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.

itchy and scratchy

I don't know why, but I kind of feel like blogging again. Maybe it's because I have big kid things to do like find an apartment and figure out how I'm going to get all my stuff and my two cats to Baltimore (oh yeah, I'm going to nursing school in Baltimore) and take that last college course I need to take before school starts in TWO MONTHS and this makes me feel like I'm being productive while avoiding actually being productive. Or because I'm going to be leaving all my friends and the place I've lived for the last 11 years and that is scary and maybe my friends will read it again and that way I won't disappear into a black hole of 7 a.m. clinical rotations and pharmacology flashcards. I don't actually have anything in particular to say, though, so here are some links to things that other people wrote.

It's been a long long time since I felt compelled to read someone's personal blog from start to finish, errr...from most recent post to start. But I fucking love this girl Allie Brosch (a 25-year-old unemployed elite-level distance runner and super-funny ADHD sufferer living with her boyfriend in rural Montana) and a few months ago I did just that, in about two days. There's so much good stuff on there, but I'll go ahead and highlight her most recent post, which pretty much sums up my entire life, and the improved pain rating scale she designed and sells on Zazzle and that I bought to motivate me to start my own healthcare practice someday, largely so I can put it on the wall in the waiting room.

Also, I still love Mimi Smartypants. Because of stuff like this:

I saw this on the blog of someone in the process of adopting internationally: Mom’s Without Boarders.

You know, I don’t really want to live in a fascist grammarian dictatorship where people have to grasp how the English language is used and punctuated before they are allowed to become parents. Except I kind of do. Maybe. Sometimes.

Me too. Maybe. Sometimes.

I go through phases with Gawker that range from mostly love to total meh. I've been feeling it again lately. Still, I am ashamed to admit it is pretty much my primary news source. I should really start watching The Daily Show more regularly. Anyway, they even have a health section now! Science!

an announcement of sorts*

So, uh, I am going back to school. About nine months or so ago, thanks to either my therapist or my chemically stabilized moods or my waning ability to sell cheese with a smile 40 hours a week or my weariness of the ill effects of an irresponsible hedonistic lifestyle or probably some combination thereof, I got to thinking that maybe it was time that I get, like, a career, or something. Actually, the word "career" used to make me super squeamish and still does (I think it's the nerdy nasally sound of the "eer" part), so I'll just be calling it a profession. So long story short: I am applying to nursing school.

I've talked about it with my friends quite a bit, but it still feels weird for me to say out loud (or on the internet). Almost every major life decision I've ever made has been based on impulse and often irrational** gut feelings (see: Going to Columbia, My Five Apartments Since 2003, My First Tattoo). Except for the tramp stamp and the two times I attempted to save money by living with roommates, these have all been good decisions. But for me to be choosing a path that will affect the rest of my life based on practicality and lots of forethought and planning just doesn't feel like the me that I've been growing accustomed to for the last 28 years. And then there's the fact that I've been wavering on "what I want to be when I grow up" for, like, ever, and at times I've been so paralyzed by indecision that I've gotten overly excited about plans that never ended up getting realized. I'm afraid of crying wolf again.

But I've officially begun the application process with a pre-requisite college course I cannot afford, a volunteer gig at a hospital, and a GRE book (I recommend the SparkNotes version!), so I think I'm probably actually doing this. Change is hard, but I think I can do it. Case in point: I just made a week's worth of lunches for myself and no peanut butter or jelly was involved.

*The first time I typed this it came out "aorta," and I just registered for an Anatomy and Physiology class, so this MUST be the right decision, right?
**See above.

a 28 year old's first omelet

No, not the first omelet I have ever eaten (ooooh, brunch...), but the first I have ever made. I vaguely recall attempting an omelet back in the summer of 2003, but since I only recently learned that eggs should not be cooked on full blast but rather a medium-low heat setting, every time I've tried to make an egg dish I get frustrated and end up scrambling it and dousing it in salt and pepper to make up for the rubbery blandness. But no more!

I almost never cook for myself, so what prompted this extreme culinary adventure? Aside from financial woes due to a summer of living like a person who makes twice as much money as I do (woops), I have been selling cheese at the NYC Greenmarkets. Perks include outSTANDING people/dog watching (I've got an essay floating around in my head somewhere about market demographics, but until I regain comfort writing anything longer than a Facebook status update, I recommend this video from the amazingly insane Bill Cunningham), meeting character-filled country-mouse vendors, and, of course, free food.

Last week I snuck away from the cheese and paid a visit to the farm stand a few stalls down where one particularly attractive country mouse sells his produce. After a few minutes of swooning and pretending to inspect his organic pea shoots, I had to make a selection and grabbed the nearest item--a carton of eggs. (From his own chickens! He put them in that carton himself!) Anyway, so I got some eggs. And thanks to this fine lady, I made an omelet! Certainly not the "perfect" omelet, and not as pretty as hers, but it only stuck to the pan in a couple places and when you stuff something full of fresh goat cheese, well, you're doing pretty alright for yourself. I have also had recent success with egg salad, thanks to a website on how to hard boil an egg called How To Hard Boil an Egg.

I'm turning over a new leaf here, my friends.

a woman after my own heart

From Jezebel's Midweek Madness:

Is Britney "unraveling" again? Recently she went shopping and changed her outfit in every store. Then, in London, she "tearfully shut herself into a closet" and "her assistant had to coax her out by promising to buy her tacos."

A note to any future boyfriends: if I am ever crying uncontrollably or being otherwise irrational, just promise to buy me tacos and I can pretty much guarantee that the issue will be 100% resolved.

Relatedly, here is the SNL Taco Town skit. An oldie but a goodie.



And here is the first Google Image Result when one does a search for "britney spears taco":



Perfect. I love the internet.

on trend!

Oooh look, a Style Section article about this complex phenomenon of people abandoning their blogs. (I always knew my friends were ahead of the times.) Now where's the trend piece about people who basically abandoned their blogs three years ago when they stopped working in offices but just can't let go of the dream of internet fame and fortune and "sharing their genius with the world" (where "world" equals their friend Ellen who uses their sidebar for websurfing--Hi, Ellen) and therefore keep their blog hooked up to life support by posting occasional lazy links and uninspired inanities? Look, I can pose with my laptop and look serious, too!


Gina G. still writes on her blog, sometimes, and frequently uses a stability ball for lumbar support, and also needs new blinds and/or curtains.

stage fright

I love a good dorky competition, and I especially love a good documentary about a good dorky competition (see: Spellbound--spelling bees, Wordplay--crossword puzzles, Word Wars--Scrabble, King of Kong--Donkey Kong, Air Guitar Nation--uh, air guitars, Monster Camp--LARPing). So I was pretty excited to learn about the Air Sex Championships via Jezebel, and I look forward to the inevitable indie documentary. It is pretty much exactly what it sounds like.



And they're coming to New York soon (no pun intended). Anyone? Please???

Anyway, not to discredit the efforts of my fellow Americans, but the Japanese, who created this phenomenon of public competitive simulated humping, really know how to bring it. And, unlike their irony-loving counterparts, they take their air sex seriously.



"If there are no children being born because we're all having air sex, we will become extinct."

So true.

more!

A recent text from my friend Ellen: "I'm in a cab listening to a country song called 'god is great, beer is good, and people are crazy.' Truth."

The whole truth.

And the Youtube comments prove the truth of at least one of Mr. Currington's assertions.

playing ketchup

After three years working in direct contact with actual human beings, I am back to spending an unhealthy amount of time on the internet. Aaaah, it feels good to be home. Some recent highlights:

*A slow-moving strepsirrhine primate native to Southeast Asia (thanks, Wikipedia), called a slow loris, not to be confused with a slender loris, getting tickled. [Cute Overload]



*A blog about psychotic letters from men, called Psychotic Letters From Men. Gender generalizations aside, I highly recommend this as a way to kill four hours and marvel at the magical workings of the human mind. Plus, there's great commentary:

Even at 12, Lea realized Matt had a controlling and bossy personality. In fact, Matt was hellbent on teaching Lea about the two most important things in life.

First, Lea needed to accept Jesus Christ as her Lord and Saviour. Only Jesus could lead Lea to happiness, and only by following His word would Lea would be accepted into Heaven. Lea needed to be saved, and Matt would willingly assist Lea in accepting Jesus Christ.

Secondly, Lea needed give to Matt a blowjob.

And even the occasional video! Read back story, watch video, send me your lobotomy bill. You're welcome.

*A blog about awkward family photos, called Awkward Family Photos. A lot less reading required for this one. It's hard to pick a favorite, but if I must:



*A band called Garfunkel and Oates: Two cute LA actor girls with musical-theater voices singing folk songs about annoying boyfriends and annoying pregnant women and annoying 90's top 40 hits.

More time wasting to come. Maybe.

the best sentence ever written

There are thousand and million of monkey residing inside these chopstick