Márquez

New glasses.  

And so I rest here

A day ends a year ends here

At the end I rest. 

This is not what I could have expected, but I think a year ago I would have been glad to know there was respite. Not salvation, no paradise, but an easing, less pain, a chance. 

I have been vaccinated just over a year now, a second vaccination, a booster. Tested and shown antibodies, likely had it two years ago now.  Love in the Time of Corona. 

The war started long ago continues, the outcome unknowable.  The peace lays in our hearts, in our love for each other, and will not be extinguished. 

Lantern

Dylan and I gave each other Lucy. She is so soft and gives wonderful hugs. 

Our tree is less shiny this year, but full of our ornaments. 

On the advice of an artist friend, I got some paints and touched up the old lantern that belonged to Granny. 

It was a light, lit up when I was very small. The paint was almost gone on one side, worn away on top and bottom. This is good enough for me, and it's come back to life. 

From earlier years, the wear is visible. Of course I didn't take a good Before this year.

I may touch up the weird baby ornament next. 

A time for renewal. 

 

Culture

 Thankfully I asked about the culture in the new job, in several ways, of various people. And I got olive wood spoons from trader joes and holiday cards. Because my three close colleagues got presents for us as well.  They seemed to be appreciated, not food, not smelly, but pretty and useful. 

These will get the most use. 

The other two gifts were scented, the hand soap in festive theme is actually really nice. The candle will go to a different home, although it is visually pretty. 

Token gifts, not extravagant, thoughtful enough in a professional setting.  I also gave our schedulers cards, with a bit of cash. Seemed important. 

I have my usual Thursday off, Friday off as the official holiday, and of course Saturday and Sunday. Next week will be the same.  Since the hand clinic I'm responsible for is on Fridays, it means two really slack weeks. The last three days I had way too little to do, but had to be there to handle alerts and a few fractures.  So, I had some use, but not enough to fill the whole day.  Sort of guard duty, be available in case.  Getting a reputation for keenness, due to disliking being idle that much. I love a slow day as much as anyone, but this week was too much of too little. 

Grocery shopped this morning, since our only absolute requirement for this holiday is to have enough food. 

I keep thinking tomorrow is the holiday, and it's not. Not that it much matters, really.  Storm coming in, warm and windy. Hoping it will be mountain snow valley rain. MSVR. 

I think they are planning to give us a mouse, don't tell them I guessed. It's a surprize. 

Encrusted

When I finally headed up to work the other day, the sun was out. Usually this means a lot of melting of our typically fluffy, salty snow.  Not this time. The trees are still thick with snow in branches. And a lot of trees in this area have lost a lot more branches than is typical with this much snow. 

Eleanor adores the heating pad today, I've been keeping it on for her. Took her a moment to realize what it was, but once she figured it out, "OH! it's That!" she was stretched out and not going anywhere. 

The tree is mostly decorated, less than usual for me. That could change as the week passes. Or I might leave it with just enough rather than my usual "totally encrusted" style.  We shall see. I have time. 

 

Later

The Utah Highway Patrol asked motorists to work from home or delay driving if possible Wednesday morning.

 I FINALLY get to follow this direction, for the first time since I was in school! No patient is waiting for me, no doctor tapping their foot, nothing so urgent I can't delay it a few hours. The snow started last evening, and it's still plummeting down. I got a text from my colleague saying she'd be in late. And I texted back, What a coincidence! 

 I'll go in later, no problem. I'm up and dressed and ready to go when it's safe. BUT THAT ISN'T NOW! and I don't HAVE to. I can use my judgement and stay off slick, slushy roads. Gosh. I get a Snow Day.

Granted

 I've noticed a degradation in my writing here. The job really is sucking up my mental energies, not surprisingly. I have to trust that my flow will return, once I get over the steepest curves learning the work. I know I can get it back with consistent, daily practice,  that simply isn't possible at the moment. 

I'm not even making photos daily, which takes a lot less brain work than writing. 

It does feel like a new phase of my life. The beginning of the last third - if family lifespans hold true for me. I've worked on all the damage, created and found and salvaged. The future is unknowable, and the past is a fading dream. 

I love and am loved. This is never to be taken for granted. And can never be taken. 

Lachrymating

Showed up in the Atrium at work. 

Then it snowed, and it deflated. 

Zeppo looking out. 

Before the storm. 

"When we meet somebody whose separate tunnel-reality is obviously far different from ours, we are a bit frightened and always disoriented. We tend to think they are mad, or that they are crooks trying to con us in some way, or that they are hoaxers playing a joke. Yet it is neurologically obvious that no two brains have the same genetically-programmed hard wiring, the same imprints, the same conditioning, the same learning experiences. We are all living in separate realities. That is why communication fails so often, and misunderstandings and resentments are so common. I say "meow" and you say "Bow-wow," and each of us is convinced the other is a bit dumb." -Robert Anton Wilson, Prometheus Rising 

 The cold rain and snow falls 

Tired eyes raw with blue screens 

Hope sleeps deeply now.

Bowling

 

Cat or bowling ball?  He's very short bodied, and picking him up is a bit like picking up a fur covered bowling ball.  Seems to be just his cobby shape, the vet expressed no concerns about his weight.  He likes the laundry room, and this spot on the folding table. 

He does not like the vacuuming that has been happening the last few days, and has been keeping his distance. Did not come out to visit when friends appeared yesterday, which is not terribly surprising for him. 

Luxury

 Eleanor knows what she's thankful for. In this case, who. And he's the same one I'm most thankful for. 

Vacuums

There will be photos here later. 

I wake on this day of gratitude in thankfulness. 

With a job, enough income, puzzles to solve and people to help. 

Tomorrow we make it a another day, because there is more to be thankful for.  Our 31 years together and the friends we have gathered. I got yesterday off because Thursday is my usual day, so I get the day before. Friday I get off because my surgeon cancelled that clinic, and my colleague agreed, which is how these things work in this job. 

Before I left on Tuesday, I made a point to tell her how grateful I am, for the time off, and for this job. She expressed similar sentiments, glad that I do still like it, after all the frustrations, and that I am there doing this work. Apparently there really wasn't anyone covering hands/shoulders/Foot & Ankle/oddball, as a dedicated employee. 

We got a new vacuum, since the old one has a tear in the electrical cord that makes it unsafe, and we don't know how to fix it. We will pass it on to someone who does. Yesterday, I got up the past two years of dust and grime that had accumulated as a result of my despondency and lack of vitamin D, and the general lack of anyone to notice coming to visit. The last time this place got a proper scrub was when we hired a cleaner after I broke my wrist. 

I am thankful for the vacuum. Yes, I am thankful for nothing as well. Actually, nothing - especially. Letting my brain rest a bit, this work really does push me to think in different ways, and work a lot harder. 

Today, we will have frozen Thanksgiving Dinner inna Box from Trader Joe's, for the sake of form. Tomorrow, chili. Today I will send messages to everyone we know and love, making sure they know we appreciate them. Tomorrow we will see some of them here - all the vaccinated with decent immune systems. Not as much hugging as once was, but presence. 

 Electile Disfunction. 

There is a video at the bottom of the page. It's very much to the point. 

Boosted

 Yesterday I got my booster at work, which was a nice break. Sitting down waiting for the shot, another 15 mins in a recliner (!!!) after to make sure I didn't have a bad reaction. Shot so smooth I did not feel the needle at all, only her hand on my arm.  Brought my paper card and the app to show I'd already gotten the first two. It was reassuringly busy.  We have to remember we are the majority.  We really are.

My arm was so sore overnight, and I had a headache. Today I ache in every joint, but I'm not feeling ill at all.  I have today off because the official day off on Veteran's Day is my usual Thursday off, so I get this as my comp day. Two days off, in case the booster decided to play rough with me. So far, so good. 

The Utah Pork Producers provided free lunch for Vets and Staff yesterday, so T and I went down to get ours and enough for the residents. Three slabs of pork loin each, a small bun, decent BBQ sauce, chips and cookie, with bottled water. I ate one of the meat slices in the bun, with the sauce, and the cookie. Our residents ate far less of the protein than expected, and a lot of it wound up in the trash. I hate wasting food, but no one was going to eat it. And today I feel like mostly being vegetarian for a while.  It didn't taste bad, as such, but there was something too heavy about it, too dry, too... something. It will be a very long time before I even eat crispy bacon again, possibly never. 

Espresso

 I had to try it. And, with cream, it's oddly appealing. Won't be my favorite go-to tea, but I'm happy to have it as an addition and occasional tea. 

When I first started in the OR, a traveling scrub tech, at the sterile field, once very seriously asked me for some... sterile (tap the table) espresso. Ha. 

So when I was asked a few years later by a surgeon for an espresso at the field I said, "Yeah, pull the other one."  But. There actually is a tool called an Expres-sew.  Can't win. 

The compost piles are high and rather light with leaves from neighbors on both sides. Winter rain and snow will tamp them down in time. 

Looking forward to my short week, I get Wednesday for Thursday when I'm off anyway. First time getting Veteran's Day off in many years. I can certainly use a bit of time off.  Then over Thanksgiving, when I get five days in a row. Let my overheated brain cool off a bit. 

Mouser

Eleanor happily cuddles with both of us pretty much all the time.  Zeppo does as well - when he's in the mood.  He must get his hind haunches and tail rubbed as I eat breakfast.  Cats are so individual,  tail tugs and belly-rubs are this skittish cat's favorite things ever. 

Our neighbor lost his cat Sebastian last month.  Sebastian adopted Mike when he moved in, with the condition that he would always have the option to go outside. He was a mouser of great skill. So when he died, the mice, or possibly rats, moved in. For a few weeks we both noticed them, I put out snap traps in places where cats and squirrels wouldn't accidentally get caught. But I needn't have bothered. Over the past week and a half, I have been gifted no less than four very large mice, or smallish rats. I do not know how to tell them apart. Two on the front porch near the door, two in the back on the walkway. 

I thanked our new Mouser, in abstentia.  I do wonder if it is Mr. Kenny, the black kitten my other neighbor and I fed several years ago during his first winter. None of the rodent gifts were eaten, except for one front leg, so the Mouser is, presumably,  being fed by someone in the neighborhood. 

 

Cancelling

 I found out Monday morning that my hand surgeons were going on a medical mission. This month. And it is my job to cancel and shift clinics and OR schedules. Leaving over 20 people who thought they were going to be seen for their hand pain left back in limbo.  And another four people who thought they were going to have surgery, now back on the waitlist. 

Most were annoyed, but patient with me. A few were angry, and I let them blow off steam at me, as I validated their frustration. Some told me they were going to report this, which I agreed was appropriate. 

This is all made worse by the fact that with the holidays, we had even fewer clinics and OR days. And referrals for care in the community - outside the VA system, is very regulated and there is a big backlog. Some of the regulations were eased during the worst of Covid, but were re-instated and re-enforced in the past few months. So, to get their care covered by non-VA providers, they have to be pre-authorized to have it paid for. 

Of course, a lot of people don't have insurance, or it's expensive, or will leave them with a massive bill, and insurance loves to disallow paying if they can. ACA has improved care for a lot of people, but it's still part of an insurance system that is out to make money, not provide care.  And this is for those who don't have access to the VA at all. 

When we got back from Gulf War I, we were covered as Vets while we were still in the national guard. Since I had no other access to medical care, and barely enough income to cover rent and ramen, that's where I went. Walked in, took a number, and waited. It always took at least 4 hours no matter how early I got there. About 2 hours to be seen, and another 2 to get a Rx or tests. Antibiotics for URIs & UTIs, steroids and an MRI for my sinuses, a lump taken off my shoulder, I paid in time that I had rather than money that I didn't. I was grateful as hell, even knowing it was not exactly ideal. 

So yesterday, in the midst of a busy hand clinic, with a computer access issue that meant our MDs didn't have access to charts and x-rays, and we got behind 60-90 minutes, and two or three patients who lost their shit at us because they didn't get what they wanted, my old hand surgeon came in after the OR was done, rubbed my shoulders and apologized for the mess he had me clean up. 

Well, cleaning up after surgeons has been my job for over 25 years now, so, here I am. This is what I'm paid to do. Best do it cheerfully.  I managed, I dealt with the minority of crabby and mentally ill vets, I deescalated and sorted and worked the problems until it was all done. And even working 40 hours a week at this, I'm not in pain as I was working 30 hours a week in the OR. This is my last hard climb to a decent retirement. 

I can do this. I can. 

Dylan had a procedure this week, and got his booster, so he's feeling more than a little ragged. I got to see him a bit disinhibited with drugs, so that's my consolation prize for being his nurse as well. I'm still not getting much energy improvement from the vitamin D supplement, but that can take several months to be noticeable. 

Later this weekend, I'll write about the cats and the compost and some new tea.

Circo

"no es mi circo, no son mis monos"

Not my circus, not my monkeys.

Fridays are going to be my solidly crazy busy days. With the day off before, and being in clinic that day, it will be a scheduled "pelt the coordinator" season. It's ok, it's kinda fun, really. So glad to be back in our little office cubicle later in the afternoon where it is quieter.  My life for the next six years. I know the time will whoooosh by.  

It's a good gig, and I am content. I don't take the grumpy people personally. I make mistakes, I fix my mistakes, I solve problems and move on and do the best job I can. I rattle cages, that is a big part of the job. Patient calls, no one has called them, no one has listened to them, they can't get through. I break up the clog, inform a bunch of people, get some texts and calls and emails oiling the machinery, and follow up. I live in a forest of sticky notes.

But I also am learning when to step back, when a patient is trying to work the system for their own addictions, manipulations and unreasonable demands. Like wanting their surgery on one particular day, and there is no surgeon to do the procedure that day. Or they are out of narcotics and want a refill, long after they should need one for their particular issue. "I know my congressman's phone number!" - Good, we all should, but I still can't kidnap a shoulder surgeon and make him do your surgery on that particular day. 

This is when I just need back up to tell them, no.  No, but here is another way through. No, but we do care, and want to help you get better, just not like that. 

As a scrub, I often heard surgeons make the not-entirely-a-joke instruction, "Give me what I need, not what I ask for!" This is in reference to them asking for an instrument, but they mis-speak, and the scrub probably knows this, but gives them what they asked for.  Learning to be semi-psychic is part of the job.  Pattern recognition, mostly.

People who have been through the military are often not the most stable of people from the most secure families. It leaves fracture lines. We were already a bit broken before we signed up, in all the ways that humans can be crazed* and that environment both stabilizes and creates new damage. Age shows the wreckage beneath the facade, as well as the determination and strength. 

*

When the old job threatened to blow up in my face, one of the most important determining factors in my decision to let go, was Dylan gazing at me and saying "If you don't have this job, your back might heal."

My back is feeling much, much better these days.

No, I can't do that job anymore, but here is another way forward.

Now, just got to get my Vitamin D up to measurable levels.

Radical

"What does it mean to be radical, to tell radical stories in our time, to win the battle of the story? The North American tradition seems to focus its activity on the exposé, the telling of the grim underside of what we know: the food is poison, the system is corrupt, the leaders are lying, the war is failing. There is a place for this, but you cannot base a revolution on the bad things the status quo forgot to mention. You need to tell the stories they are not telling, to learn to see where they are blind, to look at how the great changes of the world come from the shadows and the margins, not center stage, to see where we're winning and that we can win something that matters, if not everything all the time." 

- Rebecca Solnit

From the hospital 4th floor, I can look out on the mountains.  Rain fell on the valley for several days, and left the mountains covered in snow. At least the tops of the higher peaks. The drought is not over, but the potential for respite, is welcome. The skiers are happy. Us gardeners are as well. 

As I get the hang of the job, often in the clean up of the errors I made when I didn't understand it as clearly, I can feel my brain chugging away. It really is like a complex puzzle, and working through it requires an endless persistence. All while responding to new requests requiring attention and solution. 

I love it. 

I'm tired, and it's hard, but when I find a way through, it's a satisfying thrill.  And I really like my co-coordinator who is teaching me. We have a similar approach, and she is so patient about my learning process. She has a great sense of humor, too. The nurse who runs the clinics told me we seem to really work well together, after I'd mentioned how grateful I was to have such good people to work with. 

Sadness, too. Cancellations due to covid are common. But then pretty much all our patients are people with multiple issues. And it's not just that they were in the military, but the reasons that being in the military was a choice they made to start with.  I mean, I joined because I was lost and needed a way to get back into school.  That was due to the emotional disruption and poverty of my childhood, the army wasn't so bad. We may need a public service system that includes education as well as physical and emotional health for all young adults.  Let them rebuild their lives, find colleagues and family, work through their emotional issues, get proper healthcare, save some money rather than incur debt. Without the goal of maybe killing people. Instead, learn skills, become proficient in.... well, whatever. Farming, plumbing, building, coding, doctoring - all while making life better for themselves and others. Give them a boost up rather than bury them in a hole. 

Indigenous

 Went out to replace my trench tool, the single most used gardening tool I had. Some random dude stole in in the spring, when I could not replace it because I wasn't spending a dime I didn't need to.  Today I have a new one, and bulbs to plant. The spring garden was so sparse, still, and I wanted more color. Found these, and look forward to their blooming. 

Spending the day getting a few things done, but mostly letting my brain rest.  It's been raining all weekend, and the week ahead looks wonderfully wet and cold.  My northern soul is perking up.  The glow-in-the-dark skeleton is up on the porch. A pumpkin is on the table. Next year I may again try to grow pumpkins.  

Big story about my work and the change to the computer systems. I'd heard already of course, but how long it will take... I may retire before it happens. On the other hand, there is a lot of hiring going on, or at least in the laborious process. New positions, changes in protocols. And me trying to figure out what is old, what is new, and how to get it done, when my access is limited. 

I figure, make it six years, and I can retire in relative security. Assuming the world hasn't completely fallen to bits by then. 

Here's to Indigenous People's Day!

Or Columbo's Day (the tv detective played by Peter Falk)

AWOL

 An old friend, from the old job, stopped by on her way home.  Big hugs and a bit of gossip were entirely welcome. I've been head stuck down in the job, almost phobic about writing here or messaging anyone for the last few weeks. My brain is full.

Starting to see the whole scope of what my job will be, at least if I want to do it well. Which I do. It's like an enormous crossword-jigsaw puzzle with other people moving the board. Mostly I'm keeping up, largely because doing it right is what is important, and the sense of RUSH in the OR is largely absent.  Getting to use my knowledge base, and adding to it in lumps and chunks and tangled masses of fine detail. 

I will stop by and read all of your lovely stories soon, really I will. At the moment, I'm still struggling not to just fall asleep after dinner. Reminds me a lot of my first year in the OR, trying to cram everything into my brain so that I could already be good. 

Still, working with a lot of good people, and we are all fucking vaccinated. Unlike my former place of employment, according to P. 

This weekend, more this weekend. I have the Monday holiday off. I will rest and write. 

Everyone

Fuck.

Ring

 

Rubbed

 

He hopped up and rubbed Nicole's arm several times last evening. Very happy about this.  He's letting me rest my head against his body, if I reach back and pet him, he purrs. We make progress. 

This past week working my job alone has been difficult. Keeping my nose above water, but I was right to be daunted. I have my tomorrow mapped out, as I begin to make it my own. Lots of problems, and dealing with problems is the job. It's all awkward, I'm still pretty slow, trying not to let it infest my dreams.

We've been watching the new Ted Lasso series. So well written, acted, made, very glad to have found it. 

We went to the street fair yesterday, in light rain it was much nicer than when the sun beats down. Found a ring that suited, Dylan got it for me. Not expensive, wouldn't know what to do with expensive, but appealing, with a lapis stone. 

Tunnels

Took her out this morning, since the smoke is clear at the moment. She loved the green tunnels under the overgrown sunflowers and catnip. Got her line snarled, so I unclipped her.  She's no longer prone to bolting, I trusted her to stay in the garden. When she was done, she low-crawled to the front door.  

Zeppo still has me on probation. I can pet his back and tail and that's it. Since I'm not coming away with a smear of loose fur now, it was worth it to get him brushed.

UPDATE: I have been provisionally forgiven. 

 So. My colleague/trainer is going on her long awaited two week vacation. I'm being trusted to keep things running until her return. I find this daunting, of course. There is help around, but mostly I have to be up to speed on all the tasks I've been trained to do. It seems they trust me to ask questions and not go off the rails too badly, and admit mistakes. Feels so much like when my clinical instructors in nursing school would put me off on my own, not because I was any better especially, but they knew I wouldn't do anything too far out of expectations. 

Friday, in clinic, I managed to schedule three surgeries, one in the Procedure room, two in the OR requiring different criteria. As well as all the other consults and orders and... well, stuff. I first looked at the time at 1215. Nothing like busy to make time whooooosh by.  I make mistakes, I fix mistakes, I keep going. This has got to be good for my brain, right? 

One patient had his service dog, big, broad, fluffy creature. He stopped at the office area where we, the coordinators and residents chart. I admired his dog "I know I can't pet her while she's working..." He said, Oh, of course you can! All three nurses were immediately were giving her ruffles and "good-girl!"s.   Looked like a Husky/German Shepherd/Newfie mix, with a shorter snout, and the softest fur ever.  Made our day. 

The feedback I'm getting so far is very positive, and appreciated. I don't think I'm doing anything different than in the OR in terms of work attitude, but for some reason I have not figured out yet, I'm seen very differently. I got a secure message back from a patient right before I left yesterday, thanking me. That never happened in the OR - because of drugs. I'm not terribly motivated by thanks, but once in a while... yeah, it's nice to be noticed and remembered, proof that I've made a difference.                                                                

Shut

 Reminded of jobs I did as a kid today. One summer, I painted the fence, a dark thick green, the paint had a  stink* to it I would never forget. I worked in the dirt and heat until it was done. I think it was the next summer I painted the garage, white, and up a ladder, which was better. I received for these projects... a sense of satisfaction. 

Meals-on-wheels was my next unpaid job, my mom drove sometimes as I "jumped" - taking the meal in and doing a wellness check (not that I was told that was part of the job, didn't think of it that way at the time) on some rather lonely people. I would use this as a source of references, from the organizers, when I applied for work at my branch library.  The Library was my second real job, which I worked for years through high school. (First being at a summer camp, and I wound up quitting - which was good because there were issues that got worse as the season went on.)

My oldest brother's in-laws were managers at Hudson's Department Store, and when I was maybe 15 or 16, I was invited to make a days' wages (maybe it was two days?) on inventory. Counted a lot of clothes.  Got a very small amount of cash. Still, good practice. 

I forget these jobs, but they are also about my sense of doing the job in front of me. One of my residents told of being a kid and joining a friend and their family for hikes.  She told how they made her feel welcome, but the family had three rules, 

1. Show up

2. Keep up

3. Shut up

The last rule was to stop complaining and whining, not conversation.  She was a terrific resident, I'm sure today she is an excellent surgeon. She always showed up, kept up, and shut up, and told good stories with a vivid sense of humor. 

Today I watered, cleaned the tub, made lunch. Yesterday I vacuumed and dusted (very much needed after the waves of smoke.)  Laundry. Trash out. All the little chores I've been half doing or putting off. 

Finally got Zeppo well brushed - which he was not best pleased about. Had to be held and that's what he does not like, or perhaps does not trust. Pulled a significant wad of fur off him.  He'd horked up a hairball, so it was necessary. Got his claws trimmed as well - he was catching on everything. Again, doesn't seem to mind the grooming, can't abide being held to accomplish it. He's been keeping his distance from me ever since. He'll eventually get over it, but for the moment I'm back on probation.

Thinking about my clumsy exit from the former job. I don't know how else I would have gotten out of it. I had to feel desperate enough to open my mind to any possible honest work. I don't know if I would have been so eager to do this job without that painful break. I had to change, and scrub away old assumptions, mourn. 

*One of the houses we looked at when we were looking had the same sort of paint. Smells a bit like PlayDoh, shiny and a bit gummy. I could not get out of there fast enough. 

Puzzles

 So, I'm going to 10 hour shifts starting Monday. Apparently I'm doing well enough, and am sufficiently trusted, to work semi-independently.  This feels so good. Still daunting, but it still feels like such a good fit.  Lots to learn, and that will never end.  Also, I'm using my deep knowledge base in ways no one else there has, which is helpful. 

I really enjoy the puzzle aspect of the work. And reading so many stories in the complex medical histories that are the heart of the work.  After four weeks, this seems like I will do ok.  I will still make mistakes, I will still have bad days. This is life.  I will keep doing the job in front of me. 

This has swallowed my attention. I came home last night, crawled in bed at 7, and slept through to 6.  Today was a good day. 

Sidewalk

My beautiful Eleanor. 

More wind and rain last night. Not enough to fix the drought, but welcome, so welcome.

Tree dropped across the sidewalk in the strong gusts. Neighbors cut it up and cleared it this morning. Our urban forestry people are usually pretty good about this, but not so much on a Sunday morning. 

Trying to do a little internal clean up, the house has been bit neglected. Looking forward to ten hour shifts, once I am capable of being on my own. Another month and change. It really will work well, do clinics in the morning, then catch up for the last 2-3 hours in the office away from distractions.  

And it is quiet up there, no music, people mostly just working through their own lists.  Some conversations. Coming to believe all the noise and music in the OR was a big contributing factor in my anxiety levels.  Quiet is good. 

 

Tiny

The new job involves a lot of little details. I'm slowly sticking them together into little clumps of knowledge and processing them. It's very easy to get confused and put them in the wrong way round or in the wrong order or in the wrong place, but I'm working through the problems. And I'm persistent, and remarkably patient with it all. 

 I learned this when I broke my arm, when speed was not an option, I would have to take three trips when once I would have used all my arms and taken one. That it would take twice, maybe three times as long to do simple tasks like making a cup of tea or using the toilet or brushing my hair. Those tasks filled my days for several weeks. Everything took longer, everything took a lot more effort. And there was no rushing it, or I'd be left with a far worse mess, and time would start running backward. That way lies madness...

I'm honestly a bit amazed at my patience with it all.  I'm at peace. The old anxiety is off sleeping it off. 

Got to scrub on two little hand cases yesterday, patient numbed but awake. Lots of good data showing that carpal tunnel releases and trigger finger releases are at least as safe, if not safer, done in a clinic/office setting than the way we used to do them in full ORs. I know if I ever need this done that would be my choice, keep it simple, no sedation.  

The LPN who runs the clinic talked to the patient, and she did the charting and support. She kept apologizing about being required to watch me and "check off" my skills, when I clearly knew that part of the job much better than she did.  Well, I'm used to being watched doing this, we all watch each other in the OR, it's easy to let skills and attention slip, develop bad habits. Yeah, I've scrubbed liver transplants and back surgeries, but that can be an asset and a trap at the same time when doing a finger cyst incision in a clinic. Easy to dismiss small cases as less important, just because they are less involved. Easy to say "I've been doing this for 25 years...." and then screw up a simple task. 

The little things are just as important as the big things. The big things are just the little things all in a big pile. 

My job these days is to sort through the pile, tease out all the little things and deal with each one.  The people I've met, the ones I'll be working with, are good folks. Serious and careful and competent. The patients have complex lives, and their hard stories and issues, demand my attention. People who joined the military often did so out of desperation, few other choices. And the experiences added more troubles on, marked us and left us forever changed. Even if it was only a few years when we were much younger.  

We've been watching The Repair Shop, and it's good for my soul. To deal with each detail carefully, and with love. Yes, it's a big job, made up of one little thing at a time. Watching someone piece back together a broken chair or ceramic vase or carefully clean a painting or a wooden chest or rusted bicycle, mend a tattered teddy bear or disassemble an old stuck clockwork, may not sound like a good show, but somehow it is.  Unlike some "antique" shows, there is no greed, only love and gratitude.  Craftspeople who love a challenge, and tell their own stories. 

I have nothing in my childhood I'd want to be 'brought back to', I don't want my own connections and history. I remember it all far too well, and could do with a lot less. So watching the people who bring in items soaked in stories they want to keep, is lovely and hopeful.  They bring in their pain and grief and loss, and ask for help to transform it into something beautiful again. 

 If you read only one thing about the current mess in Afghanistan,  let it be this. 

Pique

 Zeppo has always been fascinated with grapes. It may be the smell, or something about how they look. He does not eat them, he just likes them. 

Stank

 Yesterday the smoke from the California fires got mixed into the front that brought us rain.  The air stank of wet smoke, tasted like when a pan is left on the stove and burns, a mud pie of ashes. Horrible, to go out to smell fresh rain and get a lung full of damp toxic fumes. 

It stayed like that overnight. Improved through the morning. Still not great, but we'll take whatever air we can get.  And the rain is still welcome, the garden doesn't care that much about the cremated and aerosolized remains of their woody brethren.  Plants are just fine with cannibalism, really.

Yesterday was a bit difficult, a training session with one person that went on way too long, and altogether too pointlessly, shoving out my lunch (which I didn't quite realize until I got home.) Three and a half hours. Really dispiriting. Today was much better. Slowly making progress. Still stumbling a lot, but less. And an online class that was actually pertinent, interesting and important, and only two hours. 

Parleys

 

Fire up Parleys Canyon started yesterday afternoon. This is the view from the end of my block. Several small communities up there evacuated, the highway through closed for miles. Still going this morning, 1500 acres, and smoke laying across the valley again. 

 "The blaze started Saturday afternoon when a vehicle with a bad catalytic converter spread hot particles along I-80 in the canyon and started the fire."

Fire and flood.  The flooding will come later this week, on top of the burn scar, which will mean landslides.  These are serious mountains, part of the Rockies. Storms are already lining up. 

Bulletin

The bees love the sunflowers. So do the squirrels - who climb the stalks, break them often, and steal the seed heads. I swear, I thinned them mercilessly in the spring. But two storms that dropped an inch of rain per gave them a big boost. It's a forest of sunflowers. 

One of a handful of programs I have to learn looks like this. Right back to the BBS I started on, run by a friend of Dylan's, and one of his colleagues. (I was only allowed on because Dylan was established and agreed to provide tech support for me.) It's as clunky and old-school as it looks. I've lost track of how many different programs I have to use, but this one is the oldest looking. I assume this makes it very difficult to hack the system, since even with access it's not easy to find information.  Still, got through the lists from two days to get each chart seen, and orders set up for x-ray, for this week's clinics.