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Monday, June 20, 2011

in retrospect

Today I ate lunch with one of my friends, a cardiovascular tech who does the EKG and hemodynamic monitoring in the cath lab.  Actually, she was the one person who took the time to teach me a lot about reading EKGs and how to use Holter monitoring software to make reports.

I don't remember how we got started on it, but I started rambling about some of the "cool stuff" that I had the chance to see in real time when I worked in the ICU: torsades de pointes, other ventricular tachycardias,  ventricular fibrillation and other lethal arrhythmias that you hope you won't be encountering when you're reading outpatient Holter monitor recordings 48+ hours after you stuck your electrodes to your patient.

I paused for a minute, thinking about the last episode of torsades.

"The guy was actually dying," I told her.  He was really sick: on a ventilator for weeks and weeks, feverish in septic shock (from a strain of VRE that seemed to take forever to find, after endless blood culture draws and procedures ending in -centesis).  He was completely unresponsive by that point, and he was alone.

I remember sitting outside his room, looking at the monitor, watching in awe as the amplitude on his EKG twisted like crepe-paper party streamers.  I had seen it books, but never in real life.  He was a DNR, and so we sat there still, leaving the crash carts tucked against the nursing pods, as the torsades turned to coarse vfib that slowly grew finer until it was just a haphazard line.

I don't know why I didn't go in there and hold his hand, or even just sit with him.  I don't know why any of us didn't.  The idea of dying in the middle of the night, in a hospital bed, alone, just doesn't seem okay. Maybe we were feeling mildly inconvenienced by the idea of having to gown up to go into his contact precautions room or divert our eyes from the monitor or documentation.  I don't even remember what I was thinking while I sat there doing nothing. Hopefully something besides "wow, cool EKG!"

I wonder, had death started to become so familiar that it had lost its significance?  I really don't know.  After he died, I cut up his strips, somewhat somberly affixed them to pages and pages of strip sheets, labeled them, and thought about how sad they were -- how they told a story all by themselves.

Sunday, June 19, 2011

a sea of strawberries

okay, so maybe the "sea" was more like four quarts
MiniMan and I went strawberry picking this morning.  Well, maybe more accurately, I went picking and he went eating.  It probably would have been fair to weigh him before and after (and pay the difference), but it seems like the unsaid rule of "u-pick" is: you eat.  And so he did; he picked and shoved strawberry after strawberry in his little mouth, juices dripping off his already berry-stained chin.  We had a good time.

Strawberry season, in the northeast, comes and goes alarmingly fast, sometimes lasting only around a week.  It's worth the effort to get out of the house and pick these tender, lustrous berries; they really set themselves apart from under-ripened and bland grocery store varieties.

I think that with these, I'll probably hull and freeze half (smoothies), and eat the other half.  I keep dreaming of picking more and saving them for the fall and the winter, in an effort to preserve a little bit of summer.  I have the feeling even the ones that end up in the freezer won't last long.  Oh well.


I also picked up some garlic scapes, which are available almost as fleetingly as the summer strawberries.  The first time I got a few, I had received them as part of my vegetable CSA and I really didn't know what to do with them.  If you gather enough, you are left with a medusa-like mass that you can turn into amazing pesto.  Garlic scapes, by the way, are the little shoots that come off the top of the garlic plant.  They are milder in flavor than garlic cloves.  The recipe that I usually use is the one on Dorie Greenspan's blog.  You should try it!  

Monday, June 6, 2011

money matters

I found myself seated at my laptop the other night asking my husband what his take-home pay was per week.  It had been almost a year since I drafted a budget.  Last time I did it, I don't remember it being so discouraging.  We weren't paying a whole lot for daycare, and it was before our house got reassessed (at 250% of it's original value).  Uugghckk..

After some brief number crunching, I realized that we have about $300 worth of leeway each month if we pay all the bills and never spend money on anything other than gas (40/week) and food (30/per person/week).  I keep telling myself: it could be worse, it could be worse.  Really, it's enough money to save for a class, I guess, if nothing goes wrong, if the cars don't break, if no one needs clothes or shoes or to go to the dentist.

I keep looking at jobs in other states.  I keep dreaming of some way to get more cash.  The Mayo Clinic pays their hospital aides no less than $14.80/hour because of union regulations.  Is cost of living higher in Rochester, though?  I have no idea.  It's probably not enough of a justifiable pay increase to move, especially considering that we own a house and no one wants to move.  I keep looking, anyway, though.  I'm just not really sure what else to do.  I feel a little trapped.

I've started to wonder if maybe I should apply to some kind of accelerated RN program (some of which take only a year), just to make enough money to go to school.  There's some overlap with the premedical prerequisites, and I can't help but wonder if the financial aid situation is more encouraging.  And, when I would be done, I would be able to make twice as much money per hour which would mean that I could work half as much, leaving more time for classes.  I don't know.  I don't know if it makes any sense.  I guess it would totally depend on financial aid offers.

Probably most nursing programs would hate me if I admitted that I decided apply to nursing school so that I could shield my family from financial collapse and eventually go to medical school.  At this point, I'm just really not sure what to do.  If I save and manage to put aside money for a class, as soon as I stop working, we'll be screwed.  The only thing that seems even remotely feasible would be working part time (which I'm not even sure is an option) and taking a class.

My husband and my parents keep telling me that I'm young, that I have lots of time.  It just seems like they don't understand how deflating it feels to not have an even remotely promising plan. 

I don't get how I am making this so complicated. 

It seems like it shouldn't be so complicated.  Really, though, things have changed a lot, especially how difficult it is to procure educational loans these days for more undergrad classes when you already have a bachelor's degree.    

So, I just keep looking for better jobs, and going to work, day after day, which I guess is okay.  I just don't get how so many people live this way.  How are so many people are okay with their mediocre dead-end jobs?  Are some of them honestly content, or is this just an illusion?