Sunday, September 28, 2008

Sunday Poetry: Louise Gluck This Time

The Fear of Burial

In the empty field, in the morning,
the body waits to be claimed.
The spirit sits beside it, on a small rock--
nothing comes to give it form again.

Think of the body's loneliness.
At night pacing the sheared field,
its shadow buckled tightly around.
Such a long journey.

And already the remote, trembling lights of the village
not pausing for it as they scan the rows.
How far away they seem,
the wooden doors, the bread and milk
laid like weights on the table.

Louise Gluck

From 1980's Descending Figure, presently collected in The First Four Books of Poems.

Years ago I picked up a copy of Ararat and upon reading a few poems in it I immediately realized that I'd found a voice that I really liked; generally "disaffected or angry," but transforming and masterly. She was soon welcome in my little pantheon of favorites.

From her introduction to The First Four Books of Poems:

"I felt, even before I learned to read, that a book was a holy object; this awe perpetuates itself in each attempt to make, of a pile of poems, a speaking whole."

I recall that when I was little I had the same feelings, though then unschooled in music, about melodies.

The Next Day

She had a little fall at home. No major injuries, thank goodness, but an emergency department resident put a stitch on the back of her head to close up a small laceration. Overnight telemetry monitoring is typically ordered for an 82-year-old presenting after a syncopal episode.

Over many years in telemetry nursing I've seen this hundreds of times. Often, but not as frequently as it should, it indicates a critical change of direction for the patient's life journey.

The patient had come to the hospital by ambulance the previous day. Her husband, also in his ninth decade, had driven himself in. He got tired and wanted to go home but he couldn't remember where exactly he'd parked his car.

One of our hospital security people was helping out. The husband gave her a description of the vehicle (which turned out to be wrong) and the keys to the car. She couldn't find it, naturally, because she was looking for a white station wagon when in fact, as we later learned, he'd driven a tan Corolla. At nine at night they provided him with a cab voucher so he could get home.

The white station wagon was in their driveway.

The patient herself was slightly confused. She couldn't accurately state the day or date and she didn't know which hospital she was in. When I asked her "who's the President?" she winked at me and said "Well! Not that little chimp Bush! I think Dick Cheney has been pulling all the strings for years now."

So she wasn't totally disoriented.

She wanted to go home so badly. I disconnected her IV fluids so she could walk around freely and I got her a cane (she said she used one at home) from the physical therapy closet. I probably should not have done that. If she fell here in the hospital and fractured a hip or something then my ass would've been skewered like a baby pig on a stick.

She dressed herself in her own clothes. She looked wonderful. A very hip blouse, a stylish long fall-colored skirt, and blingy flats. I recognized that style, and when she told me where she got it we chatted clothes for a few moments.

Me, not so stylish. Cool, but retro-geek.

Later another nurse came along with the husband, who had been wandering aimlessly in the hospital lobby area. He was so glad to see his wife. They kissed. The nurse, Lacey, pulled me aside and expressed her concerns about him. He'd forgotten where he'd parked his car again and he was lost in the hospital. By this time it was eleven in the morning and he'd apparently arrived hours earlier.

He was just as cognitively loose as his wife. But impeccably dressed, I must say, with a really nice tie. Picture Tim Gunn in short sleeves.

"That tie must've set you back fifty bucks," I said.

He replied that his wife had bought it for him. "More like double that!" he said with words salted in love and and long-held appreciation for his equally snazzy mate.

There seemed to be no medical reason to keep her any longer in hospital so the residents wrote discharge orders. Their daughter Carol, who lived in another state, called me and explained that such events happen monthly.

"This is just this just the crisis of the week," she said, "I want them to sell their house, which is way too big for them anyways, and come live near me in Denver. There's this beautiful assisted-living place a mile from me that's like a resort. They'd have their own apartment and all their things with them. But they're so stubborn."

That story. I've heard it a thousand times.

The patient's very nice and appropriately concerned nephew called me too. He lives here in The Valley. He and his wife were very close to the patient and her husband, checking in on them daily. He came by later to take them home. After all, they couldn't find their cars and it was getting late.

The patient just wanted to hop in her car and drive home. Same for the husband.

David, the nephew who obviously loved the genteel old couple very much, chimed in: "Well, it's getting late. Why don't I just take the both of home in my car. Maybe we could stop off someplace and get a late snack. There's that new Paradise Bakery at the Biltmore." They liked that idea. So did I.

In his caring eyes I saw the plan unfolding. He hated to do it, but it had to be done.

I looked at him. He looked at me. I sighed deeply. He gave a little shrug.

After they all left I called our security office and gave them the descriptions and tag numbers for the two cars. These would be on hospital property for a day or two or so... maybe even longer. They said they didn't mind. They probably know the story, too.

One day you're independent. When you run out of half-and-half for your morning coffee, you just drive out to the store. You pick up a few other things while you're there. And then the next day you never drive again.

Saturday, September 27, 2008

See The Difference

There's happy:

And then there's happily married:

Not the same.

Friday, September 26, 2008

Tea Set

Monday, September 22, 2008

Seven-Hundred-Billion-and-One Reasons Why I Am Going Crazy

A woman driving an old Jeep Cherokee flagged me down as I drove into the grocery store parking lot.

"Excuse me, but could you help us?" she asked and I already knew. She must have been the grandmother. There were three school-age girls in the car with her and a woman who was likely the mother of the young ones.

"We've been living in our car," said the grandmother, "And we need help getting someting to eat."

I gave what I could. I had less than thirty dollars in cash on me. It's almost all on the debit card these days. They were very thankful. The girls smiled and waved good-bye.

Then there's this:

Sec. 8. Review.

Decisions by the Secretary pursuant to the authority of this Act are non-reviewable and committed to agency discretion, and may not be reviewed by any court of law or any administrative agency.

Guillotines are actually very efficient. Did you know that they only have one moving part?

Sunday, September 21, 2008

A Night at the Opera You Are Powerless to Stop

After you've been doing this for a while you can generally see most of them coming from a couple-few miles off. Codes, I mean. But once every so often you walk in on a surprise. Half a year ago we had two at the same time on the our unit. At the change of shift. Naturally.

That poor oncoming nurse! Both rooms were hers. I was at one of them, and I don't think we ever lost a rhythm from what I could see. The patient wasn't exactly sitting up and chatting with us about the Diamondbacks and they had a femoral pulse, but what do I know? Somebody said they didn't, and the next thing I saw was a nursing assistant beginning compressions and then I heard ribs cracking.

Some events take on a momentum of their own. I probably would have just checked a blood-pressure again...

The oncoming nurse ran in panicked-looking, saw me handing a Yankauer to the respiratory therapist (who suctioned up the blood) and I told her we had this one so she could go to the other room. That other one died. Bad GI bleed. Just admitted. Probably should have gone to MICU straight from the ED. Ours woke up and went to CICU. Although when we were done with them they probably should have gone to Trauma.

I did mention my thoughts, both during and after the code. I guess I could have shouted at the top of my lungs, but there's still the possibility that nobody would have heard me over the general commotion.

Later I talked to my boss about it. "Maybe we could have gotten by without breaking ribs and blood spurting out their nose with each compression, " I suggested.

"Yeah, maybe," she said.

Friday, September 19, 2008

Comfy Chairs

Republican Dictionary

"Capitalism" means flushing billions of dollars down the drains of failing corporations and allowing the perpetrators to walk away with their golden parachutes.

"Cutting spending" means trimming millions of dollars from the budgets of schools and hospitals while blowing billions on war.

"Energy independence" means $5-per-gallon gasoline. Soon to be $10-per-gallon.

"Freedom" means keeping big government off your back, unless you're gay. Or pregnant.

"Representative democracy" means vote-caging, scrubbed voter-registration lists, and rigged ballot-counting machines.

"Fairness" means the rich get it all and you get crumbs from their table.

"Government of the people, by the people, for the people" means that Republicans get to take as much money as they want and give it to their rich friends and supporters.

But "change" means we can do better than this.

Actually, that last bit must have come from a different dictionary. Pardonnez-moi.

Tuesday, September 16, 2008

Average High

Sheriff Joe's "Tent City."

The average high daily temperature this time of year here is a degree or so under one-hundred. Imagine yourself in a situation like the one in the photo, but in August when it's a hundred-fifteen day after day after day.

But you did something really bad and you deserve to suffer, right? Like maybe you got caught with a seed in your pocket. Or two seeds, in which case that would make you a dealer.

Sunday, September 14, 2008

More Interesting Than the Characters in His Novels

I don't read much fiction. I get enough of that just from watching the news. But when I do sink my teeth into a novel, I like the gritty realism and ultra-noir subject matter of the Burke novels by writer-lawyer Andrew Vachss.

"Burke" is an off-the-grid fixer who works on the dark side of law and society, with an unwavering hatred of child abuse and the monsters responsible for it. Much like Vachss himself, whose law practice works with children exclusively.

So if you're in the mood for a good read, toss some coin at Vachss. Your money will go to a noble cause and you'll be sure to enjoy the wild ride into the zero with Burke and his family.

Friday, September 12, 2008

Sunday, September 07, 2008

Disraeli Nursing Gears

"Shrimpy shrimpy shrimpy! I think I need some help!" said Mona as she raced down the hall towards me at the nurses' station.

Actually I don't call it "the nurses' station" anymore. It's the "EBTN station," for "everybody but the nurses," because even if we weren't all in either the patients' rooms, or the medication room, the supply room, the other supply room, the linen room, the other other supply room, or just roaming in the hallways with bursting bladders and empty stomaches looking for anybody, just anybody, to help us pull up in bed that very large lady with the chest tubes; well, even then all the computer stations at the EBTN station would be occupied by residents, attending doctors, nurse practitioners, dieticians, therapists, and that woman who looks like Grace Slick and nobody knows what her job is.

"What's up, Moaner?" I asked. We all call her that. She's not a complainer and she doesn't really moan or anything; at least, not that we know of. One of the other nurses picks on her a little, and it just stuck. She used to mind, but now she's used to it.

"There's a visitor in room 6 and she's having labor pains."

Right, I thought, and I'm Queen Elizabeth. Pleased to meet you.

The floor secretary had answered the room's call light, and she was telling me that "they said she's having contractions."

"She can't do that," I said sarcastically, "This is a tele floor."

I took a deep breath and went down the hall. I expected Moaner to follow me, but she didn't. I guessed she figured she was done with that now that she'd told me. The woman was sitting on the couch in the patient's room, holding her belly and *moaning* in pain. She said that she was six months pregnant and that at four months she had some vaginal bleeding.

"They said I had a ruptured placenta," she told me.

"Bedrest?" I asked.

"For two weeks," she said.

The little word-balloon over my head was filled with those cartoon %#$@(*& thingies.

Mona came in. She had stopped to get some IV insertion stuff for the patient and had not gotten sidetracked. I called the secretary. She had already called transportation. The woman was in some distress but she was holding herself together really well, all things considered, and she wasn't bleeding.

I said to the woman "Well, I'll go boil water and tear up sheets," and she laughed a little, "And you just stay right here until we can get you to the right people. Don't go running out for coffee just yet."

I called the house manager to let her know what was going on. Then I gave trauma-maternity a call and the nurse I spoke with there was very nice about it all. She said to bring her down and they'd see her right away.

The transportation director herself brought up a stretcher and settled the woman in for her ride to trauma-maternity. The patient got a new IV site and Mona assured her that if we got word of anything from the nurses downstairs we'd let her know.

Later on when the shift was almost over and we were at the EBTN station charting, Mona said "And you know what? They're a lesbian couple."

"Who?" asked Rayanne, who was busy with other things when this all went down earlier, and then she asked "How?!"

Winnie said "Well, I can think of a couple of different ways."

"Don't you dare say it out loud!" said our secretary Gina, but it was too late and next thing you know we're discussing different ways of cooking turkey.

"I hope she's all right" said Mona, and we all chimed in on that. Our boss called maternity-trauma and found out that at that time it didn't look like they were going to admit the woman. Good news, that.

It wasn't going to happen.

"Strange brew, kill what's inside of you."

Brother Can You Spare a Clue

A transcript of John McCain's acceptence speech can be found here.

He starts is right off with a big fat myth-making lie:

In my life, no success has come without a good fight, and this nomination wasn't any different.

The only reason his sorry plane-crashing ass wasn't kicked into a Navy brig was because his father and grandfather were admirals. That's also the only reason he even finished at the Naval Academy, graduating fifth from the bottom. By the way, whatever happened to those other four guys who finished below him? Are they senators, too?

As always, I'm indebted to my wife, Cindy...

Yes, we know. Speaking of indebtedness, how about your old sponsor Charles Keating? He should get a mention, no?

I'm not in the habit of breaking promises to my country and neither is Gov. Palin.

Well, that's obviously another lie. McCain recently broke his promise to abide by election-spending laws when he reneged on his agreement regarding use of public campaign funds. And Palin ran for mayor as a fiscal conservative, then ran up $22 million in debt for her little town of 6,000 people. Promises mean nothing to these people, at least not for you and me, because we don't represent giant oil, banking, and development interests.

I've fought lobbyists...

McCain's campaign co-chair is a lobbyist. McCain's senior policy adviser is a lobbyist. Campaign spokesman Charlie Black is a lobbyist, as is Mike Dennehy, a McCain senior campaign advisor. McCain's campaign is run by lobbyists.

We believe in low taxes, spending discipline and open markets.

Well, NO. He believes in shifting the tax burden from the very rich to everyone else, borrowing money up the Chinese wazoo, and no-bid government contracts for war-profiteers.

We believe in a strong defense, work, faith, service, a culture of life, personal responsibility, the rule of law, and judges who dispense justice impartially and don't legislate from the bench.

He just means that he hates "teh" gays, etcetera. It's red-meat blather that the brain-dead religious-right likes to hear. He says these things because he knows they'll open their wallets upon hearing this nonsense.

We have dealt a serious blow to al-Qaida in recent years.

How?! By increasing their recruitment? By leaving Saudi Arabia and bogging ourselves down in a senseless middle-eastern war, as Bin Laden demanded of us in his 1998 fatwa? Some blow.

Then he goes on and on in non-specific and grandiose verbiage about how he's going to do this and that and Obama isn't. Then he reminds us that he was a prisoner-of-war. Like we could ever forget that. It's all he's got, really. Then he says "fight" a lot. The end.

Then the Democratic base donates a few million bucks to Obama/Biden, on top of the eight million they gave after the Palin speech.

Saturday, September 06, 2008

Springtime for Palin

Sarah campaigned in Wasilla as a “fiscal conservative”. During her six years as Mayor, she increased general government expenditures by over 33%. During those same 6 years the amount of taxes collected by the City increased by 38%. This was during a period of low inflation (1996-2002). She reduced progressive property taxes and increased a regressive sales tax which taxed even food. The tax cuts that she promoted benefited large corporate property owners way more than they benefited residents.

The huge increases in tax revenues during her mayoral administration weren’t enough to fund everything on her wish list though, borrowed money was needed, too. She inherited a city with zero debt, but left it with indebtedness of over $22 million. What did Mayor Palin encourage the voters to borrow money for? Was it the infrastructure that she said she supported? The sewage treatment plant that the city lacked? or a new library? No. $1m for a park. $15m-plus for construction of a multi-use sports complex which she rushed through to build on a piece of property that the City didn’t even have clear title to, that was still in litigation 7 yrs later–to the delight of the lawyers involved! The sports complex itself is a nice addition to the community but a huge money pit, not the profit-generator she claimed it would be. She also supported bonds for $5.5m for road projects that could have been done in 5-7 yrs without any borrowing.

I first came across this, written by Anne Kilkenny in The LA Progressive. Kilkenney is a real person and it's been verified that she actually wrote this and sent it to about forty people on her e-mail list, then it rose to national attention.

A long time ago I read about then-governor George W. Bush in The Bush Files put out by the wonderful Texas Observer. His character flaws, policy muffs. and total disregard for fiscal responsibility were things that I tried, in my own small way, to warn people about.

Now some of us are trying to issue warnings about Palin. Her story is an unsavory one. But then, modern American politics is divorced from reality, and Republicans are very good at spinning lies and fantasies into support for their new fascism.

I fear that the same folks who brought us Dubya will now give us McPalin. They will not be happy until they make all of America look like a poor neighborhood in Cuba or Bangladesh. But with flat-screen televisions everywhere touting Fox News.

Even then they will remain unsatisfied. Everything must be ruined. It's their religion, really. A crazy belief that after ultimate ruination, everything will get better.

It didn't, did it?

Friday, September 05, 2008

Alarm Systems

Tuesday, September 02, 2008

Cue Ringing

I posted this thought over at The Crack Den in a comment thread that was going on while Joementum was at bat. I thought of this myself, but if someone else should have had the idea somewhat contemporaneously; well then, that would be odd.


I hear things sometimes.

Like this one time years ago the person I had been seeing romantically said that they thought we "should try dating other people" and I thought I heard them say "sell my VCR and keep the money."


What if Levi is in Minnesota because it's been arranged for him to go down on bended knee before Bristol, present her with a ring, and ask her to marry him?

In front of the whole congregation. On TV.

The family welcomes him into their arms. The crowd roars. Balloons drop from the ceiling.

I should get paid to think up this stuff.

This Is Better Than the First One, Even, and It Removes All Doubt

The ice bridge is a difficult subject for me to think about, too.

Governor Sarah Palin Vlog #1

My new most favorite politician, ever. In the history of the world.

So True

One picture is worth a thousand words.

Or billions of dollars. Whatever.

Hat tip.