PS- dreams come true

1 year (and a couple weeks) ago, I wrote this post- a general update on my life.  In it, I wrote the following paragraph regarding work:

I like being a paraeducator and I really enjoy working in special ed.  It's also fun, as a substitute, to go around the district and see how different teachers run their different classrooms.  Very educational for me and helpful in generating ideas for how I want to teach my own kids someday.
But the scheduling of a substitute sucks and is something that has ended up being really hard for me.  It used to be good because I would work work work and then get sick and take time off no problem.  And then I went to school and was able to cut way back my working hours so I could study... no problem (except a decrease in income, obviously).  But now it's to the point for me that I don't really like my job.  I mean, I often enjoy it when I get to wherever I'm subbing, but at the same time, I don't come home from work with a sense of satisfaction that I made a difference and stretched myself today.  Usually I come home with a sense of satisfaction from simply knowing that I made money today.  I don't want that out of a job and to be honest, it is not enough to get me out of bed in the morning when I don't feel well.  This may be a character flaw in me, but it is the way I am (at least for the time being).  Last summer I made a "bucket list" of sorts and on that list is "work in an emergency room".  I think I might just pursue that.  It appeals to me, I think would really enjoy the job, learn and see a lot, make decent money, and be doing something that will be good for whatever career in medicine/health care I decide to go into.  I've still got more praying to do about it, but at this point I'm thinking I'll start pursuing it after I have recovered from my upcoming surgery.

It just tickles my fancy to think that 1 year ago, I had a dream to work in an ER.  And it really was a dream-- I didn't have much reason to see it happening, as I wasn't even a certified CNA, let alone my only experience was in CNA school-- and almost zero brand new CNA's get a job anywhere other than a nursing home.  But I had this dream, and I decided to pursue it.  And Heavenly Father helped me out.  1-2 months after this post, I found out about scribing.  It sounded like a dream job to me-- I couldn't believe it actually existed!!  I wanted this job sooo bad!  And I talked to my family about how awesome it would be all the time.  I could see myself doing the job and enjoying it.  I knew that's what I wanted to do.  I could have spent a lot of time doubting whether or not I'd get it- how competitive would I be anyways?  And then come Easter, my current job fell in my lap.  I now work in an emergency room.  And you know what?  I absolutely love it.

can't sleep, and i've never liked counting sheep

my first interesting (and inane) note, is how on commas. you see, as i was typing the title to this post, i put a comma right up there after "can't sleep".  my elementary school training tells me that's not necessary, but rather optional.  because it's coming before "and".  i believe there was some movement to take commas away from before "and". or at least be okay with a lack of them.  at least, that's what i recall mrs. bowers in the fourth grade telling me.  or was it mrs. rossall in the fifth?  anyways, when i was in training for my absolutely wonderful new scribe job, my supervisor told me i didn't put enough commas in.  she'd go over histories of present illness i'd written, and stick in a bunch of commas(an HPI the part of the patient's chart where you sum up all the stuff they told you about what's wrong with them today). we had a nice discussion about commas following this.  she's only a few years older than i, and so i wonder- did the anti-comma movement begin with my generation?  or is it just me?  so in order to make her happy, i began putting commas in all sorts of grammatically appropriate places which i had never previously done.  and i'm still doing it.  it makes me chuckle.
oh, and i'm not sure if this is related or not, but most physicians (and scribes) seem to be against double spacing between sentences.  i've observed doctors go over my HPI and removethe double spaces.  i adapt, and then remind myself that they probably didn't major in english.  oh, except there is one doctor who does use them, and i get excited because then i can type the way i'm trained to-- with double spaces after my periods.  except i think the habit might be wearing a little thin, because in writing this i'm havign to consciously remind myself to double space.
i flash back to that time in sixth grade when my mom, english major and all, reviewed an essay i wrote.  i remember her informing me that i needed to double space between sentences.  i told her my teacher didn't ask for that.  she responded that it's the proper thing to do, and even if my teacher didn't ask for it, i should do it anyways.  so i did.  and it became a habit.  and i never remember anyone else making a fuss about it during my school career, so either i learned my lesson, or no one cared.  or both.  but i'm glad that my mom taught me to double space.

now, if you didn't consider those previous 3 paragraphs a waste of your time, i'll just keep babbling.  and if you did, but you're still reading for some reason anyways, i'll just keep babbling all the same.

so it's 3am and i can't sleep.  why?  a few reasons.  the first being that i am a night owl by nature.  even if i get into the habit of waking early, it doesn't take much at all to get me back into my night owl-y ways.  second reason, work.  i worked night shift recently, and then some late nights since.  add that to the spring quarter being over and therefore no reason to be out of bed at 7am after working till midnight the previous night, and you have night-owlishness.  on top of that, i didn't really make it to my morning classes regularly for the last two weeks of spring quarter.  'cuz my migraines started acting up.
yeah, i should have expected as much.  and i'm pretty sure i know exactly what happened.  you see, i registered for classes full-time.  and then i started a new job.  and i still tried to spend some time with family, and have a social life, and date.  and go to church.  i was really excited at the beginning of all this, because i feel satisfied when my life is full.  when i am busily engaged in multiple good things, feel like i'm moving forward in my life, and have meaningful relationships with the people around me, i feel content.  more than content, actually.  i'm happy, and excited, and super grateful.
i knew before the quarter started that i should be looking for a job, and that i should be working.  i recall feeling confident about going to school full-time.  i was nervous about adding work to that challenge, but i knew the impression to work and go to school was an impression from my Heavenly Father.  i trusted that since that was what He wanted me to do, i would be able to do it.  and for a few weeks i did.  honestly, if i didn't have the health problems that i do, i think i would have been able to keep it up.  but that's what made me feel so grateful- i knew that there was no way without the aide of God and His angels that i could work and go to school.  and truly, even just the few weeks that i did do it and stay on top of things were nothing short of miraculous, especially when juxtaposed with my academic and health histories.

but let's catch up to where i am now.  the quarter's over and i still haven't finished my classes.  i have an arrangement with my teachers, so there's hope, but it still makes me nervous.  and i'm nervous about my future.  it kind of sucks not being able to count on the long term plans i make because my health problems have a habit of never resolving and popping back up with a vengeance for months at a time at least a few times yearly.  i like doing things, and i like making plans.  it's hard to feel limited in my ability to do both.
oh, and there's the whole thing about wanting to get married.  and have a family.  i don't want to rush into anything, and indeed, i find some fulfillment from simply getting to know and befriend the single guys around me.  i've been pretty happy with the state of my love life as of late.  but my attitude changes a little bit when i get sick, and am subsequently cooped up for days on end (where did that expression come from anyways?  when you break it down, it really doesn't mean anything... reminds me of a conversation my buddy stan and i had about the english language versus ancient languages).  in these cases, i really just want someone to have at home, to cuddle with in bed while i feel like crap and my hair is a mess.  and someone whom i don't have to worry about losing a chance with or dealing with those silly dating situations when i want to cancel, reschedule, or just change what we're doing for a date because i don't feel up to doing much.
and just so we're clear, i'm not saying that i'm looking for a cuddle-buddy.  those are nice, i guess, but mostly useless, and confusing.

also, i'm pretty sure i just babbled about a bunch of stuff to put on my public blog which i wouldn't have if i weren't both sleep-deprived and migraining.  like, my brain does weird things with migraines and pain.  one of them being a lessening somewhat in inhibitions.  dunno if anyone other than those super close to me would notice, but it happens.  i get to the point where i do something or consider doing something and just don't have the mental energy to decide whether or not to actually do it or say it, and then i just decide that it's what i'm really thinking and if the person i'm talking to loves me, or is at least a kind reasonable person, won't judge me if it comes out sounding stupid or crazy or childish or something.  because by rule i'm not stupid, childish, or crazy (technically speaking).

and i have no way to neatly sum up all of these thoughts.  there's a phrase commonly used by scribes to sum up HPI's.  first we say what the patient is complaining of, how long they've been experiencing it, any accompanying symptoms, risk factors or other pertinent information, and then we list a bunch of pertinent things they're not experiencing.  "so-and-so complains of shortness of breath, but denies any loss of consciousness, chest pain, palpitations, nausea, or vomiting" is important to note because it indicates they're probably not having a heart attack.  or "so-and-so complains of a laceration to his forearm after falling off his dirt bike, but denies any weakness, numbness, or tingling" is good to note because it indicates they probably don't have any nerve or muscle damage.
anyways.... after these things in the HPI, there are two magical phrases we use to wrap it all up.  "S/he is otherwise in good health with no additional complaints" and "s/he is otherwise in her normal state of health with no additional complaints."  it sums things up nicely (the latter is particularly good for people with lots of health problems who only come into the ER because they got a scratch that needs to be stitched up).

so, to sum up this post, i am otherwise in my normal state of health, with no additional complaints.

and here's a pretty picture for you to look at, just for making it to the end of this post.  i got these from my dad when i had my sinus surgery back in february.  pretty, eh?

to the man whose face i never saw

we stood in a semi-circle
waiting for you.
they rolled you in
pounding, pounding, pounding.
on your chest.

in the corner i stood,
never was one more
a fly on the wall
than me.
i saw it all.
pen in hand.
yellow notepad.
my job was to scribble. scribble. scribble.
everything i heard....

27 year old male.
epinephrine times seven.
he said ten minutes ago.
it's 1050 now.

tall man in blue suit.
pounding on your chest.
down. up, down. pound, pound, pound.

atropine. duoneb.
what are those drugs?
calcium. magnesium.
those can be used for the heart?
history of asthma.
collapsed in driveway.
you were on your way here.

purple scrubs. middle aged woman.
down, up, down. pound, pound, pound.

cordarone.
how do i spell that?
epi-pen
twice by family, IM.

man in green scrubs,
badge dangling over your body-

why do you have an epi-pen?

up, down. up, down. pound, pound, pound.

twelve minutes of CPR
before the ambulance came.
they found you in PEA.
he thinks he heard breath sounds on scene.
atropine.
what is atropine?

x-ray. ultrasound.
pound, pound, pound.
never stopping.

at the computer,
the lead nurse is typing.
“how many milligrams?”
“what size tube?”

the pounding arms get weary.
the second blue-suited man
moves fluidly to your side.
with a towel around his neck,
(he’s getting a work-out)
he moves his body
down, up, down.
over you, his hands go 
pound, pound, pound.

pound. pound. pound.
down, up, down.
with each impact of coupled fists,
I see, side to side,
your protuberant mass shift..

another nurse. he is pulling off your pants.
"do we have any scissors?"
naked.
you're all naked.
will someone please cover him up?
they keep pounding on your chest.
and the bag-valve mask goes,
pump. pump. pump.

i say nothing, but the nurse sees what i mean.
naked. you’re all naked.
except the blanket now covering your groin.
a small sign of respect.

your doctor is by your side.
you’ve never met him.
he's trying to save your life.

"a sterile gown!"
over his suit and tie.
shoes only a little more mature
than convers
peep out beneath his pants.

everyone gets a turn.
now it’s curly ponytail girl, in her green scrubs.
she moves down, up, down.
her hands go, pound, pound, pound.

blade and scissors in hand,
your doctor cuts into your side.
your blood on his hands.
he's trying to save your life.

“it’s been 45 minutes,” he says
“5 more and he’s dead.”
and as an afterthought,
“he’s already dead”
...by definition.

your body moves up, down, up,
with each fists’ pound, pound, and pump, pump.


until the doctor is at your side,
ultrasound in hand.
the pounding and pumping stop.
all voices stop.he finds
your blood flow has stopped.

blood on his sterile gown,
blood on his outstretched hands-
he turns-
facing the nurses, the techs, and the EMTs
(and the random hospitalist, too):
“does anyone have any more ideas?”

silence.

1102.