Sunday, December 08, 2013
The slow shutter speed of the camera phone and the bright street lamp overhead captured the motion of the falling snow in a still photograph. Some patches were L-shaped where the wind abruptly changed course. Some were squiggle-shaped caught in turbulence of some kind. Those closest to the ground and therefore closest to the camera made the straightest descent and looked like wide sidewalk chalk lines drawn on the dark backdrop of the evening sky. This serendipitous moment of being caught in a full on snow fall in the city at night was made possible by a late-in-the-day psychiatric consult. I'd already left the hospital and was making my way home driving through slushy streets under darkening skies when my pager went off. I pulled into an empty parking lot and called the number.
It seems a patient was determined to sign out against medical advise and the hospitalist was not certain that she had the capacity to do so. These cases at this time of day invariably end up with the patient being put on a 24 Hour Medical Hold so we can see them first thing in the morning on rounds, even more so if we've actually left work for the day. This call was not going that direction because the patient's family was involved and they were making things difficult for the hospitalist. After an attempt or two to problem solve with him on the phone I realized that this was going to be a late Friday night at work.
I easily found a spot in the nearly empty parking garage across the street from the hospital and made my way back in, wondering what kind of mess I was walking in to. An empty elevator was waiting to ferry me up to the top floor. It felt strange stepping out onto the floor with my coat and hat still on, more like a visitor than a staff member. This was a first for me. The feel of the nurse's station was very different without natural light coming in through the windows. The view of the city was obscured by the snow fall that was picking up outside. There was a sense that it was much later in the evening, maybe even past midnight, with so little activity.
I found a computer and read through the pertinent parts of the medical record before going to see the patient in an adjacent hallway. When I arrived outside the patient's door I saw some nurses looking on, one of whom gave me a smile that had a trace of pity. Expecting a worse case scenario that involved multiple irate family members standing around the patient's bed circled for war, I was relieved to find her alone and sitting up in bed.
She was very talkative despite only satting 80% on four liters of oxygen. Her explanation seemed a little too detailed and drawn out. I had an awareness of not looking at my watch or trying to hurry the patient along considering the late hour and the postponement of my TGIF kick off. Maybe I was resigned to seeing it through with as little irritation as possible. Piecing together what the nurse, the doctor, and the patient had told me, it was irritation that had created this situation in the first place.
After we had finished talking together I could see why the staff had bumped heads with this particular patient, but having had some forewarning I was prepared to defuse things early and often throughout our conversation. It struck me that this is exactly how these cases invariably work themselves out and my expecting the worst almost never pans out. I'd like to think my approach and demeanor are what make these cases so anti-climactic, but it's also likely that much of the drama is spent before I arrive, in the wake of the storm as it were.
So I spoke with the nurse and the hospitalist giving them my professional opinion, wrote my note, put my coat and hat back on, and proceeded to begin the journey home again, an hour or two after my first aborted attempt. Stepping outside I found myself in what appeared to be a city-themed snow globe. The street lamps overhead turned the snow flakes into sparkling bits of light falling in an erratic dance. I was in no hurry to get to my car and even snapped a photo or two as I crossed the street.
Wednesday, December 04, 2013
Still haven't figured out this writing journal thing. I've always waited for inspiration in order to write and having some direction has always made writing easier. Writing w/o direction or inspiration, now that's a different story. When there is no excitement to fuel the writing it becomes a vast desert of unexplored territory. And what to explore? Sand? Cacti? The occasional boulder?
Writing seems to be pure magic. When I can't do it I wonder at those who can. When I am writing and it is going fairly well I wonder at where all of this information is coming from and how I am able to make sense of it all. I've also learned that I'm a sucker for alliteration and it comes up frequently when I write. So much so that I have to edit it out sometimes because it can get comical when I'm not trying to be funny. "The conniving clown cut cautiously on his crusty carbuncle." See what I mean?
At present I am trying to write a story about a crow I killed when I was a kid. I sense there is something powerful and disturbing in this story. I feel a need to write it out, to think it through, and come out on the other end with some new insight into myself. I love the idea of writing as self-therapy. I was made aware of this facet of writing when I was taking pictures and writing poems during a deployment to Iraq. It was so desolate there with no escape to familiar places or a recourse to well known faces. Sitting in my little concrete room at night I could handle the fear, the tedium, and the loneliness by writing a poem and pairing it with a picture.
Another recent example was starting with the idea of "I remember when" which led to memories of visits to a laundromat in the small town I grew up in. When we first moved there I was starting first grade and we were renting a house while waiting for our house to be built on the edge of town. The rental house, I later learned from my Mom, had no washer and dryer and that is why we were visiting the laundromat that first year or so. In writing down that little walk down memory lane I was able to gain a greater appreciation for my Mom. Our relationship was pretty bumpy growing up and looking at this one little bit of our lives by writing about it as an adult brought some understanding and healing with it.
So writing *is* powerful, but you gotta put down the words and spelunk the brain. That's what this journal is all about and this is my second entry, Hurray!
Friday, November 29, 2013
Saturday, November 23, 2013
"How are you feeling today?"
is the door
the doctor steps.
Some answer, some don't,
some can't, and some won't.
A trickle may come
that is encouraged to flow.
A flood may result
and cover the floor,
two people bobbing
on words and emotions.
He provides an anchor, an oar,
a will to be present.
he must never be distant.
Above all else
it must remain open.
But if it is slammed shut,
he will wait patiently
on the other side.
Thursday, November 14, 2013
I'm pretty easy going and I like to think I can get along with just about anyone. What struck me about these two recent assessments is the arrogance and audacity that comes with making a judgment based on limited contact that has the overall effect of summing someone up and thinking I have some kind of definitive understanding of them. So much so that I can put them in a negative bracket, isolated from those who are in a positive bracket, and therefore not worthy of my good graces.
This kind of simplistic black and white thinking is all around us and hard to discern in ourselves because what isn't hard to discern in ourselves? The only reason it came onto my radar is because it has happened twice in such a short amount of time and is relatively ego-dystonic (psych-speak for something that is recognized as inconsistent with one's beliefs or personality). I'm wondering if the best way to deal with this in a healthy manner is to reach out to these people in kindness and see if that somehow burns the negativity away and puts my ego back in its box?
Sunday, November 03, 2013
Grabbed my Baltimore Ravens cap as I headed out the door to return my son's books to the library today. I've not worn it out and about before, but today seemed a good time to do so. The trees are in full Fall regalia and the sun is shining down with a cool breeze blowing.
I am not a Ravens fan nor do I know any Ravens fans in the circles I run in here in the Midwest. I've heard that someone on that team had been involved in a stabbing years ago and "got away with it." I don't know much about it, but what I do know is my Great Uncle Bob lived in Baltimore and was a Ravens fan, a mellow man with a sweet spirit.
His sister is my grandma who passed away a few years ago. Their brothers died much earlier in a run of heart attacks due to bad genes and even worse eating habits. I remember those brothers only from foggy childhood memories of a family reunion or two, especially Uncle Charlie who was a real character and had a humdinger of a son named Chucky whose antics have gone down in family legend.
Several years ago I visited a residency program in Washington DC as a fourth year medical student and Uncle Bob invited me up to Baltimore for breakfast at an old fashioned diner. I remember enjoying pancakes and coffee as well as his quick smile and uncanny resemblance to my grandma who was still alive at that time. When my wife and I moved to DC we visited him and Aunt Stephanie and later brought along our new little boy who was born there.
This past summer we went down to see my family in Southern Indiana. While we were there my Mom remembered that Aunt Stephanie had sent some of Uncle Bob's ball caps for family to have as mementos of his passing this year. My Dad brought down a shoe box full of them from the closet shelf and I went through them one by one. Many had golf themes which was a passion of Uncle Bob's though it is a sport I've never really gotten in to. Somewhere in the middle of the pack I found the Baltimore Ravens hat, a team that had just won the Super Bowl.
So, today I am remembering Uncle Bob in this beautiful twilight time of the year as the days begin to shorten. The leaves are starting to die, but not without an explosion of color to ease their passing in winning fashion.