Thursday, March 09, 2006


When I first started nursing I remember I couldn't figure out how to hold my hands when I was meeting a patient for the first time. The nurse patient relationship is incredibly intimate in a non intimate way. I will give an example: I get to see you naked , your nakedness is for me impersonal,asexual. Your response is different. Being naked in front of a medical professional brings out many feelings; exposure, embarrassment, fear. I am looking for objective clinical findings but all the patient understands is you have forced me to be naked,vulnerable. The patient is waiting to hear a judgment, a pronouncement, Even something as simple as taking your temperature..The patient waits to hear is it normal? do I have a fever? Does this mean I have an infection? The nurse is just taking a temp..We don't feel the urgency of the result.
This all changes when the nurse becomes a I know how important it is to tell my patient what their temp is and what that means and what we are doing about it.
When I first started I didn't know how to talk with a patient. They were a stranger, a stranger I knew incredibly well..but I only knew their body. I knew their diagnosis, their lab results ..I knew nothing about who the patient was. Did they like chocolate or vanilla ice cream? Did they watch CSI or would they rather watch old MASH reruns?
Did they love their children or were there old hurts there? Would they like me or think I was too slow, incompetent. I was always thinking about me.

After many years I developed a role. I wasn't me, the one who hated doing the dishes and would rather lay on the couch under a comforter than do anything else. I played the "nurse"..friendly,concerned and interested. Patients figured it out and they played their role too and we rarely if ever got to know each other.
I regret that sometimes. Every so often I meet a patient and we click for some bizarre reason and all of a sudden we are talking as if we were old friends meeting up for coffee. I love that moment and I wonder why it doesn't happen very often. Then I am reminded why..these new friends sometimes die. No matter how vigilent,diligent I am sometimes they cannot recover and they are lost.
Losing a patient is painful,losing a patient you decided to make your friend is awful.
So back I go into my role and my patient follows my example.
Patients allow us into their lives,into their bodies, into their tragedy..maybe I should try harder to let them into my life. It seems only fair.

My most recent patient is one I really like..he is my pet as we call it..we all have them from time to time and I think I would probably do just about anything to keep him alive..sad isn't it? it's not my decision who lives,who dies but I don't want anything bad to happen to him. He isn't a saint, he hasn't saved small children and puppies as far as I know. I do know he has lived hard, made some bad choices but he made me laugh. He is alive, present in the world and I respect that, envy that, admire that. So don't die on me.

CSI was weird tonight.I get the attempt at meta but it was irritating. We all know law enforcement isn't all that thrilled that these shows constantly demonstrate how criminals screw up. They are how to manuals for avoiding being caught according to some but let's be serious here. Most criminals are dumber than a brick. They could watch CSI around the clock and still leave evidence everywhere because most crimes are motivated by greed and desperation. Muggings, break and enter,robbery is all about finding some cash to buy meth..these people don't have time to watch crime shows , they are too busy getting high. The really clever criminal already knew about forensics and we can't do anything about that. So watching CSI playing on the theme of what they/we are doing is bad/good was arrogant and weird. Was the show trying to say they were better than all those "other" shows? (see every "Law and Order fill in the blank"). Were they trying to say CSI wasn't the culprit the media was talking about it was that other guy! he did it?
I didn't get it.
I also don't get how little screen time the supporting characters are getting. I like the whole cast and enough already with Marg getting every line, it's boring. I also find Margs face way too distracting. Every one else in the cast is aging without intervention except her and it shows.It makes me feel an overwhelming urge to go over to AwfulPlasticSurgery and make fun of all those idiots with their new horrible breasts and trout lips..ecck..Jessica we are looking at you WTF?

Enough complaining about television. I had a good day, nobody died.


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