Transition

Another ancient, unpublished one. The topic (death) is always a current issue, and how our industry and society deal with it.

Little Room for Hope

He suffered very long

From a well known rare disease

As he lay so still for many weeks and weeks,

There was little room for hope

And his family couldn’t cope

As his life ebbed slowly from a hundred leaks,

He had fifty different doctors

With a thousand interventions

Yet they couldn’t tame the nature of the beast,

His family suffered silently

To the depths of dark depression

Till their loved one packed his bags and headed east.

Now I know I’m very certain

That when it’s time to close the curtain

I wouldn’t want heroic measures for my mother,

Thus, the moral of this story

Is we gotta look at death

As a transition from just one place to another.

1995

Old writings, just as good

Every year, in the late Fall, I get back into sorting, collating, and supposedly, plan to publish. Today, I have sorted through about 100 old writings, and here is a good one for my pals in Neuro.

Lobotomize Me, Baby

Oh, Lobotomize me baby

I’ve got a mental pneumotension,

It’s a disease I never wanted

But it deserves an honorable mention,

I’ve got buzzing in my ears

Black spots before my eyes,

And now my doctor tells me

My cranium has flies,

They hatched from little larva

That were hiding in my brain,

Honey, please give me a sedative

Before I go insane.

1995

No Mo Thorax

No Belt Piece Prize

I had a pneumothorax

Yep, there it was,

Couldn't catch my breath,

It was because,

My pants here hanging

What a surprise,

That I had earned

The No Belt Piece Prize.

Of course, that is dumb

I blame my Uncle Mo,

He fell down on his chest

And he said, "No",

As in, "No mo thorax,

I didn't break a rib,

If you want to argue

You're outta my crib.

Leaving no more solutions

An Old Mo Thorax,

I suggest you clean it up

With good old Borax.

Legacy

Why my back hurts
On a daily basis,
Nothing to do with
Day off stasis,
No; here's a calculation
Regarding what I have lifted,
Mountains crumble
Tectonic plates have shifted,
But daily efforts
In hospital work,
Show a nurses' job
Is more taxing than a clerk.

I calculated
Thirty plus years,
How much weight
Would put you to tears,
On a year, those days
One hundred fifty and all,
Five hundred pounds
Per shift, not small.

And then, that is tallied
An enormous whole lot,
One fifty x thirty
Times five hundred and snot,
To a tune of two million
Two hundred fifty odd pounds,
Wrap your mind around that
And you will say, ZOUNDS!

That is one thousand
One hundred and twenty five tons,
A huge measure of hamburger
Tomatoes and buns,
Hauled from the farm
Way down in Modesto,
But I am not talking
Basil and pesto.

My spine discs are thinner
Scoliosis is worse,
But I am a Nurse
And that is our curse,
I'm not complaining
Just stating a fact,
If this was a stage play
I assure, it's the last act.

Yet, we soldier on
Like other service members,
Standing tall for all of those
Who missed their Septembers
Knowing they would have
Fought on like we do,
When the job is your legacy
Describing me, defining you.

Narcan Nonsense

I read an article recently that looked at one of the issues involved with overdose of narcotics; that being, premature death. At this writing, there is definitely a major problem in the USA (and the world) regarding the excessive use of analgesic substances. The author postulated that if persons known to be users of narcotics were given take-home Naloxone (Narcan) when they left the Emergency Room, this action might reduce unintentional death. To me, this seems like nonsense.

It is one thing to encourage people who are allergic to stuff like peanut butter, bee stings, and melon, to have on hand an Epinephrine injector, which can help to counteract anaphylaxis. In general, people who know about their allergy, logically and actively, attempt to avoid the substance they are sensitive to.

In contrast, when considering a narcotic overdose, we are talking about people who are intentional users. Whether they are addicted or not, is not the point; it is an illogical solution. First of all, who is going to administer it? Imagine, I’ve just taken a little too much Oxycontin, and drifted off to a pleasant dreamy state; am I going to wake up and say, “Gosh, I think I have overdosed…….where in the heck is my Narcan nasal spray?” Second, if I am addicted to narcotics, and I have an antidote on hand, perhaps I will be thinking that I can get away with taking an extra pill or two, because I have an antidote in the kitchen. Narcan, and most other antagonist / antidotes, are best left in the trained hands of health professionals.

Would the author also propose that every person who is prescribed a beta-blocker, be given Glucagon for home use, in case of overdose? Should we offer Praxbind for every user of Pradaxa, or Digibind, for those Digoxin prescribers? Of course not!

The answer is education, not medication. Whether one is addicted to something, or merely needs to take some kind of life-saving chemical, there always exists the chance of overdose. But to hand out an antidote, to every bloke out there, is just nonsense; in this case, Narcan Nonsense.

Narcan in the bathroom
For every woman and man,
Addicted to opiods
Some think, that's a plan,
For the avoidance of death
Regarding drug overdose,
Is this a sound solution?
It doesn't even come close.

Now, suppose you have an allergy
To peanut butter or a bee sting,
You actively avoid
Ever getting near this thing,
And it makes good sense
To carry an Epipen,
For that rare, but deadly exposure
You'll need an antidote then.

Contrast, the narco addiction
Some like to call it a disease,
Brain chemistry screwed up
You have pain when you sneeze,
Or a hundred different reasons
Intentional or not,
Keep the antidote on hand?
You've been smoking too much Pot.

I take a couple pills
To regulate my heart,
If I take too much
The rhythm comes apart,
Why shouldn’t I
Have some antidote?
A sensible doctor
Would never cast that vote;
Because………
The average consumer
Doesn’t know jack,
About overdose
Or heart attack,
Can barely administer
A basic eye drop,
Gets confused
When ordering at IHOP.

Too many ways
To get it wrong,
Handing out antidotes
To the public throng,
The better alternative
Is the medical approach,
Emergency responders
In the Paramedic coach.

Power Outage

When the hot topic word is "transparency" in respect to how businesses operate in the local and greater community, it is odd when an organization manages to achieve local media silence.

When Ebola showed up

Man, we got in the news,

To prove to the world

We were the place, check the views,

How we offer the best 

That branding can buy,

With moon-suits and bleach

And some good looking guy.

when the power shut down

there was nary a peep,

like the public image guys

were in a deep sleep,

and the local news outlets

ho-hummed during brunch,

but if it happened at the Arena

Friend, I have a hunch.......

That 32 Journalists

From every news station,

Would be salivating

To perform an oration,

How they got the news first

Because that's how they brag,

If you are second or third, baby

You're in a wet paper bag,

Fighting it out

To get a pink-slip warning,

To be the best reporter

You start at four in the morning.

How does a business

Suppress news in a community,

As if writing their own rules

With benevolent impunity,

We're a non-profit they say

The good of humanity, is our cupcake,

But really, if the power goes out

Isn't there more at stake?

Pretend your Momma needs a surgery

And the doctors use power tools, right?

Did they tell anyone

Why the power went out that night?

Was it shared with the public

Like the "whale shark rescue"commercial?

Quite frankly, there was a blatant silence

I know that doesn't play as well as an infomercial.

If the public was aware

Regarding the little foibles 

Of operating an old hospital facility,

If they knew about all of the steps taken

How we repair, replace and engineer with agility,

Perhaps there would be a shared

Sense of ownership and pride,

How ye olde neighborhood hospital

Was in it, for the long community ride.

But, since Big Brother took over

Millions are spent on the brand,

It's about acquisitions 

And how they expand,

To co-partner, and outsource

And run a very tight and lean ship,

While big Captain Bobolink

Has a tight grip on his gold plated whip.

Media silence

In this environment of corporate transparency,

Is clearly an outright

Anachronistic aberrancy,

When you are advertising and branding

Regarding all those touchy feely good deeds,

You better tell the public all about

The power outage, leaky pipes, the blown boiler,

And the weeds.

High Speed Train to Heaven

In general, in the year of Our Trump of 2017, modern children at age 8, are pretty much past the fairy-tale believing stage; unless of course, there is some heavy duty homey religion going on.

Grandpa's going to Jesus
That's what Auntie said,
To eight year old Jeffrey
If Grandpa gets dead,
She continued on further
Five minutes or more,
But his ears had shut down
Like a hard slamming door.

I was over in the corner
Trapped, I did feel,
It might be rude if I split
In the midst of her spiel,
Telling such a grand story
That rivalled the Brothers Grimm,
I wondered, should I clap
Or launch into a hymn?

This eight year old Jeffrey
Was wise and mature,
He seemed to understand death
Though he wasn't too sure,
If Grandpa was just resting
Would he rally in the morning?
When nothing more can be done
In of itself, that's the warning.

Jeffreys attention
Sparked brightly when I spoke,
Regarding all the machines
Without the fire and smoke,
Or the legions of angels
On the head of a pin,
I just talked about Grandpa
And the state he was in.

Maybe he'll get better?
Well, Auntie mentioned a miracle,
Indeed, that would be so
Beyond anything empirical,
Because total organ failure
Leaves little to the imagination,
Yes, his high-speed train to heaven
May have already, left the station.

Powerdown

If you work in a facility, that had its beginnings 80+ years ago, you know for sure, there's a bunch of old infrastructure, that has not yet been updated. The guys just can't get to it, because all the high tech stuff needs all the attention (to keep the dollars coming in). We all have been informed, that if there is a "brief" interruption in electricity, the generators will automatically cycle, and there will be power available at the red power outlets. But what if the generators, don't get the message?


We lost power
Just the other night,
Think, old-building blues
And lordy, what a fright,
Because for 10 long minutes
We had no juice,
Some kind of circuit breaker
Had busted loose.

But that's not all
It was really worse,
The emergency red plugs
Felt the curse,
And that shouldn't happen
Because generator power,
Should automatically trigger
For a minute, or an hour.

Meaning, that old circuit
Was isolated, dear friend,
The generators didn't know
There was no power at our end,
And when it returned
Without any intervention,
The engineers couldn't find
The cause of disconnection.

Well, that was cool
Just a little fluke,
No one knew why
If they had, they would puke,
Because three days later
The system REALLY crashed,
Five hours without power
New records were smashed.

A hospital without power
None to be found,
All kinds of devices
Fall to the ground,
Really important things
Rely on electricity,
The lack thereof
Causes spasticity.

All the bosses came running
Who run the joint,
Offering solutions
Wondering where to point,
Knowing that the blame
Would soon need a home,
Why everyone started
Shining their chrome.

One of the geniuses
Posed this opinion,
Let's fixed it with something
Right here in our dominion,
Replace that ancient breaker
With that old one in the box,
Bought back in the days
Of wind up clocks.

Yep, saving every nickel
Down at ground zero,
Make the cheapest suggestion
And you'll be the hero,
Don't look to the future
Make the easy fix now,
It's sure to work for a while
If it doesn't, disavow.

Good thing our Engineers
Are wiser than most,
Ask them, "How smart?"
And surely they will boast,
But still, in the end
They know redundancy rules,
Buy the biggest damn breaker
A whole box of them, fools!

The Gift of Giving

Be a bedside nurse long enough, and you too, will experience the gift of giving. That special patient who loves to share some precious body fluids with anyone dumb enough to come into close proximity. Be warned and be ready, kids.

I saved my BM
Just for you,
I bestow such gifts
Where gifts are due,
Because you are such
A kind caregiver,
I included a chunk
Of my dead liver.

I saved some vomit
For my best nurse,
A sweet memento
She can carry in her purse,
And as a bonus
An awesome booger,
On the lunch tray
With a packet of sugar.

I'm holding some sputum
For Dr. Astute,
When he gets near
I'll spray it on his suit,
His ten thousand dollar
Jacket from Brooks,
Just to see his precious
Hateful looks.

Yep, I am a gifter
I do it, because I care,
If you'll come a little closer
I'd love to touch your hair,
Just after I've scratched
That pustule on my arm,
A special gift for you
It's just part of my charm.

Power Break

I've worked in healthcare for 38 years now (RT & RN), and all the same dynamics are at play. Sure, technology changed, policy's and procedures were revised, diseases are better understood, and workplace interactions have improved between disciplines. What is still present, are all of the tricky interpersonal, colleague to colleague interactions. The foremost question (and answer) one needs to have in their head at all times, is; "Who do I trust?"

Lazy Nurse 16
Claims, he didn’t get a break,
When I asked the dude
He gave his a head a shake,
Seemingly saying, he had it covered
Then I’m called on the carpet
When Charge Nurse discovered,
That Lazy Nurse 16
Stated he worked all night,
Unable to stop
No one noticed his blight,
How he worked his butt off
(Except for that hour);
When I saw him on his cell phone
Attending to a higher power.

Gender Revenge

The latest news regarding Zika and mice:
"Not only did male mice infected with the Zika virus have a tougher time getting females pregnant, their levels of sex hormones crashed, and their testicles shrunk by 90%, possibly permanently".

At last, women may have their "fight back" solution, for those guys slipping GHB into their drink: just place a little Zika Dust into his drink!

Ladies, take note:
Here is your answer to the date-rape drug,
Spike the drink of your paramour
Give his testicles a proverbial slug!
Ya, see how he likes it
When he can't get it up forever more,
With the powdered dust of Zika
His romantic endeavors will be a real chore.

Dental Dana 53

Dental Dana
She's that one,
Over there in the corner
Looking dangerously fun,
The hottest hygienist
In the Dental suite,
All buttered up
Looking good enough to eat.

She looks so yummy
So gentle and placid,
But Dental Dana
Is more dangerous than acid,
She could pulverize a crown
With her nitrogen tapper,
Then catch you on the rebound
With her ultrasonic zapper.

Just play it safe
Relax and cruise,
Remember, she's crafty
And there’s a lot you could lose,
Like thirty-two teeth
Your gums and tongue,
Sliced in little pieces
And dropped in a lung.

If you get too distracted
By her tight fitting slacks,
Ask for some nitrous
To help you relax,
Or maybe something more
Some light anesthesia,
Just for you, they reserve
The milk of amnesia.

Remember, my friend
You could be easily whacked,
Do whatever it takes
To leave that office intact.

Paging the Swami

A post script to the Meth poem of two days ago.

His cardiac arrest
Took forty years off his life,
Now he's babbling like a six year old
To his mother and his wife,
At three a.m. he calls out
Will you please call my Mommy,
I respond, "Right away dude
and then I'll page the Swami".

Instantly anxious
Panicked and wheezing,
Grabbing and thrashing
I know he's not teasing,
While gasping for air
He then holds his breath,
His pulse goes way down
Turning purple, like death.

It's a two nurse dilemma
Handling this guy,
Just a couple days ago
He used meth and did die,
Revived, yes he was
But some brain cells are gone,
And quite frankly, I'm thinking
He is destined for the lawn.

Funny, but best unreported

Oh, how we love to laugh at humorous animal anecdotes; cute puppies, silly cats and romping rhino's. There are times when the our patient-population, seem to mimic those animal antics, and yet, if I say that Billy-Bob looks like a pig thrashing about in a muddy pigpen, that would likely cause offense.

Last night, changing the linen for Betty Lou, was akin to oil-wrestling with a semi-sedate wild boar. Now imagine, two somewhat elderly nurses (guys), attempting to accomplish this. Frankly, even at this moment 8 hours later, I am nearly collapsed on the floor, laughing at myself and Popeye my stalwart companion.

Things that we laugh at
On You Tube, for example,
Or those family shows
With photos to sample,
We laugh and we snicker
When Bobby falls in the trap,
Especially if it was filled
With Elephant crap.

Why do we laugh?
Because it happened to them,
Yes, anecdotal humor
Is really a gem,
We laugh while we're thinking
Thank god, that wasn't me,
While Bobby played in that crap
I was up in a tree.

Things that we laugh at
The misfortunes of others,
Jokes about everything
Even our Mothers,
We can use social media
And upload anytime,
All of us can laugh at you
Oh, isn't that sublime?

Marijuana, Meth and Myocardial Mayhem

I've discussed how at least 50% of all admissions to the Medical ICU test positive for Amphetamine. Sure, that is just a simple estimated, bystander, non-statistical guess. (that's my disclaimer, as an unqualified statistician).

But next door in the Cardiac ICU, we are seeing the same thing; the myopathies and the acute heart attacks, who also are Meth users. Henceforth, another completely avoidable disaster, Mr. Public!

The morning after
The night before,
There is writing to be done
A compulsive chore,
Ideas to expel
And words to sort,
About the cardiac arrest
Of Uncle Mort.

He's forty six
And overweight,
Marijuana and tobacco
Are on his plate,
With an after dinner chaser
Of public menace Meth,
Caused his heart attack
And imminent death.

Heck, everyone has seen
"The Faces of Meth",
If I looked like that
I would gladly embrace death,
But no one comprehends
The toxic stimulant power,
How Meth causes heart attacks
Every minute, every hour.

Good old, Uncle Mort
A sweet dude, he was,
Why did he do that stuff?
He said, because,
His life, was so damn boring
Working at the DMV,
Living in ugly suburbia
Without a single tree,
This altered reality
Destroyed all of his resistance,
Marijuana and meth
Validated his existence.

For years;
Doctors and family
Told him what to do,
Take your medicines, Uncle Mort
You'll live longer, we love you,
Kick your bad habits to the curb
Lose some weight, get exercise,
Well, Uncle Mort fell off the wagon
And it's no surprise,
Because good clean living
Is stupid boring, not fun,
While marijuana and meth
Are like facing a loaded gun,
With danger and drama
Mystery and intrigue,
Yep, it's way more exciting
Than the PTA league.

Uncle Mort had chest pain
Someone called 9-1-1,
He had a V-Fib arrest
Life support, was thoroughly done,
Got a stent to an artery
Saved his family, from mourning,
Ya, Uncle Mort, dodged a bullet........
May this be his last warning.

Dental Dana Vol II

I thought I was all done, excommunicated, exited, and never to be exhumed........but Dental Dana asked for another volume of randy, rabid, romps of hygienic nonsense.

Dental Dana 51

Dental Dana
She's so nifty,
I thought she was done
At chapter fifty,
But now I'm writing
Fifty-one,
No, Dental Dana
Isn't done.

-- -- -- -- -- -- -- -- -

Dental Dana 52

Dental Dana
Is so damned cute,
But you better duck
If she says, shoot,
Because more than likely
She has taken aim,
You've been naughty
Will be her claim.

Dental Dana
Let her do her job,
Scrape your plaque
Till your gums do throb,
Say please and thanks
You know the drill,
For the pain of pleasure
Just pay the bill.

10/7/16

Dead is not gone

I have covered this topic in 42 different ways over the years, and I am still astounded by the actions of loving families, who refuse to let their loved ones go on to heaven. Often their religious beliefs are at the bottom of this (definitely not the top). This is an old poem (2008), slightly edited.

The Work of Jesus

I'm ever more astonished

At the work, Jesus is expected to do, 

Forecasting that he will heal 

When really, death is due.

Take this patient in the corner

As example number one,

Her heart, her lungs and kidneys

Were very nearly done,

When a cardiac arrest

Knocked her to the floor,

Giving her tired soul a chance

To slip right out the door.

She had CPR

For well beyond an hour, 

Where the medical team performed 

Everything within their power, 

But they finally reached consensus 

That there was nothing more to do,

When lo and behold, her heartbeat

Went from straight-line to forty-two.

Now she’s grazing in our unit

Life-supported to the nines,

Seven vasopressors

And thirteen central lines,

An ET tube, an NG sump

And the Foley-Temp-Deluxe,

And while it seems we're doing everything

She's a DNR, oh shucks.

We finally get to Jesus

His role in this whole caper,

The family expects a miracle

According to the paper,

Written by some disciple

Two centuries post-resurrection,

How Jesus will raise the dead again

Like some cosmic lottery selection.

There are just too many people

Who need that Lazarus link,

Jesus can't heal every one

So do not even think,

That your sweet old Aunt Jemima

Is on the Jesus list today,

She tried to depart a week ago

Till epinephrine, made her stay.

The truth regarding dear old auntie

Is that she'll never get restarted,

Her body is here, and her brain is dead

While her soul has already departed,

The resident of this ICU bed

Could be likened to an empty shell,

Auntie is firmly ensconced in heaven

While her body remains here in Hell.

Technical Difficulties

Please wait, we are experiencing technical difficulties...........we've all done it at sometime or another. Accidentally did the one thing, and it caused the other thing. Solve the problem, and you're a better engineer.

I almost sent her soul
Down heavens fairway,
After I stopped
To clean her airway,
Just a little faux pas
With the suction device,
An improper position
Well, she almost paid the price.

Assessment and decision
I'm fast on my feet,
Troubleshooting with friends
At the bedside we meet,
Setting Oxygen on blast
Via bag-valve-connection,
Returned her to baseline
On final inspection.

Refreshed my memory
Old knowledge relearned,
Like Shakespeare once said
The worm has turned.

Decay and Denial

Here's a dark one.........Most folks don't recognize the amazing resilience of their bodies to counteract the battles we wage upon ourselves. I've met thousands of folks who thought they dodged the bullet of disease, cuz they smoked and drank and shot up drugs and it never seemed to harm them. And then, at age 51, BAM........collapse and misery.

In the morning
After the dream,
I remember
Last nights scream,
Or was it a moan
I am not really sure,
When we told Betty
There wasn't a cure.

There is no escaping
Our final day,
For eons we've tried
To prevent our decay,
But just the smallest peek
At our everyday behavior,
Well, it's a giant billboard
Regarding who is your savior.

Fast food for Freddie
And whisky for Willie,
Barbaric religions
With practices so silly,
And then there's the Meth
The Cocaine and shrooms,
We're all tangled up
In our lifestyle looms.

Our happy interventions
Do not prolong life,
And now it's too late
To save Betty, your wife,
She thought that her Camels
Unfiltered and rich,
Would never deliver her
Into the ditch.........
After all, there never was a cough
She could climb a mountain like a goat,
Until the cancer filled in
And plugged up her throat,
Too late for a cure
Now she's miserable and blue,
Take a look in the mirror
It could happen to you.

Cautious Ending

Time and time again, I've seen it; Ms. or Mr. Nurse counting down the last few days till they pull the plug, open the door and escape to retirement. These are the last moments for things to get dicey.........

Approaching the end
The setting of the sun,
Just 19 more shifts
And then she'll be done,
But I say, use caution
Be extremely wary,
On any given night
Things can get hairy.

Yes, anything could happen
On one of those nights,
A whacked out meth user
Knocking out your lights,
Drug addled Billy-Bob
Ramped up and squirrelly,
Ending your career
16 days early.

My worst experience
I was kicked in the head,
I had a concussion
Lo, I could have been dead,
Or the time that Barry slugged me
And Mort threatened death,
All those things happened
In the time of one breath.

Be cautious, old nurses
Don't get too frisky,
Take care of the comatose
Where violence is less risky,
Maybe, fake an illness
Or sit on a Jury,
As your days are counting down
Don't be in a hurry,
Protect your retirement
Whatever it takes,
Just a few days left
Are you getting the shakes?