December, 2007 Archive

the letter came in the mail. i had to appear in one of the courts in LA for the US citizenship oath taking ceremony a couple of weeks from now.

i was planning to wait till its over before i update you guys. not because this is something that i am trying to keep as a secret, but because i am a bit worried i might jinx it. for all i know, a few days before the ceremony, i might get a letter from the INS saying that the letter i got about the oath taking was a mistake. we’ll never know till it’s over, so i am still praying that everything will be okay.

so yeah, after endless pessimistic nights of waiting, the INS finally decided that i can now put my hand on my chest and pledge allegiance to the flag of the United States of America. your thoughts were highly appreciated. it kept me sane while waiting.

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a delayed apology can be a wasted apology. i decided to let my gut tell me what to do, so i waited till i work with P again. thing is, she never showed up after our little incident. i finally asked one of the charge nurses what happened to her. i found out she was on an indefinite leave because of a family emergency. something about their brand new house having plumbing problems, which flooded their whole house.

i honestly hope she is okay. by the time she shows up at work, i bet you she has forgotten what happened about the unlabeled specimen. i will remember, and yes, i will apologize if my guts happen to tell me that i need to.

like most of you though, everybody at work suggested that i keep quiet about it because i did the right thing. i am keeping your thoughts in my head, i am confident my guts will make me do the right thing. either way, i am at peace whether i end up apologizing or not.

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i worked last sunday, two nights before christmas. she was one of my patients again. the patient who asked me a difficult question.

she was very quiet, so i broke the ice. stupidly, i asked her about her 3 year old daughter. i used to see her in the hallway, or the charge nurse would let her see the patient for 15 minutes at visiting time. she must have had her when she was around 17 or 18.

of course, she started crying. she had a little girl, but she was also a little girl.

“i just want to be home for christmas May. they promised me that they will send me home before that. they told me they were just arranging for somebody to come see me at home to help my family deal with the feeding tube and the trach. they told me they will try to send me home before christmas. i don’t want to be here anymore. i feel like i am in jail, away from everybody else.”

i looked at the grinning picture of her little girl, taped to one of the siderails. i looked at her crying, and the sight broke my heart. there is something about motherhood. it connects you to another mother. we had this unspoken, but comprehensible language.

i didn’t stop her from crying. i told her to hang in there. i told her things take time sometimes.

“i just don’t care anymore you know. i just want to go home and be with my family and my daughter. i don’t care if they don’t find somebody to help me.”

i remember i told her to be a little more patient. i know it sounded shallow and meaningless. i don’t remember if my words comforted her, but i remember hearing her sob louder. i wanted to stay, but i had to leave. mainly because i have to attend to my other patients. and also, because i didn’t want to say something more stupid.

“i just don’t care anymore…”

that’s the last thing she told me that i can tell you. whatever you make out of that scene and that satement, i leave to you. let’s just say that if you are thinkng she sounded like she has given up hope, i will say i agree with you. if you are thinking she sounded like she has come to a point of total acceptance, i will say that i will also agree with you.

once again, this is a reminder of the confusing message of death. it is either final or passing. neither winning nor losing.

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just like any new year’s resolution, whether i change its name to new year plan like i did last year, a selfish plan is doomed to fail. last year, i started with a good plan. i don’t remember if i told you guys that i gained 40 pounds with each pregnancy, but i did. my second/youngest son turned 3 four months ago, and i still have 34 pounds to lose. i just wanted to look hot, and i failed.

if i know how to write a book, i will be able to write at least ten volumes, 700 pages each, of books explaining to the universe:

     1. why it is extremely difficult to lose weight.
     2. why pregnant women should kill every person that tells them this rusty
         but very believable line: “that’s okay honey, you are eating for two”. 
     3. why it should be illegal for patient’s family to give nurses cookies, chocolates, cakes, 
         chips, or ANYTHING that smells and looks like food.
     4. why it is critical that somebody invents a pill that erases lies/thoughts like:
                a. “i deserve to eat more, i was on my feet for 12 hours!”
                b. “i’ll just eat all the cookies, i will start my diet tomorrow anyway.”
                c. ”i don’t care if i’m fat, i am not defined by my weight.”

i could go on and on and on, but there are better things to be done, so i will spare you the boring litany. one good thing about the new year is that it brings us a certain mood of having the power to begin anew. i failed with my new year plan last year, but it doesn’t mean i should stop dreaming. besides, my goal now is to lower my cholesterol. i must admit looking hot can still be an issue, but i swear i should be done with that obsession.

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when i started blogging, my reasons were pretty selfish. free therapy and fun. i have never thought it will go beyond that.

a lot of readers who post comment and share their thoughts here have inspired me to be a better person. some readers, those who do not comment, email me and shared their thoughts about how they were able to relate to a certain story i posted, and felt better. there are even readers who just continuously lurk for whatever reasons, which i hope are positive reasons.

no matter what, i appreciate all of you guys. beyond words. you have no idea how, but you do. THANK YOU! so much. for your interest in my thoughts, and for unselfishly sharing your thoughts.

special thanks to SHANE, the one who manages this site. somebody whose name should be added in the dictionary to define the words very helpful.

a big chunk of thanks go to all the SPONSORS too. thank you!

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let us all welcome the new year with  hopeful hearts! let us enjoy the celebrations, count our blessings and believe the endless possibilities of something good.

HAPPY NEW YEAR TO ALL!

it is very seldom that i refuse to take a patient. very seldom.

i am fidgety and i don’t know what to expect, because i’m sure T’s husband will be all over the unit, following his wife’s nurse around like a hawk follows its prey. i’m sure he will see me, and at some point, he will realize that i am there, but i am not his wife’s nurse. i am not sure if he will go as much as to ask why, but he will never know, and i never intend to tell, in all honesty.

this may sound like a cover up to the fact that i am totally horrible, but i do not have the same energy as when i was younger. therefore, i do not have the patience of the so called saints.

last night, i came in and T was scratching the back of her head, the exact spot where she had the incision from a craniotomy done a month ago. the wound looked completely healed, and it was normal that it will occasionally itch. T’s loving husband, and i say that without any tone of sarcasm, was hovering around her asking her if she was in pain, and if her neck was bothering her. she denied any pain twice. he asked if she was uncomfortable, and she said no for the third time.

T would doze off and her husband would gently tap her shoulder to ask if she was in pain and if her neck was bothering her. this went on and on. and the discomfort moved from head, to neck, to the stomach, to the palate, to the throat…

i was called every five minutes, was told that T was complaining of severe neck pain, and that she was just plain miserable. the minute i get in the room, i will confirm the complaints with T, and automatically, T would deny it. i always value a family’s input about a patient’s complaint, because i acknowledge the fact that they are the ones who know the patients best. i value it more if the patient is confused, mentally delayed, or just not with it to be reliable.

T had episodes of confusion, times when she didn’t know where she was, what the time was, and why she was in the hospital. but, she was always reliable when it came to complaining about her physical discomfort. and i tursted and believe her own words.

it made me extremely uncomfortable that T’s husband and later her daughter, ignored every denial of pain and discomfort she said, and were in my face about not doing anything about everything. i was at a loss at why both of them would put words into my patient’s mouth when she was completely able to speak for herself.

the husband and daughter team finally told me that the only thing that will make them feel better was if we send T for a head CT. in my limited but humble opinion, there was no indication for the CT. i did not say this outloud, but i offered to get the on call doctor to talk to them, so they can request the CT for themselves.

the doctor echoed my thoughts and explained why the patient looked perfectly fine, and did not need a CT. the team was unhappy and they started lashing on all the nurses and techs in our unit, saying, and i quote: “we have met the most horrible nurses in this unit, this is our worst experience with nurses. they do not know how to take care of their patients, and they never take care of my mom/wife.”

what do i say to that statement? nothing. it was hard, but i am proud to say that i remained professional and treated my patient with the care and kindness i believed she deserved despite the negative reactions, comments, remarks made by her husband and daughter.

after their talk with the doctor, the daughter treated me like i was invisible, and the husband was quiet. before he went home at 11 pm, he caught up with me while i was charting. he started apologizing profusely, mainly he said, for “upsetting” me. i told him i was not upset, but i was placed in a position where i felt helpless. i told him i wanted so much to help them, but they were asking for things i cannot possibly do, like overrule the doctor’s decision and go ahead and take the patient down for CT, which of course was ridiculously impossible.

taking care of T was a breeze. making her husband and her daughter happy was beyond my knowledge and skills. in the interest of my sanity, i felt that the right thing to do was to refuse the patient for tonight. i feel a little bit of guilt, but i am confident i made the right decision.

it would be interesting to see them tonight, and it would be painful to watch the next nurse “victim”. i was the latest, and everybody who already experienced the fury of the daughter and encountered the undoable requests of the husband, thought i was so lucky to be spared for the longest time.

that may be true on some levels, but as of now if you ask me, i don’t really feel lucky.
i feel jittery.
i even thought of calling off.

i thought it was a joke. i was thinking other people had too much time in their hands, they actually had the time to have a little creepy kind of fun.

“diagnosis: DEVIL syndrome”

that’s how it looked to me, and the nurse who just got the patient a couple of hours before i came in, had no time to find out what it meant. we both smiled, probably thinking the same thing, that it was some sort of a joke.

it turned out, it was DEVIC syndrome.  i also found out there was nothing funny about this rare diagnosis.

last month, she was living the good life. at 21, her life didn’t suck. then, out of nowhere, she started feeling weak in her legs. she had difficulty of breathing, and was taken to the ED. she stayed in the ICU for a couple of weeks and came to us with a trach, paralyzed from the waist down. her vision was blurry most of the times, she can move a couple of fingers on her left arm, and her right hand was very weak.

it was shift change, her phone was ringing, she was very thirsty, she can’t reach the water. she tried the call light, but didn’t have enough strength to press it. i came in at the time when she was so frustrated and angry, all she could do was cry.

she was oblivious to my apologies and explanation about the shift change scenario, where all incoming and outgoing nurses were busy taking and giving report. she had a major question, and she had to ask it.

“why me?”

i had to place her speaking valve on the trach, because at first, i didn’t really understand what she was mumbling.

“why me?”

oh.
what do i say to a question like that?

“last month i was okay. i mean, i have not done anything bad to other people, i am not mean to them. now, i can’t even get my own water, and i can’t even pick up the phone.”

she went on and on about how it was before, and why does it have to be this way now. she wanted answers. she never said anything about her lupus. maybe because she is at peace with the fact that it is okay for now. maybe because she didn’t really have any major problem about it for years, despite the diagnosis. but now, this devilish syndrome. she wanted to know why, and she reasonably wanted to know “why me?”.

i don’t have any answer, so i held her hands, looked her in the eye and said “i don’t know”.

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who asks “why me?”

the question is obviously directed to some Supreme being. the question is mostly asked to clarify if something tragic is some sort of a punishment. the question is more intense then, if one is consciously aware that he has not done any wrong against another human being. does this question get more intense at christmas time? with all the supposed good tidings and Reason for the season, is it harder to deal with pain when one believes the angels singing “glory to God in the highest…..”

do people who do not believe in God ever ask this question? or they go around INSTANTLY accepting whatever happens, tragic or otherwise, because there is no one responsible for the world? is it easier for those who do not believe in God to deal objectively with suffering? do they ever grapple with unanswerable questions?

do people who believe in God/Jesus actually use their belief as an excuse so they can blame someone? are we some sort of ungrateful, stupid losers who just sit in the corner and say, “well, it’s His call, and He didn’t do it, let’s blame Him”. or are we some bunch of hopeful people who know there are no answers but choose to believe anyway because we know there will eventually be answers?

is believing, or not believing, some kind of a game? if that is the case, how important is winning? if that’s not the case, how irrelevant is losing?

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she wasn’t my patient this week but i went and see her. i was told she can hardly move her right hand anymore. too weak to ask for those oreos she used to dunk in a cup of milk.

i remember how she was so embarassed that i had to change her gown because she spilled all the milk while dunking the oreo. i offered to give her milk and suggested she use the straw instead of drinking straight from the cup. like a little girl, she smiled “i’m sorry, i wasn’t drinking it, i was dunking the cookies”. it was great to see her smile, almost happy.

i stared at her, breathing slowly and evenly. she looked so young, yet she smelled like death. she looked peaceful, but tired. she looked done, but unfinished.

i didn’t wake her up. i don’t know if she is still hoping to know THE answer. i don’t know if the finality of it all, the possibility of her life wasting away, made her stop believing, or strengthened her faith.

i don’t know.
but it doesn’t mean i don’t want to know.

this is what i will never understand about some confused male patients:

how can they not know their name, but know exactly where their female nurse’s breasts are, even when the lights are off?

this is what i will never understand about myself:

how can i see this same thing among confused male patients almost everyday and still get hyped up about how unbelievabe it is.

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for two nights, i ducked and was very successful on the defense. the closest he got his hands into were my hands, and the nastiest he got was when he asked me to sleep with him and made those grossly annoying kissing gestures and sounds.

either i was ready because of the “be careful, he’s a grabber” warning, or it’s just that he didn’t really have anything to grab. either way, it was a good discussion topic among nurses. at least for the past few days that he has been in our unit, we never stopped laughing about it.

i know that sounds odd, because aren’t we supposed to be mad or something?
we do have a twisted sense of humor.

and we also happen to know we cannot do anything about it.
a confused mind that is unaware of everything but sexual preoccupation is still a confused mind.
if it is a game, we lose if we choose to fight.