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.