The Proverbial Brick in the Face

I've become convinced that the universe is conspiring to deliver me a few messages. Specifically, three:

1. I shouldn't leave my house. Should I decide to leave for reasons other than work, work will somehow weave its way into my daily existence (see #s 2 & 3). Something wants me to stay home as much as possible, and it's even making my body sick in order to tell me so, forcing me to lie in bed and take care of myself, something I am loathe to do, only because Taking Care of Myself takes work, and I'd rather be out having FUN! with friends and loved ones and FUN! with my daughter, for whom summer has passed far too quickly with far too few FUN! events with her mother.

2. I need to take care of myself. Last Friday night, I had more drinks than I'm willing to admit (ahem, six), of more variety than I should account for (ahem, three: beer, wine, liquor - YEAH! WOO! WAY TO GO! What am I, 19??!!). I only share this as a lesson to the rest of you: people in their 30s and over should not imbibe in this manner, lest our bodies remind us in the most direct, painful, and stupefying way that we are officially Too Old For This Shit. Namely, we come down with a mysterious viral illness a few days later, which culminates in a fever that lasts two and a half days, manifesting itself in excruciating bone aches so bad that we lie in our bathtubs at 3:30 a.m. (ibuprofen? HA!), literally crying from the pain and the wish to fall asleep, which then leads to a mounting overall negativity that has us convinced that a) our lives in general just suck and being in pain sucks, b) no one cares, and, c) our best friends have moved on with their lives and no longer want to hang out with us, and, d) our boyfriend is secretly plotting a midlife crisis that involves lots of hot chicks, fast cars, and bachelor pads loaded with free porn because we're all sickly and gross and pathetic and really, we don't want to be around ourselves, either, so why should he. This forced self-imprisonment for two consecutive nights then leads into a progressive feeling-betterness, making us think we're all better, which leads to having a glass of wine after work - JUST ONE FREAKING GLASS OF WINE, CAN I HAVE A SOCIAL LIFE, PLEASE - which goes down fine (except for the random person who walks up and says, "Hey! Can I ask you a question? Am I bleeding?" and they are, and half of you wants some gauze and the other half just wants to tell him to look in a fucking mirror and take care of it himself) and the wine feels just fantastic until the next morning, when we are struck completely off-guard and suddenly by painful stabbing sensations in our intestines, forcing us to - yet again - remain at home, confined in our beds, until it's time to go to work again...

3. I was born to be a nurse.

We go to work, just for a few hours as a favor to a friend, which goes just fine, and then our boyfriend comes over (and how long am I going to continue this collective second-person shit? I dunno. Wishful thinking that I'm not alone in these [self]observations, I guess), with whom we have dinner at home and then decide to get out of the house for a bit. We decide upon walking (healthy! fresh air! exercise! enjoying the nightly-ness and all its nightly wonder!), and as soon as we turn the corner onto the main drag, our boyfriend suddenly says, "Guess you're nursing tonight!"

"Wha?"
(He points.)

Twenty feet ahead of us lies the body of a man, lying on the strip of grass between the street and the sidewalk, his head on the sidewalk and feet in the street, over whom is haunched another man (whom we later find out is a friend of said body). The Friend is holding The Body's head in his hands. The Body is not moving. We quicken our pace, mutter, "oh, fuck," to our boyfriend, and hurry to said scene.

The Body isn't moving. The Friend says, "It's alright."
What happened?
He fell.
Did he hit his head?
Yeah.
Sir? Hey! Hey, buddy! Can you hear me? (no response) He lost consciousness?
Yeah.
How long ago? (He's breathing. Pulse is there. Carefully looking for blood and feeling The Body's head for possible fractures)
Just a few minutes. It's cool. We were drinking.
He fell on his head and lost consciousness. It's not cool. He might have a problem. Hey! Hey, you! (The Body's eyes flutter) Hey!
(incoherent)
Hi! I'm Stephanie. I'm a nurse. Do you know where you are?
(incoherent)
Hey! Look at me! (The Body's eyes flutter open and shut again)
Do you know where you are?
Nnnnnn.
Do you know what happened?
Hnnnnh?
Look at me! (The Body's eyes open, wider this time. They're wandering independently of each other)
He's cool. It's alright. He just fell.
Hey! You fell. Can you look at me? (The Eyes open momentarily again, widening in the light. Pupils equal... I think... eyes still rolling...) You need to call an ambulance. Chances are, he's fine, but he could have a bleed. Do you have a phone? (The boyfriend says "here" and hands you the phone, smiling at the irony of it all)
He doesn't need an ambulance. It'll be fine. He lives, like, a half a block away.
That's great, and if he's fine, the paramedics will make sure he gets home. But he needs to be checked out. He should have a CT, just in case.
Heeeeeey!
Hi! I'm Stephanie. Do you know where you are?
Hunnh? Uhhhhhhh.... nnnnnnno.
Dude! We're outside _____. We just left a little while ago and you fell. Don't you remember?
Nnnnnnnno. (Eyes rolling independently of each other, then closing again)
Okay, I'm calling an ambulance.

We call 911, and MFD shows up within two minutes (love them) in an engine. The lights stir The Man who's lying on the ground.
You're ride's here.
Hahaha.
You're probably cool, but if you're not, they'll take you to the ER.
Iiiii thhhink there mmmmight be a problemmmmm.
Which is why they're gonna check you out.
Thank you.

We give report to MFD. A squad car pulls around the corner.

Do you need anything else from me?
Nah, we got it.
Thanks.

We continue our path down the street, holding hands. He tucks his cell phone back into his pocket, making sure the sound is on, just in case anyone from EMS calls wanting more information.

Told ya you were working tonight.
I didn't know what you were talking about! I didn't see him at first.
Ya know, you could have just kept walking.
The universe doesn't want me to leave my house. Every time I do, someone with a bleeding face shows up, or there's a body lying in the street. It's like, if I'm gonna leave, then I have to *work* to earn it. Do I have a fucking 'NURSE' sign flashing over my head? Last week: enemas. This week: random emergencies, everywhere I go. What the fuck.
You don't have to stop.
No, I don't. But then we'd spend the next two hours talking about, 'I wonder what happened to that guy,' and, 'I should have stopped,' and, 'fuck, I hope he doesn't have a subdural.'
Yeah.
Yes!

So he squeezes my hand and smiles. And I realize that, a boyfriend or two ago, this would have been a much different scenario, filled with anxiety and fuckedupness. But here we are, walking down the street, hand in hand, and The Man is being taken care of, and the boyfriend and I are once again just another random Milwaukee couple, walking down the street, enjoying the night air and conversation. I feel good, and in spite of the interruption, I think he feels good being with me. Maybe even proud.

You're a dork, he says.

And that makes me smile again.

The Pendulum, It Swingeth.

Oh, there's been far too much going on over the last few weeks to ever possibly catch up, nevermind the fact that I'd rather not relive some of the key points. Namely, my boyfriend being diagnosed with multiple blood clots, which wouldn't be a big deal except for, ya know, the possibility of impending stroke, heart attack, or pulmonary embolism. Nothing says lovin' like Lovenox! *sigh*

The positive end of all of this is that it has inspired some changes in both of us and once again brought What Matters to the forefront of our daily existence. Not to worry - fart jokes abound - but there's definitely a (re)new(ed) sense of purpose and mutual care. Ah, mortality. You bastard old dog, you. Now leave him alone.

In working news, I'm now officially off of orientation. Tomorrow marks Day One of me wearing my big girl panties in the ER. Let's hope I remember where we keep the Depends before I saturate myself in the corner.

Maddie has a full-sized bed, thanks to my friend Nate, and I am now convinced that she is aging at super-warp speed. Seeing her 9 year old body enveloped in a bed the same size as the one I have is only reminding me how fast this time goes, how quickly she's grown, how smart and wonderful and hilarious this person I call my daughter is.

My mother is on a two-week tour of the British Isles, including Ireland (the descriptor "British" should be in quotes, here). I received a text from her a few days ago - "Leaving Cobh - love you!" - while I was at work. What I wouldn't give to have been in the position to bring her there myself for the first time. Taking comfort in noting that she missed much of the island, and there's still time left.

Life is short. Far too many reminders of this as of late, closer to home than I'm comfortable with. Here's to recuperating, to transitions, to keeping our loved ones as close as we can. And to impromptu guitar/ukulele jams. In sickness and in health. Amen.

Biology Lesson

Apple:




Tree:




Class is dismissed.

Drawing the shade.

Atropine, a drug used during resuscitation to inhibit vagal stimulation and stimulate SA node firing and conduction through the AV node, is derived from the plant, atropa belladonna, known commonly as Deadly Nightshade. The plant's genus is named after the Greek goddess, Atropos, meaning "she who cannot be turned." Known by the Romans as Morta, she was the oldest of the three Fates. Klotho ("spinner"; Roman: Nona), the youngest, spun the gold and silver threads of life. Lakhesis ("apportioner of lots"; Roman: Decuma), the middle Fate, chose the threads' length.

Atropos held the shears and decided when the threads would be cut.

***

References:
http://www.theoi.com/Daimon/Moirai.html
http://en.wikipedia.org/wiki/Atropa_belladonna

Image:
http://irrationalgeographic.wordpress.com/category/poison/

Last Call.

I am now officially certified by the American Heart Association and the American Academy of Pediatrics to intervene with advanced life support should your child, or any child, show up in our ER. Or just pass out in the street.

It's not really a big deal - okay, maybe it is - but these little milestones, certifications and whatnot, are inching me ever closer to eventually becoming a CEN (Certified Emergency Nurse), and that excites me. I've never been one for little pieces of paper; it's the documented proof that I have at least a small clue as to what I'm doing that gets my motor humming. Lifelong learning, indeed. And it's a great prep for ACLS (Advanced Critical Life Support). All these "a" and "d" drugs get my panties all in a bundle: amiodarone, atropine, adenosine, dopamine, dobutamine... In real life, we're always consulting with each other, with online and written resources (evidence-based, of course ;) ), but it'll be nice when I can just rattle off weight-based dosages and drip rates like it's old hat. All in due time...

In the meantime, passing PALS (Pediatric Advanced Life Support) today required the successful coding of two (imaginary) kids (and the passing of a written exam). My instructor/tester was a woman I work with in the ED, so I was doubly conscious of her assessment of me, wondering whether or not she would, after my testing, feel confident coding a kid with me in the ER. My first "kid" was a baby in asystole. CPR: check. Oxygen, monitor, IV: check. Shocked him once. Nothing. CPR. Gave epinephrine. No change. Continued CPR. Shocked him again. No change. CPR. Epi. CPR. No change. At this point, she tells me I've passed. "....but.... he's dead...." "Yes. He is."

And, ya know? I was so grateful she did that. I needed that experience - even imaginary - to show me that sometimes, no matter what you do, they're gonna die. It still didn't stop me from wanting to do more - and in the real world, this cycle would have gone on much longer - but it still drove the point home. And I needed that.

So thanks, Z. For ever so gently busting my chops and reassuring me that life is life, death is death, and sometimes our machines and drugs just won't cut it. And at the same time, making sure I know what to do to try my damnedest before we make that call.

"So, how do you feel after passing?"
"Well, how do you feel about working next to me in a peds code?"
"Fantastic. Good job."

From a colleague, a "seasoned" nurse, a CEN... that's all the affirmation I need. Rock on.