The Voices...The Voices...

One thing about the long winter nights here in the great Northwest; introspection. The endless summer days which call for hustle and bustle are long gone. The gardening for hours after work or BBQ's on the West side watching the sun go down at 10pm or warm 8pm bicycle rides. Those busy times are way back in my memory and I can remember even then looking forward to the slower pace and the longer nights of winter. WHAT THE HELL WAS I THINKING?! Ah, the grass is always greener I guess but God alive bring back the longer days and the warmth and the 4:30am sunrises...please! And even the bustle...especially the bustle.
Introspection. While not really wanting my life full of the distractions of the nutty, 24/7, overstimulated, over-caffeinated, "news" filled, "weather reports every 15 minutes and traffic reports every 12 minutes" world we all think of as normal, listening to the voices in my head all the time, all winter long doesn't really feel all that great either. I keep forgetting, as I lie there in my bed this morning, that the thoughts going through my mind are just the thoughts going through my mind. Nothing more and nothing less. The fact that I start believing them or the fact that by having those thoughts my emotional state is actually effected bugs me. I've read Eckhart Tolle, man. I should know by now, and I DO know by now that the thoughts upstairs have nothing to do with what is actually going on in my life. As I lay there this morning listening to how my life is not going anywhere and I'm just wasting away this precious gift of 'awareness' on 'time-wasters' like movies or DVD's I started to get that horrible feeling of worthlessness I get when everything isn't just perfect in my life (whatever that even means since everything actually IS perfect in my life...even the imperfections). I get taken away by those thoughts and transported to some land of pain where I am less and every one else is more. Where I am a loser and everyone else is a winner. Where I can NOT and everyone else can. I forget that those thoughts are only neurons firing in my brain and nothing else. The actual reality is that I was laying down wrapped up in flannel sheets. I was feeling the softest, smoothest skin on the planet (Sheryl's) and was well rested for whatever the day brought. It was a perfect moment...until I started to spin out on the thoughts in my head. I SHOULD be doing something else with my life. I SHOULD be...oh, I don't know...happier, deeper, more aware, more outgoing, less outgoing, more friendly, less banal...it's endless and it's absolutely ridiculous as there is no fulfilling the needs of my 'shouldy' brain. Have a shouldy day it says. I've been told I need to stop shoulding on myself. And I do when I actually remember what is real in my life and what is just crazy thinking. Sheryl just got a bumper sticker. "You don't have to believe everything you think". I love that. If only I could remember it. And that is why I am writing today. So that I can have this one way conversation and expose my dark self hatred to the world and just open it up to the light and see the thoughts. It helps. Thanks for reading...that helps too. Just knowing you're out there. The weather is still too cold, and the days still too short but it still helps dammit.

The Long Winters Night

It's dark. The blank bland page stares at me daring me to write. Challenging me to be creative when all I have inside is a reflection of the the long winter days outside. In the darkness there is no reflection and as I stand at the nocturnal mirror I see just that. Yes, metaphor. I know, after 5 months of nothing in this damn blog I start up again with dark winter metaphors. But hey, give me a break here...not only have I NOT been traveling to stimulate my inner writer, I just finished reading The Road by Cormac McCarthy. Holy Crap! Talk about depressingly dark. I had to have Sheryl lock up the medicine cabinet and hide all the razor blades just so I could finish the thing. What a great read (hm, masochism anyone?)! It made me sad for that inevitable day when we go too far and the tipping point is reached and the end is nigh and the heavens will crack and the lord Jesus will come down and God will rain down his wrath upon all non-believers and the faithful shall rise up into heaven and rejoice for evermore in the love of a compassionate God while the rest of us burn forever wishing God were a bit more compassionate. But the second coming isn't really what I wanted to write about...at all. The Road, while being bleak, had the effect of me really appreciating all the wonderful things our ridiculous culture has created. When it's all gone; sunshine, warm food, chocolate, fruits shipped from 4000 miles away, hot tea, flashlights, cabinets with food inside, cars, the ability to walk out in the daylight unarmed...how sad. Not to mention the biggest loss of all, NATURE! The color green! Blue skies, fresh water, deep azure glaciers, salmon, open spaces, polar bears...oh crap, I shouldn't be walking down this road. "HONEY, KEEP THOSE RAZOR BLADES LOCKED UP A LITTLE LONGER"!
But right now we do have all these wonders. We have a beautiful life. We have plenty. We have what we need. We have love, and star fruit from SE Asia, and tennis shoes from China, and family with whom we are happy to spend time, not to mention great cheeses from France. And all of it is here right now in front of us to be enjoyed. I need to keep remembering the magic and the perfection of all that this world has to offer. Internally and externally, beauty is everywhere, even in the darkness. If I can stay present to that thought I can make it through another 16 hour winter night. Or another news headline about how our leaders in Copenhagen have sold the future of our life on the planet for short term profits (is anyone surprised here?). Or another...oh yeah, right, stay focused on the positive. Look in the mirror, with the light on, and see your reflection. You are absolutely perfect. With your messy hair and muffin topped belly and wrinkled skin and clothes, you live. Feel the air enter your lungs, you live. Every moment is kind of amazing... just because of the incredibly unlikely event that you even exist. We just get so damn used to existing it seems ordinary. IT'S NOT ORDINARY! My brain, my heart, nervous and circulatory systems seem conjured and fantastical and not to be taken for granted. How magical (and yes I really do mean magic) is it that I can write down my thoughts. How magical is it that you can read them on an electric device from wherever you are. It's all so mind blowingly cool! How can I focus on anything but the amazement of it all? And yet I can and do and get lost in the funk of the darkness. Gotta remember to keep the lights on... keep the internal spaces lit up with awareness and appreciation so that when I look into the mirror I can see a reflection there.

Complaining...It's What I Do.

I'm at work right now. Thats right, busily taking care of the sick and dying in a level 3 emergency room on a Sunday afternoon. OK, not so much. And that's the thing about the ER, you just never know. Is it the moon and tidal changes that effect mass behavior? Is it boredom, or the fact that nothing's on TV that stimulate the crowds to come in to a flourescently lit windowless box and ask for Vicodin ("sorry, I'm allergic to aspirin, tylenol, aleve, or any other pain reliever that doesn't have the side effect of making me drool"). Because it's kind of dead right now. Not as in asystole (i.e. "CLEAR!") dead but more like the tumble weeds blowing down the halls kind of dead. Not that I'm complaining mind you...OK so I'm complaining but that's what I do and that's why you read this stuff. I've been thinking of changing the name of this blog to " I suffer...so you don't have to" because as I re-read these entries I realize, Jesus I whine a lot. But who doesn't like to read about others in pain...especially if you can laugh at them in the process of thief suffering...in a good way of course. But my feet still hurt from last night (when I was complaining loudly) when the ER was a total zoo which just goes to show that any time is a good time to complain...or read about it! Growing up I was frequently reminded that my name Bryner rhymes with whiner. Which is why, maybe, I look for rhymes in other peoples' names...especially if they aren't very flattering. Like my nephew Elliott (and this took a few minutes) rhyming with smelliot. Stupid yes, yet childishly satisfying. Which is also why, in three weeks time, and since I'm getting married anyway, I'm thinking of taking a new name. Sheryl is going to change hers and I don't really think Sheryl Bryner has a ring to it. I considered taking her last name but the Triblolet men I've heard about don't have such a great track record with marriage...or fatherhood for that matter...or citizenship...or...no, better stop or I might NOT be getting married in 3 weeks. I like new age hippie names like Frank Zappa's daughter Moon Unit but I'm still employed so that won't really fly. Something Earth-muffiny like Cedar was my first choice but not Sheryl's. Going back and forth trying to find a fitting last name has been tough but we're getting close as I almost have her convinced that Crowe is an awesome last name. I love birds. The crow is one of my favorite birds...sassy, smart and very dark. I love movies. Russel Crowe is one of my favorite actors...brilliant and hunky. All in all a great last name. The only problem is some rock singer that no one but Sheryl has heard about called 'Sheryl Crow' or something.
Ooops, gotta go. someone just came into the ER...must be Vicodin-thirty.

Filth and Faith

I cleaned a house for my sister this week. It was a small place that I used to live in and rented from her two years ago. It's a studio really, with one room 15 x 20, a kitchen at one end and an old queen bed at the other. This week, opening the front door hard against piles of dirty towels I hardly recognized it. Three hundred square feet of living space. Small by any Western standards and yet this cleaning job before me had been turned down by all the professional cleaners in town. Standing there, I suddenly realized why. When I had moved into this place it was right after my bike trip to SE Asia and it seemed just right for a couple who lives with two teenage boys every other week. I mean really, who needs space and bedrooms and privacy and alone time and a spontaneous sex life anyways. Most Thai or Laos or Cambodian folks would be fine living here so why not us? Sheryl and I put up curtains around the bed and the boys slept on inflatable mattresses on the floor. It was what you might call "cozy". Turns out we're not quite as Asian-Developing-World as I had hoped we were. Cozy is sweet for about a week...two weeks tops. Then cozy becomes cute which really only lasts a few days or so quickly turning into small. Small becomes cramped after a month . As Fall sets into early Winter, with the sweating single pane windows, uninsulated walls and 24/7 space heaters droning on and humming their insufficient warmth, cramped just became claustrophobic and we just snapped...and moved into a palatial 800 square foot apartment. The magic of the simplicity and familial bonding of Asian living worn away by the schedules/desires/expectations of life in the West. But standing on that doorstep threshold last week pushing against the front door I realized that we already had lived in a palace back then and just didn't realize it.
I had been fairly warned by my sister that the place had been left in shambles by the previous occupant. Yet, even though fairly warned, I think "shambles" was being generous to whoever lived here. Cleaning up the shipwrecked flotsam of a life battered by the waves of sickness and mental illness is devastating. I didn't do it for fun or because I was bored, I did it because my step-son Julian needed a job and couldn't do this one alone. It was a selfless act of love. I also did it for the $60/hour...a self serving act of greed. Lastly I did it for my sister who was becoming desperate for the help. So there it was, the door only half open before the smell of the place hit us like a dirty fist. The stench was palpable, stale, fetid and cloying. It wasn't the kind of acrid nastiness of a steamy overused summer outhouse. Nor was it the poopy/farty tang of freshly sliced durian fruit. It was the smell of death mixed with rotting food...thrown into a fog of dirty old diapers. It was the smell of a diabetic nightmare and madness. It was the smell of a man in the last throes of a long battle with his body and his mind...a battle he had lost. The load of crap behind the door was barring entry as if to say, "Hey, we won this battle, this is our territory now". Samantha told us that the guy who lived here had been sick for a while before calling 9-1-1. He was hauled off by the poor EMT volunteers and flown to some mainland hospital and she heard that he actually survived. By the looks of this place, just barely.
Madness! So this is what an untethered mind, fully let go, looks like. It's not Russel Crowe's garage in the movie "A Beautiful Mind"...where he has 10,000 post-it notes stuck to the walls and all intricately connected by string, like some art director's spiderweb, and all fluttering in the breeze. That was eerie and kind of cool. This was more scary than eerie and there was nothing cool about this place. But we came prepared...physically prepared anyway, with masks smeared with so much Vic's Vapo-Rub that our throats burned and our eyes watered. Not nearly enough to deal with the dank air inside but it did help. Gloves and garbage bags and a positive attitude were the only other tools we needed for the next few hours. Emotionally however we weren't quite prepared and I'm not sure what those tools would be anyway. Hundreds and hundreds of wet, brown adult diapers were piled up on the floor between moist and smeared towels, half eaten boxes of cereal, smelly crumpled clothes mixed together with weeks and weeks of of strewn trash. On every surface half drunk bottles of juice breeding fruit flies or milk containers curdling yellow chunks of slime. The bare mattress wet and stained brown, surrounded by paper backs and paper wrapper of hundreds of Mounds candy bars and thousands of "Lifesaver" candies. Then I saw them. "Julian, STOP" I said as he was reaching down for another pile of filth. No, I wasn't worried about the ant collecting near his feet. All around the bed and bedside table were insulin needles. Little orange capped hornets waiting to sting. Fortunately, most still had their caps on. Unfortunately it meant that scooping up armloads of junk and bagging it up quickly was no longer an option. A needle stick in this environment, hell in this world, is a very scary thing. We were reduced to picking up each item and carefully placing them into the black bags. The good news is that neither of us got stuck. The bad news is that we had to observe each piece of grimy trash individually. We could both tell you now in full detail, if you cared to listen, how the molding spore patterns of a poopy diaper differ from the greenish hairy tendrils of mold in a half full can of refried beans.
It was horrible. There were incongruities that were jarring. Like dirty underwear on a counter top next to an open jar of olives. Or a box of Cinnamon Crunch cereal on the bathroom floor. It was disconcerting. Like going to the dump and seeing society's mixture of wast tumbling together under the bulldozer's scoop. But as visually weird as it all was, what really got to us was the smell. It stuck to my skin and hair. And even through the Vic's Vapo-Rub, the smell painted the back of my throat and no amount of clearing or coughing would remove it. But I only wretched once. Now, as a nurse I have trained myself for over 20 years to NOT wretch. Whether it be while a patient is vomiting or faced with some other horrible thing that we deal with in the ER, I don't wretch. Clearing out a sink full of roting meat and dairy products and opened cans of macaroni and cheese broke through those 20 years of training...it was just too much. Reaching my gloved hand into that brownish-gray miasma of goo brought up a smell that I can only say will be the smell that greets me at the gates of hell when I die. One wretch...no vomit. I held it down thinking I don't want to barf into this mask and drown in my own vomit...not here. "God don't let me die here in someone else's hell". The clog broke and the sink drained away, answering my prayers. I even looked for a pattern of Jesus in the muck wondering if one miracle could follow another so quickly, but none appeared. I don't think Jesus has been in this room for quite a while.
But that sink was the worst of it and when it drained and the smell abated somewhat, things got better. Well, except for the refrigerator full of melted and decaying foods that were slowly growing into one large dark green solid carpet of mold. After that though, the rest of the place was relatively easy. OK, not really, but less hellish anyway. Both Julian and I knew that taking this job was going to be hard as my sister gave us a clear heads-up. We both knew it was going to be gross and nasty and it most assuredly was. But there in the midst of another man's ruined life (through all of our boisterous "OH MY GOD"s and "HOLY CRAP"s, replete with barfing sounds and a camaraderie that accompanies shared hardships) crept into us both a profound sadness. We became quieter and quieter as we each imagined how it must have been for this poor fellow traveller as this shoe box of a space swallowed him whole in his own waste. "It's so sad" Julian kept saying and I never loved him more. Standing there in his painters mask and long orange rubber gloves, burned out from a long day of work, was this 14 year old guy who wasn't angry or resentful or callous or hard but full of love and compassion for someone he had never met. Someone whose horror he was having to deal with first hand and very unpleasantly. Someone who by letting go of the reins of his life was impacting our lives in a nasty way and Julian showed only compassion. He got it. Here in all this shit and ugliness shown the bright and brilliant light of open hearted understanding. Any one of us could go down this crooked road of slow death but for the grace of God. So we continued to scrub and clean with occasional random bursts of "yuck" or "oh, no...oh, God!" but only in the spirit of our suffering in the moment and never in resentment of the man who created the mess.
We ended up scrubbing the floors and pulling out the bed and pulling up the carpet and bagging up 50 or so black garbage bags of trash. The place actually looked pretty normal when we left but I'm not sure the smell will ever go away. I'll never step foot in there again as any warm memory of family closeness has been superimposed with new ugly memories. As we drove home in silence we both longed for a hot shower. We were happy to be returning to a home of sanity and order and were also happy that we had come through this ordeal more intact as human beings than if we had never had that experience. We survived a shipwreck together by picking up the pieces of a smashed up boat that we were never even on. And something happened to Julian that day and to our relationship. The 14 year old boy took a leap into young adulthood and we bonded more as emotional equals than ever before. It was a good thing we did and I hope we never ever have to do it again.

Sex on a Bike?

It's here! I finally know it's here...today, 4/6/09, and it showed up. I was on my bike ( I love how most of the best things in life occur while I'm cycling. If only I could figure out how to have sex on a bicycle I could die...right then and there. But if I survived it then I'd know that life would only be a hollow, empty experience living in the shadow of that pinnacle. So maybe it's better I don't looking for that high. Plus, if I really think about it, sex on a bike would probably just be awkward and uncomfortable with all the sharp, pointy bits of brake handles and gear shifters and seat posts and...jeez, this isn't what I wanted to write about today...at all. To think about? Sure. To write about? No, so sorry) when it hit me. I had already limited my clothing to only a pair of cycling shorts and multiple layers up top. No long tights today. For the first time in several months my ghostly white legs were shining proudly with no worries of frostbite. The first steep hill of the day had me pulling over half way up and pulling off my long sleeved fleece sweater when I noticed sweat dripping down my crack (another issue of sex on a bike that I hadn't considered). But that wasn't the tip off as I've been sweating under 4 layers of jackets all winter. It was the smell. I was coming down the backside of that hill rounding a bend in the shadows of a thick stand of fir trees when a faint earth smell insinuated itself into the miasma of thoughts that I constantly try to ride away from. The faster I ride from them the harder I bump into the ones in front of me...like a stiff head wind (get it..."head" wind, HA!). Anyway, as I came out of that corner and into a straight patch of full sunlight the subtlety was gone and I was punched in the nose with a thick rich smell of earth, of budding pine trees, of green growth, and of life...all mixed in with a hint of salty Pacific ocean air. I was hit with the first taste and smell of SPRING!!!!! A giddy laugh escaped me. Not the maniacal laugh that accompanies getting over a grueling pass and racing downhill at 40mph in 30th gear. That is the laugh of accomplishment and congquering known by men like Lance Armstrong or Genghis Khan. I'm talking of that silly slipping-out-of-your-soul-when-you-least-expect-it laugh...more of a giggle really...known by all 1 years olds.
Maybe I'm over-reacting to the sun a little but damn it's been a long and cold winter! And I hadn't smelled warm earth in 6 months and forgot how amazing that smell is. How can dirt smell so clean and fresh? Also, I have been so anxious to get out on the road again and travel to hot, sweltering places. The bug has bitten and all I want to do is RUN (cycle really) for the border where I can ride all day and complain about the heat and rashes and stinky smells and the thoughts that rule my head. And that is what all this sun today has done to me... reset my brain and reminded me that there are other things in life than fluorescent bulbs and sick people and videos on long winter nights and fleece and long fingered gloves and snow covering my gardening tools. Those thoughts are starting to fade and old warmer memories are coming back to me, of Hawaii and Indonesia and Cambodia and Thailand and everywhere else that sweat has rolled down my crack. Like it is right now, sitting outside of Starbucks, drinking one of my favorite corporate created coffee drinks and getting caffeinated before work...and dreaming of travel.

ps As I rode to work from Starbucks I passed a bank that flashed between the time and the temperature. All my excitement and gushing over a 59 degree afternoon. Dammit.

What one writes about after taking the Landmark Forum

I awoke today with a sense of sadness. A feeling like I was missing something in life...something deeper than what it is I now have. And don't get me wrong, I have a pretty great life. But it is a sense of loss that I can't seem to shake. The unremembered dream I had must have something to do with it. I was walking through the streets of San Francisco and wished I had the sense of camaraderie that the gay community seems to share (and no, I'm still not gay). There was an invisible wavy barrier (like in Star Trek when someone walks into a force field) between me and all the buildings as I walked down the Haight Ashbury and I knew that if I were gay...if I belonged, that barrier wouldn't be there. And yes I do realize that the same barrier exists for the gay community looking out from those buildings at the rest of the world...but this is my rant and this isn't about being straight or gay but about belonging. A sense of being in the tribe. I've looked for it my whole life and even when I'm in the middle of a community I still feel like I'm on its edge. I used to blame the different groups I was in for being too exclusive or too clique-ish. Whether it was an anti-nuclear protest group in college, or a sweat lodge group I attended years ago, or a group of actors working together on stage, or a professional group of RN's I work with in every ER I've been in, I just never felt like I belonged. I never felt comfortable in my own skin no matter what the situation was. Now I get it...I just don't feel that comfortable in my own skin no matter what the situation is! Um...DUH! It's not the group James belongs to but James! I'm not just now coming to this understanding, and there is no 2-by-4 smack-to-the-head moment for me, but there is a light shining in a dark cob webby place in my psyche that has been under-examined and hiding out. It wants to stay dark and undiscovered and unruffled so that I can continue to whine about how no one loves me and no one understands me and no one feels my pain. It's really destructive to me yet feels so right, so normal and it allows me to actually believe in what "I know is real" instead of what is real. What IS real is that the only constant in all of my groups/activities/involvements my whole life is ME and my cob-webby fears and self abusive voice that knows I'm truly unlovable so of course no group would fully accept me (hell, I don't even fully accept me!). So once again I ask the question, "where is that invisible thread I'm looking for?" "Where is that communal fire or drum circle or tribal dance inside that lets me know I belong to something bigger than me and my immediate family?" And through writing in this public journal of insecurity and self exploration I have come out with the answer I already knew of course...that I am that invisible thread. I am that communal fire and tribal dance that must love himself so that I'm able to accept the love of the community that already does love me. What a block-head! I'm kind of altering the quote (without changing the meaning of the quote) "you can't really love another until you learn to love yourself" to "you can't really know the love of another until you learn to love yourself". If I don't really love me then the love I feel from others gets put through my filter of "oh but if they knew the real me they wouldn't love me, or I better act a certain way or they won't love me anymore. Conditional. Fearful. Lonely. Time to remember to love myself and let in the love I feel everyday from so many awesome people in my life from family, to my love Sheryl, to people I work with like Jim Cole and Weyshawn, to people who actually read this blather like Margaret!

The Pro's and Con's of Cycling in Sleet

First of all...THERE ARE NO FREAKING PRO'S OF CYCLING IN SLEET! I know, I just rode in sleet this morning...again. But to be really honest, I'm from California. I'm not even sure what sleet is. I've heard the Inuit people have something like 32 different words for "snow". In the bay area and Santa Cruz area we had one. That word was snow. It was wet snow or dry snow or heavy snow. There was hail of course (not that I ever saw it) but it was kinda like snow only more icy... like a "snow"cone without the neon blue flavored topping. But I digress. Snow pellets were, or sleet was, falling from the sky as I got on my bike and rode downhill for my morning ritual of pouring caffeine into my body before going to work. As I started the steep descent, thinking of my still-warm blankets, the sky opened up and visibility dropped to 30 meters or so. All I could see through my squinting eyes was the stop sign scream past me on my right. I would have loved to stop. Loved to have just turned around and crawl back in bed and not have to contemplate why the hell I put myself in these ridiculous situations. But then I looked down at my body and noticed that the sleet balls were bouncing off of my jacket and pants. Cool. That is a plus, this isn't getting me wet at all! So I started thinking about the pro's and con's of cycling in sleet. The next thought was that cycling in sleet is akin to cycling into a swarm of bees. Even though I had glasses on, the stinging sensation in my face kept my eyes to mere slits as each ice cube from a cold dark hell bit into my cheeks and nose and lips (how's that for subtlety). My mind went back to the "pro" side of the list and faltered in it's search...but at least my legs are dry I thought. My gloved hands were starting to numb at the fingertips and I added that to the negative column. Then I thought of a solid good thing that cycling in sleet affords...a certain smugness. A sense that I'm better than all of these weak people driving by in their #$%*! SUV's staying warm and dry and sipping their lattes and listening to nice music and having warm conversations with loved one's inside. The longer my mind stayed on that tack the more I realized that smugness was just a cover for resentment which is just a smokescreen for envy. So I had to move my smugness from pro to the con side. But at least my legs (which by this time were cold and numb) were still dry. "OK", I thought, "I'll go back to the place I always go when I'm riding and begin to question my sanity or at least my intelligence". NO CARBON FOOTPRINT!! I can feel ecologically smug if nothing else! I am good because I am ecologically conscious and aware and living more in concert with nature than these polluters all around me. Of course I immediately scratch this reason off the pro side of the list as I see the absolute hypocrisy of my thoughts. With my all wheel drive Subaru wagon, with my electric heat at home and my washer dryer and my water heater and my lifestyle of traveling around the world when ever I can and...
And yes, I do see a pattern here for the need to be better than everyone else! There is a smug factor here born of low self esteem, being vertically challenged at 5'7" (calling it short is so politically incorrect), and the continual need to compare myself to Gandhi, Einstein, Lance Armstrong, Verdi, Michelangelo, and everyone else who seems to have grabbed life by the balls and achieved their true potential. So many of us settle for comfort and adequacy, and mediocrity. It feels like a stone in my shoe. It feels like a boil on my ass. It feels like a toothache, that mediocrity. What's worse is that I don't even take off the shoe or lance the boil or go to the dentist. If I did, the responsibility of being pain free, or truly free, limitless to achieve my potential, would be devastating. It IS devastating and so I create limits for myself or blocks or walls or reasons or fears to keep me from reaching some state of grace. Some greater good. Something perfect. I feel like I chose mediocrity or at least if not chose it then stay stuck in some loop that says I can't have it...that perfect state of Grace.
And it's not an egotistical thought, like "I have GREATNESS in me that the world will never know, poor me." No. It is the crystal clear knowledge that we all have it. We are here to live in our fully actualized state. We are here to express our totally unique perspective and to do it fiercely and fearlessly. And so few of us do live like this that it saddens me and freaks me out. But really, I'm not sad for everyone else...to wake up is their own responsibility. I hope everyone achieves it. What an amazing place this planet would be without all the blocks we create to achieve our own greatness. I'm sad that I can see it just in front of me, almost taste it, yet am either too afraid or too confused as to how to get there.
And right now it hits me. On the pro side of the list for cycling in sleet is the amazing opportunity to naval gaze. Not literally of course as severe hypothermia would ensue. But the opportunity to once again go to that place where I can ponder what is the reason for being here. What can I do to achieve Grace. Do I need to do anything to achieve it or am I already there? Am I truly mad in a world I don't belong to? Am I awakening to a new place and realizing once again that it doesn't fit with the paradigm we all seem to have created?

My hands are frozen. My face is all red and puffy. My eyes can't stop tearing. I can't feel my feet and even though the sleet didn't stick to my pant legs it did kind of roll down onto my ankles and into my shoes collecting there like a mini snow drift of frostbite gnawing at my lower extremities. Those are all on the "con's" side of the equation. On the positive side? Naval gazing and a pair of dry pants. If I were you I'd stick to driving the Escalade.

James vs. James

I am at a loss for words. I know you might be having a hard time believing your luck, but it's true...writers block just as I get back on the horse of writing daily. The biggest problem is that I'm reading an amazing novel called Shantaram. It's too good. And it floors me to read something that good because I go back and re-read my stuff and just get bummed at how banal and pointless it all is. Why do I have to be so cute or so pseudo-funny or make everything into a freaking joke? Hiding my fears around getting married again for instance in the story about buying a wedding ring and being lost in that whole world of diamonds and expectations and layers of cultural baggage. And then again why am I so freaking hard on myself and bother to compare my writing style with anyone else's...as if writing is some sort of contest or penis measuring device to secure my self esteem. It will never measure up...(OK, not the penis, the writing) as long as I continue to look for that sense of self worth from an external source. It has to come from within. Yet how can one build one's own sense of that if you don't have a tool box to use? Ah, the old Mr. Hyde voice crawling through my awareness tonight. Dr. Jeckyl not feeling too well and here comes the mass murderer of self esteem and feeling alright with my place in the world. No, we can't have that. Much easier to own my horrible self as it prevents me from having to move forward and improve my life. Much easier to wallow in the muck that keeps me from soaring. Life is right here in all it's glory and all I have to do is reach out and grab what I want and make this life what I want. But that means I'll have to actually figure out what it is I want. OK my BS meter is now in the red zone. I actually do know what I want and it's mostly to shut the #@%$ up. Buck up. Be aware of the whole Dr. Jeckyl and Mr. Hyde part of my brain that looks for misery in a life that is actually pretty sweet. Get off the pity pot as my friend Steve says and call 911 for the whaaaambulance. Jesus I can make myself sick of myself if I don't watch out. Self hatred is such an ego trip. After all, I get to think about James all the time! James is such a loser, James is mundane, James is insipid, James is...OK, I got the online thesaurus turned on so I could keep going here, but you get the idea...slamming James all the time is just self indulgence. So I'm off the pity pot, just flushed it as a matter of fact and man was that a stinky one. But on the positive side (for me that is), I think I'm over the writers block!

Post-op

As I curled up on the gurney last night in room 6 of the ER (if one can curl up on a rock hard gurney) and started to doze, I laughed thinking, who in their right mind goes to an ER for some peace and quiet so they can sleep? But after what I've just endured, sharing a sleeping space with screaming trauma patients and vomiting drunk teenagers is positively serene. But this tale of insomnia has its beginning much earlier in the day. That morning my mom had cataract surgery on her right eye. I was to be her designated driver and all around support system if she needed anything. (Samantha, you're on board for the left eye!) It turns out that cataract surgery is about as easy as getting one's prostate checked. A few minutes of discomfort and some post procedural blurred vision is about there is to it (and I'm talking about the prostate exam here!). Except for the potential of being a menace behind the wheel while driving blind, my mom didn't really need the help. For 80 years old she doing amazingly well. Not one known for missing out on the opportunity for some good shopping or a good meal, my mom and I were having a big breakfast of huevos rancheros an hour after surgery. Two hours post op we were strolling down the cavernous isles of COSTCO shopping for massive quantities of over packaged stuff we can all live without. When I usually go to COSTCO I get a cart and start loading it with all the really cool and really cheap stuff that is at least half the price back home in Friday Harbor. Then about 2/3rds of the way through the store I start unloading the cart, realizing that even though it's all cheap, I really don't want it. Things like an 8 pack of Britta water filters, or a case of motor oil, or a 24 inch pecan pie. Fifty pounds of C and H sugar? AWESOME. Then over in the sock isle, seeing the diabetic coma in front of me, I strain to lift that indiscreet pink bag out of the forklift sized shopping cart and tuck it in amongst the 12 packs of gym socks or the cases of Hostess Twinkies. But COSTCO isn't what I wanted to write about today...at all. I wanted to talk about the fortitude of my 80 year old mom power shopping through the madness mere hours after having undergone surgery. It was great to see although I have to admit that she looked a little goofy wandering around aimlessly with a normal appearing left eye while the right eye was sporting a pupil the size of a basketball. It was disconcerting as an ER nurse to look my mom in the eyes. Not the disconcerting feeling you get when you are talking to someone with a lazy eye and one or both of their eyes wander around and you're never sure which one to look into while you are talking with them....switching furtive glances from eye to eye, afraid they'll be thinking that you're staring at their imperfect gaze. But the other disconcerting feeling...the one that feels like you're talking to someone who has just suffered a major head injury. When we teach new EMT students to assess trauma patients for brain injury, performing a pupil check is essential. It's important that the pupils are equal and reactive to light. That's the reason we are always shining bright lights in your face at accident scenes. (And here begins our tangential medical lesson for the day: Once your brain begins to swell after experiencing a traumatic event be it baseball bat to skull, or face vs windshield, or...well you get the idea, the pressure inside your skull increases and thus begins the process of herniation. This is when your brain gets pushed out of the big hole at the base of your skull. This of course happens right before you die. But before you die and after the brain swelling occurs all that pressure pushes on the optic nerve and that causes one pupil or both to dramatically widen...otherwise known as a blown pupil. A blown pupil is a late and ominous sign of a devastating head trauma. People with blown pupils tend to die. People with blown pupils don't tend to shop at COSTCO for 96 roll mega-packs of toilet paper.) So all that was to explain why I only looked in my moms left eye today after her surgery. It helped that she had this huge clear plastic shield taped ridiculously over her right eye that, while preventing her from rubbing the wound kind of magnified it at the same time. It was sad in that way that you get sad for dogs who wear big cones around their necks when they get stitches or hot spots.
But I started this entry with insomnia. I had a flashback last night of when I was back in Malaysia in the oldest virgin rain forest in the world. Leaches and brown rivers come to mind when remember that place. That and trying to sleep in a rotten shack of a building with a rat gnawing in the wall a few inches from my head. I remember that so fondly as it was kind of a turning point for me as I came to accept a crappy situation I was stuck in and just BE in the discomfort of it. I had this flashback while lying in a hotel room last night just a few feet from my mom in the other bed. I was yearning for the peace I found with the rat. I was yearning for lots of things while lying there...an ipod, the sunrise, death. You see, my mom snores. Not just snores but saws a mean log. Not just saws it but chainsaws it...with a jackhammer. I mean, there was a sound emanating from a woman just 5 feet tall that seemed to utterly defy physics. I was visualizing her vocal cords (I've been seeing a lot of vocal cords lately while intubating patients with a breathing tube) snapping under the pressure of such a force. I wondered if the vibrations could be damaging her healing eye wound. I first heard the preliminary sounds as she dozed off while I was still awake watching CNN. I thought it would be a good idea to stuff toilet paper in my ears before I turned out the lights. Useless. Pillow on top of head and plugged ears? Futile, not to mention uncomfortable. As the night wore on it seemed to get only louder until I could actually feel the vibrations through the air shaking my bed. I am not exaggerating here. The room actually shook. Mini earthquakes rhythmically driving me mad. A rat, a rat, my kingdom for a rat! I have traveled the world on a shoestring and have stayed in a lot of sketchy places and slept in a lot of crowded hostel and dormitory rooms. Groups of smelly, scratching, farting, snoring drunken men I've shared quarters with and none of them hold a candle to my short, little 80 year old mom.
About a half an hour before we fell asleep my sister Samantha stopped by the hotel room on her way to Seattle and to save money she stayed with us that night. She slept in the same bed as my mom. This is where the story gets even more bizarre. This is when I knew I had to blog about this night. This is where it all comes together and makes the pain almost worth it...nah not really even close. Samantha was married to a snorer. My grandmother was married to a snorer as well and gave my sister some sage advice when confronted with snoring...just whistle. Apparently my grandma figured out that the frequency of a whistle could stop a snore cold yet not awaken the perpetrator. But whistling takes a lot of energy apparently, as Samantha later told me, so she has devised a way of sort of moaning at a high frequency that is supposed to mimic a whistle and quell a snore. Well, I can tell you that whistling and moaning in a sing-song voice does not in any way stop an eruption of wheezy roars. What began as annoying and quickly became exasperating snoring took on a whole new flavor with the whistles. I got that creeped out feeling that none of this could be real and that I was actually going crazy a little bit and hallucinating. I mean really. And this is what did it. This is what drove me to sleep in a busy ER where screams of pain and retching seemed like sleep aids.

The Ring

I'm getting married! You might be shocked to know that I even have a significant other as 1) I almost never write about Sheryl (in the interest of staying in a relationship with Sheryl) and 2) I can hear you wondering who would tolerate a guy so seemingly lost in the dark lint of his own belly button. But it's true and the big day is later this year in August...the 29th to be exact. So now, six months ahead of time, comes the inevitable planning process. Which leads me to today's rant about wedding rings. Not hers, that was planned last summer when I proposed. I wanted her ring to be as beautiful as possible and very traditional. Sheryl, you see, is anything but traditional. It's one of the many things I find so damn attractive about her. But she has lived an "on edge" and "alternative lifestyle" for many years of her life. We wanted our wedding (even though we plan on getting onto a large boat and waiting for orca whales to appear before we exchange our Buddhist inspired vows) to be more traditional. I know it doesn't sound that way but it's true. We have both been married before. Sheryl in jeans and a flannel shirt in front of a justice of the peace...and me in the woods wearing what can now only be described as neo-Baltic, gypsy inspired Indian chic. Sheryl's previous $20 gold wedding band, long since resold and melted down, always seemed to be a sore spot with her so I wanted this ring to be special...and traditional. After looking at a million rings that all start to blur (I mean, really...how many ways can a metal ring with rocks on it vary) I found one I really liked. The sales woman explained that there was a little "ppf" stamp on the inside of the ring. When I looked at her inquisitively she sort of sighed at my ignorance. "Past, present and future" she smiled. Like, by saying those three words a deep meaning was transmitted and understood by those who are (or about to get) married. "Oh, right, right. Yeah, past, present and future" I nodded back to her and scooted out of the kind of retail shop I try to avoid every other day of my life. "Past?" Damn, we've both been married before AND DIVORCED! So it's not as if we want to go dragging up the past as a guide for marriage. "Present?" We're doing well in our relationship right now and staying present to problems that arise and are still in love and the sex is, well, none of your damn business gutter heads, and we love raising two teenagers, so CHECK...the present is good. "Future?" WTF??!! Who the hell knows? I could get whacked by a bus on the way to work tomorrow or Sheryl could fall down our stairwell? As I was walking back to the car I wondered If I could have one of the 'P's and the 'F' scratched off but thought it might be kind of tacky and look kind of 'pre-owned'.
She picked out her wedding dress last night and it's a far cry from a flannel shirt. The 1920's style crepe-over-satin, cap sleeved dress (I know that description makes me sound gay but I'm still not) is also pretty traditional but it won't really cover most of her tattoo's so it's not as if we're going all Ronald and Nancy Reagan. I'll be sporting a new tux however, shiny shoes and all, so I'm hoping to get away from that Bosnia meets New Delhi bit I had going for me last time. In staying with the whole traditional thing I need to get Sheryl a matching wedding ring. I kind of forgot about that part...until she reminded me the other day. It turns out the ring before the wedding is called an "engagement" ring... only to be followed up with another ring (matching of course) called the "wedding" ring. Who knew? I do, now...and will plan accordingly. Then came the time to pick out my ring. In my defense I will call it ring shopping fatigue (or just plain frugality)but it seems that all the silver colored bands that I prefer look EXACTLY alike. Whether titanium, white gold, silver, stainless steel, or platinum they are all shiny silver and kind of boring and perfect for doing the job of saying "Hey pretty ladies, sorry, this hunk of a man is taken!" So I was surprised at Sheryl's response when I said "Hey look, here's a ring on E-bay for $14.95 with free shipping! A discussion was had, let's say, about the relative quality of different precious metals...value...money...quality...money...value...quality. In these matters, my grandfather Temple taught me, it is better to let the women's prerogative prevail. So it looks like along with my shiny black shoes I'll be wearing a shiny silver (scratch that) white gold wedding band. It's funny what comes up when discussing something like a wedding. Something as pragmatic as where to plan the reception becomes super emotional. What one wears becomes of the utmost importance. Emotions wear thin and ...Oh, God, we haven't even approached the subject of invitations yet!

Naked

"Hey boys, settle down or I'm coming down these stairs AND I'M NOT KIDDING!". I was standing stark naked in the locker room of the local fitness club the other day and my friend Margaret was shouting down the stairwell like a mom who has been in a cramped car too long with too many kids. She was yelling at a bunch of little boys who were totally out of control. In Margaret's defense being in the club after school during kids swim time feels exactly like being in a cramped car with too many kids! A shot of fear ran through me even though I knew it was a bluff. In thinking about it now, safe in my home in the middle of the night, with clothes on, the fear came from one of two places. Not wanting my naked ass to be exposed to my friend Margaret OR, hearing that voice triggered memories of my own mom yelling that same exact phrase at me when I was an out of control little boy. It's kind of amazing what will randomly rock me from my normal ho-hum brain activity and give me a little jolt. All those little kid neurons that are still up there in my brain will get fired off when I least expect it.
So now, as a 46 year old man, I'm looking back and trying to find out what programs still run this old computer. What garbage-in garbage-out routines are still running through me and confounding me as I try to put new, healthier programs into my subconscious not to mention the boys I'm helping to raise now? Because I sure don't want these awesome kids to be run by the low self esteem paradigm that has chewed its way through my life. The programs that run just under the radar and often over the radar and loud and clear. The "you're too lazy, too unfocused, too spacey, too sensitive, too insensitive, too 'whatever I want to slam myself with today' voice that rarely if ever shuts the hell up. Why. Why ask why I guess...it's there so deal with it and be aware of it and don't let it run my life. Is it just me or does anyone else out there hear the constant chatter in their own skull...and if you do what strategies do you employ to quiet them...drugs, alcohol, sex, running from event to meeting to chore to event? Band aids. I'm thinking death might cure it but who knows. No, I'm not suicidal...far from it as I'm not even depressed today. I'm actually feeling great. It's just that I awoke last night at the way too quiet hour of 3am and felt my heart as it pulsed in my ears. I started to watch my mind actively search for things to fret about and chew on. Old dusty corners of my brain were peered into looking for dust bunnies of guilt or regret. The flashlight of awareness was brought out to search under the furniture of past relationships or hurts or awkward situations where I have embarrassed myself. Looking to highlight once again all those times when I have screwed up so I can feel terrible all over again. The visceral gut punch of a memory is just as strong each time it is relived. That well worn road still hurts my feet every time I walk it. Why? What need do I have to search for places and feelings that make me feel bad? Are they unresolved situations or emotions that need to be sifted through until the murky water is clear and the silt is gone? Or is it that I don't think I deserve to be happy and just enjoy this life...and when my calm/rested mind can't take the incongruity goes hunting in the darkness. BLAH, BLAH, BLAH. I'll stop whining now and just put some clothes on in case Margaret comes down here into the murky depths and wants to kick some out-of-control-little-boy's ass.

The Usual Questions

Familiarity breeds, what, boredom...comfort...um, brain death? It must. How else to explain the group behavior I saw today (and everyday) while riding the ferry home from work today? As I've mentioned before, I live on a small island in the Pacific North West. It's a pain in the ass, it's inconvenient, it's dark all winter, it can be claustrophobic and can be oppressive when the clouds pile up in November (and stay until June!) from their rain gathering campaign across the North Pacific ocean. Pile up like a traffic accident. Cloud after cloud speeding through the air, crashing into one another and crying constantly at the loss of blue sky and light. The carnage continues until there are no more clouds to be seen but only a flat gray cloak of a sky with no definition and no hope of ever going away. Only a cloying blanket of dim moisture hanging above and weeping.
(OK, today is actually stunningly beautiful without a cloud in the sky. Hoar frost clings to the shadows on the ground and the water we are sliding through looks like the window pane of an old Victorian bay window. Not a perfect invisible reflection but textured just enough to be pleasantly interesting.) I couldn't actually write about the flat dull gray skies while they occur because it pushes me a little too close to the "What's the point of it all" side of the BIG QUESTION. The other end of that scale, and the one I am pondering today is, "Oh my God, how can this planet be so perfect and integrated and so damn beautiful?" It's not that I've begun a prescription of antidepressants this week...it's just that the sun is out and the sky is that perfect cold winter blue with no brown haze of summer. How can that not make the funk in my head go away? You know, the moss that builds up under one's eyelids like plaque or the lichen that grows in the sulci (google it) of my cerebrum. Which brings me once again back to where I started (in my own twisted head anyway)...familiarity.
It is a mind killer. As the Washington State Ferries ply these waterways they pass pristine islands. Trees carpet them fighting for light and space all the way down to the rocky shoreline. Not like the planned forests of recently logged tree farms to the east...like bad hair plugs on a bald mountainside. These are rascally and diverse and dense. I just saw a bald eagle sitting on a rock next to a buoy eyeing the kelp-draped low tide outcropping. Seals and river otters swim through the dark green waters. It is an amazing part of this planet to be able to call home (yes, even on a rainy day). But I wouldn't have noticed any of it had it not been for the ferry captain. He or she must have been bored enough to try an alternate route today. Normally the ferries stay on a fixed route. And even though beautiful, the same sights seen too often can become routine. Even when I consciously look for the more subtle details, familiarity kicks in and I end up reading a book as magic floats by just outside the salt sprayed window. Today, instead of passing by the south side of Blakely Island we slid through Peavine pass to the north. Books all around the ferry were put aside and the people were up and about quietly staring at a rarely seen part of our own county. Snags overhanging a low cliff ready to fall to a watery grave...a bright green meadow leaning at an impossible angle...a steep mountainside packed with fir and cedar trees. We were mesmerized as it slid slowly east. It's not as if it were that different from the south side of the island but it was just the fact that it was different at all. As soon as we passed through the narrow channel the sights were once again familiar. The looks of interest and appreciation were soon enough gone as books and magazines were once again raised and we all went back to wherever it is we go that is not here...right here. Now, I'm not preaching...or if I am it is only to myself and have dragged you along for the sermon. But how do we stay awake and alive to all the amazement that is always right in front of our freaking noses? The smooth cool feeling of the keyboards under my fingers right now...the beauty of all the love that is given and received constantly...the pain and suffering that surrounds everything there is...the power of our kids asking us a question and trusting our answers...our spouses constancy/sexuality/support...the taste of a carrot pulled from our garden...or even the fact that it will grow at all! My friend Margaret likes to quote the Bob Dylan line "Those who are not busy being born are busy dying". It's a good line...makes me wonder how much of my life I spend dead. But that's a rabbit hole I'd like to avoid going down today...it's too beautiful outside.
CONGRATULATIONS TO BARACK OBAMA!!!!!!!!!!!!!!!!!!!

Just One More Reason

I don't hate nursing anymore. I used to when I would work 12 hour shifts for six days in a row only to spend the next week recovering and dreading going back. Now, however, I have recovered from the burnout and actually enjoy my job. There are a lot of reasons why I enjoy going to work these days. This blog entry is NOT about one of them...quite the contrary. This entry is about something I hope I never see again...which is why I have to share it with anyone willing to read this mess.

A guy should change his socks, say, at minimum of , oh, I don't know, every 3 days? I'm being generous here I know. Customarily I change them every day as I'm sure do most of you. Rarely I'll go 2 days if I haven't done the laundry in a while and I'm in a jam (toe jam?). Three days is really over the edge and done by the desperate few who find themselves on a long backpacking journey. But even these folks find a stream somewhere and rinse out the sweat and funk from days of hiking so they can sleep at night in the enclosed space of a tent. I mean, has your own foul odor ever awakened you in the middle of the night... when you roll over and that little puff of air shoots out of your sleeping bag and hits like the sour gasses of a compost heap? It's disturbing to think that your own smell can wake you up. It doesn't jolt you awake like a thunderbolt but insinuates itself into your consciousness just enough for you to do three things: 1. Stop all movement. 2. Pull your arms out of the sleeping bag and put a vapor lock on the top edge to keep all future gasses IN the bag. and 3. Promise to yourself and God that you'll do laundry first thing in the morning. When I was a teenager I'd come up to San Juan Island every summer and stay with my sister Samantha. She had an awesome dog and I just loved it. That Dog (a mid-sized pointer mind you) would crawl into my mummy bag and down to my feet every night and we'd sleep together wrestling for leg room all night long. But after a summer of sweaty boy smell, dirty feet smell and dog smell my sleeping bag would out gas and stink like a laundry basket and dirty dog pillow with top notes of old wet sponge. It was a wonder I could crawl into the thing by the end of the summer but it's amazing what one can get used to.
Which brings me around to what I wanted to write about in the first place. My job...or more specifically my shift the other night. As I said, it is amazing what one can get used to and my patient in room 4 had got used to things no one ever should. STOP! As I write this I'm realizing that no one needs to read about all the detailed horrors of the human condition. There are things better left unwritten (most of my blogs some might say!) and what started out seeming like an excellent gross out subject for blogging about now seems just really sad. So I'll do what I should have started a long time ago and self edit. No need to continue today's great story of another person's suffering. There is way too much sadness and loneliness (and the physical fallout from all that pain) in the world. Help alleviate it in any small way. Thanks for reading. But I did like reminiscing about my smelly summers with Samantha on San Juan.

Full Moon Party in the ER

The emergency department where I work is small. Ten beds comprise the whole thing. When it gets busy we have to run pretty fast. The nice thing is that it doesn't get that busy too frequently. Having written that I know I'm going to get my ass kicked tonight when I go to work. ER nurses are a superstitious lot and even though I never used to be I've learned to never use the "Q" word while working. Every ER I've ever been in from Hawaii to Seattle is afraid of the word "quiet". It's weird, but true, that when someone says "It sure is quiet tonight" all hell will break loose within 30 minutes. Someone will walk in having a heart attack as the scanner pages out the fire department for a bus rollover and four ambulances roll up to the door. I used to even joke about it when I first started working by loudly saying, "Boy, it sure is quiet in here! HA HA". There would be a few seconds of silence as people stopped talking and turned to glare at me...right before the scanner started squawking and the ambulance bay doors flew open. I didn't do that for long as I kept getting hammered with critical patients every time I said it, not to mention people stopped talking to me. So I've learned to be superstitious with the best of them. I even once worked with a doctor who wouldn't let anyone say the word "pizza" when he was on shift as he was convinced it had the power of the word "quiet". Not believing anything carried the weight of "quiet", one night I joke to him that we should order a pizza later on (I know, I'm a slow learner). He only glared at me (obviously not getting the hilarity of the joke). Hours later after an impossibly busy night of trauma codes and critically dying patients I fervently apologized for my lack of faith...kind of like a professional confessional (ba da boom!).
Last night, there was a full moon. You can only imagine, that if the "Q" word (I have to go to work soon so I'll stop saying it now) works on our imaginations so strongly, something like a full moon wreaks havoc. I'm not sure what would happen if someone actually said the "Q" word ON a full moon night and I hope I never do. Let's leave that monster under bed. So, it was a rather qu, no, calm (a thesaurus is helpful when doing emergency work) night in the ER last evening when I walked by room 5 across from the nurses station. Sitting in the wheelchair next to the bed was a woman that from behind appeared to be having a seizure. Head and body twitching rhythmically and quite energetically. I would have run in and thrown her in bed but there was a nurse standing right next to her asking her questions (and the fact that she weighed approx 350 pounds was also a factor). People having seizures don't answer questions. She was. Here begins the full moon weirdness I thought as I walked into the room to assist. This poor gal was rambling on about her ten thousand symptoms and how the EMTs broke her foot so she couldn't get into bed without help. I steeled my spinal muscles and assisted her to her feet, correction, foot. Did I mention the 350 pounds part of this story? She stood bent over the bed, "wait, wait, wait! Give a minute to get ready here!" As I looked at the other nurse and prepared to roll my eyes northward, the patient startled me back to the present. "Are you offended by nudity?" It was a question that I was totally unprepared for. Multiple answers filled my mind as my colleague busted a gut in a way that only medical people can...full on gut busting belly rolling laughter without making a sound. I bit my lip and filtered through the appropriate responses. "Yours or mine" was the first to be crossed off my list. Rapidly followed by "Oh God NO!". "Yes" would have been a lie though the easiest path. All that came out was "Not at all". Cool, calculated, professional. My answer wasn't really necessary though because by the time my answer came her sweats pants were around her ankles. The mu mu slipped off her top in a speed that belied her girth.
There she was.
"I'm a nudist" was the next thing she said as she started her bizarre shaking all over again. "You have GOT to get in bed right now" was the next thing I said as we tipped her onto the gurney. As I hurriedly left the room I passed a young guy bent over in agony hobbling to room 4. He was pale and sweaty and holding onto his belly. I followed him into the room and started and IV while he writhed and writhed. He could barely answer the questions I was asking. He was in the worst pain of almost anyone I've seen before. That should have set off the first alarm bells. The scars on his belly had shown previous surgery so I was thinking of all the things that could have been causing this much pain. What I didn't think of (and why is their diagnosis always what I don't think of) is that this guy was here to get free drugs. He faked it well and actually writhed enthusiastically for over an hour and a half so I guess he deserved the 3 milligrams of dilaudid (ie, "good sh%#" in his world) he got before he put on his beanie cap and when no one was really paying attention pulled up the collar of his jacket and slid out the door with his ass hanging out of his hospital gown. Not a good look for a criminal. What really pissed me off about the whole thing is that at the same time he came in the ambulance bay doors opened up and brought in a critical head bleed (ie stroke). My energies were then split between someone who really needed all my attention and some jerk who wanted some good narcotics (not to mention the IV site he went home with to give himself all the drugs he could shoot into it). If you see someone out there with an IV hanging from their arm and a hospital gown on, do me a favor and kick him in his bare ass for me. It's now a day later and I'm already excited for the next full moon to arrive.
When I was growing up my dad had a telescope with an 8 inch mirror. A very powerful thing that he would take up onto the hillside on his place in the Santa Cruz mountains. We kids would look through it and see the rings of Jupiter and distant galaxies that were really just blurry stars. But I loved looking at the full moon and all of the craters and even the shadows of the edges of the craters. What a magical place our world is and looking up at the moon was a reminder of that magic. How I wish I could recall that magic of a full moon. These days, hidden behind a thick layer of cold northwest clouds, it now represents haunting memories of drug seekers and unhealthy nudists.

Dale

The car raced up to the emergency entrance and abruptly stopped with one of those wet skids that send shivers down a cyclists spine. Today I wasn't cycling, sadly, but working the ER and waiting for people to come skidding into the hospital.
"Hey, a guy needs help getting out of his car, he might be having a stroke."
The call for help came from Dale, our security guard who was already at the car door when I got outside. A worried looking woman was standing at the passenger door and I asked her what the problem was as I stuck my head inside the cramped little Toyota.
"We were just sitting down to dinner when suddenly he couldn't speak to me".
As I looked at him I had that instant, "Oh crap", feeling in my gut and yelled at him. "Hello, I'm James, one of the nurses here, can you tell me your name?" For some reason I tend to yell my questions at patients who are more critical as if my anxiety level is related to their ability to hear. Now, as you probably know, one of the symptoms of a stroke is a really bad headache. So it must be really annoying then to already have a throbbing cranium when some nurse comes along and shouts into your face. If he actually could have spoken he probably would have yelled, "Shut the hell up young man, I'm not deaf here I'm just having a stroke!" Followed rapidly by the question, "Why are you asking me stupid questions if my wife just told you I can't answer them?"
What was it that gave me that "Oh crap" feeling as soon as I looked into the car? Was it from some mystical 6th sense that medical people develop over years of practice? Or was it maybe from the fact that he was slumped over and limp with his eyes rolled back into his head? Because actually we nurses and doctors and paramedics and EMT's do develop that 6th sense and it is real. It is an odd thing but there is a psychic connection that exists between people that when listened to strengthens over time like an atrophied muscle. A connection that tells your gut "something is not right here...this patient is not OK", even when, by all outside appearances things look good. An example of this is actually on our trauma reports when we take phone calls from the medics out in the field. We check boxes to help determine the severity of a trauma patient. Things like, 'Did the patient lose consciousness?' or 'How fast was the car going?' This way we can prepare the ER for the severity of the trauma coming to us. But there is one box on the list that trumps all others...'gut feeling of the paramedic' who is actually with the patient. There is no quantifying it but having a person just being with the patient and feeling somehow how the patient is doing is more valuable than a lot of our data. Because, deep down we are all connected. We are communicating in ways we don't even know or acknowledge. If we did in fact open up to the realization that we are touching and moving each other in unseen ways, and feeling each others' pain and suffering, it would force us to really be loving to one another. Rather than that, God forbid, we tamper down the subtleties that connect us and instead focus on our differences. It's a lot easier not having to care so much. But not really...not in the long run and at the cost of loneliness and a feeling of emptiness that accompanies our perceived separation. But that isn't why I started to write this entry today, not at all.
A lot goes on in the first few seconds of seeing a critical patient. Visual cues from how the patient is dressed to skin color to posture and breathing rate etc. Auditory cues from what they are or aren't saying, what is everyone around them telling you. Olfactory cues like is there alcohol on their breath or do they smell of cigarettes. The list goes on and on and I won't bore you (sorry, too late?) but suffice it to say that it can be a bit stressful at the very beginning as your brain processes thousands of bits of data in a very short time to direct your next action. Maybe I'm writing this to justify the fact that when I shouted my question to my patient in the car, and his wife outside said "His name is Wayne" my mind heard the name Dale. I heard Dale and dammit, his name was now firmly Dale. In my own defense I have bad hearing and both Wayne and Dale have a long A sound. Also, Dale the security guard was standing right next to me helping me get the patient, Dale, into the wheelchair. Whatever. I put my index fingers into the patients hands and shouted, "Dale, squeeze my fingers"...no response. "C'mon buddy squeeze my hands tight!" This time there was a strong and equal grip from both hands. I was happily surprised as I was expecting one grip to be much weaker than the other if he squeezed at all (a classic stroke sign). He was actually able to stand and move to the wheelchair and my mind was starting to think of the many other neurological problems that could present like Dale but stroke was still high on the list.
I quickly wheeled Dale into the ER bed 1 and his wife went off to register him in admitting. A lot of things then happened in the next 15 minutes before we whisked him into the CT room for a CAT scan. For a play-by-play it went something like this.
"Dale, we're putting you on the monitor and giving you some extra oxygen now". With this, Dale gave a grunting noise.
"OK, Dale, we're getting an EKG now hold really still". "Hhrrmmph" was all he could muster".
"Dale?", now a more agitated grunt, "I'm starting an IV don't move your arm".
"It's all good, Dale, I'm taking you to CT now to get a picture of your brain".
You see, I like to think I'm a good nurse. And a hallmark of good nursing isn't just skill level and speed and knowledge base but also patient advocacy. I was keeping Dale in the loop. Keeping him oriented to what we were doing even if he couldn't understand I was hoping he could hear and understand some of what we were doing.
This time his lips moved and a long "NNNNN" came from his mouth. "Hey Doc, I think he's perking up a bit, maybe this is just a TIA" (mini stroke that has no lasting neurological impairment) I said, and as we pushed his gurney down the hallway someone from admitting came and put a name band on Dales wrist. Once in CT I had to let him know to be as still as possible for the exam. "Dale, hold as still as you can for the next 2 minutes and we'll be all done". This time his eyes opened and he looked confused and mouthed, "NNN NNN".
I reassured him with "It's OK Dale your in the ER and we're taking good care of you". I was feeling really good about the care we were giving him as he was in the CT room in record time with bloods drawn and all the diagnostics done and in the bag. There was only one thing that was a little concerning. When I got him onto to CT table I looked down at his wrist band and instead of reading Dale as I expected, I saw the name Wayne. Two thoughts ran through my mind as the pencil thin red laser scanned down his face. Either someone put the wrong name band on Dale which I could easily fix...or I had been calling this poor guy by the wrong name all this time.
I pulled him from the CT table back onto the gurney he was looking at me now quite clearly and I knew he was rapidly improving but he was still unable to speak. His eyes were tracking mine now although he did still look a bit confused. The CAT scan was encouraging and showed no signs of a bleeding stroke. "It's alright, um...Dale" (hell, I was already this deep, might as well go all the way), "so far so good".
The TIA symptoms were rapidly fading away like memories of a bad dream and he was now trying more successfully to enunciate. Apparently Dale wasn't lying there just worrying about his terrible stroke symptoms and the possibility of never speaking again or going through months of occupational and speech therapy. He was lying there wondering if we were treating the right guy for the right problem because the first words he uttered were...and the most important thing he wanted me to know was..."NNNOT....DALE!"




Of course the names have been changed to protect the guilty...except mine! We laughed about the name exchange all night and "Dale" ribbed me mercilessly. As I was going home at the end of my shift change that night I heard him yell across the ER, "Goodnight Dale"!