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.