in the past 2 years, she lost over 100 pounds.

the old fashioned way. meaning, she committed to a portion controlled diet, and, she exercised regularly. things were looking up. she felt good about herself, she gained that confidence and self belief that she can do anything if only she puts her heart, body, and soul into it. shedding the excess weight that everybody said threatened her health and her chance in life over all, made her feel secure.

then, out of nowhere, pancreatic cancer. what started as a sudden severe abdominal pain led to the big C. probably the latest stage, with the prospect of death obviously very tangible.

somewhere between the silence and the physical effort of taking in air, even without words, i heard her say that sometimes, life can be really unpredictably unfair. and THAT sucks.

i didn’t say it outloud, but yes, i agreed with her.

it’s like being sober for a year, getting comfortable with the fact that you have done your best to preserve your health and make it better, then being killed in a bizarre car accident that makes no sense.

i totally agreed with her unspoken words. which i’m sure she understood when i stood there in silence, looking at her without anything profound to say.

let me start off by setting it straight that i totally agree with geena.

the money spent in forcing an unwilling alcoholic to detox, is, in my opinion a waste of money. and yes, thousands of dollars would have been spared if there is a clear protocol or policy that states that anybody in the healthcare system does not have the right to impose to a patient the decision of when or how he will battle his addiction.

i have no doubt that the suggested, and what have been done, based on the first comments on the post is a reasonable way to save a lot of money. you know, when a drunk patient comes in for let’s say a broken bone because he tripped over out of extreme drunkeness, fix the bone, give him a few bottles of beer after surgery, then send him home with the teaching that he was lucky to just have a broken bone this time, but if he does not stop opening the bottles, a time will come when he will be harder or impossible to fix. financially, this is the most logical thing to do. i absolutely agree with that statement.

i will not elaborate further on the idea because it will be redundant. what i am going to talk about is MY own feelings about the whole thing.

in the hospital where i work, we do exactly what most hospitals do with alcoholics. we fix the presenting problem, then “impose” the detox. ativan here, librium there, restraints there, prolong the hospital stay here. when i worked in the philippines, i have not encountered this issue maybe because most of the sick alcoholics are never brought to the hospital. what this fact means is that i have never given any patient an alcoholic drink.

the thought now is not that i do not agree with this idea as logical, because i already set it straight that i agree it is very logical. the question is, will i be comfortable in doing it? my problem is, logic doesn’t always synch with my personal comfort zone. if one day, a doctor tells me to give my patient a beer, will i open the bottle, and with a smile, offer it wihtout a second thought?

it didn’t surprise me that my answer to the above question is a  loud, bold, NO. just as i will do everything within my power to convince a patient not to go off the unit to smoke, i will probably go around looking for excuses not to give the alcohol.

at first, i cannot think of any reasonable explanation for this. why would i have inhbitions in doing something that i believe to be logical? i have already concluded that dealing with an addict, whether it is food, cigarette, or alcohol is a complicated situation. i have also established that no matter what kind of teaching, even “threatening” we do, (”yes sir, smoking can affect your sexual capacities”) it will never be up to us to decide what the patient wants to do with his body.

then, i realized something…

the desire to fix other people’s addcition is rooted from a childhood experience. i clearly remember the times when my siblings and i had to drag my dad or brother out of the street in fear that they will be run over or killed because they already looked worse than dead.

i have vivid memories of the pain alcoholism inflicted on me and my loved ones. there have been countless number of times when i wished i can just wave a magic wand and make all the drinks disappear. the idea that “if they don’t see it, they will never dirnk it, then, they’ll be better” have always been there. turns out, it is not just an idea, it is wishful thinking.

you know, just maybe, this patient wants me to intervene, and he just doesn’t have the courage to say it. maybe. maybe if i step up for him, and start the whole detox process even if he didn’t really ask for it, maybe he will come around and commit. maybe.

this is why i have no problems in giving the ativan. this is why i never question the supposed imposition of detox. in my head, even as i stand in front of the patients as their nurse, in my heart, i am still that little girl, terrified that alcohol will take away my dad, my brother, or my aunt. and maybe, i can save them. just maybe. just maybe.

so, i have a lot of questions. as always.

am i the only one having second thoughts in implementing such a simple but logical solution?

those who are uncomfortable in giving their alcoholic patients a drink or two in the name of logic, how do you psyche yourself to do it?

those who are comfortable in doing it, do you ever feel, even in a small way, like an enabler?

the loved ones of alcoholics who are in the hospital for other health issues, what do you think about all this?

those patients who have experienced the “forced” detox protocol, how do you feel about it afterwards?

those patients who were left alone, given a drink to prevent withdrawal, was there ever a time you “wished” the doctors “forced” you to detox?

i’d like to hear your thoughts. any thought. please?
THANKS.

and thanks to geena for bringing this up.
pondering on a saturday morning is always a good thing.

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blogosphere buzz is explained here.

i got a fleece jacket with my name and hospital logo on it. i got a small set of screw drivers. then, at the beginning of the shift, 2 large pizookies were delivered.

that can only mean one thing…

it’s Nurses’ Week!

to all the nurses…enjoy the goodies.

we all know it would have been greater if it was an all expense paid holiday to the bahamas or something. or it would have been better if it was something that will change some frustrating glicth in the systems. instead we got other stuff.

little stuff maybe irrelevant to what you think is the best nurse’s week appreciation gift but  that doesn’t mean we shouldn’t be grateful for the little stuff, right? cheap that i am, i was endlessly smiling while wearing my fancy blue jacket. and even if i am clueless as to where or when i’m going to use the miniature screw drivers, i still placed the kit in the glove compartment.

anyway, have fun!

when i was a kid, i have seen women being possessed by the devil.
they had this freaky aura that gave everybody the chills.
the way they behaved and the stories they told after the supposed episodes scared me to death, i had endless nightmares that i can still vividly picture.

don’t get me wrong. i am no expert in devil possession. what i have seen in my childhood were things unexplained to me by science maybe because science and technology were not really available where we were at that time. it could be that i just accepted everybody’s “devil possession” explanation because i was ignorant and impressionable. or it could be that the old folks were right. obviously, we choose what we believe in, and still, that doesn’t define us.

anyway, the above is some kind of a disclaimer. because yeah, i will totally understand if like my charge nurse last night, you’ll think of me like i have three eyes and say “and you’re telling me you really believe those things May?”

so, enough digressing. last night, i took care of a patient who brought back all those memories of women possessed. i kept quiet about my observations until another nurse pulled me to the side and told me “i don’t think she can be helped here, i think what she needs is an exorcist.”

P is in her early 60s. aside from a common antidepressant she had been taking for awhile now, she was considered healthy. a few weeks ago, she was admitted to a different hospital because of pneumonia. she was apparently better after a few days, so she was sent home with antibiotics and was given some steroids.

a few days after going home, after taking the prescribed meds, she started acting weird. “weird” is really a  light way to say it, because if you ask me, her behavior was beyond weird.

she constantly fiddled with her little stuffed teddy bear. she caressed it with such tenderness, i wasn’t the only one who thought that the whole sight was extremely uncomfortable to watch. she kissed the bear’s mouth and stroked the bear’s supposed crotch with such sensual longing look, it appeared like she was having a  sexual experience.

she alternately stood up, knelt, or laid in bed and continuously made this elaborate, fluid motions with her hands and legs like she was enjoying a moment with an invisible lover. she slept very little and when she happened to focus her gaze on me, she had this creepy, freaky smile that made my skin tingle.

she has not eaten for almost a week now, and have never initiated to go to the restroom. for 12 hours, she had three episodes of being herself and those times were so short, and unpredictable, it just freaked me out more. like at 3 AM, she all of a sudden took the blanket off her face and out of the blue said “i think i’m thirsty, can i have a drink?”

i went out of the room to get her a drink and when i came back, she was kneeling, both her hands raised in the air, her fingers delicately moving like flickering lights, and she stared back at me and the juice i was holding, like i wasn’t there.

in between what appeared to be a practiced dance, she stared at me for 10 minutes straight, clicked her imaginary remote and acted like i was a telivision set. she frequently changed my channel and smiled for a few seconds when she thought the show was nice. or, she moved around like the second hand of a clock and curled into a ball when the whole 360 degrees work was complete.

psych consult notes were not very helpful. if i read it correctly, they were thinking this sudden change of behavior was a reaction to the mixture of medications. in medical terms, “altered mental status secondary to drug reaction”, that’s what they said. she had been off the steroids for four days now, and all it is really, is a waiting game. physically, the tests revealed nothing significant. so, we wait. and wait.

for the meantime, i will sit at the foot of her bed again tonight, let my imagination spook the living daylights out of me, and like a real pro, appear to enjoy her uninhibited exhibitions. i will be a witness to an unplanned, uninterrupted show of orgasmic trance that will go on and on for rest of the night.

i redundantly felt like an opportunistic voyeur. you see, i’m not even supposed to watch her. i stay in the room because of my other patient in the other bed. a schizophrenic who is obssessed with drinking water. when left alone, she will live in the restroom and attempt to drink the water from the faucet, expecting she can drink enough till it runs dry.

i can do psych. i think i really can. so, can somebody tell me again why they ignored my application at the behavioral health?

just wondering out loud really.

_________________________

thanks to awake in rochester, who tagged me with this 6 word memoir. please check her blog for tagging rules, because i’m lazy to always follow the rules. sorry.

anyway, the following words came up at the moment. they are not constant. the irony doesn’t escape me. i have been comfortable in my contradictions so to speak.

thoughtful.
careless.

opinionated.
apathetic.

joyful.
sentimental.

i don’t have anybody specific to tag. if you feel like playing, considered yourself tagged.