Teabaggers Are Not Racist.

A white separatist has caused outrage by building a 10-foot-tall Ku Klux Klan snowman in his Idaho yard.
The pointed-hood wearing, noose-holding, dark-eyed sculpture sat in front of Mark Eliseuson's Hayden home, just down the street from a local elementary school.

The Daily Mail story is here.

It features a photograph of the artist. Sigh. Once again, as a First Amendment fan, I find myself defending shit. Oh well.

Just remember, Teabaggers Aren't Racist. Tell all your friends.

A Squadron of Pelicans

We were all chatting about our children. Many of us have kids who are coming-of-age, and it seems that this brings about differences in them. Newly adolescent girls, for example, we noted to have become moody and verbally aggressive at times. Terms like "total bitch on wheels" and "such a nasty little fucker" were heard among us parents.

Why would this be the case? Why would girls who are reaching reproductive age develop personality traits that might drive others away from them? This seems like a rather poor evolutionary strategy, unless it is meant to keep others away from these girls until they are older.

*

I was told that dogs are colorblind. Then why do dogs come in such a variety of colors? As it turns out, they are not completely colorblind at all.

*



Violinist Janine Jansen. Her recent recording of the Beethoven concerto is the one I consider to be the best in my collection. She also has out a recording of the Bach two-part-inventions and sinfonias played chamber-music style with other string players, and that's a lot of fun.

*

The Black Sea used to be a freshwater lake. It was much smaller and its surface then was probably over four hundred feet lower than it is now. Sometime over 7,000 years ago the Bosporus was breached and the Black Sea was quickly inundated with Mediterranean seawater. This is the origin of the flood myths familiar to us from Genesis and the Gilgamesh epic.

*

If you have a friend or relative in the hospital and you wish to call to inquire about their condition, their nurse will not be able to provide you with any information unless the patient has authorized this. Even then, since identification is practically impossible just over the phone, such authorization doesn't really extend to phone calls. The nurse cannot legally admit that the patient is even there. This is federal law.

It's also a big waste of my precious time. Time which I would rather spend on patient care, not explaining to callers that I cannot tell them anything.

I might be patiently trying to thread a small-bore intravenous catheter into a wiggly little rubbery vein in a sweet little old lady's arm when the phone rings and a caller, without identifying themselves of course, demands information on another of my patients. I hate that.

Phone rings, I answer. "Why yes Mr. MethMouth, your Aunt Zelda is here. She just got out of surgery and though doing well she's probably going to be in the hospital for several days, so feel free to burglerize her home and jack her car. She won't be home to notice."

A Knob of Widgeons

There's a scene around the kitchen table in one of the Godfather movies, probably the second one. They are discussing Vietnam. Micheal reveals that he has signed up for the Marines, after one of his brothers, I think it was Sonny, derided enlistees as saps.

So why did Michael join? It is never explained in the movie. Perhaps it was because he was a psychopath and he wanted to hone his skills.

*

I keep my laptop computer screen scrupulously clean. Yet I often find that someone has left grimy fingerprints and such on it. I will get a fingerprint-identification kit and find out exactly who has been doing this. Then I will confront them. I will derate them for their slovenliness. I will give them very harsh looks.

*

"You can lead a horse to water, but you cannot force them to take their Levaquin."

*

When did such things begin, these new American norms? Was it with the infamous photograph of the naked Vietnamese girl running away from the napalm? Was it when Reagan sold armaments and spare parts to our Iranian foes in order to fund the Contras? Or was it much further back, with the Tuskegee syphilis experiments?

Waterboarding is acceptable now. Pundits openly call for the summary execution of flood victims who have been forced to loot stores to get bread to survive. Material witnesses are detained without charges forever. We bomb weddings.

It was always this way, wasn't it? This is how we are. We are not guided by words on paper. We do not read.

*

The Union troops could plainly see the mortally wounded Confederate soldier that lay in the field between the opposing forces. They watched as he loaded his rifle, put it to his chin, then fired.



What was the Civil War all about? I do not know. Power, I suppose, like all things. Like the abortion debate. Like tax cuts for billionaires. Like Marshall guitar amplifiers. Like poetry.

Stilts

Glenn Gould
Anna-Sophie Mutter
Catrin Finch
Eroica Trio
Jan Cizmar

A Flight of Comorants

It is not unthinkable to propose that any given person's, say for example, musical talent, lies along a gradient. Some people are naturally very good musicians, Mozart probably being the best example of one born with supreme innate musical ability. Similarly, some people are good ball players and some people are not.

I would consider that the ability to change your mind also lies along a spectrum. At the upper end of such a scale there are people who change their minds quite easily as new evidence presents itself. Scientists do this. And at the other end of the scale there are people who cannot change their minds at all.

Such people may even be able to hold two contradictory ideas at once in their heads; even their own beliefs will not persuade them to change their thinking. We all know such people. We see them on television all the time. Often we put these people in positions of leadership in political or religious matters.

*

Your fellow citizens do not all like you. Sorry. Some of them would slit your throat for fifty bucks; others might do so just for kicks. They do not care that your children receive access to education. They would ship your job overseas to pay a third-world laborer mere pennies if they could. Many already have. Of course there are some nice people. Like nurses, who generally are a supportive and social lot. But aren't they the exception?

We seem to villify and hate one another. What's the point of even having a country if we are all behaving like self-centered greedy little monads? The very idea of having a country for such people seems ridiculous. I have to wonder if "countries" even present our species with evolutionary disadvantages. All the better for us to kill one another off.

*

Consider this news:

"A 9-year-old boy was flown to a hospital after he was found lying unconscious in a street in Gilbert Sunday afternoon.

[snip]

It was unclear whether the other occupants of the car knew the boy had fallen out or if they had left the scene."

*

Cross Bayou Elementary School is just down the street from the hospice that treated Terri Schiavo back when that was all over the news. A man called the school one day during the protests and said that he was going to hold the entire school hostage and kill a young student every ten minutes unless feedings were resumed for Schiavo.

School officials just couldn't take anymore and over that weekend they abandoned Cross Bayou Elementary.

Things are back to normal there now.

*



Hilary Hahn's new recording of the Higdon concerto, which was written for her, coupled with the Tchaikovsky. Talk about talent. This music is a treasure. I'm especially fond of the Higdon. If you knew me, you would already know that.

*

We had brunch yesterday at St. Francis. It was excellent. Outside and down a few seats from us a hipster and a young woman were getting to know one another. "I feel sorry for people," I said to my spouse, "Because they have to get to know one another. It's so much easier with a person when you already know them." The orange juice was freshly-squeezed.

*

Nursing stuff:

We were in the car waiting at the corner of 19th Avenue to turn onto Camelback. A woman staggered through the crosswalk in front of us. She looked to be about fifty, or maybe thirty-five-going-on-fifty-five. Her blue eyes stared blankly ahead. "What's she on?" my spouse asked me. "Probably just alcohol," I replied.

When a staggering middle-aged alcoholic woman looks at the sea, how does she look at it and what does she see? Is the ocean a repository of memories for her? Does she, like Citizen Cane, see Rosebud? or does she see herself merely drowning?

"How do you look at the sea" is the question I silently ask of the patients I work with.

*



Girls surfing in Gaza.

“What do you wear when you swim in America?” she asks. I hesitate before replying, “Not much.”

Rawand nods sagely. “When you surf in America, do people stare at you?”

“No,” I answer.

“They do here,” she sighs.

Surfing in Gaza. That is so cool. It might just save the world.

A Chattering of Starlings

The Greek hoplites, ountnumbered at least 20,000 to 10,000 at Marathon, had to attack the Persians early in the day. They were basically done slaughtering them by about 9 a.m. which gave them time to run 25 miles back to Athens to protect it from invading Persian ships. The famous "marathon run" was not made by Phedipides. Instead, the Greek army made the run. Phedipedes did however run from Athens to Sparta, about 140 miles, to implore them for help. That, amazingly, took him about a day-and-a-half one-way. The Spartans, being sticklers for religious observation, said they'd come help fight when the moon was right. 6,400 Persians will killed at Marathon, while the wildly outnumbered Greeks lost 192 men and their allies the Plataeans lost 11.

Knowledge is constantly subject to revision. Belief, not so much.

Everyone must drink their own tea. But the cat you pet belongs to no one.

Twenty-six out of the approximately 8,600 species of birds use tools. Even then only a few individual birds have been observed to do so. Good for them.

The Greeks made a thorough counting of Persian bodies on the Marathon plains because they had promised the goddess Athena that they would sacrifice a goat for every enemy soldier killed. 6,400 was way too many, so they made arrangements to offer the goats on an installment plan of 500 per year. That's still a lot of goats.

A Trip of Dotterel

When I am inserting a peripheral venous catheter into someone's vein, I am doing nothing. When I am in love I am doing nothing. When I am picking up groceries I am doing nothing. This is how I survive. By doing as little as possible.

The ancient Persians carried large wicker shields that protected them from arrows and spears. They would march their line to within about one-hundred meters of the opposing army and set up their shields like a wall. From behind this they would take to their bows and darken the sky with arrows. After this initial attack, the cavalry would ride in among the enemy and do battle with those who had not been killed or injured by the archers. Meanwhile the foot-soldiers would again attack but now with their spears and swords. They were usually successful.

We are repeating a more recent past.

It looked like asystole to me. I was assigned to the defibrillator so I figured the doctor would call it done and I could leave and get on to other things. "It could be fine v-fib," he said and he asked me to shock the patient again. We all looked at each other. "Clear?" I said, and then I pressed the button for 360 joules. The husband of the patient was standing in the corner of the room. Nobody was explaining anything to him. I could see that he was on the verge of tears.



Rachel Podger is my favorite Vivaldi player and her solo Bach is great, too. She specializes in Baroque violin, but I'd really like to hear her do the Beethoven concerto someday.

An omniscient and omnipotent deity would know what he was going to do next. Indeed, he would have to do what he was going to do next, and he'd know it. He would be like Sisyphus.

It pleases me that dogs dream.

White Roof Walk Us

We live smack in the middle, geometrically, of Phoenix.


View Larger Map

As you move east from Central Avenue, every fourth street is zoned for retail. 12th has the car wash, a nice restaurant, a convenience store, a liquor shop, and a coin laundromat. One of the bays of the do-it-yourself carwash has been fenced and converted into a "dogwash." Shrimpbowl and friends can always make a few bucks by sudsing up the dogz.

Atrios came to our house and in the interests of energy reflection painted the roof white.

16th street has several gourmet restaurants as well as fast food. There's a running store, an electronics trade and repair place, a couple coffee shops including a drive-through Starbucks, an excellent butcher shop, a Japanese bakery, and many other delights. The Italian grocer and the Polish bakery are also nice to have around.

The next major corner north (a few streets up and about a ten-minute walk from home) has a large local chain grocer and a drugstore that mostly sells wines and spirits; I assume that because half the store is occupied by such. You can eat sushi while the woman at the dry-cleaners fixes buttons missing from clothing you dropped off to be mended there.

The other way down 16th leads to the corner with the school and Senator McCain's office, outside which is encamped a group in support of the Dream Act.

I like the idea of universal education. It should be free or at least easily affordable to all who work to pursue it to any level they wish. What would result? Would we end up a nation with bus-drivers who held doctorate degrees?

Who's to say.

I am convinced of one thing though: education makes us better.

Us.

That's another thing that education can make us.

The Cat in Catholic

This is an image from the most wonderful and ancient Book of Kells, which is probably about a thousand years old. It appears to show a mouse gnawing on a communion wafer. Hence the importance of church cats.

A Dole of Doves

Sisyphus did not push the boulder up the hill over and over. He did not have reconciliatory thoughts as he padded his way down the slope. Sisyphus did not suffer endless monotonous back-breaking toil.

Because he did not exist.

You, however, do.

I am making a sauce. I will not put too many things in it.

Dogs, generally speaking having four legs, love to walk. They jump and skitter about when we go for their leashes. Not so the cats.

What does it mean, really, to finish? I am not trying to be obtuse. I just do not understand the term.

Sam Phillips

Baby I Can't Please You




Songs like these are just too good.

Hopefully, not too good for you.

Search for them.

A Wisp of Snipe

A cat may look at a king. A particularly human-like cat may look at a mouse and think it a king.

I heard it explained this way: The singer was offering praises to his woman in long melismatic and rhythmically flexible melodic lines. The guitars and drums were percolating away. People danced. But the talking drum, that was literally another story, for it was saying to the singer's woman that the singer had been sleeping with her sister.

The criminalist dusted the crime scene and obtained fingerprint specimens. He then ran these through the computer system that catalogues the prints of other individuals. He finds that there is a match. The prints are those of god. However, fingerprints that match those of Mozart are also found on the scene, making certain conclusions impossible.

The warm desert air is perfect for drying clothes, and the smell of sheets dried out-of-doors is just wonderful. Jeans are stiff when you pull them down off the line but then they soften and cleave to your legs when you put them on.

How many times have you genuinely looked as hard as you could, yet you just couldn't see it? You may have nodded in agreement anyways. You wanted to remain friends. In fact, you are quite the "friendster."

Fiordiligi and Dorabella think they are going to marry Albanians! What a joke. Cosi fan Tutte.

For Eve Who Found the Grace to Fall From Adam (MacLeish)

She was found down somewhere out on the edges. Parts of this megalopolis abut reservation. The highway divides the sprawl from the wispy and scrawny rural fields and widely-separated dilapidated shacks.

They beat her up pretty good. She had a cervical collar on until Neuro-Surg cleared her. Lacerations above the eye and it was swollen shut. I cleansed that area very gently and put some anti-bacterial ointment on it. Nurse K. from the night shift told me that she had pushed a little harder and she could feel the pulpy fragmented orbital bones just beneath the rough laceration.

She reeked of alcohol. Nurse K. couldn't get a history from her. I had better luck during the day as she woke up a little bit. Thinking that she was an alcoholic, the docs had me scoring her for withdrawal. I didn't really see any evidence of that.

She said she had been homeless for two months because her boyfriend stole her truck and kicked her out. She also said that she ran out of her medications, listing Tegretol, Seroquel (which she spelled for me on a scrap of paper,) and Haldol. She took them "to help stop the voices." She had a job at an auto-upholstery shop on the south side. She also said that she only drank occasionally, although to excess, again to "stop the voices."

Don't we all.

Trauma and Plastics were on her case, and we added Neuro, Psych, and a Medicalist to help. Good. The more the better.

The Plastics surgeon did a great job on her but it left her looking rather strange. He shaved the front portion of her hair to expose the scalp, then cut from ear-to-ear over the top of her head. That way he could peel her forehead skin down to work on her crushed-up orbital bones underneath. When her hair grows back she will appear as if nothing had happened to her.

Initially she came out with a mummy-wrap dressing around her head. Yes, we get this stuff all the time on our thoracic telemetry unit. When the Plastics doctor came by the next day he removed the dressing and wrote orders to just put ointment on the staple line. She also had a bulb drain sticking out of the right side of her head. A fourteen-inch tube about an eighth of an inch in diameter, leading to a grenade-sized clear-plastic bulb which, when compressed, applied a little suction to the line and drew bloody drainage from her head to reduce swelling. It fit into the pocket of her hospital gown.

"Well," said the Plastics guy, "I'm all done and she can go home. Just have her see me on Friday."

She doesn't have a home.

She doesn't have her medications.

Fucking A she didn't even have any clothes.

I had asked her about that. She had no family to call, and the nearest thing she had to a home was the downtown shelter. Being a schizophrenic, she had varying unsubstantial stories about how she obtained her medications. She told me she got them from "somebody."

I did not want to discharge her to a shelter with a fucking drain sticking out of her head and a row of coronal staples openly exposed, though she promised me that "would not let any germs get in there."

I desperately called the medicalist and since it was getting late anyways, Case Management wouldn't have time to help us arrange things for her discharge.

"Don't hurry," the patient said to me.

The thing aboiut being a hospital nurse is that you never have the time to hurry.

We finagled her another night in the hospital despite that all the teams had already signed off on her. She kept thanking me.

It's one thing if it were you or me. We could sit home and watch Law & Order reruns and take quite good care of our drains and incisions ourselves. But this was a schizophrenic under-medicated street person with no family ties. Imagine if you were walking down the street and you saw this woman coming at you from other way with a drain sticking out of her head.

Imagine what you might say to her.

Hello.

Having a nice day?

A Dray of Squirrels

The dog chewed my eyeglasses. This is not the first time that such a thing has happened. I have tried to explain to the dog that eyeglasses have no nutritional value.

Similarly I have tried to explain Social Security insurance to libertarians, with as much success.

Mud and adulthood.

"I am not much for forgiveness," I said to my spouse.
They were little concerned, but asked "Is there anything I have done for which you have yet to forgive me?"
"Yes," I said. "Once fifteen years ago you stepped on my foot and you never apologized for it."
"Well, I'm sorry now," they said.
"You should be," I replied.

The phone rang and I actually picked up the receiver because I knew the person calling and it was for my spouse so I would not be obliged to talk for very long. At the end of our brief exchange I said "I'll see you later, Cort," and I realized then that yes, I probably would be seeing her later but she will be all fuzzy because I do not have my eyeglasses.

Last week we travelled to New York and I met with someone I used to love very deeply. It was nice. I will never forget it.

We also heard Garrick Ohlsson play the Rachmaninoff 3rd Piano Concerto with the Philadelphia Orchestra. He made it look easy, which of course it isn't. Rachmaninoff himself said he "wrote it for elephants." A week previously we saw "The Magic Flute" performed in Santa Fe. It's been a good month. Except for eyeglasses.

The patient had been with us for a very long time, many months. He had been plagued by chronic diarrhea and for a while we had been using rectal tubes. With much patience on our part, the nursing staff, and much work from him, yesterday we assisted him to sit on the commode to pass stool. He did not have any episodes of fecal incontinence in bed nor chair. For the entire day. "Mr. D., you're continent now!" I told him. He cried a little and said, "Yes, you helped me get some of my manhood back." That was really cool. I congratulated him for his hard work and I asked him to pat himself on the back for that.

A Rafter of Turkeys

I am on trial for my life. The courtroom is packed with onlookers and members of the media. From behind the desk at which I am seated with my lawyers, I look over at the jury box. The jurors are all dogs. I like dogs, and dogs like me.

I look forward to the day when Leonardo DiCaprio and John Cusack make a movie together.

I am a hospital nurse but due to the specialty nature of the unit I work on, I cannot much discuss some of the things that we do. Just the occasional interesting tidbit. For example, I recently had a patient who had been suffering from diarrhea. For months. The routine tests for such things as clostridium difficile were negative, but we kept sending the tests anyways. We switched around his tube feedings. We stopped these for awhile. Nothing seems to work. He did not have surgery on his digestive tract. I remain puzzled, but a devoted and attendant nurse. Lots of gentle cleansing and protective ointments for his raw skin areas. The patient has become really depressed, but I never give up.

In the wild, cats (Felis catus) do not "meow." They only do this in the realm of humans. Conversely, when I am in the wild I often struggle with the desire to meow and make gutteral hissing noises at birds and small woodland creatures. Which reminds me, today I have to refill the birdfeeder.

Tycho Brahe computed the procession of equinoxes as 51 seconds of arc per year. He didn't have a telescope because they hadn't been invented yet. The modern value is accepted as 50.23 seconds of arc. Not bad for a guy who lost the bridge of his nose in a duel. He wore a silver and gold fake.

Lemonade

So this knucklehead is driving around with his family and they happen upon some kids selling lemonade. Well, actually they were not selling it. It was a very hot day so they were giving it away. So what does Mr. Knucklehead do? He gives them a lecture on free-market ideology.

That really set me off, as my regular readers can imagine.

"No!" I exclaimed from the back seat. "That's not the spirit of giving. You can only really give when you give something you own. They're giving away their parents' things -- the lemonade, cups, candy. It's not theirs to give."

Yes. He has regular readers. Ones who have bowel movements on a routine schedule. They read him here. God in heaven I so hated providing that link.

No wonder America is getting it all wrong when it comes to government, and taxes, and policy. We all act as if the "lemonade" or benefits we're "giving away" is free.

He says.

I call a straw-man argument. Nobody thinks this stuff is free. We all know the costs. This information is everywhere.

The cost of war. Over $1 trillion dollars and growing daily, and so far we've gotten absolutely nothing out of it except a few thousand dead and ruined soldiers.

Chump change, though. Remember the bank bailouts? You have to google that, because your average journalist has the attention span of a heroin-addicted housefly so there's no headlining that today. How does $4 trillion sound to you? Good? Free? Not free?

But of course Mr. Knucklehead doesn't mention those things. No.

And so the voters demand more -- more subsidies for mortgages, more bailouts, more loan modification and longer periods of unemployment benefits.

The real problem with America and its profligate government is voters. Especially those who have homes. Or those who have lost their jobs. They're not worth a few billion dollars. Well, a little more than that. The unemployment benefits extension recently stymied by Republicans would have cost about $33.9 billion. That's a lot of cash, though a tiny number compared to what we spend on war and banks. It's cash that would get immediately spent and circulated throughout our economy though, unlike the hundreds of billions we spend on ordinance that ends up buried in the sands of Araby or bailout cash that winds up in some rich Republican's Swiss bank account. Whatever.

Anyways, Savage is an idiot. There's no arguing with him, I am sure. Ideology like his is impermeable. Fossilized. Never changing. Not reality based.

And because he is that deranged, he lectures little girls on a hot summer day, trying to persuade them out of their joyful kindness.

What an asshole.

There Goes Half

Fired for speaking Tagalog at work.

Well, there goes half the night shift.

I personally work with nurses and other staff members from the Philippines, England, Mexico, Nigeria, Italy, Ethiopia, Canada, India, and even the faraway and exotic realms of Idaho, to name a few places off the top of my head. I hear languages other than American English all the time. Even the doctors can be heard conversing in other languages sometimes.

From ABS-CBN News:

BALTIMORE, Maryland - Four Filipina ex-staffers of a Baltimore City hospital haven’t gotten over the shock of being summarily fired from their jobs, allegedly because they spoke Pilipino during their lunch break.

[snip]

“They claimed they heard us speaking in Pilipino and that is the only basis of the termination. It wasn’t because of my functions as a nurse. There were no negative write-ups, no warning before the termination,” she added.

The nurses were previously required to sign paperwork agreeing to limit lunch and snack breaks, and included in it was an English-only policy that "directs that English should be the only language spoken while the nurses are on ER duty."

Fair enough. Like the guy says, in a code situation you don't want people yelling out commands in a variety of different languages. It's bad enough we still have to deal with all the crappy Latin abbreviations and such that we use everyday. But these nurses were allegedly overheard while they were at lunch. The hospital hasn't actually specified when exactly the nurses violated policy.

And they were fired for this?! What, is there an oversupply of E.D. nurses in Baltimore?! It's going to cost that hospital a good 10K a piece to train replacements. If they can find any. I wouldn't work there. In times of stress I sometimes let out a string of words from Olde Englishe. That would be bad.

Of course, this being Arizona, here it could actually get worse.

"The Arizona Department of Education recently began telling school districts that teachers whose spoken English it deems to be heavily accented or ungrammatical must be removed from classes for students still learning English," The Wall Street Journal reported.

So, joo con be fired por sayeeng "biolet" eensted uff "violet."

Los yikes. There goes half the teachers in south Phoenix.

News You Can Use

Oscar the bionic cat.

Hat tip to Chris Tucker:GOP Delenda Est! over in The Crack Den. Like he says: Science Works.

Have a Heart, Not a Kidney

A sign put up by a Florida urologist who apparently has a problem treating people because of how they vote. Story here.

Rep. Alan Grayson (D-FL), the congressman who represents the district of the Florida doctor discriminating against Obama voters, said, “Maybe he thinks the Hippocratic Oath says, ‘Do no good.’ If this is the face of the right-wing in America, it’s the face of cruelty.”

Cruelty indeed.

I suppose this is where I once again proclaim my Constitutional right as a nurse to refuse to defibrillate Republicans. I just won't do it. I don't give code drugs or do compressions, either. I'll record, and if it's my patient I will facilitate communication with the doctors and staff at the bedside, minimally. But I just don't see the point. I don't defibrillate clams, either.

I walk away and check other patients. They are always ignored during codes, anyway. Well, not if I'm around and the decaying cardiac rhythm belongs to a Republican.

If you cannot tell whether or not this is snark, please refer to the article about the Florida urologist. Do you think he was snarking?

Oh, and by the way, fuck you, doctor.

Keller

Helen Keller was a radical feminist and socialist. She was a founding member of the American Civil Liberties Union. She was not polite and grated hard against the conventions of the day which would keep women out of the public sphere. I like her.

She said "It is hard to interest those who have everything in those who have nothing."

Our current batch of bile-filled corporate talking-heads would hate the likes of her. She would be reviled and ridiculed by Limbaugh, for example, and Hannity would feature her on his show only to interrupt her and badger her. O'Reilly would do the same and then try to probe into her sex life.

But you know what? She could handle it. She had to deal with worse. People who didn't even think that women should be allowed to appear in public; certainly not to speak outside the home.

A Cloud of Blackbirds

The person you are dating is a vampire. Hilarity ensues.


If you ever forget how many cats you have, simply open a can of tuna. Then count them.


I was hanging some IV antibiotics for a patient and I overheard the family members talking. One lady was telling a younger male visitor that Jesus was coming soon and recommending that the man get close to God before this occurs. "I'll be glad to get by God if he allows me to smoke weed," said the young man. They then agreed that Jesus was a stoner. The young man claimed that there are neuroreceptors in the brain that are specific to THC bonding, and he suggested that The Creator made it this way.

The patient himself had suffered a hemorrhagic stroke. One pupil was fixed and he had a facial droop. That was nothing really. During a trans-esophageal echocardiogram he had sustained a perforated esophagus. Later he developed a collapsed lung which required chest tubes. His swallowing was impaired so he was fed through a tube. He was unable to walk or even sit up on his own. Yet the family held to an unshakable faith that he was going to get better.

That's probably not going to happen. He's probably going to go through a series of infectious processes and eventually die of pneumonia or something. I've seen it happen a thousand times before.

I gave that patient everything I had. I gave the family everything I had, too. They loved me. But the patient is still going to suffer a prolonged, very expensive, and miserable death. It's too bad.

A miracle could occur, but it would not be that the patient amazingly recovers. The miracle would be that the family members get some sense about them and see what is really going on. I doubt that is going to happen.

I knock myself out trying, anyways. That's what nurses do. I do not judge. I just work.


Statistics show that mothers earn less and less money with each child that they have. This is part of what we here in America call "family values."


Phoenix is a "horse town." If you have enough room on your property, even if you live smack in the middle of the city, you can have livestock. We were jogging along Central Avenue today and ran by a house that had a goat in the yard. Is Philadelphia like this?


Whoever first said that "necessity is the mother of invention" got it precisely backwards. First things are invented, then everyone has to have it and cannot live without it.


"You cannot make a silk purse out of a sow's ear." My spouse just said that. I am listening in on their phone conversation. My dream for some time now has been to open an internet cafe called "The Pig's Ear." We would serve tasty and nutritious snacks and beverages and feature live jazz on the weekends. Like a 19th-century lyceum, we would also feature guest lecturers on important topics of the day.


Can you love that which is unseen?

A Dole of Doves

I drove by the pawn shop on 12th Street on my way home. There was a woman with a baby carriage outside the late-night window. Now, every time I think my life sucks, I think of her and her baby.

The patient was one of those all-day drinkers. He'd start from the moment he woke up in the morning. Of course he had problems during his hospitalization. He went crazy, really. Delusional. His son called and angrily accused us of not providing his father with enough alcohol. (We were giving him two beers with each meal, including breakfast, plus enough Ativan and Haldol to knock out a herd of rhinos.) "You're not giving him enough alcohol." That is now officially the most co-dependent thing I have ever heard in my entire life.

I have discovered a new kind of cuisine called "crudo." (Restaurant link here.) It's essentially Italian sushimi. Raw fish treated with sea salt, lemon juice, and a bit of olive oil. Dee-lish! But (here it comes) I have a friend who has studied parasitology... And we recently worked with a patient from southeast Asia who had acquired a really nasty lung-eating parasite from consuming raw crabmeat. Dead lung tissue surgically removed. That's actually two "buts."

I know that there are different levels, ranks so to speak, among doctors. Neurosurgeons, for example, seem to have more status than hospitalists. Yet they all treat one another as members of the same elite club and they are polite and deferential to one another's thoughts. Not so with nurses. I sometimes get the feeling from nurses in other departments that they think me and my coworkers are stupid or something. Nurses do not play well together. I do what I can to change this but I am only one person.

I have a Siamese cat with a very long snout. The longest I have ever seen on a house-cat. Yet I have never actually taken the time to measure it and compare this finding with other cat snouts. He also has no upper teeth. I know this because one day I thought "I wonder what it's like in my cat's mouth?" and I acted upon this.

There are many seriously bad things happening in the world. I sometimes occupy myself with smaller concerns, things I can actually address. Not unlike Candide working in the garden, if you will allow me to make the comparison.

530 lbs.

Though many of their residents are somewhat sick, in the sense that they are chronically ill and cannot live independently, nursing homes are not hospitals and there are many rather simple interventions that cannot be done in that setting. For example. most nursing homes cannot provide sustained treatment with intravenous medications. They just don't have enough licensed staff to provide such. So if a resident medically comes to require that sort on intervention, they must be transferred to a hospital.

That is one of the beautiful things about a good nursing home nurse. They can tell when it's time to move a patient.

I have to congratulate the people who discovered that this particular patient had gained thirty pounds. Not real weight as in fat and muscle, but dangerous "water-weight." Because the patient weighed well over five hundred pounds to begin with.

I don't know how they caught this. Did she have a bed with a built-in scale? I do not recall. Even those become decalibrated and useless on a day-to-day basis. Did they have a sling scale that went up that high? I cannot imagine the practicality of doing this. The logistics involved just to roll this woman onto a bedpan were complex and involved four people. Let alone getting her out of bed and onto a scale of some sort.

Anyways, they discovered the dangerous and relatively sudden weight gain (over a month's time only,) and she was sent to us. We diuresed her with intravenous Lasix. Bless the nurse that somehow found a vein to establish IV access. It wasn't me. The woman urinated gallons and gallons. Bless the nurses that inserted the urinary catheter, too. That little procedure took five nurses; two to hold each leg and one to fish around and insert the tube.

The woman responded well to treatment. She still weighs over five hundred pounds and that will kill her someday soon, but in this case, no. Not this time.

We were all surprised when the patient's mother and sister came to visit, for they weren't "big people." Actually they were rather athletic-looking, not even zaftig. Nearly slim. They said that there had been other quite big people born into their family though. As one would expect.

A Bevy of Quail

You cannot say that nothing is as it seems.

We saw a bevy of quail yesterday, the little ones only a couple inches tall scurrying along with their parents.

If I hadn't checked his blood pressure, if I'd gone to lunch instead, he'd probably had circled the drain. Instead I went hungry.

It isn't enough that you have someone to love. That someone has to be near you much of the time. Close counts.

Caramelized onions and prosciutto ravioli in a pink vodka sauce.

Tidings of Magpies

There is no law either natural or civil that says the rich must become richer by any means.

I told a friend that I wouldn't ask her about the novel she is secretly writing. I think I may have lied.

Profits are privatized , while liabilities must be socialized. This is called capitalism.

May I see your papers please? What!? No?

During my university years I was once ticketed by the police for driving an unregistered moped. Remember those?



The police impounded it. One drove off on it, which was comical enough, (imagine a big fat cop steaming along at about 12 miles-per-hour on a red moped) while the other put me in the back of the police car to be brought to the station. There was a bunch of guns in the back seat with me. I mentioned that to the officer driving. "Hey officer, there's a bunch of guns back here," I said. He screeched to the curb. "Get in the front," he said, and I did but he wouldn't let me play with the radio.

After a few days I'd gotten my moped properly registered and I went back to the police station to retrieve it from impoundment. The officer at the desk was disdainful and very rude. I remember telling him right to his face to "fuck off and die." Actually that is an exaggeration. I left out the part about dying. You cannot offend a police officer. It is perfectly okay to use crude language with them as long as it does not contain threats, and apparently this officer forgot to feel threatened at that time. I would not recommend doing this though.

He eventually gave me my key to my "vehicle" and I pedal-started it and rode off. Later the same policemen stopped me for riding without a helmet, even though at that time there were no laws requiring that I wear one to ride a little moped. It was slow. People in wheelchairs used to pass me regularly.

I promised a friend that I would always be there for them; the same one writing the secret novel. Even if they were to leave me, I assured them that I would wait decades for them. I did not lie about that. I am an elephant in that way.

Your Career

There is no aptitude test to take before you become a nurse. The same is true, of course, for many other professions. Any idiot, fool, or halfway intelligent psychopath can wait their turn and go to nursing school, just like I did.

Therefore, fellow nurses, you may find yourself in difficult situations as you negotiate the twisted path of your profession. People will give you bad information. You will react appropriately, only to find out later that you may have caused harm, through no real fault of your own, but it will be on your hands.

This is the story I was told, by a lab technician who I can trust implicitly with everything: a blood glucose level of 526 is reported to a nurse. That's odd, because the glucometers don't even read that high; at that level it would just read "HI." As if it were glad to see you. Our glucometers are then programmed to prompt the user to report the result to a nurse or doctor. The nurse calls the doctor to get coverage for the very high blood sugar level, the lab draws a repeat level to run on their big fancy million-dollar blood chemistry analyzer, the nurse gives the patient a boatload of insulin, and then the lab calls.

The true blood sugar level isn't above 500. It's 220. And here's the kicker. It never happened. The blood sugar level of 526 was ignored because it was an accident that the patient was even checked; they had no order for glucose levels. Somebody checked the wrong patient, got a way abnormal lab value, and blew it off. The patient went untreated.

What went wrong?

People.

If you are working in an environment in which things like this happen, there's really only one thing you can do. Quit and get another job someplace else.

If that is impossible, then make as many friends as you can among the competent people among the staff. Respiratory therapists are good friends. Lab techs, aides, and especially house-keeping people! Call them by name. Ask them about their families. Tell them when they do good work. Bow reverently to them.

They are all you have.

In Wall Speakers

Vivica Genaux
Saluki
Grand Canyon
John Cage score
Acapulco cliff diving

In reverse order!

Monday Dickinson

I DIED for beauty, but was scarce
Adjusted in the tomb,
When one who died for truth was lain
In an adjoining room.

He questioned softly why I failed?
“For beauty,” I replied.
“And I for truth,—the two are one;
We brethren are,” he said.

And so, as kinsmen met a night,
We talked between the rooms,
Until the moss had reached our lips,
And covered up our names.

I Died for beauty by Emily Dickinson. Too good to spoil with comment.

Friday Plath

Winter Trees

The wet dawn inks are doing their blue dissolve.
On their blotter of fog the trees
Seem a botanical drawing.
Memories growing, ring on ring,
A series of weddings.

Knowing neither abortions nor bitchery,
Truer than women,
They seed so effortlessly!
Tasting the winds, that are footless,
Waist-deep in history.

Full of wings, otherworldliness.
In this, they are Ledas.
O mother of leaves and sweetness
Who are these pietas?
The shadows of ringdoves chanting, but chasing nothing.

November 26th 1962



She had, at this point in her life, three more months to live. Her journals seem to have ended the previous July with a description of the funeral of her neighbor Percy, so we don't have any direct access to Plath's thoughts at the time she wrote this. Leda was the mother of Helen.

P.E.

From RadioGraphics.



This is an emergency. This will make you late for lunch. This will spoil your lunch. Get the dilaudid, start the heparin drip, apply O2 if you haven't already, and get more dilaudid. With a little luck, soon your patient will feel better.

Hilo Protest 3/20/10

Notice no teabaggers. Just a bunch of nice people out protesting these stupid wars. We honked and waved and talked to the kids in the back seat about war and better things.

The Chorusing of the Waves

Clarinets, flutes, and oboes, for example, are just tubes. Of air, set into motion by a player. So are trumpets and french horns. So are voices. So are pipeline waves; you know, those tall breaking waves that surfers shoot down the middle of. For a moment, when the wave-tube is correct and the air within it is vibrating, a complex set of pitches can be heard emanating from it. These waves sing.

Bobby McGee

Photo stolen from a most excellent island blog called The Daily Flow. Her travelogue charts the same course of Hawaiian back roads that we took. The picture is of Alahanui State Park.



The ocean beaches here are dangerous and many people have lost their lives in the high surf. This area, however, has an enclosed pool that is warmed to 90F. by lava-heated waters. Perfect. Clear and refreshing. We swam and then went out to walk along the lava flows at water's edge. We found hermit crabs double-hiding in the inches-deep pools maintained by splashing surf.

Back at the rental I espied a sea turtle skimming the waves and called the others to see it too. We saw whales going by the day before.

Like a sea turtle, my ocean is wide. Unlike a sea turtle, I have no shell.

Fossil Braggery

Dr. Donald Johanson had just come out with a new book and he was holding a signing at a store in Scottsdale so off I went, with my young one in tow. There was a group of about thirty or so people there, most of whom had the air of academia about them. My child was the only sixth-grader among the crowd.

During his talk Dr. Johanson must've noticed how my little bowl of shrimp was doing because he drew the audience's attention to the pictures and illustrations in the book, much on behalf of my dear one. Afterwards when we went up to his table to get our copy of Lucy's Legacy autographed, he asked shrimpbowl if they were interested in human origins and to my dismay, they answered, "my dad just made me come here." Ouch.

Then in the days and months that followed, shrimpbowl read the book. They carried it everywhere in their school knapsack. I was not allowed to take it to read for myself. They learned how to recognize various hominid species by being shown drawings of their skulls. Homo floresiensis is their favorite now and shrimpbowl wants to study at the Institute of Human Origins when they grow up.

Anyways, I e-mailed Dr. Johanson this story and he very graciously wrote back that same day, inviting shrimpbowl to come visit the Institute anytime. And we shall do so very soon after we get back on the mainland. Right now, we are still here on The Big Island. Yesterday we watched whales swim by.

Yeah, Another Day

(Photo stolen from the web so sue me.)

My head wasn't really in the game today, but nothing came up at work that was much challenging. A lung patient who was doing well, a paraplegic whose short-term prognosis was very good because he'd soon be over this bout of pneumonia, a guy waiting for Monday to roll around so he could get a video-assisted-thoracoscopy and wedge resection (his sats kept dropping to 80% but he looked good doing it,) and a guy who went home first thing this morning. The patient I got in his place had a complex history including a perforated esophagus with an esophageal stent.

Now that's more like it.

Anyways, I blithered away the day thinking about other things.

My guitar studies have taken an intense turn and this has tossed me into the throes of a deep melancholic nostalgia; for music school, for my old musical friends, and indeed just for the repertoire I used to have. So there's that. I loved it all. The competition, the pressure to perform, the essence of perfection that only marks the beginning of understanding the performance of any given piece of concert music... well, I guess a lot of that can be translated into nursing, but it's not the same.

Nursing is a beautiful thing and I love my coworkers, but nursing lacks music. Sort of. Sort of not.



Tomorrow spousie is taking me to The Big Island along with our child and their same-age cousin. So I had that to distract me from work, too.

Lust and Greed

The Passionflower I have. Because, you know, passion is first.

For My Future Postoperative Patients

I work on a specialty unit. There are types of surgeries done here that no other hospital in the state, and no other nursing unit either, especially works with. I do not write about these things because it might betray my fragile anonymity.

Ironically, I may soon require just such surgery. I will be operated on by doctors that I deal with every working day, and I have complete confidence in them. I will be treated postoperatively by my coworkers. Hopefully it will make me an even better nurse. Hopefully it will be minimally embarrassing.

How would you like to get out of surgery knowing that your nurse has undergone the same thing? I will have been there and done that! So no excuses, buddy. Get up and walk, use your incentive spirometer, get better, and get the fuck out of here.

A Band of Jays

You don't really need anything in order to do nursing. Having a hospital around helps, though.

Six strings will do, but perhaps the ideal is eleven. With bass courses tuned scale-wise downward.

The fucking dog took one of my socks. Just one. I'd rather she took both of them.

Everything is a coincidence.

They tried to have one of their friends (for lack of a better word,) impersonate a doctor to give one of the nurses phone orders for intravenous dilaudid. The scheme didn't work. This is the kind of bullshit nurses have to put up with.

Schools are mostly comprised of empty space. If I were a teacher, I'd have my students use all the space they possibly could, for doing things.

Somewhere, there is a desert that is only one rainstorm away from not being a desert anymore. Lately I feel like I might be living in just such a place.

If pain did not exist, somebody would invent it.

Practicing

The guitar is the most beautiful instrument.

I have had many musician friends who who scratch their heads in puzzlement over that statement. Maybe they don't get the rather small sound, or the repertoire of mostly short concert pieces and etudes. Maybe it's the whole rock music electric thing that throws them off; violinists and pianists are found among rock musicians, but it's a guitar-based style for sure. For me, since I was a teenager, it had been the classical guitar.

It's like holding an orchestra in your arms, it's so colorful. The instrument that seems closest in ability to express different colors is to me the oboe, on which every note seems to have its own distinct vowel sound. I've always liked that, and I could never understand why anyone would want to even out that difference between each note on their instrument, as many are instructed to try to do.

The guitar is, fortunately, a contrapuntal instrument. Like a piano, but without that instrument's incredible ability to generate different lines in music. And the guitar has a huge repertoire, if you include all the lute music from the Renaissance and Baroque period that can be made to fit under the player's fingers. Having said that, we guitarists are always stealing music from other instruments' repertoires. I've played Chopin piano pieces, Bach solo violin music, and Mozart opera arias transcribed for the guitar, and I must say these things sound beautiful on the instrument.

Saint John's Wort

Echinacea

Don't Let it Bring You Down

She remained such a pleasant young woman, a software engineer from yet another midwestern city, with a slight smile and gentle optimism on her face at all times. That is what amazed me. She had been having a run of bad luck, so one might expect her to be a little bitter about life and such, but she wasn't.

A year ago her mother went to the operating room to have colon cancer treated, and she coded on the table and died a few days later. A few months after that her father passed away, as much from grief as from his own fight against cancer. So she moved from the midwest, along with her quietly devoted husband, here to Phoenix, hoping for a change of luck.

Phoenix has not been good to her.

They bought a house but before they could entirely settle in, it "burned down with them in it," as she said, though they were unhurt. They moved to an apartment in an affordable neighborhood, where she was shot in the lung in a random senseless drive-by assault.

"I was just in the wrong place at the wrong time," she explained.

That was a couple-few months ago. After several weeks of hospitalization she was discharged, only to subsequently develop some complications that landed her right back in. More surgery, chest tubes, and thankfully a pain medicine pump.

Aside from handing her a few pills and helping her get around some, that was my job: to help keep the pain under control, which merrily it was. Without that, it would have been a completely different story, and a startlingly different patient too. With uncontrolled pain, even the nicest person can become a total bitch on wheels.

The Hanged Man

If a hospital, or perhaps a chain of hospitals, has a nursing shortage and also due to the poor economy has instituted a hiring freeze, then that shortage of nurses becomes fixed.

As wealth is concentrated upwards into the hands of the lucky few, so misery is concentrated in the lower echelons of society, and there is no one lower on the scale of being than hospital patients. They walk around bare-assed. They are bankrupt. They are not working.

I have a facsimile of John Dowland's First Book of Songs. It folds open with each of four musical parts facing to the four different sides of a table. Four singers and a lute player can seat themselves around it and read the music with their own part facing them. People knew how to sing music from written parts back then.

A rather fancy family might have a chest of recorders, viols, or some other consort of instruments. Sackbutts and krumhorns, anyone? It was home entertainment in a low-energy time, when we did not have electricity funneling various amusements into our homes for us.



An early music specialist came to my college and we formed a "broken consort" of unlike instruments (lute, bandora, cittern, viola da gamba, and flute,) to rehearse and perform a concert of Elizabethan music. I played the little cittern. The only time I ever have. I had been studying on my own and I could read the tablature notation, so the early music professor recruited me for the gig.



The headstock of the cittern I played had a blindfolded man's head carved into it.

Citterns, lutes, mandoras, and other instruments used to hang from the walls of Elizabethan barber shops. Loops of string tacked to the walls would hold the instruments by their headstocks. The blindfolded man was a sort of common joke, as the loop of string would circle under the neck of the hanged man.

While you were waiting for your shave or haircut, you would take an instrument down from the wall and play upon it.

Now we have fucking Fox News everywhere. So I refuse to have my hair cut at a salon anymore. It can grow to my knees.

What You Don't Hear

I always inform my patients when I am about to do something to them that will cause pain. Usually it involves needles.

My patients like me. They tend to like the unit in which I work, and often they say complimentary things, such as "The nurses here are so good. Very professional, and everybody's been so nice."

Meanwhile the cartoon word-bubble over my head is silently reading out "wait until you get the bill."

That doesn't work on Canadians, though.

Brought to You by Your Health Insurance Premiums

Well, eventually they ordered a temporary hemodialysis catheter and proceeded with thrice-weekly dialysis. It was a concession to reality. That's what the man needed in order to live.

However, we were unable to just keep him in the hospital and provide this service indefinitely. So one day they decided to send the patient home. After he was dialysed, they removed the catheter and presto! he was discharged home.

The best possible scenario was for him to return to Mexico for treatment. But he hadn't lived there in fifteen years; he was a legal alien here and had been so for the past twelve years. Unfortunately he had no medical insurance, and legal residency doesn't include that. He really had no place to go back in his home country.

In all likelihood, he just stayed here in The Valley of The Sun. He will soon get pretty sick and he will present at another hospital. Or maybe he will just come back to ours, where we will start this all over again.