Friday, July 31, 2015

If I see one more preachy Facebook post about air conditioning. . . .

Look: I know air conditioning costs money. I know it's bad for the environment, it makes people fat, it destroys the great plan that the universe has for us, and that it's one small step from central a/c to us telling our children and our children's children what it was like in America when men were free.

But I live in Texas. Central fucking Texas, where even the Native Americans didn't hang out in the summer, unless they could do so while standing up to their necks in spring-fed rivers.

So when I get tagged by well-meaning friends who live in Michigan and Wisconsin and Maine, where sure it gets hot during the day but it cools down to less than 80* at night, I get homicidal. They send me fun little articles about how people lived "before the age of air-conditioning." There's then this competition, with Europeans chiming in (bless their hearts), talking about how *they* don't use a/c until mid-July, and only then if their aged Aunt Maude is visiting. Hot? Just open a window, they say. That's what people used to do.

Yes, people had fourteen-foot ceilings and transom windows and heavy draperies they could pull to keep out the sun. They had cross-ventilation and attic fans and houses built on pier-and-beam foundations that allowed cool air to circulate. They had strategies for allowing cooler air in at night. They had huge ice blocks with fans blowing across them.

And you know what? They still left this part of the country and went to cooler places if they could possibly afford to. Whether it was a few miles away, to the Comal and Guadalupe and Frio, or down to the coast, or back East or to the mountains, they got the hell out of Dodge while things were baking. If they didn't, they either were miserable or they died.

Next time those friends get buried in snow, I'm going to post articles about how shoveling snow is bad for the planet and makes you a lesser person.

Yes, I'm a little grumpy. It's the heat.

Sunday, July 26, 2015

If you've not yet listened to RadioLab's broadcast "Telltale Hearts," you should.

It has (you can find it here) not only a great story about a heart, but an appreciation of Oliver Sacks by Robert Krulwich.

Dr. Sacks has liver cancer. As these things go, his prognosis varies depending on whether a given treatment has worked, or whether he has new metastases (the original one came from a melanoma that was eliminated from his eye nine years ago). Robert Krulwich, who's been friends with Dr. Sacks for thirty-five years, took a possibly-last opportunity to talk with him about his life.

It's an amazing, heartbreaking, heart-healing interview.

If I have one regret, it's that I'll probably never get to sit at Oliver Sacks' feet and listen to him talk, or take a look at his collection of elements from the periodic table, or be there when he makes some remarkable connection between the way things are ordinarily and the way they can be in the strange land of the human brain. It was Dr. Sacks who awakened my love for the human brain and the way it intersects with and informs the mind. Before I was ever a neuro nurse, back when I was a music major, I read one of his books and knew that *this* was what I wanted to learn about, forever.

If you want to skip the cardiology part, though I recommend that you *not,* his part of the show starts roughly halfway through. Don't miss the story of his philosophical conversation with the spider.

Dr. Sacks, I hope you get nothing but indigo from here on out.

Tuesday, July 21, 2015

Heads-up and queries:

I. . .I noticed the other day that, um, my blog design is like, you know, ten years old? And a lot of the links are broken or outdated? And I got really embarrassed? But I didn't actually do anything about it because I am a curb-crawling, lazy SOB blogger with a mind on Higher Things.

So now I wanna give all y'all Minions a heads-up: In the next week or so, maybe, I might kinda be re-doing some of the links and maybe the text size and so on, so if the blog goes down totally, that's why.

Queries:

How does the text of the main body resolve for y'all? It's really small for me.

How does this bad boy look on mobile or tablet?

Should I ditch the full-text thing and go for "more below the break" formatting? I know I talk a lot, and I'm wondering if that would make for easier scrolling or if, as it does to me, it would drive people insane.

How does the Garnier Nutrisse Warm Copper compare to L'Oreal Preference 7LA Lightest Auburn? Good match, or Bonzo Orange?


Wednesday, July 08, 2015

Well. A whole lot just happened all at once.

*whew*

To recap: I work in a critical-care unit that's embedded on a floor that is not critical-care. My immediate managers, the Assistant Manglers,  are not critical-care nurses. They don't have neurological or neurosurgical backgrounds. There are two of them, and both of them have shown a positive disinclination to be trained in the way we take care of critical or acute patients, despite having been told to get that done fourteen months ago. As a result, we folks in the NCCU deal mostly with our Head Big Mangler, who is a critical-care nurse.

(I should mention here that we are the only unit in the wide swath of hospitals that Ginormo Research, Inc. owns that does exactly what we do. If you're in reach of a Ginormo ED, and you have a specific problem, you will end up on my unit.

Four months ago, give or take, Keith showed up. Keith has been nothing but badly-groomed, unhygienic trouble since he showed up. He makes decisions on a weekly basis that, if he were working for Planned Parenthood, would get him fired the same day. . .but because this is a big corporate bureaucracy, have been allowed to accumulate in his file. He endangers patients and makes bone-headed mistakes that are simply inexcusable in somebody who has as many certifications as he does.

I bypassed the Assistant Manglers last week to report a particularly dangerous Keithism, and was written up. I discussed it yesterday with the Head Big Manager, and today got called into her office. Here's what happened:

I presented her with the rebuttal I wrote to the quote-unquote verbal warning I got. She read it, and then cross-referenced it with the writeup that the Assistant Mangler had submitted. I watched as her eyebrows climbed and she made little snorting noises.

Then she said, "I hope you understand that I can't, unilaterally, take this off your file. . . .but I am going to talk to Assistant Mangler about removing it."

I didn't know that using gentle terms like "misunderstanding" rather than the more accurate "I checked this out and it's a baldfaced lie," or "lower-acuity skillset" rather than "this person refused to complete mandated training" would be so effective. But they were.

Head Big Mangler agreed that I had done the right thing by going to the unit coordinator. She agreed that I had done the only thing that was logical, in light of various issues I didn't expand on here. She asked me to pass the word that any future Keithishness be brought to her attention, immediately, even if she weren't physically there.

I heard a distant hum, like large machinery.

And then she said, "So. . . how do we deal with our weakest link?"

The hum grew louder and more distinct, and all I could think of was


But unfortunately that would leave us short-staffed. I said, "Well, we're already manipulating the assignments so that we can keep an eye on Keith's patients as well as our own. . . ." and Manager cut me off. "No," she said, "you guys have enough going on with your own assignments. We need a way to keep an eye on him without burdening you further."

The hum resolved into the singing of a choir of angels, bursting through the Keith-colored clouds that have made my life a misery since March.

End result, TL;DR, was that Manager will be auditing charts and being much more present. She won't delegate this, since there aren't any sub-Manglers that can make good decisions about critical-care patients. And she promised to keep us in the loop. She told me, "I've noticed that people have been calling in rather than work with Keith, and I don't want to lose strong nurses because of one person."

So damn if I didn't get all validated and shit.

And, much more importantly, the entire unit, working as a group, got validated. We saw a problem, we followed the rules in so far as we could follow them rationally, I broke a couple because what the hell am I here for otherwise, and it's all slowly working out.

Now--whether this actually happens is a different deal. Having seen Head Big Manager's face today, though, and learned the meaning of the words "her lips narrowed into a grim line" as she was reading my write-up, I feel a bit more hopeful.


Sunday, July 05, 2015

Once in a while, I am reminded that I am no longer young.

Most of the time, I'd say I feel about. . .oh, twenty-seven? Mentally, at least. When I'm not being an eight-year-old boy.

Sometimes I am reminded that this is only a lovely fiction, a way that my brain has of denying the inevitable decay and death that attends every one of us.

Like when I tried to get into and then out of Kitty's car.

We had a strategic meeting, Kitty and Marcie and Marcie's husband and their dogs and I. Kitty drove the five minutes to Marcie's house--believe me, this is not a place you want to walk when it's numpty-bumpty degrees outside--so we took her car.

Kitty has a Japanese rocket of some sort. It has letters and numbers after its name. It's low to the ground and feels like an old sports-version Mercedes to ride in: you can feel every bump, and it's very, very tight and heavy. And getting into it is like getting into a bucket.

I folded in half and sort of fell in with a "GNMPH" noise and managed to buckle my seatbelt. Getting out? Well.

Have you ever watched a bullrider in the chute before the bull's released? He'll grab the harness with one hand, put the other up above his head, and then do this back-and-forth rocking three or four times. Then the chute's opened, and a huge mass of fat and muscle, enraged at its captivity, bolts forth with unpredictable and probably disastrous results.

That was me.

ANYway. We got there in one piece and met dog #1, dog #2, and husband, in that order, as well as Marcie's sister, who was there visiting. And we talked.

About Keith. And about us.

See, nothing's been done, as far as anybody knew as of Monday of last week, about Keith. I'd been assured by our mangler that Keith would be retrained in the areas where he showed deficiencies. . .but nothing's happened. And he's still doing totally unnecessary, stupid things, like not giving blood pressure medicine to people who need it. Because they've had brain bleeds. And their systolic pressure is in the 230's. When the top limit for them is 140. But I digress.

Because things are not moving along as we would've liked, and for a number of other reasons, I contacted the person who coordinates the neurocritical care unit. It was just a "hey, how you doin', we've got this moron here, how's the baby" sort of casual thing, bringing her up to speed on what's been and not been happening. Because, you know, I figured that, as the coordinator of the whole fucking unit, somebody might've mentioned this stuff to her.

Well, nobody had. And my calling her led to a number of people suddenly waking up to the fact that a) other people above them in the org. chart had been made aware of this running disaster by the coordinator; b) something had to be done, and; c) everybody's hair was on fire. It escalated, even though I didn't mean it to. Now everyone from the CNO on down's been made privy to every single write-up and suchlike.

And Marcie and I have been disciplined. Marcie for "falsifying" charting that she didn't actually falsify--in fact, the whole reason she got a black mark is because an assistant manager who's had nothing to do with this whole situation can't understand how our machines work*--and me, for going "outside the chain of command." Which means that that same manager is upset that she got called out for not doing more to help us with Keith.

In her defense, she never knew about Keith. Because we never told her. Because she showed a positive, proactive disinclination to learn or understand anything about the NCCU, not being a critical-care nurse herself. Because she's declined to be oriented, she's shoved off responsibility for us on to other people, and she's thrown mini-tantrums about us calling on her for help.

Tomorrow I get to walk back into a forest of people taller than me, all with smouldering hair. I'll probably be pressured to sign the write-up that's on my file, and once again, I'll have to refuse. Hell, I might have to write a rebuttal, or take it to HR.

I might have to quit nursing altogether, change my name, get plastic surgery, and move to Brazil.

That might be okay.

Unless all they have is cars like Kitty's.

---   ---   ---   ---   ---

*LSS, our machines time-and-initial-stamp vitals when they're verified by a nurse. Our assistant mangler (Ass Mangler? Mmmmaybe) doesn't understand that, and so thinks that differing initials on one chart mean that somebody's lying. It's stupid, but it's what I've come to expect from Sunnydale.

Monday, June 29, 2015

Product Review: How Long Has It Been Since I Last Did This?

People, you need to know: I am the Queen, Undisputed, of Mascara.

I am asked routinely by perfect strangers in the grocery store if my lashes are actually mine.

They are the one truly, undeniably, irrevocably good feature I have. No matter how short my hair is or what my nose happens to be doing on a given day, my eyelashes are On Fucking Fleek, as the kids say, all the time. They don't fall out, they take dye easily, they're long and thick and look like false ones if I load up on mascara.

If I have one vanity, it's my eyelashes. They are the one immutably good thing about my face. My eyebrows go from Crazy Recluse to Mountain Man in a day; my cheekbones appear and disappear like blue sky in the Spring; my nose may or may not have a bump in the middle or on the end, depending on how much salt I've eaten in the last twenty-four hours. But eyelashes? I so have that shit covered.

Currently my eyelashes are longer than my hair. Really.

As a result of all this, I've become obsessed with mascara. See, when your lashes are long and thick but transparent, you depend on mascara to make them visible. Without mascara, I remind people uncomfortably of a white rabbit, like I'm about to be locked in a cage and have household cleaners tested on me. Without mascara (or dye in the summertime), my eyeballs blend seamlessly into my face at large, making me look like a washed-out X-Files alien.

I fucking live for some goddamned mascara, is what I'm sayin'.

And, today, I have reached a milestone: with the delivery of a one-hundred-point sample from Sephora, I have now tried every mascara currently available on the US market. I'm not exaggerating. I've spent something like a thousand bucks in the last two years on mascara: drugstore, mid-market, high-end. There is no grocery-store trip I take that doesn't end with a couple of tubes in my basket. I've used Maybelline, and Cover Girl, and NYX, and ELF, and NY, and Dior, and Lancome, and Clinique, and every other mascara you can name.

Yes. I have an Excel spreadsheet.

It's taken me a decade, but I am prepared now to offer you my winner of all winners, my mascara Holy Grail, the one makeup product that, if it is discontinued by the manufacturer, I will spend good foldin' cash money to buy a hundred tubes of offa eBay before it all goes dry.

That mascara is:

Ardency Inn Punker.

It comes in one color: black. It has a curved brush, which is a pain in the ass, but I'm willing to put up with it for the formula. It's wax-based, it dries incredibly fast, it does not clump even when you come to the end of the tube, It is not waterproof, but it is tear-and-sweat resistant. It does not smudge under your eyes, even if you have oily undereye skin like I do. It is safe for contact lens wearers and has never amplified my allergies. It makes lashes look great with one coat, amazing with two, and drag-queen-worthy with three.

You do not have to comb out between coats unless you want to.

And it works with false eyelashes.

My Asian coworkers love it because it dries fast enough that it doesn't dot up on their eyelids. My Indian coworkers love it because it gives them that natural-looking, yet-can-be-seen-from-space look that they love. My Hispanic colleagues love it because it's a true neutral black, not something with blue or red undertones. I love it because I take my makeup tips from drag queens and it makes me look amazing. I routinely put four coats on before work, combing between each (though I don't need to) and slay strangers with my full, soft, incredibly draggy eyelashes.

You can get it at Sephora or on Amazon, but it's twice as expensive on Amazon.

Dior Diorshow comes in a distant second, but you'll pay more for it.

Maybelline Full & Soft is a good drugstore replacement, but be prepared to reapply and reapply and reapply and reapply to get the same effect.

Ardency Inn Punker: if you wear mascara, go get you some.

Tuesday, June 23, 2015

Cancery McCancersons. Don't like it? Click back.

I had the first of the five-year hurdles last week: I saw my dentist. Me and my surgical deficit, we went in to the same office and sat in the same chair, but with a different hygienist, one who didn't once have twins kicking me in the face while she worked on my teeth. I sat and looked up at the same goddamned pine trees that I saw when they said they thought I might have cancer, and I waited for a verdict.

Everything is fine, they said. My teeth and gums are really healthy. I need to floss more. There is no evidence of disease.

For anybody else, that would be a milestone, a real one. For me, it's kind of a milestone. It's a milestone that everybody else has created, not knowing that the sort of tumor I had shows up again, usually in a nastier form, after twenty years.

Those of you late to the game should know: five years ago, at forty, I had half my hard palate and all of my soft palate removed due to something called polymorphous adenocarcinoma. Mine was low-grade, leading to the initialism PLGA, and try searching *that* on Google. You'll end up knowing more about golf than you ever wanted to.

When I was diagnosed, the article on Wikipedia was a stub. You could've edited it to add what you knew to help others. There was one paragraph in one textbook about it.

ANYWAY. After a hellish year that you can read about by clicking on the 2010 and 2011 archives, I had a prosthetic that was better than my original mouth. I had no need for nightlights, since I had had enough rads to glow in the dark. I was well-versed in CTs and PETs and MRIs, with and without contrast, and with the recovery process that goes with having bone saws in your head.

In October, I will be officially five years out. The trouble is that five years means, simultaneously, nothing and everything.

In October, it'll be five years since I stood at my kitchen sink and looked out the back window and prayed and wished that I could spend more time gardening.

I haven't spent any more time gardening.

In October, it'll be five years since I called The Brother In Beer with the news that my lump was malignant. He spent the next couple of nights wondering what the hell he was doing so far away.

We're together now, and he's The Boyfiend, but I haven't been as present as I should've been.

In October, it'll be five years since Nikki and Lara got really sick, not just big-surgery-and-plastic-shit sick, and had to lose their hair and get irradiated. I never had to do any of that. They were solid as rocks, the both of them, when what I was going through was so much small potatoes.

The Boyfiend's father is celebrating his five-year anniversary too, celebrating freedom from a much nastier type of cancer that meant a G-tube and head-and-neck radiation and all the things that go along with that.

Here's the breakdown:

I didn't have a really nasty cancer.

The cancer I did have has a recurrance period way beyond what most people think about. Anything can happen in twenty years, and most things do.

Max, the dog who kept me company when I couldn't talk at all, is dead. Mongo is here now. The cat-boys were barely out of kittenhood then, and are now adult cats. One is huge and muscular, the other is sleek and flexible. They'll all be dead by the time I have a real clear checkup. Hell, the guy who did my surgery will have retired by then.

Things have moved on, except they haven't, really.

I realized today that I've internalized this bullshit anniversary. Mostly, I think, because twenty years is too much to think about. If I can make it five years, then maybe I can make it seven, or nine, and eventually forget about what happened, except that I'll still have that Thing I have to put in my mouth to talk. Maybe I can reconcile myself to another fifteen years of wondering if the tumor's come back.

If I think about it as a whole, as in "I have to fear every checkup for the next fifteen years," then I want to fling myself out a window.

I realized today that I've spent the last five years putting things off, vamping 'till ready, because I believe in this five-year mark that means nothing. And now I wonder if I'm going to keep putting shit off for another fifteen years. I hope not.

Wouldn't it be fucking hilarious if my CT or MR shows something growing on a lung? Or my intestines, or liver, or meninges? It would certainly give me something to do, but I'm not sure I'd be grateful.

What do you say when you have nothing to be afraid of, yet you're still afraid?

I never realized until now how much having most of the inside of my head exposed to air had affected me. I'm ashamed: it shouldn't be such a big fucking deal. Lara has gone out and run marathons, for God's sake, and I've just sat here paralyzed, navel-gazing.

Despite all of that, I'm still afraid. I have no reason to be, but I am.