Top ten in 2010

The top ten things going on in my life...

10.) Breaking in a new pair of Dansko clogs...exciting

It is so much more sexy than wearing heels or various other fashionable shoes that one may wear to an office job, a firm meeting or a lunch date. The thick european sole on occasion, will catch the sticky linoleum floor often causing a motion that looks similar to, but is not quite, 'tripping'. Shoe envy has never killed a woman...it makes me want an office job or inspires me to be a super model. Could you imagine a nurse in stilettos? It might just happen.

9.) Bottles of Melatonin so we meet again...

That little white bottle is becoming my closest companion. The nightmares and bizarre happenings that accompanied me during my last stint as a night nurse weren't life shattering enough to drive me from the stuff but I have tapered from the mega 5 mg tablets to the more subtle 2.5 mg sub-linguals. I find the drowsiness has less interference on my day-to-day and the quick dissolve makes me wish I would have invented sublingual medication. Brilliant. A girl has to sleep sometime.

8.) You can leave the hospital at shift change, but the hospital can never leave you...

Or something like that. At first, I thought my multiple run-ins with patients on the streets was because I lived a mere 4 blocks from the hospital. I would wake to Mr. Sanchez urinating in our flower beds then flicking his cigarettes butts on our steps, or Senora Chavez buying milk at the corner market. One time while walking down the street, Mr. Abdominal-Pain Every Day, called out for someone to call an ambulance. To the casual walker on the street, an immediate dialing of 9-1-1 would have been instinctual. For the nurse that deals with bullshit chronic pancreatitis on an hourly basis from people who drink liters of vodka daily, called his bluff. Is this what people call an 'edge'?

Then I moved miles and miles from the hospital. I guess no matter how far I distance myself, the fact that San Francisco is a city 7 miles by 7 miles will never change. Just last week I saw Mr Krohn stumbling the charming strip on Polk st. He is horrendous while intoxicated; mean, angry, temperamental at best. It can be quite amusing. I laugh after I cry. When he sobers up, I want to put him in my pocket and carry him with me at all times.

And then there is Ms. Bell, who was sighted the other day after lunch. Completely hammered midday on a Tuesday. The sad thing about her is that when she is not in her manic phase, her normality is frighteningly parallel to my own reality.

The scene goes as follows...

With thick black eye-liner leaking down her cheeks, an over sized black leather jacket draping her frail malnourished frame and the un-febreezible scent of stained urine on her clothing, Ms. Bell is wheeled into Trauma Room 2 for a complete evaluation for her witnessed fall. She was too drunk to stand on her own, so she fell over and landed on her head. The cement caught first sight of the occipital region and then gracefully maneuvered to her parietal leaving a notable laceration. Patients in this state of disarray are usually quite combative and aggressive. (I often dodge punches and/or spit wads right about now.) But Bell was as peaceful as ever. Lying still in the gurney. Refraining from calling me a 'cunt-bag whore who can go fuck herself!" (eye muffs for the youngens, I know this is a family friendly blog) verbatim from our last interaction.

I mentioned how I had never seen her this calm before. She started yapping about the business of the ER, and how she used to be a nurse herself and knows the trials and tribulations of what it takes to work in such a stressful environment but somehow the mental illness got the best of her and now here she is, on her 7th visit to the white halls this month, heading towards her 4th Cat Scan all while lays a fifth of gin in her backpack. I was taking it with a grain of salt as one must in my line of work. You can not be played a fool. And the ER is no place for the naive...as I am quickly learning.

Me: Do you take any drugs?

Patient: Yes.

Me: What kind of drugs?

Patient: I inject heroine. Mostly skin pop. I smoke crack. And special K.

Me: Skin pop? Special K? What's that?

Patient: (blank stare)

Oh that silly grain of salt.

Ms. Bell continued to tell me that she was from Chicago, graduated as a BSN and worked at Northwestern. Well that certainly rang my bell. All of a sudden the room jumped 25 years in time and I saw myself lying in the gurney, in her exact position, makeup caked on my face from the previous nights party, two head injuries away from permanent brain damage, recalling the memory of my "nursing days", apologizing to staff and the like, that the smell of urine was from my inability to squat properly in between two cars to pee, and if someone could heat me up a bologna sandwich and give me a bus token on discharge, I would refrain from cursing their name out the door and falling asleep in the waiting room.

My annoyance quickly simmered to compassion as I realized that mental illness is such a tragic reality. How sad. She was once a someone like you and me. A working contributor to society. And a nurse of all things. I would have pinned her differently. It made me wonder about the others. What was their life story before all the drugs, alcohol and the liberal appeal of San Francisco hit them like a plummeting pile of pebbles?

7.) Interning at UCSF in the Women's Health Research Center...

I am phone recruiting women and men for a study that looks at the metabolic syndrome and whether or not therapeutic stretching and yoga can help decrease pre-diabetic stages in over- weight americans. I have keys to an office so it makes me feel important. I get all sorts of passwords to computer systems that confuse me and the security guard Lou and I have become quite close. By close I merely mean he swipes his security badge so that I can get up to the 6th floor after hours and he rolls his eyes at me when I interrupt his nap to do so. I like it because it is the opposite of clinical. The only thing I touch is the phone. No gurney pushing, no CPR, no monitors to hawkeye or medication to give. I just listen to fat people tell me how much they weigh and how little they exercise. My gateway to Graduate school.

6.) I have discovered that I am the opposite of a slut...

While sipping tea and reading The Red Tent, a book about womanhood, sister bonding and the bible (I'm not lame) in a cafe last week, I overheard 3 ladies chatting. One was telling a story about her date on Friday. She got all dressed up and went to dinner with this guy, he paid and she put out. He had to work early in the morning so couldn't stay the night. Instead of staying home and daydreaming about the next date, she goes to a party where she subsequently hooks up with another dude. I was shocked. 2 hook ups, 1 night.

After judging her a tramp for a solid fifteen minutes, my thoughts went from How dirty! to How Impressive! as I haven't even had 2 hook-ups the entire year. I closed my book. How does she do it? Where can I learn? What literature does she read? Oh, I bet she has STD's.

5.) I crave Brussel Sprouts...

I know, and you thought I couldn't get lamer. But seriously. It is like I have been taken over by the little vegetable that is identical to a mini cabbage. I often wake up to my cheeks salivating with the consideration that I may eat them at some point in the day. I just can't get enough. We made them for thanksgiving which was the first I had tasted the divine sprout in years. And now, I have eaten them for dinner 24 out of the last 38 days...and plan on making some tonight. Co-workers are no longer surprised to see (and smell) sauteed brussels in my tin lunch pale. They just look at me and say "Really? Again?" But I just can't help it. Addiction is a curse and when I lay to rest to take my final breath, I wish to be cremated with a heaping scoop of them and scattered across the land so that my complete infatuation will grow with each new crop of the delicious and succulent Brassica Oleracea. My roommates cringe each time I remove the bag to prepare yet another serving as they despise all vegetables. I simply explain to them if I do not get my fix, there could be a seriously unhappy bitch that explodes from my person. You don't want that boys...back away from my cast iron pan.

Here is how I make them:

One skillet (preferably a non-Teflon one as I don't want you to die from poisoning)

Olive oil or Ghee (clarified butter)

Brussel sprouts sliced in half

Salt

White wine vinegar

Turmeric (optional of course but your joints will be thanking you for the anti-inflammatory effects)

Heat the oil in pan until it is real hot. Drop precious sprouts into pan. Stir around until they start to brown. DO NOT OVER COOK. DO NOT UNDER COOK. Salt while hot. Scoop into bowl. Drizzle vinegar. Dollop of turmeric. And Voila...savor a masterpiece.

4.) Getting the itch to travel...

No matter how much I scratch it though I am certain this will never go away. I can't believe that I have been in San Francisco for almost a full year. ALMOST A FULL YEAR. It is asinine. Per my mom, my North Node destiny has me coming into this life as a wanderer and exiting as a home body ready to grow roots. My karma for the 'now' is to balance what I want, what I know and what I need. The problem...I want it all. I want to be settled and see friends and spend time with family and have a husband and some kids who grow up with their Grandma and know there Uncle Charlie and their Aunt Sam, while carpooling and hosting weekly book clubs. But I also want to bike from Cairo to Cape Town, run a marathon in Europe, write a book in South America, learn French and Swahili in the Congo, eat fresh seafood in New Zealand while bungee jumping from ridiculous heights, break bread in Jerusalem and drink tea with old men in Turkey. I can not be stopped now...I will not be stopped now.

3.) I love my hot sauna...

My apartment is located directly on the panhandle, in the best neighborhood in San Francisco. I am a paltry 20 steps from the stunning Golden Gate Park which offers an oasis of quasi urban living with scents of eucalyptus, every array of pine and stinky marijuana. I shack up with two amazing French men who make me laugh and teach me funny words at breakfast. Our ceilings are high, our doors conveniently French as well and the lack of carpet makes me pet the hardwood floors in adoration. But it wasn't just the location, nor the open and large kitchen, nor the 2.5 bathrooms that made us sign our year to a man named Stuart.

It was the sauna.

Yes. I have a sauna in my room. It is real. It is warm. It is amazing. In the comforts of my own home, I can step into a handcrafted, cedar-benched sauna that makes me sweat bullets all sans other naked women. I crank the dial to ten and each time I enter I make myself stay until I feel my heart beat in my head. Not really but if I die from overcooked internal organs, you will know why. It is the best after a long run, strenuous yoga class, in between TV shows, right before a shower, right after a shower, before bed, when I wake up, after laundry, before laundry...are you getting my point? What it really offers is clarity and reassurance to why I signed a year lease when I obviously have commitment issues. Who wants to come visit me?

2.) The 2010 Arbor Push... http://www.arborcollective.com/snow/boards/view/47/push

Just a little present to myself after my ten year old P.O.S snowboard binding snapped in half at the top of Great Western on my second run. The mountain air had hardened the plastic leaving it vulnerable to my deft-less gloves and freezing the right binding solid. I couldn't undo my right foot. We marched right to REI where I made a very expensive decision. The Arbor Collectives are amazing. Made from sustainable Poplar wood for women who surf mountains.

As the very helpful Nate was mounting my bindings, I started getting nervous that I was making an impulse buy.

Me: Do you think it is weird that the there is a green skull graphic on the front of this board? (my hand strokes the shiny surface)

Nate: No, I think the little birds make it less death-y. It evens out the gothic-ness.

Me: Really? Are you sure people won't think I am a lover of death?

Nate: Yeah, no one is going to be like "oh that girl is a death lover because she has a scary, strange green skull on her snowboard."

Me: I hope you are right Nate.

First run on the beauty is next week at Tahoe!

1.) In with the new, out with the old...

It is the most typical sentence this time of year. It makes sense right? Each December 27th-ish people begin the reflection of the past 12 months. 2009 fared to be a year that most people would like to give two middle fingers to. I didn't particularly love it, but I didn't hate it either.

A recap:

I started exploring meat recently as I was on a little 8 year hiatus from the stuff, and discovered some of it isn't half bad. Still can't stomach chicken but Moms elk chili is delicious. I switched jobs yet again offering a new variety of learning experiences while hand delivering me about 70 new friends. I tried to stay in one place for a while and look...I did it. I made out with one person. That certainly must change in the coming year. My hair is recovering from the horrible cut I received in November of 2008. I have read a lot of books. I attempted a mini-triathlon but never made it to the start line because K.C.'s mom went into Cardiac Arrest. I started getting manicures and pedicures frequently. I decided to never deny myself anything. I fell in love with the city by the bay. I started rock climbing. My eyes got worse.

My NYE was spent at work, so I rang in the new with Mr. Schwartz; a 33 year old man who got arrested for public intoxication. While sitting handcuffed in the back of the paddy wagon he hit his forehead on a corner creating trauma for the 911. When I unwrapped the gauze, there was a puncture hole that spurted blood like a sprinkler. He was rolled into a room, blood oozing down his cheek, spilling from his mouth and staining his nice gray suit fifteen minutes before midnight would strike. When he smiled, his gums were lined with dried blood. He was obnoxious and inappropriate as he undressed from his gown multiple times and wandered the hospital hallway in his boxers. He was so confused that he rose from his bed, dismantled his IV pole and carried it into his neighbors room as he was asking for water. While drawing his blood, his fingers crept up my arm and began tickling it as if he was seducing me or as if he knew me well. "Oh, Your so sexy Jamie Dwyer RN Special Emergency Nurse (as my badge reads)...your so sexxxxxxy." I couldn't help but laugh. It was pretty hilarious. But then I stopped laughing and remembered that I really need to block out my last name. It was funny seeing this totally unattractive, half conscious man, covered in dark red blood hit on me as if we at a bar and not in a hospital discussing his possible intracranial bleed. It was the most flattering conversation I have had in a long time. Happy New year...may the schwartz be with you.

Sometimes patients like that make me hate my job. It is annoying. But then sometimes they make me love it. Last night I had a 91 year old man named Frank who had fallen down 16 stairs and lost consciousness. He was missing his right index finger but had a smile that lasted a mile. He was disoriented while he stood tall in front of the desk, dropping his soggy diaper to his ankles and began peeing in a plastic urinal all while talking about the veterans hospital. We watched and instead of calling for reinforcements from the police staff per usual, we sighed at his cuteness. He had served in WWII, had lived in France and had fallen in love with a woman named Jackie from Finland. As I rolled him to the CT scan he divulged his life story. I got teary eyed when he told me he never got married and never had kids...just fell in love with many women. He was adorable and I hugged him when I discharged him home.

So, in with the new, out with the old. I haven't made any resolutions this year but I have a slight idea which direction I want my life to head. More writing, less analyzing. More time with friends, less time online. In with the Brussel sprouts, out with anything not brussel sprouts.

I hope 2010 brings light and happiness to all the fans of Blind Karma :)

Ex-boy-tation

I just finished reading a great book. Quite my style and very David Sedaris-esque, this 200 some odd pages took me through short stories of a lady living in New York City, single and self-deprecating. She exploits everyone she knows; her friends, her family, her co-workers. And I love it. I was enthralled with her enthusiasm to hold nothing back. I wondered, do people she actually knows read her book? I couldn't imagine them being pleased with the words in bold print.

Having an often ignored blog, I took to questioning my own style of writing. My fear is that if I were to tell the truth, the whole truth and nothing but, I would live a long lonely life of spinster-hood spending Thanksgivings alone eating trail mix by the handful and watching reruns of Ellen Degeneres while dressed head to toe in spandex. (Eh. Could be worse I suppose.) And maybe this is why I ignore my online diary sometimes; some stories are just too fragile to reveal so I hold back. I hesitate to allow the finger tips to write what culminates in my head.

I am in the mood to exploit but I will make it subtle. On my way to the library this morning, in my new beloved neighborhood (that's right people...I have moved yet again) I ran into a boy I used to date. I use the word boy with great meaning here. I knew this was his neighborhood first. I should have known better than to step foot in his territory and better yet, to relocate myself and all belongings. In fact, I gave him the two-thumbs-up/go ahead to rent his apartment during our futile 7-second relationship, months ago. And damnit for doing so. Upon signing my lease, I gathered this would be a huge concern; random Sunday morning run-ins to grab coffee on said trips to the library. Who goes to the library?

I see him from afar. We make the recognition. We awkwardly hug. He asks where I am living. I want to lie and tell him far away but I tell the truth; that I am only 30 or so houses from his.

"What are you up to today?" he asks.

"Going to the library. I still don't have a library card," I say.

"Yeah, they are free you know," he states.

We say goodbye and he tells me to call him later. As I walk in the direction of the closed Library I think I will not call you later, but what I will do is go blog about you to the world of Blind Karma...I am inspired.

I know him from high school but I can't say that we were really that good of friends. He was nice to me, I was nice to him and other than the occasional run in at a keg party and perhaps an English class together, we rarely spent time breathing in the same oxygen. I thought about him as often as one thinks about cleaning out air ducts in a heater; rare to never. We graduated high school and went our chosen paths. We would see each other while home for spring break or summer vacation, cheers a red dixie cup to the yesteryears and be on our way.

Somehow and unbeknownst to me, he got on my mass email list while I was traveling and was reading about all my adventures abroad. He knew my trials and tribulations with the Indian train system, my bout of Dengue Fever, my bad luck with owning things. My friends from home would make comments about how he would say things like "I love Jamie Dwyer." or "I want to marry her." or "She is stunningly beautiful." Really? I wonder why? If I had a dime...I would have $0.80.

Then the out-of-no-where text messages flooded my inbox like a tsunami. It would be 2:30 in the morning and I would get verbatim song quotes from obscure artists. Drunk messages abounded and I was confused where this love was coming from. Had I given the wrong vibe at our last 2-minute interaction? Was I wearing a low cut shirt that night? Did the witchcraft Elizabeth and I dappled with in the 8th grade really cast spells? I was lovable and had supernatural powers?

My responses were vague and sometimes none at all. He had moved to San Francisco some time after graduating, so when I made the decision to move there myself, and he being one of the two people I knew, communication picked back up. I sent emails as follows:

Oh hey there,

Guess who is moving to your neck of the woods? You got it. I will let you know when plans are more solid. Let's forge a friendship and in the meantime can you ask around if any sane people you know are looking for a roommate?

cheers!

San Francisco is similar to Chicago the way that black is similar to white. San Francisco has hills. Chicago is flat. San Franciscans are mostly eclectic homosexual and/or transgenders who wear a lot of plaid and join drum circles on their days off. Chicagoans are more often than not straight, chubby and mostly from Michigan. But there was something oddly comfortable about this new town of mine that made me feel just as at home. Perhaps I was riding high on the cloud 9 from a new space, a new job, a new future. And perhaps this is why my impeccable judgment was so skewed those first few weeks.

I had made plans with this aforementioned boy to grab a drink and see his co-worker play a show at a bar in the Mission. Cool, I thought. Friends. I met him there and we drank beer and reveled at this 40-something year old polka band that was rocking the house. We caught up like we knew each other well. He told me about his new job and the prospects of it being a good one. He briefly discussed his ex-girlfriend and her drug problems. We talked about who was pregnant and/or getting married from our class. By beer number two, we had made our way through the yearbook and I made the decision. He was attractive; a thought that I a.) never had before and b.) never thought would ever have. Was it the lighting in the bar that shadowed his complexion just so? Maybe the sounds emitting from the accordion were sending us into a trance? Was it the fermented wheat circulating in my veins? Huh.

A few days later we found ourselves rolling around on my carpeted studio floor, making out. I was confused. Had this foggy air gotten to my head? Was I really kissing this turd? He was so lame. Or so I thought. Actually, he was funny and smart, well-traveled and played soccer. His prospects of business school in the Fall made me assume he had an interest for ambition. Like wine, he was getting better with age I guess. I was allowing my harsh yet accurate judgements of my teenage years strip away from my critical mind. It was somewhat cleansing I suppose, my new like for someone I never thought would be worth my time. Only assholes make comments like that. I am an asshole.

So the following weeks were spent drinking coffee with breakfast sandwiches and listening to NPR, going to dinners at romantic little nooks in cute little covens throughout the city. You know, 'couple-like' activities. We once strolled a farmers market and I was impressed to learn that he liked cheese as much if not more then me. I didn't think that was possible. On my days off, I would bike to his office and bring him fermented tea which he hated and cookies which he pawned to his cubicle-mates. It was sweet. The early morning text messages returned and instead of fearing for my salvation, I would smile and glow the rest of the day. It had been a while since I had gotten this much adoration from someone who was not homeless and 50 years or older, so I was swimming in it.

But still, I refused to tell anyone, save the casual email I dropped my mom and sister one day . I was explaining how much I liked the views of the Bay and Eucalyptus trees and how biking to work was very dangerous but fun. And oh yeah, I am making out with this random boy from high school. Call me when you can. XOXO.

I certainly told no one we associated with of this newly budding intimacy for complete consternation that high school would get wind of it. This included my best of friends who would undoubtedly look down upon me as if I had taken the life of their pet hamster. The most solid link that two of us had was our dear friend Dominic whom I claim as my longest-to-date friend and who couldn't keep a secret if his life depended on it. Good for memory lane, bad for potential reputation ruining information. Since Kindergarten, Dominic and I have been bosom buddies. I used to jump on his trampoline after school. He was my first boyfriend, claiming I looked like Courtney Cox thus making him the luckiest boy alive. I pantsed him in the fifth grade which he has never forgiven me for but says he will be my friend until we die. Thanks Dom!

If Dominic found out, all of Salt Lake City would so mum was the word. I would make sly comments in the nature of "tell anyone from home about this and you die" while laughing but in all seriousness, this boy knew I wasn't joking. My friend Erika came to visit in the thick of this not-so-public affair and caught on immediately. Something about our "body-language" and our "proximity" in the diner booth gave it away. I was mortified. The truth had to be told.

I let the cat out of the bag and explained to Erika that he was different then the one we knew in high school. He was somehow mature and manly in his very own 5 foot, 9 inch way. And although he lacked the ability to grow a beard in full, he seemed stable and normal. But as I tried to rationalize my annoying feelings for him over shots of tequila and sangria, I felt guilty, like I was doing something illegal. Erika was baffled and when we shared it with our friend Elizabeth, I thought I was going to be disowned. I would be the Be Fri taken out of the st end. And their bafflement made me insecure and doubtful. I should have taken that premonition and run a marathon with it.

The red flags started popping like kernels in a Orvile Redenbacher commercial. I realized that I had not once seen where he lived. His vague attempts to take me there always seemed to be interrupted by "last minute plans" or inconvenient "work events". I never once met a friend of his outside of his workplace and I started to question if he had any. When I told him that I had four consecutive days free from work one weekend, he mentioned how we should take a little trip south to Santa Cruz and live the life of luxury in the mansion sized house of his sisters' husbands' parents'. Wonderful I thought. And when people would question my motive for the excursion, I could casually pass it off as a trip to purchase hippy-dippy dangling earrings and hemp lotion. None the wiser. But somehow the day of the supposed trip came and all I heard was crickets. In fact, it was a Thursday and I didn't hear from him until Sunday...as he was returning from a quick trip to Tahoe. Sketch. Ball.

And this is where the record screeches to a halting stop, where the breaks get slammed and tire marks are strewn on the asphalt with power that deploys airbags. Was I being played? No?! Could I be? Wait. I thought I was the one playing him? I know what you're thinking. What a bitch! I know. Strangely, this perfect secret relationship that I so badly wanted not a single soul to know about had gone to the masses. I hate to admit it, but it slightly rocked my bitchy world.

The week it ended I came down with a horrible flu. I had swollen lymph nodes so round and swollen, if extracted and embalmed, you could play a tennis match with them. It flattened me supine for a week solid so in true woe-is-me form, I dragged myself to the first solo movie date I have ever taken myself on, and watched He's Just Not That Into You while hacking my left lung up. Huge Mistake. When the phone calls and G-chat messages stopped robbing me of productive time, I began the mantra...weird, he is just not that into me. He must really not be into me. Into me, he really is not. Impossible.

Quite Possible. Short lived and for the better this phase was transient at best. Too whacky to be sustainable, I figured I should find someone that I am not ashamed of. Someone's name that I will yell from the rafters in glorious praise and rather than hide our handholding, show it off like a well deserved gold medal.

Unlike previous breakup disasters I have lived through, the decision to erase his number from my phone in hope to permanently extinct him from my memory was made. Since this was mostly on his terms, I couldn't trust he was sane enough to be on any contact list. So off of my email he went. I am on good standing with all ex-boyfriends, but he...I wanted nothing to do with. Something about our little situation made me feel absurd. I deleted him and all evidence that he existed. To me, he was dead.

As a few twinges of rejection would hit my stomach now and I then, I contemplated how I could have handled the situation a bit less callously. Did it hurt his feelings to be cast in the dark and hidden from our shared world? I didn't think so but my sister did.

Sam: So what's up with that guy?

Me: Nothing. He is dead to me.

Sam: Why? You told me he was funny and possibly had ambition.

Me: He is a faker of ambition and can't grow a beard. I also think he is a closet coke addict and cheap. Good riddance.

Sam: Did you ever tell your friends about him?

Me: Yes. Unfortunately they found out. How embarrassing.

Sam: You're a bitch.

Me: You're a bitch.

Sam: Well, you should find a real boyfriend soon, preferably one you like and will tell people about.

Me: Fine, I will try. Thanks for the advice.

It wasn't until months later, the day before my sisters wedding, that I heard from him again. As I paraded down the grass of the Field Museum, practicing the steps to give my sister away, I received a text message from a random number with a 415 area code. In the print...'I am a fucking idiot.' I didn't recognize the number...like I said, I had banished him. But then it clicked and it all made sense. Indeed he was and I couldn't have agreed more.

So then starts a slew of messages exploding from his creepy fingers about how he was so sorry that he blew me off, how he thinks about me all the time, how he told his mom he handled things very wrong...blah blah blah. I felt neither happy nor relieved. Just sorry that I had wasted so much time with a presumable lowlife. I texted back and we chatted a bit. I told him his apology was three months late.

A few weeks after that I agreed to meet him for dinner. I thought it would be nice to officially close this nagging chapter of my life. Exchange a "so, what have you been up to lately?" and "did you ever end up buying that orange bike?" and be on my way. I was about 30 minutes late, not a surprise to those who knew me well. He thought I was standing him up.

Boy: When you weren't here at 9:15, I thought you weren't coming. I know I deserve it.

Me: You just can't catch a cab in this city. It is definitely no Chicago.

Boy: Nice to see you. You look great.

Me: (pointing across the street) Hey remember when we ate at that taqueria and the chicken burrito gave you explosive diarrhea? That was funny.

Boy: So what is it like to work in the ER?

Me: I am surrounded by crazy drunks, who throw things at me and swear constantly. I hated it at first but am learning to love it. Do you have any friends yet?

Boy: I know my shortcomings, you don't need to remind me.

Me: I know, that was rude.

Boy: How is your family?

Me: Good. You never knew them and you most likely never will but they are all doing great.

Boy: My mom was in town and asked about you.

Me: Interesting. I never met your mom.

Boy: I told her that I fucked up.

Then, it happened. Something so unexpected I had to squint my eyes and lean in closer as to get a better look. He starts crying. Not just tears welling in his eyes, but streams of salt running down his cheeks partnered with the type of breathing that happens during an anxiety attack. I looked around to see if anyone else noticed and thanked god that the pulse of the busy restaurant was darkened and loud. He broke down and regurgitated an hour of bullshit that equaled apology, regret and remorse. I asked for the check and we left before anyone could recognize us.

I could sense that he meant it. This was the type of conversation that I believe is challenging for anyone to profess. I really felt awful for him as it seemed he has seen better times. He looked skinnier and his eyes were sunken in. Cocaine? Sleep deprived? Sad. He explained to me that while I was denying his existence to colleagues and loved ones, he was miserably trying to put a hold on his flailing life. A new job, new friends sans his ex-girlfriend, surfing his friends couch and homeless for some time. All aspects that he was secretly hiding too. Apparently, neither one of us were being honest. So I accepted his multiple sorry's and told him that he has some serious issues that could greatly benefit from psychiatric attention. He nodded in agreeance. I told him that because I am a kind and compassionate person, I would listen as he tried to make sense of his life in shambles. But only as a friend. He tried to grab my hand and hold it. I told him not to touch me.

I invited him to an event supporting an organization that brought music to children in the developing world. The more the merrier. Why should the children suffer? An attempt to be the 'friend' I told him I would be. It was an evening where a plethora of my friends and fellow nurses joined in art exhibits and mingling. He showed up in a suit jacket and acted like we was on drugs yet again. His words were not linking to make coherent sentences. He realized I was ignoring him so he left 5 minutes after he arrived. Enough is enough. I realize there are limitations on my ability for friendships. I reinstated my vow to ignore him.

Now, we share a similar address and I am certain that this mornings' run in will be one of many. A little uncomfortable but the boy cried over me so I guess it can't get any worse. Come the day I am walking, arms wrapped around a tall gentleman and giggling about something adorable he whispered into my ear, will be the real kick in the gut that I was too shy and nice to deliver. Until then, I will exploit him namelessly and shamelessly here on my world wide weblog.

And Pie was all it took

I think a bubble has migrated from planet un-motivated and gobbled me up. I can't define the source, but it seems the last three months has put me in a realm of schizophrenia unmatched by anything previous. Blind Karma stories are like heavy lead balls, once you get a tiny source of motion, they roll and roll and keep rolling until, hey...lesson learned. But lately, I feel like my brain has stepped into an unfortunate puddle of superglue....and you know what comes next.

What happens is this. I go to work and I see things that most people shouldn't see. I see men who have spent the better half of a week sitting in their own feces, women who have sent the San Francisco police on multiple fleet high-speed chases, kids that fall out of windows, elderly with one foot literally stepping into the other side, criminals that are sweet but just got busted with rifles (plural) in the trunk of their car so they are handcuffed to their gurney, drunks who have lacerations to the temporal, occipital and frontal portions of their skull but are so wasted, they can't remember what happened or who they are, domestic violent cases where jealous boyfriends raise a full bottle of wine just so that it can crushingly meet the front of a girlfriends face, car accidents, motorcycle accidents, bike accidents, construction accidents, suicide attempts, suicide success...the list goes on.

As most of you know, my intention was to literally document every moment in that trauma center. To relive every story as a chapter that would soon regurgitate my award winning bestseller. But something happened. I would come home, sit in front of this electronic white square, and try with all my might to spew to you my interactions with the craziness that is San Francisco. It was a blank. white. screen. 

Nothing came. Nothing came the next day. Nor did it come on my runs, or while I was trying to fall asleep. When I would ride my bike, my once constant mill of commentary was silent. Every detail that I soaked in at work seemed to dissipate in the foggy air the moment I stepped outside, as if the lives and happenstance of my patients was theirs, and theirs only.

But then my French neighbors, who are soon to be my french roommates, hosted a barbecue on this fine breezy night. They bought cheap meat, I made a salad and we set out the array of dishes, spoons and wine glasses that chime bienvenu. Various people came, mostly friends of Damien and Pierre who work with them in the bistro. The most riveting of the group was Pierre's' girlfriends' mom. Her name is Pie...as in...a piece of. Pie is a Native American Buddhist lesbian from Seattle who works at the University of Washington as a recruiter for the medical school. So naturally, she was a character. As she is telling me about the disparity of her native people, she removes a 'one hitter' marijuana pipe from her pocket, lights up, tells me that the reason she is in town is to harvest pot up north, and doesn't skip even the littlest beat in her story of struggle. 

Maybe it was the Chardonnay, the possible swine flu symptoms I feel glossing over my body or the unintentional hot-boxing of our garden experience but as I sat and watched Pie, in her black leather cowboy hat and baggy black t-shirt, my love for Blind Karma stories flooded over me. People are so interesting...and I must go write about it!

So, in honor of Pie encouraging me to be a strong, independent woman of this world and a solid fear that she was hitting on me, I set down my wine glass and sprinted to the black and white keys. I sit now...the fingertips are on fire.

TRAUMA INDIA

Ironic that the most significant trauma patient that I have had, has the name of the very country that has hosted some of my most traumatic experiences. In the world of emergencies, everyone is a John Doe. Everyone has O blood type. Everyone could have HIV, a pneumothorax, a head bleed, cervical spine fractures, a family. So in order to keep them in order and a way to find uniform in chaos, we use the military alphabet (Alpha, Beta, Charlie, Data, Echo...and so on). Each case a letter with a crisis.

The morning is underway. Paramedics are floating in and out, dropping off patients, chatting with the nurses, looking hot...per usual. One starts to tell us that a white truck has been reported as driving off the embankment of the Bay Bridge. The initial story we got was that this poor man had been submerged in the glacial cool of the Bay water for nearly 20 minutes. Apparently, the first medical personnel to arrive on scene, didn't have the proper gear to retrieve him, so they had to wait for backup. Paramedics don't transfer dead people to the hospital, contrary to what television depicts, so we had to wait to see if the man pulled from the dredge would be a likely candidate for one of our trauma letters.

And not 10 minutes later, a 30-35  year old ice cube makes his way into room 1. His rotund belly gives evidence that he is not in the healthiest shape. His three layers of chin second that notion. His skin is pale and frigid. The chest wall inflexible at best. Compressions are underway as to mimic his absent heart beat. His mouth exploding with rubber breathing tubes.

I stand to his right in a crowd of about 25 people...everyone wanting a slice of the action. I am in charge of the IV. It is my job to find a vein that has not yet retreated to the inner space of his frosty  limbs, to attach tubing and to aggressively pump the absolute warmest fluid into his body by way of the Level One. The Level One is like the Cadillac of IV pumps. In just 60 seconds, you can infuse an entire liter of fluid...including blood. His first temperature; a nippy 32 degrees Celsius (that's 89.6  Fahrenheit you lowlifes). Game on.

I tie the tourniquet high on his arm and watch the paleness turn mottled. Usually, when body temperature decreases, the vessels in your body constrict. Like what Pakistan is to India the country, Vasoconstriction is to India the trauma; a worst enemy. But, this man had a slight glimmer of the vein angels flying above our surgery lights, because I was able to perfectly place a 16 guage (big) needle into his ante-cubital.

In slow motion I see movement everywhere. Gowned fiends with blue latex gloves, scurrying  about, dousing antiseptic fluid over the mans body as if he were a canvas and this was an art project. I am about to infuse liter number 11 and while on auto pilot, I think about his hypothetical wife and what she is doing at this exact moment. The same moment her chubby husband lies lifeless amongst strangers. While she is sitting in traffic, we are warming her frozen life partner. While she is tuning the radio, I am seeing blood spurt from her lovers mouth, and watching it run into his eyes. I then think about his hypothetical boss and how pissed he must be right now wondering where his chubby employee is. Why was he late? He is never late? OR He is always late. And as he lays with a fake pulse, at a temperature too cold to sustain life, he is simultaneously getting fired. It is all playing out in my head, the revolving door of Trauma India's life. How sad. How devastating. 

Another Level One is rolled in for overtime. Bilateral chest tubes are inserted in hope that circulating warm fluid around the thoracic cavity will do the trick. But because we are a county hospital lacking a few essential resources, like the tiny connector piece that keeps the system in check, we gerry-rig some tubes and voila. Water starts spraying everywhere. It looks as if my esteemed colleagues and I are taking part not in a life saving procedure, but rather a wet t-shirt contest on spring break. The pressurized system had water spraying like sprinklers, people are slipping, bandages are getting soaked. Chaos ensues and a few laughs escape because sometimes, we just have to laugh about the reality of our reality. 

By liter 22, it is clear that Trauma India is not being reincarnated. His blood pressure in nearly non-existent and his temperature never rose higher then 33 degrees. Laws state that not only do you have to be dead, to be dead, but you must be WARM and dead. We worked on him for nearly two hours. Trauma India was dead. Time of death 10:02:37.

We later found out bits of the story. Trauma India drove his white Toyota off the embankment somewhere near the Bay Bridge. When the coast guard boat sped up to the window, they encouraged and yelled for the man to get out of the sinking vehicle. It was slowly sinking and he had time. He turned to them, shook his head and locked the door. 

This 'accident' was intentional. He wanted to end his life and went about doing it in the most dramatic, traumatic and expensive way possible. I am not sure the exact statistic, but suicide attempts are more common then successes. It is rare to treat such a success. And there I was, infusing liter after liter, expelling all my emotions on this man and his hypothetical life. I was physically draining every ounce of my energy to bolster every ounce of his that he had left. As I read about it on the cover of the paper the next morning, I couldn't help feeling less sorry for him then those back breaking moments while trying to save him. And my thin skin feels guilty about that. Because it wasn't just his loss, it was a loss of a trauma team. That was one we didn't get back.

Crazy huh? What's crazy is that it all seems to be falling into place. It just took a little Pie for me to figure it out.

 

By the way...I prefer Tricia

My roommate and I were recently discussing our personality types.  We generalized ourselves as the outgoing, confident type who rarely confront rude people and smile at everyone we see. We take on hefty challenges with the idea that we are pursuing a lifetime dream of childhood goals and aspirations. But we shortly realize that we are just overwhelming ourselves with stress that is both unneeded and harmful to our efforts of anti-aging and our goal to live to 100. We tend to plan plan plan but when it comes down to it, when we look the bottom-line square in the face, we are actually super anti-productive. It is the sad truth.

But it is this personality that has gotten me stuck right in between a rock... and shall we say a hard place? Yes, I will go the cliched road and say a hard place. 

The first 8 weeks in the ER has me working with Tricia, a 28 0r 29 year old (not quite sure because our conversations have never gotten that far) small and mohawked Chinese woman. There is nothing wrong with either a Chinese woman nor mohawked hair, in fact, I once liked both of them. However, now that I am 2 months into having the worst preceptor of all time, I can validly say I hate them when they come as a unit. 

Nothing short of smart, Tricia is an emergency knowledge phenom. I am sure she could recite every pharmacological concoction starting with generic name, brand name, mechanism of action and all the scary side effects...in English and angry Cantonese. No, actually. I think I know more Chinese then she does. She just looks mean enough that she could stand as a double in a Jackie Chan movie. She could guide a nasograstric tube (a nose hose) with one hand and most likely do it blindfolded. She has been working the tribulations at General Hospital for 5 years and I heard through the grapevine that she accelerated through her training 2 weeks faster then the rest of her cohorts. That's like skipping middle school and going straight into high school at the age of 11. If she were an animal, she would most likely be a lion, at the very top of the food chain.

But alas, she is a raging bitch. And in addition to the large gap that separates us intellectually, there is yet another enormous barrier that separates us socially. I am a butterfly and she is a vulture. I am human and she is some rare species of alpha female rodent who eats her young alive. For example: I enter the room, I smile and greet my coworkers. We discuss the happenings of the weather, the crazy weekend plans or the visits of friends and family. Tricia enters the room, smiles at everyone but me, answers everyones questions but mine, gives longer then one-word-replies to everyone but myself. From the moment I introduced myself to her I have gotten nothing but the cold shoulder that inconveniently is at the level of my 4th rib. I see her interactions with everyone else and it is nice and friendly. 

Personally? Why wouldn't I take it that way.

Circa my 5th day of work:

"Tricia, I like your (ugly) shoes. They are pretty funky (ugly)." This is me just trying to make small talk as we sit and wait for the crazy patients to pour in. Co-workers do this sort of thing right?

She rolls her eyes. "Thanks."

She proceeds to ask me questions about the Cushing's Triad and grills me on the three signs we note when this life threatening syndrome occurs with brain trauma. I am almost positive that no one in the room (attending doctors included) could answer this question to the degree Tricia is looking for. She wants perfection and I frankly am close to it, but where I really fall is somewhere in between amazing and compassionate. Just like the rest of mankind,  I get a little lost on the road to perfection. So my palms start to sweat a little and my answer comes out a bit jumbled. Somewhat accurate but not really medically precise. She rolls her eyes and walks away. 5TH DAY MIND YOU.

Circa 2nd week of work:

Tricia and I are sitting in the break room eating lunch. There are three other nurses as well and Tricia is asking all sorts of friendly questions about their kids and husbands and funny traffic confusion which all Asians tend to share. She is laughing up a storm! Glowing with light loftiness found only in the air of good friends. The three nurses finish their last bite and exit back to the chaos which is our job. Tricias' body turns away from me, the smile disintegrates and she grabs the JCPenny catalog that I note has been on the table since I started. We are alone.

"So, Tricia, are you from San Francisco originally?"

"Yes." She keeps her eyes at an angle and flips the page.

"Oh that's nice. So do you have some family near by?" Grinning. I take a bite of my apple.

"Yes." She puts the paper down and takes a bite of her lunch.

"Mmm, what did you bring for lunch today?" Digging pretttttttty deep now.

"Ravioli." She takes the last bite, stands up, throws her fork in the trash and walks out of the room. Absolutely no attempt for a conversation. Nothing. I chalk it up to perhaps a sad past family circumstance. Maybe she has no family. Maybe each time someone brings up the topic she is transported to the image of her arthritic grandmother who bears no teeth when she opens her lips because they could never afford proper dental care in rural China. Or maybe she just hates me? I fear the latter is more honest.

There is so much clear and evident neglect one can stomach until it starts to rip away dignity. I have really tried not to take her rudeness as personal assault but it is nearly impossible when I witness her go out of her way to avoid interaction with me. This job is challenging enough, I really shouldn't have to kiss major ass at the same exact time as trying to learn the quintessential pearls of life saving. People like me. Generally. I have never not gotten along with someone I work with. In fact, I was once told by a manager, when I was a hostess at the Macaroni Grill in high school, that if he were to ever have a daughter, he hoped that she would turn out just like me. (Awwww). And when I quit my job at Northwestern, I am quite certain that tears streamed from every nurse on that unit. And when I left my job in New York I was coined the "flyest travel nurse Methodist Hospital eva' has seen." So to feel this sense of "dislike" from Tricia has made me question her judge on character.

Like all names with more than one syllable, it is common for people to shorten them. It allows for smoother communication. For example: I know plenty of Josephs that go by Joe. Many Elizabeths that go by Liz or Beth (but the most important one hates that :) Some Sarahs that respond to Sar or even Dominics that answer to Dom. When I address my mom by her first name Julie, I more often than not shorten it to Jules. I think this ties to the evolution and efficiency of  the human brain as it is much quicker to call someone, "Trish" for example than "Trish-a". For "Trish-a" does not roll off the tongue as easily as "Trish."

And I really knew that Tricia hated me when this happened...

(I am walking over to the pediatric cart to pull a pulse oximetry sticker to check an oxygen saturation on a febrile and barfing child which means absolutely nothing to you who are reading this but just know that I was doing the right and perfect thing. Tricia is behind me, following, but I don't know this. I grab the sticker. I turn. AHHHH! She is right next to me.)

"When you go into the room, does the child always start crying?" She glares me down.

"No. She cries whether I am in the room or not." I know what you are insinuating, A-hole.

"Oh. I prefer Tricia, by the way."

 Well, Trish, that's about as non-sequitur as it can get.

I smile. "Of course you do."

Ten minutes later, Dr. G calls across the hallway, "Hey Trish! Can you help me move this Gurney?"

The next morning I hear Dell, the transport man, greet us in Zone 4. "Good morning Trish, how goes it?"

Just last week, the unit clerk gets on the overhead and pages ever corner of the unit: "Trish, you have a phone call on line 2. Line 2, phone call for Trish."

I better alert San Francisco General Hospital in its entirety that "Trish-a" is the new "Trish"...I clearly was the only one to get the not so friendly memo.

There are nights I wake up from tremendously vivid dreams and feel a pit in my stomach that burns like acid. (Some call this anxiety.) I hear her shrilling voice enter my ear, creep through my ear vestibule and end up in the confines of my thoughts. I then throw up a little in my mouth and have a hard time falling back asleep. I am literally losing sleep over how rude this person is. Does anyone else find this unfortunate? If school teachers can laid off for budget cuts and priests ex-communicated from the church for child molestation, then certainly Tricia could lose her job over this rare form of cruel and unusual hazing....right? 

The weird thing...I feel bad. I feel guilty to exploit her on Blind Karma like this...even though the anthology of her wicked behavior should warrant a citizens arrest. Trish and my time together has come to an end (woowoooo) and although I have not said a word to her (I returned that ball to her court the very first day when I said "Hi" only to have her ignore me and curl her lip in a funky direction...) I saw that she had a very nice shade of purple nail polish on today. Nice people like purple so I am sure somewhere under that thick layer of mean and her teenage mutant ninja turtle hairdo, there is a kindred spirit. Maybe even a comrade that, over time, I will be able to hand her an Auto-Transfusion tube and say "Hey, Trish, let's you and I go give that man 700 ml of his own blood together and then laugh about it later when we are giddily restock the trauma carts." Maybe one day, as we are getting off work and punching off the clock, we will walk outside...me to my bike and her to her car...and she will wave..."See ya later Jame. Hope that chain stops falling off! See you bright and early :)!" 

For now, I will take it for what it is. Tricia and I are not a thread that looks well woven into a common quilt. We are different. And that is OK. I see that I am learning more than just skills for a job. More than just skills that critical for the well-being complete strangers. I am learning that in order to have personal well-being I need to embrace the "Trish"-es that ebb and flow in my tide pool of reality.  I don't need a new friend. I have plenty of those. I need Tricia as an instrument to guide me in a direction that is beneficial for myself. 

So, instead of pondering emotions of complete agony in your presence, I want to thank you Trish, for being a bright compass that motivates navigation towards positivity. Right? Because it is easy to show compassion to what you like. What is life worth if everything was so easy. In trenches of negativity, this may be the blindest karma of all.

Jack of all trades, Master of none

The bad news, is that Blind Karma has seriously gotten the brushoff. If it were an object perhaps it would be quite dusty.

The good news is, that the reason I haven't been spewing stories of lice infested alcoholics with eruptively phlegmy and TB infested coughs, who make unnecessary swings at a compassionate nurse, while simultaneously dying from HIV, Hepatitis C, severe pneumonia and a slew of co-morbidities (more on Mr. Tex later), is that I have been overwhelmed with the task of learning how to save lives. 

Some relatively minor and basic essentials for survival in the field of emergency medicine have infused into my brain. Such as how to pharmacologically decrease a Supraventricular Tachycardic heart rhythm when a patient presents with a pulse of 220. Or the simple Intra Osseous access port(inside the bone...people) used on the unfortunate souls who present with little to no veins. These can only be placed by using a hand drill. No biggie. Or how about the amateur task of consciously sedating a patient while pushing versed and fentanyl, while manually extracting clots from their uterus. Elementary.

What has been challenging is this. Urine. Vomit. Urine and vomit. The worst is when a patient has both urinated and vomited while phasing into a seizure, a cardiac dysrhthmia, an altered mental state, or all of the above. The most vital take home point that I have actually taken home on my scrubs, is that I can't stand the smell of urine and, I throw up a little bit myself when I see someone vomit. What can I say, I am weak. I have also learned that there are only two types of Paramedics; there are the very hot, attractive ones that are tall, dark and handsome and there are the short, stout, lesbians. Nothing in between. 

So, because I am learning to prioritize and manage in a way I didn't think my brain was capable of, I render to you a glimpse of my new job...from the beginning....

The San Francisco General Hospital has quite a reputation. A county hospital set on the slope of Potrero Hill, 'The General', serves as the only level 1 trauma center for the great city by the Bay.  It is refuge for the uninsured, the underinsured, the homeless and the mentally unstable. It is gritty, worn in, worn out and weathered. The minds that steer its' course are incredible. So, I stand professionally on my first day, in the ambulance bay, stethoscope around my neck, pen in my hair, smile on my face, butterflies in my stomach, staring at the large bold, red sign; EMERGENCY. This is where dreams come true, huh? No, this is where people come to die. This is where the magic happens? Or, this is where miracles happen...sometimes...if luck chooses to be on your side. Is this where my brain will grow enormous from becoming so smart because I have to know everything there is to know about saving a life? I guess so.

I meander through the line of sick people, waiting by the dozens at registration. I am one of 6 newbies today. All brand new to the art and science of this environment, weaving in the delicate thread of our previous work experiences, adding to the fine medley of colors that make up our new dynamic work force. We shyly crowd into the report room where faces stare at the unfamiliar. These strangers crack ribs. Soon, I will crack ribs too.

Quick introductions rally around the room and soon the WELCOMES! and the GREAT TO HAVE YA's! and the I FEEL FOR YOU'S! start firing like a torpedo. There is only one male in our training group, which makes me feel bad that he will be inundated by estrogen. But, he knew what he was getting himself into as he registered for that first nursing course and put on a pair of the ugly, white starchy scrubs. I bet he feels overpowered by the stream of lady energy that is circulating the room. Or maybe he feels awesome.  I take a look around. I inventory the staff and see that unlike Labor and Delivery, the ED offers a variety of genders; both male and female and likely some that are in the middle, being San Francisco and all. I see there are actually several Murses.

The two standing managers do a fast official welcome speech and I am finally able to put faces with the voices that I have been talking to over the phone for the past two months. They reiterate their excitement of our presence and explain the theoretical 'open door' policy encouraging that all and any questions be brought to their attention without hesitation. 

We are reminded that the General is a diamond in the rough, a sanctuary in a world of chaos, a haven for the lost. We are told that everyone who works within these confines upholds the utmost respect for all, regardless of how many times a drunk man comes to the ER, reeking of bourbon, drooling and trying to touch the nurses boobs. You smile, you push him away, and then you pump his stomach. Easy. And all with a smile.

But what really permeated into my brain during this initial 30 minutes was what was said about the nurses whom we now can call colleagues. "We are a solid bunch. We work together. We are the jack of all trades, but the master of none."

The room fell silent for a moment as these words escaped her mouth and into our thoughts. Her silvered hair spoke volumes to her experience yet her modesty gave evidence that her head was not imploding with self-righteousness. A head that balanced Harry Potter shaped glasses and that sat upon a pear shaped figure. 

As you all can guess, I have a terrifying fear of commitment (as evidenced by the 4 different moves I have made across the country in the last 9 months and my ever changing work status). I hope that I will one day grow out of it so that I can have a family with a husband and great, respectful children, and that I am not found hallucinating and delirious like my patient, Ms. Fawn,  was found today. No medical complaint. She was very happy. The paramedics just happened to see her minding her business as she rhythmically undulated against a public garbage can. Her arms were swaying gracefully up above her head as if she were conducting an orchestra. Her eyes softly closed like she was in a dream, sifting and riding the tunes emitting from her make believe symphony. When we would ask her 'how are you?', she would say 'what?' When we would ask "are you in any pain?", she would say "What?" When we would ask "Ms. Fawn are you crazy and did you inhale, shoot, or inject lots of crazy drugs today?" she would say 'what?' The whats were in the tone of "What, what are you going to do about it?" Not, whaaaaat? as in what are you saying. Hmmm.

I figure if I can just stay sane enough to give this department the 2 years I promised them (do I even know how to do that?) then I could certainly commit to anything. But this was just the first day and as Harry Potter sat in front of me, talking at length about California and its' sorry excuse for a budget, I fought to keep my mind free of an escape route. You are here. Be present. 

The trauma phone rings and a raspy voice is heard overhead. The sound is loud and echoes through the linoleum hallways. A 26 year old male cyclist hit a parked car and broke the windshield with his face. No helmet. My eyes went large and fixed. "I never wear my helmet," I mumbled as I pictured my body flying into a shield of glass only to be shattered by my once already broken nose. "Working here will certainly remedy that," someone replied.  

I always speculate, while riding my bike helmet free, how the scenario would play out if I were to be jacked by a semi truck or sideswiped by a suburban. I visualize my body being catapulted into the air, flipping multiple times and landing in a way that would disfigure me for life. I then see myself wrapped in bandages and hanging from a trapeze swing-like device, mobilized in the exact angle needed to heal my crumpled bones, in a facility where there are no stairs because no working legs are around and everyone has to get up and down by electric elevators. I am eating through a tube and will never again enjoy the crunch of a carrot stick nor the snacktivity of eating sunflower seeds because my jaw bone has been wired shut. I am staring blankly at a television set that plays the PGA tour and am excruciatingly annoyed that my fingers can not bend to pick up the remote control.  All because my helmet doesn't fit when I wear a pony tail.

The 26 year old survived but his girlfriend was pissed at what his face looked like. 

The trauma radio chimes again. A 56 year old female, found on kitchen floor, suspected of shooting herself in the head. Breathing. Alive. Just barely. 

I didn't get a chance to sneak my head in on this one as there were already 17 people crowded into the trauma room.  In the air though I see things flying. IV tubing and monitors, gloves and medication viles. After a few hours of hard work, the woman came out of it alive, no thanks to us. I assume when she wakes up to find her heart still beating and more holes in her head, she might be disappointed. 

A loud nose expels from the ambulance bay and a woman, who is 32 weeks pregnant, is rushed in, legs spread with a head propped between her thighs. They are hauling her into a room so that the child is born with class, and not on the unlucky surface of Gurney #8. This baby is coming and nothing is going to stop it. A smile collects to show my pearly whites as this is the first normal process I have seen today. Looks of disgust wash over my colleagues as I hear them, almost in unison, say how gross it is when they deliver in the ER. 

Hold the train. You can watch brain matter and internal organs erupt from skulls and abdomens and it's no big deal? You can daily remove soiled clothing from crack attacked psychos and flush nasogastric tubes without a flinch? And you think the delivery of a baby, the miracle of life, the most joyous moment in most parents life, is repulsive? This made no sense. And although no one knew my name, they simply referred to me as the 'the one with labor and delivery experience', I was pushed into the room where a natural progression from in-utero to extrauterine life was unfolding. The obstetrics team was on hand and both mom and baby were fine. Sometimes, they just come faster when it is your 5th child.

And this was just an 8 hour day. I left feeling enthralled. Eager to learn and read and practice very small vein and arterial blood draws. To know how Sepsis really effects the organs. To determine how crystals form on synovial fluid when diagnosing gout. To see the progression of infection follow the airway, in through the mouth, down the wind pipe and spread through the branches of the bronchioles. To differentiate the signs and symptoms of meningitis and how it differs from other viral and bacterial infections. To learn the 8-point blocking system when someone threatens to rip my head off. To learn how to talk a suicidal patient down from their manic phase. To know why a pint of vodka a day is incredibly disgusting and how debilitating alcoholism can be to your body, your life, your family. To quickly fasten those damn condom catheters to prevent fireworks of tainted urine from spraying me and the already yellow tinted walls in zone 4. 

To be able to save a life. 

Carnival: Mission Style

The South American celebration of Carnival (Carnivahhhhl, if you will) has been transplanted to my neighborhood here in San Francisco. I often refer to my hood as Little Guatemala as when walking, biking or taking any type of public transport, you feel like you are in another country. My neighbors, the hombres that hang out on the corners and the women at the produce markets don't really speak English. I can't count my choppy Spanish as conversational so really, I often feel like I am abroad. It is the most amazing place I have ever lived. Here are some pictures of the celebration...

The parade started right on my corner. Apparently every year they festivities kick off following this Aztec blessing. Their feathers were pretty radical.

Next years halloween costume? You can't really see them but her anklets are loud and awesome.

Although it feels like Latin America...the reality remains San Francisco through and through.

Omnipresent.

My newest goal...including socks and hat.

This mans belly kept rubbing my arm and my back, and my hand (now that I think about it), as I leaned over the rail. He looks like Santa but when he smiles his missing teeth just look scary. He said I was the nicest person he has ever met.

I really can't say enough great things about where I live. I see the sense of community in every thread and thumping beat. In the loud music that often expels from each corner dive bar. From the bumping of low riding cars adorned with bright orange flames. To the magnificent murals that paint the sides of the building and alleyways. The smell of tortilla and frijoles linger from the early mornings late into the nights, and is often replaced by the smell of urine in our front stoop planters. The sound of clanking bottles and cans stroll by as random passersby wheel them away in their stolen grocery carts. My roommate and I just heard a gunshot and after I called 911, I had a real sense of belonging; like I really am becoming apart of something. Such a wonderful and charming neighborhood. It is.

Goodnight to the life of leisure. Tomorrow I start my job in the ER where I am sure to see some of my smiling neighbors as patients....for a number of reasons. Bienvenido!

Can I have your attention please?

It felt less like an airplane and more like a lounge, really. It is nearly midnight. Fluorescent purple lights line the row of black leathered seats. A red glow bounces off the drawn window shades from the individual television sets that adorn the back of each headrest. You can't pick out the flight attendants easily because they are not wearing a common uniform nor do they pin their names to their chest on generic winged badges. You just assume the man greeting you, cell phone in hand, helping you with your overhead carryon is an employee. Smooth jazz music plays over the speaker. Virgin America is ranking high in my book.

I make my way to row 19...and glance to seat E. The sleepy and handsome Indian man sitting in seat D stands to let me in. The window seat is unoccupied and I silently hope that F remains empty for the remainder of the flight, so that I can rest my feet maybe on the window sill and my head maybe on my neighbors shoulder? I nestle in and begin to read the screen in front of me. What? WiFi? Yes, WiFi. Virgin America not only appeals to very attractive people...as that is all I see on this aircraft, but it also offers wireless internet service. Is this a dream?

All the overhead bins fill and the flight attendants begin to close them for takeoff.  My eyes wander to the numbered rows and I notice that I am a huge moron. I have mistakenly sat in row 20...not 19. I start to get just a bit nervous as I am already crammed into my seat. The sleepy Indian man has already comfortably relaxed, with his arms folded nicely into his lap. I would feel like a fool to make such a tired man move because I messed up. I turn to him and say "this isn't row 19 is it?"

He glances at the number, 20, that looms above. "No, it's not." 

I exhale loudly...maybe too loud? and express my deepest hope that no one else boards. The man looks up and we both witness an empty hallway. "Looks like you may get lucky," he says. This is when I notice that he is really attractive and wonder if the luck will get me a new york date.

And then it starts. An hour or so of small talk. He is originally from India (fist pump) but lives in New York as a banker. But he isn't as lame as most New York bankers because he lives in the Bronx and I give home extra points for that. I can't resist. I tell him my crazy thievery story of Delhi and he tells me that it is the most incredible thing he has ever heard. Because it is. He likes that I am from Utah and tells me about the camping trip he took just last year. He says that Delicate Arch is the most beautiful thing his eyes have ever laid upon. What he MEANT to say is that Delicate Arch is ok...but you!...you are stunning! 

We both yawn (it is the Red Eye you know) and he says he unfortunately has to work in the morning. I agree that some sleep is in order, I mean, I have to shop for my maid of honors dress in the morning. Exhausting.

Just as my eyelids meet each other for some rest, an announcement is made. "Can I please have your attention. We are experiencing a medical emergency. If there is a Nurse or Doctor on board could you please ring your call light. Thank You."

Now, if I recall, the last red-eye flight I took, this same exact thing happened. Lesson learned. Is this a nightmare? No matter how many life threatening situations one encounters in a hospital there is something that remains calming...you are in a hospital. 

I reach my hand up and hit the call light. I notice that 2 or 3 other lights go off and some relief lays over my nerves. But the relief dissipates...the others 'refused' to help. Assholes. So me and a man stand in the aisle, offering up our services. Apparently, a lady found her way to the back of the plane so that she could barf all of her insides up. A nice deed as that bag could have easily been her neighbors lap. We glance at her sorry state. "You know, I'm just a medic. You're the nurse...you should go." Then, the man I thought was a helper; a renegade; a man with no fear, turned around and sat his selfish self right back down in his seat...19 F. My should-have-been neighbor.

The ailing, vomiting passenger couldn't have been much older than myself. She looked so sick. Her elbows resting supportive on her thighs, her head bowed and leaning forward, perfect and proper throw up posture. An oxygen mask held up to her mouth by the female flight attendant. Her hair was a little wet from the sweat that dripped down her face. Her skin was clammy and cold to touch. Her body convulsing.

"I don't know what is wrong. I just don't feel right," she was able to mutter. It was clear her anxiety was increasing as the number of people staring at her rose. She was starting to panic. The male flight attendant in a not calm enough manner shouts "HERE! Take this!", as if we were in an action film. It was a small black bag, the size of a carryon perhaps. I unzip it to reveal a mini clinic. Clinic in a bag. Every emergency drug you could imagine. 

I ask her the basics. Are you pregnant? Are you allergic to anything? Did you eat something that just isn't sitting right? When did it start? Blah blah blah. She told me she had just spent three days in Vegas. "Ohhh so you are really hungover?" She denies that she even drank (shaw right) but claims the pizza she had for lunch came up in the airport bathroom. Her vital signs are normal, including a mild temperature of 98.1. I give her some Phenergan and hope that she can stomach it. Of course she doesn't and all the fingers point to me, again, to syphon through her puke to see if the pill had come up with the pepperoni. I am surrounded by Assholes. I feel bad as there is nothing I can really do for her. I tie her hair up and rub her back assuring she will live to eat pizza another day. 

I ask her name. When she responds it gets drowned out by the loudness of propelling engines which made it really difficult to be a personable nurse when I didn't know what to call her. The flight attendants didn't remember either. I try to make small talk. 

"So what do you do in New York?", I crouch and ask her...loudly so she wouldn't have to puke and try to decipher what I was asking at the same time. 

"I'm...(gag)..unemployed." Shoot.

It all pointed toward the flu, which at 30,000 feet above the earths surface can feel like the plague. The congregation of the young flight crew stared at me in awe. They wanted to be nurses. They wanted the ability to break that little plastic lock on the anti-nausea zipper. They wanted the pilot to be nice to them, the way he was to me when he realized that I could probably save this persons life (my back rubbing skills are that good).  They asked me what is takes to go to nursing school and soon, the attention is no longer on the patient but all 6 sets of eyes are on me.

"You know, nursing is hard. It is a lot of bull shit sometimes. But so much reward comes from the work I do. Especially when people are grateful for your help." I smile , casting a bling in my pearly whites.

"Is it like Grey's Anatomy? Are nurses and Doctors hooking up all the time?"

"Well, I can't say that it is, however, I can say that most anesthesiologists are pretty hot and eager to meet nurses. Especially if they are Indian...as in from India. They will even cheat on their wives for a night of a wintry makeout session...so I hear. Especially if they are Indian. They are very smart and intellectually stimulating. Mostly the Indian ones." So then every single flight attendant on board is circling around me, as my patient remains puking, and I tell them about all the scandals of the nurse/anesthesiologist love triangles. They are loving it and I have them all convinced that they indeed need to trade the swanky flight attire and those neat can opening rings for that of scrubs and a stethoscope.  Their eyes grow big and round and almost in unison I hear them say "wow...ane..sthes...iologists...huh?"

"Yeah, pretty slimy characters but quick with an epidural and quite fun to look at." I turn to the patient who seems un-entertained by our conversation as her body is twitching with each dry heave. 

"My uncle is an anesthesiologist," she says. I look up to the others, creasing my lips in a manner that without speaking says 'oops'.  "He's not from India, though right?"

We clear a row for her to lay down and she can't stop thanking me. Thank you for this and thank you for that. I tell her that it was my pleasure to fish through her puke, hold her hair, remind her she doesn't have a job and pretty much say, in so many words, that her uncle  is most likely cheating on her aunt with an attractive young nurse. I tell her that I really hope she can find calm in all the turbulence that is happening now and likely for the remaining hour and half of the flight. "I also really hope you can find a job...the market is just so bad right now." She closes her eyes. The look of disgust remains on her lips.

She lays her head down on the tiny plane pillow, her knees as crawled into a fetal position as she can manage, her face looking miserable. 

Yes, the life of a nurse. The feeling of accomplishment. The feeling of knowing you have helped someone. Really saving a life when it is on the brink of ending. Ahhh, what a sense of satisfaction. 

I sit back down and tell my heroic story to the my 20th row crush. He says he is glad that I was able to help. "Does it make you want to ask me on a date?"...is what I want to say but I just describe to him in detail what her throw up looked like. Then I start to get pensive. How much life saving did I really just do? Eh. I close my eyes and begin thinking about how I could wiggle my way into 19 D's life, saving it of course from a life of boring banking. 

Only on a red eye flight...