Monday, January 31, 2011

A new perspective

I really don't like to get all mushy in my blog, but take this as your warning: it's going to get mushier.

As you can probably gather, I went back to work and survived to write about it. I can't exactly describe it, but something about my attitude towards patients really changed over the weekend. I finally understood that it wasn't some kind of intellectual insult to help people on a basic level (to get some ginger ale, to help reposition an uncomfortable patient in bed for the tenth time, to give someone a bath). I realized that being a patient in the hospital really sucked (okay, I knew this before, but now had this entirely new level of empathy) and that I wanted to do whatever I could to take care of my patients and ease the misery of being trapped in the ICU. So there, that's my mushy revelation.

Now for the highlights:
-Inventoried and checked expiration dates on one adult crash cart and a Broselow crash cart. It was pretty tedious, but I liked that it familiarized me with supplies and that during a code I would know exactly where to look for something. I had never opened the Broselow before; my reaction was a combination of amazement and concern as I sorted through through teeny tiny ET tubes and their stylets, feeding tubes and Foley catheters. I didn't want to imagine this stuff ever being needed.
-Changed a bag on an FMS (first time). I will probably lose my sparkly enthusiasm for that pretty fast.
-Assisted Dr. Nolan with a central line (first time I had ever worked with him since I came in as a patient). It was a little weird, but okay.
-Saw an episode of torsade de pointes in realtime when a monitor was alarming. The patient was given magnesium sulfate and lived.


Sweet little old lady: Could I have one more pillow for over here?
Me: Sure, do you just want some extra padding around the side rail?
Sweet little old lady: I want to keep out the mice.
Me: The mice?
Sweet little old lady: I want to keep them out of my bed.
Me: I can promise you won't have to worry about any mice crawling into your bed in the ICU.
Sweet little old lady: They're already in my butt.
Me: What's that?
Sweet little old lady: The mice -- they're up my butt.

Thursday, January 27, 2011

Chicken or the egg?

People (my husband, bloggers) keep telling me that I need to get in a better place, to get my head sorted out, or something along these lines.

Here's the part that I don't understand, though. I've been grappling with these same issues (depression, suicidal ideation, etc.) since I was a preteen. This is the first time that things have really come to a head and made me feel like my life is falling apart. The thing is, before I overdosed, I wasn't depressed. I wasn't thinking about suicide constantly. Although I was exhausted, I was usually happy.

Do I really need to eliminate stressors? Is that really going to make life better? I feel like it's just the opposite. Stressors are usually what motivate me to be productive. They make me feel useful and provide meaning in my life. I always thrived off of being challenged and being busy.

I only started feeling really content after I started going to Oberlin where I was surrounded by musicians, convinced they were all better than I was, and scared shitless half the time. It was intense, but it gave me a reason to live. I know that having a kid and a family should be a way more important reason to live, and I don't know why I don't feel the same way, but, as Kara mentioned to me, time does move in slow motion when you have a child.

I guess I always thought not that I was depressed, and that working really hard was my coping mechanism, but instead that working hard, being challenged, and learning were what brought meaning into my life and gave me control over my mood.

Wednesday, January 26, 2011

I just don't get it.

I signed up for some shifts at work the other day. I'm supposed to work tomorrow night in Friday morning, Friday night into Saturday morning, and Saturday night into Sunday morning. This was usually how I'd try to schedule my overnights: all in a clump. It really doesn't make sense to space them far apart, because then you never get back on a daytime schedule and just become a useless zombie for the rest of the week.

Today I went through a big box of random paperwork that I had stowed in the corner upstairs. I spent half the time crying. Fat stacks of xeroxed opera scores; memos and travel itineraries from the recital series that I used to work for; letters to hospitals requesting to volunteer; notecards with praise from conductors and colleagues, binders and folders crammed with notes, assignments, and papers; my name on old concert posters and in programs. I don't know why I saved so much. I guess I figured maybe I would need it. Maybe the old me would have needed it. I slowly leafed through it all, and put almost everything in a pile to use as kindling for the wood stove. It was sort of devastating to review the things I used to do in my old life, versus everything I don't do now. I miss life as a student. I liked being sheltered from the real world -- from owning a house, from having a frustrating full-time job, from paying property taxes.

I need to go to work but all I can think about is how I'd rather be trapped under the ice on a frozen lake or browsing the aisles of Agway for rat poison. I keep telling myself not to indulge in thinking this way -- I mean, it really isn't me, right? They're just stupid thoughts. I don't really know anymore. Maybe it's exactly the opposite; maybe I'm irrevocably drawn to these patterns of thinking; maybe they define who I am.

Monday, January 24, 2011

Joining the masses

I saw my doctor this morning and got a note to finally return to work. I told her I needed to work full-time, because our expenses are greatly outnumbering our income. My husband's paycheck covers the mortgage, the electrical bill, and maybe a little gas. That leaves groceries, the phone/DSL, diapers, car insurance, life insurance, health and dental insurance, and more gas for the cars. I recently had to explain to my toddler that he could not watch "Caillou" on Netflix because mommy's credit card is maxed out. Yeah. Not good.

So, I'm going back to work. This is good, right? No more eating rice and beans constantly (for a while, anyway). No more seemingly unending state of financial disaster looming over our heads. I know I need to do it, but when I lay down in bed and think about it I have to stifle the tears insisting their way out of my closed eyelids. I keep telling myself, it's really not that bad. I love the night nurses in the ICU. I love working with patients on vents. I love their complex situations and scrolling lists of comorbidities.

Still, I dread the idea of staying up all night and potentially doing this for years until I finish my pre-reqs. I'm tired of bringing people ginger ale and cleaning up their fecal incontinence. I'm tired of placating disgruntled patients, giving bed baths, and spending hours stocking random supplies in room, after room, after room.

I know. It really doesn't sound that bad. I'm sure tons of people aren't happy with their careers. Still, it's driving me apeshit. I hate that I can practically feel my brain start to atrophy when I go to work. I want to do something that isn't just a check mark on a list.

I don't know if I have ever written about my sequence of events after Oberlin, but during my last year there, I applied to masters programs in opera and post-bac pre-med programs. I got into both and ultimately decided to give up the singing to pursue medicine. I was supposed to start my post-bac program in the fall of 2007, but was terrified by the interest on the loans (by the time I finished med school, the interest would have quadrupled the cost of my post-bac program). My parents urged me to stay home and save some money, and this seemed like a reasonable idea to me, so I deferred from the program until the next year, lived at home with my parents, got a job as a caregiver at a nearby nursing home, and stowed away my earnings like a chipmunk.

Meanwhile, I'd been fooling around with this nurse at work. He was nice, real easygoing -- not really my type (loose definition of my type: bookish socially inept Caltech students who could ALWAYS help me with my calculus problem sets), but interesting. He had really amazing taste in music, but it was none of the stuff I normally listened to. Still, he was really not my type. He had a huge tattoo covering his entire back and he liked to wear camouflage pants on his days off. He was devilishly intelligent but had a complete disregard for the educational system and had dropped out of highschool as a teenager. He was really rustic. He lived in a cabin in the woods, he had a huge dog, and he used to have his own sawmill before he became a nurse. He wasn't my type, but he was hot and magnetic.

Historically, I had always put my education before guys. I highly valued my independence. I had convinced myself that I was my own star leading my way; that I was content with myself and my academic pursuits; that I didn't need a boyfriend or a husband to find happiness, and that I would never be blinded by love (or lust) and let a guy screw up my plans -- I had worked too hard for that.

So, what did I do? You guessed it. I became hopelessly enamored with this rustic man-nurse and let him screw up my plans. Idiot. Idiot. Idiot. Still, I don't really regret that part (most days, anyway). Then I got knocked up. When I found out, the idea was so ridiculous that I laughed. Me? Kids? What? I didn't like children; I didn't think they were cute; I'd never even babysat a kid.

I had always thought maybe I would have kids, but not until I was around forty or fifty...or sixty. Maybe I'd adopt. Pregnancy and childbirth seemed sort of overrated. I always thought that if for any reason I needed an abortion, that it would not be a difficult decision to make. Things were becoming complex, though. I had been working at this nursing home eighty hours a week wiping butts and playing scrabble, I was emotionally exhausted and confused about my interest in healthcare, and had all these weird pregnancy hormones surging through my body. I was depressed and was worried that if I aborted this little dude we had been calling "Cletus the Fetus," that I would crawl into a hole and never come out. My rustic-man nurse was about fifteen years older than me and ready to have a family. I knew he'd be an awesome dad. He was totally willing to play stay-at-home dad while I went to school. In some ways, it was like I had found the perfect guy. And so, even though kids have sticky fingers and dirty diapers and boogers and destroy everything, the idea of one seemed kind of happy. This is how I became a mother.

When I told my parents, the shame was pretty much equivalent to getting pregnant at age 12 by some five foot tall eighth-grader with a gameboy. My dad banished me from the family for three years.

I got over it and started taking my post-bac classes one at a time while working full-time as an EKG tech. The day that MiniMan was born, I went to work and I went to a class afterwards and took an exam. I was having contractions but just wanted to get the exam over with. I had studied well and I didn't want to have to study for it again (especially with a newborn). By the time I got home it was pretty much time to turn around and go back to the hospital. MiniMan was born about an hour and a half later. All the nurses said "if it were that easy for me, I'd have another one." All I knew was that it felt like squeezing a TV out of my nostril.

Things were okay at the hospital, but then I came home. I realized this crying, pooping, never sleeping torture device had taken over my life. I knew it would be bad, but it was worse. "What was I thinking," I asked a few days after he was born, bawling hysterically to my midwife. "I've given up my entire life." Somehow she was able to console me, and things did gradually get easier. Still, the snaillike pace of my coursework was driving me up the wall.

About a year later, I started applying to programs again. I applied to post-bac programs and for second bachelor's degrees. I looked into taking courses "a la carte" and just taking what I needed. I seemed to have researched every school within a 2-hour radius and how much it would cost. I got into a wad of programs. I could have done a post-bac program again and I could have gotten another degree with a full scholarship. I opted to take my courses at the big state school as a non-matriculated student. It seemed like the most practical use of my time (I wouldn't have to take two years worth of extra courses to fulfill a degree requirement), and it was still one of the less expensive options.

Anyway, you get the point. Then I went to school and went to work, and went back to school, and never slept and eventually flipped out. I guess my point is, I feel like I've been putting off the remainder of my post-bac courses forever. I'm becoming so impatient with and practically intolerant of my menial job (which pays less than half what I made singing with opera companies). I chose to be in this situation, but I never anticipated that this period would last so long.

I think I just need to suck it up, but really, I need to have some kind of end in sight. I have a really hard time dealing with the idea of being a hospital aide for the next five years. I'm not planning to take classes again until next fall. If I work and take one class at a time, though, it would take four years for me to finish these. It really horrifies me. I don't know what to do.

Saturday, January 22, 2011

Picking up the pieces

I've been on short-term disability for four months now. It's strange to consider myself "disabled." More and more, people are uncovering the neuroscience behind mental illness, but I can't help but wonder if this whole mess is just the manifestation of my flawed character.

I'm finally starting to feel okay again. I still have really off-days, but for the most part, I feel more like myself. I've been hanging close to home, mostly to avoid spending money (on groceries, on gas, at coffee and bookshops -- you get the point). I initially felt weird about taking the disability money, but honestly, I'd be so screwed if I didn't. I have no idea how I'd pay for my health insurance. After deductions I end up getting $54.00/week. My husband and I have started doing some seriously frugal living. I now shop almost exclusively at Aldi (although still have a huge weakness for the big bags of organic lemons at our co-op).

Lately our diet has been lots of variations on rice and beans (chickpea masala, moong dal, a north Indian style chili with kidney beans). Yay for soluble fiber! I've mostly stopped buying bread and instead bake our bread. Most of it is from this no-knead cookbook that I am really into (Kneadlessly Simple, by Nancy Baggett). Here's a ciabatta I made the other day:

I've been raiding my stores of slightly shriveled produce and the freezer, and canning a lot (at least for me): blueberry lemon jam, cranberry jam, orange marmalade, applesauce (just apples), and applesauce with crystallized ginger. I am not sure what is up with my jam binge, other than the fact that the other day I went to the store and wanted to buy jam, but did not have enough money. NOW I HAVE JAM. Lots of jam. I will eat it on my bread, and let my toddler smear it on his face, and on the table, and on the windows, and on the dog...

As if this level of cooking tedium were not enough, I decided to venture into the land of craftiness and whip up some homemade play-doh for MiniMan. He has really enjoyed creating little sculptures in the snow, but seemed uh, pretty unimpressed by the homemade play-doh. In the process, though, I found this tutorial on the same website for making lampshades out of parallelograms with little hooks at each corner. This required one template, and then cutting out and assembling what seemed like a gagillion pieces of paper with little hookies (which was oddly soothing). However, now I have this kind of cool lamp thingie:

I was e-mailing my mom and sent her some photos of MiniMan, and some of the lamp. My parents called me a few hours later, and my dad told me (in regards to said lamp) something along the lines of "you're so creative and talented, I hope that you actually apply it to something someday." Uhh. All I could do was laugh.

Wednesday, January 12, 2011

In the snow

My totally awesome mother-in-law got us really, really fun Christmas presents this year: snowshoes for me, my husband, and MiniMan.

I had never been snowshoeing before and had always imagined the circumstances for snowshoeing something along the lines of being buried in rural northern Canada under three feet of snow and walking around with tennis rackets on your feet. I guess they still sell the traditional woven kind, but snowshoes seem to have become way more hardcore.

I had no idea how easy they are to walk in, or that a lot of models now have crampons on their undersides to give you traction in icy conditions (see photo, above, of my new snowshoes). Our snowshoes were easy to put on (they have bindings that you adjust around your everyday boots or shoes), and MiniMan did really well. I was a little skeptical about a two-year old traversing around in snowshoes, but he actually walked about a half a mile during his first time out. He was insanely excited and completely into it.

This morning, I was reading some stuff online and it turns out that some companies have developed snowshoes with spring-loaded suspension systems so that a person can actually go running in them. It seems like the perfect winter solution for any kind of trail runner. Our property borders public state land and I love to run on the dirt roads and trails, but in the winter, I'm pretty deterred because of the risk of falling on a patch of ice and taking out an ankle. Heading out on a trail to run in snowshoes instead of braving a road covered in slush seems fantastic, though.

Monday, January 3, 2011


"Mama, my turn."

My two-year old climbs into my lap and squeezes himself between me and my laptop. He closes my computer and tries to walk away with it.
"Mama, share. Mama, share it."

My MacBook has patiently tolerated a considerable amount of toddler strife. It's been dropped on the floor; thrown on the floor; sat on; stepped on; colored on (both crayon and sharpie, to my horror); taken baths in milk, coffee, and tea; and had plenty of CDs and DVDs shoved in its disc drive, which is currently jammed because it has two CDs stuck in the space for one.

Now, maybe you're reading this, haven't had a child/children, and are thinking to yourself, well, if I had a kid, he probably wouldn't that. This kid sounds kind of like a terror. It's probably best to continue deluding yourself.

So, as you can probably gather, MiniMan is really curious about my laptop, although right now he uses it almost exclusively to stream Netflix. He likes to watch Dinosaur Train, along with some other kids shows. We don't have a TV hookup or cable, and it's okay with me if he uses the computer to watch TV sometimes. My husband calls it a lobotomy in a box, but this lobotomy has provided some much needed sanity for both of us.

I also currently share my laptop with my husband (who, when I met him, professed to be so technologically disinclined that he did not want to have high speed internet, wireless, or use a computer more than rarely). Let's just say this has changed.

I'm starting to think maybe it's time to introduce a new electronic member to the family. Should I start seeking something new, but cheap for the boys? Would a PC be more durable? Should I get a refurbished Mac? Should I wait a while and save for a new MacBook, keep it for myself, and let them inherit the damaged goods?

Sunday, January 2, 2011

Visiting the nursing home

I walk in with MiniMan, past plastic-coated couches, fake flowers and a large faded fish tank housing one lonely fish. MiniMan runs down the hall immune to the poor d├ęcor, eager to push the elevator button. He gives it a push as I wonder what kind of bacteria live on that button, and we walk inside the dingy elevator with its flickering fluorescent lights and chipping pale green paint.

The doors reluctantly open. The scent of urine permeates the stale air. MiniMan grabs my hand as we walk past a middle-aged woman slumped in a wheelchair and a tiny grey-haired woman holding a baby doll, her arms outstretched to us. I find my husband down the hall standing in front of what looks like a giant filing cabinet, unlocking drawers and popping pills out of plastic and foil. My husband works as a nurse at one of the largest nursing homes in the area.

I could never understand why he continued to work there. I always described it to friends and coworkers as “a shit hole,” because that was really my honest impression. In his unit (which houses about 60 patients) staffing ratios are disturbing:

-3 to 4 aides to do daily care, toilet, transport and/or help feed patients
-1 nurse to do the med pass
-1 nurse to do treatments

As someone who has worked in a nursing home as a caregiver, I couldn't even imagine bathing twenty people in an eight-hour shift. Probably the reason I couldn't imagine it was because it doesn't happen. Same with some of the medications. Oh, you're supposed to get eye drops? Definitely don't have any time for that. And this is just when things are going according to plan, not when Mr. Schneider wipes out in the hallway and is lying in a huge puddle of blood. The staff who work there are placed in hopeless situations. No matter how much they want to take care of everyone, it's almost impossible to do.

I sometimes ask my husband why he keeps working there. It doesn't seem like an enjoyable place to work, it doesn't pay especially well, and the staff never have their needs met, even on a basic level (like supplying pens, having a sterilization system for bandage scissors, etc.) My husband's reply is one of the reasons I love him. He tells me that he enjoys being around the residents, and that if someone needs to do this job, it might as well be someone who actually cares. I think he sort of sees it as his contribution to society, and admittedly, it's a noble cause. I still don't know how he does it, though; I don't think I could work there more than a week without ripping my hair out.

Probably one of the most nauseating aspects of being stuck in a nursing home is the bill. I am sure there must be some kind of at least slightly logical breakdown to explain where the money goes, but seriously, how can it cost $7,000/month to be trapped in a small room in a poorly maintained moldy building and receive suboptimal nutritional and medical care? Something seems really, really wrong with this picture. I think it might be cheaper to live on a cruise ship. The customer service is probably a lot better, too.

When there are residents literally dying of heat stroke during the summer in a poorly ventilated building, it makes me wonder why this local nursing home has no air conditioning, but the local prison has central air, free medical treatment, and probably better lunch. It is so sad and also really angering to see people wiping out their savings in a matter of months or years to live in, well, a shit hole.