House of Plague

We almost cancelled Halloween at our house this year. Half the family is sick, including La Baby who, if she lived with normal folks, would be in the ER right now. But my children know that unless I'm getting paid $45 dollars an hour, the only thing that warrants a trip to the ER is bleeding from the eyeballs or viscera. Poor Pooter. I'm pretty sure it's not pneumonia, but I've spent the last few days with kids whose parents said, "If only I'd brought them to the ER sooner, maybe they wouldn't have quadruple pneumonia."

I also was hoping that Pooter would be able to wear her first real Halloween costume to daycare today, but she's got a fever. She was going to be a bee. Well, she still can be a bee any day of the week, just not for Halloween. We bought the outfit last week at Claire's in the mall and then she wore it at the mall playground and was the delight and envy of all the other l'il childrens. I do have great footage of her bouncing around with bee wings, if I can figure out how to get it off my phone. Once again, Susan 0, Technology 274.

Love Monkey is also sick. I'm pretty certain he no longer has any internal organs from the diaphragm down but as my attending said this week, "Green, black or red is all the description I need." So Teen and I are set to (wo)man the door as she announced she is officially too old to treat or treat. And the cat is going as a chihuaha.

Yo quiero candy, bitches.

Must Read

Well, once again Moreena puts into words all I wish I could say and more. This week, she wrote about the anniversary of her daughter's first transplant. Please go read it. Forever more, when I am confronted with an unknowable question, not unlike Douglas Adam's "42", my answer may well be 3.

Her post brought to mind this poem I wrote down years ago in my poetry notebook. Yes, my poetry notebook. Because TC is really very sensitive inside, with a crusty exterior-like a scooter pie, sort of.


Mama's Promise-Marilyn Nelson Wanick

I have no answer to the blank inequity
of a four-year-old dying of cancer.
I saw her on t.v. and wept
with my mouth full of meatloaf.

I constantly flash on disaster now;
red lights shout Warning. Danger.
everywhere I look
I buckle him in, but what if a car
with a grille like a sharkbite
roared up out of the road?
I feed him square meals
but what if the fist of his heart
should simply fall open?
I carried him safely,
as long as I could,
but now he's a runaway
on the dangerous highway.
Warning. Danger.
I've started to pray.

But the dangerous highway
curves through blue evenings
when I hold his yielding hand
and snip his miniscule nails
with my vicious-looking scissors.
I carry him around
like an egg in a spoon,
and I remember a porcelain fawn,
a best friend's trust,
my broken faith in myself.
It's not my grace that keeps me erect
as the sidewalk clatters downhill
under my rollerskate wheels.

Sometimes I lie awake
troubled by this thought:
It's not so simple to give a child birth;
you also have to give it death,
the jealous fairy's christening gift.

I've always pictured my own death
as a closed door,
a black room,
a breathless leap from the mountain top
with time to throw out my arms, lift my head,
and see, in the instant my heart stops,
a whole galaxy of blue.

I imagined I'd forget,
in the cessation of feeling,
while the guilt of my lifetime floated away
like a nylon nightgown,
and that I'd fall into clean, fresh forgiveness.

Ah, but the death I've given away
is more mine than the one I've kept:
from my hand the poisoned apple,
from my bow the mistletoe dart.

Then I think of Mama,
her bountiful breasts,
when I was a child, I really swear,
Mama's kisses could heal.
I remember her promise,
and whisper it over my sweet son's sleep:

When you float to the bottom, child,
like a mote down a sunbeam,
you'll see me from a trillion miles away;
my eyes looking up to you,
my arms outstretched for you like night.

TGIF

Have you ever been around so many insane people that when you meet some normal folks you just want to kiss them? No. Well, I have had some crazy parents in the past few weeks. Today's little patient had parents who were normal, not fighting with each other and full of common sense. It restored my faith in humanity for another day.

Yesterday was the opposite. I complained so long and hard about some folks that I felt guilty about it and yet still needed to vent. Finally, Love Monkey said, "Susan, let it go." The hard part is when it seems so clear to you what the problem is, but the person experiencing it is just clueless(at least to you). I'm sure I can be just as dense when it comes to my own issues. The hard part was that they were just, so, demanding. I can give people a lot of slack, especially when they're dealing with stressful stuff, but don't think for a second that I'm your bitch. That really pisses me off and then my compassion flies out the window. I guess maybe I'm a little fried lately because I usually have more patience. Ah, well.

Anyway, I'm off for the weekend. Time to recharge. Maybe catch up on writing?

I told you so

Well, word is out. Dumbledore is gay. In case you've forgotten, you heard it here first. That's right, I called it. Now pay up, suckas. Actually, I didn't bet anyone, but if you'd like to lose retroactively and send me some cash, I'd be ok with that. If you've got the time and would like to know where the "gay-ness" shows up in the books, the LA Times will tell you all about it.

Well, I've been spending a lot of my internet time on Facebook. What little free time I have, that is. I've now discovered zombie hugs, tattoos and quizes about my sex life. Hoo, boy, and if you think I don't have a lot of time for the internet...Anyhoo. Now, I know I'm a grownup and all, but seriously, my niece and nephew and their respective sig others are all teaching this year in South Korea and you know the kids today, they're all on Facebook. Even my teenager, who just discovered that I'm on it, much to her mortification. Want your kid to spend less time on teh interwebs, join Facebook. It's much less cooler when your MOM uses it. Tee Hee.

This week, I've actually had a little time to peruse the weekly Grand Rounds. My friend Susan over at Improbable Optimisms has the first spot with a great read on hope. Check it out.

And under the "Better late, if ever" category: The latest Change of Shift over at Kim's.

Meanwhile, Love Monkey and I spent a night at Atlantic City this week. With teh baby, of course. All paid for by his poker habit. Gotta love the comps. It was nice, we spent some time at the beach, but it's no Vegas. In fact, it's a lot like Keansburg with shiny skyscrapers. Ah well. And could someone please tell me why you can't get a decent, cheap meal in A.C.? I mean, you can mortgage your house and go to Ruth's Chris Steak House, but want breakfast for less than $12? Forget it. In Vegas you can get a steak for $1.99, but in AC, 2 eggs, toast and some freezer burned sausages will set you back 8 bucks. Other than the eating, though, we had a good time.

In organ donation news (oh, yeah, this blog is about organ donation), Scientists in the UK are doing studies on giving CO2 after transplant surgery to dilate vessels and improve blood flow to the organs. Now, the funny thing is, the picture in this article is the SAME picture the BBC uses for EVERY organ donation article. I'm thinking, if you're the BBC, you could spare a photographer once in a while to go and get a new shot of something else related to organ donation. Or maybe the Brits are just very frugal. Anyway, I'm off to work, where there's no internet. Very sad.

Ray of Hope

From ESPN, this is the story of the North Carolina mascot who was struck by a car last year and became a donor. Buy more Kleenex and pass this on to everyone you know. If you didn't believe that love conquers death, you do now.

Tuesday!

Holy Crap! I'm up early enough to read Grand Rounds! Version 4.4 is up at NY Emergency Medicine.

Memorial Day

October must be the month for memorial services. I had my pick of two this past weekend, one for the children's hospital and one for The Sharing Network. I picked the later, because I was hoping to see some of the families I've worked with in the past year. And the free food, of course. Then I notice some other folks had their memorial services this past weekend, also.

Sunday, after the service, I had this fine post practically writing itself in my head. Now, in my younger days, I could carry a half-finished poem around in my head for a week and work on it, finally writing it down in almost completed form when I got around to it. Ha! Like I really knew what busy was when I was 20. Anyway, the baby was up sick all night and I had work at 7am Monday and by Monday night it was gone, gone, gone-appropriate lead-in lyrics and all. I'll miss my brain when it's gone.

Anyway, I'm glad I went and I did, in fact, see one of my donor moms. She had driven all the way from Pennsyltucky with her sister and they were glad to see me too. The staff always does a nice job on the service. We(they? See, still doing it) offer folks the option of making a quilt square in honor of their loved one and then my old boss' wife and her friends sew them up into big quilts that hang in the office and get shown at events and donor drives and stuff. I brought one to my daughter's Career Day one year.

They also did a photo tribute at one point. It was amazing to see pictures of all the donors alive and smiling. Especially because I tend to remember them as I first saw them-intubated in an ICU. If you work in a hospital you probably know the feeling. You take care of this patient for so many days that you can forget they're a person. I remember one donor, whose family showed me a picture of her, in better days. "She's beautiful!" I said, because it's hard to visualize what a person really looks like when they're lying flat in bed, with their hair matted down and their face all puffy and their body bruised and there's five miles of tubes and wires coming out of every available body part.

It's nice, even if your patient is just sick, and not an organ donor, to see their picture. It makes them real, you know? Then they're more than just the splenic lac in 18 or whatever. It certainly is easier to do this in PICU, because kids are, well, kids and you'd have to be a cold-hearted snake to not fall in love with them, but it's still nice to see pictures of them taped up in the room.

I don't like to think that people who work with the donors forget their "human-ness" often. I mean, you spend an awful lot of time with the families, crying with them, talking about their loved ones. But it can be tempting, when sleep is a dim memory and you've been sitting around a hospital for too many days to count, waiting for something, anything to happen, to just think of the donor and not the person. How many organs can be recovered, what time can we get to the OR. It's in the language-"I got consent". No, you didn't GET anything. The family GAVE you consent. Maybe it's just me, or maybe I shouldn't blog at 5am when I can't sleep. The people in the business are some of the most caring, compassionate people I've ever met and they don't take donors for granted. As long as you can still see the forest for the trees, is all.

Anyway, I also got to see my peeps, who were (mostly) glad to see me. The highlight may have been the 4 year old kidney recipient and his parents who were on hand to thank the donor families. It's nice to see the living, kicking, cranky, I-want-to-play-I-don't-care-why-these-people-are-here-to-see-me results of your work once in a while. Also, I got to see my friend Pammy-cakes invite the Imam back to her house for drinks. That certainly was worth the price of admission right there.

Well, I've gotten my verbal catharsis and I still can't sleep. Time to clean.

Also for Wednesday

Team Annika needs your help! Moreena, from The Wait and the Wonder is in charge of the American Liver Foundation walk in her area. Help her meet her goal, so she won't have to do anything desperate AND you'll help find a cure for liver disease. Send in what you'd normally spend on beer and wine in a week and it'll be good for everyone's liver!

Meanwhile, over at Nurse Ratched's, there's Grand Rounds with an armed forces theme.

Better Send Flowers

I went to the wake of a friend's father last night. I'm always at a loss for what to say at funerals. I didn't really know anyone there, other then my friend, so I just people watched for a while. Then, I checked out the flowers. He was holding wooden rosary beads. A rosary made out of those tiny roses is nice too, but do you any idea how much that costs? The flowers made me think of my great-uncle's wake. Similiar families, although my friend's "out-Italians" my family by a magnitude of 10. Anyway, when Uncle Micky died, my siblings and I decided to pool our resources and send flowers. Then my sister suggests, since flowers die, wouldn't it be nice if we sent a plant arrangement instead? I left the details to her and ponied up my money.

The thing about my uncle, he was a terrible alcoholic. Later, as an adult, I heard some stories, but as a kid I only knew that he was perpetually cranky and I was a little afraid of him. A year before he died, he went into our community hospital with some ailment and wound up coding, being resuscitated, coding again, another resuscitation and then getting a million complications, including infections. When my aunt didn't make him a DNR, we thought she was crazy. I mean, the man had abused his body for decades, we didn't think he'd survive another code. Just to prove how stubborn he could be, he not only recovered, he made it home. My aunt recalls that the next year with him was a really good year. He certainly was nicer and funnier than I'd ever seen. Goes to show, you can play the odds in medicine but you never really know what's going to happen.

My aunt and uncle have four sons. They're my family's version of the Marx Brothers. Remember them? I think their names were Groucho, Harpo, Marco and, uh, Squiggy. Anyway, these four had an act they could take on the road. They're still the funniest guys I know. Nothing is sacred with them. If you take yourself too seriously, they'll skewer you, but they're hysterical. Anyway, we're at the wake and I look around for our "plant arrangement" amidst the enormous and lavish flower pieces. Then I see this, I don't know, some sort of tropical vine in the corner with a big bow on it. One of my cousins spots me. "Hey, thanks for the vine. I thought it was one of the funeral home's plants, then I realized you guys sent it." His brothers join in for the kill. I think there are jokes about jungles and Tarzan, I'm not really paying attention as I scan the room for my sister. She spent 75 bucks on that?

We do, all, eventually have a good laugh. We try and imagine what Uncle Micky would have said about it, which leads to reminiscing about him. Cranky, and alcoholic, that he was, he was a character and soon his sons have us laughing. Which is, if the person was old and lived a good, long life, a fine way to go about waking someone. I hope I'm enough of a character that I have folks cracking up at my funeral. If you know the person, this is always a good thing to talk about with the family-remembering them, remembering the good times you had.

What not to say? Well, I would caution you to never, ever say "I understand" unless you have been through something very similiar. My friend's dad was home with hospice care for the weeks before he died. My grandmother also died pretty quickly and was at my mom's home under hospice care. My mom and I took turns staying up at night with her. It was hard on everyone, hard to watch her dying, but worth it, knowing she died surrounded by her family.

I wouldn't offer platitudes, either. "Well, he's in a better place" or "God must have needed him more than we did" or whatever people try to come up with to rationalize the person's death. The best bet is sincerity. Say you're sorry for their loss. I like to say to people at funerals that I'm there if they need me, but I think there's too much going on at that moment. If you know of something you can do in the days around the funeral, then make a concrete offer. Can you take their kids for a while so they can make arrangements? Drop off food, run some errands for them. One nice thing to do, after the funeral is over and everyone stops dropping by is to not forget them. Like send them a card and some flowers on the next holiday or on the anniversary of their loved one's death to let them know that someone else remembers, too. Not everyone grieves, right away, either. My sister in law lost her younger brother a few years ago and I remember, almost a year later, she broke down at a family picnic crying. She just needed someone to listen to her.

Meanwhile, my aunt still has that plant. She told me it takes up most of her sewing room, it's grown so big. I'm haunted with the thought that everytime she waters the thing, she thinks about her husband's death, but she seems to have a good sense of humor about it. A trait she has passed on to her children, evidentally. I think she's even going to name it.

But in the future, I'm going to stick with flowers.

My Big Day Off

It's Friday. I've worked 8 hours of overtime last week and 4 this week, the l'il Pooter's still sick and my house looks like who done it and ran. Then working all weekend. While I'm figuring out what to do with my big day off, I'll probably read the latest Change of Shift at Madness:Tales of an ER Nurse. I've been promised some writing time today, but you know I'll probably just clean. God forbid I need an ambulance for any reason, I'll have to tell them my house's been ransacked to save face.

When Everson Walls donated one of his kidneys to Ron Springs earlier this year, it made news. Now it's making legislation. Rep William Lacy Clay (D-MO) is sponsoring a bill named after both players. The Everson Walls and Ron Springs Gift for Life Act of 2007 (HR 3635) hopes to fund a national resource center and grants for organ transplant needs. Walls and Springs together have started a foundation to promote organ donation.

For your weekly carnival update, the new SurgExperiences is up at Suture for a Living, one of my new, favorite blogs. Also, Grand Rounds is up at Musings of a Distractible Mind(note the new blog address). Great Dr. Seuss theme this week, rhymes included!

Happy Reading.