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.
Friday, December 18, 2009
Wednesday, November 25, 2009
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.
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.
Sunday, November 22, 2009
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.
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.
Tuesday, November 03, 2009
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.
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.
Wednesday, October 14, 2009
The Old is New Again
A legal immigrant who will die due to lack of money and will to take care of his failing kidneys.
The alarming number of sick calls from hospital workers this flu season.
The nasty fuss; the monkey-suit mask, gown, and gloves we have to wear to avoid spreading a simple virus.
Bankruptcies due to health care costs, even for those with good insurance coverage.
Fine coffee.
Applied technology. Medical equipment, and home entertainment.
Let's start with the last. I "had to" get a new laptop. Over the years I have accumulated a sizable collection of music on compact discs. My spouse abhors these due to the shelf space they occupy. Now I can download hundreds and hundreds of them onto my computer and Ipod. Wirelessly I can beam the music into my hi-fi system. (I am not fond of the sound derived from those little in-ear headphones; even the pricey ones.) Now I have more room on the shelves for books! at least until Spousie gets me a Kindle or other such book-reader. I can also carry nearly all of my music with me on the Ipod.
In hindsight, it's really not all that different from the little transistor radio I used to take to the beach when I was young so I could listen to Hey Jude while I read Vonnegut and sunned myself.
Interestingly, the latest-generation new Ipod Nano features the addition of FM radio.
What?! No AM radio?!
The alarming number of sick calls from hospital workers this flu season.
The nasty fuss; the monkey-suit mask, gown, and gloves we have to wear to avoid spreading a simple virus.
Bankruptcies due to health care costs, even for those with good insurance coverage.
Fine coffee.
Applied technology. Medical equipment, and home entertainment.
Let's start with the last. I "had to" get a new laptop. Over the years I have accumulated a sizable collection of music on compact discs. My spouse abhors these due to the shelf space they occupy. Now I can download hundreds and hundreds of them onto my computer and Ipod. Wirelessly I can beam the music into my hi-fi system. (I am not fond of the sound derived from those little in-ear headphones; even the pricey ones.) Now I have more room on the shelves for books! at least until Spousie gets me a Kindle or other such book-reader. I can also carry nearly all of my music with me on the Ipod.
In hindsight, it's really not all that different from the little transistor radio I used to take to the beach when I was young so I could listen to Hey Jude while I read Vonnegut and sunned myself.
Interestingly, the latest-generation new Ipod Nano features the addition of FM radio.
What?! No AM radio?!
Sunday, October 04, 2009
Set
If you come to the hospital and you display flu-like symptoms, we will either admit you to an isolation room or kick you the hell out. Nicely.
If you have a child in school, assume that they are at risk. Viruses do not work in terms of degrees of separation; instead, in terms of degrees of connection.
Think about the things that you touch as you go about your business. Gross. Yes, I know. Then think about all the other people who may have touched whatever you're touching, as you make your day.
Multiple homonyms: Flu, flew, flue
If you have a child in school, assume that they are at risk. Viruses do not work in terms of degrees of separation; instead, in terms of degrees of connection.
Think about the things that you touch as you go about your business. Gross. Yes, I know. Then think about all the other people who may have touched whatever you're touching, as you make your day.
Multiple homonyms: Flu, flew, flue
Saturday, September 26, 2009
Sedona
Tuesday, September 22, 2009
Structure of Memory
If you work thirteen or fourteen hours per day for a few days in a row, sometimes you get tired.
All of the fascinating little details from the swirl of activities around you for these past days; well, things fade away. You sit at the keyboard and think that one thing you wanted to share which seemed so universally interesting, like breathe itself, has slipped away into the land of the bland.
That in itself is sort of interesting.
What are those little French cookies called? I forget. It think the word rhymes with porcelain.
All of the fascinating little details from the swirl of activities around you for these past days; well, things fade away. You sit at the keyboard and think that one thing you wanted to share which seemed so universally interesting, like breathe itself, has slipped away into the land of the bland.
That in itself is sort of interesting.
What are those little French cookies called? I forget. It think the word rhymes with porcelain.
Saturday, September 12, 2009
A Kettle of Hawks
Jakob was telling me about reality:
"It's like five bucks," he said. "But that's not what it's worth," he clarified for me. "That's what it is."
*****
Then there was the woman who used to teach English and she tried to tell me that there weren't enough vowels.
"Well," I entertained, "If you take just the five vowels and combine them three at a time, that gives you a possible sixty combinations that could enter usage as your alternate vowel sounds, couldn't it?"
She looked at me as if I were crazy and insisted that it still wouldn't be nearly enough, and besides that it was just a ridiculous idea. She thought more alphabetical vowel letters should be created. That's when we silently seemed to agree to disagree.
*****
You have heard that dismissive expression "But you could get a Grand Jury to indict a ham sandwich!"
But just you try getting them to indict a Reuben. Then it's all "Oh no, can't do that" and suchlike.
*****
We were walking along the quiet section of The Avenue of the Pines in Saratoga Springs; the part where the pavement turns east but the old tree-lined avenue continues straight into town. It's all pine needles, shade, and big old trees.
"They sing," the person said, meaning the trees. They guided me over to a few trees, selected an appropriate one, and made me lean up against it, listening with the length of my back.
"Well I'll be," I said, "You're right."
I still hang out with that person a lot.
*****

*****
Nursing is all about the relationship between the patient and the nurse. If, for one reason or another, that relationship cannot be construed as therapeutic, then "nursing" does not happen. Instead it's some other sort of fucking miserable bullshit.
"It's like five bucks," he said. "But that's not what it's worth," he clarified for me. "That's what it is."
*****
Then there was the woman who used to teach English and she tried to tell me that there weren't enough vowels.
"Well," I entertained, "If you take just the five vowels and combine them three at a time, that gives you a possible sixty combinations that could enter usage as your alternate vowel sounds, couldn't it?"
She looked at me as if I were crazy and insisted that it still wouldn't be nearly enough, and besides that it was just a ridiculous idea. She thought more alphabetical vowel letters should be created. That's when we silently seemed to agree to disagree.
*****
You have heard that dismissive expression "But you could get a Grand Jury to indict a ham sandwich!"
But just you try getting them to indict a Reuben. Then it's all "Oh no, can't do that" and suchlike.
*****
We were walking along the quiet section of The Avenue of the Pines in Saratoga Springs; the part where the pavement turns east but the old tree-lined avenue continues straight into town. It's all pine needles, shade, and big old trees.
"They sing," the person said, meaning the trees. They guided me over to a few trees, selected an appropriate one, and made me lean up against it, listening with the length of my back.
"Well I'll be," I said, "You're right."
I still hang out with that person a lot.
*****

*****
Nursing is all about the relationship between the patient and the nurse. If, for one reason or another, that relationship cannot be construed as therapeutic, then "nursing" does not happen. Instead it's some other sort of fucking miserable bullshit.
Saturday, September 05, 2009
Le Marteau Sans Maitre
One of my art teachers from decades ago described this tool as a "many-headed hammer."

There are never two sides to an argument. Or rather, there are never only two sides. That is why I crinkle and bristle every time I hear the phrase "both sides of the argument."
We all know that, yet the useage of the phrase persists and it is consistantly abused. Two opposing ideas are all too often inappropriately given equal credence.
For example, someone like Glenn Beck may assert that "the moon is full of laser-eyed Moslem beavers who pose an imminent threat to the safety of all good American families." An opposing voice says "no, it's a barren mini-planet and quite harmless, actually." And so the discussion may proceed, as if each idea were equally respectable.
It does not matter that we consider two sides to every story, because we all know there are as many sides as there are heads on the carver's hammer. What really matters is that the hammer has a master...
Not a clown wielding it.
Bourreaux de solitude
Le pas s'est éloigné le marcheur s'est tu
Sur le cadran de l'Imitation
Le Balancier lance sa charge de granit réflexe.
*****
Executioners of solitude
The step has gone away the walker fell silent
On the face of Imitation
The Pendulum throws its load of granite reflex.
Rene Char, 1934.
This text was used by Pierre Boulez in his 1955 song-cycle Le Marteau Sans Maitre.

There are never two sides to an argument. Or rather, there are never only two sides. That is why I crinkle and bristle every time I hear the phrase "both sides of the argument."
We all know that, yet the useage of the phrase persists and it is consistantly abused. Two opposing ideas are all too often inappropriately given equal credence.
For example, someone like Glenn Beck may assert that "the moon is full of laser-eyed Moslem beavers who pose an imminent threat to the safety of all good American families." An opposing voice says "no, it's a barren mini-planet and quite harmless, actually." And so the discussion may proceed, as if each idea were equally respectable.
It does not matter that we consider two sides to every story, because we all know there are as many sides as there are heads on the carver's hammer. What really matters is that the hammer has a master...
Not a clown wielding it.
Bourreaux de solitude
Le pas s'est éloigné le marcheur s'est tu
Sur le cadran de l'Imitation
Le Balancier lance sa charge de granit réflexe.
*****
Executioners of solitude
The step has gone away the walker fell silent
On the face of Imitation
The Pendulum throws its load of granite reflex.
Rene Char, 1934.
This text was used by Pierre Boulez in his 1955 song-cycle Le Marteau Sans Maitre.
Saturday, August 22, 2009
Comparing Health Insurance Plans
Monday, August 17, 2009
That Thing I Quit
I used to, as of a couple minutes ago, go to the Opinions section of the local newspaper and write comments defending reason and compassion. I quit. It's a waste of fucking time.
A great many of the people who write letters-to-the-editor and comments thereon are a bunch of fucking assholes who don't give a flying fuck about anyone, not even themselves. They may be uneducated on the topic of choice, yet they remain staunchly convinced somehow that they know much more than they make evident. And they are never so right as when they are completely and utterly wrong.
They are mean-spirited; more then that, they are in love with mean-spiritedness. It moves them to states of excitement.
And I am fucking sick of them.
They are Blake's pebbles. Let them have the world, their world, and let them ruin it for all of us. In that they will have their hell but call it heaven.
A great many of the people who write letters-to-the-editor and comments thereon are a bunch of fucking assholes who don't give a flying fuck about anyone, not even themselves. They may be uneducated on the topic of choice, yet they remain staunchly convinced somehow that they know much more than they make evident. And they are never so right as when they are completely and utterly wrong.
They are mean-spirited; more then that, they are in love with mean-spiritedness. It moves them to states of excitement.
And I am fucking sick of them.
They are Blake's pebbles. Let them have the world, their world, and let them ruin it for all of us. In that they will have their hell but call it heaven.
Thursday, August 13, 2009
Tire on the Mountain
Sunday, August 09, 2009
Banking No Crisis
After our trip to Sedona, the car was covered in red rock dust from prowling the dirt roads in order to get to hiking trailheads and scenic views. So yesterday we went to the carwash. Phoenix has a million of these.

It wasn't busy at all, considering it was Saturday. But I counted a dozen-and-a-half people rubbing down the cars.
As we stood under the misters sipping iced tea while waiting, I noticed that workers were running across the street to a parked vehicle. One still nearby us asked another "Where do we cash our checks?" He held his paycheck in hand.

In turn, workers would cross at mid-street to approach the white pickup truck, then they'd come back counting their cash. I even saw a woman come up to this impromptu check-cashing service after walking from a nearby apartment complex.
One of the young men who used this service was the blue-eyed shaved head dude who asked us about a miniscule windshield chip when we drove up to the carwash. Every time you get your car washed at a place like this, they always provide the additional opportunity to have even the tiniest almost invisible little ding repaired, knowing that a lot of auto insurance companies will pay for several of these fixes every year.
Point being, not every person who used the bank across the street appeared to be possibly undocumented.

It wasn't busy at all, considering it was Saturday. But I counted a dozen-and-a-half people rubbing down the cars.
As we stood under the misters sipping iced tea while waiting, I noticed that workers were running across the street to a parked vehicle. One still nearby us asked another "Where do we cash our checks?" He held his paycheck in hand.

In turn, workers would cross at mid-street to approach the white pickup truck, then they'd come back counting their cash. I even saw a woman come up to this impromptu check-cashing service after walking from a nearby apartment complex.
One of the young men who used this service was the blue-eyed shaved head dude who asked us about a miniscule windshield chip when we drove up to the carwash. Every time you get your car washed at a place like this, they always provide the additional opportunity to have even the tiniest almost invisible little ding repaired, knowing that a lot of auto insurance companies will pay for several of these fixes every year.
Point being, not every person who used the bank across the street appeared to be possibly undocumented.
Friday, August 07, 2009
For No One Dose
While sipping morning coffee (French-pressed,) in the proximity of spectacular Bell Rock, this occurred to me:
A few weeks ago at work I gave a patient an injection of Epogen, a drug frequently used by hemodialysis patients and others at risk for chronic anemia. It was a high dose, 40,000 units, but that's not unusual.
As I prepared the dose in the nurses' medication room, I recall thinking that one dose costs over $500, which is more money than I earn in a 12-hour shift of work. One single dose.
So when people talk about "holding down the cost of health care," I bristle at the thought that cutting nurses' compensation may be on their minds. Or at least reducing the meager yearly increases we are fortunate enough to get.
Us nurses, yes, we really are a bunch of lucky duckies.
A few weeks ago at work I gave a patient an injection of Epogen, a drug frequently used by hemodialysis patients and others at risk for chronic anemia. It was a high dose, 40,000 units, but that's not unusual.
As I prepared the dose in the nurses' medication room, I recall thinking that one dose costs over $500, which is more money than I earn in a 12-hour shift of work. One single dose.
So when people talk about "holding down the cost of health care," I bristle at the thought that cutting nurses' compensation may be on their minds. Or at least reducing the meager yearly increases we are fortunate enough to get.
Us nurses, yes, we really are a bunch of lucky duckies.
Friday, July 31, 2009
A Charm of Finches and Away
The best and easiest way to fall in love with a person is to talk to them. You could also end up hating their fucking guts, but at least for a little while you will see that which is inside them deserving your love. Even if it isn't really there.
Red Molly loved James for more than just his '52 Vincent Black Lightning. She mistook danger for freedom. You see, that is how it is done.
As a nurse, there have been a few times when I have been with someone during the moment they died. One was a thirty-something young man who had already suffered an anoxic event that had destroyed his brain. His eyes were empty. Until he died. Then, as he took his final deep chest-filling breath, his eyes were full of all the people he had loved in his life.
I saw them, just as real as the words you see now. Then he exhaled and I saw them all swirl away deep down into his eyes, which then went dead again. For him I shut his eyelids. For them, too.
Dancing must be exhausting, because young energetic couples invariably begin by moving about quickly, then they gradually slow down, coming to a near-stop eventually. Then they wander off and sit by themselves or among others. That may be a critical difference.
What's the deal?
My spouse calls it insomnia. It's a satanic and discomforting affliction. Yet, it affords privacy.
Climb the church tower and hammer, hammer, hammer away at the bells. You will not break them.
Red Molly loved James for more than just his '52 Vincent Black Lightning. She mistook danger for freedom. You see, that is how it is done.
As a nurse, there have been a few times when I have been with someone during the moment they died. One was a thirty-something young man who had already suffered an anoxic event that had destroyed his brain. His eyes were empty. Until he died. Then, as he took his final deep chest-filling breath, his eyes were full of all the people he had loved in his life.
I saw them, just as real as the words you see now. Then he exhaled and I saw them all swirl away deep down into his eyes, which then went dead again. For him I shut his eyelids. For them, too.
Dancing must be exhausting, because young energetic couples invariably begin by moving about quickly, then they gradually slow down, coming to a near-stop eventually. Then they wander off and sit by themselves or among others. That may be a critical difference.
What's the deal?
My spouse calls it insomnia. It's a satanic and discomforting affliction. Yet, it affords privacy.
Climb the church tower and hammer, hammer, hammer away at the bells. You will not break them.
Saturday, July 25, 2009
Three For the Festival
Catrin Finch

She's just released a recording of Bach's Goldberg Variations which she plays on the concert harp. It's an amazing transcription, but that's not the half of it. It's a great performance.
Julia Fischer

Recent recordings of Mozart and Bach concertos, among other things, are attracting a lot of attention to this violinist.
Muriel Anderson

Fingerpicker extraordinaire, harp guitar player, and also simply a great classical guitarist; this woman should be a household name.

She's just released a recording of Bach's Goldberg Variations which she plays on the concert harp. It's an amazing transcription, but that's not the half of it. It's a great performance.
Julia Fischer

Recent recordings of Mozart and Bach concertos, among other things, are attracting a lot of attention to this violinist.
Muriel Anderson

Fingerpicker extraordinaire, harp guitar player, and also simply a great classical guitarist; this woman should be a household name.
Wednesday, July 15, 2009
Les Oiseaux Formidables

Nick Lane has written this wonderful book about ten iconic developments that occurred as life evolved on our planet of flux. P.Z. Myers has a review here.
I'm also working on Bach's Partita in A Minor for solo flute, transcribed by guitarist Denis Azabagic.

It's thinly textured, which seems to make it easy on the fingers compared to the thorny fugues found in Bach's solo lute and violin works. But therein lies the musical difficulty.
Saturday, July 11, 2009
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