Friday, September 28, 2007

Myth


Actually Mythbusters. What we were watching. An O2 tank went through a concrete block wall.

Bunny

Dirty

Open Letter to Mike Rowe of Dirty Jobs,

WARNING WARNING WARNING

(For you who enjoy my gross work stories only.)

I do not exactly have a "dirty" job, in fact, mostly, quite the opposite. I cannot see any way that a film crew could safely, or legally, come into surgery, and let you do what you do. Safely, for the patients. Legally, for the hospital, even with consents. The reality Life in the ER type shows even have to largely do "recreations." Our patients are in the most vulnerable positions of their lives, everything we do is to ameliorate the risk. Having an extra two or three people in this place increases the risk of infection, as well as error.

But.

If you could, and we could manage all the risks, and it was a "good" day, oh, what I could show you, get your (double-gloved-sterile) hand into, expose your (now) expert nose to. Indulge me a Fantasy Dirty Jobs episode.

I'd get you in about 0630, train you to scrub your hands, gown and glove. The trauma page would bleep, followed by the thrice repeated overhead announcement, "Code Trauma alert one, code trauma alert one code trauma alert one." In that flat, calm delivery of the PBX. We'll head down to the ER, and a bloody patient with broken bones sticking out, in a C-collar rolls in on a gurney with the airborn EMTs in attendance. Miraculously, the trauma surgeon and ortho guy are both there, and tell us this patient will be coming up right away. We call up, then go up to get everything ready.

We help open supplies, as the entourage bursts through the doors behind us. Along with about a dozen others, nurses, techs, orderlies, ER staff, Arterial line techs, we move the road rashed, broken, bloody person on a slide board onto the OR table. Code Brown. Meaning, well I have the RN, so I get a towel half wet, and wipe bottom of excrement, drying with the dry half. Towels to catch blood.

I may get to prep the surgical site(s). I'll recount the semi vs train traumatic amputation of both legs of a large woman that I had to prep, or the metal signpost through both legs in a car rollover - needing two orderlies to hold up metal and leg while something like clean, if not sterile, meant awkward sloshing of prep solution, or when both ankles hung on by tissue threads, or crushes so bad it was difficult to tell where to start, or femurs so broken that a new joint appears mid thigh, and a tall, strong leg holder needs to pull up, and out, as I scrub soap over the wobbly skin.

Once surgery is started, there is little dirty. You can scrub in and hold retractors, to closely watch the scrub passing instruments and lap sponges as fast as I (as the second circulator) can open them, count them, while holding retraction, as well as passing ties, suture, to stop those messy streams of red beads over arms, hands, if unlucky, faces. I will be there to wipe potential drips off of glasses or foreheads.

But this settles down into a fairly tidy process of stopping bleeding, rodding the leg, or putting on an external fixator (a frame with bolts through the leg bones, a quick fix on contaminated fractures - those that came out through the skin, or on a patient too unstable for longer surgery, or who need that liver laceration fixed first) instead of the old traction method. So, I take you to a nice burn room in progress.

It's 100F here, the smell is pervasive, and we wear plastic aprons to protect ourselves from the fluids. Some produced by this mercifully unconscious ICU patient, much added as dressings, and healing solutions. Nothing sterile about any of this. We remove encrusted staples holding skin grafts onto raw wounds. The residents pick away dead tissue. Nothing about our patient looks human, or unhurt, so I have to imagine, and feel a moment of "Poor dear" to keep myself human. Sweat pouring through our scrubs, I will pull you out to get fluids, and another case for the experience.

This one is a patient I have worked on before. We stand beside the anesthesiologist during induction, and find the dentures - which the patient denied having in. These teeth-in-need-of-cleaning get laid on the chest, as I hold the cricoid cartilage to facilitate intubation, and hold the underlying esophagus to the stomach closed off. Suctioning of thick yellow mucous may leave you wanting to dry heave slightly, but your mask will catch morst of it. Then, I take the dentures to clean, and get into a cup, with ID attached. Pancreatitis does nasty work on the abdomen. This one is a horror show of yellow, rotting gut. The surgeon carefully staples the ends, and removes part of the large intestine that has blown up to dramatic proportions, obstructed by a tumor. The mess of gurgling fecal matter goes into a pan, the pathologist is there, handed a scalpel and pick-up by the scrub, and shares the aroma with the room, exposing the mass. I assist the RN in the room, getting out the wintergreen, dabbing a tissue, and wiping the oil on the masks of those scrubbed in. Some refuse, as they too strongly associate the mint smell with dead bowel for it to stop the nausea.

At the end, I am back beside the anesthesiologist, and even though the sterile supplies are away, and everyone else in the room has their mask off, I still have mine on. The patient rouses, coughs as the doc extubates, and a wad of phlegm hits my arm and mask. I stand there, holding flailing arms, to keep the patient on the bed, and the IV in the arm. Yup.

We will return to the first room, just emptied, to wipe every drop, every smear, of blood from every surface in the room. The smell of blood, moistened by vesphene, has a pungent, metallic tang that stays in one's nose. We'll follow the orderlies as they pour bloody irrigation buckets into the hopper, gather overburdened laundry and garbage bags - often leaking, to the dirty instrument room. We''ll take the elevator down to decontam, following the instruments. Good folks in gowns and gloves, face shields, take the many instruments, and remove the bioburden, bone from the total joint rooms, mucous from the sinus surgeries, blood from everything, with toothbrushes, round cleaners, pressurized streams of water, enzymatic detergents, before the sets go through the high pressure cleaning machines, later, after sorting, they will be sterilized.

Finally, the real horror. It's 1900. We'll clean up the lounge, where everyone has been leaving their left-behind beverages, forgotten food containers, catalogues, newspapers, the boxes of bagels from the morning meeting - only crumbs and one half-bagel inside, the remains of a birthday cake. Blankets are strewn over the couches, a cola has been spilled over one table. I'll save you the disgust of the fridge and microwave.

So, you see, it could work, but I rarely have a day with this much. It happens in a day, some days. But some days, it's all tidy laparoscopic and well orchestrated joint replacements, tiny hand cases, tonsils, well irrigated bladders. Surgery ideally, has almost no blood loss, and is tightly controlled, calm, planned. The rooms are cool, immaculately clean, much joking among staff, a little music in the background.

So, you see, a dirty, sterile, job. Not as smelly as sewer cleaner, nor as dangerous as coal miner, but not a soft, cushy office gig either.

Z

Wednesday, September 26, 2007

Darkness

(As not wanted on an anthology site.)

The floor gives a little under me, the skin of my feet slide along subtle sags in a surface linear, wooden. Do I imagine old, stale pine tang? Or just the cleaner, wax or linseed oil, applied long ago. A faint breath of cool air comes up from the floor, too indecisive to offer directions, tweaking my nose, not brushing my cheek. I reach out to experience only cool air. My hair hangs from my scalp, settles on my neck, pulls slightly on my temple. My glasses are gone. I know I stand, but my balance does a double check, a little uncertain, adjusting with subtle pull of muscle against tendon against bone. Cotton knit drapes over my shoulders, slides over my breasts as I breathe. Dry air in my nostrils, harshing through sinuses. I keep my mouth stuck closed, lips dry and adhesive. My eyes happen to be closed, but it would make no difference. I encounter walls, painted plaster, a particular give. A light switch, I move the hard square toggle, to no illumination. I kick a table, my hands discover a lampshade, a chain, but no light reacts to the pull on the string of tiny metal balls burbling through my fingertips. A sinuous furry warmth insinuates around bare ankles, bare feet. A cat? A rat? I feel a furry tail, curling,shoving marking me.

There is no sound aside from my own breathing, a sense of the space of the room, which changes from echoing hall to close bedroom, all I touch are air or walls, more switches, hard nubbins against flat shiny plates, all useless.

This is my dream, my nightmare, of darkness and darkness, no light to be had. Only my own heartbeat, my own body, endless searching for illumination.

Saturday, September 22, 2007

Work (Photo)





No potential risk occurred in the 6 seconds needed to create these images, and no confidential information conveyed.

Friday, September 21, 2007

Handbook



Pigman's Handbook (ISBN: 0852361262) Brent, Gerry. Farming Press, Ipswich, 1982


In another part of my life, I shelved a lot of books. A lot. I grew fond of some, simply for inexplicable reasons. This was my favorite book cover ever. It's a straightforward text on pig care. But I loved the image. I finally found the book. online. I won't be buying it, but now I can share this wonderful photo of a man tickling a pig.

Wednesday, September 19, 2007

Centipede

To a Centipede and His Hundred Legs

A centipede was happy quite,


Until a frog in fun

Said, "Pray, which leg comes after which?"

This raised her mind to such a pitch,


She lay distracted in the ditch,


Considering how to run.

(Apparently Annonymous, or A. Nonny Mouse.)

Tuesday, September 18, 2007

Inches

The frustration nearly breaks me, not because the pain is worse, but because it is less, but not enough less. The struggle to maintain, to work through, wears me thin and raw. I tolerate sitting long enough to eat. Writing is awkward, jostling my already awful typing, slowing the writing to a crawl, as I prop the lap top on my knees, braced against my belly.

We have a gnat infestation.

In the car, off to get butter and eggs, and a static sticker to differentiate our identical macbooks, D and I pointedly turn off the radio to discuss history, and the staunchly held misapprehensions of pundits outside the discipline. History is not fact upon fact, but hints and allegations, stories and whatever fragments survive, the stories of the winners, weight of evidence. Names and dates are not history, any more than pots and pans are food. D has a theory of history he calls "It seemed like a good idea at the time." Given recent studies that indicate how much drinking went on in many societies, this may be more right than even D thinks.

I read a blog that asks the question, what are your strengths as a writer? And I cannot answer. I'm stumped, and feel a pompous phony for daring to think I can hope to write professionally, create a novel. After my irrational crying jag, more drugs, and D assuring me my writing has many qualities that cannot be put into words, and don't need to be, and I don't need to answer the question anyway, I get the laundry done.

Moby climbed onto me last night, kneading my sternum, then settling on my belly, purring. When I got up, iSobel, my macbook, was missing, although D's Malaclypse sat near the sofa. I only hoped he didn't need his computer for class. He tries to call, but the cell forwards to itself. I am showered and dressed, dishes done, by the time he gets home. I shopped yesterday, so we have a good lunch. Stuff is getting done, proof of my improvement.

Two inches forward, one back.

Dental (Photos)





Blame Jo(e).

And guess whose is whose.

And yes, I made the pots visible.

Sunday, September 16, 2007

Bounce (Photo)



We gathered, yesterday. A birthday, friends in town, and we congregated. First, at a restaurant. Which left me in pain, so I had to come home to find any kind of comfort, (damn the back, damn the chairs.) Friends, being friends, followed along in time, with D- who I insisted stay a while longer and get a ride with R.

Expecting perhaps five, thirteen adults and a lovely two year old filled this place with talk and laughter. I found space on the rug, after making pots of tea. This would not have happened in Boston, even if we could have fit so many in our tiny space there. Moby even came out to say hi, tolerate a toddler's petting, eat a bit, lurk under the loaded sofa, then retreat under the bed.

I wish I'd been more conscious, less distracted by central nervous system. Still, so good to see people, feel surrounded and embraced. Healing, hopeful.

Good to see happy couples, smart and brave children, geekerie in all it's glory, single guys at the center, just people, talking.

We even gathered enough toys to keep the Short One happy, George, the Inflatable Emperor Penguin was a hit, as well as the green superball.

I considered the sink of dishes, rejected it as irrelevant, eminently deferrable, gladly done much later. No sharable food in the place, but then, they'd all just eaten.

Only the stench of one person's too much perfume (gods I hate perfume) lingers as irritant. Even that I just deal with, incense, windows open wide. (I had to ask later who she was, FOAF, ok, fine.)

That here is where the gang can drop in, unannounced, welcome, no fuss, makes us both happy. Don't bother calling first, take your chances on if we will be home, or if the place will be clean, stop by. Be nice if friends we don't know are introduced, but we won't quibble.

Moby may appear for adoration, as is his due.

Saturday, September 15, 2007

Orange (Photos)




The thunder and lightening started near sunset over the Eastern Mountains, the sun gone orange to the West.

First one with "Orbs" from the flash default, which makes me crazy, but had an interesting effect.

Friday, September 14, 2007

Reality

I've been watching some shows, since we have cable. It's one of those deals to get reliable internet.

I thought I would get hooked on Animal Planet, again. But, while I still like Emergency Vets (real stories from an animal hospital - close enough but not my work) and the various Animal Rescue/MSPCA shows (NYC, Phoenix, Detroit), I find myself caught up in Mythbusters, Dirty Jobs, and finally, Cash Cab. Reality shows all, sort of. I think I've finally kicked my COPS! addiction.

We were discussing what about these shows made them fun, irresistible.

Mythbusters is a couple of guys with special effects, robotic, model building experience, as well as a rather impressive compilation of other skills, from welding to animal handling, who like excuses to blow stuff up. I love the science, the enthusiasm, but mostly, I enjoy seeing smart people working together, disagreeing, solving problems, and then giggling like children when it works, or they blow something up, whichever comes first. They remind me of the bright people I work with and laugh with.

Dirty Jobs has a self described "B-list celebrity" going out to work for a day with people doing actual jobs, like cleaning cement trucks, tarring roofs, or tagging wild geese. Most of the folks are pretty bright, the host laughs at himself, or sometimes their oddities, but never their intelligence. He throws himself into the mud and poo, soot and slobber, with wry humor and a great appreciation. Hard to hide one's true self when covered in shit, cold, exhausted or bitten red ants. He consistently comes across as a nice guy.

Cash Cab is simply a game show in a NYC cab, with a final offer of double or nothing - nothing being a free cab ride really. (Double or nothing is always a sucker bet.) I feel bad for the dim ones, cheer on the knowledgeable riders, and answer most of the questions myself. It's cheerful, even the 'losers' get a bit of free fare, and the questions are on par with Jeopardy. (One contestant actually answered in the form of a question.) A moment in their lives, a peek into relationships, which are mostly pretty good. I'd get into a Cash Cab with D any day.

My friend from work poked around my blog during downtime, me looking over her shoulder. She was asking about how to find other blogs, so I showed her to click the comments, and the sidebar. I was hard pressed to tell her how to find other blogs from scratch. I put this up, read Moira's site, clicked through the links from the comments that I liked. We have an interesting corner of the world here, this network of blogfriends, artists, photographers and poets, writers and gardeners, Zen like and thoughtful, compassionate travelers, respectful and very intelligent. All striving to be true and real.

Striving for genuine brilliance, and finding it thick on the ground. This is what this is all about. Not blogging every day. Not whether the details are boring or not. Just real people, expressing their best to share with all the world. We don't need skinny, pretty people acting at us, we are enough. Scripted drama is overrated, we have stories and insights aplenty.

Now, if only we could all safely manage high explosives...

Sunday, September 09, 2007

Monster

I was a child terrified of the dark, under the bed where piraña lurked to eat off my toes, shadow demons on the walls, skulls that stared death, tree branches come to life scratching at the window to snatch at me. Creaking floors and rattling windows. I bunched myself down at the foot of the bed, thickening the blankets for warmth and psychic protection. Stuffed animals wedged behind my back as security.

My dreams haunted by skeletons, malicious eyes, I sensed myself an immense bloated entity engulfing a tiny fragile being, or my bed flew up, over the stairwell, dumping me to fall slowly, inexorably down the long steep stairs, the door at the bottom opened, to a steep, grassy drop. Naked, cold and alone, I wandered, accused, lost in the dark, light switches everywhere, none turned on lamps.

My mother would pull me to the top of the bed. I never knew how I returned to that position, until she complained one morning that I had hit her, leaving a bruise on her face, when she'd performed this essential adjustment. I apologized to her. I was angry, though. Why could I not stay there, warm and safe? Secretly, glad I'd fought back in my sleep.

Of course, it was just the house settling, just cars driving by, just ordinary trees in the wind, nothing under the bed at all. The adults had all the answers, none of which addressed my fears, and me without sufficient words to ask. Surrounded by monsters, as all children are. They have to trust, but how are they to know that they really can? Even if they can't, what choice do they have?

And I was a monstrous child, silent, scheming, a gloss of good over rage and hatred. Incomprehension of others, as well as of myself. Drifting without compass, a wild and dangerous wraith, brittle, frightened.

The monster grew up, learned to speak, became strong enough to release the rage, to forgive, to have the power to trust those trustworthy, to look the same outside and in, to find comfort in dark and light, and the shadows between. Still dangerous, but only to those with sharp sticks. A black cat sleeps under the bed, he eats wild monsters.



Inspired by Tall Girl.

Rock

I shall not be joining into the Rock Flipping week. Not that I object to those who have a reason, experience, knowledge that will make that a meaningful exercise. But to expose the hiding creatures for my own amusement, not edification, not even curiosity, seems mean. Pohanginapete gets to the heart of why more eloquently than I can.

When I was in nursing school, in clinicals, I tended to not want to push in on patient care experience. I stood as far away as possible to observe, desperate not to intrude. Clinical instructors had to push me in, until I had an actual role. Then, I took deep breaths, entered with apparent confidence and due humility. There to offer assistance, I still will leave an OR with too many people 'helping' if I do not have a real task.

Living at home, in particular the post pubertal years of greatest tension and malice with my father, I hid in my room as much as humanly possible. He would still come shouting through the house, calling for me, until I answered. This was not just a matter of making sure I was home and safe. This was if he hadn't seen me downstairs for an hour, if he'd been out in the garage and come in, even after mom told him where I was. I feared and detested him, because I was dependent on him, subject to his orders, his pleasure in harassing me. Or perhaps, just that if he was anxious, then I must be. If he was angry, I was angry, and I had no right to be angry.

Had an anesthesiologist rip me a new one for a previously unstated personal preference that I was supposed to psychically know. He spent the rest of the day effusively buttering me up, assuring me that he wasn't mad at me, really.

Ah ha.

Jerk. Never occurred to him that I had seen what he was, and no, we weren't friends, sir. As though his feelings were all that mattered, and whatever he felt, I felt. And I would of course know how he felt.

In grade school, without a desk in my room, I studied at the dining room table. My father could not leave me alone, always talking to me, expecting a response, poking me in the ribs walking past, asking me for something from the kitchen, having me answer the phone beside him, because he was busy watching TV, then talking loudly when it turned out to be for him, after expecting me to talk with his brother for a while, or else I was being "rude." When the desk came to me, left behind from my brothers, I would pack up and go upstairs as soon as he came home, and he would assure me, "You're not bothering me, stay there."

Married one (ex) who thought me closing the bathroom door was a rejection of him.

I was thinking about this, because D keeps track of where Moby is. I have to remind myself that, well, this is different. We do want to make sure the cat is not stuck in a closet inadvertently closed. Sick cats hide. And, once found, we try not to disturb him. Still, I tend to not go looking for him on my own initiative.

Moby occasionally lies in the middle of the hall, where we have to step over him repeatedly. He looks up at us as if to say, "No problem, you're not bothering me." This is amusing. I don't have to wait for Moby to feed me.

D and I are very respectful of each other's privacy. If a friend tells either of us a story in confidence, we may allude to it, but there is no expectation of details, and both treat it with utmost discretion. He is guardian of my privacy. He asks before looking in my wallet, or opening a piece of mail for me. He has all my passwords, but always asks before using them. I would no more read his email than wear his shoes out. I have to keep nothing from him, because he would never assume. If I hid under a rock, he would make sure where I was, ask if I was ok, then sit nearby quietly.

You children, scientists, naturalists, folk of the woods and streams, you have a purpose, a right, a responsibility to flip stones. I shall let the things sleeping under rock lie. I have no good reason to bother them.

Saturday, September 08, 2007

Robe (Photos)




Well, there's this updated version of Greenstamps with a particular credit card I have used since college, 26 years ago. I got, free, this much needed robe. (To replace a ratty one, gotten on sale, from a Famous Store that has gone cheesy in the last 15 years since.) Moby approves. Feel like a chocolate bear in it.

This is the first time I have ever caught him mid-yawn.

Pooped (Photo)




It was a day. I was brave, but dinged old back too much, now I am down, for a dip in misery. Just pain, nothing wrong, nothing serious. I'm bouncing back more easily each day. I have a rubber bottom by now, or I'd've been long gone.

D enjoying his required reading for the Vietnam class, and I learn interesting stories about Ho Chi Minh. Graces all over the place.

Wednesday, September 05, 2007

Floor (Photos)




Not as bad. Really, just nurse's back. It's been a week of spasm and intense soreness. It was the cramps, then the lovely storms that blew in unlovely dusts and pollens, triggering a migraine, that stopped me. I feel such a wimp, but my temper has been eroding with each day. Even as I make small, noticeable, improvements with heat/exercise/ice/rest. For all that work hurts, and the pain exhausts, all that movement does help, gets me warmed. Not today. Taking a sick day.

I do have an appointment with an LMT with experience with this kind of injury TODAY. Tomorrow properly, scheduled, off. Jumping all over this, gently. I do have company.

Monday, September 03, 2007

(The) Windowsill (Movie)



This is an older one, from the apartment with the infinite hallways, my camera work, D did the rest. The music is from Once Upon a Time in the West, Moby as Clint Eastwood, or The Cat With No Name.

Star (Photo)





... and me.

Director (Photo)



Director and star, on the set of their new project.

Sunday, September 02, 2007

Neko (Movie)

It is with great pleasure I point you to a small movie D made of Moby walking, to the theme from Yojimbo. Did a nice job recreating the Toho slate, I think.