REFLECTING ON: Community health rotation placement and treating patients in their homes...
For my Community Health clinical rotation, I’ve been assigned to work at a nursing agency that provides in-home care to patients that have been discharged from the primary hospital. Grace is the nurse that I have been assigned to work with. She’s Puerto Rican and mainly of African descent. Spanish-speaking patients do a double take when she switches fluidly English to Spanish. She’s subtle like that—holds her cards close and lets the patient reveal him/herself. I could take a lesson. Silence is sometimes the best diagnostic tool.
We visited three patients: one foot amputee, one renal failure with dementia, and one pressure wound. They had names too, but HIPAA wouldn’t like me revealing them. The foot amputee patient didn’t take to “patient education too well. We encouraged him to elevate his foot, which he explained he couldn’t do because it made him uncomfortable. I decided to play the “dumb student” and ask Grace why a patient should elevate his foot in order to heal an infected wound. Of course I already knew, but I just thought a conversation between professionals might be less irritating to the recalcitrant foot amputee. We’ll see.
I was excited to observe wound care because, although I practiced on latex models in skills lab, my clinical placement on the oncology unit didn’t have much opportunity to manage wounds. If the low-platelet, neutropenic leukemia patients had a wound, they were usually sent to the ICU. I like skills and technical stuff, so I’m juiced that my community placement opens the opportunity to work in people’s homes as well as practice new clinical skills.
The second patient we met was a 94 y.o. Brazilian woman with acute renal failure, diabetes, and slight dementia. She lives with her 84 y.o. sister and an obviously unstable dog. The dog is named “Sister” until they realized she was a he, necessitating a name change to “Brother”. Sometimes they still call Brother “Sister” due to his being neutered.
I consulted the patient’s vitals, lab values and history. I listened to the concerned cousin that provided 8 hour/day care to both her family members. In addition to monitoring her weight, liquid/food intake, diet, blood pressure and bathroom habits, I determined that the dog was a primary concern. While I was there, the dog attacked every family member at least once, Grace twice and nipped my hand until it bled. When it jumped on our patient, it went right for her slowly healing IV wound, which had become infiltrated during a recent hospital visit. Grace and I will be prescribing a squirt gun to deal with the dog. I mean, this woman isn’t exactly a quick healer.
Thursday, September 27, 2007
Tuesday, July 17, 2007
"CLASS" test
REFLECTING ON: Being obsessed with grades...writing to teacher that has urged us to stop nit-picking tests and start thinking about matters of substance.
"Dear P--,
I told myself that I wouldn’t buy into the grades and the nonsense and the madness….but I did. Damn it. I’m all in and all about learning what I need to know in order to do this job. If I do this, I will learn what is important, which may or may not be included on the class test. But, if I am to pass the CLASS test, the real definition of class, I will realize that my sincere effort and desire to be competent can’t be graded so the grades shouldn't matter as much.
I'm trying to get this new learning curve-ball that's being thrown at me. Let me explain.
I'm trying to get the actual lesson here. I've had a fair number of "teachers" in my life, at least in name, but very few mentors. I think that's what you are trying to say here: chill out and get the real knowledge of what it means to be a good nurse. Not a wanna-be doctor, not a heal thyself case, and not an academic: a nurse. Working on it.
I gotta realize that this process is a harsh reprogramming of my mind. Having forced myself to stay academically competitive all my life (I mean, I got in to UCSF, right?) has put me at a mental disadvantage sometimes when looking for the "real" lesson. Clearly, many of us, especially me, need to be challenged to get past the nit-picky details of what we have memorized to get 4.0s, 90%ile GREs and find true, substantive, practical knowledge (wisdom?).
We'll get it--just in different ways.
I personally need to have some yell, "Hey buddy, what are you doing?" every once in a while to be reminded of what I'm actually trying to do here (something I'm still not sure I even know). Keep in my ear and maybe I'll just get it. I personally look forward to you yelling "Let's get it started" every morning.
Take care,
~Nat
"Dear P--,
I told myself that I wouldn’t buy into the grades and the nonsense and the madness….but I did. Damn it. I’m all in and all about learning what I need to know in order to do this job. If I do this, I will learn what is important, which may or may not be included on the class test. But, if I am to pass the CLASS test, the real definition of class, I will realize that my sincere effort and desire to be competent can’t be graded so the grades shouldn't matter as much.
I'm trying to get this new learning curve-ball that's being thrown at me. Let me explain.
I'm trying to get the actual lesson here. I've had a fair number of "teachers" in my life, at least in name, but very few mentors. I think that's what you are trying to say here: chill out and get the real knowledge of what it means to be a good nurse. Not a wanna-be doctor, not a heal thyself case, and not an academic: a nurse. Working on it.
I gotta realize that this process is a harsh reprogramming of my mind. Having forced myself to stay academically competitive all my life (I mean, I got in to UCSF, right?) has put me at a mental disadvantage sometimes when looking for the "real" lesson. Clearly, many of us, especially me, need to be challenged to get past the nit-picky details of what we have memorized to get 4.0s, 90%ile GREs and find true, substantive, practical knowledge (wisdom?).
We'll get it--just in different ways.
I personally need to have some yell, "Hey buddy, what are you doing?" every once in a while to be reminded of what I'm actually trying to do here (something I'm still not sure I even know). Keep in my ear and maybe I'll just get it. I personally look forward to you yelling "Let's get it started" every morning.
Take care,
~Nat
Saturday, July 7, 2007
Patients as Heroes
REFLECTING ON: Interacting with patients on the Oncology Unit at the Hospital where I have been assigned clinical rotations...
There was a distinct feeling that I got Thursday and again yesterday at the end of clinicals: this is doable. Not only that, I got the distinct feeling that I was meant to do this. I am built to be a nurse.
One of the issues that I continually confront with a “do-gooder” personality is offering help in situations where perhaps it isn’t always requested, needed or appreciated. Though there are certainly subtleties and nuances in providing care to patients, generally speaking, I am there to help and it is most certainly needed. It feels good to be needed and appreciated. Such a contrast from my last job where I continually had to grow thick skin, suck it up, and deal with all sorts of abusive language/behaviors without much of a grain of appreciation. I don’t know how I did it for as long as I did.
I am working on the oncology unit for my first clinical rotation. Everybody there is dealing with the big “C”. Generally speaking, it is my impression that in American society, cancer is synonymous with death. Sure there are treatable types, but the word “cancer” seldom describes good news unless you are defeating the disease.
These patients my heroes. They are humble, possibly because they have no choice, but nearly all of them are kind—and attitude is something that they do have a choice in. I don’t want to romanticize their situation that is so far from glorious, but then again, perhaps we need a new definition of glory.
I met this man, Alfonze, a 29-year-old father of two, who is fighting Acute Lymphoblastic Leukemia for the second time. His prognosis is not good: his cancer has metastasized. To compound matters, his youngest son is also fighting cancer at another hospital.
Bright-eyed and bushy tailed, I walked into Alfonze's room yesterday to practice taking vitals just as he had received the news that a second tumor was found in his son. The expression on Alfonze's face was clear: he already knew the second tumor was a death sentence.
Writing “Death sentence” sounds harsh to me right now, but I am not going to mince words here. I am not going rehash some tired words that “everything is going to be okay”. What a line. Try as we might, we cannot control everything—we are not gods. Not me and not the physicians who write the treatment orders. Everything is far from okay. A father and son that I know have a greater probability of dying this year than they do living and that is so far from okay.
And yet, here is Alfonze, being so kind to me as I fumble with the blood pressure cuff. That is glory: bravery manifested as kindness while facing almost insurmountable challenges. Alfonze is glorious. My definition of glory includes people that fight with dignity and character.
There was a distinct feeling that I got Thursday and again yesterday at the end of clinicals: this is doable. Not only that, I got the distinct feeling that I was meant to do this. I am built to be a nurse.
One of the issues that I continually confront with a “do-gooder” personality is offering help in situations where perhaps it isn’t always requested, needed or appreciated. Though there are certainly subtleties and nuances in providing care to patients, generally speaking, I am there to help and it is most certainly needed. It feels good to be needed and appreciated. Such a contrast from my last job where I continually had to grow thick skin, suck it up, and deal with all sorts of abusive language/behaviors without much of a grain of appreciation. I don’t know how I did it for as long as I did.
I am working on the oncology unit for my first clinical rotation. Everybody there is dealing with the big “C”. Generally speaking, it is my impression that in American society, cancer is synonymous with death. Sure there are treatable types, but the word “cancer” seldom describes good news unless you are defeating the disease.
These patients my heroes. They are humble, possibly because they have no choice, but nearly all of them are kind—and attitude is something that they do have a choice in. I don’t want to romanticize their situation that is so far from glorious, but then again, perhaps we need a new definition of glory.
I met this man, Alfonze, a 29-year-old father of two, who is fighting Acute Lymphoblastic Leukemia for the second time. His prognosis is not good: his cancer has metastasized. To compound matters, his youngest son is also fighting cancer at another hospital.
Bright-eyed and bushy tailed, I walked into Alfonze's room yesterday to practice taking vitals just as he had received the news that a second tumor was found in his son. The expression on Alfonze's face was clear: he already knew the second tumor was a death sentence.
Writing “Death sentence” sounds harsh to me right now, but I am not going to mince words here. I am not going rehash some tired words that “everything is going to be okay”. What a line. Try as we might, we cannot control everything—we are not gods. Not me and not the physicians who write the treatment orders. Everything is far from okay. A father and son that I know have a greater probability of dying this year than they do living and that is so far from okay.
And yet, here is Alfonze, being so kind to me as I fumble with the blood pressure cuff. That is glory: bravery manifested as kindness while facing almost insurmountable challenges. Alfonze is glorious. My definition of glory includes people that fight with dignity and character.
Friday, July 6, 2007
Nurses eat their young
REFLECTING ON: Nurse burnout and the old school...
The last thing I wanted to do was make waves on my first week of clinicals. Oh well. But I swear this really had nothing to do with me…this time anyway.
So there I am, in the oncology unit’s nurse’s lounge, sitting down and trying to “play nurse” with my preceptor, Lee. I’m looking at the patient file and literally trying to figure out what “MAR” means (let alone its contents) when this mean looking nurse comes in and scolds me, or more appropriately put, tears me a new one. “You’re not supposed to be in here doing work—this area is for relaxing only.” Please meet Mildred, and for all terms and purposes, this is a fitting way to meet her.
Confused, I look to my preceptor who is now making a thorough examination of the ceiling. Mildred continues, “Not only that, the student nurse shouldn’t be taking seats from an actual nurses doing actual work.” Sweet. I just stepped on toes, got thoroughly trounced, and I don’t even know what MAR means. Since Mildred is belittling me and addressing me in the third person, I think it’s safe to say that I shouldn’t ask her.
So, wow. Okay. Let’s not lose our cool. Clearly there has been a misunderstanding. Let’s approach this logically and diplomatically. After all, we’re all professionals here. “I didn’t know”, I say, “my apologies…I’ll move my work somewhere else.” I’m a bit miffed that my preceptor hasn’t said anything to Mildred since she was the one that told me to sit in here, but I let it go. Completely resolved to avoid further confrontation, I begin gathering my effects.
“And maybe the student could clean up while he’s at it.”
No way. This is a power play and I am having none of it. I don’t care if I get moved to another floor or even if this is how students are normally treated. This woman has no manners. And if this is how nursing students are treated, I don’t want any part of it. Having worked with emotionally disturbed boys for nearly a decade, I’ve developed thick skin to insults that range from my manhood to my mother…but this third-person nonsense has got to stop. God I hate bullies.
Standing up, I look at Mildred, “Okay. I get it. I’m the new guy—and a student to boot. But the student’s name? His name is Nat.” Extending my hand in a manner of greeting I am more accustomed to, I stare at Mildred straight in the eye. “Nice to meet you.”
For all her bluster and braggadocio, Mildred crumpled like a house made of cards. Extending a limp wrist handshake, she mumbled, “Well you’re still a student to me,” and walked out of the room.
Feeling vindicated, I turned to Lee who sat there stunned. “Wow, way to stand up to Millie there. She does that to everyone. She’s of that old-school style of nurse. You ever hear the saying, ‘Nurses eat their young’, well that’s Millie.”
I hadn’t heard the saying and my first reaction was that it was just horrible. Nurses eat their young? Yuck. Just disgusting. I mean, I get it, some folks need to toughen up sometimes, but I’d rather not feel that I’m going to be consumed like the runt of the litter in some unspoken, pseudo-Darwinesque training program while learning a profession that presumably embraces compassion. I mean, there’s got to be middle way. Right?
The following week, I, yet again, inadvertently crossed Millie, but this time she avoided me altogether. You see, someone had “unknowingly” assigned me to her patient caseload because I had unwittingly done pre-lab on one of her patients. Instead of shifting me off that set of patients, they shifted Millie. When I realized what had happened, a very flushed and very angry Millie stormed passed me shouting, “Twenty-five years here and they treat the students better than me!”
Later I learned that Millie had thrown a magazine and then broken down into tears in the nurse manager’s office. Clearly, this had nothing to do with me. Another veteran nurse confided in me that Millie had been the “elephant in the room” for a while now. I just happened to be the last straw that blew in and broke her back.
Millie was clearly experiencing burnout, and was given some mandatory vacation. I never saw her again that quarter, but I certainly am reminded of her on a daily basis. Burnout is a common affliction in the nursing profession. There are tireless nurses and there are tiring nurses that are under the delusion that they are the former. Having seen first-hand the exhausting and emotionally jarring work that nurses do, it surprises me that there are not more Millies in the world. I feel simultaneously sorry for and leery of Millie. Sorry, because I later heard that Millie, in fact, was an excellent nurse. And leery because I am scared that I, too, have the potential to act like her and not know it.
If I ever act like Millie, you have full permission to put me in check. I’ll thank you for it later.
The last thing I wanted to do was make waves on my first week of clinicals. Oh well. But I swear this really had nothing to do with me…this time anyway.
So there I am, in the oncology unit’s nurse’s lounge, sitting down and trying to “play nurse” with my preceptor, Lee. I’m looking at the patient file and literally trying to figure out what “MAR” means (let alone its contents) when this mean looking nurse comes in and scolds me, or more appropriately put, tears me a new one. “You’re not supposed to be in here doing work—this area is for relaxing only.” Please meet Mildred, and for all terms and purposes, this is a fitting way to meet her.
Confused, I look to my preceptor who is now making a thorough examination of the ceiling. Mildred continues, “Not only that, the student nurse shouldn’t be taking seats from an actual nurses doing actual work.” Sweet. I just stepped on toes, got thoroughly trounced, and I don’t even know what MAR means. Since Mildred is belittling me and addressing me in the third person, I think it’s safe to say that I shouldn’t ask her.
So, wow. Okay. Let’s not lose our cool. Clearly there has been a misunderstanding. Let’s approach this logically and diplomatically. After all, we’re all professionals here. “I didn’t know”, I say, “my apologies…I’ll move my work somewhere else.” I’m a bit miffed that my preceptor hasn’t said anything to Mildred since she was the one that told me to sit in here, but I let it go. Completely resolved to avoid further confrontation, I begin gathering my effects.
“And maybe the student could clean up while he’s at it.”
No way. This is a power play and I am having none of it. I don’t care if I get moved to another floor or even if this is how students are normally treated. This woman has no manners. And if this is how nursing students are treated, I don’t want any part of it. Having worked with emotionally disturbed boys for nearly a decade, I’ve developed thick skin to insults that range from my manhood to my mother…but this third-person nonsense has got to stop. God I hate bullies.
Standing up, I look at Mildred, “Okay. I get it. I’m the new guy—and a student to boot. But the student’s name? His name is Nat.” Extending my hand in a manner of greeting I am more accustomed to, I stare at Mildred straight in the eye. “Nice to meet you.”
For all her bluster and braggadocio, Mildred crumpled like a house made of cards. Extending a limp wrist handshake, she mumbled, “Well you’re still a student to me,” and walked out of the room.
Feeling vindicated, I turned to Lee who sat there stunned. “Wow, way to stand up to Millie there. She does that to everyone. She’s of that old-school style of nurse. You ever hear the saying, ‘Nurses eat their young’, well that’s Millie.”
I hadn’t heard the saying and my first reaction was that it was just horrible. Nurses eat their young? Yuck. Just disgusting. I mean, I get it, some folks need to toughen up sometimes, but I’d rather not feel that I’m going to be consumed like the runt of the litter in some unspoken, pseudo-Darwinesque training program while learning a profession that presumably embraces compassion. I mean, there’s got to be middle way. Right?
The following week, I, yet again, inadvertently crossed Millie, but this time she avoided me altogether. You see, someone had “unknowingly” assigned me to her patient caseload because I had unwittingly done pre-lab on one of her patients. Instead of shifting me off that set of patients, they shifted Millie. When I realized what had happened, a very flushed and very angry Millie stormed passed me shouting, “Twenty-five years here and they treat the students better than me!”
Later I learned that Millie had thrown a magazine and then broken down into tears in the nurse manager’s office. Clearly, this had nothing to do with me. Another veteran nurse confided in me that Millie had been the “elephant in the room” for a while now. I just happened to be the last straw that blew in and broke her back.
Millie was clearly experiencing burnout, and was given some mandatory vacation. I never saw her again that quarter, but I certainly am reminded of her on a daily basis. Burnout is a common affliction in the nursing profession. There are tireless nurses and there are tiring nurses that are under the delusion that they are the former. Having seen first-hand the exhausting and emotionally jarring work that nurses do, it surprises me that there are not more Millies in the world. I feel simultaneously sorry for and leery of Millie. Sorry, because I later heard that Millie, in fact, was an excellent nurse. And leery because I am scared that I, too, have the potential to act like her and not know it.
If I ever act like Millie, you have full permission to put me in check. I’ll thank you for it later.
Monday, July 2, 2007
Gungo Ho Balance
REFLECTING ON: General thoughts on the first week...
I’ve been up since 5:00am. I figure 6 hours of sleep is how I will roll during the week and then I will catch up a bit on the weekend. I feel so out of sorts and overwhelmed with all of this right now. We’ve been assigned like 1 billion pages of reading, and none of it is all that mellow. I mean, it all has to do with saving lives, right, so how could any of it be mellow?
As I read the pages over and over, I am inundated with the same thought: can I really do this? I answer, “Of course I can. Others have done it before me and so can I.” But I’ve never done this. I’ve never been through this. It is SOO overwhelming I can’t even describe it in words.
Then, the logical part of my brain kicks in: Okay, so if you can’t do all of the reading, then probably most other people can’t as well. Just keep working and do the best you can, Nat.
I really hope that working hard and plugging away is enough.
I’m going to school with some pretty cool and interesting people. Several of them even seem balanced so I’m going to try to take some hints from them.
Today, Sonia said that we were really lucky. We get to learn what we really want at an outstanding institution and that’s all that we have to do. We get to do this. It’s a privilege. It’s true. Not an obstacle—a great opportunity.
I get to work really hard and become competent at helping people. I get to be dedicated and focused and supported. I am lucky.
I’ve been up since 5:00am. I figure 6 hours of sleep is how I will roll during the week and then I will catch up a bit on the weekend. I feel so out of sorts and overwhelmed with all of this right now. We’ve been assigned like 1 billion pages of reading, and none of it is all that mellow. I mean, it all has to do with saving lives, right, so how could any of it be mellow?
As I read the pages over and over, I am inundated with the same thought: can I really do this? I answer, “Of course I can. Others have done it before me and so can I.” But I’ve never done this. I’ve never been through this. It is SOO overwhelming I can’t even describe it in words.
Then, the logical part of my brain kicks in: Okay, so if you can’t do all of the reading, then probably most other people can’t as well. Just keep working and do the best you can, Nat.
I really hope that working hard and plugging away is enough.
I’m going to school with some pretty cool and interesting people. Several of them even seem balanced so I’m going to try to take some hints from them.
Today, Sonia said that we were really lucky. We get to learn what we really want at an outstanding institution and that’s all that we have to do. We get to do this. It’s a privilege. It’s true. Not an obstacle—a great opportunity.
I get to work really hard and become competent at helping people. I get to be dedicated and focused and supported. I am lucky.
Friday, June 29, 2007
First Day at Clinicals
REFLECTING ON: First day of clinical rotation of first quarter at UCSF, written to fellow classmates...
Just got home a second ago and this is where I am at: I feel tired before I've even begun. Thoughts started percolating about this whole experience so I thought I'd share...please feel free to chime in and reflect too.
As the scrubs hit the laundry basket, the gargantuan-ness (I made that word up) of what I've/we've chosen to take on hit me like an anvil. Despite the fact that I got this week's "to do" lists almost done, I've got my PDA crammed with our schedule to keep me on point, I got books (and even feel like I really dig Patho), and maybe I've got some knowledge about some things in the past, really, when I stop to think about where I'm at right now, I have got no clue.
Clinicals really brought home the reality of this situation.
While on the oncology floor this morning, immune-compromised patients strolled by us, each with about fifteen IV bags filled with chemo, I became pretty damn humble. One patient shuffled on by with her nurse and managed to wave and smile at us. Yeah, I've got good intentions, but I felt like an impostor in my scrubs. You know, kinda like dress up or Halloween. No matter how I try to build myself up in my mind right now, somehow I cannot believe I'm going to be a nurse!
I also can't believe I'm seriously considering buying a fanny pack. Seriously. Though it's ridiculous, the whole fanny-pack thing is an appropriate metaphor in this whole MEPN situation. Two weeks ago, I wouldn't have ever thought that I would DREAM of buying a fanny-pack. I have never liked fanny packs. Even in the early eighties, when I was like five, and fanny packs were considered semi-socially acceptable, I thought fanny packs were silly. Now I think I need a fanny pack and what's worse: I want it to match my scrubs.
I left the comfort of my previous identity and hung it up on the coat rack as I walked into UCSF.
Yes, I know there's a learning curve. And yes I get that I'm really only expected to be a glorified volunteer in the beginning. But that somehow doesn't change the fact that I am really starting to realize the gravity of our work. It's simultaneously intimidating and awesome.
Some part of me keeps on reminding me that starting from scratch is good. You know, like doing pull ups or eating Brussel-sprouts. Builds character--or so I'm told.
I guess that's just it: I thought I was done with my character. I thought I knew who I was. I was competent at what I did--some might even say good. Now I know nothing. Now I am rebuilding my character, or more appropriately put, adding on to what I once thought was finished.
This will be good. Just not always so comfortable.
I am humbled and honored to be in this program with all of you. Truly.
Have a good weekend.
Just got home a second ago and this is where I am at: I feel tired before I've even begun. Thoughts started percolating about this whole experience so I thought I'd share...please feel free to chime in and reflect too.
As the scrubs hit the laundry basket, the gargantuan-ness (I made that word up) of what I've/we've chosen to take on hit me like an anvil. Despite the fact that I got this week's "to do" lists almost done, I've got my PDA crammed with our schedule to keep me on point, I got books (and even feel like I really dig Patho), and maybe I've got some knowledge about some things in the past, really, when I stop to think about where I'm at right now, I have got no clue.
Clinicals really brought home the reality of this situation.
While on the oncology floor this morning, immune-compromised patients strolled by us, each with about fifteen IV bags filled with chemo, I became pretty damn humble. One patient shuffled on by with her nurse and managed to wave and smile at us. Yeah, I've got good intentions, but I felt like an impostor in my scrubs. You know, kinda like dress up or Halloween. No matter how I try to build myself up in my mind right now, somehow I cannot believe I'm going to be a nurse!
I also can't believe I'm seriously considering buying a fanny pack. Seriously. Though it's ridiculous, the whole fanny-pack thing is an appropriate metaphor in this whole MEPN situation. Two weeks ago, I wouldn't have ever thought that I would DREAM of buying a fanny-pack. I have never liked fanny packs. Even in the early eighties, when I was like five, and fanny packs were considered semi-socially acceptable, I thought fanny packs were silly. Now I think I need a fanny pack and what's worse: I want it to match my scrubs.
I left the comfort of my previous identity and hung it up on the coat rack as I walked into UCSF.
Yes, I know there's a learning curve. And yes I get that I'm really only expected to be a glorified volunteer in the beginning. But that somehow doesn't change the fact that I am really starting to realize the gravity of our work. It's simultaneously intimidating and awesome.
Some part of me keeps on reminding me that starting from scratch is good. You know, like doing pull ups or eating Brussel-sprouts. Builds character--or so I'm told.
I guess that's just it: I thought I was done with my character. I thought I knew who I was. I was competent at what I did--some might even say good. Now I know nothing. Now I am rebuilding my character, or more appropriately put, adding on to what I once thought was finished.
This will be good. Just not always so comfortable.
I am humbled and honored to be in this program with all of you. Truly.
Have a good weekend.
Tuesday, May 8, 2007
30
As my time at UCSF draws closer, I become more anxious and more unfocused, though its ironic because all my efforts are to become more focused. I spend so much time fretting about what I need to do next—the “plan”—that I seldom get anything done. The image of being stuck in the mud in a truck comes to mind. I really need to relax. I swear I’ve forgotten how, and that, if anything, is what I really need to do before starting this program—full of voomph and vitality—show ‘em I haven’t forgotten how to live. The reason I stress so much is because I feel it necessary to compensate for all the experience and things that I don’t know and haven’t been exposed to. I cannot believe sometimes that I am going into the medical profession. Clearly this wasn’t meant to be. I wasn’t ever on this path. Nobody showed it to me, and yet, here I am—heading down this path that I didn’t think possible.
My mind is a jumble with thoughts of what I was supposed to do and rebelling from that type of functional fixedness. It’s time to look beyond the perceived form and perceived function of my life and really look at what I am all about. I swear I never saw it before. That’s why it’s so important that I relax and flow a little more. Focused flow, if you will. Previously, going to Mexico and traveling would be an ideal way of finding such a thing, but, no longer—not for me right now. I get so out into the universe that I forget how to walk when that happens. If I can just sit, though, and pay attention to what is around me without freaking out everytime I see something—“I must grasp this! I must own it I must own it now. Now I tell you, get in my brain you bastard!” Well, that just doesn’t look good or seem all that enlightened. It’s the juggernaut approach to self-actualization and I like to think that I am ever so slightly more sophisticated than that. Hell, I’m thirty aren’t I? Thirty. Hmmm. 30. I just need to look at the numbers because I just don’t identify them with me. I’m not 30! Not by a long shot. I guess it’s the government and all sorts of social institutions and, by default, my interactions with them that make me tell them that I am thirty makes me thirty, but I am not thirty by a long shot. No siree. Seriously. Fine, I’m a little shook up about it, but this is exactly what I was talking about earlier—I don’t recognize the form of 30 as me, nor its function. People see 30 as old and incapable and stricken with afflictions that make them less viable. I am viable, god damn it. I am viable. I am thinking and focused and more thoughtful than I ever have been in my life. Never mind the filling in of the abs with pudge—the abs are still there—just hiding.
It strikes me now how much I associate physical capability with mental ability. As if I am physically healthier, I can think and remember better—even interact in the world in a more enlightened manner. I suppose that makes sense to a certain degree and maybe I should pursue that—can’t hurt. I do think, however, it’s all rooted in my mind—this stress that I “MUST KNOW THIS NOW”. It’s overwhelming and not helping me at all. I need to relax, sit with, and be patient with the world, and perhaps, I will actually hear what is being said to me instead of it being drowned out by mindless self-chatter.
Yeah. Let’s try that.
My mind is a jumble with thoughts of what I was supposed to do and rebelling from that type of functional fixedness. It’s time to look beyond the perceived form and perceived function of my life and really look at what I am all about. I swear I never saw it before. That’s why it’s so important that I relax and flow a little more. Focused flow, if you will. Previously, going to Mexico and traveling would be an ideal way of finding such a thing, but, no longer—not for me right now. I get so out into the universe that I forget how to walk when that happens. If I can just sit, though, and pay attention to what is around me without freaking out everytime I see something—“I must grasp this! I must own it I must own it now. Now I tell you, get in my brain you bastard!” Well, that just doesn’t look good or seem all that enlightened. It’s the juggernaut approach to self-actualization and I like to think that I am ever so slightly more sophisticated than that. Hell, I’m thirty aren’t I? Thirty. Hmmm. 30. I just need to look at the numbers because I just don’t identify them with me. I’m not 30! Not by a long shot. I guess it’s the government and all sorts of social institutions and, by default, my interactions with them that make me tell them that I am thirty makes me thirty, but I am not thirty by a long shot. No siree. Seriously. Fine, I’m a little shook up about it, but this is exactly what I was talking about earlier—I don’t recognize the form of 30 as me, nor its function. People see 30 as old and incapable and stricken with afflictions that make them less viable. I am viable, god damn it. I am viable. I am thinking and focused and more thoughtful than I ever have been in my life. Never mind the filling in of the abs with pudge—the abs are still there—just hiding.
It strikes me now how much I associate physical capability with mental ability. As if I am physically healthier, I can think and remember better—even interact in the world in a more enlightened manner. I suppose that makes sense to a certain degree and maybe I should pursue that—can’t hurt. I do think, however, it’s all rooted in my mind—this stress that I “MUST KNOW THIS NOW”. It’s overwhelming and not helping me at all. I need to relax, sit with, and be patient with the world, and perhaps, I will actually hear what is being said to me instead of it being drowned out by mindless self-chatter.
Yeah. Let’s try that.
Thursday, March 29, 2007
Youngblood and me
REFLECTING ON: Adulthood versus childhood....
So, I gotta little story that I must tell. Last week, when I was volunteering at the ER, I met this guy that made me think of my whole Cal experience and thought that I would share. So. First a little background. Every Thursday, I volunteer from 9pm-midnight. In addition to the normal “go-fer” jobs and scrubbing gurneys, it’s my job to relay information between patients and families as well as calm the folks down in the waiting rooms that have been, well, waiting. If you’re a patient, it’s not fun to come to the ER—an unexpected event goes down and then: boom! There you are, stuck in the ER—totally at the whim of the institution and its elements. I get it. It sucks. Some of the waiting room folks get a little cross with me. I try to imagine switching places with them and be as sympathetic as I can. It’s not always so easy. “…No mam, I don’t know what it’s like to not pee for a whole day. It must be pretty painful [woman is also talking on her cell phone while talking to me, she finishes drinking a Diet Coke]. We’re working to get you in as soon as possible. In fact, provided we have no more ambulances come in, you’ll be next. It’s just that we had those three ambulances come in back-to-back with strokes and heart attacks so we had to bump you down. [woman becomes incredulous] Why isn’t it a first-come, first served basis? Well, we have to treat the most severe illnesses first so that those people have a better chance at recovery and, well, don’t pass on. [woman now getting gruff and demanding] Can you at least have some water? Uhm…well. I can check with your nurse, but given your condition it’s probably best that you not drink any more liquids. Drinking liquids will put more pressure on your bladder and increase your pain. I’m not a clinician, but those are just my thoughts. [woman becomes just mean] Okay, I won’t share my thoughts. [husband stands up and demands that I get her water without talking to the nurse] Sir, I understand that this is a really lousy situation that your wife is in but I have to at least check with the nurse about the water. No. No sir, I’m not discriminating against you—I would do the same thing for any patient here.”
All the while I’m trying to be cool, I am wearing khaki pants, white shoes, a white polo shirt, and a RIDICULOUS blue smock that is akin to something you would wear when you were in pre-school and about to get down with some water colors and/or finger paints. It makes me look goofy and a little less like a man. It’s okay though: I’m not there to be a man—I’m there to help out and learn.
So last Thursday, after attending to my normal waiting room duties, I come back into the ER and I notice this guy in the corner. Now normally this particular bed is reserved for the drunks that come in so that they can sober up (read sober up as “pass out and get an IV full of electrolytes and vitamins”). But I notice this guy is anything but passed out. In fact, while lying down on the gurney, he’s jubilantly shouting gibberish rhymes at the top of his lungs while arching his back, belly-up, as if in the throws of a tantric, rhyme-induced orgasm. Hey, at least he’s happy. But he’s also very loud and that doesn’t help the guy next door recovering from a stroke. I walk up to him and he’s singing…
“Ringa ding ding/I can find out if your life is in a sling…”
He’s so tickled by his verse that he shrieks like a two-year old meeting Big-Bird for the first time. It’s at this point that I notice his eyes are like freaking saucers. I mean there is barely any iris to be seen—all pupil. It’s like he’s in the midst of a full, pupil eclipse with the smallest ring of blue surrounding this vacuous black circle. I’m pretty sure he’s on a hallucinogen, though the nurse seemed to think he’s on meth. He has a healthy complexion and I didn’t notice any of the scabs or ashen skin tone that I see with folks on meth. This guy is “on one” in a way that I've seen before. My guess is LSD or mushrooms.
“Ringa ding ding/The man with the ring [he’s looking at my wedding band] thinks he’s the king, while I lay back and bask/The light the light, something I won’t fight, and that my friend is also your task.”
I smile and really look at his face. He looks like an angelic cabbage patch kid. His face is rosy and his blond hair is tussled in every direction. He’s only wearing one Teva and his shorts, I notice, are unzipped. This one-sandaled cherub has got a zeal painted across his face that, though I believe is chemically induced, I am slightly jealous of because he is obviously feeling something good that I am worlds away from. I’m pretty sure that he thinks he has the answer. I’m jealous of that too. I snap away from my thoughts and concentrate on the task at hand. Time to establish rapport. “Hey man, you’re having a good night, huh?”
He squeals with glee. Apparently he has now regressed to around six months old and starts playing peek-a-boo with me. He hides his face under the hospital blanket that is now hiding his unzipped shorts, and then re-emerges with another rhyme. “The cat and the mouse are off to play house/where will you be when…”
The nurse signals me to come over. I excuse myself, but he hardly notices that I have left because I can still hear him reciting more rhymes. The nurse asks that I establish a rapport with him so that we can get his name and insurance information. Our rhyming, saucer-eyed boy is a John Doe at this point. Though establishing rapport was what I was already doing, I acquiesce to the chain-of-command and tell the nurse he’s got a good idea. It’s better than acting like a know-it-all. More squeals in the background. The nurse also charges me with the task of calming him down. I agree, and as I walk back to him, I begin formulating a strategy. Okay, fine. I have no strategy. I really feel that this is one of those things that I am gonna have to feel out. I also wonder if this is a part of a volunteer’s normal duties. No matter. This beats scrubbing blood and feces off gurneys and making runs to the pharmacy. I’m back. He’s in mid rhyme and incorporates my presence into his ramblings. “…and was told with a kiss. Dismiss! Dismiss! The ringed man told Mathias, though I…”
“…sat in a bed and spoke gibberish.” I interrupt and finish his rhyme. He is overjoyed at finding a playmate. Gleaning his name from the rhyme, I realize that the saucer-eyed boy is named Mathias. More squeals—this time louder than before.
“Mathias, I need you to tone it down a notch. Your voice is loud and bothering some of the other patients. We got some pretty sick people here tonight and they’re not having as much fun as you.” He seems to think about what I’ve said but says nothing. I’m surprised. I guess that was the point though—he’s now quiet.
Mathias closes his eyes and smiles. I note to myself that whatever he’s tripping on, he must be having a good trip, because he hardly seems to care that the toe on his non-sandaled foot is bleeding, though not severely. Not only that, one of the veins in his right hand is connected to an IV bag of 0.9% sodium chloride. I've never done hallucinogens, but that’s the sort of stuff that I would perseverate on if I were on tripping. I’m sure I would go into a post-apocalyptic scenario where I wholeheartedly believed that the machines I was attached to were taking over my body. I do that when I’m sober.
I’m also impressed that he’s so upbeat while in the hospital. So much of how I feel is determined by where I am in physical space. I remember once being in the most disgusting bathroom I’d ever been in my entire life: shit smeared on the walls, flies hovering above me, flickering, buzzing fluorescent lights overhead, and an account of a sexual escapade scrawled on the bathroom stall beside me. After taking a quick piss, I almost ran out of there, but then paused and wondered if I was ever locked in a place like this, could I be mentally strong enough in to ever find happiness again. I’m kind of crazy, I think to myself, who thinks like that?
Damn reality…I feel that I have been dealing with it for a while.
While Mathias silently trips, I continue to trip on my own thoughts for a while. First to the front of my mind where there are lists of things to do. I check off bills that I’ve paid and think about how to find scholarships in order to pay for the nursing program I got just into. I wonder if my wife, Masako, is watching TV or studying. I then begin to worry that I haven’t been nice enough to her lately. Being married is a big deal and makes me nervous sometimes. I start thinking about our life together and the concept of “forever”. Our life is finite, but they say that we will be together forever in the ceremony. Wait. No they don’t. They say ‘Til death do us part. Why did I interject the forever part in there? Forever seems a lot more overwhelming than ‘Til death do us part. I take comfort in that thought. Typical me—always making things more overwhelming than they need to be. At least death is guaranteed. My thoughts become tangential and race around in a blue blur for a while. Then I look back to Mathias.
Mathias’ enormous eyes have opened and stare directly at me. Normally I avoid people’s direct stares, but he is so obviously content with life that I allow our eyes to meet for a full minute. Our inhalation and exhalation begins to match. We say nothing. Oh my God, I kind of feel like he’s scraping the back of my brain with his intensity. Then, as if suddenly completely lucid, he says, “I’m glad you’re here.”
I tell him that I’m glad to be there too. Taking note of this sudden fling with lucidity and forever being practically fused the task at hand, I want to ask him what he took, what his name is, and what his health insurance ID is. Bad idea. He’s only begun to come down. I ask Mathias what he’s thinking. Mathias smiles quietly but then suddenly looks overwhelmed. It’s the first time I’ve seen him without the smile of a zealot. Not wanting him to go on a bad trip, I tell him that he doesn’t need to tell me, but that if he wants to talk about what he’s thinking, I’m right there.
“I’m so juiced to be dying,” he says.
My gut reaction is to be sarcastic and condescending. Although normally I would have praise for a thought like this, I have already unconsciously characterized Mathias as a green undergraduate who has yet to truly live independently. How can he possibly be “juiced” to be dying when he’s hardly experienced life? Thoughts like this pass in a flash and then I remember my task. “Why’s that?” I ask, trying not to let condescension creep into my vocal cords.
“We’re living this monument—this huge thing and we get to experience it! Life, man. It’s really fucking spectacular. I feel it right now in every pore of my body.”
Although I continue to feel glib, condescending and dismissive, I want to believe what he’s saying because it’s true. Life is spectacular. Experiencing it is amazing. Why can’t I remember that? At the same time, this little boy named Mathias has barely begun to pay dues or feel the thumb of responsibility.
Suddenly, my mind abandons all pretense. I want to be on what he’s on. I want to feel unworn. I regain mental composure. I reach out my hand to shake his. His hand meets mine. It’s warm. I wonder where his hands have been. I like warm hands better than cold hands, though. “I’m Nat.”
“Mathias,” he replies.
“What’d you take tonight, Mathias?”
“SHROOMS!” he exclaims, and I watch his eyes just about pop out of his head. Just saying the word brings on a psychedelic roll of ecstasy. His eyes roll so far back into his head that I can only see white between his eyelids.
“Nice. So, this may be a silly question, but other than good, how are you feeling tonight? You know, is there anything else going on that you feel?” I’m intentionally not asking his last name and insurance information because I still can’t quite gauge how he will react. I really hope he doesn’t have a rhyming relapse and feel that the wrong question might send him back. Mathias ignores the latter part of my question.
“Really, really good. I FEEL SO FUCKING GOOOD! I feel lucky. Just laying here is soooo good. God damn it’s GOOD!” He begins to howl just like a coyote and bridge his back while thrusting his pelvis towards the heavens. The security guard looks to me for reassurance, I extend my open hand that signals him to hold up for a second.
“Mathias. I know you might have forgotten, but we have some really sick people here tonight. Some of them are on the verge of dying. I think they would like it very much if you could not yell.”
“They’re lucky.” I hear this and my interest in his cosmic voyage slams to a dead-stop. I thought I was condescending. How can he presume to know what they’re going though? He’s lying there, totally healthy, and aside from being in a temporary, self-induced, chemically altered state, he is completely healthy and will walk out of here in a few hours. There’s a woman here tonight who vomited up feces because of intestinal blockage. She also has pancreatic cancer and will most likely die within a couple of days. This kid will probably just get the munchies. I am angry with this boy and want to slap the taste out of his mouth. I hope I am keeping a calm exterior. He begins to speak again, “But I am like them, too. From my first breath I was dying, and so are they.”
I regain a small, tepid interest in his thoughts. At least he’s thinking about interconnectedness. That’s good. "He’s just naïve," I think to myself, "He’s not bad so much as he is green. You were like that once too. In most respects, you still are."
I calm down a bit. I can tell my ears have become red. They do that when I’m holding something in.
“I don’t think there’s any such thing as a selfish action.” Mathias says it in a way that makes me think it is an implied question. I bite. I probably shouldn’t debate with a tripped-out undergraduate in the Emergency Room that is only known by his first name, but I suddenly feel that it is really necessary to ground this guy.
“Well, I gotta disagree with you there Mathias. I think all actions are inherently selfish, except for maybe mothers protecting their children. You know, like the mama bear syndrome? Even then, she’s protecting her kin, not someone else’s necessarily.” As soon as I finish, Mathias is silent and I regret even having entertained what he was saying. Of course, he and I were just both thinking about death as being comforting, so I wonder if he picked up on that?
“What about Mother Theresa?” Mathias questions. I am glad he isn’t tripping so hard. He’s beginning to show signs of logic.
“I’m sure she gets her kicks from helping folks. I mean, I know she does amazingly hard work and it leaves her exhausted, but my gut tells me think that she must get something good out of it. If helping lepers made her feel like she was being rubbed out of existence by a thousand cheese graters, I have a feeling that she would stop. I’m no Mother Theresa, but I like helping people too. Helps me sleep at night—I feel like I’ve maybe left the world a better place than when I woke up. If it made me feel bad, I think I’d stop.” I wonder where the cheese grater metaphor came from. Mathias just harrumphs and wrinkles his forehead. I can tell he’s significantly calmer than twenty minutes earlier. I don’t know why, but I figure it’s time to ask him his name. “Look, Mathias, we gotta get you in our system and give you a name other than John Doe. Even better is if you could also tell me your medical insurance provider, medical ID number, and social security number.”
“Oh. My name is Mathias Youngblood. I don’t know my medical insurance information or my social.”
Wow. He doesn’t know his social security number. Mathias is a child, but at least he’s asking good questions and thinking about interconnectedness. At least I still am too.
“Okay Mathias. I’ll be frank with you. We can either have you figure out this information by calling one of your roommates or you can call your parents. Or, if you like, we can call your parents. Again, I can’t force this information from you, but it would make taking care of you a bit easier. What do you got?” I realize my tone has gone from rapport-building to no-nonsense and decide to tone it down a notch.
Mathias responds surprisingly quickly, as though he really wants to resolve the matter. I’m always surprised when people are cooperative. “Well, I just moved into a Co-op and don’t really think my roommate will be much use to us. Go ahead and call my parents.”
My friend used to live in a Co-op at Cal. That was a place where just about do anything could happen. Always seemed like an adventure was at hand. I remember standing on its roof with a whole bunch of folks, three stories up, and screaming at the sun to celebrate its setting. Wow. That was a long time ago. I’m starting to feel sad—like I’ve lost someone.
My thoughts return to Mr. Youngblood. He still wants to be taken care of. He willingly tells me his full name, address, and contact information for both his parents. I give this information to the nurse and he calls his folks, explaining where Mathias is and how he got there. I can hear Dad yelling over the receiver. I turn to Mathias and he has fallen completely asleep. Apparently the sedative they gave him finally kicked in. I look to the clock and see it’s well past midnight and time for me to go. The smock comes off and I say goodnight to the charge nurse and security guards. I gotta get home and get some sleep—I got work in the morning.
So, I gotta little story that I must tell. Last week, when I was volunteering at the ER, I met this guy that made me think of my whole Cal experience and thought that I would share. So. First a little background. Every Thursday, I volunteer from 9pm-midnight. In addition to the normal “go-fer” jobs and scrubbing gurneys, it’s my job to relay information between patients and families as well as calm the folks down in the waiting rooms that have been, well, waiting. If you’re a patient, it’s not fun to come to the ER—an unexpected event goes down and then: boom! There you are, stuck in the ER—totally at the whim of the institution and its elements. I get it. It sucks. Some of the waiting room folks get a little cross with me. I try to imagine switching places with them and be as sympathetic as I can. It’s not always so easy. “…No mam, I don’t know what it’s like to not pee for a whole day. It must be pretty painful [woman is also talking on her cell phone while talking to me, she finishes drinking a Diet Coke]. We’re working to get you in as soon as possible. In fact, provided we have no more ambulances come in, you’ll be next. It’s just that we had those three ambulances come in back-to-back with strokes and heart attacks so we had to bump you down. [woman becomes incredulous] Why isn’t it a first-come, first served basis? Well, we have to treat the most severe illnesses first so that those people have a better chance at recovery and, well, don’t pass on. [woman now getting gruff and demanding] Can you at least have some water? Uhm…well. I can check with your nurse, but given your condition it’s probably best that you not drink any more liquids. Drinking liquids will put more pressure on your bladder and increase your pain. I’m not a clinician, but those are just my thoughts. [woman becomes just mean] Okay, I won’t share my thoughts. [husband stands up and demands that I get her water without talking to the nurse] Sir, I understand that this is a really lousy situation that your wife is in but I have to at least check with the nurse about the water. No. No sir, I’m not discriminating against you—I would do the same thing for any patient here.”
All the while I’m trying to be cool, I am wearing khaki pants, white shoes, a white polo shirt, and a RIDICULOUS blue smock that is akin to something you would wear when you were in pre-school and about to get down with some water colors and/or finger paints. It makes me look goofy and a little less like a man. It’s okay though: I’m not there to be a man—I’m there to help out and learn.
So last Thursday, after attending to my normal waiting room duties, I come back into the ER and I notice this guy in the corner. Now normally this particular bed is reserved for the drunks that come in so that they can sober up (read sober up as “pass out and get an IV full of electrolytes and vitamins”). But I notice this guy is anything but passed out. In fact, while lying down on the gurney, he’s jubilantly shouting gibberish rhymes at the top of his lungs while arching his back, belly-up, as if in the throws of a tantric, rhyme-induced orgasm. Hey, at least he’s happy. But he’s also very loud and that doesn’t help the guy next door recovering from a stroke. I walk up to him and he’s singing…
“Ringa ding ding/I can find out if your life is in a sling…”
He’s so tickled by his verse that he shrieks like a two-year old meeting Big-Bird for the first time. It’s at this point that I notice his eyes are like freaking saucers. I mean there is barely any iris to be seen—all pupil. It’s like he’s in the midst of a full, pupil eclipse with the smallest ring of blue surrounding this vacuous black circle. I’m pretty sure he’s on a hallucinogen, though the nurse seemed to think he’s on meth. He has a healthy complexion and I didn’t notice any of the scabs or ashen skin tone that I see with folks on meth. This guy is “on one” in a way that I've seen before. My guess is LSD or mushrooms.
“Ringa ding ding/The man with the ring [he’s looking at my wedding band] thinks he’s the king, while I lay back and bask/The light the light, something I won’t fight, and that my friend is also your task.”
I smile and really look at his face. He looks like an angelic cabbage patch kid. His face is rosy and his blond hair is tussled in every direction. He’s only wearing one Teva and his shorts, I notice, are unzipped. This one-sandaled cherub has got a zeal painted across his face that, though I believe is chemically induced, I am slightly jealous of because he is obviously feeling something good that I am worlds away from. I’m pretty sure that he thinks he has the answer. I’m jealous of that too. I snap away from my thoughts and concentrate on the task at hand. Time to establish rapport. “Hey man, you’re having a good night, huh?”
He squeals with glee. Apparently he has now regressed to around six months old and starts playing peek-a-boo with me. He hides his face under the hospital blanket that is now hiding his unzipped shorts, and then re-emerges with another rhyme. “The cat and the mouse are off to play house/where will you be when…”
The nurse signals me to come over. I excuse myself, but he hardly notices that I have left because I can still hear him reciting more rhymes. The nurse asks that I establish a rapport with him so that we can get his name and insurance information. Our rhyming, saucer-eyed boy is a John Doe at this point. Though establishing rapport was what I was already doing, I acquiesce to the chain-of-command and tell the nurse he’s got a good idea. It’s better than acting like a know-it-all. More squeals in the background. The nurse also charges me with the task of calming him down. I agree, and as I walk back to him, I begin formulating a strategy. Okay, fine. I have no strategy. I really feel that this is one of those things that I am gonna have to feel out. I also wonder if this is a part of a volunteer’s normal duties. No matter. This beats scrubbing blood and feces off gurneys and making runs to the pharmacy. I’m back. He’s in mid rhyme and incorporates my presence into his ramblings. “…and was told with a kiss. Dismiss! Dismiss! The ringed man told Mathias, though I…”
“…sat in a bed and spoke gibberish.” I interrupt and finish his rhyme. He is overjoyed at finding a playmate. Gleaning his name from the rhyme, I realize that the saucer-eyed boy is named Mathias. More squeals—this time louder than before.
“Mathias, I need you to tone it down a notch. Your voice is loud and bothering some of the other patients. We got some pretty sick people here tonight and they’re not having as much fun as you.” He seems to think about what I’ve said but says nothing. I’m surprised. I guess that was the point though—he’s now quiet.
Mathias closes his eyes and smiles. I note to myself that whatever he’s tripping on, he must be having a good trip, because he hardly seems to care that the toe on his non-sandaled foot is bleeding, though not severely. Not only that, one of the veins in his right hand is connected to an IV bag of 0.9% sodium chloride. I've never done hallucinogens, but that’s the sort of stuff that I would perseverate on if I were on tripping. I’m sure I would go into a post-apocalyptic scenario where I wholeheartedly believed that the machines I was attached to were taking over my body. I do that when I’m sober.
I’m also impressed that he’s so upbeat while in the hospital. So much of how I feel is determined by where I am in physical space. I remember once being in the most disgusting bathroom I’d ever been in my entire life: shit smeared on the walls, flies hovering above me, flickering, buzzing fluorescent lights overhead, and an account of a sexual escapade scrawled on the bathroom stall beside me. After taking a quick piss, I almost ran out of there, but then paused and wondered if I was ever locked in a place like this, could I be mentally strong enough in to ever find happiness again. I’m kind of crazy, I think to myself, who thinks like that?
Damn reality…I feel that I have been dealing with it for a while.
While Mathias silently trips, I continue to trip on my own thoughts for a while. First to the front of my mind where there are lists of things to do. I check off bills that I’ve paid and think about how to find scholarships in order to pay for the nursing program I got just into. I wonder if my wife, Masako, is watching TV or studying. I then begin to worry that I haven’t been nice enough to her lately. Being married is a big deal and makes me nervous sometimes. I start thinking about our life together and the concept of “forever”. Our life is finite, but they say that we will be together forever in the ceremony. Wait. No they don’t. They say ‘Til death do us part. Why did I interject the forever part in there? Forever seems a lot more overwhelming than ‘Til death do us part. I take comfort in that thought. Typical me—always making things more overwhelming than they need to be. At least death is guaranteed. My thoughts become tangential and race around in a blue blur for a while. Then I look back to Mathias.
Mathias’ enormous eyes have opened and stare directly at me. Normally I avoid people’s direct stares, but he is so obviously content with life that I allow our eyes to meet for a full minute. Our inhalation and exhalation begins to match. We say nothing. Oh my God, I kind of feel like he’s scraping the back of my brain with his intensity. Then, as if suddenly completely lucid, he says, “I’m glad you’re here.”
I tell him that I’m glad to be there too. Taking note of this sudden fling with lucidity and forever being practically fused the task at hand, I want to ask him what he took, what his name is, and what his health insurance ID is. Bad idea. He’s only begun to come down. I ask Mathias what he’s thinking. Mathias smiles quietly but then suddenly looks overwhelmed. It’s the first time I’ve seen him without the smile of a zealot. Not wanting him to go on a bad trip, I tell him that he doesn’t need to tell me, but that if he wants to talk about what he’s thinking, I’m right there.
“I’m so juiced to be dying,” he says.
My gut reaction is to be sarcastic and condescending. Although normally I would have praise for a thought like this, I have already unconsciously characterized Mathias as a green undergraduate who has yet to truly live independently. How can he possibly be “juiced” to be dying when he’s hardly experienced life? Thoughts like this pass in a flash and then I remember my task. “Why’s that?” I ask, trying not to let condescension creep into my vocal cords.
“We’re living this monument—this huge thing and we get to experience it! Life, man. It’s really fucking spectacular. I feel it right now in every pore of my body.”
Although I continue to feel glib, condescending and dismissive, I want to believe what he’s saying because it’s true. Life is spectacular. Experiencing it is amazing. Why can’t I remember that? At the same time, this little boy named Mathias has barely begun to pay dues or feel the thumb of responsibility.
Suddenly, my mind abandons all pretense. I want to be on what he’s on. I want to feel unworn. I regain mental composure. I reach out my hand to shake his. His hand meets mine. It’s warm. I wonder where his hands have been. I like warm hands better than cold hands, though. “I’m Nat.”
“Mathias,” he replies.
“What’d you take tonight, Mathias?”
“SHROOMS!” he exclaims, and I watch his eyes just about pop out of his head. Just saying the word brings on a psychedelic roll of ecstasy. His eyes roll so far back into his head that I can only see white between his eyelids.
“Nice. So, this may be a silly question, but other than good, how are you feeling tonight? You know, is there anything else going on that you feel?” I’m intentionally not asking his last name and insurance information because I still can’t quite gauge how he will react. I really hope he doesn’t have a rhyming relapse and feel that the wrong question might send him back. Mathias ignores the latter part of my question.
“Really, really good. I FEEL SO FUCKING GOOOD! I feel lucky. Just laying here is soooo good. God damn it’s GOOD!” He begins to howl just like a coyote and bridge his back while thrusting his pelvis towards the heavens. The security guard looks to me for reassurance, I extend my open hand that signals him to hold up for a second.
“Mathias. I know you might have forgotten, but we have some really sick people here tonight. Some of them are on the verge of dying. I think they would like it very much if you could not yell.”
“They’re lucky.” I hear this and my interest in his cosmic voyage slams to a dead-stop. I thought I was condescending. How can he presume to know what they’re going though? He’s lying there, totally healthy, and aside from being in a temporary, self-induced, chemically altered state, he is completely healthy and will walk out of here in a few hours. There’s a woman here tonight who vomited up feces because of intestinal blockage. She also has pancreatic cancer and will most likely die within a couple of days. This kid will probably just get the munchies. I am angry with this boy and want to slap the taste out of his mouth. I hope I am keeping a calm exterior. He begins to speak again, “But I am like them, too. From my first breath I was dying, and so are they.”
I regain a small, tepid interest in his thoughts. At least he’s thinking about interconnectedness. That’s good. "He’s just naïve," I think to myself, "He’s not bad so much as he is green. You were like that once too. In most respects, you still are."
I calm down a bit. I can tell my ears have become red. They do that when I’m holding something in.
“I don’t think there’s any such thing as a selfish action.” Mathias says it in a way that makes me think it is an implied question. I bite. I probably shouldn’t debate with a tripped-out undergraduate in the Emergency Room that is only known by his first name, but I suddenly feel that it is really necessary to ground this guy.
“Well, I gotta disagree with you there Mathias. I think all actions are inherently selfish, except for maybe mothers protecting their children. You know, like the mama bear syndrome? Even then, she’s protecting her kin, not someone else’s necessarily.” As soon as I finish, Mathias is silent and I regret even having entertained what he was saying. Of course, he and I were just both thinking about death as being comforting, so I wonder if he picked up on that?
“What about Mother Theresa?” Mathias questions. I am glad he isn’t tripping so hard. He’s beginning to show signs of logic.
“I’m sure she gets her kicks from helping folks. I mean, I know she does amazingly hard work and it leaves her exhausted, but my gut tells me think that she must get something good out of it. If helping lepers made her feel like she was being rubbed out of existence by a thousand cheese graters, I have a feeling that she would stop. I’m no Mother Theresa, but I like helping people too. Helps me sleep at night—I feel like I’ve maybe left the world a better place than when I woke up. If it made me feel bad, I think I’d stop.” I wonder where the cheese grater metaphor came from. Mathias just harrumphs and wrinkles his forehead. I can tell he’s significantly calmer than twenty minutes earlier. I don’t know why, but I figure it’s time to ask him his name. “Look, Mathias, we gotta get you in our system and give you a name other than John Doe. Even better is if you could also tell me your medical insurance provider, medical ID number, and social security number.”
“Oh. My name is Mathias Youngblood. I don’t know my medical insurance information or my social.”
Wow. He doesn’t know his social security number. Mathias is a child, but at least he’s asking good questions and thinking about interconnectedness. At least I still am too.
“Okay Mathias. I’ll be frank with you. We can either have you figure out this information by calling one of your roommates or you can call your parents. Or, if you like, we can call your parents. Again, I can’t force this information from you, but it would make taking care of you a bit easier. What do you got?” I realize my tone has gone from rapport-building to no-nonsense and decide to tone it down a notch.
Mathias responds surprisingly quickly, as though he really wants to resolve the matter. I’m always surprised when people are cooperative. “Well, I just moved into a Co-op and don’t really think my roommate will be much use to us. Go ahead and call my parents.”
My friend used to live in a Co-op at Cal. That was a place where just about do anything could happen. Always seemed like an adventure was at hand. I remember standing on its roof with a whole bunch of folks, three stories up, and screaming at the sun to celebrate its setting. Wow. That was a long time ago. I’m starting to feel sad—like I’ve lost someone.
My thoughts return to Mr. Youngblood. He still wants to be taken care of. He willingly tells me his full name, address, and contact information for both his parents. I give this information to the nurse and he calls his folks, explaining where Mathias is and how he got there. I can hear Dad yelling over the receiver. I turn to Mathias and he has fallen completely asleep. Apparently the sedative they gave him finally kicked in. I look to the clock and see it’s well past midnight and time for me to go. The smock comes off and I say goodnight to the charge nurse and security guards. I gotta get home and get some sleep—I got work in the morning.
Monday, March 12, 2007
UCSF!
A flood of things to write about. The most of important of which is that I got into UCSF!! I really can’t believe it. I almost think that I’m not worthy. There’s something there that I need to think about, but it’s too late to get too deep tonight. I had to read the letter three times and then over the phone to my Mom to believe it. Wow. Life is going to change significantly.
Friday, February 23, 2007
"You Want Mayo"
REFLECTING ON: Feeding a quadriplegic man as a volunteer, written as assignment for Communications class on the importance of listening, pre-UCSF
In my spare time, which I don’t really have a lot of, I volunteer in the Emergency Department of a hospital in the East Bay. It’s a trip. In addition to cleaning up gurneys that have been peed, pooped and bled on, I spend a lot of time running around, acting as a communication liaison between patients and their anxious family members out in the waiting room. “Anxious” is a nice way of putting it. At any rate, the conversations I have, by and large, are very much one-sided where I am listening to or diffusing some sort of frustration that someone is experiencing. I sympathize with the patient’s and family’s situation—it sucks to have to wait for several hours in the ER while someone else is almost completely in control of your fate. I get it; I try not to take that little fact for granted. The conversations that I have with these folks, however, typically aren’t very long—two minutes tops. Last night, however, a nurse asked me if I could feed a man whom we’ll call Ishmael. Ish, which I called him, is a quadriplegic. He was in the hospital for some infected bedsores and just had some pain medication. The food, he said, helped settle his stomach from the medication. When I heard the cross-over about Ish, my mind immediately raced to the thought, “If he’s a quad, why would he need pain medication since he can’t feel anything.” Then I just let it go. Shit, if I were paralyzed from the neck down, would want some painkillers too.
The point here, however, is that while I fed this man his turkey sandwich, I realized I became the most attentive listener that I have ever been. I listened with my ears and eyes, watching and listening for the subtlest cues as to what he wanted to do next: talk or eat. I knew that he knew that I didn’t know how to feed him and I so I told him so. He just said, “That’s alright, just ask yourself how you would want to be fed a turkey sandwich, and then verbalize those questions to me.”
“You want Mayo?” I asked, and took it from there. I watched his eyes dart to what he wanted while we chitchatted about other things like the tattoos on his arms. I thought it was cool that a quad would get ink done despite having “non-working” arms and legs. He was a pretty self-aware person—able to see how newbies like myself saw him and made subtle efforts to distract me from be overwhelmed by his general situation in life. The tattoos were a good example of that—it diverted my thoughts from his gnarled fingers and emaciated arms and made me think of his life beyond the bed. Pretty clever really. Of course, maybe I’m over thinking things—maybe he just liked tattoos. At any rate, as we talked about the symbolism of the monkey-riding-the-elephant tat that he had on his right shoulder, I intuitively put down the sandwich, grabbed the can of coke, put a straw in it and gave him a sip. He burped, and I gave him another bite, noticing that he didn’t like eating the crust. When he was all done I wiped his mouth off with a napkin and then the transport person came and got him. While he was being wheeled away he said, “Good talking to you.”
“Likewise,” I said, though I really had hardly spoken but a few questions.
Ish’s obvious, physical need made me listen better than I had in a long time. I was able to listen with all my senses. The subtle yet distinct dignity with which Ish conducted himself made me wonder if I could be as perceptive as he obviously was. It seems to me that although many of us have the less obvious, less physical needs than Ish, we often still need to have those needs perceptively listened to.
In my spare time, which I don’t really have a lot of, I volunteer in the Emergency Department of a hospital in the East Bay. It’s a trip. In addition to cleaning up gurneys that have been peed, pooped and bled on, I spend a lot of time running around, acting as a communication liaison between patients and their anxious family members out in the waiting room. “Anxious” is a nice way of putting it. At any rate, the conversations I have, by and large, are very much one-sided where I am listening to or diffusing some sort of frustration that someone is experiencing. I sympathize with the patient’s and family’s situation—it sucks to have to wait for several hours in the ER while someone else is almost completely in control of your fate. I get it; I try not to take that little fact for granted. The conversations that I have with these folks, however, typically aren’t very long—two minutes tops. Last night, however, a nurse asked me if I could feed a man whom we’ll call Ishmael. Ish, which I called him, is a quadriplegic. He was in the hospital for some infected bedsores and just had some pain medication. The food, he said, helped settle his stomach from the medication. When I heard the cross-over about Ish, my mind immediately raced to the thought, “If he’s a quad, why would he need pain medication since he can’t feel anything.” Then I just let it go. Shit, if I were paralyzed from the neck down, would want some painkillers too.
The point here, however, is that while I fed this man his turkey sandwich, I realized I became the most attentive listener that I have ever been. I listened with my ears and eyes, watching and listening for the subtlest cues as to what he wanted to do next: talk or eat. I knew that he knew that I didn’t know how to feed him and I so I told him so. He just said, “That’s alright, just ask yourself how you would want to be fed a turkey sandwich, and then verbalize those questions to me.”
“You want Mayo?” I asked, and took it from there. I watched his eyes dart to what he wanted while we chitchatted about other things like the tattoos on his arms. I thought it was cool that a quad would get ink done despite having “non-working” arms and legs. He was a pretty self-aware person—able to see how newbies like myself saw him and made subtle efforts to distract me from be overwhelmed by his general situation in life. The tattoos were a good example of that—it diverted my thoughts from his gnarled fingers and emaciated arms and made me think of his life beyond the bed. Pretty clever really. Of course, maybe I’m over thinking things—maybe he just liked tattoos. At any rate, as we talked about the symbolism of the monkey-riding-the-elephant tat that he had on his right shoulder, I intuitively put down the sandwich, grabbed the can of coke, put a straw in it and gave him a sip. He burped, and I gave him another bite, noticing that he didn’t like eating the crust. When he was all done I wiped his mouth off with a napkin and then the transport person came and got him. While he was being wheeled away he said, “Good talking to you.”
“Likewise,” I said, though I really had hardly spoken but a few questions.
Ish’s obvious, physical need made me listen better than I had in a long time. I was able to listen with all my senses. The subtle yet distinct dignity with which Ish conducted himself made me wonder if I could be as perceptive as he obviously was. It seems to me that although many of us have the less obvious, less physical needs than Ish, we often still need to have those needs perceptively listened to.
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