ER

hello, muffin.

I missed two IV starts today. they should have been fine: the first was a 36-year-old man with veins you could see from across the room. he looked me straight in the eye & gave me a big, relaxed smile when I asked to start his IV; somehow, that unnerved me more than anything. the other patient was experiencing a possible heart attack. his face was bunched up in pain as I set up my supplies. I couldn't feel his vein, but I could see it faintly traced beneath his olive skin. both times I slipped the needle in & felt my heart drop when the little red flash didn't appear. the nurse silently took over, giving no further indication of my failure. but I felt it.

in post-conference, the other students eagerly asked what I did in the ER. I gave a brief report & admitted that I missed two IVs. "Both of them?" their eyes said incredulously. but they were quick to reassure me. everyone has to learn somehow. it's okay. it's no big deal. let it roll off. 

God gives us what we need. I needed a little humbling today. 

highlight of my day: being assigned to watch a patient's 4-year-old daughter, who spoke only Spanish. but that was alright, because we both spoke the language of Peekaboo, Fishy Faces, & Listen-To-Kristen's-Heart-With-Her-Stethoscope. she was my shy little friend: no questions asked. when it was just me & her, I didn't have to worry about looking grown-up and official. [I dislike acting like more than I am, but I stubbornly insist on trying anyway. let.it.go.]

as I did my 0945 charting, it hit me like a thunderbolt. 11 September. September 11th; 9/11. today. I looked around the ER with new eyes, wondering what it would be like to see its halls transformed by chaos and unbelievable reports from the field. trauma patients pouring in through the paramedic bay, trauma alerts sounding over the intercom, each room a scene of tragedy happening in real-time. what would it be like? what was it like? 

I can't even imagine. God help the people whose memories are forever stamped with that scene. may He bring them the comfort that can only come from His presence.

can you feel that? that's your heart beating against your ribs. it's your lungs expanding in perfect harmony. 

it's a gift. 

always,

rory

life is beautiful

dear muffin,

she was nervous. I couldn't blame her.

terse replies were all I could draw out as I finished my work; her face was taut, expressionless.

it's doubtful that anyone in the history of the scalpel has not been nervous in those moments of waiting. moments before the wheels begin to clatter along tile floor, rolling past sterile operating rooms. after all, the idea of having one's insides opened to the world has never been a pleasant one. 

"okay then! I think we're ready." the nurse deposited an armful of IV bags & tubing into my waiting hands. "make sure you keep that piggyback higher than the primary fluid," she said in my direction. 

we helped the woman onto her feet, allowing her to smooth back disheveled blonde hair, & began the procession. the nurse led the way with routine briskness, followed by the patient herself. I took up the rear, holding the IV bags at shoulder height & keeping the train of tubing off the floor. 

her surgery was scheduled for 0800 hours, which meant it was already 30 minutes behind schedule. but no matter. the mass of foreign tissue growing below her diaphragm would be removed, the incision sutured, & before she knew it the whole ordeal would be over. still, no reassurance can shorten the moments before the plunge.

inside the operating room, every surface glinted in sterile perfection. scalpels arrayed with mathematical precision, gauze neatly stacked, suction equipment hooked up & tested. sterile blue drapes were spread over the table, ready to receive the patient.

"and, the surgeons are here." announced the circulating nurse. "Michelle, you want to get them ready?" the scrub nurse nodded & began unfolding blue plastic gowns as the surgeons poured into the room, followed by the woman's husband-- who looked ready to faint. while they scrubbed in, the anesthesiologist struck up small talk with the patient.

"so. how're you feeling?" he asked after a moment. the woman laughed shakily.

"you know that part on a roller coaster, when you're going up & all you can hear is 'click...click...click...?' that's what this part feels like." 

"alright!" announced the head surgeon. "we're a go." the light glanced off the first scalpel as it went in. 

blood. blood trickling down a swollen abdomen. the smell of burnt flesh as cautery hits blood vessel. the surgeons opened the skin with a smooth cut & then burned back the yellow fat beneath. I moved to get a better view.

there; I could see it. a mass rose into sight as the abdominal muscles separated. it was smooth, taupe-colored, with a complex pattern of blood vessels visible beneath the surface. it was larger than I had imagined. the surgeon made one final slice, reached in deep, & pulled. as he lifted, the foreign body came free in his hands.

he held up 8 pounds, 3 ounces of tissue. & as he moved it towards the light, it kicked him.

the room launched into motion. nurses closed in, transferring the now-wriggling mass to a table. the table disappeared from view as blue scrubs bent over to perform a well-practiced dance.

"heart rate 150."

"BP 67 over 35."

"O2 sats?"

"68."

"looks good!" announced the pediatrician, laying aside his stethoscope. a nurse gathered up the bundle & brought it over to the woman & her husband, who was furiously rubbing away tears of joy.

"Here you go," said the nurse with a smile. "Congratulations; she's beautiful."

-rory

watercolor windowpanes

dear muffin,

on the playlist today: Jonsi. good stuff. http://www.youtube.com/watch?v=sVcjArU_qCo

I like this kind of day. it's a rain-on-the-windows, tea-on-the-stove kind of day.

rain is beautiful. I love the patterns it makes as it parades down the windowpane: suddenly, our ordinary backyard is transformed into watercolor. and it's not like the framed masterpieces in a gallery, where you can sit & stare philosophically at every detail for hours. [or years, if you're unfortunate enough to be a grad student.] no; this canvas keeps changing. it's always new.

this weather makes me wish I had an antique writing desk & an oil lamp. not sure what I'd write, but it would certainly be better for having been written in such a setting. seems like nothing but profound thoughts could come out under the influence of a fountain pen and flickering candlelight.

as it is, I have a computer instead of a writing desk and a keyboard in place of a fountain pen. the basement lights can't be called romantic by any stretch of the imagination.

but I do still have the rain, and it makes me want to write.

today is the 17th anniversary of my brother's arrival on earth. to celebrate the occasion, we blew up balloons [thus terrifying the dog], stuffed him with chocolate chip pancakes, and told him we plan to keep him. I think he was gratified to hear this. at least if the number of pancakes he ate is any indication.

it's a strange thought: on this day 17 years ago, my 31-year-old mother was in labor. thrilled to meet her first son, she kept glancing at the clock and wondering when he would arrive.

5 long hours and then suddenly it was over and he was there in the Navy doctor's hands. kicking and wriggling and pink in the face, bellowing his objections to the world.

mom tells me that when she first brought him home, I piled my toys around him in an effort to make friends. [toys being influential in garnering social popularity among little people.] apparently, he was not amused by the wall of technicolor plastic around him. oh well. I tried.

thereafter we went from being to best buds to arch-enemies to dear friends. it's been fun.

funny how we use chocolate cake & curling ribbon to commemorate stories like these. seems like stone tablets & sagas recited around a fire would be more appropriate.

[even as I write this, the clouds are breaking. now my window is filled with sun and floating yellow leaves.]

so. here's to chocolate cake, to years, to growing up with your best friends... to joy.

always,

rory

after the storm

muffin! oh hi. =]

firstly I ought to warn you that there is nothing of importance in this post. seekers of wisdom or profound sayings, go no further. consider yourself duly warned.

so. I basically love this: 

http://www.youtube.com/watch?v=9DPbJorCcNw

[hear it out & let it grow on you.] How have I not heard them before?!

note:: please do not tell me you've known about them since you were 4. you would simply be joining the masses of humanity who all seem to have been born with mumford&sons playing in the background, while I frolicked around in musical ignorance. 

second note:: I have heard OF them before. but for the longest time their name simply swirled through the dim, cobweb-y recesses of my brain along with similarly unknown artists such as [don't judge]

selena gomez

fallout boy

florence + the machine

eminem

flogging molly

I know nothing about their music [although maybe I have unconsciously heard songs of theirs without realizing who they were]. these are all names that are stuck in my head, surfacing every time I hear someone mention them. perhaps someday I'll look them up on youtube simply so I can say, "oh him? yes, of course; such a talented vocalist," or "she's rather too eclectic for my taste, though I'm hardly one to judge," as the need arises. we'll see.

And after the storm, 

I run & run as the rains come

And I look up... I look up...

So yesterday I had the privilege of tickling two pairs of little feet, cleaning two little faces, & being a policeman chasing two little "bad guys" all afternoon. oh yes. I make a fearsome policeman, you'd better believe it. However, I will not vouch for my ability to construct jails, as my prisoners tended to escape under cover of giggles.

I like little people. in all their sticky, banana-mushing, toy-throwing glory. granted, it's tiring to keep up with them: their ability to wreck everything within reach never ceases to amaze me.

But at the end of the day there's nothing like tucking a small person into bed with a favorite blankie, humming Amazing Grace until breathing steadies & imagination takes flight.

[side note:: it's funny that you wrote about memories in your last letter. they've been on my mind lately, too. memories fascinate me... moments imprinted on grey matter, postcards to be read&reread for years after the postmark. touching one brings an overwhelming flood of emotion: happy or sad or jolly or miserable or the rush of butterflies against your ribs. never wearing out with frequent use; dimming only through disuse. what a concept.]

Alrighty. Gotta run. My song has ended & my toast is merrily burning in the toaster. [not sure which is the greater calamity.]

Always,

rory