Back in the early '90's, I made the acquaintance of a fine nurse and nationally recognized educator, named Deborah Tuggle, RN. I attended many of her classes, worked with her a few times at one of the local ICU's and was a contributor of some poems for one of her CCRN classes. I just stumbled over my drafts for those poems and thought I'd do a little
21st-century revising and revisiting. I will load up the whole pie in this entry, as it has been more than a couple weeks since I posted last.

SVT versus TFS

Is it aberration or ectopy
S.V.T. or T.F.S.?
Sometimes I get, so darned confused
I quit, with just a guess,
I get so doggone overwhelmed
I can't recall my name,
Does it really matter in the end
Or would the outcome be the same?
I swear I think my "idiot-factor"
Has increased, by more than double,
Ever since I took that class
From the famous Mrs. Tuggle.

Let's examine a scenario
To illustrate my point,
My shift is all but over
I'm about to leave the joint,
When abruptly, I'm assaulted
By alarms and lights galore,
My patients' heart has gone whacko
(Now I'll have to chart some more),
His rhythm is wide and ugly
So I race down to his room,
My tunnel vision activates
The flashing lights spell doom.

Is he conscious?
Is he dead?
(Is he even in the bed)?
Should I stop a sec and clock him
Or just go ahead and shock him?
No, no….hey, I'm a pro
I've taken Tuggle's course,
He's fine for now….I'll stop and think
My memory, I will force.

I'll check a few key leads
Before I treat this guy tonight,
Is it S.V.T. or T.F.S.
Or Wolff, Parkinson and White?
Does a delta wave announce itself
Or remain concealed and silent?
Is it simply an aberrancy
Or something else more violent?
Is the phenomena reentry
Are the P-waves retrograde?
Does the AV node dissociate
Or do P-waves simply fade?
Is the axis indeterminate
Is it normal, left or right?
Is V1 looking up or down
Is the R-wave broad or tight?
What else was I supposed to check
What else did teacher say?
My God, that woman drives me nuts
I don't care anyway!

There's just, too much to think about
It's too much to recall,
These silly EKG rules
Are just no fun at all!
You know, he looks a whole lot worse
Let's just forget the clues,
I think that I should shock him now
And end these rhythm blues!
So I hit him with some macrovolts
To turn his rate around,
His body jerked right off the bed
He moaned a frightful sound.

Despite his pain and suffering
His rhythm was reversed,
He was mad as hell I zapped him
And announced that I'd been cursed,
In the end, what only mattered
Did I fixed him or did I not?
I halted decompensation
Plus all my nerves are shot!
But was it V-Tach or SVT
Or was it really T.F.S.?
That Tuggle Frustration Syndrome
Is the cause of my distress!

p. hupp; 1991
rev. 2007

Advanced Certification Blues

It's a lot of stress and worry
A major pain in the neck.
Some nurses want to do it
To enhance their weekly check,
Then others seek a challenge
To prove their skills exist,
Or to correct a prior-exam upset
To right the wrongs they missed.

Anxiety commences
Before beginning class,
We're talking, major chunks of money
To ensure you're going to pass,
And what if you should flop
Despite this education,
Your self-esteem will under go
Its' final degradation.

You can see the task is mighty
For the dedicated teacher,
They must ignite your feeble spirit
Like a fire and brimstone preacher,
And cast aside the devils
Of ignorance and fears,
Hoping you'll be back to take
Their class in three more years.

p. hupp 1991
rev: 2007

Balloon Pump

When your heart doesn't want to thump
It's time for an aortic-balloon pump,
It squirts the blood back, retrograde
To reduce the myocardial fade,
It unloads the diastolic side
And improves the coronary glide,
It has many complications, though
You could lose a foot, a leg or toe,
Or if a clot, by chance should travel
Some precious organ might unravel,
It could migrate up into your head
And though we saved your heart,
You'd still be dead.

p.hupp; 1991
rev. 2007

Neuro Learning

You used to think that Parkinsons
Was a place to buy your clothes,
And Babinski was a guy
That manicured your toes,
You thought a Grand-mal seizure
Was a grocery store arrest,
And a thing called quantal squander
Was a competency test.

And by now your cerebellum
Has tremors from the strain,
From cramming unrelated
Facts into your brain,
And you suspect your C.P.P.*
Is dangerously low,
From an obscure malformation
Redirecting neural flow.

But how fortunate for you
Your condition is benign,
All you have to do is study
And memorize each line,
Then the words will fall into place
Into memories, defined,
And despite your greatest worries
You've intellectualized your mind.

p. hupp, 1991
rev. 2007

Addison's Prices

No matter where you're going
No matter where you've been,
Make sure you don't ignore
The system Endocrine.

Back in the days
Of James Madison,
Came the naming of diseases
Like Addison;
One day he was shopping
For some coffee and tea,
He had a jones for some brew
(Though it always made him pee),
But he went into shock
When he saw the prices,
And thus begat
Addisonian crisis!
Hypotension
And hyperkalemia,
Pigmentation
And hyponatremia,
Dextrose and saline
For fluid revival,
Corticosteroids
For long term survival.

Don't sit around
Debating the cause,
This Addison's beast
Has some serious claws,
So if you treat it rapidly
With the latest regime,
Impending death
Will be yesterdays dream,

Don't be a doubter
A skeptic or a cynic,
Make follow-up appointments
And we'll see you in the clinic.

p. hupp; 1991
rev. 2007

G.I.

G.I. troubles
What a mess,
Gastric bleeders
I confess,
Turn my stomach
There's no doubt,
When their blood
Comes gushing out.

An acute abdomen
Or ugly bowels,
Causes people
To scream in vowels,
Call the doctor
And sharpen the knife,
It's their only
Chance for life.

Hepato this
And chole that,
Secretory
Neighbors chat,
Liver function
Out of kilter,
Won't detoxify
Or filter.

Massive ascites
Ain't no fun,
You look like a pumpkin
In the sun,
Tap the belly
Before it blows,
Ascites fluid
All over your clothes,
Kaexalate
All day on the crapper,
This is the song
Of the liver-failure rapper.

p. hupp; 1991
ref. 2007

Ketoacidosis

The acidosis diabeatus
Is not a crisis of the fetus,
It's most often those
Who are type one,
Deficient
In their insulin.

The fatty acids accumulate
Producing a keto-acid state,
A greater than fifteen
Anion gap,
Encourages their
Lungs to flap,
To dissociate carbonic acid
Meanwhile this dude, is totally flaccid.

When the patient
Is dehydrated,
Electrolytes
Become concentrated,
Aggressive treatment
Is required,
Before the victims'
Heart gets tired.

Insulin and fluids free
I.V. route most rapidly,
Check the glucose every hour
So the treatment won't go sour.
Discharge plan?
To educate;
To prevent a similar
Repeat date.

p. hupp; 1991
rev. 2007

The Big Test

The night before the test next day
There's a trepidation creeping,
A few will burn the midnight oil
To study, instead of sleeping,
Some others actually go to bed
Yet their sleep will be forsaken,
They'll toss and turn the whole night through
Afraid they won't awaken,
To the din of 17 alarm clocks
Placed strategically around the room,
So they get up in the morning
With a foreboding sense of doom.

What kind of clothes
Do you wear to this test?
Should you go as a slob
Or dress in your best,
If you give it little thought
And leave it up to chance,
Before you leave the house
Make sure you have your pants.

The test is always on Saturday
So you are the only commuter,
You spend the whole drive dreaming
That you owned a mini-computer,
Hidden in the glove-box
With a modem in your ear,
Then you'd be the only scholar
With a perfect score this year.

Outside the somber testing place
Small groups of nurses collect,
Presenting each other with questions
With the hope they will choose what's correct,
When faced with a similar topic
On the test, they will soon undergo,
The moment of truth can be merciless
When you realize how little you know.
___________

The exam is really over?
You can't believe it's finished,
The results will come in about two months
But your worries haven't diminished,
Because now you dwell on the questions
Where you clearly had no clue,
And since the test is behind you
There's not a damn thing you can do.

You might pray to your Gods and your Goddesses
To grant you just one small request,
Sacrifice a lamb and rub that rabbits foot
To guarantee that you passed the darn test.

p. hupp; 1991
rev. 2007

Necrotizing Needlepoint

Perhaps you thought that breathing
Was a commonplace event,
And the term, "A dime sized lesion"
Was just money that you spent,
Did you think that hypoxemia
Was a viral titer test,
Or that tracheal malacia
Was a common household pest?

Did you know that bronchiectasis
Hung out with atelectasis?
Or grasp that wheezing airways
Were often found on stairways?

Don't ignore that pneumothorax
Muffled breath sounds are a clue,
A deviated trachea
Accompanies it too,
Hypoxemia develops
Mental confusion in the head,
You better place that chest-tube quick
Or this fellow will soon be dead.

Hospital-acquired pneumonia
Is the going thing today,
If you never wash your hands
You'll put a lot of them in play,
And the antibiotic resistant bugs
Will thank you for the chance,
To do their necrotizing needlepoint
At the pseudomonas dance.
Joe Camel has retired
But advertisers never quit,
Pre-teen little Bobby smokes
His cool factor is up a bit,
In health class he just snickers
Tarry lungs, no that ain't me,
In forty years he'll curse the beast
We know as C.O.P.D.

p. hupp; 1991
rev. 2007

Blood Cell Party

The white cells attack foreign proteins
The red cells just go with the flow,
The platelets are seen stuck together
On their way to a matinee show,
It's a film about tubules and solutes
Of osmo's and creatinine clearance,
It adds up to only one thing
A very confusing appearance.

The syndrome of I.A.D.H.
The SED rate and left-to-right shift,
Require the proper translation
Before you catch on to their drift,
But sooner or later the meaning
Will find itself well understood,
When these systems are all out of kilter
The outcome won't look very good.

p. hupp; 1991
rev. 2007

Another reawakening, an eye-opener of realization. I wrote about it back in 1995, and now a recent issue of a local Nursing magazine, has substantiated what I feared back then; Nursing is burying itself in "after-the-name-titles identified with mysterious letter combinations", where everyone and anyone, has to make their little stamp of recognition. It seems so childish to me. Who gives a rats-ass? Why not just show the RN, and then carry around a little card with all your extra-special, super-duper, ain't they awesome, look what I did, credentials identified by their "letters" and what the heck it all means. Stop giving me a headache, every time I pick up some nursing literature, Ok?

And this is just the beginning! Stay tuned for the latest interpretations.

Toxic Credential Syndrome

I was present at a seminar
Just the other day,
Presented by some experts
They captured me all day,
Enthralled I was, I must admit
Astounded, I confess,
I learned some facts I never knew
But I pause, and now digress.

What captured my attention
Were the credentials after each name,
Without a glossary to help me
I was almost put to shame,
When I realized no one else
Would know the meanings, either,
I silently relaxed
And took a little breather.

Little do these experts know
They have a sickness; it's incurable,
Toxic Credential Syndrome
Rarely, is insurable,
It's a chronic, life disorder
Of self-substantiation,
Seeking after-name initials
That defy interpretation.

After days of in-depth study
And cryptogram decoding,
I almost had the cypher, but
I felt my mind eroding,
The breakthrough came, when I was sitting
Upon the holy throne,
While bearing down, I visualized
A new Rosetta stone.

My interpretations
Are that and nothing more,
Other scholars may follow me
But I warn them, it's a chore,
Fellow collaborators
Have chosen to stay unnamed,
I understand their reluctance
The risk of being blamed.

I may become notorious
Denounced, more likely banned,
But I have my convictions
And have to take a stand,
The TCS condition
Is a threat to any nurse,
Should this research halt their suffering
I will gladly bear the curse.

Fibril_late; 12/95

Remember when we all laughed about that silly "Valley Girl" song, by Frank Zappa. It was filled with all those juvenile forms of speech such as:
Like, He's like, I'm like,……
As if
Ya know
Bitchin'
Totally Rad
Oh my God……

Now our whole flippin' society talks in this manner. The problem I see, is that when professionals speak this way, it makes them at best, appear poorly educated and at worst, just blathering idiots. So, there I was at some ACLS course and the physician instructor kept saying, "If you will" with a smattering of "ya know's" thrown in (like, every sentence, and it was not even, totally, like rad). Word.


Listen Carefully To Speech

"If you will", please let me clarify
A point of worthy status,
"If you will", I'm very tired
Of catchy phrase-like flatus,
"If you will", is touted daily
From the mouths of modern man,
"If you will", is like, I mean, ya know
Over and over again.

If this is too confusing
Listen carefully to speech,
Repetitive terms, like um, it's all
Are enough to make you screech,
The continual daily bombardment
Of sloppy vocal expression,
May undermine the professional
Leaving a less than desirable impression.

Fibril_late; 12/95

More about cost-cutting and budget cuts.

A Dangerous Method of Efficiency

Casting caution to the wind
Making budget cuts galore,
It's a dangerous method of efficiency
Kicking your people out the door.

Our industry needs to be streamlined
With careful consideration and pride,
Unlike the methods you see today
Which is technically suicide.

Fibril_late; 12/95

Some thoughts about the final destination: Death.

What it Means To Die

I sought a definition
Of what it means to die,
I asked for a description
And then I pleaded, why,
A man might suffer needlessly
While his life-force slowly drains,
A victim of this system
And our God-almighty brains,
How we can define atomic physics
Or support the gasping breath,
Yet we shudder when we're faced
With the choice of life or death.

Afterlife, what's after death
What goes on beyond the after breath,
It is a question, understood by few
While even less, know what to do,
In a world of increasing technicality
We grapple with our ultimate finality,
Exactly where this road may lead us next
Can not be found in any medical text.

We seek a lot of answers
To define our own morality,
When at the bottom of it all
We fear our own mortality.

Fibril_late; 12/95

Who would think 12 years ago, that we'd now be viewing a television reality-show, covering the life and slices of a young, rich, Beverly Hills Plastic surgeon (and all the customized men and women plopping down the big bux for a new shape or look)?!?

My Belly Button

I am currently recovering;
I had my belly-button moved,
I never liked the way
It puckered and it grooved,
I began to think about
The way my ears are tweaked,
And how I hate my natural nose
Because it's sort of beaked.

I called the Plastic Surgeon
And he offered me a deal,
So the next time that you see me
I'll have some sex appeal;
Isn't it great, we have the chance
To change the way we appear,
Because life would be so boring
If we looked the same each year.

Fibril_late; 12/95

Probably once a year, there would be a family so dysfunctional, screwed up, and angry, they would literally be fighting over the estate of the poor fellow who was at the precipice of his journey into the afterlife. It was so disheartening to see such consummate selfishness at play. Thus begat,

The Family

A dying patient's family, can
Do more harm than good, I assure you man,
While contesting the contents of his will
They're hovering closer for the kill,
They may be harboring hidden guilt
About the time the milk was spilt,
Then clutch at every thread of life
And claim it's for his loving wife,
When life support, becomes death denial
He feel like he's been put on trial,
He wonders what his crime must be -
The poor fool had a family!

Fibril_late; 12/95

Another trip to the Dentist. Everybody got excited when they thought I was having angina; me, I was awakened out of a reverie, dreaming about the dental assistant.

Mondo Pick

I gazed upon, your lithe and limber
While the novacaine was spreading,
Under your hypnotic gaze
I almost started shedding.

Your ever smiling sidekick
With her subtle perfumed pose,
Calibrated instruments
While I began to doze.

Is a I dreamed a tale of triplicate
My arm began to ache,
I wondered, "Is it Memorex"
Or is this feeling fake,
The dental crew began to play
A game of different rules,
They checked my mouth for hardware
Or any missing tools,
Perhaps a stainless Mondo pick
Was lodged behind a filling,
The office girls placed wagers
While I tossed in a shilling.

It all worked out, without a glitch
My Dentist has it down,
She liberated my decay
And left me with a crown.

Fibril_late;
12/95

Whoa; I lost a whole week in illness. Felt like I picked up one of those virulent strains and deposited it into my lungs, to see how tough I was. Not tough enough!

So, back to the chronicles of the underside. Here is a tale about a coworker making the transition, following a promotion to a position of higher authority. Kings are not made in a day.

A New Title

You once were a friend
A comrade at work,
You earned a promotion
And now you're a jerk,
Afraid to lost control
Of your acquired dominion,
A perfectionist at heart
You don't want an opinion.

We continue to be equals
No, you're not our God,
Your power of office
Is just a façade,
A couple more initials
Written after your name,
You have to read the rules
If you want to play the game.

Rule number one, is
"Little has changed",
You get a new title
Yes, that was arranged,
You henceforth are known as
An Assistant Head Nurse,
It's up to you to make it
A blessing or a curse.

Rule number two, is
"Remember your roots",
Your fellow staff-nurses
Are not the dust off your boots,
We're equals, remember
On whom you depend,
Treat us like dirt
And that will soon end.

Rule number three, is
"Be a student of history",
To become a great leader
Is no longer a mystery,
Practice fairness and respect
You will earn it in return,
Or be a control freak
And watch it all burn.

Fibril_late; 10/95

"Active Listening", I'm sure you've heard about that much-hyped tool of communication. It goes something like this. Bob: I hate my dog. Mary: I hear you say, you hate your dog. At this point Bob wonders, what is the matter with this woman; does she need her head examined?
Well anyway, I probably simplified this complex mechanism of truth seeking, but it's right up there on my list of the Top 10 worst ways to carry on a real conversation. As soon as I hear a person speaking like that, I automatically tune them out.

As a matter of note, I also clump this into the list of useless Nursing tricks, along with Care Plans with their "special" nursing language. Doctor Dude writes, SOB, or short of breath. Nurse Clump has to write, "Impaired Gas Exchange". Take it from me, if you stand downwind of Nurse Clump, you will clearly discover there is no impairment in her gas exchange, and quite frankly you will be S.O.B. too. I suspect most of these Useless Nursing Tricks are devised by underpaid Nurse Researchers. More on this another day, ok?

Back to the main topic of Active Listening:

The Wilderness of Speech

Active listening, is one of those things
That is destroying this life, as we know it,
Repeating the works that the other one said
Prompts me to tell them to "stow it",
It doesn't feel right to me, I will admit
It isn't a part of my vernacular,
And I have a suspicion that the active adepts
Undoubtedly feel quite oracular.

It's touted quite often, by communication experts
As a fabulous, simplified tool,
But who has the guts, to agree with me here
Just who are they trying to fool?
It sounds too damned phony, I'm not put at ease
By the smooth talking, active practitioner,
I'm a small voice of protest
In the wilderness of speech,
Wondering who is the language commissioner?

Fibril_late; 10/95

Here is an oddball rhyme that I didn't write. A colleague comments about their aged, female poodle and her stinky habits. Actually, if you will read a couple of days back, this certainly falls into line with the topic of Nursing Research.

"Case Study: Canine Sexual Deprivation Resulting in a Perverse Desire to Consume Bananas and the Effects on Owners of Said Dog":

You know the virgin sturgeon
The Virgin Mary too,
Now may I introduce to you
The virgin Suki-poo?

Some have expensive toys
Or discount fantasy,
But Suki states (naively)
"Bananas are for me".

Bananas have a friendly
Compliant sort of way,
They're always firm and ready
For Suk's indulgent day.

With teeth now old, but eager
She masticates the pulp,
It forms a little bolus
She swallows in a gulp.

But gone is not forgotten
The fruit did not depart,
At six o'clock that evening
It comes back as a fart.

This precious Virgin doggie
Groomed, trimmed, and spayed, so fair,
Enjoys her sweet revenge
As she permeates the air.

And so, ye doggie owners
Take warning from this tale,
Leave those ovaries intact
And get yourself a male.

K.B., RN
10/95

It's totally gross! Don't read it if you just had a meal. Wait, hold on; if you're a nurse, of course you can stomach it, because you've seen something just like it - maybe only 5 minutes ago. No doubt you were momentarily taken by surprise, until you realized it was only..................

Activated Goo Blobs

Genital yeast farm
As a gross-out, it’s top notch,
Crawling in the linen
Growing in the crotch.

Activated goo blobs
Multiplying every hour,
When your shift is over
Be sure to take a shower.

Proceed at your own risk
When you travel in the area,
Wear protective clothing
It’s a lot worse than malaria.

Dark forces are at work
And the humidity is prime,
In our antibiotic wasteland
You can grow some killer slime.

Resistant cream cheese exudate
Its quality can’t be beat,
With genetic engineering
It might be good enough to eat.

Fibril_late; 9/95

Another episode of the cost-cutting days of the gay-nineties.
However, it's still pertinent today. Just keep your eye on the topics of research and no matter what, you will see a plethora of dubious ideas, wasting countless hours and dollars. One of my favorites was the study regarding the variation in counting a radial pulse rate. Did you begin at "0" or "1" with your counting? Let's see now, did you end up with 100 or 105 and what did the next nurse do 8 hours from now? Now me for example, I always started at "1"; who knows, maybe countless lives were lost because of my carelessness?!?

Nursing Intensity

The intensity of some nurses
To be a part of research history,
For complexity, severity
And the psycho-social mystery,
Emblazoned with multiple credentials
Exalted with power, with purity,
Producing results, without question
That threatens their own job security.

The unacceptable growth-rate of health-care
Has little to do folks, with nursing,
It's more about top end mismanagement
And the deep pocket ways of reimbursing,
The financial investments of technology
Far outspend the paltry cost of our salaries,
But as the single greatest body of workers
We're the targets for their shooting galleries.

Yes, I am a skeptical nurse
And I question the work of our scholars,
Is it money well spent in the long run
A well invested use of our dollars?
How many nurses will be out of a job
At the mercy of staffing acuity,
While top management back slapping big boys
Will applaud their cost cutting ingenuity.

Fibril_late; 9/95

Here's a jolly reminder why smoking is such an appealing habit.

Things To Look Forward To

Things to look forward to
After years of smoking,
Sputum in the morning
And midnight choking,
Nicotine stains
On your teeth and fingers,
Wherever you've been
A scent of smoke lingers,
Ashes in the toilet bowl
Burn marks on the tables,
Are guaranteed signs
Of the nicotine fables.

Premature aging
Self-inflicted disease,
You can't climb the stairs
Because you rattle and wheeze,
Bronchitis and asthma
And C.O.P.D.,
Retire on oxygen
At age sixty-three.

Set fire to your lungs
Day in and day out,
Make plans for pneumonia
Every year a new bout,
Smoke when you're pregnant
Have a low birth weight kid,
When he's slower than the others
Deny that you did.

You'll taste like an ashtray
Each time that you pucker,
So you'll marry a guy
Who is a nicotine sucker,
Your non-smoking friends
Will leave subtle hints,
To bring along perfume
And a mouth washing rinse.

Pay higher insurance
More sick days each year,
Cancer and heart disease
Surprise!, they appear,
Like silent assassins
They attack without warning,
Remember it started
With a cough in the morning.

Things to look forward to
On the nicotine cruise,
You have nothing to gain
And too much to lose.

Fibril_late; 9/95

Whew, time for just a couple more ode's (or is that odors) to the tales of the toilet seat.

This Chamberpot

There is something about this chamberpot
The seat is neither cold nor hot,
It's comfortable and built for speed
With accessories for personal need.

I'm kind of jealous, I admit
This is a really fancy place to shit,
I'll leave a tip for my gratuity
And praise American ingenuity.

State of the Art

This toilet top is state of the art
It can accommodate the largest fart,
With its custom, elevated seat
And a bowl designed to take the heat,
The paper dispenser on my right
Is clearly art-deco and out of sight,
Across the room, that fancy urinal
Was written up in the Wall Street Journal,
I'm proud to work for such an employer
Who is obviously a bathroom enjoyer!

Fibril_late; 7/95

You've probably seen those toilet seats that actually have two seats, right? Who came up with that idea? It always seemed kind of silly to me. Kind of like those booster seats at IHOP for the toddlers. I don't think you'll find those two-story lifters anywhere else, but in good old USA. So, two seats deserve two poems.

The Two Seated Concept

I've done my research
About this chair,
While sitting upon it
I noticed the air,
Was quite a bit fresher
At that elevation,
The two seated concept
Is some revelation.

I don't get the chance
To visit here much,
But I'll never forget
This toilet seat touch.

The Jacked Up Seat

I’ve wondered long
And pondered deep,
I’ve lost a lot
Of gash darned sleep,
Trying to solve
The mystery,
Of the jacked up seat
Where I must pee.

I’ve measured it
And found its weight,
The manufacturer
Place and date,
But it isn’t clearly
Understood,
Why a raised up toilet seat
Is good.

Fibril_late; 7/95

I'm pointing the finger of blame in many directions, against any of us, who choose the work setting as the place to make our cultural stand. What do I mean by this?

Here in the United States, English is the language of communication in the health-care arena. If you and your cohorts, think the office/clinic/hospital is the perfect setting for your special cultural clique, excluding those around you by speaking in your home language, I've got a hint for you; save it for the weekend parties at Uncle Festers house, ok?

Sure, cultural diversity helped you get the job; but the intent of the writ, is that people of many cultures can work together, and to do so, it helps that they speak in the common language, while they are together in their place of work.

Enough of explanations; I've got the NYC Blues!

NYC Blues

I know what you're thinking
Or I suspect that I might,
When you look at that title
You want to put up a fight,
And defend your dear village
But I beg you to wait,
It's about New York city
But the title is bait.

Someone told me a story
Based on rumor and hearsay,
Supplied hints of nepotism
Power struggles, unfair play,
Out in the corn patch
Of the furrowed nursing field,
It would be easy to discount
Until my conscience appealed.

Because I am a nurse
And I've been there too,
Amidst the culture of our kind
There are small minds in view,
Hanging out with their brethren
Speaking a language of their own,
An isolation foundation
Built stone by stone.

In position's of power
They will gather their forces,
While speaking in tongues
And crapping like horses,
Then you better know your brother
Or you'll step in their shit,
And the NYC gestapo
Will force you to quit.

Before I go further
I'll quit while I'm ahead,
Secret NYC agents
Just might want me dead,
And in the past 20 years
I've paid many dues,
But there's nothing quite like
The Not Your Culture Blues.

Fibril_late; 1/07

Toilet seats. What's up with the double seat, one on top of the other, concept? Why not just make one seat that is double thick? In 1995, I looked at this topic right up close, (what was I thinking, you ask); and I came up with some theories. Here's one of them now:

A Tale of Two Seats

Mystified, I am indeed
About this toilet seat,
While one is really common sense
Why two? - It's got me beat.

If it's just a simple case
Of elevated view,
How come bathrooms have no windows
Instead of one or two.

Well, maybe for the shy folks
It's O.K. to have one seat,
And the toilets with two lids
Are designed for friends to meet.

All in all, I'm still not sure
About this complex issue,
And I still can't figure where to put
The sanitary tissue.

Fibri_late; 8/95

Tensions can run high in the care-giving environment. Angry words spoken in the midst of a crisis, can lead to the destruction of friendships. All that is left is the aftermath.

In the Days of Aftermath

Just another casualty
In the days of aftermath,
Trumped up charges, petty crimes
Fear and loathing on the path.

Accusations, hurled in anger
Pressure cooker, tempers flashed,
In the name of jurisdiction
Camaraderie and friendships trashed.

We’re the actors, we’re the victims
Floating face-down in the bath,
Much too late for intervention
In the days of aftermath.

Fibril_late; 6/95

Nurses are hands-down, the masters of the universe, when it comes to dealing with feces. But, that's nothing to brag about, I think!

The Mystery of Life

Welcome to our special
Old fashioned kind of action,
Push up your shirtsleeves
It’s time for dis-impaction,
Bedrest is the burden
The damnation of immobility,
The loss of muscle tone
And G.I. motility.

Nurses far and wide
Despise this ugly task,
You have to get real close
And you need a scented mask,
After milk-o-magic citrate
And a dulcolax bullet,
You need to grope around inside
Find a knobby chunk and pull it.

The colon is lengthy
Sinuous and twisted,
How deep can you reach
When your gloved hand is fisted,
It may require some force
To open the tunnel,
So you may need a grease gun
And a fifty -french funnel.

I focus on the misery
Visited on our species,
The mystery of life
Once again is feces.

Fibril_late; 6/95

What happens when a business leaves a community, after 17 productive years. It's a problem situation with outcomes that stretch into the community as a whole.

Seventeen Years

Seventeen years of loyal service
Out the door with the morning trash,
Save some dollars, remove dissension
The local media, ignores the crash.

Seventeen years of community involvement
Pull up roots and move away,
Spread sheet columns of gains and losses
It’s just another corporate day.

Seventeen years, too much of a lifetime
To be thrown away like yesterday’s news,
Sowing the seeds of revolution
Corporate cutthroats will pay their dues.

Angry bombers and innocent victims
Society bears a burden of shame,
A friend of seventeen years is gone now
The community states, “We’re not to blame”.

Fibril_late; 6/95

More ranting about the days of "reorganization" and all that. The title is a nod to Neil Young ("Keep on Rockin' in the Free World).

Downsizing in the (not so) Free World

Everybody's worried about their job
Will I be working next week,
If I don't pay my child support
My ex-wife will moan and shriek,
She'll threaten me with a lawsuit
And garnish my wages with glee,
But if I don't have a job
She can moan for eternity.

My friends are worried about security
Their seniority is shorter than mine,
Going home with a clear conscience
Is really the bottom line,
If they are laid off and I am not
We'll share some mutual pain,
Downsizing shrapnel everywhere
Leaving its bloody stain.

Reorganization is an industry fantasy
Destroying its structural strength,
Cutting the competitive edge of discovery
When the budgets are pared at great length,
The money that was in our wallets yesterday
Still circulates inside the machine,
Lining the HMO's pockets
They get fat, while we become lean.

The pendulum slows in its arc
Preparing to reverse its direction,
After cutting a swath of destruction
It's time for a little inspection,
The unusual pattern of injury
Tells a tale of dishonesty and greed,
As the downsizing moguls of mayhem
Return again and again to feed.

A workforce is like a foundation
Supporting the structural frame,
You can take it apart a block at a time
But it's a Russian Roulette kind of game,
Understanding the risk of mortality
While betting the odds of survival,
Nonetheless shocked when the bullet
Makes its untimely arrival.

Everyone’s worried about living
In the cost cutting days of Our Lord,
Insurance companies becoming much richer
While there is little, that we can afford,
What recourse is there, for the little guy
Struggling at the end of the hook,
Maybe it’s time for a revolution
Rewrite the current chapter of this book.

Fibril_late; 6/95

I got to thinking that the hospital could be characterized as a specialty restaurant, where you could order just about anything you wanted. Thus was born, "Flo's Diner".

Flo’s Diner

Bring your family and friends
To sample our food,
An eclectic selection
Cooked by Chef Dude,
An expert on fish
His favorite is sturgeon,
He moonlights for money
As a Cardiac Surgeon,
He interviews customers
In his favorite recliner,
And gives them free drinks
Down at Flo’s Diner.

High fat or low fat
Whatever you wish,
Cholesterol entrees
With your favorite dish,
TPN slurpees
And Pulmocare punch,
Fantastic nutrition
For an affordable lunch,
You want it, we’ve got it
Just don’t be a whiner,
That’s the only restriction
Down at Flo’s Diner.

Stop at the jukebox
And drop in some change,
Our music selection
Covers a range,
From the Screaming Tourettes
To the Stokes-Adams Blasters,
The Korsakoff Kids
And the Menopause Masters,
No musical menu
Could ever be finer,
Than the soothing tones found
Down at Flo’s Diner.

Chef Dude is an artist
When it comes to dessert,
He knows human nature
And what makes us hurt,
For the sweetest delights
The man is an ace,
He has studied the ways
For stuffing your face,
A vociferous vocalist
He knows every one-liner,
You’ll have nothing but fun
Down here at Flo’s Diner.

Fibril_late; 5/95

About trying to kick the coffee habit, and the possible alternatives.

The Coffee Grip

I tried to kick
The coffee grip,
Because my heart
Began to skip,
Occasionally
I felt a pause,
Which made me wonder
About the cause.

Am I anxious
Should I worry,
Is my life, just
Too much hurry,
Is it age
Or lack of bravery,
After years of
Repressed slavery.

I talked it over
With my Doc,
I left his office
In a shock,
Because he offered
Fix-it schemes,
That echoed Doctor’s
Greatest dreams.

And then I couldn’t
Stay awake,
Each night at work
With lives at stake,
So, I embraced
The coffee bean,
Because all-in-all
It’s a healthier scheme.

Fibril_late; 5/95

It was the early mid-1990's here in our capitol city; almost every hospital in town was reorganizing into some kind of "it's the best way to save money", business model. Well, we all know what a total flop that was and the entire health-care industry is still reeling from the long-term complications of that debacle. Can you say "nursing shortage"? They left in droves, never to return; thanks to the Cost Cutting Days of Our Lord.


The Cost Cutting Days of Our Lord

Health-care downsizing?; you have to be kidding
That’s the typical political flash,
It’s a high stakes game of money, my friend
With the HMO’s grabbing the cash.

My unit was closed last week
I was angry because I wasn’t told,
I’d been a productive slave
Now suddenly I’ve been sold.

There is little threat of losing my job
I’ve been here forever and more,
They’ll redefine my job description
Then send me to some other floor.

With my accumulated years of seniority
I’ll displace someone else on the heap,
When that guy loses his job
I won’t be able to sleep.

The wages are frozen, positions unfilled
In contrast, the workload has soared,
Top CEO’s, whose salaries are doubling
In the cost cutting days of our Lord.

Fibril_late; 5/95

A true story that I wish could be played back. We could try different interventions, like maybe an Intra-aortic balloon pump. That was probably the only thing that would have helped. It's always wrenching to second-guess in the aftermath of disaster.

This Moment in Our Fame

Another San Onofre’ meltdown
Was headed for our floor,
A mystery diagnosis
Seven drips and so much more,
A scant report was taken
On the phone an hour past,
I was ready for disaster
But the time went by too fast.

A commotion could be heard
In the hallway by the door,
As I walked to meet the entourage
I tallied up the score,
The patient was attended
By a crew of EMT’s,
With a Doctor and a Lawyer
Haggling over fees.

A hundred different IV lines
Were tangled on the gurney,
I had to push aside the Doctor
And wrestle the Attorney,
To acquire my position
Of authority and leverage,
I tossed them both a dollar
To get some candy and a beverage.

With the patient safely settled
And his life support attached,
I did a brief accounting
To see if facts and figures matched,
Then I sent some bloody lab tests
To bring us up to date,
When we had gathered all the data
We could figure out his fate.

In the meantime I was struggling
With a metabolic mystery,
Profound acidosis
And a complicated history,
Respiratory failure
In cardiogenic shock,
There weren’t a lot of hours
Left upon his clock.

What a night, it seemed like days
But the morning finally came,
Was he better?; not at all
Though we’d fought a vigorous game,
We had stabilized his pressure
But his oxygen was worse,
In this metabolic setting
Could his heart rate be the curse?

In the future we’d look back
At this moment in our fame,
We’d search for untold answers
And try to shake the blame,
That the choice of intervention
In this case, to beta-block,
Was the icing on the cake
In fact, it stopped the clock.

His heart rate slowed, that was the plan
But the progression wouldn’t stop,
His pressure held on for a bit
But soon began to drop,
The Code-blue team performed on cue
But the fiber of life unraveled,
Before the survivors left the scene
His soul had long since traveled.

Another San Onofre’ meltdown
History written in a book,
We could read the notes in retrospect
To contemplate, to look,
Prepare to meet the future
A little wiser, that’s for sure,
In certain situations
Beta-blockers aren’t the cure.

Fibril_late; 5/94

Some nonsense about bleeding where I butcher all poetic syntax; and then a poignant tale of a little old lady with dementia, who should not have had open heart surgery.

Where It Spurts

Hemorrhagic shock, oh my
Too much leaks and then you die,
You have to find out where it spurts
And the mechanism of the hurts.

Compensatory means
Of life survival,
Forego thera-
peautic arrival,
Recognition
Is the key,
And that comes down
To you and me.

Mama, Mama, Mister

Mama, mama, mama
She chanted all night long,
It was just a long refrain
To the, “Mister, help me” song.

So confused, she had no clue
That her chest was sawed in half,
She said, “Mama, mama, mister, lord”
So much we had to laugh.

Her nights stretched into days
The days became a week,
Her mantra echoed in the halls
Our situation bleak,
Because we couldn’t send her home
In her current state of fitness,
The program might be threatened
If she was called to be a witness.

Now she’s parked out in the pasture
Because we didn’t have a choice,
If you’ll take the time to listen
You can hear her plaintive voice,
Chanting, “Mama, mama, mister, lord”
Come help me won’t you please,
Or it might be just a trick
Of the early morning breeze.

Fibril_late; 3/95

Nurse: The mighty protector! Even dragons whimper before us.

That Nurse At Your Bedside

Welcome to our hospital
We’re renowned by advertising,
Come into our heart center
You’ll find the care surprising,
The nurses, a cohesive bunch
Have slaved for many years,
Studied hard and honed their skills
To minimize your fears.

Each one a patient advocate
Each one your only friend,
When life and death are racing
Towards a painful end,
Experienced in hand to hand combat
Experts in knowing what’s next,
On the lookout for unforeseen danger
Like doctors who don’t read the text.

So honor your bedside companion
Your survival is no fickle of fate,
Forget all the doctors and interns
Your nurse knows if death has a date,
Regardless of your final destination
Of your body or even your soul,
Remember that nurse at your bedside
Is the ultimate one in control.

Fibril_late; 3/95

Fads of phobia's, egads! Sounds like a 1990's thing.

Disorderly Conduct

Every day I think I hear
About some other kind of fear,
A phobia for every man
Is the 1990’s plan.

The industry of fear ablation
Enables this neurotic nation,
While the victims gladly pay the fees
For a multitude of therapies.

Practitioners claim a cure for all
And a voice mail number you can call,
With testimonials abundant
A second opinion would be redundant.

An animal guide or spirit master
Can help you solve the problem faster,
It’s the best thing going, take my word
There’s no messy cage with a spirit bird.

To summarize, I will agree
There is a place for therapy,
Though I think it represents a fad
About the treatment everyone has had.

Fibril_late; 2/95

Amidst chaos and disaster, a simple story of love.

Linguistic Angel

Tragedy, horror, oh tragedy
Where is the foreign translator,
This patient is babbling furiously
And I am beginning to hate her,
She's decompensating, her heart is in failure
And she won't let us take off her clothes,
Diuretics have made her incontinent;
I'm by her side, holding my nose.

A pretty young lady, a linguist
Enters this scene of disaster,
She says a few words to the patient
Who responds in her language much faster,
She states, "All I have is a fever"
As she clutches her urine drenched pants,
The linguist is gasping for breath
As I assume a formidable stance,
With the help of another brave nurse
We approach clothed in full body plastic,
Our mission: to apply bladder drainage
Before the old lady gets spastic.

With the mission accomplished, I turn
To the linguist now on the floor,
The air must be fresher down there
Because she's doing the crawl, towards the door,
Before I can halt her departure
She has gone, without leaving her name,
I've been saved by this angel of language
And now my poor heart is aflame.

I called upon translator services
To discover the name of the lass,
But no one could match the description
Was it just an effect of the gas?
Some toxic ammonia illusion
My senses all out of control,
No, no, I just can not accept it
That girl had a body and soul.

Now I wander the miles of hallways
My purpose is clearly spectacular,
To find her and tell her I love her
That angelic girl of vernacular.


Fibril_late; 2/95

The ethical dilemma of this day and age; allowing people to make their own decision when to die. Nurses hate getting stuck in the middle, because we hold ourselves to be patient advocates, and if the patient wishes to die, the wishes of the healthcare team should not interfere.

To Be A Dead Man

I want to be a dead man
I do, why can't you see,
Withdraw my life support
And let the angels come to me,
I thought I'd made it clear
About the treatment I desired,
If I only had the clout
I'd have my doctors fired.

I want to be a dead man
My organs all are shot,
My wife died seven years ago
And children, I have not,
I have no living relatives
To squander my estate,
And now I'm being tortured by
Some medical miracle fate.

I want to be a dead man
Gosh darn it, let me die,
Every night and day
I'm filled with pain
And still you question why,
The Medical Ethics Committee
Came by and wagged their tongues,
They refused to turn me off
Because I still have working lungs,
But I could see the dollar signs
Trail their footsteps on the floor,
As those unethical medical morons
Went marching out the door.

We fawn in all our glory
About this modern age of science,
With ten thousand types of medicines
And each year a new appliance,
To banish all the beasties
That plague the human race,
Because we’re so afraid of meeting
Our mortality, face to face.

Well, some of us are ready
To walk the paths of death,
Prepared to make the journey
And cease the physical breath,
It’s as natural as the passage
Of a day into its’ night,
And it’s morally unethical
To deny this basic right.

Fibril_late; 2/95

Here's a follow-up to a post a few days ago, about the language challenged rail diver.


Over The Rail

Out of bed again
He’s way to big, I’m afraid,
When the sun comes up in the morning
He makes a lot of shade.

Over the rail he goes
Down to the floor on his butt,
His legs too weak to lift
His ponderous, bulging gut.

May the god of workman’s comp
Bestow on me a gift,
I need a miracle from heaven
A nuclear powered lift.

His surgery is in the morning
Should he survive the night,
He just might die before then
If he takes another flight.

This choice of work is dangerous
Sometimes it makes me gulp,
If this blimp collapsed upon me
I’d be reduced to pulp.

Fibril_late; 2/95

This one was written by another nurse friend. It looks at the often, snooty way that doctors talk down to us nurse-peons. Oh, how good it feels to turn it back on them.

Bluer Than Blue

The Doctor’s looked up
And one of them sighed,
As the Code-team ran in
To see who had died,
But the patient was sitting
In the chair as he fed,
His leads in one hand
Quite clearly, not dead,
He said, “I am sorry
I turned off the alarm,
The cords wouldn’t reach
And I thought it no harm”.

Yes, the Code I had called
Was bluer than blue,
And I hate to admit it
But I wish it were you,
I stood there embarrassed
As the Doctor just sat,
He said, “Don’t you know sinus rhythm
From a rhythm that’s flat,
Would it help if I drew
Some P-waves and such,
To show you the difference
Or would that be too much”?
And he laid it on thicker
Through each smile and smirk,
I already felt
Like a number one jerk.

I can not remember
The last words that he said,
Because the patient slumped over
And looked very dead,
Not a breath, not a pulse
So I gave a quick shock,
As he came back to life
I just looked at the Doc,
I gave him a smile
And nodded my head,
Then I winked at the Doctor
“Intuition”, I said.

Steve H./ 4/'95

Heard in the news a month ago; some famous guy died. The story related that he had gone under the knife for not just one or two, but 3 cardiac bypass surgeries! It reminded me of this poem I wrote in 1995.

In Love With Your Disease

It is morally unethical
To waste our money on these sinners,
The ones that abuse the cigarettes
The alcohol and high fat dinners,
Revasculated bodies, we saved them
And what for?
They’ll resume their usual habits
When they exit out our door.

We ought to offer just one trip
On the luxury surgical cruise,
Forgiveness for their sinful ways
Why, everyone pays their dues,
But should they come back crying
And begging, “Doctor, please”,
We’ll send them packing, “Sorry, pal
But you’re in love with your disease”.

Fibril_late; 4/95

Just yesterday while listening to NPR, I heard a medical researcher, discussing at length the detriments of lack of sleep, on the overworked Residents and Interns, who commonly work 2 thirty hour days, each week while in training.
Over 10 years ago, I did my own research and discovered PVS; the Persistent Vegetative State.

Persistent Vegetative State

There’s an all pervasive condition
Rampant in medicine today,
It crosses all sociological boundaries
I’m concerned that it’s here to stay,
Overt in the overworked intern
To become concealed at a much later date,
Abbreviated as P.V.S.
The persistent vegetative state.

There’s a glazing of the eyes
When information must be extracted,
The mind just a jumble of synapses
The thought waves hopelessly impacted,
No cure has yet been discovered
To treat this unfortunate bunch,
Though, there’s a cottage industry developing;
They make a great planter, at lunch.

Fibril_late; 4/95

More complications in the teaching setting. Every year, rethinking old ideas, with fancy new formulas and tools. It's enough to drive you bonkers!

Fancy Formulas

Each year the vascular hobbyists
Play with a brand new device,
In the name of research and development
The golden boys pay any price,
To maintain a national ranking
And thereby attract research dollars,
The University plays right along
Granting the wish of the scholars.

Down in the battle scarred wards
The nurses are screaming, “Unfair”!
Inundated by this years’ new formulas
They hardly have time to give care,
The vascular intern on rounds
Is demanding the latest results,
Suddenly, I see an analogy
Between science and paganism cults.

They rely on their own special language
And a feeling of limitless power,
They’ll demand your utmost attention
To listen to them for an hour,
Traditionally, the charismatic leader
Is regaled as a genius by his clan,
And just like the doctor in charge here
The megalomaniac is a man.

What does one do in this setting?
Wear garlic and carry a spike,
If an intern should get in your way
Hold your papers and scream, “Take a hike”!
Because sooner or later he’ll learn
The valuable facts he must know,
That no matter how fancy the formula
A nurse is a friend or a foe.

The equations of shunt and elastance
Heat transfer, compliance and Fick,
Creatinine clearance and anion gaps
Are enough to make anyone sick,
Hemodynamic parameters
With cerebral perfusion indices;
If you don’t know your way in these waters
You just might be the one causing crises.

Fibril_late; 4/95

We've all the read the news accounts about people who have had the "wrong" part removed, such that now, they still have to have the "bad" part removed, that was intended for amputation in the first place. Just imagine the lawsuit!

Undefined Compensation

Amputated the wrong leg
Cut off the wrong breast,
If life is a lesson
Then this is a test,
We'll proceed with forgiveness
As we march to the court,
They took off the good parts
And now they're selling us short.

Removed the wrong hand
Took out the wrong eye,
You might call this living
But we want to die,
We'll proceed with forgiveness
But these Doctors must pay,
They took off the good parts
And that's not OK.

Each side will gather lawyers
And medical scholars,
To define compensation
In a matter of dollars,
But you can't say we're happy
With the settlement planned,
It's tough to applause
When you don't have hand.

Fibril_late; 4/95

Working in Intensive Care Units (many different types, many people dying) I came to realize, that Nurses had an opportunity to play a unique and special role, as advocates and agents to the living, who would soon be dying. It was not our choice, what their final destination would be.

Agents of the Afterlife

It’s a savage beast of an undertow
That steals away the breath,
In these evil lands a shadow stands
To escort the mystery death,
As agents of the afterlife
We have a bill to sell,
To guide those worn and weary souls
To heaven or to hell.

Fibril_late; 1/95

English as a "national language" - give me a break. We don't live in England; we live in the country known as the "melting pot". Lately it seems like our pot is having a meltdown, but that's a political issue. What I'm talking about here, is dealing with an ill patient who doesn't speak a word of English, and there isn't a translator within hollerin' distance. Rudy Burmenko, talked to us fluently in Russian, as though we were his compatriots. All I knew in his language was "Yes, no, pain and toilet". That's all a nurse needs to know, right?

Life and Limb

Don’t get me wrong
It’s not a song
Of foreign persecution,
But the language challenged victim
Demands a difficult solution,
When I say, “Sir,
Just wait a minute
Don’t climb out of bed”,
He smiles broadly
Takes the plunge
And falls upon his head,
The family wants to sue me
This financially challenged gringo,
I’ll counter-charge, upon the grounds
He should have known our lingo.

Consensus says, the kids will learn
The language from their peers,
While the immigration parents
Hoard their native speech for years,
A cultural dichotomy
This comfort zone mentality,
Finds me risking life and limb
I may be the next fatality.

Fibril_late; 1/'95

Becoming an adult; when does that really happen? Not sure, but I don't think it's an age thing.
Here is an up to the minute, latest rant, about a couple young adults, in my adult education class. If you read this, you know who you are. The class is Massage Therapy.

Talking in Class

Unfortunately I, have been with the adults
Not the quiet ones, that hang with cults,
These talk so constantly, in the midst of a study
With their colloquial, localized age-related buddy,
They're speaking about hot cars and dudes
Jammed up in the jail, doing 'ludes,
And the hemi-headed Mustangs with lifters
Hip-hop artists, in cahoots with shape-shifters.

While I'm just about going, so deep 'round the bend
Imagining ways I could personally suspend,
These two classmates, to the hellroom of perpetual doom
They should be in the parking-lot, while I stay in the room,
Studying and learning, in the way that seems best
Because this is a classroom and this is a test,
Of my best darned behavior, in this time of dire need
If these guys don't shut up, rest assured they will bleed.

In the context of my imaginings
I'm not violent at all,
A hit-man in secret
I don't hear the call,
But even I, have my limits
Within the classroom, in this place,
Keep your personal life at home
Before I get in your face;
About talking in class
Regarding fights, cars and what?
Do you know all the actions
About the muscles of the gut?
Or maybe the Trapezius
Movements instead?
If you can't describe these
You get a boot to the head!

It's all about self-control, calmness and Chi
Shut your mind and be quiet, and listen to me,
The classroom is sacred, relaxing and peace
You must be like an iron, and make a good crease,
Stay good and well home, unless you're defined about learning
If you can't focus and study, there will be no future earning,
And while the rest of us suffer, through your endless jabber
There's a contract on you by Jack the backstabber,
At the end of your rope, you're now at the juncture
To make like a mannikin, so we can practice acupuncture.

Fibril_late; 12/1/2006

Cerebral Aneurysm; it kills the young and the old. You better be near "911" for you to have any hope of survival without sequelae. Sometimes there can be symptoms of headache, but very often, there is no pre-warning, thanks to our amazing bodies and our ability to cope with adversity. So, if you should feel as though there is a hammer on an anvil in your brain, maybe you ought to have it checked out!

Hammer on an Anvil

Cerebral aneurysm
Malformation in the brain,
You have a splitting headache
Doesn’t quit, it’s too much pain,
Close the windows, pull the curtains
Lay in darkness all day long,
Your sudden death would mean relief
Unclear what’s right or wrong.

A hammer on an anvil
Beating ceaselessly inside,
Excruciating torture
Doesn’t stop, good lord you’ve tried,
A thousand different measures
That never halt the pain,
Cerebral aneurysm
It’s a time bomb in your brain.

Fibril_late; 1/95

'Tis the Christmas season again. No matter if you have any sort of affiliated religious connection to this major U.S. holiday, is of no interest to me. I just know it's worthwhile to consider it a special time of year. And that's a "Happy Holidays" to members of the gang factions, too. They seem to celebrate this time of year as well, in their own certain way.


Oh, Glorious Night

It's a typical night
In this famous village,
With the peasants performing
Their usual pillage,
With gunshots galore
At a drug transaction,
Relieving our streets
Of gang impaction,
Oh, glorious night
Our business is good,
Emergency patrons
The boys in the hood.

There's a typical crowd
In the waiting room,
A grim faced bunch
All dire and doom,
Posturing boldly
With threatening looks,
Like evil transgressors
In comic books,
Oh, glorious night
In this Christmas season,
Who are we saving
And what is the reason?

Do unto others
As they do unto you,
This teenager wants
A stitch and some glue,
A colt 45
With a nine shot clip,
Fully automatic
He shoots from the hip,
He's a wired little monster
Looking for a fight,
Deck the halls with dead bodies
On this Christmas night.

Fibril_late; 12/94

Why is it called "practicing" medicine? Wouldn't you rather have some one "skilled" at medicine, instead of just practicing? I might practice the piano for 40 years and never be good enough to perform, but even if I play 27 wrong notes, nobody will die; at least I don't play that bad!
And then there is the whole thing about people who destroy their bodies, and then expect society to pick up the tab. And along comes the outraged family, who seem to think that we can create a masterpiece out of faulty materials!?!

Training the Scholars

Cirrhosis cause by many years
Of IV drugs and a million beers,
Disabled with his liver disease
He wants a medical miracle please.

On public assistance, he has no job
No health insurance plan to rob,
Saint Mother of Money hospitals, say
"Don't come to us, if you can't pay".

So, off to the University joint
We charge triple, that's the point,
All in the name of research and knowledge
You have to remember, that this is college.

Last year Biology, frogs in the lab
This year an Intern, people on a slab,
Poking around for landmarks unseen
Unlicensed drivers on every machine.

You chose the lifestyle, of abuse and addiction
Now you're begging for help, to reverse the affliction,
You agree to proceed, did you pause to repent?
There's a chance you will die, but you gave us consent.

Your family is angry, they threaten to sue
But you know the truth, the blame is on you,
And it seems like a waste of our health-care dollars
But then I remember, we're training the scholars.

Fibril_late; 12/94

Last year a remarkable young woman from California, died in Iraq. She was killed by a car bomb blast in Baghdad. She founded the Campaign for Innocent Victims in Conflict (CIVIC), an organization that assists Iraqi victims of the 2003 US invasion of Iraq. I was moved by her story and her dedication to her self-assigned task, to help those in need in Iraq. If you haven't heard of her, check out CIVIC: @ http://www.civicworldwide.org/

A Disturbance in the Force

It’s a movie cliché’
But it speaks to us all,
Marla Ruzicka was chosen
By the grim reapers call,
He trails in the shadows
Of the footfalls of men,
Who wage war on the innocent
Again and again.

She was the purity in the wasteland
The light in the dark,
Such strength for the victims
An ember, a spark,
Her vision a firebrand
To make us aware,
And walk a path through the wilderness
With compassion and care.

At 28 years,
Too early to go,
But her work will be legend
I want you to know,
How one person with focus
Someone’s wonderful daughter,
Can cast waves to infinity
Like a ripple on water.

4/20/05
Fibril_late

I am often humbled by the mystery of love and support that people display towards those who mean the most to them. This was written about a woman, a mother, a wife, a person, spending many months in a hospital for severe and chronic respiratory failure.

Humbled

"This lady is fun"
Her daughter said to me,
The portrait on the wall
Displayed her lovingly.

She held her mothers hand
And gently stroked her hair,
It felt like I was standing
In a sanctuary there.

Her husband gazed into her eyes
And only saw her beauty,
He'd gladly suffer all her pain
In love, and not for duty.

The part I played seemed minor
In the drama on this stage,
I felt just like a footnote
At the bottom of the page.

"My mother is the strong one"
Her daughter said to me,
And in a moments silence
I was humbled by the three.

11/94

Amidst a little nonsense, there is a poignant message about Love. If "true-love" is truly unconditional and non-detached, then that love can let go, and allow a person to die, when it is obviously their time to go.

Love Is Letting Go

Why go on
When your body has failed,
Why send a letter
That never was mailed,
Why own a comb
If you've lost all your hair,
You can't hold your breath
If there isn't any air,
Why go on reading
If it isn't making sense,
Can you say you have a farm
If it doesn't have a fence?

Why prolong the suffering
Of the one you love the most,
Are your grief and loss so great
You are clinging to her ghost,
Sit beside her, hold her hand
Feel her pain and you will know,
That love is giving and receiving
And love is letting go.

Fibril_late; 11/94

Thanksgiving. It certainly touches a place inside for me, being far away from my original family; they all live in the Midwest, whereas I am in the "out west" as we used to call it as children. So I was looking for something I had written, about old time friends, knowing that it's always good to remember to remember. I'm writing to this and listening to Albert Collins...."If Money Were Trouble, I'd Be A Millionaire". Check it out and download it to your iPod.

A Longtime Friend

Words have their limitations
To express the deepest meanings
The greatest writers hold their pens
And pause for inspiration,
They are waiting for a voice
Or some subtle distant music
Perhaps a ripple on the water
Or a tickle of vibration.

Or perchance a longtime friend
Has been hidden by a shadow
Overwhelmed by circumstances
And struggling in the riptide,
If you wait there, at the shoreline
Like a lighthouse, never moving
Know for certain, you are needed
To mend the great divide.

And even when the distance
Is enormous by a measure
Know your actions are important
Despite how small they seem,
When we keep our loved ones with us
In the center of our hearts
The woven fabric of our lives
Is the dream within the dream.

fibril_late;
12/18/04

Emotional abuse; what we say and how we say it to others, particularly those who are closest to us, is a twisted way to showing "we care". Someday, that table is turned, and it comes back to us. Ouch!

Terms of Abuse

I tell little stories
Of life, death and bravery,
Unlimited options
To counteract slavery,
Of the words, thoughts and actions
Created by men,
May my stories reveal
The abuse once again.

On a personal level
It's a look at the past,
On a day by day basis
It goes by so fast,
That you have to watch closely
To see the threads of misuse,
Human lives are at risk
In terms of abuse.

Was it something you said
To your spouse in the morning,
A cutting remark
That sliced without warning,
Your shirt had a wrinkle
Or she drank all the juice,
Your complaints, so unloving
This is emotional abuse.

Later, at work
To your employee you say,
"You're doing it wrong
So do it my way",
Your demeanor is threatening
Like a tightening noose,
You're dishing it out
In heaps of abuse.

A buddy at lunch
Whispers, "Hey, did you hear,
That chick over there
She really is queer",
Like the sinking of ships
By the lips that were loose,
Words of gossip, my friend
Are a form of abuse.

At home after work
As a husband or father,
Your daughter says, "Daddy"
And you say, "Don't bother",
You sleep on the couch
Because sex was refused,
Wondering why you're the one
Who gets so abused.

Fibril_late. 11/04

Many painful poems, or poems about pain, depending how you interpret my writing.

Well Disguised Lover

I have witnessed so much pain
But when can one say, "too much",
It's an ongoing dilemma of man
Because pain is a matter of touch,
A signal to pay close attention
To our singular state of being,
And as a giver and taker of pain
I suffer from what I am seeing.

Do you harden your shell for survival
Do you harden your heart if it's breaking,
Do you pray to the Gods for your strength
And offer the pain that you're taking,
Do you turn to the bottle for numbness
Because their pain is making you cry,
Do you pray to the Gods for forgiveness
For wishing that someone might die?

Pain is a double edged sword
It cuts everyone within reach,
Pain is a friend or a foe
Its' objective, is only to teach,
Examine the pain that you're feeling
Touch it until you discover,
That healing is just letting go
Because pain is a well disguised lover.

Fibril_late, 11/94

This one is a heartbreaker. True story of young woman 21, dying of a drug overdose. I uncover the root cause of the distressing reality.

Only Time For Tears

Twenty-one, is just too young
To die from an addiction,
It points a finger at a cause
A glaring dereliction,
A charge is made that someone failed
To raise the child right,
Her parents bow their heads in shame
Their grief returns each night.

When interviewed, her fourth grade teacher said
"She was so quiet",
The school nurse that came monthly, wrote
"She really needs to diet",
Her brother teased her constantly
And called her awful names,
Her self esteem belittled
In all his clever games.

Her father was a busy man
He'd say, "Later child, I'm thinking",
She loved him like a daughter would
And didn't see him drinking,
Her mother came home late each night
She'd smell of smoke and beer,
There was never time for family stuff
They'd always say, "Next year".

Her city didn't give much thought
About those too young to vote,
It was real-estate and industry
And "Restore the River-boat",
The library, her favorite place
Was closed, for lack of vision,
By the city council members
"Waste of money", their decision.

The local voice, the newspaper
Would rail about "Our youth",
Hanging out and unemployed
And never print the truth,
Taxpayers in an uproar
Police prepared to scrimmage,
Who cares about the lousy kids
They're ruining our image.

Seemingly unwanted
She withdrew for her protection,
She buried all her feelings
In the absence of affection,
With no guidelines of behavior
Or a sense of wrong and right,
She listened to outsiders
And sought solace in the night.

Yes twenty-one, is just too young
To die from an addiction,
The grown-ups she relied on
Performed her crucifixion,
Nailed her to the cross of life
Without a chance to live her years,
Her death is such a tragedy
Now there's only time for tears.

Fibril_late; 11/94

How crass, they will say. The terms of "kill" and "atrocities" are merely euphymism's for describing some of the wild scenes like emergently opening someone's chest to do open cardiac massage, or drilling into a patient's head to relieve pressure. So dear public, understand, everything is on the up and up and entirely copasetic; no snafu's present.

Code Team Member

I'm a code team member
What a thrill,
It's not called murder
When we kill,
It's either a save
Or he didn't make it,
No reason to cover up
Or fake it.

We commit atrocities
So very often,
Who bothers to look
Inside the coffin,
It's all in the name
Of the healing arts,
We're always looking
For donor parts.

We've got a transplant
Program here,
We pickle the organs
In ice cold beer,
The surgeons have
The whole thing mastered,
And just like the organs
They're totally plastered.

So, as a prominent member
Of donor acquisition,
I'll proudly direct you
To a well known physician,
Who will sell you a condo
On body failure road,
And before you know it
You'll be the next code.

Fibril_late; 10/94

I applied to be a member of a Transplant team, and it struck me, that having clients that were dead might be ok. It wouldn't matter if I was a slob or not. Thus begat:

Donor Manager

I wanna be a donor manager
I really do,
I always took apart my pets
To get a better view,
I'd pop a couple eyeballs out
For marbles with the boys,
There wasn't anyone I knew
Who had my kinds of toys,
So I think I'm really qualified
To get this sort of job,
It won't matter to a dead man
That I'm really just a slob.

Fibril_late; 10/94

Bonus post of the day!

A Cute Patient

Given a preference
Though the point may be moot,
I’d rather see a cute patient
Than a patient, acute.

Fibril_late; 2/04

A couple of things ran through my brain on this one. First, in my early years as a Respiratory Therapist, I did know of a patient that "exploded". Some weird edema thing that blew up their head. It was ugly. Then another time a patient that had a violent skin reaction to pronestyl, where their skin peeled off like the sunburn from hell. And last of all, it's about the horrid state of end stage diseases, where you'll hear the stupidest comment on earth, "Oh, he's lucky to be alive". Ya, just like that Ariel Sharon guy in Israel. Hello! Brain-dead isn't anything to rejoice about -- "lucky to be alive"; yes, quite easily the most unkind statement ever.

Lucky Man

Itching uncontrollably
Flesh in patches peeling,
When I explode, they'll need a knife
To scrape me off the ceiling.

Veins that once were viable
And a heart that pumped the juice,
I've had a bowel infarct
And now my stools are loose.

Since a nasty brain stem insult
I can not take a breath,
They tell me, I'm a lucky man
I've somehow cheated death.

Fibril_late; 10/94

I can't keep silent about the epidemic of obesity. This particular person weighed greater than 900 Lbs! We didn't have human-lifting equipment large enough to accommodate this fellow, so it usually fell upon the shoulders and backs of 8 people. Our CCU was small, so there were never 8 people working. We would have to enlist help from nurses from another ICU to help us. Now, everytime I see people walking around who are >300 pounds, I think, there goes another Nurse killer. Because someday (and probably soon) that person will be floundering in a hospital bed somewhere, incapable of moving themselves, and ultimately may play a part in ruining someone's career with a back injury.

Just Attracting Flies

He's a whale of a man
And he's beached upon our floor,
He gained a hundred pounds
And he won't fit through the door,
Moving him is murder
He's busting nurses backs,
We lost a couple good ones
When they died of heart attacks.

We'll have to size and quarter him
If he ever dies,
Otherwise he's trapped here
Just attracting flies,
Or maybe we will witness
An angelic intervention,
We're praying pretty hard
For chariot ascension.

But, I have some major doubts
If Saint Peter will allow,
An admission into heaven
Who requires so much chow,
His afterworld departure
Will therefore be delayed,
He'll have to stay on earth
Until he has decayed.

Fibril_late; 9/94

Mold! It's everywhere and in the hospital it grows most stupendously in and on warm, damp, dark, hidden places. Many of us humans, harbor these pathogens, often to our detriment. But not so, to this strange fellow in this latest poem.

Gluteal Cheese

When you can't dry the moisture
In the gluteal fold,
You probably will develop
Some gluteal mold,
It's better than yogurt
It rivals French cheese,
It's really quite a delicacy
The Creme de Menthe of disease.

Fibril_late; 9/94

Adolescent humor; I excel in it. Gross, unpalatable and just plain funny.


You Can't Beat It, If You Eat It

You may recall a story
Written by a fool,
The author claimed delight
At the sight of charcoal stool,
He held it in his lap
And kept some in his purse,
It's a stress related symptom
Of the so-called, burnt out nurse.

Now me, I've got an appetite
For purulent secretions,
I love to suck the fibers
Of abdominal adhesions,
And savor every bleb
From tubercle cavitations,
For dessert I crave the filaments
From the cardiac ablations.

To get along in life today
Is not an easy feat,
But I've always been the happiest
In a job, where I can eat.

Fibril_late; 9/94

When I was a kid, there was a company that sold a kit for almost anything you wanted to make. I think that would be a great idea for our hospital population as well.

Do It At Home Autopsy Kit

Each night and day
Around the clocks,
We prepare them for
The plain pine box,
We pull the tubes
And cleanse the skin,
There's a zippered bag
We put them in.

Now if you're wondering
How Grandpa died,
You can take him home
And have a look inside,
We'll pay the taxi
Right to your door,
And as a bonus
There's one thing more,
We put a gift in his bag
It was easy to fit,
The "Do It At Home"
Autopsy kit.

Then it's time for twenty questions
Can you venture what disease,
Laid asunder poor old Grandpa
I think it started with a sneeze,
And included with your instructions
Are some recipes (Their winners!),
Just save your favorite body parts
They'll make a lot of dinners,
And when it's time to ditch the leftovers
You can call us at the station,
We'll send you our most popular kit
For do it at home cremation.

Fibril_late; 9/94

Just a little TLC..............well, I've got an acronym for those "back-stabber" types, where TLC = Total Loser Crap; which is what you get when you have to work with people like that.

Total Loser Crap (T.L.C)

You know the type
They have a way,
Of ruining
Your night and day,
They have an attitude
Of ruin,
While claiming
Someone else's doin',
You can't escape
This bogus trap,
Ensnared by
Total loser crap.

Complaints their
Modus operand,
The bold faced lies
Go hand in hand,
They'll take each chance
To stab your back,
So many times
You can't keep track,
There's just no dodging
This phony rap,
Befouled in
Total loser crap.

The only way
To deal with these weasels,
Is to expose them to
The German measles,
Infect them with
Some mutant strains,
Designed to blenderize
Their brains,
Then hopefully
Their jaws won't flap,
With all that
Total loser crap.

Fibril_late; 9/94

Parking-lot Attendant; it's a dirty job, but someone has to do it. Right? And if you have never gotten a ticket, lucky you. The rest of us citizens, have special words for their species and I can't reveal them here. But I can rant and rave to my hearts content.

Exhaust Sucking Meatheads

I'm a hard working serf
For a local employer,
It's been a fine place to work
But now I need a good lawyer,
Because the parking-lot attendants
Have gone one step too far,
Those power hungry gnats
Have ticketed my car.

It's a typical situation
For powerless peons,
A self esteem vacuum
That's gone on for eons,
They're assigned special uniforms
With pseudo regalia,
A flashlight and notepad
And other paraphernalia,
They're at the bottom of the barrel
In the hierarchy tower,
Groveling for a sense
Of fictional power.

I pay my monthly dues
Like clockwork, on time,
I never break the speed limit
And I stop on a dime,
But those exhaust sucking meatheads
Are hot on my trail,
And if I don't pay this ticket
I might go to jail.

To be honest with you
I'm not the last to admit,
That our local parking problem
Is a big crock of shit,
Big brother is charging us
A leg and an arm,
Exploiting us peons
While we work on his farm;
Why not gouge the customers
Like we do in the store,
Get them coming and going
For ten dollars more.

This city is famous
For its lung wrenching air,
I participate in a car pool
Because I'm environmentally aware,
But as drivers, we receive
A group parking I.D.,
It's the crux of the problem
Why they ticketed me;
There is no provision
If I'm working overtime,
There will be no compromise
From these parking-lot slime,
If I'm driving alone
Without the parking pass,
The scum of the earth attendants
Will ticket my ass.

If any one knows
A lawyer without scruples,
I want to mortgage their souls
And gouge out their pupils,
But I won't stop there
I'll take it to the ceiling,
Until the bureaucratic bigwigs
Are ticketed and squealing.

Fibril_late; 8/98

Don't live too long if you can possibly avoid it, otherwise you may be subject to "damaged fate", like this poor fellow (and all those he came in contact with as well).


Damaged Fate

He never rests, he never sleeps
He’s constantly in motion,
His good wife stands beside his bed
Enraptured with devotion,
Upon his face, a frightened look
I think he’s scared of dying,
His wife displays a happy smile
But when she’s home, she’s crying.

He didn’t always look this bad
He used to be a farmer,
His wife would give a little smile
And say he was a charmer,
His kids would swear he never raised
His voice or hand in wrath,
He walked the road of honesty
And never left the path.

But somewhere in the course
Of his catastrophic illness,
A personality synapse
Came unraveled in the stillness,
Now he fights the very people
He depends on for his needs,
Did he spend his prior lifetime
Saving up his evil deeds?

Who knows, it hardly matters
He is chaos incarnate,
His nurses stop and wonder
About their damaged fate,
The family comes reluctantly
Embarrassed for their father,
And as the days and weeks wear on
They begin to think, “Why bother?”

I’m sure you think it’s just another
Case of burned-out nurses,
Who found themselves, some poor old chap
To work out all their curses,
But he pulls out his invasive lines
And soils all the linen,
They treat him with undue respect
But he’s malevolent and grinnin’.

The family wants a full Code Blue
Their guilt is his domain,
He’s devious and still intact
And wants to share his pain,
It hardly matters in the end
His illness has him beat,
He’s a banquet for bacteria
And, how they love to eat!

Yes, once this charming farmer
Led a different kind of life,
Respected in his village
Loved deeply by his wife,
But one day it came crashing down
He had lived his life to late,
And despite our magic medicines
He succumbed to damaged fate.

Fibril_late; 8/94

CVA or stroke can be so horribly devastating, if emergency care can not intervene in time. Imagine being unable to speak or move.................

Slowly Dying, Living Hell

The shock of instability
On previously solid ground,
The shock of broken silence
By an unexpected sound,
The horror of paralysis
In a body that was well,
Trapped inside forever
Slowly dying, living hell.

The terror of an illness
That strikes without a warning,
It erases all the sunsets
And the sunrise in the morning,
The loved ones at the bedside
Stand forlornly, with their sorrow,
Partaking in the agony
As each day becomes tomorrow.

The victim prays that death will come
To liberate her soul,
The family starts to bargain
If only God, could make her whole,
But this illness shows no mercy
It’s a torturous tale to tell,
A family in captivity
Slowly dying, living hell.

At last, the liberation
The agony does end,
A relief for her survivors
But will they ever mend?

Fibril_late; 8/94

Completely off the track here today, because I didn't get time to access the records of "The Underside". So instead, I have a little poem about my niece and the amusing things she's up to with 3 of her friends; precision rope-jumping, of a style known as "Double Dutchess"! Take a look at their website: http://doubledutchess.com/


Double Dutchess

They jump through the ropes
With the greatest of ease,
Those Double-Dutchess chicks
How they dress, what a tease,
The provocative theme
Of their skits makes me snicker,
When they jump, skip and jiggle
It puts a strain on my ticker,
And the park-bench leering geezers
Those randy old men,
Holler, "Keep jumping, chickies
We give you a ten!"

Fibril_late; 6/29/06

Pain. Actually going out of my way, to get a biannual dose of it. Crazy!?!

My Irrational Fear

Don't get me wrong
The lady is great,
But she's not one I'd ask
On a romantic date,
Her features are nice
Her complexion is fair,
But I'm sitting before her
In her dental chair.

We get along fine
But I'm scared to death,
So anxious and nervous
I can't catch my breath,
And what is the source
Of my irrational fear?
The table of tortuous
Instruments here.

My gums will be prodded
My teeth will be flossed,
My insurance company
Will buffer the cost,
But that will do little
To allay my distress,
I derive meager pleasure
From her gentle caress.

I endorse her skill
Her faultless ability,
When the appointment is over
I exhibit agility,
As I leap from the chair
And leave her office on the run,
The lady is great
But she isn't much fun.

So, don't get me wrong
She's a wonderful dame,
But I don't like playing
In her kind of game,
Though you can be sure
That in the upcoming year,
I'll call her again
To reexamine my fear.

Fibril_late; 7/94