Tuesday, December 28, 2004

If I'm quiet...

...it may mean that things are going on which will make awesome stories, but not yet.

Because things are too fresh in my mind, and need to be processed; because I need to think of cool pseudonyms for people I'll need to talk about; because I need to obscure identifying details; or maybe because I've been too dang busy to write.

The urge to blog is not insignificant. Someday this will be a sort of a record of selected impressions, opinions, and reflections from this particular part of my ongoing drama. And it will be a depository for amusing and maybe even interesting stories. Plus, it's practice for me, as I learn to formulate thoughts about these topics in a way that holds together.

But the urge to sleep is stronger, dude. No contest. So I'll just say I recently met some cool people, and I did some extremely cool stuff.

Hey, and I left a message for Turk. They need techs on that show, truly. Sassy, intelligent people who describe themselves as "low-life-techs," but who in reality make the place run well and help docs to be on their best game. It's TV gold, I'm telling you.

Wednesday, December 15, 2004

things that make me laugh, with glee, on the bus

1) "Indie RnR" by the Killers came up on my iPod. I'd never heard it before, and it was awesome. It helps that yesterday, I read the essay that Rivers Cuomo wrote when he re-applied for admission to Harvard.

(to be continued)

Monday, December 13, 2004

tonight's dinner

Just as a glimpse into the way I live these days, let me describe dinner for ya.

Arrived home a little after 5, already starving. Munched Corn Nuts while surveying pantry and fridge. (Side note -- Hanukah gift from mom was a giant bucket full of foodstuffs. Quite the care package. More of that when I go to school next year, plus some time in the Fitness Barn, and I'm in good shape).

Contents of fridge include skanky au gratin potatoes made from scratch four to five weeks ago, in need of disposal. Milk, past expiry date by more than 10 days, in need of disposal. Film on bottom of pitcher where sugarless "-aide" style drink evaporated. Rice and beans, made from scratch like the potatoes, and similarly skanky due to dearth of preservatives, plus lots and lots of time. Eggs, reading 'Sell by Oct 5.' Mushrooms, fresh two days ago. Shredded cheese, fresh two days ago. Onion, sorta fresh, sealed in zippy-bag. Leftover salmon-in-phyllo-dough deals made-- hm. Over a week ago.

Oh, and wait, some of mom's turkey-and-stuffing (another thing that I hauled home from the Open House of Lights this weekend), a goopy and delicious concoction that is more souffle-like than many other, inferior stuffings. But at the moment, I was not thinking of it much. It just sat there, looking bored. Also, jaunty seafoam green boxes containing vials of Enbrel, plus syringes for reconstituting and injecting the drug. Much as I'm pleased with what recombinant live cells derived from Chinese hamster ovaries can do for me, a dose costs my HMO like $200 to $400. So that's more a specialty item, not part a wholesome winter meal.

Pantry: pasta, instant brown rice, popcorn. Mac & Cheese mix, but that would mean going out for milk. Did I mention at this point it's about 15 degrees Fahrenheit outside? The guy from the TV Weather said (by way of the phone recording one can call) "Wind chill, 4 degrees." Four flippin' degrees. As I walked home from the bus, about 10 minutes previous to this, I had decided I'd be staying in for the night. If I'm going for milk, I may as well go to the airport and fly to a hospitable part of the world.

Inspected coupons for local chicken/pizza joint. Yes, I'm curious about the broasted chicken, but keep those eggs long enough and maybe I can broast one here. Feeling like cooking, dammit.

Inspiration: olive oil plus 'shrooms plus onions, over rice, little shredded cheese, there we go.

Checked freezer. One pork loin, frozen. Hallelujah. (Yes, I did say "Hanukah" earlier. Also, "cheese" and "pork.")

So, when all was said and done, I carbed it right up by oven-broasting the pork at 400 degrees for 35 minutes over a pile of the stuffing, which gave a nice moisture to the meat. I stirred the stuffing back together, the crunchy bits and the juicy bits, together with some of the sauteed mushroom/onion mixture, the rest of which adorned some rice. With cheese on top.

There are times, usually those rare occasions when I bring lunch in to work, when people talk as though I was a good cook. Maybe there's something to it. I really could use a bunch of steamed broccoli, I don't mind saying. And a tall beer.

But it is freakin cold out there.

Monday, December 06, 2004

CALL-TURK update

I actually got through last Friday, and was able to leave a message. We shall see.

Also, I worked in the trauma room over the weekend. Just apropos of nothing at all, if ever I'm feeling weird and sort of dizzy, and a head CT at my friendly, competent, perfectly good small-town hospital shows nothing wrong but I'm admitted to the hospital anyway for other sorta-related neuro reasons... please make sure the staff doesn't let me sleep for like 10 hours straight without waking me for vitals, talking to me, or doing a crapload of neuro exams. Because, while I do like helicopter rides, and I love to take naps, I also like waking up.

DISCLAIMER: I actually don't know how this patient is doing today. Could be anywhere on the spectrum. Plus, there's not a lot of info about what happened in the case before the patient's arrival, and I may not have seen the whole chart. This is more a story about how things might go, sometime, somewhere... but back to our story.

Preferably, if I'm checked in with a nonspecific problem in the noggin, you'll room me with a noisy 8-year-old insomniac who is not actually all that sick. I say this because either playing Ratchet and Clank or plotting revenge against a tiny tormentor would be a higer brain function, and in times of neurological distress, I'll want a reason to practice those.

Like I said, the facts of the case are admittedly a little sketchy (which by the way helps me to obscure the identifying details; convenient!), but the principle here is like I was taught: "if you don't put it in the chart, there's no way to know it happened." And we know that the scan done less than 24 hours previous, at PGSTH, was read as normal while ours was really, really... not. Whatever the specifics, my part of the story ends with a CT control-room-ful of EM and Neuro docs anxiously watching successive slices of brain imaging come across a monitor screen, like really shitty cards being dealt, and going "arrrgh" in unison. That's just never a good thing.

One resident commented, later, that the systemic kind of bad luck is the kind that can sometimes really screw a patient. Hospitals with sprawling residency programs training new doctors, and with med students rotating through, sometimes get scoffed at. Sometimes the scoffing comes by way of well-fed, comfortable small-town docs who work in hospitals with fewer than 50 beds, and sometimes by way of their patients. But it's a fact that some poor schmuck intern who has to come see you at 11pm, then 1am, then 3am could be the one to notice something that, if noticed soon enough, might not kill you. Food for thought. And when the day comes when I'm that poor schmuck, I guess I've learned a little something about being glad I'm there.

Tuesday, November 16, 2004

Things That Have Actually Happened To Me, and Which Would Fit On "Scrubs," Part One


(FEBRIFUGE enters. He's decked out in maroon scrubs, and carries a clipboard. The PATIENT is a middle-aged man, propped up in a mass of blankets, waiting calmly.)


Hi. How are you feeling now?


Ehh, you know. Not good. Not terrible. Kind of bored.


Well, you'll be a lot more comfortable upstairs in the main part of the hospital. (he lowers his voice, and sing-songs a little) Cable Tee-Veeee... (and he's back to being all-business) So, one of the things we do, when someone is being admitted to the hospital, is make a list -

(he indicates the form on the clipboard)

- of all the personal property, the clothing and whatnot, that a person has with them when they come in. That way, when it's time to check out, we know and you know that nothing got left behind. Okay?


Yeah, okay.


So I just start by looking around the room, and seeing what you have with you; here's a pair of jeans (he writes), here's a shirt (he writes), I see you're wearing eyeglasses, so those go on this blank here, I see you've got a ring on your right hand there. Cool ring, by the way.




Any on your left hand?

(The man smiles and holds up his left arm. It's been amputated just above the elbow. Probably a long long time ago.)

Okay, so I'm gonna say no to that one...

If I can get real surgeons to call me back, maybe it'll work on Dr. Turk

By now, you've probably heard that you can in fact call Turk. Which is to say, the mobile number that the fictional Dr. Turk obtained on last week's "Scrubs," 916-CALL-TURK (actually, said the character, "...it's CALL-TUR. But I'm hoping people will dial the K anyway").

So it's a real number. The people who make the show bought the phone, bought a mobile contract with the number, and the phone sits on the set, taking messages. Cast, crew, and production staff will pick up the phone and chat with fans, if the mood strikes. If I were less lazy and more Blog-smart, I would link you some examples of the hilarity which has already ensued. Somebody got "Ted, the lawyer." Somebody got the guy who plays Dr. Kelso, also in character. Apparently it's a fun diversion, and a chance for actors to screw with the minds of their audience. From first-hand experience, I understand how deeply amusing and satisfying this can be.

Between this and an NPR "All Things Considered" interview I listened to recently, where show creator Bill Lawrence and star Zach Braff spoke for like 25 minutes, I had to call Turk my own self this morning. See, Lawrence has a good friend who really is named Dr. John Dorian, and really did go through training as a student and a resident, all the while remaining (from his friend's point of view) essentially the same lovable goofball he always was. The interview was great; at one point, Lawrence summed the whole thing up by saying that the real JD was this guy he'll always remember with an empty cardboard beer case on his head, and it's a special kind of horrifying to imagine being wheeled in to a hospital and having such a person be the one telling you, "don't worry about a thing, sir. You're in good hands."

Lawrence claimed in the interview that the show has yet to do anything medical, any little workaday moment that touches on the hospital/ doc/ nurse experience, that is not directly derived or distilled from somebody's real-life experience. The real-world medical community has embraced "Scrubs" like no other show (I can vouch for this myself), and there's some kind of an informal deal going where show-creator-people's doctor friends, family, and random party guests can submit ideas and anecdotes to Lawrence and the writers, often times having a character named after them for the trouble.

Obviously, the combination of my performing/writing background, coupled with my love of the Internet and new modes of communication and community - not to mention my gigantic ego - make it seem to me like a great idea for the show to have some minor, one-episode character just like me. Hey, I see Internal Med and Surgery docs all the time, when they have to come to the ED for a consult. They may not see me, but still...

I envision a few different scenarios that could work, and one or two of them don't even require building a new set. (Although, they might have one. In season 1 or 2, they did a five-second cutaway to the ED at Sacred Heart. There was a hippie surfer with a tie-dye t-shirt and long white coat, giving a differential with more hedges than the Queen's garden. That was funny.) Anyhow, you could call somebody down, or a tech scutmonkey like me might come up to the floor or the ICU, with a bag of personal belongings for a patient. Or a patient. Hilarity might ensue.

So this morning, I parked my car near the hospital, and started walking toward Day Job (I work in the ED later, from 5pm to 11pm). Once I was off hospital grounds, I no longer felt quite as funny about calling a fake doctor at a fake hospital. I expected to leave a message. I was prepared to talk to a live person, should anyone be up and on set at 5am Cali time.

But the mailbox is full, or vm has been turned off. Dang.

However, it said I could leave a call-back number. Hmmm.

So, what the hell. It's not the trauma pager, but it'll do.

Thursday, November 11, 2004

Patch Adams Can Bite Me

...however, I do tend to get chatty with patients. I crack jokes when it's not horribly inappropriate. I acknowledge the absurdity of situations. I play with kids. Last night, I asked a 14-month old child what 15 times 6 is. When he told me "baabwoooo," I agreed he was probably right, and thanked him. Then I wrote down "90." This all happened after I'd plugged my stethoscope into my ears, listened to the frame of his stroller, listened to the top of his head, listened to my arm, and then finally listened to his little heart. 30 seconds earlier I had been approaching the kiddo's personal space with a foreign object of nefarious design, and now we were burbling about math. The parents appreciated it too... or at least put up with it.

People need to understand what you're doing, and why you're doing it. If they're drugged to the gills, in severe pain, can't breathe well, really anxious, or 14 months old, this may not be possible. Still, it's better for them and for you if they know you're not a sadistic equipment-weilding boogeyman. At the very least, they should have some indication that you're someplace in the neighborhood of okay, and at the very very least, they should be distracted and confused, because the process of trying to decipher "what the--" can be enough to lessen pain and fear, for a moment.

I also had occasion to meet a grownup or two on last night's shift (see below). I mentioned that the patient in that story served in WWII, and this information came out during small talk while he was on a gurney having a heart attack. This may seem odd, but trust me, this is the thing that "ER" the show lacks most egregiously, in my opinion. There is some sparkling conversation and dramatic opposition that happens in those rooms. The bongo drums are a cheap way to inject tension that could be there tenfold, if the situation were presented well. It's mind-bending and sublime, the mingling of the mundane and the literally life-or-death. I'd be riveted by a scene where a patient chats about some random quotidian thing while people, machines, and drugs that come out to several thousand dollars in hourly costs did their work.

But here's the thing about why I like to chat so much: talking to people is a great way for me (and the half-dozen people in the room with ten times the education I have) to assess their airway, their mental status, and their pain level. Also it's friendly, and a nice thing to do. Not least of all, if I were the patient I'd be reassured by the idea that the painful scary crap that's going on with me is also, on some level, just a normal day at the office. If something that is rocking my world in a bad way is no big deal to some group of people somewhere, then I want to be with those people at that moment. I never want to be an "interesting" case, much less a stressful one, for people whose job is to save lives.

If I'm ever lying there, having my clothes cut off and my circulatory system temporarily reconfigured with the help of needles and plastic tubing, I want to hear some chatter from the team. I don't want to hear clenched jaws and see beads of sweat on foreheads. I don't want terse commands and silence puncuated by beeps. I want to hear about restaurants and car payments and kids' baseball. I want to hear people giving each other crap. If a vein should blow and a nurse says whoops, that IV needs to be re-done, I want somebody like me dabbing blood off an arm like it's not a big deal, because it's really not. It's all good. It's under control.

in which I slip away for five minutes to thank a Veteran

The work at Day Job is well under control (my team kicks ass... plus it's generally slow at the moment), and so I had time to call the hospital switchboard and get up to the team station in a particular unit. There's a gentleman under their care, around 80 years old, and I met him last night. I was helping out in the trauma room, since it was one of those moments when we had two unstable patients at once, and my counterpart who was assigned to the room was occupied. We were "up" at the moment - I was extra, in other words, and was assigned to float to wherever I was needed most. And so I was there when this polite, dignified gentleman was brought in, in the midst of a heart attack.

The only-sort-of-"ER"-like whirl of stuff got done, he got somewhat better, and about 30 minutes after arriving, he was on his way upstairs, where he rests comfortably right now. I called back today to speak to his team because as we were all talking, it came up that this gentleman fought in Germany for the Allied side in 1945. I called the team station to make sure the people taking care of him take a minute to say thanks today.

The RN I spoke to was really glad I called. So was I.

Yeah, war is dumb. But soldiers are professionals, and their job is harder than most of ours. If you've ever been impressed by or grateful about the fact that the really violent and unstable things that happen in the world, within and between political entities, usually don't happen here; if you've noticed that they usually don't interfere with our going about daily life, the people who serve in the military have a lot to do with that. Veterans especially.

Thursday, November 04, 2004

the inevitable post-election post

I've been doing a fair bit of participatin' over at New Patriot -- and since Blogger has eaten this post at least once, failed to acknowledge it, and then spit it out twice in two minutes, prompting me to trash one of the copies... well, anyway I don't want to lose this idea.

I'm responding here to someone who argues that the Left has been bitching about joblessness and the decay of the support network all his/her 31 years, and it's a big turn-off. In responding, i may have accidentally said something cogent and helpful about what I think the left side of the middle ground is about.

Anonymous 5:17pm, I hear what you're saying -- that message sounds a lot like "wolf" to most people, as long as the cable TV works and there's a paycheck coming on Friday. But it's amazing how little there really is between any one of us and poverty. Think about where you'd be, if two paychecks in a row failed to arrive, and there wasn't unemployment to work with. Or if you needed a $2700 visit to the emergency room, with insurance paying for only $1800 of it.

Nobody wants to be reminded of the gloom and doom crap, and if we really did live in a world where people really did get to keep what they earn, where they used only what they paid for and only paid for what they use, then there might be a position to defend there. But the fact is, things might be fine right now, for you, but there's a lot more to it than that.

They used to make fun of the Left by saying, 'a Conservative is a Liberal who's ever been robbed.' Well, these days, a Liberal is a Conservative who's ever been sick. Or had an accident they couldn't sue somebody over. Or lost a job and been unable to find another one. Or had to work way below their training level. I sincerely hope you don't have to understand any of this first-hand, but it really does happen, and it happens a lot more than it used to. It just happens to, you know, OTHER people.

Conservatives like to talk about the politics of self-sufficiency. I got mine; you go earn yours. Which, again, WOULD be fine... if everyone who could earn a living actually had a shot at a job someplace near their skill level. If getting sick or getting hit by a car wasn't an instant ticket to financial ruin. If the arena where talent and hard work are all you need wasn't so damned hard to get into in the first place.

If random bad luck ever tosses you on the scrap heap, with the teenage moms and the homeless vets, the people who get sicker because prescriptions cost more than rent and the families declaring bankruptcy without being able to shake the credit card companies, I guess you can keep on espousing that message of "just one more day, one more lottery ticket, and I'll be back on top." You can keep on voting like people who have enough money they don't need anyone else's help... but it won't ever help you become one of them.

Thursday, October 14, 2004

what the-- ?

How are y'all finding this place, anyhow? This blog barely exists. Never mind; I know how. Clicking on my little name on some other Blogger board. I even know which ones: I finally registered with Blogger so as not to have to leave "anonymous" posts at Velcrometer and NewPatriot. (I'm so new here that I can't even make those into links yet. )

So I guess my question is, gosh, why? There's nothing here yet.

I hypothesize that the advent of the Blogosphere was inevitable, because people are naturally social. And as my grandfather and Trash from Velcrometer make abundantly clear, some people can literally start (or induce others to start) a conversation anywhere, anytime. About anything.


(not that I have to say it)

Wednesday, October 13, 2004

a note about the ER

From time to time, I will talk about what I saw and did while working a shift in the Emergency Department. I wanted to say a couple things about how I do that. The following applies in perpetuity, since it's my standard practice in person, out loud, in text, in public and in private.

1) Patient confidentiality is so important that it actually trumps a good story. There will be things I just plain can't write about. When this is the case, I'll talk about something else that's approximately (...and this is a goal, not a promise...) 75% as entertaining. That's my pledge of quality to you, the reader.

1a) There will be no real patient names used. If a patient's name is so cool I have to talk about it, I'll make up a name that's 75% as funny or interesting, in a germane and similar way. A patient named Blender DuPree might be changed to SaladShooter Delacroix, or maybe I'll save that analagous name for some other story. Remains to be seen. (Okay, suddenly I need to go write a hard-boiled mystery novel set in a Baton Rouge Appliance Mart.) Any name you see in a story is so totally fake. Don't worry about who's who. And anyway, I change identifying details all the time, unless they're vitally important to the story and keeping them specific and correct doesn't identify the patient.

2) I tend not to talk about exactly where I work. I don't like to name people, buildings, streets, or areas of the hospital that might have catchy names. Not that it's a big secret, but I am by no means a representative of the hospital in any real sense (unless of course you're a patient; if that's the case, then I'm the human face of the organization, I'm an ambassador, and because I want for you to understand how much we appreciate and value you, I'd like to know is there anything else I can do to help you today?).

And frankly, I don't ever want to have to have a conversation with a lawyer about something I once said on the Internet. That would be a really nonsensical way to mess up my career before it ever starts. Telling a story (or even arguing) years from now, about a decision I made as a resident, which I thought was right and best for a patient in my care? Well heck, that's compelling drama. Not being able to do residency at all because I alienated, mis-quoted, or accidentally annoyed someone would be crushingly stupid. And avoidable.

3) After all the above, believe me: it can still be funny. And close observers (or people who know me outside of here) will be able to piece together the not-too-subtle clues. I'm not relying on a cloud of secrecy. But I'm not speaking in any capacity other than my own personal view. That's bigger than one job at one hospital (since I plan to have many of them, in many places). At the same time, it's much much smaller, and more specific.

Capisce? Okay, then.

Friday, October 08, 2004

Lorika wins the nerd prize for first one in

sweet merciful crap! a comment! And I'm just screwing around. This is all sawdust, and stuff in shrinkwrap, in here.

Okay, yes. I'm thinking of starting a blog.

Uhhh... yeah. I'll be attending Bennington next June, and I think it's in the handbook or something that all students have to have blogs, write poetry, or LARP. To not have a place to catch all the little mental slips of paper that line the linty pockets of my wayward soul and shit, would be like, so tragic, man, y'know? (yes, this explains what looks like bad poetry earlier. in my own defense, my chosen genre is loud alterna-pop, of a kind I'm not actually competent to play or sing, but anyway that takes some lyrical pressure off.)

Plus, I got tired of posting "anonymously" in all those blogs I frequent.

fresh out of bad ideas

round enough corners and you start to see it
rounding of corners is how the world turns
love it or hate it, you soon have to be it
this is the reason the element burns