Saturday, December 29, 2007

Sunday Term

William Carlos Williams was both a talented poet and a doctor.

You can hear him read the following poem here, as well as many others. I always enjoy hearing people perform their work.

The Term

A rumpled sheet
Of brown paper
About the length

And apparent bulk
Of a man was
Rolling with the

Wind slowly over
And over in
The street as

A car drove down
Upon it and
Crushed it to

The ground. Unlike
A man it rose
Again rolling

With the wind over
And over to be as
It was before.

Thursday, December 27, 2007

Motion Detectors

Who Is So Insane As To Now Be Saying "Problem Solved?"

I've always liked her. And Aung Sang Suu Kyi. Who's next?

I am rageful.

Tuesday, December 25, 2007

Of This I Am Convinced, Xmas 2007

There are many things which are not things.

When I was little I discovered the mythology books in the grade-school library. I read Greek and American Indian creation stories as soon as I graduated from Doctor Suess.


In junior highschool I fancied stories from the vast literature of Hindu culture and to escape Vonnegut and Tolkein I read the Gita. I forgot every word when I jumped head-first into existentialist writings while in college.

I'll tell you now to save you the trouble of examining "The Stranger" yourself: Meursault shot the Arab because; well, the sun got in his eyes.

There are probably over a dozen slight references to Meursault's eye sensitivity in the novel that precede his fatal lapse.

Young Albert Camus is front-center dressed in black, as you may have assumed.

Stories are nice, and sometimes they sort of explain things. But just as basketballs have no corners, some questions have no answers. Basketballs do not require answers, or anything really. But they're fun to play with.

I think Lao Tzu is pretty cool.

The sage does not distinguish between himself and the world;
The needs of other people are as his own.

He is good to those who are good;
He is also good to those who are not good,
Thereby he is good.
He trusts those who are trustworthy;
He also trusts those who are not trustworthy,
Thereby he is trustworthy.

The sage lives in harmony with the world,
And his mind is the world's mind.
So he nurtures the worlds of others
As a mother does her children.

Verse 49 from the Tao Te Ching, entitled "People."

I am no sage.

But I am a nurse.

There may be reasons for that. It pays well considering it requires just two years of schooling. I only have to work three days a week. There's a shortage so as long as I am not negligent I'll always have a job. Other nurses tend to be very cool people.

And people are not just things. They require greater consideration than mere objects. They are not a means to an end.

Sunday, December 23, 2007

Hughes on Sunday

The Seven Sorrows

The first sorrow of autumn
Is the slow goodbye
Of the garden who stands so long in the evening-
A brown poppy head,
The stalk of a lily,
And still cannot go.

The second sorrow
Is the empty feet
Of a pheasant who hangs from a hook with his brothers.
The woodland of gold
Is folded in feathers
With its head in a bag.

And the third sorrow
Is the slow goodbye
Of the sun who has gathered the birds and who gathers
The minutes of evening,
The golden and holy
Ground of the picture.

The fourth sorrow
Is the pond gone black
Ruined and sunken the city of water-
The beetle's palace,
The catacombs
Of the dragonfly.

And the fifth sorrow
Is the slow goodbye
Of the woodland that quietly breaks up its camp.
One day it's gone.
It has only left litter-
Firewood, tentpoles.

And the sixth sorrow
Is the fox's sorrow
The joy of the huntsman, the joy of the hounds,
The hooves that pound
Till earth closes her ear
To the fox's prayer.

And the seventh sorrow
Is the slow goodbye
Of the face with its wrinkles that looks through the window
As the year packs up
Like a tatty fairground
That came for the children.

Ted Hughes

From the Autumn section of his 1976 collection Season Songs.

Saturday, December 22, 2007

Not Doing

In nursing, after a while on the job you don't really get to "practice" anymore. A certain level of perfection is expected in your work performance. Sure, you might miss an intravenous stick once in a while, but generally speaking everything you do has to be done just right the first time, every time.

It's not that big a deal if you just happen to be an obsessive-compulsive, triple-checking-everything, wash-your-hands-ninety-eight-times-a-day kind of person to begin with.

Maybe it's a little bit like driving a car. Even though it is a part of your everyday routine, you do it perfectly. Or else. You are past the learning curve. You don't get any do-overs.

This is the first etude in the Segovia collection of twenty guitar studies written by Fernando Sor. All guitarists meet these early on.

It's good to practice. Even etudes that I can play note-perfect are not "done," because there are other elements of musical study, like relaxing.

That's what scales are for. Not to play the notes nicely. That's just rudimentary. It's about settling the hands, letting the shoulders drop into position, breathing, listening, and drawing out phrases. It's about trying, not doing.

Friday, December 21, 2007

Stand Mixers

Sunday, December 16, 2007

Sunday Hughes Poetry

This poem is from Ted Hughes' 1970 collection Crow.

Apple Tragedy

So on the seventh day
The serpent rested,
God came up to him.
"I've invented a new game," he said.

The serpent stared in surprise
At this interloper.
But God said: "You see this apple?"
I squeeze it and look-cider."

The serpent had a good drink
And curled up into a question mark.
Adam drank and said: "Be my god."
Eve drank and opened her legs

And called to the cockeyed serpent
And gave him a wild time.
God ran and told Adam
Who in drunken rage tried to hang himself in the orchard.

The serpent tried to explain, crying "Stop"
But drink was splitting his syllable.
And Eve started screeching: "Rape! Rape!"
And stamping on his head.

Now whenever the snake appears she screeches
"Here it comes again! Help! O Help!"
Then Adam smashes a chair on his head,
And God says: "I am well pleased"

And everything goes to hell.

A man, a poet rather, whose two wives had died by suicide, the second taking their child with her; well, such a person might know something about hell.

Saturday, December 15, 2007


The house is chilly at five-thirty and the morning is still dark. The dough is rising. My spouse is out doing a peyote ritual or some such thing. They are like that. The pets are quiet and my child-unit is sleeping.

Though I do not have to work today, I am thinking about my job as a nurse.

Nefarious thoughts. I am probing the depths of evil. Instead of merely typing on a computer keyboard, if I could I would cut out berzerkowitz letters from magazines and paste them into this message.

A handful of terrorists could bring down all the hospitals in this sprawling city. It would cost nothing and involve no complex training. Institutional health-care delivery would cease almost instantly if medical centers were infiltrated by scrub-clad insurgents who simply took away all of the coffee-making machines.

This cannot happen.

Friday, December 14, 2007

Chair Rail

Wednesday, December 12, 2007

Yet Another Safety

Though I am old and have long been exposed to recordings of the Chaconne, I have never tried to play it. I have never held a copy of Segovia's notorious transcription in my over-washed nurse's hands. Of course I've heard it many times and I own more recordings of it than I can think of right now.

Hillary Hahn was a teenager when her debut recording of Bach was issued about a decade ago. Her performance of this magnificent work is the most clear-minded I've yet heard.

Rachel Podger is a British early-music specialist whose baroque-violin version gets a bit of play in these parts.

Rachel Barton-Pine is the baroque violinist whose sound is most likely to actualize what Bach himself may have heard... in his head. Though he was a keyboard virtuoso I sometimes doubt he had the violin chops to play the sonatas and partitias he wrote for violin solo. These pieces are way difficult.

But hey, Mozart was a keyboard genius whose father regretted that he was so, just because Wolfie was also such a good violinist. Bach may indeed have been a doubler. Like Illinois Jaquet, the jazz sax player who always renders "Around Midnight" on the bassoon.

John Holloway rounds out my little list of baroque enthusiasts who have taken up this wonderful piece of music.

I have pretty much ignored the guitarists' versions of this absolute masterpiece. I can honestly say I've never heard the Segovia version. However, I did once hear a live performance in a very small venue in which the lutenist Hopkinson Smith easily soared his way through the whole Partita in which the Chaconne serves as a gargantuan culmination.

I had worked that Sunday, then left the ICU at 1530 to catch the concert at an intimate venue, Bob Conant's little barn. I sat in the first row only a meter away from Smith. I heard his breathing. His fret squeaks. Not many of those. His technique was very clean. Most excellent. Actually, it scared me. Lute strings can be a bit squishy but his sound was much free of artifacts.

I have spent the past few years rebuilding my technique. My left hand is now quite traditional and archly correct. The angle of my right wrist is also approptiate but one can always use advice concerning the way the fingernails strike the strings.

Now I claim the Chaconne. It's my year for it.

Yes, there is the "Morimur" interpretation which considers Bach's knowledge of popular songs and relevant church melodies which he probably imbedded in his artifice. Personally I think Johann was into that. I'm on it like paint on a park bench.

I resolve to make my own grab.

I have always enjoyed difficulties. That led me to run Boston six times. It got me through music school and nursing school.



D Minor.



It is a mission of religious intensity. Just give it to me please.

Sometimes I'll be starting an IV, taking a phone order, or punching out meds from the Pyxis, and I will have the moto perpetuo minor-key section of the Chaconne running through my mind's ear. Or the repeated tonics in the major-key mid-section. Or just the opening bar itself.

That sound is full up in my ears and eyes. Sometimes I hear it unhinged from any particular instrument. Just an abstract sound. No violin, no Busoni or Segovia transcription. Just that form. As if it were a wonderfully amusing string of numbers or a joke involving some of your closest relatives.

Sunday, December 09, 2007

Plath, Sheep, Fog, Devonshire

Sheep in Fog

The hills step off into whiteness.
People or stars
Regard me sadly, I disappoint them.

The train leaves a line of breath.
O slow
Horse the colour of rust,

Hooves, dolorous bells -
All morning the
Morning has been blackening,

A flower left out.
My bones hold a stillness, the far
Fields melt my heart.

They threaten
To let me through to a heaven
Starless and fatherless, a dark water.

Sylvia Plath

These are the hills that Plath travelled when she was taking her riding lessons. She rode a lazy old horse named "Ariel." Slow and methodic, hesitant to even trot. But mindful of a nice view.

She would mount Ariel and ride sluggishly I am sure, given that horse's age and temperment, up the hill to possibly obtain the summit of the tor. Or maybe not. Tired old steed!

The tor is a metaphor. Back in her day, it would not have been assumed that a woman of even Plath's monumental talent could achieve success.

The sheep are probably very much like those that inspired the poem. They were photographed in Devon where Plath once lived.

Saturday, December 08, 2007

Nursing Story: Oh Don Piano (Homenaje a Borges)

We chatted a little as I did vital signs and my morning bedside assessment. He was telling me that he had no family and lived in an assisted-living arrangement, and added that he had a check coming and he planned to move into his own place in the south side of town.

He had been admitted with some kind of neurological thing but none was apparent now and the neuro team had cleared him. There were other little problems, though. He had been developing urinary incontinence issues and he had a history of obstruction; actually, he said that last spring he'd had a kidney removed because of obstructive disease.

The residents wanted me to do a post-residual catheterization and we got a liter-and-a-half of urine out of him so I left the Foley in and let the docs know.

Later he went for an ultrasound of his remaining kidney and urinary tract. He came back from that at the end of the shift as I was giving a report to the oncoming nurse. I settled him in and returned to the nursing station to continue reporting off after getting him a blanket because he said he was cold all over.

I went in to his room to say good-bye for the night and his eyes rolled up into his head and he didn't answer me. I went to get a vitals machine and brought the charge nurse and her orientee into the room. I had walked by the monitors and he was a little bradycardic but in sinus. They said they couldn't feel a pulse and we called the code.

Soon he was intubated and there were a thousand people in the room.

That's when he began to see himself as if from above his hospital bed.

Next he was on the sidewalk beside a man with a brick in his hand. The man muttered that he thought he was Satan, so Don Piano took him to Starbucks for a caramel macchiato and they talked. Eventually the man settled down and went home peacefully. He'd had a very bad day, apparently.

Don Piano then found himself on a school playground where he noticed that a little girl was crying about her cat who had been struck by a car and killed that morning. He sat with her through her classes all that day, then he went to the animal shelter with the girl and her parents and they found the most wonderful kitty... an adult long-haired mostly black cat who immediately took a liking to the girl. Don Piano paid the adoption fees and helped them get the pet to its new home.

One of the nursing assistants who had answered to the code started doing chest compressions because radial pulses were not evident, but the nurse running the defibrillator stopped him for a moment and said that he saw sinus rhythm. I got a pressure in the 120's over 70's. Respiratory continued to bag him.

Evening had fallen and Don Piano was down by the Arizona Center where he saw a man approaching strangers going to the movie theater, asking them for spare change. The man was dirty and reeked of alcohol. Don Piano spoke to him briefly, telling the man that he was never going to drink again. The man said that he could probably stay with his brother for the night, so he did. He went to meetings after that.

We moved him to Intensive Care and I went along because there was just no way the night-shift nurse could just jump into that; besides, another one of her patients was crashing. Another code was called for that one. Like the Keystone Cops, the team members scrambled back onto the unit and into the other room.

Don Piano was placed in an intensive care bed and while the team "lined him up" with a central venous catheter and an arterial line, I reported off, again, to another nurse who would take over from there. He had a rhythm and a pressure but he wasn't breathing on his own and he never woke up.

Outside the home of the man's brother a car sped by. It seemed to be going awfully fast. It spun around the next corner and ran through a red traffic light. Don Piano was in the passengers seat next to the driver. He admonished the young man to slow down and enjoy life.

There were other rowdy young men in the back seat of the car, and one of them chimed in "Yeah, man, why you act so crazy?" and they too told the driver to ease off.

The bleed in Don Piano's brain continued, his intracranial pressure increased and his blood pressure dropped. Vasopressors were discussed, scans were ordered, the neurology team came back on board, but it was too late. His heart rhythm decayed. The hospital chaplains consulted with the ethics committee and it was decided that he would continue life support.

Don Piano hovered over his limp body, then felt himself drawn into a warm darkness. The monitors ceased their blipping noises, the tell-tale flatline appeared, and before long, Don Piano realized that he no longer needed them.

Oh Don Piano.

Friday, December 07, 2007


Tuesday, December 04, 2007

Static and Pun

Many of the patients I work with are not primarily English speakers, and even then I suspect many of them are poorly educated. Growing up in a shack made of corrugated metal in a community that derives most of its income from methaphetamine production is hardly an enviroment that encourages going to college.

They come here where they can run a leaf-blower for eighty hours a week so that their children can at least finish highschool and perhaps open a restaurant or auto-repair shop. Then in turn their next generation might obtain a real advanced education.

You have to admire that. I certainly do.

Then again, a lot of our patients are just stupid assholes who drugged and bullied their way through their school years and then went on to street life or the presidency. Whatever.

Some fun statistics:

One-third of high school graduates never read another book for the rest of their lives. Many do not even graduate from high school.

58% of the US adult population never reads another book after high school.

42% of college graduates never read another book.

80% of US families did not buy or read a book last year.

70% of US adults have not been in a bookstore in the last five years.

57% of new books are not read to completion.

--Jerrold Jenkins.


Most readers do not get past page 18 in a book they have purchased.

--Bookselling This Week, November 10, 1997.

How about this literacy rate, eh?

1992: 20% of adults in the U.S. read at or below the fifth grade level.

--National Adult Literacy Survey reported in Publishers Weekly, January 6, 2003.

By listening carefully to the way people speak, sometimes you can tell that their language use is "unhinged" from the written word. Pronunciation, grammar, and general usage instead for them does not mentally link up to an underlying parallel "text."

Sometimes this presents as a jazzy and informed manner of talking, but more often than not it's an indication that the speaker is literally handicapped.

Sunday, December 02, 2007

Sunday Poetry: Hughes and Serpent


"No, the serpent did not
Seduce Eve to the apple.
All that's simply
Corruption of the facts.

Adam ate the apple.
Eve ate Adam.
The serpent ate Eve.
This is the dark intestine.

The serpent, meanwhile,
Sleeps his meal off in Paradise -
Smiling to hear
God's querulous calling."

Ted Hughes

Wodwo is a collection of stories, poems, and a radio play published in 1967. Hughes' wife Sylvia Plath had died in 1963 and he had been writing mostly childrens' literature in the intervening years; Wodwo was his first all-adult work since that tragedy.

The title word comes from old English and is translated as 'the green man,' 'faun,' 'wood goblin,' or some such. Hughes is said to have thought of himself as one sometimes.

Hughes had this to say by way of explanation in a 1976 presentation:

"I wrote a series of lectures for an ideal college, where the whole lecture course would last about half a page. So the whole university went into about twenty pages. This is the theology:" and then he went on to read the poem above.

He had no idea what was to soon happen in his life.

As for me, I have no quarrel with what the poem says. It seems rather obvious, actually.