Cardiac Infarct

So Sorry, My Sister

...but now I see
I had her before me always,
like a shield. I look at her wrinkles, her clenched
jaws, her frown-lines - I see they are
the dents on my shield, the blows that did not reach me.
She protected me, not as a mother
protects a child, with love, but as a
hostage protects the one who makes her
escape as I made my escape, with my sister's
body held in front of me.

From The Elder Sister, Sharon Olds
For you, in loving memory of
S.B.M. 09/08/1972 - 07/22/2009

Kozure Ōkami

From the manga of the same name.

Recap

Time for a recap of the past few months:

The winter ends, psych and peds rotations begin... and end, I join Facebook, The Kid graduates to the *fifth* grade, the MEPN year ends (hurrah! hurrah!), I meet new MEPNs with new neuroses, I leave Facebook, The Partner finally visits Montana, I receive my interim permit to practice nursing in the state of California, I register for the NCLEX and I come back to Circus Nurse, fresh and new. Okay. Now we're all squared away.

Per Sempre

Without impatience I'll dream.
I'll bend to the task
That can never end,
And little by little at the tips
Of reborn arms
Succoring hands will reopen,
The eyes reappeared
In their sockets will give light again
And suddenly in tact,
You'll have resurrected, your voice
Will be my guide again,
I'm seeing you again forever.

~Giuseppe Ungaretti

The Trick of Humanity

I spent the first day of pediatric clinicals in the intensive care unit. My patient was very young, under one year, born with congenital anomalies that included a heart defect, this one specifically, choledochal cysts and biliary atresia, meaning that she needed both open heart surgery and a liver transplant. She received both, preceded by a miriad of other surgies. When I cared for her, she was nine days post-op. I counted eight IV lines going into her body, exclusive of her pacer wires, NG tube, Jackson-Pratt drain, CPAP and ventilator.

I didn't mind the PICU so much as I expected. In fact, pediatrics seems like a place I would be excited to work, a great surprise to me. Maybe it's the timing. The most significant obstacle would be coming to terms with advanced technology out-sizing the patient. Following yesterday's rotation I felt like this was a huge moral dilemma, so I sought out reserach on the subject and found an interesting article that takes on the distress that PICU nurses face in the wake of modern technology that outpaces moral questions about life at any cost. The authors ask how medical and "life-saving technologies are outstripping our human abilities to comprehend and live with the consequences". Certainly a very worthy ethical question and definitley one that represents what I find the most difficult aspect of peds: what it means to be humane. To me, it looks like humanity tricking us again.

A Home in the World

"I can't consider any of that time as time away, because you don't want to spend half of your life being away or where you shouldn't be. I choose to think of all the time as being present. I'm always home."

I Have Not Seen You

...but slowly you are
forming above my head, white as
petals, white as milk, the dark
narrow stems of your
ankles and wrists,
until you are always with me,
a flowering branch suspended
over my life.
~ for E.J.T. 1973-2009 &
C.V.O. 1995-2009

from Absent One, by Sharon Olds

Movie: A New Euphemism For..?

So The Partner says, "Look at all of those trucks along the side of the road. Do you know what they're doing there?"
"No...." says The Kid.
"They're making a movie."
"What's a movie?"
"Um, a movie" I say, "have you ever seen one?"
"Oh," says The Kid, "I thought you meant something different by 'a movie'... like something truckers get together and do in the woods."

Like the End of Something Wonderful

Were you worried Billy'd crossed over to the other side? Me too. I guess we were wrong. Today's New York Times sports a long-deserved and up-front review of the new album which is weirdly flattering and, at the same time, disparaging.

"Mr. Oldham’s persona is a little bit of a lonesome romantic and a lot of a fool. He sounds generally optimistic, even when he’s singing about treachery...He never flatters himself. He’s not special. His love is effortful and can be one-sided. He’s easily satisfied. He can’t be counted on... Something is always lost in translation with him."

My favorite is the last line in reference to breadth and depth of talent in his accompanying musicians, "There’s a sense here of smart people being made to focus on a strange project."
It's refreshing to see he can still make the critics stutter.

Kandahar Treasure

"I heard a mother had lost her son due to a suicide bomber, and she got up to speak, and she said a beautiful thing. She said, “Whether it’s a Talib who’s being killed, an Afghan policeman who’s being killed, or an international army military person who is being killed, he leaves behind a mother, a sister or a daughter and/or a wife who mourns for him.”

So that saying was quite powerful in saying that women have this inclusive idea of security and owning peace. Stopping the killing for all... is reason enough for them to wage peace. You know, mothers feel the pain of human beings, and they’re calling for and they want this killing to stop." Rangina Hamidi. ~ Kandahar Treasure

The Feminist Conundrum

"So do you have men in other rooms studyin' about theirselves?"

"Not necessary. Men are already studied in every kind of study. Women have been forced to study great men ---"

"Maybe that's the problem... Ditch great people! Erase the bastards... from books and stuff. Just do folks - regular ones - the failures." Snowman (1999)

No Room at the Inn

I discharged my patient to a shelter yesterday with heparin induced thrombocytopenia recently “resolved” by argatroban (tx stopped 2 hours prior), but with no coumadin. I discharged him with a foley. I did so because I was told to do so by the doctor. I put up a totally meager fight and then sent him packing with Thursday’s copy of the New York Times that I’d brought from home, a bag with handles donated by the gift shop, a pair of flip flops and a sweat suit donated by social services, a walker donated by physical therapy and no clear idea of where he was going or how to care for himself. We just put him in a cab and sent him away.

I Am Goodbye

New bonnie video from Drag City

Featured bonnie article from The Wire

And a picture gallery

About Anonymity

Opinions expressed on this blog are experientially based opinions. Everyday goings on from the life of one mother, student, ABD*, Oldham fan, jobless, amateur circus performer.

I just want to make that clear to anyone lurking around these parts who thinks I might actually know something about something.
For the record, I don't.

*someone actually called me this at a party over the weekend, ew!

He Who Would Be Prince

Bonnie's getting a lot of press lately, e.g. this boring interview. (Can I just ask, who is McLaughlin talking about when he says that "many" compare Oldham to Dylan? Jesus. Please.) Anyway, check it out simply for the ancient "Horses" video plucked from youtube.

Army of Shadows

This is an excellent movie.
Left speechless.

The Attending

Did I tell you that I inadvertently called the attending physician on Friday for blood pressure parameters for my patient's Cardizem? Learned my lesson about the hierarchy in a hurry. Yes, in fact, it was totally humiliating. And I'm not sure why, except that I didn't live it down in a hurry... And I did not get the damned parameters.

For those who don't know the system it's like this, top down: attending, resident, intern... with, at my institution of practice, multiples thereof under the attending. "Nurse" is somewhere waaayyy down at the bottom of that totem*, falling fast when one phones the attending instead of the intern.

*Oh wait, we're not a kinship group. There I go, mixing up my careers again!

Garden Poetry

My mind is longer than any tree's branch.
My arms are like the trunk of a tree.
My hair is a bush in the garden.
My room is a treehouse swaying in the treetops.
My feet are the roots on a tree.
My fingers are like bonsai, each its own.

~The Kid, February 2009

Hello, Marmoset!

The latest greeting I receive when I see The Kid.

This nicely complements the insult he shouts when the dog is attacking:

"You little juvenile!"