the Dopamine drip too.
Some of the night shift people were beginning to arrive. One of them, Diana, knew the post-op patient from the night before and I gave her a five-second snapshot: "they didn't get it all in surgery and there's Dopamine at 5 for some low pressures." Then I promised to fill her in on the details after she clocked in.
I took a few minutes to call one of the more sane relatives of the post-op patient and updated them on things. They said they would call the family member who had verbally drilled me to give him the news, so he wouldn't feel any need to call me again.
My phone rang and it was the monitor room telling me that the patient in room 13 had her leads off. As I walked to that room one of the other night shift nurses said that they were ready for report. I settled demented lady down and grabbed my notebook so I could read off some of the details of things that had occurred during the day.
Then the rest of the oncoming nurses cornered me for their reports.
About fifteen minutes later I went to the linen cart and got a few washcloths, towels, and a fresh gown for the patient that had spilled a little Bicitra.
Finally.
I freshened them up. I went home. Kissed he family unit members, walked the dog, practiced scales, and watched a bit of a documentary about plate techtonics.
"I'll be back in a flash," I told the patient.
My phone rang as I moved to the door and it was Transportation wanting to take another patient off for a test, so I stopped there to get them ready to go. They had Heparin running and the bag of solution was nearly empty. I had to replace that because their test might take a while and I didn't want it to run out while they were gone.
My phone rang again while I was in the medication room and it was PACU calling report on a post-op patient that went down that morning for surgery. Rather than hold them up and call them back later I just took a few minutes right there to get report. Then I sent the other patient off with their fresh bag of Heparin.
I heard the patient in room 13 calling out for her mother and I was worried that she might be getting tangled up in something. She was 95 years old and a touch demented. Of course her mother was long gone but when this patient got (more) confused she became fearful and appealed to her loved ones who had died years ago.
She was soiled so I cleaned her up and repositioned her. Then my phone rang again and it was one of the residents wanting to know if a stress test report had become available for one of my other patients who was admitted for a myocardial-infarction rule-out. I checked the fax machine and asked the unit secretary about this but the preliminary report had not come yet.
By this time, the post-op patient was being wheeled back into their room so I followed them in and started to look them over. They said they "felt fine" but I talked them into taking some pain medication anyways. I do not always medicate patients for the pain they are having presently; I medicate them for the pain I do not want them to develop in an hour or two.
Their drains and dressings looked good, they were alert and taking oral fluids but their blood pressures were a little low: 82/52. But they were also generally puffy and edematous. Not a lot of urine in the Foley bag, either. Aside from their surgical problem, which was renal in nature, they had aortic stenosis. The doctors wanted to see systolic pressures over 110. I called the medical hospitalist on their case; he was at home, and he suggested that I get orders from the cardiologist.
We took a few more pressures and these still hovered in the 80's. When the cardiologist called back we talked about the low BP's and edema and he told me to cut back on the intravenous fluids, which were running at 150 milliliters per hour, and to start a Dopamine drip at 5 mics. He said he really wasn't too worried about the pressures but thought this might help.
For a moment he considered sending this patient to Intensive Care but if we weren't going to titrate the drip there was no need to transfer the patient.
I was expecting the Dopamine order and had told another nurse about that a moment before the cardiologist had actually called back. We set it up, double-checked the rate, and got it going. Soon we were getting systolic pressures in the 102-106 range. Close enough for jazz. They were putting out urine too.
One of the family members had called during all this and basically harangued me with "what are you going to do about her blood pressures" and "you should call doctor-so-and-so (who was a urologist!) right now" and otherwise putting the rush on me, as if he didn't think I had enough fast-twitch muscle-fiber or something. Fuckhead.
The patient was feeling a little nauseous so I gave her some Zofran and a few minutes later that problem had subsided.
My phone rang again and it was one of our monitor techs to tell me that the post-op patient just had a little run of SVT. I explained the nausea, which probably went along with that, and told them about the Dopamine drip too.
Some of the night shift people were beginning to arrive. One of them, Diana, knew the post-op patient from the night before and I gave her a five-second snapshot: "they didn't get it all in surgery and there's Dopamine at 5 for some low pressures." Then I promised to fill her in on the details after she clocked in.
I took a few minutes to call one of the more sane relatives of the post-op patient and updated them on things. They said they would call the family member who had verbally drilled me to give him the news, so he wouldn't feel any need to call me again.
My phone rang and it was the monitor room telling me that the patient in room 13 had her leads off. As I walked to that room one of the other night shift nurses said that they were ready for report. I settled demented lady down and grabbed my notebook so I could read off some of the details of things that had occurred during the day.
Then the rest of the oncoming nurses cornered me for their reports.
About fifteen minutes later I went to the linen cart and got a few washcloths, towels, and a fresh gown for the patient that had spilled a little Bicitra.
Finally.
I freshened them up. I went home. Kissed he family unit members, walked the dog, practiced scales, and watched a bit of a documentary about plate techtonics.
Tuesday, September 18, 2007
Outstanding Women
The Champions
When we go to home games we always sit in the same seats; a few rows up and on the aisle right behind this lady, and everybody acknowledges her respectfully and they call her "governor." I've read that she was quite the athlete herself back in the day.
When we go to home games we always sit in the same seats; a few rows up and on the aisle right behind this lady, and everybody acknowledges her respectfully and they call her "governor." I've read that she was quite the athlete herself back in the day.
Sunday, September 16, 2007
Saturday's Protest March
While thousands rolled down the streets of our nation's capital city I stood by myself, but not alone, for a couple hours on the corner of Camelback Road and 24h Street, holding up my sign.
A lot of people driving by flashed a thumb's-up and a smile. Some honked and waved. Of course a few of the less-mannered gave me the finger and called out insults. Usually these were service-age young men travelling in safe groups encased in oversized vehicles. One was a guy and his woman in a dark Porsche with a license-plate that started with the numbers "888." He scowled and flipped me the bird.
"Hate-hate-hate." Right there on the back of his car, proudly displayed.
For every castigating gesture or remark there were dozens of showings of support. It was breezy, cloudy, and cool. Somehow, being the only one seemed right and good. One person with a message, many busy people travelling by. It was something that had to be seen, and it was.
A lot of people driving by flashed a thumb's-up and a smile. Some honked and waved. Of course a few of the less-mannered gave me the finger and called out insults. Usually these were service-age young men travelling in safe groups encased in oversized vehicles. One was a guy and his woman in a dark Porsche with a license-plate that started with the numbers "888." He scowled and flipped me the bird.
"Hate-hate-hate." Right there on the back of his car, proudly displayed.
For every castigating gesture or remark there were dozens of showings of support. It was breezy, cloudy, and cool. Somehow, being the only one seemed right and good. One person with a message, many busy people travelling by. It was something that had to be seen, and it was.
Another Sunday Plath Poem
The Dead
Revolving in oval loops of solar speed,
Couched in cauls of clay as in holy robes,
Dead men render love and war no heed,
Lulled in the ample womb of the full-tilt globe.
No spiritual Caesars are these dead;
They want no proud paternal kingdom come;
And when at last they blunder into bed
World-wrecked, they seek only oblivion.
Rolled round with goodly loam and cradled deep,
These bone shanks will not wake immaculate
To trumpet-toppling dawn of doomstruck day :
They loll forever in colossal sleep;
Nor can God's stern, shocked angels cry them up
From their fond, final, infamous decay.
An early poem, one which her husband Ted Hughes saw fit to include in his collection of her "Complete Poems" which was published well after Sylvia's death.
A lot of people are first drawn to Plath's work by her biography, but after learning a little about her they realize that she was an absolutely astonishing master of her craft. This is so evident in her early efforts such as this sonnet. It's all there; the warm sea, the easterly breezes, the seasonal currents, and the tipping of the butterfly's wing.
Saturday, September 15, 2007
Why I Chose Nursing and a Certain Kind of Apple
Nobody talks about "Muslim beauty" as if it were somehow different from Catholic, Baptist, or some other religiously-based concept of truth and loveliness in architecture, music, or art. Or in human behavior, really.
Beauty is non-sectarian. A Renoir is a wonder to behold despite one's religious affiliation. So is oud music. So are granite counter-tops. So is helping one another.
The same "goodness" that underlies beauty in aesthetics also underlies beauty in ethics. This is despite rather than because of sectarian differences. Ethical ideals and aesthetic ideals transcend and undermine ideological divides. Beauty is beauty. Truth is truth. No matter the medium in which it is made apparent.
That is why I am both a classically-trained musician and a nurse. I am beholden to that which is good in both the spheres of human behavior towards others and human behavior towards manipulating artistic materials.
Good is good. Period. No matter what.
Ethical beauy, aesthetic beauty, and even mathematical and scientific beauty (which is simply truth,) is all the same thing really.
That's my story and I'm sticking to it.
That's why I am a nurse.
That's why I'm writing this on an old PowerBook G4.
Heheheh.
Beauty is non-sectarian. A Renoir is a wonder to behold despite one's religious affiliation. So is oud music. So are granite counter-tops. So is helping one another.
The same "goodness" that underlies beauty in aesthetics also underlies beauty in ethics. This is despite rather than because of sectarian differences. Ethical ideals and aesthetic ideals transcend and undermine ideological divides. Beauty is beauty. Truth is truth. No matter the medium in which it is made apparent.
That is why I am both a classically-trained musician and a nurse. I am beholden to that which is good in both the spheres of human behavior towards others and human behavior towards manipulating artistic materials.
Good is good. Period. No matter what.
Ethical beauy, aesthetic beauty, and even mathematical and scientific beauty (which is simply truth,) is all the same thing really.
That's my story and I'm sticking to it.
That's why I am a nurse.
That's why I'm writing this on an old PowerBook G4.
Heheheh.
Friday, September 14, 2007
Parable of Erin the Problem Solver
Perhaps you are familiar with a brain-teaser called the Konigsberg Bridge Problem. A Swiss mathematician named Euler developed a way of working with graph theory to "solve" the puzzle, but the sixth-grade math teacher posed it to his class anyways.
He drew a diagram of the two islands in the Preger River and the seven bridges. The students scribed their own versions on lined notebook paper and began trying to find a way to trace a path over all the bridges without crossing back.
All the students except one, that is. Some students briefly lifted their heads up from their work upon hearing the loud crumpling caused by Erin squishing and rolling up her pencilled-on-paper worksheet into a ball. Then she took a freshly-sharpened pencil and began stabbing away at the wrinkly paper orb.
After a few seconds she stopped, unravelled the paper wad, flattened it as best they could on their desk, and looked upon it smiling.
The pencil stabs had indeed traced a successful route, but a new bridge had been torn into the problem by the pokes of graphite. Without another bridge it was unsolvable.
Upon inspecting her solution the teacher was amazed but not amused by Erin's inelegant method.
The teacher returned to the front of the class where he graphed out the problem on the chalkboard, using Euler's technique. After all he couldn't just wad up an entire blackboard and stab away at it as Erin had done with her paper.
He drew a diagram of the two islands in the Preger River and the seven bridges. The students scribed their own versions on lined notebook paper and began trying to find a way to trace a path over all the bridges without crossing back.
All the students except one, that is. Some students briefly lifted their heads up from their work upon hearing the loud crumpling caused by Erin squishing and rolling up her pencilled-on-paper worksheet into a ball. Then she took a freshly-sharpened pencil and began stabbing away at the wrinkly paper orb.
After a few seconds she stopped, unravelled the paper wad, flattened it as best they could on their desk, and looked upon it smiling.
The pencil stabs had indeed traced a successful route, but a new bridge had been torn into the problem by the pokes of graphite. Without another bridge it was unsolvable.
Upon inspecting her solution the teacher was amazed but not amused by Erin's inelegant method.
The teacher returned to the front of the class where he graphed out the problem on the chalkboard, using Euler's technique. After all he couldn't just wad up an entire blackboard and stab away at it as Erin had done with her paper.
Tuesday, September 11, 2007
There
She was a very sweet little old lady and her only current serious medical problem was that she couldn't swallow effectively. She had failed more than one modified barium swallow test.
She'd come to us initially with respiratory failure and she had been intubated for a few days. The residents felt that her swallow reflex would recover after a while and that insertion of a PEG tube would be overkill.
She was basically homeless but compliant with her medical regimen and she always showed for her clinic appointments, but pushing a grocery cart
around town successfully and maintaing an abdominal feeding tube were quite different things. If anyone could do it she could.
But it was decided to send her off to a skilled nursing facility to see if her swallowing difficulties resolved and in the meantime she'd be fed through a nasogastric tube. That seemed fair. And realistic.
An hour before she was due to be transported to the skilled facility her duotube got loose and drifted up to her throat. She was out walking around the unit when this happened. I didn't want food formula dripping into her lungs so I immediately pulled the tube and let the resident know that I'd be sinking a new one.
He was concerned about the timing, as I was. The tube went down easily enough and the X-ray said it was okay to use but it wouldn't flush: it had kinked in the stomach instead of passing into the duodenum.
I can stick it in someone's nose but since I do not myself have X-ray vision I'm unable to direct the tube right through the stomach into its outlet to the duodenum. Oh well.
We pulled it (nurses always say "we,") and sunk anothe. The repeat X-ray said we were a little short of the duodenum so the resident on-call ordered to advance it and get another X-ray. Okay. Done.
Of course by this time transport was here to take the patient to the skilled facility. We weren't ready. I made a few phone calls. Then the radiology guys called to tell me that they wouldn't do another X-ray for four hours because of hospital policy.
Hospital policy.
I told the technician that we wanted to get the patient to a skilled nursing facility but he was adamant.
Calls to the resident and our evening nursing supervisor were unfruitful. Radiology wouldn't budge. There's probably some federal regulation about waiting before you irradiate a patient again. Anyways, we had to wait.
In the meantime I'd sent all my other patients out and the empty beds were filling. Admissions mean paperwork, and paperwork means stress, so I was very busy taking report on the new patients and settling them in, as well as reporting to the oncoming night shift nurses who had begun to show up.
The moral of the story is that because of "hospital policy" regarding repeat X-rays the patient had to spend another night in the hospital, taking up a bed that could have been occupied by an actually sick person.
I'm not complaining. I'm describing. I guess you had to be there.
She'd come to us initially with respiratory failure and she had been intubated for a few days. The residents felt that her swallow reflex would recover after a while and that insertion of a PEG tube would be overkill.
She was basically homeless but compliant with her medical regimen and she always showed for her clinic appointments, but pushing a grocery cart
around town successfully and maintaing an abdominal feeding tube were quite different things. If anyone could do it she could.
But it was decided to send her off to a skilled nursing facility to see if her swallowing difficulties resolved and in the meantime she'd be fed through a nasogastric tube. That seemed fair. And realistic.
An hour before she was due to be transported to the skilled facility her duotube got loose and drifted up to her throat. She was out walking around the unit when this happened. I didn't want food formula dripping into her lungs so I immediately pulled the tube and let the resident know that I'd be sinking a new one.
He was concerned about the timing, as I was. The tube went down easily enough and the X-ray said it was okay to use but it wouldn't flush: it had kinked in the stomach instead of passing into the duodenum.
I can stick it in someone's nose but since I do not myself have X-ray vision I'm unable to direct the tube right through the stomach into its outlet to the duodenum. Oh well.
We pulled it (nurses always say "we,") and sunk anothe. The repeat X-ray said we were a little short of the duodenum so the resident on-call ordered to advance it and get another X-ray. Okay. Done.
Of course by this time transport was here to take the patient to the skilled facility. We weren't ready. I made a few phone calls. Then the radiology guys called to tell me that they wouldn't do another X-ray for four hours because of hospital policy.
Hospital policy.
I told the technician that we wanted to get the patient to a skilled nursing facility but he was adamant.
Calls to the resident and our evening nursing supervisor were unfruitful. Radiology wouldn't budge. There's probably some federal regulation about waiting before you irradiate a patient again. Anyways, we had to wait.
In the meantime I'd sent all my other patients out and the empty beds were filling. Admissions mean paperwork, and paperwork means stress, so I was very busy taking report on the new patients and settling them in, as well as reporting to the oncoming night shift nurses who had begun to show up.
The moral of the story is that because of "hospital policy" regarding repeat X-rays the patient had to spend another night in the hospital, taking up a bed that could have been occupied by an actually sick person.
I'm not complaining. I'm describing. I guess you had to be there.
Sunday, September 09, 2007
Sunday Poetry: Plath on the Rhine
There the Rhine River runs at its most narrow and deep. The slate cliffs that rise above are called The Lorelei and legend says that here a siren can sometimes be heard, or an echo from the steep rock face.
Plath's poem "Lorelei" appeared in her first collection, The Colossus and other poems published in 1960 three years before her suicide at age 30.
Lorelei
It is no night to drown in:
A full moon, river lapsing
Black beneath bland mirror-sheen,
The blue water-mists dropping
Scrim after scrim like fishnets
Though fishermen are sleeping,
The massive castle turrets
Doubling themselves in a glass
All stillness. Yet these shapes float
Up toward me, troubling the face
Of quiet. From the nadir
They rise, their limbs ponderous
With richness, hair heavier
Than sculptured marble. They sing
Of a world more full and clear
Than can be. Sisters, your song
Bears a burden too weighty
For the whorled ear's listening
Here, in a well-steered country,
Under a balanced ruler.
Deranging by harmony
Beyond the mundane order,
Your voices lay siege. You lodge
On the pitched reefs of nightmare,
Promising sure harborage;
By day, descant from borders
Of hebetude, from the ledge
Also of high windows. Worse
Even than your maddening
Song, your silence. At the source
Of your ice-hearted calling --
Drunkenness of the great depths.
O river, I see drifting
Deep in your flux of silver
Those great goddesses of peace.
Stone, stone, ferry me down there.
By that time Plath had already begun her tragic journey into herself, eventually culminating in the unleashing of her "Ariel" voice. There are more than hints of this in the above cited poem: the compressed terza rima and watery dark imagery, the shadowy feminine power, and the threatening tone, all very finely wrought.
Friday, September 07, 2007
Wednesday, September 05, 2007
Here
Two days away from work are always better than just one, and a week away allows the necessary distance to develop, to allow different body rhythms to arise, maybe even to approach relaxation.
Sitting on the beach plodding through a Kellerman crime novel instead of a heavy tome about Crusader history or modern politics, nice breeze against my bare legs, the sounds of waves and happy people, occasionally still my thoughts brush up against work and I get that little visceral freeze-up of stress. I blow it away with a deep breath.
In nursing, as in medicine in general, the expectation is that the work will go perfectly. Everything is over-wrought and rechecked. Confirmed by others. Documented. It's stressful, and this can sometimes be compounded by demanding people. Personality-disordered lungers. Crystal addicts. The demented.
One of the tricks to functioning at that level is to find a way to relax into it.
That's an unnecessary abstraction here, though.
Sitting on the beach plodding through a Kellerman crime novel instead of a heavy tome about Crusader history or modern politics, nice breeze against my bare legs, the sounds of waves and happy people, occasionally still my thoughts brush up against work and I get that little visceral freeze-up of stress. I blow it away with a deep breath.
In nursing, as in medicine in general, the expectation is that the work will go perfectly. Everything is over-wrought and rechecked. Confirmed by others. Documented. It's stressful, and this can sometimes be compounded by demanding people. Personality-disordered lungers. Crystal addicts. The demented.
One of the tricks to functioning at that level is to find a way to relax into it.
That's an unnecessary abstraction here, though.
Tuesday, September 04, 2007
Inside
Sometimes there is a thick smell. These are sucked out of the air, bundled, and tossed down a chute.
There's no breeze and the air is always a little too warm, but often people complain of feeling a chill. There's no sunshine. The light is stale and for lack of a better word, 'clinical.' There is no day nor night. Just clocks.
It's never quiet. Oops. There is a prohibition against using that word. There is never a moment in which someone is not talking on a phone.
The monitors blip in overlapping rhythms like a gaggle of ill-tempered metronomes. They frequently alarm. These are always meaningless annoyances, except when they signal critical emergencies.
There are nocturnal creatures here whose behavior escalates when night comes, outside. There's no moon or stars in here. The birds cackle in the trees even in the pre-morning hours.
Most of the people here have actually very little to do; no tasks assigned, no work, just rest and recovery. But everything is urgent. There is no time.
If you need something it is usually rather far away. Out of reach. The ones who are not resting are always walking to get something or walking to bring it to where it is really needed. Of course the resting ones occasionally walk, too; at least they are supposed to. But they walk slowly and often with assistance. There are falls.
Nobody will be here for very long. Lots of people coming in and going out. Everyone leaves eventually. A handful of people come back.
There's no breeze and the air is always a little too warm, but often people complain of feeling a chill. There's no sunshine. The light is stale and for lack of a better word, 'clinical.' There is no day nor night. Just clocks.
It's never quiet. Oops. There is a prohibition against using that word. There is never a moment in which someone is not talking on a phone.
The monitors blip in overlapping rhythms like a gaggle of ill-tempered metronomes. They frequently alarm. These are always meaningless annoyances, except when they signal critical emergencies.
There are nocturnal creatures here whose behavior escalates when night comes, outside. There's no moon or stars in here. The birds cackle in the trees even in the pre-morning hours.
Most of the people here have actually very little to do; no tasks assigned, no work, just rest and recovery. But everything is urgent. There is no time.
If you need something it is usually rather far away. Out of reach. The ones who are not resting are always walking to get something or walking to bring it to where it is really needed. Of course the resting ones occasionally walk, too; at least they are supposed to. But they walk slowly and often with assistance. There are falls.
Nobody will be here for very long. Lots of people coming in and going out. Everyone leaves eventually. A handful of people come back.
Sunday, September 02, 2007
Sunday Poetry: Coffee in La Jolla
From the work of Jefferey Meyers about Sylvia Plath:
"Ted Hughes has pointed out that Sylvia Plath began her close and sympathetic study of Roethke when isolated at Yaddo in 1959. She plundered him directly at first, but in "Poem for a Birthday" transformed his work into her own distinct style: "She had always responded strongly to "Theodore Roethke's poems, but it was only at Yaddo, in October, that she realized how he could help her. This sequence began as a deliberate Roethke pastiche, a series of exercises which would be light and throwaway to begin with, but might lead to something else the result was a series of pieces, each a monologue of some character in an underground, primitive dream. STONES was the last of them, and only one not obviously influenced by Roethke. It is full of specific details of her experience in a mental hospital."
Plath's Journals confirm Hughes's statement about Roethke's influence. Just before her birthday, on October 27, she adopted Roethke's greenhouse imagery and began to write a sequence of seven poems-on her breakdown, suicide attempt and confinement in a mental institution-which expressed, for the first time, the distinct voice of Ariel: "Ambitious seeds of a long poem made up separate sections: Poem on [her] birthday. To be dwelling on madhouse, nature: Meanings of tools, greenhouses, florists' shops, tunnels, vivid and disjointed. An adventure. Never over. Developing. Rebirth. Despair. Old women. That greenhouse is a mine of subjects. Yesterday: an exercise begun, in grimness, turning into a fine, new thing: first of a series of madhouse poems. October in the toolshed. Roethke's influence, yet mine."
The gardens of Yaddo are familiar to me, as I have mentioned too many times. All of us Saratogians (as if we lived in "Saratogia" and not "Saratoga Springs,") also grew up hearing the story of a Trask child who saw her reflection in one of the ponds and, trying to say "shadow" instead said "Yaddo," hence the name of the beautiful estate. All four young Trasks died in childhood.
This poem is considered to be a turning point in Plath's development as an artist. The formulaic terza rima of her youthful studies has undergone a vigorous refashioning. The Ariel voice sizzled into this world like a lit match; later, as Plath suffers difficulties with Ted compounded by her own psychological anguish, the focused heat of that voice would rise to nuclear intensity.
The Stones
This is the city where men are mended.
I lie on a great anvil.
The flat blue sky-circle
Flew off like the hat of a doll
When I fell out of the light. I entered
The stomach of indifference, the wordless cupboard.
The mother of pestles diminished me.
I became a still pebble.
The stones of the belly were peaceable,
The head-stone quiet, jostled by nothing.
Only the mouth-hole piped out,
Importunate cricket
In a quarry of silences.
The people of the city heard it.
They hunted the stones, taciturn and separate,
The mouth-hole crying their locations.
Drunk as a foetus
I suck at the paps of darkness.
The food tubes embrace me. Sponges kiss my lichens away.
The jewelmaster drives his chisel to pry
Open one stone eye.
This is the after-hell: I see the light.
A wind unstoppers the chamber
Of the ear, old worrier.
Water mollifies the flint lip,
And daylight lays its sameness on the wall.
The grafters are cheerful,
Heating the pincers, hoisting the delicate hammers.
A current agitates the wires
Volt upon volt. Catgut stitches my fissures.
A workman walks by carrying a pink torso.
The storerooms are full of hearts.
This is the city of spare parts.
My swaddled legs and arms smell sweet as rubber.
Here they can doctor heads, or any limb.
On Fridays the little children come
To trade their hooks for hands.
Dead men leave eyes for others.
Love is the uniform of my bald nurse.
Love is the bone and sinew of my curse.
The vase, reconstructed, houses
The elusive rose.
Ten fingers shape a bowl for shadows.
My mendings itch. There is nothing to do.
I shall be good as new.
Saturday, September 01, 2007
Benjamin Hearts Women
That's "kash" with a kapital "k" you know. From the morning sorry excuse to pulverize perfectly good trees:
"The letter writer's retort on Alberto Gonzales' legacy is typical of the leftists and liberals.
The so-called intelligent left worries about wiretapping our enemies but guts the Constitution otherwise. With the liberals so-called "protection" of the Constitution, we the people have huge, wasteful and bloated government under the perversion of the "general welfare clause," are unable to utter the name of the Christian deity anywhere near a government building and will be utterly defenseless against our enemies because they want to limit guns and are afraid to wiretap our enemies."
Bush has created the biggest government debt ever seen in recorded history.
He's fashioned a way to bypass habeus corpus, neatly decimating about 700 years of common law. Gonzales himself said notoriously "The Constitution doesn't say every individual in the United States or every citizen is hereby granted or assured the right of habeas."
Of course John is just mouthing a pure, unadulterated, and above all stupid lie when he claims with boastful exaggeration that liberals disallow religious freedom of expression near certain kinds of buildings.
"ABC News video on September 8 showed National Guard troops going house-to-house, smashing down doors, searching for residents, and confiscating guns. Every victim of disarmament was clearly not a thug or looter, but a decent resident wanting to defend his or her home." Hopefully John would not berate this source for liberal bias. Here's news for you, John-boy: Liberals do not want to take away your guns. Deputy Chief Warren Riley and the National Guard were not acting on behalf of progressive political activists when they did this.
No liberal/progressive has ever come out against legally wiretapping possible terrorist communications. There has, however, been some concern about the Bush Administration's illegal monitoring of others. Why can't Bush just follow the FISA laws? These are very liberal.
Not that much good would arise if Bush had such information. A few years ago he held in his very hands a memo indicating pending attacks on American targets using airliners and he went on vacation.
"Liberals gutting the Constitution." That's a vicious, defective, and spiteful lie. The Constitution was written by liberals.
I'm fairly convinced that the kinds of personalities beholden to rightwing crap like this have been fashioned into such ugly deformity by childhood trauma.
They can't help it. They had this nonsense beaten into them. At their own expense they must, without fail, support malignant authority figures; male ones, that is, or their world-view heaps in upon itself like a house of playing cards blown over by the breath of a child.
"The letter writer's retort on Alberto Gonzales' legacy is typical of the leftists and liberals.
The so-called intelligent left worries about wiretapping our enemies but guts the Constitution otherwise. With the liberals so-called "protection" of the Constitution, we the people have huge, wasteful and bloated government under the perversion of the "general welfare clause," are unable to utter the name of the Christian deity anywhere near a government building and will be utterly defenseless against our enemies because they want to limit guns and are afraid to wiretap our enemies."
Bush has created the biggest government debt ever seen in recorded history.
He's fashioned a way to bypass habeus corpus, neatly decimating about 700 years of common law. Gonzales himself said notoriously "The Constitution doesn't say every individual in the United States or every citizen is hereby granted or assured the right of habeas."
Of course John is just mouthing a pure, unadulterated, and above all stupid lie when he claims with boastful exaggeration that liberals disallow religious freedom of expression near certain kinds of buildings.
"ABC News video on September 8 showed National Guard troops going house-to-house, smashing down doors, searching for residents, and confiscating guns. Every victim of disarmament was clearly not a thug or looter, but a decent resident wanting to defend his or her home." Hopefully John would not berate this source for liberal bias. Here's news for you, John-boy: Liberals do not want to take away your guns. Deputy Chief Warren Riley and the National Guard were not acting on behalf of progressive political activists when they did this.
No liberal/progressive has ever come out against legally wiretapping possible terrorist communications. There has, however, been some concern about the Bush Administration's illegal monitoring of others. Why can't Bush just follow the FISA laws? These are very liberal.
Not that much good would arise if Bush had such information. A few years ago he held in his very hands a memo indicating pending attacks on American targets using airliners and he went on vacation.
"Liberals gutting the Constitution." That's a vicious, defective, and spiteful lie. The Constitution was written by liberals.
I'm fairly convinced that the kinds of personalities beholden to rightwing crap like this have been fashioned into such ugly deformity by childhood trauma.
They can't help it. They had this nonsense beaten into them. At their own expense they must, without fail, support malignant authority figures; male ones, that is, or their world-view heaps in upon itself like a house of playing cards blown over by the breath of a child.
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