Sunday, October 21, 2007

Once in a while, in our CCU, we would have in our care someone who would be waiting for a heart transplant. That person would be high on the waiting list to receive a donor heart, perhaps "hoping" for some unfortunate motor vehicle accident victim to visit our Emergency Room.

No Longer at the Top

It's lonely here
No longer at the top,
As my cardiac function
Grinds to a stop.

I'm just waiting and waiting
For a suitable donor,
It's a serious commitment
I need a permanent loaner,
But someone must die
So I can survive,
Each day I deteriorate
Wondering when they'll arrive.

As the days turn to weeks
And the weeks into months
My room starts to feel like a jail,
My veins are sclerosed
I'm catecholamine dosed
And my kidneys are starting to fail.

My future is grim
But I'm not without hope,
I'm becoming an expert
At trying to cope,
And I'm thankful the nurses
And doctor's are trying,
Their utmost endeavors
To keep me from dying.

Fibril_late; 1998

Wednesday, October 10, 2007

I must have been thinking about what a gang member would want for Christmas, and what would be the absolutely, most important #1 thing. Yep, a free-admission pass to the Emergency room!

My Christmas List

It's the Christmas season once again
And I've been good all year,
My wishing list ain't very long
So why not lend your ear?
A case of liquor and some wine
And a couple other trifles,
A tear gas mask, some throwing knives
Plus automatic rifles,
A kilo of Columbian
A water-pipe from Seoul,
A pound of methamphetamines
And an ornate hashish bowl,
A vehicle that's nondescript
But advertised as fun,
It should have a lot of gadgets
Like a loaded drive-by gun,
For those fickle freeway freakouts
And the turf related games,
The hassles with the homeboys
And someone else's dames,
A worn and tattered trenchcoat
For flashing Lois Lane,
Some mescaline and LSD
To fry my little brain,
But if you find my list too long
I have one priority,
A year long E.R. admission pass

Fibril_late; 1995

Monday, October 08, 2007

Nursing is hazardous work. Every year, you hear from someone, "Did you hear that so and so died. Yup, got shot by a patient." One time I was kicked in the head by a berserker, and suffered a concussion. Patients get sick, and then crazy, and you never know what will happen next. Back in the day, it wasn't like that.

In Days Long Gone

In days long gone
Of innocent youth,
You could go to a Doctor
To get at the truth,
Because disease back then
Was fairly simple,
Unwanted babies
Or maybe a pimple,
A week in the hospital
Would do the trick,
If you didn't die
You weren't really sick,
Because medicine men
Didn't have many drugs,
No antibiotics
For bacterial bugs,
Just common sense
Like fluid and rest,
Surgical wounds
Were debrided and dressed,
Life support measures
Not yet invented,
Many more sinners
Took stock and repented.

But today, man, it's different
This hospital scene,
Each organ system
Has a machine;
Any mechanic can tell you
This carries a price,
It's Russian roulette
With a medical device.

Central line catheters
A bacterial threat,
Ground fault dysrhythmias
If a pacer gets wet,
Gastric perforation
From sump pumping hoses,
After long-term use
They'll have a nasal necrosis,
Tracheal malacia
And traumatic intubation,
Will lead to a permanent
Horse voiced oration,
Tympanic rupture
From a doppler detonation,
Uremic poisoning
From bladder ablation,
And that's just the patients
But, what about the nurse,
Each day at the job
Is surely a curse.

Consider the dangerous
Equipment itself,
Monitor boxes
That fall off the shelf,
Land on your head
Bruising your brain,
There's no medication
For this kind of pain,
Suspended televisions
That swing in an arc,
Causing serious damage
At night, in the dark,
Colonic disasters
From overfilled pans,
Body fluid exposure
On your clothes and your hands,
Broken thermometers
With mercurial spills,
Inhaling poisonous dust
From all those crushed pills,
Exposure to X-rays
That zoom through the walls,
Effectively neutering
Ovaries and balls.

Good god, it's a nightmare
There is nowhere to hide,
But who keeps statistics
On the nurses that died,
In the course of their work
By their choice of career,
They silently vanish
Year after year,
As their spirits race homeward
At the crack of each dawn,
The days of their innocent youth
Are long gone.

Fibril_late; 1997

Sunday, October 07, 2007

In most hospitals, there is rivalry between different ICU's, where each arena, likes to believe they know the most, have the most critical patient's to care for, and therefore, are the "best" critical-care nurses. Working in what is known as the Coronary Care Unit (medical) meant that you took care of people with CHF, acute MI's, Unstable Angina, pacemaker's, etc. You didn't have to deal with many wounds, virtually no post-op surgical patient's and rarely any infections. In other words, a pretty clean place. So when one of "our" nurses, decided to transfer to the Surgical Intensive Care Unit, I was forced to put my disbelief into words.

Oh, Marge

Oh, Marge
I have to tell the truth,
Will steal your youth,
We'll miss your
Always wonderful self,
Like empty bookends
On a shelf.

Trauma surgeons
There's not doubt,
Really love to
Shake and shout,
Measure outputs
Like fanatics,
And drink the juice
Of drained lymphatics.

So sure, the place
Is great for learnin',
Q-2 hour
Crash and burnin',
Busted faces
Legs and brains,
Fifty thousand
Sucking drains.

But you'll be back
To plead your case,
And fool us with
A happy face,
Nostalgic for
The pretty view,
At sunrise
In the C.C.U.

Fibril_late; 1994
The word Obtunded is not used in everyday conversation. Its meaning is; mentally dulled. A person may be obtunded due to head trauma. Yet, you can understand why it might be commonly used, among certain medical persons.
Even less used is obtundation, which means, a dulled or reduced level of alertness or consciousness. One might report, that "Mr. X is in a profound state of obtundation." One of the ways to determine if the person is arousable, is to rub their sternum briskly and firmly, with your knuckles. Yes, it cause a noxious pain. Early in my career I worked with a nurse named Jan, whose sternal rub was legendary. Numerous obtunded persons, came to wakefulness under her forceful rub.

The Obtundation Rap

The shift was OK
Until he tried to spoil it,
Circling the
Obtundation toilet.

I lit up his pupils
And screamed, "Look here, Bub",
I'm known far and wide
For my killer sternal-rub,
You might think you can fool me
But as your nurse, I get first dibs,
To rap out the death-march
On your skinny little ribs.

Your brand of behavior
Will not be endured,
One way or another
Your obtundation will be cured.

Fibril_late; 1992

Thursday, October 04, 2007

WARNING: This poem is totally gross.
Unfortunately, it was inspired by my own, real-life experience, getting involved in some TID dressing change, on a stage-4, infected decubitus. The only way I could deal with the demolition of "Universal Precautions", was to write about it.

Pseudomonas Stew

When the wound begins to fester
Oozing yellow goo,
When the pungency develops
Into a powerful pee-yoo,
When the macerated tissue
Melts into a slurry,
It's time to plan for dinner
Though there isn't any hurry.

When, necrosing blisters burst
And splatter you with blood,
When the stage-four lumbar crater
Starts leaking thick green crud,
It's time to think of dinner
Invite a friend or two,
The main course is a favorite
That pseudomonas stew.

FIbril_late; 1995
It seems like every big city has a Trauma Center, smack dab in the center of all the action. It's so convenient for the gangs and what not. When you get shot or stabbed, your friendly neighborhood Emergency department is just down the street looking for new business. Hey, we groove on it too; after all, there is nothing more boring than twiddling your thumbs all night in the E.R.

The Stockton Boulevard Shuffle

At night we go out cruisin'
For something fun to do,
We pack the glove compartment
With rock cocaine and glue,
We inventory weapons
And check our ammunition,
Then analyze the dress code
To prepare for demolition,
We'll boogie on the boulevard
Until the moon has set,
We're hunting for our rivals
It's a turf related debt.

We're doin' the Stockton Shuffle
It's our favorite expedition,
We'll keep our zip guns loaded
And ready for attrition.

The happy hombre' hideaway
Is actively recruiting,
Respect is guaranteed
If you've done a drive by shooting,
Because our leader, Jesus Wannabee
Got blown away last week,
He took a double shotgun blast
Directly on his beak,
Thus splattering his sacred essence
Upon the dashboard fur,
Now, when we take a low ride cruise
The windshield is a blur.

It's a party, it's a shuffle, on the promenade
We're kickin' up our heels out in the street,
We're paying our respects to Jesus Wannabee
While jamming to our favorite gangland beat.

Fibril_late; 1993