I love kids. Always have and always will. And when it comes to sick kids, I feel fortunate to have been trained in a demanding EM residency program where the pediatric emergency department was directly attached to the main trauma center. As a result of such exposure, treating ill kids became as natural to me as treating ill adults. Those little buggers, with their fevers, snotty noses, abdominal pain, and piercing shrills, don't scare me. Some get an "A" for effort, though, pulling out all of the stops in their vain attempt to get me out of their room. Regardless, because of my comfort, I try to see the really sick kids that come through our doors during my shift.
Over the holidays, with the flu season in full swing, I treated many children who were swept up in the epidemic. Some parents simply needed reassurances that they were giving their little Johnnie and Susie all the proper care, while other parents, with their heavy concerns, were right to bring their children in for a workup, including some IV hydration and anti-emetic medication. All-in-all, there was a much heavier flow of pediatrics than what we typically see.
Walking into Room 22, then, thanks to an alert by the nurse, I knew I was about to face another sick child. "This one is 'punky', Doc," she had said, "he hardly flinched when I started his IV." Never a good sign.
I quietly pulled back the curtain to the room and entered, finding a fatigued two-year-old boy sprawled on his back on the medical cot with his cotton sheet kicked into a ball at his feet. His oversized hospital gown had one loose tie in front, opened to reveal his skinny frame. His blond bangs were sweaty, matted to his forehead, and his skin was pale. Before introducing myself to his parents, I walked up to him and felt his forehead with the back of my hand. He was "burning up," as we say and, more importantly, didn't even shrug to a stranger's touch.
I shifted my focus to his parents, walking up to the young mother sitting in a chair alongside her son's cot. She looked as wiped-out as her son, the livelihood of her existence threatened by her son's illness. She was tearful, a mother's angst clearly etched into her face. I took her right hand in the both of mine, squeezing it reassuringly. "We'll get him feeling, better," I said, nodding to her sleeping son as I spoke. She dabbed her eyes with a Kleenex and gave me a feeble smile.
Next, I walked up to the father, his disheveled baseball cap barely clinging to his head as he paced three steps back and forth in a tight corner of the room. We shook hands and I held his gaze for a few extra seconds, trying to silently reassure his concerns. He, like the mother, was young, worried, and quite upset over his son's circumstances. He looked me in the eyes and took a deep breath. "Can you really make him better, Doctor?" he asked, a glimmer of hope escaping his watchful eyes.
"Let me talk to you both, do a thorough exam of your son, and order some tests and treatment for him, okay? But yes, I do think we'll get your son to feel better by the time we are done treating him." Their son looked like several other patients we had recently treated for influenza.
Between the two of them, I learned that they were first-time parents and married. Although neither of them were ill, their son went to daycare two days a week, where they thought "a bug" was going around. He had been born full-term and was up-to-date on his immunizations. This was his first major illness, barring a few past ear infections. Over the past few days, they watched their son eat and drink less, urinate less, become less active, and start a fever that they couldn't control. Eventually, all of their son's symptoms worsened and became boggled in their minds, totally confusing them (like any first-time parents) as to what symptoms were most serious and needed addressed immediately.
That's where we came in.
After a thorough exam on this patient, I had no suspicions for focal illnesses (such as pneumonia, bronchitis, or strep throat) on this patient. His temperature was quite high (103.7) and he appeared clinically dehydrated, so we treated him with a Tylenol suppository, aggressive IV hydration, and some IV Zofran, a God-sent anti-emetic that helps control nausea and vomiting. Then we sat back and waited--one, to see how the child would respond to our interventions and two, to review the results of our blood and urine tests as they returned.
Within the hour, I was walking into my work station with another patient chart only to find Dad standing at the counter, waiting to talk to me. He was smiling.
"He's doing better already?" I asked. "Come take a look," Dad said, practically grabbing my hand and pulling me towards his son's room.
We got back to his son's room and, before opening the curtain, the father stepped aside, sweeping his arms as if welcoming me to step into his home.
Pushing aside the curtain, I was extremely happy to find their son sitting upright in bed, licking an Italian ice while watching a cartoon on the TV. He looked at me with apprehension, turned to his mother who gave him a reassuring wink, before turning his attention back toward the TV, continuing to lick his popsicle. He was a new kid.
The mother jumped from her chair, then, and rushed me, giving me a big, grateful hug. "I can't believe how good he looks," she said, muffling her words into my shoulder. "Yes," I said, happily agreeing with her, "he looks great!" She left my side and went back to her cot-side chair, sitting clumsily down before wrapping her hands back around her son's torso. Her face held the most genuine expression of thankfulness and love that could ever be.
Within the next hour, as the patient's labs returned with adequate results, the nurse and I took turns going into the room to educate the parents and answer their questions.
How frequently are they supposed to use Tylenol and ibuprofen?
What doses of Tylenol and ibuprofen are they supposed to use?
How should they use the Zofran prescription we'd be sending them home with?
What type of fluids should they give their son?
What foods would be okay to reintroduce back into his diet?
How much sleep should they let their son get?
It's easy to see how confusing it can get the first time your child has a serious illness. Their questions for us were endless and repeated several times, but we, in the medical field, all know that education and knowledge is most empowering to recover from an illness. Our patience in the parent's education is paramount. Besides making sure each of their questions were answered, we also wrote down their instructions for them to take home.
By the time we were ready to discharge this patient, he was a new kid, running around his room, drinking watered-down juice, coloring the staff pictures, and covering himself in the stickers we gave him.
To us, another successful but predicted response to our interventions with a child with the flu. To the parents, though, this was nothing short of a miracle. The clouds had parted, the rays of sunshine had dispersed before refocusing on the head of their sick child, and the gods had sung. Anyone who has had a sick child recover knows these feelings of exhilaration that follow the many pangs of doubts that haunt us during our child's illness.
I've been there...have you?
The nurse and I stood together at the counter and watched this young family walk out of our ER after being discharged. Three big smiles, plus two more if you count ours.
It was another good day in the ER...
As always, big thanks for reading. I appreciate the nominations and support for the 2010 Medgadget awards for best medical weblogs...thank you, thank you. I hope this finds you well...
Monday, January 31, 2011
Monday, January 17, 2011
My Buddy, For Always
A few months back, I had been cleaning out my overflowing desk folders when I happened upon one filled with lots of letters and pictures and cards from my kids. Some older, some more recent. All of them precious.Of course, despite the folder's bulge and disarray, not a single thing would be discarded. I wouldn't even think of it. And in a Clark Griswold moment (when he was sitting alone in his house attic watching old family videos) , I leaned back in my office chair and began to rummage through the collection, slowly being taken back to moment after memorable moment of my children's childhoods thus far. Deep sighs, silent smiles, and bittersweet emotions rushed me.
Yes, time certainly does fly by. Darn it all. If only a rewind button or a pause button had been invented to control the pacing of our lives, I'm certain that we would all be pushing it frequently. Shamelessly. Without abandon. Heck, I could almost guarantee my finger would be calloused from my efforts.
While reviewing the collection that sat in front of me, though, I was reminded time and again of one giant thought--that I am a lucky guy. A very, very lucky guy. Two beautiful daughters and one resilient son. Kind and compassionate, all of them. Various notes printed in crayon and colored pictures documenting the world from their view were soon scattered all over my desk, my lap, and taped to my office walls.
What follows is one of the pieces, currently hanging on my office book shelf, that I am allowed to share with you, courtesy of my son, written several years ago as a homework assignment in third grade for Mrs. F. My heartfelt thanks from me to her. And to heck with grammar and punctuation and new paragraphs. The beautiful childlike cursive and use of "my dad" ten times is all I really needed.
My Inspiration
My Inspiration is my dad because he teaches me things I need to know. He also helps me when I need him or if I get hurt my dad is there to help. My dad is a great cook and my favorite thing he makes are egg whites. My dad helps me in my baseball skills and helps me in other sport. My dad has helped me so much in my fort in the woods. My dad drives me places I need to go like baseball practice and baseball games. At night my dad would come in my room and say goodnight. Then we would play this game. My dad works so hard so we can do things we want to do like go on vacation. My dad helps me clean up the yard when my mom says to clean the yard by myself. When I grow up I want to be just like my dad.
Cole in 3-F
As soon as I had read this piece, I stood from my office chair and hurried myself into our foyer, to the northern wall, where my favorite picture of my buddy and I was hanging in an antique frame among the numerous other framed pictures. I stood on my tiptoes, barely reaching its lower border, until I successfully lifted it from its hanging nail.
I returned to my office and sat back down, focusing on the picture. Immediately, I was taken back ten years to the beautiful North Carolina coastline. To our family vacation. To a healthy Cole. To the summer before Cole would spend a full year on his induction chemotherapy to beat his illness.
I posted the picture above. In case you don't know, I am the one on the right, with the wedgie.
I still look at this picture often, always amazed to think that it was taken at a time when our life was pollyanna, when bad things happened to other people--not to us. I look at my son's little hand, raised up into my own, and feel the surge of the bond from our contact. I carry a sand pail in my right hand, ready to tackle another project together, my buddy and I. Together. Regardless if it entails building a sand castle or fighting a life-threatening illness. I am there for my kids, always.
Finally, look at the view that faced us as we walked forward. The big, big ocean, although only a small part of our bigger, bigger world. The enormity of symbolism in this picture staggers me. Come hold my hand, Cole, I must have thought, I'll take care of you. And together, we head on into the waves, into the roughening path that life sometimes leads us on.
Blindly and unknowing, we walked, but with a strength and a conviction that any obstacle will be faced to the best of our ability.
And although it took a couple hard-fought battles, we won Cole's war. He won his war.
I don't think I need to tell you who my inspiration is...
As always, big thanks for reading. I do cook more than egg whites, I promise. And my wife does help pick up the yard, sometimes (she asked me to let you know--lol). I hope this finds you well and that you are both inspiring and inspired in your own life...
Monday, January 10, 2011
Take A Picture
Like anyone else who works in the ER, I wish I could take pictures and videotape some of our more absurd, inebriated patients. Of course, though, I can't--patient confidentiality and all that blah-blah stuff. But how great would it be to sit a patient down, after they sobered up, and show them how ridiculous their behavior was while in our care? Maybe, even, send a copy to their proud parents or spouse.
Personally, if I ever had twelve beers and ten shots of tequila before proceeding to crap and vomit all over myself, I would like a picture or two to convince me it really happened.
It was 2 am and I was standing at the counter of our nursing station nearest the ambulance bay doors, finishing a chart while dreaming about going home within the next hour, when the doors suddenly swung open and a prehospital team proceeded to wheel a disheveled patient into our ER hallway. Usually, the team contacts us by radio to alert us of their pending arrival with a patient, so their unannounced visit was a surprise to all of us.
The chief paramedic shrugged. "Sorry," he said, "but we picked her up at a bar just a few blocks away and didn't have time to call."
On their cot, obviously intoxicated, sat a peroxide-blond female, in her mid-twenties, with her head slumped to her right side and her breasts barely contained by her skimpy halter. Her hair was messed, the hairspray she spritzed earlier in the evening unintentionally spiking clumps in all directions. Her face was streaked with tears, darkened trails of waterproof-less mascara collecting at her chin. Drool gathered at her mouth's angles.
So, so pretty.
Of course, I was intrigued. "She was at the bar," the paramedic continued, "drinking for the past three hours, when her friends got concerned because she wasn't 'acting right.' Remembering she had diabetes, they called us to come 'check her out.' When we got there, she was passed out on a bench in front of the tavern, a puddle of vomit at her feet. Her finger stick was 87, so we decided to bring her in. She doesn't have any signs of trauma, doc."
Well, thank you fellas.
As the paramedic was speaking, as if on cue, the patient cocked her one eye open and, realizing she had an audience, started wailing and shrieking, her cry alternating between forced hiccups and gasping sobs. The hallway filled with various heads poking out of the treatment rooms, wondering how a hyena ended up in our ER.
"Room 23," the charge nurse said. The paramedics hurried off with their patient.
A few minutes later, walking back to my computer station, I passed Room 23, slowing down to check-out what was going on with our new patient (yes, I was nibshitting). I'm glad I did, though, if for no other reason than to find the paramedic holding this patient in both arms, a hero carrying his damsel-in-distress, while transferring her dead-weight from his cot to ours. I stopped and waved to him, laughing, and he shook his head in disgust. "Sometimes I hate my job," he muttered with a smile.
I stopped in and did a brief primary exam, listening to the patient's heart and lungs, confirming her stable vitals, and making sure she had no evidence of trauma. She didn't. All the while, she kept asking for the bouncer from the bar. Over and over and over. "Maam," I finally said, "nobody came with you. I'm sure the bouncer had to stay to finish out his shift."
"Ahh," she slurred, "screw him. He has a small penis, anyway." As she spoke, she pinched her thumb and index finger an inch apart from one another, giggling to herself while amusing us. "How do you know that?" her nurse, Barb, asked. "Well, duh," the patient replied, "I can hardly feel him when we have sex." I almost threw up in my mouth from her sharing so much (or so little) information.
So, so classy.
As the nurse removed this patient's clothing to put her in a gown, we discovered that the patient had on three layers of compression garments around her middle--a spanx, a girdle, followed by another spanx. For those of you not familiar with spanx (and I wasn't, so the nursing staff kindly informed me), it is a stretchy, spandex-type piece that, after you hold your breath and squeeze yourself into it, acts like a casing to your sausage body. Miraculously, you look thinner and more fit. Without going to the gym or watching your diet. Your difficulty breathing, profuse sweating, and pinched-up, cyanotic face, though, might just be dead-giveaways that you are wearing one.
"Why in God's name," Barb continued, not learning her lesson about asking questions from before, "are you wearing three of these? I've never seen anything like this."
"Well, duh," the patient answered again, "maybe so I can get laid by a guy who likes skinny girls." I get it--three layers tripled her chances.
I'm assuming that she was assuming that she looked more attractive all squished into her itty-bitty jeans and shirt with the help of her garments, but really? Did she think this situation through? What guy, one who was probably out drinking at the same bar as her, would be able to remove three of these things? Would the effort be worth it? Would his spanx-removal talent have a big payoff? Sober, I doubt any guy would be able to succeed in getting this patient out of her spanx, but throw some drinks into the equation and what do you have? Besides the fumbling, frustrated fingers of her date? Failure, through and through.
All the while, the patient continued talking in a slurring half-whisper, occasionally bursting out in giggles from her self-amusement. Several times, she belched so obnoxiously that it would have made any beer-guzzling, football-watching male proud. And one time, she dug her finger so high up her nose for a booger that I think her elbow was resting on her chin. Needless to say, I was fascinated by her influenced behavior and lack of awareness.
Finally, though, my biggest shock of the evening came from what the nurse shared with me. It seems that as the tech and nurse finished undressing the patient for observation, they were unpleasantly surprised to find this patient and all her southern female parts barely covered by her thong underwear.
Her American flag thong underwear!!! Three square inches of red, white, and blue fabric.
I was never less proud to be an American.
For various reasons, I found this news appalling. And so did the nurse and tech. Never before, in my vast experiences, did I see some skimpy underwear fashioned in this manner. When did a manufacturer start finding it appropriate to place the American flag, our sacred national symbol, on a little triangular patch that covers a woman's privates. Or worse (I'm shuddering here), a man's? I mean, let's reason this out. If our flag touches the ground, out of respect, isn't the protocol to attempt to lift it up from the ground (if possible) and, if not, burn it. Yet, it's perfectly okay for someone to wear our prideful flag pressed against their privates? Something about this thought just didn't sit right with me.
Let's be proactive. I say we gather all the existing American flag thongs out there and have ourselves a big--no, make that huge-- bonfire. Quite honestly, though, that's one bonfire I would probably dread attending.
I did get to eventually leave at my scheduled time, 3 am, after signing out my active patients to the overnight doctor. The patient, who had no sober friends or family available to come take her home, did fine throughout the night's observations, barring the occasional outbursts of swearing, drunk mumbling, and promiscuous suggestions. When she sobered up, however, according to the morning team, she turned out to be a very nice, pleasant young woman who just happened to "have a rough night."
"She could have been your sister or mine," the nurse added.
"Umm, no," I thought to myself, "I don't think so." I wasn't about to picture any of my sisters in an American flag thong, let alone being ridiculously drunk while holding their thumb and index finger an inch apart.
My final thought...maybe I don't need to take a picture or videotape this stuff, after all. Really, the mental image is reminder enough for me. Who needs a timeless picture to document such dread? Or the nightmares that would follow? If anything, I guess you can just take a picture of me, the treating physician. I'll give you permission. Just excuse my gaping mouth, my surprising eyes, and my befuddled expression when you get it printed...
As always, big thanks for reading. If you own a pair of American flag thong underwear, do me a big favor and throw them out. STAT! See you soon...
Personally, if I ever had twelve beers and ten shots of tequila before proceeding to crap and vomit all over myself, I would like a picture or two to convince me it really happened.
It was 2 am and I was standing at the counter of our nursing station nearest the ambulance bay doors, finishing a chart while dreaming about going home within the next hour, when the doors suddenly swung open and a prehospital team proceeded to wheel a disheveled patient into our ER hallway. Usually, the team contacts us by radio to alert us of their pending arrival with a patient, so their unannounced visit was a surprise to all of us.
The chief paramedic shrugged. "Sorry," he said, "but we picked her up at a bar just a few blocks away and didn't have time to call."
On their cot, obviously intoxicated, sat a peroxide-blond female, in her mid-twenties, with her head slumped to her right side and her breasts barely contained by her skimpy halter. Her hair was messed, the hairspray she spritzed earlier in the evening unintentionally spiking clumps in all directions. Her face was streaked with tears, darkened trails of waterproof-less mascara collecting at her chin. Drool gathered at her mouth's angles.
So, so pretty.
Of course, I was intrigued. "She was at the bar," the paramedic continued, "drinking for the past three hours, when her friends got concerned because she wasn't 'acting right.' Remembering she had diabetes, they called us to come 'check her out.' When we got there, she was passed out on a bench in front of the tavern, a puddle of vomit at her feet. Her finger stick was 87, so we decided to bring her in. She doesn't have any signs of trauma, doc."
Well, thank you fellas.
As the paramedic was speaking, as if on cue, the patient cocked her one eye open and, realizing she had an audience, started wailing and shrieking, her cry alternating between forced hiccups and gasping sobs. The hallway filled with various heads poking out of the treatment rooms, wondering how a hyena ended up in our ER.
"Room 23," the charge nurse said. The paramedics hurried off with their patient.
A few minutes later, walking back to my computer station, I passed Room 23, slowing down to check-out what was going on with our new patient (yes, I was nibshitting). I'm glad I did, though, if for no other reason than to find the paramedic holding this patient in both arms, a hero carrying his damsel-in-distress, while transferring her dead-weight from his cot to ours. I stopped and waved to him, laughing, and he shook his head in disgust. "Sometimes I hate my job," he muttered with a smile.
I stopped in and did a brief primary exam, listening to the patient's heart and lungs, confirming her stable vitals, and making sure she had no evidence of trauma. She didn't. All the while, she kept asking for the bouncer from the bar. Over and over and over. "Maam," I finally said, "nobody came with you. I'm sure the bouncer had to stay to finish out his shift."
"Ahh," she slurred, "screw him. He has a small penis, anyway." As she spoke, she pinched her thumb and index finger an inch apart from one another, giggling to herself while amusing us. "How do you know that?" her nurse, Barb, asked. "Well, duh," the patient replied, "I can hardly feel him when we have sex." I almost threw up in my mouth from her sharing so much (or so little) information.
So, so classy.
As the nurse removed this patient's clothing to put her in a gown, we discovered that the patient had on three layers of compression garments around her middle--a spanx, a girdle, followed by another spanx. For those of you not familiar with spanx (and I wasn't, so the nursing staff kindly informed me), it is a stretchy, spandex-type piece that, after you hold your breath and squeeze yourself into it, acts like a casing to your sausage body. Miraculously, you look thinner and more fit. Without going to the gym or watching your diet. Your difficulty breathing, profuse sweating, and pinched-up, cyanotic face, though, might just be dead-giveaways that you are wearing one.
"Why in God's name," Barb continued, not learning her lesson about asking questions from before, "are you wearing three of these? I've never seen anything like this."
"Well, duh," the patient answered again, "maybe so I can get laid by a guy who likes skinny girls." I get it--three layers tripled her chances.
I'm assuming that she was assuming that she looked more attractive all squished into her itty-bitty jeans and shirt with the help of her garments, but really? Did she think this situation through? What guy, one who was probably out drinking at the same bar as her, would be able to remove three of these things? Would the effort be worth it? Would his spanx-removal talent have a big payoff? Sober, I doubt any guy would be able to succeed in getting this patient out of her spanx, but throw some drinks into the equation and what do you have? Besides the fumbling, frustrated fingers of her date? Failure, through and through.
All the while, the patient continued talking in a slurring half-whisper, occasionally bursting out in giggles from her self-amusement. Several times, she belched so obnoxiously that it would have made any beer-guzzling, football-watching male proud. And one time, she dug her finger so high up her nose for a booger that I think her elbow was resting on her chin. Needless to say, I was fascinated by her influenced behavior and lack of awareness.
Finally, though, my biggest shock of the evening came from what the nurse shared with me. It seems that as the tech and nurse finished undressing the patient for observation, they were unpleasantly surprised to find this patient and all her southern female parts barely covered by her thong underwear.
Her American flag thong underwear!!! Three square inches of red, white, and blue fabric.
I was never less proud to be an American.
For various reasons, I found this news appalling. And so did the nurse and tech. Never before, in my vast experiences, did I see some skimpy underwear fashioned in this manner. When did a manufacturer start finding it appropriate to place the American flag, our sacred national symbol, on a little triangular patch that covers a woman's privates. Or worse (I'm shuddering here), a man's? I mean, let's reason this out. If our flag touches the ground, out of respect, isn't the protocol to attempt to lift it up from the ground (if possible) and, if not, burn it. Yet, it's perfectly okay for someone to wear our prideful flag pressed against their privates? Something about this thought just didn't sit right with me.
Let's be proactive. I say we gather all the existing American flag thongs out there and have ourselves a big--no, make that huge-- bonfire. Quite honestly, though, that's one bonfire I would probably dread attending.
I did get to eventually leave at my scheduled time, 3 am, after signing out my active patients to the overnight doctor. The patient, who had no sober friends or family available to come take her home, did fine throughout the night's observations, barring the occasional outbursts of swearing, drunk mumbling, and promiscuous suggestions. When she sobered up, however, according to the morning team, she turned out to be a very nice, pleasant young woman who just happened to "have a rough night."
"She could have been your sister or mine," the nurse added.
"Umm, no," I thought to myself, "I don't think so." I wasn't about to picture any of my sisters in an American flag thong, let alone being ridiculously drunk while holding their thumb and index finger an inch apart.
My final thought...maybe I don't need to take a picture or videotape this stuff, after all. Really, the mental image is reminder enough for me. Who needs a timeless picture to document such dread? Or the nightmares that would follow? If anything, I guess you can just take a picture of me, the treating physician. I'll give you permission. Just excuse my gaping mouth, my surprising eyes, and my befuddled expression when you get it printed...
As always, big thanks for reading. If you own a pair of American flag thong underwear, do me a big favor and throw them out. STAT! See you soon...
Monday, January 3, 2011
The Beaten Path
It has been almost five years since my mother lost her brave war against leukemia. Within this time frame, sadly, some of Mom's familiar traditions have become more of a fond memory rather than a continued reality. For example, although we can all cook a Christmas ham, it was Mom who criss-crossed those seasoning cloves just right on the hind, drowning them again and again with her secret glaze until the browning and flavoring were perfect. And it was Mom who decorated our home and Christmas tree into a welcoming, warm winter wonderland, season after season. Sure, my wife and sisters could probably duplicate her feats, given enough time, but it's just not the same without that extra ooomph of Mom's energy swirling among all the festive activities. Of her love swirling among her family.The realization (or maybe, rather, fear) that someday my kids wouldn't remember Gramma, with her specialness and unique ways, was so strong, so biting, immediately after her death that I, along with my siblings, worked hard on trying to keep things just the way they were before she died. We tried to arrange the food in the fridge like she did. We continued keeping a pen and paper on the counter in the kitchen, right where she did. We folded towels just right, "like Mom taught us." We changed bedsheets from the cotton variety to flannel and then back during the revolving seasons of each year. We spritzed her perfume in the bedroom, desperately trying to keep her scent fresh. Writing cards, cooking a favorite meal, shopping in excess (with seven kids, if something was on sale, you bought ten of it), calling one another on Sundays...
Not only us kids, but Dad, too, seemed to expend a momentous amount of energy into recreating a surrounding environment much as Mom would maintain. As if somehow, despite Mom's permanent absence, submerging ourselves into a specific physicality of life would sustain our memories and souls.
Wrong.
Slowly, we each learned (at different paces and different depths) that it was okay to create new memories. New traditions. That it was not a betrayal of Mom or her memory to not bake a ham on Christmas or to not fold the towels in tri-fold but rather bi-fold. Memories injected with her presence, I learned, would always make me smile, no matter how things may now be done.
As a result, new traditions have begun to emerge within my family, poking their hesitant faces through the stomped, packed-down soil (laid by moi) and into our sunlight. They are now welcomed whole-heartedly. Fresh Polish sausage and perogies have become our Christmas dinner staple.
Dad, like a few of my siblings, will still occasionally struggle over the exactness of maintaining Mom's traditions. However, he too has gradually learned to let go of some of the uniqueness of these traditions and, instead,"go with the flow." His smiles and good-naturedness seem to walk hand-in-hand with releasing some of that burden. As they say, a remake is rarely as good as the original.
Just like the rest of us, Dad has also created some of his own rituals and traditions. And recently, while visiting him over the holidays, I was reminded of one of his rituals that I hope he never abandons.
It was during the drive home to visit my father that I explained to my wife that I was struggling to find material to write through the holidays that did not carry too much "heaviness" to it. It seemed all I was observing in the ER were patients and families with too many problems, too much heartache, and too high a level of expectation that we could fix all of their problems. On Christmas day alone, I continued, I had seen several elderly adults, without any complaints, "dumped" off in our ER by family who then immediately left to resume their holiday celebrations. "You'll have to keep Mom a few days," said one son, "so don't call me to come pick her up." After seeing an older gentleman for "trouble walking for ten years," abandoned by his family in our waiting room, I was losing a little faith.
Where was the love?
As we approached my childhood hometown, much like we always do, we turned off the main highway onto a small country road, a road that leads to the cemetery where my mother is buried. Single-lane and winding, my kids love how I beep before each sharp curve to alert an opposing vehicle or pedestrian that we are "coming around the mountain." It is a five-mile country journey that we have grown to love, anticipating the moment when we can pull off the bumpy dirt road and into the cemetery, where Mom is always waiting for our visit, right beside Christ on his crucifix. A visit back always starts this way.
Cautiously, because of freshly falling snow, our vehicle ascended the cemetery's small entrance knoll, turning left and then right and then left again, until we parked alongside the field where Mom is buried. As the kids always do, they hurried from our SUV and ran to Mom's grave stone, appreciating the fresh evergreen wreath, the new plaque, the winter flowers, and the leftover sea shells brought by Gracie the previous summer.
As my wife and I took our time getting out of the vehicle, my wife pointed down to the snow-covered ground and exclaimed, "Jim, do you see what I see?" I looked to where her finger was pointing, to the aisle leading to my mother's grave, but remained oblivious to her point.
"Look at all the other grave sites and aisles leading to them," she continued, "and tell me what you see."
I looked around at the cemetery, paying extra attention to the aisles. They were covered in freshly-fallen snow, hardly disturbed, except for the occasional lone foot prints leading to a stone and back. I looked back at the aisle leading to my mother's grave site. And then I got it--my wife's amazingly simple point.
"Do you see the footprints?" she asked, as I looked down to appreciate the well-worn path made by my father's size 15 winter boots, a path that lead right to my mother. His multiple trips back and forth were evident.
And suddenly, at this very moment during this very holiday season, I had found the love. A diamond of wonder among the sparse holiday rubble of disappointments.
My father will soon be turning 81 and, yet, twice a day, every day for the last five years, he has visited my mother. Through thick and thin. Through sunshine and snowstorms. Through the emerging dawn and the pending dusk. Rearranging fresh flowers, lovingly trimming weeds, and cursingly wiping bird poop for her stone's top. Crossing himself time and again while whispering his prayers. Sometimes, I imagine, wiping a tear from his eye. Sometimes, I'm sure, smiling his big smile while immersed in a warm memory.
And down at my feet, where I stood, was the proof of his five-year tradition--his beaten path leading to and from Mom's grave.
I smiled big, hugging my wife for pointing out this almost-missed moment. How could I have not seen this beaten, well-worn path? I grabbed my cell phone and immediately took several pictures, one included above, although none captured the minute details of each of my father's boot prints. It didn't matter, though. The moment had imprinted itself into my mind, forever.
And suddenly, as I looked toward my wife, who had joined my kids at Mom's grave site, I spun myself around, taking in the magnificent surrounding mountains while breathing in the clean country air. This world of ours made sense--the clarity of things changing, of the constant coming and going of new and old traditions that would continue to feed our wanting souls.
I wonder what traditions my children will continue when they become adults. Me? I know one tradition I hope to someday emulate or be the recipient of...
The beaten path.
To Karen, thanks for pointing out the obvious to me. As always, a big thanks to you for reading...I hope you each had a great holiday season and are enjoying the new year.
Friday, December 24, 2010
Continued Prayers, Wishes, & Hopes
I pulled up my last-year wishes for you and found myself nodding my agreement as I read, finding that the sentiment and spirit are as strong today as when I wrote them one year ago.
My continued prayers, wishes, and hopes for you and yours...have a Blessed and Happy Holidays.
Another holiday season is upon us. For all the unbridled joy and excitement that surrounds us, however, there is an uneasiness within my core that seems to seed itself every year. I don't think I am alone.
I have seen enough heartache through the year to know that joy and excitement can be very temporary. Can you even imagine wrapping presents only to return them after the holiday season because of an untimely death, never having the chance to give them? Over the holiday season, especially, heartache seems to magnify itself into a swirling tornado ready to touch down on so many lives. I've seen a lot of energy spent outrunning that tornado.
So, for all the happiness, I still can't help but be reminded of how hard these upcoming days will be for so many. My heart goes out to them. Especially the children.
How do I remember the important things in my life? And not just over the holidays, but every day? I know I have been blessed in my life. When I think of these blessings, none of them have to do with material things but rather things that spiritually feed my soul. Companionship, loyalty, kindness, and love. And more love. These make me a better person.
So, in the spirit of this holiday season, I share just a few of my prayers, my wishes, and my hopes with you.
I pray for my family, my friends, and those in the world that are in need. I pray that my son remains in remission for another five years, and another five years after that. I pray that my mother can look down on my family and smile. I pray she knows the power of her prayers, asking a forgiving God to show my son mercy and take her in His arms instead when they were both battling their malignancies. I pray that I can be gracious in adversity, always.
I wish for my family, my friends, and those in the world to know love, to embrace kindness, and to step outside the box and give more of themselves. I wish for endless hugs. I wish for good health. I wish for every child to know warmth in their heart and comfort in their soul. I wish for peace.
I hope that the ripples from compassion will disperse beyond our wildest imaginations. I hope that random acts of kindness multiply. I hope that thoughts of others will replace thoughts of ourselves. I hope that we all remember that we are in this together. I hope that your joy, your happiness, and your excitement is not temporary but rather infinite.
I pray you have a wonderful holiday season. I wish for all your expectations to be fulfilled. I hope the most important presents you will give this holiday season are gifts you can give each day through the year.
Happy Holidays...
As always, big thanks for reading... To my amazing readers...I truly hope this holiday season is blessed and happy for you and all the people in your lives.
My continued prayers, wishes, and hopes for you and yours...have a Blessed and Happy Holidays.
Another holiday season is upon us. For all the unbridled joy and excitement that surrounds us, however, there is an uneasiness within my core that seems to seed itself every year. I don't think I am alone.
I have seen enough heartache through the year to know that joy and excitement can be very temporary. Can you even imagine wrapping presents only to return them after the holiday season because of an untimely death, never having the chance to give them? Over the holiday season, especially, heartache seems to magnify itself into a swirling tornado ready to touch down on so many lives. I've seen a lot of energy spent outrunning that tornado.
So, for all the happiness, I still can't help but be reminded of how hard these upcoming days will be for so many. My heart goes out to them. Especially the children.
How do I remember the important things in my life? And not just over the holidays, but every day? I know I have been blessed in my life. When I think of these blessings, none of them have to do with material things but rather things that spiritually feed my soul. Companionship, loyalty, kindness, and love. And more love. These make me a better person.
So, in the spirit of this holiday season, I share just a few of my prayers, my wishes, and my hopes with you.
I pray for my family, my friends, and those in the world that are in need. I pray that my son remains in remission for another five years, and another five years after that. I pray that my mother can look down on my family and smile. I pray she knows the power of her prayers, asking a forgiving God to show my son mercy and take her in His arms instead when they were both battling their malignancies. I pray that I can be gracious in adversity, always.
I wish for my family, my friends, and those in the world to know love, to embrace kindness, and to step outside the box and give more of themselves. I wish for endless hugs. I wish for good health. I wish for every child to know warmth in their heart and comfort in their soul. I wish for peace.
I hope that the ripples from compassion will disperse beyond our wildest imaginations. I hope that random acts of kindness multiply. I hope that thoughts of others will replace thoughts of ourselves. I hope that we all remember that we are in this together. I hope that your joy, your happiness, and your excitement is not temporary but rather infinite.
I pray you have a wonderful holiday season. I wish for all your expectations to be fulfilled. I hope the most important presents you will give this holiday season are gifts you can give each day through the year.
Happy Holidays...
As always, big thanks for reading... To my amazing readers...I truly hope this holiday season is blessed and happy for you and all the people in your lives.
Tuesday, December 21, 2010
Defining Emergency
Emergency, as per the all-knowing Webster, is defined as an unforeseen combination of circumstances or the resulting state that calls for immediate action. Furthermore, an emergency is also defined as an urgent need for assistance or relief.
These definitions sound pretty spot-on, right? When thinking about emergency room settings, even, one can easily correlate the words of Webster to what one would necessitate to be a situation requiring emergency medical treatment. A trauma. Broken bones. A heart attack. A stroke. A seizure. Respiratory distress. A cardiac arrest. The list goes on and on and on. When a critical illness or injury occurs, then, we should all be thankful that we live within a society where emergent, life-saving medical care is available.
Lately, though, it seems the system meant to provide this care is being bogged down by questionable decision-making. Instead of providing emergent care, it seems I spend at least half of my emergency room time now playing doctor to chronic illnesses. To pain control issues. To mildly elevated blood pressure readings. To months of nonspecific weaknesses and fatigue. To office appointments sent to the ER because "we are overbooked today." And our ER is not alone. I hear the frustration of my colleagues and see first-hand how overworked most of us who provide health care in the ER setting have become.
A month back, I was in the middle of a very busy shift. Several patients with chest pain (one requiring immediate catheterization), two patients with respiratory distress (one from skipping dialysis and one from a COPD exacerbation), and three patients from a motor vehicle collision presented almost simultaneously to our ER. Within minutes, all of these critical patients had been treated with efficient, appropriate life-saving care. The team on deserved kudos for doing their job well and making a difference in these patients' outcomes.
Walking back to the nursing station, then, I was surprised to find our secretary being berated by a gentleman in his thirties at the counter. His voice was loud and menacing. His face was pinched with anger. His fists were clenched by his side.
"Whoa," I said, walking up to him, standing between him and the secretary, "what seems to be the problem, sir?"
"We've been waiting two hours to be seen by a doctor!" he exclaimed. "What the hell is going on around here?"
Are you kidding? All he had to do was look for himself to find the organized commotion that was occurring in our ER setting. What followed was the briefest of conversations.
"Sir," I asked, "what brought you to our ER today?"
"My daughter's left ear is hurting her."
"For how long?" I asked.
"Two hours," he replied.
Two hours of ear pain? I get it--maybe he was worried about his daughter. I would be as well. But my daughter would also have gotten Tylenol and Advil and watched her daddy patiently wait for their turn to be treated once the dire situation had been explained. Better yet, we would have probably waited until the morning when a call could be placed to her personal physician.
I explained to him that we had multiple critical patients brought to us and we would be with his daughter as soon as possible. "We're all trying our best, sir," I added, "but you're going to need to be a little more patient."
The father stared me in the eye. I stared back. Finally, he blurted out what he had been thinking to say. "Well, then," he spoke, sarcasm dripping from his pathetic words, "try harder." It didn't end there, though. He continued. "This is bullshit waiting two hours to be seen."
Before I could respond, he turned his back and huffed himself back into Room 27 where, the nurse shared with me, his eleven year-old daughter comfortably sat watching TV. "And," the nurse added, "I had already explained to him why they were waiting to be seen."
After this, one of our regulars who had been to our ER over 200 times (since we started tracking in March of 2006) arrived via ambulance. Then a gentleman carrying a big bottle of Mountain Dew was escorted from his ambulance, by foot, into our ER because his main complaint was "I just want to take a nap and was too far from my apartment." Next, an asymptomatic patient with elevated blood pressure for three years, non-compliant with her medications for financial reasons (yes--I noticed the pack of cigarettes hanging from her purse), was sent to us from her family doctor to be cured on the spot. "Go right to the ER," she was told.
Can you appreciate the obviousness of the long waiting times in the emergency department? Although we all pride ourselves on providing expedient care, a four to six hour wait is sometimes the reality for some of our noncritical patients.
As if to hammer the point home, my last patient during my shift that night (I was working 5pm to 3am) was a sixteen year old female who had presented to our ER, via ambulance at 2am, with her mother.
I walked into her room to find this patient and her mother both lying in the cot, laughing while watching TV, the patient in no obvious distress. I introduced myself to them before I started asking questions. "What can I do to help you tonight? What brought you to our emergency room?"
The girl looked at her mother and started giggling, my first sign that she would survive whatever her ailment may be.
"Well," she said shyly, "I've had some burning when I pee for about a week. And," she added, not done "I have something gross leaking from down there (she swept her hand towards her pelvis as she spoke)." Upon further questioning, I learned that she had been diagnosed with a yeast infection from her family doctor one month ago but failed to get her prescription filled. I also learned that she was sexually active with not one, but two partners. Unprotected.
I was disheartened. "What made you come to the ER at 2am when these symptoms have been going on for over a week?" I asked, hoping there was some rhyme or reason to her seeking out emergent care at this time. There wasn't. Her answer to my question--"Why not?" I didn't even approach her on why she came in by ambulance. Some things are better not known, I guess, especially at 2am.
I'm not sure this is the system that was imagined when emergency departments started gaining favor in our society. Don't get me wrong, though. I, like all of my colleagues, are 100% committed to providing respectful and appropriate care to anyone who shows up in our department, whether it be a critical, life-threatening illness or a chronic "nuisance," so to speak.
I can only hope that people will be patient and understanding as we all cope with the evolving changes that seem to be occurring with our health care system. And my hat is off to all the medical folks who work hard, day after day, treating our fellow mankind as best we can within this currently accepted system. Because, even as bogged down as we can sometimes become, what an awesome privilege we have in meeting and greeting and treating our fellow kind. Of helping them out in their time of need.
Salute!!!
As always, big thanks for reading. I wish a blessed holiday season to each and every one of you...
These definitions sound pretty spot-on, right? When thinking about emergency room settings, even, one can easily correlate the words of Webster to what one would necessitate to be a situation requiring emergency medical treatment. A trauma. Broken bones. A heart attack. A stroke. A seizure. Respiratory distress. A cardiac arrest. The list goes on and on and on. When a critical illness or injury occurs, then, we should all be thankful that we live within a society where emergent, life-saving medical care is available.
Lately, though, it seems the system meant to provide this care is being bogged down by questionable decision-making. Instead of providing emergent care, it seems I spend at least half of my emergency room time now playing doctor to chronic illnesses. To pain control issues. To mildly elevated blood pressure readings. To months of nonspecific weaknesses and fatigue. To office appointments sent to the ER because "we are overbooked today." And our ER is not alone. I hear the frustration of my colleagues and see first-hand how overworked most of us who provide health care in the ER setting have become.
A month back, I was in the middle of a very busy shift. Several patients with chest pain (one requiring immediate catheterization), two patients with respiratory distress (one from skipping dialysis and one from a COPD exacerbation), and three patients from a motor vehicle collision presented almost simultaneously to our ER. Within minutes, all of these critical patients had been treated with efficient, appropriate life-saving care. The team on deserved kudos for doing their job well and making a difference in these patients' outcomes.
Walking back to the nursing station, then, I was surprised to find our secretary being berated by a gentleman in his thirties at the counter. His voice was loud and menacing. His face was pinched with anger. His fists were clenched by his side.
"Whoa," I said, walking up to him, standing between him and the secretary, "what seems to be the problem, sir?"
"We've been waiting two hours to be seen by a doctor!" he exclaimed. "What the hell is going on around here?"
Are you kidding? All he had to do was look for himself to find the organized commotion that was occurring in our ER setting. What followed was the briefest of conversations.
"Sir," I asked, "what brought you to our ER today?"
"My daughter's left ear is hurting her."
"For how long?" I asked.
"Two hours," he replied.
Two hours of ear pain? I get it--maybe he was worried about his daughter. I would be as well. But my daughter would also have gotten Tylenol and Advil and watched her daddy patiently wait for their turn to be treated once the dire situation had been explained. Better yet, we would have probably waited until the morning when a call could be placed to her personal physician.
I explained to him that we had multiple critical patients brought to us and we would be with his daughter as soon as possible. "We're all trying our best, sir," I added, "but you're going to need to be a little more patient."
The father stared me in the eye. I stared back. Finally, he blurted out what he had been thinking to say. "Well, then," he spoke, sarcasm dripping from his pathetic words, "try harder." It didn't end there, though. He continued. "This is bullshit waiting two hours to be seen."
Before I could respond, he turned his back and huffed himself back into Room 27 where, the nurse shared with me, his eleven year-old daughter comfortably sat watching TV. "And," the nurse added, "I had already explained to him why they were waiting to be seen."
After this, one of our regulars who had been to our ER over 200 times (since we started tracking in March of 2006) arrived via ambulance. Then a gentleman carrying a big bottle of Mountain Dew was escorted from his ambulance, by foot, into our ER because his main complaint was "I just want to take a nap and was too far from my apartment." Next, an asymptomatic patient with elevated blood pressure for three years, non-compliant with her medications for financial reasons (yes--I noticed the pack of cigarettes hanging from her purse), was sent to us from her family doctor to be cured on the spot. "Go right to the ER," she was told.
Can you appreciate the obviousness of the long waiting times in the emergency department? Although we all pride ourselves on providing expedient care, a four to six hour wait is sometimes the reality for some of our noncritical patients.
As if to hammer the point home, my last patient during my shift that night (I was working 5pm to 3am) was a sixteen year old female who had presented to our ER, via ambulance at 2am, with her mother.
I walked into her room to find this patient and her mother both lying in the cot, laughing while watching TV, the patient in no obvious distress. I introduced myself to them before I started asking questions. "What can I do to help you tonight? What brought you to our emergency room?"
The girl looked at her mother and started giggling, my first sign that she would survive whatever her ailment may be.
"Well," she said shyly, "I've had some burning when I pee for about a week. And," she added, not done "I have something gross leaking from down there (she swept her hand towards her pelvis as she spoke)." Upon further questioning, I learned that she had been diagnosed with a yeast infection from her family doctor one month ago but failed to get her prescription filled. I also learned that she was sexually active with not one, but two partners. Unprotected.
I was disheartened. "What made you come to the ER at 2am when these symptoms have been going on for over a week?" I asked, hoping there was some rhyme or reason to her seeking out emergent care at this time. There wasn't. Her answer to my question--"Why not?" I didn't even approach her on why she came in by ambulance. Some things are better not known, I guess, especially at 2am.
I'm not sure this is the system that was imagined when emergency departments started gaining favor in our society. Don't get me wrong, though. I, like all of my colleagues, are 100% committed to providing respectful and appropriate care to anyone who shows up in our department, whether it be a critical, life-threatening illness or a chronic "nuisance," so to speak.
I can only hope that people will be patient and understanding as we all cope with the evolving changes that seem to be occurring with our health care system. And my hat is off to all the medical folks who work hard, day after day, treating our fellow mankind as best we can within this currently accepted system. Because, even as bogged down as we can sometimes become, what an awesome privilege we have in meeting and greeting and treating our fellow kind. Of helping them out in their time of need.
Salute!!!
As always, big thanks for reading. I wish a blessed holiday season to each and every one of you...
Friday, December 10, 2010
Keep Your Cranky
Although the majority of my emergency department time is spent in a local 36-bed trauma center, I continue to work a few shifts each month in the small rural hospital near my childhood hometown, several hours away. It is a great change of pace, treating the local folks, while affording me a chance to spend a few evenings with my father and siblings' families.
Last week, I had to drive through white-out blizzard conditions during my most recent two-hour trip, taking approximately four hours each way because of the weather. White knuckles, breath-holding, tense and contracted muscles, stress headaches, and bouts of complaining to myself in the car--these were all part of the package deal. I imagined the cozy, 12-bed emergency department awaiting my arrival, however, and kept plugging along the icy roads, refusing to abandon my place in the thirty-car line of traffic. Going 20 mph. And braking every five seconds. Yep, good times, as any of you ever caught traveling in a snow storm are familiar with.
Arriving at the small ER, then, I was pleasantly surprised to see the festive decorations that adorned the department. Gold, shimmery garland draped the nursing station. Felt stockings and striped candy canes hung in random fashion along the glass enclosure walls. A Christmas tree was standing tall, twinkling and proud, in a nook of inactive space in the corner. It felt Norman Rockwelly and old-fashioned, and I felt welcomed. 'Tis the season.
The first of my scheduled shifts was quite hectic. From my prime seating in front of the ambulance bay doors, I was able to appreciate the outdoor weather. Blustery gusts of snow and heavy thick blankets of engorged snowflakes descended and tormented, without pause, the small town through the day. Although I felt worry and concern for anyone out in this weather, a blazing fireplace, a good book, and a glass of wine were the only things that would have added to the enjoyment and appreciation I felt for this crazy weather.
Three hours into my shift, though, I remembered what the first snowstorm of the season means to an ER staff. Multiple MVCs (multiple vehicle collisions). First-time-of-the-season shovelers developing chest pain as they try to clear their sidewalks. Frequent falls resulting in contusions and broken bones and lacerations. Cough and cold symptoms magnified tenfold with every ten degree drop. Frostbite. And on...and on...and on...
By mid morning, we were swamped. And I loved it. All twelve beds were filled and the waiting room was starting to spill over. The multiple ambulance runs to pick up and drop off ill patients created a steady, rhythmic sense of humming chaos. Despite the craziness, the staff I was working with (many of them friends from my childhood) continued to smile while pushing onward. I was proud to be part of such a team, their hardwork quite evident. We were providing excellent care in a very efficient manner, discharging and admitting and transferring patients left and right.
So, was it really a surprise to me to find that, eventually, all good things come to an end and this run of busy but gratifying work would be interrupted by something unpleasant? I guess not, although I could still hope, right?
The unpleasantness came early afternoon, in the form of a man's booming, angry voice resonating from the hallway. I had been in Room 2 at the time, examining a new patient, an elderly female with dizziness.
"If you'll excuse me, maam," I said, "I need to go see what's going on in the hallway."
I left her room and shut the sliding glass door. Several nurses were in the hallway already, standing in front of a 60ish man, his mouth moving while he leaned forward into his walker. The obvious source of the angry yelling.
"Excuse me, sir," I said, walking between the nurses and right up to him, "what seems to be the problem?"
If any of you have seen the movies Grumpy Old Men and Grumpier Old Men, picture a shorter version of Walter Matthau with slightly more gray hair peeking out from his baseball cap. A pinched-up face. Angry, flaring eyes and a reddened, ruddy complexion. His flannel shirt was untucked from his blue denim pants. And his hands were balled into fists while maintaining his grip on his walker.
Those angry, flaring eyes didn't take long to focus on me. "Who the hell are you?" he asked, practically spitting on me with his disgust.
"I'm Dr. Jim, the emergency room doctor on shift for the day," I said, keeping my cool. "And you are...?" I deliberately left the question open.
"I'm the God-damned boyfriend of Room 6, if any of you lazy sons-of-bitches care," he screamed out, "and I need somebody from this God-damned first-aid station to tell me what the hell is going on with her."
I was surprised at this man's behavior, wondering to myself if he had tipped a few back during lunch. The level of rudeness and obnoxious behavior I encounter through my shifts continues to amaze me. Trying to placate this man would turn out to be an obvious failure.
Room 6, this patient's girlfriend, contained a woman in her 60s who had lingering burping and belching for six months. Today, this day of stormy weather, was the day she decided to pursue her symptoms, for no other reason than just "because I figured it was time to get checked out." She was right to come in, since her EKG revealed signs of heart ischemia that were confirmed by her elevated cardiac enzymes via blood work. I had seen and treated her immediately upon her arrival to our ER, as well as checked-in with her multiple times, making sure her symptoms had resolved and explaining the results of her tests. Currently, the cardiologist was on his way to the ER to make further recommendations.
At no time during this woman's hour stay did a boyfriend present himself. She had been in the room alone.
"Sir, keep your voice down," I told him, "we have a lot of sick patients in this ER today. And when did you get here," I continued, "since I've been in your girlfriend's room multiple times in the past hour."
"Me, too," piped in Marsha, the patient's nurse.
"I just got here," he said, shaking his head in disgust, "and nobody made it a point to explain things to me." He continued to rant and rave, insulting anyone associated with the small rural hospital.
"That's not true," Marsha disputed, "I explained everything I knew to you, just a few minutes ago, after you walked into your girlfriend's room. I even offered you a chair, coffee, a blanket."
"Regardless, sir," I said, proud of Marsha, "you could have asked in a much better way than walking into the hallway and screaming like this for everyone to hear." He eyed me up, surprised at my confronting him on his behavior. "Now," I said, "these are your two choices. Either leave the department and wait in the waiting room, or go back into your girlfriend's room and act like a gentleman. After she answers your questions, I'll be in to answer anything further. With her permission, of course."
There was a standoff. He eyed me. I eyed him. The nurses all held their breath. Finally, he spoke. Or yelled. "Screw you. I'm going to go, God-damn it, and feed her God-damn mutt of a dog. But I'll be back," he said.
Before leaving, he tried one last parting shot. "I envy your God-damn generation," he muttered, "none of you know what hard work is. Not a single one."
Well, I thought back to my 14 hour days working with my father's crews in the woods when I was a teenager. I thought about waking up in my childhood on Saturdays and Sundays to cut and stack firewood and cut grass. I thought about the numerous chores our parents expected of us. I thought about the endless sleepless nights I spent, first studying through college, then medical school, and finally through residency, before some semblance of normalcy finally arrived to my life.
"Sir, you don't know me or any of the nurses, do you?" I asked, sweeping my hand towards them. He nodded "no." "Then how," I continued, "can you say such a rude thing? I would never consider insulting you the way you've insulted our staff. It's not necessary and your bad attitude isn't helping anyone. It's time for you to go."
"Well," he stammered, "even if you aren't lazy, most of your God-damn generation is."
And with that, he continued on his way out of our "first-aid station," decorated to celebrate the joy of the wondrous holiday, shaking his head in disgust until he walked through the waiting room doors.
After he left, our staff regrouped in the nursing station. Amazingly, not one person was affected negatively by this gentleman. Everyone had the good sense to dispel his insults and demeaning behavior without a second thought. "I can only hope," I warned them all, "that I'm not that grouchy when I get older."
I visited Room 6, the girlfriend. She was still clear of all her symptoms, but looked teary-eyed. "I'm so sorry for his behavior," she said, obviously hearing the conversation that had just occurred in the hallway, "he's like that all the time. But Doctor, just so you know, your staff treated me wonderfully today." She assured me, upon my questioning, that she was safe and not being abused physically. She declined any counseling offers. "He's a dog with a big bark and no bite," was how she put it. I wanted to ask her "Why?" Why in the world would she stay with a man so unpleasant, so abrupt and obnoxious? But I didn't. We all have our reasons for living our lives the way we do, and she was no exception. Besides, the world was continuing to revolve and I was needed in several other rooms.
An hour later, Mr. Crank was back. Before even entering his girlfriend's room, he walked himself right through the nursing station, stopping on its edge. "Now what the hell is going on?" he yelled, lifting his walker from the floor before banging it back down, startling me from the chart I was working on.
And the conversation continued as before--him insulting our staff and hospital with vulgar language, me giving him the option of either going to his girlfriend's room or the waiting room. In my book, this was his last chance, and I conveyed it respectfully to him.
He walked to his girlfriend's room, entered it, and shut the glass door behind him. Surprisingly, he was only in there for a minute or two before opening the door, walking into the hallway and out the ER while muttering to himself. Whereas before he had conveyed, with his body language, some misplaced pride, this time while walking past our nursing station he looked like a man who had just been brow-beatened. No doubt, the girlfriend had the last say in this matter.
Throughout this holiday season, we will have many opportunities to spread good cheer and love. Compassion and kindness. And endless smiles. Or, we will have opportunities to spread poison and malignant anger. Hurtful words and deliberate insults. And pinched-up frowns.
The choice is yours. The choice is mine. Just remember to pause and look at the infinite garland, the Christmas trees, the stockings, and the candy canes--all of the beauty of the season that surrounds us. Notice and acknowledge the smiles on the faces you pass. Remember your inner child's spirit and reflect on the deeper meaning of this holiday.
I can only hope your choice fills your heart with warmth.
And I wish for nothing less for Mr. Crank.
As always, big thanks for reading. Despite our respectful attempts to break through Mr. Crank's grumpy exterior, we were unsuccessful. Darn it! I hope this finds you well and ready for the holiday season and all it brings your way...see you early next week.
Last week, I had to drive through white-out blizzard conditions during my most recent two-hour trip, taking approximately four hours each way because of the weather. White knuckles, breath-holding, tense and contracted muscles, stress headaches, and bouts of complaining to myself in the car--these were all part of the package deal. I imagined the cozy, 12-bed emergency department awaiting my arrival, however, and kept plugging along the icy roads, refusing to abandon my place in the thirty-car line of traffic. Going 20 mph. And braking every five seconds. Yep, good times, as any of you ever caught traveling in a snow storm are familiar with.
Arriving at the small ER, then, I was pleasantly surprised to see the festive decorations that adorned the department. Gold, shimmery garland draped the nursing station. Felt stockings and striped candy canes hung in random fashion along the glass enclosure walls. A Christmas tree was standing tall, twinkling and proud, in a nook of inactive space in the corner. It felt Norman Rockwelly and old-fashioned, and I felt welcomed. 'Tis the season.
The first of my scheduled shifts was quite hectic. From my prime seating in front of the ambulance bay doors, I was able to appreciate the outdoor weather. Blustery gusts of snow and heavy thick blankets of engorged snowflakes descended and tormented, without pause, the small town through the day. Although I felt worry and concern for anyone out in this weather, a blazing fireplace, a good book, and a glass of wine were the only things that would have added to the enjoyment and appreciation I felt for this crazy weather.
Three hours into my shift, though, I remembered what the first snowstorm of the season means to an ER staff. Multiple MVCs (multiple vehicle collisions). First-time-of-the-season shovelers developing chest pain as they try to clear their sidewalks. Frequent falls resulting in contusions and broken bones and lacerations. Cough and cold symptoms magnified tenfold with every ten degree drop. Frostbite. And on...and on...and on...
By mid morning, we were swamped. And I loved it. All twelve beds were filled and the waiting room was starting to spill over. The multiple ambulance runs to pick up and drop off ill patients created a steady, rhythmic sense of humming chaos. Despite the craziness, the staff I was working with (many of them friends from my childhood) continued to smile while pushing onward. I was proud to be part of such a team, their hardwork quite evident. We were providing excellent care in a very efficient manner, discharging and admitting and transferring patients left and right.
So, was it really a surprise to me to find that, eventually, all good things come to an end and this run of busy but gratifying work would be interrupted by something unpleasant? I guess not, although I could still hope, right?
The unpleasantness came early afternoon, in the form of a man's booming, angry voice resonating from the hallway. I had been in Room 2 at the time, examining a new patient, an elderly female with dizziness.
"If you'll excuse me, maam," I said, "I need to go see what's going on in the hallway."
I left her room and shut the sliding glass door. Several nurses were in the hallway already, standing in front of a 60ish man, his mouth moving while he leaned forward into his walker. The obvious source of the angry yelling.
"Excuse me, sir," I said, walking between the nurses and right up to him, "what seems to be the problem?"
If any of you have seen the movies Grumpy Old Men and Grumpier Old Men, picture a shorter version of Walter Matthau with slightly more gray hair peeking out from his baseball cap. A pinched-up face. Angry, flaring eyes and a reddened, ruddy complexion. His flannel shirt was untucked from his blue denim pants. And his hands were balled into fists while maintaining his grip on his walker.
Those angry, flaring eyes didn't take long to focus on me. "Who the hell are you?" he asked, practically spitting on me with his disgust.
"I'm Dr. Jim, the emergency room doctor on shift for the day," I said, keeping my cool. "And you are...?" I deliberately left the question open.
"I'm the God-damned boyfriend of Room 6, if any of you lazy sons-of-bitches care," he screamed out, "and I need somebody from this God-damned first-aid station to tell me what the hell is going on with her."
I was surprised at this man's behavior, wondering to myself if he had tipped a few back during lunch. The level of rudeness and obnoxious behavior I encounter through my shifts continues to amaze me. Trying to placate this man would turn out to be an obvious failure.
Room 6, this patient's girlfriend, contained a woman in her 60s who had lingering burping and belching for six months. Today, this day of stormy weather, was the day she decided to pursue her symptoms, for no other reason than just "because I figured it was time to get checked out." She was right to come in, since her EKG revealed signs of heart ischemia that were confirmed by her elevated cardiac enzymes via blood work. I had seen and treated her immediately upon her arrival to our ER, as well as checked-in with her multiple times, making sure her symptoms had resolved and explaining the results of her tests. Currently, the cardiologist was on his way to the ER to make further recommendations.
At no time during this woman's hour stay did a boyfriend present himself. She had been in the room alone.
"Sir, keep your voice down," I told him, "we have a lot of sick patients in this ER today. And when did you get here," I continued, "since I've been in your girlfriend's room multiple times in the past hour."
"Me, too," piped in Marsha, the patient's nurse.
"I just got here," he said, shaking his head in disgust, "and nobody made it a point to explain things to me." He continued to rant and rave, insulting anyone associated with the small rural hospital.
"That's not true," Marsha disputed, "I explained everything I knew to you, just a few minutes ago, after you walked into your girlfriend's room. I even offered you a chair, coffee, a blanket."
"Regardless, sir," I said, proud of Marsha, "you could have asked in a much better way than walking into the hallway and screaming like this for everyone to hear." He eyed me up, surprised at my confronting him on his behavior. "Now," I said, "these are your two choices. Either leave the department and wait in the waiting room, or go back into your girlfriend's room and act like a gentleman. After she answers your questions, I'll be in to answer anything further. With her permission, of course."
There was a standoff. He eyed me. I eyed him. The nurses all held their breath. Finally, he spoke. Or yelled. "Screw you. I'm going to go, God-damn it, and feed her God-damn mutt of a dog. But I'll be back," he said.
Before leaving, he tried one last parting shot. "I envy your God-damn generation," he muttered, "none of you know what hard work is. Not a single one."
Well, I thought back to my 14 hour days working with my father's crews in the woods when I was a teenager. I thought about waking up in my childhood on Saturdays and Sundays to cut and stack firewood and cut grass. I thought about the numerous chores our parents expected of us. I thought about the endless sleepless nights I spent, first studying through college, then medical school, and finally through residency, before some semblance of normalcy finally arrived to my life.
"Sir, you don't know me or any of the nurses, do you?" I asked, sweeping my hand towards them. He nodded "no." "Then how," I continued, "can you say such a rude thing? I would never consider insulting you the way you've insulted our staff. It's not necessary and your bad attitude isn't helping anyone. It's time for you to go."
"Well," he stammered, "even if you aren't lazy, most of your God-damn generation is."
And with that, he continued on his way out of our "first-aid station," decorated to celebrate the joy of the wondrous holiday, shaking his head in disgust until he walked through the waiting room doors.
After he left, our staff regrouped in the nursing station. Amazingly, not one person was affected negatively by this gentleman. Everyone had the good sense to dispel his insults and demeaning behavior without a second thought. "I can only hope," I warned them all, "that I'm not that grouchy when I get older."
I visited Room 6, the girlfriend. She was still clear of all her symptoms, but looked teary-eyed. "I'm so sorry for his behavior," she said, obviously hearing the conversation that had just occurred in the hallway, "he's like that all the time. But Doctor, just so you know, your staff treated me wonderfully today." She assured me, upon my questioning, that she was safe and not being abused physically. She declined any counseling offers. "He's a dog with a big bark and no bite," was how she put it. I wanted to ask her "Why?" Why in the world would she stay with a man so unpleasant, so abrupt and obnoxious? But I didn't. We all have our reasons for living our lives the way we do, and she was no exception. Besides, the world was continuing to revolve and I was needed in several other rooms.
An hour later, Mr. Crank was back. Before even entering his girlfriend's room, he walked himself right through the nursing station, stopping on its edge. "Now what the hell is going on?" he yelled, lifting his walker from the floor before banging it back down, startling me from the chart I was working on.
And the conversation continued as before--him insulting our staff and hospital with vulgar language, me giving him the option of either going to his girlfriend's room or the waiting room. In my book, this was his last chance, and I conveyed it respectfully to him.
He walked to his girlfriend's room, entered it, and shut the glass door behind him. Surprisingly, he was only in there for a minute or two before opening the door, walking into the hallway and out the ER while muttering to himself. Whereas before he had conveyed, with his body language, some misplaced pride, this time while walking past our nursing station he looked like a man who had just been brow-beatened. No doubt, the girlfriend had the last say in this matter.
Throughout this holiday season, we will have many opportunities to spread good cheer and love. Compassion and kindness. And endless smiles. Or, we will have opportunities to spread poison and malignant anger. Hurtful words and deliberate insults. And pinched-up frowns.
The choice is yours. The choice is mine. Just remember to pause and look at the infinite garland, the Christmas trees, the stockings, and the candy canes--all of the beauty of the season that surrounds us. Notice and acknowledge the smiles on the faces you pass. Remember your inner child's spirit and reflect on the deeper meaning of this holiday.
I can only hope your choice fills your heart with warmth.
And I wish for nothing less for Mr. Crank.
As always, big thanks for reading. Despite our respectful attempts to break through Mr. Crank's grumpy exterior, we were unsuccessful. Darn it! I hope this finds you well and ready for the holiday season and all it brings your way...see you early next week.
Thursday, December 2, 2010
I Got Me Some Flu
I am one of those people who has avoided the flu shot, at least for the past six years. Outside of diligently receiving it during the few years that my son, Cole, and my mother were on chemotherapy, I find that the constant bombardment of exposures to various infections during a typical shift in my emergency department has given me the small doses of immunity needed to remain healthy and infection-free.
Although I'm not one to ascribe to the notion that the flu vaccination is the cause of a multiple sequalae of ailments after receiving it, several years ago I myself had developed an odd peripheral neuropathy after my third yearly shot. After multiple MRIs and blood work, including a spinal tap, failed to reveal the reason, I have since avoided the flu shot on this basis. And my peripheral neuropathy, thankfully, is a thing of the past.
Do I think the peripheral neuropathy was due to the flu shot? It depends on the day you ask me. After witnessing the flu shot being blamed for everything from causing heart attacks to promoting cancer, though, I was hesitant to put the blame on it for my own symptoms. I was young (in my thirties), healthy, and in great physical shape. I was admittedly stressed out, however, between Cole's relapse from remission and my mother's battle with leukemia, all the while desperately struggling to show the world nothing but a smile on my face. We all know how important a healthy mental state translates into physical well-being (known as "psychosomatic" in the medical community), so I had obvious other reasons, besides receiving a recent flu shot, to suspect my body's failings.
That said, I think the flu shot is a wonderful option for people who pursue it after an informed decision, and I have no doubt that it is responsible for saving a significant number of lives, especially those from the populations of being elderly, young, or immunocompromised.
It's just not for me.
Recently, after having several days off during this past Thanksgiving holiday, I returned to work, on Sunday, only to learn that the nasty GI bug had exploded in our community. Diffuse abdominal cramping, nausea with uncontrolled vomiting, diarrhea, fevers, aching muscles, headache--it seems this little bug was responsible for a multitude of holiday gifts to a multitude of people from every background. Gifts, unfortunately, that kept on giving. According to one of our senior resident physicians, during his prior day's shift, he treated twenty patients, seventeen of which had this flu syndrome. And, it seemed, the virus was working its way through our staff.
Uggggggghhhh. Welcome back to me.
I took every precaution I typically take before starting my shift. I got the industrial, kill-everything wipes (in the container warning to wear gloves before touching them) and wiped down my phone, my computer and its keyboard, my workspace counter, my pen, my stethoscope, my chair handles, etc. If there was a chance I was going to touch it during my shift, it got wiped. I may have even gone overboard, obtaining a clean bed sheet, folding it several times, and putting it on the cloth chair I was using. In my mind, I ridiculously believed I had effectively halted any bug from climbing from the navy blue seat, through my khakis, through my underwear, to my skin, where it would multiply and overtake me, unselfishly sharing all of its pleasant symptoms with me. I'm surprised at myself, on hindsight, that I didn't soak the bed sheet in ammonia first.
I'd be damned if I was going to get that nasty flu.
As usual, I made sure to put on latex gloves, from the hallway station, before entering any patient's room. Every time. Without exception. I wasn't going to be shaking any hands or touching any bed railings if I could help it. When necessary, I also donned a mask and disposable body gown, rendering me as a wrapped mummy. You can only imagine the screams from the pediatric patient who, on a normal basis, suffers from white-coat syndrome now being approached by a tall blob of a person bulkily wrapped in pastel-yellow paper, purple latex gloves, and a light-blue mask, two eyes peeking out of its top border. I think I would probably scare myself, even.
For added precaution, to make sure I didn't pass anything on to my family, I stripped myself immediately after walking into our mudroom from a shift, depositing my clothes in the washer and running quite briskly through the house to our bedroom shower, where I proceeded to scrub myself down. I'm hopeful I won't hear from any of our neighbors claiming to see, through our house windows, a naked man running around. Make that a sexy naked man, thank you very much.
So, after all of my precautions and not getting the flu for the past six years, I was pretty confident that I wouldn't be one of the unfortunate many getting ill during this recent outbreak. Nope, not me. Get out of here, you nasty bug, and find someone else to populate a new colony in.
Fast forward to my third and final shift. Tuesday evening. Eight hours into my ten-hour shift. Me, sitting at my computer in my tan cords and long-sleeved rugby shirt, happily typing in orders on yet another patient, thinking about having off the next four days.
And suddenly, just like that, I heard it. And then felt it. A loud gurgle, followed by a wave of cramping. "On no," I thought to myself, "it must be the fish sandwich and steak fries I ate for dinner." How easy our minds can hide the truth from us, sometimes. Despite my denial, the gurgling continued and the cramping waxed and waned. Finally, the shift over, I drove home, mumbling useless prayers, barely making it into my house before visiting the bathroom.
What a great way to spend a few days off! After missing basketball practices with my son and youngest daughter, skipping family meals, taking numerous small sips of water with repeated doses of ibuprofen, and imbibing in several warm baths followed by extended naps (yesterday from 1 p.m. to 5 p.m.), I am actually able to stand up from bed this morning without getting dizzy. I am hopeful that the cause of these past two days of misery is now on its way out.
I even missed writing group last night, which speaks volumes of just how miserable I was.
Are there any benefits to having the flu? Heck yeah. Like I just mentioned, the warm baths and extended naps. Trust me, those two things alone almost made being sick worth it. And being pampered by the family; for example, having a cup of tea made lovingly (after threatening to lick her face) by my youngest, Grace. However, if I am being honest, I don't think I was pampered nearly enough by my kids or wife. Whether it was simply avoiding me to prevent getting the flu themselves, or possibly avoiding my incessant manly whining, I'm really not sure. A moan from me, though, was more often met with laughter rather than concern. Maybe I was imagining it, in my febrile delirium, but I don't think so.
When I'm done finishing this post, I may go lick the clean rim of my wife's coffee mug before replacing it back on the shelf. That would teach her to give me more lovin' when I'm near-death.
Not really, of course. After all, at some point during my recovery, she and the kids carried up all of the numerous boxes of Christmas decorations from the basement and began to transform our house into a welcoming winter wonderland. What an appreciated, beautiful sight for me to behold after being bed-ridden for a few days.
If anything, though, now I may just have to reconsider the flu shot.
Oops, I have to run--the bathroom is calling for me. I hope this finds you all flu-free and healthy during this post-Thanksgiving season.
Flu shot or no flu shot? That is the question...
I'm back. As always, big thanks for reading. I hope you all had full bellies during this past Thanksgiving holiday. See you soon.
Although I'm not one to ascribe to the notion that the flu vaccination is the cause of a multiple sequalae of ailments after receiving it, several years ago I myself had developed an odd peripheral neuropathy after my third yearly shot. After multiple MRIs and blood work, including a spinal tap, failed to reveal the reason, I have since avoided the flu shot on this basis. And my peripheral neuropathy, thankfully, is a thing of the past.
Do I think the peripheral neuropathy was due to the flu shot? It depends on the day you ask me. After witnessing the flu shot being blamed for everything from causing heart attacks to promoting cancer, though, I was hesitant to put the blame on it for my own symptoms. I was young (in my thirties), healthy, and in great physical shape. I was admittedly stressed out, however, between Cole's relapse from remission and my mother's battle with leukemia, all the while desperately struggling to show the world nothing but a smile on my face. We all know how important a healthy mental state translates into physical well-being (known as "psychosomatic" in the medical community), so I had obvious other reasons, besides receiving a recent flu shot, to suspect my body's failings.
That said, I think the flu shot is a wonderful option for people who pursue it after an informed decision, and I have no doubt that it is responsible for saving a significant number of lives, especially those from the populations of being elderly, young, or immunocompromised.
It's just not for me.
Recently, after having several days off during this past Thanksgiving holiday, I returned to work, on Sunday, only to learn that the nasty GI bug had exploded in our community. Diffuse abdominal cramping, nausea with uncontrolled vomiting, diarrhea, fevers, aching muscles, headache--it seems this little bug was responsible for a multitude of holiday gifts to a multitude of people from every background. Gifts, unfortunately, that kept on giving. According to one of our senior resident physicians, during his prior day's shift, he treated twenty patients, seventeen of which had this flu syndrome. And, it seemed, the virus was working its way through our staff.
Uggggggghhhh. Welcome back to me.
I took every precaution I typically take before starting my shift. I got the industrial, kill-everything wipes (in the container warning to wear gloves before touching them) and wiped down my phone, my computer and its keyboard, my workspace counter, my pen, my stethoscope, my chair handles, etc. If there was a chance I was going to touch it during my shift, it got wiped. I may have even gone overboard, obtaining a clean bed sheet, folding it several times, and putting it on the cloth chair I was using. In my mind, I ridiculously believed I had effectively halted any bug from climbing from the navy blue seat, through my khakis, through my underwear, to my skin, where it would multiply and overtake me, unselfishly sharing all of its pleasant symptoms with me. I'm surprised at myself, on hindsight, that I didn't soak the bed sheet in ammonia first.
I'd be damned if I was going to get that nasty flu.
As usual, I made sure to put on latex gloves, from the hallway station, before entering any patient's room. Every time. Without exception. I wasn't going to be shaking any hands or touching any bed railings if I could help it. When necessary, I also donned a mask and disposable body gown, rendering me as a wrapped mummy. You can only imagine the screams from the pediatric patient who, on a normal basis, suffers from white-coat syndrome now being approached by a tall blob of a person bulkily wrapped in pastel-yellow paper, purple latex gloves, and a light-blue mask, two eyes peeking out of its top border. I think I would probably scare myself, even.
For added precaution, to make sure I didn't pass anything on to my family, I stripped myself immediately after walking into our mudroom from a shift, depositing my clothes in the washer and running quite briskly through the house to our bedroom shower, where I proceeded to scrub myself down. I'm hopeful I won't hear from any of our neighbors claiming to see, through our house windows, a naked man running around. Make that a sexy naked man, thank you very much.
So, after all of my precautions and not getting the flu for the past six years, I was pretty confident that I wouldn't be one of the unfortunate many getting ill during this recent outbreak. Nope, not me. Get out of here, you nasty bug, and find someone else to populate a new colony in.
Fast forward to my third and final shift. Tuesday evening. Eight hours into my ten-hour shift. Me, sitting at my computer in my tan cords and long-sleeved rugby shirt, happily typing in orders on yet another patient, thinking about having off the next four days.
And suddenly, just like that, I heard it. And then felt it. A loud gurgle, followed by a wave of cramping. "On no," I thought to myself, "it must be the fish sandwich and steak fries I ate for dinner." How easy our minds can hide the truth from us, sometimes. Despite my denial, the gurgling continued and the cramping waxed and waned. Finally, the shift over, I drove home, mumbling useless prayers, barely making it into my house before visiting the bathroom.
What a great way to spend a few days off! After missing basketball practices with my son and youngest daughter, skipping family meals, taking numerous small sips of water with repeated doses of ibuprofen, and imbibing in several warm baths followed by extended naps (yesterday from 1 p.m. to 5 p.m.), I am actually able to stand up from bed this morning without getting dizzy. I am hopeful that the cause of these past two days of misery is now on its way out.
I even missed writing group last night, which speaks volumes of just how miserable I was.
Are there any benefits to having the flu? Heck yeah. Like I just mentioned, the warm baths and extended naps. Trust me, those two things alone almost made being sick worth it. And being pampered by the family; for example, having a cup of tea made lovingly (after threatening to lick her face) by my youngest, Grace. However, if I am being honest, I don't think I was pampered nearly enough by my kids or wife. Whether it was simply avoiding me to prevent getting the flu themselves, or possibly avoiding my incessant manly whining, I'm really not sure. A moan from me, though, was more often met with laughter rather than concern. Maybe I was imagining it, in my febrile delirium, but I don't think so.
When I'm done finishing this post, I may go lick the clean rim of my wife's coffee mug before replacing it back on the shelf. That would teach her to give me more lovin' when I'm near-death.
Not really, of course. After all, at some point during my recovery, she and the kids carried up all of the numerous boxes of Christmas decorations from the basement and began to transform our house into a welcoming winter wonderland. What an appreciated, beautiful sight for me to behold after being bed-ridden for a few days.
If anything, though, now I may just have to reconsider the flu shot.
Oops, I have to run--the bathroom is calling for me. I hope this finds you all flu-free and healthy during this post-Thanksgiving season.
Flu shot or no flu shot? That is the question...
I'm back. As always, big thanks for reading. I hope you all had full bellies during this past Thanksgiving holiday. See you soon.
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