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

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
To UCDMC.

Fibril_late; 1995

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

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,
S.I.C.U.
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

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

Who wants to get old and remain happy and productive? Most everyone would agree to that plan. But how about getting old and suffer dementia? Not a very desirable scenario, right? Well, here is one possible avenue of escape.

Demented Blues

Getting old
Don't look too fun,
I'm gonna get
A suicide gun,
Fill it full of bullets
Then hide it in my bed,
When I get demented
I'll ventilate my head.

I want a one way ticket
On the euthanasia bus,
Just let me die in peace
If I get delirious.

Fibril_late; 1993

Oh, my gosh; back to the topic of sputum once again. Since you're just reading the latest poem, you must become aware that I was once a Respiratory Therapist. Yes, many long years ago, prior to my exalted career as a Nurse. So yes, I know the ins and outs of sputum. After a while, one gets an attitude about it all...............

Cauterized

If you spit your sputum
On the floor,
Don't expect me
At your door,
Because the house-rule states
And, I'll be brief,
You have to use
Your handkerchief.

So heed my word
Don't be a fool,
It's easy enough
To follow my rule,
But if you continue
Don't be surprised,
When you find your lips
Are cauterized.

Fibril_late; 1994

In the presence of people with advanced stages of disease, you (Nurse) become sensitive to certain expressions of speech, or how they describe how they are feeling at the moment. Some of those expressions, portend impending doom and disaster.
For example, when the patient who has had a major Myocardial Infarction, suddenly states, "I don't feel so good" , yet all the while, everything has been looking peachy-keen. Don't ask questions, just call out the door, and say something like, "Would someone please bring the crash-cart to room-17, ASAP!!!". Yes, that is a clear example of your critical-thinking skills kicking in (aka, "intuition"). If you overlook it...................

Cruisin' Heaven

A mysterious event
Happened just today,
The man said, "I don't feel so good"
Then his heart-beat went away.

I told him not to do that
But he didn't seem to care,
His heart rate slowed dramatically
Until it wasn't there.

With bells and buzzers ringing
We wailed upon that man,
His color went from purple
To a lovely desert tan.

He received a hit of atropine
Some calcium and epi,
He replied with tachy-rhythms
But his pump just wasn't peppy.

With the force of seven doctors
And the strength of twenty nurses,
Collectively their aura
Dispelled the evil curses,
That had bound him to his destiny
In a room without a view,
Now he's cruisin' heavens highways
With an angel friend or two.

Fibril_late; 1997

A short story about a dying heart..............as told to me by (name withheld by request).

Ectopated

He had some pain
But then, he waited,
Because he didn't know
What it implicated,
Then he got real sick
Or so he stated,
When he became dizzy
And nauseated,
Because it's uglier than pain
When you vomit unabated,
Its the worst, God-awful feeling
That you ever have hated.

So he came into the hospital
To be evaluated,
He was worried that his body
Would soon become outdated,
He had never been a patient
And thought health was overrated,
He had never had a cause
Until death seemed almost fated.

His breathing was tachypneic
His neck veins were inflated,
His rhythm Sinus tach
And very ectopated,
His ischemic myocardium
Gave up and fibrillated,
We zapped him with the stunners
Till his heart electroplated.

Unconsciousness ensued
When his brain waves were ablated,
His astral body floated
To the ceiling elevated,
Then the angel guys arrived
And he participated,
There was no turning back
Because his life force dissipated.

Fibril_lated; 1995

Regarding the study of EKG, it is the topic of Heart Block that appears to confuse most persons. Let's take a look at it:

Demystifying the EKG

At work I ponder images
The waveforms of an EKG,
In the language of the beating heart
It usually is clear to me,
But sometimes I am mystified
About the A.V. block,
It manifests so many ways
My brain goes into shock.

First degree or second degree
Third degree and more,
P-waves are advancing
And can't get through the door,
I must utilize some rules
As my analyzing key,
To unlock the great unknown
Of this crazy EKG.

Fibril_late; 1997

This is another old, Joint Commission rant, regarding how all departments of the hospital must tidy up all their charts and documents.
It is also a poem where, with each succeeding line, the first letter subsequently spells out a phrase as you read downward through the lines. It's kind of a fun exercise in writing.

The Joint Commission

Justify each document
Condense a neat reply,
Harp on education
And answer what and why,
Organize your data

Within a structured format,
Anachronistic rules
Need you for a doormat,
There is really little
Sense to this, And I will tell you why

Piles of needless documents
Are mounting to the sky,
Plugging up the landfills
Eliminating trees,
Reasoning is absent, I think everyone agrees.

Fibril_late; 1996

Ok, (not OJ, ok?).
3 days a month, I am an Instructor in a class of students learning the fine art of Basic Cardiac Monitoring. I tutor as well. Over the years I have written quite a few arrhythmia poems and this one too, about AV conduction.

Just An Impulse

I'm on a Roman holiday
To find the Mother Lode,
The treasure map I'm following
Describes the A.V. node.

Yes, I am just an impulse
A vector plus or minus,
Traveling on a pathway
That started at the Sinus.

I'm scheduled for a rendezvous
A well earned coffee break,
A hang out at the Junction
To discuss which road to take.

At the crossroads there's a signal
That will guide my future travels,
If I violate the timing
Synchronicity unravels,
Then the trip that I had planned
Will require transformation,
As an impulse, I may follow
A course of aberration.

In the future I will hire
A tour guide for instruction,
As a stimulus, I must know
The pathways of conduction.

Fibril_late; 1998

Allegory is a form of extended metaphor, in which objects, persons, and actions in a narrative, are equated with the meanings that lie outside the narrative itself. The underlying meaning has moral, social, religious, or political significance, and characters are often personifications of abstract ideas as charity, greed, or envy.
Thus an allegory is a story with two meanings, a literal meaning and a symbolic meaning.

Well, this is something akin to an allegory. It's about a man who is dying, and in the course of his death, he loses the compass of his mind.

No One at the Helm

Stormy winter landscape, where
White capped waves
Wash a stony beach,
All within the minds eye,
This man is out of reach.

Cellular degeneration
In the microscopic realm,
The captain is in the forecastle
And there's no one at the helm.

The three-masted schooner
Of his body, mind and spirit,
Are hopelessly adrift, yet
He doesn't sense, to fear it.

Self induced or inorganic
The end result the same,
He won't remember where he lives
And might forget his name,
Once, the captain of the ship
That ruled the awesome seas,
Reduced to live out life
In diminishing degrees.

Fibril_late; 1997

Usually with each posting, the poem that I wrote 10 years ago or so, I actually remember that event associated with it; thus, this was a journaling of my reality at the time. But other times, I don't have a clue to what I was referring too. This poem is about near-death, something about EKG arrhythmia's, possibly about PVC's, but your guess is as good as mine.

The Death Bumps

Take heed, the rolling eyeballs
Beware, the gasping breath,
Take note, the tachycardia
Watch out for bumps of death,
They hide behind the rhythm
And rarely show their face,
But increase the vagal tone
And you'll see the death bump pace,
Attempt to stay the inevitable
The course, that all life takes,
Remain alert and ready for
The trail the death bump makes.

Fibril_late; 1995

There is an entire science built around the results of automobiles ramming into each other at high rates of speed. I think forensics fits in there somewhere, and no doubt, a whole lot of other stuff, like what I am about to describe.

The Multi-Auto Pileup

The Multi-Auto Pileup
Loose body part trajectory,
Has prompted in-depth studies
At the cannonball refrectory,
Those bug-eyed, quasi-scientists
Will poke their noses deep,
At the site of any accidents
Where body parts might heap.

Several questions come to mind
About these missing limbs,
Do you have a separate funeral
And sing fragmented hymns,
And then, there is the theory
About the phantom pain,
Is there a phantom body
If you find an intact brain,
You may find this topic gruesome
And too disgusting for your mind,
But someday in the future
We may cure the phantom blind.

Fibril_late; 1997

Thanks to TV and movies (I suspect), the most common sights that are recalled about the medical/nursing professions, have to do with the excitement in the Emergency Department or in the ICU. And to those of us who've spent a lot of time there, it often seems like:

The Outskirts of Hell

Some nights like this
Are too darn boring,
It takes a maximum effort
To keep from snoring,
But I must be ready
For catastrophe and clamor,
The component of nursing
That provides all the glamor.

Saving the lives of
The sick and the broken,
High fat consumption
And cigarette smokin',
Uppers and downers
Liquor, cocaine,
Greasing the pipes
As they slip down the drain.

Being an angel
Of mercy and death,
Holding the keys
To their heartbeat and breath,
Then going home hungry
And burnt out, as well,
It's a glamorous life
On the outskirts of Hell.

Fibril_late; 1998

When patients bleed unexpectedly, it is always worrisome. When it's enough blood to leak from the bed to the floor, it's a serious situation. Let me tell you about it:

Bloody Shoes

Petrified, I am indeed
I'm nervous, when
They start to bleed,
When blood leaks out
And stains the bed,
I get kind of dizzy
In my head,
If I find a pool
Upon the floor,
Spreading towards
The open door,
I want to run
The other way,
Because bloody shoes
Just ruin my day.

Fibril_late; 1999

I admit it; I'm over 50, and the AARP is sending me subscription queries on a quarterly basis. What's up with that? I'm not old, and certainly I'm not anywhere near retirement (but unfortunately, I fall back on that excuse to substantiate why I haven't worked much in the past 4 years).

Anyways, I do still suffer from some degree of chemical sensitivity, which I believe I acquired from the many years of hanging around in hospitals (25 years+). Here it is, 4 years since I officially left the "big-house" and most perfumes that are included in any type of household product, cause my eyes to burn and I become irritable ("what in the heck is that smell, and get it out of the house, NOW").
Considering all the chemicals Nurses are exposed to from the medications we have to handle, formulate and deliver and the myriads of "sanitation-cleaning" materials we come in contact with, there is no question that Nurses have to be counted amongst those with excessive chemical exposure issues. And the proof is in the following poem I wrote, back in the day............

The Saga of the Shiny Floor

Who would think
That critical-care,
Would need a floor
With a shiny glare,
Perhaps, it's for
The public eyes,
Who might be concerned
If Junior dies,
Inside a joint
With a dirty floor,
Patient care
May be less; not more.

To me it seems
A poor decision,
The chemicals
Irritate my vision,
As such, I may not
Spot the clue,
That Junior's demise
Is imminently due.

It's plainly clear
That someone wise,
Must find a suitable
Compromise,
To save the Nurses
And the sick,
Who are dropping like flies
Pretty damn quick.

Fibril_late; 1998