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Thursday, December 30, 2010

Podunk Living



It dawned on me today that we are really doing some backcountry living. This year, we have been heating our house entirely with wood. We have one monstrous wood stove and a chimney running straight through the middle of the cabin. Last year we bought a few cords of wood, but this year (at least in regard to heating) we've been living off the land. My husband selectively thins out trees on our 40 acre property, cuts and splits them to size, and lets them dry for firewood. We drive into the woods with an old pickup truck and bring the wood back to our house, where it sits in a long winding stack between the trees.

I went outside today to bring some wood into the house. The sunlight against the snow was a visual assault. After a few minutes, though, it became a welcome change to stand alone baking in the sun, surrounded by slowly melting snow.


I don't know when the switch flipped -- when this comparatively rural lifestyle stopped seeming foreign and became instinctive. Driving on dirt roads has become commonplace. Threadbare barns and towering oceans of corn have lost their novelty (although continue to charm me). A backyard dotted with bear scat, mystical-looking white goats emerging from a neighbor's tree line, and the occasional escaped holstein in the middle of the road are no longer totally crazy scenes.

A suitcase crammed with at least a dozen pairs of high heels now collects dust in a corner upstairs. I'm a serious klutz, and it took at least a year to master walking across the brick sidewalks in Oberlin. I don't wear them anymore, even at the very rare formal event. I can't even imagine tolerating heels again; I think I would have to relearn how to walk in them. I've traded pumps for galoshes, dresses for flannel-lined jeans, and delicate sweaters for free Molson Canadian t-shirts that came in 12-packs of beer.

Tuesday, December 28, 2010

Getting by

I've re-read my previous posts, and to say I feel sheepish would be the understatement of the year. I can't really explain what was going on. Even when I was feeling at my worst, I understood that my life was not that bad; that my med school plans were salvageable; that MiniMan needed a mom, and my husband, his wife. Even though I could grasp those ideas, everything still seemed hopeless. I knew that my reaction wasn't rational, but it was completely overwhelming.

Not long after writing those posts, I ended up talking to my doctor (even though I was terrified that she would involuntarily hospitalize me). She didn't. We both agreed that it would make me feel worse. I agreed not to do anything until the next time I saw her. For a while I was seeing her practically every day. I don't know why she was willing to invest so much attention in me (it definitely would have been easier to send me off to the hospital), but I'm grateful for it.

Monday, December 13, 2010

Winter

I've been living life in my not-so-favorite style, which (although it sounds cliche) is just trying to get through one day at a time. I don't know why it's so difficult. I really don't have any responsibilities other than keeping up with laundry, hanging out with MiniMan, cooking, and cleaning. Wow. I completely sound like a domestic housewife. It's funny how all of a sudden I'm living this life that I never could have even imagined for myself.

Last night my husband asked me what class I wanted to take this spring. I had originally planned to take some kind of science elective just to keep me engaged, since I'm pretty sure that the classes I want to take are not being offered out of the regular sequence (i.e. take ChemI in the spring, and ChemII in the fall). My reply instead was, "I don't really want to take anything." I wonder if I'll feel differently later. I hope so. Right now I can't even imagine leaving the house to buy groceries.

Instead, I've been planning. I set a deadline of being dead by the winter solstice. Part of me knows this is completely ridiculous and that I should just let it go, that it's disturbing, that of course I shouldn't do it, but the rest of me tells me that I have things to do: make sure that the Christmas presents are wrapped; that letters are written (I don't know how I'll ever explain my goodbye without being a completely hurtful and selfish asshole -- then again, it won't really matter, I'll be dead!); that I take most of my clothes to the Good Will; that bills are paid; that I make sure not to jump with my husband's engagement ring on (it was his grandmother's). I figure that if he gets married again, he should be able to have it without associating it with my shattered body.

I researched the bridge I chose. Apparently the university near me recently constructed some kind of net underneath the bridge, so now I have to navigate that, too. I think it's only enough to deter a drunk person from being impulsive, though, not someone who is really determined to die.

Just recently I started to feel guilty about destroying a perfectly healthy body when there are so many people who need organs. Maybe jumping is wrong. We had a student in her early twenties in the ICU who hung herself from a tree with a dog leash. Her family kept her on the vent long enough to donate her organs. Seems straightforward enough, but the timing would be kind of a crapshoot to coordinate. I hate the idea of my husband finding me in a tree, though, and I hate the idea of him seeing me brain dead in the hospital. The girl I took care of -- she looked terrible. Her entire head was swollen; her eyelids bulged out from her head like a frog's.

Saturday, December 11, 2010

scratching the itch

a calm drive
full of silent streets
and warm memories

soft blonde curls
my two-year old's maniacal grins and
uncontrolled giggles--
the huge hands of
my tickling husband

I keep driving
into my childhood neighborhood past
Christmas trees glowing though
living room windows

I park on the road near
the trails where
I used to run
and the bridge that overlooks
the gorge our small city has become
so famous for

under the street lamps
nestled in my long down coat
I savor this instant of comfort

I take
one great step
to tiptoe on the balance beam
before the lights of the town below me

all it takes is
a trusting collapse
to fall though the air

I gaze straight ahead
at the stars
a cold blast of air on my back
as I watch the snowflakes float
up into the sky

Friday, December 10, 2010

So this is my life

After my night of flipping out at work, I later saw my family doctor (she goes by Molly) who suggested I take two weeks off. One morning, I came to her office with MiniMan to pick up paperwork. I sat in her waiting room while MiniMan played with toys. I couldn't stop silently crying.

One of the nurses pulled me into an exam room. She told me that Molly wanted to talk for a minute. I curled up on the floor in the corner. The office staff started playing with MiniMan. When Molly came in, I don't remember what she told me. All I remember is being in the corner of an exam room, crying all day while she checked in on me between patients, until she called my husband at work who picked me up later that afternoon.

I don't know why Molly let me stay. She told me a story about having a breakdown in the NICU during residency and crying relentlessly in a corner.

It's hard to write about this. It's difficult to describe what was going on, because I don't even remember what I was thinking. This psych stuff is especially frustrating because it was my choice to sit on the floor and cry all day. I don't know why I felt like I couldn't do anything else.

Since then, things haven't been great. I nearly got readmitted as an inpatient again, but instead stayed at home. My husband took family medical leave from work and took care of me while Molly quickly increased my dosages of antidepressants. I stopped going to work. I stopped taking classes.

I didn't feel like doing anything, but I would go for a run most mornings, cook quite a bit, hang out with MiniMan, force myself to get dressed. I was going through the motions, but I wasn't feeling significantly better. I was obsessively pondering my suicide, whether I felt sad or even when I felt mostly fine.

I don't know how my life went from looking so bright to becoming a wasteland so quickly. I went back to work last weekend. The night nurses were so nice. They brought in celebratory food and everything was really thoughtful.. but when I had to go back a few days later I just couldn't do it. Every time I drive to work I have a panic attack in my car. I never used to have panic attacks. I've gone from being driven and capable to being this unstable, totally useless person.

Thursday, December 9, 2010

Just give up

The next day, I decided to drop chemistry, too. I wasn't prepared for my lab. If I wasn't going to get near-perfect grades, it seemed like maybe it just wasn't worth bothering right now. Everything felt like an uphill battle at my big state school. My professors didn't appear to care about anything (other than their workload and trying to avoid contact with students). I felt completely isolated in all of my classes. I wasn't having fun. I gave up.

I drove back to my big state school one more time to fill out more forms, to pick up MiniMan's things from daycare, to attempt to tie up all the loose ends. MiniMan was beside himself about leaving daycare. I remember when I first started going he would cry when I left him in the morning to go to classes. That day, he instead cried when he couldn't stay. He still talks about his friends from daycare practically three months later. I feel guilty taking all that away from him, knowing he'll probably never see them again.

After I stopped going to classes, I felt even worse. I was able to get a lot more sleep, but half the time I would spend the greater part of the day curled up on the couch, crying, while MiniMan watched TV. My husband would come home from work and MiniMan would walk over to him and say "Mama sad." The first emotion he had learned was sad.

Since I'd been a teenager, I had always had issues with depression. Some years were more difficult than others, but I was always functional. I hadn't taken antidepressants for years until just recently. Things had been okay. I thought I knew how to keep my emotions under control. I thought I knew how to kick myself in the butt when I needed it, and get myself out of a funk.

This time I couldn't do it. I don't know exactly why. I stopped showering. I stopped eating. I wore my PJs all day long. The only thing I could muster up the motivation to do was feed MiniMan and change his diapers.

I fantasized about my death constantly. It just seemed like such a relief to turn off the switch. I imagined death as a comforting void. Black, silent, empty. Nothing to worry about, nothing to be happy about: no more thinking. Would I jump off a bridge? Poison myself with carbon monoxide? Slit my wrists? I have a weird anomaly: a superficial artery on my hand that I had always thought would be interesting to slice. But I don't have a bathtub, I thought. Do you need a bathtub? Does that interfere with clotting? I needed to research this... I definitely wouldn't be overdosing again -- what if someone found me, took me back to the hospital again? Should I get in a terrible car accident? No, seemed like too high a chance of just getting maimed and not dying. But I had a good life insurance policy. Maybe I could make it look like an accident, not a suicide.

In the end, the bridge seemed like the best option. Plus, it would be almost like sky diving. I wondered if I'd change my mind during free fall.


Wednesday, December 8, 2010

Somehow it became December

I expected that I would have blogged more by now, but I never felt like writing. I still don't really feel like writing now, but somehow I persuaded myself to start typing.

I don't know where to start. It seems like so much has happened over the past few months yet I spend my days doing nothing at all, just wasting time, rotting.

As for the rest of the story, well... On a Friday, after two nights that seemed like an eternity, I left the hospital. My husband forgot to bring my shoes so I walked out in beige hospital socks, carrying my clothes in a brown paper bag. I prayed no one I knew would pass me in the hallway.

I took the weekend off, and then went back to classes on Monday. I decided to drop physics, because it seemed like between the lack of sleep and the hours spent commuting and the full-time job, there just weren't enough hours in the day (or night) to get everything done.

It took most of the morning just to drop physics. I was trekking all over campus from one end to the other to get my list of signatures that had to sign off on me dropping the class: first the grad school, then my professor, then the grad school again, then student accounts (not only would I not get any tuition refunded, I had to pay a fee to drop it (talk about adding insult to injury!), then the registrar...etc.

I had a problem set to finish for my chem class, a lab report to turn in, and the prelab for the next lab which was the next morning. I thought I would be able to get on top of things, but by late afternoon, I had only finished the problem set and my lab report. I was having chills and wondered if I was feverish again. I had a note from the hospital explaining that I was "ill" and excusing me from the lectures that I missed (both classes used iclickers for attendance monitoring, ugh). I decided to see if it was possible to get an extension: I had to pick up MiniMan from daycare to then drive home and work an overnight that night. There was just no way to get everything done by the next morning, and on top of being overwhelmed, I felt like shit.

I tried to contact the professor for my chem class, but I realized that he didn't list his e-mail or his office location in the syllabus (and also didn't offer office hours). I went to the chem help lab (run by TAs), but there were about twenty students in there and one TA milling around answering questions. I waited about half an hour, and then finally one of the TAs suggested that I contact a different professor who oversaw all the chem labs. When I finally talked to her, she said that it wouldn't be possible to have any kind of extension because it wouldn't be fair to the other students. I was fucking amazed.

I walked out, made it to my car, closed the door, and cried. I picked up MiniMan from daycare and we drove home. We made it home, and then I got dressed to go to the hospital and started driving to work. I felt nauseated. I started sweating in my car, crying the closer I got to the hospital. Part of me knew it was ridiculous to be consumed by dread, but it was hard to ignore such a visceral reaction. I made it work, pulled myself together, walked inside. My unit was so good about maintaining confidentiality, almost none of my coworkers knew that I had been admitted just a few days ago.

I muttered a few brief hellos and sequestered myself to the med room to stock supplies. I ripped open boxes and filled drawers with syringes; I just couldn't deal with patients. If a call bell went off, I would ignore it. I had never done that before. I just felt like I couldn't go into a room again, like I wasn't strong enough to take care of someone, to converse and be cheery. I looked out the med room window into the ICU room where I had stayed. Everything was still so raw. I faced the wall and unpacked bags of saline and silently started crying again.

Forty-five minutes later my charge nurse discovered me and sent me home. I drove home in the dark, trying to decide if it made more sense to drive home or to drive into a tree.

Monday, November 1, 2010

My life exploded (Part IV).

Day 3
The night was mostly uneventful. It consisted of me waking up, feeling like crap, walking over to the nursing station, taking more Tylenol, going back to sleep, waking up feeling bad again, tossing and turning, putting my sheets back on, etc.

By the time it's morning, I no longer feel like sleeping so much and decide to acknowledge the pile of papers that I had been given upon arrival to the unit. I sift through them: some kind of form about being involuntarily committed to the mental health unit; a big packet full of information about their adult recovery program. I'm expected to participate in group sessions; shower, come to meals, keep my room clean, make my bed, wash my clothes. Visitors are allowed once a day. I may be granted to go outside if I obtain a special pass from my psychiatrist. The list went on..

7:30a.m.
I decide to take a shower and wash my hair. Bathing, that's compliant patient behavior, right? I scrub my torso until my skin becomes raw; it's impossible to get the adhesive off from the series of electrodes that I had worn. I towel off, put on the one remaining pair of clean underwear that I have, and finish getting dressed. I have no hairbrush, but eventually manage to get the flimspy hospital comb through my thick, knotted hair. I braid my wet hair. I make my bed. I sit down on my bed and read the one book I have with me: My Stroke of Insight.

8:00a.m.
One of the psych techs knocks on my door.
"I just wanted to let you know that you can get breakfast down the hall." She said.
I look up. It's Megan, one of the people I had oriented with when I first started working at the hospital. We had gone to high school together. Her expression changes when she realizes I'm me.
"Oh..man. Umm....I'm really sorry to see you here. What happened?"
"I overdosed."
There was an awkward silence.
"Well, I know this is kind of weird," she said "but let me know if you need anything."
I nod. She walks away.

8:05
I'm not hungry. I don't want to get breakfast. I don't want to sit with other people. I do want to get out of here, though, so I walk out into the hallway. I look at the other psych patients sitting around the table eating, and tell myself that I'm just an observer, I'm just a journalist doing an expose. I'm not like everyone else. This is the only way I know how to get through things.

I walk into the eating area and pour myself a cup of coffee. I take a piece of fruit.
"Do you want a bagel?" Asks one of the nurses.
"Okay."
"What kind?"
"Wheat."
"Do you want it toasted?"
"Um, okay." I reply.

She hands it back to me a few minutes later. I'm not allowed to use the toaster. I guess it would be too easy to strangle myself with the electric cord, or stick my hair in the toast slots and light myself on fire. I sit down across from an overweight, bearded man in his fifties who has a huge plate of eggs with American cheese melted on top and is incoherently talking to himself. I spread some cream cheese on my bagel with a plastic spoon. I open my book so I don't have to talk to anyone. I take a few bites of my apple.

At the other end of the table a (most likely) transgendered person who appears to identify as female sits and eats some bacon while talking to a young, withdrawn Latino girl next to her. It seems like both of them have been here for a while, they seem at ease around each other. The transgendered girl is dressed in a hot pink tube dress with black leggings. She looks like she isn't more than twenty. She twirls her shoulder-length brown hair and continues to chat.

I take a bite of my bagel, and then pick up the remnants of my lunch and throw them in the garbage. I walk back to my room in my slipper socks. I still have no shoes.

8:20a.m.
I look at the schedule posted outside my door: community meeting at 8:30, group therapy (DBT - Dialectical Behavioral Therapy) at 9:00. One of the nurses comes up behind me with a paper cup of water and some pills.
"Are you E?" He asked.
"Yes."
"Here's your Celexa and some more Tylenol, if you feel like you still need it."
I take the pills and go to my room.

The minutes tick by. Finally, it is about 8:30. I walk out into the lounge to attend the "community meeting." A lot of people are already sitting down, so I quickly grab a spot on a love seat next to a grey-haired woman who looks nervous and exhausted, but comparatively benign. Patients continue to filter in, and finally one of the nurses begins to speak.

"Hi everybody," she said cheerfully. "I'm Michelle, one of the nurses, and this is the community meeting. First off, I have a couple announcements. Our washing machine and dryer are currently broken, but if you are having a laundry emergency, then let me know, and we'll figure something out. If it's not an emergency, please wait, we should have it fixed in the next day or so..." She continued on about meetings during the day, the procedure for getting a "pass" to go outside (where to everyone's dismay, is a no-smoking area). "Now I'd like all of you to tell us your name and one goal that you'd like to accomplish today. E, let's start with you."

I force a smile and hear myself saying, "Hi, I'm E, and I'd like to become familiar with the routine on this unit." At least that's over.
I listen to the other peoples' goals:
"I'd like to color, today. And I'd like to see the male psychiatrist, not the female one. Do I have to see the female one?" The girl in the hot pink tube dress asked.
"I'd like to see my family," a young guy with a cane said.
"I'd like to change my sheets," someone else said.

9:00a.m.
Finally, the meeting comes to a close, and now it is time to go to DBT. I walk into the meeting room. A chipper recreational therapist comes into the room and tells us that the person who normally does the DBT won't be leading it, and that she's going to lead today's session. She starts to launch a conversation and asks each person to "name on thing that you are proud of that has happened in the last week." Here we go again.
"I was proud that my brother came to visit me."
"I was proud that I got to go outside."
"That I'm feeling better. I'm really proud of that."
"I was proud that I called my friend."
"I was proud that I got a perfect score on my chem exam." I say quietly. I hate this kind of stuff. I seriously hate this stuff.

The conversation takes a turn and then the recreational therapist asks us to talk about recreation and how mental illness has effected that.
"Well, I used to go roller skating a lot, but then I got a really bad spider bite and now I can't go at all and now I'm really fat."
"I used to make a lot of jewelry, but now I'm too depressed to get out of bed or even watch TV, so now I don't do that anymore."
Dr. Martin pokes his head in and asks me to exit with him. I never thought I would be glad to see him again, but at that moment, getting stuck with him seemed like the lesser of two evils.

9:45a.m.
Dr. Martin walks me out into the hallway.
"Can we talk for a while?" he asks.
"Sure," I say. We sit down in two chairs in the corner.
"So, how are you doing..?"
"I'm fine. How are you?"
"Great, thanks. And how are things going on the unit," he asks.
"I don't know what you want me to tell you. I don't feel like this is helpful for me, but if you would like me to stay, I will cooperate with your routine and do whatever you would like so that I can get out of here as quickly as possible," I reply.
He nods. "So you would like to go home."
"Yes."
He rubs his chin. "Do you still feel like harming yourself?"
"No."
"Any suicidal plans?"
"No."
"I'd like you agree to follow up with someone on an outpatient basis."
"Okay."

Eventually Dr. Martin agrees to let me go home, and not long after my husband arrives. I chat with my husband for a few minutes.
"We'll have to be careful around MiniMan with the MRSA." He says.
"What MRSA?" I reply.
"When they ran the cultures on your finger it was positive for MRSA."
"Dr. Nolan told me it was just plain old staph..."
"I don't think the cultures were back that early." My husband replies.

I get a sinking feeling in my stomach. Had I not washed my hands well-enough? Had I gotten this at the hospital (where I work closely with patients who have MRSA all the time); had I gotten it at the grocery the grocery store; had my husband brought it home from the nursing home where he works? I felt guilty, and so hugely screwed by healthcare. I take care of all these people who are sick and sometimes dying, and this is what I get, MRSA?

When I used to work in the hospital there were always clear boundaries that separated me from patients. I know that must sound strange or maybe insensitive, but I think it was one of the ways that I compartmentalized; patients were like a subspecies. My patients might have MRSA or VRE or some other form of nasty resistant bacteria, but I didn't; they were sick, but I was healthy; one patient was on a forty-eight hour psych hold, but I was stable; my patients wore hospital gowns, but I wore scrubs. I was finally forced to realize we weren't so different. It disturbed me.

Tuesday, October 26, 2010

My life exploded (Part III).

Day 2
7:15a.m.
"E, I need you to wake up." I look up and Dr. Nolan is standing over my bed in green OR scrubs. "Did anyone from behavioral health come to evaluate you last night?"
"No." I reply.
"How are you feeling?"
"Okay."
"Do you still feel like hurting yourself?"
"No."
"Okay. Well, I think Dr. Martin, one of the psychiatrists, will be over soon for a consult later this morning. After that we'll go from there."

7:45a.m.
New nurse, Sarah. She comes in and explains that Dr. Nolan wants to run an IV antibiotic for the infection. I talk to her for a few minutes as she sets up the antibiotic, and then she leaves. I lay in bed for a minute, and then glance at the IV tubing hanging from the pump and realize that it was never connected to me and is creating a puddle on the floor. I laugh. I guess if anyone has shock-value and could distract a good nurse, it would be me.

Sarah walks back in sheepishly, and examines the bag which is now totally empty. A while later, a second bag arrives from pharmacy and she hangs a new bag of antibiotics.

I go back to sleep. I don't remember if I was tired by this point or if I just didn't want to deal with being awake.

11:30a.m.
I wake up to MiniMan and my husband standing in the doorway. MiniMan is scared. I didn't expect him to be. He's been to the ICU many, many times. He knows most of the nurses, who adore him and his curly blond hair. He knows where we keep the graham crackers and who will give him toys and stickers. I guess he knew something wasn't right when he saw me in bed instead of walking around, wearing scrubs.

I ask my husband to bring him over, let him sit in the bed, but MiniMan shakes his head and clings to my husband tightly. He starts to cry. He doesn't want anything to do with me.

"Has the psychiatrist come yet?" My husband asks.
"No."
"I talked to your nurse on the phone two hours ago and she told me he was on his way over."
"I don't know.. I haven't seen him, maybe something came up. I'm sure I'm not a very emergent patient."

My husband explains that he has to go, that he has to drop MiniMan off with his mom, that he would be back. I hug him, pull the covers up around my neck, and fall back asleep.

12:15p.m.
Dr. Martin knocks on the glass door.
"Hi, I'm Dr. Martin. I'm one of the psychiatrists."
"I know." I remember seeing you at the hospital coffee stand flirting with nurses and telling them that all women should really take the time to treat themselves to a facial more often. Probably not all women, however, have your salary.

"So.. can you tell me what happened?"
I sit up and try not to act upset. "I had been taking some classes at the big state university: physics and chemistry to complete my premedical prereqs. I was also working full time doing overnights here as an aide. It ended up being kind of tough because a lot of nights I just didn't get to sleep. I'd go to school all day and then work all night and go back to school. I recently learned from my physics professor that we were going to have three exams over the course of the semester (not finals) that were going to be at 9:00 p.m. on Monday nights (this wasn't in his syllabus). I had e-mailed the professor telling him that I had a conflict, that it would be insane for me to take my two-year old son to daycare there, then drive him home when the daycare ends at five, and then turn around and drive back to school (1.5 hours each way) and then drive home again. My only other option would be to hire a babysitter on campus (or nearby) to watch him until ten, who would have to put him to bed, and then I'd have to wake him up, put him in the car, and then wake him up and put him to bed again. This just didn't seem fair to my son.. Anyway, my professor e-mailed me back and told me that he was sorry, but that he couldn't help me and that it would be impossible for them to proctor three exams for me, that I'd have to figure out a way to make it work... When I got the e-mail I just sort of lost it. It was early in the morning, I was getting ready to go to class. I was so upset I just got back into bed and cried. My husband couldn't figure out what was wrong, he couldn't calm me down. I told him that I just wanted to sleep and he forced me to get up and I couldn't calm down so I took a lorazepam that my GP had prescribed PRN for anxiety. I barely ever take them. My husband wouldn't let me go back to sleep and I don't know. I just took the whole bottle. I didn't think about it, I just did it. I wanted to sleep.
"You work in this unit, right?"
I nod.
"Do you see a lot of patients who overdose?"
I pause. I guess we see a lot of patients who overdose, but if you think that I had some kind of scheme have a vacation in the hospital, let me tell you, having your coworkers undress you while you are unconscious is far from therapeutic. "Probably more than many other units in the hospital."
"Do you think you might harm yourself again?"
"No."
"Do you think you would benefit from spending some time on our unit?"
"I don't really think so. I've floated to the mental health unit before and I don't think I would really be very comfortable there. I don't really feel like this is still an acute situation and I'd like to get out of here as soon as possible to get back on top of my coursework."
"Okay.. Is your husband still here?"
"He had to drop off our son."
"All right. Well, when he gets back, have have your nurse call my unit. I'd like to talk to him as well."

1:00p.m.
My husband is back, minus MiniMan. He meets with Dr. Martin, who agrees that it would be okay for me to go home without getting locked in the psych unit. I silently rejoice. I would get getting out. Dr. Martin leaves, then my husband, who is going to stop at home and bring me some clothes and shoes. It will take a while to get the discharge paperwork together.

1:30p.m.
My legs are killing me. My nurse, Sarah stops in my room to take out my IVs.
"My legs are really achy."
"Might just be from staying in bed so long." She walks out to complete some paperwork.

1:50p.m.
I ring my call bell. One of the aides comes in. "I'm having these body aches. I really don't feel good." In retrospect, I probably should have been direct and just asked for Tylenol, but for whatever reason, it doesn't occur to me.

2:00p.m.
I'm lying in bed crying. The monitor is alarming because I'm tachypneic. Dr. Nolan walks in.
"Well, I didn't expect to see you like this." He remarks.
"My legs really ache. I don't know what's going on."
"I don't see how I can send you home like this. I'm going to talk to Dr. Martin again."
"I need to get out of here. I need to get back to school."
"No kind of school is worth dying for. Clearly you're not ready to go home."

2:45p.m.
Dr. Nolan comes back in, tells me that he's talked to Dr. Martin, that they have a bed for me in the psych ward. I start bawling hysterically, begging him to let me leave.
"I can't lose my license over you. I can't guarantee that you won't hurt yourself when you get out of here."

3:00p.m.
Sarah comes in with some Tylenol for the leg pain. My husband walks in behind her, tells me he's talked to Dr. Nolan, and reiterates that I won't be discharged -- that Dr. Nolan said my discomfort was "a cry for help."
"Have you had your Celexa?" My husband asks.
"Not since Monday."
My husband walks out of the room following my nurse.

"She hasn't had her antidepressant in three days," he says, following Sarah out to the nursing station.
"It wasn't ordered," she replied.
"Why?"

3:45p.m.
Sarah comes back in with the Celexa.
"Some nurses are going to be over from the mental health unit soon to walk you over," she says.

4:05p.m.
A male nurse and a pysch tech arrive. I walk through the halls of the hospital with them, hoping no one will see me.

4:10p.m.
My belongings are being checked by one of the nurses. "You'll have to have your husband take your sneakers home, they have laces." I now have no shoes. My pants have a drawstring and are also confiscated and replaced by faded elasticized scrub pants. I now am the stereotypical psych patient, I haven't showered in days and wander around in hospital pants and beige non-skid socks.

4:30p.m.
I am starting to feel really bad, again. My legs are aching and it's freezing in my room. I get under the covers but I just can't get warm. I finally get up and try to turn up my thermostat, but it can only be turned up with an allen wrench or something. I walk out to find one of the nurses, who comes back in and turns up the heat.

5:00p.m.
I still can't get warm. I wander out of my room and ask for another blanket. One of the nurses returns and throws it on my bed.

5:15p.m.
The blanket doesn't help. I decide to call my husband, see if he will bring me a sweatshirt and sweatpants. It's so cold here. I don't know how they can leave it like that. I wait in line to use the phone.

Some gaunt woman in black stretch pants is angrily gesticulating while she yells into the phone. She says some closing remarks, hangs up the phone, and then mutters "fuck you, you cunt," walking away.

6:00p.m.
I'm shivering. I ask one of the nurses for another blanket.

6:15p.m.
My husband arrives. I tell him how cold I've been. He puts his hand to my forehead.
"You're hot. Has anyone taken your temperature?"
"No."

He walks out, and comes back with one of the nurses who is carrying a thermometer. She takes my temperature. It's 103.2.


Friday, October 22, 2010

My life exploded (Part II).

Night 1
My nurse, Sue, comes in. It's dark now, and the night shift staff has arrived. These are the people I normally work with.

The last time I worked with Sue I had been doing a 1:1 observation on one of her patients: a hyponatremic college student who had been admitted to our unit for the third time. He had intentionally been drinking water by the gallons and depriving himself of salt in his diet. I think he may have had some kind of psychogenic polydipsia going on but I don't know if that was an actual diagnosis. He was confused, hallucinating, and vomiting. I sat next to him all night, talked to him, cleaned the vomit off his body, changed his clothes, his sheets... Sue thanked me profusely for dealing with him and for being patient, revealing to me how much she hated working with psych patients. This isn't really unusual, a lot of nurses I know admit having little tolerance for "crazy patients," not to mention those who intentionally harm themselves.

So here I am, another psych patient. I wonder how many nurses and doctors I'm pissing off.

I have to pee. I ring my call bell; Sue comes over.

"Is it okay if I walk to the toilet?"
"Sure," she replies, untangling my IVs and monitor wires.

It is more effort to move around than I expected. I walk several steps and sit down on the toilet. Sue walks out of my room to give me some privacy.

I stare down at my blood-stained underwear. Awesome. I got my period. I sit there for a minute, wondering if there was such a thing as pre-menstrual insanity, and then ring my call bell again, this time requesting a pair of the disposable stretchy fishnet-type underwear that we give to OB/GYN patients. Sue returns with the (sort-of) underwear and some pads. The pads don't really stick to the underwear. This is going to be great. I have visions of me tossing and turning in bed, soiled maxi-pads stuck to my forehead and my bed becoming a bloodbath.

I stand up, empty my hat, flush the toilet, and report a 900ml void. It is too weird to have my coworkers dump and flush my pee.

I keep waking up to pee. I look up at a big bag of normal saline and realize that I have been receiving tons of fluids, which must explain my continued propensity to urinate. I feel guilty ringing the call bell, making someone come into my room. I'm probably fine to walk there myself.

I fall asleep, and wake up to some alarm going off on my monitor. Blood pressure, 68/41. I fall back asleep.

I wake up again, some other alarm on the monitor. I pulled off some of my EKG leads tossing and turning. I reconnect them and turn on my side, trying to get comfortable. One pops off again. I realize this is going to be an all-night affair.

Friday, October 8, 2010

Back in time

I realize that I hadn't really posted anything in my blog about how school had been going. The reality of it was that things were okay, but pretty much any free time I had I was spending studying or with my family, and as a result wasn't really blogging.

It turned out that I had to commute to school five days a week (initially I thought it would only be three), and then work three days a week (12-hour shift overnights). MiniMan went to on-campus daycare three days a week with me, and those days were nice, because it meant that whenever I wasn't in class I could use the chunks of time to do homework and study.

Chemistry was going really well. My lecturer was good, and I was getting A's on my tests. Even though I was doing well, it was kind of maddening to be in a class with four-hundred other students. The professor was impossible to contact except after the class (he didn't even list his office location or e-mail in the syllabus) and we had to rely on TAs for everything. I was impressed that they had chem office hours 9-5, five days a week, but then I realized that the office hours were in fact, a room filled with twenty students looking for help, and one TA milling around helping one person at a time. Sometimes people would wait forty-five minutes before the TA even talked to them. It was really screwed up.

Physics was going okay. I think that math-intensive courses will always be more challenging for me. My homework assignments took up huge amounts of time. I wasn't able to get everything done on campus and during the evenings, so I ended up hiring a baby sitter on the weekends so that I could spend more time on my problem sets.

When I wasn't in class, I was spending tons of time in the car. The commute was pleasant. It was a pretty drive, but when I realized how much time I was spending in the car (over fifteen hours a week), it started to drive me crazy. I could have been spending that time studying. As a result, I devised a sort of flash card study system which I brought with me in the car. I think this really disturbed my husband. He was convinced that I was going to crash my car through some combination of distraction and sleep deprivation.

Crash my car, I did not, but be sleep deprived, I'm sure I was. I was yearning to work only two nights a week instead of three, but if I did, I was guaranteed to lose my health insurance and other benefits. This resulted in a sort of bizarre schedule which went something along the lines of:

6:00a.m. Get up to get dressed.
6:45a.m. Start driving to school.
8:15a.m. Arrive at school.
8:30a.m. Go to my chem lab.
12:00 noon Drive home.
1:30p.m. Watch MiniMan, eat lunch, attempt to tackle laundry, make dinner.
5:45p.m. Get dressed for work.
6:00p.m. Leave for the hospital.
6:45p.m. Arrive at work.
1:00a.m. Eat "lunch" again.
7:15a.m. Leave work, pick up MiniMan, drive to school.
9:00a.m. Drop MiniMan off at daycare.
9:25a.m. Park, walk to class.
9:40a.m. Chem lecture.
10:40a.m. Study, eat lunch No. 3.
12:00 noon Physics lecture.
1:00p.m. Physics "discussion" with useless professor who constantly gets confused and gives quizzes during practically every class.
2:00p.m. Study.
4:15p.m. Physics lab with TA who talks way to fast and seems irritated by the prospect of having to teach us.
5:40p.m. Pick up MiniMan from daycare.
6:00p.m. Drive home.
7:30p.m. Get home, figure out some form of dinner.
8:30p.m. Fall asleep on the couch next to husband.

There were always a couple nights like this, days where I had to go to school and then work and then go back to school. Or nights where I had to work, couldn't sleep during the day, and then had to work another night. At first I wondered if I would be able to do it, and then I realized I could. I felt important and invincible. I had a purpose. I was more giddy than tired. It was like being drunk.

Thursday, October 7, 2010

My life exploded.

For over a week, I've been debating whether or not I should blog about what has been going on in my life. My first inclination was not to write -- after all, who wants to announce to the world (or more accurately, my small pool of readers) about how they've failed?

After talking to my husband, I had a change of heart. My blog is an anonymous outlet for me, and I've decided to share my story. It will probably come in installments as a narrative, because I just don't feel that motivated to write about everything all at once. I don't really feel motivated at all. Life sucks.

Day 1:

I'm in the emergency department of the hospital where I work, barefoot, lying on a stretcher. Familiar nurses are doing an EKG, putting IVs into my arm, hanging saline. My husband, somewhere.


“What did she take?” Someone asks.


I wake up in the ICU. I'm in room 8. My shirt is gone. My bra is gone. I'm wearing a gown. I don't remember taking my clothes off. I try to sit up. It doesn't really work. It's like the force of gravity has doubled. I succumb to my hospital bed, fading in and out of sleep.


My nurse (also one of my coworkers), Claire, comes in. I like Claire. She lives in the country, has a little farm with her husband. “Hi E.,” she says. “We're just going to monitor you for a while, make sure you're doing okay.” I close my eyes.


“E.? E, it's Dr. Nolan. Can you tell me what happened?” Dr. Nolan is one of the intensivists. I used to assist him with procedures when I still worked days, inserting central lines, doing lumbar punctures. He must think I'm such an asshole. I wish this bed could engulf me.


"I.. I.. took some pills. I was just really tired. I just wanted to sleep. I had gotten in an argument with my husband about the schedule for my physics class and I was just really tired and upset, and he refused to let me sleep, so I took the whole bottle. " It was stupid. It was stupid and impulsive. There are people here who are actually sick, unlike me. I'm just wasting your time, destroying any kind of once positive rapport we might have had, I thought to myself.

He continued to ask me questions for his history and physical in a detached manner.
"Past medical history?"
"Chronic sinusitis; aseptic meningitis."
"Surgeries?"
"Tonsillectomy."
"Anything else I should know?"
"I think my finger is infected. I had cut it a few days ago, and it's just been getting worse. I had been waiting to see if it would get better on its own." I held up my hot and puffy finger.

The rest was a blur.

I wake up again. Lauren, one of the aides, tells me she needs to draw blood cultures. I stick out my arm, barely aware of needles, of any kind of pain. I drift back to sleep.

Tuesday, August 31, 2010

Crayola Crayon Colors -- Medical Edition 2010

The other night at work, some of the nurses and I were sifting through an old Avon catalog that someone had made behind and giggling over their products. After perusing the nail polish section, I admitted that I had always had a secret career ambition of being one of the people who comes up with the names for new Crayola crayon colors.

After some brainstorming, we decided that our hospital assortment might include:
-Cyanosis
-Meconium
-Last night's mac and cheese
-Jaundice
-Mahogany stool
-Bile
-Leukorrhea
-Turbid tea-pee

Feel free to contribute your own!

Monday, August 30, 2010

My husband rocks.

Last night, I was getting everything ready classes and setting it all on the kitchen counter before I packed it up. Wallet, important forms, notepad, glasses, diapers, extra clothes for MiniMan, etc. Of course, it didn't take long for MiniMan to pull a stool over to the counter and have a seat. I didn't think much of it, until he picked up my glasses and in one swift motion, broke them apart at the hinge.

I was too late this time. My glasses were literally in two pieces. I made a joking remark to my husband about now how people could really make fun of me for being nerdy, as I looked around for some tape to do a makeshift repair.

When I woke up this morning after my husband had already left for work, I found my glasses sitting on the counter, the hinge reshaped, held together with some kind of tacky clear glue. I wouldn't have to wear taped-together geek glasses on the first day of school! It's been a good day.

Note: this post comes to you from the campus of my large state university. I have attended two lectures and a discussion section, and everything is going great. Yay!

Sunday, August 29, 2010

The Saab Strikes Back

I have been basking in this wonderful, sort of giddy feeling for the past few days about taking classes. I'm excited. It's hard to sleep. It's like Christmas Eve when you're five years old.

My husband just came home after borrowing my car and putting some gas in it. Turns out, it broke down AGAIN. I just don't get it. My car breaks down the day before classes start? You've got to be kidding me. I think this vehicle has bad karma or something. Our mechanic, who we have a super-friendly practically family relationship with has graciously offered to let me take one of his loaner cars to classes tomorrow. Meanwhile, though, financial disaster looms once again. Oh man.


Wednesday, August 25, 2010

The saga continues...

Monday morning: I wake up and call admissions. "What's the quickest way to pay my [third!] application fee?" I ask. "Can I give you my credit card over the phone?"

"No, you may only pay by credit card online, but it will take a few days before you have the option of paying online." Don't ask me why this is. I talk to the admissions lady for a few more minutes and we decide that it makes the most sense for me to drive the hour and a half commute there to drop off my transcripts (for the third time) and a check. She also recommends meeting with the continuing education advisor, to see if she can help me sort this out.

I call the continuing education office to ask if my advisor will be there in the afternoon and if she'd be available to meet in person. Her secretary confirms she'll be around. I get my things together and start driving.

I arrive on campus. It's pouring outside and I'm wearing these bright orange mud-covered galoshes that probably make me look like I've just stepped off of a dairy farm. That's okay. My feet are dry, my hair is wet. I decide to head to continuing education first and look for my advisor. The secretary is gone. Everyone is at lunch. I'm told to come back in a half an hour.

I walk across campus to the building where the admissions office is. I drop off my check and my transcripts. I head back over to continuing education, but everyone is still gone, so I decide to do a miniature self-guided tour in the rain. Student union. Check. Campus bookstore. Check. Science library. Check.

I head back over to continuing education. It's been a good forty-five minutes, now. Everyone is still gone. I decide to wander through the building, get lost, and eventually find my way back over to their office. The secretary is back. I introduce myself. "Oh," she replies, "we wanted to call you, but I couldn't remember your name. It turns out that your advisor has a dentist's appointment today and won't be in until later this afternoon. You can wait for a few hours or just call her when you get home."

Rather than walk around in the rain for a few more hours, I decide to go home.

I call my advisor when I get home. She tells me that I should be registered by the next morning, and that if I'm not, that I should check in with admissions.

Tuesday morning: I still can't register. There are two more spots left in physics. I'm getting freaked out. I call admissions again and talk to the same unpleasant guy who I talked to last time.

"I'm calling to inquire about the status of my application," I tell him.
"Did you check online?" He asks with exasperation.
"Yes. It has been received but not processed. My advisor in continuing education suggested I call you and check in if I was not able to register by today."
"Can you hold?"
I hold for five minutes, literally. No joke.
"We've received your application online."
(Duh, I knew that).
"Have you submitted a payment?" He asks.
"Yes, I dropped off a check (and my transcripts) in person yesterday."
"It will take us a while to process the check. First it needs to be deposited, and then it needs to cleared. After it clears we can process your application. I doubt that we'll be able to process your application until after classes start, so I suggest you contact departments independently and see what their processes are for getting into classes that are closed."
I politely detail the nature of all the crap that I've been through already. "Is there any way that you might be able to expedite things considering these extenuating circumstances?"
"I'm sorry, you'll just have to be patient," he says unsympathetically.
"Okay. Thanks for your help." (Not).

I hang up the phone and start sobbing somewhat hysterically. MiniMan, my nearly two-year-old, is sitting at the kitchen table with me looking disturbed. I blow my nose. Then I cry some more.
"Mama. Sad." He says. He picks up the used tissue and wipes my nose.

I give him a hug and pick up the phone again to call admissions back.
"Admissions, can you hold?" I wait. And wait. And wait.
"Hello, admissions." Finally.
"If I drive up today and drop off cash instead of a check, will this speed up the processing of my application."
"We do not accept cash. You may pay online with a credit card, though."

Am I going out of my mind? I think I'm going out of my mind. I pay online with a credit card, and then call the chemistry department as recommended by the unpleasant guy in admissions.

"Chemistry department, this is the really nice secretary speaking."
"Hi, I'm E. Greene. I talked to you last week. The unpleasant guy from admissions who you suggested I call suggested I call you again."
"Oh dear."
"He told me that I couldn't be deferred and that I'd have to reapply. I reapplied but now I've been told that admissions won't be able to process my application until after classes start..." My voice wobbles as I try to hold back tears. I start crying again.
We talk for a few minutes. I must sound really pitiful, because she starts making jokes to try to cheer me up.
"Okay, I'm going to have to call some people, but in sum, you're looking to take undergraduate classes as an unaccepted, non-matriculated student, right?"
I laugh. "Exactly!"

Tuesday afternoon: Super-nice chemistry secretary calls me back.
"I talked to admissions and they're processing your application. You should be able to register this afternoon, or by tomorrow morning at the latest."
I gratefully thank her and wait expectantly at my computer.

About an hour later, I actually register. I get the last space left in my physics class, and a spot in the huge gigantic chemistry course, too. I am not sure how I ended up being so freakishly lucky, but I am forever indebted to the really nice secretary in the chemistry department. I wonder what she said to make admissions give me the time of day? I have noticed that sometimes only by breaking down and exhibiting signs of complete desperation, will people actually notice you. I'm not sure if that was the case in this instance or not. Anyway, how do I thank her? I want to write her a note and perhaps do something involving food. Chocolate cake with fresh raspberries? Wine? Both?!

Friday, August 20, 2010

Greetings from Grumpyland

I am getting really, really, really frustrated with my huge state university. I had contacted continuing education early in the summer to make sure that everything was on the right track and I wouldn't have any problems with the registration process. I was assured that everything was in order.

About a week ago, I logged onto the campus student website (what people use to look at unofficial transcripts, pay bills, register, etc). I got some kind of weird message that I needed to reapply. So I called continuing education and asked what the deal was. Continuing education said, "we don't know, call the graduate school." I call the graduate school. "You need to reapply," I am told. I was annoyed to say the least. It's not like the application process is that bad, but this was the third time that I would be applying to the same school where I had repeatedly been accepted in the past year. Now I need to apply again? Apparently so.

I end up calling admissions again to ask them if I'm eligible for an application fee waiver. I talk to a student who puts me on hold, and then finally puts me through to an admissions counselor who never answers the phone and doesn't have voicemail. I call back, listen to their five minute automated message, and talk to another student. They put me through to the assoc. director's voicemail who is on vacation. The associate director calls me a few days later when he returns from his vacation, and says that I have to contact a different office. I call the other office and am told by a woman on their staff that I will have to reapply. She promptly hangs up. I call her back "what about the fee waiver?" I ask. She replies that that is not available and that I will have to reapply. I start explaining my situation to her and then she puts me on hold. She says that if I contact the department that I'm taking classes in (for ex. the chem. dept.) then they may be able to grant me a deferral and then I won't have to reapply. Okay, now we're getting somewhere.

I contact the chemistry department and repeat my story, once again. The woman who I talk to says that she's never heard of anything like that. She says that she will have to call some people and get back to me. She leaves me a voicemail today, saying that I need to contact someone in the office that referred me to her. I talk to this guy, and he says that I'll have to reapply, and that there are no fee waivers except for poor minority students who are in their poor minority student program (which is only for matriculated students).

I get online, repeat the application this afternoon, and then realize that unlike their other application, there is no way to pay the application fee online. So now I have to drive an hour and a half to the school on Monday to drop off another check, and more transcripts (which I've already given to them, twice).

To make matters worse, registration begins for students with my lowly status on Monday. So, I'm pretty much screwed. I feel like this is some kind of secret test of patience and endurance. If that's the case, bring it on.

Monday, August 9, 2010

SDCOD

SDCOD (sleep-deprived comment of the day) should probably be changed to SDCOW (week) or SDCOM (month). I'll aim for SDCOW, and we'll see how that goes.

And now... an excerpt from doctor's orders for a patient in our unit:

0.4mg sublingual nitroglycerin for chest pain, every 5 minutes x 3 doses PRN. If chest pain unrelieved after 3rd dose, call 911.

Thursday, August 5, 2010

Did I make the wrong choice?

I just called the daycare center at the university where I'm taking classes in the fall. I learned I'm not eligible for their financial aid program because my husband and I make over $3500/year together. It's frustrating. I sometimes feel like some of these aid programs are practically an incentive to quit my job, because then if I did, I'd actually be poor enough (by their standards) to get assistance.

The cost of daycare plus the cost of gas to commute to school alone will eat all of my take home pay each month. I still haven't figured out how to pay tuition (or any other expenses like the utility bills, groceries, etc). After finally giving up on private loans (which were all variable interest rate and scary), I applied for a second credit card in an act of desperation. I can pay for tuition with a credit card, right? And after all of this, I still don't even know if I'll be able to get into the classes I needed to take because I'm non-matriculated.

I opted to take the "design my own post-bac program route" because I thought it was more direct and made more sense financially. But honestly, I don't even know how we'll pay the bills. The whole thing stresses me out so much I can't sleep.

Did I make the wrong choice? Last year I applied to the bioengineering program at the same school and was offered grants that covered the entire cost of tuition, plus ample money for cost of living in federal (not scary) loans. I would have had an advisor. I would have been able to get into classes. I would have been able to take voice lessons and get involved with research. It would have taken four years instead of two, but now I'm not even sure if I'll be able to figure out how to take classes this year. I would so much rather spend some extra time in school and be intellectually engaged then spend some extra time waiting to take classes and pulling my hair out.

Is it completely insane to call the director of the program (I met with her last spring) and tell her I changed my mind? Do you think they would actually let me back in?

Wednesday, August 4, 2010

Weighty Matters

I've been called in with four other people to help hold up the panniculus of a fifty-year old woman in our emergency department so that one of the nurses can catheterize her. The big flap of abdominal tissue that nearly extends to her knees is firm and pocked, and almost scaly in areas with patches of dry skin flaking off under my gloved fingers. With the help of my coworkers, we grab the the heavy lump of tissue and pull it up so that Matt can prepare to insert the Foley.

"I can't find her vagina," he mutters in exasperation.

We all shift around a little bit, trying to pull the panniculus up a little higher and shift the position of her legs. After a few more minutes, Matt manages to find her vagina.

"Are you guys doing okay?" He asks. "How are your backs?"
"We're fine, don't worry," says one of the ED techs, her forehead damp with sweat.

Mike unwraps the catheter package, puts on his sterile gloves and prepares a sterile field, lubes up the tip of the tube, drapes her, swabs her, and gives it a go. The catheter is in. None of us thought it would be that easy.

"You're done?" Our patient asks. She smiles. "I've never had anyone put in a catheter that fast before!"

These kind of situations were initially really shocking to me, but more and more, I'm realizing that they are becoming commonplace. It is not all together unusual that I will come to work and we'll have a patient in the ICU who is so obese that she is unable to move her legs or even turn onto her side. I will later read histories and physicals, and see that some of these patients were not in nursing homes before they were admitted to the hospital. How do they live independently? How do they go to the bathroom, take a shower, clean their house and get groceries? Who takes care of them? It is terrifying to me that some peoples' obesity has become so out of control that they are nearly trapped within their own homes.

It is physically strenuous to care for these kinds of patients, even in the hospital setting. It sometimes takes four or more people to turn and clean up the patient in bed if she has a bowel movement. They seem predisposed to skin breakdown between the folds of their skin. We need to find special bariatric commodes, wheelchairs, and beds (in our hospital, there are a limited few) with special bariatric sheets, and use bariatric gowns because normal hospital gowns do not provide adequate coverage.

Many of these patients are in the hospital due to complications of their obesity (heart disease, hypertension, diabetes, sleep apnea), and some healthcare personnel are not terribly sympathetic, having an attitude something along the lines of it's your own fault that you let things get this out of hand.

I don't know exactly how I feel. As an aide, it's rare that I have the chance to get a very complete picture of any of our patients. I don't really know what the contributing factors are to their obesity, how they got there, what they tried to do to help themselves. What did their doctor try to do to help? Did they even have a doctor? There's a part of me that's always a little baffled. I always imagine if I were becoming seriously overweight, I would be alarmed at my weight gain and I would do something. If my attempts didn't help, I would seek help until I found a weight-loss strategy that worked.

At the same time, I feel like these patients who are so obese they can barely move are practically past the point of no return. How can they exercise if they can't stand up? Even just as a pregnant woman it was uncomfortable for me to exercise, so I can't even imagine what that would be like if I were 300+ pounds. By the time these patients are in the hospital, their prognosis is likely even more dismal, so in my book, these patients are deserving of any kindness and help they can get. After all, it's our job.

So I guess my big question is, how does a healthcare provider keep patients from getting apathetic about their weight? Do you think it's an issue of motivation, education, or something entirely different?




Tuesday, August 3, 2010

Where did I go?

I've been really grumpy, lately. Everything seems like kind of a crapshoot. I delayed taking classes until the fall, but then I encountered an insane car bill and have now spent most of the money that I had been saving for tuition. I applied for several private loans but was rejected for all of them even with a cosigner (which surprised me, because my credit rating is in the 700s). I think it is really hard to get loans as a non-matriculated student taking 5th year undergrad courses. I'm feeling screwed.

Spending nearly four years exploring menial jobs to confirm my interest in medicine has proved to be overkill, and now I feel like I'm going to lose my shit. Working overnights sucks. I never get to sleep during the day as much as I would like to (between two and six hours) and I think the sleep deprivation is messing with me.

It's depressing not to be challenged, and I constantly feel torn between wanting to learn (one of my favorite activities is reading charts, and looking up terminology that is unfamiliar to me) and doing what needs to be done (emptying foleys and urinals, stocking supplies all over the unit etc.). Stocking is this endless task that no one wants to get stuck with. We stock about a hundred supplies in each room; it's mostly boring stuff: shampoo, toothbrushes, suction liners, tubing, yankauers, emesis basins, etc. Initially it was cool to familiarize myself with some unfamiliar equipment, but it's just banal repetition. Compelled to do my job as well as I can, I always do whatever needs to be done over what I enjoy doing. The thing is, I stand there filling these cabinets while I imagine my brain atrophying and grow more and more bitter. The nature of my job involves few puzzles, little problem solving. If I actively seek it out too much, I feel like I'm slacking off. I guess the good news is that it's not forever, but I just don't know if I'll really last two more years as an aide while I finish my pre-med requirements.

Despite this, we recently had a patient who was detoxing, but two weeks later, was still significantly confused. He came in reasonably oriented, and I was puzzled as to why he wasn't getting better. I asked one of the nurses if it was normal to have DTs for such a long period of time -- don't they usually subside by this point? Do you think the benzos are making him loopy? And then wide-eyed and excited, "maybe he has Korsakoff's Syndrome!" recalling tidbits from a human neurobiology class from undergrad. His nurse looked up at me, "what's Korsakoff's Syndrome?"

Tonight I was reading a progress note by one of the internists whom I really respect, and he too, was curious about the origins of this guy's encephalopathy. And what did he consider? Tail end of DTs, adverse reaction to benzodiazepines, and you guessed it, maybe Wernicke Korsakoff's syndrome. I was really surprised with myself. Usually I just laugh at myself and the ridiculousness of an aide throwing out ideas as a diagnostician. I think the thing that I have to remember is that I'm learning, even if only by osmosis, a lot the time. Hopefully some day some of that will actually be useful.

Monday, June 14, 2010

Penn or Wilson?

In the mental health unit at the facility where my husband works as a nurse, one of the patients was complaining of rectal bleeding. After some investigation, one of the nurses learned that he had been using a tennis ball can as a dildo. She had to call the patient's attending, who wrote orders for a comparable sex toy and 1:1 observation by a staff member until a new, safe sex toy was procured.

My husband's coworker, Leanne, who is the manager for the unit, was somehow elected to buy the replacement dildo. She is notoriously polite and very slight in stature. All the staff members are harassing her to hurry up and buy something, so that they don't have to keep observing this guy. The patient threatens that the replacement dildo must be at least as wide and as long as his tennis ball can, or else he won't use it and will continue to insert random foreign objects up his butt.

All I can imagine is Leanne sheepishly bringing some huge dildo up to the register and trying to explain "really, this is for my job."

Sunday, June 13, 2010

SDCOD

Husband: Did you just fart?
Me: No.
Husband: What was that noise?
Me: I don't know.
Husband: You did fart, didn't you...
Me: Smell my butt; I did not fart.

Sunday, June 6, 2010

Sleep Deprived Comment of the Day

Inspired by the Medical RNinja and her cat of the day and Latin of the day series, I have decided to trial a sleep deprived comment of the day series (SDCOD, pronounced: sad cod).


So, here goes:


This morning, I walked into a patient's room to empty his Foley bag and noticed that his nasal cannula was way up on his forehead. I leaned over and said to him "I'm just going to readjust your Foley and put it in your nose, okay?"

Thursday, June 3, 2010

Instant Popularity

Last night I was floated to the emergency department. They were slammed with mental health patients and had something like five patients who required 1:1 observations, so of course I was perched on a stool, watching one of the patients, and waiting impatiently for each second, minute, and eventually hour to tick by. After being in the general calm of the ICU for all these weeks, I had forgotten the pleasing chaos of the ED: a very new baby crying, constantly chiming call bells, staff bustling back and forth, the obscene shouts of a combative drunk guy, and the eighties rock Dr. D likes to play on the radio.

A guy in a white coat walked past me and asked one of the techs where the commodes were kept. I thought he was a physician, but if he were looking for a commode then maybe I was mixed up.

I stopped one of the techs. "Jess, who is that guy?" I asked.
"That's Dr. Cho. He's awesome."

Twenty seconds later I saw him emerge from the storeroom, commode in hand, walking it into the patient room he had just come from. It seems like a sort of goofy, exaggerated reaction, but I was shocked. I have never, ever, in the three plus years that I've been employed in healthcare observed a physician get involved in toileting.

So, Dr. Cho, I agree with Jess. You must be awesome (as demonstrated by your crazy and unexpected act of awesomeness last night). I don't mean this in a political way, or that all doctors should start emptying bed pans. However, I do think that anyone who occasionally steps out the constraints of his or her job description to pitch in and help the team ends up building some significant camaraderie with the staff. I will remember this when I want to be awesome.