Giving Thanks, 2010

I finally got a picture of myself in scrubs, which I get to wear this rotation instead of my hideous nursing school uniform. Took the picture in the mirror of the men's locker room at Mercy Hospital in Chicago.

My clinical group completely lucked out. Not only did we get a clinical instructor who is one of the finest teachers I've had the privelege to work with, but we are actually getting to do a lot of stuff. The other clinical groups, who are in other hospitals have been complaining-- justifiably-- that they're not getting to do anything. One group is in a hospital that is getting recertified, so they're hiding the students. They're watching movies, listening to lectures-- but not even going on the floor. My group each helped deliver a baby-- or two, in the case of me and one of my classmates-- on the very first shift we worked.

We've continued to rock on our rotation. I have finally mastered a bunch of skills I'd been struggling with, including taking a blood pressure. I can even get the pulse on a baby-- no mean feat, since their heartrates run between 110 to 160 beats per minute.

There was, though, one skill that terrified me, and I hadn't done it yet-- taking a blood draw.

A couple of Sundays ago, I watched up close while the person I was partnered up with, Denise, did one. She did a marvelous job, particularly considering that the patient had very small veins.

Last Sunday, as we prepared to hit the floor, my instructor rattled off room numbers and what we would do that day. And when she said "Johnny-- you've got a blood draw for a CBC (Complete Blood Count) at 10 am," I was at once excited and nervous.

My partner and I went and checked on our patient, a Chinese woman (our hospital is near Chicago's Chinatown) who'd given birth just after midnight. We split the assessments; I took the vitals on the mom, while my partner took the vitals on the baby. I told my patient that we'd do a blood draw in a couple of hours.

The mother and baby were both doing well, so my partner and I took a caffeine break. My partner that day was a woman I'd had run-in's with before. We'd not always gotten along well. Earlier that morning, I'd done her a favor that saved her from being late to the shift. I think it was the moment that she realized two things: that you've got to choose your battles, and that you never know who's going to help you out at some point. We had a good day together.

As 10 am arrived and passed, I reminded my instructor of the blood draw. She let me know she'd be there soon (she was showing a couple of other students how to give a newborn its shots, something I've already done).

About 10:15, she arrived. I'd already gathered up what I needed, with the help of David and Denise, who helped me scour the floor for the supplies I needed. I practiced tying a tourniquet on an arm on my instructor and two classmates-- not as easy as it seems. And then I grabbed my supplies and entered the room.

I struggled a little with the tourniquet, and my instructor quietly guided me through it. We looked at-- and palpated-- the two "good" veins on my patient's arm. The vein that was most visible was not the most palpable. She asked me which vein I thought was better; I told her the one less visible that you could feel more. "Okay, then, go ahead." I checked that the bevel was up and quickly guided the needle into my patient's arm. I saw the blood rise up slightly into the tube, I attached the vial and the blood quickly filled it. (Unlike the person in the picture I have here, I wore gloves-- Mediums, a size smaller than what I usually wear, so that I could get a good grip on the needle, tube, etc.) I remembered to take the tourniquet off before I withdrew the needle-- you could get a spurt of blood otherwise. I put a piece of gauze where the needle was, clicked on the little button and the needle withdrew, safely covered. My partner grabbed the needle for me and put it in the "sharps" container. I held down the gauze and put a bandage over it.

And it was done.

My instructor told me I'd done a good job, and helped me clean up the bits and pieces of paper and debris left over.

It was the thing I'd had the most anxiety, a fear, even, of doing. I'd done it quickly and flawlessly, with minimal pain to my patient. I put a label on the vial, put it in a "biohazard" bag, put it in the tube and sent it on to the lab.

Afterward, I talked to my instructor. I told her that it was like that old Peggy Lee song, "Is That All There Is." I'd had months of anxiety bordering on fear about that moment. And in the end, I'd quickly and quietly added it to my skill set. After all that anxiety, my thought was "Is that all there is? Is that all there is to a blood draw?"

I know that they're not all going to be that easy, but I know that I'll be able to do them.



Yesterday, while I was on campus taking care of some odds and ends, I ran into my 102 instructor, who was yet another great instructor I've had. And mentally, I began counting my blessings. I've had mostly great instructors, beginning with my wonderful 101 instructor, who's in this picture. I thought of the great friends I've made-- people I know I'll stay in touch with. People I've worked with, sweated tests with, people who have been there while I've crossed milestones in the program. and I realized how thankful I am not only for what finishing this program will give me regarding finances, but how it's changed me.

I thought back to the worst week of my life, over four years ago. In a single week, I got laid off a teaching job I loved, discovered my dad had a potentially terminal cancer and Mark, one of my oldest and closest friends, was murdered. I compared where I was that week, how low I was, and I reflected on this semester. This semester, we'd heard, was the "make or break" semester; most of the people who dropped out of the program would drop out this semester. They were entirely correct. Class this semester has been like "Ten Little Indians." Every day we come to class and another person or two has dropped out. My current clinical group, pictured here, has thinned out; two have dropped and rumor has one or two might drop too after this last test, which was a tough one. I didn't do as well as I wanted, but I didn't flunk it. And I'm still clinging to my "B" in the class overall. When I run into people I know from various classes, and they ask how I'm doing, I tell them: "I'm still in the program." And I'm feeling pretty damned good about it.

So on this Thanksgiving, I give thanks for many things. I am thankful that I got into this nursing program. I'm hearing that hospitals employ students from this school over some bigger "name" schools because we tend to have more skills walking onto the job than the other programs, and have a better work ethic. I'm thankful that I had the financial resources, thanks to a decision I made years ago (to start a retirement account, which I was able to tap into), to finish the program.

I'm thankful for two happy, healthy, wonderful kids who have moved into teenagehood and are still a blast to be around. They're approaching adulthood frightenly fast. I'm thankful that my son, who has missed the most time with me because of the decision to go back to school has been terrific about this. He understands how important it is to me-- particularly that it's important to me have the financial resources to make sure he doesn't have to worry about the money for college.

I'm thankful that my wife and I are employed. I'm thankful that we have an intelligent, wise and compassionate person as President. I'm thankful for the magnificent group of friends I've managed to acquire over the years. Best wishes to all of you for Thanksgiving!

The "Leap of Faith" Friday Random Ten

Big week. I'm studying for one of the hardest tests I'll take this year-- test is on Monday. I've got care plans to do-- want to turn those in Sunday. And I took a bunch of money out of my 403b retirement account to pay some back bills and for the rest of school. Now I definitely have to finish school. I've taken a big financial leap of faith.

Had a good, if not long enough talk tonight with old friend Jamie. Made plans to get together with him over my very long holiday break (from about Dec 10 or 11th to around January 19th or so). Looking forward to both the break and to hanging out with him.

1. Flake- Jack Johnson
2. Cool Metro- David Johansen
3. All The Young Punks (New Boots and Contracts)- The Clash
4. More Than A Name On A Wall- The Statler Brothers
5. I'm Only Sleeping- The Beatles
6. Coyote- Joni Mitchell
7. Long Train Runnin'- The Doobie Brothers
8. Just Like A Woman- Bob Dylan
9. Will To Love- Neil Young
10. She Came Along to Me- Billy Bragg and Wilco


1. When this song was a hit in 2002, I had just separated from wife #2, and had fallen in a relationship with an ex-girlfriend that this song pretty much summed up. I love the line "It seems to me that maybe/Pretty much always means 'no.'" Still one of my favorite songs.
2. From David Johansen's first post-New York Dolls solo album. And a good one it was.
3. From their second album, a rip on the "punk" posers emerging from the London Scene.
4. A really powerful song from the guys who did one of my favorites, "The Class of '57"
5. From the great "Revolver" album.
6. From "Hejira," one of my "Desert Island" albums. I just read "Girls Like Us" a few months ago; it's about songstresses Joni Mitchell, Carole King and Carly Simon. The author revealed that the song is about Joni's ex-boyfriend Sam Sheppard, the playwright and actor.
7. Managed to see the Doobie Brothers on their last tour, in 1982.
8. From another of my "Desert Island" albums. The song is supposedly about Warhol hanger-on Edie Sedgewick, but Dylan's denied it.
9. From "American Stars and Bars," which is, IMHO, an underrated and underappreciated album.
10. From "Mermaid Avenue," an album Billy and Wilco did of unrecorded Woody Guthrie songs. My old friend Dan had a heads-up about this album when the airline he works for shipped Wilco's equipment from Chicago to Dublin for recording sessions.

These Are A Few Of My Favorite Things: My Cast-Iron Cookware

I've been mulling beginning this feature for some time. In Tom Robbins' book "Still Life With Woodpecker," (which will be a future "My Favorite Thing"), Robbins discusses objects. He points out that a dime-store philosopher would say that your stuff owns you-- that you orient your life toward keeping stuff-- but our stuff has the magic we impart to it. For example, the piece of the Berlin Wall that I have safely stashed away has value to me not only because it's a piece of history, but the fact that my friend Mark, who was murdered four years ago, broke the piece off for me during a back-packing trip through Europe in 1990, only months after the wall came down. It's cool to have a piece of history, and it's a keepsake of one of the best and most important friendships I've had in my life.

This new feature is also based on a conceit: that people who read this blog give a shit about my life. I think that this is pretty much an assumption between the bloggers who read one anothers' blogs.


One of the things I've thought about for my future is the possibility of purchasing an Airstream, maybe renovating and updating an old one, vacationing in it, and maybe even living in it as I get older. This would, of course, entail condensing my life, my stuff in particular, down to a minimum. I've frequently thought of how I would do this. If you had to essentially reduce your belongings to one or one and a half rooms, what would you do?

A computer, with a large hard drive would enable one to bring along tons of movies. An internet connection would increase it further. A Kindle would knock the number of books down considerably-- maybe 30 or so physical books (I'd have to have a copy of "Still Life," being as much as a totem or talisman as a book to me).

What about cookware? In "Kitchen Confidential," Anthony Bourdain correctly points out that a cook really only needs a couple of good knives. A decent set of pans, and of course plates, bowls and flatware. But one of the things I will not do without, despite it's weight and bulk, is my cast-iron cookware.



Cast-iron cookware is one of those things in life that is rare: it actually improves with increased use. You "season" it-- basically burning oil onto it in order to fill the spaces between the iron molecules with carbon molecules-- and with each time you use it, being careful to clean it with little or no soap, in order to keep from washing the seasoning off-- it becomes better. Each layer of carbon you cook onto it makes it stick less. The cast iron spreads the heat, making anything you cook on it cook evenly-- the heat is not concentrated right over the flame like in lesser cookware (aluminum-- I'm talking to you!).

The pan that is right and front has a history. I remember seeing the three-pan set for only ten bucks in the Ace Hardware on Lincoln and Diversey (despite the gentrification that overran it, it's still there, right by Delilah's, one of Chicago's only remaining punk clubs). It had to be right around 1992. I had no car, so I had it on the bus, along with a couple of picture frames-- the kind with the clips on it. I remember oiling and heating the pan, along with the other two pans in the set, which were smaller. I had to open the window in my kitchen, since the burning oil was billowing out of the stove.

That pan is one of my favorites; it has a nice thick handle that doesn't heat up too much. It's also large, making it perfect for cooking up a couple of turkey burgers, making hash browns or cooking up turkey bacon, all without burning the food.

The set is a Wagner set. The company went out of business since I bought the set, but another company has begun manufacturing it again. I plan on buying a set for my son after I finish nursing school; this will let us get it reasonably seasoned before he takes them off to college.

The pan to the right and back was from a co-worker, who'd bought a set a while back. I seasoned the set and have used the big pan a lot. I'm not crazy about it though; the handle is thin, and heats up a lot. I don't think this one will make it to the Airstream.

The big griddle probably will. I had another one that my mother had sent me, but it's been missing since our kitchen renovation a couple of years ago. It's possible it went to Goodwill by mistake. It's also possible it's in a box, buried in my basement. In any event, a while back, Aldi's had them on sale for only $14.99. They're awesome-- a flat griddle on one side, for pancakes, burgers, etc. The other side has ridges, so you can cook a steak to perfection. I bought two of them, and alternate using them. This way, when my son goes off to college, I'll have a one perfectly seasoned griddle for me, and one for him, along with the Revereware pans I grew up cooking with-- given to me by my mother and like all well-made stuff still in perfect condition.

The "Dash For The Finish" Friday Random Ten

More schoolwork today. Clinical all day Sunday, but at the end of the day, I'll be half way done with the clinicals. In three weeks I'll be done with the semester, and one semester later I'll be done with nursing school-- or at least this leg of it. I'll have to start work on my bachelor's in nursing, probably online, almost immediately after I finish. But for now, the finish line is in sight.

Looking forward to my son being here, and to a visit from our friends Robin and Phil on Saturday night. And looking forward, in a little over three weeks, to five weeks off school.

1. Hallelujah- Jeff Buckley
2. Flowers of Evil- Mountain
3. Amarillo By Morning- George Strait
4. Country Pie- Bob Dylan
5. Long Tall Sally- Little Richard
6. Isn't It a Pity- George Harrison
7. My Best Friend's Girl- The Cars
8. Pretty Boy Floyd- Bob Dylan
9. Door Number Three- Steve Goodman
10. My Sister- Juliana Hatfield


1. This song did more to spread the gospel of Leonard Cohen, it's author, than anything. And as a long-time Cohen fan, I'm delighted by that.
2. Mountain was best-known for the "classic-rock" song "Mississippi Queen," but I love this one, about a guy who comes back from Vietnam as a heroin addict, but re-enlists to go back to feed his habit.
3. A lovely song about a struggling rodeo rider.
4. From "Nashville Skyline," essentially Bob Dylan's country album.
5. I love the scene in "Predator" where they play this song in the helicopter.
6. This one was the b-side of "My Sweet Lord" in the US release.
7. From the first Cars album, which came out in 1978, 32 years ago.
8. Great cover of the Woody Guthrie classic, seems really appropriate lately: "And it's through this world of ramble/I seen lots of funny men/Some will rob you with a six-gun/And some with a fountain pen/And it's through this world you'll ramble, it's through this world you'll roam/You won't never see an outlaw drive a family from its home"
9. The late, great Steve Goodman taking a comic country turn, about an appearance on "Let's Make A Deal." Co-written with Jimmy Buffett.
10. One of my favorite songs of the '90's, by Blake Babies alum Juliana Hatfield.

Reflections On An Autumn Night

It's one of those perfect autumn nights here in Chicago-- they kind that makes us put up with the summers that are too hot and winters that are too cold.

The last two days I've plowed through a staggering amount of school work. Tomorrow I'll plow through some more. It was quite a week. It began Sunday with the first day of my new clinical rotation, OB. The teacher had tried to moderate our expectations; the last rotation, fewer than half the clinical students got to participate in a birth. Furthermore, she told us, because it was a Sunday (7 am to 7 pm), there was less chance-- the hospital typically didn't schedule induced births on Sundays.

It was, therefore, pretty humorous when all seven of us (two more of my clinical group have dropped out of the program) assisted in births. I assisted in two. The second one, I got to do just about everything but cut the cord. I helped with the mother during contractions and birth, did the "Apgar" assessment-- the one and five minute assessments of the newborn's well-being-- dried the baby off, checked her vital signs, weighed her, then took her to the nursery, gave her her hepatitis b and Vitamin K shots, put the erythomycin gel in her eyes, cleaning her and brought her to her parents.

Because of various circumstances, I was not at my son's birth; these were the first births I've been at. I don't know how one can see a human being draw its first breath and not be awed and humbled. It was life-changing.

In the meantime, various things have brought me some peace of mind. One of the biggest ones was a few weeks ago when Larry, one of my closest and oldest friends, finally found a journalism job, after over a year of hustling to make a living since being laid off by a major east-coast newspaper (along with most of the rest of the staff). I was also relieved to know another friend, who is prone to negativity, has a more positive outlook than he'd had recently and a plan. I was also relieved to find out that my son is addressing a major health issue that he'd ignored for a long time.

I also made a tough decision, but one that I think is right. I was faced with not having enough money to finish school, with only a little over a semester to go. I decided to pull some money out of a retirement account I'd set up about five years ago. I had long hesitated to do it, but realized that it was an investment in my future-- I can't tell you how many people, including my clinical instructor last rotation, who, like me, got into nursing later in life-- told me that I was making one of the best moves I could have made in getting this nursing degree. It means my kids not having to worry about where college money is coming from. It means not being able to retire at a reasonable age. It means being able to take vacations again. It means not living in fear every day that a car breakdown is going to throw my finances all to hell. It means being able to go out for dinner once in a while. In the end, the sum I took out is going to be trivial compared to the benefits of finishing school. And I'll be able to replenish the money pretty fast once I am working.

One other decision I made was to stop drinking entirely until I'm done with school. I had come to the realization that what I considered "normal" drinking was pretty excessive. The crowd I went to school with and hung out with when I was done drank a lot. I'd come to realize that what I considered moderate was not all that moderate, and that it was interfering with the grueling pace I've got to keep for the next six months. When I'm done with it all (god willing and the creek don't rise), I'll have a glass of champagne or red wine to celebrate and assess whether I can drink moderately.

So tonight, I'm here on the back porch on this chilly November sipping grape juice out of a wine glass. It's begun to rain a little bit. I'm feeling pretty exhausted after studying most of the day. But I'm also feeling pretty satisfied.

Doonesbury

I started reading Garry Trudeau's "Doonebury" in 1972, when I was 11 years old. Nearly 40 years later, as I approach 50 (Mr. Trudeau is now 62), I'm still reading and enjoying the comic. Doonesbury is still smart, relevant and funny. Yesterday's cartoon was no exception (click on the comic to make it bigger).



It is astonishing to me that when I started reading Doonesbury, the comic centered around the United States' involvement in the Vietnam War. Here we are nearly 40 years later, and we're involved in two wars in Asia. So many of the bad guys from that time-- Cheney, Rumsfeld and such are still around. The more things change...

The Bad News/Good News Friday Random Ten

Interesting week. Monday was a total bad news/good news day-- and that was just the beginning of the day. As I mentioned before, on the way to a very important test, a guy opened a car door in front of me and my bicycle. I was bruised and cut up a little, but otherwise okay. I got an A on the test. Anything that you can walk away from...

I was mildly annoyed by the election results, but being a student of history, I'm reminded of this: the Dems lost seats in both houses in the 1962 elections (though though they kept control of both houses). The Republicans got hammered in the 1982 midterms, when Reagan was President. And the Dems got taken to the cleaners in the 1994 election-- the "Contract With America" nonsense with Newt Gingrich. The American voting public mostly has a short memory. The GOP now owns the economic disaster they created. And there are a bunch of out-and-out nuts in that party. It's one thing to get elected, another to produce for your constituents. 2012 will be interesting indeed. Like I said, anything you can walk away from...

1. Long Train Runnin'- The Doobie Brothers
2. Back In The USA- Chuck Berry
3. Working Girl- The Members
4. Eli's Coming- Laura Nyro
5. I'm Straight- Jonathan Richman and the Modern Lovers
6. Nobody But Me- The Human Beinz
7. Gommorah (A Nursery Rhyme)- Rodriguez
8. I Never Loved A Man (The Way I Love You)- Aretha Franklin
9. Candy Man- Roy Orbison
10. SWLABR- Cream



Notes:
1. "The Best of the Doobie Brothers" was one of the first albums I ever bought.
2. I've loved some Linda Rondstadt songs, but her cover of this one wasn't one of them.
3. Loved this vid back in the eighties.
4. One of many great songs Laura Nyro wrote; I'm working on a post just about her.
5. From Richman's first and best album; many people consider it to be the first New Wave album.
6. Dave Marsh' "Rock Book of Lists" actually lists how many "no's" are in this song-- around 100, I think.
7. Discovered this guy within the last year; imagine if Donovan, Santana and Dylan had written Marvin Gaye's "Inner City Blues." This album, "Cold Fact" is a classic.
8. Read yesterday the Ms. Franklin had to cancel part of her tour for health reasons. Hope she gets better; she's a national treasure.
9. I love me some Roy Orbison. One of my great regrets is that I didn't see him perform while he was still alive.
10. The title is an acronym for one of the lines in the song-- "She walks like a bearded rainbow."

Close Calls

I had a test this morning, my second and last in the Med-Surg (Medical/Surgical) rotation for this semester. I needed to do well on the second one, because I tanked the first one-- barely eking out a C in our ridiculous grading scale (you can get a 76% and get a "D"). I hit the books and notes all week and into the weekend. I was fortunate that my son had a debate tournament on Saturday, so I didn't feel like I took too much time away from him. I found it humorous that I rode my bike to The Book Cellar to study, while he drove.

The extra studying paid off. I got a 47/50 on the test this morning, a solid "A," even by the inflated grade scale. It was not without a detour, though. On the way to school, a guy opened a car door in front of me. He saw it coming and so did I; I swerved, he tried to get the door closed, but the right pedal of my bike still caught his door. I was swung around and ended up coming down on my right side. Oddly, my two concerns were my bike and getting to the test. I stood up and did a quick self-assessment. The guy ran over to check on me-- he was profusely apologetic; he's a bicyclist too. He'd been watching for cars, not bikes, though. For my part, I'm usually more observant on that stretch. I was thinking more about the test and about the fact that there'd been a murder Halloween night about 100 feet from where I was riding. I realized that but for a couple of bruises and scrapes, I was all right. The bike was fine. I talked for another minute with the guy, hopped on my bike and went to school.

This last week has been a flurry of putting out fires. I'd had to run to the University of Illinois-Chicago student medical center to get a titer to check to see if the mumps part of my second MMR (Measles/Mumps/Rubella) vaccination had taken. It had apparently not the first time. Fortunately, this time the vaccination worked. Had it not, there was the possibility of me not being able to start my next clinical, my OB leg, on time. Oddly, the blood draw, last Thursday, left a far bigger mark on me than bashing into a car door. This happens every time I have an IV or a blood draw. It looks horrible, but it doesn't hurt at all.

Perhaps the closest calls in the last week were financial. I got a nasty email from my ex- about a medical bill for my son that I didn't know about. Because it was unpaid, she couldn't book a doctor's appointment for him. I didn't bother to remind her that she's supposed to have been paying half of all the parts of the bills that insurance didn't cover. A quick phone call, while observing under my breath what an asshole she is, took care of that. That day I also got a notice that our electricity was going to be cut off by today if a past-due bill wasn't paid. On top of all this, my last auto-pay for this semester's tuition is coming due. Fortunately, between a loan from my best friend Jim and a very good Saturday night at work, I was able to pay the electric bill and should have enough left over for the tuition payment.

Today in class, I noted that two more people, both of them young, were not there for the test; in all likelihood, it meant that they're dropping out of the program. It saddened me a little; I liked both of them. As of November 11th or 12th, I'll have exactly six months left in this program. I've had some close calls-- academically, physically, medically, financially, and may have a couple of more (hopefully no more physically, though!), but I've come this far. I'm too close to the cheese to not finish.