Deflated Like a Flan in a Cupboad*

*partial Eddie Izzard quote..



So my romance with the musician fizzled. All I wanted to do was talk about anything but school and all he wanted was to hear stories about medical school.  Besides, he wouldn't listen to any music but his own. Not cool.

The first block of classes has successfully ended. Starting off with material that was familiar and came easily had spoiled me. Now, I'm nervous to all git about this new block: DUM DA DUM... anatomy!...

I like concepts, pick them up pretty quickly and love figuring new ways to apply them. Going into exams for cellular bio, chemistry or the MCAT (I can't believe that I'm admitting this...), I would secretly get excited like I was starting a new trivia pursuit game. Woohoo! A challenge! It was easy to see the trees and not the forest. I would approach each question like I was playing Whac-A-Mole.  Long confusing question? BAM! Knock that varmint back in the hole. I would leave the test giddy for all the rodents I had smushed and unconcerned about the few that I knew I missed. We all miss some of the little buggers when they pop up. The significance of the test in the grand scheme never really occurred to me until long after the effect.  My nerves have always twisted in those spare seconds before opening the results.

Well.. I just can't seem to get excited about anatomy. No game, nothing to figure out, either I memorized the material or I didn't. I'm really a pretty lazy person and an easily distractible one. This is something of a nightmare: sitting down for four months of nothing but brute memorization on an epic scale.

It's going to be an amazing struggle to keep up with the material. Bah.

Oh.. and herb plant numera tres esta muerta. Descanse en paz, Aloysia Citrodora...

I Cried Today

A few months ago, I met up with a childhood friend. We had drifted a little apart over the years. I had moved out west, he went to seminary school in Massachusetts.  But we communicated every couple of months and I still counted him as one of my most trusted friends.

When he came into town for the Easter holiday, we made an effort to get together. It was the first time in almost ten years that we met face to face.

It started off great. We caught up on our daily lives (he's building a massive orthodox church in Vermont- I recounted my school application adventures) and then we talked philosophy. It had been a shared passion in high school-one that we'd both explored deeply since.

I minored in moral philosophy in college and absolutely love the intellectual sport of debate. We found ourselves discussing the continental rationalists and I argued Spinoza's work over Leibniz's. I joked that it was ridiculous that Leibniz couldn't comprehend infinite regression in his monadic theory but that he had no problem with it mathematically. After all, calculus is, in part, the study of infinite series.

Everything was going great, we had coffee, we laughed, we reminisced. I treasured that, despite our differences on the religion front- rather because of those differences, he offered an intelligent insightful world viewpoint. One that, as a scientist and atheist, I'm not often privy of. Most of my other friends hold similar views to my own.

Well. As our brunch wound up, he tried to save me, spiritually- that is.

I'm not a militant atheist. I hate that I'm labeled by what I don't believe in. I don't believe in many things- Santa, the toothfairy. I wouldn't like to be called adentemfatist. It seems another useless qualification.

I tend to be very shy about my lack of belief. I've seen how much comfort the sick, the dying and those left behind obtain through their beliefs. I saw how much it helps my grandmother to believe that she'll be with my mother again in the Catholic heaven.  It seems to me, that broadcasting my own thoughts to others would only result in being hurtful for them. In fact, I sometimes wish that I could acquire that same comfort. I miss my mom.  But I can't convince my rational mind that it exists. It's just not there.

And I can live my life, fulfilled, happy and with purpose without believing in god. I truly think that it is impossible to convince, with a rational argument, the rightness in a religious belief to someone who doesn't hold that belief.

Anyway. Suffice to say, our brunch did not end happily. I tried to explain that I wasn't going to change my mind and "let's celebrate the diversity our differences bring to the lives of each other".

He wouldn't have it. He told me that he couldn't truly trust someone who didn't believe in god.  And he dropped our friendship in the rubbish can on his way out.

Well, that hurt. All of my care in choosing: eating ethically, minimizing my carbon footprint, volunteering in underdeveloped countries, helping people, spending days helping to clean out his father's church after a flood, all negated in his mind because morality can't exist without a deity to police our behaviors.

Today, I received a call from the financial aid office of BCMS. They chose me as the recipient in my class of their *Service to Humankind* Scholarship. It's a huge huge honor and I'm floored and humbled and thrilled and sad. 

I cried because a big institution, one that doesn't yet know my heart, the responsibility I feel to people and the world, looked at my CV and talked to my interviewers and decided that of all the brilliant amazing and worthy 200 people in my class, that I -stupid, underachieving, insignificant me- most represented to them, a moral spirit. (which is totally weird btw- seriously? me? I'm going to school with Rhodes Scholars, people who organized major endeavors to help others, people who have accomplished so much more than I in much less time. Weird.)  But my 'friend', someone who had known me, my heart, my choices and actions for over two decades... Bah.

Sigh. I guess everybody has to deal with getting over toxic relationships at some point in their lives.  I'm just having a really hard time doing that today.

Patient Remembrance

A recent patient (P) of mine was a peripheral co-worker of my mother's. They both worked in different departments of a large institution.

I recognized her immediately but, fortunately, she didn't remember me. I'm always ill at ease when acquaintances of my parents meet up with me and express their own grief.

As the day went on, people from this workplace came and went visiting P. Well, someone inexorably knew me. Sigh. The news spread like wildfire through the waves of visitors and I was stopped a number of times in the hall to answer questions about my life, how my family is without my mom and to listen to how sad they were, how much they miss her etc.

Don't get me wrong, it's comforting to know that so many people were affected by mom. She was an amazing special woman. She was, without a doubt, my closest friend.

It just makes for an uncomfortable workday.

I'm training someone in the end stages of orientation. This person was practically running the group and so I was able to avoid more of the prolonged interaction.

It wasn't until the end of the night that I had to re-enter the room solo.

P. saw me and thrust out her hand.

"Kate! There's another Kate on the floor whose mom worked with me. It was so tragic her dad died and then her mom... Oh.. What was her name? Oh.. Not Kate.. that's the daughter's name.. What was her name?..."

I sighed.

"Her name was M___. I'm Kate ___. The only Kate on the floor."

P. stared at me for a moment then burst out in sobs.

"Oh.. your mom was the sweetest lady ever. We all miss her so much and think about her every day... blah blah blah blah."

I found myself comforting a hysterical patient for over forty five minutes about the death of my own mother; a woman whose name she couldn't even remember!

To cap it off, P. sent candy and a card to the unit after her discharge thanking everyone personally for their care. "Sue was so kind and helpful. Janet was so smart... etc" But she didn't remember my name! I laughed and laughed. It was so poetically ironic!

I sure ate some candy though.

Sheepishness

After my last 'oh woe is me..' post, I've actually had a good time at work and made plans to share some vino and conversation with one of the new nurses.

We've discovered a mutual appreciation for Bollywood movies and the absolute awesomeness of SRK.



She's new to the area and I think that she's lonely too.

I've got an interview in Chicago next month for school. I'm excited. I love Chicago!

Settling In..

Well, I'm getting used to my new apartment. My neighbors are musicians. Yep. Alt Rock. Sigh. Toulouse is not amused.




I love it nonetheless. Here are the aforepromised photos.





There's been a delay on the house closing. Lawyers. Hopefully, we'll finally finalize it this week. In the meantime, I've been popping up there to check on it and take advantage of the laundry. Yesterday afternoon, I was vacuuming and heard "knock, knock, knock" on the door.

I opened it up and, lo and behold, there was the mayor of my small town holding a small ceramic bowl.

I invited Mr. B in and we chatted for a few minutes. Apparently, his son bought the house and the mayor was unaware of the delay in closing. He was wandering around the property last week, found my collection of wheat pennies in the garage and took them home. When he found out about the delay, he wanted to return the money. He was embarrassed. We walked through the house together and he mentioned some things that 'John-John' wanted to change and asked about the family. I had never really known him, his kids were older than me, but he was my brother's little league coach and shared booster club responsibilities with my mom and several aunts and uncles.

After he left, I burst out in laughter. I was robbed by my mayor! It struck me as incredibly ironic.

Work has been remarkably smooth. The nightmare patient that I had mentioned last time was only with us for a few days and since then, our census has been mostly comprised of easy ortho patients.

No more news on the medschool application front. I'm still 'under review' at all of the other schools. The waiting is impossible. BAH.

Isolation

All five of our isolation rooms are sequestered in one hallway on our unit. I was walking back from helping woundvac dressing change and found myself stopping in each room to chat with the patients. I knew them all well. I chatted with Dean* (MRSA) about his kids; Ira* (VRE) shared his news about his UNOS status; Frances* (MRSA) asked me for a cigarette and we laughed together at the inside joke; and for a few minutes, Robert* (CDIFF and MRSA)and I competed to see who could get the most Jeopardy questions right. He won. Stupid "Sports Venues".

I headed back to the desk and, out of curiosity, checked to see how long my friends on the I-ward had been here. At July 7th, Ira was the newest admission. Three months. Like the others, he's settled in. He has his favorite snacks in the kitchen fridge, a mountain of pillows to burrow into, piles of linens, dressing changes and unopened Nepro spilling out of cupboards and closet. Photos of his dog are on the wall and an extension cord keeps his cellphone and nook within reach.

After her transplant, my mother lived in the hospital for 11 months. We settled her in as best we could with soft throws, poster-sized photos of family on the wall, homemade hospital gowns, radio, magazines, toys, anything that we could think of to make it more comfortable. She hated it. She had no interest in anything but getting home.

I don't see that with my I-ward friends. Both Robert and Frances have been on the verge of going home several times over the months but they got stressed, become enraged and argued with the discharge planners. Then they had relapses, Robert became septic and Frances' tissue flap reopened.

Over the weeks, I've learned bits and pieces about my patients lives. Ironically, the time they spend in the I-ward is less isolating than their home lives. They each have a different story but, without exception, they are lonely and enjoy the 'perks' of living in a hospital: constant company, all the food they can eat, any need/desire filled by just pressing a call bell button.

Over the last year, I've noticed a steady increase of 'social admissions' to our unit. I think it's due to the aging local population, the depressed economy and the cutbacks at the nearby psychiatric hospital. A lot of its inpatients have been reevaluated to outpatient status. The recent flooding also destroyed 2 nearby nursing homes and countless homes.

It's scary and sad to me, that the awfulness of being in a hospital is actually preferential to what awaits outside.

Though my mom never made it out of her hospital stay, she had something better to look forward to, to work for. We all, up until the very end, had hope and desire that she'd make it home. In that way, we were fortunate.

No news on the med school application front.

Chicken Pox

One of the new nurses on the unit has a moderate case of the chicken pox. Policy here is that anyone who had contact with the infected needs to demonstrate either a recent immunization or an adequate varicella titer.

When I was hired last year, my titer was low. When I was six, I had had a severe case of chicken pox; if you closely examine my cheek and shoulders, you can still see the pockmarks. Because I've read that those who actually have had the disease demonstrate lower measured titers than those who are vaccinated, I declined to get a booster shot when I went through orientation. The clinic was across town and I didn't want to take an entire afternoon to get a shot I didn't need.

I am now presented with a choice: either take 28 days of unpaid medical leave or get the booster shot. I, of course, am getting the vaccination - I would need to for school next year anyway. It's just one more irritating errand in my already insanely busy life.

The irony is that the new nurse's infection is due to a booster shot she received during her orientation.

Nighttime Events

Yesterday, because of the construction, the census on U8 was low and I was expecting to get called off. Rather, another unit needed an aide so I floated down to the JD Rehab Center, a subacute care wing of the hospital.

I arrived to find Andrea, an ICU nurse, had been borrowed too. Andrea and I have worked together many times and have become friends. We laughed together as the night began because it was a vacation; most of her patients didn't even take medications and many of mine were independent.

Ironically, I wasn't allowed to do anything but task, no charting, testing glucose or vitals because I'm not a certified nursing assistant. So my responsibilities were minimal. After the last few months of juggling both the responsibilities of an aide and unit secretary, this was refreshing. Andrea teased incessantly, tickled by my certification limitations. She thought it was a riot and would demand proof that I was qualified to carry a dinner tray or empty linen carts.

The night dragged painfully though. After what would have been a double upstairs, the clock read only 3 hours into the shift on JDR.

Then the fall occurred. Apparently, the family of Grandma Smith* had unplugged her bed alarm while they were visiting. Its shrill beep was annoying to them. After they left without resetting it, 94yr Granny Smith decided to go to the bathroom to change. We found her crying for help in a pool of blood and vomit.

Andrea and I kicked into gear like Emil Fischer's lock and key enzymes. She checked vitals and stabilized her head while I went to the desk to call a rapid response team and the ED for a lift board, cervical collar and stretcher.

The nursing staff on JDR is amazing. They're friendly, good with patients and very good at their job. They don't have many medical emergencies there though and so seemed grateful to step back to let Andrea and I take control.

The residents, newly minted PGY1 and PGY2, examined her pupils, spoke with their attending and down we went to CT. I stayed at Gran's head, pushing the stretcher with one hand and holding the emesis basin with the other. When she would get sick, I would stop the stretcher, we would slowly angle the lift board and let her vomit on her side. Her wide eyes locked with mine and she held my hand tightly. I know that she was frightened by the fall and the rapid conversations flying over her head. I wasn't really needed in the medical part of the emergency other than as a strong back so I tried to keep a constant gentle flow of words to only her to give her something to focus on. I explained everything that they were doing before they did it and her breathing slowed and deepened.

We took her to CT, then XRAY and back to her room. She settled in quickly. Andrea dressed the wound on the back of her head and I swabbed her mouth out, washed the blood and vomit off her face and shoulders and changed her gown. She even laughed at some of my lame jokes. "What did one snowman say to the other?**" Then I stepped aside and let the CNA test her blood sugar.


*not Mrs. Smith real name. Also many details have been changed to protect her, or his?, identity and the identity of my medical institution.

**answer to really lame joke: "do you smell carrots?"