This I Believe

I believe in putting people back together.

I believe that life happens, that sometimes we do it to ourselves and sometimes other people do it to us and sometimes it looks like an act of God but however it happens, things fall apart and someone has to pick up the pieces and put them back together in as close an approximation of their original form as possible.

I believe that the mother who may or may not have hurt her baby in a fit of rage or exhaustion should still get to spend as long as long holding, cuddling and crying over the baby’s body as she needs to. I believe that the addict who came in with heroin in her sock still needs antibiotics and fluids to treat the pneumonia that she’s battling. I believe that the girl who’s still drunk who has a laceration on her scalp from a fight that she may or may not have started needs a CT and someone to clean the blood out of her hair. I believe that the man who calls me “baby girl” with a leer while being held down on the stretcher with his hands cuffed behind his back while I get the restraints out, needs time to sober up and a chance to talk to the social worker.

I believe that the 19 weeks pregnant mother who’s bleeding and who is not going to be pregnant for much longer needs someone to hold her hand. Even if she’s 17. Even if she’s the one who decided not to be pregnant anymore.

I believe that sometimes the one thing a person is asking for is the last thing they need.

I believe that failure to plan on your part sometimes does constitute an emergency on my part.

I believe that the 85 year old man, whose 83 year old wife is getting confused, who is facing the new reality that he may not be able to care for her any more needs to hear his options and needs someone to tell him how sorry they are, if nothing else.

I believe that all the planning in the world can’t prepare you for everything.

I believe that a broken tibia is not the end of the world but that it may feel like it is.

I believe that being all the king’s horses and all the king’s men and trying to put together every Humpty Dumpty that walks through the door sometimes helps put together your own personal Humpty Dumpty parts of life.

I believe in tough love, and soft love, in holding it together and letting it fall apart. I believe in doing the best you can in a tough situation and I believe that sometimes that requires help.

I am honored to be that help.

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Le Sigh…

Last Sunday night I was on call (just like every Sunday night),  I got called in to do a case that ended up taking all of 45 minutes, tops.  Unfortunately on the way in to the parking lot at the hospital I hit a patch of black ice and slid into the curb resulting in a bent wheel, a mysterious (and unpleasant) rubbing noise with any and all forward motion and a suspicious vibration in the steering wheel (again, with any forward motion).

I limped the car back towards home and called Sean asking that he just meet me at Big O, that car wasn’t going anywhere until it was fixed.

One day and $700 later it was fixed, making last Sunday night the most expensive call shift I’ve ever worked.

Just Like the Guys at Veggie Tales

I don’t write a lot about my job here.  There’s lots of reasons for that.  One is just basic HIPPA, I could lose my job kind of stuff, but honestly I’m not that worried about it.  Mostly because the idea behind HIPPA is that medical information about particular identifiable patients isn’t shared but if I so desired I could almost certainly obscure what I was doing and when I did it sufficiently to prevent your knowing who I did it to.

Part of the reason that I don’t want to brag.  No really.  My job is so freaking cool that if I told you about you’d all just sit around all day thinking, Alison has the coolest job.  What can I do to be as cool as her? And the answer is you could get a job as a surg tech at the children’s hospital but I can’t guarantee that that’ll make you as cool as me.  There are plenty of other people who have my same job who are, alas, not as cool as I am.

However, despite all of those good reasons for not talking about my job I’m going to talk about my job today anyway.  Because it’s really cool.

When I finished my training and was looking for a job I thought I wanted to work anywhere but the children’s hospital.  Who wants to cup open babies after all?  I was sure that it would be too sad, too hard.  But then I didn’t get a job and I didn’t get a job and after a while I stared to get a little nervous and a little desperate.  So when I saw a listing of open jobs at Primary Children’s I applied.  And when they offer the job I accepted.

But I wasn’t that excited about it.

On my first day we were operating on a kid who was about the same age as the Pea (who was quite small at the time) that child had no interest in being operated on.  We tried chatting and singsonging and cajoling but he was having none of it.  So eventually the nurse and the anesthesiologist held him down while he screamed, put the mask with the inhaled anesthetic over his mouth and nose and within 15 seconds he was asleep*.  I was not a fan of this.  At this point I was pretty sure that this job wasn’t for me.

But I wasn’t going to quit without having something else lined up so I carried on.

Then, that Friday everything changed.  On Friday we did an exploratory laporotomy (surgical look into the belly to see what the heck is going on) on a baby that had been born that morning.  The baby was tiny and that was sad but the baby was also very unwell and that was really sad.  The problem was that we didn’t know what was wrong with him.  Until we got into his belly at which point we found that his intestines had twisted on themselves.  They had twisted so that nothing could pass effectively ending his digestion in a blind pouch.  This kind of a problem is fatal.  And it doesn’t take too long.  As distasteful and socially unacceptable as the bodily function that eliminates solid wastes is it’s pretty necessary.

But it’s only fatal if it’s allowed to continue.  We got  in there, found the problem, pulled the blind pouch out to the skin and opened it up, giving him a colostomy (which is distasteful but certainly better than the alternative and babies don’t really mind as much as adults do anyway).  I asked the surgeon about what would happen next, was he going to spend his whole life attached to a bag that he pooped into?  “No, we’ll give him a few weeks to let his intestines rest and heal a bit and then we’ll come back in and hook him back up, he’ll be fine.”

And just like that I had taken part in saving a life.  And I decided that maybe this job wasn’t so bad after all.

In the intervening years I’ve done some horribly sad cases.  I’ve been there, more than once, when we had to hold down a screaming child.  I’ve seen some sights that turned my stomach. And I’ve been there, more than once when some kid, when someone’s child, took their last breath.  And I’ve cried.

But with only one exception the last act of that child’s life was giving their organs to save another, and usually many more lives.  And in the case of the one exception we had at least ten, probably fifteen, people in there doing everything we could to prevent it’s being that child’s last breath.  We failed.  And we all cried.

I’ve also done life saving procedures.  I’ve helped put a new liver, someone else’s last ultimate gift, into a child literally on the brink of death.  I’ve helped fix more, many more, twisted intestines and I’ve taken out hundreds of appendices.  I’ve fixed broken bones and sewn up lacerations.  Most of what we do is routine and not exactly lifesaving but even the routine can be pretty amazing.  To the parent of the child who’s had ear infections for months on end who finally got ear tubes put in, what is a little nothing case to me, is a pretty life altering, if not lifesaving, procedure.

And that my friends is why I do what I do.

*I’m going to mention to you who have trouble with the idea of holding down a screaming child, that part of the medicinal cocktail that we give kids in the OR is a drug that has a retroactive amnesic effect, meaning that not only do they not remember anything after they get the drug, they don’t remember what happened a few minutes before they got the drugs.  In other words they don’t remember being held down.


For any of you who are interested, there’s a link to sign up for organ donation (at least in Utah) over on the side bar. I think you should check it out.

This Morning

Over the Weekend I had a pretty good idea for a blog post but I just can’t make it work out today and I’m giving up trying.

Mostly I can’t make it work out because I have a lot of other stuff on my mind this morning, stuff that’s making it really difficult to focus.

So I thought I’d tell you a little bit about that stuff instead.

(In no particular order)

1. My boss is currently in the ICU at a local hospital.  He was in a motorcycle accident over the weekend and last I heard, was on a ventilator.  I believe that his prognosis is fairly good (as in they don’t expect him to die and he’ has the use of hands and legs) but still it’s a little … worrying.

2. I’ve been having trouble with one of my co-workers.  There’s a gal that I work with who I don’t particularly like.  I’ve been making a conscious effort to have a better attitude about her (not spend quite so much time finding fault etc…) but this weekend there was an incident that is causing trouble for another gal that I work with, one that I love to death, and it looks like I’m going to have to do better than I have been so that I can make work ok for my friend.  (That’s a little convoluted and confusing, I know but I’m trying to explain without getting specific).

3. My kids are off track.

4. I have a test on Wednesday.

5. I have a project due Wednesday.

6. The InfaDel is currently cutting the (not so) Baby’s hair.  I Gotta go…

More Money Than Sense…

… it’s not just for the uneducated anymore.

A few notes to start today’s post: First I want to say that you may agree with some of the villain’s thoughts and opinions in this story. That’s fine, it doesn’t change the fact that you’re both wrong.

I also want to say that I’m sorry about all the cycling related posts lately but well, I’ve been riding my bike a lot and reading a lot of this blog and I’m harboring a minor obsession which means that’s what I’m thinking about which means that’s what I post about. [Mostly lately I’m thinking about how much my bike sucks and how much I wish I had the money to upgrade.] But if you’re sick of all the bike talk don’t despair, before too long it will cool down and the snow will start flying and my bicycle will go back to it’s completely neglected in the carport status and I’ll pick up a new obsession.)

At work the other day I happened upon two of my co-workers chatting about bikes. One of them, we’ll call him Dr. New Boobs (because he’s a plastic surgeon [yes, I work at a children’s hospital, no, we don’t do boob jobs. But he also works out of a surgical center where they do.]) was excitedly telling the other one, we’ll call her Whitney (because her name is Whitney) about the new bike he’s getting. He’s getting a top of the line road bike. (You’ll notice, if you follow the link, that there are no prices listed for the frames shown. This in one case where the old adage “if you have to ask, you can’t afford it” holds true. But since I wasn’t asking so that I could buy it, I looked around a little more and discovered that the frame costs about $5000. And then you need to buy wheels and gears and a fork and handlebars and…)

Except Dr. New Boobs was conflicted, “should I just get it now or wait 3 months until next year’s model comes out?”

“Are you riding at a level that you would be able to tell the difference between the two models? ” I asked.

“They’re the same” I was told “next years model is just a different color.”

Whitney told him he should wait.

I banged my head against the wall.

Then, as one would expect, talk turned to other things bike related.

Dr. New Boobs told us about how he thinks that lycra looks ridiculous and he’ll never wear it. We explained that the lycra offered some padding. He continued to be insistent, he was not going to be wearing lycra. Now to be fair, I don’t wear lycra when I ride. But well, have you heard about my bike? It’s a piece of crap, you can’t wear lycra on a bike like that. (Actually,you can and I would. If I could afford it.) On a bike like the one Dr. New Boobs is buying however… I believe that lycra is a requirement. (I understand that this is a subject on which a lot of you agree with Dr. New Boobs, I get that. I do. But let me put it like this, not wearing lycra while riding a top of the line road bike, even if you’re just riding the thing to get some exercise as is Dr. New Boob’s stated intention, is a little bit like swimming laps in a t-shirt and shorts. It can be done, but it’s ridiculous.)

The talk turned to clip-in pedals. Dr. New Boobs doesn’t want them. Now I understand a healthy fear of clip-ins. I have one myself (although I also have a demonstrable, and frequently demonstrated, lack of all things coordination [gross motor, eye-hand, etc.]) and I’m quite sure that when and if the time comes that I scrape enough money together to upgrade to a bike worth the same as the average 13 year-old’s cell phone I’ll fall over with some amount of regularity. That doesn’t change the fact that you can’t put platform pedals on a Time NXR Instinct. I believe that he understood that, he just didn’t like it.

Then we moved on to seats. I’ll spare you the pain of this conversation; suffice it to say that he wants the most cushioned seat that he can get away with. (I think he’d put a banana seat on the thing if he could.) (Again, I know this is where I lose a lot of you, that’s fine. Except that you also have to understand that it’s not always about the padding or even the size of the seat. A seat with very little padding, if molded correctly for your underside can be very comfortable and not matter how much padding you put on a badly fitting seat, it’s never going to be comfortable.)

At this point we again mentioned the padding in bike shorts. Whitney declared that she didn’t always wear hers but that if she was going on a longer ride she would.

“What do you mean by a long ride?” he asked.

Whitney shrugged, “thirty miles.”

(Thirty miles is really not that long of a ride. For serious cyclists it’s hardly even a warm-up, and even for a not very serious cyclist it’s not too big of a deal. I rode about 25 yesterday and that was in addition to working for 12 hours.)

Dr. New Boobs didn’t pause to consider, he didn’t even miss a beat. “Oh, I’m never going to ride thirty miles.” He said.

He’s buying a bike worth more than my car and he’s only going to take it around the block.

The One Where I’m Stupid (because that totally narrows it down)

For those who haven’t read it yet, check out my last post.  There are still two copies of my book for sale.

As I mentioned last week, Friday was my anniversary. 12 years.  It’s been a great 12 years, but that’s no what this post is about.  I still love Sean like crazy, but that’s not what this post is about.  If I had to do it again, I would, without hesitation, but that’s not what this post is about.

What this post is about is this:

Currently I only work one normal day shift per week, usually on Wednesday, but I’m still full time.  I’m full time because on Fridays Saturdays and Sundays, from 7pm to 7am, I take call.  For each of these call shifts I’m paid for 8 hours whether I go in or not (sometimes this works out fantastically well and I’m paid for 8 hours to sit on my couch and watch “White Collar” and then to climb into bed, snuggle up to my husband and drift off to sleep.  Sometimes, most of the time, it doesn’t go quite like that.)  It’s a great schedule, it works out well for my family, I can attend the classes that I need, etc. the problem, in case you didn’t catch it, is that I’m on call all weekend (nights) every weekend.  That’s not too big of a deal, I’m married (have been for 12 years) I have kids, it’s not like I was going to be going clubbing, in general I don’t mind.  If I pay attention I can even request the evenings that I need off ahead of time.

Unfortunately, the last time request calendars went out I was not paying attention.

I failed to request my anniversary off.

Now this isn’t exactly catastrophic.  There are options, I can get someone to cover me.  Usually.  Unfortunately (that’s a word that’s going to feature prominently in my tale, I’m just warning you now) the gal that is usually my first choice to cover me couldn’t, she was headed out of town.  Kristen, the girl who is usually my second choice works until 11:00pm on Fridays so I didn’t even bother to ask her.  She did however, hear about my dilemma and offer to take the shift from 11:00 on.  That was fantastic (and incredibly nice of her) and I told her so, but I told her that I’d see if I could get someone else to just cover the whole thing.   (Also, despite the incredible niceness of her offer, Sean had to be to work at 6:00am Saturday morning so no matter what we did, we weren’t going to be up very late so after 11 wasn’t really the part I was worried about.)

I tried (to get it covered).

I was unsuccessful (I thought).

My follow-up was not what it could have been.

So Friday rolls around and, as far as I know, I still don’t have anyone to cover my call from 7-11 and I’m not sure whether Kristen is planning on taking after 11 (There’s paperwork that’s supposed to go along with covering shifts that did not get done and while that doesn’t necessarily mean that the shift’s not being covered, it’s unwise to assume that it is if the paperwork has not been done).  Probably (definitely) I should have called the hospital and talked to Kristen or anyone who could look at the schedule book or… well, I should have done SOMETHING, but I didn’t.

I did nothing at all.

So Friday night I made dinner early enough that I could go to work if I needed to (mahi mahi and rice, it was fantastic) and then we did the usual Friday evening stuff, the kids ran around outside, and then we called them inside, cleaned them up, put them to bed, watched an hour or so of White Collar, we went to bed… all this with the pager (more or less) on my hip.  Because I just didn’t know.

But I didn’t get called in.

This morning I found out that not only did Kristen cover my call from 11pm-7am, Mary, a girl in the OR whom I’m not sure I’ve even ever talked to, took my call from 7pm-11.  That’s right I had the whole thing covered.  I got the email about it this morning.

PS. In my defense it’s not like we had a sitter for the kids and these days we can’t really afford to do anything, even just dinner, anyway [probably I’ll tell that story later this week] so even if I had somehow not been on call it wouldn’t really have changed what I did that evening.

PPS. The email was sent last week, I just didn’t see it (possibly because I didn’t really look) until today.

Speaking of My Untimely Demise…*

I know people who plan their funerals, I know people who feel really strongly that there be a lot of weeping and wailing and general distress that they are no longer occupying useful space on the planet.  Me?  Well, I guess I’m ok with that.  I mean, I don’t love the idea of no one minding that I’ve died, but I’m ok with a little laughter too, come on people, I’ve done some really stupid funny things in my life, share a few stories, just to lighten the mood.

The thing I’m going to get a kick out of (oh, come on, like you don’t plan on attending your own funeral.  I’m so going to be there.) is watching the people from the different parts of my life interact.  Mostly those who think they know me, and those who really do.

The best example I have of this is the fact that Sean is going to have all these people from my work come up to him and tell him about how I was always so positive and so cheerful. And he’s going to tell them that they are at the wrong funeral.  (You guys probably will too, you’ve heard enough snark out of me.)

But the folks at work, most of them anyway, haven’t really.  When I’m asked how I am at work my answer is almost always something along the lines of  “fantastic”, “great”, “living the dream”, that kind of thing.  When I’m assigned more work, especially towards the end of my shift when I’m tired and just want to sit down for a minute, I usually say “awesome!”  I regularly tell my doctors and my nurses that they’re great and the best and wonderful.  I’m not trying to brown nose, I’m not sucking up (I talk about myself in the same terms), I just don’t see the point in complaining, I got bored of the let me tell you how tired I am discussion in highschool  (and I think everyone likes to hear nice things about themselves).**

I’m not quite that nice at home.

The thing is, that I’m not intentionally different at work it’s just that my job is so far removed from my home that I just am.  My work is sometimes difficult and sometimes stressful, but most of the time my job’s not about saving lives it’s about setting bones and taking out tonsils and other mundane boringness.  But it’s mundane boringness that I’m only going to have to put up with for a maximum of 12 hours, because when I’m gone, I’m gone, heart and soul, except on very rare occasions I do not bring my work home with me.  I’m not the doctor so I don’t have to worry that I chose the wrong treatment, I don’t stress that patient X has an infection, that’s not my job, so for the 12 hours that I’m doing my job I can afford to be almost unrelentingly cheerful.

At home on the other hand, well, I never really leave here.  Even when I’m at work I’m still wondering if I dealt with the Princess’s problem the right way, what I can do to get the Pea to stop driving me, and everyone around him, crazy, whether I should be worried that the Infantile Delinquent doesn’t know his letters yet.  And they way they turn out is my responsibility.  And then there’s the car that needs fixing and the flat roof that’s really going to be a problem sometime soon and …  it’s harder to be cheerful all the time and that’s what home is.  So I tend a little more toward the snark.

I have a brother who made it his new years resolution (of sorts) to be cheerful.  Not more cheerful, just cheerful.  I know him and he’s amazing and while I’m not sure that he makes it all the time, I’m pretty sure that he succeeds most of the time.  (As an aside, I’ll mention that I think this is a fantastic and worthy goal, but it’s not one that I have, nor am I likely to.  Just saying…)  He’s not going to have people at his funeral with conflicting opinions.  But me, well, I plan to enjoy the show.

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*I’m seeing a theme to my recent posts and I’m not sure that I like it.

** I do NOT lie in my compliments.  I just make a point of noticing the things that people do well.

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