Thursday, November 29, 2012

Outfitted

Sigh.  And I actually got dressed in real clothes today!  I made more of an effort because I got invited to go to the monthly Morbidity & Mortality conference over at the hospital this afternoon and I thought hey, a little professionalism never hurt in those situations.  But then I got home and did that thing where I come in the door after being at school for 10.5 hours (yes, really) and I was all like, I need to pee and then I need to take off these tights and this skirt and this sweater and this thong and this underwire bra and I need to be in sweatpants and a t-shirt NOW.

Once upon a time, this shirt belonged to the boy.  I don't drink soda.  But omigod it's so comfortable.

Dear sweatpants,
Thank you for being there for me.  Especially when I am exhausted, unshowered, and out of clean underwear.  I think our relationship is bordering on codependence but at least for the next two and a half years that I am in grad school, I really don't care.
Love,
Me


30 Days Hath November
Day 01: A place I'd like to travel.
Day 02: A favourite movie.
Day 03: Something I never leave the house without.
Day 04: A friend I adore.
Day 05: My hometown.
Day 06: A book I'm reading.
Day 07: A song for the day.
Day 08: Three inspirational quotes.
Day 09: A close-up of my day.
Day 10: A favourite recipe.
Day 11: Three years ago today.
Day 12: The last item I purchased.
Day 13: Something I'm proud of.
Day 14: Style inspiration for the season.
Day 15: Three blogs I always read.
Day 16: Someone who inspires me.
Day 17: My family.
Day 18: What I wore today  am wearing right now.

Family Ties

My family is big.

My siblings and I.  Aren't they all ridiculously tall?  In this picture, I am wearing three inch heels.  And they still tower over me.


I love them.  But my family is also this girl:


And these girls:


And the boy.  He's included now too.

* * *

Family can be blood.  But it doesn't have to be.  Family is this:


Family is the people that care.  The people that give a shit.  I'm lucky to have so many.


30 Days Hath November
Day 01: A place I'd like to travel.
Day 02: A favourite movie.
Day 03: Something I never leave the house without.
Day 04: A friend I adore.
Day 05: My hometown.
Day 06: A book I'm reading.
Day 07: A song for the day.
Day 08: Three inspirational quotes.
Day 09: A close-up of my day.
Day 10: A favourite recipe.
Day 11: Three years ago today.
Day 12: The last item I purchased.
Day 13: Something I'm proud of.
Day 14: Style inspiration for the season.
Day 15: Three blogs I always read.
Day 16: Someone who inspires me.
Day 17: My family.

Wednesday, November 28, 2012

Twelve Weeks Later

When the five of us shuffled into the hospital for the first time, we were worse than useless.  We were useless but dressed in scrubs and with ID badges, giving us the profoundly misleading appearance of being way better than useless.

Our first day on the floor, only twelve short weeks ago, the following things happened in my clinical group:
A. started sweating so badly in her contact precautions gown that our preceptor had to lead her out of the room, sit her down, and take her vitals.
K. delayed going into her patient's room for so long that by the time she did, her patient just wanted to go to bed.
T. lost her stethoscope and spent an hour looking for it on every mobile computer station on the floor.
W. listened to her patient's heart with the wrong side of her stethoscope and flew into a panic when she couldn't hear any heart sounds.

And I...well, you all have heard tell of my many clinical inadequacies.

But now?  Times have changed, y'all.  And today, on our second to last day on the floor this year, I looked around at all of us and my heart swelled with pride.  My group, these girls, they inspire me so much.  Every shift, we grow and adapt in ways that seemed impossible twelve weeks ago.  I held a stack of papers for A. today while she gathered her patient's meds, donned some gloves, and headed into his room.  I stood outside and listened while she calmly and confidently asked to see his wristband, confirmed his name and birthdate, and doled out three cups of pills with grace, charm, and precision.  She knew every med, she made sure he knew what he was taking and why, and she did the whole thing without a second thought.  That might not seem like a big deal, but trust me, it is.  Or two weeks ago, T. and I gave her patient a bath and the tenderness with which she washed and combed her patient's hair while talking to her and telling her a story nearly took my breath away.  It was beautiful to see, and the patient's heart rate fell below 90 beats per minute for the first time all morning.

I know we are not nurses yet.  We have a lot of learning yet to do.  But when we're bustling around the floor, confidently heading into patients' rooms, handing out meds, emptying bedpans and changing sheets without a second thought, advocating for our patients to their doctors, looking up their labs and explaining procedures to them, ordering them meals, and flushing their IVs, I think back to the first day when we all were such disasters and my spirits lift.  These friends of mine inspire me to work harder every day.  I'm so sad that next week is our last week.


30 Days Hath November
Day 01: A place I'd like to travel.
Day 02: A favourite movie.
Day 03: Something I never leave the house without.
Day 04: A friend I adore.
Day 05: My hometown.
Day 06: A book I'm reading.
Day 07: A song for the day.
Day 08: Three inspirational quotes.
Day 09: A close-up of my day.
Day 10: A favourite recipe.
Day 11: Three years ago today.
Day 12: The last item I purchased.
Day 13: Something I'm proud of.
Day 14: Style inspiration for the season.
Day 15: Three blogs I always read.
Day 16: Someone who inspires me.

Tuesday, November 27, 2012

A Wordy Hunger

When I just cannot take another minute of pathophysiology, I let my eyes glaze over while perusing the beautiful recipes on...



And when I want to imagine that someday I'll branch out enough to try a different pie crust recipe or buy a seventh kind of flour to make one very specific scone recipe, I gaze wistfully at the recipes on...



And finally, when I need a story with my food porn eye candy or my heart hurts and I miss my nanny kids or I feel like the precariously constructed box I've built around me is crashing in, there is always...



* * *

Because feeding the soul is just as important (or maybe even more important) than feeding the body.

* * *

30 Days Hath November
Day 01: A place I'd like to travel.
Day 02: A favourite movie.
Day 03: Something I never leave the house without.
Day 04: A friend I adore.
Day 05: My hometown.
Day 06: A book I'm reading.
Day 07: A song for the day.
Day 08: Three inspirational quotes.
Day 09: A close-up of my day.
Day 10: A favourite recipe.
Day 11: Three years ago today.
Day 12: The last item I purchased.
Day 13: Something I'm proud of.
Day 14: Style inspiration for the season.
Day 15: Three blogs I always read.

Monday, November 26, 2012

Not Inspiring At All

At least half of my clothes don't fit me.

When I was an emaciated size 2, I convinced myself that I would never, ever, ever gain back the weight I had lost and so I got rid of almost everything I owned that was too big for me.  While I am usually such a fan of decluttering and donating, for the last few months, I have been kicking myself that I got rid of so much stuff that (whether I like it or not) I would fit into again these days.

So yeah.

Style inspiration for the season?  Not much.

I still don't like how my body looks.  I don't like what I see in the mirror.  The boy will routinely tell me to "stop mean mugging" myself in the mirror because he's a little sick and tired of me grimacing at what's looking back at me while I struggle to find clothes to wear each day.  I wind up wearing either some version of leggings and a sweater most days, or my one pair of jeans that fit, or my scrubs when I have clinical, or sweats when I just can't take it anymore and give up before I burst into tears (or after, as the case may be).

Pretty much the only time these days that I don't care what I look like in clothes is when I'm running.  Usually it's darkish, so that helps.

Sorry for the debbie downer post, you guys.  But yeah.  Sometimes recovery is awesome.  And sometimes it sucks so fucking much you want to punch it in the nads.

30 Days Hath November
Day 01: A place I'd like to travel.
Day 02: A favourite movie.
Day 03: Something I never leave the house without.
Day 04: A friend I adore.
Day 05: My hometown.
Day 06: A book I'm reading.
Day 07: A song for the day.
Day 08: Three inspirational quotes.
Day 09: A close-up of my day.
Day 10: A favourite recipe.
Day 11: Three years ago today.
Day 12: The last item I purchased.
Day 13: Something I'm proud of.
Day 14: Style inspiration for the season.

Saturday, November 24, 2012

To Be Here Now

A few weeks ago, I took the train to New York to see my dear friend, J.  It was a week after Superstorm Sandy devastated the East coast and they had managed to turn a post-Halloween costume party that was doubling as a birthday party for one of their dogs into a kind-of-fundraiser "Wear a Costume and Bring a Canned Good" party that extended the promise to lots of friends that if we provided food and booze, then they should donate a little something to the hurricane relief effort.  Oh, and everyone had to wear a mustache.  (We provided those too, lest anyone show up and lament that they couldn't wear a mustache because they just didn't own one.)

Sitting on the couch, chatting with a friend of theirs whom I hadn't met before, he said something and I replied something about one of my patients from the week before.  Then this happened:

Him: Oh, where do you work?
Me: Oh, I'm still in school, in nursing school.
Him: At NYU?
Me: No, no, I live in Connecticut, actually.  I used to live in the city, which is how I know these guys.
Him: Whereabouts in Connecticut?
Me: Um...in New Haven...
J (from across the room): She goes to Yale - Cait, you go to Yale, it's okay to tell people that!

Enter me blushing furiously, and why, exactly?  I mean, yes, I go to Yale.  But I go to grad school there, which is something that - at least in my head - is fundamentally different than coming out the other side of the lions' den that is their undergraduate admissions process.  For whatever myriad of reasons, I don't talk about where I go to school.  I don't like the connotations that the name carries, and I certainly don't think it lends me any extra clout or prestige in the nursing world.  But grad school itself (nameless or otherwise) is something of which I am intensely proud.

College was a given in my family.  Not because either of my parents finished their own college educations.  And certainly not because we could afford to be sending all seven children on to four years of post-secondary education.  No, purely because my mother was bound and determined that we would all be given the best possible future she could muster for us and so out went the TV, in came the homework and the extracurriculars and the part-time jobs and the wrinkled-up cried-over admissions essays but by golly, she did it.  We all went.  Every last stinking one of us.  And by the time I was old enough to be aware of it, the standard was set: I was going to college.

Grad school, on the other hand, was up to me.  From start to finish.  And there are days, still, where I look around at my life and I think, holy shit and Is this real? And it is!  It is real!  I actually am in grad school, becoming a nurse, and then later becoming a nurse-midwife and it's so freaking cool that it still makes me smile.  I am proud of myself for being here.  That I got myself here, all by myself.  That I'm doing this with my life.  And that when the question arises: What would you do with your life if you could do anything at all?

My answer is this.  Exactly what I'm doing right now.


30 Days Hath November
Day 01: A place I'd like to travel.
Day 02: A favourite movie.
Day 03: Something I never leave the house without.
Day 04: A friend I adore.
Day 05: My hometown.
Day 06: A book I'm reading.
Day 07: A song for the day.
Day 08: Three inspirational quotes.
Day 09: A close-up of my day.
Day 10: A favourite recipe.
Day 11: Three years ago today.
Day 12: The last item I purchased.
Day 13: Something I'm proud of.

Friday, November 23, 2012

The last item(s) I purchased

1.  Gas for my parents' car
2.  Brandy, for the fruitcakes that take from now until Christmas to be complete
3.  Crisco, for the cranberry-apple and mincemeat pies we ate yesterday (and today)
4.  Fenugreek, for a recipe I want to try
5.  Coffee.  Because I'm me.

FUN FACT: tea made from fenugreek is said to increase milk supply.  It's also a tasty addition to Indian food.


30 Days Hath November
Day 01: A place I'd like to travel.
Day 02: A favourite movie.
Day 03: Something I never leave the house without.
Day 04: A friend I adore.
Day 05: My hometown.
Day 06: A book I'm reading.
Day 07: A song for the day.
Day 08: Three inspirational quotes.
Day 09: A close-up of my day.
Day 10: A favourite recipe.
Day 11: Three years ago today.
Day 12: The last item I purchased.

Tuesday, November 20, 2012

Three Years Ago

In the fall of 2009, I had...


...some truly amazing, irreplaceable friends.  They pulled me from the darkness more times than I could count.


...days, still, where I was so paralyzingly sad that I couldn't see how to keep going.  Days that felt like even a year out from being hospitalized and being on the right meds was not enough time to hold back the growling, howling, teeth-gnashing beast of crazy that had crash-landed into my life.

But - also, this:
(from my Facebook, late November, 2009) "...is exponentially happier than she was last year at this time."

I loved Alix.  And she loved me.  And three years ago today, her love was a force of good in my life that propelled me through my last (drama-filled and anxiety-packed) year at Smith.

All that said...it's good to be where I am now.

* * * 
30 Days Hath November
Day 01: A place I'd like to travel.
Day 02: A favourite movie.
Day 03: Something I never leave the house without.
Day 04: A friend I adore.
Day 05: My hometown.
Day 06: A book I'm reading.
Day 07: A song for the day.
Day 08: Three inspirational quotes.
Day 09: A close-up of my day.
Day 10: A favourite recipe.
Day 11: Three years ago today.

Monday, November 19, 2012

Eggplant Can Be Sexy

I used to loathe eggplant.  I thought it was slimy, and bitter, and rubbery and I resented its very existence in the world of food.  Sadly, eggplant can be all of those things - but it doesn't have to be.  It can be silky and smooth and smoky and - dare I say it - sexy.  Yes, sexy.

I am a firm believer that baba ganouj is better than hummus.  It's hummus's awkward cousin at the summer barbecue, who has a weird name, like Anastasia that no one can pronounce, but at the end of the movie, everyone is going to realize how much more awesome she is than her simply-named and conventionally-pretty cousin, Kimmie.

Here is the only recipe for baba ganouj you will ever need.  Originally, it came from a Moosewood cookbook and has four or more extra ingredients, like parsley and scallions and other unnecessary things.  There are five gazillion Moosewood cookbooks, so please don't ask me which one it's from because I have no idea.  All I know is that I have committed this recipe to memory and people moan over it when I bring it to potlucks, and then sidle up to me like I'm operating an undercover meth lab out of my kitchen and ask me in an undertone, "How did you make this?"  Good readers, here is how:

Preheat your oven to 400.
Take two eggplants and cut off the stem end.  Then prick holes all over the eggplants with a fork.
Put them into the oven, directly on the racks.  It's a good idea to put some tinfoil on your oven floor to catch drips.
Set your timer for at least 45 minutes, though it can take up to an hour.
When the eggplants are falling apart, practically sinking through the oven rack, and look like something dead on the side of the road - carefully take them out of the oven with some tongs and a big bowl and let them cool until you can touch them without swearing.
Scoop all of the insides into a food processor.  Make sure no skin gets in, and leave no insides behind.  Be fastidious.
Add 1/2 cup tahini, the juice of one lemon, 3 (or 5, if you're me) crushed garlic cloves, 1 tsp coarse salt,  and five or six grinds of fresh black pepper.  Whiz it up until it's smooth.  Taste and adjust seasonings.
Serve this warm with bread, pita, vegetables, a spoon, your fingers.
Prepare yourself for the moans and admiring glances at your next potluck.
If there are leftovers, eat them with a spoon, in the dark of night, with the fridge door propped open.
It will make you happy.

* * *

30 Days Hath November
Day 01: A place I'd like to travel.
Day 02: A favourite movie.
Day 03: Something I never leave the house without.
Day 04: A friend I adore.
Day 05: My hometown.
Day 06: A book I'm reading.
Day 07: A song for the day.
Day 08: Three inspirational quotes.
Day 09: A close-up of my day.
Day 10: A favourite recipe.

Sunday, November 18, 2012

Liebster: Like Lobster, but Without Butter

Allison, over at Allison the Meep nominated me for a Liebster award.  Which is not something that comes on a roll with mayo, because that chick is so gluten free that her head would spin if you brought a bread product near her face.  What it is, however, is an award for wonderful, but lesser-known blogs of the big blogging world.  It made me smile, because my tiny corner of the internet makes me very happy but apparently also entertains a few others as well!  So I'm gonna answer my given eleven questions, and then nominate eleven five other blogs (I am sorry to say, I simply do not know 11 bloggers well enough to nominate them for this), and give them eleven questions to answer as well.  Read on.

1. What book(s) are you currently reading?
Usually (and most depressingly), my Med/Surg textbook, as discussed here.  But now that I am on break (italics are necessary because it is still so shocking that I am still very excited), I am attempting to finish The History of Love, by Nicole Krauss, a novel that I have been working on since August.  Yes, August.

2. If eating a cockroach guaranteed you and your family financial security for the rest of your lives, would you do it?
Abso-fucking-lutely.  I'm sorry, but would anyone NOT do this?  I am going to be delivering babies from my wheelchair in the senior center in order to pay off my Yale loans, you better believe I'd house some crunchy suckers in order to wipe that clean.

3. Do you have any phobias?
Phobias, no.  Fears, yes.  I'm scared of the open ocean, and sometimes heights make me queasy, but I don't rearrange my life to avoid these things.

4. If you could possess one super power, what would it be?
I used to think I'd want to be invisible, but is there anything worse than feeling like you're invisible in a room full of people normally?  Why would I want to perpetuate that feeling?  Unconventional, perhaps, but I would love to be able to function and thrive on four hours of sleep a night.  I'd sleep from 2 AM to 6 AM, and I'd be golden.  I'd get so much studying done!  It'd be awesome.

5. What is your favorite food?
Let's do this systematically.  Sweet: rhubarb pie.  Savory: cheese.  Plant-like material: tomatoes, raspberries, mangoes, avocados, brussel sprouts, butternut squash, and radishes (right?  Obviously with the radishes).

6. What do you like best about yourself?
When I go to read this question, my brain makes a farting sound.  It wants to say, "Thbpppbth...NOTHING!"  Not true, I tell Brain.  I like my nose.  It's cute.  I also like my hair.  I used to hate it, but age has improved it.  It's long, and blonde, and I've never dyed it, and it's wavy and hippie and swings around my shoulders and gets gnarly when it's a little dirty.  Also, I'm kind.  Not perfectly, and not without faults and missteps, but I am kind, and compassionate, and can be fiercely protective.  See what I did there, Brain?  Shut your pie hole.

7. Do you give money to homeless people when they ask? Why or why not?
Only once.  To a man in the subway station I passed through every day, I saw him, his sign had only one word on it: AIDS.  I put a $20 bill in his cup.  The reason I don't usually give money is because I used to volunteer in a homeless shelter, and I heard firsthand what most people do with the money they panhandle for.  It wasn't pretty.  I'd rather volunteer.  Or if I have extra food, I'll always ask if they're hungry, if they'd like an untouched sandwich or a fresh piece of fruit.

8. If money was not an issue and all of your basic needs were taken care of, what would you do with your life?
This question makes me happy, because truly, truly all those things being taken care of - I'd still want to deliver babies.  I'd love to be able to do it for free, of course, but no such luck, future clients of mine.  Maybe I'd love to work a little less and have a few more babies of my own, but hey.  If it's not one thing, it's another, right?

9. When do you feel the most clarity?
About mile five of a run.  Everything has (mostly) stopped hurting at that point, and the mind clouds drift away.  I would run forever, if I could just stay right there.

10. There are 3 contestants, and only one can win: cake, pie, or cookies?
This is not even a question.  Pie.  Made by me.  I am cocky about my pie skills.  Yes, yes I am.

11. Squirrels: Love or hate?
Are squirrels like a thing?  Do people love them or hate them?  I find them mildly irritating.  Get out of the road!  Stop taunting my dog!  That kinda thing.  I reserve hate for things like when people touch my belly button.  Now THAT is something to get fired up about.


* * *

Nominations

* * *

Their questions, should they choose to accept them:
1.  What is the correct way to pronounce Nutella?  (NEW-tella, or NUH-tella??)
2.  How do you sign off on emails?
3.  When is the last time you were proud of yourself?
4.  Do you ever talk to yourself?
5.  What do you eat for breakfast most days?
6.  How does it make you feel when someone tells you that you're beautiful?
7.  You don't need to elaborate on who you would say this to, but what's one thing you need to say, and haven't yet (or never will)?
8.  Tell me a memory that involves crazy weather.
9.  Which is better, mechanical pencils or good old-fashioned No. 2's?
10.  Should clean underwear be folded?
11.  What do you do when you can't fall asleep?

Friday, November 16, 2012

Today

 Sometimes I feel like each day is a pile of jagged puzzle pieces that I have to piece together as I go along.  And every day the puzzle is different.  But deceptively so, because I'll think I know how this one (say, the Thursday puzzle) goes together, but then I'll realize oh no, wait, this week it's actually completely different.  Try again.  It's a good lesson in time management and task focus (neither of which I am very good at).  So.  This is what Thursday, November 15, 2012 looked like for me...

This is what time my alarm went off.


I only groaned a little.  I was definitely up and into the 45 degree air by 5:10.  In half an hour, I cut up a grapefruit to have for breakfast, I made a PB&J to pack for lunch, I drank four big glasses of water, peed twice, hopped around in the cold, took a deep breath before shimmying out of my pajamas and into my yoga clothes, double and triple checked that my school bag had everything for school and my yoga bag had everything for yoga and showering afterwards, and then went to 6 AM Bikram, which is really just 90 minutes of why why why whywhywhy going through my head until I'm done.  Fastest shower of my life.  Into sweats and off to school by 8 AM.

The clothes go into a plastic bag because yes, they are dripping with sweat.  And two towels.  One for sweat, one for shower.
Not very many people came to my pharmacology class this morning - our professor usually (generously) cancels class on the days when we have a Med/Surg test at 10 AM, but she couldn't today because Sandy made for some missed days of school and we were behind.  I chugged coffee, ate my grapefruit, chugged water, and convinced our professor to tell us a few stories from her days as a pharmacist in NYC once we finished our lecture on anxiolytics and antidepressants.

At 10 AM, I had my third Med/Surg exam.  88 questions.  All of the possible answers are at least partially correct (not kidding).  It's brutal.  We sit in this windowless room, packed in like pickles, and slog through the 24 page test packet, frantically rechecking our bubbles on the Scantron we're filling in as we go.  Dazed and confused, I finished around 11:30 and retreated to my school's atrium to eat some lunch.

Mindless Facebook-ing, Twitter-ing, and PB&J scarfing commenced.

At 1 PM, I had my last pathophysiology class before Thanksgiving break.  We finished up membrane potentials and started on central nervous system signaling.  I had to dig deep in my brain for my senior year of college neurophysiology knowledge and managed to dredge up the key bits.

Ahh...done with class by 3 PM!  Fell asleep on the shuttle home.  Dani shook me awake at my stop, thank goodness, or I would still be on that bus.


Really, really, really didn't want to go for a run but that half marathon is not just going to run itself, now is it.  It took me until 5:15 to summon the energy, but by golly I did.  Pulled the negative splits I was aiming for and made it home in time for a shower before babysitting.

Met a new family tonight, close by in my neighborhood, they need a few date nights a month.  Sweet baby, slept the whole time.  Libby (a Labradoodle) and I cuddled happily on the couch, while I enjoyed:
a) heat that I didn't have to pay for
b) muted TV on all of the cable channels we can't afford, on a TV five times the size of ours
c) a chance to talk to my sister on the phone, which just doesn't happen enough but is so wonderful when it does.



Parents got home at 11:15.
Came home.
Climbed into bed.
Zzzzz......


30 Days Hath November
Day 01: A place I'd like to travel.
Day 02: A favourite movie.
Day 03: Something I never leave the house without.
Day 04: A friend I adore.
Day 05: My hometown.
Day 06: A book I'm reading.
Day 07: A song for the day.
Day 08: Three inspirational quotes.
Day 09: A close-up of my day.

Thursday, November 15, 2012

Quotables

The room is 105 degrees Fahrenheit.  Yes.  I'm serious.  A hundred and five.  And I - voluntarily, mind you - continue to go back, day after day now, and subject myself not only to the room itself, but to what goes on in there.  It's like the worst parts of yoga, for ninety minutes straight.  It's the parts of yoga where you start to tremble at the end of a pose, and your knee twitches or your hip twinges and you impatiently wait for the instructor to release you to something else.  It's those few moments in a regular yoga class but it's constant and it's so much worse.  It's Bikram yoga, and it's an instructor telling you, "This is supposed to hurt.  Be brave."  Or, "In twenty-five minutes, we'll all take a water break."  Or, "Your body is a folded box, your hands are under your feet, your stomach is GLUED to your thighs, your chest is GLUED to your knees, your face is flush with your shins, EYES OPEN, and there is no room for light or air between your halves, now pull up on your heels, straighten your legs and lock your knees - do it, do it now - LOCK YOUR KNEES and breathe normally, through your nose, don't give up on this pose..."  And in my head, I am like, "WHY AM I HERE?" and also, "I'M GOING TO DIE, I'M GOING TO BE A DEAD FOLDED BOX," but also, and best of all, and the reason I keep going back -

If it doesn't challenge you, it doesn't change you. 
-Fred DeVito

* * *

The patient's team of physicians gather around the foot of his bed and I can't even tell if they are just discussing the case with each other, or if they're under the impression that anything they're saying is making sense to the patient.  He struggles to shift his head up so he can look at their faces as they tower over him, but I cannot raise the head of his bed more than 20 degrees, or it will put too much weight and pressure on the rapidly deconditioning skin of his coccyx and sacrum.  The doctors ignore me, and I listen intently to what they're saying about his renal biopsy results because I know that as soon as they leave, I'm going to have to explain all of this again to the man whose colostomy bag I am attempting to empty.  I look up and see one med student fling a sidelong and disgusted glance at the bag that I am attempting to empty efficiently, with some modicum of dignity, but it's hard because no one has emptied it in the four hours that he's been off the floor and down in dialysis.  He's so uncomfortable and  he's so hungry and I'm so mad at these doctors for knowing so much and still not being able to fix him and cure him of this terrible condition that came on so suddenly and I feel the wave of helplessness starting inside me as I think to myself, If you knew more, maybe you would know what to do for him, maybe there's more tests they can do or answers to be found... but I stop.  I look at his hands, lying clenched in fists on the bed below me and I remember the words that are like a song in my heart, the number of times I have repeated them to myself, over these last ten weeks:

Not all of us can do great things.  But we can do small things with great love.
-Mother Teresa

I finish emptying his bag, clean up, and wash my hands.  I ignore the doctors.  I say, "Excuse me," firmly and with conviction and they scoot away from his tray table.  I maneuver it over his legs, adjust it to the perfect height for him so he can eat even though he is almost flat in bed.  I open his food, and his cup of apple juice, put in a fresh straw, and tilt the straw way down so he can get it in his mouth.  I stir up his pasta and comment softly to him that his spaghetti looks delicious, that I know he waited so long for this dinner, and now he can relax and enjoy.  I tell him, here's your call bell, I'll be right outside if you need me, I hand him his fork and touch his shoulder.  He smiles at me, starts to eat, and I blaze past the doctors on my way out the door.  They might know more than me.  They might do big things, like diagnose, and order meds, and perform surgery.  But I do small things.  And I do them with love.


30 Days Hath November
Day 01: A place I'd like to travel.
Day 02: A favourite movie.
Day 03: Something I never leave the house without.
Day 04: A friend I adore.
Day 05: My hometown.
Day 06: A book I'm reading.
Day 07: A song for the day.
Day 08: Three inspirational quotes (I only did two).

A Song for the Day

I know there's California, Oklahoma

It is a danger of being busy, of being swamped with studying, the danger of inflating your own importance.  

And all of the places I ain't ever been to but

How will I ever learn the difference between the five different types of hepatitis, know what immunoglobulins indicate latent infection or chronic disease, and what the heck is hepatic encephalopathy anyway?  Is that the one that causes asterixis?

Down in the valley
With whiskey rivers

And then, every Wednesday, I walk into the hospital and take a deep breath of the Purell-scented air on the renal unit where I spend my days now.

These are the places you will find me hidin'

And I remember.  I remember that I get to walk away at 7 PM.  That I can comment on the weather with some knowledge of what that air feels like outside, because I was in it that morning and will be in it again that night, cold or rainy as it is.  I remember that yes, I have a lot of studying, and it feels overwhelming, but - I can go to the bathroom when I want to, and I don't need anyone to help me.  I can eat what I want to, and my kidneys work, and my blood is not slowing to sludge in my veins because it's so loaded with toxins that I should be able to pee out but can't.  I remember that I can walk more than three feet without getting out of breath, and I remember that when I dream about being on a beach, or being home with my Mom and Dad, or even just being asleep in my own bed...those things are possible for me.  Some are more likely to happen than others, but they're still possible.

These are the places I will always go

People in end stage renal disease can dream of leaving the hospital, but most of them never will.  The places they go in their dozes and daydreams, after I dim the lights and pull up their blankets, are places they will probably never see again.  The inside of their bedroom, the slope of their front steps, the sky outside their kitchen window.

These are the places I will always go

A document entitled "Discharge Plan."  It's blank inside.

I am on my way

I pull up the order list, updated this morning after the patient met with his physician team.

I am on my way

Comfort measures only.  Morphine, PRN.

I am on my way back to where I started

I catch my breath again and say a prayer that the sky is beautiful there.  He's on his way.


Lyrics from: Down in the Valley, by The Head and the Heart.


30 Days Hath November
Day 01: A place I'd like to travel.
Day 02: A favourite movie.
Day 03: Something I never leave the house without.
Day 04: A friend I adore.
Day 05: My hometown.
Day 06: A book I'm reading.
Day 07: A song for the day.

Pages and Pages Before I Sleep

Far be it from me to call reading about diabetic ketoacidosis boring.  Me?  Never.


There are 1,577 pages in my Med/Surg textbook.  I saw that number on the day I brought it home from the bookstore and sighed a sad sigh as I looked longingly at my bookshelves.  Someday, when I have graduated, I will read for pleasure again.  In the meantime, I keep some of what I wish I could read by my bed, essentially as talismen.



Someday.  In the meantime...from page 841:

"...[The] hyperosmolality of the extracellular fluid characteristic of diabetic ketoacidosis leads to the stimulation of thirst with resulting polydipsia, and fluid shifting from intracellular to extracellular space.  The sodium shift that follows is referred to pseudohyponatremia..."

30 Days Hath November
Day 01: A place I'd like to travel.
Day 02: A favourite movie.
Day 03: Something I never leave the house without.
Day 04: A friend I adore.
Day 05: My hometown.
Day 06: A book I'm reading.