we should all have the good sense of this dog and curl up in jesus' lap from time to time

Oh hi! I'm alive. And most importantly, I am done with my third semester of nursing school, save for the aforementioned writing class for which I am still working on an assignment that was due exactly three weeks and one day ago. Sigh.

Naturally, I have spent my first day of freedom obliterating time on the internet, and now I feel the need to compile and share.

A poem (that I actually like/understand!) from my writerly friend Meg.

A positively pastoral nativity scene from my Jewish friend Susie.


A hipster dinosaur coloring book from my American Spirit-smoking boyfriend. (Apparently I am late to the party on this one. Fashionably late, I say.)



Realistic children's paintings...


...and a disgruntled would-be teenage librarian from my soon-to-be librarian sister.



Happy Holiday Season, Everyone! May all your dreams come true and not be ruined by evil librarian social networking accounts.

writing about cats

So I am taking this writing class. I'm taking it because 1., it's free since I'm paying full-time university tuition and apparently a full course load plus one other elective and a part-time job wasn't enough, and 2., I like writing and it makes me sad that I don't do it so much anymore and so instead of actually, you know, sitting down to write, I just get sad about it. So I am trying to be more proactive.

Aside from turning in my first assignment a week late and almost quitting (after the drop deadline, academic record be damned) it is going pretty well. It is a nonfiction class, but today our in-class exercise was to write a fictional paragraph about an animal, including dialogue, in five minutes. At first I was horrified because I took a fiction class in college (the first time I went to college) and it did not go well. Not well at all. But I was kind of amazed at how cathartic this exercise was.

Walter and James were napping on opposite ends of the living room, Walter on the back of the faux leather couch and James over on the green velour armchair, on top of a pair of Gina's boots. Gina had been sitting at her desk for hours, periodically getting up and returning with glasses of water and little square things in shiny, crinkly, packages. She closed her laptop and headed toward the bedroom. 'Hey Walter, wake up bro!" cried James. "I think she's going to bed!" Walter awoke with a start. "It appears that way, indeed," Walter said. "Would you like to wrestle each other and run up and down the hallway and knock things over for the next two hours like we do every night?" "Yeah dude!" replied James.

So I wrote that and then I realized that my first assignment was also about my cats. WHAT AM I BECOMING.

I Don’t Like My Cat
by Gina G.

I have recently come to a conclusion it’s taken me over two years to reach. I have this cat, James, and I don’t really like him very much. It breaks my heart to say this, because, well, you’re just not supposed to say things like that, especially if you are someone who volunteers for animal rescue organizations. Also, James is curled up with his head on my thigh as I type, periodically looking up with eyes full of sleepiness and contentment, oblivious to the thoughts running through my head. Or maybe he’s just trying to make me feel guilty.

I got James two and a half years ago, when flyers for a rescue group’s adoption event lured me into my local pet store. I had been thinking about getting a second cat for a while—my first one, Walter, had been acting up ever since I started living alone, and I figured he’d do better with feline company. I had decided that Walter’s companion would be a grey female kitten. James was a year-old orange tabby. But he was cute and he rubbed his face on my hand when I stuck it in his cage. And the adoption counselor told me how James had been living in that cage for four months, and that the staff referred to him as The Butterscotch Stallion, after Owen Wilson. I liked Owen Wilson. As I was filling out the adoption paperwork, the counselor made an offhanded remark about how James always made a big mess of his cage. And that raised a red flag for me. But I am really good at ignoring red flags (as evidenced by my romantic relationship history), and I had already made up my mind.

The first few weeks with James were telling. If I thought Walter was digging to China every time he used the litter box, James was reaching China and then blowing it to pieces and tossing it all over the place. He also had a piercing, persistent cry that the adoption counselor described as “vocalizing” when I called her a few days in and expressed second thoughts. I decided to give it some time.

Some time has turned into two and a half years, and in those two and a half years, James has destroyed: three sets of window coverings, a lamp, countless glass- and dishware, a couple of picture frames, a carved wooden figure of my name I’ve had since I was a little kid, an awesomely weird ceramic bowl shaped like a rabbit that my mom had as a child, a jewelry box. He seems to have an aversion to my being in bed and will start wailing at night when I go to sleep, every morning at 5:45 regardless of the level of sunlight (it’s amazing, really), or when I am taking a much-needed afternoon nap. I can’t play with Walter anymore, because James will jump in and take over as Walter slinks away to watch from the sidelines. James needs to be in my immediate vicinity pretty much all the time, which wouldn’t be the biggest problem except that he is about the same color as my hardwood floors, and so I trip over him at least daily.

When I’m upset, I’ve tried to remind myself of his good qualities, kind of like a mantra: James is a great photographic subject. Unlike Walter, he lets me pick him up. He often grooms himself in a half-supine position that is hilarious and adorable. When they’re not fighting, James and Walter lick each other’s faces—an endlessly watchable spectacle. But this attempt at reassurance that I am not in fact a bad person who dislikes her cat has done nothing to quell the rise in blood pressure I feel pretty much all the time that James is not napping or licking something (cats do both of those things a lot, thank God).

In the time I’ve been writing this, James has gone from sleeping to trying to get Walter to play with him, to crying in a tone that I swear sounds defiant, to knocking something over in the kitchen that I have yet to investigate, and back to sleeping. Recently I’ve had thoughts of finding him a new home. But it’s not just the probable difficulty of that undertaking that is holding me back. James has taught me some life lessons. Like, it is illogical to yell at or punish a cat, much like a very small child, and so you eliminate their ability to commit the offending behavior in the first place. And, not having small objects sitting around on surfaces is not only good for preventing cats from knocking them over, it results in a more tidy aesthetic and easier dusting. And at the end of the day (and I do mean at the end of the day, like when I come home from work/school and it is dark out), he does this thing when I turn on the lights where he looks up at me, squinting because his eyes are sensitive to the light, and it’s just so goddamn cute.

it's the little things

So, America's Next Top Model is back and idiotic as ever. More importantly, fourfour is recapping again, as brilliantly as ever. I was surprised, though, that he made no mention of one of the makeup artists on last week's episode. This last name is pretty much blowing my mind.



Update: A Google search reveals that Beaglehole is a popular last name in Australia and New Zealand. And now I really want to go pay a visit to Porpoise Spit.

"do not affect a breezy manner"

Show of hands: who here owns The Elements of Style and purports to love it but has not actually gotten through it all, despite its being less than a hundred pages long for chrissakes? Just me? Okay then.

I was recently encouraged to read the last chapter, An Approach to Style (With a List of Reminders), a 1959 add-on by E.B. White. Words cannot express how much I do indeed love him. Or, rather, my words can't, so here are some of his.

E.B. White on not "injecting opinion":

If you have received a letter inviting you to speak at the dedication of a new cat hospital, and you hate cats, your reply, declining the invitation, does not necessarily have to cover the full range of your emotions. You must make it clear that you will not attend, but you do not have to let fly at cats. The writer of the letter asked a civil question; attack cats, then, only if you can do so with good humor, good taste, and in such a way that your answer will be courteous as well as responsive. Since you are out of sympathy with cats, you may quite properly give this as a reason for not appearing at the dedicatory ceremonies of a cat hospital. But bear in mind that your opinion of cats was not sought, only your services as a speaker. Try to keep things straight.

E.B. White on not taking "shortcuts at the cost of clarity":

Not everyone knows that SALT means Strategic Arms Limitation Talks, and even if everyone did, there are babies being born every minute who will someday encounter the name for the first time.

E.B. White on choosing "the standard over the offbeat":

Youth invariably speaks to youth in a tongue of his own devising: he renovates the language with a wild vigor, as he would a basement apartment.

All pretty compelling advice if you ask me. But then again, I am a cat lover/hater with a history of basement-apartment living and a current post learning to help birth babies, which babies I will from now on be envisioning doing their drooling instead in high school history class.

monsters, brah

I was taken aback when reading this entry in the servicey first pages of Urbanite magazine. It's great that this store carries stuff for plus-sized ladies, but is it really okay to call the bras MONSTER-sized? Then I Googled "monster bra" (as you do), and it turns out it's a thing. A monster bra is a bra, with monsters on it. You learn something new every day!

Other new things I learned today:

*I have been riding my bike around with a wheel "really out of true" and a broken spoke. (I took it to the bike shop for a measly flat tire.)

*To replace a wheel "really out of true" with a broken spoke and a measly flat tire, it costs $78.

*C-sections are not conducive to mother-baby bonding, due to a lack of endogenous oxytocin release and the time needed to recover from major abdominal surgery, yet in a semi-recent survey of obstetricians, 30% said they'd elect to have one.

*A can of corn with some salt on it (the corn, not the can) is a pretty satisfying snack.

reuniting with compassion and heart energy

In a couple days, I am heading to Asheville, NC for the first time. I will be driving there with my super cool cousin who, until a couple years ago, I hadn't seen since I was about 10, and we will be staying with our eccentric uncle who used to be a psychiatrist and now builds furniture up in the mountains. I consulted the Asheville alt weekly's website to see if there might be any good events going on when we're down there. Boy was I not disappointed...

Totally Telemann Oboe Concert:
SU (8/21), 3-4pm - Local oboists Kathryn Potter and Cheryl Tuttle will perform Telemann Fantasias and Canonic Sonatas in a teacher/student concert at St. Mary’s Episcopal Church, 337 Charlotte St. in Asheville

An Evening With Spirit:
MONDAYS, 6-8pm - You are invited to an evening with Spirit. Theo Salvucci channels messages from the angelic realm

Healing the Heart/Genital Split:
TU (8/23), 7-9pm - Join Steve Torma for a presentation on how to remove blockages to sexual energy and reunite with compassion and heart energy. Held as part of the Hold On to Summer Heat series at 2 Westwood Place in West Asheville, on the grounds of the Asheville School of Holistic Herbalism. Presented by the Asheville Wholistic Sexuality Collective.…

Rockin’ with the Docs:
TU (8/23), 6-10pm - "Rockin’ with the Docs" will feature local doctors and performing with their bands. Proceeds will benefit the Western Carolina Medical Society’s charitable foundation and Project Access. Held at Pack’s Tavern, 20 South Spruce St. $5.

smalltimore

Of Baltimore's many monikers (including Charm City, The Greatest City in America (seriously--it says so on the public benches), The City That Reads, The City That Bleeds, and Mob Town), my personal favorite and most used is Smalltimore. One, because it just sounds silly, and two, because it's true. Don't let the big city trappings fool you--if you spend even just 24 hours here you WILL run into someone you know. Case in point: My friend who came to visit this weekend got hit on by a dude in a bar. We went to brunch the next morning on the opposite side of town. Dude was our waiter.

After spending such a long time in New York City, I find this aspect rather comforting. It makes me feel like I'm a part of something, and it's forcing me to deal with my social anxiety--the "look at your cell phone and pretend not to notice" trick doesn't work as well when you're the only two people on the sidewalk. And you're more accountable to how you treat people. Not that I was ever a total jerkface or anything, but it's making me think hard about my moments of inconsideration. No longer can I just ignore the texts of someone I've been on a few dates with and say to myself, "Oh well, it's not like I'll ever run into him again." (Which doesn't mean I won't still ignore the texts, just that I can't say that...IT IS A WORK IN PROGRESS HERE, PEOPLE.)

A new element of the smallness I hadn't considered until recently is the likelihood of running into patients. Unfortunately, ICU patients are less likely to be seen out and about than those from other areas of the healthcare continuum, but their family members aren't. Two weeks ago I saw the daughter of patient I took care of for three days crossing my street. This morning I noticed the son of another one at the farmers market. And then I noticed the wife. And then I noticed...the patient! I was more than a little bit surprised. Three weeks ago, I suctioned bloody sputum out of his lungs and stood by as a newly minted MD performed her first paracentesis (i.e., draining the "beer" out of a beer belly). And here he was, all cleaned up and inspecting peaches with his family on a sunny summer morning. There was a tear or two beneath my sunglasses. And then I felt kind of creepy.

from the "poignantly sad moments in nursing" files

I arrive to work and one of my two assigned patients is already in a body bag. We spend the morning taking care of the living one and waiting for Transport to take the dead one to the morgue and for Housekeeping to clean the room. I look in and notice an "About Me" poster on the bulletin board. I make a mental note to make sure it's gone before the next patient arrives. (Housekeeping sometimes forgets about the bulletin board, and having cards and things from a prior patient in the room is, obviously, not ideal.)

Sometime in the late afternoon (this transport and cleaning business takes forever), the new patient arrives. We do all the new patient things--vital signs, EKG, swabs in various orifices for various cultures, etc. I open the garbage can to throw away the used blood glucose finger stick supplies. At the bottom lies the "About Me" poster. "My name is John," it says. "My pet is Lucy--Chow-Chow mix. I like astronomy, running, and classical music."

Next!

Fuck.

from the "wildly inappropriate moments in nursing" files

Two nurses and I are bathing a patient--a 23-year-old girl with acute liver failure due to drinking a pint of vodka a day since age 15. She is in bed, yellow as a Simpsons character, and on the wrong end of the coma scale. I am holding her up on her side so that Nurse 1 can scrub her back. Nurse 2 is emptying her rectal tube drainage bag into a measuring container.

Nurse 2: I kind of want to go to Nearby Pub tonight. You working tomorrow?
Nurse 1: Yeeeeah. Sorry.
Nurse 2: Just for a little bit?
Nurse 1: Ok, sure. I guess a drink won't kill me.

Eye contact is made. Jaws drop. I turn my face away from the patient because I am trying to suppress that particular kind of laughter that comes on in awkward situations and it is not working. We go about the remainder of the bath in silence.

speaking of nursing having its own language...

In the hospital, there is no time for actual, you know, words. As a result, medical professionals have come up with various acronyms, abbreviations, and mnemonic devices to document patient data and aid with assessments. Some of them have more than one (very different) meaning, and many of them make no sense to anyone not high on marijuana (or whatever the kids are getting high on these days...someone in the pediatric ICU let me know?). Here are some of my favorites, so far, in vaguely alphabetical order:

B-52 (or, how to knock out a belligerent psych patient) - Benadryl, 5 mg of Haldol, 2 mg of Ativan
BM - black male, bone marrow, bowel movement
BRBPR - bright red blood per rectum
BRP - bathroom privileges
BURPS - building and understanding roots, prefixes, and suffixes
CABG (pronounced "cabbage") - coronary artery bypass graft
DIAPERS (when assessing for urinary incontinence in the "older adult") - delirium, infection, atrophic urethritis, pharmaceuticals, excess excretion, restricted mobility, stool impaction
ED - eating disorder, emergency department, erectile dysfunction
FFF - fat, female, forty (the most common gallstones demographic)
The Six F's of Abdominal Distention: fat, fluid, flatus, fetus, feces, fibroid (such a ring to it, no?)
DNKA - did not keep appointment
NKDA - no known drug allergies
GSW - gunshot wound
DSW - discount shoe store
(just kidding)
CVA - cerebrovascular accident (woopsies!)
I GET SMASHED (when assessing for pancreatitis) - idiopathic, gallstones, ethanol (booze), trauma, steroids, mumps, autoimmune, scorpion sting (WTF), hypercalcaemia, hypertriglyceridaemia, hypothermia, ERCP (endoscopic retrograde cholangiopancreatography), drugs (e.g., azathioprine, diuretics)
LLL - left lower lobe (of the lung)
RRR - regular rate and rhythm (of the heart)
mg - miligram
Mg - magnesium
MG - myasthenia gravis
MVA - motor vehicle accident
MVP - mitral valve prolapse
OLDCARTS (when assessing anyone complaining of anything) - onset, location, duration, characteristics, associated symptoms, radiation, treatments, summary
PE - physical examination, pulmonary embolism
PROM - passive range of motion, premature rupture of membranes
PUPPP - pruritic urticarial papules and plaques of pregnancy (in other words, an itchy rash)
SOB - shortness of breath
TLC - tender loving care, total lung capacity (RIP, Lisa "Left Eye" Lopes)

a letter to a friend

because sometimes it's easier to write to a person than to the black hole that is the Internet


In other news, I am seven shifts into my job in the ICU. Things are going really well, which is more a relief than anything because I was so scared going into it. I'm learning a ton and am starting to feel somewhat competent! Also hospital nurses are a pretty hilarious, salty bunch. Especially the older ones. The weird part though is that in school I'd always joke that my main goal was just to not kill anyone, but in there I almost wish I could. For the last two days my patient was a homeless man being kept alive on a ventilator and various meds that kept his blood flowing, and he was absolutely going to die, but we couldn't withdraw any care because he didn't have anyone to speak for him. By the end of my shift yesterday my preceptor and I were just kind of fed up, and when hospital staff would come by to inquire (he was obviously in horrendous shape), she'd say, "Oh, you know, we're just letting him slowly suffocate." Which is exactly what we were doing. And what we legally had to do. If I saw a freaking cockroach going through such suffering I'd feel like a bad person for not putting it out of its misery. The man was unconscious but you just don't know what's going on in there... So yeah, I'm thinking I'll go into primary care. Your Friendly Neighborhood Nurse Practitioner! With healthy snacks in the waiting room! (That last part is probably illegal.)

emphasis on the "maybe"

Ok, so I'm going to try to write about this nursing business. Since, you know, "write what you know", and right now I know nursing school. And cats. But there's enough of that on the internet.

I'm on break between school and a summer job, and because I didn't have much time in between and mostly because I am broke, I stayed in Baltimore. And because most of my friends have fled our funny little city, I've had to get creative with my time. A few nights ago I took my most recent clinical instructor up on her offer to let students shadow her at her day...er, night job in the ER (which is now called the ED, "D" for Department, I guess because it's not really just a room? I learned this about halfway into the first semester. Anyway.) I should also probably backtrack at this point and explain what a "clinical instructor" is. Nursing has its own language and when almost everyone you hang out with is in nursing, it's hard to remember that the rest of the world doesn't know the lingo. So a large part of our curriculum involves clinical rotations aka "clinicals", which is basically just time spent learning in the hospital. We're divided into groups of 6-8, and, along with an instructor, we invade a particular type of hospital unit once or twice a week and try really hard not to kill anyone.

We don't do Emergency or Urgent Care or Shock/Trauma in school, so I didn't want to pass up the chance to hang out in the ED, because it really is just so fucking cool. (And yes the doctors--male and female--are as hot as they are on TV. Something about those teal scrubs and saving lives and stuff.) Anyway, I was only slated to be there from 7-11 pm, and my instructor paired me the with the trauma nurse with the hope that I'd get to see some action. By the time 8 o'clock rolled around, pretty much all I'd seen aside from the requisite drunk man tied to a bed in the hallway was a gangrenous foot. Now, if you've never seen a gangrenous foot, I highly recommend you not do a Google Image Search for "gangrenous foot". I wanted my instructor to feel like I was learning something, so I joined her in triage to describe the soon-to-no-longer-be appendage. "Well," she said, rearranging her face after expressing a combo of joy and disgust, "I don't want to say it's a slow night, because that'll jinx it and make it the opposite, but it really IS quite a slow night." And then, of course, the ambulance dispatch phone rang to report that three people who appeared over the age of 16 were currently being extracted from a car wrapped around a tree, and they would probably be arriving shortly.

I can't even really begin to describe the intensity of what happened next, and I probably shouldn't since the accident made the news and, you know, privacy laws and stuff. Suffice it to say, CPR, unlike the doctors, looks absolutely nothing like it does on TV. And, I have a ridiculous amount of respect for everyone who works in emergency care. Twenty people can be in the same tiny trauma room working on one patient, and somehow everyone fills their roles without getting in the way of anyone else. (My role, in this case, was plastering myself against the wall, trying to keep my jaw off the floor, and occasionally handing someone a roll of tape.) When my mini-shift was over, my instructor asked if this was something I could see myself doing in the future. I gave her an enthusiastic, "Yeah, maybe!" and then went outside, cried, and called my mom.

an overachiever's guide to overcoming anxiety

I can get competitive about pretty much anything. Except for sports involving a ball, in which case, take the ball...no really you can have the ball...I do not want the ball please get it away from me. (This does not include bowling. I love bowling.) Anyway, there often does not even need to be another person involved for me to get my game face on. Since I've started riding a bike I can't help but race my school's shuttle bus to school. I usually win. Granted, the bus doesn't know it's in a race, but still. Last night was the night before our last day of final exams here in nursing school, and I was befelled by a pretty serious bout of anxiety. I really, really don't like anxiety (depression suits me much better), and by god if I wasn't going to kick that anxiety's ass. Here's a list of my plays, in chronological order, to the best of my ability to recall:

* some yoga poses (I like downward dog, child's pose, and a supported fish, if you were wondering. No? Fine then.)
* one can of delicious Resurrection Ale
* petting of cats
* 3/4 of a cigarette
* making of a to-do list and detailed schedule of tomorrow's tasks
* a lot of mint tea
* impulsive ordering of Tina Fey's book (including downloading of the Kindle app so I could read it RIGHT THEN)
* 1/2 a Klonopin
* hugging of cats
* staying up past my bedtime reading 1/4 of Tina Fey's book

Note that nice balance between healthy and unhealthy coping mechanisms! And now here it is, 7 a.m., I'm bright-eyed and rested and enjoying hearty breakfast, ready to get in some last minute cramming for the exams I'm no longer worried about (probably because I never really had a good reason to be worried about them in the first place). Most importantly, I WIN.