The Cost

Today (March 7) I was at a hospital that I work at frequently. There are some things I love about it: the view, for one-- it overlooks Lake Michigan and Lincoln Park. It was also a hospital I had clinicals at and my favorite clinical instructor was at this hospital. And four of my nursing school classmates work there. There are some things I hate about the place: their charting system sucks; it's particularly bad for dialysis people. And there are a few really stupid people that work there, though really every place has some of those. 

Today, though, after I arrived, it occurred to me that 19 years ago, to the day, my son was born just a few blocks down the street at another hospital that is now gone. It was, like today, an unusually cold day in March. 

My life at that point was a train wreck. I felt lost. I felt like this was just the icing on the cake; a child I was totally unprepared for.

I got a call late the night that he was born. I had a son. I was barely speaking to his mother at that point, but she called me to tell me I had a son.

I went the next day to the hospital and laid eyes on him for the first time. I'd never seen a newborn at that point in my life, and had certainly not held one. I was stunned to see how helpless he was. I felt fear rising. I was responsible for this little pip of a guy for the next eighteen years. I overcame my fear and picked him up.

The 19 years since then have been a wonderful journey. His mother and I reconciled, then split eventually. We had a horrible custody fight. I've had to deal with her infantile behavior, and until recently had a good portion of my income taken out for child support. The cost was high. But the rewards were higher. I got to see him grow from a helpless newborn to a young man who is ridiculously independent. I got to see his first steps-- so many firsts. We had so many good times-- movies, baseball, great talks. Seeing him develop his unique personality-- his humor, his intelligence, his kindness. Discovering that other parents on our block loved having him over playing with their kids because he was so intelligent, kind and respectful. Reading to him, then seeing him learn to read. Seeing him thrive in an internship, then seeing him succeed in his first job, persevering when a lot of co-workers quit at the door-to-door sales job after just a few days. And then, at the end of last summer, with my ex, driving him to college in New York. I remembered the drive home from the hospital with him, which I recounted in this post. I chuckled at the symmetry of it all-- that we drove him home together, then drove him away together nearly two decades later.

When his mother discovered she was pregnant, she told me she had decided to go through with the pregnancy, and offered me out. I couldn't stand the idea. I told her I would stick around to raise him. The costs, both materially, and otherwise, of this decision were high. But the rewards have been so much higher. 

Decisions

About four years ago, I was taking an Anatomy-Physiology course and had made a decision that was to have a huge effect on my life.

I had left teaching a couple of years before with the intention of trying to get into pharmacy school. I had tired of the tight job market in my profession at the time, education, and wanted to get into the medical field. The aging of the baby boomers would guarantee me, I knew, of a job.

However, the prospect of getting into pharmacy school was daunting; there is now only one pharmacy school in Chicago, and only about 10% of candidates who apply get into the school. And even if I could get into pharmacy school, it was going to be two more years of prerequisites, and then four years of pharmacy school. I would be 56 when I finished, and my oldest kid would be done with college, and my younger one nearly done. The whole point was to be able to pay for most of their college.

I had been taking classes with my friend Leslie, who I also worked with; she was getting ready to go to nursing school, and the prerequisites for nursing school and pharmacy school were nearly identical, so we took classes together whenever we could. Leslie pointed out that it would make more sense for me to go to nursing school. First, with the Anatomy and Physiology class I was currently enrolled in, I would be finished with all the prerequisites for nursing school. Secondly, I could apply to the Chicago city college that I was already taking the prereqs at; a bonus was that the school was extremely affordable.

I had to make a run to my old high school to get my transcripts, but I got my application in on time. Two months later, I got the notice: I had been accepted.

Later I discovered just how fortunate I'd been. There were approximately five applications for every open slot in the school. Most people have to apply several times before they get accepted.

The month I started nursing school, my wife got laid off her job. The recession that had started the year before caught up with us. She searched for months for a job with no luck. We had a hard decision to make. She was getting unemployment benefits (which were extended thanks to the President's stimulus packages-- thank you President Obama!) but we were still struggling-- I no longer had a teacher's salary; I was working as a waiter. We were living on less than half of what we had been living on, and now I had to pay for school on top of our regular expenses.

We sat down and talked about it. Our kids were going to be in college in a few years. It was going to be a lot easier to pay for colllege on a nurse's salary than a teacher's. We knew it was going to be tough, but we had to have faith we'd work through it.

After six months of job-hunting, my wife finally went back to work, although for less than what she had been making. I had been hoping to drop down to part time at work in order to go to school, but that obviously wasn't going to happen. I continued to go to school full time and work full time. My next two years entailed very little sleep and lots of caffeine.

I graduated nursing school in May of 2011, the day I turned 50. In July of that year, I passed the state nursing exam and a few days later got a job. Since then, I have worked as much overtime as I can handle. When I got my W-2 a couple of weeks ago, my jaw just about hit the ground. I made a lot of money last year. A lot of bills got paid off. And a lot of school costs got paid for my son.

Today, when my wife got home, she told me of a conversation she had with a friend of ours. The couple, whose old home we got married in, is in a lot of trouble. They had been wealthy at one time; both of them come from wealthy families. It turned out that they had been living off of their inheritance and had finally hit the bottom of their well. They lost that home last year, and were evicted from the apartment they had been living in. They're staying in a temporary place, but they are on the verge of being homeless. We are trying to figure out how to help them.

In the meantime, I am glad about the decisions we made. I'm glad that I had an open mind, and listened to my friend about changing my plans. I'm glad that we decided to tough out my wife's unemployment, and for me to stay in school. I'm glad that I decided to jump at the job that was offered so quickly. I'm not thrilled with the job, but it pays well, and has allowed me to work a ton of overtime, which has allowed us to catch up financially. I'm glad that I made the decisions, day to day, to live within our means, and to do the things that assured we would be better off in the longer term. Tonight, my wife and I are going out for an early St. Valentine's Day dinner. Despite having a kid in college, we can afford to go out for a nice dinner (and though she doesn't know it, she's getting a couple of small pieces of jewelry). Thanks to decisions we made, all of it-- the kid in college, the dinner and the baubles-- are within our means. I feel pretty good about that.

The Long Haul

Last night I had the pleasure of getting out with one of my oldest, closest friends. As we had a couple of beers and chatted, I was amused thinking that I had no idea 31 years ago, when we first became friends at the ages of 18 (him) and 20 (me), that we'd be a couple of middle aged guys, 49 and 51 now, talking about our kids, our wives, our careers and our retirement plans.

I thought about the handful of old friendships I have; most, like my friendship with him, are from the state college in central Illinois I got my bachelor's and master's degrees from in the mid eighties. There were times I lost touch for years at a time with some of those people, but eventually we reconnected, and as we head off into middle age and start getting ready for the last couple of acts of our lives, the friendships seem to be really strengthening.

I've told both of my kids that the friends they make in college will end up being the strongest one of their lives. I can tell that my son, in his freshman year of college, is beginning to understand this.

I remember that in my twenties, I dreaded getting older. I really thought that life would really suck as I get older, and that my youth would be the high point of my life. While I did have some great times then, I was totally wrong. I had no idea that I'd hit my fifties with gusto and joy in life. I had no idea that friendships I'd made when I was 22 or 23 would become so rich, or that I'd make a second wave of great friendships thanks to this blog (that's you Skyler's Dad and Bubs!) that would make life even richer. In my youthful naivete and stupidity, I thought that life really would be over after 30. I had no idea that it was only beginning then. In the long haul, my life's been rich and fascinating, and continues to be.

The Next Step

Just before I became a nurse, the unit I work for got a new manager. He is not a nurse-- he's got an MBA.

That was our first warning.

Since it was my first nursing job, I was too busy learning the ropes to pay much attention to what was going on above. But it didn't take long. By the second or third monthly staff meeting, I began to realize that a series of increasingly disjointed, and sometimes nonsensical changes were being attempted-- harebrained schedules, attempts to use smartphones to dispatch us, etc.

When those things didn't work, it was, according to them, our fault-- that we were not trying hard enough to implement his genius ideas.

Over the months, I began to realize that I'd seen this story before: The Peter Principle.

In 1969, Laurence Peter published a book that purported (correctly, I believe) to explain a lot of organizational dysfunction. Basically, it said that people are promoted upward in organizations as long as the master each level. They rise until they hit a level they cannot master-- their "level of incompetence." Over time, position after position becomes filled with someone who cannot do the job. They cannot be promoted upward, and are rarely demoted. Organizations become filled at the top with people who cannot do the job, like a clogged filter.

I quickly realized that our manager had been promoted to his level of incompetence. And now here's the painful part:

His name is Peter.

In August, the Nursing Manger, the woman who hired me, saw the writing on the wall and left. The nursing manager position was taken over by a great guy, a nurse in my unit who did a lot of my training. He has struggled to do his job, but "Peter Principle," as I've nicknamed him, has thwarted him at every turn, taking away resources he needed to do the job. He is currently doing three jobs-- his, a former assistant who also quit, and coordinating day to day, which was formerly done in alternating weeks by two of the nurses in our unit.  The nursing manager, who has two young children, and was working 80-90 hour weeks (on salary), turned in his resignation.

Things are about to become very bad. I've been getting my resume ready, and have been encouraging a co-worker who is just as disgusted with recent events, to do so too.

In the meantime, I'm keeping my eye on our "Lumberg" until I can turn in my resignation as well.

"That'd be greeaaaatttt....."

A Year and a Day

My first real day as a nurse-- the first day I got paid to be a nurse-- was August 7, 2011. I had spent the previous 2 years plowing my way through nursing school, and the two years before that plugging away at the pre-requisites for nursing school, and all four of those years working full time and raising a couple of kids.

I had gotten a job more quickly than I could ever have hoped for-- basically, four hours. I had passed the NCLEX, the test that officially makes you a nurse, in July of 2011. A few days later, my wife and I talked-- she works in employment, so is really good at finding job postings. She found one quickly that, unlike most of the others, did not require previous job experience; they would, in fact, train.

I got online and applied for the job. Four hours later, I got a call, and set up the interview for the following Monday. On Wednesday, the woman who interviewed me called me and told me I had the job.

My first day of the classroom work for my new job, I sat behind a guy who was a few years younger than me. At first, he annoyed me-- he was a real "eager beaver." Over the next week or two, my guard lowered.

Then, one night, he and I were both sent to a hospital that was about 45 miles from Chicago. We were covering the hospital in emergencies, so they wanted us to know all the ins and outs of the place (as it turned out, they had a lot of emergencies-- we were sent there a lot, much to our chagrin).

That night, though, as we were leaving, talking about our day, we walked to the parking lot. I got in my car and saw him get in his. And then out of his car. He popped his hood, and I realized that there was a problem.

I went over and discovered that his car battery was dead. We talked to the hospital guard and discovered they had a jump starter for such an occasion. We tried, but the thing couldn't crank his car. I remembered that I had given my jumper cables to my wife and neglected to get myself new ones.

He lived about 30 miles south of me, and I lived about 45 miles south of the hospital; he was stranded 75 miles from home. His girlfriend, who lived with him, had a car, but it seemed silly to have her drive `150 miles round-trip. I told him to call her-- if she left their place when we left the hospital, we would meet at my home about the same time. He called her and the plan was in action.

On the way to my place, he and I got to talk at length for the first time. We had a lot in common-- both of us went back to school after other careers-- he worked printing presses, I was a teacher. Both of us had kids who were grown or nearly grown. Both of us loved baseball. We both had pretty well misspent youths. We also discovered we were opposites in a lot of ways-- He was a metalhead; I loved punk rock. He grew up in south suburbs of Chicago, I grew up mostly on the north side of Chicago. This led to that other great opposite-- he was a Chicago White Sox fan, I am a Chicago Cubs fan.

By the time we got to my home, and his girlfriend picked him up, we were friends.

My helping him out was not forgotten. We were pretty much inseparable after that-- if not in person, by text. My wife noticed that the number of texts I sent or received went from about 50 a month to about a 1000 a month. As he and I struggled through our job, the first nursing job for both of us, we texted asking questions, or sometimes just joking around. It became my lifeline. Sometimes it was a question about the dialysis machines we used, or about a particular patient. We had been rushed through and out of training, so there was tons more to learn. We came to really depend on one another.

Since I had a kid about to start college, and he had a kid in college, both of us loved to work overtime; we were, in fact, dubbed by our co-workers "The Overtime Kings."We discovered that despite looking very different, and being 9 years apart in age (he was 42, I was 51), people confused us for one another, in part because our names were similar-- starting with the same first two letters-- and they saw us both all the time.

As summer arrived, we began to realize that we were finally getting the hang of a rather difficult job. We started making plans to try to make it to a baseball game.

On August 7, he, Neal, another friend from our training class, and I sent one another vulgar text messages "congratulating" one another on our one year anniversary at the job. We had all become quite annoyed with the job, but kept good humor about it.

Later that night, I got a text from him; turned out he was heading to the hospital I was working at that night to check on some documentation on the dialysis machines in that hospital. After that, he was planning to go home, have some vodka and Red Bull (ick!) and then was going to interview to be head of our unit-- our boss had resigned recently. He texted me a picture of the pint of cheap vodka he had purchased at a convenience mart on the way over, and a while later popped his head into the room of the patient I was doing dialysis on. He came in, checked the documentation on the machine and stopped to chat for about ten minutes. We talked about the usual stuff-- our kids, our mates, baseball, laughing about the job. He was doubtful that they would offer him the manager job, and if they offered it, and he couldn't do it the right way, he wasn't going to take it.


The next day, I was at a hospital getting ready to set up a patient, when I got a text from another nurse in our unit who he and I were friends with. He asked if I'd heard something about my friend having a heart attack. I knew nothing.

I called his phone and left a message, expressing the hope that he was in a doctor's office dealing with some minor health scare. About ten minutes later I got a call from his girlfriend, who had seen his phone go off, and seen my name on the call. She knew he and I were tight. She told me that they thought he'd had a brain aneurysm. They didn't know how severe it was, but he was not conscious. That morning, her teenaged son had heard him fall in the bathroom, and had gone to check on him. He was not breathing. He ran to get their neighbor, who called 911 and then started CPR.

Two days later, he was on a ventilator in an ICU. She asked Neal, who had also been in our training class, and a good friend, and I to come visit him, and to assess him. We drove to the hospital and got to his bedside. He was intubated; he was not breathing on his own. He had not breathed on his own since the aneurysm.

It was weird for Neal and I to be friends and nurses to him at once. We checked for a pupillary response-- none. We talked to his nurse, who explained how they had confirmed that he had no more neural activity. In turn, we explained this to his girlfriend.

It was rough seeing my friend, who was so vibrant, funny and alive, like this.

We discussed what was ahead. Ultimately, his brother was going to make a decision regarding life support. At this point, they were maintaining it so that his organs could be harvested for transplant. There was no chance for a recovery.

A day later, life support was removed. They could not use his heart-- unbeknowest to me, he'd had a heart attack previously-- or his lungs; he was a smoker. But they took his pancreas, his corneas, some other tissue-- and his kidneys. Neal and I were later to remark on the irony, that two people were soon going to get off of dialysis thanks to the kindness of this guy, who made sure that he was an organ donor.

My wife warned me that I had a rough couple of months ahead of me; she knew that he and I were close, and on top of that, my son was about to go off to college. She was right. It was rough. I'd also lost my mother-in-law, whom I adored, and my friend Larry's mother, who was like a second mother to me, a few months before.

It was rough-- I'd come to depend on him at work for advice and just to liven up my day with the in-jokes and such. I'd come to depend on his friendship. I felt like I'd had a huge rug pulled from out under me. But as the weeks wore on, I came to realize that it was a big lesson in enjoying the time you have with people. Despite the fact that we worked like dogs, we still managed to get out and hang together when we could. And I realized that I was lucky to have met him-- it was only a year and a day, but sometimes a year and a day is all we get with someone. 

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