Saturday, September 27, 2014

Weekend's Early Start

Saturday morning and it's growing light.
I look out my window and remember the night.
The story is starting and this story ends
And I feel like I need you again.

Time used to mose softly when I was at home.
It went on without me, and left me alone.
Now it's sits at my shoulder and claws at my hand
And I feel like I need you again.

Well, I recall September, and leaves turned brown
Remember October, left leaves on the ground.
And here comes December like an elderly friend.
And I feel like I need you again.

-- Tom Chapin

It is nice to have weekends off, for the most part. I get to spend time with my family, which is something that was denied to me for years due to the demands of the job. And most of the time I can sleep in. Except for this morning;  I was awake at 4:30. For no reason. But I've been relaxing and watching Peyton exercise her incredible imagination. Later on I think Martha and I are going to go to the beach. Even if we don't go, just being able to spend time together is enough.

There is enough to do here that I wouldn't necessarily have to leave, either. That's true enough. However,  it is a nice enough day today (and tomorrow is supposed to be nice also) that I may get nothing done. Not a problem, though; sometimes it's perfectly fine to do nothing.

And I'm fine with that.

Monday, September 15, 2014

The Dark Morning

"It is always darkest before the dawn breaks" is a quote I have heard more than once. The meaning of this is usually that in a bad situation the worst of it occurs before turning the corner. In this case, however, I have the more literal interpretation that quote in mind.

As I write this I am at work, and there is nearly nothing going on. I'm sitting at the desk us Paramedics refer to as "The Penalty Box." It is approximately the same size as a regulation hockey rink sized penalty box with not a lot of room. On the desk surface in front of me are a computer screen and keyboard, a telephone, a monitor for security cameras,  a multifunction device that has a blood pressure cuff, a pulse oximeter,  and an oral thermometer,  various office supplies, a container of disinfectant wipes, three boxes of nitrile gloves, and a two-way radio. The tablet I am writing this post on goes back and forth between resting on my knee and the table.

It is nearly 5:00AM, and it is pitch black outside. Plus, for early September,  it is cold outside. It is 44 degrees Fahrenheit - admittedly not below freezing, but a bit cooler in September than one would expect. I was surprised to see the temperatures,  but not as surprised as I should be. We do live in New England;  the weather and the temperatures can be somewhat labile.  We should expect that, though. I suspect there will be more of the same as the season changes further. We haven't seen changes to leaves yet, but I wouldn't be surprised if that starts soon too.

Tomorrow I have to report to the Federal court in Concord, NH, for jury duty. The second time in that court since 1993, and the fourth time in 20 years. All because I vote.

Perhaps I shouldn't be snarky.  It is an obligation,  and it isn't like I've never served. But it is inconvenient, and I would be lying if I said that I was looking forward to it. There are other things I would rather be doing. Like working - sounds strange, but yes, I would rather work than do this. However, I have been called. And I will do the right thing.

The sky should start to lighten in the next hour or so. And I will wait for it to happen. Because at that point, it is the beginning of a new day.

Friday, August 22, 2014

The Bounce

Well then. I finally drew up the strength to write this post. It has been a challenge this summer, to say the least. It has taken me a while to digest everything I've been working through, but I think I'm finally able to write about it all.

Since the last post I wrote on May 2, a few things have happened that I probably should comment on.  The most significant of these is the passing of my mother. She died on May 5 after a long struggle with her health. She had a lot of stuff going on, some of which I have written about in the past. The most significant thing she had to deal with was dementia.  She was aware of her memory loss for a great deal of time, which was really hard for her as well for us who survive.  By the end of her life, however, her short term memory was pretty much gone.

In addition,  she also had pernicious anemia. By itself this played a huge part in her decline. Over the last year of her life she received a huge amount of transfused blood products.  I suspect this contributed to her demise by the effect it had on her immune system. Plus, she was the victim of her own choices during her life. COPD,  a number of Transient Ischemic Attacks (TIA's) that were likely undiagnosed,  and issues with heart disease probably all associated with her lifelong smoking, were all most certainly contributory.

All of that said, she was incredibly stubborn.  Fiercely independent,  in spite of all of the problems she faced, she lived by herself until about 6 weeks before her death.  My brother Jay found her on her living room floor, the result of a fall.  One of the last things she did before finally leaving her home was to smoke a cigarette.  It would be her last.

When we made my mom's final arrangements,  we were all surprised at the number of people who came to her funeral. But that in itself was a testament to how much people cared about her. She was a good person, a great mother, and a wonderful friend to many. And I miss her.

Another significant event was dropping one of my jobs. I no longer work for Cataldo Ambulance. My last shift there was Saturday,  August 9. It was time to go - after 6 years there I had enough. The main reason I left was because I wanted to spend more time with my family. Not having Saturday available to me was really starting to wear me down. Plus, the resources that were unavailable during  Saturdays and not being able to get anything done was becoming frustrating.  I think the straw that broke the camel's back was the Saturday three weeks before my last. Too much happening that day as well as dealing with people who were just making my life really difficult.  I simply hit my personal wall. At that point it became clear that it was time to go.

So now I have Saturdays back. The first one was spent with Martha and with my granddaughter Peyton. Great day in Boston. Tomorrow may be a beach day, weather permitting.  I look forward to many more.

On that, time to sign off. I will do my best to write more. Maybe now I'll be able to.

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.