Saturday, October 28, 2006

Who are these other guys?

Aside from my dad, I wonder who these other guys are?
LogoThere are:
people with my name
in the U.S.A.

How many have your name?

Thursday, October 19, 2006

Beneficiary of kindness

Today started early. By 6:50 AM I stood waiting for a UT shuttle bus to take me to campus where I’d catch the Airport Flyer bus. A fellow male nursing student and I are attending the American Assembly of Men in Nursing 2006 Conference in Portland, OR. I was feeling a little stressed because the Cameron Road bus hadn’t arrived when a car pulled over. The driver rolled down the window asking, “Are you going to campus? Get in and I’ll drive you.”

Seeing as how she was an older woman, I wasn’t too worried about being kidnapped, robbed, and beaten. An offering of ribbon candy was possible, but as long as I demurred politely I figured I was safe. Throwing my bags in the back, I got in. Turns out she’s an English professor at UT and picks up students on her way to work all time. At roughly the same time every day, she drives along the Cameron Road route and offers a ride to whoever is waiting for a bus that early in the morning. Remarkable.

We chatted about my impending trip and she told me her great experience with the nurses that cared for her (several men among them) during a hospitalization. When we got close to campus, she asked me where I needed to go and I offered that she could drop me off where it was convenient for her. “I have a handicap permit dear, anything is convenient for me.” So I directed her to the bus stop. She wished me a good trip, I thanked her profusely, and that was that.

I’ve got to find a way to have her kindness recognized.

Monday, October 16, 2006

A great day as a nursing student

Yesterday afternoon I went to the hospital to pick my patient as I do every Sunday. This entails looking through patients' charts on the unit to which I'm assigned in search of one that would provide a good learning experience. I wanted this one patient I'll call Mr. B, but was told he'd be going to surgery in the morning and would be off the unit for hours. As my instructor would not appreciate me sitting on my ass for those hours, I moved on and picked another patient. I spent the requisite time recording all the patient's medications, abnormal labs, history, course of illness, etc into what we call a client database. It's a way of pulling information together in order to be ready to provide nursing care. Driving home, I was disappointed that I wasn't able to take Mr. B.

This morning I arrived to find that my patient had pulled his IV out of his hand the night before, refusing to allow a new one to be started, and was generally hostile to staff. Hmmm, maybe an opening here. I asked about Mr. B and found out that he hadn't gone down to surgery yet. I approached my instructor about switching patients and she was a little apprehensive in that I hadn't prepped to take care of him. In an effort to convince her, I quickly read through his chart, copied down his meds (most of which I knew), and made a case that Mr. B was a much better learning experience. I think it was probably my ebullience that won her over.

I quickly did a general assessment (listen to heart and lungs, take vitals, assess neuro status, etc.) right before transport came to take Mr. B down to surgery, with me in tow. We arrived in pre-op and the nurse started the pre-op questionnaire. When asked about allergies, Mr. B said he was allergic to some __________ drug he was on. The nurse went to answer the phone and I thought, "But he's not on a __________ med. I wonder if he means __________?" So I asked him and he said, "Yes, that's it." Then I did a little teaching about what that medication was used for and confirmed the reaction he experienced. When the nurse came back, I was able to show her in the chart where his negative reaction had been documented earlier. Whoo-hoo, mental hi-five.

There was still some question as to whether I could observe the actual surgery. The patient couldn't take food and drink orally, so the surgeon would place a tube through his abdomen into his stomach to allow for what's called enteral tube feeding. Then liquid nutrition could be regularly pushed through the tube using a syringe. The operating room circulating nurse came by and said I could observe. I put on a cap and mask and off we went to the operating room. The scrub nurse was already laying out the various clamps, cloths, retractors, needle and thread, etc. that would be needed. The anesthesiologist and nurse anesthetist started an IV and got the meds going. Within three minutes, Mr. B was under. The circulating nurse asked me if I'd like to insert the Foley. Absolutely (not ironic in the least)!

At this point I'd like to say that I've already seen more than a few lame Rep. Mark Foley/Foley catheter jokes, and will not propagate more. OK then.

I'd put in a Foley once before, so I wasn't too nervous. Plus A) the nurse was walking me through it and B) the patient was unconscious. That done, I stepped back so she could finish prepping him. A few minutes later the surgeon arrived and in less than 30 minutes:
- Sliced down the center of Mr. B's abdomen through the skin and subcutaneous fat
- Cauterized the small blood vessels (it doesn't smell bad at all really)
- Made an incision in Mr. B's stomach and introduced the tube
- Made an exit incision in Mr. B's left abdomen and pulled the tube through
- Stitched and stapled Mr. B closed

Totally routine, but tremendously cool.

They woke up Mr. B and then off we went to Recovery. The recovery room was bustling - lots of surgeries today - and the nurses were busy hooking patients up to EKGs and oxygen saturation monitors, recording their vital signs, and administering pain medication. I pointed out to Mr. B's nurse that he had an IV medication that had been sent along with him that needed to be started. She told me to find the doctor's order in the chart (always necessary). I did and she started the IV thanking me for catching it. Mental hi-five again. Mr. B was doing great and so we disconnected him from monitoring and back we went to his room. Later in the day, I got to deliver his crushed medications and liquid nutrition through the tube.

I'm sure five years from now all this will seem mundane, but today it was awesome.

Sunday, October 15, 2006

Meat Purveyors R.I.P.

They didn't actually die, but Friday night the Meat Purveyors played their last show in Austin. Sigh. Man they are/were so very entertaining.

The night started with Mybloody and I going to End of an Ear so I could exchange some CDs. A store employee (via a scrawled note on a LP sleeve) dared me, so I bought a Juice Newton Japanese import record for $1. Then posed for a photo holding it with a smile that said either "I've been looking for this rare import version with the airbrushed cover forever and now, at long last, I'm holding it!" or "I'm a total douche who buys shit like this just because store employees dare me to." In my defense, it was $1. And her version of "Angel of the Morning" is pure cheezy goodness.

We left and drove over to Joolie's house to pick her up. She showed us some printing she'd been working on. I need a pack of her "Eat a dick" notecards, as do you. Then we headed to Continental Club for the show.

The Weary Boys were meh and we spent most of their set outside talking and going for a slice of pizza down the block. Then Meat Purveyors started and it was glorious. Mybloody had never seen them do their Madonna trilogy ("Lucky Star", "Burnin' Up", and "Like a Virgin" played at breakneck pace) so he was happy when they opened with it. Later they tore through their wonderful version of Ratt's "Round and Round." It's a testament to Ratt's songwriting and the Meat Purveyor's talent that the song sounds so good with twang vocals and mandolin. In between the band energetically zipped through a swath of their own great, punkish, bluegrass originals with at least a few from every album. I really should have gone to see them more often.

We ended the night happy to have seen them one last time and went home to put up our sore feet (mine were from dancing, not from being old).

Saturday, October 07, 2006

My fat scar

Are you lookin' at my gut? I'm workin' on it!

Since a couple people commented on it, I guess I should explain. My scar is rather noticeable and so for years whenever someone asked me about it, I told them about it.

When I was in sixth grade, I sat next to a boy who'd already failed twice. He was much bigger than all the other boys and even had that wispy, teen moustache. I did well in school, he did not. Very soon after the school year started, he let me know that he would be cheating off of me and that I was to let him. If I didn't, or squealed to the teacher, I'd get pounded.

I didn't care for this, so I came up with a plan. For the next multiple choice test I would circle the wrong answers. He'd copy me, then I'd subtly change them to the right answers. I'm sure at the time I thought it was brilliant. Of course, I hadn't thought it through to the logical conclusion. We got our tests back; he got a 0, I got a 100. That afternoon he intercepted me as I walked home from school, pulled out a knife, and slashed me across the stomach.

Except none of that really happened. The kid was real, but he never cheated off me. I just loved telling people that story and seeing their eyes get big.

The real story is more complicated.

When I was ten I started having abdominal pains often. One night it was bad enough that my mom took me to the emergency room. An ultrasound revealed that I had a multitude of small gallstones. Gallstones, deposits of cholesterol or calcium in the gall bladder, are usually a problem in older folks. It's uncommon for kids to have a problem with them. I only had one of the common risk factors: female, fat (obesity), fair (Caucasian), forty (middle-aged), fertile (multiple children).

After various doctors conferred, the recommendation was removal of my gall bladder. It's not a secretory organ itself, it just stores bile produced by the liver. So you really don't need it; the liver will just dump bile directly into the duodenum (first section of the small intestine). The idea was that if I had lots of small ones when I was ten, it was going to be a problem sooner rather than later. I wonder if part of it was also that I was to be the youngest person at the time to have a cholecystectomy - a badge for the doctors.

My roommate at the hospital scared me a little. He'd been accidentally shot in the jaw while hunting which shattered it, and so couldn't speak distinctly. He also drooled a lot. I got to like him after a day though. I imagine some of my distaste for guns came from seeing what happened to him.

The surgery itself wasn't an issue, though I wasn't awake at the time. When the anesthesiologist started the meds, he had me count back from ten. I recall getting to sev...

Recovery was annoying because I couldn't walk well or eat much. I hobbled down the hallways clutching the handrails on the wall; it felt like my thighs was sewn to my chest. I'd get full after a cup of broth. I steadily improved and was happy to go home with a stitched incision. A couple days later I was eating a hamburger (often fatty foods after cholecystectomy cause upset, but I never noticed it) when somebody wanted to see my incision. I pulled up my shirt and everyone saw the small purplish bump on the incision. Not so good.

The sequence of events is hazy, but I ended up back at the hospital being examined by a very concerned doctor. It was an infection for sure. The doctor was worried enough that he started working on it right there in the exam room. No time for anesthesia to take effect so I got the topical cold spray. I was swabbed with some sort of antiseptic and then the doctor popped my stitches.

The next part explains why I have a high pain threshold. The doctor inserted his gloved fingers into the incision and starting pulling out what I recall as pockets of pus. I distinctly remember looking down and seeing his fingers inside me to the knuckle. A nurse - the one who wasn't holding me down - was talking into my ear trying to get me to visualize something more pleasant. She was talking me through getting a good hit in a baseball game. I remember being annoyed because, though I played, imagining a baseball game wasn't all that wonderful for me. But then how was she to know that I'd rather have her talk me through Greek mythology or the plot to The Westing Game?

Now, when I assess patients' pain level ("What would you rate your pain on a scale of 0-10 with 0 being no pain and 10 being the worst pain you can imagine?"), I always remember the intensity of my level 10 pain.

I can't remember much after the fingers-in-the-incision part. I didn't pass out, I just don't recall. The next vivid memory is being in a hospital room with an IV full of antibiotics and the incision packed with gauze. There wasn't room on the infectious unit, so I had been given a room on what I used to call the "terminal kids" ward. Several bald cancer kids and two cystic fibrosis kids were on the same unit. It totally weirded me out when one of the cystic fibrosis kids came to my room and gave me his toys "because I won't need them soon." His mom came by later to get them, apologizing profusely.

I stayed in the hospital for quite a while getting antibiotic therapy and wound care. The wound care consisted of taking off the cover dressing, pulling out the gauze packing (with yellow-green goo), pouring in hydrogen peroxide, gritting my teeth as it foamed up and stung mightily, twitching in pain as silver nitrate sticks were applied to cauterize the wound, then repacking. Twice a day for a long time. Even after I got out of the hospital, my mom picked me up from school to perform the wound care. Because of the infection, I couldn't just be sewn back up again.

So 20 years later I still have a thickened scar running across my abdomen on the right side rather than a thin, white line. Presently, the standard procedure is to perform cholecystectomies laparoscopically eliminating the need to open the belly. Patients now end up with three white dots where the camera and instruments are inserted. Damnit. At least I got a good story out of it.

Friday, October 06, 2006

Emesis assessment

Here's the text of the Powerpoint slide we just went over in class. Fun stuff.

Emesis [also known as vomit] -- Look at it!

- preceded by nausea, precipitating or relieving factors, frequency, is it sudden, projectile, or persistent

-Note color and volume
Clear or greenish vomitus with undigested food-stomach
Bright yellow- bile or upper intestinal
Dark brown with feculent odor- prolonged bowel obstruction
“Coffee-ground” or BRB (bright red blood) - bleeding

The Pumpkin-ing of Yogurt

I just finished a container Lucerne Limited Edition Pumpkin Pie yogurt. As an avid consumer of pumpkin-flavored items (see very first first blog post), I was excited but wary. Turned out to be kinda gross. Oh well. Guess I'll be heading over to 7-11 sometime this weekend to see if they've got the Pumpkin Spice Latte back.

Update: In a pleasant turn of events, the Lucerne Limited Edition Cranberry Orange yogurt is wonderful.

Wednesday, October 04, 2006

Stoopid medical humor

Today in Skills lab we learned how to operate IV pumps. The instructor demonstrated at the front of the lab so we could all see, but since there wasn't a bed and a dummy right there she let the end of the IV hang down into the trash can. Immediately I thought/said, "This trashcan is hypovolemic. Hang a bag of saline before it gets shocky." See, this is what has happened to my sense of humor. Sad really.

Later, the instructor was explaining that it was important when learning how to use unfamiliar equipment to read the manufacturer instructions or watch the training video that is usually available. Relying on co-workers can result in a game of telephone where proper procedure is transmuted into bad habits through a steady accretion of errors or shortcuts. I turned to a friend and before I could even open my mouth he got there first, "Make sure the cartridge lever is pushed down. Purple monkey dishwasher."

Oh Simpsons, is there any situation for which you don't have a relevant quote?

Sunday, October 01, 2006

Anatomical art

Mybloodyself hosted a craft night on Saturday. I'm not particularly crafty, but I do enjoy making shrinky-dinks. Here's a couple:

Shrinky-dink: Myocardial infarction

I just had a test about heart attacks on Friday (96%, whoo!) so it was fresh in my mind. The black part is dead tissue.

Shrinky-dink: The Gall Bladder

This is a salute to an organ I haven't had for more than a couple decades now. The sister of a school friend of mine had to have her's removed this weekend. She'll have three tiny white dots from the laparoscopic surgery while I have a fat 10 cm scar. Ahh medical progress.

Saturday, September 30, 2006

Three bloody patients

Don't worry, there won't be any pictures. Unless you really want to look at bloody things. I saw all these people when I was working in the ER.

Patient #1: Gored by a bull

Brought in by helicopter from out in the country, this guy had a scalp laceration and a punctured cheek. He wasn't even in a rodeo, just going about the work of raising cattle.

Patient #2: Open leg laceration

Poor guy was helping a friend with some roof work when a piece of metal sheeting gashed his calf almost down to the bone. You could plainly see the different layers of skin and muscle, fascinating really. Luckily for him, compensating mechanisms had kicked in and he wasn't in any pain. He said it just itched.

Patient #3: Mulitple shallow razor cuts to the face, self-inflicted

I knew what she'd done when I took the paperwork in for her to sign, but I had to make an effort to make eye-contact and stay composed while looking at her face streaked with dried blood. Even though this was the least serious physically, it was the worse of the three. The other two were accidents, this was intentional and indicative of some profound problems. I can't imagine what it will be like to live with fine white scars all over your forehead and cheeks. I hope she got the help she needed. Since then I've seen more than a few girls who cut and the scars on their arms and thighs depress me terribly.

Dang. Didn't mean this to end this under a dark cloud.

Wednesday, September 27, 2006

On the comedy of trauma, death, and burns

One of my instructors this semester has a great, morbid sense of humor. I often bust out laughing at some of the odd things she says. For instance, “People coming in to the ER are scared because it’s probably the first time that they’ve felt like they were dying. And they’re right, it might happen.” It’s funny to me at least.

Another time she was talking about people who drive themselves or a family member to the hospital instead of calling 911. “I can’t tell you how many people have died of a heart attack at corner of 38th & Lamar [one block away from Seton Main Hospital].” All I could think was, “The corner of 38th & Lamar is haunted! Restless souls at Subway and Relax the Back store!”

During a lecture on shock, our instructor had just said “If that happens, call the rapid response team,” when the phone in the classroom started ringing. She pulled off a great double-take. It was unexpected, perfectly timed, and therefore really funny. It does beg the question of why we have a phone in the classroom. Incoming calls are always wrong numbers.

Just last week she was lecturing about how percentage of burns are estimated and she said that genital burns count for 9%. The class quickly pointed out that her slide said 1%. “I was just trying to wake y’all up. Y'all don’t have a sense of humor.” Cause genital burns are hilarious. In fact, I’m going to show up at open mic night at Velveeta Room and do five minutes on genital burns. It’ll kill.

More odd comedy as it occurs.

Monday, September 25, 2006

"Yay! I like to like stuff I don't like."

- Joolie, after I told her I'd loan her my Sports Night DVDs so she could enjoy a TV show about coworkers putting on a ESPN-like sports news show.

Saturday, September 23, 2006

A long Saturday

I worked a 13-hour shift today. Scheduled for 8, but they needed someone to do a transport to a medical hospital for imaging so I volunteered. Transporting is easy money. I accompany the patient to the hospital, sit in the waiting room while they do their thing, and accompany them back to the psych facility. Patients who are cleared to leave the facility are always easy-going, so it's usually a calm trip. We mostly chit-chat about the weather or what the procedure will be/was like, stuff like that.

Afterwards, I went to a friend's place and we watched The Wire on DVD. Didn't get any schoolwork done like I had planned, but I made some money and had a nice evening.

Thursday, September 21, 2006

R.I.P. Don Walser

I don't remember when I first heard Don Walser, probably when I was at DJing at KVRX while getting my first degree. I do remember the shiver I felt when I heard his incredibly beautiful yodel. At KVRX there are requirements that DJs exhibit some genre diversity and a Texas component. I played Don Walser's "Cowpoke" regularly partly because he met two requirements at once, but mostly because the power and clarity of the yodeling gave me goosebumps.

I saw him a half-dozen times in the mid-'90s. He was great live with a tight backing band. My favorite time was when he played with Kronos Quartet at Bass Concert Hall. The Quartet was a fan of his and put togther some string arrangements for two of his songs. That arrangement of "Rose Marie" was then recorded for his next album. When they finished playing at Bass, there was a long standing ovation. Knowing they had to give an encore but having prepared nothing else, Walser et al. just played the two songs again. It was wonderful.

Walser stopped performing some time ago due to his declining health. I'm sad to say that I forgot about him until I heard the news of his death yesterday. I pulled out Rolling Stone from Texas and "Cowpoke" thrilled me all over again.

Cowpoke (from the album Rolling Stone from Texas)
Rose Marie (from the album Down at the Sky-Vue Drive-In)

Tuesday, September 19, 2006

Austin City Limits Festival 2006

I've been late in posting because I was sick during and right after ACL. Note to self: if you don't sleep enough, you always get sick. Right. Moving on.

I skipped Friday in an attempt to generic Nyquil myself to sleep and therefore wellness. I slept about 17 hours on and off from Friday afternoon to Saturday afternoon. It kinda of worked. No more fever, but still with the chest congestion and general malaise. Wait, wasn't I going to move on from the sick talk?


I Love You But I’ve Chosen Darkness
I like you but you are less-than-compelling today and as a local band I can see you within the next month and there's a big crowd over by the Heineken stage so I've chosen Ghostland Observatory.

Ghostland Observatory
Energy! Charisma!
Local band that I have been extrememly remiss in not seeing. Wow. A guy twiddling knobs and playing keyboards (in a floor-length cape mind you), while another guy cavorts about singing in a brash falsetto. Sure, I like that kind of thing, but these guys were pulling people in from all over the place. I'll chalk it up to things sorely lacking from some ACL acts (I'm looking at you Iron & Wine), to whit energy and charisma. Keyboard guy just stood there, but managed to still get across a sense of competence and "Whee! This is fun!". I'm sure the cape helped. Singer dude was a firecracker. Dancin' and singin' and jumpin' and worked it like nobody else I saw all weekend. Bravo Ghostland Observatory, I'll see you again as soon as possible.

The Secret Machines

TV on the Radio
Bad sound mix and I wanted to see The Shins more so...

The Shins
Marty of The Shins
Generally good. Since touring after their first record, The Shins have become a more muscular, tight band. Unfortunately, they've also smoothed out some of the odd angles that made me love them. Sure Marty (keyboards/guitar) is still hilarious and the songs are punchier, but my brain doesn't melt with joy over them anymore. Maybe's it's my problem. Hard to say. Still, good show, looking forward to their new album out in January. Oh, they asked people to video record them on cameras and cell phones during one song for a video they were making. 1st problem: most people don't have enough room on their devices for an almost four minute song. 2nd problem: the upload site sucked and couldn't handle my large file.

Reliably great, but I was less enthused than during previous shows. Maybe being sick? No, I took that into account when evaluating performances. Well, when you seen a band like 12 times in five years every show can't be fantastic. Surprisingly, they didn't play anything from the EP they did in collaboration with Iron & Wine.

The Raconteurs
Just heard them from across the way. Unremarkable. "Steady As She Goes" was great, but nothing else made an impression as I read about various anemias (yes I studied during the festival, nursing school doesn't stop for culture breaks).

Iron & Wine
A windswept Sam AKA Iron & Wine
Snore. Wanted to like it, but couldn't.

Explosions in the Sky
So great to lie back on the grass as darkness descended and have this band take me away. Lovely. I really should go see them more often.

Massive Attack
Massive Attack
Daddy G (original member) was off with his wife and brand-new baby so it was up to 3D (original member), the vocalists, and the backing brand to bring it. And they did. And it was so very good. Despite being a band based in DJing and samples, the live version went far above standing on stage and pushing a button every now and then while the light show does all the work. Granted, the light show was fantastic, but the band (two drummers!) was bombastic and coiled and sinuous and noisy. Seriously y'all, I was in heaven even though I think my fever had returned. While it was great that long-time vocalist Horace Andy was there, it blew my mind that Elizabeth Fraser (ex-Cocteau Twins) was there to sing as well. "Teardrop" was gorgeous. Never thought I'd ever hear her do that song live. Anyway, best band of the festival by far.


José González
José González
I don't think an outdoor festival is the best venue for José. The crowd was respectful, but a solo acoustic guitar-playing singer just doesn't work in the middle of a humid day with thousands of people milling around or rocking out to other, louder bands not too far away. Not nearly as good as when I saw him at SXSW 2006, but still decent. Did an interesting cover of Massive Attack's "Teardrop". Did not do his cover of Bronski Beat's "Smalltown Boy", maybe when he comes back later then Fall. Why do I like this acoustic-guitar singer/songwriter when so many others bore me? To (mis)quote comedian Zak Galifianakis, "The way you play music makes me feel good inside."

Practically a parody of themselves now. Have gone over to the dark side, by which I mean that they've become a jam band. Wanky guitar work all over the place. I walked up when they'd started "Spinal Meningitis" (yay!) and walked away at minute two of the wank solo (boo).

White Ghost Shivers
White Ghost Shivers
They were probably a new band for a lot of the crowd, hence the almost immediate aggregation of more and more audience and the big smiles. They are very good at showmanship. Look at the outfits and the instruments, you know where there at musically. Naughtier than you might expect though.

New Pornographers
New Pornographers
Reliably great. Why isn't this band huge? Big hooks, great singing, what else do you need? I guess Neko isn't dressed sluttily enough. Snerk. I was bouncing around throughout. "Laws Have Changed" makes my endorphins skyrocket. Also, Neko is funny.
Soon after taking the stage, “I can’t peform in these freezing conditions. Stage manager, fetch me my parka.” Later she acknowledged Ween playing across the way and quoted some song that expressed the sentiment "I'd give a blowjob for a joint," which she quickly followed with, “Not really. Well, you’d have to catch me in the right mood.” Hee.

Flaming Lips
Packed audience, they really should have been a headliner. Their theatrics still worked in the daylight though. Streamers everywhere, confetti blowers, dancing girl aliens, dancing Santas (girls & boys), superheroes (or if you prefer, underwear perverts), Wayne in a giant hamster ball rolling around on top of the crowd; it was a show. They really have their visuals honed, I wish they’d play more songs though. As much as the crowd really enjoyed it, I can't help but do that annoying "you should have seen them back in the day." They still play "She Don't Use Jelly," but I miss "Halloween", "You Can’t Stop the Spring", "Bad Day". I tell you, it was incredible to see them in 1994 wrapped in Christmas lights at Liberty Lunch. Still, it's great that they're popular now and so many more people know and love them.

I generally like the BoDeans, but I'm in love with "Fadeaway". It's definitely a loop song for me, I'll listen to it for 20 minutes at a time. While waiting for Tom Petty, I wandered over figuring they'd play it at some point. They did and I got all gooey with joy. Sure it was waaay too long with multiple solos, but I love it so. After some song, they broke into The Ramones' "I Wanna Be Sedated". Nice.

Tom Petty & the Heartbreakers
Knowing that I had to be up for clinical at 5:45 the next morning, I told myself I could only stay for three songs of Tom Petty. I walked out the gate while the third dong was fading away. Good thing too, because it started to rain just before I got on the shuttle bus. Apparently the band stopped playing after the fourth song.

Generally a good year. Not as good as last year or The Pixies year or the REM year, but Massive Attack bumped it up for me.

Thursday, September 14, 2006

Ann Richards didn't like me

Like some other people I know, I voted for Ann Richards in 1994. She was so very entertaining. Yay Ann! Sadly, Dubya defeated her. Boo Dubya. Then she went to work for a lobbying firm and while she herself did not lobby for tobacco companies, the firm did. Boo Ann.

I had two run-ins with Ann Richards. The first was in 1999 when I lived near Clarksville. I was walking down West Lynn when I saw her getting out of her car in front of the dry cleaners. For seemingly no good reason, she looked at me disapprovingly. I'm quite certain my hair was my normal color. OK then.

The second time was in the summer of 2001 when I was petitioning outside of Bookpeople for a campaign finance reform measure. Knowing that she was not a supporter, I approached her anyway,
"M'am, can I get you to sign to support campaign finance reform in Austin?"
She stared daggers at me and said, "You cannot. It's a terrible idea."
She marched past me and into the store. Whoo-hoo, Ann Richards chastised me.

So that's my Ann Richards stories. Oh, also just a few months ago I saw Anna Deavere Smith workshopping a new theatre piece about the body and illness in which Smith performed as Ann Richards in addition to many other real people as she's done before. It was great, Smith really captured the voice and presence of our former Governor. See it if it comes back around.

Wednesday, September 13, 2006

Rectum, reptile, whatever

Tonight I was reminded of a patient that was seen in the ER last summer when I worked there. A quick check of the blog confirmed that I inexplicably hadn't shared this story yet. I heard it second-hand, but I believe it to be accurate.

A frequent flyer (patient that comes in often) strode up to the triage desk and when he wasn't tended to immediately begain knocking on the desk,
"Uh excuse me, excuse me, I need to be seen."
"What brings you in today?" asked the triage nurse.

The patient matter-of-factly stated that his ass was bleeding, probably due to anal sex (I guess he wasn't doing it right). The triage nurse misheard him, but being an ER triage nurse who's seen it all, nonchalantly asked,
"What kind of animal?"
"Animal?!" the patient exclaimed.
"Didn't you say animal sex?"
"Uh-uh. A-NAL sex. Janeesha does not do animals."

Tuesday, September 12, 2006

When the patients start assessing the staff

Sometimes patients who have prior experience with hospitalization turn it around on staff. After answering several questions from a nurse, once a psychotic woman started asking questions herself like, "What month is it? What year is it?" These are orientation questions to assess mental status. The questions cover orientation to person, place, time, and situation. So staff would ask a patient, "Can you tell me your name? Can you tell me where you are? What's the date (or break it down if the patient knows the year and season, but not the month or day)? Can you tell me why you're here?" Sometimes staff throw in a "Can you tell me who the President is," but these days that might instigate a round of name-calling (can you blame them?).

The psychotic patient continued questioning the nurse, "Do you hear voices?"
"Yes," responded the nurse.
"Your's, right now."
Patient, slyly, "Hmm, you're a smart one."

Thursday, September 07, 2006

Unexpected poetry

"Simple nails, simple tales" - patient

I took care of a patient recently that was psychotic with thought disorder. Psychotic in general use conjures images of a maniac killer. Actual psychosis is severely impaired thought processes and/or perception. It may manifest as hallucinations, delusions (fixed false belief, "There's a microchip in my brain"), paranoia, thought disorders, and/or lack of insight (unaware that thoughts and behavior are bizarre).

This young woman had profound thought disorder. April* spoke constantly, quickly ("pressure of speech" and yes I know this describes me as well), and without coherence. The syntax of her speech was correct, there was just no meaning. It was just a stream of phrases with constant rhyming. I've been told that rhyming is unusual. Regardless, it's remarkable to witness. It would be unethical to record patients but I wish you could have heard her when she was really going. Further, she would incorporate words she heard around her into her utterances. Fascinating, and awfully sad. It's like she had something terribly important to tell you, but couldn't pull it together.

“Suddenly, suddenly this sickness”

In the midst of a stream of nonsense, April said that phrase. It stuck out. Was this a coherent statement? An awareness of what was occuring? Or is that just me imposing order on a virtual white noise of words? I suspect the latter and hope against the former. It would be kinder if she was consciously unaware of what was going on with her and wouldn't have memories of it, particularly given one facet of her behavior.

“Come here so I can taste it. I promise I won’t waste it.”

The staff joked that April had a crush on me. That's putting it lightly. She was very sexually inappropriate, mostly with me. I quickly became very good at flinching away from her grabs at my crotch and eschewing her offers of sexual favors. Sometimes she'd just lean against the wall or straddle a chair, stick out her butt, and somewhat wearily suggest we get started. It wasn't embarrassing for me - she's clearly out of it and I strive to be professional - but it was a tad frustrating.

During shift change when I was giving report to a staffperson coming on, April tried to sit on a table. I gently dissuaded her, "Let's not sit on the table. It's not stable." My co-worker and I shared a rueful laugh, apparently April was a powerful influence.

I think about April's stream of words often. Is it at all connected to the bursts of inspiration that artists experience when they write a great song in 10 minutes? The way freestyle rappers flow? How can we "unhinge" ourselves temporarily while maintaining self-awareness?

* Fake name. As always, I often change details of patients' sex, age, etc. to protect their identity.

Friday, September 01, 2006

Blood Sugar Death Magic

As a nursing student, I like to think I bring a little more to the table while I'm working as a clinical assistant at the psych facility. For instance, I'm constantly trying to educate patients on good food choices. When it comes to the diabetic patients, I'm quite stern. "No, you cannot have ice cream. You have diabetes. Let's think of something that will be a more appropriate snack for you."

I do this work only to see it disastrously undone by patient's families. A patient will have already eaten their facility-provided meal which is physician order for an 1800 or 2100 calorie per day diet, and then patients' families come in for visiting hours with pizza and non-diet soft drinks or big bags of Taco Bell. A meal like that can easily top their ordered calorie intake for an entire day. It's not true in every case, but I've seen it plenty of times and it mystifies me. It's not like the patient was just diagnosed with diabetes. Diagnosing doctors and nurses usually do a comprehensive job of educating patients and their families on food intake, blood glucose monitoring, etc.

"Are you trying to kill your [loved one]?" I'm tempted to say, "Why not just roll a stick of butter in sugar and batter, freeze it, then deep fry it?" Usually I just pull them aside and point out that we're trying to encourage good eating habits and that while food often plays a part in comfort and they of course want to help their loved one feel better, an entire medium pizza or eight tacos will make them feel worse in the long run.

I'm generally not a fan of scare tactics, but sometimes I just want to hand them a photo of diabetic foot ulcers.

Wednesday, August 30, 2006

Recent events

Whew I'm getting really lazy with the posting. Or maybe it's not having a computer at home (why did you crap out on me iBook and after all the nice things I've been saying about you). Now that school is starting, I'll likely be more dutiful.

Some high- & lowlights from the past few weeks:

- Went skiing again and got up on the wakeboard immediately. Something clicked and I just got it, that happened to two other guys too. More fun than skis, but harder to cross the wake. I really need to bring a videocamera with me next time so I can document the spectacular wipeouts while tubing.

- Drove to Arlington to enjoy Six Flags only to find that it was closed. They changed their operating hours only a few days before we went. Hateful. More on that trip here.

- Saw When in Rome, Psychedelic Furs, & DEVO(!!!) in San Antonio. When in Rome were better than expected. I expected utterly awful and it turned out rather cheezy. When When in Rome (ha! fun sentence construction) broke it down during their one hit "The Promise" so the singer could introduce the band I turned to mybloodyself and said, "I'm getting goosebumps. Of revulsion." Psych Furs were good, three original members and all their hits. I was surprised and pleased that they played "Dumbwaiters", an abrasive (well, abrasive for Psych Furs, I mean it wasn't Merzbow or anything) and punky song from their first album. Of course Devo were magnificent. It wasn't all that different from the show I saw in New York last year and yet it was better because I was crammed up against the stage (my choice, there was plenty of room) and spazz-dancing throughout. Three young guys near me had driven 14 hours from Memphis to see the show and I was impressed by both their committment and that Devo still inspires such devotion in dorkish college boys. Thank goodness I had a shirt to change into because I completely soaked the one I was wearing. Wheee!

- Scaling way back on my work hours now that school has begun. The shift I had last Sunday was miserable. Understaffed with some fairly sick patients. I've said it before, I'd rather have 10 depressed people than one manic. You think I talk a lot. I almost offered the manic patient $500 to stop talking for 10 minutes knowing she wouldn't be able to do it, but good judgement won out. At least I further endeared myself to the nursing staff by keeping order.

- School started today. Just a review of assessment, vital signs, blood glucose checks (me and my partner bled all over the place, damn defective clotting mechanisms), drawing up and delivering injections, that sort of thing.

UPDATE: Mybloody posted photos of Devo, Psych Furs, & When in Rome.

Thursday, August 10, 2006

When it comes to poetry, I'm a callous meany

National Poetry Slam 2006 is happening this week here in Austin. I've been a slam fan since 1998 when it was last in Austin. I even went to Nationals in '99 and '00 just as a fan. After that lack of money and vacation precluded further trips and I fell away from slam aside from watching Def Poetry on HBO.

I was cancelled from work last night so I went to see a couple bouts. Even though they were free last night (and will be tonight), there wasn't much of an audience. In fact, 15 minutes before the start of the 7 PM bout, I was the only audience member not connected to a team or working on crew. In other words, an automatic judge. They rounded up four more and we got started.

The idea of "judging" poetry is admittedly kinda odd. I recommend reading the Wikipedia entry on Slam Poetry to get a sense of the whys and wherefores.

I'll post more about individual poets and teams later, but this post is mainly to record what a demanding asshole of a judge I am apparently. Throughout the evening I was almost always the lowest scorer, and since the high and low scores are thrown out, all I did was set the low-end point. I'll admit I'm demanding. Having been to three Nationals before, my expectations are high. Yelling continously, painfully bad confessionals, and political speeches that just list terrible US military actions do not impress me. In fact, they kinda piss me off because it's been done and by far better poets.

Scoring ranges from 0.0 to 10.0 with 0.0 being, I don't know running off stage after one line I guess, to 10.0 being a perfect poem. PERFECT. I don't tend to give below a 5 unless the poet messes up badly. Basically a 5 for memorizing and performing it. Everything above that is quality of the text and performance. My scores average around 7.2. I've given a 10 before, twice I think. Both times the hair on the back of my neck stood up and I recall twitching with energy. Last night I have a lot of scores in the 6s and 7s; highest score of the night from me was an 8.8.

At one point after a loud, "emotional" poem that I found cliche and derivative, an audience member saw my score (you hold them up high), turned to me and said, "What do you want?!" To which I responded, "I know it when I hear it," which was really a joke reference to Supreme Court Justice Potter Stewart's famous line about obscenity in relation to pornography, "I know it when I see it."

What I really wanted to say was I want innovation, flow, truth, beauty, to laugh or get goosebumps. I want my pulse to race. I want tears in my eyes. I want to hear something I've never heard before. I want poetry, not a directionless rant, a catalog of ills, a demonstration of singing skill, an artless plea for tolerance, or a humorless brag. I want to hear/see/feel great poems.

People who haven't ever seen to a slam before tend to be easily impressed; especially when they politically agree with the poets (there are few to no right-wing slammers) or empathize with a poets sad personal history. I was like that too once upon a time. Now, I've seen far too many great performers to be impressed with just energy, volume, and hand gestures.

So, I'll continue to be a judge (I tend to get picked by the bout managers when there aren't that many neutral audience members), suffer the "boo"s of the audience (picking on judges is allowed and expected), and glare at other judges who give four 10s in one night (whatthefuck?!).

Wednesday, August 02, 2006

Junior Senior totally dissed me, sorta. Well no, not really.

Several months ago, a friend of a friend put out a call for people to join her in a fun endeavor. The band Junior Senior had requested that fans shoot footage of themselves lipsynching to the song "Can I Get Get Get". The footage would be edited into a video for the song. Junior Senior wanted to get submissions from all over the world and noted that they'd like to get a sense of the city/country the fans hailed from. Also, the presence of yo-yos was suggested as they were to be a recurring theme on the album.

So one Saturday I reported to Niki's house to find that I was the first person to arrive. She taught me the song while we waited for the others. Who never came. So the two of us (with a cameraman in tow) danced and sang "Can I get get get to know know know you better better baby" a ridiculous amount of times outside the Guadalupe I Love Video, in front of the giant Austin postcard mural, and while cavorting around the huge star in front of the Texas History Museum. A giant inflatable crab was attached (mounting? humping?) the star. We shook its claw and waved balloons about while tourists gawked at us. I provided yo-yo action as well. At the end of the day we agreed that we were very much rockstars. Niki sent off the footage.

The video is now out and I'm massively disappointed. Either many Junior Senior fans are somewhat cute but rather boring or the video editor is untalented and/or vision-impaired. Almost no one shows off where they are from by say, dancing with the Eiffel Tower in the background or atop a Mexican pyramid. And only one clip of yo-yoing, tragic.

What it really all comes down to is this, I'm not in the video. Laaame. Niki has two brief shots, one lipsynching in front of the Austin mural (not that you can read it in close-up), and the other showing her dancing legs (there was much, much better dancing leg footage). I'm not jealous of Niki, what I'm saying is that we should have constituted at least 25% of the video. Watch it for yourself, I guess. Grumble sourgrapes grumble.

Tuesday, August 01, 2006

More fun with Spanish

Today we were going over food vocabulary. We had to go around the classroom and find fellow students who liked and didn't like various foods. A girl came to me and asked me about vegetables. What I was supposed to say was, "Me gusta calabaza," or "I like squash." What I actually said was, "Me gusta cabeza," or "I like head," which is true, but not really appropriate to say in Spanish class. I think I blushed.

Monday, July 31, 2006

How would you behave?

A multiple choice question:

You want me to pay attention to you. How would go about it?

A) Ostentaciously clear your throat
B) Broadly gesticulate
C) Say, "Excuse me. Might I have a moment of your time?"
D) Break the plastic cover of a ceiling-mounted fluorescent light, then hold a piece of it to your neck

If you answered D, than you are very much like a patient I took care of recently. I admit the question was vague, what I should have asked is:

I've spent the day mostly looking after just you. It's getting close to bedtime and you are resisting the fact that the communal dayroom closes at night. After a sequence of pleading, bargaining, and threats from you, I conclude that this behavior is attention-seeking and inappropriate. I tell you, "You don't have to go to sleep, but you need to go to your room and be respectful of the other patients trying to get to bed." Then I disengage and walk away. How will you get me to pay attention to you?

Put that way, what other answer could it possibly be but D? Such is the logic of the troubled I guess.

Wednesday, July 26, 2006

Fun with Spanish

Yesterday in my Spanish for Healthcare Workers class I cracked myself up by composing this sentence:

El bebe el bebé.

Translates as "He drinks the baby." From the perspective of today I realize that I'm stoopid, but dang it was funny yesterday.

Tuesday, July 18, 2006

Alpha male alert

A little while ago I encountered a new kind of patient. I've seen the incredibly depressed and disheveled, the haunted schizophrenic, the mile-a-minute manic, but this was my first bipolar young turk. The testosterone coming off this guy could stun a rhino (and Barry Bonds). Shirtless push-ups in the dayroom? Sure, why not. Hitting on every female under the age of 50? Of course. Ostentaciously adjusting his package? All in a day's work. Yeesh. I had to have the "it's not appropriate to discuss your sexual conquests here" conversation with him twice.

The kicker was he's tremendously hot. Seriously, best-looking psych patient I've ever seen. How annoying is that? At least he wasn't hot and even-tempered without a trace of grandiose delusions.

Monday, July 17, 2006

Odd psych drug ads

Thanks to BoingBoing, I stared in head-shaking wonder at this collection of Japanese psychiatric drug ads. Some of my favorites:

Serenace® (haloperidol)

"Do you hallucinate that a giant bird-of-prey is after you? Serenace® can help." This and the rest of the Serenace ads are not what I would call soothing.

Rivotril® (clonazepam)

It's not uncommon for me to ask patients where I work if they're feeling anxious. Now I know that my follow-up question should be, "Would you rather feel like a naked child sitting in a field of flowers while a large umbrella protects you from the metaphorical storm? Great, let's see if you've got clonazepam prescribed."

Doral® (quazepam)

I don't know about you, but if just the ad is soothing my insomnia imagine how well the drug works. Ridiculously adorable.

These ads reminded me of a previous posting, this collection of American psychiatric drug ads. Faves:

Not sure how a child slumped over on a swing represents a Stabilized Epileptic, but then I never studied advertising in school aside from a brief analysis of its ever-refined means of manipulating people.

"See? You can poke her in the eye and she doesn't even flinch. Sweet!"

Mom: Umm, I'm a little concerned that Timmy's pupils are freaking huge.
Nurse: Don't worry, Nembutal is the "gentle" barbituate. If he stops breathing, call us.

The hits keep coming

I added a site meter to the blog awhile ago. Every once in a while I'll check the referrals to see how people found me. Mostly it's Google searches where the searcher never even came to the blog. People search for some weird things. Weird ungrammatical things. I'm the 8th return on Google for "picture of opening ladies urethra." 4th for "boy nipple sting dermatology."

Doesn't "boy nipple sting dermatology" kinda maybe sound like a Belle & Sebastian song that was written while drunk and never recorded?

Sunday, July 16, 2006

Sounds of the psych unit at night

ring binders of med charts snapping open and closed
jangling keys of the staff
shuffling feet of the patients

I came up with the title of a mongraph, but I don't want to write it. I just like the title: On decreased muscle tone in the lower extremities of psychiatric patients, or Why the mentally ill shuffle when they walk

Saturday, July 15, 2006

Reading material...Part II

I went with Douglas Adams, specifically Dirk Gently's Holistic Detective Agency. It's odd that I hadn't read it before being a fan of Adams. It was great. I love comic time machine stories, Connie Willis' To Say Nothing of the Dog is a big favorite of mine. After I finished Dirk Gently's, I polished off that memoir of a guy in a psych ward that I started last week on a graveyard, Nervous System by Jan Lars Jensen. It wasn't great, but interesting and provides good insight on the thought process of psychotics.

Around 6 AM I started in on Michael Azerrad's Our Band Could By Your Life. I'm not much of a fan of Black Flag, Big Black, Mission of Burma, and several of the other bands it profiles. Azerrad's such a compelling writer though that I enjoy just learning more of the history of these bands and the American underground scene of the '80s. Thanks go out to Choo for selling this at Dan's garage sale last year.

Thanks also to jlowe for the Vonnegut suggestions. I've been eyeing Player Piano lately. I'll bring it along tonight, though I'll be reading the Dirk Gently sequel The Long Dark Tea-time of the Soul first.

Friday, July 14, 2006

Reading material for monitoring the suicidal

I worked another 16-hour shift last night/this morning. I wasn't scheduled for it, but when asked I thought, "Well I'm up already, it's good money, and I mostly have to just sit here, read, and make sure this guy who is sleeping doesn't try to kill himself. I'm in!" About 4 AM I was regretting it. Mostly because I was very tired (I'd been up since 7 AM the day before), but also because I was reading a crappy play called Bus Stop written by William Inge that was later turned into a movie starring Marilyn Monroe. Just cliche as all get out, though since it was produced in the '50s maybe Inge was the first to write them. Wait, is that better or worse?

By 5 AM I was slightly more alert and reading Arthur Miller's The Crucible which almost made me cry is was so good and relevant. I'm working graveyards for the next couple nights and I'm thinking of reading Douglas Adams or Kurt Vonnegut. Funny science fiction or rabidly satirical science fiction?

Tuesday, July 11, 2006

A proposition

Tonight a female patient told me I had pretty eyes and that we should have a baby together. I'd have been flattered, but she'd already tried that line on a male patient and a female staffer.

Monday, July 10, 2006

Dragged around on a rope all day

I was all set to write an amusing account of my day at the lake with friends last Saturday, and then I saw that Joolie beat me to it. Read it, it's funny. If I was talented, or even had the program, I would have photoshopped a picture of Joolie with fins and gills cause she was totally amphibious, if by amphibious you mean "able to get up on skis and wakeboard immediately despite not having practiced in many years."

My two best wipeouts of the day were off the tubes, no surprise if you read Joolie's account. One crash had me barrel-rolling off the side of the tube for two full revolutions. On the second, I ended up skidding backwards on my back so forcefully that I created my own wake at least a foot high and my swimtrunks were yanked below my ass.

Next time we go out, I'm going to record video of the tube wipeouts.

Friday, July 07, 2006

3 PM to 7 AM

My night and early morning was divided into 15 minute increments. Every quarter-hour I would leave the nurses station and walk the unit checking the patients on precautions. Suicide precautions, assault precautions, elopement, fall risk, self-injurious behavior, sexual behavior. Poking my head in to see the patients sleeping or more objectively, to see their eyes closed, respirations deep and slow. Poking my head in to make sure they weren't cutting themselves or going into other patients' rooms or trying to strangle themselves with an improvised ligature. Then I returned to the nurses station to make notes, add paperwork to charts, and resume reading a memoir about a writer who was hospitalized in a psych ward.

I worked 16 hours straight yesterday/today. I'm tired.

Tuesday, June 27, 2006

White plastic knives

white plastic knives

These are plastic knives I had to remove from the meal trays of certain patients at the psych facility. Looking at them now makes me a little sad.

Monday, June 26, 2006

Sticks and stones may break my bones

I’ve worked the last several evenings on a unit for high risk psychiatric patients. This is not to say that they are necessarily violent, though they might be, but rather that they are higher risk for hurting themselves or others, need to be watched for sexual behavior, or just have greater medical needs. They could be depressed, delusional, paranoid, borderline, psychotic, schizophrenic, any number of things really.

Besides my actual name, here’s what I’ve been called by patients on this unit:

a puppet
yes man
nice man
patient (the adjective, not the noun)
The Spanish Inquisition
toilet water
a good guy

Most of the patients are polite and appreciative, or they just stare blankly at me when I address them. The majority of the negative terms for me came from one person in particular. Today when she called me a nerd, I almost laughed. “Geez lady,” I thought, “that’s so tame compared to all the other things you’ve called me. It’s practically a compliment.”

What do I do to earn her scorn? Oh just things like: checking on her every 15 minutes as required by policy, asking her to keep her voice down when she’s shouting in the dayroom, telling her that it’s inappropriate for her to leer at another patient and say, “I’m licking this chocolate pudding like I want to lick your body.” I know, I’m such an asshole. Oh yeah, she called me that too. Well, she mouthed it. Could have been mouthing “Ice gnoll.”

Thursday, June 22, 2006

I see that you are lunging at others with a sharpened chunk of plastic. Are you angry?

A couple weeks back I had containment training. It is sometimes colloquially known as takedown training, but I really do have too much respect for it to call it that any more. The program we use at our facility is called SAMA (Satori Alternatives to Managing Aggression) and was developed by this zen-calm guy who developed the old method used by the Texas Department of Mental Health and Mental Retardation. I strongly suspect he's a badass in a Tai Chi kind of way. And as my friend Carole will tell you (and maybe show you too), Tai Chi has awesomely-named moves like Repulse Monkeys. How cool is that?!

Anyway, SAMA begins with verbal interaction; trying to de-escalate the situation before it becomed physical by conversing with the aggressive patient and guiding them to productive thoughts and actions. The practice exercises were pretty hokey, but I've already used the technique twice with good results. I can absolutely see the applicability anywhere, not just in a psych/medical setting.

If that's not working, we might have to move on to protection and containment. I feel fairly confident that I could prevent myself from being strangled, extricate myself from a grip, and/or retrieve an object, say a board with a nail through it (shoutout to Kang and Kodos!), if need be. A couple Sundays ago I put Joolie down on the floor in my excitement when I really shouldn't have. Sorry Joolie! You were such a sport to fake strangle me, and then look what I did. Thankfully I didn't go full out and "guide" you down the hall to a seclusion room (straight-jackets and padded rooms are soooo passé).

I was politely informed by the instructor that since I am a guy and didn't flabbily perform the maneuvers like some of my fellow trainees, I would surely be recruited to the on-call security team which responds to Code Grays (abusive/assaultive behavior). Good thing I'm already going to the gym. Sure I've been told my short hair, goatee, and forehead wrinkles can be interpreted as menacing, I'd like some shoulders to go along with the deadeye stare. I've already seen two situtations where an aggressive patient completely backed down at just the sight of the security team down the hall.

And so I issue a guarded invitation to my friends to behave aggressively next time we meet so I can practice.

Wednesday, June 21, 2006

An emergency

I haven’t posted in awhile for a couple reasons.

A) I’m working full-time all over the schedule. Bouncing around from days (7 AM – 3 PM), to evenings (3 PM – 11 PM), to graveyard (11 PM – 7 AM), while throwing in a few 12-hour shifts really screws up my sleep schedule.

B) I was unsure how to write about the psych facility and the patients there. I feel very protective of the patient’s privacy and recognize the unjustified stigma that mental illness bears in our culture. Unlike the ER last summer, there just aren’t many patients culpable in their illness and the environment doesn’t lend itself to shaking my head while thinking, “These crazy people.” You know, cause the place is actually for crazy people. Not that we use that word.

On the way home tonight, I finally worked out how I was going to write about work and was keen to get home and start typing. That’ll have to be in the next post though because as I turned onto my street, my headlights swept across a man lying facedown in the gutter. “Oh shit. This is not good. Okay, he’s probably passed out drunk, but what if he’s not, or he’s got alcohol poisoning?” I debated getting out of the car to check his pulse and breathing for about three seconds before deciding that it was better to call EMS first, then run back to him.

It was only a few hundred feet to my house, so I drove home and rushed to my phone to call 911. There’s an EMS station less than a minute away and I surmised that they’d likely arrive on scene before I returned. Still, I was eager to get back to him just in case. Nothing doing, the 911 dispatchers have questions to ask. I understood, so I made myself breathe slower and just get through it. No I don’t know his condition, didn’t even see if he was breathing. I’d say early 30s. Blue jeans and a grey t-shirt. After summoning EMS, the dispatcher patched me in to the police and they took down my name and what I was wearing (stop it pervs, it was so they could identify me at the scene if necessary).

I hung up and ran back to him. I called out to him, then shouted. Concluding that he really was unconscious, I felt for a pulse and watched his back for breathing. Thankfully, his pulse was RRR (regular rate and rhythm) and breaths were deep and regular. Just then, the fire truck showed up. I’m fairly certain that all firepersons in Austin are EMT-certified and they are regularly summoned to medical emergencies, probably because their response time is exemplary. True in this case at least as they arrived before the paramedics even though the fire station is twice as far as the EMS station.

After reporting my assessment to one of them, they rolled him over, concluded he was drunk and waited in a circle for the paramedics. They police showed up and shined flashlights at Drunk Guy for around 90 seconds until EMS arrived, loaded him on a gurney, and trucked him off to the hospital. Police said I wasn’t needed for a report, so I walked back to me house. Whew. When it was first happening, I was thinking of that nursing instructor at our school who was on her way home from work when she drove by a man lying on the ground, stopped to render aid, and had to start CPR. Thankfully it wasn’t necessary in this case, but you better believe I was running through chest compressions and all that as I trotted down the street to Drunk Guy.

Just to head off some friends, yes, if I had a cell phone I could have stayed with him and assessed his condition while on the phone with 911. That is a very good reason to have a cell phone. Good enough to cave in and get one? Meh.

Lastly, it’s been noted by others before me, but dang Austin has hot firemen. Sure the whole hero thing helps, but handsomeness was in plentiful supply tonight. The cops were pretty smokin’ too. EMS not so much.

Tuesday, June 06, 2006

Oh What a Night

Late December back in '63... Um, sorry. Got a little carried away there.

I got home a little while ago from my first evening shift at the psych facility. I'll just say this, I'm glad that I'm getting defensive and patient take-down training on Wednesday and Thursday. Could have used it during the events of this evening, but things worked out all right.

It's a good thing that I'm confident and not easily riled by patient behavior, cause there was button-pushing tonight! Insert lyrics to The Facts of Life theme song here. Wait, here's the actual song. Hmm, now that I've listened to it, only the first stanza makes sense in this context. Oh well, "C'est La Vie".

Sunday, June 04, 2006

A pig roast

Inspired by Joolie's run-in with a roast pig, I decided to share a roast pig story of my own.

A few years ago, I was invited to a pig roast by my friend. Said friend's brother is a Park Ranger in some Southwestern state and had occasion to shoot a wild pig that was menacing the park. Figuring it would be a shame for it to go to waste and thinking ahead to when his brother would be visiting, he froze it solid and had it waiting as a present. My friend was delighted by not only the present, but also the creative-thinking that would required in getting the pig carcass back home to Austin.

They decided the direct route was best and so they double wrapped it in game bags, then put it in a sturdy canvas duffel. At the airport, my friend checked it as luggage. He half-expected security to take him aside when the pig skeleton showed up on the x-ray machine, but he and the pig arrived in Austin unhampered.

He quickly let all his friends know that there would be a roasting the next weekend. Then the question of how to thaw the thing came up. If just left out, the outside of it would surely begin to warm to unsafe temperatures while the core was still frozen. So he and his wife emptied their refrigerator of everything, including shelves, and bungie-corded the pig into it. The door barely closed.

Five or so days later, the pig was thawed, a fire pit was dug, a spit was erected, and everything was ready to go. An intrepid team of BBQ experts assembled at 6 AM to begin the roasting. When guests begin arriving around 11, the pig was still not cooked through. Never one to panic, my friend ran to a hardware store and purchased two sheets of corrugated metal which the roasting team then used to construct a lean-to over the fire pit. It worked magnificently and just a few hours later, the pig was done. It tasted okay. Sweet, though rather gamey.

I wish I had pictures. The process was much more fun than the result.

Thursday, June 01, 2006

TV makes me happy, then sad

When I started writing tonight I turned on the TV just for some background noise. Turns out the 2006 Scripps National Spelling Bee was on live. I love spelling kids ever since I saw the glorious documentary Spellbound, so I watched the Bee out of the corner of my eye while typing. As it went on and more kids were eliminated, I watched it with increasing attention. When it was down to the final three (all girls), I was on tenterhooks [In a state of uneasiness, suspense, or anxiety].

Word after word went by, the majority of which I've never even heard of. Apparently, the way to do well is to not just obsessively study word lists, but learn the patterns of spelling in French, German, and Hawaiian. There were an awful lot of words of those origins. Here's some fun stuff from the final rounds:

poiesis - production, creation, formation. I actually knew this one because of nursing school. Hematopoiesis is the production of blood cells. Hooray, a word I actually know.

aubade - a poem or song greeting the dawn. It's of French origin and now that I know the word, I want to write one.

weltschmerz - mental depression or apathy caused by comparison of the actual state of the world with an ideal state; sentimental pessimism. Ha! I knew the word, a great example of the hilarious specificity in German compound words concerning mood, but "sentimental pessimism?" Genius!

The penultimate championship word:

kundalini - the yogic life force that is held to lie coiled at the base of the spine until it is aroused and sent to the head to trigger enlightenment. I'm more familiar with the sexual aspect of this word and was mildly surprised that the word came up. Shame on me I guess.

Championship word:

ursprache - language that is the recorded or hypothetical ancestor of another language or group of languages.

Congrats to 2006 Champion Katharine Close!

So, spelling bee yay! And then I kept the TV on as Diane Sawyer introduced a Primetime special, A Call to Action: Saving Our Children, about foster care children. One and a half minutes into it and I was already in tears. Sure it was mildly exploitative - giving a mother who's child was taken away from her because of neglect and sexual abuse a chance to "tell her story"? Blech - and yet, it was captivating. Diane Sawyer, you are good with kids, at least on camera.

And then the show closed with a bit about the kid who made me cry at the beginning. He was adopted by two dads and doing well. To which I say, "Right-wing nutballs? Fuck right off."

My new job at a psych facility

Today was my second day of work at my new job. I'm a Clinical Assistant at a psychiatric facility. If I was working at a hospital on, say a post-surgery floor, Clinical Assistant (CA) would mean I'd be taking samples of various bodily fluids, vital signs, and probably making beds. At the psychiatric facility, the work I'll do doesn't have much of a physical component. I take vital signs once a day, but other than that, most of the chart notes I'll make concern behavior and clients' adherence to the program and rules.

I'm not getting paid as much as my job last summer, but it is easier and I like that I have therapeutic contact with clients. I doubt I'll end up going into psych nursing, but it's always nice to get exposure to different aspects of nursing and I'll have a leg up on my fellow students when we have our mental health clinical in the Fall.

I was explaining the work to my roommate when I mentioned some of the items that I have to search clients' bags for as they aren't allowed, for instance shoe laces, aluminum cans, and aerosol containers. She looked at me quizzically and I explained they weren't allowed because:

Shoelaces - can be used to attempt suicide by hanging
Aluminum cans - can be torn apart and used to cut themselves or others
Aerosol cans - contents can be inhaled for a cheap high

She was horrified, which I absolutely understand. It all makes perfect sense if you consider it from the right perspective, but most people don't automatically think of the violent uses of everyday things. Which is precisely why some of the clients are in the psych facility in the first place.

Tuesday, May 30, 2006

Orientation hell

Today I went to orientation for my new job, except not really. The orientation was for all new employees of the hospital system without being specific to anyone's job. I can see the advantage of covering general information that applies to everyone like benefits and safety. I could do without the extensive examination of the over-long mission statement. Plus there's the fact that I just went through the same orientation a year ago. I didn't sleep well the night before, so I was a little irritable when I arrived. Here are some notes I made:

It's only five minutes in and I'm already simultaneously bored out of my skull and preoccupied with violence. Hmm, not the best mindset for a healthcare job. Clearly I need to be fired immediately. Hee.

There are many awful jobs, cleaning pig pens or cold-call sales for instance, but high on the list must be leading weekly orientation sessions. Repeating the same information every time, answering the same insipid questions, forcing a smile every damn week when some self-amused joker cracks wise at the start of Q&A by asking, "When do we get paid?" Ha, ha, ha! Ha, ha, ha...ha. Sigh. Someone jam a pair of forceps in my brainstem and stir vigorously. That's what I'd say if I had the job.

As soon as I walked in this morning I said to myself as I scanned the room, "Don't sit at the all-guys table. It's nearest to you with several empty seats, but you know for a fact since you did this last year that forced camaderie and lame art projects are on the agenda. Guys generally aren't good at these things. Sit at the table with the sparkly-eyed women who glory in this crap and they will allow you to eschew enthusiastic participation with only mild looks of disapproval." Alas, I hesitated and was lost. The HR folks sent me to the guys table (wouldn't HR want to prevent such a concentration?). At least at this table nobody is going to nosily ask what I'm writing.

Sitting at an all-guys table has some distinct advantages, a minimum of forced conversation and the barest effort to complete lame, "team-building" exercises being the two that come to mind. The primary disadvantage is that no one wants to volunteer to be our table's speaker. Fortunately we have a go-getter dad at our table and it practically defaulted to him.

Orientation is over. Note to self, do not quit your job and then go back to the same hospital system for another job more than six months later cause then you'll have to sit through this again.

Tuesday, May 23, 2006

Pulled across water on slabs of fiberglass

Yesterday I went waterskiing for the first time in over 10 years. My roommate's parents gave her their old boat and she's been going out to the lake for the last few days with some friends trying it out. After I finished up some errands yesterday, I drove out and met up with them. It went well, I got up fine and had one good, long run. I guess it's like riding a bicycle. I forgot that waterskiing uses muscles that do not come into play much in my regular life. The muscles in the top of my feet (extensors?) were sore this morning. I'm looking forward to a summer of boating and skiing. It's good to have friends with boats. Boats, boats, boats. Wheee!

Sunday, May 21, 2006

Pop Prom '06

Voxtrot at Pop Prom '06

Went to Pop Prom last night. It was fun, I'm glad DJ Jennifer organized it. Voxtrot played, mixing in a lot of covers. My personal favorites were Magnetic Fields' "You and Me and The Moon", a ragged, just-learned version of OMD's "If You Leave" with Jennifer assisting on vocals, and Bruce Springsteen's "Dancing in the Dark". The King & Queen were good, dressed well and game for dancing, but nowhere near as awesome as Jenny and me when we were Queen and King. I'm just saying.

Click on the pic above for more.

Saturday, May 20, 2006


One of my last classes at school concerned the lower GI tract. Specifically, the anus and what comes out of it. So, whooooo! GUAIAC test cards, otherwise known as a fecal occult blood test, were passed around. It would be a lot more interesting if it tested for magickal, fortune-telling bloody shit, but no, it just tests for hidden (occult) blood in the stool. Usually indicative of a problem.

Our instructor, a very enthusiastic person even about fecal occult blood tests, asked, "Has anyone done a GUAIAC in their clinicals? Nobody has done a GUAIAC? Oh, you’ve missed out on some real fun."

Err, yes, real fun. Just what we were all thinking.

Then she hauls out a piece of medical equipment called a hat, though you do not want to put one on your head. They look like this (upper right corner)

All sorts of fun stuff

and they are for assessing urine and fecal output (yeah, we say output). So she's waving this around and it's clear that there is a brown mass contained within. “Don’t worry," she says, "It’s just frosting.” So there goes the idea of chocolate for at least the next few days.

While running us through the procedure she notes, “And you’re breathing through your mouth.” Of course, everyone in the classroom is well aware of how odors actually work. Little tiny particles of whatever you're smelling go right up your nose. So breathing through your mouth is not really better, per se. Like many things involving the body, it's best not to dwell on the aesthetics.

Friday, May 19, 2006

Murderously angry

I've always had a high opinion of Mac products, but right now I'm seething. After I take pictures with my camera, I import them to my Mac with the software that came with my camera. Then I import them into iPhoto and use it as a management tool. It also has a nifty way to export them to Flickr easily. I had assumed that iPhoto just organized the photos that could be anywhere on my hard drive. Last night, while looking to delete files to free up space, I came across iPhoto files of all my pictures. "Huh, I guess it was actually copying them into new folders. Wow, I've been storing my pictures in two different places, what a waste of memory."

After double checking it, I went about deleting the original picture files. Tonight I just pulled up iPhoto to find that the thumbnails are still there, but the actual picture files? Gone. Searched all over, trying to figure out what happened. Still clueless. Last night the files were all there in iPhoto file folders, tonight they're gone. WTF?

I can only be comforted that most of those pictures I uploaded to Flickr, so they still exist, but not all. Seething I tell you.

End of the semester

So here it is over a week since my semester ended and I'm just now posting. I can only claim extreme laziness. I talked to a couple of my school friends and we've all been doing the same things, sleeping and reading for pleasure. I swear it's like my body downshifted from the frantic pace of the semester and now I'm plagued by lethargy.

I haven't been a complete slug. I've been organizing CPR classes as a fundraiser for our nursing student association and gone to the gym four times since my last day of tests. Next week I go for drug screening in preparation for starting my summer job as a clinical assistant at a psychiatric facility. So that should yield a plethora of stories on par with last summer when I worked at an ER.

Tomorrow I will be carrying a flag as part of the nursing school graduate procession at UT's combined graduation ceremony. When I volunteered for it I did it out of sense of duty, but was pleasantly surprised last night at practice when the orchestra played a part of Verdi's Aida. It's the only opera I've seen, and while I don't enjoy operatic singing, the music is great and I happily hummed along last night.

Ummm, I guess that's it for now except I got a 4.00 this semester and scored a scholarship for next year. So, rock on.

Tuesday, April 25, 2006

Yep yep yep yep yep, cow. Mooooo!

I really should be studying or sleeping right now, but a friend posted up some links to Sesame Street bits on YouTube. Man that site is a timesucker.

I got tears in my eyes from laughing at this Yep Yep aliens sketch. My sister used to talk like them all the time. I think I know what I'm going as for Halloween.

Saturday, April 22, 2006

Having trouble peeing? Yeah, we got something for that.

Catheter lab

Thursday's skill lab was devoted to learning how to insert urinary catheters. Wheee. Doing it on the mannequin was fairly simple. Of course, they don't wince when you shove a tube up their urethra. And unlike some real women, the mannequin's urethral opening is easy to find. I did learn a trick though. When cleansing the inner labia with the betadine swabs, the urethral opening often winks when stroked. So there's that.

Test that balloon

The demonstration video we watched to prep for the day had live models in it. Some friends and I were wondering how much they got paid for it. First, there's the irritation factor, and second, your junk is out there preserved on video for posterity.

Ready for action

We took home foley kits to practice on our own and I briefly considered trying it out on myself, just to see how much it hurt. I didn't do it, but the next day I told a small group of students that I had. No one batted an eye, and a few people said that they had considered it as well. I fessed up to the lie, but was somewhat concerned that my fellow students so readily believed me.

Someone told a story about a female student who was assisting a nurse with a catheterization on a male patient. The student was holding the penis and the nurse was just about to insert the catheter when she was called out of the room. So the student is left holding this guy, who is 17 years old. Annnnnd he gets an unintentional hard-on. She drops it and hastily exits the room. Embarrassment all around.

Wednesday, April 19, 2006

Cigarettes or fingers, your choice

I'm in my adult health lecture class right now learning about peripheral vascular disease. My instructor just went over the danger of tobacco use when patients have other predisposing factors to obstructions in their blood vessels. Tobacco use causes vasoconstriction (arterial muscles constrict the vessels), increased platelet aggregation (and therefore blood clot formation), increased levels of epinephrine & norepinephrine which cause further vasoconstriction and increased heart rate, and the introduction of carbon monoxide which interferes with oxygenation.

Severe peripheral vascular disease can result in tissue death and may require amputation of the affected extremity (arms and legs). All of that is just background to what the instructor said next:

"Physicians will often tell their patients, 'You can choose cigarettes, or your extremities, but not both.'"

To which I added, "And remember, it’s hard to smoke without hands, so..."

Sunday, April 16, 2006

Rather nasty experience

*Not for the squeamish*

Turn back now if you know what's good for you.

I'm in a confessional mood, so I'll share. When I got home tonight, I ate some mint chocolate ice cream while watching Arrested Development episodes. I'd finished my ice cream and was washing it down with some water when some funny bit happened on the show. As everyone knows, swallowing and laughing at the same time is not well-tolerated in the body. It's pretty much a war between the two. In my case the battle was settled thusly:

1) Swallowed water went into my trachea instead of esophagus
2) Coughing ensued
3) A small quantity of mint chocolate ice cream came back up my esophagus
4) Regurgitated ice cream entered my mouth (still mostly full of water) and nose
5) Watery ice cream fell out of my mouth into my glass
6) Into a paper towel, I blew a mixture of ice cream and mucous out of my nose
7) Coughing continued while I contemplated how vile it all was

Saturday, April 15, 2006

Calexico at Emo's

I saw Calexico play a free show acoustic show tonight. It was pretty good. I've seen them play better, but you can't argue with a free show. I was surprised that they didn't play more songs from their new album as this and the scattering of other US dates they're playing are to promote Garden Ruin.

More out of focus pics here. I didn't squeeze up front because I was with someone, and where we were standing was not conducive to picture-taking.

Thursday, April 13, 2006

Day surgery

Once during our first semester of upper-division classwork, every nursing student at UT has a chance to observe day surgery.

I saw:

1) Three colonoscopies

The first was routine. The doctor was cool and pointed out anatomy like the entrance to the appendix, the liver (blue patch on the colon wall), and the prostate. The second one was interesting because the patient chose not to be sedated. He was a trooper, breathed well through the painful parts, and didn't make a peep. The third guy was well-sedated and yet still groaned loudly throughout it. Poor guy, it was a rough go for him. Thankfully we won't remember it because of the amnesiac effects of the sedation.

2) Uterine and cervical tissue sampling

Just what it says. It requires a lot of prep for a procedure that's over quickly. Sterile drapes all over the place.

3) Two hand surgeries

First was removal of a benign tumor from a woman's hand. The surgeon specializes in hands and was happy to tell me all about what she was doing and why. The second surgery wasn't as cool, but still interesting. I got to fetch the nurse a sterile finger nail cleaner and open up a sterile gown for the doctor.

So nothing too bloody for me. A fellow student got to see a nose job where they pulled out a guy's middle nasal turbinate.

That was really bloody as the tissue is well-perfused by capillaries which you'd expect because one of the functions of the turbinates is to warm inhaled air.

I'd never been interested in surgery before, but after this experience, I can see myself possibly working in day surgery at some point. The high turnover and variety would keep it interesting.

Of honkers, hoo-hoos, and hornpipes

Today in class we learned assessment of the breasts and genitalia. Usually we assess each other, but since assessment includes inspection and palpation, today we just watched videos and looked at medical models. Even that made some people anxious.

The breast exam video played without controversy. During the male genital asessment video though, there was a bit of an uproar. The "patient" in the video was uncircumcised and the narrator explained that with such patients, the examiner asks them to retract their foreskin. The guy in the video did and you'd think there was mouse in there or something. Gasps and actual muffled screams from the ladies in the audience (I didn't hear any of the five other guys, but maybe they freaked too). I'm not sure exactly why they were so surprised and/or horrified. Once he pulled it back it looked like a circumsized penis, something I assume they'd seen before. Maybe they were shocked by the amount of foreskin? Cause he did have a lot. Whatever the reason, it cracked me up to see and hear such an extreme reaction.

Later, our instructor asked the teaching assistant to start handing out medical models so that the students could palpate the testicles for lumps. What she said, in a completely casual tone, was "S____ is handing out the testicles as we speak." Priceless.

Tuesday, April 11, 2006

On the the subject of infants' level of cool

From last Wednesday to Sunday, I was at the National Student Nursing Association convention in Baltimore. I’ll write more about that later, but I just remembered something.

One of my guy nursing student friends calls things “gay” all the time, like in the 5th grade sense. “That test was gay,” and so forth. He used to apologize to me when he did it, until I convinced him that I knew what he meant, it didn’t offend me, and that it actually made me laugh because it was so childish.

During the convention we were at dinner one night and someone started talking about her experience on the maternity floor at the hospital. Several other people joined in, cooing about how precious the babies can be. In a lull in the conversation, both as a rebuke to all the goo-goo talk and a crack at my guy friend, I said in my most contemptuous surfer dude voice, “Babies are gay.”

Tuesday, April 04, 2006

What happens in skills lab, stays in skills lab

I had an assessment performance exam yesterday. In front of our instructor, my lab partner and I had to assess each other’s skin, gastrointestinal, and neuromuscular systems. In the real world, we wouldn’t be doing large parts of the exam, but it’s useful to learn. While we perform the exam, we talked out loud so the instructor knew that we knew what we were doing.

It was my turn and I was about to assess my partner for sensation in the face and extremities (arms and legs). To do this, you have the patient close their eyes and tell them that you will lightly brush their skin with different stimuli (in this case either a cotton wisp, the blunt end of a tongue depressor, or the end of a unwound paperclip). The patient is to tell the examiner where they feel the sensation and whether is was the soft, blunt, or sharp stimulus.

I never practiced exactly how I was going to say it out loud. What came out was, “OK, close you eyes and I’m going to touch you in various places.”

There was a pause in the exam as my instructor and lab partner laughed heartily. Yeah, that was fairly inappropriate.

Monday, April 03, 2006

The pointy end is the patient end

I gave my first injection today, and I wasn’t nervous at all. I think I was so focused on proper technique, that anxiety couldn’t take hold. It was a subcutaneous injection (into the layer of fat between skin and muscle) of insulin into the back of the patient’s upper arm, which is a preferred site for insulin. The patient’s been getting insulin injections for a long time now, I don’t think I hurt him.

I didn’t tell him it was my first time with a real person, but he didn’t really need to know that. Why create unnecessary anxiety? Or have him flat turn me down? When we practice injections in lab, our teachers actually address this. The hypothetical conversation between student nurse and patient would go something like this (with the parts said only in our heads in brackets):

Student nurse: OK, time for your medication.
Patient: Nursing student huh. Have you done this before?
SN: Yes [on a mannequin].
Patient: Who?
SN: I just gave an injection to Mr. O’Dell [which is the name of our mannequin].

I didn't have that conversation with my patient. He seemed at ease with me and I was ready to go. Prep site, dart in, stabilize, inject slowly, withdraw. No problem.

Thursday, March 30, 2006

The Go-gos at Stubb’s

I had hemmed and hawed about going to this show. What decided it for me was so many of my friend decided to go. I’m very glad that I did. To celebrate the 25th anniversary of it coming out, they played the Beauty & the Beat album all the way through. Rock on. I never thought I’d ever hear them play “This Town”. So very happy. After that they played a bunch more songs from all over their career, the hits sure, but also more obscure stuff. I can’t recall what exactly those songs were, but it was cool. They were tight and Belinda and Jane’s vocals were strong and clear. Great show to see in the open air. It I hadn’t been sick, I would have been dancing up a storm. All I managed was some shimmy and shake during “Head Over Heels.”

What really amused me about this show was the audience. There were tons of people who clearly have been fans since the band was in their heyday. I saw at least five original tour t-shirts and lots of mouthing of lyrics. I noticed that local TV meteorologist Mark Murray was there as well. After seeing him at so many shows over the years, I’m convinced that he’s a big music geek and probably lived at clubs when he was younger. The next time I see him at a show I think I’m going to go talk to him.