Tuesday, March 31, 2009

Emergency close to home

I was sitting in my apartment this morning when I heard a huge boom and the power went out. I went outside and in the direction of the boom to find a massive accident a few blocks away. Two firetrucks had collided with one ending up on its side. I walked up to see if I could help but upon noting fire crews, EMTs, and police swarming all over the place, I left. I hate Looky Lous.

The whole story is here. Really sad/frustrated for that bicyclist.

Note to self: Put together a first aid kit with gloves, mouth-to-mouth guard, etc. Just in case

Sunday, March 22, 2009

SXSW Music 2009: Day Four

Friday I went to the Flatstock poster show (yay for me, I kept to my pledge to buy only one poster) and had to navigate through a massive line waiting to see Third Eye Blind. My right brain cried a little at the sight. On to Saturday!

Echo & the Bunnymen
Not as exciting as seeing them a few years ago when they were mounting their comeback, and a rather perfunctory performance. The sound was good though and they played "Villiers Terrace" so I was happy.

Fond of the song "Coast of Carolina", on Merge Records, and the frontman is a drummer/singer (always impressive to me), so I went. Disappointingly generic at this point, though there is hope for more interesting work in the future.

A bit worn out musically, I decided to sit down in Esther's Follies for some comedy.

Natasha Leggero
MC for part of the night and so her jokes were scattered between the other sets. I admire her moxie. Would like to see a full set sometime.

Martha Kelly
Yay. Kelly started in Austin and I love her guileless delivery.

Eugene Mirman
"There are three kinds of bands playing this week. Bands I like, bands that are just not for me, and bands who are angry at quiet." Hee. The tossed-off SXSW jokes were clever and the slightly older material (much of which I saw at All Tomorrow's Parties) still worked well. The set-ending "duet" with John Wesley Harding fell flat, but still a good set.

Hannibal Buress
Never heard of this guy, but he destroyed. Love seeing someone without expectations (well, always low expectations with unknown comics) that just kills. Must to look into further.

Todd Barry
Barry's stage persona isn't capable of delivering a rousing set, but still did well. I laughed so there you go.

Janeane Garofalo
Admittedly "wackadoodle" on Lyrica and "Vicadoodles", she was sloppy and hilarious. I hope she taped this set because the tangents were brilliant. I doubt it can be recreated, but if she can approach the free-ranging, giddy charm she exhibited here she's due for fantastic HBO special.

Other, terrible comics will go unmentioned.

Handsome Family
15 years ago at SXSW I was the stage manager for the venue they played at before their first album came out. Fell in love then and never stopped. So good. Pretty big, enthusiastic audience too.

Six Finger Satellite
They're back, one of my favorite bands of the mid-90s, though really it's only J. Ryan (singer/keyboards) and Rick Pelletier (guitar). I wasn't hoping for much as their last album and tour were quite bad. Not much has changed and it's clear that John MacLean (now peforming as The Juan MacLean) was the standout talent in the band.

So SXSW music ended with a fizzle. That's OK. It was an above average year.

Oh yeah, and I got to see a another movie.

I've wanted to see this since hearing the buzz out of Sundance and it didn't disappoint. Free-spirited Andrew comes to town to visit his old friend Ben and shake things up a little. Ben's chafing under his now-staid life while Andrew needs to find justification for calling himself an artist. The gist is familiar (Old Joy), but the execution is fresh. Out late and quite drunk/stoned, the friends concoct a plan to prove to themselves that they're not boring, namely make an amateur porno featuring them having sex with each other. It sounds preposterous, but the naturalistic performances sell it from start to finish. The really wonderful thing is that Humpday is funny, engaging, sweet comedy who's laughs arise from spot-on characterization rather than gags. Magnolia Pictures has picked it up so it will be see a probably limited, art house release. Highly recommended.

The Q&A afterwards with cinematographer Benjamin Kasulke and co-star Joshua Leonard was illuminating. The film was shot in sequence and improvised. Director Lynn Shelton wrote scene outlines, but left the particulars to the actors. This great method is largely responsible for the naturalism and believeable motivation on display here. Kasulke and Leonard were especially excited that the audience "got" the tone, humor, and tension of the film. Apparently at Sundance it was received as a much broader comedy. Loved it.

Saturday, March 21, 2009

SXSW Music 2009: Day Three

The Thermals
Energetic, fun. If I was young and relatively new to the whole seeing bands live thing, I'd be crazy excited.

Little Boots
Does one song barely listened to count as having "seen" a band? Yeah probably not.

American Analog Set
Yay! Reunited to play The Golden Band from start to finish, the hot sunny environment wasn't ideal for Amanset (nor were the dubious acoustics of Club DeVille) yet the material, performance, and my own engagement carried the day. Lovely.

Pains of Being Pure At Heart
I hate the rigamarole for Fader/Levi wristbands and so just don't bother. No problem as a security guy saw me mouthing the words to "Come Saturday" and practically forced me inside. Another band I probably would have flipped for years ago. Enjoyable.

Wanted to see this show based solely on the idea of their Willie Nelson tribute album. Have to agree with friends who saw them the day before, technically proficient but lacking in spark.

Tuvan throat-singing otherwise known as xoomei!! Though I'm a huge fan of Tuvan music, I haven't kept up with the current state of it and thus hadn't heard of these guys. Turns out they're all national champions of various styles or instruments and they absolutely killed. The cognoscenti in the audience loved it and the uninitiated freaked over the sound. If you're not familiar with the style, check them out. Some day I will go to Tuva.

Camera Obscura
Inert. They didn't seem like they were having any fun at all which was in sharp contrast to the ebullience of the terribly monikered Dananananaykroyd who played right before. Just saw the last couple minutes of Dan, etc. but the singer closed their set with this plea, "I don't want to leave!" It was cute. Anyway, Camera Obscura couldn't muster much enthusiasm so I moved on.

The Rosebuds
Never much cared for this band aside from the great song "Leaves Do Fall," but figured I should give them another chance. Conclusion: Just don't do it for me. After "Leaves" and a quick "much respect to you" to Mac McCaughan, I took off. That's the nice thing about SXSW, there's always another option.

Eating. Got to keep the energy level up. Caffeine helps too.

Man I loved (still do) his first three albums, everything since not at all. Only saw the last half of the set, but dude if you've only got 45 minutes to re-introduce yourself to everybody don't waste time doing extended versions of old songs that far outstay their welcome. Plus, Devo is up next so I can't get into you at all.

So very very good. If this was the first time I'd seen them, I think I would have had a hypertrophic spazzmodic episode (Ed note: Not a real medical phenomenon). As it was the 3rd time in four years, I pretty much knew what we were going to get and still swooned. Wheee! The one drawback of the show was that I only had demonstrative fans on one side of me, the kind that jumped up and down, sang along to the call-and-response bits appropriately, etc. Otherwise, it was stand-very-still-and-applaud-sedately. Oh to be up front with the be-flowerpotted.

Don't Shoot, I'm a Man (new song)
new song
Going Under
new song
Girl You Want
Whip It
Secret Agent Man
Uncontrollable Urge
Smart Patrol/Mr. DNA
Gates of Steel
Devo Corporate Anthem
Freedom of Choice
Jocko Homo
Gut Feeling/Slap Yer Mammy
Beautiful World (sung by Booji Boy)

Friday, March 20, 2009

SXSW Music 2009: Day Two

Peter Murphy
Due to the colossal line out front of Elysium, I didn't even bother. Who knew aging punks had so much goth in their soul? As the mohawked, crow's feeted punks waited, next door Beerland was practically empty ahead of the Circle Jerks performance (Keith Morris was sitting out front reading quietly).

Grizzly Bear
Every year I look for the peak experience of SXSW without trying to force it. This year it came early on. After waiting in line for a long time, I almost left so I could see something in this time slot. Finally managed to grab a seat upstairs in the balcony just as they started. The view wasn't good, but oh the sound was. Already tired, I leaned my head back and just drifted to the gorgeous sounds of Ed Droste's voice drenched in church reverb. Man that new album is going to be great. After 15 years of SXSWs and much talk amongst friends of how jaded we can be, seeing a set like that from Grizzly Bear tanks up my faith in the eternal wonderment of great music.

After that set, I hardly cared about the rest of the night so floating on musical bliss was I.

These Are Powers
Waaaay too long to set up for this tepid, murky cacaphony.

The hippie vibe was too great for me to fully engage with this.

Written up all over the internets and playing a ton of shows during SXSW, this kid's got good PR and poor performing skills. At future shows, he spouted the same line I heard here, "We're playing like 950 shows so this is goin' be short." Quality over quantity dude. Stay home and rehearse.

Reliably blistering. He should be huge. Tiny audience, hopefully he had a much bigger one for his Mess With Texas show.

Beach House
Hey guys, which is more annoying, the "monotonous" lighting or your incessant complaining about it? Also, you're better on record.

Dinosaur Jr.
Very much like the show I saw them play at All Tomorrow's Parties last Fall. Just stayed for "The Wagon" and then headed out.

Thursday, March 19, 2009

SXSW Music 2009: Day One

Ulrich Schnauss
Just laptop mixing, even "Stars" (and how I love that song) was a letdown

Shut up and play boys. Quit critiquing the audience. Oh, you're (hardcore punk) music's tedious as well.

Heartless Bastards
A band, playing music competently. Nothing particularly of note.

Avett Brothers
Lots of energy, rather samey in song structure/sound/subject. Points for working hard to engage the audience.

The Decemberists
This was the debut of their new album, The Hazards of Love, played in its entirety, as it will be on their upcoming tour. I was tired and that may have affected my reception, but aside from about four songs, I found the material to be mediocre. The typical Decemberists elements were all there (with again more classic rock influence as on The Crane Wife), the songs just weren't all that interesting. Though the album lists 17 tracks, several musical themes repeat so that it's largely just more verses of the same song. I'm not one to listen attentively to lyrics of new songs, so I have no opinion of the storyline.

It was great to have guest vocalists Becky Stark and Shara Worden reprising their roles on the album as well as adding some instrumentation. That was the best thing about the show, the varied instrumentation and particularly the pounding version of "The Rake's Song" where five people banged away on drums. Maybe it will take a few listens to the record to engage properly with the material.

They encored with "The Raincoat Song" (just Colin and John singing) and "I Was Meant for the Stage".

It happened many times

Every time I saw an obese person smoking today I thought, "See you soon," as in "at the hospital for your coronary bypass." Well, better me than a mortician.

Wednesday, March 18, 2009

SXSW Film 2009: Trust Us, This Is All Made Up; Passing Strange

Trust Us, This Is All Made Up

David Pasquesi and TJ Jagodowski are masters of improvisational theater. For years now, they've been creating a long form improv show from nothing. No audience suggestions, no props. They just look at each other and start talking. Trust Us is a record of one performance bookended with Paquesi and Jagodowski in the hours before and immediately after a show. While the improv itself, blossoming to seven distinct characters, is impressive and very funny, the framing sequences are revelatory. To these guys, they're merely walking into a story that is already in progress and will continue after their gone. Their job is to play it out for the hour they are in front of the audience.

The day before this screening, I saw Paquesi and Jagodowski perform live at an Austin improv theater. While I would subjectively call the live show better, this is merely because of the particular subjects covered. The film is it's own entity and can be appreciated by improv newbies and veterans alike. The Q&A afterwards revealed that if they film ends up on DVD, a whole second performance will be included. So distributors hop to it!

Passing Strange

I've struggled with how to organize my thoughts about this film. It's great, just hard to put into words. So I revisted the notices from Sundance that spurred me to see it and realized that the AV Club's Rabin and Murray said it all much better than I could.

Director Spike Lee was at the (poorly attended, see Murray's fears on that one) screening and talked a bit about how he became involved. He was a fan of the off-Broadway (then Broadway) run of the show, seeing it many times. When the show's attendance started to decline and it was clear it was close soon, Lee stepped in to document it so it wouldn't be "lost". Hooray for him because Passing Strange is an amazing, deeply personal piece of theater and deserves a wider audience. Transcendent is the perfect descriptor here. I'm very glad that I got to see it on a big screen at the Paramount.

Tuesday, March 17, 2009

Todd Haynes is Not Not There, er Here. At SXSW.

I just chatted with Todd Haynes (director of I'm Not There, Far From Heaven). I try to avoid "you're so great, I love you" pawing in these situations so I tend to try for a topic of mutual interest. Knowing the copyright issues associated with his first film, I suggested that he consider Creative Commons licenses for some of his older films, Superstar: The Karen Carpenter Story at least. He hadn't heard of CC so I did a 30-second pitch and managed to intrigue him. So hooray for that.

Friends might remember that I promoted Creative Commons a few years ago by doing this to my head. And I ran into Ryan Junell, the designer of the CC logo (and a fellow DJ from our days at KVRX radio) a couple days ago. Synchronicity!

Monday, March 16, 2009

SXSW Film 2009: Anvil! The Story of Anvil, Drag Me to Hell

Anvil! The Story of Anvil

How long would you pursue a dream to no avail? How does 30 years sound? In 1984 a massive rock festival in Japan featured a prescient line-up of metal music stars. Bon Jovi, Whitesnake, Scorpions, etc; all of whom became a success, except Anvil. Despite much love and respect from their musical contemporaries and a core of stalwart fans, Anvil never caught on. So here they are, 30 years later, still playing small clubs in their native Canada and hoping for a big break.

Let's just get this out of the way, this is the best film screened at SXSW in years. I loved it from top to bottom and very much around the middle. I'm not a fan of metal, but now count myself among Anvil's fans. I don't care for their music at all, and yet I want them to succeed passionately and it is this portrait that has put me in their corner. It's funny, heartbreaking, transcendent; I left the theater with a song in my heart (not "Thumb Hang" or "March of the Crabs", but still).

Aside from the travails of being a down-list band on tour, the doc focuses keenly on the relationship between singer/guitarist Steve "Lips" Kudlow and drummer Robb Reiner. They call themselves brothers, with all the love and acrimony that implies. Lips is the hothead visionary, Reiner the cool pragmatist. When tensions boil over during a recording session, Reiner walks out and is subsequently "fired" by Lips, an obvious Spinal Tap parallel in a film full of them (seriously, it's kinda spooky). The bonds of love and music are strong however and almost immediately they are reconciling with tears all around onscreen and in the audience.

Anvil is so compelling as a subject that the form and directing of the doc is almost immaterial. Respect though must be paid to the intimacy and trust that director Sascha Gerva has earned from his subjects. Technical skills can be acquired, getting subjects to open their lives is an ability that is much harder to learn and use responsibly. A+++

Drag Me to Hell

Sam Raimi (Evil Dead 2, Spiderman and the sequels for both) brought the work-in-progress to a exceedingly receptive audience at this midnight show. After the blockbusters of Spiderman 1-3, I suppose he has the funds and a burning need to get back to his roots in low-budget, horror/comedy. Thanks be that he still has the chops for it. My expectations were middlin', Raimi & Company exceeded them handily.

The plot concerns Lohman's character angering a old gypsy woman who then curses her soul to Hell. Funny, mostly quick-paced, with quite good performances from lead Alison Lohman and supporting players Justin Long, Lorna Raver, and Dileep Rao. The work-in-progress moniker was definitely due to several unfinished special effects sequences, though I hope some of the dramatic sequences are tightened up a bit in the final edit. Less whip-pans than "usual" for Raimi, but the gross-out gags, supernatural themes, dutch angles, and other hallmarks of his classic style are in full effect. Just the kind of thing you want to see at midnight with a like-minded audience.

Sunday, March 15, 2009

Nailed it: Those little patient details

Nurse K wrote a fantastic post about when the routine sadness really gets to medical staff. Great story and absolutely conveys what I've felt more than a few times. Sometimes all it takes is a small personal detail to collapse the professional distance and bring on the waterworks.

SXSW 2009 Film: Pulling John, Objectification, Moon, The Last Beekeeper

Pulling John

Saw this, my first film of the festival, on a whim because I was there and it was starting. Yay for convenience! The John of the title is armwrestling world champion John Brzenk. Yes indeed, there is a robust armwrestling community that exploded worldwide with the release of Sylvester Stallone's Over the Top in 1987. Not coincidentally, Brzenk appeared in the film as himself and even had an action figure. I love this sort of thing, people who are famous to a small group of enthusiasts, but who are a blank to the general public. Brzenk is a great character. Humble, self-effacing, yet a champion. Incredibly charming with just a touch of bravado. Totally the opposite of up-and-comer Travis Bagent who is outwardly in love with himself in rather cliche, jock-lunkhead way. The audience was initially charmed (not so me), but eventually turned against him what with the constant boasting about how "pretty" he is. The film restores a measure to sympathy for him when it becomes clear Bagent worked very hard developing his strength and skills to earn his father's attention. The third character is massive Russian Alexey Voevoda. He's a pretty boy and knows it, but being Russian is rather reserved.

Pulling John follows the standard tropes of sports docs with all the scrappy glory and sudden reversals that typically show up in this narrow genre. The competition sequences are thrilling and the biographic elements interesting. If the structure and form are merely functional, the story is engaging enough to make this worth your time. Brzenk was at the screening (nice guy, just like in the film) and it was fun to see the obvious armwrestling fans there for him and the culture as opposed to the film-in-general fans.


From the guy who directed Helvetica comes another design-centered doc in the same static, immaculate style. Liked it, though interestingly it had the same problem as Helvetica in that it opens with a burst of wonderful images and great talkers before petering out. Which is unfortunate really because while Helvetica was able to exhaust the subject, Objectification's subject matter is so broad that it should be able to fill it's time without losing focus. A talking head or two could have been trimmed with no loss (or more interesting people profiled with much to gain). Apple chief designer Jonathan Ive and New York Times Magazine's Rob Walker were far and away the best talkers, offering thoughtful observations and a good dose of humor. Overall, worth it, especially for people like my friend Jennifer K if that means anything to you.


I was really looking forward to seeing this based on the positive reviews from Sundance. Sam Rockwell plays a blue-collar guy stationed on a Moon base which mines energy for the folks back home on Earth. He's nearly done with his three-year solo stint when an accident occurs that sets the plot in motion. After a great opening 10 minutes documenting his routine, rather dreary life through a revealing montage, I started to get a tickle of discomfort which then expanded further into full-on disappointment. I won't give away the plot, though it's quite difficult to discuss much about the heart of the film while staying vague, but will say that I expect better representation of (my beloved) science fiction genre. Way too many plot holes and contrivances for even a silly rom-com, let alone SF. What is the actual science/business reasoning behind sending one, general-utility guy to man a mining station that is already automated and then providing him with a nurturing computer/robot companion? I mean, besides it being an interesting set-up for a movie. He doesn't do anything that the robot couldn't do, so why is he there? And why bother to program a nurturing robot when there could just be a bigger crew? The questions accrue at a rapid pace with only a few answered with glib, throwaway explanations. Rockwell is quite good, the set-design is practically another character (with hefty homage/steals from 2001), and the music by Clint Mansell sells the tension. Still, I just couldn't get past my exasperation.

After conferring with a few people today who saw the movie, I'll say that my standards are high. Some found the movie confusing and wanted more explication of the plot, where I found that element right on. Many were intrigued with the exploration of boredom and alienation in the midst of all the technology, where I—well-versed in this common aspect of science fiction literature—found it overly broad. One more thing, when the plot starts cranking, there is an obvious parallel to the film Alien (and no, there is no alien/monster here) for which Moon suffers in comparison. It's unfortunate really that 30 years after Alien, director Duncan Jones feels he has to hit you over the head with it. A little too much tell, not enough show. Despite all this, I'm glad that Sony Pictures Classic has picked the film up for distribution. Hopefully, it will help increase the prevalence of science fiction films that lean more heavily on ideas than special effects.

The Last Beekeeper

Oh for a different, more talented editor. The story and footage are all there, it just wasn't put together right. This doc attempts to tell the story of the collapse of bee populations across the US through the experience of three commercial beekeepers. Science with a healthy dose of human (though sadly not much bee) characterization. Absolutely the right strategy. And yet The Last Beekeeper goes about it all wrong. Rather than initially foregrounding the story of the bees while building empathy for the beekeepers through seeing them talk about and do their job, the filmmaker immediately leap into the "here's why this person is interesting" element. Within a couple minutes of introducing the first beekeeper, we find out she took over the business when her step-father died in a tragic accident. Tears are shed onscreen before we even know this person. Second beekeeper, a stout good 'ole country boy is first seen opening the gay porn catalogue that just arrived in the mail. Uh, director? Save that for later! Let us think we know this guy, then upend our expectations. Ach.

Another detrimental element is the heavy use of text on the screen. Why are we reading about the statistics when we could have the scientists tell us the scope of the problem? Why the constant, repetitive expository text ("You are here now and about to see this")? Just show it, quit telling. The problems continue with the awkward cutting between the beekeepers' stories and the entomologist laying out the science of Colony Collapse Disorder. Momentum and rhythm are never established. As I said, the building blocks are all there, they just need to get put together better. A last, minor note, either the bee business is truly an incredible emotional wringer, or beekeepers are a weepy lot. Lots of tears shed, almost exploitatively so.

Friday, March 13, 2009

SXSW 2009: It begins

South By Southwest 2009 has begun and I'll be in the thick of it for the next 10 days. Right now I'm working (15th year, whoo!) Registration at the Convention Center, hence the online access. Not much to report so far. The morning rush was over 20 minutes after we opened. I helped Bruce Sterling again this year. He's dapper and very polite. Film-wise, I'm mostly looking forward to a few narrative films that received good reviews at Sundance: Moon, Humpday, Passing Strange. I'll spend today's downtime scoping out the documentaries.

More later as warranted.

Thursday, March 12, 2009

Legislating nurse to patient ratios in Texas

There are bills in the Texas House & Senate now to establish mandatory nurse staffing committees to help set policy on nurse to patient ratios in hospitals. It's well established in the literature that smaller ratios equal better patient outcomes. Less patients per nurse means more time spent with the patients. The current bills were introduced by Senator Jane Nelson and Representative Donna Howard. Howard is often cited as former nurse, but 1) I doubt she's let her license lapse and 2) even if you're not providing direct patient care, once you've put in a few years you're always a nurse.

The bills are supported both by the Texas Nurses Association (I'm a member) and the Texas Hospital Association in a good example of positive collaboration between organizations that are sometimes at odds. Essentially the bills require at least 50% of the nurse staffing committee members to be bedside nurses chosen by their peers, use patient-sensitive measures to evaluate their staffing, and it also extends whistle-blower protections to government-run hospitals and clinics (this doesn't already exist?! I need to look into that one further).

At the same time, there are competing bills supported by the National Nurses Organizing Committee—really an arm of the California Nurses Association that's aggressively pro-union and organizes in other states—that mandate specific, low nurse-patient ratios. While this sounds good, in reality the inflexibility of the ratio is a major stumbling block. Our ratios in ICUs are one nurse to two patients or 1:1, or even two nurses to one patient if acuity requires it. On the non-ICU patient floors, the nurse to patient ratio varies widely from hospital to hospital. Around 1:5 is decent, getting around to 1:8 is unacceptable in my opinion. Setting a specific ratio is nice, but ignores the reality. What if two of your patients need a lot of care? In that case a mandatory 1:5 doesn't really cover it. If your patients are doing well, 1:5 could be a light assignment.

As well, those mandatory ratios mean that staff nurses can't just give a quick report to a co-worker who will watch her patients during lunch. The hospital would have to hire extra nurses to cover meal breaks. Just really unnecessary. I'm for letting staff nurses make the best staffing plan at their hospital. Sure, step up investigation of hospitals with poor patient outcomes, but don't lay out a one-size-fits-all requirement as a panacea.

I didn't think the National Nurses Organizing Committee (and I am a fan of nurse unions, just not the way NNOC is going about it) had a chance of garnering much support for their bills, but I just read that Rep. Senfronia Thompson and Sen. Mario Gallegos filed them. Thompson did so after her granddaughter waited four hours at a hospital ER with a high fever. I'm going to have to call her office, because this bill has nothing to do with wait times in ERs. Patients seen in an ER are not in-patients until they're admitted upstairs and therefore nurse-patient ratios don't apply. The long wait times in ERs has more to do with many people not having coverage or access to a primary care physician and therefore the ER serving as their doctor or clinic.

OK, more on this later as I tease out the intricacies.

Monday, March 09, 2009

You just can't believe me

Awhile back at work, I had transferred one patient of mine to a different unit and picked up another at 11 PM, a frequent occurrence. My new patient was originally some distance away (it's a big care unit) so I had to move her to be side-by-side with my first patient. I introduced myself and explained why we were moving. She was pleasant and rather sleepy. While the patient care assistant and I rolled her bed down the hall, she nodded off. By report from the previous nurse, she hadn't been sleeping well so this was good for her. She didn't have any medications due and so after a quick physical assessment, I let her be to get her rest.

When I came back from lunch around 1:30 AM another nurse in my section was walking down the hallway to get me. My lady had woken up, shouted loudly for help, and then promptly dismissed two different nurses from her bedside.

"She's a little crazy," the nurse told me.

I went to her bedside and asked what was wrong. She requested that she be rolled out into the hallway and left alone. I replied that I couldn't do that, there would be no one to look after her. She retorted that she didn't need anyone and besides, we'd been ignoring her all night. Oh, and that there was "no way you people graduated from nursing school." OK, so we have confusion with an obstreperous streak mixed in.

I calmly explained that I was her nurse,

"See my badge here says RN and that we haven't been ignoring you. You've been asleep."

She snorted, "I have not been asleep. Now take me back downstairs."

Now I was confused, "M'am, you are downstairs."

"No I'm not. A doctor stood right there at the foot of my bed and said I was being moved upstairs."

"M'am that was me, not a doctor, and I said we were moving you to a different part of the unit. You'll leave the ICU and go upstairs to a regular room tomorrow."

She just wasn't buying that. I realized I'd already been doing it, but I cast my mind back to my psychiatric hospital days and broke out my mental health skills. Was she feeling anxious? "Don't try that with me." A different tack then, a distraction with an offer of a drink. "No, you'll put something in it." OK. Could I change the dressing over her surgical incision? "You're not touching me mister." Thinking it might be cause I'm a man, I offered to get a female nurse. "If they really are a nurse."

We went round and round, me trying to reassure and reorient her, she denying anything I said. After she refused to let me draw blood for ordered lab work (painless for her thanks to a catheter already inserted in an artery), I ended up calling her daughter and son. They said they'd come up and talk to her. When I went back to her bed, she was sound asleep again. The kids showed up a little later and talked her through all the nursing care we needed to do. We went outside for a little conference.

Nothing was explicitly said, but I got the feeling that their mom had always been strong-willed. They'd picked up the knowledge somewhere that morphine could cause confusion, especially in older folks. That's true, but she hadn't received any for a whole day. Could be lingering medication effects, could be not enough quality sleep, could be after effects of being on a heart bypass machine during surgery which can cause memory loss and confusion. They thanked me for my patience and headed off to a very early breakfast. I went back in to find her asleep again. Excellent.

About a hour later, after finishing up my other patient's bath and dressing change he said, "Thanks Doc."

As I always do, I corrected him, "Oh I'm not a doctor."

"Well," he said with a mischievous grin, "You're not really a nurse so..."

Funny guy. It was nice to break out the psych skills again, and thank goodness she didn't really get riled up and try to get out of bed or something. So it worked out all right.

Thursday, March 05, 2009

Beatbox Timesuck

Let's say you have 3 to 45 minutes of free time today. Why not use it to craft splendid beatbox backing tracks? Go here and experience joy. Make sure to click on the robot face too.

Getting All Het Up: Won't Somebody Think of the Children?

A few years ago I went to a national health-profession convention where delegates could propose resolutions to be debated and possibly adopted. The quality of these fell equally into three categories: worthwhile, innocuous, ill-advised. Having previous experience in such things, the group with whom I attended encouraged me to be a delegate. They demanded that I continue to be a delegate for their own amusement after witnessing my participation in the first session.

As some might know, I don't suffer fools gladly at that goes double at events like this. If you're going to take up time at a once-a-year national meeting, you'd better have your ducks in a row and not waste it on poorly written inanities and resume padding, "I wrote a proposal that was approved blah blah blah." On the first day, I tore through a few of the more egregious proposals to the delight of my compatriots. I supported quality proposals as well, I'm not an obstructionist.

Down the agenda I could see a few odd proposals of which I couldn't make sense. The way I understand it, a few years before I attended someone proposed focusing on a relatively uncommon disease calling on everyone to "raise awareness" when they returned home. Worthless. Not only could you practically guarantee that no one would do it, focusing on an uncommon disease—what constitutes raising awareness anyway—isn't a good use of limited time and resources.

This convention, there were several candidates for "disease of the year" as I took to calling it. The most inconsequential one concerned *****, a rare genetic disease that is almost always fatal. ***** is commonly cited in biology classes during the genetics modules because it's an autosomal recessive disease and the mutation is much more common in Ashkenazi Jews, Cajuns, and French-Canadians of SE Quebec; 1 in 30 vs. 1 in 300 for the general populace. It's also significant because it was among the first genetic diseases for which a reliable, cheap screening tool was developed making it largely avoidable with proper knowledge.

The convention proposal was to "raise awareness" that ***** exists and that it's also more common in those of Irish heritage; 1 in 50 is a carrier. As was expected (and feared) the proposer was a mother whose child had *****. I could have let it go I guess, but I could see how this trend was developing so I stood up to speak against. My points were

A) The proposal offers no real action, just feel-good statements about "raising awareness"
B) This "Disease of the Year" trend was counter-productive and invited more each succeeding year, drowning out substantive proposals in favor of what amounts to emotional pleas
C) Why was *****, a disease that in its most commonly expressed form kills unremorsefully by age 5, more worthy of attention than more common and more treatable diseases like sickle cell anemia or cystic fibrosis?

The for arguments boiled down to

A) This is my personal story and that's why it's important
B) Oh my God you guys, this is like, so sad

After the session was over, the woman who proposed it came up to me with a pitying look on her face, "I’m sorry that you feel that way about *****." Taken aback by this passive-aggressive attack (I'm so sad/smug that you're an awful person), I was flustered and started to say, "It’s not about *****. It's..." when she threw up her hands in my face and shouted, "No!" before turning and practically running away.

I hate that shit. Of course you can disagree with my arguments, but don’t approach me, accuse me of being a heartless asshole by way of "apologizing", and then refuse to listen to my response. Of course, did I really expect any kind of logical or diplomatic discussion to spring from a wholly emotional proposal?

Over night, the tide turned and I received much more support when I spoke against it again the next day. Yay for logic and reason. Out of respect for that mother I declined to pursue the scorched earth strategy that a few compatriots put forth, an endless series of amendments about every genetic disease we could find with increasingly harrowing personal stories about each accompanied by vituperative declamations against any who disagreed. See, I do have some sense of decorum.

UPDATE: I've edited this entry to remove the name of the genetic disease so that it doesn't return on web searches. People looking for information probably aren't interested in discussions of persuasive argumentation. This isn't about the one disease anyway, but about my frustration with empty, button-pushing rhetoric shouldering aside reason and science, especially when it comes to healthcare.

Wednesday, March 04, 2009

Say it with me

While sitting on the bus recently, a grand wave of dorkitude swept over me and I spent a good 15 minutes pondering my favorite medical/physiology terms to say out loud. Valsalva maneuver, nosocomial, chorionic gonadotropin, xyphoid process, metabolic acidosis, how I love to say you all.

Tuesday, March 03, 2009

25 Albums That Changed My Life

I already put this up on Facebook but figured I'd include it here too. I've chosen to make this roughly chronological.

Run DMC - Raising Hell
I asked for and received the tape for my birthday. Suddenly I was popular among my classmates who really just wanted to borrow it. One of my first thoughtful music choices and I'd be prouder if I hadn't also asked for and received the "Rock Me Amadeus" Falco tape for the same birthday. I spent equal time learning the lyrics to Raising Hell as I did learning (phonetically and wrongly) the mostly German lyrics to Falco.

Devo - Q: Are We Not Men? A: We Are Devo!
With this album I began to understand that bookish spazzes could rock out. Songs like "Uncontrollable Urge" were a little scary with the obvious sexual frustration with which I identified, but they were undeniably catchy. Still am a devoted Devo fan and am psyched that I'll be seeing them in a few weeks.

REM - Life's Rich Pageant
I first heard of REM by paying attention to my sisters' taste in music and they went big for "The One I Love". At a garage sale in my neighborhood I paid fifty cents for LRP, a tape without a case, and proceeded to wear it out. "These Days", "I Believe", and especially "Fall On Me" still hit me with a passion and energy undiluted by time.

The Cure - Disintegration
This album was quite popular at my high school because the singles (and even non-singles) from it were in regular rotation on KDGE, a radio station that introduced me to a lot of great music. In college this album became one of my go-to albums when I was feeling depressed, allowing me to really wallow in it. To this day, I have to be careful when I listen to it or risk falling into a dark place.

The B-52's - Wild Planet
In my mind the B-52's and Devo were linked as proud weirdos. Where Devo was worried about the future, the B-52's were dancing to the beat of a past rife with tension. Dance party numbers like Private Idaho frosted with paranoia? Yes please! When I introduced to the idea of camp years later I thought, "Oh, like the B-52's (specifically Quiche Lorraine)."

They Might Be Giants - Flood
Ah, more music for the nerdhouse in my soul. How nerdy? This was the soundtrack for my summer debate camp crew. I trekked to Bill's in Dallas paying outrageous prices to secure their first two albums and haunted the Prodigy boards in my gigantic fandom. I lost interest in their new music around the time I graduated from college (the first time) but still pull out Flood for road trips.

The Pixies - Doolittle
Noisy, odd, captivating. I saw the appeal of dissonance, and that yelp! Paved the way for the next album. Thanks to Kevin who patiently explained why they were great and pointed out that there was a monkey with a busted halo on the cover.

Nirvana - Nevermind
Well really, why wouldn't it be on the list? This really channeled my adolescent, male, dawning-realization-of-being-gay angst.

Orchestral Maneuvers in the Dark - Best Of
Permanently borrowed this tape from my sister and listened to it often while riding my bike around the neighborhood. I liked OMD's electro-pop better than Depeche Mode's. It was weirder, but also more lush and romantic. The life-changing thing happened when I inadvertently chose it as a soundtrack to outrage. When I sat down to write a government paper about the Reagan administration's response to the AIDS crisis, I popped in OMD's Best Of as background music. My Dad's tape player had auto-reverse and I was so into the writing that I just couldn't change the music. As my arguments came together, I grew more sad and furious while songs of love, technology, and destruction played in the background.

Talking Heads - Remain in Light
I had always liked this band, known mostly through their singles and the Stop Making Sense live album (one of my first five CDs from BMG Music Club). Here though, was the most cohesive, flawless album I'd ever heard, both musically and thematically. Seriously y'all, it's really really good. Thanks to Talking Heads, Devo, and The B-52's I hold a fervent believe that I should have been a 21 year-old New Yorker in 1979. I also realized because of these three bands that I looooove gorgeous, tense, paranoia-tinged music. Set me up to like Tricky, Portishead, Braniac, Shudder to Think, and on and on.

The Ramones - Mania
Yeah, yeah another Best Of, but I couldn't afford to buy the first four albums, more bang for the buck eh? Back in my more judgmental days, I was initially wary of my friend Matt because he had a popular, athletic vibe, liked Soundgarden, and wanted nothing to do with the Pixies. But he loved the Ramones and had seen them live. So yes, this is a fellow I could get to like. Thanks for having good taste Matt (and he did finally come around on The Pixies).

Faith No More - Angel Dust
The only metal-ish record I own. Still a thundering achievement. Just the other day I was reading an article about how Faith No More made it big with The Real Thing and then derailed their career with this bombastic, excoriating album. I loved it from day one along with my friend Matt from the above Ramones entry. We drove to Dallas to see them on this tour and rode a wave of euphoria for days afterwards. I would kill to have Mike Patton's vocal range and power.

Huun Huur Tu - 60 Horses in My Herd
My initiation into college radio was through a fellow named Andrew with a reputation for delivering opinionated, sneer-y diatribes against things he disliked, and he disliked a lot of things. The reputation was mostly deserved, and yet Andrew also deeply loved what he loved. Thanks to his sometimes gentle, often rough tutelage, I opened my ears to music of all kinds and discovered lots of stuff I wouldn't have without the KVRX library and Andrew's prodding.

Huun Huur Tu's album was in the new bin at KVRX when I picked it out randomly to play. The sound and story of Tuvan throat singing (two or more tones produced simultaneously, just watch Genghis Blues for a primer) captivated me. Just ask my friends about those days, I was all about the Tuvan throat-singing. I still want to go there and take lessons from Kongar-ool Ondar.

Bill Hicks - Relentless
When I started college my taste for stand-up comedy ran heavy to the apocryphal story-telling of Bill Cosby and the lunacy of Jonathan Winters, the stuff my Dad liked. Unfamiliar with works of Lenny Bruce or George Carlin at the time, I was scandalized/delighted to hear the profanity-laden, politically and socially astute observations of Bill Hicks as a freshman. Bill made me realize that comedy can be a form of social discourse, a way to discuss the issues of the day and advocate for your beliefs while making people laugh. Many thanks to my friend Eric who also introduced me to the comedic joys of Firesign Theatre and Rick Reynolds.

Aphex Twin - Selected Ambient Works Vol. 2
This opened my eyes to a new kind of music where percussion and melody were extraneous. Sure I vaguely knew Eno's stuff, but this felt more like mine and less like the 70s. Another Eric recommendation.

Soul Coughing - Ruby Vroom
The first band I ever interviewed, they were very kind to a nervous kid with weird questions. Thanks to them I found out how great Shudder To Think and Cibo Matto (1st album and EP only) were. They inspired me to go on road trips with my friends to see them and spend long hours on message boards with friends I never met in person. Also, the music was really good.

Low - Long Division
Sparse songs played very slowly. Sounds gimmicky, but oh the sound and the spaces between! Another band that uses beauty and tension incredibly well. Low remains tied for my favorite band today (see the next album for the other band) because they continue to put out great albums and tour regularly. Even after years of being so, I'm still rather awestruck that we've become friends.

The 6ths - Wasps' Nests
Over a span of just a few days, multiple people at KRVX radio where we worked told me they just knew I'd love this record. And they were right. Thanks guys! You started me on the Stephin Merritt-Magnetic Fields-Future Bible Heroes obsession that continues to this day. I'll never get them all, but for years I stalked performers in an attempt to collect the autographs of every singer on this album.

Spoon - Telephono
I went to college with Britt and Jim. I went to the house parties where they started out, and then the club shows. I knew these songs backwards and forwards. Then they got signed to Matador, the home of Pavement and Yo La Tengo and Guided By Voices. Holy shit, they did it! Finally, a band I knew and loved from my town was being heard all over the place. Now they're a big deal, but don't play any of these songs anymore.

Emmylou Harris - Wrecking Ball
Soundtrack to snowmelts and the road passing under your wheels. Thanks for coaxing me into loving it Jeffrey.

Julia Sweeney - God Said Ha
It's frustrating to me that most people only know Julia Sweeney, if they know her at all, as the androgynous character Pat from Saturday Night Live. I know her as a incredibly gifted storyteller who created the best spoken word album I know of. Go Said Ha is the hilarious and tragic story of Sweeney's post-SNL life in LA where her plans are disrupted by her brother's cancer diagnosis and all the trouble that comes with it. Every time I listen to it (got to be 50 times by now) I laugh out loud at the funny bits and cry through the sad ones. Tremendous.

Neutral Milk Hotel - Over the Aeroplane
Thanks to Merge and KVRX, I randomly plucked Neutral Milk Hotel's first album, On Avery Island, out of the To Be Reviewed pile and promptly fell in love, especially with "Song Against Sex". My ecstatic recommendation of that track convinced a guy named Jay to play it on his radio show and also fall in love. Jay later became my friend, roommate, and the newspaper editor who fired me in a misguided attempt to make me a better writer. That's a lot of words not about the record I should be talking about, but hear me out. Knowing On Avery Island prepared me to anticipate, but still be completely floored by Over the Aeroplane. Tremulous singing, funereal horns, sex and Anne Frank. I don't know how to even say how great it is, and yet how off-putting it can be. When I think of the best albums of all time, this one leaps to mind right off. Sooooo glad I went to that show at the Electric Lounge. Standing in front of Jeff Mangum as he belted out "Two-headed Boy" is one of the best musical moments of my life.

Sigur Rós - Ágætis Byrjun
Who put me onto this? I can't remember and that's too bad cause I like to give credit where credit is due. Just fucking gorgeous. I played it for friends in the car and they burst out laughing at first calling it whale music, and then grew to appreciate it. On their first tour through Texas, I saw them play an astounding show. During the final song, I lost track of myself for a few minutes and came back to consciousness with tears on my face. Music can get down to places that no other art can touch and Sigur Rós are masters at it.

Arcade Fire - Funeral
I'd heard the growing praise for Arcade Fire through the Fall after Funeral came out and when I heard it was impressed with how put-together and fully-realized they sounded on their first record. When they came on tour in January I went to see them with Dan and Jennifer figuring it would be a good show. The three of us are big music fans and each of us has seen at least a thousand bands. We're jaded when it comes to music. About three songs in I turned to them and said, "This will be the best show we see all year." And then it kept getting better. The energy passing between the stage and the audience was incredible. They played their hearts out and we loved them for it. When they encored with a Magnetic Fields cover and a Talking Heads cover, I was head over heels. It *was* the best show I saw all year (Dan thinks so too) and this album forever convinced me that I must keep my ears open for the next bit of art that will change my life.

In lieu of a 25th album, I'll just mention a few songs that changed my life though the albums they came from didn't:

New Order - "Blue Monday"
When, as an awkward teenager, I first abandoned myself to the joy of dancing in the unselfconscious manner of kids.

The Buzzcocks - "Ever Fallen in Love?" and The Smiths - "There Is a Light and It
Never Goes Out"
Impossible love and the ache of being young and gay. Broke my heart and helped me put myself back together.