Beds

Bed! Bed, bed, bed, bed, bed, bed, bed, bed, bed.



I had no idea how good, how much of a difference this would make. No squeaking, no shifting and the blankets didn't drift much at all through the night. Same mattress we've had over a decade - still good, but it felt larger. The only way I think that works is that the frame is a little wider, so the edge of the mattress has a smaller beachfront, steeper drop-off, more usable, supported,space. Frame's also a little longer, which we bolstered with the rolled up army blankets at the foot to keep futon from sliding. This is a bed to be handed down. Not at all a second-best. Or, as usual in my life, an it'll-do. Having just a little more income really does make life less expensive, because one can get decent and lasting to start with. When I think of how much I've spent on it'll do starting out, and replacing it over and over, the waste, the cost, is extraordinary.

Started out in a crib, and in hard leather shoes to correct turned-in feet, I am told I kicked loudly through the night. Then a second hand youth bed was given to us, low to the ground. Liked it, never really understood why I needed a different bed. Oh, I wanted a canopy, but as recently noted, the one given me was not at all what I'd imagined. Lots of plastic parts, making it more of a toy. And way too far off the ground, the mattress suffocatingly deep foam.

When I moved out, I had a folding foam chair-bed, on the floor.


It was better than a bug infested secondhand mattress. Had a friend with such a thing, and I considered my foam monstrosity a blessing in comparison.

Later, a proper futon mattress, on the floor. For many years. Some of which are no longer in my memory, and I'm not sending to the warehouse for the records.

When I moved out on my own, I invested in the cheapest, plainest pine futon frame and mattress I could find, luxury. D and I got one of the fold out sofa-bed frames and used the now lumpy mattress on it as a couch. First full-time paycheck, and he wanted a really good mattress, a futon with springs inside, and it still serves us well. We slept on a very good air mattress in Boston until our truck arrived, used the old wood plain frame until it broke apart in a move. Got another cheap, slightly less-plain frame, which got us through until now. But, oh, the whining and squeaking and creaking! So many moves, so much dismantling, and it finally had quite enough, sheesh.

New frame is hardwood, ash and oak, instead of soft pine. Went together beautifully, clear easy instruction. We clambered on, and said "It's quiet. Not at all TOO quiet." Moby inspecting at all points, the first Under. Eleanor only coming in later, checking out the Under, then hopped up over the footboard, with a slight fumble at the higher jump. "Hey, that's not in my calculations!"

Last night, I heard Moby (yes, I know them by their walks) poking around, he jumped up, walked over me and onto D. Jumped down, around a few more times, up on me, over to D, settled down purring madly. They got up, to check on the food situation.

In the morning, D already up, I felt Eleanor in the small of my back, and Moby at my feet. Well, happy birthday indeed. The bed is a hit all around. An heirloom. We've done us a solid.

We both slept… um, all four of us slept well last night. Higher off the ground, it's simpler to arise, for us humans.

I'm enjoying a day with my dearest near, no need for anything else. Except a free cupcake from a local bakery, where we get our hot cross buns during Lent. Strange thing, I brought in a print-out of the email, handed her my ID with birthdate,"Hi, I got an email about a free cupcake for my birthday," which she didn't bother look at, well, fine. But neither did she say any version of "happy birthday." Also fine, but a bit odd.

D says to me, on the way home, "'It's my birthday, gimme a cupcake', 'Ok, here."" It was that strange. Not that I mind, she just had neither officiousness nor friendliness, and I expected one or the other. Cupcakes are not my favorite, but this one was nice. D got an almond danish for himself, because they didn't have lemonbars.

He opined yesterday, "I should have gotten you a cake or something!"

And I replied, "I don't really like cake much, and I'm getting a cupcake anyway." It actually was a nice cupcake, given that it was a cupcake.



We got groceries, my idea, all good. No rushing today, no crisis, all mellow. Errands are fine. Don't care what I'm doing, as long as it's together, and calm. Then we retire to bed. It's a very nice bed.

Organic

Spring in February has a surreal quality. Warm and sun, which brings the cats to the open window. Not exactly sharing, but taking turns, of a sort.



So, I went to get seeds. Pease, beans, sunflowers, more Scarlet flax, because it took so well last year. Spinach and lettuce, too. Waiting to plant them on the 17th of March or thereabouts. Had some organic* potatoes sprouting in the drawer, so I got them in the ground, lest they sprout in vain. Still may not produce potatoes, at least they have a shot now.

Everything else will be buying plants, tomatoes, peppers, chilies. And more long grasses and statice. The green onions are already flourishing, we were assured they are unkillable, which is fine by me.

Much work on the house across the street, including laying the walkway concrete, and delivery of large appliances. Trucks blocking our driveway, but we didn't mind as we weren't taking the car out. I walked to my massage, which was lovely. Large trucks were gone by the time of our delivery.



Delivery guy looked at the house, and said "wow, this is beautiful!" We had to agree, we got very, very lucky.

New bedframe does not squeak at all. Taller, which is better for us. Really lovely, D chose the color. Best bed I've ever had in my life, and it should last us the rest of ours. Very solid. Getting the old one moved out was a struggle. Poor old thing, so many moves, cheap to start with, creaking at every joint. We know how it feels, so it's getting a gentle retirement to the guest room. One day, we may have a guest, even.




His parents' card for me arrived, and left me with a tear in my eye.

Overflowing with gratitude, in awe of the generosity of it all.


*Yes, I know. I took chemistry and organic chemistry. Even though I scraped by with Bs, I know this much. Try those inorganic potatoes some time. C-H-O-N-P-etc.

Balm

The chasing is less hissy, the tree sharing less fraught. Moby lounged on the sofa last evening, as we nestled in to listen to "Clouds of Witness", Eleanor snuck inbetween D and I. Bilateral sleeping cats, really can't ask for more.

Warm today, unmitigated warm. Got out and dug a bit, pulled up more of the damngreenplasticnetting, rearranged the rocks, left the mulch. Off to get seeds on Wednesday. May plant some potatoes as well. Dirt under the fingernails, remembering why I love the garden. Veronica greening up the back, wild parsley reappearing in front. Even cleaned the front windows today, and it's all beautiful.

As I write this, both cats have come up and settled on opposite ends of the sofa, beside me.

Soon, off to clear the back room, to make space for the new bedframe, one without a symphony of squeaks.

Blues

I have a massage already scheduled this week. Which is good. Had to update my BLS (CPR training) yesterday. Intentionally scheduled it at the class offered at our facility, rather than the main training site for the whole U system. Smaller classes, and all geared toward those of us who have been trained for years, and many of us have actually done CPR on actual people. Our own people run it, and test us. It's serious, but often fun, with stories shared that bring the rote process into real life.

Instead, the director of the Education department came to observe, after arriving late, giving us false hope that we could get through the material at speed. The guy is also an ass, thinks he's an old style comic, stupid, borderline offensive jokes. And a stickler on the kind of detail that doesn't matter - mostly because it gets lost when the adrenaline rushes into a real situation. So, our instructor has to go through every bit, in tedium, in order. Well, if it saves the satellite classes for the next time and for everyone else, we endure.

Making people go slowly through old material is a horrible way to teach. As a bright kid, bored to tears in school sometimes, frustrated at slow readers laboriously slogging through a simple sentence, I know the torture. It bred a contempt for the less bright in me. A personal grudge, that I was held to their speed when I wanted to run. I didn't mind helping tutor a kid who struggled, occasionally. But mostly, I'd love to have been put through my paces, without having to wait for the slowest, and forced to plod.

The BLS class from the 'Merican hart* is all on video, terribly repetitious, and in the situations where we work, largely off the mark. We've been in codes, we've done CPR, we were not out in a park, or in the cafeteria, but in a hosptial, and it was a patient. Not that we shouldn't have a plan if we are out in the wild, as everyone should. But we have to take this course because when we are most likely to use it is AT WORK. It's our job. And teaching from that perspective would be really, really useful. Instead, we get this tedious, generic, and largely not applicable, mandatory and torturous training.

The best ones have been taught by fellow nurses, ICU and OR people, who tell stories, of what actually worked, and how often it doesn't. And when they relate a tale of BLS out in the world, it's the one who saw her crawling neice put a marble in her mouth, and stop breathing. She grabbed the babe up, walloped her on the back, and dislodged the marble from her airway, shooting it across the room. Kid wouldn't go near her afterward, for years.

The "proper" method also involves going through the rather arduous physical process over and over. Now, my back, and my thumb, just can't tolerate this. If it was for an actual person, hellwith my back and hands, I'm throwing myself in there. But for demonstration? It's silly and harmful, to no purpose. And, when I have done it in the OR, we get the young guys with good upper body strength in as fast as we can. Plenty of them around. They get to feel all heroic, they do it much better, and the rest of us get the defibrillator and epi, while the anesthesiologist takes care of the airway. Any of us, offered an AED, could figure it out, without formal training, in a crisis. Which is what is going to work, while the CPR provides a bit of time to get it. Modern version of blowing smoke up our ass.

Which is all to say, my back hurts, my thumb hurts, and I have most of next week off work for a smidgen of a vacation.




*

Bathing

And then the sun appeared in beams of bright warm light.

Purpose

Saw this coming. At least the weather service did, and I attended. Sometimes blowing sideways, or droppping these huge conglomerate flakes, some the size of squashed quarters, these snows of February. Rather beautiful, as I sit with a cat and a cup of tea.

Thinking about Dorothy L. Sayers, and P.D. James comment about how Sayers' problem was, she fell in love with her detective. At the time, I could see her point. But since my therappy, I think Sayers did what she had to do for her own life. When we can't have what we need, we flexible humans can create it inside and fill that need. Patch it up, make do.

Also realized that my insistence on facing the truth, although useful at certain stages of my life, became… well, how do I put this? I somehow thought that by facing the ugliness, I could make those who inflicted it, or stood idly and witnessed it, to see the harm. I could shove it in their faces, somehow, by bringing it up in my own head over and over. A test of courage, that was actually self inflicted martyrdom. This is not rational, of course. My therappist taught me to reimagine it, and I resisted abandoning the truth. Struggled with that, until I realized - I knew what laid beneath, nothing wrong with a fresh coat of paint, maybe a doily and a flowerpot.



What it was, what I needed to do, was to take what I had, and recreate it imaginatively. Just as an old, leaky tub can be filled with dirt to grow flowers. Make the rotten fruit into compost. Break it down until the parts are useful. The reality is not denied, still there, but turned from garbage into growth, art, function.

So Sayers took her broken heart, and wrote clever books with a love story to heal herself, and for some of her readers as well. Sour grapes. Stories to calm our yearnings.

Emotional recycling.

Bounce

Bouncing back. Spring is in the air.

February

Quietly idle
Slackening lines, dropping loose,
Unfrozen, unsprung.



She loves this blanket, will sniff and suck it, curl up in bliss.

My redness is ever present, but no longer at critical mass. Improved, itch calmed, soothed.



But once there is some sun.



Moby and his warm friend.

Detective

Watched A Very British Murder with Lucy Worsley over the past month. Which lead to getting the Dorothy L. Sayers series. And means I may be getting a touch of amateur-detectivitis.

However. With the fire last week, I thought it had to be arson, and probably a thrill arson - or at least to no personal gain. Brief news item last evening, someone had admitted to intentionally starting the fire, and I thought - someone who worked there. Sure enough, they identified him as an electrician working on the site. Some minor drug violations and warrants outstanding.

Today, chatting with two neighbors with their dogs*, found out the meth (everyone knew it was) house in the middle of the block got raided and shut down on Friday. I immediately wonder if the two events are related. With the alleged arsonist's drug history and a drug operation abutting the work site, mix in an ATF task force, likely all are related. Maybe not a direct cause, but all tied into the same sweep. I expect he wasn't the only drug customer among the construction workers, either.

Gotta wonder. I do, anyway. But the neighborhood began to feel unsafe when half the duplex had those sketchy people move in, and now it's back to feeling more like the middling to shabby home ground it was before. The duplex will no doubt stay abandoned, with occasional squatters, again.


We've been noticing much more than the usual number of people, wandering around here, in groups, starting yesterday. I wonder if we have a small local tourist attraction. Everyone saw the big building go up, it's been in the news every day this week, so they probably thought, "Where exactly was that? Let's go take a look. Go downtown, do some shopping, stop by the charred ruins."

It's a fairly guiltless gawp, really. No one injured. Just a lot of money incinerated, ultimately.


*Spike and Mocha didn't know anything.

Mysterious

Such a warm February here, although with water accumulating in the mountains.

Reminded of a mild Februrary in Michigan as a child, my mother organized a birthday party for me. Cake and streamers, other little girls, and we played outside in flowery dresses and light sweaters. I have no recollection of who was there. I can't remember ever wanting a birthday party. I'd been to a couple of other kids' parties, and had come home in tears from both. I can't imagine I asked for one, although perhaps I did in an offhand or thoughtless way. I don't remember ever actually wanting one.

Not that it was terrible, inasmuch as I can recall. Just, mysterious. A rather lavish, undesired and awkward gift. I expect my reaction disappointed my mother. But putting me in a party dress and telling me to go play made about as much sense to me as putting me in a snowsuit and telling me to go swimming.

A brown February. Tomorrow a holiday. Friday half the day in BLS class. Next week taking a few vacation days. Keeping the month in check. February can be cruel and capricious, but will settle if left in peace.

Firm

Realizing that the therappy is holding. I poke at the space, and it's filled in, if only as a semi-solid. Gelling.

Made a joke at work about how I knew the BLS class was on the 21st, because it was my "dead dad's birthday." The three people around the front desk, J, B and G, laughed, it is funny. Well, it is; funny, and dead dad's birthday. B mentioned her father's birthday was the same week. I told her "I'm sure he is a much nicer man." B agreed. J added she knew what I meant. Fathers are difficult for many of us.

Another discussion at lunch with an anesthesiologist, sterile processing tech, and scrub, about how their mothers take care of them, where they go when tired of their kids, need a break and food, or laundry. I stayed silent. Not that my mother wouldn't have cooked for me and fussed over me in her house, but I would never have found that comforting nor pleasant. I preferred my own meager cooking, taking care of my own self, my own privacy and competence. She rarely visited me in my apartments, and only for the shortest possible time. Then, as now, I much preferred hosting, but she was having none of it. Never said why, just evaded and excused.

Even thinking about mother, and brothers, the reactive anxiety is gone. I only want to keep my distance. They endured their realities and lived in their fantasies, of which the real me played no part. Now, I'm just one of their demons. They so wanted me to love them, as long as they didn't have to love me more than the saying of it.

On another site, a comment on a post about family, essentially that people just want to blame their parents and get an apology, such a modern foolishness. No point in my answering there, so I will here. I couldn't imagine an apology from either parent, beyond imagining. I'd have been overjoyed with a simple acknowledgement from my mother.I hoped for a sort of neutral dutiful contact. I did insist on no further emotional assault and disparagement. Since that was way too much for her, I dropped the issue and the possibilty of any kind of relationship. No challenging her view, just taking myself out of the balance.

And my balance improves. I can tell. Learning from the cats.

Hail

Hail in February is pretty rare, got some this evening. Lightening took out power to traffic lights on my way home. More and more rain, refilling our reservoirs, building the snow-pack we survive on. Up to average, and just a bit above now.

Lt Rain
50°F
10°C
Humidity83%
Wind SpeedN 12 MPH
Barometer30.05 in (1016.3 mb)
Dewpoint45°F (7°C)
Visibility10.00 mi
Wind Chill45°F (7°C)
Last Update on 13 Feb 5:53 pm MST


Cats finding their comforts. Eleanor taken to walking on me in the morning. Moby sitting by his best friend, the electric heater.

I hugged D, "Thank you so much for not giving a fuck about Valentine's Day."

"No," he responds, "Thank you for not giving a fuck about Valentine's Day!"

"Well, we probably wouldn't be together if I did."

"Yeah, I can't see how that would have worked."

The rain still falls. The hail short lived.

Processes

Making noodles, then baking them in a dish with sauce, pepperoni and cheese. A simple meal, but tasty and filling. As I mixed in the cooked noodles with cold sauce, the sounds were a bit disgusting. I think this is why, although I like good food, hot, smelling good, for me and in front of me, I never enjoyed cooking. The process is somewhat unpleasant, meat at certain stages of cooking has a very unappetizing odor, for instance.

I've gotten used to some of it, it's not that terrible. But it goes a long way to explaining why preparing food is a chore, and that is all. I can't imagine a meal ahead in a way that effects me. The most I can muster is a "that might be ok." We struggle to shop well, making sure we are at least a bit hungry, so we don't just get sweets and condiments. The diswasher helps, so I don't get worried about what bowls will need cleaning after.

Having our own kitchen, and a decent one for the two of us, does make it a lot easier. Still consider people who enjoy cooking a bit like people who enjoy cleaning. Acknowledge it's a real thing, but all I will ever get out of it is the satisfaction of a job done. Or people who run for pleasure. I ran because I was paid to do so, and under orders, so I did. When I didn't have to, I didn't.

On the other hand, I'm plotting my garden. With all this rain, I really want to get some cold weather seeds in the ground, pull up more of the plastic netting. That will have to wait another month, but my fingers are already itching to get into the dirt.

Remains

It's one of those city mixed neighborhoods, office buildings and apartments, houses and a few little stores.




Investigators on the job. The buildings on either side unharmed.



That sign, directing deliveries was there before the fire, unmoved, unburnt.



Snow above.

This is how it looked with the old building, demolished for the new one, now charred. This is from at least five years ago.




The half-way house to be seems to be more than half way. Looking rather attractive.

Dosage

Idling, after my early teeth cleaning appointment. Always wind up headachy and wrong-footed, especially since I've seen a doc three weeks running. Ophthalmologist, GP, Dentist, each with a bright light glaring into my sensitive eyes. Tired of being poked and prodded and analyzed, examined. I prefer to blend and vanish, as a general principle.

Still, blood not alarming. Face much improved. Teeth squeaky. Eyes well dropped.

The investigation into the Big Fire continues, with a group of serious men in serious suits, and dark suit coats, beside an antenna ridden posh trailer, conversing. Half the street is still closed. The site had a rather awful office building from the late 60s-early 70s, fallen into disrepair and abandoned for a few years. The lot cleared, the new over half finished, and looking rather nice. I hope the project isn't just scrapped, the site left to weed, again.

Drizzly, rainy, which isn't bad. But, as mentioned, it doesn't rain so much here that we get soaked-in perma-dampness. I remember how Michigan never really dried out, the mold and mossiness of the insides of homes, swimsuits always clammy, mud all summer. Even Boston had a fungal green that lingered, always. Here, when the rain stops and the sun comes out, it takes very little time to completely dehydrate. I feel for those of you being flooded, as I feel for the far-southerners getting snow. The rain here is a moderation, and a bit lacking. Although this last atmospheric river got us to about average for snow-pack water, and this week will help replenish us a bit.

It's all a matter of dosage.

Afar

These from the local paper. We knew it was big and fierce, but didn't have a clear idea of how scary it looked from a distance. No wonder friends and family tried to reach us. It does rather look like the whole block is on fire. Thankfully, it was just the one, albeit large (61 unit apartment) building. Not even adjacent buildings were singed, because the FD were all over it, and fast.

So, no, the halfway house for homeless young men across the street is still fine, still there at the far left. Although it glowed orange in the light from the fire, for a while.

Infernal

Despite the rain, the apartment building under construction went up in flames, a few lots away, within our block. Sparks fly up. Lost internet, and for a short while, power. Huge pile of wood framing bonfire. But the weather so mild, no real wind, fire department contained it quickly, could have been much worse, in this old neighborhood. Before we knew where the fire was, we feared one of the old houses in the half street, was on fire. Which would have been very sad, and likely fatal, with spreading to the tight little neighborhood. Instead, no one hurt, no one lost their home, although a few of the close houses and apartments were evacuated as a precaution.

Never seen so many people in the streets on a Sunday evening.



I'm thinking it has to be arson, a thrill arsonist. There was no one working on the building, no power to the site, no heat sources, cleared a fire marshall inspection that week.

This fire was visible all over the valley and beyond.

Pouring

Raining the last day or so, a cold and persistent rain. Since I don't have to shovel rain, and we are desperately in need of water here, this is just fine. Snow in the mountains, promising the skiers some happiness, although it's not their ideal snow, and the avalanche danger is very high.

Raked out the clogged gutter of muck and trash. Lots of trash. Amazing how a small proportion of people can leave so much. Someone had been standing near the hedge, dropped a pack of cigarettes, and a score of butts, on the front garden, evidently stood there a long time, smoking. Apparently the sort of person who doesn't see that as very weird. This is the neighborhood. Lots of decent folks, a small but significant number of seedy ones.

I miss days out east when the rain rains all day, and all night, and all the next day too. The drizzle and fog, rain to scour the winter away. It all gets a bit much out on a great lake or ocean, sometimes. Here, never enough for me, and I find it comforting. Today, we are communing with the napping cats.

Eleanor walked up on me this morning, sat on my chest with her haunch against my cheek, her tail flipping around my ear. I called out to D, "I have a cat." He answered "So have I." When she'd decided that was enough, she sat up on my shoulder, her back legs on my clavicle for several minutes. Must've looked funny. Sure felt odd.

Moby purred on D's lap long after Eleanor let me get up. They've been largely ignoring each other lately. Well, as long as it's peaceful, it's their business, we just watch.

I should start on dinner. Not much interested in food, but putting it off too long doesn't help. And lunch for work. So tired of thinking about food. Two meals a week, I could get excited about. The rest of the time, just something nourishing and unremarkable. I enjoy tasty, spicy, healthy meals, but only while I'm eating them, and only then if I'm hungry. Makes shopping difficult, and learning to be a better cook an uphill battle.

Pope

Well, I have known my share of crispy nurses. Found this over at Arbroath.



Not lovely, but oh so much less red. No longer vaguely afraid my face will explode off in a puff of dry, itchy skin. Not cheap, even with insurance, but think how much I've saved not wearing cosmetics all these years, and it evens out. Really remarkable improvement, even if the photo doesn't show it.

Watching a show about Pope Joan last night. I'd thought it pretty much debunked, but apparently there still seems to be ambiguity, which feels right. The story as told is almost certainly urban* legend, so pat and with a twist at the end. But that women got into church positions, over two millennia, seems inevitable. That one made it to pope is also rather likely, although not as the tale goes. More like James Barry, a British Army Surgeon who lived male, but who's body was at least technically female.

What I suspect is that s/he was not clearly male or female, not wholly either. Most cultures don't have a tick box for Other. Or, A Bit of Both. No matter how much needed. Pope Joan the story, expressed the anxieties of a female hating institution. Pope Joan the real person may have been ambiguous, passing even in her/his own mind, only 'discovered' after death. Perhaps more than one. The odd bishop and cardinal as well. More than a few monks and priests in every generation, I would think, although kept quiet and hidden.

And most of us, perhaps all of us, are not at those extreme ends in all ways. Good, because there is no balance out there. Humans are both, in order to be full human. We don't belong in boxes with clear labels, no escape. Trapping both the jailor and prisoner, inside and out.

I have a female body, no question. I am only attracted to men, although I had mild, vague crushes on a couple of women when I was younger and in love with the world. I have the weak and feeble spacial skills of a female, sadly. Never had any use for dolls, although I adored stuffed animals. Hated pink, and had no interest in most of the girl-toy aisle, preferring the baby toys, games, or building blocks and balls. The boy aisle, all OD green and brown with explosions and war scenes and models in dull colors, held even less appeal, save for the cars and train sets.

I can talk squishy emotions with the best of 'em, (how else could I have made it through much of nursing school?) but I prefer talk with content. This is, I'm sure, why I don't get chatting about food and babies, nor sports for that matter. It's bonding talk, making sounds to join in. I get that, can only stand so much before I want to add that what they are talking about it actually an urban legend… or somehow misunderstood. Sometimes, I manage to resist.

We are all such mixes, what else would we be? Both parents, and whatever siblings had that womb before us left traces, antibodies, graffiti on the walls. To be fully human is to be both, and neither, swirled together as uniquely as our strands of genes. Bespoke.

All this in response to several insightful and intelligent posts over at flask's place.


Anyway, each one of us is a true and genuine pope.



(Yes, I do carry one of these.)



*Vatican City is certainly urban.

Fuzz

Managed to keep from scratching my face madly the last few days. Easily the worst outbreak of this, so, good thing I got seen. The stuff got to my work pharmacy, picked it up on my lunch, applied, it burned. But I endured, and within an hour, my face felt a bit better. Didn't look better, but that don't really matter.

Also got labs back, all clear, nothing worrying at all.

By the time I got home, D actually could tell my face had improved visually. Which is nice.

Sometimes, just gotta pull out the potent stuff.

Brain fuzzy.

Roses

It's not like I've ever had a flawless complexion. Never had bad acne, always some. Which provides me with hours of entertainment. But it was never an issue.

Appointment today, and at least it was still in full flare up when I saw the doc. Itchy and red, irritated and obvious, easy to diagnose. My face felt raw and unhappy, in need of care. PA student set on me, with permission.

"Part of my job."
"Oh, not really, I appreciate it."
"Well, I work for the U, so, yeah, this is what we do, even as the patient."

We all need to teach, and learn.

Doc is knowledgable, which I love, dismisses some of the concerns. "Part of our job is to scare people into getting help" he says. I suspect the loss of vision from rosacea is one of those rare things, like enchondromas that are actually lung cancer metastacies. Which is important to know, for a specialist. So, I follow up.

Getting some lab work as well. I'm sure it will come to nothing, but I don't want to be that nurse. The one with the bilateral, end stage breast cancer, who had a positive biopsy two years before, but delayed treatment until the sister she'd been caring for, with breast cancer, died. I'm sure she's long gone now, and that image, those hard oranges, the dissection down to muscle, will stay in my mind all my life. Given a clue, best to take it. Foolish not to. Ignoring the unlikely is one thing, turning a blind eye to a roaring monster, not so much.

So, I take solid advice, and follow it to a reasonable conclusion. Just the eye drops have helped over the past week, the lid tick is much calmer. Hopefully, the facial skin will follow along. Getting medicated cream for it, and maybe some tea bags for them as well. See what works.

Not much of a day off. And I went in to help cover lunches. Only a couple of hours, but it's so appreciated.

Chin, chin.

Beverage

I drink tea. Have done since childhood, that was the hot beverage after being out in the snow, or just coming home from school. Mostly milk, enough tea for warmth, when I was small. The ratio would alter over the years. Red Rose bags, with the little porcelain figure in each box. Whistling tea kettle, large mugs, a flavor of comfort.

In adulthood, I learned not to even try and order tea in a restaurant. A diner might provide passable tea bags and a two cup stainless pot with fairly hot water, although it sometimes tasted of coffee. Chinese restaurants would usually produce a decent oolong in a pot. Other than that, I was simply ordering up disappointment.

Coffee I could never abide, and believe me, not for lack of trying. In Basic, as the only source of caffeine, or at least not sugary fluid, I once downed a half cup, and could no go further. Not sure why it gags me, perhaps because to me it smells of wet dog. My father would pour hot (instant) coffee over shredded wheat, and that had a stank to fill a house.

Coffee is always on offer in this country.

At the day surgery in Boston, there was a kettle on and a stash of tea bags of dubious age, but it was something, and I appreciated it. Usually, though, at work, there was no tea, nor a way to brew it, however low my expectations. At the hospital where I worked longest, there was a soda machine, which was not good for me. I tried to bring an immersion heater and my own stash, but it took longer than I was comfortable with during not long enough lunches. Never really worked well enough to balance the effort.

Where I work now, the coffee maker has a hot water spigot, which although not boiling, is plenty for oolong, which I supply, and a place for me to keep a ceramic mug. A month ago, our office manager stocked one cupboard full of various teas. Mostly the fruity and flowery tisanes, but also a passable black tea, and the spiced chai is not bad.




Yeah, not what I keep at home, but I'm being provided with a realistic version of my lovely beverage of choice, two in fact, by my workplace. A small gift that I'm very grateful for.

Consternation

Eleanor started on the first step of the tree, which meant Moby couldn't go up on HIS tree without a scuffle. Eventually, she left, he got up, then she hopped up to the Second level. There was mild disagreement, but they eventually tolerated each other, in part because I opened the blinds so the second shelf had a view (pictured above.)

A little later, Moby had the tree to himself, but she hopped up again. Ok. Until she tried to provoke him into a chase.

\

Ah, the drama.

Scrub

I learned to scrub concurrent with learning to circulate, back when nurses in the OR were expected to perform both roles well, even as there were scrub techs who only scrubbed. This is no longer the case, as scrub certification programs became the norm. I'm glad I had the chance when I did.

These days, when I scrub, it's often just hands or feet, as those are the less technically demanding cases. When I was taught initially, I learned general cases, urology, peripheral vascular, transplants, gyn, and a few simpler orthopedic cases, eventually a bit of arthroscopic cases. Learned ortho scrubbing in Boston, scopes, backs and trauma broken bones, but never total joint replacements. Those are very complex to scrub, and the surgeons expect the scrub to have it all memorized, just handing them what they need in the proper order. Huge set-ups, many pans of instruments.


So, when I'm scheduled to scrub, I take off my watch and ring, and check my case carts. Make sure I have everything I need for the whole day, from two to ten cases, usually more like four or five. Check the schedule for special equipment or implants, pull the extras for the specific cases, light handles, gloves - in various sizes and types - for everyone, fluid bottles, other commonly used sets for just in case, like k-wires or 70˚ scopes, different shavers, or osteotome/curette sets. Sutures as needed, depending on the case and surgeon preference. Deciding what needs to be open, what needs to be just available, and knowing what we have as a facility so as not to screw over another room, or myself later in the day.

Go to the sink, do a 5 minute scrub, dry, apply surgery scrub approved antibiotic gel, take a quick break. About 15 minutes until the first case, get mask on, open all the supplies, re-gel to specifications, self gown and glove to sterile standards, set up table in a clear and organized way, counting sharps with circulator, setting out drapes, pulling out frequently used instruments, setting up the mayo stand with cords used at the beginning, light/camera/remote/shaver, bovie, suction, drill cords.

Surgical team comes in scrubbed, I hand towels or gowns, glove them, drape or assist draping. This can be just a surgeon, maybe a fellow &/or resident, sometimes 2nd resident, occasionally med student or PA.

Then the case starts, and I hand instruments pretty much constantly throughout as they dissect and repair, as well as handle irrigation, specifically requested implants as handed to me by a rep or circulator, replace anything dropped or contaminated, protect everyone from scalpel blades and suture needles, watch for any potential contamination by anyone, hold retraction as needed, move my table to allow access, drape c-arm or mini-c-arm, move in and out as x-rays are taken and the c-arm is moved in and out of the way. Anticipate needs based on what they are doing, and mumbled plans that change as they see the actual damage, and communicate that to the circulator.

For fractures, handling the drill bits, tissue protectors, k-wires, changing out heads or chucking up different items, hand the depth gauge while getting the proper screw driver for the proper screw. When given the size, pulling it out of the screw rack (sometimes ain't easy) measuring it and confirming as I hand it over. Noting it so the circulator can document implants.

I adjust what I have up close depending on the part of the case, to avoid a pile of instruments that could pierce a glove or be dropped or simply to make it easier to hand what is needed without rummaging through.

This little bugger has cut through more doubled gloves than anything else. And everyone uses it.



And knowing all the names, and alternate names, and joke names for them all. Handing an instrument in a rapid, fluid, steady motion to the surgeon's hand in a way that they can use it properly without looking at it, and to the proper hand. Sometimes two instruments, one to each hand, at about the same moment. No, that's not even uncommon, a needle driver(there are many different kinds) and a pick up (innumerable different varieties) so they can sew.

This all becomes second nature, the variations are what takes attention.

Then closing, as I do final counts with the circulator, accounting for every sponge and sharp. As I cut suture as the resident stitches. Circ gives me dressings, which I prepare to surgeon preference. Once unsterile, I cut away drapes, make sure no instruments are discarded, remove tourniquet and bovie pad, coil cords, usually with help from the circulator or whomever comes in to assist turnover, get all the wet stuff safely in garbage bags - mostly just for arthroscopy, there is remarkably little blood. Discard my sharps properly, take my now tidied table to decontam beside sterile processing(SP), toss the laundry in the bin, garbage in the other bin, pour out suction containers, wash my hands, get another table, and go right back and do it all again.

After double checking the schedule so I have in my head what I need next, I make sure SP knows any one of a kind, or not enough of a kind, instruments or sets I need turned over. Meaning, cleaned and re-sterilized for the next case, or perhaps the one after that. Or for another room. Making sure no one has stolen the drill I knew was there first thing, but might have been needed sooner for another case. Or that the patient's hardware that they wanted has been processed for them. I may have to take specimens to be sent, or broken items brought to the SP staff's attention.

I return to the room, and hopefully the core guy and the resource staff have mostly cleaned the room, and will stay to help me open. If not, I will wipe everything down, mop, make the bed, change linen and garbage bags, adjust spotlights as needed, before opening supplies. But, hey, at least we have packs with most of what we need all in one place. When I started, we had to open everything, table cover down, every individual part of the drapes, bovie, gowns, pitcher, every scalpel blade, needle counter, suction and tip, bulb syringe. This is much faster now.

Our turnover time, from patient out to next patient in, is about ten minutes. Getting a few more minutes because the patient is still in the block room is wonderful. Although too much, all day long, because of a slow anesthesiologist, makes a big day much longer. As long as I'm open when the patient rolls in, I have time to set up.

This all sounds so much busier than when I circulate, but in terms of actual jobs and the time it takes, it's not much different, depending on specifics. And as circulator, I help with all the scrub does, and make sure they feel as cared for as I want to be when I'm scrubbed.

Some days, it's actually pretty chill, getting to joke with everyone, as the automatic responses take over.

Circulate

For those who have not been reading all this time, I feel I need to explain what I actually do. This is not clear to most people, even other nurses.

Circulating. This means I meet the patient, make sure Pre-op nurses have the consent, ID bracelet, allergies, identified, and I ask the patient the name they prefer, that their surgery side has been marked, and know what friends/family are waiting for them, or not as the case may be.

I set up the room, with the scrub tech(or nurse), make sure the video is working, set up for all the charting, get all needed equipment is in the room, the bed is made appropriately for the position, all positioning aids are present, name is on the whiteboard, suction, bovie (electrocautery) x-ray, drill power, compression boots, warmer, padding, and prep all ready.

Patient rolled in by anesthesiologist, I get time recorded, warm blankets brought, untie the gown so they don't get caught or choked, move them over to the correct position, deal with any special needs, put the armboard on the gurney side, and take the gurney out to the hallway. Add any padding, safety strap, warming blankets needed. For a prone position, or a shoulder positioner, this adds several additional steps. Compression boots, foam pads, clamps on the bed for later additions. All with patter.

If there is a resident, I can start counting sharps and sponges with the scrub, giving them fluids, local, putting on a tourniquet, charting. If not, I hang out and am available for hand holding, helping with the intubation (holding cricoid pressure, or moving it to assist visualization of the airway, pulling the stylette, whatever) or holding the O2 mask.

I put the patient in the correct position, with the resident/fellow/surgeon. Strapped, taped, padded, depending on what is being worked on. Legs go up in stirrups, shoulders have beach chair positioners with wedges under the knees, with the other arm on a padded holder, or lateral with bean bags and axillary rolls, hands are the easiest, with just a working side table. Warming blanket placed, monitors so they can be seen, camera, pump, shaver on.

Tie gowns as the surgical staff come in scrubbed, plug in bovie pad, compression boots, warmer. Available for draping, catching strips from the adhesive stripes, plugging in camera, bovie, drill, fluids (with controller) for the arthroscopy &/or backtable, shaver, suction to the neptune, lightsource. Grab the hand from the suspension for the surgeon to drape it, make sure the scrub has everything, including closing sutures. Dim the lights, or make sure they are on, depending.

Chart like the wind, get implants to the correct size, chart and charge for medications, implants and drapes. Then I stand, or I run, not much in between. If the inside is not exactly as expected, I get other instruments, implants, grafts, as needed, then chart them, often extensively. I get local for post op pain, draw it up for the scrub, deliver it to the field and chart it. Then dressings, splint supplies or slings/boots/immobilizers, call Recovery, move the patient over to the gurney, O2 on, chart with them, walk them over to PACU and give report.

Rinse, repeat.