Friday, March 30, 2007

Happy Day (A Green Acres Interlude)

[Scene: The conference room, 8 a.m. Several staff are waiting for morning meeting to start. There are two boxes of donuts on the table. Dr. Turbo walks in.]

Staff #1: Happy Doctors’ Day! I got you guys donuts!

Dr. Turbo: Oh, thanks—that’s really nice of you.

Staff #2: Wait a minute-- it’s not “Doctors’ Day"! It’s Social Work Day!

Dr. Turbo: Actually it’s Social Work Week right now. They get the whole week. We just get a day. They happen to overlap.

Staff #1: The nurse from the clinic is having cake for the doctors at 11:00…

Staff #3: …but you can’t go, because you have a treatment team meeting.

Staff #1: And the administration is having punch and cookies for you at 1:00…

Staff #2: … but you can’t go, because you have a new admission coming then.

Staff #1: So anyway, Happy Doctors’ Day!

Monday, March 26, 2007

Proof Positive

Some while back I wrote a post about global warming, which garnered considerable derision from “Anonymous”.

But there really is no argument. It’s happening. I’m convinced. The proof is that my snow tires have been coming off earlier and earlier ever year. If it wasn’t getting warmer earlier in the spring, the summer tires would not be coming out so soon. This year they came out on March 25th! My grandpa used to say, as a general rule, that snow tires stay on till Easter. Well, that may have been reliable back in the 80’s—but these days, not so. Just look at the graph below. Hard data don't lie.

Saturday, March 24, 2007

Why Can't They Make VW Engines Out Of The Same Materials?

I have demonstrated a certain amount of passive aggression towards my pagers, over the years. As a resident, one hot evening after work, I went canoeing down the river and decided to jump in the water, forgetting my pager was still in my shorts pocket. I realized it pretty quickly, sort of had a "serves you right, you beastly device" attitude, but nonetheless tried to revive it. I took it home & put it in the oven overnight, at about 160 F. Annoyingly, it was its beepy little self in the morning.

Later on in residency, I was in a hospital men's room and put my pager on a little stainless-steel shelf for a moment while I changed into scrubs or something. Then the pager went off. Unfortunately, it was in "silent vibrate" mode, and silently vibrated itself off the shelf and plop into the toilet below. I borrowed some disposable surgical implements to fish it out, soaked it briefly in antiseptic solution, rinsed it, and baked it again in the oven. Voila-- resurrected.

About six weeks ago, we had a good sized blizzard in the Smallish State. I got home from Green Acres and set about shoveling the parking spaces, driveway, neighbor's parking space, sidewalk, and a clear path to the main road. At the end of the hour or so of shoveling I noticed that my pager, which had been clipped to my belt, no longer was so. I surveyed a hundred yards of waist-high snowbanks. I went in the house, got my cell phone, repeatedly paged myself, and paced all around for half an hour straining my ears for the faint, hated "beep". It was similar to an avalanche-rescue drill I once participated in. But I could not locate the victim. Back at Green Acres, I received a chiding for losing my pager (which, by the way, I had faithfully protected for over five years) and was issued another one. As punishment, though, my new pager is bigger, heavier, and much more shrill than the old one. It's so hideous in tone that, even though almost everyone at G.A. has a pager, when mine goes off everyone turns and says "What the hell was THAT?"

But! Today was a warm and sunny day in the Smallish State. We drove a state over climbed up Mt. Monroe (next to Mt. Washington) for the above-treeline brilliance. Walking back up the driveway, I saw, poking through a small remaining slushpile, my old pager. It was muddy and battered. It didn't turn on. I brought it inside. I put a new battery in. Beep beep beep beep.

I gotta go, they're paging me.

Wednesday, March 21, 2007

Farm Living Is The Life For Me

Green Acres is fairly rife with “therapy animals”. Originally, years ago, there was just one authorized non-human “therapist”, a clueless but loveable elderly black lab. He left when his master was fired from the hospital. About the same time one of my shrink colleagues had a new puppy, which couldn’t stay home alone all day. So she brought the puppy to work, forging a phony “therapy dog certificate” so that Green Acres administrators wouldn’t give her trouble. She was ultimately fired too, quite spuriously, for reasons having nothing to do with the dog (which, so far as I could tell, had no therapeutic skills.)

A year or two back, there began a proliferation of “therapy” creatures, such that we sometimes had more than one at a time in-house. During a particularly active “therapy” session, involving two dogs and a half-dozen patients, on mutt collided with another head-on at high speed, causing the first to be knocked unconscious, bleed from his head, and have a dramatic grand mal seizure. The patient had to be whisked away for emergency veterinary care. This whole scene greatly distressed the (human) patients, one of whom came screaming back to the ward, demanding that the offending dog be killed, then stating that she herself was suicidal. It took all afternoon to calm her.

Subsequently, someone brought “therapy” miniature goats into the building. I am not making this up. A nurse came to me and said “You should go over to the gym and see the goats!” It was like some sort of Greek nightmare.

Today, I found myself roaming the hospital with a patient’s family in tow, trying to find a private place to have a brief meeting (this can be a very challenging quest at Green Acres.) The patient related to this family nearly died of a severe drug reaction, and remains in a precarious state—so I have been working hard to let the family know that we are professional, trustworthy, competent people. During our expedition through the facility, we abruptly entered a corridor of staff offices. There was no hiding the fact that the corridor was littered with dog kibbles, that a recreation staff person was standing in the middle of the buffet, and that a small, hyperactive dog was running about gobbling up the food.

It was one of those many moments when I almost, almost quit.

Tuesday, March 20, 2007

This One Goes to 200

At Green Acres, the nurses and other staff commonly record patients’ mealtime eating in form of a percentage—for example, “Client ate 100% of breakfast”, or “Client picked at his lunch, ate 50%”, or “Client said supper looked like feces, ate 0%.”

This morning, however, I found an entry reading “Client ate 200% of his dinner.” There’s only one way I can see this happening, and it’s not pretty.

Give Me Silver, Blue and Gold

En route to Taos, I was out in Mountainous State visiting Co-Chief. It sure was great to hang out with him again, and spend some time with his family. In case you’ve never visited Mountainous State, here’s a photo of what heaven looks like (minus the angels.)

P.S. You can't see the "gold" in the photo, but it refers to the cost of a lift ticket at this particular location.

Thursday, March 15, 2007

That's Right I'm Not From Texas

Fading down here in Taos, New Mexico for a short bit. Warm air, warm adobe, still some snow in the mountains— all as expected. What I hadn’t expected is the overwhelming preponderance of visiting Texans. Virtually everyone we’ve met is from Texas. The lower ski slopes at Taos Ski Valley were crammed with snowplowing Texans. One guy in the lift line was wearing a cowboy hat and full-on leather chaps. The cafeteria was full of “y’all”-ing. The parking lot was wall-to-wall SUV’s with Texas plates. Every lift ride was with a Texan—“It’s the closest skiing to home—just a 12 hour drive, you know.” When we mentioned being residents of the Smallish State, people would ooh and ahh—so exotic!

This morning at breakfast a family with distinctly foreign accents sat down adjacent. I overheard that they were Isreali, and struck up a little conversation. “Long trip for you to get here!”, I said. “Oh,” said the dad, “We’re from originally from Haifa, but we’re living in Austin right now.”

Monday, March 05, 2007


Full moon again, and all hell breaking loose at Green Acres. Why haven't I learned to take these weeks off? Seriously.

Friday, March 02, 2007

Strange Medical Orders I've Had To Write, Part I

"Patient may shovel snow today with nursing supervision."

Green Acres Snow Day Attendance Scorecard

On my unit:

Docs: 2 for 2
Nurses: 5 for 6
Sign-Language Interpreter: 1 for 1
Recreation Therapists: 1 for 2
Ward Clerk: 0 for 1
Social Workers: 0 for 3
Patients: 24 for 24