Reading Lips

Most of my patients can't talk. Some of them can mouth words. They talk to me and talk to me and I can't understand what they're saying. The worst are the people that die. People often wake up right before they die. They catch your hand, look at you for the first time and say something. Their mouths move, but there's no sound. And they need to say it, whatever it is is probably the most important thing they've ever said (Tell Myra I always loved her, even though I married Nancy. All my gold is buried under the McBain Oak, and it's yours, dear Nurse. Who knows?) and it's so absurd. Luck of the draw. They get me. Who can't read lips.
"What?"
"One word at a time. Let me get the word board! Can you point? Hang on! Oh. Oops. Bye."
What an idiot, they probably think, as they lapse back into darkness. Of all the people to get stuck with. And I'm not even going to get to live to fill out the Press Ganey on that one! Darn. Oh, there's the light!
No, I don't know what they think or say, and it's just awful. We are in such isolation, so dependent on externals. Wiz, of course, can always understand what they're saying. In detail. "No, I don't think Oprah's on right now. It's a Sunday. You've been unconscious for about 2 days. " he'll reply. "Your elbow itches? I'll get that for you. Your cast is twisted."
But yesterday, I was taking care of this woman I'd taken care of several months before. She was in a car wreck, then sent to a rehab facility, then returned to us septic, in terrible condition. Her hair matted and dirty--with mold in it, her trach ties reeking and green, yeast under her breasts, pressure ulcers under her braces, starving. Terrible. We were horrified. We had gotten her in such good shape--what had they done? I felt I'd been punched in the stomach when she came in. I took everything off, drenched it in hydrogen peroxide (hydrogen peroxide can solve almost everything--and it's only 80 cents!) She's doing better now, after a week. Most of her hair has fallen out, but we combed it and cut it and put it in little braids on top of her head. Lavished her with care. Sometimes, putting someone right is so satisfying. She wasn't septic, just neglected and starving. Wiz taught me that. I came in to nursing contemptuous of the little things. I liked things that made me think--I liked out diagnosing the doctors. I still like that, but the other stuff is just as important. Maybe more so. People give Wiz a lot of crap. I remember my preceptor saying, after Wiz had made a comment about our patient's fingernails, still dirty after a week in the unit, that if he liked all that nurse tech stuff, he could just do that--save the hassle of being a clinical supervisor. As if it was beneath us.
So anyways, I'm fussing over my patient. She was having a lot of gas. We'd had one ostomy bag explode, and I was burping her new one. She mouths something, and--it was the strangest feeling--I heard her words in my tummy--silent but there--like my own thoughts, but located in a different place in my body--she says, I don't think I can take this any more. And without thinking, I respond. "This is all part of the process, Gretel. You've been starving. Your gut is waking up."
They were so mean to me there. Will I have to go back?
"No. You don't have to go back."
It was the strangest thing.
I remember when Spanish finally clicked for me. I had really been trying to learn Spanish, since everyone speaks it in Miami, with very little success. I listened to Spanish radio all the time and I was driving home from work, listening to Radio Ritmo! and an advertisement came on. I never understood the ads, but all the sudden, I found myself musing "That's a really good price on pillows! And we need new towels." It was an ad for Bed, Bath & Beyond and I'd understood it without even realizing it. Language is only one part of communication, I think. Listening is getting your ego, your overactive "I'll figure this out!" part of you out the way and being present with where you are. Letting go of your own story.
It's a zen task, I think. You have to give over to the other person to really understand what they're saying.
Life can be full of awakenings, can't it?
That's my 1/2 hour.

How Not to Eat Dinner

I have more than a cold. I have pneumonia.

It finally sort of let up yesterday, but I still have a fever. I've been out of commission for a good six days at least. Amazing. I haven't been this sick in years.

I feel a little better today, but still as if I've been hit by the truck. My breath has this dry raspy feeling, this heaviness. I can't taste anything very well or smell, either. I keep forgetting things.

I've spent the whole week with doctors.

Lilly's doctor on Monday. She lost weight. I argued with the doctor about it. The number she had was different than the number on the scale. I didn't want to get the nurse in trouble, but it had been written down wrong. Still and all, even though the number was wrong, Lilly had still lost weight.

I don't like Lilly's doctor.

In the office, Lilly confessed that she'd been lying to me, and she hadn't been eating what she said she had. I felt stomped. So much for the Gilmore girls.

I feel like these people are trying to drive a wedge between Lilly and me.

"Have you been eating?" They ask her.

"Not always." Lilly tells her, not looking at me.

I'm exhausted. The pneumonia, school, the job, Lilly, the boyfriend, Nick into college. He got into the state university, not a sure thing, given his GPA. He's not really excited about staying in town, but, oh, well!

Lilly and I met with the therapist that afternoon.

"Have you been fighting about food?" She asked us.

We've only had one fight about food, but it was a doozy. "No," Lilly and I start to say, then "well..."

Tell me about it, the therapist says in her gentle voice.

Lilly begins: "Well, I was making myself dinner, because Mom was sick, and I was taking too long, so Mom thought I wasn't doing it and she got mad. But I wasn't trying to keep from eating dinner."

"So your mom misunderstood?"

"Yeah."

"Is that what happened, Mom?" the therapist asks me.

Here's what happened.

At 6 pm, I was flat on the couch. Fever, coughing up a lung, etc. "You need to get yourself dinner," I told Lilly.

The refrigerator is full of food. It was Thanksgiving, after all. We have 1/2 a turkey, ham, sweet potatoes, mashed potatoes, vegetables, squash soup...dinner is not an issue. Cooked. Ready to heat up and go.

"I don't want any of this,"Lilly declares. "I want to have that egg and tuna salad Amanda makes." She calls Amanda. Amanda isn't there, so she leaves a message.

"Amanda, I'm getting ready to eat dinner and I want to make your egg and tuna salad. Could you call me back with the recipe, please?"

1/2 hour later. The phone rings. It's Amanda. They talk for awhile. Around 7, Lilly calls out, "Mom, do we have relish?" A list of other ingredients follows. Tartar sauce. Mustard powder.
"Look in the fridge," I tell her. I highly doubt we have tartar sauce.
"Mom, are you too sick to go to the grocery store."
Is she kidding? I'm too sick to walk to the bathroom. She asks her brother.
"No," Nick says, not taking his eyes off his video game. "I'm not taking you to the store for relish."
"But the dinner won't be any good without relish."
She decides she can do it without relish. I hear the sound of water being brought to a boil.
She keeps taking to Amanda. An hour goes by.
"Lilly," I shout out hoarsely, "have you made your sandwich?"
I get up and stagger in to the kitchen. "What's this, Lilly? Why is the egg still boiling?"
She puts her hand over the mouthpiece of the phone. "The other egg wasn't the right consistency. I had to do it again."
"How long has this egg been boiling?" I croak.
"Not long enough. Mom, I'm on the phone."
Another 15 minutes goes by. The egg is still boiling merrily.
"Lilly, you need to make yourself dinner."
"I am, Mom," she snarls.
"Ok. Tone. Off the phone."
"You've got to be kidding."
"Now.'
She rolls her eyes. "Sorry, Amanda. My mom wants me to get off the phone."
2 hours and 37 minutes after I first told Lilly to get herself something to eat, Lilly has finally managed to prepare herself an egg and tuna salad sandwich. Then I have to nag her about the fruit.
"I don't have to eat a piece of fruit at dinner!" she tells me. We've had the same diet for 2 weeks.
Mental illness is so fucking fun.
"You're the mom," the therapist says. "You can tell her when she needs to eat."
"I was going to eat." Lilly says, sulkily.
"I know that." I say.
Duh. 2 and a half hours of Lilly not eating.
Her father is this way, too. "I'm doing it, " he'll maintain--whatever it is you ask him to do. And then he'll delay and delay and delay--creating more and more and more rules about how to do it and when to do it. Preparing to prepare to prepare. It's psychotic. "Well, for organizational purposes, I want all the checks I write for the kids to end in '2', so I couldn't send the orthodontist money until the new checks arrived--and we'd switched banks." That sort of thing. The way to avoid having mentallly ill children is not to marry anyone mentally ill, I've decided. But the mentally ill are usually so charming and good in bed! So what do you do?
Oh, well. Too late now. I guess I'm stuck with her.
That's my 1/2 hour.

Home Sick

Okay.

What gives? I'm still sick.

I got a little better by last Monday, had a pretty good Tuesday, started feeling bad again Wednesday, floated through Thursday, woke up Friday, thought "Oh, no, I'm still sick! I can't call in again." Went to work. Got sent home by Wiz at 1500.

"You're going home at 1500." He tells me.

"I don't need to. My voice sounds a lot worse than I feel. It's just laryngitis."

"The float is coming at 1500. I'll be in MRI. Give report and go."

It is good to have someone who knows you well. I really needed to go home. I felt like hell. But I would never have requested to go home. The only way to get me out of there was to arrange for my replacement and pack me up and out.

I went home. Lilly wanted to go to a movie. I thought, "what's the harm? I'm on call, officially, not sick." So we went to see Happy Go Lucky. Lilly liked it a lot, but I didn't. For some reason, I walked out sad. I thought the driving instructor was way too disturbing. It's funny, because I've had almost the same exchange with someone in my life. Angry, screaming, offended by my good humor. I've had the same strange conversations with street people.

I had so much fun being YOUNG ME, I am always surprised at how much I do not want Lilly to be anything at all like YOUNG ME. "You know," I tell Lilly, "after she saw him stalking her apartment, she should never have gone in the car with him after that."
"I know, Mom."
"And you know, you must never get some place lonely with a homeless person, like she does. Never."
"I know, Mom."
All those walks at 3am on Mary Street in Coconut Grove or on the South Side of Chicago, or under bridges, or through steam tunnels, deserted churches, the lovely mystic wild lonely parts of cities. Singing sea shanties at the top of my lungs.
But maybe, by being this careful, I've starved Lilly, somehow. Maybe she needs to get wild to get a little fatter?
What was great about the movie is that it really reinforced for both of us what we already knew, that we create our own reality. Here's Lilly, starving herself in the midst of plenty--what sort of artificial reality is that? The world is really what you make it. It can be a trap, filled with rules and games, or a playground. I mean, for the average, middle class person living in a country not being plagued by war or famine. I.e. For us.

Here's my secret strange worry. Have you ever read any of the books by Carlos Castaneda? There's this teaching by Don Juan that humans are these egg-shaped energy fields, but that the people who have had children have a hole in the middle. Carlos goes back, reconnects with his daughter, and steals his energy back.

But I always wonder--how could you do that to your kid? And sometimes I wonder if I've accidentally done that to mine. I mean, I look so young and I have so much energy (well, not today) and the music and the writing--maybe I'm not supposed to have this much? Maybe Lilly is starving herself because I've somehow, psychically taken something essential from her?

That's my 1/2 hour

An Exemplary Day

I'm sick. My sinuses are completely full and I have a fever. I was at work til 2130 last night. My head feels like a nasty magic trick, like it's bigger on the inside than outside. I look in the mirror, and the swelling has actually filled in a crease or two, my eyes are all puffy. How can those two little ethmoid sinuses filling up make you feel like nothing will ever be okay again?

On top of that, it's cold. Freezing. And I hate the cold. I had to wear long underwear beneath my scrubs.

My parents are going nuts. They are showing up at the house at early in the morning and late at night, and leaving up to ten messages a day on both phones. Nothing messages, but full of bile. "Did you know that Lilly is going to a party at Diddle's? Did you know that?" My mother says, in one. They both leave long messages that take up the entire message space. If a guy was doing that to you, you'd get a restraining order. The subtext is "your kids suck and so do you." I can't describe to you how unpleasant and really mean spirited my mother is. I try to tell people about it, and they're kind of dismissive. Then they meet her and they understand. She's told Lilly that she's evil and has no heart and will never marry because boys will sense that. She told me the same thing. She once accused me (at 13) of having "something going on" with my father. She takes every experience and emotion you relate to her and coats it with grime. Talking to her is like "eating a dirt sandwich. You want to rinse your mouth and heart out afterwards.

"We never talk," she complains.

That's right!

So, I have a terrible day yesterday. Lilly lies about breakfast and I catch her. So I have to go to her school and make sure she eats her snack, which is humiliating for both of us. I was called off in the morning, but get called in by the rude staffing clerk who has a way of treating nurses as if we're call girls. At work yesterday. I have a patient covered with gorgeous tattoos of skulls and demons and pentacles with a lot of skull fractures and asked the RT, who's just this doofus, to help me bring him up in bed, and he slams his head into the headboard. In front of the family.

The fiance, who's already unfriendly because a pastor walked in unannounced and "why didn't I know about it?" goes screaming to the hospitality people, my manager, the house mom, and my supervisor.

Fortunately, as my manager tells me, when I go in to tell her about the incident, "she thinks your name is Julie."

And it wasn't my fault. It was that horrible RT's fault.

Then I get a trauma, who's just a mess. And takes up all my time and energy for the rest of the afternoon.

"Exemplary day." Wiz says to me at the end of the shift. "You had an exemplary day."

"It didn't feel that way."

"That's just your ego talking. Fucking you. Brain and body. The big fight" He says, nodding cryptically.

On my way out the car, my phone rings. The hospital is under construction, so we have to park far away, about a 20 minute walk. There's a shuttle, but it doesn't run at night and it's always slow. I have to trudge out late, in the dark, past the dead unblinking black eyes of the new half-constructed structures, the chain link fences, the piles of building materials, pipes, bricks, gravel. The phone rings, and pick it up, and it's my mother. Yellling at me about Lillly. "Why didn't you tell us she was going to a party?"
"Because she doesn't need your help getting there or getting home with it."
"Did you know she's going to a movie too? Did you know that?"
I'm climbing up a gravel incline to get to the level of the lot where my car is. Since I'm angry at my mother and not watching where I'm going, I slip and fall, scraping my knees right through my layers and twisting my finger.
"God damn it," I yell into the phone, losing my cool. "Quit calling me. Quit leaving messages over every god damn thing. Quit showing up at 6 am. Just stop it. I'm not talking to you. I don't have to listen to this." I hung up. Reached the saab, all by itself except for an SUV with steamed windows and its motor running about 4 spaces down.

I throw my phone and my coffee cup and purse into the back seat of the car. There's a ticket on the car.

A ticket! In this freezing lot they charge me to park in--a half mile away from the hospital in a construction lot. And the fucking powers that be had the gall to give me a ticket. Some stupid workstudy officious little college student wandering around with his pad. What's happened to all the young people, man? Why have they all turned into such nazis? What have we done wrong?

I kick the car. Then I apologize to it. Not Elka's fault.

A window rolls down on the SUV. Santeria by Sublime, blares out. A young blonde woman sticks her head out.

"Dude." She says, "you look like you are having a bad night. Want to smoke a bowl with us?" Her friend, dark haired, leans over. Both are smiling, pretty long haired girls. Girls like I was. I would have done that, at that age.

I walk over to the car.

"Come one," they urge. "Climb in. It's good shit."

My bad mood disappates. I shake my head. Smile. "No, thanks, though. There's no way I can sit in the parking lot where I work getting baked. With the kind of day I've had, I'll just bring the murphy karma right in on you."

"Yeah, dude," the blonde girl says, nodding her head. "I get you. Well, have a good night! Feel better."

And I don't. But I do, too.

That's my 1/2 hour.

Anorexia Nervosa

In big block letters, on Lilly's lab requisitions, the ones we had to take from the Dr's office to the lab. Dx: ANOREXIA NERVOSA

I mentioned before that Lilly's been losing a lot of weight. We went to the eating disorder specialist yesterday.

There are no magazines in the waiting room. Only that wretched upstart, Paloma Life, which is meant to be a social magazine (about Paloma!) and mostly features the stretched, chicken-skinned faces of doctors wives standing next to each other in pic after pic. There are also stacks and stacks of Neurology Today, incongruously. I have no idea why they have them. I'm a little frustrated by this, until I think, Oh, yeah, it's an eating disorder specialist. Not good to have pics of skinny models and celebs lying around.

They give me a "why you're here" sheet to fill out, which I hand immediately to Lilly. She checks off "Eating disorder/weight loss" without hesitation and hands it back to me. We don't talk. She stares right ahead. Her eyes are so huge. They look like agates.

They take us back. Get a blind weight on Lilly. 111.7 pounds. "And how are you related?" The nurse asks me, "friend? Sister?"

"Mom!" Lilly says.

"You look so young!" The nurse says, then leaves.

"We're so sick," Lilly says, after the door closes. "If we were really psycho, we'd be like, 'yay! Lilly, you've made it! You're finally skinny enough to have to go to the hospital! You go girl! And my mom looks like a teenager! Screw this psychological health shit. We win! We win!"
We start giggling, which confuses the medical student sent to do Lilly's intake.

The student is good. Slight. Indian. Mature and respectful. We like her. The doctor knocks on the door in the middle of the interview. "I'm interrupting. I'm taking over," she says, and sits down.

"She was doing really well," I offer.

"Yes, but this is very serious. I was just reviewing her chart."

Well, duh. That's why we're here.

"So, Lilly," she begins. "Why do you think you're here?"

"Well," Lilly says, and I can tell she's going into her beautiful mature interview mode. "I think I need to establish a better balance between eating and activity."

Lilly should become a campaign manager. She has spin down.

"Do you want me to leave?" I ask.

"Do you want your mom to leave?" The doctor asks.

"No. I won't tell you anything I don't tell my mom."

The interview unfolds. Lilly, for the most part, has a handle on the problem, but it's interesting to see the blind spots. For example, Lilly tells the doctor that she eats all her food. Which she never does. Ever. I interrupt to point this out.

"Yes I do."

"What about last night?"

"I ate all my pasta last night."

"No you didn't, remember? We were going to band practice and you got up to look for a CD, and then we were late, and you only ate a mouthful and threw the rest away."

"I ate it when you weren't looking."

"I don't think so..."

The doctor interrupts. "You need to trust yourself on this one, Mom."

"Ok," Lilly shrugs. "maybe I forgot."

Lilly's heart rate is 55. "she's a runner..." I offer. "I'm a runner, too."The doctor has Lilly lie down. "I'm going to leave the room. Let you rest. If your heart rate after resting a bit is below 50, I'm going to have to admit you."

So Lilly lies down. I sit next to her holding her hand. We talk quietly. Mostly jokes. I look at Lilly, and suddenly see her. I see how terrible she really looks. Skeletal.

"So this is a big deal?" Lilly says..

"Yeah."

The doctor comes back. Heart rate is 50.

"Ok, I'm not hospitalizing you. But if you haven't gained weight by next week, I am. "

We meet with a dietitian then, get labs drawn. Lilly takes the sheet, plans out all her meals for the next 4 days on a grid. Then makes a shopping list.

That's my 1/2 hour.

How to get a Minor a Passport

Shu Jo Mu Hen Sei Gan Do

Bon No Mu Jin Sei Gan Dan

Ho Mon Mu Ryo Sei Gan Gakku

Butsu Do Mu Jo Sei Gan Jo

Infinite are all beings, I vow to save them.

Infinite are all attachments, I vow to be free of them.

Infinite are all Dharmas, I vow to master them.

Infinite is the Buddha Way, I vow to attain it.

We went to get Lilly's passport today. It was Wacky Day at school. Lilly wore mismatching socks, athletic shorts over neon pink fishnet tights, my big grey cable motheaten cashmere sweater, and a plastic replica of the Time Turner from Harry Potter. She told me this was a hit with the sixth grade boys, who all wanted to play with it. Last night, while I was working on my paper, we'd somehow found the time to dye Lilly's hair red. So she had red hair again, too.

I didn't really think about all this until we were standing in line at the post office, waiting to have her pic taken.

The big bald guy with the big ears was at the counter. He's kind of loud and bossy. "Do you have an i.d.?"

"We have a birth certificate."

"You need an i.d."

"She's 16. She doesn't have an i.d."

"She has a school i.d., doesn't she?"

"She goes to a private school. They don't have school i.d.'s" What's with all this i.d. crap, anyways, for minors? I mean, isn't this in the constitution?

I produce the notarized letter from her father, allowing her to go out of the country. "We don't need that," he tells me.

Last time I was here, he had told me I did. But I didn't argue. Don't argue with officials. Yes sir, no sir. Get through the line.

"I have an i.d." Lilly pipes up. "It's in the bottom of my locker."

"You do?" I ask, incredulous. I want to kick her. Another lesson is that whatever your mother says, never contradict her. Didn't she watch The Godfather? That sort of thing is what got James Caan shot.

"It's ok. You don't really need one," he informs us. "It's just a good idea to have one. Ok. Let's go over and take your picture."

We head over to the other side of the counter, where the camera is. On the way over, I see someone I know. Phillip Lundqvist. Phillip was the weirdest, wildest, sexiest, most interesting guy in our high school. He became a curator for the Guggenheim. He had beautiful lush curly brown hair and he drove a jeep. He was my best friend, Heather's boyfriend. We never really did anything to betray Heather, but every day after school, my mother would drop me off downtown and go back to work, and I would just wander for 3 or 4 hours until she got off work. And somehow, Phillip and I started running into each other. And then, somehow, we started meeting on the corner of 9th and Cherry every day and going for ice cream. Then we would take off in his jeep with our ice cream at 90 miles an hour out into the country and drive like maniacs on the dirt roads through the fields in the county until it was time for me to be picked up. We hardly ever talked. Lots of crazy laughing, though. And he never kissed me or anything. Or even touched me. But we never told anyone we did this.

So there he was. Lots of thick curly grey hair and wrinkles. But the same eyes. Wearing overalls and a slicker. He looked like he'd been through hell.

He told me his mother had died, and that he'd quit work to take care of her when he was dying and now he was busy wrapping up the estate, selling the farm, etc. He told me none of his seven brothers and sisters had pitched in.

Then the bald guy came over. "Are you done filling out the form?"

"No," I said. "I'm talking. I'm sorry."

"Well, I have to go on break."

"Oh, I'm sorry."

He goes.

A short black woman with a prominent scar on her face that looks exactly like a dog bite, teeth marks and all. I hand her our documents.

"Where's her i.d."

"He said we didn't need one."

"You need one."

"But he said we didn't."

The bald guy comes back over. "I told her she doesn't need one. It's just for their convenience. She's a minor."

"Ok." the woman says.

He leaves.

"Ok then," I say, handing her the documents.

"You need to get an id."

"But he just said...."

"I didn't."

"But he just said that I didn't need one, I'm just going by what he said. Why didn't you say something?"

She gets really nasty. "Because I don't INTERRUPT YOU WANT ME TO INTERRUPT? THAT OK WITH YOU? NOW YOU GO GET AN I.D. I'M THE PASSPORT CLERK AND IF I SAY YOU NEED AN ID THAN YOU GO GET ONE."

I don't know what to say. I take a deep breath. Lilly sucks in her breath and we both stare at the woman, who stares back.

"Ok." I say. "Will a school i.d. be okay?"

"State. Drivers permit or state i.d."

We leave, meekly.

"Oh, my God," Lilly says. "I can't believe that just happened."

I'm shaking. "Did I do ok? Did I act mad?"

"No. " Lilly says, "you did great."

We head out to the drivers testing building, way North of town. It's in one of those buildings they put up in the 70's without windows. It's across the street from a Krispy Kreme, a Korean grocery store, and a trailer park. When we were on food stamps, we used to go to this building. Lilly goes in, starts taking the test. The older woman at the desk leans into me.

"Does she have trouble with her 's's?" She asks.

"I'm sorry?"

She repeats herself. "Does she have trouble with her s's? I always had so much trouble making the s sound."

I look at the woman more closely and realize she has a cleft. Repaired. But I can see the faint tracing of a scar. We start talking to each other like long lost relatives. She's so nice and kind. I tell her all about Lilly. It turns out she's from Miami, too, and went to high school at the school where my grandfather was a guidance counselor in the late forties. She tells me about her pretty mother, how they moved around as her mother went from man to man. It's a sad childhood, but things worked out. She's been married 51 years and has a daughter, lived all over the world

Lilly fails the test. Twice. We head off to the DOR to get a state i.d. But I feel like I've made a friend.

We go back to the post office.

I steel myself to deal with the mean dog bite woman.

She arrives at the counter cheerful as a lark.

"You got it?"

I hand it to her.

"that'll do. You go to a private school?" She asks Lilly.

"Paloma Independent." Lilly says.

"I sent mine to Catholic school."

"We thought about that for Lilly," I say. "but they stop at 8th grade here."

"Yes," Dog Bite nods, "then you have to ship them to Daviston for the high school there."

We talk about the public schools. She tells me about her daughter, how she wants to be a nurse (how did she find out I'm a nurse, I wonder?). She gets everything done, stamped, signed. Gives me a receipt.

"I'm so sorry about that earlier," she whispers, grabbing the counter.

And I got to say. "Sorry about what? No worries!"

"That worked out well, " Lilly muses, as we walk back to the car.

That's my 1/2 hour, and then some

Anniversary

Today's my wedding anniversary.

Small death? Derailment? Salvation? I have not decided. I have no idea whether my marriage was a mistake or not.

One of the benefits (or detriments?) of my practice is I don't really see things as mistakes.

I ran away in the middle of the night with my husband. I had only known him six weeks and had only dated him for three. We were having a fight. We had slept together once and then he had dropped me. I had run into him at a party. I poured a beer on his head and I guess he thought, "this is the girl for me!"

He had just finished doing his laundry. He took the laundry basket filled with clean clothes and put it into the back seat of my Chevy Impala filled with 1/2 empty packs of packs of unfiltered camels (I was trying to quit--don't ask about my strategy--even I'm not sure what it was). We headed south. I think the reason I did something so crazy is because I was nicotine deprived and losing my mind.

So now I have Nick and Lilly and a crazy ex-husband.

I've been at the library all day, doing a "health promotion paper" on the dangers of cell phone use. There aren't too many, but they aren't completely harmless. So, as with anything magical, use it carefully. That's really a good rule. Things that are too magical always exact a price--love, birth control, cars, x-rays. Think about the stories. If some new technology virtually confers upon you magical powers, it's bad for you somehow.

I called my crazy ex husband yesterday. I'm taking Lilly to an eating disorder specialist Thursday. She just hit 112 lbs. Her hip bones stick out like conch shells and her periods have stopped "I think I'm getting a little weird about food." She says in this off-hand way. I found myself spilling all this to this nurse I work with, not someone I particularly respect or am close to. He's kind of sloppy--not really as a nurse, but personally. Doesn't shave, scrubs always rumpled and sort of dirty looking. Looks like he's always rolled out of bed. Doesn't look like he showers very much. Now I know why. It's strange the way you always know the right people to talk to about things. It was at the end of my shift and he was taking over. "I'm going home to watch my daughter not eat dinner," I said as a joke. Then the whole thing just came lurching out.

"We're going through the same thing with Wanda." He tells me. "She's institutionalized right now. We can't handle it at home. " He and I swap crazy eating stories about our daughters. We start laughing. The stories are so similar.

"This will rip your home apart," he warns. "An anorexic ends up controlling every single person in the house. We have five kids, but we only have one, if you know what I mean."

5 kids. One severley disturbed. No wonder he looks like he just rolled out of bed.

Just like an alcoholic, I suppose. The craziest person wins.

"Get on it early. We kept ignoring it, trying to make it go away." He gave me the number for his doctor. Then he called me the next day to make sure I called. I wanted to cry.

At dinner last night I watched Lilly do anything except eat. Twirl the pasta, move it around her plate, get up, search for CD's. I realized, when does she actually eat? Ever?

I've done this to her. I never remember to eat. I'll go for two days sometimes, when I'm by myself. Always have done this. I don't have an appetite. Only for sweet things. Then I'll be sort of cranky and tired and wondering why everyone is so stupid and insensitive--then I'll think, oh, yeah, I haven't eaten in two days. I mean, I am totally disconnected from my gut in this respect.

So I called her dad, because I thought he'd like to know. Being her dad and all. He's so deranged. "Well, I've been telling her--she's been after 3% body fat--but I've been telling her that's unreasonable. Girls aren't supposed to have 3% body fat. I've been telling her she needs to eat."
"She exercises constantly." I tell him.
"She did that all summer. Hours on the treadmill every day."
I want to ask him why he didn't stop her when she started exercising all the time over the summer. Why he left her alone in the house all the time. He's so charismatic, such a powerful personality. Talking to him, I am once again swept up into his story, even though I know it's not accurate. I find myself in the same conversational pattern, wanting to please him, agree with him. I came to be so afraid of him. It kicks in, briefly. I know how to please maniacs.
I hang up.
Return to myself. Whatever that is. Return to quiet. My own lack of noise. Take a deep breath.
I realize that the reason I am still alone is because I am afraid of that happening again, of becoming so subsumed by someone else's personality that I lose myself.
That's my 1/2 hour.

Small Death

Jay got back last night from New York. Not til midnight. I screwed around all day, then went to my friend Luz's bachelorette party.

It's amazing how I never feel uncomfortable socially any more. Ever. I don't always have the best time, but I never feel awkward. It's not like I've stopped making faux pas (if anything, they've increased). I just don't care. I slip up, see the glances get exchanged and think, "Oops. Oh, well." Then I move on.

I love Luz. She's thirty-three. Cuban. How did she get to be thirty-three? One day at a time, I guess. I was only a few years older when I started nursing school. We were in school together. Beautiful girl. Woman. She has a hard time keeping friends because she has a pretty serious drinking problem which everyone knows about and no one knows about, if you know what I mean.

But she's met this guy, a fireman. And they're getting married. His sister threw the party, and it was one of those events where no one knows each other very well, and no one really knows Luz very well. The sister had invited her own friends as "filler". They were all very nice. Just like butter. Uncomplicated, pretty young county women, professionals. The sister-in-law is a civil engineer, as were all of her friends. Dressed conservatively. Jeans, turtleneck Luz's "friends" were all nurses. And they were dressed to party. Sequins, 4 inch heels, lots of eye make-up. Luz and I, incidentally, dressed the same, but in reverse: she wore a black and white print dress with a black cardigan, I wore a black dress with a black and white print cardigan. Funny. Not too sexy. There was a little too much talk at the table about nursing stuff. But what can you do? We were there 5 hours. You have to talk about something.

Everyone was very nice, but stilted. Luz kept getting up through the course of the evening and going outside to smoke by herself, so there were lots of quiet moments. I sat next to my friend Lisa's new best friend (she picks up best friends like she does men), and thought, maybe this is how I should have presented myself in life--blonde, straightened hair, skinny, lots of make-up, --I mean, mysterious, feminine and "done"--social worker, dating one of our young plastic surgeons. Woman, woman, woman. The kind of girl that makes men confused and weak in the knees.

I'm too furry and friendly, I decided, sitting next to her, silently through our conversation. I'm drawn by Roz Chast. She by Patrick Nagel. No one has ever been weak in the knees over me.

Oh, well. What are you going to do? Too late now.

5 hours in, I dipped. Went home. No word from Jay, which irritated me. Napped on the couch. Finally, I called him. "I'm almost home," he says, "but I have a flat tire, so I have to stop. Listen, could you drop by the grocery store on your way out and buy some wood?"

I'm pretty much still asleep, and for some reason, this request really annoys me. I mean, I've gone out there every god damn day, played with the dog, fed the cars, sorted the mail, deposited the checks and paid the bills--why at 11:30 at night do I have to go to the grocery store?
"Yeah, sure." I say, but my peevishness must have come through, because he calls me right back.
"Listen, don't worry about the wood. We've got wood. I just didn't want to haul it in."
I must have done what Wiz refers to as "the exhale of impending doom." ("Right through your nose, just a short little puff. The only way I can tell when you're pissed. Then I know we're all in trouble."
But I go anyways, because I remember the cats need food.
I have the sense he's lied to me about something recently. That squishy nauseated feeling, but I don't know what it is. And I'm not excavating. Lies grow. It'll pop up.
This morning, we're sitting on the couch drinking coffee, and he says, out of nowhere. "I'm truer than you think I am."
Bingo.
I don't say anything. Just drink my coffee.
Then. "What do you think I think about you?"
"I think you think I come on to all these other women, and I don't. I'm only attracted to you. You're the only woman I want to be with."
I sip my coffee. Amazing the way things come up. "I don't question your fidelity. I don't think you always tell me the truth."
He nods. "That's true."
Christ. What an infant. "Any whoppers lately?" I ask.
He hazards a joke. "Well, instead of going to Bath, I really stayed home and made love to strange women. I just made this whole job up" Which isn't funny. Because last year he did make a whole job up and stayed home so Hali could spend the weekend out at his place to wean Elena.
What do I do? I want to let this go, but I'm chilled to the bone. Not funny. I just keep quiet and send him nice energy. Squeeze his hand.
"No, " he says, "no whoppers lately."
The thing with men is that if you pounce on them, they will make their bad behavior your fault. They will make their guilt your fault. Not just men. Everybody. Watch what you know about people. Watch what you let show.
I thought about Gordon Wolfe, the bringer of small deaths. Here's another one.
That's my 1/2 hour.

How to Waste a Morning

I need to get to work. I took the day off today with the idea that I would spend it doing homework, but instead, all I've been able to do is lie on the couch in my flannel nighty (square necked snowflake pattern c no buttons--I hate buttons--from the Vermont Country Store Catalog) reading the New Yorker and googling information about Santa Muerte.
I read a Charles de Lint story this morning (I've been useless, I tell you) called Small Deaths. I really like Charles de Lint, but sometimes his writing leaves me with sort of a headache--like I've eaten too much cheap candy. Like Edmund eating the witch's turkish delight. Some of his stories are wonderful, and I love the urban American psyche he excavates for material. There is a lot of magic in the streets, white and black. And reading him, sometimes, that part of me that ran away in Atlanta wakes up and wants to go walking again, following my nose through the alleys. But sometimes....
Well, in this story, a well-dressed man comes up to a woman in a cafe. She thinks he's hitting on her and rebuffs him. He warns her, "don't mock me, for I am the bringer of the small death" or something like that. Then the idea doesn't really develop. But what an idea.
Santa Muerte is thought to be associated with Oya, the santeria goddess of wind, storms, change. Oya is the mistress of Chango. There's a really funny Cuban song about Chango--how this American tourist thinks an altar to Chango is a buffet, eats the fruit offering and really pisses the god off. I used to hear it all the time in Miami. In fact, laughing out loud at that song one night while I was driving in the car by myself to boxing match in Hialeah was my first indication that I was finally understanding spanish. Reading about Santa Muerte made me want to hear that song, so I went to www.playlist.com and looked for it. I didn't find it, but I did find this great group called King Chango and another one called the Brooklyn Artists. I put their songs on speaker, cha-cha'd around the living room a little while. Thought about Miami. Thought about Xavier. Santa Muerte. Chango. Both love and shelter prisoners. I hope he is all right.
I've had my dance with Santa Muerte myself, recently, as a handmaiden. Always, but this particular go round really has taken it out of me.
I hope I am not like that tourist, taking the offerings, eating the food, but not understanding their meaning. Not understanding or anticipating what I am invoking. I am afraid that many times and in many situations, I do not know what to take seriously and what to leave lie. Buddha touches the ground to withstand Mara. But it is also root his heart to the earth, I think.
Random musings. I'm going to go sit now. Lilly's at the mall.
That's my 1/2 hour.

Storm Crows

Waiting for the bank to open. I can't find my roll of quarters. I've parked in my usual spot by the library, but I don't want to get another ticket. No money! I'm already close to my budget limit and it's only 6 days into the month.

It's just going to get worse. Nick hit a car yesterday in the parking lot at Gerbes. He called me. "Mom, I just hit a car."
"Are you okay?"
"The guy's really nice. He says he thinks it'll only cost $2,000."
"Was he driving?"
"No, he was coming out of the liquor store."
"Nick, give him our phone number and the insurance information and get out of there."
"But he's being really nice..."
"Did he call the police?"
"No! He was so nice, Mom, he refused to let me call the police. He said it just wasn't that big a deal."
"Ok. That's nice. Just do what I say."
The kids get home.
"I think you're not being fair to this guy," Nick says, as I dial the phone. "He was really nice."
I call the number Nick's handed me. A man answers. Young voice. 30's? 40's? "Oh, Hi!" he says, I can hear ice rattling in a cup. He's clearly drunk. "Your kids are so sweet."
"Thank you. I'm so sorry about this..."
"No worries...listen, if you want to keep insurance out of this, I'll just take the car to the shop, get an estimate, I know all about insurance..."
I bet you do, I think. No wonder he didn't want Nick to call the cops. Either that or there's a warrant out.
"Listen--I'm semi retired, so I don't get going til 1 or 2 in the afternoon sometimes, can I call you then and we can talk about this some more?"
"That's fine."
"You've got some sweet kids, there."
"Thank you. Thank you for being so kind. Nick was really rattled."
Big sigh. "Oh, I could see that, honey. I could. I remember being a teenager, runnin into stuff."
I feel immensely irritated with Nick. Nothing gets me hotter than seeing my children's naivete. Like lambs to the slaughter. Nick especially. He often misses what I can see so clearly. Here's a chance for practice, I remind myself, as I feel the rage rising. But, you know, sometimes when you expect the best out of someone, that is what you get--even if that is not who they are. People really respond to non-judgment. And people who are basically good, even if they're a little screwy, respond to trust. Maybe not in the long term. But in the short term. For example, you might not be able to trust them with a blank check, but you could trust them with a twenty.
Sat yesterday. I am so happy I found my sangha. I need sangha. I need community. While I sat, I tried to focus on my breath, with the usual indifferent success, and I also tried to think of everyone in the room with me. Not block them out, but be there with them. Breathe together. Seido, that old crow, looks like he's been through a hurricane. Robes tattered around his ankles. I wondered what happened. I walk back with him to his office, helped to carry one of the bags of zafus, prattling on about umbrellas. The sun is almost down, and the wind is blowing with the scent of storm on it. As we walk across the plaza, people stare at us a bit--the robes, I realize. I hardly think twice about them.
"You doing okay?" I ask. We're not close. Occasional bouts of confessional conversations over rum tonics in his basement when I was the only one there and he couldn't face sitting, but always with this weird, strangers-on-a-train formality.
"I'm restless," he tells me. "I feel like something's missing. I feel a void. I don't know what my next step is. I'm thinking about moving to Mount Baldi permanently. Becoming a resident monk. Or staying here. Buying a house. Turning it into a zendo. They're some people who would fund it."
I just nod. I don't know what to say. I think that Seido's void would be filled if he rolled his sleeves up and really got dirty. But maybe not. My solution isn't everyone's. I think going to Mount Baldi is probably the wrong thing for him to do. But what do I know? I can't even remember when to bow, and I've been doing this crap for 26 years now. 26 years! Almost every damn day.
His office is in the old law school. I know the building well. My mother went to law school for a year and a half. She is was in the first class that admitted women. She would take me with her (I was three) and she would sit in the far left corner of the classroom and I would hide under the table (they all sat at these long tables) and color. I was absolutely quiet. Hours. (Jesus, my kids would have NEVER behaved that well--shows how terrified I was of my mother). She flunked out. It was a different time then, and it wasn't okay for the wife to let the dishes pile up while she studied. Too much pressure.
I tell Seido a little bit about this. We go up to his office, which is painted the same color as my bedroom, periwinkle. And filled with books and his paintings and a nice old chintz couch. Great place.
"You should live here." I tell him.
"I do. I take naps on the couch."
Naps. Seido lives in a world where naps are possible. What is he complaining about? He starts to take off his zen gear, I say goodnight and go.
That's my 1/2 hour.

Chinese Food

Well, we have a new president.

I hope this means what I think it does.

It's a beautiful day, here. Now I have to get down to business and focus on my coursework. Last night was a lost cause, of course. Jay drove to the airport in the city--2 hours on the road in his radio-less Saab. Ancient Saabs seem to be the vehicle of choice for the genteel liberal poor--have you noticed this? And none of them have radios. Or, they do have radios, but the shady people we purchase them from don't know the code to turn them on. So I had to call him every 15 minutes with updates: "McCain won Kentucky."
"Shit!"
Yesterday was also my online class chat. One of my classmates, whom I met last week during mandatory on-site clinicals, informed me and the rest of the class that I had correctly diagnosed her ear infection. I think if I could just find the time to focus on it, that I might actually be pretty good at this stuff. Last week was just a lost cause. I had too much on my plate. Nick's Tulane application had to be in and we were just crazy getting all the last minute stuff wrapped up. My father is helping, but he's also hindering, too. Some times he calls or comes by 6 or 7 times a day. Hopefully this week will be better, but I don't see how.
Lilly announced that she is going to be an opera singer. She's scheduled herself for Tanglewood auditions in Chicago and has announced she is going to take piano lessons. Lilly just sets off, arranges things, and sends me the bill. Nick requires a lot more pushing. He's like me--always asking for permission.
We should all be like Lilly. Except for the weight. Lilly's losing too much weight. She suggested Chinese on Monday night, before her band practice (Lilly started a funk band. They already have two gigs coming up. They're really good.) We went to our favorite Chinese restaurant, Kai Min, which is on the second floor of one of the old buildings downtown, across the hall from the community radio station. It's been there forever, and seems to have fallen on hard times recently (they served us on paper plates shaped like footballs) We were the only people there except for two overweight pimply college girls, sitting in a booth by the window. As far as I could tell, the girls weren't talking to each other. The only people running the place seemed to be Chinese teenagers, not the usual owners. No one spoke English. The radio was playing syruppy pop tunes. About 3/4 of the way through the meal, one of the college girls started singing along with the radio (Fergie and the Black Eyed Peas) at the top of her lungs in a strong clear voice, "I hope you know, I hope you knooooowwwwww......that this has nothing to do with you...."
She kept going. Lilly and I stared at each other. Spoons frozen above our egg drop soup. I had hoped that the chinese food would make Lilly want to eat (all that MSG), but she only ate 1/2 of her soup and a crab rangoon, packing up the rest. Well, I thought, at least we'll have dinner tomorrow.
When Lilly was five, and Kai Min was a little classier, we were eating dinner there and our local rock promoter and club owner was in eating dinner with Chrissie Hynde, who was playing a show at the Blue Note that night. She was dressed entirely in black vinyl and had all her eye makeup on. Lilly kept staring at her throughout dinner. At that time in her life, I was letting Lilly dress however she wanted to. I had this theory that it would create confidence and artistic daring and help her deal with whatever flack came her way regarding her cleft. Lilly was attracted to shiny stuff (she wore nothing but glittering ruby red slippers for almost 3 years) and sort of adapted cheap club wear that would trail on the ground. Lame dresses that she would belt with scarves, that sort of thing. This went over okay at the Montessori school she attended in Miami, but in Paloma, we were working on toning her down, and it was a bit of a process.
Lilly kept asking "Who is that beautiful lady?" Finally, in the middle of dinner, Lilly got up from the table, clacked over to Hynde in her ruby slippers and stood at the end of the table.
I was a little worried, because I'd heard stories about how mean Hynde can be to fans (squeezing Kim Deal's breast--remember that story?). Lilly didn't know who she was.
"Hello," Hynde said. "How are you?"
"Hello," Lilly said reverentially. "I just love your outfit."
"Thank you very much."
Lilly smiled and came back to our table.
Ah. Soul Mates always know each other.

That's my 1/2 hour.

Voting

I voted today, of course.

Jay woke me up early this morning. He was so excited. He wanted to be the first person at the polls. Dork.

"Wake up! We have to go vote!"

I started to get up. It was pitch black outside. The stars were shining, the hill and the pond sloping away. The sweet incense like smell of the leaves blowing in. It's very warm here. We had slept with the windows open. Then I looked at the clock. 4:30 am.

I don't love either Jay or Barack that much.

"It's 4:30 am."

"Oh, sorry."

We couldn't go back to sleep, so made love instead. Then fell asleep after.

At 6:18 sharp, I was awakened by the sound of gunfire. Lots of it.

"What's that?"

"Duck hunting season started. They have a precise time they can start shooting. First light. Changes every day."

Maybe a little grey yellow light was breaking over the hills. It almost looked imaginary. "It sounds like we're being attacked." The gunfire continued.

"Christ, how many of them are out there?"

Jay got up, made coffee. He's going to upstate New York today for 5 days, then to Alberta, Idaho, and some place else. He was going to go to Canada last week to film a duck hunting special for Bass Pro, but for some reason, the ducks blew it off. No ducks. Maybe they're getting organized--getting the word out.

Heck, if a black man can get himself elected of this country, it would not surprise me one bit if the ducks were getting wise to the hunters.

I'll miss Jay, but it's good that he's going, because I'm really behind on my classwork.

It's funny, but I haven't even thought about race during this campaign. I wonder if most people still do. I was reading a blog called "The Root" this morning--I'll post the link--and it framed this election in racial terms, which surprised me. "Yeah," I thought, "I guess they have a point." But I never thought one of the key things about Obama was his race. It was always considered impolite in my family to notice and comment on things like race and ethnicity--although my mother often did--comments utterly ignored by my grandmother and father. It fell into the same category as finances. Whether you were accepted or not ostensibly should depend on your charm and character, and not your background, race, or finances, good or bad.

Then I went to Dartmouth. And one of my housemates, Eileen Brown, said something to me that I'll remember the rest of my life. I had just made the idiotic comment that I didn't really notice whether people were white or black (I was nineteen, okay?). And she said, "If you're really my friend, you had better damn well notice I'm black. Because being black involves a lot of stuff that you'd better be mad about and worried about if you really are my friend."

I drove into town. I passed the Little Dixie county fire, the polling place by Jay's. Packed. Pick-up trucks pulled over on the side of the road a quarter mile down. I've never seen the polling places so crowded.

I vote at Unity church, which everyone who doesn't know me very well thinks I should attend. I like voting days, because I get to see all the funny little people who live in my just-hanging-on-by-our-bitten-fingernails-to-middle-class (whewww) neighborhood I have to wait in line to show my i.d. I think about being grumpy and complaining that this is unconstitutional, but the little old lady is so kind and excited as she checks my address, I can't muster up the meanness. She's wearing a lavender pantsuit, with embroidered violets on the lapels. A bent little Nigerian man with a name that takes up almost his entire nametag (his wife, equally bent is standing beside the ballot box in a bright head scarf) explains in great detail to me how I am to fill in the circles next to the candidates of my choice. They've changed pen brands for this election (thick, sharpie magic markers were used in the past), and the pens they've supplied us with have much thinner tips, so the poll workers are very anxious that we get this right. (Paloma never has problems with votes being messed up, let me tell you. The city of OCD.)

I complete my ballot. It does take longer with the new pens. Give it to the Nigerian lady.

"Sticker! You must have a sticker!" She calls after me, runs up, hands me an "I voted" sticker. "and you're taking the pen." So I am. I sheepishly hand it back to her. Then I walk outside the church. An older woman I don't know in sweeping scarves is walking towards me. "You look so beautiful!" she tells me, beaming. "What beautiful colors you're wearing." I hadn't noticed, but I guess they are--wine and amber and brown courdouroy tree of life skirt, green suede jacket, plum pashmina.

"thank you. Have a good day!"

"I am, oh, I am." she says, beaming.

A man is several feet behind her. "Good morning," he says, smiling.

"Good morning!" I reply.

"It's going to be a beautiful afternoon." He says. He stops on the walk. He is in his late 50's, neatly, cheaply dressed. Khakis, blue and white striped shirt. Hair needs a trim. I've never seen him before in my life "It's going to be a good day tomorrow, too, I think."

"I think." I say. "I hope."

"I hope."

We look at each other. He has tears in his eyes. I pat his hand. He nods, gives my hand a squeeze, and goes inside the church.

Oh, man. I hope.

That's my 1/2 hour.

Where the dead go

Oh--weird stuff on our floor.

The mean winds are blowing through, I think.

Last week was hell. After last week I didn't know why I was still doing this. I am getting tired.
The OR called mid-day. "We have a patient. We need a bed right away."
"We don't have a bed," I tell the OR nurse.
"Well, what are we supposed to do with this patient?"
"You're ACLS trained," I say. "I'm sure you'll figure out something."
SI was full. All 18 beds taken. We hastily arranged for one of ours to go to the floor--even though he probably shouldn't have. He was in traction and I was worried about compartment syndrome. Initially, I argued them into stepdown, but no beds were available. So he went to 5.
He was in traction, and the beds on the floor and in the ICU's are different. The overhead frame doesn't fit. So getting him from bed to bed is a little harder than normal. This takes some time.
Then the room has to be cleaned. Both in our unit and on the floor. 5 is finally ready for report, and I'm calling it when the phone rings again.
"Is that bed ready?"
"No. I'm calling report."
"When is the bed ready?"
"45 minutes."
"45 minutes!"
"Yes. We have a patient in it. A critically ill patient is in the room. Then the room has to be cleaned. It will be about 45 minutes."
I hang up. Go back to giving report to the 5 west nurse.
Our unit clerk comes over. He's short, clean, gay. A biochemist. Great clerk. Smart.
"The OR's on the phone. They say they're reporting us to the patient safety network. Do you want to talk to her?"
"Tell her to fuck off."
"I can't do that."
"which line?"
I get on the phone. She's hung up.
The doors burst open. The OR nurse comes steaming through.
"Why isn't that room ready?"
"Don't you ever threaten my clerk again. We don't have rooms instantly ready. Why can't you take care of this patient in the OR?"
"The patient is very unstable." she says.
"Then the OR is the perfect place for her."
"We need the room now!"
She starts ordering my staff around. Our staff being who they are, don't comply.
"Don't order my staff around. You're being completely inappropriate."
"What can I do to make this happen faster?"
"I still don't understand why you can't handle this in the OR. What's the big mystery?"
She said nothing. Kept her badge turned around.
Finally, the patient's out of the room, the room is cleaned by housekeeping, and it's ready. I call the OR.
45 minutes later, the patient rolls through the door.
The anesthesiologist is pushing something as she comes through.
"What are you pushing?" I ask.
"Epi." He stutters.
And then I understand. The patient is already dead. But they didn't want to handle the death in the OR.
I check for pulses. Nothing.
"No pulses."
"No," the anesthesiology resident sort of stammers, "no pulses. You won't feel any. She hasn't had any throughout surgery."
Fran, who's walked over to help, says, "I thought that was called pulseless electrical activity."
"Code! Call a code! "
Every thing happens at once. We slap pads on her, spill open the drug box--no pulse, some strange reading--a number, might mean something, might not. The dance begins. She's pale, yellow, not alive.
"Call my attending," the resident says.
The attending appears as if by magic, calls for a thoracotomy tray, opens her up, squeezes her heart in the rhythm it will not do on its own. "We need blood. I can't do this without blood"
But there's no blood ready.
"Why isn't there blood ready?" Our attending asks--he's fairly new. McGowan. I like him most of the time.
"No one told us she needed blood. We had no idea she was in this kind of shape."
Blood takes 23 agonizing minutes. I call down. Blood bank is irritated, rushed. Wiz runs for it. We start pouring it into her--but nothing. The fluid warmer breaks down in the middle of the code. At one point, Wiz will tell me later, there are 27 people in the room. I have no idea. The only thing I can see are my hands. Wiz will tell me later the code lasted 53 minutes. I feel like I'm moving through jello. Wiz will tell me that we look like kittens being drowned in a stock tank.
McGowan finally calls it.
I go with McGowan to talk to the family.

The mother twists away from me as I lead her back to the room. I try to prepare her a little for what she will see. "She looks very different.."I begin.

"Of course she looks different." Her mother says harshly. "She's dead."

I feel like a creep.

Marcy and Ileana and Fran help, silently. This phrase comes into my mind "the women wash the bodies" what is that from? Is that a poem? Ileana helps me afterwards. We bathe her. After the family has visited, Ileana helps me put her body in a bag. As we turn her, we notice a lac in her flank. Blood spurts out. A lot of blood. Cups and cups.
"Renal artery?" Ileana guesses. "Did they miss that?"
Wiz is strangely silent throughout all this.
McGowan wanders back in, for whatever reason. I'm sitting at the computer. Things have settled down.
Wiz scoots one of the stools in the pods over.
"Sad day." he says to both of us.
McGowan concurs, nodding his big head.
Wiz continues. "I just wanted to touch base with you--see what you thought could have gone better during the code."
"Well,"McGowan said, "we need to be able to get blood up here faster when we need it."
"You think we could have saved her if we had blood right there?" I ask.
McGowan shrugs. "Maybe."
"Well," Wiz says, his voice so polite and kind, I give him a sharp look. What's up? "It was good of you to get here so fast."
McGowan gives this strange little grimace and shrug.
"Enjoy it." Wiz says, now nasty.
What has happened? I look from one to the other. McGowan gets up and walks out of the unit.
Wiz looks at me, shakes his little fuzzy carp head.
"He was the surgeon."
I feel really stupid. Nauseated.
"She was dead when she came through the door. He just didn't want her dying technically on him. Then it's not his statistic."


That's my 1/2 hour

What if?

Obama's coming tonight.

I had to park way down on Broadway, by the old railway station, across from 2nd Baptist to get to yoga. Every parking space was taken by 5:30 pm. I cut through the alley for a few blocks, padding across the bricks on my disintegrating eccos, carrying my yoga pants. The sun was setting. The whole town bathed in golden light. The old Bell South building lit up like the temple of Solomon, amber against the clear blue sky. It's warm this evening. People were drifting South along the streets towards campus. All sorts of people. There's this happy feeling in town--it feels quiet but charged. It feels like Easter morning, only a little more carnival.

After yoga, the sun had set, but the feeling in town was the same. Everyone I saw smiled at me and I smiled back. I got some ice cream (chocolate orange sorbet) and went across to the Dakota, called Jay from the house phone.

"I just called you." He said.

"I figured."

"Are you downtown? I feel one hundred years old. We were shooting in the woods all day--three miles in three miles back--boom jib camera all on my back. I don't know whether I'm cut out for this."

"Are you going to go to the rally?"

"No...that whole crowd thing..."

"Me either."

His phone went dead then and he hung up.

I went home. Lilly and I watched The Office. I went back to working on my research proposal.
Then, Lilly suddenly said, "I want to go."

"Go where?"

"To see Obama. I want to go."

I looked at her. Shrugged. "Okay. Let's go."

All the sudden she was on fire to leave, nagging us. "Come on. Hurry. "

"Jesus, Lilly."

Nick dropped us off. We started walking toward campus, getting caught up in the flow, the crowd, going faster and faster. I called Jay. "We decided to go."

He laughed. "Me, too!" I could hear the crowd over the phone. "I'm here, too! You won't be able to find me--but I'm here, too."

But we did find him. That's the funny thing about Jay and I. We always make the same decisions--turn right, turn left. We instinctually follow the same path. Jay took turns lifting Lilly and I up on his shoulders, and I could see Obama--far away.

It was a nice crowd. Easily 50,000 people. Everyone polite. Everyone happy. Good feeling. I hope he wins.

The thing is, though, with Obama, I always expect him to say something else. I don't know what it is. But somehow, I don't get what I expect. It doesn't move me. Maybe I'm cynical, maybe I'm tired. But the words don't roll. The words don't ring. Just about--but they never go over the top. Almost...almost...

Well, we'll see. I hope he wins. I hope he keeps his promises.

We need a lot. We need so much.

I want this to be the country of the kind. I want the hungry fed. I want there to be dignity for the poor. I want us to be reasonable. I want the hate to disappear. I want things to be...real again. I'm tired of turning on the television and seeing these fake lives. I'm tired of our aspirations centering on material gain instead of ideals. I want there to be earnest young men running around college campuses again. Where are all the earnest young men?

I don't know. I want change, but I'm afraid to even hope for it. Something in me has copped to the fact that politically, I don't count. That the best I can do is duck and cover, and scrape out some small place for me and mine.

What if things were fair again? What if that was the expectation? What if the poor weren't villified? What if? What if? What if one out of three people didn't get cancer? What if our sick were cared for? What if we woke up again to the conviction that if we wanted to, we could make a difference? What if we didn't have the inner certainty the cards were stacked against us from the beginning?

Interesting.

That's my 1/2 hour.

That's my 1/2 hour.

My 42nd Birthday

It was my birthday yesterday. I got sick.

I dropped Lilly off at her school, did my accounts. Every day, I look at how much I have to spend and how far I am in the hole. I am about 1200 in the hole this month. I had a bill from the university I wasn't expecting, and Elka had to get repaired.
"Next time, " Stavros says, "please to bring me the car for the roof before the rain storm!" $435. Brakes, windshield wipers, and roof. I was okay driving it without the wipers and brakes, but you gotta have the roof working in Little Dixie in October. It rains all the time.
I was doing pretty well until that bill. But, guess what! I had enough in savings to pay for it! It didn't go on a card--so I consider that a small victory.
I watch Lilly walk into the school--it's an old red brick building downtown. She's getting too thin. She has almost straight A's this quarter--the first time ever in her life. Hard classes, too. AP European history, Latin...but she just keeps losing weight. Every time I go back to school, Lilly falls apart in some way. It's this constant gnawing worry. No lightness possible. I watch her walk up the stairs, jeans hanging off her. Then I pullout into traffic. My parents wanted to take me to breakfast at Ernie's. I don't really have the time to go--I have to work on my research proposal and really need the time--but, I think. It's my birthday and having breakfast with my aging parents is more important in the universal scheme of things than going to the library and working on my research proposal.

As I pull into the left-hand turn lane, a pick-up truck turning right across the street from me by Senior Hall slams on its brakes, and a bicyclist goes down under the wheels. She hits her head on the bumper and sort of rolls and twists in a forward tumble onto the street.

"Shit," I think.

I start to get out of the car right there, but then think about all the other people in back of me. I drive over instead, pulling onto the sidewalk and get out, running to where she's fallen.

"Call 911" I tell the stricken driver. (Just like in the training video!) Then I make her lie down and stablize her neck. She's completely coherent. "I knew that." she tells me. "I knew I should do that. I'm a physical therapists. I know you!" Her pulse is racing, but not too fast. She doesn't appear to have any injuries. I put my jacket under her and put another coat over her and wait for the calvary to arrive.

"Don't move," I tell her.

The fire truck arrives and the paramedics get out. I get out of the way. This bald guy in carhart overalls kneels over her and places his hands on either side of her head. Then the ambulance from Crockett County Hospital--our nemesis--arrives and this sort of fat, middle-aged guy gets ou.
"Stand up." He tells her.

"Don't you think you should put a collar on her, first?" I ask politely.

"Ma'am," the bald guy says to me, "please leave this to the professionals. We know when she needs a collar."

She needed a collar. Right away. C2 fractures can destablize--look okay--then, crack, hi! You're a quadraplegic!

But I'm not going to get into it. I gather my coats and leave before they can get my name or interview me. I've done my duty.

But I'm angry. I call my unit educator. Tell her the scenario. "She needed a collar, right?"

"Of course she needed a collar."

Crocket County Paramedics. Bunch of morons. Horrible hospital. There was a van wreck 3 years ago--18 illegal Guatemalans. Crockett's ambulances were first on the scene. Took them to Crockett first, before ours, Crockett turned them away. Refused to even triage. Some of the victims were level 3's, could have been easily treated at Crockett--we lost precious, precious time, sifting through them, transporting them across town--a woman died, bled out. If we'd gotten her in time? If Crockett had done their job instead of practicing wallet triage...no legal risk, right? They were only illegal aliens. How on earth do you call yourself a nurse and do that? How do you wake up and look at yourself in the mirror?

Then I get to Ernie's. My parents aren't there. But my friend Alice (Alice the doctor who hung up her MD pretty much and now communes with plants) is. With a handpainted table cloth.
"Figured you'd be here on your birthday."
We wait for my parents. I finally call. They forgot. I'm their only child!
"No worries--" truel. Actually, I'm relieved. I didn't have time for a long horrible breakfast at Ernie's, smiling at my mother's snipes.
But they arrive anyways.
My mother launches into it right away. "It's just ridiculous that you're encouraging Nick to apply to all these colleges. What is he going to be? A history teacher? He should go to community college. You can't afford it. He'll never be able to afford it. This whole thing is stupid."

The tirade continues through breakfast. My mom. The mean fairy.

Alice excuses herself. She gives me a hug. "I love you like a sister, " she whispers, "I don't know how you ended up okay."

I don't react, eat my breakfast. My stomach hurts. Kiss everyone goodbye. Go to the library.

Xavier's best friend, Saul, has tracked me down, I find. He's emailed me a picture of himself, taken on a train in China. Golden fields behind him. I look at the picture and so much comes rushing back. Like a ghost wind over grass. Saul. Creaky and dear. Prematurely grey. Cuban. Jewish. We both loved Xavier equally. In a way, we were more partners than Xavier and I ever. United in our caretaking. 10 years since I've seen him. Oh, there was so much that I loved in Miami and left behind.

"How are you? Happy birthday."

Nick calls me. He's skipping school to take me to lunch. No studying today! What do you do? I go to lunch with Nick at Nino's. We get the soup.

I decide not to go to the library. I go to the Dakota instead. Lilly calls me and informs me she's going to hang out downtown with her friends. Okay.

The Dakota's internet doesn't work, so I walk over to the Pear Street Bohemia--another coffee shop--a little more upscale than the Dakota---leather couches, fake fireplaces. That sort of thing. There's only one table with an outlet. I plant myself there, and immediately, the guy at the next table starts hitting on me. This used car salesman type. I mean, he won't stop talking. God. I try all these sort of polite ways to shut him down. Finally, I text Jay to come over. He does. Pick-up over. But so is studying.

Lilly comes by the Bohemia, we go home and go for a run together. She literally runs circles around me, but I make about three miles--pretty good for not running for 2 weeks.

Nick is working on his college essay for Tulane. He's blocking it.

I have a date with Jay. He's made dinner, but I can't eat anything. He gives me this beautifual card with nice loving things written inside. I don't understand why he can write "I love you" but can't say it. Oh well. You take what you get. He gave me a silver and white turquoise bracelet, nestled in desert sage and lavender that he picked in the Nevada wilderness. I'm definitely running a fever at this point, but find it in me to make love anyways. Funny how that works. Saul pops into my mind, briefly, right afterward. I send a blessing. I never feel guilty about things like that. The subconscious is exactly that...sub.

At 3 am I wake up, head pounding. Mouth dry. Feverish. I call into work. Sleep in. Too sick to even drink coffee.

It's grey and cold. Now I'm home. Lilly is doing situps. Postal Service is playing.

42. That's what I did on my birthday. And that's my 1/2 hour.

Homecoming

Nick is back from Tulane. He went there with his grandfather. I think they had a good time. They took a streetcar to Bourbon street and had alligator sandwiches. But he's not talking too much about it. I think the whole college application thing makes him very nervous.
My friends say it's good that he feels secure enough to go away. I'm not sure how we'll pay for it. He got a 31 on the ACT, which is enough for him to get a full scholarship to our state university, so that may be it.
I've never been to New Orleans. I feel really terrible that my dad is the one taking him on college trips instead of me. I shouldn't have gone back to grad school. It's too much. 8 weeks ago I was really happy, feeling like I'd bet on all the right horses. Now I'm a mess. Lilly got her braces off, and dropped 8 more pounds. Her periods have stopped.
"Lilly's too thin," my mother says on the phone tonight, stating the obvious. "I took her out to eat and she only had a peanut butter sandwich."
My mother is having trouble with Nick growing up, too.
Both of my folks retired this year, and they're going crazy. They paved over their entire front yard with decorative bricks. They also put up a gazebo, decorated with party lights and artificial autumn leaves. Then they turned their attention on me.
My mom showed up at my house at 6 am on Friday.
"What are you doing here, Mom?"
"I'm going to sit with Lilly."
"Lilly's sixteen."
"You're putting Lilly in danger. You shouldn't be working weekends."
I finally convinced her to go, but not before she'd made me late to work.
I told my friend Ileana about it at work. I knew Ileana in Miami and she remembers me vaguely--which is just fine with me. My days as a club rat were fine, but nothing I really want showing up in my life here. She probably feels the same way. Except for the cafe con leches, we don't talk much about Miami at all.
"Just love her," Ileana tells me. "My mother just died. Heart attack. I'd just been on the phone with her."
How much more Ileana can take, I don't know.
She has four children under 6. Her husband is sick. I think he's dying. She won't tell me what he has. I'm guessing AIDS. No income. She took a paper route. She gets up at 2 in the morning on the weekends and takes the kids with her to deliver papers. She just had a miscarriage. Everytime it seems like they've hit the bottom, the bottom drops out.
"What do we do?" Wiz asks me.
"Did you know about the paper route? That's why she's late all the time."
"Oh, Christ."
He doesn't tell the House Mom when she's late. We just cover until she gets here.
We've got a troubled crew. Lots of single mothers. Marcy's kid's in rehab, Sara drives an hour to get here, is in grad school full time, has two little kids, and is going through a divorce. Phoebe's boyfriend is a quadraplegic, and an asshole. She's having an affair with Baggins. Anne(the one who hid my cup)'s husband has cancer, they think. They don't really know. Carmen just lost her second pregnancy.
I'm amazed at how cheerful and resourceful everyone remains. How we can all still smile and give. The people I work with are nicer than I am. They're better and faster and kinder. I'm really lucky.

My mom showed up again this morning.
I didn't say anything. Just a nice hello. I kept putting on my makeup.
She left after about 15 minutes. "I'll come back and take her out to breakfast." She tells me.

I don't know...
That's my 1/2 hour

Sangha

I think I wrote already about my disappearing Sangha.

Not that I was the most diligent member.

Zazen was usually held at 7am or 5:30pm, and if you're a single mom, it's sort of hard to explain to your kids they will have to find an alternate way to school so you can go sit. So I would go when my kids were out of town, but then I started seeing Jay and staying out at the farm when they were away, and, when it really came down to it, I didn't want to crawl out of his warm arms and drive 25 minutes to the zendo, not when sleeping there is so rare.

Oh, sometimes my heart just aches for a normal life and another adult to curl up with.

So, my visits became even rarer. And the last time I went, there was a sign on the door. "Final practice will be May 31 at 7am."

It was June 16th. So I called. No answer. And sent an email. No answer. Then, in Little Dixie fashion, I sent a nice little card through the mail. "Hope all is well." No answer.

What had happened?

The house is on the way to Lilly's best friend's house. So I drive by it frequently. A "for sale" sign appeared.

It's strange, you know, because I almost never went. I usually get up at 5am and sit in the peace room in my basement, or, now that Nick has started sleeping there, I sit on the bijar in front of my bed. I light my incense, sound the bell, but in my heart, I am somehow connected with both New Moon Dharma Zendo and Hokukuan. I sit in both those places, too. And with no Hokukuan, somehow, my practice felt very lonely. And a little crazy. I felt a little bit marooned.

So while I was at the library, I started trolling through the campus calendar, looking for other buddhists. College students are always into buddhism, right? And sure enough! There was a campus buddhist association. Met Wednesday afternoons. It didn't say whether it was Zen or not, but I went anyways. I got there early, sat on a bench outside the room, waiting.

And then I heard people coming up the stairs, I heard Seido's warm Boston voice and with his alcoholic "heh heh" I've always thought he was a bit of an ass, a little arrogant, a little lost. Tarred and feathered with that East coast snobbery that judges before it even knows what it's looking at. And I was so happy to see him.

He looks a little frayed. He's grown himself a little beard and let his hair grow in. He doesn't look as crazy, but he looks a little sad. His eyes are bright and black and have that bemused look my burn patients have when they come back to visit. He looks like he's been through something.

"Are you okay?" I ask him, after we get through our pleasantries.

"I'm okay, I guess." He says, with the 'heh heh'

Afterwards, he walks out with his students. With his cape. A cape! The best of us are fools.

He had a great image in the talk he gave today--that we're only looking at the world through our experience--like using a vanity mirror, holding it front of our faces so we could interact with others, but only peripherally, while keeping our eye on ourselves at all time.

So true. I'm guilty of this. Me who started sitting because I thought it would keep me from getting wrinkles (it has). I try to offset this with service, so at least I'm not doing any harm, but this blog is like that--it's a vanity mirror.

Oh, man. What do you do? Who ever knows anyone? Who ever knows you? I love him anyways, that he is still doing this, keeping this going, sharing himself and his teaching. I sat today and felt I'd accidentally made it home.

That's my 1/2 hour.

Mormons

It's late and I should really go to bed. Lilly and I spent 3 hours tonight shopping for a homecoming dress. It's really hard to find a dress in this town. There are only about 6 stores that carry dresses. Lilly got invited at the last minute by her friend, Milton Hollingsford, otherwise known as Hollingsford. For years I didn't know his first name. Hollingsford is the youngest son in a big Mormon family here in town. Apparently all the boys are called by their last names by their friends, so when you call the house, according to Lilly, it can get confusing.
Hollingsford is in love with another girl, Lilly told me. "Why don't you go with the girl you really like?" she asked him. "Don't be an idiot, Hollingsford. Take the girl you like."
He got pissy. "It's complicated, Lilly. Just be my friend and go with me, okay?"
Whatever. Hollingsford just left St. Xavier's to go to public school this year, and has done nothing but hang out at St. Xavier's. We don't think he likes his new school very much.
He used to be sort of dorky--the kind of kid who would show up at parties and spend all his time in the kitchen talking to me--not that I mind that--but then he learned how to play base, grew six inches, got his braces off, and took care of his acne. From my ancient perspective, I would say that Hollingsford now qualifies as Very Handsome.
"Oh, yuck, gross." Lilly says, when I mention this to her. "He's mormon."
I don't really see what this has to do with anything. All religious systems are equally insane. So what if he's mormon. He can still be handsome. I tell her so.
"Oh, I don't know," she says in this new petulant tone she's developed this fall. "They're all so toothy and do-right."
Okay, toothy and do-right was a big turn-off to me at sixteen. At forty-one it's interesting. I know there's a lot of buzz about the religion, but honestly, I like every mormon I've ever met. Good family values. Nice. Easy to talk to. They all seem emotionally stable.
One of our residents is mormon. One morning he said, out of the blue, "I've been thinking about you, Haley. What you need is a nice husband. Your life would be a lot easier if you were married. You're such a nice person. You should get married."
"Why, that's a great idea!" I said brightly. "I never thought of that. I'll start looking right this minute."
"Come to my church. We'll get you married off." He said.
I bet.
But you know, it kind of hit me in a soft spot. I know he was being kind. I didn't have the heart to tell him about the zen.
In the world, I'm mostly even and friendly. I'm sort of nondescript, too, but I'm pretty and clean with shiny, honey-colored hair and short clean nails. At first glance I do seem like I would be a great wife. I'm funny, and I listen really well, and I'm generally pretty good at smoothing over conflicts.
But anyone who knows me for awhile eventually realizes that I'm all twisted and lonely and tortured, etc. I'm Virginia Wolf without the talent, and too self-centered to ever put rocks in my pockets and float out from shore. Or...sink. Who will ever get close to this voluntarily? Not a soul.
It's okay. It is what it is. I do what I can. I try to make myself my own partner. I wish I'd pick up my god damn socks. I look at myself in the mirror. No sags or bags. No wrinkles. But some fine lines, all the sudden. Like the ghost of a web around my eyes. It'll go, the prettiness, eventually. It has too, right? And then I won't have any cover. Scary.
That's my 1/2 hour. I'm going to smear renova all over my face now.

Growing Pains

It's crazy time for me.

I'm back in grad school, Nick is on a college trip with his grandfather. He's going to visit Sewanee. One of my favorite people at church went to Sewanee. George Holleran. He's a retired history teacher. He has a daughter that looks and talks like Gracie Allen. He has a wife who is one of the most beautiful fat women I have ever seen in my life. She radiates purity and goodness. I don't know how else to put this. Her skin is translucent and she has short grey curly hair and when I see her I always feel like the world isn't so bad after all.

When I was putting myself through nursing school, I worked as math grader for standardized tests. George had fought a winning battle with terminal liver cancer (ha! they were wrong!), had quit his job as a history teacher at a local boarding school, and was grading tests with me. It was a great job. Everyone I worked with was really smart, but they were all screwy in some way. Some of them were leftist activists who were trying to support their ummm...activities, some were bored housewives, some were students, some were retired, some were zen monks, some were working on their novels...an eclectic, smart bunch. Multi-racial, multi-aged. Since there was no hope for promotion, there were no politics. We were all there only because we were all smart. When there are no politics, no one is careful about what they say, and the lunchtime discussions would get pretty heated and interesting. It was interesting! It was like being in my freshman dorm in college again. I brought a badminton set and set that up in the empty field behind the warehouse where we all worked, and we would play that, too, and yell at each other. That's where I heard all about Sewanee and decided it might do for Nick.

Maybe if we're all poverty stricken, our national conversations will get liberated. Maybe that's a good thing.

So he and my dad set off yesterday. I got a call at Lilly's tennis match (she won--don't ask me how. Lilly plays tennis like the ball has just appeared like a magical object in front of her--Poof! Look! A fairy! Boink!) My mom showed up and watched her. "She looks exactly like Jackie Kennedy in her tennis whites--that is until she starts to play. Then I don't know what the hell she looks like." Lilly joined the tennis team expressly for the dress, and, I hate to say this, but it really shows. "Why are you both giggling?" she asks us, midway through the match. "No reason."

So, off Nick goes. Raising kids is hard. We watched Elena last night, Jay and I. It was fun, but then we had to drop her off with Hali, who was sitting in the organic restaurant, looking beautiful. She ignored me, talked to Jay about the photographs on the wall, which are by some mutual friend of theirs from their couple days, quizzed him extensively about what Elena had eaten (christ) and then looked at me, "Hello, Haley, how are you doing?" like I'm the fucking nanny.

She's in the pretty mommy/nice little girl accessory phase of motherhood. Just wait. Maybe she'll never get out of it. Dangerous.

What do you raise children for? What is the purpose of education? You raise them to function in their society, to be productive and responsible in the most quotidian sense. They can't find happiness unless they can participate to some extent in the goals of the culture to which they are born, but you also raise them with an eye to the eternal. You also try to find that seed of soul, that part of the heart that is beyond parents and city blocks and homework assignments, and clear space for it and say--this is outside of it all. This will save you. I want my children to be carpenters with the soul and consolations of the artist. I want them to be able to lose all their money, step outside the bank, and still love the turning leaf on the tree. I want them to succeed at it all in some measure, but I want them to know that it is not really important if they do or don't.

I try to give them the tools to do this. I think a liberal arts education is key, and then, I don't care what they do after that. You grow the spirit, open the mind, then your labor is informed.

Money, money, money, money.

If only it didn't buy so god damn much.

What's that funny movie, Our Man Godfrey. "Money, money, money, money, money," Don't let it get you down. WAMU just folded. Of course, that's credit card I actually paid off. Why can't Chase collapse? Lose my debt....fantasies.

OK. This post was pretty random. Got to get back to my research proposal.

Doctors and Nurses

It's the most beautiful fall day.

School started three weeks ago. I went back to graduate school. I have discovered that the best way to be at peace about my messy house is simply not to be in it.

This works on 2 levels: 1)If you're not in it, you don't see the fuzz and cat hair on the rugs or smell the dogs. Since you're not in it, you can't do anything with your precious study time--like vacuum or do laundry. 2)If you're not in it, you also can't mess it up.

We'll see how this works. I don't know. I've been getting up early in the morning and running while the kids are getting ready for school. Lilly is making peanut butter and yogurt and fruit smoothies (these are a lot better than they sound) for breakfast. Then, if we're running early, we take the bus into town and Lilly goes to school and I go to the library. All day. If there's a yoga class in the middle of the day, I hit that, but pretty much I'm just parking myself there for 8-9 hours. So far, I'm not behind on anything...but I don't really feel on top of anything either. After school, I belong to the family and the schoolwork can just go hang itself. Except for Tuesday. Tuesday, my instructor has scheduled some god damn mandatory class chat, which is a huge fucking pain in the ass. There was also no help from the school in finding preceptors, so I've spent a lot of precious study time cold calling--something I thought I left behind when I went from PR/sales to nursing.

Don't tell me we're all salespeople. Sales culture sucks. It's so desperate and grinning and anti-intellectual. Sales culture has ruined this country. It's dulled our senses and veiled our hearts. There's a place for the market--sure--but the market shouldn't be in your heart or psyche.

I finally found two preceptors. One is my doctor. She's from Belize. Her name is Dr. Pitney. The other is Elizabeth Crane, a nurse practitioner. You can't imagine two more different women...doing basically the same tasks.

Dr. Pitney is small, black, with a British accent, and a little bit of a lisp. (Thywoid for thyroid, for example). She is absolutely correct, all the time. Correct in the social sense--she doesn't always have to be right. The limits of our relationship are very clearly delineated. I arrive in her waiting room and she comes and gets me when she's ready. When she has paperwork, that is my tacit signal to go someplace out of the way and study. I can only come during the morning one day a week. If a medical student needs her, they will have priority. She doesn't talk very much to me, and she seems unsure of my training. For example, she taught me about bowel sounds today. I felt like laughing. I mean, I'm a trauma nurse. I assess patients all the time. That's okay. She was kind enough to give me clinical hours. She never talks about the patients outside the room to either her staff or to me unless it's to discuss their clinical picture. That's it. No judgement. Bad or good. She's also imperturbable. While she was assessing a two year-old today, his four year-old brother kept hitting her leg with his coloring book. She utterly ignored it. She listens impassively, stays clinically focused. Lets the patient talk. Doesn't interrupt. Dresses conservatively, but with a little "african" touch--she always has something--today she wore a black and white skirt with a tribal print. Last week she had hair extension dreds. A cowrie shell necklass with a St. John suit. It's interesting--it's her only sort of personal touch. I like it. No make-up. Why don't female doctors wear make-up?
Elizabeth Crane, on the other hand, is a whole different story. She's my age, maybe a year older, and she's pretty but she's really let the sun do a number on her skin. She looks like Kim Basinger, only 40 pounds heavier and with bad feet. She's a little stooped (because, Christ, she's been laboring as a nurse all these years) and she has short frosted hair--frosted the way we all frosted our hair in 1983. She wears scrubs--the pants and the jacket--not the tunic top--generally over a grey ribbed tank top that shows her slightly leathered, but still generous and attractive cleavage. Like most nurses (like me) she's got a saint's medal resting there. Her mascara's a little clotted and she talks and moves non-stop. Fast. She tells me every part of her reasoning process, pulling things out from patient's charts at a dizzying speed--("See? back in July, she had another UTI--and there was blood in the urine, but it was her period--so big whoop--oh christ. Delbert's out in the waiting room? Tell him he needs to make an appointment like everybody else--so now she's back UTI blood in the pee--way bigger deal--find a lot of bladder tumors that way--No, Claire! I'm not coming out! Jesus Christ....) Dr. Pitney saw 8 patients. Elizabeth saw 15. Elizabeth let me eat lunch--called me ahead of time and told me not to bother bringing it ("pharmaceutical reps bring us lunch almost every day") There was lunch at Dr. Pitney's office, but I was very firmly dismissed to my own reconnaissance.

Interesting.

Well, that's my 1/2 hour.