shrimplate

The Hanged Man

2009-11-25T07:49:00.000-08:00

If a hospital, or perhaps a chain of hospitals, has a nursing shortage and also due to the poor economy has instituted a hiring freeze, then that shortage of nurses becomes fixed.

As wealth is concentrated upwards into the hands of the lucky few, so misery is concentrated in the lower echelons of society, and there is no one lower on the scale of being than hospital patients. They walk around bare-assed. They are bankrupt. They are not working.

I have a facsimile of John Dowland's First Book of Songs. It folds open with each of four musical parts facing to the four different sides of a table. Four singers and a lute player can seat themselves around it and read the music with their own part facing them. People knew how to sing music from written parts back then.

A rather fancy family might have a chest of recorders, viols, or some other consort of instruments. Sackbutts and krumhorns, anyone? It was home entertainment in a low-energy time, when we did not have electricity funneling various amusements into our homes for us.

An early music specialist came to my college and we formed a "broken consort" of unlike instruments (lute, bandora, cittern, viola da gamba, and flute,) to rehearse and perform a concert of Elizabethan music. I played the little cittern. The only time I ever have. I had been studying on my own and I could read the tablature notation, so the early music professor recruited me for the gig.

The headstock of the cittern I played had a blindfolded man's head carved into it.

Citterns, lutes, mandoras, and other instruments used to hang from the walls of Elizabethan barber shops. Loops of string tacked to the walls would hold the instruments by their headstocks. The blindfolded man was a sort of common joke, as the loop of string would circle under the neck of the hanged man.

While you were waiting for your shave or haircut, you would take an instrument down from the wall and play upon it.

Now we have fucking Fox News everywhere. So I refuse to have my hair cut at a salon anymore. It can grow to my knees.

What You Don't Hear

2009-11-22T05:38:00.000-08:00

I always inform my patients when I am about to do something to them that will cause pain. Usually it involves needles.

My patients like me. They tend to like the unit in which I work, and often they say complimentary things, such as "The nurses here are so good. Very professional, and everybody's been so nice."

Meanwhile the cartoon word-bubble over my head is silently reading out "wait until you get the bill."

That doesn't work on Canadians, though.

Brought to You by Your Health Insurance Premiums

2009-11-03T03:03:00.001-08:00

Well, eventually they ordered a temporary hemodialysis catheter and proceeded with thrice-weekly dialysis. It was a concession to reality. That's what the man needed in order to live.

However, we were unable to just keep him in the hospital and provide this service indefinitely. So one day they decided to send the patient home. After he was dialysed, they removed the catheter and presto! he was discharged home.

The best possible scenario was for him to return to Mexico for treatment. But he hadn't lived there in fifteen years; he was a legal alien here and had been so for the past twelve years. Unfortunately he had no medical insurance, and legal residency doesn't include that. He really had no place to go back in his home country.

In all likelihood, he just stayed here in The Valley of The Sun. He will soon get pretty sick and he will present at another hospital. Or maybe he will just come back to ours, where we will start this all over again.

The Old is New Again

2009-10-14T05:24:00.000-07:00

A legal immigrant who will die due to lack of money and will to take care of his failing kidneys.

The alarming number of sick calls from hospital workers this flu season.

The nasty fuss; the monkey-suit mask, gown, and gloves we have to wear to avoid spreading a simple virus.

Bankruptcies due to health care costs, even for those with good insurance coverage.

Fine coffee.

Applied technology. Medical equipment, and home entertainment.

Let's start with the last. I "had to" get a new laptop. Over the years I have accumulated a sizable collection of music on compact discs. My spouse abhors these due to the shelf space they occupy. Now I can download hundreds and hundreds of them onto my computer and Ipod. Wirelessly I can beam the music into my hi-fi system. (I am not fond of the sound derived from those little in-ear headphones; even the pricey ones.) Now I have more room on the shelves for books! at least until Spousie gets me a Kindle or other such book-reader. I can also carry nearly all of my music with me on the Ipod.

In hindsight, it's really not all that different from the little transistor radio I used to take to the beach when I was young so I could listen to Hey Jude while I read Vonnegut and sunned myself.

Interestingly, the latest-generation new Ipod Nano features the addition of FM radio.

What?! No AM radio?!

Set

2009-10-04T21:33:00.000-07:00

If you come to the hospital and you display flu-like symptoms, we will either admit you to an isolation room or kick you the hell out. Nicely.

If you have a child in school, assume that they are at risk. Viruses do not work in terms of degrees of separation; instead, in terms of degrees of connection.

Think about the things that you touch as you go about your business. Gross. Yes, I know. Then think about all the other people who may have touched whatever you're touching, as you make your day.

Multiple homonyms: Flu, flew, flue

Sedona

2009-09-26T08:41:00.000-07:00

Sedona viewed from Jerome

Two miles in.

The bridge

Dogs swimming at the crossing below Cathedral Rock.

It's hard to take a really bad photograph here.

Schnebly Hill Road view.

Structure of Memory

2009-09-22T05:20:00.001-07:00

If you work thirteen or fourteen hours per day for a few days in a row, sometimes you get tired.

All of the fascinating little details from the swirl of activities around you for these past days; well, things fade away. You sit at the keyboard and think that one thing you wanted to share which seemed so universally interesting, like breathe itself, has slipped away into the land of the bland.

That in itself is sort of interesting.

What are those little French cookies called? I forget. It think the word rhymes with porcelain.

A Kettle of Hawks

2009-09-12T18:43:00.000-07:00

Jakob was telling me about reality:

"It's like five bucks," he said. "But that's not what it's worth," he clarified for me. "That's what it is."

*****

Then there was the woman who used to teach English and she tried to tell me that there weren't enough vowels.

"Well," I entertained, "If you take just the five vowels and combine them three at a time, that gives you a possible sixty combinations that could enter usage as your alternate vowel sounds, couldn't it?"

She looked at me as if I were crazy and insisted that it still wouldn't be nearly enough, and besides that it was just a ridiculous idea. She thought more alphabetical vowel letters should be created. That's when we silently seemed to agree to disagree.

*****

You have heard that dismissive expression "But you could get a Grand Jury to indict a ham sandwich!"

But just you try getting them to indict a Reuben. Then it's all "Oh no, can't do that" and suchlike.

*****

We were walking along the quiet section of The Avenue of the Pines in Saratoga Springs; the part where the pavement turns east but the old tree-lined avenue continues straight into town. It's all pine needles, shade, and big old trees.

"They sing," the person said, meaning the trees. They guided me over to a few trees, selected an appropriate one, and made me lean up against it, listening with the length of my back.

"Well I'll be," I said, "You're right."

I still hang out with that person a lot.

*****

*****

Nursing is all about the relationship between the patient and the nurse. If, for one reason or another, that relationship cannot be construed as therapeutic, then "nursing" does not happen. Instead it's some other sort of fucking miserable bullshit.

Le Marteau Sans Maitre

2009-09-05T05:41:00.000-07:00

One of my art teachers from decades ago described this tool as a "many-headed hammer."

There are never two sides to an argument. Or rather, there are never only two sides. That is why I crinkle and bristle every time I hear the phrase "both sides of the argument."

We all know that, yet the useage of the phrase persists and it is consistantly abused. Two opposing ideas are all too often inappropriately given equal credence.

For example, someone like Glenn Beck may assert that "the moon is full of laser-eyed Moslem beavers who pose an imminent threat to the safety of all good American families." An opposing voice says "no, it's a barren mini-planet and quite harmless, actually." And so the discussion may proceed, as if each idea were equally respectable.

It does not matter that we consider two sides to every story, because we all know there are as many sides as there are heads on the carver's hammer. What really matters is that the hammer has a master...

Not a clown wielding it.

Bourreaux de solitude

Le pas s'est éloigné le marcheur s'est tu
Sur le cadran de l'Imitation
Le Balancier lance sa charge de granit réflexe.

*****

Executioners of solitude

The step has gone away the walker fell silent
On the face of Imitation
The Pendulum throws its load of granite reflex.

Rene Char, 1934.

This text was used by Pierre Boulez in his 1955 song-cycle Le Marteau Sans Maitre.

Comparing Health Insurance Plans

2009-08-22T04:37:00.001-07:00

A visual representation of the progressive Democratic plan:

(Seattle Childrens Hospital)

But the Republican are offering choice:

That Thing I Quit

2009-08-17T22:11:00.000-07:00

I used to, as of a couple minutes ago, go to the Opinions section of the local newspaper and write comments defending reason and compassion. I quit. It's a waste of fucking time.

A great many of the people who write letters-to-the-editor and comments thereon are a bunch of fucking assholes who don't give a flying fuck about anyone, not even themselves. They may be uneducated on the topic of choice, yet they remain staunchly convinced somehow that they know much more than they make evident. And they are never so right as when they are completely and utterly wrong.

They are mean-spirited; more then that, they are in love with mean-spiritedness. It moves them to states of excitement.

And I am fucking sick of them.

They are Blake's pebbles. Let them have the world, their world, and let them ruin it for all of us. In that they will have their hell but call it heaven.

Tire on the Mountain

2009-08-13T17:40:00.000-07:00

Why yes, that would appear to be a worn tire.

On a Maserati, no less.

It must be the economy or something. It's interesting what you can see while walking through an example of The Great American Parking Lot.

Banking No Crisis

2009-08-09T06:35:00.000-07:00

After our trip to Sedona, the car was covered in red rock dust from prowling the dirt roads in order to get to hiking trailheads and scenic views. So yesterday we went to the carwash. Phoenix has a million of these.

It wasn't busy at all, considering it was Saturday. But I counted a dozen-and-a-half people rubbing down the cars.

As we stood under the misters sipping iced tea while waiting, I noticed that workers were running across the street to a parked vehicle. One still nearby us asked another "Where do we cash our checks?" He held his paycheck in hand.

In turn, workers would cross at mid-street to approach the white pickup truck, then they'd come back counting their cash. I even saw a woman come up to this impromptu check-cashing service after walking from a nearby apartment complex.

One of the young men who used this service was the blue-eyed shaved head dude who asked us about a miniscule windshield chip when we drove up to the carwash. Every time you get your car washed at a place like this, they always provide the additional opportunity to have even the tiniest almost invisible little ding repaired, knowing that a lot of auto insurance companies will pay for several of these fixes every year.

Point being, not every person who used the bank across the street appeared to be possibly undocumented.

For No One Dose

2009-08-07T06:09:00.000-07:00

While sipping morning coffee (French-pressed,) in the proximity of spectacular Bell Rock, this occurred to me:

A few weeks ago at work I gave a patient an injection of Epogen, a drug frequently used by hemodialysis patients and others at risk for chronic anemia. It was a high dose, 40,000 units, but that's not unusual.

As I prepared the dose in the nurses' medication room, I recall thinking that one dose costs over $500, which is more money than I earn in a 12-hour shift of work. One single dose.

So when people talk about "holding down the cost of health care," I bristle at the thought that cutting nurses' compensation may be on their minds. Or at least reducing the meager yearly increases we are fortunate enough to get.

Us nurses, yes, we really are a bunch of lucky duckies.

Luceat Eis

2009-07-31T11:37:00.000-07:00

Iz nise warmi sopt, OK?

A Charm of Finches and Away

2009-07-31T04:09:00.000-07:00

The best and easiest way to fall in love with a person is to talk to them. You could also end up hating their fucking guts, but at least for a little while you will see that which is inside them deserving your love. Even if it isn't really there.

Red Molly loved James for more than just his '52 Vincent Black Lightning. She mistook danger for freedom. You see, that is how it is done.

As a nurse, there have been a few times when I have been with someone during the moment they died. One was a thirty-something young man who had already suffered an anoxic event that had destroyed his brain. His eyes were empty. Until he died. Then, as he took his final deep chest-filling breath, his eyes were full of all the people he had loved in his life.

I saw them, just as real as the words you see now. Then he exhaled and I saw them all swirl away deep down into his eyes, which then went dead again. For him I shut his eyelids. For them, too.

Dancing must be exhausting, because young energetic couples invariably begin by moving about quickly, then they gradually slow down, coming to a near-stop eventually. Then they wander off and sit by themselves or among others. That may be a critical difference.

What's the deal?

My spouse calls it insomnia. It's a satanic and discomforting affliction. Yet, it affords privacy.

Climb the church tower and hammer, hammer, hammer away at the bells. You will not break them.

Three For the Festival

2009-07-25T18:56:00.000-07:00

Catrin Finch

She's just released a recording of Bach's Goldberg Variations which she plays on the concert harp. It's an amazing transcription, but that's not the half of it. It's a great performance.

Julia Fischer

Recent recordings of Mozart and Bach concertos, among other things, are attracting a lot of attention to this violinist.

Muriel Anderson

Fingerpicker extraordinaire, harp guitar player, and also simply a great classical guitarist; this woman should be a household name.

Les Oiseaux Formidables

2009-07-15T19:53:00.000-07:00

Nick Lane has written this wonderful book about ten iconic developments that occurred as life evolved on our planet of flux. P.Z. Myers has a review here.

I'm also working on Bach's Partita in A Minor for solo flute, transcribed by guitarist Denis Azabagic.

It's thinly textured, which seems to make it easy on the fingers compared to the thorny fugues found in Bach's solo lute and violin works. But therein lies the musical difficulty.

Cheek to Cheek

2009-07-11T19:56:00.000-07:00

Moira rarely shares space, which may account for her pickled expression. PorkPie rarely doesn't.

La Deploration Sur la Mort de Ockeghem

2009-07-04T11:16:00.000-07:00

Hat tip to AndyG. Story in the StarTribune here.

"Fireworks called Run Hadji Run were pulled off the shelves of a Wisconsin store after Minnesota Muslims complained that they were racist.

The Minnesota chapter of the Council on American-Islamic Relations (CAIR-MN) said that both the name and the packaging are demeaning. One side of the package has a drawing of Uncle Sam yanking the long beard of a man in traditional Muslim attire, while the other shows a Stealth bomber flying over a group of Arabs riding camels."

It's some little girl's birthday today.

Be safe, people, and stay the fuck out of the hospital.

A Party of Jays

2009-07-04T08:57:00.000-07:00

Psychoanalysis takes a long time. Truth is elusive. The self is a chimera. People need to make a living.

We can only really speak meaningfully of things that exist. Perhaps we should put aside all discussion of promises.

We can devise a word or words for each thing that is discovered in our reality. Unfortunately, we can also devise words for things that have never existed and never will exist. This creates problems in language. These problems spread and evolve virally, becoming pandemic.

Once I knew a man named Lou. He'd had a stroke that destroyed his ability to speak, meaning that the Broca's area of his brain had suffered while the Wernicke's area was relatively intact. He could sing though. Bye bye blackbird.

I become deeply agitated upon seeing homes or buildings with complex roof lines. I absolutely could not live in such a place. No dormers nor gables for me, please. Please.

There are about five thousand breeds of dogs. Their innate ability and desire to interact with people subjected dogs to selective pressures to evolve in many different ways. Not so for cats. They only have about a dozen genes that are selectively manipulated by cat breeders for color, body style, etc. Cuteness, maybe.

Headphones on. Lights off. Feet up.

A Knob of Widgeons

2009-06-28T07:18:00.000-07:00

The poor old guy had been using an empty plastic cleaner bottle, for dish detergent or something, as an impromptu urinal. He was weak, suffering from congestive heart failure and a cardiac arrhythmia.

Anyway, he "got it stuck." He had been home for days with his penis stuck in a plastic bottle before he decided it was time to get into the system so he could get things fixed up. Maybe the bottle just got full.

At first the ED team couldn't effectively remove the bottle; they tried cutting it but this just left ragged edges in the plastic which tore into his sensitive member. Finally a talented urologist was able to remove the object without causing harm to the poor old guy.

Then his real treatment began. A diltiazem drip for atrial fibrillation and aggressive diuresis for his heart failure. A few ultrasounds showed that his anatomy was intact.

He had a daughter who lived away in another city. When she called to find out what had happened to her dad (she had been told there was a foreign object involved,) they handed the phone to me. They always do. Fuckers.

Religions are so anthropocentric. Science and evolution are not.

I think that if you practice enough introspection you will eventually come to realize that not everybody is like you. The more you explore the singularity that is yourself, the more you will be open to the diversity of all humankind.

Before you get so sick that you have to go to the local emergency department, you first have to build a hospital and train and hire the staff.

Music as we know it to be is not capable of self-replicating independently. It's more akin to a virus, which must enter something, a cell, before it can reproduce.

It now appears that the disequilibrium of protons around deep-sea alkaline vents may be the kind of energy source that enabled the first living things to occur. Disequilibrium is essential to life. Well, that explains a lot in my life, anyways.

We gave them paint and what did they do with it? They painted targets on things; everything, in fact. So let us not give them bullets.

In The Pocket

2009-06-27T15:43:00.000-07:00

PorkPie getting into the groove.

Once Upon Below

2009-06-26T17:16:00.000-07:00

Hydrothermal Life Maker

From the February article:

Lost City is exceptional, Kelley says, because chemical reactions in the seafloor produce acetate, formate, hydrogen and alkaline fluids. All these substances may have been key to the emergence of life, according to work published recently by Michael Russell and A.J. Hall of Glasgow and William Martin of Germany. In addition, acetate and formate found in Lost City fluids may have been an important energy source for the ancestors of methanogens, microorganisms that live off the methane at places like Lost City. It's perhaps one more bit of evidence about where life may have originated, Kelley says.

This could very well be the sort of place whereupon, hundreds of millions of years ago, geochemistry evolved into biochemistry.

Jogging Blood Products

2009-06-23T06:03:00.000-07:00

I could hear the whirring sounds of the pedals going 'round.

I knocked and entered the patient's room to check their vital signs again. They were sitting on the arm of the couch that each room has. For exercise we had provided them with one of those bicycle-pedal things, and the patient was spinning away.

They were also using the little hand-held barbells to work out their arms.

They paused for a moment so I could get new readings of their temperature, blood pressure, heart rate, pulse oximetry, etc. I checked the IV line to ensure that their transfusion was proceeding well. It was.

The patient was doing their work-out while they were also getting a fucking blood transfusion!

I will never again complain that I do not have time to sneak in a little exercise.

This particular patient has a chronic condition that requires relatively frequent hospital treatment. Needless to say, all of us nurses really admire their spunk. You have to respect a person who puts that much effort into their own care.