Code Books

We found out who sent the book. It was Lilly's friend, Kelsie. The girls were all over at my house, sprawled around the living room after a tennis match. All these sweaty long limbs! Where did they come from? I felt so good seeing Lilly with her friends, taking over the room. I never had easy times like this growing up. I so envied the girls who did. Girls who laughed loudly together, in their tennis skirts, easy, physical. Raiding the refrigerator, catty and gossipy and funny.

And they always include me. I feel like I gave birth to my own member of the popular crowd to ensure my acceptance.

"So," Kelsey asks me, as she's making herself a peanut butter sandwich. "Did anything exciting happen to you this summer?"

Well, a lot. But of course the most recent thing was the mysterious book. I tell her all about it.

"Wow," Dorothy says (she's on the tennis team, too) "The exact thing happened to me. The same book."

"That is so weird," Carolyn, Lilly's best friend adds. "I just got that same book in the mail."

"Oh my God!" Kelsie says. "Me too!" We all look at each other.

"Did you guys read it?" Kelsie asks. "It's a great book." And she has this funny look on her face, as if she's trying not to smile.

And I know all of the sudden.

"It is a good book." Carolyn agrees. Dorothy nods. "I'm not through with it yet."

"Oh, my God, I am so not going to read it," Lilly says. "It's probably from some creepy stalker."

"No it's a good book." I say. It is. Nothing really happens in it, but it's a pretty sweet little story. I decide to play along. "I wonder why you're all supposed to read the same book..."

"Creepy." Lilly says. My streetwise daughter. All the romanticism leached out of her already.

Kelsie looks nervous.

"It's kind of like a Nancy Drew mystery." I offer.

"Yes! Exactly like that!"

"Maybe they're clues in the book."

"I never thought of that!" Dorothy says. "Lilly, do you have your copy?"

"My mom's been reading it," she says dismissively.

I go get it. "Ok. Let's look at the first picture..."

Kelsie is getting more and more jittery.

Lilly looks at her. Lilly knows. "You did it." Lilly says. She starts laughing. "You sent us each the same book!"

"First editions, too. Only like 5 bucks" Kelsie adds. "Well, I was stuck at my grandmother's house in Maryland and it was really boring, and she had all these books in the basement. Do you ever just pick up a book and start reading it because you like the shape of the cover or something? So I started reading this book, and I couldn't put it down. So I thought it would be fun if something mysterious happened to all of us this summer and I ordered copies over the internet and sent them to you all anonymously."

I like the book because it starts with the heroine sitting in the kitchen sink. I often sit in weird places in the house when I write to shake up my perspective--often on the kitchen floor. (I would catch something if I sat in my sink).

But I think Kelsie was trying to tell her friends something about herself. She and Lilly had a terrible fight in the spring. She was really mean to her. Refused to give her a ride, turned the other kids against her, and abandoned her at a study group. I'd about had it with Kelsie, even though I'm friends with her parents--Larry is a former nurse--tiny frenetic--I know I've talked about him before. He's the one who buried 12 feet long copper poles in his yard to prevent the house being struck by lightening. The character of the father in the book a lot like Larry, I think. I think the book resonated so strongly with Kelsie, that she felt it would explain her to her friends in ways she never could. I felt it was an apology.

What is that quote? I read to know myself? Maybe it should be I read so that others may know me. We're all here in code, aren't we? Even to the people who should know us best.

That's my 1/2 hour.

Well, we found out who gave us the book. It was Lilly's friend

Gifts

We received a mysterious package yesterday. It was a book, called "I capture the Castle", by Dodie Smith. Attached to the book was a note, written in cut-out magazine letters, like a ransom note, commanding "Read this Book". It was sent in a beat up manila envelope covered with stamps in odd denominations--like 1 1/4 cents.

"Do you know anyone from Maryland?" I asked Lilly, looking at the postmark.

"No. Do you?"

We've had a few mysterious gifts lately. A purple rose was left on the doorstep for Lilly a few weeks ago. The note attached said, "From Purple Flowers." And on Mother's day, we both got flowers--yellow daisies. My note said, "For Lilly's Mother." and Lilly's note said, "You're perfect just the way you are." Hmmm.....

Maybe it's my friend Ray? He once told me that, since I was now his friend, I was sentenced to a lifetime of weird mail. I've decided I like the mail again. Lilly and I wrote letters to each other all summer while she was away. It's nice not to have the demanding immediacy of email, right there, like a spoiled child at Target. Nice to be able to write something over several days, put a stamp on it. I like the interaction. I like that people are involved. I like the paper. I miss physical things.

I stopped sending letters to people because I became afraid of anthrax. My ex fiancee, the NASA guy put this idea into my head. We used to write each other occasional letters. One day he said, "Let's switch to phone calls. I can't stand the idea that my letter might brush up against a letter containing anthrax and inadvertently poison someone." I think he just wanted to talk on the phone. Now we neither talk on the phone NOR write letters. So much for that ruse. It's okay.

But Lilly and I wrote letters. She was at Interlochen this summer, and they wouldn't let her email or talk on the phone. They had phone cards available for the kids, but Lilly flaked and didn't buy one. She resorted to using her Swiss friend's phone. I'm sure the Swiss friend's mother is going to have a cow when she sees the bill. "Can I offer you anything for your phone bill?" I asked the girl. "Oh, no," she said, "I think the minutes are free." Hmmm...free Swiss minutes? Not so sure about that. I'm going to write and ask the mother, or maybe just go ahead and send a check. Can you cash American checks in Switzerland? Well, the Swiss have all those banks, right? I mean, I think so...

I'm Swiss on my maternal grandfather's side. They were bankers. He was absolutely ruthlessly meticulous when it came to settling financial matters fairly. For example, I found a receipt for groceries when I was cleaning out the garage a few weeks ago, with a charge of $1.69 added for gas. I had just had Nick and he picked up groceries for me, drove them out to Miami Beach, and charged me for the gas. He said that this sort of tallying avoided fights later on. But I thought it was ridiculous. One time he found out he had received the Disney channel by accident from the cable company. The cable company was just going to write it off, but my grandfather figured out the difference and sent them a check. His family's bank, during the great Depression, never foreclosed on a farm, though. They were very proud of this--as late as 1991, my grandfather still received mortgage payments in the mail from those families, long after the bank had closed--small amounts--$35 or $100--but a fortune back then, I guess. I find these little scraps from him--and there are a lot--and I think about how much they pissed me off at the time, and now I just cling to them--his meticulous cursive, getting shakier as the years passed. Tangible. HE wrote those words. Holding the pen, folding up the paper. It's a dimension of contact we don't get anymore. I still have a Christmas check from him, uncashed. It's on the mantle in the living room. "You are a hard working woman" it states in the memo. High praise.

The trick, I realize, is to understand the gifts that people give you within the context of the giver. Very few people can give outside their own frame of reference. Almost no one will give you what you really want. They give what they want. Sad but true.

Or maybe not sad. Just true. I try to remember that the gift is the giving itself.

Maybe

I have a sinus infection. Which has progressed into an upper respiratory infection. Which I thought I wouldn't get.

Everybody around me got it--my boyfriend, my daughter, my coworkers--but I carry this secret (erroneous) conviction that because I'm so meticulous about things like handwashing and organic food that I am immune somehow to sickness, and also, deeply secretly, dear reader, that this makes me superior to others. So boink from the karma bat. I feel like crap.

I stayed up all night finishing my DNP application, after working three 12 hour shifts, which probably didn't help matters. I missed the skills fair, which I'd committed to manning. One of the night-time supervisors, another single parent, had waited for me to show, missing precious hours of sleep. I had called and left a message with our educator saying I was too sick to come, but it didn't get through. Her son had had a baby and she'd gone off to attend to THAT--geez. I mean it's only a first grandchild. They're cute and young. They'll be more of those coming. Couldn't she check her messages while she was holding the latest offspring? I mean the world's crowded enough already.

I'm kidding...

My boss called me at home, and thinking it was my mother calling for the 4th time I answered the phone saying, in my croaking baritone, "What?!"

"Where are you?" she asked. "Sonya's been waiting for you for two hours. She has to work tonight."

I explained. Then I apologized and apologized. Then I went out and bought Sonya a massage from the local spa and delivered it to her that evening. At least everyone could see I was sick. But, man. It's not how I want to be known, you know? And I like my boss, I really like her. And respect her and want her to like me. But this week has been hard. I keep putting things down and forgetting them, I keep letting things slide. I keep missing appointments and blowing off tasks. And drifting off into these fever dreams, this midday sleep that just inhales me right into it...

Sometimes I feel that the farther I get away from the bedside, the worse of an employee I am. I mean, I wasn't good at all the meeting stuff and political stuff. That's why I went into nursing. To do something basic and real. Maybe the degree is a mistake. Maybe trying to advance is a mistake. Maybe I should just stick it out with my two patients a day and be content. This is the first thing I've ever been good at, the first thing that absorbs me heart and soul, other than mothering...

Hmmm....don't know, don't know.

Maybe I should just take a shower and try to get out of the house and stop thinking all these negative thoughts. Maybe I should eat something other than chocolate covered pretzels and orange juice and old Thai food. Maybe I should get caller i.d.?

Maybe I should get back on my cushion. I wish I felt better! I just hate this.

More zazen!

That's 28 minutes, but that's all I can endure today.

Giving

It's better today.

I got nothing done yesterday. I mean, nothing. Okay. I put away three loads of laundry, cleaned out the kitty litter box, worked-out, did the dishes, got my labs drawn and visited the thyroid doctor, picked up my prescription, cooked dinner, went grocery shopping, and dropped off food for my advisor, whose father-in-law was just killed in a car accident. But other than that...nothing.

That's funny, because reviewing the list, I actually did quite a lot, but it felt like a vacation. I felt like an absolute slacker. Periodically throughout the day, I would burst into tears, But after I found the courage to sit, late in the afternoon, after putting it off all day, that got better, too.
You're not supposed to practice zen because it makes things better, but it does.

It's hard to make yourself do the things you're supposed to do. One of the things all the years of sitting ( or maybe just all the years, by themselves) has done is that it has woken me up to the lies I tell myself. At least most of them. It's harder and harder to get away with shit.

It's very hard for me to rise to the occasion. To give people what they want out of me. I resent it. I'm a terrible gift giver. I shop at the last minute, barely wrap things. When I do break through the mud and ice and invest myself in giving to another human being, I am reminded this is the only way to truly live. But then I forget. And I'm back to my nasty, time hoarding self.

Last week was my mother's birthday. My mother is really hard to shop for. There are all these rules--rules that you don't know about until you break them. And if you break even one, you screwed up the whole thing! The birthday doesn't count. All or nothing thinking, one of my therapists told me. Typical of children and alcoholics.

My parents drove Nick to the train station 4 hours away to put him back on the train to New Orleans (he'd been up visiting us). It was Mom's birthday.

"Can we go out to dinner and celebrate after you get back?"(they get back at about 2 in the afternoon) I asked.

"No," Mom said. "We'll be too tired."

I had clinicals in the city the next day, but I'd be back at 8pm. "What about the next day, when I get back ?"

"No," Mom said. "That's really too late for us to eat."

"Well, then, what about Thursday?"

"I have bridge. I never miss bridge."

Friday, Saturday, and Sunday were out because, again, 2000 has become too late to eat.

"Well, we'll try next week."

But I knew there was going to be hell to pay. So Lilly and I wrapped up her presents early, with beautiful bows and perfect wrapping paper (17 bucks on wrapping paper frou frou!) and I got it there to their house while they were gone, on her birthday, with balloons, so she'd have presents to open.

Radio silence.

"I think we might have done it, Lilly, " I said, excitedly. "I think we might have finally covered all the bases."

"No, we didn't." Lilly says, shaking her head sagely. "We victimized them somehow..."

Two days later, I get the email from my father. "Well, again, you screwed up Christmas and now you screwed up her birthday. You need to call your mother and take her to lunch. She's heartbroken."

I never respond to these, but this time, I was pissed. Because I felt we'd really tried. I mean, someone has to meet us halfway, right? They're like the cats. They think I control the weather.

So I pointed out that we'd dropped off presents so they'd be waiting for her, and had tried to arrange 6 outings.

He wrote back: "You always have to be right, don't you Haley? It doesn't matter whether you're right. She's unhappy. Fix it."

And yesterday: "I'm still waiting for you to call your mother."

God damn it. It's very hard to be born to a couple like this. It's hard to explain, but everything has been my fault pretty much since I was three. You fell in the pool and almost drowned--stupid kid--you never know where your second grade reader is--stupid kid--I mean. They only had one child. And my mother stayed home. How hard could it have been?

I started to call Harriette to bitch. But then I remembered that Harriette's mother had died two years ago of pancreatic cancer. Then I thought about calling Ruthie--but her mother died 3 years ago of brain cancer. Then I thought about calling Matt--but his mother has been hospitalized for alcoholism, again, and her liver's almost gone and she's suffering from encephalopathy. And she stayed home with her children--and was filthy rich on top of it--so what's her excuse?

So, I called my mother instead,

It's only an hour.

That's my 1/2 hour

Rape

So, Saturday, in the afternoon, I admitted maybe the dirtiest person I have ever seen in my life.

"We're sending you a dirty old man," the OR nurse informed me. I had no idea.

He was filthy. He'd rolled his tractor and broken his c-spine. They'd fixed it with a posterior fusion. So he'd been laying in a field for awhile before they brought him in, but this was more than that. This was personal filth that had accumulated for decades. Mildred, our Zimbabwean nurse tech (who is the most beautiful dresser in the hospital--her mother sends her cloth from Africa, which she has made into scrubs) and I spent 45 minutes scrubbing him. Our washcloths turned black. We dislodged ancients chunks of toejam the size of caramels from between his toes, practically peeled sheets of filth and dead skin from his stomach and groin. Then we discovered the burns on his knees and feet--burns upon burns, some partially healed, some brand new.

We finally got him clean. It was the most emotionally exhausting bath I've ever given. I couldn't believe a person could be in this condition, a human being. I've never seen anything this bad. Mildred and I kept holding up trophies of detritus to marvel at, silently, we didn't want to hurt his feelings if he could hear us. We washed him and washed him, occasionally each stopping to gag. Finally he was clean. We'd used every washcloth in the room and had gone through two bottles of foam cleanser (to give you an idea--usually a bottle of this lasts for 2 weeks of daily baths).

He recovered. The next day I found him extubated, sitting up in bed and alert and oriented. He had a funny round shiny (now) face, and kind of looked like a possum. Sean, the night nurse, said, "I don't think he likes women."
"Really? What makes you say that?"
"He threatened to shoot Ashley (our night nurse tech)--but he seemed to like me all right." Sean goes on to brag about the success he's had with this patient. Sean's a little insufferable. He applied to be weekend night core, was the only applicant for the position and seemed a shoe-in. But all his colleagues went to our manager and complained. Sean polices other nurses, goes behind their backs, and loves to write ST's (safety threats). I've learned to document any conversation I have with Sean in which he points out something I forgot, etc--any small issue. I put it in writing and copy it to everybody. He generally leaves me alone. Sean also almost never bathes his patients. Lazy. Leaves it for the day.

"Did you find out anything about the burns?"

"No, I didn't. Maybe you can!"

"Good morning," I say, walking in the room. "You look like you're feeling better."

"Too many city people around here." He says. "Running around. Those computers. Those don't do you no good."

"Too true." I agree. I go on to assess him and care for him through the day. We get along pretty well. He's a little cranky and cantankerous, but nothing too unusual. I wonder how he got so dirty? And where his family is? Don't they care about him? We get to the burns in a few hours as I'm slathering bacitracin on them. "Do you know these are burns?" I ask him.

"They're from the stove." He tells me.

"Really?" The word 'really' can get more information out of people than sexual favors.

"I come in, I'm cold, I sit too close to the stove. Can't feel my legs any more so I don't know when I'm burning."

"No heat?"

"Shut it off. No money."

I nod.

"Can't go upstairs any more. Living in the basement."

"Are you taking your insulin?" I ask. His initial blood sugar was 400.

"That's just a bunch of shit they want your money for." He says. "You thought I was dirty."

"That's true."

"You gave me that bath yesterday? You the one? Where's the little black girl?'

"You had a bath after surgery, yes."

"You're not going to give me another one."

"Okay."

"It causes arthritis."

"Baths?"

"Yes. You don't know that?"

"I didn't know."

He's cantankerous but compliant. He holds out his hand for me to take a blood sugar, and let's me change his dressings and get him up to a chair. I've had a lot of patients like him--cranky old farmers, stubborn, set in their ways, but who melt when they're being cared for, grumbling all the way. This is what I've decided about him. Then, at 5pm, as I'm charting his iv fluids, he says,

"If my pecker worked, I'd take you down to the creek and rape you."

I'm not sure I've heard correctly. "Excuse me?"

"I said," he says, more loudly, "if my pecker worked, I'd rape you."

"Rape me?"

"You heard me. Little bitch like you."

"You can't talk to me like that. That's completely inappropriate and offensive."

"It's true." He stares at me, pale blue eyes in his thick possum face malevolent. "You don't have anything to worry about,though. I can't get it up any more. 10 years ago--that's another story."

I leave the room, find Wiz. Wiz has a way with our really nasty patients. He has a way of getting them in line. I tell him what happened. Wiz is clerking. Night shift forgot to staff us with a clerk, so in addition to charging, he's clerking--an impossible job for the clerks, much less someone who's charging as well.

"Is he A&O?" Wiz asks.

"Mostly. Sometimes forgets the year."

"Pain?"

"5-7--sleeps frequently, though. Fentanyl drip."

Wiz shrugs.

I get pissed. "This is not a delirious guy, Wiczoski, and you need to go in there and put the fear of god into him.

Wiz doesn't say anything for a second. Then he gets up. "Okay. Let's go." I follow him down the hall to the room. Wiz has lost a lot of weight. His faded scrubs look baggy and you can see the grey line of his briefs above his scrub pants. But he still holds himself like Barishnikov. I'm suddenly struck by a pang of affection for him. He's having a terrible day. I didn't mean to give him one more thing to do. But I can't go back in there, suddenly, unless this guy sees I have someone behind me.

Wiz goes in. We stand at either side of the bed.

"So she told you, huh? I wish I was in the country. You can say things like that in the country. City girls can't take jokes."

Wiz nods. "She told me. And you are in the city. Now listen, you can't speak to her like that. You hurt her feelings,and she has given you good care. She's a person, too, and you need to respect her. Now apologize."

That's it? I think. Wiz looks at me, sees something in my face, or doesn't see something in my face and looks away. No eye contact.

"Okay, I apologize."

"Apology accepted." What else can I say? But something happens right then and there, and I'm not sure what it was, which is why I'm writing about it ad nauseum. We walk out of the room. But I can't look at Wiz, and I can't look at any of the men there. I don't know what I want.

"I know that was difficult, "Wiz says, as I busy myself going through my CMAR.

I find myself almost speechless. I just sort of sputter. I can't find words. Wiz sort of awkwardly gives me a squeeze but the last thing I want at that point is for anyone to touch me. I feel like I'm going to vomit. I can't even look at him. I try to go back to work, but I find myself crying. Wiz is back at the desk carefully not looking at me. I go into the dark, empty conference room, and start sobbing silently. I can't stop. It seems like everything I thought I'd gotten past has just gotten unearthed by that patient's threat. Every time I ever felt helpless or physically menaced or hurt or sexually exploited--and I guess the worst thing is that just in that little flicker of a gaze by the bedside, I feel that I somehow told Wiz about it, and now it's part of my life--my new life. The one I've put together so carefully--all the debasement and grime and sludge of my old self--and I just could hardly stand it. I never wanted anyone to know or guess those things about me. I am so unprepared for this reaction. I don't know what's happening. I almost never have reactions that are beyond me. But this is like being at my first autopsy. I can't get my emotions back in the box. I didn't even know they were this strong.
I hear someone coming. Of all people, it's Jolene. The one I've told you about--painted like a Geisha, babbling, slow, crazy Jolene. Drives me crazy. She comes into the conference room. She's delivering girl scout cookies. She flicks on the light, "Oh, my! Haley! Heavens!" She says in her Texas way. And then, for once, she does exactly the right thing. She turns off the light and kneels beside me and folds me in her big fleshy arms until I stop crying.

That's more than a 1/2 hour.

Valentine's Day

Are you ever so tired after a shift that your skin itches and burns when you're done, as if you're re-inhabiting yourself? Is this what junkies feel like?

I've been up since 4am. I drove to the city for clinicals. Then I drove back. Jay was supposed to drive me, but he was sick this morning. Yesterday, I worked part of a shift for a coworker, bought presents for my mother (wrapped and delivered) had the worst therapy session with my daughter we've ever had, and shopped, cooked and hosted a dinner party. We had fish soup--which is a lot better than it sounds--with cod and scallops and organic cream and wine and tomatoes and root vegetables. It's Lilly's favorite. Oh, yes, and I worked out. Then I got to listen to Jay cough and snore and toss and turn all night. I must have gone to sleep, because I suddenly woke up and realized the bed was empty and the house was freezing. He'd removed himself to the spare room. His house gets so cold. I know I'm on the grid and a slave to AmerenUE, but, Christ, it's nice to turn on a switch and have the house simply warm up...He was funny last night. A little tipsy, and feverish and miserable. He'd suddenly hug me, waking me up, and mutter, "I love you, beautiful, beautiful, beautiful." Which was nice, but a little disconcerting, since he's usually all Clint Eastwood. I'm not sure how to handle all this obvious affection. I know. I'll cheat on him!
Just kidding.
I worked Valentine's Day and I had this patient, a little old lady who'd just been diagnosed with pancreated cancer. Her husband came to visit her. He was tiny and bent and had thick glasses that made his eyes look like a kewpie dolls. He wore a red cashmere sweater vest. He brought her a pair of stuffed turtledoves (stuffed animals--like toys--not taxidermy) and when you knocked them together they wolf-whistled.
"I'm gonna give my girl a valentine's day smooch!" he announced in this adorable little-old man way. "Pucker up!" He said, which she did, obligingly. Joseph, our tech--18--and I exchanged 'aren't they cute' glances. But then they really started going at it. I think the word might be "glomming." Joseph and I looked at each other again and left the room.
"I was going to say 'get a room'" he said, "but I guess they already have one."
"At least they're married."
"Yuck."

You know, sometimes my inner 11 year-old kicks in and I just think all this boy girl stuff is just gross.

He leaves and we watch the pair figure skating short program. The Chinese couple--the ones who eventually took the gold--bring us both to tears. "I don't even like figure skating!" she says. It's not a bad day. She likes to be waited on, but she's pretty fun. And I have a thing for little old ladies.

Towards the end of my shift, my little old lady asks me: "Haley, are you anxious?"

For once I get it that she's anxious.

"No. Not particularly. Are you?"

"Can you come sit down over here by the bed for a second?"

"Of course." I sit.

"Now, let me tell you what I'm thinking," she says, taking my hand, and looking straight at me. "I'm thinking that this is probably it. You know what I mean?"

"What do you mean?"

"I think that this pancreatic thing is IT. I think that this is how I die. Is this IT? I mean you've seen a lot of things. What do you think?"

Oh, you think it's going to be an easy day, and then they nail you.

I find it impossible to answer her directly. "This is bad." I say, nodding.

"I'm so scared."

We hold hands, and watch the skaters on tv glide on to the ice.

That's my 1/2 hour.

Soot

Why is it so hard to get on that cushion? I mean, it's not like I don't know what's going to happen. It's only a 1/2 hour. But sometimes it's so hard.

I accidentally set my buddha on fire this morning. Had my incense too close to him. Jesus. If people only knew...started smelling something that wasn't "way of the heart" (the name of my incense fragrance). Maybe it's a good thing there aren't more buddhists in America. Maybe there would be more house fires if there were.

I couldn't get out of my patients' rooms while on the cushion. I kept seeing them. I have a patient with uncontrolled diabetes, who fell a few days ago while trying to fix his furnace. He was using a candle to light his way because the electricity in the house had been shut off because they couldn't afford the bill--and he fell off the stepladder and skinned his knee. Being a guy, he ignored it. Put a bandaid on it. Finally his wife noticed a funny smell and insisted on taking a look at it.

"I'm no nurse," she tells me, "but I know when something's bad, and that thing was bad." She piled him into the car at 3am and got him to our ER. He had necrotizing fasciitis. If she'd waited til dawn, he would have lost his leg.

His condition is complicated because he has pneumonia--and he has pneumonia in part because he's been living in a freezing house, using candles and inhaling soot from a faulty furnace. She has pneumonia, too, I think. She watches me suction him. Black chunks come out of his lungs. "Oh! I'm coughing those up, too," she tells me.

We've been diving--going to hyperbarics--with him twice a day to stop the spread of the infection. And daily debridements in the OR. Necrotizing fasciitis moves faster than you can imagine. Surgeons talk about opening people up and watching the infection spread under their eyes through flesh, too fast to chase with their scalpels. It's debilitating and disfiguring. This guy has no insurance. But I have to wonder, if he'd had access to stable primary care, or more simply, if he'd been able to afford electricity and heat, would he be here?

She is at his side constantly. And she never stops talking. She talks like I do, to ward off despair and silence. She talks to him, even though he's comatose. One morning she read him the room service menu. She went through every single item. "Ummm, Gregory, it says here they have parmesan encrusted tilapia. Doesn't that sound good? and you can have that with a choice of green beens, mashed potatoes, or macaroni and cheese. I'm not so sure about macaroni and cheese. That would be two cheeses in one meal and that's a little much." Coughing fit. "Oh, here's the list of beverages. Iced tea. Too cold for that. Coffee. decaffinated coffee. Apple juice. Cran-apple juice--oh, that's good! I wonder if it's 8 ounces or 4 ounces. Do you know, Haley, if the juice they have with room service is 8 oz or 4 oz?"

"I think it's 4 oz." I say, a little short. I'm trying to program the Alaris with his levophed dose and I don't want to make a mistake (levophed-leave em dead). Why we're giving a man with wounds like his levo, I don't know--but we're dumping fluids into him to make up for the insensate loss due to his extensive loss of flesh--and his pressures have been plummeting. Sometimes you choose between poisons. And it's more important to keep his heart going at this point, I guess.

"Do you think they would bring me some?" she asks.

I get her some cran-apple juice out of our refrigerator. She continues talking. I smile and nod and try to concentrate on what I'm doing.

He has 11 brothers and sisters. No one visits. But they all call. And call and call and call. And they all have something bad to say about his wife. I suggest they visit. "We're afraid we'll give him something," one of them tells me.

Finally, one turns up. Sunday. Fresh from church. She's wearing a big yellow, wool suit. She leans over him. "Oh my God, look at his nose hairs." She says to me. "Are you going to do something about those?" she demands. "How embarrassing."

"Oh, they are bad, aren't they?" his wife agrees. "I didn't even notice."

Outside the room, Yellow Suit takes me aside, "Now listen," she tells me, "I know that we have a big family and we all call, but that's just the way it's going to be. Because his wife doesn't call us. We call her, and she doesn't want to stay on the phone long, and we call the nurses, and the nurses act like they're too busy to talk to us, and we have a lot of questions. So you're just going to have to get used to us calling. And tell the rest of your people that's what's going to be happening, too, got it?"

"This is a critical care unit," I tell her calmly. "The nurses will be giving care to your brother. They'll talk to you as much as they're able. I'm so glad your brother has such a large family. I'm sure you are all giving his wife the love and support she needs during this terrible time. She's blessed."

Yellow Suit stares at me.

"And thank you for pointing out his nose hairs. Families always see the important things that we sometimes miss."

We stare at each other.

Wiz, across the pod, yells, "Haley, you have a phone call."

"Excuse me. Thank you for--"

"Now." Wiz yells.

That's my 1/2 hour.

What I do When I'm Drunk

Had clinicals in the city at Farmer Sinai, the big megalith hospital complex there. Got up at 4am. For once I had everything laid out correctly. The only thing I forgot was a second sweater for Wednesday. Drove like a bat out of hell across the rolling farmland as the sun broke over the winter fields. I like driving. I do math problems to keep my mind going, and I pretend I'm racing every car I see. Since I got back from Florida, I haven't turned the radio on. It makes me feel more engaged with what I'm doing, the silence. Like I'm back in the kayak.

I really miss the kayak.

Farmer is like my hospital, only on steroids. 15,000 employees. They're kind of high on themselves, with good reason. And they really have a place for and understand the role of advanced practice nursing--something we're behind here at the University.

But, as I get more immersed there, I find myself becoming really proud of my unit. We really function like a well-oiled little machine--and we do it with less money and less administrative support. For example, our pressure ulcer rates are far, far below Farmer's trauma unit, and our skin care team is made of volunteers. Their patients are as acute, but for different reasons--but someone who's had a tractor roll over them is pretty similar to someone who's had a Lexus roll over them. They had a map on the wall showing the area they covered for Trauma, and I felt like taking out my magic marker and correcting it--because it covered ours--and that's not true. But there are some ideas I'm stealing and bringing back to my people. I like that the nurses don't have to wear a uniform at Farmer--they just wear scrub pants--the ones that look like cargo pants--and tee shirts. Some of them wear hoodies. They all look like me at work--messy and skinny. They also are paid better and don't have to work every weekend and they belong to a union.

Jay picked me up after clinicals. He had some editing to do at the studio he uses in the City. We went to his cameraman's, Bloom, house for drinks. That's when the drinking started. Bloom's apartment was beautiful--shiny, clean--like a grown-up's apartment! Overlooked the cathedral. Bloom's put $65,000 into redoing it. It's very small, but every detail is thought out. He's married to a woman named Tina. She's his third wife. 6 months ago, they were getting divorced. She wants a baby, but Bloom's snipped. Like Jay. Then she lost her job. She used to be sort of zaftig and peppy and inane--bad dye job, smoker, too much eye makeup. She kind of drove me crazy. Now she seems flattened. She's dyed her hair brown (always a bad sign) and was wearing sweats. As I walked into the living room, she hid a Janet Evanovich novel with a kleenex as a bookmark (a habit of my mother's) deep into the cushions of the couch so I wouldn't see. I felt bad. Do I make her feel ashamed of reading trashy mystery novels? A friend of mine at work once told me I had a way of making people feel stupid.

When my mom flunked out of law school, she cloistered herself in the house and read detective novels. One a day. She never changed out of her nightgown, and didn't wash her hair very much. She experimented with bangs. Lots of weird hairstyles. My dad didn't really know what to do. I didn't really understand what was going on. The dishes went unwashed for weeks and months. At one point, when we started having a maggot problem, my mother simply put them all in garbage sacks and threw them away. My father locked himself in the basement and worked on his thesis. No one could come over. Kids in the neighborhood would come over to get me to play, and my mother would speak to them through the chain in the door. I mean, all she did was read. Endlessly.

So, the hidden Evanovich worried me. I stood at the window, looking at the cathedral and thought about Tina in this little place day after day, wanting a baby.

"The place is lovely. I love the eggplant color in this little alcove you used. I never would have thought of that color." I offered.

"Nothing in here is mine." Tina said. "Bloom was in the middle of redoing it when we got married. It's all the decorator. I was like, 'sure, whatever.' I don't have any taste." She said. I know how she feels. I don't either.

The Fifth Element was on the plasma screen in the living room. Jay and Bloom talked shop a little bit. Then there would be a gaping silence and we would fill it with wine. Every once in awhile, as I got progressively tipsy, I would speak along with the movie, which was muted. I almost have The Fifth Element memorized.

"multi-pass." This kept Tina entertained. I bet she doesn't hide the trashy novel the next time I come over. If she's still there.

That's my 1/2 hour.

Zen is not funny

After sitting, especially with my sangha, I just want to talk and talk and talk. I want to talk the way I want to pound organic cheese doodles after an exam. Want to get my mouth full of talk, want to hear what everybody's doing, want the silence filled with rattle.

I can tell this drives Seido nuts.

I finally made it zazen at his house Sunday morning. We were left overstaffed, courtesy of the nimrods on the night shift, and someone had to be sent home, so I volunteered. I needed a break. I'd been taking care of patient from the local commune, the Ashanti Pilgrim True God Congregation. And, don't get me wrong, they were very nice, but they don't wear deodorant and they have a tendency to stand about six inches from you and ask questions almost nonstop. The men wear long homespun robes and the women wear the same thing, but wear their hair back in braids. They're very sweet and simple and pure and they all have the most blissful expressions on their faces. One of our nurses lives out on the commune in a house made of plastered straw bales, but she dresses like the rest of us--even to her swingy assymetrical haircut. I just know about her commune connection because we both get raw milk illegally from the same guy. So, after taking care of this guy for two weeks, I was ready for a break. It was 0830. I hunted through my email searching for the time zazen was held Sunday, but couldn't find the email. So I called Seido.

He was asleep. "Who is this." he sort of slurred into the phone.

"It's Haley. Were you asleep?"

"Yes."

Shit, I think. Who's still asleep at 0830? Oh, okay, a college professor who lives alone and works during the week. That's who.

"1030," he tells me. "Zazen is at 1030. See you then."

Seido's new place is a lot smaller than the other that he shared with his wife, but it still has the same aesthetic. It's not as clean. Full of color, full of books and his paintings, a pot with miniature roses, tchotchkes that seem to have some meaning. It reminds me a lot of my house, actually.

He's taken the dining room and turned it into a sitting room. A black curtain separates it from the rest of the house. About 45 minutes into the session, he rings the bell and everyone stands up. Then several people, one after another, bow and leave the room. Thinking this is part of the ritual that I'm not familiar with, I do the same. Not everyone leaves the room. Some remain standing in front of their cushions. Outside, in the main room, several are milling about, hands folded, not speaking to each other. One will go into a back room, then come back out, and another will take their turn. I step into the empty room after it's vacated, but it's just that: an empty spare bedroom. I can't fathom why we're coming in here. I look around, take a breath, and go back into the formal sitting room. Everyone else is back, standing, eyes cast down in front of their cushions. Then Seido rings the bell and we sit back down and finish our session. It starts to blow outside. It's 13 degrees. Seido's new place is close to the highway and we can hear the rush of traffic. But then the wind chimes start. And I breathe, and the chimes ring, and finally, my mind is still, filled only with the breathing chimes.

The bell rings.

Seido says, "there is nothing I can say about zen that the wind chimes haven't already said." But he goes on to talk about YuMin. He reads a story, and Sara and I both laugh. "It's not funny!" He says. "It seems funny, but it's not. " He goes on to explain that the incidents described have to be understood in context and that they were targeted to specific monks, monks who were known well by the master and who were at a particular place in their development. He told us that his own teacher had been very kind to him during the first years of his practice, but had grown much harsher as time had passed. "I don't hit babies." He had told Seido. Seido told us about his friend, Gento, who developed bone marrow cancer, and who would emerge from his sessions with his teacher toward the end of his life, weeping. Zen is serious stuff. It's not funny.

We emerge from the session. Sara, who is a lot older than me, and attends with her husband, starts talking to me. We both chatter as if we need to speak to breathe. Seido stands silently in his robes, as we put on our coats and boots, rocking slightly back and forth, grimacing. I suddenly realize that he desperately wants us out the door.
"Oh, here we are, just rattling away. I'm sorry. When I'm quiet too long, I just need to talk and talk and talk."
Sara grabs my arm. "Me, too! I feel that way, too!"
"Chicks, man," Seido says, and ushers the three of us out the door.
Outside, I ask them, "What were we supposed to do in that empty room? The one everyone took turns going into?"
"Oh," Howard, her husband says, "the bathroom's through there. He always gives us a break in the middle of the session."