Sunday, September 24, 2006

Roles, beliefs, faith

In marriage we all assume certain roles.
What I would like to know is when did my role include being the person that has to clean up after pet "accidents"? No, really. I have no aptitude for this. I am sure I never tested so high on this skill I had to be the person that cleaned up cat vomit, dog vomit and small half eaten animals left as gifts.
My husband does the fake retch and wails he will throw up. I fall for it every time because along with pet mishaps I am responsible for cleaning up family mishaps...I really don't want to have clean up cat vomit and husband vomit.

I had a cat that I thought if human would have been a serial killer with a fetish for positioning his victims. I saw rabbits arranged to maximize outrage and horror. Why? He was a very nice kitty, well mannered and loving but at least once a day some small animal would be attacked from behind, dragged into a dark place and......violated. Then all their bits inside and out would be artfully displayed on the back step. I know this cat thought it was an important gift to present to his family but why in a million little pieces?

Yes, I had to clean them up too.

My husband had his awful chores too, he has to clean the, the pain, the smell..Yeah, right. He also does the dishes. I hate putting my hands into a pool of warm water filled with the unknown world of floating bits of half chewed food.

I watched a documentary this evening called Religion, the root of all evil. Wow, the hate was a living thing. Good thing all those religious people read their respective bibles that tell them to love their neighbour right? The hypocrisy was everywhere. Every religion practiced the exact same form of it except for the Muslims. They were completely honest. They( to paraphrase) said the only true religion is Islam and the Islamic soldiers will take over the world soon enough so you might as well convert now before we kill you. They weren't bullshitting and strangely I felt that was refreshing, scary as hell but still refreshing.

I agreed somewhat with the thesis of the documentary but I don't think religion in and of itself creates fanatics. I think religion is a haven for a fanatical mind. If your father wasn't quite right in the head and he was forced to go to church from a very young age he may interpret the church teachings a little differently from someone whose brain is normal. He may then get married and have children. He will then raise his children in the church of his mind, his distorted version. If this happens enough you will have a generation raised in a radical interpretation of the "bible".
David Koresh was attempting this. The polygamist outcasts in Utah do this. A lot of fundamentalist Muslims have been raised this way.
So, it wasn't the religion that created the evil, it was how some people with distorted thinking interpreted the religion they were raised in.
I note this because none of these people use the whole book , the bible, the Koran whatever. They cherry pick what they like and they ignore the rest. When asked about this practice they have these amazingly convoluted and increasing bizarre rationales. They lose the ability to apply logic to any argument and devolve into "you are calling me names and that makes you an evil person" whine. It is quite amusing to watch grown men use less logic than your average five year old to explain why they do one thing God tells them to but not another.
What was also funny and sad to watch was fat, white Christian church leaders whining about how persecuted they were in a room full of Jewish rabbis and African American evangelicals.
Hell, there was a Muslim Imam sitting there looking more than a little bemused.

I have to say my favorite part of the documentary took place in Jerusalem where this man was giving a tour of the "church" that purports to be built right over the very place Jesus was crucified and the narrator asks him "You don't really believe any of this do you?" and the guy just completely ignores the question. You understood immediately that this was this guys job, his employment, believing or not believing didn't enter the equation. The priest whose job it was to "guard" this sacred area was busy on his cell phone complaining that "he wasn't going to work tomorrow because he had four days off and they better find someone because he wasn't coming in." There was no spirituality there, only commerce.That was Christianity.
The Jews and Muslims were hardcore. I honestly believe if it was your job to guard something with those two and you got caught on your cell phone bitching about your schedule they would find a frontline for you somewhere and hand you a gun.
Jews and Muslims don't screw around with religion in the holy city. They may be polarized and hate each other but they share a common radicalism that the Christians will never reach.

I think religion is just a tool for crazy people with charm to find other crazy people to boss around.
It's all about a polarizing belief. All our most famous fanatical mass murderers had an unwavering belief, a faith in something that made it seem to them perfectly righteous to murder. Their belief was so strong, so damn unwavering and scary it persuaded millions to fall in line.

Think about it a little like the twenty million Americans that watched Greys Anatomy last week. Those people believed that it was better than CSI. Then there is the twenty million who watched CSI last week and said it was better. They were on at the same time so a choice had to be made.
We can safely assume that out of that 40 million people 39.95 million of them watched either show for amusement and if both shows disappeared it wouldn't affect their lives in any meaningful way.
But for that last fifty thousand? They would be upset. They would write letters, they would complain. It would change their lives. A television show.
So what if a few of these people were crazy and they created a group, had meetings, made plans. Charles Manson, the man who murdered John Lennon, the stalkers that break into peoples homes.Each one had faith, a polarizing belief. They were crazy but they believed. What if they found a few thousand followers? What damage could they do?
Now try a few billion who all just love that bible story they read, a million crazy people to lead them. What damage could they do?
People are sheep, groupthink can take over a lot faster than any one of us would like to believe and the end result is fanatical fundamentalism be it George Bush or Osama Bin Laden.

Your belief, your faith is all about where you live and who you live with. It's an accident of birth.
What we call terrorist? They call them soldiers, what we call soldiers? They call terrorists.
Fanatical fundamentalism isn't always religion.
The US has a fanatical, fundamental belief that they are the leader of the free world, the US believes that it's policies, it's beliefs are good and right.
The US imposes this fundamental belief through war. It is so fanatical it is willing to sacrifice the lives of it's own citizens. It is willing to kill women and children. It is willing to torture to meet it's goal. The US is willing to endanger it's own economy, it's own survival.
The US is not pushing religion, it's pushing it's beliefs.

Most of the Middle East does not believe any of the US claims. It does not believe in the US. It does not share the same beliefs.
In fact most of the middle east relies on religion for it's political stands. Their religion created their culture and that culture looks nothing like the US.
They don't want any part of the US belief system. They have a fundamental belief that their culture is right. They believe their religion is right, in fact they refuse to separate one from another. They will also choose war to protect what they believe.
They will sacrifice their people, they will kill women and children, they are willing to torture.
They believe they are the leaders of the free world, they believe their policies, their beliefs are right and true.

So, the moral is anything can be a religion, even CSI or Greys Anatomy if enough people decide that is what they believe.
It's all just stories some one told right? Some of those stories are very,very old and lots and lots of people have heard them and some stories are only a few years old and less have heard them...but if enough people believe those stories they may decide to kill you if you watched Dateline instead.

Saturday, September 23, 2006

Things I love

I love Reading. My little team that could. I know nothing about them except they play like madmen. I like that. They tied Manchester today and that is one hell of an achievement from a team that has been absent from the Premiership for so many years.....and they hadn't beat Manchester for eighty years.
That is another thing I like about football. It has such a history. I also love the outrageous songs they sing and how the fans boo Ronaldo along with me. I still hate Ronaldo, yes I do. It's a little hate though and it only shows up when I watch Manchester play.

I watched the million dollar trotter classic tonight. Brilliant race. When I first started with horses I worked for crazy, anal Germans caring for Dressage and Jumpers. Those people are awful. Mean and insane. I lasted about three months and left when I had awful impulses to stick a pitchfork in my bosses ass fifty times a day. I was scared I would just lose it and have to go to jail. I didn't want to tell my fellow inmates I was convicted of shoving a pitchfork in a Germans ass because they bitched once too many times about where the damn feed tub should be placed. That would be too embarrassing.
So I moved on to standardbreds. I loved them. They were full of personality, loving most of the time and mischievous brats the rest.
The problem was I was hired through a government training program. The program lasted three months and the government paid your wages, basically you were free labour. What I didn't know was I was the third person placed with these trainers. They were running a great scam. At the end of the three months the told the employment office "you were not a good fit" and they refused to hire you. Then they asked for another candidate. After they refused to hire me the employment office finally caught on. They were pissed. So was I.
I moved on again to thoroughbreds and there I have stayed.
I love racing and I love my horses even though they eat and eat and eat and then poop. Then they poop some more. The job is all about hauling in the food and hauling away the poop.
It's a lot like my other job; nursing..heh.
Except ofcourse horses are much less dangerous.

I am going to admit to something terrible. A bunch of Richard Pryor concerts have been on lately and well...I don't find him all that funny. I like Chris Rock and I love Dave Chappelle but Richard Pryor leaves me cold. Maybe it is a generational thing. I wasn't really old enough to appreciate the times he lived and his humour relies heavily just like Chris Rock on his personal experiences and I can't find a common thread. It disappoints me a little though. I know he is revered as a comic genius and I feel a little backward not getting the joke.
I am happy that Dave Chappelle is going to take back control of his show and start creating masterpieces again. I think I understand a little about how awful it must have felt for him to see his show sliding in a direction he hated. I respect him a lot for walking away from something he felt wasn't his real work. I am really disappointed in the people around him that tried to gaslight him because they were afraid the gravy train was going to run out.
I think that would be the scariest thing about crazy success, that the people you thought were friends would lose their minds and try to suck you dry.
I am looking forward to seeing Dave doing what he likes so I can laugh my ass off.

That is my favorite thing to do so I am going off to read mimi smartypants

Thursday, September 21, 2006


I have noticed lately that most of the people I am forced to speak to during my day seem to have no understanding of language.
Words are powerful things. Tone and inflection bring words to life and help us interpret the meaning of those words. Lately I have lost any tolerance for a certain subset of language manglers.
They are the people that when confronted with specific facts always reply "really? Are you sure about that?". This makes me crazy.
I am tempted to reply "why of course not, I just made it all up".
When I am forced to speak to a doctor I stick to the facts. So why do I have to listen to "Really?" "Well I am not so sure about that".
What are you not sure about? That the patient has a temperature? Or the lab reported a positive culture or the patients blood pressure is really low?
What the hell? I am reporting facts. This is not a subjective opinion or some new philosophy I dreamed up.
It's a language problem. Most people have no idea how irritating this is. Hell, they aren't even aware of how damn insulting is.
I am attempting to devise new strategies in my replies.
I have tried not responding at all. This confuses the hell out of them. It has the benefit of making me laugh. I enjoy watching the expressions flit across their face. First the puzzlement, then a flash of irritation. Some figure it out and smile and say sorry about that and we both have a laugh. Sometimes they just repeat the same accusation. Then I ask them what they wanted me to say. They are befuddled. I offer different variations of the facts.."Would you like it better if I said the patient doesn't have a temp and that culture thing? I just made that up?".
I try to tell them that communication is important. When you communicate poorly the patient suffers for it. Professionals need to speak properly to one another.
They all nod politely and agree and the very next day it starts again.

This group also has another failing. They want their hands held. They want nursing to get everything for them. They want progress notes or doctor order sheets or they want everything set up for them to do a procedure.
I wont do it much anymore. The only time I get notes is during your first week in the unit and I take the doc with me and show them where everything is. After that they are on their own.
I do the same for procedures . I discovered that if you handhold your docs they are disasters in an emergency. They are helpless and useless because they don't know where anything is or how anything works.
I figure if you are a fellow you know how to put in a line. You also know how to set up a tray so you can do your procedure efficiently.
I have been proven wrong a few times.
In nursing we are taught over and over how to set up our trays so that we wont have to take off our sterile gloves to go gather some supplies we didn't know we needed. I have seen some docs so completely clueless it freaked me out.
I know that every doc has to do a surgical rotation. This is when they learned all about sterile fields and dressings. I think a few docs slept through this rotation or they had nurses do everything for them.

I am not heartless to the new guys. Everyone needs an orientation to their surroundings so the first few times I take them with me as we gather up all the stuff they are going to need. Once I am reasonably confident they have their bearings they are on their own.
They don't like it. They want everything set up and me standing at the ready to fulfill their every whim and I call bullshit on that. I am busy as hell. I don't have time for handholding or servitude.
Line insertion prep isn't brain surgery. The tray is prepackaged. All they need to get is some sterile gloves and some sterile towels which helpfully are on the procedure cart. A cart that is devoted to procedures, it even has wheels so you can roll it right to the bed! Everything else is in the damn package. But they want me to open the package because in a true dumb ass move they put their sterile gloves on first and are standing impatiently at the bedside waiting for someone( a nurse) to open the tray they could have opened themselves.
This behaviour is mostly a power play. The implication is the nurse has nothing to do but service my lazy ass.
I just tell them to get another pair of gloves because they forgot to set up their tray.

The other day I had to arrange a test and I was passed through seven different people, each one declaring "it's not my job". More than a few were doctors. The test was emergent and the patients life depended on it's results. One doctor I talked to gave me a lecture on how to use the hospital phone book because he was a very busy man and it wasn't his job to give me the phone number of the only guy who could arrange this test.
I explained the situation and he point blank told he didn't care, I was wasting his time and he was a very busy man. This man was a radiologist, a doctor that has no patients, has no responsibility for any patients and spends his day sitting in a dark room reading films. But he believed he was more important, his time was more valuable than mine or my patients. Incidently he was the only guy who knew the guy I desperately needed to talk to.

I cannot tell you how this just blows me away every time it happens. Sometimes it happens a few times a day.
It's all about language. I am sure this doctor is a caring and compassionate man that does a great job but when he opens his mouth he chooses words that make it impossible to see him that way.
Sometimes docs will respond to something you say with flippancy. That galls me too. They don't listen. Sometimes they have their answer ready before you have finished explaining your concerns..It's always a flippant response.
I had to stop the group one morning and say "that is not the response I want to hear". I carefully explained the problem again and the potential tragic outcome if the problem was not addressed. They stopped being flippant and understood...This is someone's wife, daughter, mother. We all are flippant sometimes but nurses are more careful about it.
We are quietly, privately cynical. We don't share that during rounds when every subspeciality is present. It's unprofessional. It's dismissive.

I want to be a constant patient advocate but I am sick of doing everyone's job for them. I am tired of walking doctors through possible treatments for life threatening events.
I want to be surrounded by confident, exacting, brilliant and experienced doctors . I want to be able to do my job and have them do theirs so we can work towards a common goal.

I think after four years of medical school and four years of residency you should know how to treat symptomatic rapid afib. . You should be able to set up a dressing and procedure tray all by yourself with a minimum of hand holding.
I went to nursing school and learned this in three years.

I know that the docs have a huge responsibility. They have thirty patients to my one. That still doesn't release them from the responsibility of language.
Using a dismissive tone or tossing out a flippant response causes me no lasting damage but for the patient? How can anyone be dismissive of the needs of someone so completely helpless?

I take a lapse of language as an affront to the dignity of my patient.
When we are on rounds discussing my patients needs that is the time to be serious. When we are all standing around the nursing station eating donuts it's time to be flippant.

Language is all about time and place. It's about your relationships. Language reveals how you feel about things.
I would think that the hospital is truly the one place where you should take the time to consider carefully what you say and how you say it.

Maybe it's just the unit I work in that is so incredibly dysfunctional.I like to think that somewhere someone is doing it right.I wish I could find that place, I think I would love to work there.

Friday, September 15, 2006

Deal breakers

I loved this idea from Dooce but then stumped myself.
What were my deal breakers back in the dark ages when I was dating?
I didn't like short guys.
Since I am tall compared to the average I never wanted to dance with short guys. Having some one whose line of sight would always be my boobs just turned me off. I mean it really wasn't his fault was it? He was just looking straight ahead and there was my chest.
I also hated the sloppy kisser.
That gross guy who slobbered, who thought copious amounts of saliva was attractive.
I remember my first sloppy dribbler..I felt physically ill. I felt like I needed a bath towel to feel dry. He was clueless. I truly believe he thought it was excellent technique. He called a few times and I lied my ass off. I was torn though, he was cute and funny but gah! The drool was too much.

Yappy guys too. I like my men quiet, thoughtful. I like talking when there is something interesting to say. Yappy guys are irritating. I know they are probably nervous but I can't help being turned off.

So, my worst nightmare would be a short, yappy guy who drools when he kisses.

Good thing I escaped all that.

Thursday, September 14, 2006


I picked Lucas Rossi right from the start! Damn, I can always tell who people will spend money on to watch.
He is strangely magnetic, all weird moves and screaming and then this gentle, reasonable voice . He seems kind and all Canadian laid back.
Canada does seem to have an abundance of rock and roll talent. Maybe it's because we spend so much time stuck in our igloos hiding from the arctic wind. heh.

I want to not write about what happened in Montreal. Children are clinging to their lives. There is nothing to say.
But I am raging about the monsters mother. How did she close her eyes to this ? She woke every day to her child dressed in black playing with his weapons while playing a videogame that had him murdering students at Columbine.
Did she not see? Was her life so hectic, so chaotic that she walked past the monster she had made?
I am a parent. My child leads a full and interesting life. I talk to my kid, I notice her dress. I don't allow piercing or tattoos. I don't allow violent videogames. I expect an interest in the world. I expect my child to be engaged, to volunteer, to excel in school and outside it.
I know my kids friends..I know their parents. I know where my kid is.
My kid isn't allowed a television or a computer in her room. If she wants to spend any time on the computer she has to do it in the living room in full view of all of us.

I don't say all this in self congratulation, this is how parents normally parent. This is what the majority of parents do or at the very least hope to do.
There is a small minority of parents that don't do any of this. They probably have a list of excuses a few pages long but I am sick of excuses. When you refuse, willfully refuse to be a parent your children will find parents somewhere else. Sometimes they get lucky and find a role model that will keep them safe and successful but for the most part they find gangs, television, religion or some cult nut that encourages them towards destruction.

That once human thing that walked into Dawson? He was a baby, a toddler, a child, a teenager, a man. He was never someone's son. He was an orphan raised by television, violent video games and no sense that the rest of us were human beings..Just like him.
Sociopaths are shaped, built, created by the environment around them. Empathy, compassion are taught to us by our parents. Learning to share, to play with other people teaches us that we are all connected.
Sitting in front of a screen in a dark bedroom with the door closed pressing a button to kill a cartoon figure with a human face day after day, pretending to be a vampire.....and his mother blind to it all.
These monsters come as no real surprise to their own families in the end, but those families live in silence and give the rest of us no warning that the evil they grew is now loose upon the world.

Take a look at your children. Does the phone ring all the time with their friends calling? Or has the phone gone silent?
Do they spend all their time in a darkened bedroom in the glow of the computer screen?
If you asked them to name the most important event of the week would they tell you who killed the most in their favorite online game?
Does your entirely clad in black multi pierced twenty five year old son live at home and work at a minimum wage menial job? Is he friendless? Does he play endless violent videogames while playing with his guns and knives?
Please get him into counseling right now, commit him as a danger to others if you have to.
This isn't normal , this isn't a phase he is going through.
How about getting the damn weapons away from him while we're at it?

What would make a mother so blind? Her failure to parent has cost so many so much.
Frankensteins monster cannot be blamed for his atrocities, Frankenstein can be.

It's not about gun control, it's not about violent games or crappy television. It's about parents and children. It 's about parents that don't care anymore. It's about parents that no longer believe that children have to be raised with limits, boundaries and demands that they must be good citizens. It is about parents that don't care that their children are drowning. Parents that don't notice that their children cannot maintain simple friendships, can't engage in the real world.
Parents completely asleep at the switch.
What do we do? Do we create a draconian system that evaluates who gets to have a baby and who doesn't? Who enforces that? Jackbooted secret police?
The only thing we can do is be present in our childrens lives. We may have to accept that a monster or fifty is the price we are forced to pay for a free society.
We cannot force someone to love their kid, we cannot demand they get their kid help.We can try to help them see what their child is becoming, we can reach out to that child but if they both look away we are helpless.
It's a huge price but any other would make our world more terrifying than anything the monster could ever have envisioned.

I hope with everything I have that the children will survive. I hope too that somewhere a mother looked at her son and saw him for what he has become and put him into treatment.

Monday, September 11, 2006

Provoking thought with a large bowie knife

I like to read the Dilbert blog. I am not a big fan of the cartoon but I think Scott Adams can write with some wit. Lately he has tried to encourage his readers to solve the problem of the Middle East.
Okay, solve may be too strong a word. He would like them to consider all the reasons for the hate and then process these into solutions.
A thought experiment he calls it.
I don't agree.
Any experiment needs safety to expound stupidly and Adams seems a little too sarcastic for that.
What I do find fascinating is how angry people are.
I get a little angry too.
I think it's because the problem is so messy. The issues are so emotional, so scary that to try to detangle anything becomes a politically incorrect nightmare.

There are so many players here.
Everyone in the West feels a need to defend Israel at least a little bit but we also have this thing for the underdog. We want the Palestinians to win too.
We have a simplistic need for a winner in all things, everything here is a reality show competition.
So we go into these conflicts already conflicted and we manage to piss everyone off with our wishywashyness.
Both sides want to be championed and instead we play favorites as the need and mood fits .
We have used both groups for our own ends and they both know it. The Palestinians know we will never wholeheartedly champion their cause so they went looking for someone else.
They didn't do it to piss us off . They did it to solve a need they had. They thought they weren't loved so they went looking for someone to love them. It never occurred to them that the minute they found someone new we would come back with promises of friendship and help. But now they know....They pull out the Iran card and wave it around and here we come with cash and a peace settlement.
Israel then gets furious.
It's like a guy having two girlfriends, neither of which he likes all that much but hell, they are handy and come in useful every once in awhile but they have really bad tempers and it's just best not to break up with them.

So, we would be better to dump them both and accept our punishment and let them get on with it by themselves but then they start screaming they are going to die if we leave. Both of them threaten to kill each other and damn, you're stuck.

You would think that experiencing this for years would have informed everyone about going into Iraq but nope...Two new girlfriends...None you like, more than happy to blow your ass up if you make one mistake...Great.... They are using you, you are using them..No one is getting what they want but tons of people are getting dead.

To look more closely we need to understand a little more about the middle east. We need to realize that Muslims don't come in just one flavour. Their faith has as many denominations as the Christian one. So they have different groups and these groups don't like each other very much. When left alone they will usually self segregate and be less than friendly, not crazy violent, just distant like dysfunctional family members. A brutal dictator can usually force them to all get along.
So absent the brutal dictator they get a little mean. Absent any government at all and a need for vengeance against said ousted dictator? Well then you get Iraq. Everyone has a grudge against the overthrown government that was filled with the "wrong" religious side. So the new guys hate the old guys and the old guys are terrified the new guys are going to murder them in their beds so everyone starts blowing each other up just in case.
They have competition issues too.
Then we try to make them all play nicely and that just makes them furious because both sides think they are the one with the true grievance and they should be championed and hey does any of this feel familiar?
If we pick a side the other side feels misunderstood and they get scared and they start blowing up the other side to get some attention and then the other side gets angry and defensive so they blow the other guys up...Both sides too stupid to realize they are blowing up real people with real lives.

After the fall of communism we saw a truly barbaric war full of ethnic cleansing, one tribe against another. These people lived peacefully with each other while being dominated by a ruthless dictatorship. The dictators left and they fell onto each others throats fighting over a war that had been fought fifty years before. Serbia, Bosnia...Does no one remember history?
This war went on year after brutal year. The world had to step in and separate them and create new countries.

Why do we think Iraq will be any different? Would it not make sense to separate Iraq now? What are we waiting for? Are we waiting for the US to finally give in so the world can step in to clean up this mess? Isn't it time the world told the US it has to leave now? The US must know it's just making everything so much worse.
The Middle East is not a US problem. The US needs to stop trying to be that guy.
The world needs to stand up and say that is enough, everyone get to their corner and let the grown ups figure this mess out. The US is too immature , the Middle East is too immature..Let's have countries that have solved their internal battles peacefully and successfully step up to the plate and take over.
What is so damn wrong with having three new democratic middle eastern countries? I can answer that too. The US wants complete success, they refuse to consider any other solution other than the shangri-la version of a happy, domesticated Iraq . That competition thing again...The need to always win. Israel suffers from the same delusion, they want their solution to the only answer.

See? Trying to solve the problems in the middle east is dangerous. You have to choose a radical solution and no one likes the idea of that. I can already hear the complaints..Who gets the oil fields? Who gets the water access? Where do you draw the borders? Who gets to decide all this? The people that live there or outsiders?

The other solution is to walk away and look how successful that has been in the Congo, Darfur....Oh right..No one cares about Africa, home to millions of radical Muslims.......Boy that may bite us all in the ass one day soon.

The western world mourns the loss of life from September 11 2001 today..Who mourns the massive loss of life in the Congo? Millions have died there since 2001 and no one has said a word..No moment of silence for them.

List the wars going on right now , now add Africa.

The world is on fire...
Go have another Cheeto and get ready for an explosive new Survivor..Where they are separated by race., it's the least you can do.

Sunday, September 10, 2006


I hate that short form thing. It should really be something more profound, more terrifying.
I get the short hand way of communicating but for the destruction of the towers short form seems trite and lazy as hell.
The world hasn't really changed any since then other than weird new rules for flying unless ofcourse you are brown skinned.
I can only guess at what it is like to get through the day being obviously Arab.
I have Arab friends but I am too ashamed to ask them how bad it is.
I have struggled mightily with my own outrage. After hearing about the group in Toronto I was left shocked and furious.
But I didn't blame my Arab friends. I knew them. They were people to me and I knew how much they valued their new life and how angry they were that anyone would cause such outrage.
I knew they valued their life and their children's lives. They would never train their babies to murder the rest of us.

I have no answers on why some people love their lives and never lose hope that their children will have wonderful, purposeful lives and others put no value on anyone's life.
I have moved past the excuse stage..The bad childhoods, the poverty, lack of education, unemployment whatever.
African Americans have been the most abused people in the world. They have known such suffering no one could ever compare but they stayed strong. They never lost hope, they believed in their right to life, happiness, a future for their children.
They have been fought at every turn, they have fought themselves but still they survive, they prosper and dammit they do not murder innocent people in the name of religion or a history of abuse.
They chose the route that their religion taught them.
The Muslims swear the Koran is all about love thy neighbour and respect but it seems African Americans actually read their bible and radical, violent Muslims use theirs as a doorstop.
Every great leader in the Black movement used the Christian bible as the bedrock of their struggle. The lessons they learned in church were the lessons they taught the white world over and over again.

Radical Muslims made no effort to try to educate the western world. They didn't understand that we in the West are lazy. We need to hear what the issue is and we need to see real people and stuff happening on the news. We need a compelling movie version of the problem. Then and only then will we wake up and go "oh, damn I see your point..We really shouldn't have done that, sorry". Then we could honestly try to be better and more sensitive.

I barely knew anything about Palestine before September 11. I knew nothing about AlQueda or Afghanistan. Hell, I thought everything was fine in Afghanistan because the Russians had left.
I also considered myself pretty well read and well informed.

I knew nothing about how outraged some people were about the US being in Saudi. The Saudis never said anything and the news never mentioned that some Muslims felt that Mecca was being literally soiled by the presence of infidels. I was bizarrely surprised because as a Westerner I didn't get that for some people a place can be completely sacred. I had a tourists brain. Let's go into this cool church and walk around!! . Let's take culturally insensitive pictures of people!! Let's get all angry and defensive when they freak out and tell us to get out.

Isn't it awful to know that September 11th and this Iraq war could have been avoided if the US had never landed their military in Saudi?
If there had been some cultural sensitivity and that includes the Saudi royal family we could have avoided this mess we are stuck in.

I do wonder if Osama would have found another excuse but honestly I don't think so. Osama let the leaders of Saudi know his outrage and they ignored him. He then voiced his outrage to the US and was once again ignored. No one took him seriously and like all sociopaths that pissed him off. He wanted some attention and when he was ignored he decided on a course of action that got him the attention he craved.
Osama could have been stopped by the Saudis, hell his own family could have stopped him but no one took him seriously.
Osama was considered a coward and a failure during the Afghan war. He ran during bombings and he led his fighters into death way too many times. He slunk out of Afghanistan his reputation in tatters and he returned to Saudi looking for something, anything that would restore his own sense of his own wonderfulness. He found it in a radical, violent bastardization of his Muslim faith.
He then used his cash to buy himself some flunkies and ran a PR campaign of death to the West.
And no other Muslim group challenged this campaign.
Where is the moderate Muslim movement?
Is it because they can't find their voice or is that voice being suppressed?
I look at Pakistan, Afghanistan, Iraq, Iran, Palestine and Saudi and all I hear is the radicals screaming for murder. I can't hear a moderate voice of a strong leader that says "that is enough".
Where are the true leaders?
Where is the Martin Luther King, the JFK of our time?
Is stuttering George really the man that will lead us all to peace?
I think not. He may be the man that leads us all into WWIII though.

It's September 11 2006, five years later and the world is unchanged. Palestinians still fight for a home land. Israel still fights for it's right to exist. Iraq is still unstable and Iran is still run by the mullahs, Afghanistan stills searches for a path into the future. All these wars, all this horrific loss of life and nothing has changed...We aren't any safer, our world isn't any cleaner and we still can't live with each other.

Saturday, September 09, 2006

In the beginning

I am tired. The kind of tired where day and night are the same. I feel like I have been awake for days.Well, I have been really. Night shift is painful when you can't sleep.
It gets me thinking about why I started all this.
I started out being a nurse because my sister told me it was a steady job with pretty good money. I liked the idea of having a regular pay cheque.
I also didn't mind blood, guts or gore. I was made to be a nurse.
What a fool. I never even thought about feces, sputum or vomit.
They don't really talk about that in nursing school either. In nursing school it was all nursing care plans and " being a professional". No mention that most of your time will be spent cleaning up the messes sick people cannot control.
I sailed through nursing school, ridiculously naive and bright eyed.
I got my first job and I was excited.
I had a ton of responsibility. A crazy amount for a brand new grad but I thought I was more than up to the task.
I was an ICU nurse and a house supervisor. I put out fires. My first fire seemed like nothing. A lady having a little trouble catching her breath. Her daughter was with her and both were cheerful, helpful and honestly not in the least alarmed.
I called the doc and arranged for a breathing treatment as she was a little wheezy.
The breathing treatment didn't help. I put her on a little oxygen and sat her up. She was a very big lady. Very, very big.
I put her on telemetry and a monitor to check her oxygen saturation. Her vitals seemed okay..not great but certainly nothing alarming for her medical history.
She settled and seemed comfortable so I gave the standard call if there is anything else blah, blah and I left the room.
I went to the desk, called the doc with an update and charted, Twenty minutes or so passed and the call bell rang.
I went back to have a look. This lady who was incidently sitting in a recliner looked awful.
She was gasping and had a blue tint.
I knew I had to get her to the bed before she arrested or she would die in that damn recliner. Her daughter and I heaved that woman out of the recliner and pivoted her onto the bed where she collapsed as I hit the code button.
She was purple. Purple like grape juice purple. I was rooted to the spot for a horrible second.
I then checked for a pulse and found nothing.
I started CPR while her daughter wailed .
This woman weighed a lot. CPR was physically punishing. I also knew there was no way I was doing a very good job. My friend came running in with the crash cart. She ran to the head of the bed and attempted to intubate. She couldn't get the tube in. We set up the monitor , she was asystolic and I continued CPR. The doc came running in and tried to get the tube in and failed over and over again. Finally I offered to try. We all switched places and I tried to get the tube in. My patient was flat on her back, she had no neck at all. I tried every head position I could think of to create some kind of view. Finally I went in blind.
I was in.
It didn't matter, my patient was dead. We tried every algorithm available and we never got anything.
My patient was laughing with her daughter one moment and dead the next.

We found out later it was a pulmonary embolus, a huge one that killed her almost instantly.
We had failed before we even began.

I learned a very important lesson that night, well I learned more than one.
The first is no family member should ever have to witness a code first hand and I don't give a shit what some people say...All those "oh I would want to be there" bullshitters..No, no you wouldn't.
The other is every patient in the hospital no matter there diagnosis is at risk for clots. You sit or lay around long enough and clots will form and they will break off and travel to your lungs or your brain and they can kill you.
Every patient needs to have prophylactic treatment for clots.

I also learned to be afraid of fat patients.
I cannot stand having a morbidly obese patient. It's not about them being fat and "ooh gross'...It's about "oh dear mother of god they are going to die on me I just fucking know it" repeating in my terrified brain all damn shift.
I can't relax. I am sure I make them as crazy as they make me. I check their breathing obsessively, I pepper them with questions. I am sure I stare at them with fear in my eyes. I run their codes in my head trying to be prepared, to win this time.
It's not your weight that will get you a clot, it's your inactivity..Hell you can weigh 108 pounds...You lay in bed long enough you are all at risk.
But still I am afraid.
So, I think I stayed in nursing because of that woman. I wanted to save them all. She was my first and I never wanted to see that happen again.
Now I am older and wiser. I know I can't save them all. More often than not all I want is to keep my patient alive till I leave. What happens after I go home is no longer my concern.
You could literally drive yourself to suicide if you worried about these people all the time. And isn't it arrogance to think that somehow only your presence will avert death and disaster more than anyone elses?
I am not that fantastic and it's time to admit that.
So what is going to keep me in nursing now?
The money is still pretty good and the cheques are regular and sometimes I do a damn fine job.
That has got to be enough.

Thursday, September 07, 2006


I got a chance to spend some time with true baby docs this week and can I say I loved them?
To see this cheerful fourth year "I am in my last year!" med student waving her scalpel around like this was the coolest thing anyone has ever let her do cracked me up. The very idea that she thought her fourth year was "her last year" made me laugh even harder.
To spend time with a second year resident, confident but still happy about his choice made me feel like there was real hope with this new generation.
They both involved me so fully, picking my brain..Wide eyed thrilled that I had arranged all their supplies.."We don't have to do this ourselves?"..heh , even I was caught off guard.
With the docs I normally work with if I don't have everything set up exactly the way they want it they go all passive aggressive misogynistic rage. And no I never get thanks from them for doing everything but insert the damn chest tube for them.
So, it was fun and I felt like I was with colleagues, all of us working together to .....Well you just don't want to know what we were doing. Hell I still can't get the "oh holy mother of " out of my head and I do believe I threw up a little in my mouth, the fourth year was a trooper though,horror etched on her every fiber but she never faltered, gagged? Why yes..But falter? Never.

And that brings me back to my own personal nitpick.
There is a condition of the brain called locked in syndrome. It happens when you have a pretty significant brain injury..The mechanism of injury isn't that important..Stroke, car accident whatever..It's the results that matter.
Being locked in means you cannot move anything except maybe your eyes and eyelids, the muscles for swallowing maybe, some can breathe with a trach.
The horrible thing is your brain , your thinking, it all still works..... Think Lou Gehrigs without the years of preparation to plan for it.
What if no one knows you are still in there?
Or even worse they do know and to your complete horror they decide to keep you alive.
You are sentenced to a life of nothing , no laughter, no tears..watching mindless television you cannot even choose, listening to music someone else picked out. Laying fouled in your own waste waiting for someone to clean you. Seeing and understanding but never, ever speaking, interacting.
Trapped in some facility....Yes, this is what nurses have nightmares about..Someone thinking they are doing the right thing and someone else having to suffer for it.
I always wonder..Would those same people choose this living death for themselves?

So, they did some research and they" asked" people who were in fact locked in would you (to put this bluntly) rather be dead?
They answered no.
I get that. I think after enough time passes any life can seem better than being dead. Everyone adjusts, adapts to their new circumstance but I wonder if they had asked these same people in that first or second week of this new life would their answer have been the same?
I doubt it.
So, is it better to wait and hope for the patient to adjust, hell let's call it what it is, they settle for what they've got or is it better to accept that first moment when they realize they can eye blink the alphabet to tell you "please let me die"?
All I know is don't make me settle for a living death...I can't answer the question for anyone else.
An interesting side note ; the majority of those polled all had high to excellent one on one personal care with the physical ability to use and access computers for communication, moderate to high family involvement, middle to high incomes.
I wonder how those stuck in marginal, state run nursing homes without family, money or technology would have answered?

Just another reminder that not all medical care is a benefit and to fill out your living will, I can't advocate for you if I don't have a clue what you want.
Another thing is no one is required to accept any medical treatment. You have the right to refuse. You do not have to call an ambulance, you can say no to anything you don't want. It would be nice if people did that instead of complaining bitterly about a right to euthanasia..The "right to die"..Everyone has that right. Most people just don't exercise it.
If you don't want the trach or the vent or the feeding tube...Refuse it. Have your family refuse it...I am tired of having to bring this subject up over and over again...Know what you want and what you don't and tell everyone, put it in writing. Your passing is your responsibility as much as your life is in this shiny, high tech invasive world. It's not my job to know how you want to live or die.

Monday, September 04, 2006


I am sorry that Steve Irwin died.
I know everyone has an inner asshole that wont be able to resist saying "oh well, he was crazy or it was inevitable or holy shit I was sure it was going to be a croc that got him".
To that inner jerk; yes you are right but who cares? He loved what he did. He had a really cool life.
Every day he woke up and grinned madly, thoroughly fucking joyous that he was alive and he got to do exactly what he wanted.
How many of us are that happy about going to work?
Can you say that your job makes you cackle madly with glee?
Steve was a cool guy, he made crocs and snakes cool. He showed the world that reptiles were important. He showed that something freakishly scary could also have a real personality.
He showed the world that they had a right to survival.
Can you tell the world that what you do everyday is vital?

I hope his kids get to grow up proud as hell their father made a difference in the world they live in.

It has been a very difficult time for me and for everyone I know. We lost our friend. I wish he could have had one tiny fraction of the joy Steve had for life. I wish all of us could live with that little joy, that mad glee..that exuberant joy..even if it is only for a second or two a day.

Joy is what keeps us alive. Loss of it makes life unbearable.

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