St. Murse

Heinrich Kühn, a new favorite artist

2011-03-05T18:23:00.000-06:00

Gorgeous, painterly photographs from the upcoming exhibit Heinrich Kühn: The Perfect Photograph running 3/6/11 through 5/30/11 at the Museum of Fine Arts, Houston. Kühn highly developed the gum bichromate technique of printing photographs to achieve this dreamy quality. I was captivated and will definitely go see it again.

Perspective on medical costs

2011-03-04T06:26:00.000-06:00

A couple nights ago at work, I held several doses of Factor VII while another nurse went over the process of administering it with a pharmacist. It's an uncommon enough, and expensive, treatment that they wanted to be sure to get it right. As I looked at it I thought, "This costs as much as my remaining student loans." That would be $30,000.

On decorum when faced with kink

2011-02-19T06:44:00.000-06:00

I can't be sure, but I suspect the eye mask a recent patient of mine brought from home was actually intended for BDSM activities. It was black leather, with fleecy lining on the interior eye patches and little straps on the exterior eye patches. All night I kept looking at it in wonderment. I considered making a veiled reference to confirm and so he knew that I knew, but decided to stay scrupulously professional.

Pavement at Stubb's 9/28/10

2010-09-29T03:09:00.003-05:00

Great show from a reformed Pavement tonight in front of a sold-out crowd. So nice to see lots of people smiling and mouthing along with the words. Or shouting, cause you kinda have to yell "40 million daggers!" along with Bob. I haven't read interviews with the band stating the reasons for reuniting, but financial compensation and the urging of Matador upon their anniversary are likely high on the list. Whatever, I was just glad to bask again in the fun that is a Pavement show. I didn't end up sweating and exhausted at the front of the stage like I used to for Pavement shows at Liberty Lunch, but I did attend with the same guys as back then. So glad you could go with me E & M! Wonderful to see so many other friends as well.

UPDATE: The setlist to remind myself.

1. Silence Kit Play Video
2. Frontwards Play Video
3. Box Elder Play Video
4. Date w/ Ikea Play Video
5. Unfair Play Video
6. Starlings of the Slipstream Play Video
7. Stereo Play Video
8. Rattled by the Rush Play Video
9. Grounded Play Video
10. Perfume-V Play Video
11. Shady Lane Play Video
12. Fin Play Video
13. Cut Your Hair Play Video
14. Spit On A Stranger Play Video
15. Nastonovich slide whistle solo Play Video
16. Zurich Is Stained Play Video
17. Gold Soundz Play Video
18. Fight This Generation Play Video
19. Trigger Cut Play Video
20. Conduit for Sale! Play Video
21. Range Life Play Video
22. Encore:
22. In the Mouth a Desert Play Video
23. Two States Play Video
24. Here Play Video
25. Encore 2:
25. Kennel District Play Video
26. Summer Babe (Winter Version) Play Video
27. Stop Breathin' Play Video
28. AT & T Play Video

So You Think You Can Dance? Tour, Houston 9/21

2010-09-24T03:25:00.006-05:00

This is not the time to mount a detailed defense of my watching this show. Suffice to say the dancers and choreographers are talented and frequently breathtaking. I regret my early reluctance to watch during the first four seasons. Thankfully I came around. I've become a big enough fan of the show that this is the 2nd tour show I've seen.

Most of the clips I've included here come from the New Orleans or St. Louis live shows, where my comments pertain to the Houston one that I attended. Not sure why their clipped on the right side and frankly I'm too sleepy to figure it out. Just full-screen it for the best effect. Anyway, on with the show.

Introductory video, then the dancers one by one showing their stuff. Into the first routine, an adapted group piece that borrowed lots of bits from one of the first group routines on the TV show.

Dominic is a ham, but a good one. Cheesy banter flows. This is only the 2nd show of the tour so it isn't quite smooth yet. Choppy cheese. None of it was worth quoting.

Lauren & Russell (sub in for Twitch) – My Chick Bad

Russell did an admirable job, but I wish I could have seen Twitch. Excellent start to the evening.

Kent & Ade (sub in for Neil) – Shoeless Joe

This one was a little too "Broadway" for me on TV so I wasn't crazy about seeing it on tour. Decent though. Kent looked a little deer-in-the-headlights and Ade, while having plenty of power, is missing Neil's crispness.

Robert & Courtney – XXXOOO

Good. I barely remember this one from TV so it clearly wasn't a favorite of mine.

Dominic & Jose – the battle for a sword

Dominic is fantastic. Jose is a distant, over-the-horizon second. Tour clip below isn't great but shows how sloppy Jose is comparitively. Just watch the smaller guy with the bleached hair streak and ignore the other one. The superior TV version, click here.

Lauren & Billy – Boogie Shoes

Lauren is far more committed and professional than I would expect from most 18 year-olds. However, I do not like this routine. It is what I would show someone if I wanted to confirm their worst expectations of what the show was like. Boo.

Robert & Kathryn – Heaven Is A Place On Earth aka Off to the Army Dance

Why why why did they do this one instead of the great West Side Story routine from the TV show? It actually softened my visceral loathing of WSS. Why this? Because it's gooey as hell and the mom/teen girl matrix melt in their chairs for it. Awful cover, competent choreo. Meh.

By general consensus of the fans and judges, Alex & Twitch's Get Outta Your Mind routine is one of the best routines in any season of the show. Alex was injured quite badly on the show, torn Achilles tendon, and so couldn't even participate on the tour. However, knowing it makes for a nice break for the touring dancers, the producers just showed the video. Still killed. No embed again, watch here. And keep in mind Alex's (the Asian guy) training is mostly in ballet. Damn boy.

Group of 7 competitors - Royal T

This wasn't a favorite of mine from the show, mostly because half of the competitors just can't pull off Sonya's choreography. Though to be fair it is off the beaten track. Robert is yet again the standout for the guys and Courtney shows why she's such a great match for Sonya.

Kathryn & Russell – I Can Transform Ya shaky on the power moves

This was the only performance from Season 6 (which sadly did not have it's own tour) and was included here because these were the only dancers representing that season. The choreographers NapTab were at a nadir that particular season, though it's an adequate routine. Thank goodness they recovered and turned in a largely fantastic body of work for Season 7. No decent live clip again, here's the show performance (which as I watch it now was much better than the tour one anyway).

Kent & Robert (sub in for Neil) – How It Ends

Loved this one on the show and was wary of Robert taking over for Neil, but he killed it. Kent was great as well. Kent's been pretty lackluster this show, appearing nervous and lacking in energy. He must have been saving it for this one or possibly just felt it more. I admit I teared up a little, partly because it was just well-danced but mostly because that DeVotchKa song is just heart-breakingly beautiful.

Stupid compilation video of "funny" bits of the judges. More dancing please.

Group routine – All That Jazz

Robert shone again here. By this time of the night, I started to understand how good he really is. Definitely the guy to cast in a touring show.

Ashley & Dominic – How Low aka ninjas

Ashley is sadly worse than on the show. Least improved which rather bummed me out. Couldn't find any live clips so here's the show version.

Lauren & Ade – Fever

Pretty dang good. Smoky. Can't find any clips of it though.

Kent & Allison – Sundrenched World

Muscular but frantic, powerful but missing the flow needed to really land this one.

Robert & Billy – Bollywood

A definite improvement from the show version. Robert just lit up the stage.

New Group Bollywood routine

This was fun, but geez some of those guys suck at Bollywood.

Group routine – Everything She Does is Magic

Lauren taking her place as was originally intended. On the TV show she was injured and Allison subbed in for her. Definitely more sweetly charming as it was obviously intended (at the time she was the only girl left going up against I think five guys). Still, on the show version Allison brought a strength and joy that Lauren didn't quite match. Also I'm biased because Allison is my ladycrush. This one really worked great in a live setting. Very happy they staged it.

Russell, Dominic, & Jose - New hip-hop routine

Unclear from my notes where this came in the order. It was fun and significantly better for Jose because it featured his skills worked into a routine. Dom & Russell were great as well.

Season recap video

Robert & Dominic – Scars aka scary clowns

Really looking forward to this one as I loved it on the show. Both guys had some flubs and an uncharacteristic streak of mushy movement that took it down a few pegs, but still pretty good.

Kent & Courtney – Amy

Headscratcher why this was included. Probably to give each dancer another routine. Kent still hasn’t lost that awshucks quality, but Courtney smoulders. She is seriously the sexiest lady I've seen in quite a while. I almost stayed after the show and got in the teenager-heavy autograph line just to talk to her up close. Woof, er...meow? Allison's my ladycrush but Courtney sets a fire.

Ashley & Ade – Drumming Song

Disappointingly off. The pair didn’t connect as one the show. The whole idea here is that Ashley is almost bonelessly being tossed about. She was great on the TV show but here she seemed to scale back, not trusting Ade to be there. C'mon Ashley this is your showcase. However, Ade is supa-hot. Dang, dude is ripped and when he does layout backflips my tummy flutters. Also, this is one of my favorite songs of last year. Florence got some serious pipes.

Adechike & Lauren (sub in for Comfort) – Fallin’

This was a good showcase for Adechike so of course they were going to perform it. Lauren's the best girl hip-hop dancer they have on the tour (and that's quite a compliment for this 18 yo) but she just didn’t live up to the passion of Comfort on the show. Still it works.

Kent & Kathyrn – Tightrope

Somewhere in here was also a group disco routine that incorporated all the best lifts from Doriana Sanchez’s routines over the past three or four seasons. It was high energy and fun. Robert, Ade, Allison, and Kathryn knocked it out here.

Billy & Ade – Mad World

I love this routine. Yes it's has a "socially relevant" theme and that usually bothers me on SYTYCD, but the beauty of it overcomes my knee-jerk objection. Still not sick of that song so it does some heavy lifting but geez the quality of movement from both of these guys is just breathtaking. Absolutely shows off their strengths.

Robert & Allison – Fix You

I like Travis Wall's choreography, he's particularly great at hitting the climax of a song with an energetic unison section. Still, he leans over the schmaltz line a bit here. I have a massive crush on Allison for the way she completely assumes the character in every piece she dances. In group routines my eyes were often drawn to her because of the passion and precision she exhibits. Really wish I'd seen her season start to finish. Robert continues his streak of fantastic work for the night here.

Lauren & Kent – Prom routine, then immediately into latin ballroom First Kiss

The screams, oh the screams. This looks like a good idea on paper, the winner and runner-up getting all lovey-dovey in back-to-back routines, but Kent looked tired at this point and frankly sucked the energy out of what was to be the climax of the show. Never cared for these routines myself anyway.

Group – You Can’t Stop the Beat

Best of the night accolades go to Robert, Lauren, Allison, and Dominic. Lackluster nods to Jose (of course!), Kent, and Ashley.

Overall it was a pretty good show, but suffered for not having ballroom experts Anja and Pasha on the tour. Lauren's tango with Pasha played a large part in her getting to the finale and likely winning. It clinched it for me anyway. Sad we didn't get to see much ballroom at all tonight. Also, I wish the Houston stop had come a little later on the tour. We got the second show and nerves were clearly present for some of the less-experienced dancers. It would nice to see a later show for comparison.

SXSW Film 2010 Day 2

2010-03-13T23:59:00.001-06:00

Late start today so I sadly missed Thunder Soul. It should screen again post-festival in Austin and Houston as it has strong local roots.

BARRY MUNDAY

Munday (refuse to continue the all-caps silliness) is similar to Knocked Up in telling the story of a loser guy who is forced to grow-up when a one-night stand results in a pregnancy, though the source novel predates Knocked Up by several years. Despite "preceding" it, Munday suffers from the same problem; we are expected to cheer on the "rehab" of a douchey dude who is practically required to fall in love with the barely two-dimensional, harshly critical female lead as they form a happy, conservative-dream-of-family in time for the credits. Despite this glaring flaw, the film is enjoyable if taken as probably intended, a minor relationship comedy.

When it works, it's largely due to the talented cast who wring the comedy from the script. Judy Greer, hamstrung by stereotypical stringy-hair-and-glasses = ugly and the aforementioned stridency, manages to humanize Ginger and deliver sharp line readings. Patrick Wilson, underutilized as a comic actor in his career, shines here creating far more laughs than the dialogue provides. Wilson is slightly miscast in that he's far too attractive and muscular to really be this character, and yet he convinces.

And here's where we get to something I noticed in my years of SXSW attendance. There's a score-creep phenomenon that occurs. The audience is eager and the filmmakers are often in attendance which can lead to better appraisals than the film might otherwise warrant. That isn't to say Munday definitely falls into the category, but I did pick up on an early tendency for the audience to perhaps overreact to jokes and mugging. The writer-director Chris D'Arienzo also engaged in my favorite, always-charming SXSW Film cliche, walking out onto the Paramount stage and being gobsmacked by the theater itself and the idea of it full of people wanting to see his film. Yes, we likey the film and the people who make them in Austin.

Documentary Shorts

A very strong program this year.

Seltzer Works
A profile of the last seltzer bottler in New York City. Gorgeously filmed and tightly edited, this is a modest but beautifully done short.

6
Six-man football is a largely unknown phenomenon of small town Texas. Unable to field full teams but loving the game as much for entertainment as the way it holds communities together, rural high schools play a small team, high scoring version of football. 6 is the best short doc I've seen in a long time. From pre-title set-up to action footage to deeply-felt interviews, this is practically perfect top to bottom and the audience knew it. No attempt to stretch this into a feature but giving its subject a full presentation, this is what short doc-makers should aspire to make.

Big Birding Day
Lovely images, but a lack of focus in recording the attempt to set the record for most birds seen in 24 hours leaves this doc at the bottom of the pack.

Quadrangle
She-said, he-said story of a couple who embraced the "free spirit" of the late 60s/early 70s and formed a quasi-group marriage with another couple. Made by their daughter, the doc presents their stories simultaneously in split-screen. It's an effective device and elevates the film above run-of-the-mill family bio docs.

Mr. Hypnotism
Profile of con-man hypnotist Dr. Dante by SXSW alumni Brandon Beesley. Competently made, the oily charm of Dante holds your attention.

White Lines and The Fever: The Death of DJ Junebug
An early hip-hop prodigy, DJ Junebug increasingly chose cocaine over turntables which led to his early death. It felt like the filmmakers wanted this to be a feature, but correctly ascertained that the story didn't warrant the length. Great production value, great talking heads, great use of music.

Micmacs à tire-larigot
[English translation: The Slidewhistle Micmacs]

A return to director Jean-Pierre Jeunet's (Amelie) earlier madcap films like Delicatessen and City of Lost Children, Micmacs follows the pattern of most Jeunet films: lovable, down-on-his-luck "orphan" Bazil (Dany Boon) finds a new family and fights a powerful enemy—here the arms industry—using his wit and talents. After smartly establishing Bazil's history and motivation, Micmacs essentially becomes a heist film heavily colored with Jeunet's standard-yet-gorgeous visual flair and comic sensibility. Bursting with Tex Avery-esque action setpieces, outsize characters, and just a hint of sentimentality, Micmacs is a perfect introduction to Jeunet's body of work for newcomers and another winning entry for devotees who will especially appreciate the sly references to previous films.

The rest of my evening was a bust: too late to get into American Grindhouse, Centurion secret show cancelled.

SXSW Film 2010 Day 1

2010-03-12T23:59:00.001-06:00

Worked 13 hours directing lines and dealing with minor problems at Registration while trying not to talk too much because of the canker sore on my tongue. So, super-awesome. Periodic "shots" of liquid benzocaine made it bearable and the day went well, no down-time on the computer network, no loud customer meltdowns (at least that I saw).

The one hiccup was a fire alarm where we had to clear the building. It was stressful but in retrospect it was kinda fun to use my best stentorian booming voice to overcome the general noise level. If it had been an actual fire, we might have lost the videogamers because the fire alarms went unnoticed in their room full of flashing lights and cacophonous bleepbooping. I had to take the mic away from the Rock Band participants and announce the evacuation.

With the 8 hours I worked yesterday adding to the general exhaustion, I didn't even have the energy to stay awake in a theater and watch American: The Bill Hicks Story. Oh well, it'll screen again this week.

Work then no work, food, a cop, Bruce, internet, this

2009-12-09T07:37:00.006-06:00

I have no sensible reason for writing today when I so rarely do anymore. Eh.

Yesterday morning I called my boss to see if they needed more staff for Tuesday night. She enthusiastically agreed so I went in at 10:45 PM. Normally a shift starts at 6:45 PM but I wanted extra sleep and to watch So You Think You Can Dance (yes, I watch that great show and will defend it vociferously). I get to work and my boss failed to add me to the schedule. As we were overstaffed anyway—why did she said she needed me?—they won't let me work "overtime". It isn't overtime as I was out sick last week, but the lunkheads in scheduling cannot understand the concept of working extra this week to make up for being out last week (shakes lowered head in defeat).

On the walk home from the light rail station (we have that here and it's great), I stopped at Katz's to eat. My lunch was in my bag, but coffee and noodle kugel exerted a siren song I was unable to resist, there being no ship's mast available to which I could lash myself. Satiated, I continued home only to be lectured by a cop. It went something like this, my thoughts in brackets:

Me: [OK, cop car slowly coasting to a stop sign, I'm good to cross. Uh, is he gonna just roll through the sign and consequently me?! Way to set an example police officer. OK, let it go and just walk on.]

Cop: "Hey...hey! Come here.

Me: [What is *this* bullshit?]

Cop: That was dangerous man. I know you have the right of way, but I almost didn't see you and this car is 3000 pounds and you'd lose that fight. If I was you I'd at least make eye contact when you cross the street to make sure I see you.

Me: [It's dark and your headlights are creating glare so I can't see inside the car, while I am clearly lit. And how does searching for your eyes prevent you from running me over?] You were slowing down for the stop sign.

Cop: I'm looking over here (points) because there was an accident here earlier and I didn't see you.

Me: [Ah, so in your refuse-to-be-accountable mind, my not anticipating that you'd be distracted and therefore ignore street signs and what's right in front of you is somehow my fault. I need to get out of here right now.] OK.

Cop: (more lecturing consisting of what he's already said in various combinations) If I was you, I'd be more careful.

Me: OK. (turning to walk on, burning with anger, and fighting the impulse to shout "If I was you, Officer, I wouldn't blame pedestrians for my inattention and law-breaking. You know, if I was you.")

The part that make it tolerable in retrospect was that a drunk guy at the adjacent bar was catcalling the officer during the entire exchange. I really should have gone back to at least acknowledge his enthusiastic defense of me.

When I got home, I amused myself mightily by looking up the words and guitar chords to Bruce Springsteen's "Dancing in the Dark" and playing it in fast waltz time. If I transpose it into a minor key, ditch the signature keyboard line, add viola, and sing it in a Tom Waits-ian growl, it will likely wipe out the optimism of the narrator, transforming him into a defeated, sarcastic bastard. I'm thrilled to give it a try. In the video, instead of being pulled onto the stage to awkwardly dance, Courtney Cox is stared like it's all *her* fault until she bursts into tears and runs out.

Unfortunately (for me, Bruce, the world) a cursory reading of one website's Best of the Year/Decade lists turned into a multi-hour timesuck and nothing else was accomplished this night. Except for this post.

UPDATE: On his website, Bruce Springsteen has posted his support for marriage equality in New Jersey. Yay Bruce.

Birthday Karaoke, The Hidden Cameras at Emo's 11/14

2009-11-19T14:33:00.004-06:00

What a glorious intersection of events this weekend contained. I traveled up to Austin on Friday for Margaret's initial birthday festivities which consisted of dinner, bowling, and karaoke at The Highball. Dinner was good and reasonably priced, bowling was great (beautiful, vintage lanes rescued from New Orlean's Rock and Bowl), and karaoke in the Xanadu room was...enthusiastically drunken? Tipsily cacophonous? The highlight for me was witnessing three inebriated lovelies blast through the birthday girl's titular song, "This Corrosion" by Sisters of Mercy. The word committed (both definitions) comes to mind.

Saturday afternoon, friends came together again for Margaret Birthday Party, Chapter II at the Carousel Lounge. Karaoke Apocalypse, whom I highly recommend, backed us up as our already raw throats were again put to the test. I feel I acquitted myself well on Heart's "Alone", but missed the mark a bit on The Cure's "In Between Days". Next time I'll tackle Devo's "Uncontrollable Urge". The band was fantastic, well-rehearsed and very supportive of the singers. I headed home early and exhausted to catch a nap before heading out that night to see one of my favorite bands, The Hidden Cameras.

It was their third time in town and I was ready to enjoy the show, but not be blown away mostly because they'd set the bar so high when they played SXSW several years ago. Still, I quickly was into it, dancing and singing along with the small, but loyal audience. After a great main set, they tore it up in the encore. For the last song, they once again pulled people up on stage to play tambourine, me included. So much fun to bang out the beat on a crowded stage hyped up on great audience energy.

Setlist:
Ratify the New
Follow These Eyes
Pencil Case
Heji/Bboy
Mind, Matter and Waste
Death of a Tune
Hump From Bending
Kingdom Come
Fear Is On
Walk On
A Miracle
Zine
Doot Doot Plot/Do I Belong/In the NA
The Little Bit/Underage/Silence Can Be a Headline

Encore:
Breathe On It
Smells Like Happiness
Music Is My Boyfriend

This night will live in my memory not for just the band's performance, but for a very enjoyable post-show outing that was facilitated by several very cool people. Laura, Lief, and especially John, thank you so much.

Colbert praises Alpha Dog nurse

2009-08-14T22:14:00.001-05:00

Just watch and enjoy.

The Colbert Report

Mon - Thurs 11:30pm / 10:30c

Alpha Dog of the Week - Betty Lichtenstein

www.colbertnation.com

Colbert Report Full Episodes

Political Humor

Meryl Streep

Now I have to call my Aunt and Uncle who live in Norwalk, CT.

Patients, like customers, are not always right

2009-08-10T08:22:00.002-05:00

Are you familiar with the website Not Always Right? I just became aware of it a week ago and have been making my way through their massive archive of retail hell stories that seek to "level the playing field for those of us who toil and sweat every day trying to juggle demanding customers and often unreasonable corporate expectations." Pretty funny stuff and I recommend it, though if you read too much in one sitting your contempt for humanity might poison your soul a bit.

I wish it had been around when I was working at a certain large electronics chain in the music/DVD/video game department. It would have soothed. Once after closing, encouraged by my co-workers, I performed a rant about customers being confused or even angered by the concept of alphabetizing which ended with me making the case for tearing out all the CD racks, digging a giant hole, and dumping in the CDs just so we could say things like, "Oh I think there's a rich vein of Celine Dion thereabouts."

That reminds me of the time that a middle-aged guy came up to me with a vague request for mood music. After a couple failed attempts to find what I thought he was looking for, Windham Hill-type music or cool jazz was what everyone else wanted, he leaned in close to me and murmured, "Mood music, you know, like for sex?" More than a little put off, and being the snarky little music snob I was, I marched over to the compilations section and put an Excursions in Ambience volume in his hands nodding portentously. Sure I was messing with him, but in all honesty, I think Seefeel, Air, and Spacetime Continuum provide a great soundtrack for doing it.

Anyway, I was especially excited/trepidacious to come across several medical stories on Not Always Right.

Story 1
Story 2
Story 3
Story 4
Story 5
Story 6

That last one reminded me of my patient who had had their aorta repaired just the day before. Since it was the part of the aorta that passes by and supplies blood to the stomach and intestines, she was NPO (no eating or drinking). She asked for ice chips and I explained that she couldn't have any.

"Your digestive system is not up to speed yet and taking in fluid could cause nausea and vomiting might cause your repair to bleed."

"The last nurse let me have ice chips!"

"Well she shouldn't have. The doctor has ordered nothing by mouth, I'm bound to follow his orders, and I've explained why it's detrimental to your health."

"But I've already had ice today," she whined loudly.

I told her politely but firmly that she could wet her mouth with oral swabs, but no more ice. What I really wanted to say was,

"Do you really want to risk massive internal bleeding for the ephemeral treat of ice chips?! Would you let your child eat candy until they writhed on the floor with a searing stomach ache just because Grandma let them go hog wild on a bag of Jolly Ranchers? Lady, get your priorities straight."

I like my patients, but sometimes...

HawthoRNe, not improving

2009-07-07T07:44:00.000-05:00

I finally got around to watching the 2nd episode of HawthoRNe. The fact that it sat on my Tivo for two weeks, and that I forgot to record the 3rd ep, tells us both that I wasn't looking forward to it all that much. Still, I said I'd stick with it for at least two more episodes.

"Healing Time" has a couple of name guest stars in Cloris Leachman and Malcom-Jamal Warner. Ms. Leachman's subplot, about a cantakerous, demanding patient who abuses the nursing staff led to a nice little speech by title character Christina Hawthorne, "Nurses are not servants. They are professionals. They should be treated with respect." Right on, superladynurse on a mission! No seriously, I loved that.

Warner's subplot was much worse in it's sentimentality, unrealistic medicine, and giant ethical no-no. He played a man with a cerebral aneurysm that initially caused decreased level of consciousness and impaired mentation (believable) that caused him to think Hawthorne was his wife (dubious), which she did not refute and in fact "used" to comfort him (not cool at all). Later when the doctors offer him with two treatment options—why they were asking him, a man they know cannot provide informed consent rather than his wife who's already been called by phone, is left unexplored—and the patient defers to his "wife's" judgement, she still acts the part and gives her opinion. Massive ethical violation, off-the-charts lose-your-license kind of violation. Boo superladynurse. Booooo.

So then...uh, no I've completely lost interest in continuing. Suffice to say the writing is still treacly, the humor tepid, the direction and acting pedestrian. If the next ep is equally as poor, I won't bother to write it up. Fingers crossed!

Simpsons + monkey ≠ Mr. Teeny, at least in this case

2009-07-06T06:38:00.004-05:00

Before I tell a couple stories from work, I have to explain that in medicine, D/C means discontinue. So when a doctor writes "d/c heparin", it means "stop administering the medication heparin from now on." OK, now that's defined.

The other night at work I went over to talk to a colleague and was startled by her patient's severe jaundice. I blurted, "She looks like a Simpsons character."

Thankfully the patient was sedated and didn't catch my rude comment. Later, the nurse came up to me, "After you left, I kept trying to think of which person on The Simpsons she looks like. Then I realized you meant all of them."

The same night another patient's chest tubes were draining a copious amount of clotting blood. The nurse had to manipulate the tubes frequently to ensure the blood passed into the collection chamber instead of clogging the tubes. It's rather mindless work and takes away from other aspects of patient care, but it's still necessary to perform. I suggested that a trained monkey with dextrous hands would really free her up, "Dressed up in little scrubs just squeezing and twisting away."

"And possibly making a mess I'd have to clean up, not to mention the chattering and infection risk," she countered, "In the morning Dr. Never Smiles would come by, annoyed, and write d/c monkey!"

You may disagree, but at 4 AM, "d/c monkey" is very, very funny. I ended up in tears stifling my laughter so I wouldn't wake the patients.

Houston Pride Parade & intermittent dance party

2009-06-28T03:10:00.000-05:00

I really had no excuse not to attend the parade since A) it happens at night when I'm awake anyway and B) the parade route is one block away from my apartment. Plus at least once a year I like to see my peoples all glittery and stuff. Unfortunately there was what I consider to be a serious dearth of glitter/feather/hi NRG silliness. Too many staid oil company employees and church groups, not enough gyrating. Also, I didn't check my camera batteries before I walked out the door and so no pictures.

The highlights for me were:

- PFLAG, cause parents in their 50s, 60s, and 70s marching in support their gay kids is a beautiful sight to see

- Lesbians Over Age Fifty, or LOAFers mostly because of the awesome elderly lady waving out the window of the car. I know it's wrong to infantalize old folks, but she was adorable and inspiring.

- The Asians & Friends group who all held giant Hello Kitty head placards. Kawaii indeed.

Afterwards, I met up with some Austin friends for an intermittent dance party. No one had the energy to stay out on the floor the whole time, so intermittent it was. Yay for poorly conceived "sexy" photos, putting a certain inebriated lady to bed, and fantasizing about band reunions (Smiths, Jawbreaker, Archers of Loaf, Afghan Whigs).

6 Months, 60 Minutes, 16 Songs

2009-06-25T01:53:00.004-05:00

So I made a compilation of songs I've been particularly fond of the last six months and wanted to share it. Enjoy, hate, or be suffused with dispassion.

UPDATE: If you register with imeem, you can full versions of almost all the songs. It's a nifty site.

[ed. note: The actual El Goodo track I wanted, "Aren't You Grand" wasn't available on imeem so I swapped in another good (but not as good) track. I wasn't able to find any tracks from Handsome Family's new, great album Honey Moon on imeem, which is why the playlist only has fifteen tracks. So after the Matt & Kim song, pause and go here to listen to a short clip of "The Loneliness of Magnets" and just imagine that old-timey sound continuing, then go back and resume this playlist. Or you could just skip this whole suggestion and destroy the integrity of this carefully curated flow.

6 Months, 60 Minutes, 16 Songs

Who's up for Six Flags?

2009-06-19T09:07:00.002-05:00

Friends,

I will be going to Six Flags in Arlington on Sunday 8/23 if you'd like to join me. It's the last day before the local school systems start up and the park is practically empty. As others who've joined me in the past can attest, it's glorious. No lines and on many of the rides, the employees will let you ride multiple times in a row. The park's open from 11 - 7, but I usually leave around 5 because I've ridden everything multiple times by then.

Spread the word and let me know so I can start planning carpools, etc.

Oh, and Joolie gets a free ticket from me because years ago it was my fault that she was denied rollercoasters and had to settle for the Stockyards.

HawthoRNe review

2009-06-18T09:03:00.002-05:00

This is a bit self-serving, but it's worth noting that three of the new medical shows (Nurse Jackie, HawthoRNe, and starting in the Fall, Mercy) have nurses as main characters rather than doctors. As a nurse myself, it's about damn time. One main character and a handful of secondary ones on ER never cut it. Don't even get me started on the often nameless, ignorant, frequently dumped on nurses that populate the background of House, Grey's Anatomy, etc.

I was reading an online review (which inspired me to write my own) and it was telling that several commenters on the review didn't get that the main character isn't a doctor. We're so used to doc-focused shows that it's going to take some effort to get the necessary shift in the viewing public's mind. My biggest beef with the doctor-focused medical shows (aside from the frequently awful misrepresentation of actual medicine) is that they take away the work of nurses and give it to doctors. Why? Because non-trauma doctors mostly examine, diagnose, and write orders. Not exactly heartwarming or exciting. Doctors don't hold patients' hands, get social work consults, or stay at the bedside at the bedside continually monitoring and responding to changes in condition. All that shocking the patient and giving medications in a code? Never actually seen a doctor do it, always nurses. Sure the doctors there giving orders, but it's all mental work though which while absolutely important isn't terribly heartwarming or exciting to watch.

I'm going to write more about this phenomenon in the future, but I'll move on to the show at hand. HawthoRNe (and yes, that's a stupid name) features Jada Pinkett Smith as the Chief Nursing Officer of a mid-sized hospital. I don't watch The Closer or Saving Grace, but I get the impression that HawthoRNe is a continuation of the "strong woman taking on a male-dominated world in which she is underestimated" theme. Unfortunately, Hawthorne is portrayed as a superwoman capable of practically anything. Here she is starting an IV in a newborn's head vein! There she goes defending her staff against arrogant, deeply wrong doctors! Ad nauseum. She's too good. It's the pilot still, so hopefully she'll settle down and fail in future episodes.

I rather doubt the show will stick with a realistic portrayal of a Chief Nursing Officer, which is mostly meetings and paperwork. Why a CNO? It's an important job and gives an excuse to have her roam all over the hospital, but the position is not all that interesting. There was a much better opportunity for stories at the patients' bedsides and over hospital policy if the character was nurse manager of a unit. Oh well.

OK now I get into overcritical mode over specific plot points.

- If a knowledgeable nurse tells a doc that a patient has a Do Not Resuscitate order, the doc doesn't say, "Show it to me in the next five seconds or I don't believe you." The correct way to over-dramatize the scene is for the doc to note that attempted suicide is not covered by DNRs. Of course that route doesn't serve double-duty to show that the doctor is a jerk while Hawthorne is a fierce patient advocate and all-around superlady type.

- No surgeon would ever want to get this call in the middle of the night, "Uh, your patient is up on the roof threatening suicide. Do you want to hustle down here and talk him down?" Clearly Michael Vartan's character (portrayed as a surgeon, but the attending doctor for a cancer patient???) is supposed to be the shining white knight among the doctors, but this was a rather goofy way to try to get that across.

- A CNO would never not contact Child Protective Services as it professionally negligent and in this case would probably mean suspension of license and therefore loss of job. And making a social worker be the bureaucratic bad guy? Let's not exalt nurses and crap on social workers OK? We're all good guys.

- The "giving the patient a handjob" scene. Yes it seems gimmicky, except I can cite an actual occurrence of this shameless, really unprofessional activity. The nurse who did it giggled about it to two colleagues who didn't report it. Manager found out and fired all of them. So, believeable on this show.

Semi-accurate portrayals:

- Mention of verbal abuse from docs (a real, unacceptable issue) which was immediately undercut by stupid "paramedic is cute" comment.

- The "you're a guy, you must be a doctor" misunderstanding. Happens all the time to me and other guy nurses even when we're wearing the same scrubs as the women. Is it so hard to believe these days?

- Questioning doctor's orders when they don't seem reasonable, though 6 units of insulin (what kind of insulin? Though that may be a bit too picky) isn't crazy. And is definitely, definitely the nurses job. "Just following orders" isn't a defense against getting your license yanked for violating the Nurse Practice Act. The questioning the order scene was decent, but we really didn't need that nurses-are-just-failed-docs bit. I love being a nurse and would never want to be a doctor. Two quite distinct jobs not on a continuum (damn you ER's Abby Lockhart). Also, no recapping your needles! You're a suck-o nurse for that. Lastly, insulin overdose doesn't cause shockable heart arrhythmias. And if you were that worried, check his blood glucose as a follow-up, if you see it drop below normal levels, give the patient some orange juice. That's good nursing care. I'm not impressed with your work.

OK, that's enough. If this wasn't my profession, I wouldn't be watching the show. The feel-goodiness of the show is too saccharine, but I'm going to keep watching for a few eps to see if this mellows and to see how they handle the portrayal of nurses as main characters.

I don't have Showtime, so I haven't seen Nurse Jackie, which is a much more jaundiced view (in keeping with an ED nurse's job I'd say) apparently.

A trip to see Grizzly Bear

2009-06-17T21:29:00.001-05:00

After their fantastic performance during SXSW, I couldn't miss seeing Grizzly Bear again when they came to Austin on Tuesday night. Thirty minutes outside Austin, I realized that I'd left my wallet in Houston. Slightly troubling as I had no cash, ATM card, credit card, or ID to get into the show. Counting on the good graces of my credit union, the venue staff, and my own earned music karma, I wasn't overly concerned. First, I went to my beloved credit union, who helpfully explained that they could give me $100 after asking some security questions. So pleasant.

Then I called Joolie to set up dinner plans and then was off to trade in some CDs. Waterloo Records was staunch in their no-Texas-ID-no-trading-in-IDs policy, so I headed to End of an Ear which was second on my list only due to geography. Having no ID policy and by virtue of the owners knowing me, I traded in some unwanted music for the new Vaselines compilation (Remastered! Live versions! Naïve, superfun pop!), Baby Loves a Funny Bunny by Fuck (in a wonderfully designed matchbook package), and classic album that will end up as a gift for a friend and therefore will not be mentioned by name here. And I still have an $ 0.80 credit! While at the store, I happened into an in-store for Here We Are Magic, who were opening for Grizzly Bear that night. I liked them well enough.

A call to a Walgreen's in Houston confirmed that I hadn't left my wallet on their counter which meant it was probably sitting in my apartment. "No worries! Everything will work out fine!" he fervently said out loud to no one.

Arrived at House Pizzeria to find a pleasantly designed restaurant with a nicely stocked jukebox. The music's a mix of classic country and whatever we're calling Elvis Costello-Wire-Lou Reed-The Pixies-etc. and I passed the time waiting for Joolie and Mr. Joolie thinking of a setlist that would drive out the abrasively loud and demanding children over there in the corner, not the sweet little thing that eventually sat next to us. Between us we ordered Potato & Goat Cheese, Pepperoni, and Olives & Capers pizzas. Another friend and boyfriend showed up to my delight, and we gorged on yummy pizza while chatting amiably.

I realize now that when Joolie asked me about work and I shrugged it off with a "same old thing, nothing interesting" that I was being a bit too dismissive. Of course interesting stuff happens at work, I guess I just wanted to talk about something else. Sorry Joolie! I'll work on some stories for you.

From there I was off to a quick hello to my poker buddies who had just started the regular Tuesday game (it's been so long since I played, sigh) before heading down to The Parish for the show. I barely started my woeful shpiel about the forgotten ID, when the list guy said, "Yeah he's here," and the ID guy looked at me for about 10 seconds before slapping the drink band on my wrist. It's good not to look anywhere close to 21 sometimes. Oftentimes.

I have excellent music karma which has aided me in the past and will likely continue to do so (does citing music karma cause one to lose some?). I recall one extreme example at my only time seeing New Order. My friends and I had lawn seats at whatever their calling Starplex in Dallas these days, but having laid in a surfeit of good relations with the security staff, we were able to slip up to the front section for the openers (808 State, Stereo MCs) and then neglected to leave. When New Order hit the stage, we had managed to worm our way up to 3rd row from which seats we were never kicked (silly non-showing up ticket holders). After a pretty good show, which ended slightly early in that Bernard Sumner stalked off stage before the (according to the setlist we snatched from the stage) final song of the encore "Blue Monday" (my heart breaks), we were too hopped up to just leave. So I and one friend ran around the back of the venue, crawled under a gate, and insinuated ourselves with a group of lucky people escorted backstage to meet the band.

This was back in the days when I'd pursue autographs, so we got Gillian and had joined the throng around Bernard when my friend was discovered not sporting the required sticker and was rudely propelled out the gate. I had thought to drape a shirt over the spot where the sticker should have been and so went undiscovered. Sure Bernard sometimes is a jerk to his bandmates, but kudus to him for standing there for 30 minutes politely asking each fan their name so he could personalize the autographs. Nice guy.

Blah, blah, blah. The Grizzly Bear show was very good. I'd write a review, but just read this as I completely agree.

From there I dropped by some night owl friends' place to chat for a bit that turned into a couple hours, before heading over to the Joolie and Mr. Joolie house for some leftover pizza and a much needed nap. I crept out again at 6 AM to hit the road back to Houston where I found my wallet right next to my computer.

So happy ending all around.

RIP Leigh Boone

2009-05-07T06:17:00.004-05:00

A couple weeks ago I was walking home deep into the early morning hours when I was brought up short by this memorial.

The bicyclist who was injured in the multi-firetruck crash I wrote about here died twelve days later.

I find specific, handmade public memorials like this beautiful and moving. Though they are often not as cleanly designed as the Oklahoma City National Memorial or the Vietnam Veterans Memorial for example, they are as conceptually loaded and resonant. Austinites, think of the tribute to Ivan on the Lamar at 5th St underpass. Have you ever wondered who Ivan was? Or who renewed his memorial from time to time?

No surprise that there's a book that speaks to this phenomenon.

UPDATE:

My friend Patricia clued me in to the Ghost Bikes phenomenon. Boone's memorial is included on the website.

National Nurses Day

2009-05-06T21:15:00.000-05:00

Today is National Nurses Day, though the party doesn't stop here. National Nurses Week continues through May 12th, Florence Nightingale's birthday. To all my fellow nurses, we are teh awesome, the bee's knees, the cat's pajamas, the snake's hips, the caregivers par excellence, the sine qua non and other such terms of wonderfulness. Woooo!

A couple years ago at the last National Student Nursing Association convention I attended, the keynote speaker whipped up our professional egos by insisting that we think of ourselves as "a treasure". Being the kind of smartypants we were, my group started exploiting this immediately. For the rest of the day it was, "Fetch me a drink, I'm a treasure!" and "I don't see why I have to finish this 30 page care plan, after all, I'm a treasure." So, this is me, thinking I'm all treasury at least for the next few days.

Black Crystal Goatwolfdeerbear

2009-04-15T08:33:00.002-05:00

This list of goat-monikered metal bands recalled an impromptu contest we had in the SXSW badge print room this year. The question was, "How many bands playing this year have 'black' as the first word in their name? As long as 'black' is first everything counts, i.e. Blackie." I guessed 12, the winner guessed 15, it was actually 18. Dang.

Then I remembered one of the games at a Saucony-sponsored day party. It was Pin the Crystal on the Overused-in-Band-Names Animal. Blindfolded (w/ Saucony shirts) contestants attempted to place a crystal magnet in the target area of a wolf, deer, or bear. Who knew the Saucony people were capable of such wit?

Birthdays and Morrissey

2009-04-14T17:12:00.002-05:00

After finishing up my Advanced Cardiac Life Support class on Saturday, I hopped a bus to Austin for Mybloodyself's birthday party. It had all the classic elements: good people, food, alcohol, dancing. This year brought the added element of shirtlessness whilst dancing. There is photographic evidence somewhere out there.

Sunday was laid back for the most part. Dinner at Titaya, so that we wouldn't become hungry on our subsequent emotional journey, then off to see Morrissey at Bass Concert Hall. Of the times I've seen him, this was the most aggressive and rocking. Didn't tear up for "How Soon is Now?" like the first time, but it was certainly affecting. Would have liked more early solo work, but I'm not going to argue. Thanks to Mybloody for getting tickets and this setlist.

1. This Charming Man (Smiths)
2. Billy Budd (Vauxhall)
3. Black Cloud (Years of Refusal)
4. How Soon is Now? (Smiths)
5. Irish Blood, English Heart (Quarry)
6. When I Last Spoke to Carol (Years of Refusal)
7. How Can Anybody Possibly Know How I Feel? (Quarry)
8. I'm Throwing My Arms Around Paris (Years of Refusal)
9. Some Girls Are Bigger Than Others (Smiths)
10. Something is Squeezing My Skull (Years of Refusal)
11. Seasick, Yet Still Docked (Your Arsenal)
12. The Loop (World of Morrissey)
13. The World is Full of Crashing Bores (Quarry)
14. Death of a Disco Dancer (Smiths)
15. One Day Goodbye Will Be Farewell (Years of Refusal)
16. I Keep Mine Hidden (Smiths, a B-side to a single)
17. Sorry Doesn't Help (Years of Refusal)
18. Ask (Smiths)
19. Let Me Kiss You (Quarry)
20. I'm OK By Myself (Years of Refusal)

21. First of the Gang to Die (Quarry) -> Swingin' on a Star (cover)

Monday I was back on the bus to Houston. The flip over from being awake during the day to at night occupied Monday night (there is a process) and now I'm off to work. Oh and Happy 15th anniversary Turner Classic Movies, you are a great TV channel.

No car, no problem + tuberculosis!

2009-04-08T08:37:00.001-05:00

I chose not to replace my broken-down car when I moved to Houston for my job. I'd already picked my neighborhood for it's walkability and proximity to public transportation. Aside from trips back to Austin, a car was superfluous. That decision is now numerically quantifiable via this website. I score an 83/100. Ignoring the rampant advertising on the site that might skew the results, how 'bout you?

Also, via that site's Google map of my area, I saw something that I'm shocked I hadn't noticed before. I live fairly close to Houston's old City Tubercular Hospital. Online searches reveal no details. This bears closer examination.

This night, that night

2009-04-07T09:07:00.001-05:00

Another dichotomous pair of nights a little while back. The first was the easiest night at work I've ever experienced. Came in at 6:30 PM to find out we were overstaffed and it was my turn to float to another ICU along with a few others. The ICU supervisor changed her mind at the last minute and kept me on my home unit, but by that time everyone was assigned and so I had no patients. I'm decidedly not a "whoo-hoo, extra break time!" kind of person, so I helped out all over the unit with transfers out, completing paperwork, and helping bathe patients.

When it was close to 11 PM, we were still overstaffed, in part due to the transfers with which I helped, so I floated to a medical ICU upstairs. Though we're all ICUs, the ones upstairs from my cardiovascular surgical recovery unit are arranged differently both physically and in terms of workflow. They use some computer charting that we don't, supplies are stored in different places, medications available on the unit are slightly different, etc. Thankfully, the med ICU staff observed both common sense and policy in giving me a fairly simple pair of patients. When floating to such a different environment, this is the way it's supposed to happen. Just as we would never assign a fresh surgical patient to a float to our unit, they're not supposed to assign us just-admitted patients or unstable ones because we aren't familiar with the lay of the land.

Both my assigned patients were doing fine. One was due for transfer out of the ICU to a regular acute care floor, there just weren't any beds available. His big issue was very high blood pressure, we're talking 200/120 (normal is less than 120/80), which kept surprising me for the first few hours. Though his status only warranted charting blood pressure every four hours, out of ICU habit I still recorded it hourly. When I'd peak in to read his BP off the monitor, seeing 190/100 or somesuch kept making my brain go, "Too high, ack! Must take action! Assess patient, medication, notify doctor!" In reality, he'd been living with blood pressure this high for awhile and rapidly bringing it down would put him at risk for a stroke. The plan of care was slow reductions through careful increases in his medications. As the night progressed and he slept soundly, the pressure came down nicely.

The other patient was a lovely lady who's heart arrythmia caused fainting spells (syncopal episodes) at home. With medications administered at the hospital, that arrythmia was now under control and she would probably be transferred to the floor the next day or even discharged home. We had a few nice conversations and I reinforced some of her health teaching. It was such a slow night that I finished all of my online education modules that aren't due till October and tried, mostly in vain, to help out the other nurses on the unit. A couple of them joked (semi-seriously) that I was so willingly helpful that I should transfer to their unit permanently. A nice compliment, but also a necessary trait on my home unit. Easy, easy night.

Just a couple nights later I was back "home" working with another nurse in caring for an unstable patient. Blood pressure propped up with several continuous IV medications, multiple blood products needed, an air leak in one lung causing massive accumulation of air under the skin, no neurological response to painful stimuli hours after surgery - very sick patient. The air leak was the most immediate striking. Because his lung wasn't completely sealed like in a normal person, every "breath" delivered by the ventilator caused some air to leak into the body cavity resulting in subcutaneous emphysema. Chest tubes inserted in his chest were helping drain fluid and air, but couldn't keep up. So air accumulated in the chest, then made it's way down the arms and up the neck to his face.

When there's a little accumulation, you can feel and hear air bubbles popping under the skin. It's called crepitus and it feels (and sometimes sounds like) Rice Krispies. In this patient, the accumulation was so great that his skin bulged out and sounded resonant like a drum when percussed. Warning to the especially squeamish, there's no blood but maybe you don't want to see this (not our patients BTW). His chest x-ray was incredible. Because of all that air, you could see the striation pattern in the pectoral muscles, something that won't turn out on a normal x-ray.

He didn't look good, but subcutaneous air isn't especially dangerous in and of itself. More important was the blood pressure and the fact that he wasn't waking up. We had orders to paralyze him with medications, but we never started them because he wasn't moving around at all, even to painful stimulation.

As I explained here, when we're working as a two-nurse-to-one-patient team, one person does the charting and directs the team, the other person performs the physical work. I took the physical role this time. It worked out well, because she needed to sit down for most of the night and my brain wasn't running 100% due to poor sleep the day before. I'm pretty well-known for being let's say energetic at work. This night, around 4 AM, I walked past our charge nurse and she pulled a double-take. "I've never seen you look so worn out. What's that patient doing to you?" she half-joked. It was true, except for a 30 minute lunch, I didn't sit down the entire night.

At one point, the patient's heart converted to an arhythmic condition which impacted his blood pressure. We gave an arythmia medication to try to break him out, but it didn't work. We moved on to synchronized cardioversion where we attempt to shock the heart back into a regular rhythm, but that too failed. Still, we kept the blood pressure up, the pulses intact, and the oxygenation status good. In the morning, the attending physician - a notoriously critical doc - actually told me and my partner nurse, "Good job." Could have knocked us over with a feather.

That's how it goes at work. Sometimes you have an easy night and sometimes you get beaten up.

Grad school for free?

2009-04-02T08:14:00.001-05:00

A bill has been introduced in the U.S. House that would essentially pay back student loans for grad students who commit to becoming faculty at nursing schools. Since that's the whole reason I want to go grad school, I fully endorse this effort.

Time to contact my Representative and Senators.

UPDATE: Just read a Washington Post story much like others I've been seeing lately about how the nationwide nursing shortage is being relieved in some areas due to nurses returning to the profession or upping their hours to full-time. This surge is being explained by nursing being a steady, good-paying job in a terrible economic climate. I know a few nurses who went back to full-time because their spouses lost their jobs or took pay cuts.

The WaPo article goes on to note however that this trend will not be able to keep up with demand in the near future. When the economy recovers a bit, lots of nurses will go back to part-time or less, and those who put off retirement will leave for good. Relevant to my original post, the article notes that too many potential nurses are being turned away from nursing schools due to lack of faculty and mentions the bill reimbursing nursing faculty for grad school costs.

Emergency close to home

2009-03-31T16:30:00.002-05:00

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

SXSW Music 2009: Day Four

2009-03-22T15:34:00.002-05:00

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.

Telekinesis
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.

Humpday
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.

SXSW Music 2009: Day Three

2009-03-21T12:08:00.002-05:00

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.

Phosphorescent
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.

Alash
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.

Tricky
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.

Devo
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.

Setlist:
Don't Shoot, I'm a Man (new song)
Peekaboo
new song
Going Under
new song
Girl You Want
Whip It
Secret Agent Man
Satisfaction
Uncontrollable Urge
Mongoloid
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)

SXSW Music 2009: Day Two

2009-03-20T11:51:00.003-05:00

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.

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

Wavves
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.

Busdriver
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.

SXSW Music 2009: Day One

2009-03-19T10:41:00.005-05:00

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

Gallows
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

2009-03-19T02:34:00.004-05:00

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.

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

2009-03-18T01:15:00.002-05:00

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.

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

2009-03-17T12:51:00.004-05:00

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!

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

2009-03-16T09:28:00.001-05:00

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.

Nailed it: Those little patient details

2009-03-15T15:52:00.003-05:00

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

2009-03-15T01:08:00.005-05:00

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.

Objectification

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.

Moon

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.

SXSW 2009: It begins

2009-03-13T09:36:00.000-05:00

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.

Legislating nurse to patient ratios in Texas

2009-03-12T23:51:00.001-05:00

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.

You just can't believe me

2009-03-09T15:52:00.003-05:00

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.

Beatbox Timesuck

2009-03-05T05:02:00.002-06:00

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?

2009-03-05T01:21:00.003-06:00

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.

Say it with me

2009-03-04T23:07:00.000-06:00

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.

25 Albums That Changed My Life

2009-03-03T06:13:00.002-06:00

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.

Good news for terrible music fans

2009-02-27T03:56:00.003-06:00

Dear lord this is so Strongly Disagree it goes all the way around to being Strongly Agree, if you believe that Likert scales are circular or perhaps Möbius strips.

These guys have taken lots of popular songs and run the vocals through Microsoft’s Songsmith which purports to compose music behind bedroom singers’ tunes. It’s truly awesome/terrifying. I won’t prejudice you with my favorites, just explore and be entertained. Yay for the internets!

Oh well, here’s one favorite not on the site above, “Runnin’ With the Devil”.

Moving up, in one way

2009-02-26T20:52:00.000-06:00

After showing interest, I've been appointed one of my unit's representatives on the Staff Nurse Professional Practice Council. This is a group of bedside nurses (as opposed to management) representing every unit and service in the hospital who gather to discuss policy, lobby for change, and serve as a communication link as part of a shared leadership model. Fancy words sure, but so far I'm seeing the value. Other services like nutrition or pharmacy can present to us, get nursing feedback, and together we can make make beneficial changes. It's also a forum where we can discuss matters both positive and negative with the Chief Nursing Officer.

As our unit is large and employs many nurses, we have two representatives, one from the day shift and one from nights. It should come as no surprise to my friends that I'm taken on this role; I tend to be an enthusiastic change agent. Flipping to daytime wakefulness once a month is no fun, but it's nice to get paid for an eight-hour meeting.

In reference to the title of this post, I'm moving up professionally in that I'm entrusted with representing my co-workers. At the same time, I'm a little frustrated that I haven't gotten the opportunity to advance clinically in the manner I'd like. They've only had one training class since I've gotten off orientation, but I really want to start taking kidney and liver transplant patients. They have special needs that vary from our standard patients, but having talked it through with experienced nurses I should be able to handle them without a problem. It's just a matter of being offered the class and checked off on the knowledge. I also would like to get checked off to run two pieces of equipment that are frequently used, CVVHD units (continuous dialysis) and balloon pumps (support heart function). There's a waiting list for the training of course and more tenured staff are ahead of me, but I'm champing at the bit for something more.

Shameful

2009-02-25T22:45:00.001-06:00

Two nurses in Wisconsin were reported to police for taking cell phone pictures of a patient’s x-ray showing a “sex device” stuck up his butt. And then one of them allegedly posted it on Facebook. Total, unethical idiots. Way to promote the profession classy ladies.

2:1 nursing

2009-02-24T21:06:00.000-06:00

Recently I’ve been the 2nd nurse for 2:1 patients a few times. These are patients whose care is so demanding that two nurses are needed to provide it all. They are usually unstable and on external devices to support their heart and/or kidney function.

In the most recent case, the patient was on ECMO which stands for Extra-Corporeal Membrane Oxygenation. On ECMO, the patient’s blood supply is routed out of the body via tubes inserted in the large arteries or more commonly veins in their groin to a device that oxygenates the blood before returning to the body. It’s used when a person’s lungs or heart-lung system isn’t working properly. Before ECMO was started on this patient, their supposed-to-be oxygenated arterial blood was black rather than the normal bright red. Post-ECMO insertion they were doing much better.

The workload for 2:1 patients is divided into inside and outside nurse. The outside nurse is more experienced and is the brains of the team. They made the clinical decisions and chart. The inside nurse is the hands of the team. They administer medications, adjust IV flow rates, draw blood for labs, suction the patient, etc.

It’s a show of confidence and respect that I’ve been assigned to be the inside nurse and let me tell you I was both proud and raring to prove myself worthy. Each time it’s worked out very well. It helps that I’m friendly with pretty much everyone at work and get along very well with the veteran nurses that often lead the 2:1 teams. It’s great experience and I look forward to doing it in the future.

Smartier and smartier

2009-02-22T01:24:00.001-06:00

Joolie likes learning. I like learning too. Whoo for dimensions 3, 6, and 9!

Visitors, not the alien kind

2009-02-15T22:35:00.002-06:00

Daniel and Elana came down to visit me this weekend. I've not been very aggressive about inviting people down so it was nice when Daniel expressed interest a little while ago and we were able to work out a good time for all of us. Rain delayed them on Friday night so by the time they arrived, we only had the energy for beer at a bar/coffee shop around the corner.

It's an interesting place, but noisy at night and as I usually like to read when I'm alone, I don't go often. We had a spirited conversation about Lost and sending NSFW-but-rather-tame photos to friends' cellphones. Now that there's sufficient medical applications for the iTouch, I'm starting to think about getting one. You know, for work.

Saturday was leisurely as well. A little "antique" store and fabric store perusing before we headed to the museum district. After a tour of the museums last year shortly after moving here, I've been holding off on revisiting so as to have a visitor-friendly destination just in case. We only managed to get to the Menil main building and the Cy Twombly annex (I'm not a fan) before rain sent us scurrying. We ate a nice Thai dinner and then returned to my place for whatever we're calling disco naps now. I guess we were all exhausted because the disco naps turned into sleeping all night.

After a serviceable Sunday meal (there was no slice of cantaloupe at the end so I could hardly call it brunch), D&E were off and I puttered about doing laundry for the work week ahead. If others want to visit, I'm game. Just book with me with plenty of advance notice so I can arrange my work schedule and flip over to being awake in the daytime.

Frankly, the kids are bored

2009-02-13T23:48:00.002-06:00

Today I took some high school boys from a local Communities in Schools project on a tour of my hospital unit in a likely vain attempt to interest them in nursing. One of the nurses in the education department regularly brings high school kids in to generate some interest in medicine as a future career. The groups vary in enthusiasm I was told and this one was only slightly more engaged than our sedated-into-unconsciousness patients.

I gave them a rundown of what our patient population was like and the role of the nurses on our unit, trying to make it sound exciting (it really is) and rewarding (emotionally and financially). When that failed to inspire any questions or even change in facial expression, we went through the various medical TV shows and ascertained which were reasonably accurate (ER, though with less death of staff) and which were ridiculous (Grey's Anatomy, Scrubs, House). That ate up five minutes. Thank goodness the Communities in Schools staff had good questions. I think I might have even convinced a staffer to consider nursing.

After the unit tour, we went to lunch with several other male nurses speaking as part of a panel. The best part of the day was when we shared our stories of how and why they got into nursing. The kids couldn't of cared less but I was inspired, especially by the guys who immigrated here. I'm a big dork about this, but I really do love nursing and have an inordinate amount of pride in the profession so I love to hear stories from co-workers about how their making a difference in people's lives.

I'm on the list now so I'm sure I'll be presenting again to students in the future. Here's hoping the next group is a little more receptive.

Footwear

2009-02-11T02:03:00.001-06:00

All through nursing school and through most of my first year working I wore athletic shoes to the hospital. I've never cared for the chef shoes that are popular and, though I don't own a pair, I can't imagine that Crocs provide enough support for me.

Last year a friend of mine who works long hours in retail recommended I try out Z-coil shoes. After a test run I decided they worth the hefty price tag. I don't have back or joint problems, but knowing their prevalence in the nursing workforce I figured I'd try to head off any future problems. Nurses are rather fond of prevention.

They're not particularly stylish and what with the thick heels, I sometimes feel like Karloff’s version of Frankenstein’s Monster. When wearing them I have to be vigilant of feet placement. It would be rather distressing for all involved if IV tubing got caught in my shoe coils and I were to yank a large central line out of patient's neck. It's second nature to me now to look down at my feet whenever I'm at the bedside.

Now I need to pull out the receipt to see if taking the tax deduction for work-related apparel is worth it.

Frustrated plans and a girl named Scout

2008-10-20T05:47:00.005-05:00

After the Magnetic Fields show in Austin on Tuesday, I worked three days in a row. I never like doing that, it exhausts me. Friday night I started with two patients, transferred one to a different ICU around 11 PM, came back to pick up another patient, and transferred that one out to another ICU at 3 AM. Whee.

Saturday was sleepsleepsleep, then up and downtown for a free Girl Talk show. I'm not a big fan of his, but couldn't turn down a free night of sweaty dancing. Any time I think I'll be in line somewhere, I bring a book. Wanting something that would fit in my pocket and could be cast aside if need be, I started reading To Kill a Mockingbird again. I've read it every couple years since 8th grade and its pleasures never cease. Sadly, I slept in too long and after waiting in line for an hour the venue was full.

Through most of that hour I was able to tune out the conversations around me but this one comment pierced my bubble of reading satisfaction, "If you see kittens that aren't the same color as the mom or dad, that means that the mom got like, gang-raped." I didn't hear what preceded that bit of science, but I doubt that context would have helped.

Denied my original entertainment plan, I walked across downtown to the Angelika Theater thinking there would be something I'd want to see. Bought a ticket for Burn After Reading and was promptly driven mad by the jittery picture and loud projector. Twenty minutes in I had a headache from trying to focus on the screen. Nice manager said she couldn't fix the picture and wrote me out a free pass without me having to ask.

So back home and a marathon reading session to finish To Kill a Mockingbird. A bust of a night was redeemed by the wonderfulness of Harper Lee's prose. Sometimes I wish she'd written another novel, but mostly I'm just glad that she sent this one out into the world.

Magnetic Fields 10/14 in Austin

2008-10-15T05:16:00.002-05:00

Every time The Magnetic Fields play in Austin they upgrade from the previous venue. This time it was at the Paramount and I wasn't surprised to see the orchestra section full and a good chunk of the balcony occupied. It was also old-home week as I chatted with several people I haven't seen in years. I'm generally not a fan of seated venues - too staid - but it works for MF. They haven't had a rhythm section for 14 years and play at a moderate volume and tempo.

After a fun set of very short, nonfiction stories and very short, news-of-the-day songs (with a slide projector providing visuals) by Michael Hearst, MF took the stage. Before the first song, Claudia asked the audience, "Are you ready to rock?" To which Stephin replied, "Then go somewhere else." Ba-dump bump crash (cymbal). Aside from the actual songs, Claudia and Stephin's banter provide a good bit of the entertainment.

Of note was the debut of Stephin's new bouzouki purchased that day. The previous one had grown fatigued. This reminded me of the throwaway gag in This Is Spinal Tap when the manager Ian rants about how hard he works for the band to little appreciation, "Do you know what I spend my time doing? I sleep two or three hours a night. There's no sex and drugs for Ian, David. Do you know what I do? I find lost luggage. I locate mandolin strings in the middle of Austin!" Which is very funny to me because it was and remains tremendously easy to find mandolin strings in Austin. Less so with new bouzoukis but still.

Also, though Claudia is terribly excited by the idea of Holiday coming out on vinyl because she loves the cover, it will not be the next vinyl release. That will be 69LS next year to celebrate the 10-year anniversary. I hope it comes with a big version of the little book.

Setlist (with notes):

When I'm Out of Town
No One Will Ever Love You
Dear lord do I love Shirley's voice.
California Girls
Lots of laughs for this one.
Walking My Gargoyle
Claudia: Sadly The Tragic Treasury sold out tonight making several songs less...
Stephin: Urgent.
The Nun's Litany
All My Little Words
Old Fools
I Wish I Had an Evil Twin
Dreams Anymore
This Little Ukulele
Personal freak-out as I adore this song.
All Dressed Up in Dreams
Wonderful harmonizing from the ladies.
Javier Says
Claudia: This song is about two homosexuals in the East Village throwing shit at each other. Verbally. Like "Uh-uh Mary."
Stephin executes pro-forma, entirely sass-less Z snap to the delight of all.
Zombie Boy
Several aborted starts as Stephin interrupted to say things like, "Everyone is someone's
zombie boy."
Papa Was a Rodeo
Swoons all around.
(Intermisson)
Take Ecstasy With Me
Strangled screams of pleasure from some.
Courtesans
Crows
Love this! Creepy, weird, and wonderful.
The Tiny Goat
As always, heartbreaking.
Too Drunk to Dream
Raucous adoration for this one.
The Book of Love
Sam looked particularly sentimental here.
Give Me Back My Dreams
Drive On Driver
What a Fucking Lovely Day!
Introduced, "So Tu An-Gu has just impaled what he thinks is the orphan of Zhao and then he sings this."
Yeah, Oh Yeah
With Claudia swanning about the stage
It's Only Time
Claudia notes that after the previous murder ballads, this one is often played at weddings. To which Stephin added, "Before the murder ballads begin."

Encore:
Three-way
First "Three-way" just Stephin, John, and Sam. 2nd was Claudia, Shirley, and an
out-of-the-wings Michael Hearst. 3rd was really a six-way.
As You Turn to Go
Grand Canyon

Musically gorgeous (aside from that mic short explosion that startled everyone), attentive audience, great setlist; it was a wonderful show and exceeded my expectations.

Sometimes I can only be funny in my own head

2008-10-01T19:21:00.001-05:00

I met with my new nurse class again and one of the topics was dealing with workplace stress. The presentation was mostly garden-variety stress management techniques with some nurse-related window dressing (mixed metaphor alert). Though one bit of wisdom made my ears perk up, "Don't bring the bear home with you and into bed."

It was all I could do not to raise my hand and ask, "But what if I find it very stress-relieving to bring a hairy gay man into bed?"

Austin City Limits 2008

2008-09-29T06:08:00.005-05:00

Too much travel, not enough sleep = sick me. Missed work and slept 18 hours out of 24 for a few days. I was still feeling tired and mucous-y when ACL started so I missed most of 1st day including half of David Byrne's all-Eno-collaboration set. Dang dang dang. Like most years, I skipped out on the headliners which was a definite necessity this year. At least the copious mucous trapped the particles from the ubiquitous dust clouds.

Fatigue curtailed my note-taking this year so I just have a few impressions and quotes. The best of the festival for me was the Neko Case show where she noted this was the last date of her Fox Confessor tour (and quite a long one too). She'd been through Texas before on this tour but I wasn't able to attend. So glad I got to hear these songs before she inevitably retired a good chunk in favor of new material.

Despite their statements to the contrary, Fleet Foxes easily take to festival performance and delivered my other favorite show of the festival. Relaxed presence, superlative musicianship, and entertaining banter all contributed to a great set. Fleet Foxes put out a wonderful EP and debut album this year and I expect great things from them in the future.

Jose Gonzalez:
Not a likely festival performer, but thankfully people kept relatively quiet. I almost corrected the exceedingly pompous guy behind me when he loudly informed his girlfriend that Gonzalez wrote "Heartbeats" and his "original vision" was clearly superior to The Knife's. I let it go. She was doubtful anyway.

The Kills:
"Come see us when it's dark. This is bullshit." Huh, from where I was standing the bullshit was clearly centered on your lame backing tracks, ridiculous faux-worn cowboy accoutrements, and general air of insolence.

Stars:
Comments from the stage moved from "The bottled water has sodium in it. It will make you thirstier," to frontman Torquil referring to it as "poison water." Uh no, a little sodium is good when you're sweating so much. Brawndo, electrolytes, all that.

MGMT:
Really looking forward to this show as I looove several songs on their album and like most of the others. I was concerned that it wouldn't work on a festival stage, sadly it was worse than I feared. Far too wanky and lame for most of the set. "Electric Touch" was the highlight with "Kids" as a close second. Managed to summon the energy to dance a bit and wore myself out quickly.

Yet again Austin is confirmed as a big little city when I randomly bumped into five people I know, including two high school classmates. Seems like it's more challenging to not find run into an acquaintance.

Gillian Welch:
Marvelous as always. Alison Krauss came out to sing on "Didn't Leave Nobody but the Baby" which was nice as I wasn't sticking around for her and Robert Plant's set.

Flags:
In past years I've documented the various Here I Am! flags, but couldn't work up the enthusiasm this time. I did note with approval the perennial Beer Mug, Don't Tread On Me, and Bear Pride flags.

Uh, that's it I guess.

I'm fine

2008-09-23T13:29:00.002-05:00

Hey all, sorry I haven't kept up the info stream. Myself and my residence are fine. Got power back quickly at my place, but cable/internet was out for awhile and I didn't have time to post from the hospital while I was working then I flew to NY for a planned trip. I'll put up a lot more tonight after I sleep a bit.

Ike Day 2 & 3

2008-09-14T22:00:00.000-05:00

Though I'm writing this over a week after the events depicted, I've backdated the post so the correct chronology holds.

The brunt of the storm finally hit the Medical Center in the wee hours. Rain lashed everything and the wind was strong enough to uproot young trees. The lights flickered when the generators came on, but otherwise there was no sign that power lines had failed. Through it all, a news crew van parked out front barely moved. It must have been heavily weighted. Never did find out if anyone stayed in the van. We heard that a few windows broke in the tower, though no patients were affected.

I left the desk a few times to assist others with baths and dressing changes, and of course to bust out some morale-boosting karaoke. One of the other nurses brought a karaoke machine and we hooked it up to a TV in a room. I sang John Denver's "Annie's Song," Foreigner's "Waiting for a Girl Like You," and The Cure's "Boys Don't Cry". Sadly, no one else took up the mic when I returned to the desk. In a post-apocalyptic world, I'd be useful. I can't bow hunt or fix cars, but I can patch up minor injuries, organize resources, and keep spirits up.

By first grey light, Ike was still over us though waning. Moving at only 10-15 mph and as large as it was it took a while for it to completely pass. The day crew came on shift reporting that the sound of the wind had interfered with a restless night's sleep. Seeking to avoid the travesty of trying to sleep on cots in an auditorium, our unit went en masse up to an ICU where most of the day crew had spent the night. In less than an hour, we were booted out. The PACU had developed leaks and patients needed to be moved back to the unit we were occupying. We scattered, most to empty consult rooms. I ended up in an office bedding down in a reclining chair. After a fitful couple hours, I moved to the linoleum floor. It was hard, but at least I could stretch out.

After a total of 5 hours sleep, I grabbed a quick shower and a meal before heading outside. A friend working at Texas Children's Hospital across the street had inviting me to drop by. We hung out and chatted for a bit before she got busy. Now that the storm had passed, there was a trickle of people bringing their kids in to the ER. After a semi-successful attempt at a nap, I went to work again pairing up with my former preceptor to care for a busy transplant patient. I can't take transplants yet, but I can pair with another qualified nurse to assist. She did all the charting and oversaw the care, I administered all the medications and changed out the fluids on the dialysis machine.

The mood was grim Saturday night. The storm was behind us, but no one had slept well and energy was low. The karaoke machine stayed in its bag. Sunday morning the managers sent the night crew to breakfast after we reported to the oncoming crew. Executive discussions occurred and we returned from eating to find out that we could leave. Friends took me home with only one detour around high water. Electricity was back in patches, but not at my apartment. The area of town where I live isn't low-lying so flooding wasn't a problem. Tree limbs were down everywhere you looked though. One had busted through the roof of my building causing a slow leak in the apartment above mine. The guy living there put a bucket under the leak and went back to his girlfriend's place.

I'd noticed the $1 store down the street was open so I walked to it looking to pick up the extra water and candles I'd forgotten to buy pre-storm. The store owners had a small generator powering one cash register. They handed out flashlights and let five people at a time roam the store. It seemed like some people lined up just as something to do. On the way home I noticed standing water all over the place so I cleared brush and leaves from a couple storm drains feeling particularly useful. When I got home I fell into bed. When I woke up around 8 PM, the power was back on. No cable & internet, but I wasn't going to complain.

Ike Day 1

2008-09-12T23:57:00.003-05:00

The city buses stopped running at noon today so I came in to work early. It felt like a Sunday morning. As I walked down to the bus stop, I saw varying levels of preparation for Ike. Some houses and stores had boarded up their windows, some just taped them, but most were left as is. Aside from the grocery store and a few casual restaurants, businesses were closed with handwritten signs in the windows, CLOSED SATURDAY, OPEN SUNDAY. One gas station had wrapped their pumps and shut down, the station catticorner was raising their prices as I watched from the bus stop.

The ride to the Medical Center was uneventful; less people out and about than usual, but still some riding bikes and walking dogs. As I came into the building clouds were beginning to roll in, though it was still warm and sunny. Out front was a line of cars picking up discharged patients.

After checking in with my unit I was assigned a bed upstairs in a cleared-out patient care area. Shoes off, ear plugs in, diphenhydramine pill taken, I slept for five hours before heading down to my unit at 7 PM. I’m working the desk now. There are more than enough nurses to go around so I’m answering phones, putting orders in, assisting as needed with patient care, those sorts of things.

I haven’t been outside since 11:30 AM. I’m told that now at 11 PM it takes two people to hold the door open due to the wind. Maintenance crews boarded up the windows on the unit so we can’t see outside. There’s a lounge down the hall where you can still see out, I’ll check it out when I get a break in a couple hours.

Updates to come as time and circumstances allow.

Letter meme

2008-09-12T00:00:00.000-05:00

The rules: Comment and I'll give you a letter; then you have to list ten things you LOVE that begin with that letter. Afterward, post this in your journal and give out some letters of your own.

Seagulls Screaming gave me M (well, I asked for M and she assented):

Music - Big surprise huh? I'm one of those people that fly to other cities to see bands/music festivals. Magnificent Ms (or what I can make out on my CD shelf as I squint from here): M83, The Magnetic Fields, Man...Or Astroman?, Massive Attack, Marumari, Kathy McCarty, The Meat Purveyors, Ministry (early- to mid-period), Morrissey, The Moth Wranglers, The Mountain Goats, Movietone, μ-Ziq, My Bloody Valentine.

Movies - Love almost as much as music. Marvelous Ms: M, Metropolis, The Miracle of Morgan's Creek, Mulholland Dr., Man Bites Dog, Manhattan, Manhattan Murder Mystery (three Ms!), Miller's Crossing, Mom & Dad Save the World, McCabe & Mrs. Miller, The Muppet Movie. Hey look at that, films by Preston Sturges, Coen Brothers, Woody Allen (2), Robert Altman, Fritz Lang (2) - great directors with distinguished careers all.

Elizabeth Murray - In high school I kept pictures of Murray's artwork taped to my walls after reading about her in the newspaper. There's a wonderful playfulness to her art that thrills me. Several times at museums, I've rounded a corner and been pleasantly surprised to see one of her works across the room.

Medicine - More than just a job.

Midnight - I love the turning of one calendar day to another in the dark of night. On my off days, when I see that it's around midnight I think, "Six to eight hours before I have to go to sleep. Awesome."

Memory - Just the idea of remembering is so incredible when you think about it. Moments imperfectly encoded into organic structure, then summoned forth by will or external trigger.

Moths that drink the tears of sleeping birds - Nature is frickin' amazing.

Monkeys - Well yeah. Monkeys. Even the word is fun to say. Course if I lived in one of those Indian towns where fearless monkeys maraud then I probably wouldn't like them so much.

Moshi moshi - So great that Japanese has a phrase that's only used in one context, answering the telephone.

Matt(s) - Two specifically, here's to you Mr. R and Mr. L.

pre-Ike preparations

2008-09-11T23:35:00.000-05:00

As expected, I got a call this evening from my boss at the hospital. The disaster emergency plan is active and I am to be there tomorrow at 3 PM in preparation for Hurricane Ike's landfall. After the nightmare of Tropical Storm Allison, Houston's hospitals put emergency plans in place to deal with future calamities. At my facility, the staff sign up to be on either the Prep and Recovery team or the Ride Out team. P&R works before the anticipated emergency, then evacuates or stays home. The Ride Out team staffs the hospital just before and during the event. Then the P&R team comes in afterwards to relieve the RO staff. Having no local family or pets to look after, I signed up for RO.

I'm neither nervous nor annoyed by the circumstances. I was well-aware that Houston is at risk of experiencing hurricanes and being a nurse at a hospital means contributing to disaster preparedness. It's part of the job. Frankly, I'm glad to go in. I have no car so I couldn't easily leave Houston anyway and the hospital will take care of all my needs.

Tonight I'll pack a bag in preparation for living at the hospital for a day or two. The expectation is that I'll work my regular 6:45 PM to 7:15 AM shift, then sleep in makeshift housing at the hospital. I'm guessing this will be empty patient rooms as part of the plan calls for slowing admissions and stepping up patient discharges in an effort to reduce the hospital census. As all non-emergent surgeries get canceled, it's possible that I'll be working somewhere other than my normal surgical recovery unit.

Currently the eye is predicted to make landfall near Galveston very early Saturday morning. Just looked up the bus schedule and dang, service shuts down at noon so I have to leave even earlier. Alright then, two antihistamine pills are in my near future as I need to be asleep by 3 AM. Updates as time and circumstances allow.

Drank found, imbibed

2008-09-08T06:09:00.003-05:00

After reading a AV Club review, I was interested in trying Drank but none of the three non-chain convenience stores in my immediate area had it. Sure, it's distributed out of Houston but my neighborhood was not exactly ground central for screw hip-hop. Then one day I went into a store and there it was. I was way too excited about the purchase and considered drinking a can right then just to take the edge off.

Wait, let's establish some background. A Houston guy named DJ Screw invented a style of hip-hop called screw that slowed down and chopped up the music. Purple drank (or oil or syrup or any of the other names for it) was the drug of choice to accompany the music. Cough syrup containing codeine and promethazine is mixed with Sprite or what have you. Adding Jolly Ranchers is optional, that's how Oscar-winners Three 6 Mafia liked it ("Rainbow Colors", thanks Wikipedia). Codeine is a narcotic and promethazine is an antihistamine mostly used to combat nausea and as a cough suppressant. It also causes drowsiness. So, drink drank and feel kind of drunk, get a lean going. Oh, and DJ Screw and several other musicians closely identified with screw probably died from complications associated with consuming purple stuff.

Drank is marketed as an "anti-energy," completely legal version that will "slow your roll." Instead of prescription medications, the active ingredients are valerian, rose hips, and melatonin. It tastes like carbonated grape Kool-Aid and I can report that it does indeed make one sleepy. Both times I drank Drank, it was in the morning when it was time for me to go to bed (I work night shift remember) and I wasn't particularly tired. Drank worked to send me off to sleep.

The can lists the amount of valerian, rose hips, and melatonin it contains but of course as herbal preparations, there's no standard dosages for them. Oddly, Drank also contains 100% of the recommended daily value of B vitamins, something usually in energy drinks because they supposedly make people feel more alert. Even if that were true (I have my doubts, though not enough interest to research this, sorry), 100% of a vitamin isn't going to have powerful effects. On the down side, Drank is loaded with high fructose corn syrup.

Sadly, the store I bought it from no longer stocks it. I'll endeavor to find another source so that I might bring some on a certain camping trip coming up soon.

Read and unread

2008-08-31T02:41:00.002-05:00

Instead of doing something truly productive, I've been catching up on Spacebeer's blog as is obvious from my citing her posts below and adding her to my blogroll. Hi Spacebeer! Why did it take so long for me to read your blog? I've been remiss. Please forgive. Anyway, to placate your ferociousness, here you go:

"someone compiled a list of the top 106 books tagged "unread" on Librarything, and started a nifty little meme.

Here is the plan:
Bold = I've read it for fun [I guess this is a catch-all]
Underline = I read it for school
Italics = I started it but didn't finish
Asterisk = I own it, but haven't read it"

Jonathan Strange & Mr Norrell
Anna Karenina
Crime and Punishment
Catch-22
One Hundred Years of Solitude
Wuthering Heights
The Silmarillion
Life of Pi : a novel
The Name of the Rose
Don Quixote
Moby Dick
Ulysses
Madame Bovary
The Odyssey
Pride and Prejudice
Jane Eyre
The Tale of Two Cities
The Brothers Karamazov
Guns, Germs, and Steel: the fates of human societies
War and Peace
Vanity Fair
The Time Traveler’s Wife
The Iliad
Emma
The Blind Assassin
The Kite Runner
Mrs. Dalloway
Great Expectations
American Gods
A Heartbreaking Work of Staggering Genius
Atlas Shrugged
Reading Lolita in Tehran: a memoir in books
Memoirs of a Geisha
Middlesex
Quicksilver
Wicked: the life and times of the wicked witch of the West
The Canterbury Tales
The Historian: a novel
A Portrait of the Artist as a Young Man
Love in the Time of Cholera
Brave New World
The Fountainhead
Foucault’s Pendulum
Middlemarch
Frankenstein
The Count of Monte Cristo
Dracula
A Clockwork Orange
Anansi Boys
The Once and Future King
The Grapes of Wrath
The Poisonwood Bible
1984
Angels & Demons
The Inferno
The Satanic Verses
Sense and Sensibility
The Picture of Dorian Gray
Mansfield Park
One Flew Over the Cuckoo’s Nest
To the Lighthouse
Tess of the D’Urbervilles
Oliver Twist
Gulliver’s Travels
Les Misérables
The Corrections*
The Amazing Adventures of Kavalier and Clay
The Curious Incident of the Dog in the Night-Time
Dune
The Prince
The Sound and the Fury
Angela’s Ashes: a memoir
The God of Small Things
A People’s History of the United States: 1492-present
Cryptonomicon
Neverwhere
A Confederacy of Dunces
A Short History of Nearly Everything
Dubliners
The Unbearable Lightness of Being
Beloved
Slaughterhouse-five*
The Scarlet Letter
Eats, Shoots & Leaves
The Mists of Avalon
Oryx and Crake: a novel
Collapse: how societies choose to fail or succeed
Cloud Atlas
The Confusion
Lolita*
Persuasion
Northanger Abbey
The Catcher in the Rye
On the Road
The Hunchback of Notre Dame
Freakonomics: a rogue economist explores the hidden side of everything
Zen and the Art of Motorcycle Maintenance: an inquiry into values
The Aeneid
Watership Down
Gravity’s Rainbow
The Hobbit [6th grade reading group - cool teacher]
In Cold Blood: a true account of a multiple murder and its consequences*
White Teeth
Treasure Island
David Copperfield
The Three Musketeers

Man I'm way behind on the classics. Oh well, too many books, too little time.

even patient nurses wound know

2008-08-31T00:36:00.001-05:00

Spacebeer finds cool things on the internets. For instance, Wordle. I suspected that somewhere there was a site that created word clouds, but never looked for it assiduously. Here's a cloud of St. Murse blog:

I think I might edit the text a bit and make a T-shirt out of it.

Floating

2008-08-30T00:01:00.000-05:00

Last night I worked in another ICU at my hospital for the first time. The surgery schedule has been light with some surgeons on vacation, so my unit has been overstaffed with nurses. It's the way of hospitals, if one unit is overstaffed and another is under, then nurses float to even it out. Technically I'm not supposed to float until I've been off orientation for six months, but my home unit had to keep the experienced nurses to look after the complicated devices (continuous dialysis machines, intra-aortic balloon pumps, ventricular assist devices) which I cannot. Oh well, that's nursing for you.

It was great experience actually. The principle is that floated nurses shouldn't be given a difficult patient load because they're not in their regular environment. Doesn't always happen that way, but it did for me last night. My patients weren't confined to bed, had stable vital signs, and each had only one IV medication running. After assessing them, administering their meds, and performing one dressing change, I didn't have much to do for the rest of the shift aside from charting their vital signs and changing out their IV lines. Then one of my patients who had transfer orders to move to a lower level of care got a room at midnight. After I packed him up and moved him out, I only had one patient for the rest of the shift.

I was able to talk with the other nurses and get a feel for the unit which, though laid out much like the majority of ICUs at the hospital, is very different from my home unit in cardiovascular surgical recovery. With free time on my hands, I read my one patient's H&P (history and progress notes made by doctors) to get a better feel for the situation. Then I moved on to re-reading some hospital policies in an effort to A) know them better and B) stay alert. All in all, it was a nice break from the pace in CV Recovery.

Gross, in a sort of cool way

2008-08-28T10:33:00.000-05:00

Squeamish alert! Do not read on if discussion of open wounds gives you the willies.

A nursing classmate of mine told me a wonderfully vile story. The patient she was caring for was a woman whose hysterectomy incision had opened up. I don’t know the specific circumstances of the case, but even well-approximated incisions (the edges coming together nicely) can open up if the stitches or staples burst open due to a forceful cough or errant Valsalva maneuver.

Anyway, that’s just academic. The reality was that the patient was quite obese and the wound was a foot deep. Yep, from the skin all the way down to where her uterus used to be was a solid 12”. Care for such a wound involves cleaning the bed of the wound to minimize the risk of infection and promote healing. It took two people bracing themselves on either side to pull back the sides of the wound enough so that another nurse could get all the way down in there with a sponge.

Wheee! Sometimes nursing is just delicious huh?

Memo to Mr. Misogynist Q. Patient

2008-08-27T09:34:00.000-05:00

If, when you ask if I have a sense of humor, you mean laughing when you say, "Now that I've got better blood flow, maybe I can do something with it," while I'm cleaning your catheterized penis, or joining you in denigrating your female relative's job as a way of complimenting mine, then no, I don't have a sense of humor.

Also, refrain from automatically assuming that male staff are doctors. Despite us referring to ourselves as "your nurse," you continually called the day shift nurse and I doctors. The women in the white coat with her name clearly printed on the pocket? She's the surgical resident who scrubbed in on your operation, not as you assumed, the charge nurse.

I am being a little hard on the guy. He was anxious, feeling out of control and his coping mechanism of choice was joking around. It's a much more positive mechanism than regression or somatization. It's why I gave him some slack, kept quiet, and ignored his attempts at humor. And yet, even though he "comes from a different era", you have to know that making sexual comments about the female staff is big fat no-no. By the morning, I was weary of it.

When I leave at the end of my shift, if my patients are awake and likely to be transferred out to a lower level of care that day, I sincerely wish them well. This guy, I just said, "Feel better," without eye contact. Petty, I know, but man he was grating.

Another thing I love is tarnished, though electroplated in hate would be more accurate

2008-08-26T10:45:00.000-05:00

While my love of science fiction began in high school, it truly flowered in college thanks to books loaned and recommended to me by a couple of friends (thanks M & E). Many college bullshitting sessions were spent discussing the implications and questions arising from the works of Le Guin, Varley, Brin, etc. Above them all though, was Orson Scott Card. How we adored him. He's descended into almost total suckage over the last decade or so, but still, Ender's Game, Speaker for the Dead, The Worthing Saga? Masterful.

Well, now he's done it. Sure I always knew he was a devout, Elder-kiss-up Mormon, but now he's calling for violent revolution against the U.S. government if gay marriage becomes common. No need for me to rant on as Michael Swaim (who knew Cracked.com had such astute writers?) has laid out the arguments beautifully. Warms the heart really.

Unlike Swaim and others I've seen, I'm not tossing the Card books I treasure. I won't buy another copy new, but good stories are good stories even if they're told by a greedy, bigoted asshole who I nonetheless will endeavor to consider a person deserving of love. And I don't even claim to be a Christian.

2008-08-25T08:27:00.000-05:00

Where to start with the wonderfulness of Tom Giesler's anatomical chart art? Hilarious and gorgeous.

Attention to detail: How to avoid dumb questions

2008-08-25T02:06:00.000-05:00

A few weeks ago at work the patient care techs were busy and my patients were tucked away so I answered a spate of phone calls to the unit. One call was from the lab, "Patient X? The sample in the green top [test tube of blood] is hemolyzed [red blood cells are ruptured]. We need another one sent."

I walked down the hall to convey the message to the patient's nurse, "Lab called. That sample's hemolyzed. Can you send another one?"

"Well no," she said, looking at me curiously, "The patient's dead."

I looked over at the bed and monitor for the first time. Sure enough.

A little medication-based nursing humor. Very little.

2008-08-24T03:22:00.000-05:00

This week I was talking with a couple of women at work and the conversation turned to diets and losing weight. We’re all nurses so we know about the physiological processes involved and how some diets (i.e. Atkins, South Beach) initially show quick response because they result in mostly water loss.

That reminded one nurse of the time she found Lasix among her deceased grandmother’s things. Lasix prevents the kidneys from reabsorbing sodium and where sodium goes, so goes water due to osmosis and all that. No sodium reabsorption means peeing out a lot of fluid. Water weighs 2.2 pounds per liter (or the metrically more sensible 1 L = 1 kg), so that can add up to tidy weight loss. Along with all that water, important electrolytes are also peed out, particularly potassium, a dearth of which can cause life-threatening heart arrhythmias.

With all that in mind (I know, it’s a lot to keep in mind), the nurse explained her logic thusly,

“I found Lasix pills in my grandmother’s medicine cabinet and I was thinking about fitting into pants better, but I had no way to monitor my potassium levels and I don’t like bananas so…”

“Aside from the ethical implications of a health professional taking medications not prescribed for her,” I responded, ”You could have just eaten avocadoes.”

“Avocadoes?!” she exclaimed, “The whole point was to make my butt smaller.”

“Yeah St. Murse,” the other nurse said, “Duh.”

I love my co-workers.

Take every 6 hrs as needed for indifference

2008-08-23T23:14:00.000-05:00

Every couple of months the class of new nurses with whom I started meets for continuing education. The day’s agenda always includes time to talk about the challenges of the job. Essentially it’s a good-natured bitch session. Last time we met, someone brought up calling residents for orders and getting a less-than-confident or lackadaisical answer. Residents are still training as doctors and don’t know everything so nurses often coach them along. A common response from the docs is, “What do you usually do?” or “What do you want to do?”

I prefer the first question because it falls back on the routines of the attending physicians. They’re usually asking because hospitals differ in their preferences, not because they are clueless. At Hospital A, the typical orders for nausea are medication X at such-and-such dose and timing, while at Hospital B it’s medication Z. The second question, “What do you want to do?” is more annoying to me, because, you know, they’re the doctor with prescriptive authority. It’s putting the onus on the nurse with the doctor just agreeing or not with the suggestion. The worst though is when they obviously aren’t engaged. As one fellow nurse dramatized it:

Nurse: Doctor, Mr. Smith is getting increasingly hypertensive.

Doc: Uhh. Hydralazine 10 mg, or whatever. I don’t care.

In class I wistfully offered how great it would be if we could write out the order and fax it to the pharmacy just like that.

8/23/08 1935 Hydralazine 10 mg, or whatever. I don’t care.
TORB (telephone order read back) Dr. Apathy/St. Murse, RN

Found: paranoid chart

2008-08-11T07:40:00.000-05:00

I found this taped to a bus stop. "Beware LADIES HE Will Come and SEX you at Night" and by HE, the author means SATAN.

My favorite part is "Stupid Idiot Daft Punk." Sure they might be harder, better, faster, and stronger, but apparently they are also stupider, idiotic, and somehow involved with Satan.

Obese begets obesesier

2008-08-11T05:30:00.000-05:00

In an August 9th New York Times op-ed piece, Olivia Judson writes about rat studies which show that mothers who consume large amounts of junk food (as opposed to balanced rat chow) while pregnant give birth to babies with a hankering for junk food. Human studies are less definite but,

"...the results of several studies suggest that the very fact of a woman being obese during pregnancy may predispose her children to obesity. For example, one study found that children born to women who have lost weight after radical anti-obesity surgery are less likely to be obese than siblings born before their mother lost weight. Another study looked at women who gained weight between pregnancies; the results showed that babies born after their mothers put on weight tended to be heavier at birth than siblings born beforehand. Since the mother’s genes haven’t changed, the “fat” environment seems likely to be responsible for the effect."

Speaking as a health care professional who routinely cares for obese people, uh, yikes. This could result in a nasty geometric progression of obesity and related disease (diabetes, hypertension, heart and vascular disease, stroke, cancer, sleep apnea) in the next generation. Not to mention the increased incidence of lower back problems in the nurses who have to move such patients. Body mechanics of moving patients was one of the first things I learned in nursing school skills class and rightly so.

Heart, in wire

2008-08-10T02:17:00.000-05:00

I commissioned this sculpture from a talented artist, CW Roelle. I like it.

Dark, only slightly muggy, night

2008-07-21T05:05:00.001-05:00

As I've said many times before, I don't miss having a car. I really can get to almost everything I need on the bus with advanced planning. Or even spur of the moment. After reading several enthusiastic reviews last night, I immediately wanted to see The Dark Knight. One series-of-tubes search later and I had a ticket to the Angelika downtown. After one bus and a few minutes walk, I was ensconced in a nice seat in an only half-full theater. Hooray for working nights and therefore seeing movies at 9:15 on a Sunday when few jerkwads clog the theater with talking or rampant cell phone use!

Anyway, the movie was great, really pushes out the boundaries of superhero movies. I recommend it. Be prepared though, it's long (2.5 hours) and densely plotted. There's enough plot for two films really, which actually detracts from the last 30 minutes as it introduces a new element, though anyone with a basic knowledge of Batman lore will see it coming. Let me also jump on the pile-on of praise for Heath Ledger's performance. Astoundingly, creepily awesome. I went in with high expectations and he blew me out of the water. Multiple times I audibly, involuntarily horror-giggled.

Though I was prepared for this via a review, it was still remarkable how much of an ensemble film The Dark Knight is. Bruce Wayne/Batman is decidedly *not* foregrounded in either plot mechanics or screen time. I won't take away from the story by explaining further, you'll know what I mean when you see it. Also great is the degree to which the citizens of Gotham are involved in the story. Multiple, nameless Gothamites are essential to the theme of ordinary people taking responsibility for creating civility.

Some elements that distracted me:

- That goofy, scary-voice Bale employs as Batman.

- Why is Nestor Carbonell (the Mayor) wearing so much mascara and eyeliner? (Also, is
his casting a fun nod to him playing Bat Manuel on The Tick?)

- A certain medical aspect of the last bit drove me up the wall. Can't say what it is without spoiling, but argh! No.

- Is the minor character Berg Ramirez (or as his nametag says, Ramirez, Berg) an
obscure shout-out to UT Austin Film/Latin American Studies professor Charles Ramirez-Berg? Cause Berg is not really a first name.

So go see it and then we can talk about it.

At last, poker night

2008-07-16T17:17:00.000-05:00

For the first time since moving to Houston I made it back to Austin to play poker with my McJo's buddies. As was clear from my play, I really wasn't paying attention to the game. I'd build up a nice little stack then piss it away while I chatted with everyone, just happy to be surrounded by snarky, opinionated, politically-aware, ego-hammering, magnificent bastards. Regardless, I held on and finished third.

Slept well then had a late breakfast before Mick convinced me to make a specialty shoe purchase. Some other folks at work have Z-coil shoes (spring in the heel) and swear by them. Haven't broken mine in sufficiently to wear them to work for 12 hours and now I'm having a touch of buyer's remorse just from the price. I'm still in the refund window though. We'll see.

Lastly (for Corrosion), shark wants a taco.

Hopkins

2008-07-14T00:46:00.000-05:00

ABC has been airing a six-part miniseries documentary about the staff and patients at John Hopkins Hospital in Baltimore. Though it delves a little too much into the personal lives of the doctors (more medicine please!), the ballad-heavy soundtrack is egregious (apparently husky-voiced singer-songwriters = emotion depth), and more nurses should have been profiled (duh), I recommend it as an interesting look at medicine being practiced today.

Thankfully, the episodes are available to watch online.

The Cure, Austin Music Hall

2008-06-11T23:53:00.002-05:00

Despite a couple missed opportunities that are too ridiculous to go into here, I've previously only seen The Cure once. As a way to get fired up for the show, I made up a dream setlist as I drive to Dallas. As the encore began, I was struck with gleeful awe when I realized that they had played every damn song I wanted to hear! This is what I love about The Cure's live shows. They have a extensive career and dedicated fans, so play long shows with songs across their whole discography.

When my friend Dan heard that they were coming to Austin, and to the relatively small Austin Music Hall we were committed to going along with other friends. Tragedy struck when computer problems (?) or something prevented Dan from getting tickets for everyone and the show sold out. After seeing the setlists from this tour, I knew I couldn't miss out and so paid premium for ticket off eBay (grumble, grumble).

As the carload of friends drove to the show, we engaged in the witty banter that's a mainstay of our group (how frickin' self-agrandizing can I be? Ass). We speculated on the intricate goth outfits that were sure to be on display and then we rounded a corner to the sight of miles of black cloth and fishnets. As Chad put it, "Ladies and Gentlemen, Exhibit A."

Austin Music Hall has been extensively refurbished with more seating upstairs, a fancier entryway, better sound, and much improved intimate feel. After some nosing about, we set up downstairs about 30 feet from the stage. After a bland, boring opening act The Cure took the stage and blew us all away. Disintegration and Wish are about tied for my favorite albums and so opening with, well "Open" and then going right into "Fascination St." made me extremely happy. The show continued with plenty of songs from both albums with others sprinkled from across their career. It wasn't until they ripped into it that I remembered how much I love "Push" from Head on the Door (I re-listened to that CD later and rediscovered how great it is). "Catch" resulted in a happy emotional meltdown for Karen which was great fun to witness. During the show Dan and I confirmed out loud what was obvious, it had vaulted into our top ten concerts of all time.

Push from elsewhere on the tour

In Between Days

Sure Robert's put on a lot of weight and looks a bit silly with the make-up and hair at his age. This was balanced out by Porl Thompson ripped physique (how nice to have him back in the fold after years away and just killing on lead guitar) and the fact that Simon has not aged in 25 years. Jason the drummer isn't as good as Boris but I'm not complaining. They were in fine form. One of the coolest thing about the show is that they had no keyboards. All the synth lines were played on guitar by either Porl or Robert. I think The Cure uses keyboards very well, but it was invigorating to hear the songs without them.

From previous shows, we knew there would be at least two encores, but we still clapped and called for more. "M", "Play for Today" (and yes I sang the keyboard chorus melody), and "A Forest" just killed. Away to the wings, more clapping, and then back out for the highly anticipated run of seven songs from their 1st album. Even though I knew it was going to happen, it was still wonderful.

Jumping Someone Else's Train & Grinding Halt

After a 90 minute nap, I drove back to Austin tired but exhilirated for work the next morning. Absolutely worth the lack of sleep and jacked-up ticket price.

One last thing, coming so soon on the heels of the REM show in Berkeley it was inevitable that I'd compare the two. Both started off as "college" bands and broke into the mainstream before settling into the rock canon. Their best work is behind them but they both still write some good songs and play well. My estimation of these shows however is miles apart. REM played a good set to a rather flaccid audience who couldn't care less for older material. The Cure played a fantastic, almost three-hour show for a energetic audience filled with big fans. Blame it on the difference between Berkeley and Austin or the intimacy of the TX show to the outdoor venue in CA, or maybe the band themselves. Whatever reason, it certainly bumped up The Cure in my estimation.

The full setlist:

open, fascination street, alt.end, torture, the end of the world, lovesong, the big hand, pictures of you, lullaby, catch, the perfect boy, from the edge of the deep green sea, the figurehead, a strange day, sleep when i'm dead, push, doing the unstuck, inbetween days, just like heaven, primary, the only one, signal to noise, the hanging garden, one hundred years, end

E1: at night, m, play for today, a forest
E2: three imaginary boys, fire in cairo, boys don't cry, jumping someone else's train, grinding halt, 10:15 saturday night, killing an arab

REM in SF

2008-06-04T05:56:00.002-05:00

The timing of my trip to SF was dictated by REM's tour stop in Berkeley. They weren't/aren't coming anywhere close to Texas and I always said my first trip after graduating from school would be to visit MidSav and Rob in SF, so the timing worked out well.

I've been an REM fan for a long time, but back in the late '80s I was deemed too young to attend the Dallas stop on their Green tour. After that they didn't tour for years. So I've only seen them three times, Monster tour, Up tour, and at ACL during a tour promoting a Best Of. All good shows, though the ACL one wins out because A) I was so close, B) I was surrounded by great fans, and C) they played plenty of old stuff (setlists from that tour). The one-two punch of "Finest Worksong" and "Begin the Begin" made me wish yet again that concert joy could be bottled to enjoy later. Still, I was bummed when I saw the setlist from Houston. Maps & Legends?!

REM's new album, Accelerate, has been hailed as a return to form which really just means that there are some loud rock songs and it's not so wan like that last couple records. That sounds like damning with faint praise, but I really do like it for the most part. Anyway, I was excited to see them again and especially at the Greek Theatre on the University of California, Berkeley campus. It's a open-air, tiered venue so everyone can hear and see well. I'd bought my ticket early but since I'd let my fan club membership lapse missed the prime seats right up front.

MidSav & Rob dropped me off outside and I hurried in as The National had already started playing. They were good, but really belong inside a dark club. Next up was Modest Mouse, a band with several songs I like and many I find tedious and uninspired. The show was OK. The best part was (finally!) seeing Johnny Marr play guitar. Even when I closed my eyes I could pick out his lines. That Smiths reunion will never happen but if it ever did, I'd get there some way. Marr stills play beautifully and Morrissey can still belt it out.

Then REM hit the stage to huge cheers. The three actual members (Peter, Mike, Michael) were supplemented by usual tour guitarist/keyboardist Scott McCaughey and new-to-the-fold drummer Bill Rieflin. Rieflin's a great drummer and I wondered if anyone else in the audience knew that he used to play drums for a long line of industrial bands like Ministry and KMFDM.

They kicked things off with a new song "Horse To Water" to a muted reception considering. Next song was "Little America" and I was all excited, "Yay old stuff!" and then I looked around and slowly realized that though a big chunk of the crowd was the right age to have been fans of REM when during their mid-80's IRS years, they didn't know this song. Third song was "What's The Frequency, Kenneth?" and the crowd roared its approval.

This sad pattern continued through the rest of the set and severely impacted my enjoyment of the show. Song on the radio? Big cheers. Not on the radio? Boredom and tepid response. Me all ranty in my head, "C'mon people, "West of the Fields"? "Wolves, Lower"?! They haven't pulled that out for almost a decade. But oh you'll finally start moving around when "The One I Love" starts up." Grumble, grumble, gnashing of teeth.

Best part of the show (aside from the lovely old chestnuts) was their reworking of "Let Me In" into a gorgeous acoustic-guitars-and-organ version. Even Rieflin came down off the drum riser to play guitar. Here's a recording from a different show:

With this wonderful version arrangement and the subject matter, I got all teary (wouldn't be an REM concert if I didn't at some point). The main set ended with "I'm Gonna DJ" which grates because it indulges Stipe's penchant for twangy hollering. Encore proceeded as per usual (when did encores for headlining acts become customary? The '70s? When did bands start intentionally putting popular songs in the encore rather than deep cuts or unpolished covers? A topic for another post) kicking off with the best song on the new album, "Supernatural Superserious". After another new one they started up "Driver 8" which sparked at least a little recognition in the audience before tearing into "Life And How To Live It"! I danced up a storm and focused on the band and the little group of superfans up front. Show closed as it often does with "Man On The Moon" which I've grown tired of, especially Stipe's silly hollerin' version.

La la la, get back to MidSav & Rob's place, talk about the lame-o audience, still enjoyed the show, go to bed.

Well, a little more to the story. REM sold out the Greek Theatre so fast that after I bought my ticket they added a second night. At the time I had thought about buying for that night (for which I was sure to get a better seat) and just selling my first night ticket, but I didn't. Sigh. After I got home from SF I pulled up the setlist for the 2nd night and was crushed. Leading up to my trip I'd been listening to a lot of REM, particularly my favorite album Lifes Rich Pageant. Four songs on that album I love particularly and are among my favorite in their whole career. The 2nd night in Berkeley they played three of them, "Begin the Begin", "These Days", and "Fall on Me". Oh the disappointment. Full setlists for the whole tour here.

The lesson I learned from this is that I will go see REM whenever feasible for back-to-back shows and I will do my best to be right up front with the superfans who love the old stuff too.

UPDATE: I found a note I'd jotted down during the show. After they played "West of the Fields," Stipe talked about the lyrics and how early REM songs were fairly impressionistic and didn't always make a lot of sense. It's well-known now that he doesn't have a great memory, even for his own lyrics and that's especially true for the early songs. When they started playing them more often live, he went online to find out what the fans thought they were. He was amused to see what many lyric websites had posted for "West of the Fields".

Stipe: Now, I wrote some bad lyrics when I was 21 and did drugs back then. But I never wrote, "The animals are strange, try to put it in."

Mills: What are the words?

Stipe: (mock testily) I don't know what the fuckin' words are. What were you doing in 1981 Mike?

Mills: Oh, this and that.

Stipe: Yeah. I have photographic evidence.

My trip to San Franciso, and overcast Berkeley

2008-06-03T07:42:00.001-05:00

After working 12 hours, with a 2 hour nap under my belt, I left the apartment for my trip to San Francisco. I was glad that I found a bus route that goes to the airport, less enthused when I realized how many stops it made on it's way there. Oh well.

The flight was uneventful with a layover in Arizona only noteworthy for this odd, planes-circling-a-vortex carpet pattern in the terminal. Thankfully, SF/Oakland has a great metro system of trains and buses. I easily navigated from the Oakland airport to the Mission district where I met up with Middle Savagery and Rob. Though quite tired, their sparkling conversation and enthusiasm perked me up and we had a great time eating dosas at Dosa.

Eating round, flat things would turn into an unintentional theme for the weekend. Thursday dosas, Friday pupusas, Saturday pizza. I don't think Sunday's meal, Mission burritos, held true but MidSav argued that they were round and flat before being rolled up so they counted. Though all the meals were yummy, the pizza from The Cheese Board was phenomenal. Also a standout was the Bug Juice Ale at Triple Rock, a brew pub in Berkeley.

Most of my time in SF & Berkeley was spent eating, reading graphic novels late at night, walking, and window shopping. SF is stuffed with little shops selling cute things. I think we went into at least four stores along the line of Giant Robot, which we also visited. The best window display goes to DoublePunch. Despite all the browsing, I didn't buy much. A few things from Little Otsu and a pile of CDs from Amoeba Records Berkeley branch. I went into the main Amoeba records too, but after a few minutes I was just too overwhelmed to focus. I'll go with a specific list next time.

Saturday night I went to see REM, but I'll cover that in the next post.

On Sunday we hit the Castro generally so I could see the gay(er) part of SF, but specifically so we could see the new Indiana Jones movie at the historic Castro theater. See, MidSav is an archeology grad student and so we just had to see the movie. The theater itself was grand and it was great to have the curtain part and the movie start. No ads, no trailers. I went in with low expectations, yet was hooked in the first five minutes by Spielberg's fantastic use of mirrors and shadows. And then the George Lucas crap came in and those low expectations came rushing back. Best action sequence of the film? The motorcycle chase, which un-coincidentally had no (or at least subtle) CGI effects. Anyway, we laughed walking out.

The two best things I saw in the Castro was the sex toy shop, Does Your Mother Know? because I love inappropriate ABBA references, and the guys in pink bunny suits giving out free hugs and roses. On the way to eat, we passed an alley covered in impressive graffiti. Turns out it's the well-known Clarion Alley.

After burritos, we returned to find the vehicle gone. Towed. Suck-o. Well, we weren't parked legally, just had followed others illegal lead. Between the three of us we worked out who to call and where to go to get it back. Sorry about that budget buster friends!

Monday I had some time to kill before my flight out so I rushed to the city and hit the SF Museum of Modern Art. I wrote some notes about the work that impressed me most, but I seemed to have misplaced it. I'm sure I'll come across it and then I'll just edit this entry.

UPDATE: The notes were found, though really it's just a list of works I liked.
Gerhard Richter - Lessende (Reading)
Lichtenstein - Rouen Cathedral Set V
Rothko - No. 14, 1960
Richard Serra - Boomerang

Oh yeah, we also went out to the beach, ate at a diner overlooking the ruins of the Sutro Baths, walked through Chinatown, drove through the Presidio, and got offered "nuggets" while walking through Golden Gate Park. MidSav, according to the DEA, love nuggets are marijuana, so now you know. At this point, I'm kinda tired of writing, so the activities of this paragraph shall not be expanded upon.

More trip photos here.

Fun night

2008-05-28T11:16:00.000-05:00

I wasn't with my usual night preceptor one night, though I don't think the events of the night would have gone differently if I was. Night.

One of my patients had gotten out of surgery earlier that evening and was to remain intubated and on the ventilator all night. Usually we try to wean patients off the ventilator and get the tube out as soon as the anesthesia has worn off sufficiently. Though I don't remember the one time I was on one, it's clear that people mostly do not care for ventilators. Instead of gently sucking in air as usual, patients now have a tube down their throat that blows air into their lungs. Unnatural, uncomfortable, and often anxiety-producing.

This young man was prescribed medication to decrease his anxiety and surgical pain. They weren't really keeping up despite a couple calls to doctors for increased dose and over the course of the night he was getting increasingly agitated. His hands were tied down with soft wrist restraints as we usually do with intubated patients who are not yet calm and rational enough to not grab for their tubes and IV lines. This guy was clearly not with it mentally, yet had the presence of mind to try wiggling down in bed so he could get hold of something to pull on. Several times an hour I had to readjust his position because he was close to grabbing his Foley catheter or airway suction line. Through rubbing it against the mattress, he managed to slightly dislodge the line going into his radial artery (the wrist) that measures blood pressure continuously. While I was trying to re-tape it, he yanked back and it came out. Great. I bandaged the site and got an order to follow cuff blood pressures instead.

With all this, and upon the advice of my temporary preceptor, I called a doctor to get the patient started on a sedation protocol where we could adjust a continuous drip of medication to the desired effect, calm and not fighting the restraints. Unfortunately, the middle of the night is not the best time to request the needed medication pumps as the supply staff is only a skeleton and take forever to deliver items.

At one point, I had to reach across this guy and hold his arm down because he was grasping at his chest tubes. These are tubes that are inserted between ribs or under the sternum to drain blood and other fluid from the chest after surgery. They also help reinflate lungs that have been deflated either for surgery or because of a pneumothorax (good picture of deflated lung and chest tube there). I couldn't go around the other side of the bed to readjust and retie his restraint because I was worried that during transit, he'd grab and pull his tubes out. I said, "Sir, I cannot let you pull your chest tubes out." He looked right at me and vigorously nodded as if to say, "Oh we'll see about that!" The other nurse in my pod had gone to the supply room and my preceptor had stepped away for a moment. So there I was leaned over the patient, holding his wrist, craning my head around toward the hallway waiting for someone to walk by. It was kinda funny. Kinda. After only a couple minutes, another nurse walked by and quickly came over to help.

Around 4:30 I started to give him his bath. My temp preceptor, who is a large, strong guy, held the restraints while I washed down the patient. Despite doses of medication before the bath, the patient was still agitated. The medication pump had arrived, but we hadn't titrated the medication up enough yet to have the desired effect. At one point while we were concentrating on his upper body, he managed to get his Foley catheter tubing between his toes and yanked on it. Um, dude. There is a balloon inflated in your bladder to anchor that catheter. You do NOT want to be yanking on that. Can you say traumatized urethra? Well, not with that tube down your throat.

Toward the end of the bath he settled down though. I was just finishing up redressing his surgical incision when the patient jerked suddenly and I looked up to see a look of shock on my preceptor's face. The patient, moving quickly, had grabbed a chest tube and yanked it out. My preceptor covered the hole with his glove and called for help, I ran to the supply room for some gauze impregnated with vaseline which is used to cover the hole so air doesn't leak in.

A couple other nurses came over to help and I paged the resident on-call to come reinsert the tube or suture the hole closed. Woken up in the sleep room, the resident was groggy when he called back and at first didn't really get what I was saying. "Just come down here now please," I said as nicely but firmly as I could. The patient wasn't putting out much fluid through the tube and had another one on the same side so when the resident showed up fully awake, he just sutured it closed. While he was working, early morning visiting time had come and I tried to head off the family before they came on the unit. I caught the mom in the hallway and explained the situation, worried she was going to panic. Nope. "I thought something like this might happen," she said looking apologetic, "He's a pretty anxious person usually. I sorry he's giving you so much trouble." Oookay, then.

From there, we switched to a different, more powerful sedation med which worked well. The pulmonary doctor showed up soon after, thinking she was going to be extubating him. "What's going on here?" she asked innocently. I told her the whole story and she sympathized. I paused the sedation med so she could see his behavior (it gets out of the system quickly) and within five minutes he was back to pulling and wiggling. By this time we were at shift change so I reported off to the next shift nurse and went home to well-deserved sleep.

A couple days later I walked by the same pod and saw the pulmonary doc. She beckoned me over saying, "Look here." I rounded the curtain and there was my guy, sitting in a chair eating dinner. Thanks to the amnesiac qualities of the sedation meds, he didn't remember a thing.

Night shift and getting the hang of it all

2008-05-20T04:11:00.000-05:00

I've been working nights for a couple weeks now and it's going well. My night preceptor is great and I've learned a lot from her. It was up in the air how long I'd be with her before I'm off orientation and working solo. At the end of last week, we both agreed that I needed more practice caring for unstable patients needing interventions such as vasoactive drip titration (regulating the dose of constantly delivered IV meds to keep heart rate and blood pressure within certain parameters) along with a second stable, but still critical patient. Managing both while still making and receiving calls, delivering scheduled medications, completing paperwork, and drawing labs, all within the alloted time, is a skill I've yet to completely master. Then of course I also have to be using critical thinking to work out what's needed when.

A beautiful thing

2008-05-19T03:03:00.000-05:00

I laid down for a little cat nap tonight and unintentionally fell into a deep sleep where I had an incredible dream. It was late at night and a big group of my friends ringed a microphone set up in Mybloody's front lawn. We were playing a gorgeous song. Some had acoustic instruments: guitar, orchestra bells, viola, banjo, shakers, wood blocks; everyone was singing. It was a gentle, sweet song cut with a fair bit of longing and even though the words were sad, we kept looking at each other and smiling as we played on and on and on.

When I woke up to the roar of the A/C fan, I laid in bed stunned by how wonderful it all was. Then I scrabbled for a tape recorder, trying to hold on to the melody. Like many dreams though, it faded away and didn't make much sense when I tried to get it down on tape. I admit I teared up a little, both for the idea that my friends and I had made something so beautiful and out of frustration that I'd lost it.

I'm not convinced that dreams are a window into the subconscious, but this dream integrated two things I love very much, music and my friends, in a way I wouldn't have in my waking life. So friends, pick up an instrument today or just sing and try to catch a moment of joy or fear or sadness. I'll do the same.

The Art Guys - Nothing To It

2008-05-13T06:58:00.000-05:00

After a work shift on Saturday 5/3, my preceptor dropped me off at the University of Houston so that I could see The Art Guys' show Nothing To It: An Evening of Itty Bitty Witty Ditties. Despite the trying-too-hard-to-be-humorously-obnoxious name, it was a lot of fun. The Art Guys are a Houston institution. I won't recount their biography, you can read that here. In brief, they are performance artists with an emphasis on the fun and funny rather than the dull and ponderous.

This show was a retrospective of their work performed in front of an audience that was clearly heavy on their friends, family, and ardent supporters. The first work sounded like a good idea, but in practice only partially worked. Called Future Music [In Three Movements], a projector displayed instructions that each audience member should, at a random time during the rest of the show, shout out one word. As soon as the description was up, people started calling out. The words were almost exclusively nouns like asparagus or chicken, you know "funny" words. And once the children got started, oh man was that annoying. Again, good idea for a piece, but when the audience is full of wannabe comedians and hyperactive, bored children, it don't work no good.

I won't go through every piece, just hit the highlights. A great work that worked was Kiss Piece where the two Art Guys applied lipstick and kissed every member of the audience. It was funny and sweet. Good friends and (I think) family got kissed on the lips, bald guys got kissed on the head, shy little girls on the hand. I can imagine that for a different audience it could be uncomfortable or even hostile (which would also be interesting), but for this hometown crowd it went smoothly. Kiss Piece was immediately followed by Guzzle A Beer - At Any Time - (For Tom Marioni). It's exactly what it sounds like. For the rest of the night, the director would intermittently flash up the title on the projection screen and the guys would crack open beers and guzzle them. Near the end they handed them out to some of the other back-up performers and even one guy in the audience. Seeing as the guys aren't really party animals, it was more to be endured than enjoyed, at least after the first round.

Inverted Karaoke was great. Jack, who cannot play, sat at a piano and attempted to perform "Bridge Over Troubled Waters" while listening to it on headphones that blocked out all other sound. Michael, equally horrible, "sang" along while also listening to headphones. It was cacaphonous and hilarious. Another mostly auditory work was Wrap Piece where the guys pulled out giant rolls of industrial-strength plastic wrap and proceeded to stretch it around rows of seats and handrails, working to express all the squeals and thrums they could. Plywood was a visual spectacle with dancers and chorus singing the praises of plywood. While fun to look at, this elevation of a mundane object to glory went on too long.

The last piece was also the most serious. Entitled For Martin, Jimmy and Bill, it consisted of Michael breathing audibly into a microphone while Jack slowly turned a rain stick. Sounds kind of lame, but in the near-dark, as a meditation on breath and the end of life, for someone like me that cares for people on ventilators every work day, it was beautiful and moving.

The whole show was filmed and will air on the Houston PBS station at some point. There are photos from the show on their website as well as clips from other performances.

Amorous RN, or how not to be accused of same

2008-05-12T03:54:00.000-05:00

During a brief moment of live TV, where as I'm usually watching something recorded by my Tivo, the weekend weather guy for the Houston CW affiliate was doing his thing. I was a bit dumbfounded by his name, Casanova Nurse. Really and truly, that's his name. Unfortunately his bio does not reveal the provenance of such a unique moniker. I like that he (most likely) does NOT live the life that his name could have dictated, skillfully wooing then abandoning patients in an endless string of medically-based conquests.

On that note, last week I was advised that I should make sure a female nurse or patient care tech was present whenever I examine female patients and to leave bed baths to the female staff as precautions against allegations of impropriety, which have ticked up recently. With the pain, lack of natural light (and therefore cues to the time of day), dearth of quality sleep, medications for pain and anxiety, or just idiosyncrasies, patients who've been in an ICU for days can become confused and somewhat paranoid. For instance, even in my short time working I've seen several patients who think that all staff discussions are about them, including gynecological surgeries for men and imminent childbirth for elderly women. Good thing I have a psych background, it's useful.

It's rather annoying that I have to be so cautious as I have no interest in molesting my clients and I can't really imagine a nurse getting in to this line of work with that intention. Still, better safe than sorry or as we often say, CYA.

Up all night

2008-05-06T10:47:00.000-05:00

I started working nights this week. My schedule in general is:

- Wake up at 5 PM
- On the bus to work at 6:05 PM
- Work 6:45 PM to 7:15 AM
- Home by 8:00 AM
- In bed by 9:30 AM

Soooo much better than waking up at 5 AM. On my days off I'll wake up and hit the gym, do laundry, and grocery shop before those places close at midnight, then enjoy the peace and quiet of the night. At first I'm sure I'll do a lot of reading and movie-watching, but I do plan to go on some photo excursions around my neighborhood and finally get out to the music clubs to see some bands. A social life would be nice as well.

I was going to advise my friends to avoid calling me during the day, but I accidentally left my phone on yesterday and didn't wake up despite three separate calls. Yay for the air conditioner/white noise generator in my bedroom.

Hectic day, but I did it

2008-04-30T21:23:00.000-05:00

Started the day with two patients, both of whom were ready to transfer out of our unit. After getting the requisite doctor sign-outs and orders for Patient #1, I started packing up the his things when the monitor for Patient #2 alarms. I look over and see no blood pressure on the monitor, then flick my eyes over to the patient who is calmly sitting up in her chair, then to the blood on her wrist. Dang, the arterial line has come out. I ask another nurse to grab a blood pressure cuff while I get some clean gloves and gauze to hold pressure on the site of bleeding. Cuff goes on, site stops bleeding, secure it with tape, then toss the bled-on pillow.

Call report on Patient #1 (the one who didn't bleed) and move him upstairs. Back to the unit and my open spot is already assigned for a patient currently in surgery. Call housekeeping for a stat clean and start setting up for the admit. Intersperse setting up suction cannisters, tubing, monitor cables, etc. with prepping Patient #2 to transfer upstairs. Call report on her then hand off to my preceptor cause here comes the admit, a "pump case" - cardio-pulmonary bypass pump during cardiac surgery - who will be on a ventilator while recovering from anesthesia. These guys can be quite unstable and this one is initially very hypertensive. Treat that, have family back for a quick visit and status update, and then catch up on charting.

Now as Patient #3 warms up (they're chilled during surgery to reduce metabolic demand), he's vasodilating and dropping his blood pressure. Calls to doctors for fluid orders. Hang multiple bottles of albumin (yes the protein in egg whites and shampoos, though this version is human albumin) as an intravascular volume expander. Success! He's stable, which is good because now it's time to set up for another admit in the bed formally occupied by Bleeding Wrist Lady. It's not part of some cruel hazing, just happens to be the only spot open for an admit.

My preceptor helps me set up the spot while I keep one eye on still-intubated dude. Patient #4 rolls out and we're off again with stabilization, family update, and charting. While fetching a medication my preceptor says in passing, "Don't worry about the bloody sheet behind [Patient #3]'s head. It's all good. Just wanted to warn you so you don't look over and panic." I appreciate the heads up.

90 minutes later it's time to report off to the oncoming shift. Whew. Four patients in one day with two of them pump case admits is unusually heavy. Of course I had lots of help from the other nurses in my section as everyone pitches in during new admissions and nobody's going to let you (and the patient!) drown. I was most proud when a co-worker said, "I like that I didn't hear any crying over here."

Love my Car Olé

2008-04-28T21:26:00.000-05:00

Another nice weekend in Austin. This time I came up to visit with my wonderful (but slightly misanthropic), adorable (yet occasionally menacing) friend and former roommate Carole and her sister. Both now reside elsewhere and it had been a while since they'd been back to Austin. I didn't join them for the requisite trip to Toy Joy and Momoko, but I did attend the night swim at Barton Springs. Sure the water is 68 degrees but if you just start swimming, the exertion keeps you warm. Getting out is mildly uncomfortable, though I find that vigorous towelling and thoughts of perhaps going to Kirby or Magnolia for pancakes soon resolves the shivering and goosebumps.

Lots of eating out including meatloaf at Hyde Park, Thai pizza from Flying Tomato, breakfast tacos at Tamale House, and a strawberry cheescake snowball from Casey's where we heard but did not directly witness a two-car collision. Thankfully everyone was OK and I didn't have to spring into action. It makes me nervous that I might be called upon to render medical aid outside my job and volunteer activities. Of course I'll do it as needed, I'd just rather not have the "opportunity".

Oh hey, I just realized that Carole, her sister, and I failed to convene a meeting of the organization we founded many years ago. BOTA, or Bring On The Asteroids, is dedicated to periodically becoming so frustrated by the general suckiness of people that we throw up our hands and welcome an asteroid bombardment that will wipe out humans and allow the rise of a new sapient race. Hopefully the bonobos who are generally groovy and prefer sex over violence.

Medicine on TV

2008-04-24T23:50:00.000-05:00

So I was watching an episode of a TV drama and there occurred a medical emergency which played out so poorly, I shrieked, "WHAT?!" at the TV. A very fit young man is in the hospital after being beaten up. One minute he's talking, then suddenly the EKG monitor (which an assault victim with no history of cardiac problems would not have) alarms and IMMEDIATELY a doctor comes running in saying "He's crashing. Get me O2 and an ambu bag." The monitor completely flatlines (wrong) and a couple more staff members (nurses, possibly) run in. The MD starts totally ineffective, fake-ass chest compressions with the patient still up at a 30 degree angle in the bed. The nurse with the ambu bag gives a few breaths, then caresses the patient's chin. Huh?

Oh it was so bad. I'm sure police and lawyers get riled by horribly inaccurate portrayals of their professions too. A guy asked me once which TV shows were the most medically accurate. The best one is Trauma: Life in the ER but that's a documentary show so it really doesn't count. I haven't watched it in a while, but ER was pretty decent in that the actors had practiced doing fake intubations, chest compressions, and other procedures. I recall as well that the treatments they rattled off by and large were accurate for the patient's condition. Of course, like all medical shows, the doctors did tons of stuff that really nurses do.

Scrubs is rather bad, both in the wildly inaccurate depiction of medicine and in severely dropping off in quality after the third season. Don't even get me started on House.

And then there's my favorite quack doctor. No not Dr. Nick of The Simpsons. I'm speaking of Dr. Spacemen (SPA-CHE-MEN) on 30 Rock. A couple episodes back Dr. Spacemen (wonderfully played by Chris Parnell) rushes in to see an unconscious man who he instantly and correctly identifies as being in a diabetic coma. After some ineffectual bungling, Alec Baldwin's character says, "Couldn't you just, you know, inject something right into his heart?"

Dr. Spacemen, with a look of concern and pity, responds, "I'd love to, but we have no way of knowing where the heart is. You see, every human is different."

BWAHAHAHA! Thank goodness for Tivo so I can pause and rewind because they weren't done. Spacemen grabs the phone and says, "Is it 411 or 911? [pause] New York. Uh, diabetes repair I guess?"

Oh how I love, love, love Diabetes Repair.

A typical Monday of late, in that it involves work, frustrated desire, and something funny

2008-04-15T12:52:00.000-05:00

I didn't make it to the dramatic presentation. I transposed two theaters when I was looking at directions originally and when I realized the mix-up it was too late to make the show. Oh well, there will be other opportunities. I'll just have to stay on top of what's playing and plan ahead. What I like about Houston is that classic and contemporary, much-lauded works get mounted here. Quite different from Austin.

Yesterday work was a study in contrasts. When I started the day, I took two patients with the plan being that I'd give them up at 9 AM to another nurse so that I could get more practice admitting difficult cases. Two hours to assess the patients, document, give medications, while also managing phone calls from family, updating doctors on condition, and providing comfort care isn't much time. I didn't quite make it and by 9:30 just ended up fetching one patient's meds for the relieving nurse to give. Dang. Then I found out that the surgery schedule started late because resident interviews had begun that morning. We wouldn't be getting the kinds of patients I needed till much later in the day. I kept myself busy helping others and studying a little till my manager called me up for my 90 day review. I'm doing well apparently and get a small raise. Yay.

At 3 PM (or 1500 as medicine uses military time) I took back one of my original patients and prepared for a fresh post-op case. He came out at 1700 and the race was on to do as much as I could get done before the next shift showed up at 1845 while also, you know, taking care of the patient. As I was saying to Mybloody last night, I once started to write a post about post-operative care of patients who required heart bypass during surgery but when it took three paragraphs just to establish the basics of hemodynamics, I deleted it. Too complicated and therefore boring for anyone that doesn't want to actually do it I think.

Anyway, I again didn't quite make it in the time allotted. Between assessment, calls and conferences with doctors, warming the patient, managing blood pressure, giving meds, and documenting I didn't get to some paperwork and a few of the less important medical orders. I was and am disappointed that, though improving, I'm still slow. My preceptor said, "You did fine. Are your patients still alive? OK then." To which I replied, "That is *not* the standard I'm shooting for at this point." I'll get there eventually but I'm not one to be patient with my own progress, grumble grumble.

On a lighter note, this made me laugh:

I was ready to be impressed

2008-04-12T21:28:00.000-05:00

Oh Houston, I'm trying to like you but you're making it difficult. Last week I got excited because I found out about the Westheimer Block Party. Lots of bands and artists, free, and just a 20 minute walk away. It started at noon, but after a long week at work I slept in, read a bit with Muriel's Wedding on in the background, went to the gym, and ate a leisurely early dinner before heading down to the Party. Three hours later I was walking back home rather disappointed. Here are some notes I jotted down:

- This band would like to be the Strokes. Now they're playing Tom Petty's "American Girl". Huh.

- Bandana. Why?

- The painter of stylized rotund people is here.

- Shitty drummer for a jazz band. Saxomophones.

- Screw is still a going concern in Houston. [Reading the Wikipedia entry, it's still a going concern everywhere. Shows what I know.]

- Between song time > song time = no good + me moving on

- Suck.

- Nice guitar, belongs in better band.

- A song I like! Now sucking.

This was the most entertaining thing I saw.

I really should stop comparing Houston to Austin, but it's hard when the city you love to pieces is not the one you're in and the one you're in jabs you in the ear with mediocre to poor music.

Tomorrow I get my first taste of Houston theater. My cultural hopes are elevated yet wary.

Tiring, yet fulfilling week

2008-04-11T23:42:00.000-05:00

Very busy at work this week, particularly today. My preceptor has almost completely stepped back, leaving me to handle things on my own unless I specifically ask her input on my plans or for a hand in boosting in patients in bed and the like. It's stressful doing the job without her help, but she and I agree that I'm ready and I best get as much practice handling the work solo because I'll be switching to night shift soon enough. After a couple weeks with a preceptor to get the hang of the work flow at night, I'll be on my own. Of course I can still ask the other nurses for help or input, but the responsibility will be mine with all the little mental freak-outs that come with shouldering it.

As I said, today was busy. I started the morning with one patient, admitted a fresh surgical patient, transferred the first one to the floor, admitted a third patient, transferred the second one out, then managed the third until shift change. Despite it being so busy, I had time to fall in love with my first two patients. Though their quite different backgrounds played a big part in why I was so taken with them, for confidentiality reasons I can't go into detail and changing the details to hide their identities just defeats the point. I can say that their motivation was a joy. Too often post-surgical patients just want to lie still in bed. These patients wanted to get better and followed the medical plan of care to achieve that. More than once I told one of them, "I wish I could shoot a video of you to show other patients how it's done!" I'll have to remember them both when I have the inevitable bad day.

I still really like my job. Yay.

A taste sensation?

2008-04-08T15:41:00.000-05:00

A little Tex-Mex place near my apartment has a drink on the menu called Vampiro. It's a combination of orange, carrot, and beat juice [sic]. In rapid succession I thought of the following definitions for that last ingredient:

beat juice

1. the combination of blood and saliva that flies or leaks from the mouth whilst being pummeled: After he provoked those bikers, they extracted at least a pint of beat juice.

2. reputation for DJing skill: He's got massive beat juice.

3. semen: After holding off for 18 days, the masturbation session resulted in massive beat juice. At least a pint.

Beyond adding a deep red color and therefore justifying the name Vampiro, beet juice just doesn't sound all that appealing. Still, it's preferable to making a drink with definitions 1 and 3.

Anti-clotting med shortage

2008-04-07T23:14:00.000-05:00

Though reports vary, it appears that there is a world-wide shortage of heparin. Heparin is an injected medication that prevents clot formation and extension. Where I work it's used to keep IV pressure lines and dialysis catheters from clotting off, to reduce clot formation until longer-term anticoagulation therapy kicks in as well as for the prevention of thrombosis formation in patients who have reduced mobility, i.e. lying in bed all the time. We got word that the normal supply was disrupted and so for single doses would have to use syringes that Pharmacy is preparing and distributing.

After some reading of wire reports, I think I got a handle on the shortage. Starting at the end of last year, there were reports of patients experiencing allergic symptoms such as difficulty breathing, rapid drops in blood pressure, nausea, and vomiting after single doses of heparin. In February, Baxter Healthcare Corp. issued a recall of heparin after many more reports of reactions including some deaths. Later Baxter announced they were suspending manufacturing. A couple weeks ago B. Braun Medical Inc. and American Health Packaging issue a voluntary recall as well.

Turns out that some of the ingredients were originally produced in China. In early March, the FDA found that the Baxter heparin had a substance called chondroitin sulfate in it that had been chemically changed so that it had a similar effect as heparin. Chondritin sulfate is much cheaper - shades of lead-based paint on toys huh? At first, the Chinese government said that quality control on the manufacturing of heparin should be carried out by the importers. They about-faced several weeks ago and issued new guidelines for stepped up testing and registering of suppliers.
Between this lax control on manufacturing and the Tibet crackdown, I'm a little peeved at China.

The Federal Drug Administration (FDA) publicly stated that there was no heparin shortage because of the recalls but, uh, when you've got three of five manufactures recalling it and hospitals practically rationing supplies, that's a problem.

St. Arnold's Brewery, an afternoon of beer

2008-03-30T19:23:00.001-05:00

Yesterday I went to the St. Arnold's Brewery here in Houston with some friends. The brewery conducts a tour and tasting every Saturday afternoon. It was packed so the "tour" consisted of an employee with a mic explaining a few things about the brewery, which maybe 25% of the audience cared about. Then he explained the way the tasting worked, which I guess about 75% of the audience cared about (the other 25% were clearly veterans who knew quite well how it worked).

$5 gets you the speech, a souvenir St. Arnold's half-pint glass, and four tokens you redeem for drinks. Even the kids or teetotaling friends can join in as St. Arnold's has a root beer. If your kids are bugging the hell out of you I guess you could go half root and half real beer so they'll become sedated, or possibly belligerent. I kid of course, alcohol for children is a no-no.

I had two Lawnmowers and an Amber. By the time the final call came, I was too full from lunch and beer to use my last token. Next time I'll be more diligent. Click the above pic to go to Flickr for more photos, if you're into that sort of thing.

The South Park me

2008-03-25T21:02:00.000-05:00

South Park Studios, where you can watch any episode from the series, recently launched. Following the lead of other animated program websites, they have an avatar generator.
This being South Park (with all that implies), you can chose from the basic body types of Female, Male, Canadian, 4th Grader, and Kindergartner. Skin tones offered are Hispanic, Caucasian, African, and Gay Tan. Yeah. I went with Male and Caucasian. The outfit is the closest I could get to scrubs, though the color is exactly right. Wish I had the Photoshop skills (and the actual program) to take out the "T" and add in a stethoscope and a pocket with pen, scissors, and hemostats. Still, fun!

UPDATE: Mybloody made my wishes come true. Picture now updated with stethoscope, pen, and hemostat. Thanks Mybloody!

My nursing assessment Part I

2008-03-22T16:06:00.000-05:00

As I've written about before, patient assessment is a major part of being a nurse. Here's Part I of what I do within 30 minutes of getting a patient either when I'm coming on shift or they roll out from surgery. I was going to type up the whole thing in one post and then I realized how long it takes to write it all out versus just doing it. It's organized by body system and yes, we have a form to remind the nurse of all the things to check.

Neurological

Shine a flashlight in their eyes and watch for pupil constriction. Grade the size of the pupil (esitmated in centimeters) and the speed of constriction (brisk or sluggish). Grade their level of consciousness (alert, lethargic, obtunded, stuporous, or comatose). Grade their behavior (sedated, inappropriate, confused, agitated, or combative). Ask them their name, the day/date, where they are, and why they are there to judge how oriented they are. People who only know they're name are Ox1, if they know they're in a hospital and why and at least can get the month then they're Ox4. While they're speaking, grade their speech (clear, slurred, incomprehensible, or they have a breathing tube in and cannot speak). If they are aphasic, note whther they are having difficulty speaking (expressive aphasia), understanding what I'm saying (receptive aphasia), or both (global aphasia). Put two fingers in their hands and ask them to squeeze and release. Have them push against my hands with their feet and pull back their feet toward their knees. Grade their strength in these movements. Note if they have a drain or pressure monitor to their cerebral spinal fluid and if so the condition of the dressing over it, the level it's at, and the type of drainage (clear, serosanguinous, sanguinous).

Cardiovascular

Listen for heart sounds, note presence of S1 & S2 (the lub-dub sound) and any extra sounds. Check capillary refill at fingers and toes, grade brisk or sluggish (<>3 seconds). Note nailbed color (pink, pale, dusky, cyanotic). Grade the temporal, brachial, radial, dorsalis pedial, and posterior tibialis pulses (palpable, heard with Doppler, absent). Note chest tubes, their placement (pleural, mediastinal), suction applied if any, and what they're draining (clear, serosanguinous, sanguinous). Note pacemaker and/or internal cardiac debrillator and whether it is on. Note whether unused transcutaneous pacemaker wires are wrapped. Print a EKG strip and analyze it for the heart rhythm. Note or adjust the alarm settings for heart rate, blood pressure, and ST segment elevation or depression.

Note all IVs, their size and placement, when they were inserted, how the insertion sites look, and if the dressings over them are intact or due to be changed. If A-line (arterial line used for continuous blood pressure monitoring) and/or CVP (central venous pressure line used for monitoring that pressure as a measurement of right-side heart function and fluid status) present, calibrate the transducers and note how the monitor waveform looks and that the dressings over them are intact and up-to-date.

That's enough for now. I'll get to pulmonary, renal, etc. later. Is this boring? Should I spice it up with stories of things gone wrong?

How explicit before most turn away? Or A Ridiculous Joke

2008-03-21T23:06:00.000-05:00

Those that know me well know that I love the band The Magnetic Fields. I interviewed band leader Stephin Merritt a couple time while writing for the UT Austin newspaper. There was a time when I had the money and vacation time to justify flying across the country to Boston or New York mostly to see MF. And despite dropping out of all the other music-related listservs, I've kept up with the Stephinsongs listserv for 11 years. Yah, supa-devoted fan.

Mr. Merritt does not compose autobiographical lyrics despite the seemingly heart-felt pronouncements in many of his songs. Though a relatively modern element in popular music, the confessional, when-I-say-"I"-I-really-mean-me style of lyrics seems to be the default interpretation of critics and audiences. Nobody really thinks that Bob Marley actually shot the sheriff or that David Byrne was a psycho killer do they?

Recently Merritt was interviewed about the release of the new Magnetic Fields album Distortion and had this to say, “In the lyrics, there’s only so much intimate detail that heterosexual audiences can put up with. So even if I were autobiographically inclined, I don’t think I would go very far into details. Fortunately for me, I’m not at all autobiographically inclined, and when I put autobiography into my songs I’m generally joking.”*

So, if Stephin was autobiographically inclined and if he went into intimate details, then we'd have, what, More Songs About Butt-Fucking? Actually, that sounds like a pretty good idea. I'm officially claiming that title for my new queerpunk band Big Black Dildo. Or Cock. Is Big Black Cock better?**

*Stephin Merritt, Los Angeles Times, Jan. 27.
** I almost can't believe that I went this far for stupid Steve Albini joke. Almost.

My SXSW week

2008-03-20T19:47:00.000-05:00

So my schedule last week went like this:

Monday

Work 6:45AM - 7:15PM

Tuesday

4 hours of computer modules at work, gym, watched California Split

Wednesday

Work 6:45 AM - 7:15 PM
Drive to Austin 8:30 PM - 11:00 PM
Stuff badges for SXSW 11:15 PM - 11:50 AM

Thursday

Listen to REM from behind Stubb's 12:00 AM - 1:30 AM
Sleep 2:30 AM - 10:30 AM
See bands, wander 12:00 PM - Friday 1:30 AM

Friday

Drive back to Houston 2:00 AM - 5:00 AM
Sleep 5:00 AM - 7:00 AM
Classroom education at work 8:00 AM - 4:00 PM
Watch TV, eat, sit around 4:45 PM - 6:30 PM
Sleep 6:30 PM - Saturday 08:00 AM

Saturday

Drive to Austin 9:00 AM - 12:00 PM
See bands, wander 12:00 PM - Sunday 2:00 AM
Sleep 2:30 AM - Sunday 7:30 AM

Sunday

Drive back to Houston 8:15 AM - 11:00 AM
Think of about how attached I am to Austin and SXSW 11:30 AM - 11:32 AM
Nap, gym, laundry, grocery shopping, watch the original Funny Games 11:32 AM - 9:45 PM

So that's what I did last week. It wasn't a successful SXSW in that I didn't see too many things that impressed me and wasn't able to see any films. In fact the only band I really enjoyed whole-heartedly was The Raveonettes. A few were interesting, but nothing more than that. I'll chalk it up to my own fatigue and jadedness. The kids are alright, must have been me.

UPDATE:
I forgot to write that Black Moth Super Rainbow were great Saturday night/Sunday morning. I really enjoyed their collaboration with Octopus Project last year at SXSW and they clearly came ready this time. They had confederates in the crowd who, at climatic moments, would throw out candy and confetti, spray fake snowflakes, and float (empty) piñatas through the very engaged audience. Every couple of songs, the guy in the band who was crouched on the floor playing keyboards or vocodering would stand up, look around, and seem amazed at the size and excitement of the crowd. Yay for them.

Hi-ho, the derry-o

2008-03-04T10:07:00.000-06:00

So I'm at home, organizing stuff with Wigstock: The Movie playing in the background. I've never seen it before and I do like talented drag queens, but still I'm barely paying attention. Near the end of the movie I look up during Crystal Waters drag king performance and say to myself, "Is that Michael K. Williams, better known as Omar on the best TV show ever The Wire, as a back-up dancer?!" Through the magic of Tivo (and a quick Google to confirm that he was a dancer for Waters), it is confirmed. Michael K. Williams, pre-scar, is in Wigstock: The Movie furiously workin' it.

Couldn't find a online clip of it so I just took pictures off the TV screen.