Friday, May 02, 2014

Twilight

My mother is dying.

Someday we all will die - that is a fact. In my line of work I see people actively dying often enough, plus I deal with enough situations where efforts to resuscitate someone who is clinically dead is called for.  Sometimes we get them back. Most times we don't. And I suspect this will not be one of those times.

We've been watching her decline for some time. Between suffering from dementia and battling the hematologic disorders she was diagnosed with, plus other chronic conditions that have affected her, she has had a difficult time. All of her medications, with the exception of those being given for comfort, have been stopped.

Probably the hardest thing was watching her cognitive abilities slip away. She was talented with various arts and crafts, and she had a way with people. And she could tell good stories.

As I write this I am sitting next to her bed. She is sleeping fitfully; she has been medicated due to her being agitated and disoriented.  She has not been eating, either. One of the staff brought her lunch in, but I don't expect she will eat.  She stopped that last night, from what I have been told. I don't hold out a lot of hope for her eating anything now, either. But all of us - I and my family - will keep watch over here while she is still with us.

She has a living will and a do not resuscitate order in place. They were implemented when she still had some semblance of memory. We will respect them.

And we will wait.

Monday, April 21, 2014

Marathon Monday

As I write this post there are two major events going on in Boston: the 18th Boston Marathon and the Red Sox and Baltimore Orioles at Fenway Park. I'm not certain how many years the Sox have played on Marathon Monday, but I know it has been many. For a number of years I worked during the Marathon with staff covering the portion of the route that runs a through Newton. There are a good number of my friends and colleagues of mine working on the route now.

The air is definitely different this year. Last year, with the events surrounding the race and the aftermath, turned out to be unspeakably hard for so many people. The stories of those who were affected - and came back - have been, to say the least, both encouraging and inspiring. And it has made me realize that the issues I have faced have simply paled in comparison.

I am very proud of the people I work with. They are good at what they do, and their courage and character are unmatched. I think of them, and I am hopeful that they have a really good, positive,  and uneventful day on the race course. And I hold out the same feeling for my friends working the game at Fenway Park.

I have the game on now, and the voices of the Red Slx, Don Orsillo and Jerry Remy, are wearing  running shoes. They are doing so in support of the runners on the course. And that is awesome.

They and everyone else down there today are Boston Strong.

Thursday, April 10, 2014

The Night Shift - Round Two

Another mobile post on the overnight shift. It is interesting being the first person people see when they walk in. Regardless of who they are and why they come, in principle all should be treated the same way. Sometimes, however, it's difficult to do that, mainly because the people who come are not always forthcoming with the truth. When that happens, my inner cynic wakes up, and the voices in my head become loud indeed.

Some general observations I've made:

1. The sickest people don't come on their own. And usually they don't want to come here if they can help it. Those are the ones you know will die without help.

2. Those people who could stand to wait until normal business hours to be seen inevitably show up at 3:00 in the morning. And it is usually for problems that don't need intervention then and there.

3. Those who are homeless that are seen here, if it's cold or the weather is inclement, will inevitably try to hide out in the waiting room so they don't have to go outside.  That happened last night, in fact; a patient who had been seen for a couple of different issues managed to get under the radar for a couple of hours before she was discovered.  Clearly she was stalling; her plan was to get admitted so she would have a place to sleep. But that didn't work out for her. And I discovered her at 6:30 yesterday morning...

4. The people who deserve misfortune the least seem to be the ones who suffer the most, no matter what the reason is.

5. Time flies when you're busy.

Some of these observations bleed over into my work in the field as well. The thoughts I have in the end don't always fit precisely into the same mold, but they are close enough.  And I'm sure I'll come up with more as time goes by.

Tuesday, April 08, 2014

Hands Free

I'm trying something new. Rather than use a keyboard, I'm going to compose this with my voice rather than with my fingers. My new phone has hands free capability. My old phone did as well, but I never used it because I didn't think I could. Also, I didn't realize the phone had it until it finally died. 

The only thing that I'm having trouble figuring out is how to insert carriage returns or extra spaces or any specific punctuation. I know that if I say certain words like the word "period" or "comma" they will insert automatically. However, I don't know how to plug in other types of punctuation or anything that is special in terms of text. But I'll figure that out as I go.

Between insanity at work and being sick, it's been a rather interesting week. This past saturday wound up being a 20 hour work day. It was mostly do to a lot of volume, but there was a very interesting call that came in from overseas involving a child, a stressed out international medical team, and a big time crunch. That ended up keeping me busy for a lot longer than I planned. In the end, however, it worked out just fine. But it did take a lot out of me. Plus, there were internal shenanigans at the end of the tour that kept me on the clock for about three hours extra. By the time I left it was almost exactly 3:00AM. That made my day twenty hours long instead of the normal sixteen.

On Sunday and yesterday Martha and I were dealing with either an intestinal bug or we ate some bad food. I suspect the former semi colon if it were bad food I believe we both would have had similar symptoms but they were just a bit different. And I was able to go to work yesterday. Martha stayed home and slept because she really needed it.

As I compose this post I am multi-tasking. I'm working on household chores. That means doing dishes , laundry, and the general pick up of household that has a small child living in it. And that work seems to never end as the girl is a four year old tornado. Because she is such a lovable child, though, I overlook a lot. That's tough for me to do because I am somewhat obsessive-compulsive, and seeing anything out of order makes me insane. But I really work at understanding that she is learning about how to avoid entropy in her own time. And hopefully she'll be a lot more casual about it than I am.

Tonight is an overnight shift in the emergency department.  Considering how things are, I'm sure it will not be boring. And I have no doubt I'm right about that. As for the hands free writing, I got about three quarters through. The last couple of paragraph so are typed. Not perfect, but it's something new to learn how to fo. It will get easier over time.

Friday, April 04, 2014

A New Toy

I had to replace my phone. I was having trouble with applications crashing regularly and with the phone running out of memory. It was starting to become a real issue as this is how most people I know contact me. Plus I wasn't due for an upgrade until October.

Last night Martha surprised me with a new phone. A Samsung Galaxy Note 3. I had an idea she was getting it for me but I wasn't entirely sure. But she showed up at work last night with a Verizon bag in her hands. In the bag was the phone. The tech at the store got the number activated but left the rest for me. I was absolutely fine with that because I am somewhat particular about how I wanted it configured.  I have it mostly the way I want it now. With a bit more fine tuning I should be good to go.

As I already have a Galaxy Note 10.1 tablet as well this will be a solid complement to that. I really like Samsung products; they are well designed and very friendly, not to mention powerful. So far I'm very happy with it. And today I put the phone in an Otter Box Defender case as well as a screen protector. This should support the phone quite completely.

This post is coming from the phone, in fact. It is proving to be very easy to write. And I expect to be able to do this more frequently now that I have such a good tool for the job when I'm out and about.

For now, I'm going to recuperate from some long work days before it starts again tomorrow.

Monday, March 17, 2014

The Night Shift

About six weeks ago I started working in the Emergency Department at one of our hospitals. I work up front, greeting patients and doing the first step of triage. In a nutshell, that is the core of the job. It is not that difficult, but the key skill someone in this position has to have is the ability to discern who is really sick and needs immediate care as opposed to those who can wait. Most of the time it isn't difficult. Sometimes it is; it depends on the volume and the circumstances.

Most of my scheduled shifts are overnight, from 10PM to 8AM. Occasionally, however, I'll pick up other shifts as well. I work approximately 24 hours a week in this job. I find that between this, my job in Boston, and my shifts with the Fire Department keep me plenty busy.

Right now I am sitting in the greeter chair. I've been here for a couple of hours and it has been a little bit busy. We see mostly minor stuff, but as I said, it can get hairy from time to time. The last tour I worked here had that quality, especially near the end. We'll see what happens here as the night progresses.

I am back here tomorrow, eight hours after this tour ends, but only for six hours instead of ten. That will give me enough time to get some breakfast, take a nap, and do it all again. The good thing is that it is not sixteen hours in a row; I did that yesterday.

It is hard to believe that it is nearly Spring because it is so cold outside. I know the weather will change and start to warm up. Right now it is a waiting game; what I suspect will happen, and always seems to, is that the change of season will occur in the blink of an eye. And people will complain about Summer showing up out of nowhere. But I expect no less.

At the moment I have nothing to pontificate about. But give me time; I will come up with something.

Friday, February 07, 2014

Four Degrees

That is the current temperature outside as I write this post. Nearly 1:00AM and I am still awake. What a surprise.... I suppose that has become the new normal over the past few weeks. Probably due to the changes in my work schedule; I have no doubt that the modifications I've made recently have contributed to the weird hours I keep these days.

One of the changes is relatively recent; I started working in the Emergency Department at Catholic Medical Center in Manchester a couple of weeks ago. I was hired for 24 hours per week to work up front, and I am orienting in the department now. It will take me approximately 5-6 weeks to get through the department orientation, but I think once it is done it should be a pretty interesting job. It will certainly add to my experience, and that is something I look forward to. More learning, but it is good to learn new things. Learning is like exercise; the more you learn, and the more different things you learn, the more well-conditioned the brain becomes. And I believe the folks at Lumosity have gotten it right, in terms of the word "neuroplasticity"; the neural networks we possess expand exponentially when they are stressed. And that is as it should be.

We got a load of snow out here yesterday. My back step had a total fall of approximately 10 inches, which was more that what was predicted. And the temperatures reflect the snow counts as normally when there is no snow the air is a bit warmer. Not now, I'm afraid; it is simply cold. But it is winter in New England; shouldn't it be cold? And this one is as I remember it when I was growing up.

As I write this I am working. Not a surprise there; it is technically Friday morning, and I have been here for a bit shy of 7 hours. We got in from a call a little while ago: an elderly male with mental status changes. Hallucinations and visual disturbances, to be more accurate. Pretty interesting and diffucult at the same time. History of end stage kidney disease - he is supposed to have a dialysis shunt implanted soon. Maybe that will take care of some of the issues, but it is hard to know. Also a diabetic; this always compounds things because of the nature of diabetes. It is an insidious, vicious disease that destroys organ systems over time because of the damage done to peripheral nerves if glucose levels are not controlled. And there is no such thing as age discrimination as it can affect anyone no matter how healthy the person is. But it has to be tough to deal with when you're already compromised metabolically, not to mention physically. And the damage to his kidneys is already pretty much complete. Between the two pathologies that are present, he will likely continue to have a rough row to hoe as time goes on.

I am hoping not to have to deal with the cold again tonight. Hopefully I'll be able to get a nap in. But anything can, and usually does, happen, so if I expect crazy things to happen I won't be disappointed when they do.