My Patients

I haven’t shared too much about my job here on the blog, but this is a story about my patients.

I can tell you that very often my patients are grumpy, or down right angry. They even cry uncontrollably and unexpected. Most of the time they sleep, right through my prodding them and talking to them. They don’t seem to find it especially important to thank me when I call them beautiful or compliment their long, dark hair and chubby cheeks. They do make interesting faces and most of them have the ability to go from a grimace to an angelic and peaceful repose within seconds.

I know that they wouldn’t want me to share that they burp quite often, or even have a tendency to gag and spit readily. Some just can’t help themselves and fart or poop while I’m with them. Sometimes stuff like that just happens, especially when you aren’t really adjusted to so many changes and hospital rules.

Even though they don’t have much to say I can always tell who is going to be totally bored with my visit, or just as easily the ones who are already wide-eyed and following my every move. I always think that those are the ones I have to watch out for, that those patients will be the ones to purposefully and obstinately refuse to listen. Then they surprise me and I find myself wishing I could spend more time with them as they dismiss me and settle in for sleep.

Some of them try to be helpful. They want so badly to help me detach sensors or ear hugs and it often takes a lot of explaining to them that no, I really do have to tuck their hands back inside their swaddle blankets, but I so very much appreciate all their efforts.

I really can’t tell, even anonymously, any funny or whimsical stories that I hear from my patients. Most of them are just trying to comprehend how their world has turned upside down and why they can’t go back where they came from just hours ago. They’ll have stories for sure, but I won’t be privileged to hear them. I would like to assume that they will be happy and bright and optimistic stories.

Those are the patients that I visit in a quiet room with their loved ones close by.

Some of my patients are alone. I meet them in a large, sometimes noisy, space. Their freedom is tested because they are attached to machines. Many of these patients rarely notice when I stop at their bedside. Of course they hear me remark on their beauty and strength just like all the others. Some will show their displeasure for me with the occasional frown or soft high-pitched cry, but I move forward with my work.

These patients are almost always asleep. If they aren’t they twitch, and appear jittery. I move them about, touch them only as much as is absolutely necessary and watch them startle over and over again. There are some that I come to visit and I have to stop. They tell me that it is too much, too soon and they begin to scream in pain. These are the patients that are telling me their stories over and over and I see at least one every day that I am at work. These are the patients that don’t get to go home wrapped in loving arms at 24 or 36 hours.

These are NAS patients. Rather in severe withdrawal, or on a monitoring hold, these patients were born to mothers who used opiates during pregnancy. Those in withdrawal are given morphine. I work in a small facility. Our NICU can house six patients routinely with overflow for 1-2 more. Very sick babies are transferred to a Level IV facility. Most NAS babies stay with us until they are well enough to go into foster care. Since I began work on September 1st, there has only been one of my shifts without an NAS patient.

The work that I do with most babies is rather routine, and predictable in many ways. However, it will never be routine for me to stand in the doorway of the NICU and see a baby, only hours old, being given another dose of morphine. I could never predict how much an infant can tremble, and twitch and startle, never seeming to find peace and quiet.

I can only wonder what these babies stories will be, what their future will hold. I will not be privileged to hear them. I would like to assume that they will be happy and bright and optimistic stories, because to assume otherwise is too painful.

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A Heartfelt Reminder

This is Cece Mae. She turned 2 on Thurdsay.

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On Friday night, instead of playing with her new toys, she was admitted to the Pediatric Intensive Care Unit to be monitored for 24 hours.

Cece found a pill on the floor, inadvertently dropped by a visitor to her house. That pill, a diabetes medication used to control blood sugar, was chewed and swallowed before anyone could stop Cece.

Her big sister tried. At 5 years old, Miss G knows that pills are not candy. Pills and medicines that are not given by mom or dad do not go in your mouth. Pills that aren’t meant for you can hurt you. Miss G tried to get Cece to spit out the pill, but it was too late. Miss G ran to tell her mom and dad what Cece had done.

Cece and her family will be back home tonight, thanks in part to Miss G’s fast thinking and her parents fast response. Had Miss G not seen what the pill looked like and also reported to her mom and dad immediately what had happened then Cece, on her way to bed, without anyone’s knowledge of what she chewed up… well, we are all thankful that we didn’t have to face that what if.

Besides the IV in her arm, and the hourly finger sticks to test her blood sugar, Cece is taking this whole experience like a trooper. We imagine that she won’t even remember the past 24 hours.

So readers, my plea to all of you, especially if you take medications, vitamins, herbal supplements and happen to be in the home of a small child-

Never assume that your medicine is not of interest to a small child.

Never assume that a child will not find, look for or make attempts to reach that interesting bottle or gummy-style looking “candy.”

Never assume, no matter how many times you say not to, that a child will remember not to put anything into it’s mouth, no matter their age.

Never, ever assume that all your pills actually make it into your mouth when you take your dosage, especially if you are one of those people who can, and do, swallow multiple pills at one time.

If you are in a home with small children, always check the area where you just took your medication. Counters, beds, tables, the floor. Any place a child can see and reach may have a harmful surprise waiting for little hands to find it.

And finally, if an accident happens with a medication, please know what to do, right away. Call your Poison Control help line, or if your community doesn’t have one, call 911. It is imperative if you know a child has ingested anything that you do not wait.

 

Revelation

Nothing major, but something that has been growing on me since about mid-September.

I like my job.

I cannot honestly say that I remember the last time I said that. Likely it was years ago when I was teaching childbirth classes. I loved that job. That job felt right. I probably used the word like a few times during my dental assisting career as well, although I suspect that I liked the doing of the actual job more than I ever really liked where I worked.

I also don’t really know why this admission strikes me as rather incongruous. I suspect that we can all find something about our work to complain about. The commute, a co-worker- or two or three, overtime, workplace drama, etc. I would be surprised to find anyone who would say that their career, and the inherent aspects that surround doing that career, is perfect, but I do assume that many/most of us like the path we have chosen or the career we have ended up in. Yet again today, as I spent time educating a father about what I was doing and why, the revelation popped quietly into my head: I really like this job.

Those extra shifts that I picked up when we lost one of our screeners haven’t been a burden at all. I could literally do this job five days a week. I don’t remember feeling this way when I worked at the same job five years ago. Just like the dental career, I liked the doing, but the place and people- no connection, no sense of belonging.

New parents haven’t changed. I meet them when they are bleary-eyed, sleep deprived but high as the sky eager and anxious and terrified humans contemplating the new person in their lives.

Babies certainly haven’t changed. The babies are the most predictable aspects of my job in so many ways…most of the time…until they aren’t. Babies will surprise you when you least expect it. They will force you to adapt and to think on your feet. Their job is to challenge and I am finding that amazing and humbling.

The job really hasn’t changed with the exception of a few procedural differences. Autonomy, self control and responsibility, the aspects that I craved last time around, still give me a sense of purpose, and self-worth, and feelings of capability and ownership in my work.

So with so much the same I wonder why I am so much in like with my job. Could it be because the facility is smaller with a calmer atmosphere, or that the staff is simply more welcoming and so I feel more grounded; more of a team member; perhaps even more valued. I remember always feeling intimidated when I had to enter the NICU to check on or screen a baby. Now, with my desk just 4 feet from the NICU, I am building a rapport with the nursing staff who feel like colleagues rather than strangers. I am greeted regularly by the housekeeping staff and nutrition staff delivering breakfast. I even got a physician (maybe anesthesiologist) who is always there on my shift, to finally smile and tip his head in greeting.

I’m sure that all of this is a factor, but I also wonder what’s different this time around with me. Five years ago I had just ended my career in dentistry because of arthritis. Five years ago I was beginning my role as grandma. Five years ago I knew that my marriage was over, although I had no idea that I would actually come to the decision of divorce. Five years ago it was difficult to take a job that had me working weekend evenings, even though I was beginning to welcome being out of the house more and more. I think in some ways guilt led me to take that job five years ago. I felt a need to still contribute, maybe even to prove something about my place in a marriage where it was becoming clear that my not working was frowned upon, and the reason I stopped working was implausible in the mind of my ex-husband.

Today, I hold this job for myself. I still feel a need to contribute, but the contribution is to my own sense of self, my own well-being, my own desire to learn from and interact with other adults. Of course, I am also contributing to my finances, and I won’t deny that the extra money every 2 weeks is a bonus! Selfish reasons maybe, but there is no burden of proof that is owed to anyone anymore. I get up and go to work on Saturday and Sunday mornings because I want to. Because I like to. Because it is necessary for me to forge a sense of ownership about myself. Because I do not have to think of how my days and nights are, or are not, making someone else happy or content.

I do this job for me, and that makes all the difference.

 

 

Not a day over 40

I am 58 years old today. That doesn’t seem possible. How is that in two years I will be sixty? I swear to god that just yesterday I was graduating high school. Only a few years after that I was a brand new dental assistant, already coming to understand what working for a sexist a**hole was going to mean.

My children are adults, like real adults, not just beginning the “newly out of college phase” but actually marking their own year by year climb up the age ladder. Okay, I have to give Alison a little leeway- she’s only 24 so still just a toddler in the adult world. I can remember every moment of labor with each of them. How can I be almost 60 and remember those events, but forget where I put my phone only seconds after setting it down?

I have two grandchildren. Aren’t grandma’s supposed to be all round and cushy and wearing a full head of white hair while carrying around lined faces and crepe-skinned necks and saggy jowls and chicken wing arms? Alright, I will admit to a degree of round, but hey, I carried and birthed 3 children remember. I do have some crepe-ish skin, somewhere under my drooping eyelids, and I will admit to a few fine lines, but those are mostly on my well-worn hands. Chicken wings for arms–yeah, it doesn’t take much to get some flapping to occur under my arms, but white hair- no way! Garnier Nutrisse 5RB will never allow me to look like a snow queen.

I wonder, on the day I turn 68 and realize that at that time I am just two years shy of seventy, if I will finally be able to acknowledge feeling mentally the same age as my body tells me I am. My head consistently tells me, on these annual birthdays, that I am somewhere around 25. I used to say 18, but that’s pushing a bit these days. I’ve had too many life experiences to claim to be the mental age of a naive 18 year old.

I wonder when the mental clock will finally catch up with my chronological age. Perhaps we always imagine ourselves to be younger. Maybe it’s some sort of self-preservation mechanism, a way to stave off our mortality. If that’s the case, then today I’m going to hop back to about 40. I think that was a pretty good year.

Am I the only one who experiences this? How old are you- in your head anyway.

Closing Scene…

Open on a shot of a nondescript courtroom in Pierce County Washington.

A few dozen people sit on uncomfortable benches, waiting to stand before the court commissioner.

One by one each player is asked to come before the court, paperwork in-hand. Each scene unfolds with alarming regularity. Each player is found to have some issue or other that causes the commissioner to send them away to either fix or add to their pleadings.

Some are even told that their case will not be completed because they are too far off the mark with their attempts at supplying the correct legal documents. Some should clearly not even be in the courtroom.

The cameras, as they are lurking in every corner of the room, all pan towards me- The Petitioner in case 17-3-01458-2, Dissolution of Marriage. I begin to worry that after countless hours and checks and rechecks that I may have forgotten something, or left something out. I wait as each name is called, equally anxious to be done but also dreading that I may be one of those who is sent away with unfinished documents. My brain cannot grapple with the fact that I may have to return to this room another day.

My case is called, and like everyone before me I proceed through the swinging gate and step to the microphone in front of the clerk and commissioner.

“Please raise your right hand and repeat after me…”

“Right? Which one is my right?”

“State your name.”

“Already too many questions. Can’t he see that I don’t want to get sent away. Just sign      the papers, please”

Most of the rest is a blur. I was asked basic questions about the marriage. I was asked numerous questions (probably about 4 actually) about the division of assets. I was not scolded about my paperwork being messy or inaccurate. I was not sent from the room to add to or fix anything. I watched the clerk place a large letter G next to my name on her list. It only struck me later that she was signifying for her own notes that my decree had been granted.

Pan to the commissioner’s desk. One by one he signs off on all 5 documents that I had put in front of him. He announced his signature with each one, and as those before me had done, I politely said “Thank you, Your Honor.”

With the signing of the final decree it was announced to the room, “You are now divorced. Thank you and have a good weekend.”

The lights begin to dim as I collect my notebook and purse and move back through the swinging gate, already forgotten by the commissioner and those players still waiting for their turn in the spotlight. I exit the courtroom with the realization that I am now divorced.

And we close the scene at 10 AM July 21, 2017 on what was just over 34 years of marriage.

Curtain.

**This process was probably the most surreal experience I have ever had. The reality for me is that this entire marriage was truly over so long ago that this was a formality. The emotion levels of this process have come and gone, climbed up and down, and been a constant presence in my life for so long that earlier today, and even now almost 4 hours later, I feel emotionless. It is just another day and nothing feels any different. I wonder how long this will take to really sink in. Maybe when I move into my new apartment and can just sit, quietly and alone and reflect. Or maybe this is all there is. Maybe there will never be anymore to care about or reflect upon. Maybe I can just move ahead now because this is finally, unquestionably over.

Thank you all for reading, and supporting, and being willing to stick through this process with me.

 

 

Divorce Stories

Since I have all this time on my hands I’ve decided to share some of an interesting/disturbing/disgusting incident surrounding this divorce process.

It was right around the time that I was finally prepared to tell my spouse that it was time to end our marriage. I had made an appointment with our long-time financial planner so that we could get our taxes prepared- close to the end of March it must have been.

I sat down and before anything else, told him that we had agreed to divorce. The man nearly became unhinged. Now this was a person who had come well recommended years ago. We began our relationship with him when both of my parents passed away within a few months of each other and there was inherited money that needed to be dealt with.

We have kept that relationship going for 20 years or so and have had no complaints about how our money has been managed, or how he has helped us navigate through things like college student loan issues for our kids as they all moved through higher ed. This person has always been soft-spoken, knowledgeable, sort of nerdy, definitely focused on facts, and never pushy about any decisions we have made.

I’m not sure that I can even begin to describe the person who presented himself to me on that day in March. It was not the man I had known for 20 years. I understand and acknowledge concern. I comprehend shock over the news that I had just shared. I can even accept, to some degree on his part, a sense of disappointment or failure that the future we had been growing was going to undergo a significant change. I am still in disbelief that I became the victim of a tirade for most of that tax appointment.

I listened to him tell me, over and over, how he had seen the lives of clients fall apart after divorce, how the process would be contentious; how it would be a struggle at best; how it would go on for a year or more; how no matter what we may believe there would always be something that would come up to cause disagreement or even open warfare.

He stressed, almost vehemently, just how much attorney’s set out to line their own pockets, caring little for their clients, and how they clearly delighted in pitting party against party in a divorce.

He felt the need to assure me, repeatedly, that there would not be enough money to live. I assume he was speaking about me (rather than us) with that comment because of the fact that I no longer work and my spouse has an income.

He felt the need to tell me the story of his own parents horrid marriage…tell me 4 times that they were married for over 50 years and readily admit that the marriage should have ended decades earlier…except that they would never have been able to live. They stayed married, living in separate areas of their home until his mother died.

He liked to stress that line, “you won’t be able to live” along with his constant observation that “I’ve seen this so many times” or that “it always happens this way.”

He shared the horror stories of just how much healthcare would cost me each month, based of course on the fact that he supports a family of 4 and that I had only 3 choices of plans. It made no matter to him that neither of those facts applied to me.

He encouraged, between the dire warnings, that my spouse and I go to counseling. Again, it was no interest to him that with each cajoling plea to seek guidance I stressed that we both clearly know our own mind and our decision would not change.

Intermixed throughout all of this was the clear insinuation that I would do myself a great favor if I simply settled in for the long haul, forgot about my own happiness and needs and rode out the rest of my marriage until, like his parents, one of us passed on. He even, without any subtlety or grace, noted that my only alternative was to find myself “someone with money to take care of me.”

**I must inject a note to my dear blogger pal Alice at this point– calm down dear. I have ranted and raged over this man enough for both of us since this day happened. I am almost to the point that I can find a pitiful sense of amusement in the story now. Don’t waste your time or energy.

I had a rather bad cold that day, so I think that much of what he was spouting off about actually didn’t faze me at the time, or I was just more focused on trying to breathe and not cough myself out of the chair. Believe me, I heard his words, over and over, but it wasn’t until the drive home that they actually began to sink in.

A few times during the 45 minute appointment I remember looking at him incredulously. I asked him at one point, after the 3rd time around with his parents story, if he was honestly telling me that I had two choices: stick it out and be miserable for 30 more years, or find myself a cardboard box to live under the local overpass. After a shrug, and likely his interjection of one of his favorite ‘you can’t live on that amount’ replies, I clearly remember telling him I would gladly choose the box.

The irony of that meeting is evident in the fact that nothing that he predicted, at least so far, has come to fruition. We discussed, agreed, moved forward, continue to make progress without lawyers sucking our money from us or being involved at all, have made quite equitable decisions that will allow us both to live, not in a box, but between walls and with a roof, and remain amicable.

I have had to have email contact with him a few times since that day. I remain coolly detached, ask my question, and move ahead. Today in fact, in a reply to me, he managed to throw in one of his favorite statements when answering my question- the one about how he’s seen it happen before, so many times.

My amateur psychology degree tells me that there’s something underlying these reactions. There are some deeper issues here that this man cannot move beyond, that this man must project on to others. Or perhaps he was just a misogynistic horse’s ass all along…

I have to admit that I find myself feeling rather smug during those moments when I can share with him in an email just how easy this process has been, just how smoothly we are moving ahead, just how things like his dire prediction of an $800+ health insurance bill per month will actually be a mere $25 per month- all thanks to my spouse candidly and openly reminding me that I can take advantage of the fact that I am still covered by the military healthcare system, and will be for life.

The best day, I predict, is yet to come. That will be the day when all of this is over and I walk into his office for the last time. I plan to leave him a small cardboard box and perhaps a tarp as my final goodbye gesture prior to firing him as my CPA.