Watch Out What You Wish For

About a year ago, I was beginning my new life as a nurse. I'd struggled for two years to go to nursing school-- struggled financially, struggled to balance school, work and time with my family, and worked hard to plow through a nursing program that packed a whole bunch of school into two years.

My wife got laid off right about the time I started nursing school, adding another challenge to the process. I worried that my kids would feel like they missed time with me during that time, but they told me emphatically that they never felt that way. I have a feeling that the fact that whenever they had a board game night, I was almost never too tired to play (okay, I was, but I never forgot that I would never get that time with them back, and toughed it out).

I remember back around this time last year, how exhausted, frustrated and sometimes downright scared I was. I was struggling to master dialysis nursing. As someone who has been terrified of needles my whole life, putting two 15-gauge needles into someone to do their dialysis (think "needle about the size of medium sized knitting needle" size). I had to be able to spot when someone was in trouble medically, sometimes before I started treatment. I remember wishing, right about mid-December, that it was a year from then, and that I'd gotten a year in, and had all these skills.

And here I am.

I had a really difficult day at work-- it didn't even have anything to do with working Christmas Day. I had a really difficult patient who had a rather difficult "fistula" (an artery and vein hooked together through surgery to give an access to do dialysis with those 15-gauge needles I mentioned). He was also a general pain in the ass. And yet, I was able to "cannulate" him, and got him to sit still for 2 hours (of what should have been three and a half hours) of treatment.

I also had another patient go into respiratory arrest. I spotted it quickly and responded quickly. I returned her blood and called a "code." In  this case it was a "code purple"-- she had a pulse but had stopped breathing. My heart was pounding, but I stayed calm, quickly returning her blood and calling the code. It's weird hearing your voice god-like through a whole hospital.

The latter patient was revived, but about an hour later, as I was talking to the doctor who responded to the code, I suddenly heard the telemetry machine stop beeping; I pointed this out to the doctor, who looked puzzled. I had to spell it out-- "Doctor, I think we need to call another code." He agreed. This time it was a "code blue." Her heart had stopped. The "crash team" poured back into the room and went back to work. This time, they were unable to revive her. She had expired.

As I sit writing this, sipping a glass of red wine, with satellite radio playing the "Handsome Dick Manitoba" radio show, thinking about it all, I realize that I made every play correctly today. Most importantly, I stayed calm in an extremely stressful situation. I remembered everything I'd learned. I did everything correctly. A year in, I'm where I wished I'd be. It wasn't an easy day. As always, you have to watch out what you wish for. But this is the life I chose. And I'm glad I chose it. 

Back For More

Okay, I'm still here! I realized it's been nearly a half year since I've posted. A ton has gone on, including my son moving in with me after his mother threw him out in May after a Mother's Day celebration (holy irony, Batman!) I've been working like a fiend, trying to catch up financially-- a break coming soon regarding that. And I've been dealing with the deaths of three of my favorite people. I started a huge post trying to cover it all, but realize that I need to take it in smaller pieces. I've missed blogging, and have promised myself to start doing it regularly again. More to come...

A Year In

Where do I begin?

A couple of weeks ago, I realized that I badly missed blogging. There has been so much going on-- being a first year nurse, getting my oldest kid off to college, working crazy amounts of overtime. And dealing with the death of a friend.

So where do I begin? Let me start at today-- and a year ago. Just about a year ago, I was turned loose to do patient care on my own. Yes, I had finished nursing school. Yes, I had passed the NCLEX. Yes, I had finished the two months of training for the company I worked for, learning the ins and outs, ups and downs of dialysis. But I had a lot to learn. I thought a lot about one of my first days actually working as a nurse a year ago-- a really shitty work day-- and today. More on that later.

So, in May, right after they celebrated Mother's Day, my son and my ex got into an argument. It ended with her telling him to move out and move in with me.

Needless to say, both my son and I were very happy about it.

There were some problems to work out. The main one was how he was getting to school. His high school was just a couple of miles from my ex's house-- he would take her car, about a ten minute drive. I live about eight miles from his school, and did not have an extra car. We decided that since it was only about three weeks, that he could take the bus. It was two buses, and took nearly an hour, but it beat renting an extra car for those three weeks.

At the end of May, he graduated from college. My mother drove up from Tennessee for it. At the graduation, the parents sat with their sons (my son went to an all-boys school), sitting on either side of them. It was weird-- I'd spent so little time with my ex. When I met her, she was 24 and I was 31. Now I was 50 and she 45. We both have a lot of grey. It was funny to see him between us; I'm six feet tall, very white and lived it up a lot in my life. She's five foot one, Asian and didn't drink and only dated a few people. And there was the result of that union in between us.

He got a summer job selling home security systems door to door. He did quite well at it. He learned a lot about people through both his interactions with the homeowners he talked to and through his co-workers. I also realized that after years of letting out a little rope at a time, I was about to cut the ties.

In August, he asked me to talk to my ex; she wanted to drive him to his college, in Buffalo, New York, but he wanted me to go as well. I talked to her, and told her I would drive and pay for gas, etc. She agreed.

It was really strange spending 10 hours in the car with she and him. The first couple of hours, she and I caught up on family. And then had not much more to say. I realized that there were good reasons I left 15 years ago.

There were a few activities that weekend that we all participated in. I met two of his three roommates; they seemed like very nice guys. I kidded my son that he had the "diversity room;" he's a mix of Asian and white, and his roommates are African-American, Latino and White. I kidded him that the college recruiters would drag prospective students by his room to point out the diversity at the school, which actually appears to be about 90% white.

When it came time to leave, I had to drop something off for him that my ex had forgotten to give him. He came down from his dorm room to get it, but I could tell that he was ready for me to leave. It was time.

My ex, to my relief, had planned to fly back home. I didn't have to deal with her alone for ten hours, and had some time to decompress. My wife had pointed out that this-- and another thing-- were going to be really hard on me. And she was right. The other thing, just about a week before this, was the death of one of my closest friends.

My first day of my new job, August 7 last year, we gathered in the corporate office in a suburb of Chicago. Over the first couple of days, I gravitated to Neal, who it turned out lived near me. Another guy, Brent, annoyed me at first. He was way too eager.

I came to realize that the reason Brent was so over-eager was that he was extremely proud to be a nurse. He's struggled, like I did, to go to nursing school, paying for it himself like I did.

A couple of weeks into our training, he and I were at a hospital that our unit was covering. It was annoying. For me, it was a nearly 50 mile drive. For Brent, who lived in the in the suburbs to the south of Chicago, it was an 85 mile drive. At the end of the long day-- we worked about 15 hours-- we walked out to the parking lot and got in our cars. I was about to drive off, but noticed that he had gotten out of his car and put the hood up. Something was wrong.

I turned off my car and went to see if I could help. Turned out that his car battery had died for some reason. I kicked myself, realizing that I'd given my jumper cables to my wife and had forgotten to replace them. We thought that the security guard could help; he had one of those portable starter devices. Unfortunately, it didn't help.

I couldn't leave him up there stranded. I would have driven him home-- which would have meant about 150 miles of driving-- but his live-in girlfriend agreed to pick him up at my home, which was about half way between the hospital and their home.

As we drove home, we had a chance to talk. I can't even remember now what we talked about, but I realized two things: we were both happy with the career change choice we had made, and we were now friends.

As our Brent and my year as nurses and co-workers rolled on, my wife noticed something-- that I'd gone from having about 100 text messages a month to having over 1,000. It was mostly me and Brent. We texted back and forth about work related stuff-- some of it serious, much of it not. He and I could not be much more opposite. He'd been a blue collar worker before, running the printing presses for one of Chicago's papers. I'd been a teacher. And we were opposites in that most Chicago way-- he was a lifelong White Sox fan, I was a northsider, and a Cubs fan.

But for all that we were opposite in, we were also a lot alike. In the end, we were huge baseball fans, beyond our team loyalties. We were both fathers first, everything else after that. Both of us had been badasses in our lives before having kids had settled us down.

On August 7 this year, he, Neal and I had all sent similar texts to one another-- "Happy ^**^%%% Anniversary!" We had all come up together, all of us loved being nurses, but all three of us had become increasingly irritated with the stupid shit that came with working as nurses for a corporation. And we were all good friends.

The next day, I was working at a hospital near my home. Brent, who was having an interview the next day to possibly replace our boss, who had announced her resignation, stopped by that hospital to take care of some paperwork regarding our dialysis machines. He knew I was there, so popped his head in to the room I was working in to shoot the breeze for ten minutes or so. He was looking forward to going home afterward, having a couple of drinks, then getting up the next morning for the interview. He told me what his plans were if he actually got the job-- he doubted he would. He had a ton of great ideas. Which was probably why he wouldn't get it, both of us joked.

The next day I got a text from Aaron, a young guy who came in a couple of months after we did. He knew Brent and I were close, and wondered if I'd heard what he'd heard-- that Brent, who was only 43, had had a heart attack.

Since everybody knew that Brent and I were tight, I started getting calls from everybody in our unit as word spread that something had happened. Problem is that I knew nothing.

I finally called his phone, hoping that he'd had some kind of scare and was in a doctor's office, or being held at a hospital for observation. About ten minutes later, Lisa, his girlfriend, who I'd only met once for a moment, the night I gave him a ride home when he was stranded, called me. He had collapsed that morning. Her teenaged son had heard him fall in the bathroom, and gone in to check on him. He was not breathing. Her son ran to get a neighbor, who quickly called 911 and started CPR. The paramedics arrived within a few minutes and "bagged" him-- started artificial breathing for him. He had a heartbeat, but never breathed on his own again.

Lisa and I started burning up the cell phone lines. As she knew anything, she called me, and I called a few people to put the word out; everybody loved Brent, and wanted to know what was going on.

It turned out that Brent had had a brain aneurysm that had burst suddenly. The doctors were telling Lisa that there was no neural function. Lisa asked Neal and I to come out to see him and to assess him and confirm what she was hearing.

That Sunday morning, Neal and I drove down to the hospital, which was in Evergreen Park, where my mother had grown up. When we got to the room, Lisa, who had been keeping a 24 hour vigil, happened to have run out for coffee. It was a weird scene-- the three of us together, but now Brent was intubated and unresponsive. Lisa arrived, and Neal and I began our assessment. I opened his eyelid and shone a light into it, checking for pupillary response. There was none. I took his hand into mine and told him to squeeze it. No response.

We talked to his nurse and asked about various things. She told us the assessments they had done. It was clear to us that our friend was clinically dead.

We talked to Lisa about Brent's last wishes. He was an organ donor. If they were going to harvest his organs, they had to take him off the ventilator and do so within the next 48 hours.

On the way home, Neal and I talked about the irony-- that a the death of a dialysis nurse was going to result in two people being able to get off of dialysis.

A few weeks ago, I got a text from Neal. A few months ago, he had applied for a job at a hospital near the area he and I live in. He'd gone through the interview process, and had gotten the job. He was leaving.






Today I was sent to a hospital I rarely go to, doing dialysis on a patient for a doctor I rarely deal with. About a year ago, I was doing dialysis on a patient in this hospital, and had a lot of trouble with that patient; he was what we call a "stick" patient-- a patient with a graft or fistula, rather than a central venous catheter. We have to put big damned needles into these patients in a fistula or graft that was created surgically by attaching an artery and vein together. They're considered

Hello? Hello? Does this thing still work?

Wow. Where do I start. I last posted in June. It was what, three, four months ago? Seems like a lifetime.

One More Father's Day

Tonight I had an unexpected treat-- a few hours to relax at home alone.

Don't get me wrong-- I love hanging out with my kids and my wife. But I worked over 170 hours the last three weeks. It was financially rewarding, but I'm beat. I needed a few hours to decompress. My wife is having dinner with friends, and my kids are at parties. I'm relaxing, watching an old episode of "Mission: Impossible" on Netflix, and will soon be enjoying a glass of red wine.

Tomorrow is Father's Day. Tomorrow evening, I'll cook up some food on the grill and hang out with my family. On Monday, my son starts orientation for his summer job, and my daughter starts her theater camp.

This morning, though, I had a great "dad" moment. My kids had a friend over last night. Their friend, like each of them, is the product of a split family; her mother, a close friend of ours, divorced their friend's dad recently, having split from him a few years ago. We kid-- only half-kidding, really-- that the daughter has been "adopted." She spends a lot of time here. We're happy about it; she's a nice kid and a good friend to our kids.

This morning, I got up and made pancakes, turkey bacon, scrambled eggs and fresh fruit for my kids-- my son, my daughter and their friend-- and joined them. It was a delight not only to not have to work this morning, but to be able to join them for breakfast. Afterward, I had some things to do, but the kids helped me clear the table, and they played "Settlers of Catan," a favorite game of theirs, and then played "Rock Band" and watched a scary movie on Netflix.

In a few weeks, my son will be running off to college. My daughter and their friend will be starting their second year of high school. But today, I realized, with some satisfaction, that whatever mistakes I've made in my life, I've done one thing well: I made sure these three kids have had a childhood full of good memories-- memories that will carry them through the ups and downs life will bring them. I'm pretty happy about it.

Just When You Least Expect It

"Want to make God laugh? Tell him your plans."

The above quote is one of my favorites. I've seen it attributed to so many people, I'm not sure who actually said it. Ironically, I'm an atheist, but I agree with the basic premise-- life is what happens while you're making other plans.

In 1992/93, I'd been dating a woman on and off. I finally ended it when I decided that things were not working out. On July 4, 1993, I got a call from her-- she was pregnant.

She decided to go through with the pregnancy, and after my son was born, we decided to try to work it out. I lasted about two years with her, and moved out when I realized her fits of uncontrollable rage were not ending any time soon. I'd spent my whole childhood in fear of my father's fits of uncontrollable rage, and had no desire to live with it again.

Things were fairly amiable for a while after the split-- until she realized that I was not coming back. I'd come to realize that she was always going to be abusive. She hired a lawyer, and tried to keep me from ever seeing my son again. I hired a lawyer and kept her from doing that.

For the last 16 years, my son has shuttled between two households. He had planned to move into my home permanently a few days after his high school graduation on May 26.

About a week and a half ago, I was home alone on a Saturday-- he normally would have been there, but his mother asked to have him for an early Mother's Day celebration with her family (irony alert here!) My wife and my daughter had other plans and were elsewhere.

I'd settled in with a movie and a couple of glasses of wine, when I got a text from my son, asking if I was working. I was not, I replied. Then could I come get him-- he was moving in that night.

I was floored. I called my best friend Jim, who has become, basically, Adam's uncle over the years. I knew (as did he) that Adam's mother could be very aggressive. I asked him to come with me. Jim had also settled in for the night, but without hesitating, told me to give him a few minutes to get out of his pajamas.

About an hour later, I got to her home. I texted Adam, and he started bringing stuff he'd hastily packed out. His mother came out, and was, surprisingly, calm.

It turned out, as I discovered, that she'd started arguing with him, and needled him, asking why he was unhappy. He wanted to tough out the last few weeks with her-- her home is much closer to his high school than mine is-- but she kept going and going. Finally, he let loose with 18 years of what she'd done, including kicking him out-- twice-- when he was 8 and 9. Her general anger and pissiness. She still could not understand what he was upset about.

After all these years, after all the anger and acrimony, it all ended quietly. He moved in with me, and will stay with me until he goes off to college. I can't even describe how happy I am about it. His sister (his stepsister technically, but they think of one another as brother and sister) is happy to have him here, as is my wife. It's been a long, long time coming.

A Couple of the Good Ones

It's been a very hectic last couple of months.

There has been job stuff-- specifically, lots of overtime, but that's secondary. I've lost a couple of my favorite people in my life.

My mother-in-law, Ellie, died on March 9. She had suffered from emphysema and a related illness, COPD, for some time. I learned in nursing school that most people with COPD eventually develop a bout of pneumonia that they can't fight off. Ellie was right out of the textbook. A few nights before, she'd become very agitated, which is often a sign of pneumonia in older adults that people miss; they never develop a fever, because their bodies are too weak to mount a fever response to the illness. She was hospitalized, and sank fast. My wife, thanks to the kindness of one of her friends, was able to fly up to Minneapolis and be with her at the end. I talked to her on the phone the night before. She was lucid and loving; she told me how much she loved me and how much she appreciated me being a good husband to her daughter and a good father to her grandchildren. She died peacefully the next day, with my wife beside her.

This picture, taken in a visit Ellie and George, my father-in-law made around Thanksgiving, is my favorite. Ellie's ailments made life a lot of work for her in her last years, yet she kept her humor and spirits, and was a delight to be around. She adored her grandkids, and just couldn't get enough of them.

The day after my mother-in-law passed away, I got a call from Larry, one of my closest friends. I could tell right away, by the tone of his voice, that something was wrong. His mother, Sandra, who lived alone, had taken a fall. She'd hit her head and had been unconcious for an unknown amount of time. She was in a coma. The next day, Larry got terrible news: there was, as the physician told him, "no chance of meaningful recovery."

The last time I'd seen Sandra was last year, at the funeral of Larry's sister, who had passed away from a heart attack at the age of 49. As sad as the event was, I was very happy to see "Sandy" as Larry kiddingly and lovingly referred to as. When I was in college, where Larry and I became friends, my parents moved to California. They had bought me a car, and Larry would usually catch a ride back to Chicago with me during the breaks. I was always welcome at his mother's home, and loved hanging out with his family. I always joked that Sandra had "taken in a stray."

Sandra was already high in my book for bringing a guy who has become, over decades, one of my closest friends into the world. Giving me some stability at a time when I was sometimes estranged from my own family made her one of my favorite people too.

Ellie and Sandra will be missed. A lot. 

No Regrets

There's a handful of days in my life that I'll always remember the date of. July 4, 1993 was one of them.

An old friend and college roommate, Garrett, was visiting for the weekend. I'd been having a crazy year-- working two full time jobs, and carrying on a couple of relationships. I was looking forward to the summer-- that would mean a break from one of the jobs-- the teaching job-- and a break from both of the relationships I'd been carrying on. My life had become impossibly complicated because of it all, and I needed to back up and figure it all out. A weekend with an old friend was just what the doctor ordered.

My friend and I had been out hitting our favorite watering holes-- he'd roomed with me for a couple of months when he'd gotten out of the military a couple of years before, and wanted to go to the places we'd hung out in back then.

I got a call the morning of July 4th-- I was hung over, had my friend and a couple of other people sleeping at my apartment. It was one of the women I'd been seeing. She was, she told me pregnant.

I felt like a building was collapsing around me.

Over the next nine months, I struggled to keep it together. I felt completely unprepared to be a parent. I kept thinking of an old Firefall song, "Cinderella."



Cinderella by Firefall

"Last December I met a girl
She took a likin' to me
Said she loved me
But she didn't know the meanin' of the word

She imagined love to be grand
Me holdin' her hand and
Whisperin' sweet things and
Cooin' softly like a song bird

Then one mornin' she came to me
With a tear in her eye
And a sigh on her breath
And Lord, she said,
"Hon, I'm heavy with child"

And I said, "God damn girl, can't you see
That I'm breakin' my back
Just tryin' to keep my head above water
And it's turnin' me wild"

Cinderella can't you see
Don't want your company
You better leave this mornin', leave today
Take your love and your child away

Rockin' chair on the front porch
Well, I'm thinkin' about all the things that I did
As a young man
Now that I'm old

And I remember her and the boy
Did he have all the toys and the joys
That a young man should have
Before he gets too old

Cinderella couldn't you see
I didn't want your company
You shoulda left that mornin' left that day
Took your love and your child away"

One night, I was drinking with a couple of friends and discovered they had a copy of the album this song was on. I played it several times, drunk, letting the song sink in. I puzzled over the meaning of the song. Did he stay, giving up his youth to make sure his son had all the "toys and the joys that a young man should have before he gets old?" Or was he sitting on the porch in a rocking chair, full of regret, wondering what happened to the woman and the boy?

In the end, I stuck around. She and I made a go at it, but eventually ended. But the boy stayed. I took an ass-whipping dealing with his mother but I have no regrets. I don't have to wonder. He had baseball and Yu-Gi-Oh and Spongebob Squarepants and Star Wars and music and nights out for Chinese food and friends and the things a young boy should have. He's had laughter and love around him-- at least in my home.

He turned 18 earlier this month. He got into the college he wanted to go to. He got a scholarship and some loans and my plan, to get a nursing degree and a nursing job, worked; thanks to that, I'll be able to come up most of the rest.

His imminent departure brings out conflicted feelings. I did my job. I did my part in raising a smart, happy, confident adult. But my heart is breaking knowing I'll only see him a few times a year.

I keep coming back to a moment right after he was born when my father, who was full of regrets about his own children, told me: right now you're looking at the next 18 years as a long, long time. But you'll discover someday that it will turn out to be a short, short time. You get them such a short time in their lives and then they're gone. They come and visit, and you have a relationship with them and talk to them on the phone, but this time, this next 18 years, enjoy it. Remember that money comes and goes, but you can never get back time missed with them.

I'm sure glad I listened to my father.

At Long Last Friday Random Ten

Hello? (echo, echo, echo...). Anybody still there?

My posting has been incredibly lax. I do have a pretty good excuse-- working lots and lots of hours. Lots of overtime. We're very shortstaffed, and with a kid starting college in August, I'm not inclined to saying no to overtime.

Still, I've missed blogging. Lots has gone on besides overtime. I'll post more on it later-- two losses recently, two of my favorite people. My mother-in-law passed away about three weeks ago, and my friend Larry's mother, passed about a week later. Both shall be sorely missed. As I said, more later.

On the job front-- feeling more and more confident, and at the same time getting really disenchanted with it. The unit I work for is so poorly run. I've got some feelers out about other jobs. It'll be a year in August, and maybe time to move on. More on that later too.

I've got a list of posts to write: thoughts about the upcoming election, the Supreme Court hearing on the healthcare law, some music and art stuff, and of course, reflections about my son turning 18 recently, and his imminent leaving of the nest to go to college.

But until then, I've got to get back to my blogging duties, including posting my Friday Random Ten. Without further adieu...

1. Nobody But Me- The Human Beinz
2. It's Hard Enough Knowing- Pete Shelley
3. All My Loving- The Beatles
4. New Gun In Town- The dB's
5. That's Entertainment- The Jam
6. It Keeps You Running- The Doobie Brothers
7. West LA Fadeaway- The Grateful Dead
8. Show Me The Way- Peter Frampton
9. Chicago/We Can Change The World- Graham Nash
10. Souvenirs- John Prine


1. Great one-hit wonder that's on the Nuggets set. I think the word "no" is said over 100 times in this song.
2. The closing track from the Buzzcocks' frontman's first solo album, which I played to death in 1982.
3. One of the Fab Four's first hits
4. From the dB's' record "Like This," which I played to death in 1984 and 1985. The cd was very rare for years, until it was re-issued, thankfully, a few years ago.
5. Heard recently that Jam frontman Paul Weller quit drinking. He'll probably suck now.
6. "The Best of the Doobie Brothers" was one of the first records I ever bought, along with Bowie's "Ziggy Stardust" and the Eagles' "Hotel California."
7. Wasn't crazy about the "Touch of Grey" album when it came out, but have come to love it. Particularly like this ode to the dangers of the Chateau Marmont and its temptations.
8. Was delighted by the story recently where Peter Frampton was reunited with the guitar he had on the cover of "Frampton Comes Alive," which was lost in a plane crash in 1980.
9. About Bobby Seals and the Chicago 8/Chicago 7 trial relating to the 1968 Democratic Convention events.
10. "All the snow's turned to water/Christmas days have come and gone/Broken toys and faded colors/Are that's left to linger on." Maybe the most melancholy and beautiful song ever.

The Price

This has been a week at work. On Monday, I was in an "acute room" at one hospital-- instead of going to the bedside to the patient to do the dialysis, the patients are brought to us. In this particular hospital, two nurses work at once, two patients each. And in this particular hospital, we have a Licensed Practical Nurse (LPN) that the hospital provides, to help us with everything.

The other nurse and I were setting up, and the LPN started bringing in our patients. I had gotten in a little earlier, so I determined, with the LPN, which patients were going where-- the patients have different prescriptions for which dializer, dialysate, etc they use, so each machine is set up individually for each patient. As the other dialysis nurse got ready to set up one of his patients, who had been sleeping while waiting for dialysis, he tried to take an initial blood pressure. He realized he couldn't get a blood pressure.

We called a "Code Blue," and a "crash team" descended on the acute room. They worked on the patient for about half an hour, but were never able to revive him.

Yesterday, I was called to a hospital to I hadn't been to for a couple of months. I recognized the name, but it wasn't until I got there that I remembered the patient. I had done the first dialysis treatment that she had gotten when she entered that hospital, in late December. She had been lucid-- because she had a trach tube, she couldn't talk, but she could mouth words. She was one of the few patients who had ever thanked me for her life-saving treatment.

I noticed that she had nothing personal in her room-- not the pictures, flowers and cards I usually see with a lot of the patients. I talked to the primary nurse and discovered that she had no visitors. I made a mental note to stop the next time I was going to have her as a patient (we are usually told the night before who our patients are going to be) and get her a little pointsetta plant or some other little piece of holiday cheer.

As luck would have it, I wasn't called to do treatment on that patient, or even to that hospital, for a couple of months. When I arrived at her bedside, I was in for a shock. She looked nothing like the last time I saw her. She was not alert; her skin was dull and lifeless. She opened her eyes, but I could tell there was no cognition.

As I set up to do her treatment, I talked to her primary nurse, who told me that she had been doing better and better-- until two weeks ago, when she "coded." Obviously, she had been hypoxic (deprived of oxygen) while her heart and lungs were stopped long enough to damage her brain.

She was never going to get better.

As I finished the treatment, I quietly apologized to her that we medical professionals, with all of our expensive equipment and meds, couldn't help her get better. I found myself regretting that I hadn't been called to that hospital to treat her, and that I hadn't been able to drop off a pointsetta to brighten up the dreary room that will probably be where her last days will be. And I realized that the price I will pay to be in a profession that I love, and one that allows me to make a living helping people, is to be looking death in the face.

The Lesson of Egypt

I've been fascinated by the events in Egypt in the last year; they've been one of the participants in "The Arab Spring."

My interest in Egypt is, in fact, nothing new. When I transferred to Eastern Illinois University in 1981, I had plans to go there for a year and transfer to the University of Illinois to study Biology. This changed when I took one of my prereq courses, a Political Science course taught by, believe it or not, a professor named Faust.

Looking back, I know now that it was that class that led me to get a bachelor's and then a master's degree in Political Science. I hadn't been so fascinated in anything in years.

One October morning, as Dr. Faust was dismissing class, a guy ran into class and blurted out that Anwar Sadat had been assassinated. Everybody who was left in the class stopped and talked about it. I was hooked.



Three and a half years later, I wrote one of my Master's papers on Gamel Nassar, the first President of Egypt. It originally started with Samuel Huntington's idea, one of the ideas put forth in Samuel Huntington's classic "Political Order in Changing Societies," that sometimes military rule-- temporary military rule-- can be one of the means by which a society can establish the order by which development-- political, social, economic development-- can begin. Nassar started out as an idealist young military officer overthrowing the corrupt king of Egypt.

My faculty advisor encouraged me to base my Nassar paper on how much he followed the imperatives outlined in Huntington's book for the leaders of developing countries to stay in power. The idea was that they in order to enact change they must stay in power. But we all know that this is not necessarily always the case; Egypt's Mubarek stayed in power for three decades and little changed. Reading the accounts of the power struggles after the fall of Mubarek, it's like reading my Master's paper again; the military, the Islamic Brotherhood-- all the same players.

Nassar took the tack, which Huntington described, of creating an outside enemy. In his case, it was Israel. This was, of course, disasterous. Israel soundly thumped Egypt-- and several other countries allied with Egypt against it-- in 1967. And again, after Nassar was dead, in 1973.

In my Master's paper, I tried to compare Nassar to then-current leaders. Presciently, as it turned out, I compared Libya's Ghaddafi to Nassar (Ghaddafi was open about his admiration for Nassar). It turned out that the comparison was pretty apt. Ghaddafi, in his reign, more than four decades, was able to maintain power, but did not develop the government and social institutions that would allow Libya to thrive. Libya is suddenly a nation of armed gangs. Not a promising prospect.

The other person I compared Nassar to was Flt. Lt. Jerry Rawlings of Ghana. On May 15, 1979, Rawlings attempted to overthrow the extremely corrupt government of Ghana. His attempt initially failed-- Rawlings was court-martialed and sentenced to death-- but a group of military officers succeeded in overthrowing the government and rescued Rawlings.

Rawlings, who was then only 31 years old, led a military council, the Armed Forces Revolutionary Council (AFRC) in cleaning up the government. Rawlings then stepped aside for an elected government.

However, in December of 1981, Rawlings, unsatisified with the progress being made, overthrew the government again. Like Nassar, he ran for president (Rawlings would finally retire from the military in 1992). He won, with 58% of the vote. He would serve as President until 2001. He was prevented by the Ghanian Constitution from running again.

Was Rawlings successful? The fact that the Constitution actually prevented Rawlings from running again might be a measure of that success. Ghana is still poor. It is staggering, like many developing countries, under a lot of debt.

A book I picked up at a used book store years ago, one I've been reading on and off over the years, is about the resumption of civilian rule after the military coup that overthrew the government of Nkrumah, the Ghana's first post-colonial ruler. It's the kind of book that, probably, only someone like me, who has a Master's degree in Political Science would find fascinating. The upshot of the book is that the military voluntarily relinquished power in Ghana because as an institution, it did not have the attributes needed to process the conflicts and needs of a society. It's actually an amazing story. It plays into the ideas that Huntington brought up-- ideas that we're still trying to deal with today. What happens first-- political and social order followed by economic progress or vice versa?

Looking at Somalia now, or the horrific violence the engulfed Yugoslavia after its dissolution in the early nineties, one wonders if a bad government is better than no government. The military government of Egypt is finding the hard lesson that so many militaries have discovered in the 20th and 21st centuries-- indeed, what the United States discovered after easily defeating Iraq and Afghanistan-- that it's easier to overthrow than to govern. In the end, while a leader may stay in power, using the imperatives of Huntington, Machiavelli, Sun-Tzu or anybody else, in the end, if a society that does not have a form of government in which the needs and dreams of its citizens cannot find a way, or in which its citizens cannot even express those things, it is probably doomed. In the end, it may be Winston Churchill who said it best:

"Many forms of Government have been tried and will be tried in this world of sin and woe. No one pretends that democracy is perfect or all-wise. Indeed, it has been said that democracy is the worst form of government except all those other forms that have been tried from time to time."*

Delayed Friday Random Ten

I'm on call tonight-- so far haven't been called in yet. I worked over 40 hours this week, so it's a win/win-- either I get called in and make time and a half, or I don't and have a night off.

There's been a lot going on at work-- I've alluded to it previously. They've picked a bad time to be giving us a hard time; with the economy improving, the hiring has ratcheted up. Classmates who'd been struggling to get jobs, are being hired now. For my part, I'm keeping my head down and using this time to increase my skill set in order to be ready for my next job.

1. Good Old Rock and Roll- Quicksilver Messenger Service
2. Bridge Over Troubled Water- Simon and Garfunkel
3. Little Queenie- Chuck Berry
4. I'm Five Years Ahead of My Time- The Third Bardo
5. New Lace Sleeves- Elvis Costello
6. A Hard Day's Night- The Beatles
7. Brooklyn (Owes The Charmer Under Me)- Steely Dan
8. One of these Days- Ten Years After
9. Get Off My Cloud- The Rolling Stones
10. Wishing the Days Away- Billy Bragg


Notes:
1. QMS came out of the rich sixties San Francisico scene.
2. Still remember a great bit in the early days of Saturday Night Live where Charles Grodin wore an "Art Garfunkel" wig and imitated Art, while harmonizing with Paul Simon. Art Garfunkel came out and took over-- after confiscating the wig.
3. Bob Seger did a great cover of this one on his "Live Bullet" album.
4. From the great "Nuggets" garage rock collection.
5. Elvis Costello doing his best Burt Bacharach impression. Not that that's a bad thing...
6. Gotta watch this movie again soon.
7. From Steely Dan's debut album, which is, believe it or not, 40 years old.
8. Used to hear this one late at night on the local prog-rock station when I was in high school in the late seventies.
9. One of the Stones' funnest and funniest songs.
10. From "Talking To The Taxman About Poetry," one of my favorite albums of the eighties.

Flexible Friday Random Ten

My day today required flexibility. I was scheduled to do dialysis on two people. I couldn't get the access (an arterio venous graft) to work on one patient, and left word with the doctor. I packed up and went to my next patient. At the end of treatment, I discovered that they are mother and son. At 72, the mother has lost both legs to uncontrolled diabetes. The second one must have been recent-- the staples from the amputation are still in. The son, who is 45, has lost one. Both are obese; he weighed over 500 pounds. It was really, really sad.

Since I did not do one of the treatments, I was sent to another hospital to do another patient I'd tried to treat on Wednesday. A doctor was supposed to put a new venous catheter in at 4 pm. I got to the hospital about 4:30 and it was not done. In fact, the doctor was not even at the hospital. I ate my lunch-- which was now really a dinner-- and discovered that the doctor was still not there. I was sent home at 5:30 with my boss' blessings.

My immediate boss, the one who is a nurse and not an accountant, was there, having met with the big chiefs of the hospital chain that is our main account. The other nurse who was waiting for the same doctor to put a new catheter in another patient and we got to chew the fat with our boss for about 45 minutes and get the skinny on what's going on. It put me at ease-- for now.

If there's anything I've discovered is that to be an acute care dialysis nurse, I have to be flexible. And that I am.

Tomorrow I'm working-- the first Saturday I've worked in a while. Tonight I'm meeting some classmates for a drink. I've got to take it easy since I'll be working 12 or 13 hours tomorrow. But tonight, it'll be good to catch up with my classmates, who have all got jobs now. I'm looking forward to hearing about their experiences, good and bad. And I suspect they've learned that they need to be flexible in their jobs as well.

1. Too Much Too Young- The Specials
2. Make Me Smile- Chicago
3. LIttle Bit O' Soul- The Music Explosion
4. Fallout- The Police
5. Tighten Up- The Black Keys
6. Only Women Bleed- Alice Cooper
7. I Say A Little Prayer- Aretha Franklin
8. Psycho Killer- The Talking Heads
9. Living For the City- Stevie Wonder
10. Autumn Leaves- Tony Bennett


Notes:
1. Love, love, love that first Specials record.
2. The great thing about being middle-aged is not having to make excuses for loving big old dumb pop songs.
3. Great mid-sixties one-hit wonder
4. A Police B-side
5. Love the video for this one
6. Alice Cooper's grown on me over the years. Didn't hurt that he had a great time lampooning himself in "Wayne's World."
7. Grew up listening to my dad's copy of "Aretha's Gold."
8. My kids love this song since doing it in "Rock Band."
9. This song is still powerful today.
10. Tony's still on my "Bucket List." Gotta fix that this year.

Groundhog's Day

I think I've mentioned this before-- the movie Groundhog's Day has a local connection-- it's only a few blocks from where I live. Most of it was filmed in the town of Woodstock, Illinois, a town that is about 50 miles north of Chicago. However, the scene in which he saves the life of the town's mayor, who is choking in a restaurant, was filmed at a German restaurant that is gone now, Hessberger's, at Lincoln and Cullom Avenues in Chicago. This is how it looked then.

I happened to pass by it today while running errands. It's now a popular restaurant/bar called The Bad Apple that has a great beer selection, and from what people have told me, good food. I've only been there a couple of times for drinks. When I was still in nursing school, and we were still in our old place, I used to walk or bicycle past it on the way to and from work 4 or 5 times a week.

It was recently the 20th anniversary of the release of the movie Groundhog Day. Though I like Harold Ramis, the director, and the actor Bill Murray, it's not one of my favorite movies, though I like the message-- that sometimes we have to keep doing it over and over again before we get it right. It has a personal ring for me lately-- although I'm not too happy with my current job, I do love my profession, nursing.

Tonight, I was texting with my buddy Brent and discovered that he had an interview offer in a telemetry unit. He was going to pass on the interview and I talked him into going to it-- and taking the job if it's offered. It's a step up-- it'll increase his skill set and get him ready to do anything-- being a regular floor nurse, ER, ICU, etc. It also reinforced my decision to start looking for another job.

More On the Job

I just had a text back and forth regarding work with the guy who's turned out to become a great friend at work-- a friendship that'll continue, I'm certain, after we both move on from the job. More on that later.

I ended up having a day off-- a badly needed and helpful day off. I've mentioned before that the scheduling snafu is one of the things I hate about the job. I understand that as acute care nurses, we need to be flexible. But this has gone beyond flexibility; the "schedule" is more like some abstract impression of a schedule. I've mentioned before that the unit had an ill-fated scheme to cut back on overtime in which some members of the unit would work 6 am to 2:30 pm in the "acute" room (where nurses and techs do two patients at a time) and be relieved by people working 2 pm to 10:30 pm; the people working the afternoon/evening shift would pick up a "solo" patient in the evening if needed. This scheme came unravelled immediately. I was one of the two people first scheduled for the 2pm to 10:30 pm shift, and worked it exactly twice. I came in at all hours-- noon, 2 pm, 4 pm, etc. and left at all hours-- including, one day, 7:15 am. And never once at 10:30 pm.

At the monthly staff meeting last month, they told us they were discontinuing that schedule. They did not. I worked, ostensibly, the 6 am to 2:30 pm shift-- with an actual schedule that was similar to last month's, except starting very early. And often ending very late.

At this month's staff meeting last week, they said they're discontinuing that schedule and going back to the old one-- 3 or 4 twelve/thirteen hour shifts a week plus a "call" shift every week to two weeks. It's rigorous, but works for me, and most of the other nurses and techs.

I have other beefs. They regularly schedule some of us for over 40 hours a week-- and then complain that we have lots of overtime. They are getting worse and worse about stocking. The fact that they've gone from having three drivers delivering to one-- they bragged at the last meeting that one of the drivers, who was, according to co-workers the best and most reliable-- was fired for "excessive overtime." Yeah, hilarious. So we all hoard supplies, knowing we may have trouble doing treatment if we don't have those supplies, or take longer to do them-- incurring more overtime-- if we don't have them. And we are constantly being criticized for hoarding supplies.

Communication is a constant problem. For starters, we are dispatched to our patients by an archaic paging system-- yes, pagers. That's how backward we are. And once in a while it doesn't work. Since our schedule is chaotic-- sometimes we have a day off when we're scheduled, and sometimes we're called in when we're off-- one would assume that if you're not paged, you're not working. But since the paging system is unreliable (sometimes not only do we not get a page that was sent, but when we call to confirm our assignment, sometimes that fails to go through too).

Another communication problem: there's a hospital chain that is our main account. We are all set up to sign in and chart at all the hospitals in that chain. A couple of months ago, word came down-- 2nd, 3rd and fourth-hand-- of a new way to chart the dialysis treatments. It was, we were told, mandatory. Here's the problem: five different people told me five different ways to do this mandatory way of charting.

But never fear! We finally got an email with an explanation of this way to chart. Problem is these instructions are hopelessly muddled. I'll do my best.

Today, I was relieved to be told that our patient census was low and I had the day off. It allowed me to do a bunch of errands-- groceries, laundry, cooking-- and to think about it all. I've decided to tough it out. I'll try to make it to August, when it'll be a year. That year is magic in the profession. Once you have that year, jobs open up.

In the meantime, I'm trying to make the best of it all. And remembering some of the fine people I work with.

My first day in "the field"-- my first day working in a hospital with another nurse/preceptor, I worked with Molly. She's literally about half my age-- 25 or 26. If you didn't know her, you'd think she was a sorority girl. But when you get to know her, she's anything but a sorority girl. She's smart and got a wicked sense of humor. When I'm working in the same hospital, she always checks up on me, and she's someone I can always call for advice and information.

Another person who's good for advice and information is Ben. I worked more with him than anybody else when I was training. He and I shared a love of music and being parents-- though, at 28, he's just starting the parenting game-- his kids are 3 and a newborn). I'm at the tail end of it, with kids who are 17 and 15. Ben, who is Filipino-American, grew up just a few blocks from where I grew up in Chicago's Albany Park neighborhood, but obviously decades apart. When I have larger nursing questions, I talk to Ben, who I think would be a great teacher.

In my training class, I became friends with two guys-- Neil and Brent. We're all close in age, and doing nursing later in life-- Neil and Brent are in their late forties (I'm 50). I always enjoy running into Neil. He's smart and sardonically funny. As we've gotten to be friends, he's opened up about his life a little more. He comes from a tight Irish family. He's been with the same guy for some time now; they're trying to decide whether or not to move in together. He worked as a nurse for a couple of years before this job, so he's also someone I ask for advice at times.

The guy I've become really tight with is Brent. At first, he annoyed the shit out of me; he was, at times, way too eager. He was one of the only ones who would wear his scrubs during the classroom part of training. He talked a lot. But pretty quickly, he and I became friends. In the end, we had a lot in common; we came from different fields than the medical field (he ran printing presses for one of the Chicago newspapers, and I was a teacher) and we both have kids (and ex's).

Once we got in the field, we not only became better and better friends, but came to depend on one another for help. Our cellphones were lifelines, texting back and forth, sharing experiences, observations and new information. And in one case, when we were training, commiserating about an unbelievably awful preceptor. As the job has turned more disappointing and frequently more stressful, it's been great to have a friend and ally to talk to. It's turned into a total Bromance. I know Brent's always got my back and I'll always have his.

Looking ahead, I know that I won't work at this job until I retire. At this point, I'm hoping to make it a year. I know that the next job will certainly have a its share of nonsense-- what job doesn't? But there will be a next job. Knowing that is helping me tolerate this job.

One More Haircut

This weekend, my kids and I were playing Monopoly and we started talking a little bit about the past and future. My son will be turning 18-- a legal adult-- in a few weeks.

A couple of years ago, my son said, in front of the whole family, that he remembered when I had blonde hair. I have a lot more grey than blonde these days. I found it pretty amusing. This weekend, as we played Monopoly, I realized that his hair, which was blonde when he was little, had turned a very dark brown, almost black, like my ex's. She is of 100% Chinese ancestry-- both parents were from China. I chuckled and pointed out that I remembered when we both had blonde hair. Both of my kids realized that I was alluding to his comment from a couple of years ago, and we all had a good chuckle.

My ex had asked me to take him to get a haircut this weekend. He doesn't like getting haircuts-- he likes to wear his hair longer, like I did when I was younger. But his high school, a Catholic high school, has hair off the collar as a part of the dress code, and he prefers the barber I take him to over the one my ex takes him to, and so we went to my barber.

As he got his hair cut, my mind drifted back to the first time I took him to get a real haircut, when he was about 2 or 3; up until that point, my ex's mother had given him haircuts. I let him watch me get a haircut, so he could see what to expect. When my barber, who I went to for years until he retired, pulled out a straight razor to finish up, my son's eyes became the size of pies, and he asked if he was going to have to do that (this was before he'd seen "Reservoir Dogs," even). I chuckled and said "No."

When I was finished, Jerry, my barber, put the booster they had in the old barbershops for the young kids that went across the arms of the chair so they could sit up high enough to get a haircut. As Jerry began cutting his hair, my son chatted with him like an old guy. There was a reason people always called him "The Little Man."

As he finished his haircut today, I realized that it was going to be the last haircut he got as a child. It was the last haircut my ex or I would have a say in.

Years ago-- fifteen years ago-- as I sat with my ex and a couple of lawyers and signed a custody agreement, March 7th of 2012 seemed like it was a million years away. Now it's only a few weeks away. Back then I thought I was going to be the happiest guy in the world on that day. To be sure, I'll be happy for a lot of things-- that I successfully navigated my son's childhood, that I'll have to deal with my ex a lot less, that when he finishes high school in May, I'll be done paying child support (though that'll soon be replaced with college tuition). But in the end, his eighteenth birthday in a little over a month will be a bittersweet affair.

The Transitional Friday Random Ten

No call for work today-- they're trying, once again, to cut back on overtime. Nice to have a day off today, but I'll miss the dough in two weeks. Still, it'll be nice to get some things done today. In the meantime, I'm adding "update my resume" to that list of things to do.

1. Ah Leah!- Donnie Iris
2. Samba Pa Ti- Santana
3. Only Good For Conversation- Rodriquez
4. What Is Truth?- Johnny Cash
5. Who Loves You Pretty Baby?- Frankie Valli and the Four Seasons
6. It's All Over Now- The Rolling Stones
7. The Oldest Story In the World- The Plimsouls
8. Don't Let Me Down- The Beatles
9. Wild Horses- The Rolling Stones
10. Life Is Hard- Timbuk3

Notes:
1. Donnie Iris was part of three "one-hit wonders:" this one, "The Rapper" by the Jaggerz and "Play That Funky Music White Boy," by Wild Cherry.
2. From the great "Abraxas" album
3. Rodriguez put the album this one's from, "Cold Fact," out in 1969, but it could have been recorded last year.
4. Johnny Cash played this one when he was invited to perform at the White House by Richard Nixon
5. Frankie Valli's token disco song.
6. The original of this was done by The Valentinos, which was Bobby Womack and his brothers
7. This one and "A Million Miles Away," also by the Plimsouls, were standouts in a movie with a great soundtrack, "Valley Girl."
8. From the stripped down version of "Let It Be"
9. The Stones in a reflective mood
10. Timbuk3's big hit was "The Future's So Bright, I Gotta Wear Shades," but this one's my favorite of theirs.

The Peeps

Okay, so today I ended up having a day off; I was scheduled in our shitty schedule, but since Tuesdays and Thursdays are "low census days" typically (most dialysis is scheduled Monday, Wednesday and Friday), I had those two days off.

So that tops my list of gripes-- their inept attempts to come up with a schedule that will cut back on the overtime. It made my schedule a living hell the last two months and burned off whatever goodwill I had. The asinine staff meeting just infuriated us even more. Among the other gripes I have:

-- Their training program sucked. As a former educator, I give it a D+. The classroom material was uninspired, one of the instructors was one of the worst teachers I've ever dealt with. Some of the nurse preceptors I worked with were great, but couldn't do nearly as good a job as they might have, because instead of working with one nurse through the whole training, we worked with one on one day and another and another... There was a lot of stuff we never went over because they had no way of knowing whether it had been covered or not
--Massive disorganization. I know that acute care dialysis is bound to have a little chaos because you don't know how many patients you'll have from day to day, but at least one of the coordinators, the people who actually tell us which patient to dialyze at which hospital, has no idea what she's doing
--The paperwork. The paperwork is disorganized, chaotic and in many cases completely redundant. We put the start and stop times of treatment on no fewer than four different sheets. The machine logs-- the logs of tests of the water, disinfection, etc. of the dialysis machines-- were apparently designed by a drunk person. There is no rhyme or reason to them. They also moved recently from a timesheet we turn in once a week to a hyperdetailed timesheet we turn in every day. And of course they issued this timesheet with no instructions on how to fill it out properly.
-- Too many chiefs, not enough Indians. I think there is about one administrator for every four nurses. And all of those administrators except the two who actually do some work, the coordinators, are standing around trying to figure out how to make us more productive. Here's how to make the unit profitable: fire the head of the unit, "Lumbergh" and the person who is on "light duty" from injuring herself doing something stupid, and is now charged with "auditing" the other nurses, trying to catch them doing something wrong. She's a tech-- not even an RN. She has no business auditing RN's.

But with the bad, comes the good. The peeps-- the people I work with. I'll tell a little about some of them.

One of my favorite co-workers is Patrick. He's young-- about 25. His family moved from the Phillipines when he was about 13, so he's grown up in two worlds. He's very quiet, but when he opens his mouth, he shows a wide breadth of knowledge. He's also been one of the people who has helped me a lot. It could be very humiliating having to ask a kid half my age about how to do my job, but he has always been respectful, never showing a bit of condescension.

Another favorite is Saint. He's lived up to his name a couple of times, including yesterday, when I had a patient accidentally pull a needle out. I had to keep pressure in order to keep the patient from bleeding, and asked another nurse to see if someone was available to help me. It turned out he was right around the corner; he quickly and quietly helped me with the patient and the machine, and calmed me down afterward. He's helped me out in a couple of other situations. He's also Filipino (there are a lot of Filipinos in the unit). He's another guy who's always ready to help without making me feel stupid.

Ramon is a guy I always get a kick out of working with. I thought he was latino when I first met him, but he's also Filipino. Picture a Filipino guy who looks latino, but acts like a combination of Warren Beatty and Bill Murray. He's got two families, one with the ex-wife and one with the current one. He's by all accounts a great dad. He's also my hero in that he's openly contemptuous of the managers.

Yesterday, he and Manny, another guy who is openly contemptuous of the management were scheduled in the "acute room" together. The reason became obvious; the unit manager who is a nurse, and pretty competent, and the woman who's on "light duty" spent the day in the acute room with them auditing them. It was farcical. Ramon and Manny weren't intimidated in the least.

A couple of weeks ago, I was working at one of my hospitals and I had to find Fernando, one of the veterans, to get a key. The hospital has only one key for the dialysis storage room, and so if a second (or third) nurse is called to that hospital, he or she has to find the other nurse. This is usually no problem-- we have a list with all of one another's cell numbers on it.

I went to the room Fernando was working in and had a chance, for the first time, to chat with him. It turns out that he's a tech-- not an RN. He told me that until pretty recently, the unit was a great one to work for-- until they brought in "Lumbergh." He has been doing dialysis for about 20 years, he told me. He added that he was stuck there; not being an RN, he can't go anywhere but the other big dialysis corporation. If he were an RN, like me, he told me, he'd be looking for another job.

I've taken his advice under strong advisement.

There are other folks I work with who, for the time being, are making a situation that is becoming increasingly uncomfortable and stressful tolerable. Between that and knowing I'm helping folks, I think I can tough this out for a while. I'll write more about my terrific co-workers soon.

The Job

Last night, my boss asked me if I would take on a third patient shift if needed (we do two patients or sets of patients a day, usually). Since I'm trying to get on top financially, I said yes. More on that later.

Today, we had a staff meeting. That meant I had to be in a suburb of Chicago that's about a 45 minute drive away at 7 a.m. Not a thrilling prospect. But since I have been bitching about a lot of things, I felt like I should go.

I'm glad I went, despite having worked a 17 hour day the day before (until midnight). Since the last meeting I've learned a little more about the unit I work for. I learned that it used to work a lot better than before-- until an accountant, rather than a nurse was put in charge of the unit.

That accountant, I've come to realize, is our Lumbergh. This was the boss in "Office Space" if you've forgotten, played to perfection by Gary Cole. He plays like he's a nice guy, but in the end is a corporate dick. He knows nothing about what we deal with day to day in our jobs. He announced today that we are trying yet another computerized system, with smart phones, that will start accounting, nearly to the minute, where we are and what we're doing.

One of the other nurses joked about using the GPS on the smart phones to track our movements. The accountant hesitated before answering, and we all realized that they had considered using the GPS on the phones.

This unit is about to become a lot less nice to work at-- and there are already problems. My plan is to try to work there a year-- the magic number for a first year nurse-- and then check out my options.

In the meantime, I'll be blogging about some of the people I work with, who are mostly wonderful. I'll be telling a little bit about my job-- as much as I can without compromising the privacy of my patients and my co-workers.

Which leads to my third shift last night. As I said, I jumped at the chance to work some extra hours-- not only for the extra dough, but because it was at a hospital I did two clinical rotations at, and know a lot of the staff at and am consequently quite fond of.

I was asked to call ahead to give an ETA. I called and was told to take my time-- the patient was having a central venous catheter installed at that moment, the catheter I was going to use to do the dialysis. Since I was close to home, I stopped there to have a quick dinner and then headed out to the hospital.

I got to the hospital and headed upstairs to assess my patient. My boss had gotten the machine ready for me already, saving me some time. When I got to the room in the ICU, I said hello to the patient's parent; my patient was only 23. She was suffering from a chronic disease that prevents the body from producing all kinds of blood cells.

As I looked at my patient, I could see my kids; my eldest is about five years younger than her. And as I looked at her mother, I could see myself. There is nothing more helpless feeling than having a sick kid. And having a kid who's got a cold, the flu, asthma, bronchitis-- is one thing. To have a kid in renal failure on top of a serious chronic condition-- I can't even imagine.

I set up and got my patient ready for treatment. As I did this, I explained to the patient's mother a little bit about how dialysis works. I could tell that it was allaying a lot of fear and anxiety. Later, she told me that she'd been hesitant to do treatment-- she knew little about dialysis. I told her that it's not surprising; I knew next to nothing about it until I was a dialysis nurse.

As I got treatment going, the mother, who lives in Virginia, fielded phone calls about her daughter from friends and relatives. The treatment was scheduled to be short-- only 2 hours. This is typical for someone new to dialysis, or someone who does not normally get dialysis treatment. Since there are frequently complications in early treatments, I asked the patient about those complications. She was fine. And so was the mother; I could tell that it comforted her to know that I knew at least a little bit about what I was doing.

About 40 minutes into treatment, my patient started looking better and became more responsive. As the toxins in her blood-- toxins that affected her level of lucidity-- were pulled from her blood, her condition rapidly improved. I could feel her mother's relief as she began answering questions, something she hadn't been able to do that morning.

My patient's mother asked my patient if she wanted some diet ginger ale. I checked with the primary nurse to make sure she wasn't on fluid restrictions, and her mother helped her sip it as she quietly chatted with her, telling her about her friends, her boyfriend and her relatives asking about her.

Toward the end of treatment, the mother thanked me for taking on the extra shift to treat her daughter. It was not a problem, I told her, and I meant it.

I worked hard to finish nursing school. I was lucky enough to get a job quickly, and am happy that after four years of sacrifice-- time given up with family, financial sacrifice-- that I've got a job that's paying me pretty good money. On the other hand, I've had this job long enough to hate aspects of it.

But last night, seeing my patient improve because of my treatment, and seeing the relief in a fellow parent's face as she saw her daughter's condition improve-- that is what it is all about. All the past sacrifice and current aggravation are worth it in spades.

RIP Anne Keegan, a Chicago Original

A few weeks ago, I stopped into the restaurant I worked my way through nursing school at to say hello to some of my old co-workers. I discovered, talking to them, that one of my favorite regulars, reporter and author Anne Keegan, passed away last May.

For a long time, I waited on Ms. Keegan not knowing who she was; I'd read her articles in the Chicago Tribune since I was a kid, but I had no idea what she looked like. In reading her obit, I discovered that there was a reason for this: she refused to create a "personna" for herself, much to the frustration of the Tribune.

I originally ended up waiting on Ms. Keegan for the simple fact that I was the only one who wasn't afraid of her. She intimidated the other servers. Having worked as a teacher on the tough West Side of Chicago, I wasn't easily intimidated. I suspect this may have endeared me to Ms. Keegan. Once she lowered her guard, she was a fascinating, warm and charming person.

Ms. Keegan spent her career writing about the regular Joes and Janes of the world. In a blog post, an old Tribune co-worker captures her duality-- a lady who was very charming, but the next minute could outswear a trucker.

She also authored two books. These also showed her dichotomy. Her first was "On the Street Doing Life," about a tough-as-nails Chicago cop. The other, published just a few years ago, was a children's book about a cat that she wrote for her granddaughter.

I remember my last couple of encounters with Ms. Keegan, at the restaurant. She liked sitting in front of the restaurant so that she could pop outside to smoke a cigarette. She had her usual drink-- she loved that I remembered it-- and usually something light to eat. The last couple of times I saw her, it was late, so the restaurant wasn't very busy and I got a chance to chat with her. She was, as always, interesting and gracious. She was a Chicago original, and I'm glad I got the opportunity to know her. She will be missed.

"All's Well That Ends Well" Friday Random Ten

I was relieved today when I got my assignment; it was the hospital closest to my home. A snowstorm was expected here in Chicago, and I was glad to know that when I came out to a "winter wonderland" I'd have only a short drive home.

As my day wound down, I was closely watching one of my patients, who showed signs of instability. My other patient (we do dialysis on two patients at once in the "acute room") was stable-- or so I thought. With no warning, his eyes glazed over, his blood pressure dropped precipitously and his breathing stopped.

My mind raced, remembering what we'd been told to do in this scenario. I opened up the saline line he was attached to and poured saline into him and shouted to the other nurse in the room to call a code. She got on the phone and called it while the respiratory therapist, who miraculously happened to be in the room because we'd called him because the other three patients in the room kept having respiratory alarms, and my friend Jojo, a very, very experienced dialysis nurse was also miraculously in the room. The respiratory therapist started CPR while Jojo and I set about returning his blood and disconnecting him from the dialysis machine. The crash team was there nearly instantly, along with the house doctor. They "bagged" the patient-- put a vent bag on him, continued the CPR and gave him epinephrine.

Several minutes later, he was breathing on his own and his blood pressure was normal.

My heart was racing a thousand miles an hour. I still had my other patient to take care of, and needed to make sure all my ducks were in a row with documentation.

My patient was taken to the HAU (High Acuity Unit, which is what we call the ICU now), where he'd been taken out of only a day or so before. Obviously he was taken out too soon.

I had to call the patient's nephrologist, which wasn't so bad-- and then my boss. I didn't know until after I called her, but Jojo had had a patient code as well this week. His patient didn't make it.

At the end of it, I still had to go find my patient in the HAU and flush his dialysis ports with saline and dwell a med that keeps them from clotting. I kept my cool and did my job.

After I got everything documented, charted, cleaned and put away, I grabbed the form I need to fill out for the company and headed out the door. I stopped at Trader Joe's on the way home and grabbed something for dinner and some wine. I'm enjoying a much-needed glass right now. It all ended well. My patient's still alive.

1. Absolutely Sweet Marie- Bob Dylan
2. Accidents Will Happen- Elvis Costello & the Attractions
3. Ace of Spades- Motörhead
4. Across the River- Bruce Hornsby and the Range
5. Across the Universe- The Beatles
6. Adam Raised a Cain- Bruce Springsteen
7. Add It Up- The Violent Femmes
8. Adult Books- X
9. AEIOU Sometimes Y- EBN-OZN
10. After the Gold Rush- Neil Young


Notes:
1. Jason and the Scorchers do a great cover of this one.
2. Still miss the angry Elvis Costello
3. Motörhead singing about the death card
4. Love this song, about a woman having to admit defeat-- temporarily
5. This is the version from the "Let It Be Naked" version, where Phil Spector's silly strings and heavenly choruses that were added without the Beatles got taken out.
6. A blistering song from the great "Darkness On the Edge of Town" album.
7. Even frat boys discovering this song couldn't ruin it for me.
8. Just replaced my copy of "The Unheard Music," the great documentary about X. It's one of those things you lend out and never get back because it gets lent out again.
9. Love this synthy, quirkly one-hit wonder from the eighties.
10. The band "Prelude" had a one-hit wonder with a cover of this song, in 1974

Book Review: "A Man On the Moon: The Voyages of the Apollo Astronauts," by Andrew Chaikin

Full disclosure: I'm a bona fide space geek.

That being said, Andrew Chaikin's book is basically a biography of the Apollo space program, the program that allowed a dozen human beings to walk the surface of the moon. It's also about not only the physical journey the men (in the less enlightened all-male early NASA days) took, but the intellectual, life and spritual journeys the men took. It was also largely the basis of the great HBO mini-series "From the Earth to the Moon."

In May, 1961, the month I was born, the United States' new president, John F. Kennedy, spoke before a joint session of Congress and proposed something that must have seemed preposterous at the time: to land a man on the moon and return him safely before the end of the decade. Earlier that month, Alan Shepard had become-- just barely-- the first American to fly into space with a fifteen minute flight that did not even orbit the earth.

The journey to fulfilling that promise, on July 20, 1969, was a fascinating one that involved scientific and engineering ingenuity, political wrangling, personal sacrifice-- including lives-- and the dedication of many thousands of men and women. The men who were at the point of the spear that was pointed at the heavens and the moon, the astronauts, were, on the surface, very similar: white, male military (or former military) officers who were in their late thirties and early to late forties. Beneath the surface, however, they were remarkably different in background, interests, temperment, and even politics. The paths they took to becoming part of the select few who made the journey to the moon and back were diverse, but the paths they took afterward were just as diverse. Some, like Frank Borman, who headed the now-defunct Eastern Airlines, became businessmen. Others took less worldly paths: Al Bean became an artist, recreating his memories of the moon on canvas. Jim Irwin, who had never been particularly spiritual before becoming the eighth human being to walk on the moon, was profoundly moved by his experience, and spent the rest of his life as a minister after returning to earth.

Chaikin's book lays out the history of the Apollo program beautifully, putting it in the context of the times and avoiding overly technical jargon. He humanizes the astronauts, who were often placed on pedestals, and in the process making them much more interesting. He recognizes the contributions of the many people of many talents who brought about one of the United States' greatest triumphs. In doing so, the book makes a compelling argument for why we should once again reach for the stars.

When Did That Happen?

The other day, I was running round doing errands on a rare day off and I happened to drive past the park where my son spent six wonderful years playing little league.

As I looked over, I remember dozens of days watching him play baseball, chatting with the other parents. I remembered how as each season progressed, he became closer to his teammates and, while happy my ex and I were there watching the games, it was more and more his own thing; he and his teammates talked about the bats they used, stances and other fine points of the game.

In a few weeks, he turns 18-- a legal adult. A few months after that, he's going off to college.

I remember being the most scared guy in the world the first time I picked him up after his birth. I couldn't believe I was responsible for this little guy for the next 18 years. That time seemed a million years away. And now it's nearly here.

When did that happen?