Tuesday, February 15, 2011
Patient today, UQ professor of english and linguistics. Whole life organising and exploring in his mind, wakes up at the apex of his career with a headache and a massive lesion over his language centres. Alive, reasonably well, just difficulty speaking or organising thoughts. At best its start again and get roughly back too where you were up to just in time for the end. Your days of ground breaking contemplation in your lifes work, or even understanding your own work, over. Realistically, there will be more incidents from here and u'll be compelled to choose another perhaps more simple life. Yet, most all the rest of you, undamaged, will still be the same old you striving, against walls already past and worse. Its this scenario, when I find the one I'm in already similar in so many ways, that knocks me for 6 the most when I see it. My organising and personal 'progress' is what I have. And hope for the right cva that brings a kind of peace Idk what to think about that position.
Monday, February 14, 2011
So here is an ethical one.
I'm trying to buy jelly beans from the pharmacy in the few minutes between a nerve root injection and a biopsy when a patient, who has just had a scan of some variety but not with me (but wool on his arm so very possibly CAT scan as no other out patient scan uses IV), has a 'turn' where he suddenly can't talk, drops his films ect. Wife is going mental. But not my patient. I'm not a physician. And I'm due back with the other patients who I do actually get paid to take care of. And I don't need to be involved in things, its not exciting for me, I've been involved in enough things in my medium sized low trauma private hospital. If anything its a major hassle and I kinda want my jelly beans. And besides, theyre all sick! What is the difference?
But the pharmacists seem confused, and are asian cause its late, I am here and it is technically an xray patient. So I ask if there was an injection for the scan to kind of assess what's going on and that's it; I realise accidentally I'm involved. I can't just then say 'oh shit eh. Well good luck with all of that' and keep walking. I don't know what my legal obligations are, but after he coded in the hallway n came for an inpatient CAT scan in 20mins I would have been recognised for sure. I grab a dr, a new xray dr by chance, in the hall who's on his way home: not interested. Helps me lift him into a wheel chair n leaves. The wife keeps harping about them not missing their specialist appointment 'cause its about cancer', like that means anything, you do not get sudden cancer emergencies n I'm thinking 'its gonna be a short consult if the guy can't speak you dumb mole' but instead I say 'look I'm taking him to emergency, you can call the specialist from there if you like, but that's what we're doing here'. To which she replies 'well, you know what's best'! Total 180! Why do I suddenly know what's best?! Insanity. The whole place is so surreal, none of it flows.
The infection control officer leaves caps off syringes and doesn't swab high risk injection sites or wash his hands but lectures others. There are at least 3 more stories from everyday, but I guess the only point is, for next time in this type of case, surely the pharmacists could have handled it? Maybe not in a timely fashion, but his death\irreparable brain damage risk would have increased only, Idk, 1%? 20%? 50%?who knows. Not by too much. Unless she tried to keep her appointment and the pharmacists where asian. Idk. Idc. Isn't it all just about us wanting to be helped; which is unrelated to anything we do. If it wasn't for the 'he just had his scan and now he can't speak' comment I probably would have just got my jelly beans. Idk.
The point is xray is my department, they did need help, I was there. But was I the only one who could give any kind of hand over? Isn't that what the hysterical wife (but who can't miss her appointment) is for? I'm sure her screeching would have done just fine. I had access to wheelchairs and dr's most quickly n emergency was pretty much on the way back anyway, that is all true. I mean I think we all agree I shouldnt really be working there at the end of the day anyway. But where else. And I know its a hospital but I just want that stuff kept out of my jelly bean runs at the very least, I think that's the crux. Really ali's grandmother had just written to me and I was miles away in thought so being brought back to work jarred me.
Actually, believe it or not, I was thinking of the thousands of dollars bill wise I commit this family to the minute I wheel this fellow thru the staff emergency entrance if I was wrong. The wifes weird reaction was throwing me. But the dr agreed (on the way to his car), I mean the guy lost the power of speech n his movement was going too. Just like that ER dr, george cloony, telling me to start compressions cause a patients not breathing after he's been called because I think the patients not breathing. And then the bill, no longer on ABC. Its all so criminal. Oh I just remembered I forgot to check if a mother can breast feed post injection. I did promise I wouldn't forget, but as with all medicine it changes by what dr is asked anyway.
And no, I never got the jelly beans.
I'm trying to buy jelly beans from the pharmacy in the few minutes between a nerve root injection and a biopsy when a patient, who has just had a scan of some variety but not with me (but wool on his arm so very possibly CAT scan as no other out patient scan uses IV), has a 'turn' where he suddenly can't talk, drops his films ect. Wife is going mental. But not my patient. I'm not a physician. And I'm due back with the other patients who I do actually get paid to take care of. And I don't need to be involved in things, its not exciting for me, I've been involved in enough things in my medium sized low trauma private hospital. If anything its a major hassle and I kinda want my jelly beans. And besides, theyre all sick! What is the difference?
But the pharmacists seem confused, and are asian cause its late, I am here and it is technically an xray patient. So I ask if there was an injection for the scan to kind of assess what's going on and that's it; I realise accidentally I'm involved. I can't just then say 'oh shit eh. Well good luck with all of that' and keep walking. I don't know what my legal obligations are, but after he coded in the hallway n came for an inpatient CAT scan in 20mins I would have been recognised for sure. I grab a dr, a new xray dr by chance, in the hall who's on his way home: not interested. Helps me lift him into a wheel chair n leaves. The wife keeps harping about them not missing their specialist appointment 'cause its about cancer', like that means anything, you do not get sudden cancer emergencies n I'm thinking 'its gonna be a short consult if the guy can't speak you dumb mole' but instead I say 'look I'm taking him to emergency, you can call the specialist from there if you like, but that's what we're doing here'. To which she replies 'well, you know what's best'! Total 180! Why do I suddenly know what's best?! Insanity. The whole place is so surreal, none of it flows.
The infection control officer leaves caps off syringes and doesn't swab high risk injection sites or wash his hands but lectures others. There are at least 3 more stories from everyday, but I guess the only point is, for next time in this type of case, surely the pharmacists could have handled it? Maybe not in a timely fashion, but his death\irreparable brain damage risk would have increased only, Idk, 1%? 20%? 50%?who knows. Not by too much. Unless she tried to keep her appointment and the pharmacists where asian. Idk. Idc. Isn't it all just about us wanting to be helped; which is unrelated to anything we do. If it wasn't for the 'he just had his scan and now he can't speak' comment I probably would have just got my jelly beans. Idk.
The point is xray is my department, they did need help, I was there. But was I the only one who could give any kind of hand over? Isn't that what the hysterical wife (but who can't miss her appointment) is for? I'm sure her screeching would have done just fine. I had access to wheelchairs and dr's most quickly n emergency was pretty much on the way back anyway, that is all true. I mean I think we all agree I shouldnt really be working there at the end of the day anyway. But where else. And I know its a hospital but I just want that stuff kept out of my jelly bean runs at the very least, I think that's the crux. Really ali's grandmother had just written to me and I was miles away in thought so being brought back to work jarred me.
Actually, believe it or not, I was thinking of the thousands of dollars bill wise I commit this family to the minute I wheel this fellow thru the staff emergency entrance if I was wrong. The wifes weird reaction was throwing me. But the dr agreed (on the way to his car), I mean the guy lost the power of speech n his movement was going too. Just like that ER dr, george cloony, telling me to start compressions cause a patients not breathing after he's been called because I think the patients not breathing. And then the bill, no longer on ABC. Its all so criminal. Oh I just remembered I forgot to check if a mother can breast feed post injection. I did promise I wouldn't forget, but as with all medicine it changes by what dr is asked anyway.
And no, I never got the jelly beans.
Friendships and intimacy
I see so many variations around me, and I envy none. But I'm forced to perform like a jester. What I don't get is why it should be hard to find decent intelligent friends or relationships prospects. And ppl are so hung up on putting all their eggs in 1 basket. I see many basic variations of the friendship circles, but how hollow they are and how little sharing actually goes on. And at work. I watch ppl date for 5yrs, but the day they break up can't see each other naked or shower together. Taper that down back to stranger level, yeah good idea. False boundaries and nonsense doomed to see ppl die alone, even with ppl at their side.
Then there is the early relationships (I see in all age groups up teen to 35) where ppl pretend that they will never break up complete with fresh tears every 6months - 2yrs or so, and the flip side the 5yr+ of ultimately empty but stable repeating patterns; the extreme being 50yr marriages just because that was what's done or its too hard to break a lease or split the house in the only life they'll ever have. The point is friends who would take a bullet for you, but can't kiss you, what kind of bullet do you think it is they could take?
Our wars in the first world are fought in the mind (well, and the soil of poorer nations). But mostly we have the luxury of being bound only in the mental. And maybe pure social psychosis and particulars of programmes to 'be a good person' could see a friend take a real bullet in the heat of the moment. It'd be a poorly thought out television taught accident tho. My point again is this; if you're sharing your life with ppl who offer you little more or the same or less than the chick at centrelink or a social worker who's name got pulled out of a hat; what are you working with exactly? What do you have aside from an extended masquerade party filled with tired armed guests who continue to struggle to hold a mask because they don't want to leave a party that's over, even tho the sun is up, the champagne is flat and tasteless and the police are ushering ppl towards the door.
Vigilance against illusion and reason where thought is lacking or emotion tries to go alone. I'm not selling 'the' better brand of intimacy, just 'A' better brand. Give it a try, the alternative is always gonna be there. But its a relic no different to the appendix and the catholic church. It is the appendix and the catholic church! Wait, no not the appendix. Well, you know, well I mean you know what I mean. Relationships don't eat gumleaves anymore, and maybe they never did. Ok, what am I talking about, anyone? Anyone?
Then there is the early relationships (I see in all age groups up teen to 35) where ppl pretend that they will never break up complete with fresh tears every 6months - 2yrs or so, and the flip side the 5yr+ of ultimately empty but stable repeating patterns; the extreme being 50yr marriages just because that was what's done or its too hard to break a lease or split the house in the only life they'll ever have. The point is friends who would take a bullet for you, but can't kiss you, what kind of bullet do you think it is they could take?
Our wars in the first world are fought in the mind (well, and the soil of poorer nations). But mostly we have the luxury of being bound only in the mental. And maybe pure social psychosis and particulars of programmes to 'be a good person' could see a friend take a real bullet in the heat of the moment. It'd be a poorly thought out television taught accident tho. My point again is this; if you're sharing your life with ppl who offer you little more or the same or less than the chick at centrelink or a social worker who's name got pulled out of a hat; what are you working with exactly? What do you have aside from an extended masquerade party filled with tired armed guests who continue to struggle to hold a mask because they don't want to leave a party that's over, even tho the sun is up, the champagne is flat and tasteless and the police are ushering ppl towards the door.
Vigilance against illusion and reason where thought is lacking or emotion tries to go alone. I'm not selling 'the' better brand of intimacy, just 'A' better brand. Give it a try, the alternative is always gonna be there. But its a relic no different to the appendix and the catholic church. It is the appendix and the catholic church! Wait, no not the appendix. Well, you know, well I mean you know what I mean. Relationships don't eat gumleaves anymore, and maybe they never did. Ok, what am I talking about, anyone? Anyone?
White tail jumping spider bite, this guy today his arm muscles stripped back, nearly amputated, either way he could barely use it, been in hospital over a year still fighting it but nothing works.
Another city not country guy got bitten by a pale face wood snake lifting up some MILK CRATES behind a store. Got bitten by a small non venomous snake, but same neurotic bacteria. He's been in hospital 10 months, his leg is incredibly painful to touch and COMPLETELY BLACK. And they'll probably need to cut it off.
And that last lady, trying to put a tube up her butt for rectal contrast, as soon as we spread her cheeks black blood filled goo just continues to poor out without stopping and an interesting smell, probably ischemia bowl. She was in a lot of pain and she is almost certainly dead. We call the nurses and emergency Dr. The Dr's comment "this is why you Don't call your daughter Melena".
So yeah, how was your day so far?
Another city not country guy got bitten by a pale face wood snake lifting up some MILK CRATES behind a store. Got bitten by a small non venomous snake, but same neurotic bacteria. He's been in hospital 10 months, his leg is incredibly painful to touch and COMPLETELY BLACK. And they'll probably need to cut it off.
And that last lady, trying to put a tube up her butt for rectal contrast, as soon as we spread her cheeks black blood filled goo just continues to poor out without stopping and an interesting smell, probably ischemia bowl. She was in a lot of pain and she is almost certainly dead. We call the nurses and emergency Dr. The Dr's comment "this is why you Don't call your daughter Melena".
So yeah, how was your day so far?
Living deficient in intelligent conversions is making me numb and dumber. Unchallenged and empty. And it makes me want to stay in bed all the time. I swear I go literally days maybe even weeks where every day the entire day there isn't a single conversation I really needed to be part of. Certainly unsolicited insight is well beyond a rarity. Everything is effort and boring and repetitive no matter what I out put. I send so many txts so there is at least a chronical of a version of me in some minds so there is a chance I don't have start from square 1 when I run into the ones who have shown that pattern of thought, even if basic replies are few and far between. That's not an issue so much as why I treat it like a chronical; If I don't already have the answer, there almost certainly isn't one easily accessible. But currently when it comes time for something that may have a chance at being energy generating, I'm so numb from months of bombardment I have nothing in reserve, and things end just as they are beginning with massive gaps in between each meeting because of fucking bulllshit life logistics. If I do drink it makes me extremely depressed for the next 3 days at least, I've already decided that is another drug that is too difficult for me to use properly and my body knows it. So effectively; I can't leave my room. I have no buffer strong enough to sift through people. Medications get me through work alone. And I hate not being able to call anyone in here to react to anything interesting I conceive of, discover or enjoy with any real interest. And all my communication devices are still not working hundreds of dollars and a month later. My biggest problem right now is being tired all the time. And the fucking ali thing. I'm not entirely sure why I'm so angry about that, it really isn't any different to anything else except its a prime example of a chance for focus and depth and I get nothing. Platitudes at best, and MULTIPLE invites for nights where I 'won't have to pay for a single drink' from all the people I'd need to be already drunk to put up with their 'help' to begin with. And its no kind of genuine, its barely even sweet; more just another spotlight of the same colour. I don't know what to look for, how else to ask, where to look and I'm not even sure I want to chronicle anymore.
I have no one intelligent to talk to, no one. Consequently no philosophy gets solved as more insanity piles on top. I get 5min bursts of brief intellect with a slice of creativity if I'm lucky. No one open minded with any medical knowledge, no medical knowledge in the open minded. And I don't know how to unwind. I don't want to drink or get high so now I'm having trouble relating to people AT ALL. I am so exhausted. Its just such bulllshit that people don't want to talk about anything going on. Who am I making art for? For me? For future generations? I don't see how stage performance is any different to what I do everyday and people laugh when they are suppose, clap when they are suppose to but then don't leave! And no one is really watching the show.
So I'm signing off on medications that I didn't order now. What a circus. This nurse comes up to me 'whats happening with this patient, is the carotid angio finished?' n I'm like no he's had a previous anaphylatic react to iodine contrast in the past so steroids need to be given before to stop a reaction. N she's like 'well they haven't been written up, who administered?' n I'm like Dr lang ordered them n she's like 'no, who administered?' n I'm like well I administered 2 prednisone at half 12, n she's like 'well you have to sign for it then'. N I'm like fine, gimme the pen. Its like working at a zoo. I mean I guess its fair enuf but paper work really is more of a nurse or primary physician job I say. Meh, at least I've studied some pharm n new that particular patients history better than any1 by that stage. Still the moral; Don't get sick.
I've been trying so hard to not to spew all morning, I'm taking an early lunch just to sit down. Maybe I could get a bucket behind the scanner n periodically pretend to be checking on something? Its because I rushed; multi vit plus 500ml energy drink at the same time as a chocolate milk popper = bad. So busy. Just tissued 200cc's under pressure into a young girls arm. Had to give another 100cc to finish the scan in the other arm, so her kidneys will be happy. Came in for a day procedure, found uterus cancer. Good day for her, good day all round. Did a pulmonary angio on a patient with a creat of 155 and gfre at 34. Called his dr who ok'd it by phone, which is cool. But now its my name on the referral n if he goes into renal failure all the doc has to say is 'I got not a phone call' and its all me. Just like me signing for the prednisone at half dose, ordered by a dr, just cause i administered it. I think that's my job, to be here to take the fall if something happens. I'm essentially a permanent fall guy. I bet medical insurance company's pay my wage.
Something about being here makes me wanna blow me head off. I'm getting very blow my head offy again lately, metaphorically speaking. I think that's why I'm sleeping so much. Its usually creatively good tho, and I have been working on things. I never have any energy atm tho. My contemporary's content watching star gate reruns ad infinitum n being green. It ain't easy being green. I think martin luther king jr said that. Suspicious that guy. Ill bet the postman was a muppet, or a sock puppet. Something. He looked nothing like his dad is all I'm saying.
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